“Sick Husband,” oil on canvas, by Vassily Maximov, 1881.
In 2017, I published The Geek’s Guide to the Writing Life, a memoir developed from a Huffington Post column I wrote some years ago. During an interview after it came out, my friend, Tanya Baker, at National Writing Project Blogtalk radio, said, “you describe this as a writing life memoir. But I think this book is as much a love letter to your husband as anything else.”
I had never thought about this, but in that moment, I knew she was right. It was a love letter, albeit an unintentional one.
Every Saturday night for most of our married lives has been date night. Tonight is no exception. You have always loved to cook, to plan elaborate gourmet meals, set the table and pair the wine and so, from the bedroom where I read, I can hear you clearing the counters, preparing your mise en place, hear your footsteps across the scuffed wood floor, the way you like to talk to yourself as you go, “Okay, then. Okay.”
Then, a hard crash.
“John?” I call, “Are you ok?”
Nothing. I call again. At this point, under normal circumstances, you would have answered with a vaguely annoyed, “Fine, I’m fine!”
Silence.
I find you on your back, on the floor in front of the sink.
Your eyes, your beautiful blue eyes, are open, but you are not breathing.
No.
No. No. No.
I find my phone and dial 911.
“Talk me through CPR,” I tell them after they establish our address.
“Ok,” the operator says after finishing instructions. “Every time you see him breathe, say it out loud.”
“Breathe,” I say as the air comes out of your lips in soft puffs.
Begging.
“Breathe.”
Imploring.
“Breathe.”
Pleading.
Twenty-five years ago. Abundantly pregnant with our oldest child, struggling to perform CPR on a mannequin on the floor, while you knelt beside me, to take your turn.
“I know most of you are here to learn CPR to be better parents for your children,” the instructor, in a white polo shirt with American Red Cross stamped on the breast, told us. “But chances are you won’t perform it on them. You’ll perform it on an adult having a cardiac arrest. On a stranger. Or someone you love.”
Sudden cardiac arrest is a leading cause of death. Cardiac arrest is when the heart stops beating. Some 350,000 cases occur each year outside of a hospital, and the survival rate is less than 12 percent.1
“Can I still talk to him?” I ask from the hallway where I go to get out of the EMT’s way.
“Sure,” he says, kneeling to position the defibrillator.
After the first shock. “We got a pulse!”
“Stay with us, honey,” I call. “Please stay.”
“We lost it. We lost it. Try again.”
This will happen three more times before you are stable enough to move to the ambulance.
“Ma’am,” they say. “Do you have someone you can call?”
“He’s stable for now,” Dr. Nagy, the cardiologist on call, tells me in the nearly-empty waiting room outside the ICU. “But his heart stopped and he was down a while. There’s damage. Death is still a possibility. What we’re looking for in the next twenty-four hours is that nothing else bad happens. No setbacks. That’s what we need.”
CONWAY REGIONAL HEALTH SYSTEM
CONSULATATION/AGE/SEX: 60M
NAME: VANDERSLICE, JOHN
DOB 5/29/1961
UNIT#: MOOO198400
ROOM: /CATHLAB
ADMITDATE/TM: 10/16/21, 1930
Consult HPI
Physicians
PCP: Bart Throneberry, MD
Chief Complaint: Cardiac Arrest
HPI: 60 year old man with history of hypertension presented status post cardiac arrest witnessed by his wife. By the time she came in he was laying on the floor having seizure-like movements. She started immediate CPR and called 911. EMS came on the scene and affected V. fib the patient required multiple shocks and he restored pulse in about 40 minutes. On his admission EKG he had new left bundle branch block. He had a traumatic CPR, some hemoptysis blood suction during intubation and NG tube placement. Given his new left bundle branch block in the setting of cardiac arrest he was taken to the Cath Lab emergently. The patient was intubated and sedated.
ADDENDUM: LH cath showed mild to moderate non-obstructive CAD with no clear culprit. LVgram showed EF 35-40%. Cooling catheter was placed via Right femoral vein.
After they put you in the coma and start the hypothermal protocol designed to save your internal organs, your brain, from the shock and inflammation of the cardiac arrest, Amy, the weekend nurse who administered the protocol, tells me they had to put you on a paralytic because you were shivering so badly. Of course you were; you are always cold. She also tells me she is hopeful you are “in there” based on how hard you were to intubate. “That,” she says, nodding assuredly, “is always a good sign.”
Amy is tall and slender with wavy dark hair that just brushes her shoulder and an open, energetic expression: wide, hazel eyes. She sits, erect, at a computer stationed just outside the door of your room, monitoring your vitals on the screen while keeping you in her gaze.
“Why is that a good sign?”
“He was aware enough not to want the tube. It says right in the notes,” she explains, “intubating him was traumatic.”
I tuck this information away, at the top of the mental list of “reasons why John might wake up,” a list I, a lifelong list-maker, never imagined composing as I stand beside your bed, your silver and black hair medusa-ed by tubes.
It is also Amy who tells me, “Well, his pupils look good,” after she examines your vitals with your new nurse, Kathy, at the shift change.
“What does that mean, his pupils look good?”
“They’re not dilated. His brain stem is functioning. You can’t do anything without a functioning brain stem. He has beautiful eyes,” she adds. “Doesn’t he have beautiful eyes?” she says to Kathy.
“He really does,” Kathy agrees.
I used to think my eyes were my best feature until I met you, when I had to concede that while I had pleasant-enough blue eyes, yours really were extraordinary. They were also routinely fussed-over, often by total strangers, your reaction routinely awkward and embarrassed. Their color a luminous blend of aquamarine and peridot they still disarmed me from time to time, even after thirty years. And so, “your pupils look good,” goes next on the mental list of hopeful signs, even as I am afraid to hope.
Of the three ICU nurses upon whose every word I hang (we will get to Rachel in a bit), the new nurse, Kathy, is more cautious. Circumspect. I put her at around my age, mid-fifties, tall, with a loose skein of long, dark-brown hair graying at the roots and a commanding knowledge of her field.
A student nurse, with glossy brown hair pulled into a bun and cheeks that seem permanently flushed, shadows Kathy that first day. Kathy quizzes her throughout the shift.
“And why do we do this?” she says as they adjust the sheets to shift you, sling-wise, to the left side of the bed.
“So he doesn’t get bed sores?”
“Correct,” Kathy confirms.
“Do you think it looks good for him,” I venture timidly toward the end of the shift, after the student nurse has left. I know I shouldn’t put her on the spot, but I can’t help myself. Obviously, Kathy knows things. “Do you think he’ll wake up.”
She shrugs. “It’s so hard to tell. There are some good signs but you never really know. You just have to wait.”
Dr. Nagy returns in the early evening. The day has passed relatively quietly. Nothing bad has happened. You slept, your head and mouth still blooming with wires and tubes, but your face was placid, your eyelids smooth.
“Ok. So far so good,” Dr. Nagy acknowledges. As I’m coming out of the fog of the last twenty-hour hours, I am realizing that he speaks rapidly, with an accent I can’t quite place—Eastern European maybe. He has dark curly hair, graying slightly at the temples, an olive complexion. “Next, we bring in the neurologist, do an EEG and a CAT scan to see where we are. We’ll start tomorrow. But we won’t know anything for sure until we try to wake him up.”
“When will that be?”
“I don’t know,” he says. “Couple days. We have to see. We don’t know.”
Every day, I park in the same row near the hospital entrance. Otherwise, I cannot find the car. Fortunately, because I live nearby and tend to run home at odd hours, early in the morning or late at night, there’s usually a space. I park carefully, pulling in and out a few times to perfect the angle, because I know you like a good parking job. I also lock the car when I leave it, even though the few seconds it takes to find my keys in my bag right now brings on a wave of tears. Before all this, I parked with relative abandon and considered leaving the car unlocked the best solution to digging for my keys. But that was then. Now I finding myself doing these things because I know you’d approve. As if doing them will summon you back to me.
When I arrive, Dr. Tarcher, the neurologist, is standing at your bedside. My own neurologist, Dr. Becker, a kind, earnest man who treats me for the mild tremor in my left hand, the one you gently pointed out some years ago, also attends at this hospital but he must not have been on call. I’m not sure how I feel about Dr. Tarcher. For one thing he seems a bit glib for someone who regularly confers with people about whether their loved ones will ever be conscious again. But mostly I just wish he was Dr. Becker, because I know him, because he comes from my own past, such as it is now.
According to Dr. Tarcher, they need to do the first brain scan because of the paralytic. Every time they try to take you off it, you start shivering violently. But since you can’t move on the paralytic, a brain scan is the only way to know if you’re having seizures, which could potentially cause further brain damage.
Dr. Tarcher is what I suppose one would call conventionally handsome, with short, wiry silver hair, steel-blue eyes and a soft, vaguely patronizing voice that reminds me of the male evangelical radio hosts who make me instantly reach to change the station. “Brain injury often doesn’t show up for at least 72 hours so we probably won’t see anything,” he explains. “And anyway, we’re looking for seizures. But we could see brain injury. So if we see nothing it doesn’t mean anything but it is better than if we do see something.”
“So we’re hoping not to see anything. Especially not seizures?”
“Exactly,” Dr. Tarcher says, smiling approvingly at my apprehension of this neurological version of “Who’s on Second?” “That’s it.”
I spend a lot of time those first three days leaning on the metal railing of your bed, staring at you. Partly just because I can, because not long ago, I was not sure I would ever be able to see you alive again and partly because in spite of the terrifying place I have found myself, your face is so calm and even, it’s kind of beautiful and almost comforting. The rhythm of the vent reminds me of when I first I caught a glimpse of you sleeping with your CPAP mask on, years ago. The most restless sleeper I had ever known, for whom our bed sometimes seemed more an object of torture rather than a place of rest, fitted for the first time with that plastic mask over your mouth and nose, the machine humming rhythmic breaths, you were so still, so serene, I almost burst into tears. Instead, I stood at the end of our bed, staring at you for several moments, just taking you in, in a way that after more than twenty years of marriage, I’d never seen you before. Peaceful. Peaceable. At rest.
But I’m not at your bedside staring at you when Rachel, the new weekday nurse, is adjusting your IV. I step out of the way whenever the nurses need to do anything, taking the opportunity to update our family on your status, which means I am probably staring at my phone.
“Oh my God, did you see that?” Rachel says, mouth agape. Rachel seems impossibly young, a tiny blond with long, straight, center-parted hair and imploring green eyes, but she is just as quick as the other nurses have been, perhaps even more so. Nothing gets past Rachel. “He just reached for the vent!”
I hadn’t seen it and to be honest, the idea seems a bit far-fetched, if only because I want so much for it to be true.
“Mrs. Stephanie, I just had to hold down his arm to keep him from grabbing it again.”
“Wow.” I say, still unconvinced.
“That,” Rachel says, nodding conclusively, “is a very good sign.”
Reaching for the vent, she explains, demonstrates a purposeful motion that could indicate brain activity. But I don’t put it on the list. Not yet, anyway.
My caution bears out when Dr. Tarcher returns later that afternoon and says that he is more inclined to attribute what Rachel saw to wishful thinking, partly because he tried to get you to do it again.
“I don’t know,” he says glumly, as if you are just being stubborn. “He won’t do it for me.”
Rachel shakes her head. “Nope,” she insists, resolute. “He reached for that tube. With his left hand. I had to hold it down.”
My heart leaps so hard it hurts. “He’s left-handed.”
If you were going to purposely reach for the tube, you would absolutely do it with your left hand. You reached for the tube.
“Well, at least he hasn’t been seizing,” Dr. Tarcher says. “The scan hasn’t shown any damage, so far anyway, although we’re still not at 72 hours yet. I would say I’m cautiously optimistic.”
Cautiously optimistic. I’m a writer and a college professor. I know what cautiously optimistic means, but I look it up on my phone anyway: “Hopeful but recognizing problems.” “Cautiously optimistic” tells me Dr. Tarcher thinks, “this could turn out okay but I’m still hedging my bets.”
I don’t know what I think. But I don’t add it to the list.
“He said he was cautiously optimistic?” My cousin, Thomas, a cardiologist in Scarsdale, says that night during our check-in. “Stephanie, that’s good. That’s really good. Doctors never say that.”
I know I am lucky to have my own personal cardiologist on call, especially since Dr. Nagy is not especially forthcoming. Born when I was a freshman in college, Thomas was a fragile, premature baby who grew into a sturdy, good-natured toddler with bright blue eyes and a wispy nimbus of white-blonde curls. Now he talks me down every night in a quiet, unoccupied hallway around the corner from your room. I recount what happened that day, what the doctors said, and he explains what they are doing and why, and reassures me, usually, that they are doing exactly what he would do in your situation. And, he reminds me, “this is the hard part. The waiting.”
Three of my cousins, all brothers, are doctors in the New York metropolitan area: Eddie, also a cardiologist and Michael, Jr. an anesthesiologist. Thomas is the youngest. Their father, my uncle, Michael Pettei, is a pediatric gastroenterologist at Cohen Children’s Hospital-Long Island Jewish. Not long ago, in the early days of the pandemic, as it pummeled New York, they were at the nexus of all our familial worry, our sighs of relief practically audible when photos of them receiving the first wave of the vaccine began to appear on social media. Apparently, they were all commiserating on your case, but Thomas had volunteered to be the point person.
Fifteen years before, they had all stood side by side performing a vigorous rendition of “Sweet Caroline,” at their sister’s wedding.
“Future doctors of America,” you had said, grinning at me as we took a spin on the dance floor. “Future doctors of America, right there.”
A strange thing began happening to my memories that week. They froze. Before, my memories seemed to exist on a sort of continuum that had been our life together. Now the continuum had vanished, and each memory that passed before me had a period to it, like an end-stop in a line of poetry. An end-stop to us.
Rachel is your day nurse. Joon is your night nurse. Joon has straight black hair and a wide, easygoing grin. He’s been a critical care nurse for over thirty years. His kids are older than ours. Half-stars radiate from the corners of his eyes as he tells me about his grandchildren.
Just before Rachel leaves, she takes me aside. “You should sleep at home tonight,” she says. “He’s safe here. Tomorrow’s going to be a big day. They’re going to try to wake him up. You should get some rest.”
I know you’re safe here, that you’re safer here, now, with machines counting every breath, every heartbeat, than anywhere else in the world. I just want to be with you. I don’t know if I need to count the days now. The hours. The minutes. But Rachel makes a fair point. It’s impossible to get a full night’s rest sleeping beside you on the recliner in the ICU. Amy already warned me if I didn’t get more sleep I might start hallucinating and as if to illustrate her point, last night my uncle told me about the mother of a recent patient who got so little sleep she started to believe her child was possessed by demons. “You don’t want that to happen,” he says.
So, I stay until around eight and then tell you that I am going home for a bit, to eat and walk the dogs, which is always a good excuse where you are concerned. We have some of the best walked dogs in the neighborhood thanks to you. I am not so solicitous. We have a big, fenced backyard for them to run around in. As far as I’m concerned, once a day around the block is enough. In fact, I am tempted to remind you that another reason not to die is that the dogs will only get walked once a day if you do. But I am holding that in reserve.
Joon is not at the computer station in front of your door when I leave because he is the shift leader. “Please take good care of him,” I plead when I find him at the nurse’s station. “He doesn’t have any grandchildren, yet.”
I’m not beyond invoking a little pathos in my desperation.
Joon smiles a reassuring, don’t worry, I have seen it all smile. “You can call and check on him if you want,” he tells me. “Before you go to bed.”
In the end, I do not call. I know that if I call and they give me the slightest whiff of not-so-good news, I will start obsessing and not sleep at all, which is what I came home to do. I’m planning to sleep tonight like it’s my job. People call and need updates, so I don’t get to bed until midnight but that still leaves a solid seven hours before I go back for the shift change.
Our dogs, a rat terrier-dachshund mix and a lab mix draped on either side of me, do not stir.
My phone goes off at 7 am.
“He’s awake, Mrs. Stephanie. He woke up around 4:30. I asked him if he knows who Mrs. Stephanie is. He said yes. Well, he nodded. He really wants that tube out. We had to put him in restraints to stop him grabbing it.”
“I’ll, I’ll be right there.” I tell her. “I just have to throw on some clothes.” Why didn’t I sleep in my clothes?
I pass Joon in the hallway as I run to your room.
“You said you’d call,” he chastises, grinning still. “He gave us a lot of trouble.”
“I know. It got too late.” A half-truth.
“Go on in,” Rachel says from your doorway as I tear down the hall. “He’s waiting for you. Mr. John, Mrs. Stephanie is here.”
And then there you are, your eyes, those beautiful blue eyes, wide with fear and confusion.
I take your hands and stand there, staring into them. I tell you, I’m here, I’m here. You’re going to be ok. I tell you what happened. I tell you we’re going to take care of you, that’s it’s all going to be ok. I tell you so many people, so, so many people, here at home and all over the world, have been holding you in light. I tell you I love you like a period, at the end of every sentence. I stare into your face, at your wide, frightened eyes, greedily consuming your features, your consciousness.
You will remember none of this. None of it. I don’t blame you. You’re anxious, confused, uncomfortable. Erasing the memory protects you from the trauma, or so they tell me.
“Don’t talk above a whisper for forty-five minutes,” the pulmonologist tells you, after your gulp for air when he removes the vent. “Otherwise, you could damage your vocal cords.”
Besides nodding and shaking your head, you don’t have much to say. You are with us, but tenuously, still groggy, and bewildered.
After an awkward hour passes, I ask Rachel if you can talk yet.
“Oh definitely,” she says. “You don’t have to whisper any more, Mr. John.”
You gaze at her blankly, so she starts asking questions.
“Do you know where you are?”
You shake your head. No.
“You’re at Conway Regional Hospital. Do you know why you’re here?”
Again, no, although this has been explained to you several times.
“You had a sudden cardiac arrest. EMT’s had to revive you and bring you here.”
Again, your eyes widen in surprise as Rachel tells you this, as they will several more times in the next twenty-four hours when you are given the same information. But slowly, it will begin to stick.
Your room is on the first floor, looking out on the rear of the hospital: a loading dock, a parking lot, and then an expanse of lawn that leads to one of the oldest houses in Conway, the Frauenthal House, an enormous brick colonial shrouded by pine trees. After I open the blinds you stare into the distance as if trying to make sense of it, find your place in a new world.
“It’s the back of the hospital. If you keep going that way,” I point toward the Frauenthal House, “you’d reach Prince Street.”
You nod, a sober flicker of recognition passing over your face.
“The sunsets are nice out this window,” I tell you. “The light is kind of golden.”
You nod again. Making words is still difficult. I hold your hand and we gaze out the window in rare, tranquil silence, just the two of us, until the cleaning woman comes in. She was here yesterday as I was reading aloud from my phone all the names of the people sending their love. Their prayers. After she finished emptying the wastebasket, she put up her hand. “Lakeisha Cordon,” she said, nodding toward me. “Add my name.”
Today she is smiling. “Oh, I know,” she says, shaking a new liner into the wastebasket. “I know when you fell for this one. The minute you saw those eyes.”
You give me a sheepish look and I add another sign to the new list I have just started. “Reasons Why John is Going to Be Okay.”
You have begun to speak more today, haltingly. There are long hesitations after every question while you form your answer.
“Is it hard,” the speech pathologist asks, “to make words?”
A few moments. Then, “Yes.”
“Okay,” she says. “Today I’m going to ask you questions and all you have to do is say “yes” if the answer is true and “no” if it’s false.”
You nod.
“An apple is a fruit.”
Pause. “Yes.”
“Good,” the speech pathologist says. “Try this one: A bird is a mammal.”
“No.” You shake your head.
“Ok,” she continues. “It is sunny at midnight.”
“No,” you say, then pause. “Unless you’re in Alaska.”
“That,” the speech pathologist says, barely concealing a smile, “is true.”
Another sign to add to the list, the list I will soon stop composing, as the signs start coming faster and faster.
In 2005, hypothermia after cardiac arrest was added to the American Heart Association guidelines for post-resuscitation care, but adoption of this protocol had been largely limited to major academic centers and tertiary care hospitals.2
In 2005 our sons turned five and nine. We moved into our second home, which was one hundred and four years old. We had been married thirteen years. In 2005.
By the end of this morning you will be moved to a regular floor. By the end of the day, you will be asking me what channel ESPN is on.
Months later, I find a photo of Joon in a local magazine, at the opening of the hospital’s new ICU.
“This is Joon. One of the nurses who took care of you in the ICU.” I point at the image of him in his scrubs.
You shrug. “I don’t recognize that person.”
It is not certain that those who wake up during the time at ICU will remember it later. Instead, it is often later in the hospital’s cardiac care ward that conscious awakening takes place. Some patients describe the time at the ICU as a large black hole.3
We have been together now many more years than we have not. And yet, I carry those seven days, first the worst and then the best days of my life, without you.
“Savor these days,” another writer friend urges me as your waking continues, as I witness it to our friends and family, day by day. The dark days, the fearsome days, are still to come—and go—as we will stagger together through your recovery on what feels like the surface of the moon, but right now it is fair to say I am almost delirious with joy. “Savor them.”
I do savor them. I also don’t want to forget them, forget what this kind of elation feels like. I have been in love—with you, with each of our children after they were born. But I have never felt anything like this before.
So I write them down, here, these days. And I offer them, now, to you.
*
2. Prognosis and therapy after cardiac arrest: https://journalofethics.ama-assn.org/article/prognosis-and-therapy-after-cardiac-arrest-induced-coma/2009-08
3. Life After Cardiac Arrest: https://www.hlr.nu/wp-content/uploads/2022/04/livetefterhjartstopp_ENG.pdf
Stephanie Vanderslice teaches creative writing at the University of Central Arkansas and directs the Arkansas Writers MFA Workshop. In addition to many books and essays on the teaching of creative writing, she is also the author of The Geek’s Guide to the Writing Life and the novel, The Lost Son. She lives in Conway, Arkansas with her husband, John, where they raised two sons.
