Every Note Played(64)

He can feel his tongue wriggling inside his mouth, undulating as if a family of earthworms were dancing within it, celebrating a rainstorm. When he speaks, his tongue feels thick, the volume thinned and barely audible. His words, once a finely detailed painting, are painfully slow to produce and almost impossible to comprehend, strangled and lacking consonants. A Pollock piece. Free jazz.

Already compromised to what Dr. Goldstein says is now 39 percent forced vital capacity, every single inhale is a struggle. Every exhale is incomplete. He’s forced to sip air a teaspoon at a time when he’s desperate to gulp it down by the gallon, each taste an agonizing disappointment, evidence of the withering muscles surrounding his ribs, his abdomen, his diaphragm. Pulling in enough air to simply sit motionless in the wheelchair is conscious, draining work.

He’s probably close to needing the BiPAP 24-7 but won’t admit this aloud or even request it for purposes of a temporary rest during the day. He won’t let anyone advance his wheelchair one inch onto the handicapped ramp of that slippery slope. Even now, every single night, he still can’t believe this is his reality. He’s traded bed partners, beautiful women for a BiPAP. It’s the worst monogamous relationship of his life. And they can never break up. Without the BiPAP at night, he might retain too much carbon dioxide in his sleep and suffer brain damage or suffocate and die.

He doesn’t want to die.

He opens his mouth wide and closes it several times, regrettably sensing a new and unmistakable slackness in his jaw. And so it begins. Once the weakness ensues, there is no abortion, no retreating, only a relentless, insidious icy downward luge into paralysis. Soon, his jaw will hang open, ribbons of saliva will continually stream over his bottom lip, and he won’t be able to talk. He frowns as he imagines this likely development, the impossible-to-mask spectrum from pity to disgust in Karina’s and Bill’s and every stranger’s eyes when they look at him. He doesn’t even want to face his piano like that.

When will this next irreversible insult be inflicted? Tomorrow? Next week? End of the month? This summer? The answer is yes.

He studies his hands that will never again look familiar to him, fingers that used to carry exquisite strength and agility, that a year and a half ago played eighty-seven pages of Brahms I without error. He misses playing Brahms, feeding himself lunch, scratching his nose, touching a woman, making Karina laugh. He apologizes to his beloved piano for abandoning it, to Karina for abandoning her, and he suddenly feels the cumulative weight of every single loss all at once like a concrete slab dropped onto his chest.

And he can’t breath. Without the slab on his chest, every inhale was already an intended dive into open ocean, stopped dead in ankle-deep water. Now, suddenly, the tide has gone out. He’s gasping, drowning on dry land. He can feel the adrenaline kick, the fight-or-flight animal instinct. This is life threatening. More air now. Yet, he can’t run, and he can’t fight, and he can’t get more air now. He tries to use his next exhale to call for help, but he succeeds only in spitting. Karina’s in the kitchen drinking coffee, and he’s dying in the living room without notice.

Inhale. Exhale.

His body is seized, the tendons and muscles of his neck squeezing, shaking violently with effort. Each breath feels like drawing air through a thin, clogged straw. It feels like suffocating. Fear rises in his throat where oxygen should flow. He swallows, choking on it.

Breathe in. Breathe out.

Shallow sips. He’s so hungry for air. His cells are literally starving for oxygen. Keep breathing.

He calls up what it took to master Rachmaninoff’s Piano Concerto no. 3. Ten grueling hours every day, relentlessly focused, playing each movement over and over, fighting through excruciating physical pain and mental exhaustion until he could play the entire piece by memory and without error. Now his tenacity, his will, his purpose, is trained on breathing.

In. Out.

This is now his song to play. He is not this paralyzed body, these screaming lungs, this primal fear. He will be an instrument of breathing.

Breathe.

Again. Pull the air in. Push it out. Again. It’s not enough. He’s fatigued, strangled, starving for air, failing.

A few short and long months ago, playing piano was like breathing to him. Now breathing is breathing to him. His work. His purpose. His passion. His existence. He has to keep breathing.

He doesn’t want to die.





CHAPTER THIRTY


Karina panicked and called 911. Richard was intubated in the ambulance by a woman with intensely focused blue eyes and a raised coffee-bean-brown mole above her right brow. He never lost consciousness and kept his eyes on hers while she worked on him. Insertion of the endotracheal tube was violently swift and invasive, and the gagging, discomforting pressure of the first few moments was quickly eclipsed by the massive relief of air moving in and out through his windpipe. Once in the ER at Mass General Hospital, someone drew blood, and he had a chest X-ray, which revealed pneumonia. A nurse ran an intravenous line of antibiotics, and he’s now in the ICU with Karina, waiting for Kathy DeVillo.

Karina is standing next to him, over him, her arms crossed as if hugging herself, watching him intently, studying him, which worries him because he’s not doing anything. He wonders what she’s seeing. She looks scared.

The antibiotic fluid running through his veins is ice-cold. Despite staring at him like a specimen under a microscope, Karina doesn’t seem to notice that his skin is covered in goose bumps. He wishes she’d lay a heavy blanket over him. His face itches where the tube is taped across his mouth, and he wants to ask Karina to scratch it for him. He tries to talk, but his effort is smothered, blotted out when it hits the impenetrable wall of hard plastic running the length of his throat. He cannot speak. He stares wide-eyed at Karina, sharing her fear.