Authors: Mary Curran Hackett
“I don't know, Dr. Basu. This seems awfully fast. It seems like you're just pulling this procedure out of a hat. It doesn't even make sense. You don't even know Colm. You haven't even ordered any tests. You don't even have a diagnosis.”
Cathleen couldn't believe she was suggesting ordering more tests. They were the last thing she wanted for Colm.
“I assure you, Ms. Magee, I stayed up well into the night reading most of the information in Colm's hefty chart that Dr. Jakes sent me. There is only one explanation for your son's condition. I don't think the other doctors were too far off with their diagnoses. He has dysautonomia. You see, the part of his brain that sends automatic messages to the heart to continue beating is malfunctioning. Your son's heart stops beating, and when he collapses, his body lies flat, and the blood can eventually get back to his brain, which starts sending messages again, and your son's heart begins beating again. It's a magical thing really. The heart can't operate without the signals from the brain, and the brain can't produce the signals without the correct pumping action of the heart. People often treat them as two completely independent organs, but they are notâthey are interdependent. The brain and the heart must coexist peacefully to keep the body functioning. There is no peace in Dove's body today, but if we put the pacemaker in him, then when his brain starts acting up and his heart rate drops below a certain number of beats per minute, the pacer will step in and do the work for the heart and brain.”
Colm looked at his mother and then back at the doctor.
Cathleen popped up, grabbing her purse as she rose. “Thank you so much for your time. You must be very busy. We won't keep you any longer.”
Cathleen headed for the door, grabbing Colm's arm as she went.
“You don't want to schedule the surgery?” Dr. Basu asked in a surprised voice, thinking he had convinced her.
Cathleen stopped, dropped Colm's arm, and turned to the doctor.
“There is no way in hell I am going to let some doctor I barely know cut open my son, insert a device that may or may not work, based on an idiomatic love story between the heart and the brain! It's clear to me, and everyone else who sees it happen, that once Colm collapses he does not wake up right away! He lies there for minutes without a heartbeatânothing. And all of you âdoctors' say the same thing to me. I am sick of hearing about this dysautonomia and vasovagal. Not one of you can explain why he stays out so long!” Cathleen snapped loudly.
“Please, just listen to me. You have to trust me. I don't know if I can explain why Colm stays unconscious for so longâwhich I admit seems beyond my own comprehensionâbut I think I can prevent his collapses from happening in the first place.”
“I need to think about this,” Cathleen said, softening a little. After all, Dr. Basu was the only one who had ever offered to help, the only one who didn't ask her if she was giving her son drugs, or ask her if she was depressed or lonely and trying to make her son collapse to get attention from the boy's absent father. He was the only one who said he had looked at Colm's chart, had studied it even, and had offered her a way to heal him. He seemed to be, if she thought about it, the answer to her prayers.
“Of course, absolutely. Although I recommend the sooner, the better. Here are some pamphlets with all the information. Here is my card and the nurse's card. When you're done thinking about it, call my receptionist and we'll set up another appointment.”
Colm had never seen his mother so angry. And he had seen her angryâplenty. As his uncle Sean would often say, “That's her MO, kiddo: always POed. If you know what I mean.” Colm always laughed, but he had no idea what his crazy uncle meant.
Colm had decided he liked Dr. Basu from the moment he had walked in the door and began to speak directly to him. No other doctor had ever done such a thing. Doctors always pretended that he wasn't in the room.
As Cathleen left, Dr. Basu bent down on one knee and looked at Colm. Colm could smell the doctor's breath mint and the musky perfume emanating from his hair.
“I will see you soon, Dove. I am sure of that. In the meantime, try to stay standingâand alive.”
“Yes, sir.”
Colm laughed as the doctor rubbed his hands through his hair. Cathleen came back into the room and snatched Colm's hand before heading out the door.
On the bus ride home, Cathleen pulled the straps of her purse back and forth. She was finishing the heated argument with Dr. Basu in her head. She was really sticking it to him. Colm had seen her do this many times before. Cathleen could never muster the nerve to tell people
all
that she really thought. Instead she grumbled, mumbled, and had little wars inside her own mind.
“I like him, Mama,” Colm admitted. “I have a feeling he knows what he's talking about.”
“We'll see about that. I have to talk to your uncle Sean first.”
C
athleen saw her brother only once a week, when his shift schedule or a hangover didn't get in the way. She and Colm joined him on most Sunday mornings at St. Patrick's. Since their mother had died more than six years ago the two had an unspoken pact that this was how they would honor her. Granted, they had given the woman her fair share of grief over her daily attendance at church, but now the ceremony rooted them in their past, in their present, in their future, even if they didn't believe everything the church espoused. Church was like a name, or a neighborhood, or a sibling; it was theirs, good or bad, because it was all they had ever known.
They rarely missed a Sunday, even around Christmas, when the streets were packed with tourists. Afterward, they fought through the crowds and took Colm to visit the Metropolitan Museum, the American Museum of Natural History, or to the Central Park Zoo, or even to the Times Square Toys “R” Us. Uncle Sean always bought Colm something from the Lego section and later helped him build it. Colm couldn't get enough of playing with Sean, and Sean was always immensely proud that he could do this one thing for his sister. Even if he couldn't make her happy, he could make her son happy.
When mother and son arrived at St. Patrick's on the following Sunday morning after visiting Dr. Basu, Colm immediately spotted Uncle Sean waiting for them in the back near the gift shop. His tall, broad, uniformed body was hard to miss. Colm broke away from Cathleen and leaped into Sean's large arms. Together the three walked down the center aisle and took their regular spot in the pew.
Colm started to say something, but Uncle Sean put his finger over the boy's mouth to remind the boy where he was. Uncle Sean was usually all fun and games. There was no limit to the noise they could makeâwrestling, dancing, and chasing each other around his apartment. Colm loved to turn on Uncle Sean's stereo as loud as it would go and dance on the coffee table and the sofa. Life with Uncle Sean was always a party, and Colm loved to watch his uncle move his hips and slide his feet across the floor, swaying to the music, sometimes stopping only to swig his beer. “You move like Timberlake,” Colm often heard his mother say. Colm had no idea what that meant, but he loved to watch his uncle and mother dance around the living room as if they were floating on clouds. It was the most wonderful place in the universe, he thought, and he often vowed that when he grew up, he would be as free as Uncle Sean, except he wouldn't bother with church.
For the life of him, Colm never understood how his uncle, who was so unrestrained outside the walls of the church, could be so different inside them. Church was such a letdown for Colm, and the worst part of it was sitting still. Colm believed his mother and uncle chose to take him to the world's longest Massâwith a choir that sang every response, with a priest who seemed to go on and on during the homily and who talked with his mother after every Mass. Colm didn't get it. Why did people come to church? What was the point? But then he quickly reminded himself, he knew something that the others didn't. He glanced at his mother, who at that moment was staring up at the windows above the altar. She looked to Colm as she had often described the angels in heavenâa glowing blast of radiant light and beauty. But Colm knew better.
His mother was beautiful, but she was no angel.
Despite all evidence to the contrary, Cathleen never paid much attention in church. The rituals had become so ingrained, her body moved without knowledge it was moving. Her lips spoke without awareness of what she was saying. She didn't feel the words in her mind, heart, and spirit as she spoke them. She let her imagination run. She sat and admired the beauty of it all, the work that had gone into designing these magnificent buildings for the glory of God, all to give humans a piece of heaven here on earth.
Sean had assured her that the cathedrals in Italy made St. Patrick's look like an ersatz copy, but she had never been to Europe, so to her, St. Patrick's was the supreme church. Sometimes after Mass she took a moment in one of the side chapels with her mother's stack of prayer cardsâa collection the older woman had earned by visiting various wakes and funerals of friends, relatives, and firemenâand began to recite them. The first card in her mother's deck had an illustration of St. Florian, the patron saint of firefighters. On the back of the card was the Firefighter's Prayer and imprinted on the bottom was her father's name and a date:
Michael Patrick Magee, June 15, 1985.
Sean and Cathleen's father had died when a backdraft caused a warehouse floor to collapse, crushing him and another firefighter instantly. Their mother, an Irish immigrant, thousands of miles from her own family, was left all alone. Dressed in a black maternity dress and carrying her nearly three-year-old daughter on her hip, she marched behind an engine carrying her young husband's coffin to St. Patrick's while bagpipes echoed down Fifth Avenue. Cathleen always thought it was a blessing that her mother had died before Sean became a firefighter. She knew her mother could have never survived the possibility of losing another loved one. Cathleen could barely handle it herself.
After Mass, as they headed out of church, Sean and Cathleen grabbed Colm's arms and swung him. Some people, the
regulars,
Sean called them, glared at them. But some of the older people who still had memories of their own children smiled at the three of them, thinking quietly to themselves:
What a happy, young family.
People often mistook Sean and Cathleen for husband and wife. Sean looked nothing like Cathleen. He had auburn hair like Colm's and blue eyes. He was lantern jawed, like his own father. And unlike Cathleen and his mother who were tall and slight, Sean's body was a massive bulwarkâwide and seemingly unbreakable. When Cathleen was a child, she found a picture of their father standing next to their young mother. She couldn't imagine how a building could have ever crushed the man. Like Sean, he seemed like Atlas to her; he could carry the whole world on his shoulders and never succumb to its weight. Cathleen had been looking for that same strength in a man her entire life.
“How did the visit with the new doc go, Cate?” Sean asked as soon as they were out on the sidewalk.
“It wasn't like all the other visits. He didn't order any tests.”
“I thought you hated all the tests.”
“I do. But it all seems to be moving really fast. He says he wants to put a pacemaker in him.”
“What's wrong with that? I thought you said you wanted someone who would help Colm.”
“You agree with this guy?”
“From what you're saying, he's the first one so far who seems more worried about fixing than diagnosing. Let's face it, Cate, most people go through their entire life not knowing what it is that is killing them.”
“So you think we should do it? I'm just so torn . . . I . . .” Cathleen stopped when Colm began pulling on her arm.
“Now what, Colm?” Cathleen was annoyed, and she didn't know why. Church with Colm always tried her patience though. As a child she would never have behaved the way he did in Mass, with all of his fidgeting, climbing, and sighing. She was tired of being constantly tugged and called. Motherhood was an endless stream of unsolicited nudging and urging on, when all she really wanted to do was stay put.
Sean saw what Colm was trying to do, and he reached in before Colm hit the ground.
“Oh, crap, here we go,” Sean said audibly, although mostly to himself. It came on so fast, Sean could barely make sense of it. Although he knew Colm had done this four times beforeâhe had never seen it firsthand.
He rested Colm's body on the ground as a small crowd began to gather on the sidewalk in front of the cathedral. Using his paramedic training, he felt for Colm's pulse and checked to see if he was breathing, but the boy had already stopped. As he started chest compressions, Cathleen yelled out for help as she dug through her purse, trying to find her phone.
As Sean pressed on Colm's chest over and over, all he could think was that he had no idea how his sister had managed it all these years. Despite all the emergency calls he had made during the past two years as a firefighter, Sean wasn't prepared to watch someone he loved die in front of him. Worst of all, he knew he was powerless. No amount of training could save Colm once his mysterious heart stopped beating.
As Colm's face lost its color, Sean started, for the first time in several years, to pray, really pray. In his head, with every compression he repeated over and over: “Hail Mary full of grace.” Press. “The Lord is with you.” Press. After a minute of praying, he began to beg God to not let Colm go. He bartered with God.
Take me.
Press.
Take me instead.
Press. Sean thought how much easier it was to lay down one's life for a friend, or even a stranger. As a firefighter, he had put himself in a fair share of sticky situations to save people he had never met, and he had even been called a hero for it, but suddenly he knew saving lives was the easy part. It was nothing like watching someone he loved die. The heroes were the ones who were left behind, who endured it all. He had known from the beginning of his own life that death was always felt more by the living.
Five minutes later, after the paramedics arrived and took over, they told him to stand back and take care of his sister. Sean began to shake uncontrollably and reached for Cathleen's hand and took it. She looked at him, feeling the fear in his body rise in her own. The monsignor worked his way through the crowd and came to stand beside Cathleen, taking her other hand and praying out loud. Cathleen didn't even notice. Her mind was on only one thingâher son.
“Where could he be?” Cathleen whispered to herself, staring blankly at the scene before her.
The monsignor and Sean said nothing.
The paramedics worked on Colm a long three minutes before they grabbed the shock paddles and jolted him several times. Each time, Cathleen jumped, as if she could feel the electricity and pain running through her own body.
Suddenly, Colm's eyes popped open. Above him, he could see the dark shadows of people standing over him and behind them the towering steeples of the cathedral and the blast of morning light pouring through. He closed his eyes again.
Cathleen lunged for him. “Colm, come back!”
One of the paramedics explained how they had to get the boy to the hospital and that they might have to intubate him to keep oxygen flowing to his brain. The boy had a pulse, she said, but it was weak, and he needed help breathing.
Another paramedic asked Cathleen and Sean, “How long do you figure he was out before we arrived?”
“At least five minutes before you started working on himâI guess that means about ten minutes total,” Sean said.
The paramedic looked at Sean. She didn't have to tell him what she was thinking. Sean already knew. It was too long.
He is most certainly brain-dead,
Sean thought quietly to himself.
“Can we ride along?” Sean asked.
The paramedic nodded, and Sean and Cathleen broke away from the monsignor and climbed into the ambulance. In the ambulance, Cathleen held her son's hand and glanced quickly out the window only to see the monsignor's worried face and the church behind him grow smaller as the ambulance sped away.