Chapter 14

There was constant foot traffic in and out of Alison Giles’s hospital cubicle. Until now Charlie had seen only one shift change, but that was enough proof for him—his brother, Joe, was on a first-name basis with every nurse on the floor. Without fail, every time a nurse came in to check on Alison’s condition, they would first go over to Joe. With sympathy in their eyes, they would ask how he was holding up and if he needed anything. He’d always say fine and no, but Charlie could see the delight in Joe’s face when they asked.

Charlie wished that a nurse were in the room with them now. It was also clear to him that the doctor in with them now wasn’t going to be able to talk any sense into Joe.

“You’ve been here two days already and home only once,” Charlie said. “You need some rest, too, you know.” He took off his glasses and rubbed at his eyes.

“I’m not going anywhere if she might wake up,” Joe said. “Is she going to wake up?”

Charlie sighed. He looked to the doctor, who offered only a slight shrug. It was as if he were saying, “He’s your brother. You deal with it.”

“Joe, nobody knows for sure. You’ve been told that a hundred times,” Charlie said. “You can’t go on living in the waiting room until she does. You need to get some real rest.”

“And someone needs to be here for Mom when she wakes up,” Joe said.

Charlie turned back to the doctor. “Tell him again,” he said. “Is she going to wake up tonight?”

Dr. Stan Abrahams looked down at his pager while he spoke. His long, slender fingers worked his keypad as he typed his message. This was Joe’s third go-around with the same exact questions. By the impatient look on Abrahams’s face, Charlie suspected the doctor wouldn’t be sticking around for a fourth.

“It’s unlikely that she will wake,” Abrahams said. “As I’ve said, your mother experienced something called hypertensive encephalopathy with brain swelling and, as a consequence, suffered multiple is-chemic strokes. I’m sorry to say that she is in a near-vegetative state.”

The rhythmic drone of Alison Giles’s ventilator seemed suddenly louder to Charlie. Maybe it did to Joe as well, because he looked over at her ventilator, too. Several bags of IV fluids circled her bed, and tubes seemed to flow from her in every direction. Charlie touched his mother’s arm. Then he reached across her lap and took her thin, frail hand in his. Her skin felt cold, clammy to the touch—perhaps without the constant rhythm of the ventilator he might even think lifeless. How many times had she bandaged his skinned knee or cheered for him from the sidelines of his soccer games? All the gratitude, love, and admiration he felt for her at that moment was soured by the specter of regret that she might never hear him say “I love you” again.

“Is there anything we can do to help her?” Charlie asked.

“Just being with her. Talk to her, though research on that is inconclusive. The good news is we didn’t see any other life-threatening processes, such as a hematoma or abscess,” said Abrahams. “Though she had extensive hemorrhaging, which isn’t common in patients with kidney failure, and which we believe contributed to her hypertensive encephalopathy. We’re treating that with platelets and vitamin K IV drips. It seems to be helping to stop the bleeding and protect other organs from failing. We are looking into what’s causing the hemorrhaging, but I do have to remind you, we believe chances for her recovery are very slim. She may partially come out of the coma, but she will be severely injured. Do you understand?”

Abrahams seemed cold and detached. Normally Charlie would be able to relate to his demeanor. He often acted the same way at work—a pragmatist, his workplace mantra was to hold back your tears and piss them out later. But this was his mother, and Abra-hams’s icy professionalism, though tactical, was borderline offensive.

“How did it happen? Is she going to be paralyzed?” Joe asked.

Abrahams looked back down at his pager and took in a deep breath.

“You need to be patient with my brother, Doctor,” Charlie explained, his voice firm, but calm. “He’s under a great deal of stress, as am I. But Joe handles stress differently than you and I. So I appreciate your explaining things to him again, even though you feel they’ve already been explained.”

He watched as Abrahams hesitated for a second. Charlie was glad to see him put his pager away. This time Abrahams kept eye contact with Joe while he spoke. Charlie could see that it helped Joe to relax.

“We’re not sure exactly what caused the stroke. My first suspicion, and I told you this earlier, was confirmed by lab tests. It was her high blood pressure.”

Charlie snapped his head toward the doctor. “What did you say?” he asked.

“I said we’re suspicious that her high blood pressure might be a factor.”

“I heard you, but that’s impossible,” said Charlie.

“I’m sorry, Mr. Giles. One of the first things we did when your mother was brought to the ICU was to perform an ophthalmoscopy, an examination of the blood vessels in the eyes. They showed clear signs of hypertension. That is a leading cause of stroke and would explain her kidney failure.”

“I don’t care what you did. Have you contacted her primary care physician?” Charlie asked.

Abrahams nodded. “We have left messages. Apparently she’s on vacation.”

“Great. That’s just great. Well, listen, Doctor,” Charlie said, staring Abrahams down, “if you do talk to her, then you’ll know my mother doesn’t have high blood pressure.”

“The evidence seems to be contrary,” Abrahams said.

“What about waking up?” Joe asked. “When will she wake up?”

“We’re still running tests,” said Abrahams. “We can’t predict when a patient will come out of a coma or if. Okay? The best thing you can do is get some rest. We promise she’s in the best possible care, and that you’ll be notified immediately if her condition changes.” Abrahams turned to leave.

“What about operating?” Joe yelled to his back.

Abrahams turned. “Surgery isn’t really an option,” he said. “I believe I told you that already. Several times. Listen, I have other patients I have to attend to. The nurses are here. I promise they’re taking excellent care of your mother.” Abrahams glanced over at the nurses’ station. “I’ll be back to see her in the morning. Dr. Saunders is working the overnight. I’m sure she’ll be happy to answer any other questions you have.”

Then he was gone. A few seconds later a young nurse came into the room. Joe recognized her, and he said a warm hello. Charlie figured she had overheard the conversation and could see that Joe was upset. Without hesitating, she put her arm around Joe’s shoulders, having to stand on her tiptoes to reach. She patted him on his back.

“If they could operate, they would,” she said.

Charlie blessed her arrival. He had been keeping Joe calm for the last several hours and was beginning to run out of steam. He looked at the white board hanging beside his mother’s bed. If she was the on-duty nurse, then her name was June. Saint June is more like it, Charlie thought.

“What if she’s paralyzed? I hear strokes can make you paralyzed,” Joe said.

June guided Joe into the small green vinyl armchair by the side of the hospital bed. “Dr. Abrahams said only time will tell. So that’s what we’re going to do. We’re going to wait. And I’ll wait with you. How does that sound?”

“Thanks. You’re really kind,” Joe said. “Do you want to get married?”

June didn’t skip a beat and played along, laughing. Charlie didn’t even break a smile. To him Joe’s impromptu proposal was like nails on a chalkboard. Vintage Joe—out of the blue and socially bizarre.

“I already am, sweetie,” she said. “You’re just a few years too late for me.”

“Well, just so you know, I’d marry you. And then if we had a son, you know what we’d have?” Joe smiled his signature Cheshire smile.

“What?” June said, grinning in return.

“June’s son and Joe’s son. Get it. Johnson and Johnson, just like the baby shampoo,” Joe said.

Charlie grimaced, but June laughed.

“I get it. Like the baby shampoo. That’s funny, Joe. Really funny,” June said.

“Do you think they can operate?” Joe asked.

“I don’t know, Joe. Only time will tell. Remember?” June replied.

“Yeah, I remember,” Joe said, taking hold of his mother’s still hand.

Charlie decided that if Joe was going to stay the night, he wasn’t going to do it in his white, food-stained shirt. It was just a few minutes past midnight. He had already arranged for Brenda to take Monte home with her. Given the circumstances, there hadn’t been a moment’s hesitation on her part. Another saint in a long line of saints he suspected he’d be needing.

He decided to take a cab to Waltham to pick up some clothes. Joe would never agree to wear any of Charlie’s clothes. It had to be his own stuff, or he’d rather go naked. That was part of the disease. Then he’d come back and crash at his own apartment, which was only a ten-minute walk from the hospital. He wanted to stay close. There was something else he wanted, too. He caught up with June, who was filling out a chart at the nurses’ station.

“Is there any way I could get some flowers for my mother’s room?” Charlie asked. “She loves sunflowers the most.”

“Florist is closed now,” June said. “But I do have some flowers at my desk. I can put them in her room for you if you like. You can get new ones in the morning.”

Charlie nodded in appreciation. She reached for him and touched his hand. The moment she did, a lump formed in his throat. The adrenaline of the crisis had long worn off, leaving in its wake the raw emotions of fear, regret, and hope.

“Thank you,” was all he could manage to say.

Bleary-eyed and wobbly, Charlie stepped out into the cool night air for the first time since arriving at the hospital that afternoon. He slumped across Beacon Street and began searching the deserted road for a cab. The third one to pass saw him and stopped. Charlie slept for a minute or two en route but kept waking as the cab jostled him from side to side. Normally he’d pass the time fretting over work, firing off e-mails from his BlackBerry, but that had all been taken away.

In his gut, Charlie believed he would come out of this on top. He trusted his instincts. That perseverance was a trait for which he could thank his mother. Running from adversity would be his father’s genetics, he supposed.

Arriving at Cleveland Street in Waltham, Charlie stood outside the two-family home where he grew up. He paused before climbing the paint-chipped wooden stairs to the front landing. There were memories of this home he longed to forget. He went in through the back door, entering into the kitchen, using the key his mother hid under the flowerpot.

The house, as always, was impeccably clean. For Charlie, it was like stepping back in time. Nothing had changed since he had lived there. Same yellowish linoleum floor, same brown electric stove, same flimsy round kitchen table. But the chairs weren’t pushed under the table as he would have expected. And a cupboard had been left open. There were still dirty dishes in the sink. Charlie reconstructed the moment his mother had collapsed by examining the mementos left behind.

Leaving the kitchen, he took the narrow staircase to the upstairs floor. The stairwell still had the same claustrophobic feel he remembered from his childhood. The drop ceilings on the second floor were so low, he had to stoop a bit when he walked. The place always made him feel the same—anxious to leave.

Charlie went into the guest room first. It had been his room before he moved. He remembered his mother saying something about it being converted into Joe’s practice studio since he had started playing the drums. Charlie knew Joe enjoyed listening to music, but had never thought he had the inclination or interest to actually play it. His mother had explained that playing an instrument helped him to stay focused, improved concentration and communication. It was suggested therapy, a part of the new treatment program Joe was involved with at Walderman Hospital. The program headed up by Dr. Rachel Evans.

Charlie figured Joe’s choice to play drums had something to do with his brother’s borderline obsession with the rock band Rush and their undeniably talented drummer, Neil Peart. He was somewhat impressed to see that it was a real kit, not some cheap knockoff set. Charlie ran his hand across the smooth pearl white base drum and banged his knuckles against one of the three Zildjian cymbals. The kit itself rested on a nappy carpet that Charlie thought used to be in the basement. Flakes of paint from the peeling walls littered the floor, probably shaken off the walls by a vicious snare snap.

He wondered what sort of player Joe was—if his skill was commensurate with the quality kit he owned. Charlie had begun playing music when he was seven years old, after his mother bought him a guitar for a Christmas present. That winter their father had been well into his losing battle with reality, though Charlie hadn’t known it at the time. His mother later admitted to buying the guitar with the hope that Charlie would learn to play and reach his fast-fading father through his one remaining love—jazz music. Charlie understood now that his quick-to-develop devotion to guitar study had been largely fueled by his own desire for the same thing.

After Joe’s diagnosis of the rare condition musicogenic epilepsy, and the stunning revelation that Joe’s listening to their father’s favorite Miles Davis song, “So What,” was triggering his brother’s trancelike seizures, Charlie had put the guitar down and boxed the turntable. Jazz music had been as much a part of the Giles household as their father had been, and like him, it was gone.

Joe didn’t turn his back on music entirely. It was only the song “So What” that doctors proved was dangerous for him to hear, but as a precaution not a single note of jazz music was played in their house again. In place of jazz, Joe became somewhat of a devotee of rock music—the classics mostly and, of course, Rush. Charlie wasn’t surprised to see Joe’s makeshift studio walls decorated with some of the same rock posters he recognized from when they were kids. The Bowie, Beatles, Dylan, and Hendrix posters were less faded, and Charlie assumed them to be new. There was a small turntable on a paint-chipped white table next to the kit, with about a dozen classic rock albums scattered about on the floor beneath. Keeping music in his life, Charlie figured, was Joe’s way of keeping their father in it as well.

Charlie closed the door to Joe’s studio and went across the hall to Joe’s bedroom, the same room he’d had as a kid. The wallpaper had been changed—cowboys and horses replaced with adult-appropriate wide stripes of alternating brown, white, and yellow. Curious, Charlie moved the bureau away from the wall, until he could see the long, thin groove he had made in the wood with his penknife. That had been more than twenty-five years ago.

Most of the furniture he recognized from when they were kids. He had offered his mother so much: money for new furniture, even to buy a new house. But the familiarity of his belongings was comforting to Joe. Their mother had been fine with things just the way they were. So he’d let it rest. Still, coming here made him feel guilty about the luxuries of his modern apartment, knowing that his mother’s furniture and appliances put together wouldn’t add up to the price of his living-room set.

By Charlie’s standards, Joe’s room looked as if it had been ransacked by thieves. Charlie couldn’t tell the clean clothes from the dirty ones, so he just grabbed a handful of whatever he could find on the floor. Perhaps he could convince Joe to stay with him for a day or two, but he knew it was unlikely. He and Joe weren’t close, but that didn’t mean he’d want him sleeping at the hospital every night.

There was a time Charlie had felt privileged just to be granted entry into his big brother’s bedroom. The two had had an undeniable closeness once. Even now, when Charlie noticed the time was 7:57, be it morning or night, he thought about how they had pretended to be airplanes for precisely sixty seconds, flying up and down the narrow staircase, fingertips scratching the walls as mock wingtips. But the time for brotherly play was now long past.

On occasion, whenever a movie or commercial depicted two brothers with a close bond, Charlie would find himself playing a what-if game. What if my brother didn’t accuse me of stealing from him things he had never even owned? What if he wasn’t calm one minute, yelling at me the next, accusing me of the most absurd, fantastical offenses against his make-believe world? What if his schizophrenia didn’t terrify me? To have stayed in a close relationship with Joe would have required sacrifices beyond Charlie’s emotional capacity to make.

There were two options going forward as Charlie now saw it. Either Joe would have to move in with him until their mother recovered (and she would recover, Charlie assured himself), or he would hire somebody to look after Joe. At least Joe owned his own car and could drive himself to and from work, which was good for all involved. Charlie ran his fingers across the windowsill in Joe’s room and then blew away the dust he had picked up in the process. One thing was for certain: there was no way Charlie was moving back home to live with Joe and look after him.

On his way out, Charlie noticed the small silver-framed picture of sunflowers hanging on the wall by the front door. Joe took the picture years ago, while apple picking in the quintessential New England town of Hollis, New Hampshire. The trip was one of several Walderman-sponsored outings, intended to foster a greater sense of community and camaraderie among patients and staff. Joe thought the picture magnificent and enlisted Charlie’s help in getting it printed and framed. It had been hanging in the same spot ever since. Charlie took it off the wall. Their mother would like it with her, he thought.

The cabdriver was waiting outside, just as instructed. Charlie’s cell phone rang minutes after they pulled away. He didn’t recognize the number. Might be the hospital.

“Charlie Giles?” a woman asked.

“Yes?”

“Charlie, this is Rebecca Harris. I’m your mother’s attorney. I’m sorry to call so late.”

“That’s not a problem, Rebecca. What can I do for you?”

“I just found out about Alison. She and I had an appointment this evening. When she didn’t show, I called the house. Nobody answered, so I got worried. It’s not like her to miss an appointment,” she said.

“That’s true,” Charlie said.

“Normally Joe would answer the phone if she was out. Anyway, I couldn’t stop worrying, so I started calling area hospitals to check and see if anything had happened.”

“You found her,” said Charlie.

“I had no idea she’d been there so long. It’s just terrible.”

“I know how you feel,” Charlie said.

“The reason I’m calling is to check up on your mother, because the hospital wouldn’t give me any information. Also, I needed to talk with you.”

“With me?”

“Yes. There are reasons. How is she doing?”

“I don’t know, Rebecca. She’s in a coma. The doctors have no idea how long it could last. The only good news I’ve heard is that she doesn’t have any other life-threatening conditions. At least, not that they’re aware of.”

She let out a loud sigh. “Okay … God, that’s such good news. Is it all right if I visit tomorrow?”

“Of course. That would be fine. Was there something else? You said you wanted to speak with me specifically.”

Charlie found Rebecca’s pause uncomfortable.

“Your mother is a very thorough and well-planned person,” she began.

“I know. She raised me.”

“Of course. Well, she left instructions regarding Joe should she ever become …” She paused again. “Incapacitated. It’s her living will, Charlie.”

Charlie’s heart dropped. Instructions regarding Joe?

“Go on.”

“Joe’s schizophrenia is severe,” she said.

“You’re telling me things I already know.”

“He’s in a specialized treatment program at Walderman Hospital. He’s been making wonderful progress. Your mother was so encouraged with the neurophysiologist he’s been working with. The difference has been tremendous.”

“It’s possible,” Charlie said, though after what he’d seen that day, he wasn’t convinced. He softened. “I’m not with him as much as my mother.”

“I see,” Rebecca said. “To get to my point …”

“Please.” Charlie could not disguise the anxiousness in his voice. He wasn’t at all sure where this was going.

“Your mother felt it was imperative that Joe continue with his treatment at Walderman. That his home life not be disrupted in the event something was to happen to her. She knew that Joe wouldn’t trust anyone to live with him—unless, that is, it was someone he knew intimately. She was worried that without the care he needed, he might be remanded to a state institution. That would be devastating to her. Joe can lead a normal, healthy life. He’s getting closer every day. To go into state care … Well, that would just destroy all the progress they’ve made together.”

“What is it that my mother wanted?” Charlie asked.

“She wanted you to become Joe’s legal guardian.”

Charlie hands trembled.

“And she wants you to move into the Waltham house. To live with Joe until she recovers.”

“And if she dies? Does she want me to live with Joe in Waltham forever?”

Rebecca stayed professional. “You would be the only family Joe has left, Charlie. I suppose your mother trusted you to do what’s right.”

The cab sped past the neighborhoods and memories Charlie had struggled long and hard to leave behind. Now he was being asked to return. Moving back into that house would be no different than being handed a prison sentence. Charlie held the phone to his ear but did not say anything to Rebecca. For the first time, he could empathize with his father.

Sometimes running away makes the most sense of all.