The doctors and nurse staff in the ICU here are flabbergasted by it. Even before she moved to Canada, over three years ago, her medical records correctly reported that her heart was in critical condition. Yet, during check-ups doctors thought that since it seems to work, there’s no use tinkering with it. They were most likely right. The condition and quality of life she enjoyed is stunning to me, and to the doctors. No one can seem to wrap his head around the reality of my mother, her strength, and good dumb luck.

Now her ejection fraction hovers at around ten, sometimes a little higher, others a little lower. Again, it’s hard to believe that my mother has stuck it out these past five days. The doctors have installed a balloon pump to alleviate some of the stress on her heart, but it is only a temporizing measure and can’t stay in longer than five or six days. The same goes for most of the medication she’s on. They’ll keep her on the ventilator longer if need be. She only takes about ten breaths per minutes on her own. They oxygen levels on the lowest possible setting, though, 30%. And they’ve been weening her off the drips and balloon. Right now it pumps once for every two of her heart’s. That’s medium. We’re aiming for low (1:3).

I should note that many of her neural and cognitive functions have not suffered. She is very aware of her surroundings. She knows that she’s incredibly uncomfortable and that she doesn’t want to be in the hospital anymore. She has recovered only enough strength to move her hands, one at a time, from her side onto her stomach. When asked questions she can nod in response albeit slightly, open her eyes for several seconds at a time, focus on others, and once Janice and I believe she blew me a kiss. Her doctor uses a crude scale to quantify the relative condition his patients. When my mother arrived at the hospital, she was a one, perhaps even less. Now she’s a three. They won’t consider moving her until she reaches at least a five, ideally, seven.

Studies on those obnoxious family newsletters demonstrate that families can’t help but put a positive spin on everything. Some items don’t need much spin. “Jordan and Angie have decided to get married. They’ve already got a cute apartment priced within their budget and will move in right after the wedding in April,” for example. Here the spin comes from the adjective, particularly from “cute.” Others require a little work. For massive, reconstructive spin, it is often necessary to tack on an unrealistic and unnecessarily optimistic phrase at the end as in : “David has been charged with a count of DUI and involuntary manslaughter after a messy break-up with his high school sweetheart last Friday, but it looks like he might get off!”. It’s within our nature to hold onto those tenuous threads of hope wherever we can find them. Of course, pessimists are never disappointed. Aware of both approaches, I elect to leave you with this bittersweet, moderate summary in proper positive-then-tempered-with-negaitve order.

My mom is doing outstanding well within the confines of a tremendously bleak prognosis.

Sudbury is a small city to me, but up here, with a population in excess of 150,000, the Greater Sudbury metropolitan area a behemoth in the Near North. I am constantly baffled by this mismatch of opinions. Mining is the primary industry, and it seems that most people have a personal connection to it, either directly, or through family ties. We met another couple here to see their mom. Like ours, she had been airlifted from hundreds of miles away for heart failure. Like ours, too, she is young; this one even younger, clocking in at only 47 years. Sudbury’s renown for cardiology, at least in Ontario, is wide-spread. Sonny, a man at the the Peddler’s Pub, told me that the first bypass surgery was done right here, and that he knew the patient. Sonny is an old man. We have plans to visit him on his seventieth birthday, November 2, 2009.

The daughter’s name is Mel. She and her boyfriend Jason were the first to arrive. They agonized during the mandatory wait period. Janice and I visited our mom, who was relatively stable by comparison, and left them. Before leaving, I ran to the car to fetch the camera from the car. DJ and I had been working on a 500-piece jigsaw puzzle of Paddington Bear, the smallest, least complicated puzzle we could find. While we did not finish it, we had assembled enough of it that the image was recognizable. And the scattered, extraneous pieces, which were mostly of a solid color and filler anyway, framed the interior nicely. So nicely, in fact, that we thought it fitting to capture the whole set-up for later.

When I returned from car in the adjacent lot owned by CTC college—the adjoining building has space to lease if anyone’s interested—, I discovered Jason tooling about the elevator in the main lobby. He paced back and forth, stopping only long enough to decide whether we had met before. I spoke to confirm his suspicions, and to be nice, “So, we meet again.”

He responded, “I hate this place.” I had to leave Jason. I was on a mission; Paddington and his toggles were waiting.

Janice and I made it back for the next round of visiting hours. We didn’t expect to see the doctor. I was told she wouldn’t be around until the morning, but she was there now. So were Mel and Jason. This time a huge crowd of people accompanied them. Family, Mel told me.

Janice has found the courage to walk into the room and sometimes even speak to my mother. However, her focus and strength are not unlimited. From time to time dizziness overcomes her and she has to leave the room to sit. The doctor winked at the nurse, Bonnie, “It must be all this fresh air.”

“From those two smoke stacks,” Bonnie agreed.

Because of the mining culture, the three hospitals that serve Sudbury see all sorts of perverse diseases caused by airborne nickel and sulfur in uncommonly high concentrations. So much for that fresh air.

We’re looking into medivac options to bring mom to Boston. She has to go somewhere else for the transplant, anyway. She’s well beyond a bypass.

Everyone else is doing fine. We haven’t used the pool yet, but I plan to tonight.

A vast array of medical equipment surrounds a bed placed in primary position. To the left, a number of IVs drip medication to keep her blood pressure low enough for what’s left of her heart to maintain a pulse. She receives liquid nutrition through a tube that enters through her nose. Another, snaked down her mouth, aids her breathing. Her medical outfitting is extremely unconfortable, and when she is awake, she is very adamant about letting her medical staff know. They tell me she tries to take out the tubes, complains that her throat is sore—she first went to the hospital because her throat was sore; she exhibited serious flu-like symptoms, common for women, and diabetics in particular during heat failure—she is so violent in her opinions and actions that they have tied one foot and arm to the bed and doubled her sedation treatment to keep her more comfortable and more manageable. My mother’s strong, stubborn personality is to her benefit. The nurse marvels at her surviving this long. Right now she’s resisting everything, treatment and death alike.

Her body makes a small amount of urine, which proves that her kidneys are functioning, however slightly. The same is true of her lungs. If her condition does not improve quickly, her organs will fall into disrepair due to their disuse. The heart medication also damages the kidneys. Unfortunately, last night she was not strong enough even to be transported to another hospital for a transplant. I will check today soon.

Scott, the bartender, told me that last call on the fourth was scheduled for midnight. DJ and I left, the last ones to leave, close to 1:30am. Just months after my college graduation, I’m too old and too out of practice to close a bar and not pay for it twelve hours later. The sun is too unkind. The trees are too loud.

After work, Janice picked me up at the Braintree T. She was tinkering under the hood in a no standing zone near the main entrance. Her car burns oil and we had quite a drive ahead of us, and it was already close to midnight.

“JC called. Mom had a heart attack,” she told me as she helped me load my bag in the trunk.

“I told her to go to the hospital yesterday when I talked to her. I thought she needed a few liters of fluid,” I answered.

This morning JC called again. This time I picked up. My mother was air-lifted about four hundred miles away to a hospital in Sudbury, second best in Canada he said, but things looked bad. Her heart had failed her. Only about a quarter was still functioning, the rest of it was probably dead. I stood in the middle of Commercial Street, the main thoroughfare in Provincetown with my father, sister, and her boyfriend Andrew. We were on a mission: to find Andrew a bathing suit. I had just picked up a pair of navy blue running shoes for myself, a purchase about a year over due.

“Thanks for calling. I appreciate your taking care of my mother,” I told him with utter sincerity.

“Well, I didn’t do a good enough job, now did I?” he answered. JC and I have never exchanged more than 250 words, less than a middle school book report. Now his voice was shaking. Emergencies can make strangers into family.

I replayed critical scenes every movie I’ve ever seen in mind head, measured my words, and tried to be comforting and appropriate. “You’ve done the right thing. There’s nothing left to do. All we can do now is wait.” My voice was noticeably flat. I put on a smile for my audience to explain that my mother was ill and almost certainly going to die. Now I know why couples break up in public. No one was angry. No one cried. We continued on our way to the next shop, to find Andrew a suit.

On the way I snapped at my father and apologized.

Once there, I ducked out again, this time to talk to my grandmother for the second time that day. I thought we were done talking, but she interrupted our goodbye with a very simple and moving prayer. I winced but the public setting saved me. I didn’t cry.

The walk back to the hotel lasted about twenty minutes. On the way Ellen, Paul’s wife, pulled me out of the crowd. She was with her daughter Gracie, who was happily nursing in the stroller, and Alice, their dog. A moment later Paul bounded out of the cigar store across the street. I walked into him, head down, and quickly. It seems to surprise everyone every time. For a moment I was able to suspend the severity of reality; I smiled without thinking too much about it. He reminded me that I find out about a job tomorrow. Even if I don’t get it, “there’s still purpose to your life,” he told me.

On the walk back, I pondered what that purpose might be. My dad filled the time with talk of submarines. The Germans or the Swedes, he couldn’t remember which, have developed a new submarine that leaves an almost invisible signature. It uses diesel and fuel cells rather than conventional nuclear technology. The hull is rubberized to absorb sonar, and all of the metal, even the dishwashers, are magnetically neutral. Maybe I’d take that commission in the navy, I thought. I could fight the good fight against Ikea.

There wasn’t much to do back at the hotel except swim. My dad challenged me to a few races. I gave him a crash course to the butterfly. Then we stewed in the jacuzzi a while. As he lounged, I practiced holding my breathe. First trial: 70 seconds; then: 63; third: 71; and finally: 82. I laid on my stomach with my arms and legs extended and my eyes closed. I tried to imagine what it’s like to be dead. I aimed to last longer at the start of each go and to be more convincing, at least to me, of my death. I let my limbs go limper than before. Over time I found muscles I hadn’t realized her tense and relaxed them. The bubbles turned me onto one side. I floated. I felt free.

Janice and Andrew left for the pool just as dad and I returned. Now there wasn’t anything left to do. I played a little Tito Puente in the background and started my routine of push-ups and crunches. My mother isn’t stable enough even to be a candidate for a heart transplant. The first from a collection short stories by Judy Budnitz, Flying Leap, crept into my mind.

In this story, a woman needs a heart transplant. Her sisters cajole their nephew, the woman’s son, to donate his. At the end of the story, the woman lives and thanks the son, who promptly dies. I’ve read most of the other stories in the book, and heard this one on NPR, and even installed an AC for the author’s sister a few weeks ago, but I just can’t get into it. Magic realism just isn’t my thing.

Tonight my sister made her signature boiled dinner. Tomorrow I may be in Ontario. Check me out if you’re in the Greater Sudbury area.

In a course on noise and data analysis conducted in the astronomy department, we had to tackle problems like:

One test for a deadly, rare disease is 97% accurate. The disease is genetic and only about 1% of the population has it. The only treatment for this disease is expensive, but effective if you actually have the disease and potentially deadly if not you don’t. What would you do if your test results came back positive?

The correct answer, of course, is to take the test again. Even though the test is pretty accurate, because almost no one has the disease, the inaccuracy of the test will be responsible for most of the postive readings; false positives will far outnumber positives reported because disease is actually present. But because of the high accuracy of the test, the likelihood that you will get several false positives is low. The more times you test positive, the better the chances are you actually have the disease. And with the scenario I’ve presented, it’s worth your time to take the test again.

We also did astronomy in this class, too.

Thankfully, I’ve stopped drinking coffee before it became a habbit. You see, I try never to touch the stuff. And so, when I do, it does a number on me. You can ask some pre-law non-resident tutor Amy. I ran into her last night in the dining hall a full two hours after I had but one single cup of coffee. (The redundancy was for emphasis.)

By that time, of course, the effects of the drug had dissipated. On my way to section — I had stopped by the dining hall for cookies and coffee on my way to music section — I fantasized about what would happen should I continue drinking coffee. I would purchase a lizard, I thought. Frank — as that is what I called the lizard in my head at the time, though I noted carefully and to myself, that his name would depend essentially on his temperment and to call him Frank without regard to his personality would be unfair. For simplicity, I draw upon the stereotype that all lizards are called Frank. At least the hypothetical ones are, in much the same way humans use John or Bob as a common enough name when describing some abstract, fairly anonymous man. This stereotype, regarding the name Frank, is particularly less well-known in human spheres simply, I believe, very few of us speak any of the varieties of lizard; and few of them, human. So, you, kind reader, will excuse my use of the name Frank — he would sit upon my shoulder and sip my coffee. But, as my tastes are well set in their place, and for a generic lizard, as Frank is, we would almost certainly disagree on the ratio of sugar and cream to coffee. Being a lizard, he would demand more sugar. Lizards, you well know, have an insatiable sweet tooth. Between the caffeine and the fights with Frank, I’d lose too much sleep, never finish my thesis, and be forced, by a hypothetical lizard no less, into the navy for the next five years, never to rise above the rank of lieutenant junior grade.

Instead, I’ve turned to my collection of hats. For they and I bicker far less. Today my grey tuque and I purchased a very nice new set of jammers. They are navy blue with a yellow stripe down either side. You will note their accidental but happy coordination with my goggles.

The jammers wear like the skin of a seal that I onced clubbed and skinned while on a trip to a reservation in northern Oregon when visiting a friend who worked on a reservation investigating native forms of art, specifically vase painting, but also sculpture. When I swim in them I feel agile, and breathless, and deft. It’s like a good novel. But underwater and not on the back cover, breathless is a desperate adjective. I swam at the MAC, not having the patience to try out my new suit in at the Blodgett. The warmer water and heavy chlorination makes for dry skin. Even if that skin happens to have come from a seal.