Every Note Played(67)

She’s such a coward. She didn’t used to be. She used to be fearless. She left her family, her home, her country, when she was eighteen and never looked back. Where did that woman go? She wishes she could reclaim that courageous spirit who graduated with honors from a college in a foreign country and played piano in New York with the best jazz musicians in the city. Maybe she could start by being a woman who finishes her coffee, takes the elevator to the ICU, picks up that letter board, and finds out what happens next.

What if he wants the surgery?

She can’t be his 24-7 caregiver. But there’s no one else. His parents are dead. His brothers have jobs and wives and kids to raise. Private help is insanely expensive, and Richard’s money is gone, already sunk into his care, the wheelchair, the lift, Grace’s college. He can’t ask Grace to do this for him. Karina won’t let him.

He’s not her husband anymore. She doesn’t have to do this. He’s not her burden to bear. She thinks of his affairs, of all the women he’s slept with. Where are all these women now? Not in the hospital cafeteria. Not in the ICU. Not in her den every day for the rest of his life.

She thinks of the decade she spent lying to him, pretending to want more children, feigning disappointment every month, feeding him medically plausible reasons for her fictitious infertility, pretending to go to doctor appointments. The first coffee sours in her stomach, and she feels as if she could throw up.

He wanted more children. He especially wanted a son. Every month for years, he thought they were trying to conceive. She got an IUD when Grace was three and never told him. She was afraid to tell him the truth, that he wouldn’t want her anymore, that he’d divorce her. And then where would she be? Disgraced and alone, a single mother to a preschooler, divorced and unemployed in a foreign country.

When Grace was thirteen, Karina went to her ob-gyn to have the IUD replaced. But it wouldn’t come out. It had embedded in the wall of her uterus, and she needed surgery to remove it. Petrified of surgery, she confessed everything to Richard. Her decade of deception.

When she allows herself to remember that day, she’s still haunted by the reaction on his face, his expression evolving from shock to grief to rage. The rage remained, burned into his features and probably his heart. It took them a year to separate and another two to get officially divorced, but their marriage was over the day she told him what she’d done.

He’s never forgiven her. She doesn’t blame him. Whatever his sins were, this one was entirely hers. Maybe caring for him on a vent for the next decade is what she deserves, penance for this unforgivable sin. Maybe that would finally absolve her.

If he says he wants the surgery, can she refuse to be his caregiver? She’d essentially be sentencing him to death. If he wants to live, who is she to say that he should die? Should she shut up and do whatever he wants, whatever it takes to keep him alive? An old but familiar resentment flares. Twenty years ago, he accepted that teaching position at New England Conservatory, made the decision to move them from New York to Boston without regard for her happiness, her freedom, her career. He stole the life she wanted from her. And here she is, all these years later, considering the real possibility of playing jazz again, and Richard still has the power to stop her.

She doesn’t want to be sentenced to life as his caregiver, a prisoner chained to his paralyzed body. What will he do? It’s going to be a death sentence for one of them.

“Is that it?”

“Huh?” Karina looks up, baffled.

“Is it just the coffee?” asks the cashier.

“Oh, yeah. Sorry.”

Karina pays and finds an empty seat at a table for two. She wraps her hands around the paper cup and brings her nose to the lip, inhaling the smell instead of drinking. She checks her phone, hoping for a text or email that will keep her busy. She has nothing.

She tries to imagine where Richard’s head is at, to gamble on his decision. While his body is useless and essentially dead already, his mind, his intellect, his personality, are still perfectly intact. What would she do? She takes a sip of the coffee she doesn’t want and knows her answer before she swallows. She wouldn’t get the surgery. She wouldn’t go on a vent. She wouldn’t want anyone giving up his or her life to keep her alive. She wouldn’t want to linger on like that, locked in, totally dependent on others for everything.

But Grace. She wouldn’t want to leave her yet. What will Grace do after college? Who will she marry? What will her life look like? Who is she going to be? Karina wants to know, to be here to see it all.

What if it’s not forever? What if he chooses the surgery so he can see Grace graduate in two years, or he only needs caregiving for one more year until a bed becomes available in a facility? Could she do that? She stayed married to him, trapped in their broken relationship, persevering for at least ten years for the sake of Grace, appearances, her religion, and security. So she could do this for one or two years. But what if it’s more? What if he wants to go on living at any cost?

She closes her eyes and prays, searching for the right thing to do. She opens her eyes and stares into her coffee, at the doctor reading his phone at the table across from her, at the cashier ringing up the next customer. No one and nothing have an answer for her.

Even Kathy couldn’t tell them what to do. The trach surgery is a horrible choice. I would never do that. I recommend extubation and death by suffocation at home with Hospice. That’s the only way to go. Karina wishes the decision were black-and-white like this. Instead, she and Richard have been thrown into the deep end of a gray ocean. There is no horizon, no North Star visible in the gray sky, only these impossible choices before them.