This is what they call reverse-culture shock. Take a bush pilot from the barren expanse of southern Sudan and drive him into New York City.
I pressed my face against a cold window in my uncle’s mini-van. Stretching my eyes upward, I watched the massive girders and cables of the George Washington Bridge stream by above us. A steely, grayish-blue, with giant rivets and a taught, cold symmetry, the bridge was a monster and a monument for another world. A world I didn’t know very well anymore. I imagined a giant wrench somewhere, the size of a bus, and a giant man to turn it. How else could they tighten those hundred-foot turnbuckles? Something powerful created this, I thought. And then the city opened up before me and I sunk even lower in my seat.
We were on our way to Sloan-Kettering memorial hospital. It’s somewhere in New York. I don’t know where, just somewhere. I couldn’t remember the turns if my life depended on it. The many lane-changes, and the one-way streets, deeper and deeper into the shadows through blazing fast traffic. More steel, and stone, and people in a hurry. I had a flash of Sudan run through my head. Of a village made of nothing but straw and dirt. And then I was awakened by the rumble of a truck four inches from my window, traveling in parallel, passing us on a curve in the narrows.
We arrived at a nondescript building but I saw nothing. I just followed the back of dad’s shoes. He knew his way in this hospital which spanned a couple of city blocks. Just the simple mistake of choosing the wrong elevator, dad told me, would get you lost. I wondered how that could be, for on an elevator you can only ever be lost in one dimension. But I didn’t ask. I just watched the shoes and we finally ended up in what felt like the middle. There were no windows in sight–the ceiling a little too low for an office and a waiting room without windows.
Dad, I could tell, was a “regular” here. Not the sort of place you want to be a regular, but he seemed to enjoy it as he greeted familiar faces. In fact, the man seemed far too happy to be there. But part of it was because we were all there with him. Two brothers and a son, he proudly introduced us. A son from Africa no less. “All the way from Africa to be with his pop,” was what he said exactly. And he was right. I’d come all the way from the moon if I had to. My uncles and I were there for more than just the moral support on this, dad’s scheduled chemo day. We were more than just family. We were unique genetic possibilities–some of the most likely in the world (my uncles more so than I) to match my dad’s bone marrow, and among the best chances to be the donor for his upcoming transplant.
At one of what seemed like an inordinate number of blood-drawing stations around the hospital, I sat and placed an arm on the table, vein up, and face turned away. Next to me a friendly man assembled with speed and precision the tube and vial and little individually-wrapped IV needle before he told me to take a deep breath. I thought that this place, perhaps, might hold a record for IVs inserted in a day. It’s so fundamental to what they do. I thanked him when it was done, but mostly because the needle wasn’t in my arm anymore. As I stood to leave, he stopped me. I was supposed to verify that the vials of blood get properly labeled before he sends them to the lab. I played along like it was really important to me too. I guess this is what they do here. Maybe people are stealing “genetic identities” these days along with your credit cards.
There’s a lot of waiting that goes on in a hospital such as this. Dad had his blood drawn and we waited for the results. Then he had a meeting with a doctor about the results. And then, they special-ordered his chemo for the day. All the while I waited. I flipped through nearly all the magazines in the waiting room. Glossy, New York kinds of magazines. Full of advertisements and pouty-faced models who seemed to say “I look fabulous and you’re in a cancer ward.” They left me feeling a little homesick for Africa. Dad emerged from the doctor’s office with a smile and some good news. They would be reducing his chemo from twice a week to only once. Apparently his blood looked clean. I had a quick and frightening thought that perhaps they mixed up my blood with his, and so it really wasn’t clean. But, no, I checked the label I remembered. And, ah, that’s why they verify the vials. And I felt a little bad about not taking it seriously before. Dad gathered us up and hurried us down the hallways to the treatment room. We could barely keep up with him.
I sat with dad during his twenty-minute treatment in another un-navigable corner of the third floor. I never knew what chemotherapy was all about. I always imagined “chemo” to be bags of hideously colored liquids surging down clear tubes. I imagined that it hurt. And I imagined that life might not be worth living if chemo was the only option. But dad treated it like taking a Tylenol, nothing to fret over, nothing to fear. The room had a couple of Lazyboy recliners and an array of beige medical equipment you’d expect to see in a hospital. Dad got comfortable and the nurses set him up with a saline IV. This is where we talked about Africa and dad bragged about how clean his blood was that day. The nurses were genuinely happy to hear it. I gathered that their days were regularly filled with bad news. “I won’t see you next Tuesday,” dad burst out.. “I only need one treatment a week now.” And they all smiled about not seeing each-other. Then dad’s chemical cocktail arrived.
The tone went a little more serious and a second nurse entered the room. The shift reminded me a little of the “sterile cockpit” concept that pilots adopt. When on the approach phase of a flight, where the margin for error narrows, a captain and copilot cut out the small talk and focus serious attention to the task of landing the plane. In a similarly professional manner, one nurse held a clipboard and a syringe side-by-side and read aloud the label on each one: Name, number, dosage and content. The second nurse repeated and confirmed what the first nurse had read. I thought perhaps next they would each pull out a red key and arm a missile. But then dad spoke up from his recliner on cue: Name and number. Check.
Dad’s chemo was not the frightening conglomeration I had imagined. Neither was it as benign as a Tylenol. The nurse handled the small syringe of clear fluid with care, commenting to dad how the chemical could injure his skin (or hers) if it were to spill. She said it in such a way that I thought she didn’t mean to say it. Perhaps this is true in any hospital, but in a cancer center the strange mix of normal life and pending mortality must always be present, even if only whispered. As the chemo made its way through dad’s body, two young women in the nurses’ station outside his door were chatting about their resumes, thinking about their futures. I was thinking about dad’s future. And dad was thinking about only one thing–where to go out for dinner. He asked me to get the nurse to un-tether him and I stepped out to inquire. “He says he’s ready to go,” I said as if asking permission, with a shrug in my shoulders. And the nurse smiled at me as if she and dad shared a secret that I was too new to understand. For him, the chemo was a gift. As was the day. In fact, every hour.
We crossed the river again after sunset but the bridge was just a string of lights. It seemed less ominous in the dark as we joined the flow of traffic to the Jersey side. I watched dad from the back seat as he put on a surgical mask. The chemo would soon be delivering a blow to his immune system and the mask was a simple precaution, like sleeping under a mosquito net in the Congo. I wondered what those chemicals were doing at that moment, there in the dark. For me, too new to dad’s illness to comprehend it all, this seemed like a hard day. But it’s his routine now. The harrowing trips in and out of the city, the endless IVs and long waits at the hospital, and coming to grips with living a life hanging by a thread–a thread of dangerous molecules in a little syringe injected each week. It could be described as a hard day, but for dad it’s a good day because he is going home. Two trips over the George Washington Bridge are better than one.
That was last Thursday. Dad’s sitting there again today as I write this. In his regular chair. Left or right hand today Matthew? He’s telling the nurses what a gift that little syringe is. He’s telling everyone how he’s living by grace today, even to the unsuspecting guy in the parking garage. And he’ll cross that bridge again tonight and come home to mom, and a special little guest. Zach’s having a sleep-over at Pop-Pop’s house. And they have big plans.