Breathe

by Joyce Carol Oates

Genres: Family Life; Literary Fiction

Synopsis

A NOVEL OF LOVE AND LOSS FROM BESTSELLING AND PRIZEWINNING AUTHOR JOYCE CAROL OATES

Amid a starkly beautiful but uncanny landscape in New Mexico, a married couple from Cambridge, MA takes residency at a distinguished academic institute. When the husband is stricken with a mysterious illness, misdiagnosed at first, their lives are uprooted and husband and wife each embarks upon a nightmare journey.  At thirty-seven, Michaela faces the terrifying prospect of widowhood - and the loss of Gerard, whose identity has greatly shaped her own. 

In vividly depicted scenes of escalating suspense, Michaela cares desperately for Gerard in his final days as she comes to realize that her love for her husband, however fierce and selfless, is not enough to save him and that his death is beyond her comprehension.  A love that refuses to be surrendered at death—is this the blessing of a unique married love, or a curse that must be exorcized?

Part intimately detailed love story, part horror story rooted in real life, BREATHE is an exploration of hauntedness rooted in the domesticity of marital love, as well as our determination both to be faithful to the beloved and to survive the trauma of loss.

Release date: August 3, 2021

Publisher: Ecco

Print pages: 368

Sample

1A Voice Out of a Fever Cloud

A hand is gripping yours. Warm dry hand gripping your slippery humid hand.

Whoever it is urging you—Breathe!

Leaning over you begging you—Breathe!

Not words but sound-vibrations rippling through water. Wavy-rippling water in which sun motes swarm in a delirium resembling joy.

Drunken delirium of joy. Scalding-hot skin, fever. At what temperature do bacteria boil? At what temperature does the brain boil?

Blink if you can hear. Blink if you are alive.

Blink squint try to see who it is leaning over you begging Breathe!—the face is obscured in shadow.

Darling I love you so much.

I have your hand. I will never abandon you.

2The Vigil

Nothing matters except: he must not die.

He must breathe. He must not cease breathing.

Oxygen is seeping in a slow continuous stream into his nostrils through a translucent plastic tube.

IV fluids into his veins, that have been severely dehydrated.

He is neither fully awake nor is he fully unconscious. You believe that he can hear you, his facial expressions are not impassive but ever-shifting, his eyes behind the closed lids are alert, alive.

You are alert and alive as you have rarely been in your life determined that your husband breathe.

Pleading in desperation. In childish hope, unreason. Begging your husband Breathe! Don’t stop breathing!

Begging as you would never have imagined you might one day beg at the bedside of a very ill man clutching at his hands which (you note, you will long remember noting with a thrill of naive hope) are warm as your own hands, and (you believe) just perceptibly responsive—when you squeeze his fingers, he seems to respond, if weakly, with the air of one whose mind is elsewhere.

Don’t leave me! Please don’t leave me! I love you so, I can’t live without you . . .

A plea, a threat, a promise, a vow—can’t live without you.

Words of pathos, futility. Words uttered how many times in the course of human history and never other than in futility.

Can’t! The Skull God of the high desert surrounding Santa Tierra laughs in derision.

TERROR OF (YOUR HUSBAND’S) DEATH has broken you, all pride has leaked away like urine through the catheter inserted into the husband’s shrunken stub of a penis.

Pride, dignity, common sense leaked away. Where?

(Into a plastic sac discreetly fastened beneath the bed.)

Begging the struggling man Breathe!

How it has happened, why it has happened—your life bound up with the life of this man.

Why him, and why you. In love.

Made to wonder—are we infants in our deepest selves, in our most profound memories, linked by our terror of utter loss?

What you love most, that you will lose. The price of your love is your loss.

Where a cruel and capricious god has brought your husband (and you) to die.

A mistake, coming to this remote place. An adventure, Gerard had said.

Not that Santa Tierra, New Mexico, is truly remote, less than an hour’s drive from Albuquerque. A smaller and less gentrified Santa Fe.

Weeks, days you’ve been here in this landscape new to you. Passing with torturous slowness even as the spool of minutes is fast unwinding.

Too fast! Too fast! A fundamental principle of physics, Time accelerates nearing the point of impact.

For your husband, whom you love with a feverish desperation that surprises you, no longer breathes normally. Not for weeks has he been able to breathe without effort, and now he has been fitted with a breathing tube, sending pure oxygen to his brain. Not for weeks has he been able to breathe without visible strain, a strain that shows in his face, and this strain has become yours as well.

For you are helping him breathe. You are convinced that you are helping him breathe.

This is not a regular breathing, a metronome sort of breathing, uncalculated, easy, rather this is a gasping sort of breathing, and in the interstices of this breathing there are pauses, caesuras, like those missteps in dreams in which you stagger, stumble, fall from a step or a curb, and jerk yourself awake.

Those silences in your husband’s breathing that are terrible to hear, terrifying.

Initially diagnosed with pneumonia. Then, a blood clot attached to the (left) lung. Then, (metastasized) cancer to the (left) lung revealed in a scan.

Then: more. And now more.

Your joint fantasy has been, you will review together all that has happened since the hospitalization. Your joint fantasy has been, there would be a time, an interlude, when you might together step out-of-time, the better to comprehend what has happened, and is happening.

But there has not been such a time out-of-time.

You have begun to understand, there will not be such a time out-of-time.

It is all you can do to grip your husband’s hand. Urge him—Breathe!

Where once these strong fingers gripped yours, enclosed your (smaller) hand in his hand. As your husband’s soul, more magnanimous than yours, embraced and buoyed aloft your (wounded, shrunken) soul.

Now, you are comforting Gerard. It is your desperate hope to comfort Gerard. You begin to see that there is no greater purpose to your life than to comfort Gerard.

Pressing blindly into the rapidly diminishing space that is your (shared) future as if this space were not rapidly diminishing but unbounded.

How can we comprehend an endlessly expanding universe?—Gerard had wondered.

Essentially, we cannot comprehend.

Cannot comprehend infinity, from the perspective of the finite.

Cannot comprehend the magnitude of our own deaths, from the perspective of our (small) lives.

You feel the loss already, the anguish to come. That you will be losing this man whom, in life, you’d struggled and (mostly) failed to know.

Older than you by nine years. Yes he has been fatherly, protective. But now you must protect him.

In a wild imagining begging the stiff-faced oncologist—Take my bone marrow, is that possible, infuse it in him—save him!

Crazed, pathetic. You would not utter such ravings, in your right mind.

Feel the strain of your husband’s heart. His strong, durable, hopeful heart. His will to live, to persevere in his being. You must hold him tightly! For the duration of his life, and beyond.

Transition to hospice. A turn in the road into a cul-de-sac neither of you had anticipated.

Disbelieving—This can’t be happening!

And yet—Is this happening? So soon?

Acceleration nearing the point of impact. No time to plan what you might have planned—a more deliberate death, a shared death. For you have been taken by surprise. Your brain has been stunned, it is slow to react. You are limping, faltering behind. You are being pushed out onto a stage. You are blinking, blinded by dazzling light. You have no script, no words. You cannot see an audience. You can only plead for a change in the script. For mercy.

I am here, I have your hand, I love you—please don’t give up . . .

Hear yourself stammer in a pleading voice. In a faint, failing voice. In a voice that quavers with dread, yet hope: you will assure your husband that he is loved, yes he is very well loved. And because he is loved he is safe, he is being cared for, he will not be made to suffer. He will not feel any more pain, he will be protected from pain, the worst of the pain is beyond him now. He has been sedated, he is floating on a warm shimmering sea of Dilaudid dreams, a very high dosage, each day a higher dosage, and so he is safe now from further injury as he is safe from the cruelty of hope to which you have foolishly succumbed out of ignorance, naivete. But hope has vanished now, the air has cleared.

Like a train that has departed from a remote rural station and is already out of sight beyond the horizon—hope is gone.

And you are not on the train. No longer are you on the train.

As the remainder of your life together rapidly spools out.

THESE MIGHT BE MY FINAL DAYS—so Gerard said to you over the phone eleven days ago. He’d called you shortly after Dr. N___ had made his rounds that morning at 7:00 A.M.

These unexpected words, calmly uttered by your husband, a voice out of nowhere, a voice out of a cloud, these damning words which through a buzzing in your ears you’d seemed at first not to hear.

Inwardly crying—No. No. No. No!

The cell phone nearly slipped from your icy fingers to clatter onto a countertop.

(Will this be the last time Gerard calls you on your cell phone? Don’t want to think yes, probably.)

By the time you arrived at the hospital you’d recovered from the shock of what you’d heard. You’d had time to prepare words of your own. Counter-arguments. Rejoinders.

Insisting that Gerard had to be mistaken, please would he not say such things, such upsetting things, it’s distressing to you to hear such things, surely these are not his final days, for Dr. N___ had seemed hopeful only a few days previous speaking of zapping the smaller tumors, starting immunotherapy to shrink the large tumor—didn’t he remember? Surely Dr. N___ would not have changed directions so quickly. And so it’s misleading to be speaking of final days . . .

Trying to keep your face from shattering like glass.

I’m here. I have your hand. Can’t you see I will never let you go, I love you so much.

You are angry, you will be bitter, no but you must not succumb to despair, don’t allow yourself to (yet) recall how you’d had to beg the curiously terse, impassive Dr. N___ to order a scan of your husband’s stomach and abdomen (for Gerard had been complaining of pain in that part of his body for weeks even as his respiratory distress was so much more critical, had to be treated immediately, the abdominal pain the oncologist dismissed as constipation and indeed yes, the patient did suffer from constipation, but this was a symptom and not a cause of his pain) and by the time the scan is taken the cancerous urethral growth is too large to be operable.

Why does Dr. N___ wait so long to order this scan? Why does Dr. N___ while nodding his head sagely seem not to hear you?

But not (yet) such thoughts. For it is another time: your husband is (still) alive.

Seeing him observing you with something like pity softened by tenderness the sudden thought came to you—I will purchase opera tickets for August! One of Gerard’s favorite operas was Gluck’s Orpheus and Eurydice, scheduled for the first week of August in the Santa Tierra Opera Festival.

In fact it was early April, which is months from August.

What are you to do with such a fact? Blunt and weighty as a rock in the hand.

A pledge that you believe Gerard will (still) be alive in August. A pledge that you have faith in whatever it is in which individuals in extremis have faith, that cannot be named.

Buy the tickets, show them to Gerard tomorrow! So that he will know that you have faith. (Unless he laughs sadly, shakes his head. Makes no comment at all.)

And now today is April 11. The thirteenth day of Gerard’s intensive care. Doctors have convened that very morning—oncologist, pulmonologist, urologist, nephrologist. Gastrointestinal consultant. Palliative care physician, palliative care nurse practitioner.

There has been scheduled a (another/final) biopsy to check a metastasized tumor in one of your husband’s kidneys. A (final) immunology treatment aimed at the (very large) urethral tumor.

Hope is the thing with feathers. But no.

Hope is the cruel thing. Banish hope!

With hope banished time will move more swiftly even as hours will move with the excruciating slowness of a clock distended by the gravity of the planet Jupiter.

You will hold your husband tighter, ever tighter. In Santa Tierra the wind comes in fierce hot gusts buffeting the windowpanes of the hospital room and so (it might seem that) you are holding your husband tight to prevent these gusts of wind from tearing you apart. Frantic to hold him, his shoulders, his torso, frantic to kiss his forehead that is both feverish and clammy, his cheeks that have become creased with fine cracks, his (beautiful) (blue-gray) (part-closed) eyes. (Will Gerard ever open his eyes fully again? And if he does open his eyes, will he see? Will he see you?) Declare that you will never leave him, you love him and will never cease loving him, he will never be alone, you will carry him with you forever in your heart; never have you, who take seriously a vow to speak/write truthfully, clearly, without rhetoric or subterfuge, without resorting to such abstract clichés as in your heart, spoken in such a way; but then, never have you found yourself so dazed, so unmoored, desperate to assure your husband who is struggling to breathe that he is safe from suffering, by which you mean (of course) that the powerful opioids that buoy him aloft will prevent him suffering the unspeakable pain that awaits, if the opioid haze is allowed to evaporate, and so his suffering is bearable, or is promised to be bearable; it is not false for you to claim to him that he is “safe”—as you would wish to think that you are safe (though poised above an abyss: when this ordeal has run its course you must decide whether you should step forward into that abyss or cling out of cowardice to your diminished and left-behind life) though you are (certainly) not safe for you are not sedated, you have not been anesthetized against the ravaging torture of cancer, cancers metastasized throughout your body; your skin bristles with sensation, your every nerve, indeed it’s as if the outermost layer of your skin has been peeled away and you are vulnerable to the slightest draft of air, lacerating the tender blood-tinged dermis beneath.

All this you will tell your beloved husband again, again and again for each minute repeats itself, each hour, interminable because unfathomable as all finite spaces (like this hospital room on the seventh floor of the Santa Tierra Cancer Center) contain infinities.

Again, and still, and again, and still with hypnotic certainty begging your husband Breathe!—for you cannot imagine the world without him, you cannot imagine any dimension of being that does not include him; you cannot imagine your own life continuing, tormented by the possibility that each of your husband’s breaths might be his last, already your brave stoic husband has endured beyond the expectations of the medical staff, continuing to breathe hoarsely, laboriously, convulsively, as a wrestler might struggle to breathe even as his chest is being crushed in the grip of a cruel opponent; managing to breathe though shuddering with the effort; managing to breathe though whimpering with the effort; unless the whimpering is your own, the shuddering is your own, through hours of interminable days he will breathe, and he will breathe, as you bid him Breathe!—and he will pause ever longer in his breathing, each time the pause is longer, you are in torment, you are in your own private agony, holding your own indrawn breath waiting to hear your husband breathe, the gasping intake of breath, the sucked-at breath, the catch in his throat, a moist click!—you are desperate to bargain as a child might bargain Don’t let him stop, don’t let him die—not yet though you have nothing with which to bargain. You cannot bargain away your soul to any god or devil for you have no soul beyond your own faltering breath. You cannot bargain away your soul for if you had a soul, by now it is in tatters like a papier-mâché lantern battered in a windstorm. It is time for your husband to die, the medical staff has expressed amazement that he has endured so long persevering in this twilit state neither awake nor asleep, neither conscious nor unconscious; perhaps he is dreaming, perhaps he is dreaming of a frantic woman leaning over his hospital bed trying to embrace him, face wet with tears, face made ugly and contorted by tears, unrecognizable as his wife, determined to hold her husband fiercely in an embrace from which not even death can pry him.

Is this a dream? Can’t be happening, must be a dream.

(But if we are dreaming together? Can we save each other!)

Not a floor beneath your feet but a kind of ice-sheet supporting the hospital bed in which your husband lies fixed in place with IV lines in his veins, ice-surface shining-blinding, your eyes blinded unable to see clearly, not daring to see clearly for you are immersed in the opioid dream that shimmers beneath your husband’s bruised eyelids. Shimmering of dreams like reflections in ice. In the freezing water beneath ice. Almost, you can see these dreams. Quick-darting as fish in the luminous water beneath ice. You can feel them against your skinless arms—quivering, thrumming, heat of your husband’s body in its struggle to remain alive even as it is being dragged downward beneath the glittering ice-surface to death and dissolution, to stammered words, grunts, dragged downward by the capricious cruel god of the high desert plateau with the name too terrible to be uttered aloud—Ishtikini. Pueblo-god of toothless laughter, god of eyeless sockets, Skull God, beast-god, scavenger-god poised to devour the body’s organs as soon as life ceases to pulse through them: heart, brain, lungs, kidney, liver, stomach, intestines.

No one but you will remember—But this man is heroic! Struggling to breathe, to persist in breathing, even as his organs are failing. Slow realization of diminishment, loss. Gradual realization that each day, each hour the patient has been growing weaker, not gaining strength from the liquids dripping into his veins but un-nourished by them, no appetite, no longer capable of walking in the corridor as he’d done initially, not even making his way with a walker, only just able at last to sit upright in a wheelchair you push for him in the hospital corridor in a loop each day losing strength as he was not (re)gaining the weight he’d lost but losing more weight, his cheeks becoming sunken, eyes brimming with moisture when you’d squeezed his hands and assured him that he’d been a wonderful husband and he’d said Wonderful?—but I failed you by dying.

A wild startled laugh, a child’s frightened laugh—What are you saying? You are not dead, you are with me here. We are both alive . . .

A spasm of coughing, your husband can’t answer you, too weak to refute you as you insist he has been a wonderful husband, your life with him has been the happiest life you could imagine for yourself, it is the only life you could imagine for yourself, you do not want to live beyond this life. As he lapses into silence you will assure him another time that he is loved, he has been a wonderful husband who is loved, and he is safe because so loved, this is a safe place where he will not suffer needlessly, he will not suffer at all, you will never leave his side. As in the exhausting interminable hours to come you will hear your defiant voice wax and wane, wane and wax, growing fainter, growing stronger, and again faint, and again stronger as the undertow of your husband’s dying tugs at you, tries to pull you under, still you are resolute—Breathe! Darling, please breathe—don’t stop.And the stricken lungs suck at air, pure oxygen seeping into nostrils through a narrow plastic tube attached to the nose. Your own audacity will surprise you, the desperate strength of which you wouldn’t have guessed yourself capable, as a swimmer who has never been tested in deep waters is surprised at her ability to keep herself afloat, to keep from drowning. You are determined that your husband will not give in, will not die and abandon you, not one moment too soon. Though by this time you will be so dazed with exhaustion your eyelids will droop, only barely you will comprehend what is happening in this hospital room, what an ordeal, what horror, why you are begging the man Breathe! Breathe!—please . . . for in this chilled space humming with monitors in this interminable interlude out-of-time there will be only the present tense in which you have gone without sleep and without food for how many hours since before dawn this morning, embracing the man to whom you have bravely joined your life, leaning over his body in the high bed, your neck aches with the strain, your shoulders ache with the strain, your throat aches with the strain of assuring this man tirelessly, defiantly that you love him, that he is safe, he will not feel pain, he will not be alone, how many days have passed, no idea how many days, hours, weeks while outside the hospital room the hot searing New Mexico winds continue to blow through sunlit daytime hours, gusts of wind bearing bits of mica, grit inhaled into nostrils, mouth, lungs, gusts of wind like the ferocious laughter of the desert gods, and after dusk the wind dies down, fades, and night is abruptly chill, no longer a warm terrain but the high desert plateau and you are made to realize how far you have journeyed, how many thousands of (reckless) miles to this place leaving behind your comfortable town house on Monroe Street, Cambridge, walls of books, bookcases in bedrooms and in bathrooms, bookcases in narrow corridors, stacks of books in the basement, books still boxed after the move of twelve years previous when bravely you’d vowed to yoke your lives together, laughing in very recklessness, in yearning and in love. Do you take this man? I do, I do! Do you take this woman? Of course—I do . . .

Sickness and in health. Till death do we part.

Recall with horror you’d uttered these words happily. As if till death do we part might be so interpreted: happily.

Damp with perspiration yet shivering clammy-skinned, anxious in terror of what’s-to-come. In a film, ominous music. In the hospital room, only the sound of breathing.

Initially, first hospitalized, Gerard had been sharp-eyed, lucid.

Fits of coughing, bronchial infection, needing to be sedated because he could not sleep because unable to breathe without coughing but clear-minded, coherent, not yet subjected to a battery of tests, not yet invaded by powerful opioids that cloud his mind. Not yet transferred to the adjoining Cancer Center—a transference that dashes his spirits, and yours. Antibiotics, blood thinner, oxycodone. CAT scans, biopsies, fMRI. Initially the prognosis had not seemed ambiguous. Initially the first-detected cancerous tumors (lung, kidney) had appeared to be slow-growing. Even with this sobering news and in his new circumstances Gerard insisted upon working, furious at wasting so much time, goddamned bad luck, eight-month residency at the Institute and already the first month was passing with very little to show for it. Desperate to work, refusing medication that made him groggy, or anyway refusing it for as long as he could,giving you instructions what to bring from his office at the Institute, how you might assist him with the four-hundred-page copyedited manuscript of his next book provocatively titled The Human Brain and Its Discontents; it was Gerard’s custom to answer each query from a copy editor in meticulous cursive script on yellow Post-its affixed to manuscript pages, thus a typical copyedited manuscript of Gerard’s was riddled with yellow Post-its like miniature prayer flags.

Maybe I can get something accomplished here, maybe my time out-of-time won’t be totally wasted.

Wanting to think that his hospitalization in the Santa Tierra Cancer Center was nothing more serious than a therapeutic time-out, an opportunity for concentrated work.

Hope is the poisoned bait. Men eat of it and die.

Not (yet) realizing that hope is the distraction, the deceit. Hope is what you must not allow to seep into your bloodstream. Hope is what you must never believe. ...