Non-fiction

A Label for My Father

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A few months after his eighty-sixth birthday, my father learned he had terminal lung cancer. Scans of his chest showed rapidly metastasizing tumors that had appeared since a routine x-ray earlier that year. The disease was aggressive, too far advanced for treatment or even—given his general frailty—a biopsy.

He didn’t react much, didn’t seem surprised. He may have already suspected this news. As Sharon Olds writes in “His Stillness,” a poem about her own father’s terminal diagnosis, “He had always held still and kept quiet to bear things.” All his life my dad was mindful of the thousands in his generation who’d died as boys, decades before, in Europe or the Pacific. He knew he’d had a good long run and that anyone who made it to eighty-six was lucky indeed.

Back home, there was a bustle of arrangements for sitters and hospice care. He would need a hospital bed. It was my parents’ wedding anniversary; they had shared a bedroom for sixty-four years, and my mother wanted my father with her. The hospice director intervened. “He needs to be in a separate room,” she told my mother. “You’ll need a retreat.”

My family looked into the long face of this woman, with its softly powdered lines, her crown of pinned brown hair and grave eyes. We thought, She knows what’s coming. She has seen this all before.

So my father was settled into my old bedroom, next to his and my mother’s room. The separation was beginning.

*

Time congealed. My brothers and I decamped to our parents’ house, putting our work and our own households on pause. We fell into a togetherness both familiar and weird, wordlessly assuming old roles in a house we no longer called home, patching routines out of sitters’ shifts and visits from nurses and friends. There was a veneer of cheer, and sometimes we almost forgot why we were gathered (was this a holiday? some protracted vacation?). But we kept tearing up unexpectedly. Beneath the sheen of the unhurried present was an interior clamor of dread, nostalgia, and sorrow.

In my old bedroom, light entered the windows at a different angle than my father was used to. When he stirred from his drowse, the bars of the hospital bed crisscrossed his view. “Where am I?” he moaned, gripping the bedrails, trying to get up. My brother David said, “Dad, you’re in Hopie’s old room. You’re at home. We just switched out the bed.” Our father nodded, and a smile of relief spread over his face as his head sank back into the pillow.

In moments of alertness that day, and the next, he looked around that sunny room and out through the wavy windowpanes, where oblongs of June brilliance trembled. “I’m so glad to be here,” he said. “Yes.”

*

When I was seven, I stumped my mother in Hangman, to my surprise and hers. Of my word’s eleven letters, she guessed its A and T’s right off the bat, and then an L

_ A T _ _ L _ _ _ _ T

—but on the page her cartoon victim grew, till he hung by his circle head, a stem of a trunk, two stick legs, and an arm.

“Are you sure you’re spelling it right?”

“It’s a word I’ve known a long time.” I counted the blanks again.

She frowned at the stick man. Then, just as I thought she might give up, a light came into her eyes. She took the pencil and swiftly filled in the blanks, laughing as I moaned at my near-victory.

“What’s that?” other kids on the playground would say, when we were talking about our parents’ jobs and I supplied my father’s strange vocation.

“He does autopsies. You know what that means?” I’d drop my voice and lean closer. “He cuts up dead people.”

Through his work I’d learned other unusual words, like “hepar lobatum,” “squamous-cell carcinoma,” and “Papanicolaou,” the man for whom the Pap smear was named. I was not too clear on the clinical details of the Pap smear, but my father told me the procedure had saved a lot of lives.

*

We lived in the central Louisiana city of Alexandria. The downtown church where I went to kindergarten, in those days before public preschool, was not far from the hospital where my father worked. Tuesday was his afternoon off, so he would pick me up at noon, the idea being that he’d bring me home, saving my mother the trip. But his morning work was never through by twelve o’clock. He’d take me back to the hospital to finish signing out the surgicals or the Pap smears or the morning’s slides.

He would bend over the microscope, silent, his glasses placed on the table beside the cardboard folder of slides. I watched his square-tipped fingers, now poised on the focus knob, now moving to shift the slide in the column of light that shone up through the viewing platform. Every now and then he’d lift his head, slip his glasses on, and roll the swivel chair over to the desk to consult some book that lay open, before scooting back over to the scope. I sat on the regular desk chair, boosted by a textbook as thick as a cinderblock, drawing on a yellow legal pad with one of the laboratory’s special pencils: red on one end, blue on the other, with a thick, satisfyingly greasy tip at either end that you exposed by peeling a shaving of wood from around the core.

Now and then I’d go to his bookcase, pull out Gross Anatomy or Surgical Pathology, and page through, lingering over the black-and-white photographs of goiters and tumors, necrosis and calcification. Sometimes these were on headless limbs and torsos. When faces were included, the subjects stared at me or to the side, expressionless as the criminals on tacked-up fliers at the post office.

Occasionally my father invited me to look through the microscope. Pressing my face into the eyepiece, I strained to keep both eyes open, to see past the fringe of my eyelashes and down into the crisp pool of light. There, in a field of radiance, another universe appeared, a miracle of rose and purple, gold and blue. Ripples of background tissue were studded with flecks, crescents, and the delicate bubbles of cells. It was luminous, strange, and still, a zoo of shapes and patterns rather than of animal forms; yet it came from the essence of life, from our very insides, and this taught me that under the apparent surfaces of things lay other worlds.

To understand abnormality one must fully grasp the normal. Pathology is a specialty demanding comprehensive knowledge. It’s the study not of lungs or gut or brain alone, nor of any other single organ or system of the body, but of disease itself. Despite their involvement with every field of medicine, pathologists remain the doctors no one sees, their bedside manner moot, a morbid joke. News about surgery tends to skirt the pathology process: “when the pathology report came back…,” people say, or “awaiting lab reports.” Rarely is there mention of an actual human being behind the diagnosis—as if it issues from an oracle or maybe an automaton; as if the surgeon inserts a specimen into some machine and waits for truth to curl out like a printed receipt.

But maybe it’s appropriate that we shroud the process in mystery, for what patients and families await with such anxious suspense when they’re “waiting for lab results” is a name, a label, to attach to whatever has disturbed their health; and naming is a potent and magical act. To bestow a right name on something is to call out its essence, transferring it from obscurity to the light of day. H. Richard Niebuhr said that before you can ask, “Is it good? Is it fitting? Is it right?” or take any action at all, you must first ask, “What is going on?” Diagnosis identifies what is going on. The disease that has been happening incognito in the body, once labeled, can then be connected to a chain of decisions about what is possible, what will happen next, what action we might take.

*

To the world he was Doctor Norman, to our mother and his friends he was Tom—his legal name, not a nickname—and to my older brothers he was Dad. To me, the youngest and the only girl, he was Daddy. The diminutive carried the effortless sweetness that floated over our relationship all my life. I defended him when others rolled their eyes at his slow habits or made fun of his absentmindedness; for me he relaxed the impossibly tough standards of behavior he imposed on my older brothers. We enjoyed simply biding in each other’s presence, whether we were planting his garden or ambling through a museum. He was demonstrative in courtly, old-fashioned ways. To be gathered into his arms for a hug, to feel his cupped hand steadily patting my hair when I was upset, or to catch his glance and the twist of a little smile when something amused us both—these were gifts whose value I didn’t fully appreciate till later in life, when I met women who don’t have adoring, steady fathers, and who feel the lack of that foundational affection all their lives.

On one of those kindergarten Tuesdays, my father and I were headed home, speculating about what my mother would have fixed for our extremely late lunch. The windows of the truck were open, and as we waited at a red light on MacArthur Drive near the Holsum bread factory, a breeze billowed in, loaded with the scent of warm loaves. We sniffed and inhaled. He loosened his tie, tired but in a buoyant mood—relieved to have finished his day’s work, and looking forward to an afternoon off. “How about you?” he asked jovially. “Do you think you’d like to be a pathologist one day?”

“No,” I said in a sad voice. “I might get hungry.”

Late lunches notwithstanding, by the time I was nine or ten I did want to become a doctor. On Saturday mornings my father would take me with him to the hospital lab. The secretaries didn’t work on weekends, and he said I could help him by taking dictation as he cut the surgicals.

Cutting surgicals was the “gross” part of clinical pathology—a source of humor to my brothers and me, but as our dad pointed out, the word’s older meaning was not “disgusting” but “big.” Slicing open the removed tissues was gross in comparison to the fine microscopic work that came later in the process.

From time to time my mother sent Tom to the lab with a brown paper sack full of washed glass jars and lids. The hospital sterilized these and used them to hold organs and tissues during their journey from the operating room to the laboratory. At home he would pull out, say, a caper jar from the fridge and comment that it would be just right for moles. “Gross,” we’d groan.

“On the other hand, don’t throw away that mayonnaise jar. It’ll be good for something like a kidney or a—”

“Dad!”

Hospitals quit recycling household jars as plastics came into wider use. Nowadays it would be unheard-of for an olive jar to carry a gallstone through the bowels of a med center.

*

The hospital was by the Red River, and the lab was at the back, on the levee side. We’d park and go in, walking on shining marbleized floors, smelling first the lukewarm food aromas gusting from the hospital cafeteria and then, as we entered the lab, the bite of a sour rubbing-alcohol smell. The laboratory suite was quiet, but doors stood open and the lights were on, and a tech might greet us from side rooms marked Histology or Cytology: “Hey, Dr. Norman. I see you got you a helper today!”

At a counter in the back of the lab, my father would spread a layer of paper towels over the dissecting board. On the counter stood a cluster of jars filled with mysterious, grooved, globular forms, swimming in what looked like pickle juice. He would tie on an apron and pull latex gloves over his hands with a snap at the wrist; I’d perch on a stool with my tablet and pencil.

“Okay, first put the date. What is today?”

The rest of the family groaned at our father’s un-mindfulness (“I didn’t forget that your birthday is September 22,” he protested once to my irate mother, “I forgot that September 22 is today”). But in my view, anyone could remember stuff like dates. He kept his mind clear for more important knowledge, like how a heart should look inside, and how it looks instead when something is wrong.

So I would tell him the date as I wrote it in the top right-hand corner, just as we did at school. He would take up a vial, the smallest first. From the label he would dictate the patient’s name and age, an identifying number, and the nature of the case: “This was removed yesterday from the left breast.” He used long tweezers to take the specimen from the bottle, describing as he went and measuring with a plastic ruler. “Within the fibro-fatty mass is”—slice—“a firm nodule measuring three point one by two point zero by—let’s say—zero point eight centimeters.” He turned the little object and made another incision. “The cut surface of the mass is firm and pale tan, somewhat granular.”

I labored to write neatly, but Daddy said not to worry: on Monday morning the lab secretary would type up my notes and check for mistakes as well.

His cuts were not only investigatory but were strategically placed through key areas—the parts whose cells, viewed microscopically, would best yield up their secrets. Plop went the specimen back into its preservative, and on we went to the next: a section of lung, a liver tumor, a piece of intestine. Sometimes when he unscrewed the lid a putrid smell would gush toward me. I would try not to gag.

After my father died, calls and notes poured in from people who’d known him over the years. “We need more men like Tom in this tired old world.” “He was a kind gentle person.” “My first fishing compadre.” “A unique, interesting and warm person.” “A role model of helping others . . . including even an active little neighborhood girl whom he involved in building a dog kennel.” We heard from former medical students, residents, co-workers, summer lab workers, and science-minded young people he’d mentored during his time in private practice. “I worked with him in the lab at Rapides for several years. He was so kind and helpful…” He “had a great influence on my life.”

I too had been his student of sorts, and on those Saturday mornings in the lab I soaked in his low-key teacherly style: “Here we have hypertrophy of the uterus—do you know that word? Hyper, unusually big, the opposite of hypo, with an o, unusually small.” He had learned Greek and Latin by extrapolating root words from the medical terms rather than the other way around—backwards, our mother would say, to his irritation.

“I didn’t learn that ‘backwards.’”

“Well”—she waved her hand vaguely—“you didn’t take it in school.”

As he peered at all sides of a specimen, his eyeglasses would gradually slip down the bridge of his nose. With his hands gloved and occupied, he couldn’t nudge the glasses back into place. “Hmm… Now this woman probably experienced unusually heavy monthly bleeding.” I’d bite my lip. “Let’s look at the endometrial lining.” By the time the last specimen had slithered out of the biggest jar, he would be looking over the top of his frames as the glasses sat at the tip of his nose.

Once the gross surgicals had been cut, measured, described, and returned to their jars, they went on to be made into slides. I had seen this procedure too: A lab tech would embed the specimens in paraffin. A hand rotor drew the wax block into contact with a razor-sharp blade, which shaved off long, transparently thin strips of wax and tissue that floated atop a chemical bath. Then the technician swooped a glass slide up from beneath, hoping to capture the critical section. As the paraffin adhered to the slide, it left minutely thin sections of tissue fixed and visible.

Next came staining, a key step. A skilled lab tech knew which brew of chemical dyes would best highlight certain kinds of tissue. This magenta concoction tinted the liver nuclei just right; that deep blue wash let the key features of pancreas cells stand out. Once the stain dried, the slides, labeled and numbered, were placed into cardboard folders that went on to Pathology for microscopic scrutiny, deliberation, and diagnosis.

Some cases were easy—cut-and-dried, in my dad’s apt words—and some were quite hard. “People think that science is black and white,” he often said, “but it’s not. Vast areas of nature are gray.” No matter how blurry the charcoal specks that were supposed to be determinative, no matter if some cells looked sickle-shaped while others appeared normal, he had to name the condition, make the call—diseased or not? malignant or benign?—knowing the repercussions of his diagnosis for that patient and family. Especially difficult cases would go to other pathologists for consultation; he knew their diagnostic strengths, as they knew his.

The hurried-up version of this process was a frozen section, when the diagnosis is made with the patient kept open on the operating table. On the mornings my father had a frozen, there was a sense of urgency at home. He left extra-early, rushing out the door with his tie untied, planning to knot it at a red light. (The techs and secretaries smiled when he arrived at work with his tie flapping loose around his neck. “Come on back, Dr. Norman. The specimen’s on its way. I see you made it on all green this morning.”) As minutes ticked by, the patient upstairs in surgery remained opened up, exposed to the dangers of long anesthesia and possible wound contamination, while the freshly removed specimen was flash-frozen and the slides quickly made. Even under such pressure, nature did not always cooperate in turning up black-and-white results. As my father struggled to make his decision—rolling his chair occasionally to consult a reference book, mostly sitting motionless, straining his eyes at the scope, alertly looking, sifting possibilities, comparing the visual cues in the slides to the knowledge foremost in his mind, his awareness of the open patient, the anxious family, like a dim background buzz—the surgeon might telephone from the fourth floor. “You got an answer yet on Jeansonne?”

Sometimes the surgeon even came down from surgery to loiter, capped and gowned and slippered, in his doorway. “Ready with a diagnosis?”

That night, rumpled and weary, his tie again loose from his collar, my father would debrief to my mother: “I felt like saying, ‘No, but if you’d leave me alone I might be!’”

Finally, he would roll back his chair and stand up, his decision made. The all-important name would fly upstairs via intercom to the surgeon, who bore it, Hermes-like, across the waiting room toward the tense, expectant family, and placed it in their keeping forever. That pronouncement would usher in diagnosis’s cousin, prognosis, setting in flow many implications for the future—outlook, treatment, chances for survival. Both terms come from root words that have to do with knowing: diagnosis, a thorough, taking-something-apart kind of knowledge; prognosis, the knowledge of things to come.

*

Autopsies seemed to happen on the weekend. We’d try to plan some Saturday outing, and my father would shake his head. “I’ve got a post. They’re sending the body up from Marksville Friday afternoon.” Or on Sunday my mother would shake hers: “Tom’s not coming to church. He’s got an autopsy.” Autopsies took about four hours—longer if the head was included—and left my dad pretty tired. He was discreet about his forensic cases, though I sometimes overheard intriguing tidbits as he unwound: “She was grossly overweight, and I had to cut through layers of fat to get to anything” or “He was a floater”—a drowning victim that had been in the river several days. We were hanging out in the kitchen once with our dad, who had just gotten home from doing an autopsy, and my brother Thomas said, “What’d the guy die of?”—keeping his eyes on the snack he was making, a stalk of celery into which he was pouring a line of salt. My father watched him draw his thumb down the groove of the celery, leveling the salt with his thumb, and said, “He died of putting too much salt on his celery when he was ten years old.”

*

Tom David Norman grew up during the Great Depression in small towns in north Louisiana. Times were lean, but his parents were fortunate enough to have jobs—his father on road construction crews, and his mother at the post office. Somehow the family got by. Even though they were poor, as whites they had access to the best of what the public system offered. The local schools for white children, though lacking in some areas (such as art), were strong in others (perhaps surprisingly, chemistry). For extra opportunities my father looked to church and Boy Scouts. From high school he went to Louisiana State University, hitchhiking to get to and from Baton Rouge. Although it was the same state it must have seemed like a different world to him: largely Catholic and subtropical, in contrast to the hard-bitten, Protestant hills of north Louisiana; the university cosmopolitan and huge. By now World War II had started. One year in, he had the opportunity to go to medical school through the Navy V-12 program, an accelerated officer training program designed to graduate numbers of doctors quickly and get them to the fronts.

In June 1943 a train bore south along the Mississippi, stopping to pick up young men from the small towns of Arkansas, Tennessee, Mississippi, and Louisiana. Tom got on in Baton Rouge, wedging himself into a crowded car. On the short trip to New Orleans he made friends he would know for the rest of his life. Along with 800 other Navy V-12 recruits—including 125 entering medical students—he arrived at Tulane University, where the gymnasium had been converted into makeshift housing, with bunks, lockers, and bathrooms where the stands and arena once were. His bunk was on the balcony. Desperate for a quiet place to study, he found a broom closet that happened to have a table where he could spread out his books and bring his concentration to bear on anatomy, physiology, and neurology. For the next three years the students pushed through the medical curriculum, barely breaking between semesters. They were on active duty and wore Navy uniforms the whole time, but my father’s class was never deployed; before they graduated, the war ended and the program was over.

He paid for his last year of med school with his parents’ help and proceeds from part-time jobs. Two days after his graduation in June 1947, he and my mother married, sealing a three-year courtship that had begun when he spotted her in the choir at her father’s church. He went on to internship and residency in general medicine, then joined the small-town practice of a doctor in Natchez, Mississippi.

The decision to go into pathology came just a few months later—according to our mother, because he caught chicken pox from his very first patient. He had never had it as a child, and his case was severe, covering him all over, even between his fingers and toes. Back for more training he went, to study disease from a different perspective at the Institute of Pathology at the University of Tennessee, with stints at the Mayo Clinic and Duke for specialty training in neuropathology. From then on he would study disease at the cellular level, the surgical level, and the forensic level, no longer in a general clinic but doing research, publishing, and teaching and—eventually—treating people behind the scenes, unseen.

He continued to feel indebted to the nation for his medical education. During the Korean War he volunteered for the Air Force, serving hospitals at two bases in west Texas and reaching the rank of captain.

*

We were used to graphic talk around the house. One night at the supper table, Mom nattered on about her friends: “Today Nancy went into the hospital for a hysterectomy, but according to Jane Ann, she didn’t end up having it after all.”

“Oh yes she did,” said my father.

“No, she didn’t,” said my mother.

“Hope—”

Mom usually won their disputes, by sheer will and verbosity if nothing else. “No. She didn’t end up having the hysterectomy. I talked to Jane Ann, who’d talked to Nancy’s sister, and she said—”

Daddy looked up from his plate. “Hope,” he said, “I held it in my hand.”

We snickered while our mother, open-mouthed, had to back down.

We nudged each other whenever he carved a roast or ham, watching him rotate it clinically before starting to slice, his glasses slipping down his nose. We grinned when he struggled to describe what was wrong with our car’s flat tire. It had a “protuberance,” he said. A sort of “contusion.”

He winced when people called their abdomen their stomach. The stomach, he maintained, was a specific organ within the abdominal cavity. If you mentioned that while climbing a tree you had scraped your stomach, he’d say, “Do you mean ‘belly’?” If you remarked that you’d worn your two-piece bathing suit and your stomach had gotten brown, he’d say, “Do you mean ‘belly’?” and remind you not to lie out in the sun: doing so put you at risk for various skin cancers, including the worst of them all, melanoma, from the Greek mélanos, meaning black.

*

“This was my father,” writes Sharon Olds. “He had known he was mortal.” To the forensic pathologist, death is always close at hand. It stretches out on the autopsy table, mundane and dissectible, as unveiled as it can ever be. Over the years my father had spent thousands of hours with corpses male and female, young and old, wasted and bloated, shot, strangled, or clobbered. Yet he affirmed the rightness of death, its place in the natural order. “Things come to an end,” he would say. “Death is a necessary part of the cycle.”

Once we were discussing some person, or maybe it was an animal, who was badly hurt and suffering. I remember him saying, “When someone’s near death, past any hope of making it, the goal of treatment should not be to try to put that off. Your goal should be pain relief. There is nothing wrong with giving morphine at that point.” He looked at me keenly from beneath his bushy eyebrows and said, “There are worse things than death. You understand?”

But did his up-close familiarity with death really make it less terrifying to him? Or did it have the opposite effect? Maybe those long hours in the cold air of the morgue, with the steely lighting and pungent smells, made it impossible to go around blithely ignoring the reality of death, the way most of us do from day to day.

I saw my father cry after his own father died in a tree-cutting accident; I saw him crushed by my brother Thomas’s early death. From time to time, as my dad lived on into an old age that his son never even got to approach, a whimper would well up in his throat, a deep animal noise he seemed unconscious of making—in vacant corners of the day as he stood looking out the window, or sat on the edge of his bed, getting ready to face the day, or lay waiting for sleep.

*

Over the years he had many interests: fishing, refinishing furniture, growing vegetables. We had a farm, a gritty operation that raised Hereford and Brangus cattle and kept my brothers and their friends employed for years. We kept a few quarter horses, and I learned to ride, spending contented hours with my father as we jogged along the rough pastures and mused about our horses’ thoughts (together we honed our riding skills with knowledge gleaned from a series of booklets—Prof. Beery’s Mail-Order Course in Horsemanship). But all these avocations were surpassed by my father’s immersion in sculpture.

When this passion for art began, I was surprised to learn he didn’t know about such basics as the color wheel. He didn’t know the primary colors. He didn’t know that blue and yellow mixed together make green. He’d had no art instruction as a child. Yet we should have recognized his predilection for visual art, as an artist friend of the family pointed out: after all, every day at the microscope he sorted colors and patterns, and gross pathology is at some level a close examination of solid structures. Even so, he came to sculpture haphazardly. His interest in furniture repair led him to take a woodworking course, which led to classes in clay portraiture and then to increasingly abstract sculpture. He fell for Michelangelo and Rodin, Giacometti and Noguchi. He traveled to Southern University in Baton Rouge to study under the acclaimed sculptor Frank Hayden, who became a dear friend. He used vacation time to go to summer art colonies and tour foundries, and spent hours at home chiseling and smoothing hunks of alabaster, marble, and wood. Thomas said, “A year ago he didn’t know who Henry Moore was. Now if you try to talk to him about the lawnmower, he maneuvers the conversation around to Henry Moore.”

My mother nodded. “He knows what Henry Moore eats for breakfast.”

*

The last day he could sit up, I showed him a photograph of a Henry Moore I’d seen on a trip to London—Mother and Child: Hood, at St. Paul’s Cathedral. “Oohhh,” he said, looking. Encouraged, I showed him a picture of Stonehenge, another place he’d loved—related a theory about how ancient builders might have levered the boulders. By then his glasses were sliding down his nose, and I wasn’t sure he could focus on the laptop.

In certain hours he was lucid. My mother lay down with him on the hospital bed and they cuddled like newlyweds. “You’re just so beautiful,” he kept repeating. “I’ve always loved you so much.”

He was courteous to the hospice sitters and rallied at the entrance of a niece who’d driven from New Orleans to see him one last time. Through his fog of exhaustion he looked her in the eye and called her by name. “I’m so glad you came,” he told her, and added intently, “Take care of yourself.”

Then his speech dwindled and became crazier, less coherent. This disturbed my mother more than his physical deterioration. But one thing I found I could do was sit at his bedside and try to ride along in that realm of nonsense. His eyes would suddenly open and rove around, and his restless hands would grab the bedrails. “I’ve got to get up!”

“Okay,” I’d oblige him. “You can get up in a minute. First, though, just lie here and gather your strength.” That would satisfy him for a while.

For years his spine had gradually bent forward, bowing his head forward. “I’ve developed a kyphosis,” he would explain. The condition forced his gaze downward toward grass, gravel, rug designs, and floorboards, kept him from looking up into the branches of trees he loved. His face had become less visible. Now that it rested on the pillow before me, I could study it for long minutes. He wasn’t even wearing his glasses. I noticed the long lines of his temples, the strong modeling of his cheeks balanced by his heavy eyebrows, his white hair contrasting crisply with his tawny skin. I have his nose, with a little knob at the tip, and his wide nostrils. His lips, though not full, had something sensual about them, the hint of a curve pushing through the red-brown thinness. As I sat looking, his eyes flew open. “Hope?”

“I’m here. It’s Hopie.” I squeezed his hand.

He raised mine to his lips for the brush of a kiss.

“M’lady,” he said with mock gallantry. We laughed. His eyes closed. When they opened again he seemed to rediscover his hands, uncurling and curling his fingers, studying them. Short fingers, square-tipped—we’d all inherited those.

“I like your hands,” I said. “Remember when we saw that Rodin exhibit of only hands?”

He couldn’t nod any more but I felt that he did remember. “You probably can still name all the bones in the hand,” I said, “the nerves, and the tendons…”

Like Prior in Angels in America, he startled. “Look!” he said. “Looka there!” He was fixed on one corner of the ceiling of my old room—not out the window, not at the ceiling fan, but at the air in the corner. “A big, beautiful hand!”

His face was wreathed in Christmas-morning pleasure, grooves of smiles making arcs in his forehead and bows in his cheeks. He said some other things that I couldn’t understand, then lapsed back into sleep.

When he did talk, his voice could be strong, infused with tone and feeling. “We can take some from the back, and move them into the front,” he said, loud and clear, then mumble-mumble… In his mind was he laying out an orchard, or his garden?

The traits we recognize as personality—stances, grimaces, lifts of an eyebrow—must stem from tiny, repeated actions of our musculature, set into characteristic habits over the years. In the stripping and short-circuiting course of dying, they expose themselves again. A few times he extended bent arms, fingers curled, and shook his hands to emphasize his words—an old gesture that I remembered in a flash, one that expressed that he’d reached the end of his patience. “Look,” he said, his eyes closed but face vexed, “I just need to know—someone just needs to tell me—what—I’m supposed—to do.”

What was it like within his consciousness now? I was feeling my way through a blizzard—no footing, no visibility, only a cable quivering with intuition for a guide. “You’re good. You don’t need to do anything else,” I said, and then, almost sternly, not in any voice I had ever used to him as daughter: “You’ve done everything that’s required.” Sending my words toward a bourn I couldn’t hazard.

His eyes shut. A nod, not quite managed. His heavy head dropped back into the pillow.

*

 “Hope, Hope!”

My mother and I have the same name. But the cry that came whenever my father roused, or when the tilting of the bed hurt him or made him feel like he was in freefall, was for her, not me.

“Dr. Norman?” the sitter would say. “She’s in her room, close by. I’ll get her if you want her, but she’s trying to sleep now. She needs her rest.” And he would nod.

At moments, in the confusion of total system failure, his body resisted. He tried to get up past the point where his limbs could support him. He fought the whiff of oxygen we tried to supply through a slender tube pinched at his nostrils, and tried to refuse the sips of water and nutrition drink and the spoonfuls of pudding laced with medicine. Still, in those days at his bedside I guessed that his intellect was still working, somewhere within. He could understand more than he could speak, and he just wanted to know what was happening to him, the rationale behind the treatment. “Daddy, this is an anti-anxiety medicine.” His eyes were closed, he was frowning and shaking his head, and I could sense the word “Who—?” trying to bumble from his lips. “Oh, who prescribed it? Dr. McBride. He thinks it will lessen some of the agitation you might be feeling. Is that okay?” Then he would nod, and open his lips for the dose. “Daddy, this is oxygen. Your blood is not quite oxygenated enough. The tube might bug you, but if you can leave it in place for a while, I think you’ll feel better.” “Daddy, this is water. You might be a little dehydrated.” We started morphine on the sixth day—tiny doses slipped under his tongue—but by then he was barely conscious enough to receive it, and there didn’t seem to be a need to say, “Daddy, this is morphine.”

*

On the seventh night after his diagnosis, we finished cleaning up the kitchen. He hadn’t eaten anything since a swallow of applesauce two days before, but the rest of us had had supper. It seemed strange to eat in the breakfast room as usual while he was at the other end of the house, slowly starving. He should be in his normal seat, driving my mother crazy with his slow ways, asking if he might have a little pepper sauce, and did anyone else want that last half-slice of bread?—tipping his head appraisingly when he heard the options for dessert. We had gotten weirdly accustomed to the vigil, as if this was simply what we did now—eat and clear the table and clean up and part and gather. As if, through the open door beyond the dining room, we couldn’t see his still form listing toward the window, and the silhouette of the sitter beside the bed, and hear the gusting humidifier that was somehow supposed to help.

David and I started the dishwasher while Mom put food away. Stephen went back to his house in town, and David headed to his son’s house to watch a movie. I went to sit by Daddy. In a little while the sitter took his blood pressure, which had plummeted to a level even I knew was abysmal. I called my brothers and they came back. With my mother we sat around my father’s bed. She stroked his hair and held his hand as we talked in bits and pieces.

Snapshots of complexity—the idiosyncrasies that make someone dear. His favorite color was brown. He was ever in search of the perfect tamale and the perfect Old-Fashioned, and in promising restaurants would hopefully order those items only to taste and, most times, shake his head, and sigh. Once again the world had disappointed him, but only briefly. With every sunset—his favorite time of day—it would redeem itself, as with the simple sight of grazing cows. He defended Richard Nixon until the moment Nixon admitted he’d lied; then, after a rightward lean during the Ford administration, he came about strongly left and remained a staunch Democrat for the rest of his days. He hated any clenched-fist salute; the gesture reminded him of totalitarian dictators. He disliked anything overly theatrical, cutesy, or what he called “too-too”; slapstick comedy made him giggle, and classical music held him spellbound.

At his bedside my brothers told stories about the years of awful haircuts he gave them to save the expense of the barber. We laughed quietly. The sitter withdrew to a corner. My mother laid her head on his chest. He would breathe three or four slow times; after the next inhalation would come a long, long pause; then he would exhale.

After about an hour we moved into the living room, but kept the doors open between the rooms; then the sitter called us back. His color had markedly changed. We took our places again around him, and were there when he took his last breaths.

Stephen took up the stethoscope that lay on my old dresser and used it, in a few minutes, to verify the death. My father’s warm hands grew cool.

The sitter called the hospice director, who came and took care of many things in a hushed, orderly way. We called family members. My husband led me onto the porch to hear the screech owl that was calling from out in that darkness in its counter-tenor tremolo—the one that we had heard back in the spring, when we were ignorant of what was coming, or how soon: what Audubon calls the “mournful notes . . . during mild and serene nights” that “by some people are thought to be of ominous import.”

*

It was past midnight by the time the sheriff’s deputy arrived, followed by the attendants from the funeral home. Stephen came into the living room and said gently, “Mom, you need to come now to say goodbye.”

I hovered in the doorway, then gave her the privacy of her last moments with him, the man she had married when she was eighteen and he twenty-one. Or at least her last moments with his physical self: the still, sallow shell he had so rapidly become.

Once someone dies, the arc of his life is complete. Nothing else will be added. The obituary’s past tense reiterates: this life is finished. “He was remarkable,” we say, and the root sense of that word is true: we want to make remarks, to mark the contours of someone who has so marked us. The surface of the life slips from our grasp, seen through the wavery panes of memory and conjecture, anecdotes tinted and sliced, never fully revealing the person’s dimensions.

I could hear the clinks of the gurney being set up, hear bumps and grunts and discussion. I shut the door to that part of the house. Now the noise was going through the dining room. Which would be my father’s final exit from the house he loved—down the dining room steps, where we welcomed or bade goodbye to company; or by the back-door kitchen stoop, where he used to come in from work, his arms bristling with mail and folders of slides, where in retirement he’d stood and puffed his pipe, and called his dog, and brought in vegetables from the garden?

In a few minutes she came back.

“How’d that go?” said Stephen—so, so gently to her.

Her pretty gray hair was mussed. Her eyes sagged with tears. She shook her head. “It’s not him,” she said, my mother, to whom correct grammar is a point of pride, my mother who for years had chirped her This-is-she to callers on the phone. “It’s not him.”

“That’s right,” said Stephen. “That’s right, it’s really not.”

Which is why, I think, I didn’t feel more grief at that moment. His presence travels with me still—an undercurrent like a steady, running river; a lens through which I see the world as layered, ever worthy of attention. What was traveling out of the house just then bore no more resemblance to my multi-dimensional father than a figure on a flat piece of paper, a stick figure under which was printed the word, PATHOLOGIST.

***