Ways to Endure, Part 7

Pat, pensive, dining outdoors in Rochester, July 2014.

I’m looking at a page of Pat’s notes leading up to her fifth surgery (and her second at Johns Hopkins) in January 2014. Among the scribbled flotsam adrift on the white sea of the page are Gretchen Oswald’s office and cell phone numbers, the name and number of a Johns Hopkins medical office coordinator, as well as random phrases jotted down, thoughts during phone conversations: “urgency of surgery” and “survival rate” and “closer hospital?” and “other areas of concern” and “then what?” Near the bottom of the page are the name and phone number of the psychiatrist Jesse was seeing and a phone number for Al-Anon.

It’s a reminder that during a time when Pat’s attention was focused on life-and-death decisions about her health, the well-being of her younger son was also on her mind. From December 2013 to October 2014, Jesse attended monthly therapy sessions with that psychiatrist, the first to diagnose his bipolar disorder. Although we more clearly understood some of the root causes of Jesse’s alcoholism, we were no closer to helping him address them. He refused the medication the psychiatrist prescribed to manage his condition, disliking how it dulled and hampered his creative bipolar highs.[1]

The previous June, Jesse had been charged with his second DUI. After his first offense in 2010, we acted quickly to bail him out and retain a good lawyer. This time he asked us not to. He seemed resigned to doing the time, ashamed of the idea of us scraping together money to pay for his fuck-up. Late that summer he completed his two-week sentence at the county jail. Pat couldn’t bear to see our youngest child incarcerated, wearing the stigma of a baggy inmate jumpsuit, but I visited him a couple times, making sure he had money in his commissary account.

Visiting an inmate at the county jail felt like its own bizarre kind of debasement, like a scene from Terry Gilliam’s Brazil. The only access was a small rickety elevator that opened onto a dingy second-floor waiting room. I’d fill out a visitor check-in form, hand over my driver’s license, and sit on a rusty folding chair under flickering fluorescent lights until my name was called so I could talk with Jesse by phone through bulletproof glass.

He had, for the most part, figured out how to survive jail time – keeping his head down and steering clear of prison drama, spending much of his time journaling and sketching. During my visits, he’d share anecdotes about the tangled lives of fellow inmates. After he was released, he self-published a zine called “Jail Mix,” a blend of reportage, observational humor, and sociological analysis, less to make light of the experience than to simply acknowledge the fact of it.

Other than her heartache for Jesse, Pat was doing well. In mid-April, she had a followup appointment with her cardiologist at Mercy Medical Center in Cedar Rapids. In his two-page report, he used the word normal twelve times. We could live with normal. A few days later, after a visit with her UIHC primary care physician, he wrote, “I am pleased to notify you that there were no problems seen on your recent testing.” Instinctively, I had begun to develop the practice of long deep sighs, discovering that such exhalations released some of the tension that built up over the course of a day. This was different, this sigh of relief. This was something we could smile about.  

Emma, Zach, and six-month-old Oscar came to visit us for a week in late May, just as my school year was wrapping up. A week later, I flew to Louisville to spend eight days reading (and scoring) AP Language and Composition essays, an exhausting experience but one that helped me better prepare my students for the exam, while also bringing in an extra paycheck. A few days after I returned, Sierra and Tina visited us for a week. The kids would help Pat cook, joining in on the kitchen magic, while Oscar crawled among us, testing out his new skills. Spending time with our kids and their young families was a great comfort, a happy distraction.

That summer felt almost normal. It was the penultimate year of my slow-pitch softball career. I’d played a lot of softball over the years, first with a New Pioneer Coop men’s team in the early ’80s, then more than fifteen years with an ACT coed team. In those days, I patrolled center field, where my ability to quickly and accurately judge fly balls helped me cover a lot of ground. After I left ACT in 2005 to become a high school teacher, I thought my softball days were over, but when Emma in her late twenties began playing on a coed team, I attended some of her games to cheer her on, and realized I still had an itch to play. One evening, I volunteered to fill in for her team’s pitcher after a mid-game injury. Five years later, I was still pitching, the one viable position for a sexagenarian. 

I developed into a fairly crafty pitcher, able to loft the ball as close to the twelve-foot limit as possible, landing the ball on the deepest part of the carpet that qualified it as a strike, sometimes toeing the far-right side of the pitching rubber and then striding even farther to the right and adding a bit of sidespin so the pitch seemed to cross the plate at an angle.

The 2012 Wonders after our second-place finish in the end-of-season tournament.

The Wonders were a fun team, unencumbered by a business sponsor, a mixture of teachers, writers, and their friends. Brad, our third bagger, taught English at West High, and Kaitlin, our first baseperson, taught Chemistry a few doors down from me at Washington. Lucas Mann’s affecting nonfiction book Class A: Baseball in the Middle of Everywhere came out while he was patrolling the outfield and batting cleanup for The Wonders. Sure-handed Rachel Yoder was working on her delightfully edgy novel on motherhood, Nightbitch, while playing second base. And one of our catchers, Caitlin Roach, was writing poems for a book, Surveille, published in the fall of 2024.

In early July I took part in my second National Endowment for the Humanities Landmarks Workshop. This one, located in Amherst, Massachusetts, revolved around the Emily Dickinson Museum at The Homestead. I was thrilled to stand in the bedroom where she quietly wrote her poems, which are still so powerful that, using Emily’s words, “I feel physically as if the top of my head were taken off.” From Emily’s south window, we could look across Main Street to a meadow, and from her west window, we could see The Evergreens, the home of her confidante and sister-in-law, Sue Gilbert Dickinson.

Emily’s chair and writing desk in her bedroom, which was being restored.

While spending my days with Emily, I knew Pat had made a series of initial exam appointments at the Mayo Clinic, and we’d be heading there soon after my return from Amherst. She had been dealing with symptoms not wholly unexpected for someone with her medical history: fatigue and shortness of breath with minimal exertion and brief periods of intermittent fever. Even with our awareness of the facility’s reputation, we were bowled over. Located in the heart of the city and employing over forty thousand people, the Mayo is an amazing medical complex. For the convenience of patients, a labyrinth of underground walkways connects the medical facilities to the many nearby hotels.

The tower of the Mayo Clinic’s 1928 Art Deco Plummer Building contains a 56-bell carillon, on which daily recitals are played.

Pat met first with Dr. Heidi Connolly, an accomplished but unpretentious cardiologist. They immediately hit it off. Prior to the appointment, Connolly had not only read Pat’s entire medical history but also spoken with her friend Dr. Cameron at Johns Hopkins about Pat’s case. On the opening page of the nineteen-page initial report, she wrote, “Ms. Duer is a very youthful-appearing 61-year-old registered nurse, extremely pleasant, highly intelligent, and articulate.”

That was a positive start, but things slipped downhill a bit after that. A new CT scan revealed an unknown fluid collected around the most recent aortic graft. It was not, as in December, a hematoma, but Connolly was concerned that it might be an infection. She referred Pat to Dr. Walter Wilson in Infectious Diseases. Because his initial exam revealed no evidence of persistent fever or chills, Wilson thought the likelihood of an aortic graft infection was minimal, but to be certain, he ordered blood cultures, a urinalysis, and urine culture, and prescribed a broad-spectrum antibiotic. “I discussed this all in full with Ms. Duer and her husband. They have excellent comprehension and asked a number of very good questions.”

The Mayo Clinic’s efficiency was remarkable. All blood draws were done in one centralized location. When we arrived there, we saw at least eighty patients waiting in comfortable chairs, but there were also at least twenty blood draw stations, and patients were briskly dispatched. We laid most of the apprehensions we had to rest, lulled by the expertise of the Mayo staff.

On our second day, we met with a cardiovascular surgeon, Dr. Alberto Pochettino. It was always a bit daunting to sit down with a heart surgeon: because of their specialty, they’re at the top of a hospital’s food chain and often possess outsized egos. But as with Dr. Farivar at the UIHC and Dr. Cameron at Johns Hopkins, Pochettino was immersed in his work but affable. He expressed his willingness to undertake Pat’s next surgery when the time came, but voiced concerns about the fluid around Pat’s aortic graft. If it proved to be an infection, surgery would be extremely risky and should be deferred until the infection was resolved.

Pat took this all in stride. Well, that’s not entirely accurate – she never stopped facing her illness, but she never let it get in her way, always turning toward life. She was determined to spend as much time with her children and grandson as she could. Two weeks after the Mayo Clinic visit, we flew to Richmond – I stayed a week, Pat stayed two. Emma and Oscar came to visit us in early October, and Pat flew to Richmond a month later for Oscar’s first birthday. Then Sierra and Tina visited us for Thanksgiving en route from New York City to the Pacific Northwest. They were relocating to Seattle, where Sierra was starting a job with one of the many gaming companies there.

An August day at Virginia Beach with Oscar and Pat.

At the end of the year Pat had another CT scan of her thoracic region at the UI Hospitals. The report noted aneurysmal dilations of the descending aorta, the mesenteric artery, and the iliac artery, but nothing that required immediate action. It also noted “a somewhat complex fluid density around the replaced aortic root.” We still weren’t sure this was a bacterial infection, but if it was, the antibiotics Pat was using had only slightly reduced it. 

In 2014, from March through September, I ran a couple days a week, logging 73 runs and 192 miles on my exercise app. Late afternoons, I’d run east from my house through Scott Park. My lungs burning, my t-shirt dripping with sweat, I abandoned myself to the moment. I ran along the Ohio River in Louisville in June, around the Amherst College campus and along the Zumbro River in Rochester in July, through the Laburnum Park neighborhood of Richmond in August. I ran a few friendly 5K races, circuits around small Iowa towns – West Branch, Lone Tree, Lisbon.

The act of running helped me maintain some equilibrium during those years. As I’d begin a run, I’d find a rhythm, timing my strides with my breaths and my thoughts … for Pat … for Jesse … for my students. Eventually, my worries would drift into the background. Three miles in thirty minutes was enough to clear my head. So I ran. I ran.

Footnote

[1] For more on this, I would refer you to two other posts on this blog, Jesse’s Story and Jesse’s Story: Epilogue.