When my mother sang I almost believed in heaven. It wasn’t just that she had a beautiful voice but also that she had a way of delivering a piece that pierced your heart. Oh when she sang she could make a fence post cry. When she sang she could make people laugh or dance or fall in love or go to war. In the pause before she began, the only sound in the church was the breeze whispering through the open doorway. The Coles had chosen the hymn and it seemed an odd choice, one that had probably come from Mrs. Cole whose roots were in southern Missouri. She’d asked my mother to sing a spiritual, Swing Low, Sweet Chariot.
When my mother finally sang it was not just a hymn she offered, it was consummate comfort. She sang slowly and richly and delivered the heart of that great spiritual as if she was delivering heaven itself and her face was beautiful and full of peace. I shut my eyes and her voice reached out to wipe away my tears and enfold my heart and assure me absolutely that Bobby Cole was being carried home. It made me almost happy for him, a sweet boy who didn’t have to worry anymore about understanding a world that would always be more incomprehensible to him than not. Who didn’t have to endure anymore all the cruel mockeries. Who would never have to concern himself with what kind of a man he would grow into and what would become of him when his aged parents could no longer protect and care for him. My mother’s singing made me believe that God had taken Bobby Cole for the best of reasons.
And when she finished the sound of the breeze through the doorway was like the sigh of angels well pleased.
Anesthesia was the antithesis of the complete, personally involved physician I had idealized to myself and my parents for all the years I studied chemistry and physics and biology alongside music and literature. It came as an unexpected, almost uncomfortable surprise to me when I discovered the immediate gratification of my specialty—injecting a local anesthetic at the precise nerve plexus to relieve the unrelenting pain of strained backs or injured limbs; calming a terrified obstetrical patient rushed into an emergency cesarean section, keeping her pain-free and hopeful, so her infant could make the miraculous transition from fetus to newborn uninjured; pulling the sleeping heart bypass patient back to consciousness and the inexpressible relief that they are still among the living. All of this, I discovered, was in contrast to general medicine, which could often do little more than shift the incessant, declining slope of mortality that begins the day we are born.I understood the general concept of anesthesia (well, as much as a layman can understand something so complex), but until I read Carol Cassella’s compelling drama, Oxygen, I failed to appreciate the incredible talent of an anesthesiologist. It is not simply the job of an anesthesiologist to keep a patient sedated, but it is also his or her responsibility to anticipate the patient’s pain in response to the various stages of the surgery, adjusting or adding the various drugs to maintain the patient’s comfort. Of course, now that makes sense, but it’s not something to which I’d ever given any thought until reading this novel.
People feel so strong, so durable. I anesthetize airline pilots, corporate executives, high school principals, mothers of well-brought-up children, judges and janitors, psychiatrists and salespeople, mountain climbers and musicians. People who have strutted and struggled and breathed on this planet for twenty, thirty, seventy years defying the inexorable, entropic decay of all living things. All of them clinging to existence by one molecule: oxygen.
There is a moment during the induction of general anesthesia when I am intimately bonded to my patient. A moment of transferred power. I squeeze the drug out of the syringe, into the IV line, and watch the face slacken, watch the last organized thoughts slip from consciousness, see breathing shallow, slow, stop.
Joe squeezes my hand as he pulls out into the runway and waits for clearance. He sounds different talking into his headset, a clipped song in the shorthand lingo of flight. My breath jumps high into my throat when we leave the ground. He banks out over the sound—the city looks like it's cupped inside the protective palms of encircling peaks: the eastern Cascades and western Olympics, the northern and southern volcanoes of Mount Baker and Mount Rainer. From this height the geometry of bridged lakes and islanded ocean sprawls like a rumpled quilt in greens and blues. It's worth the price of fear.
Lori lives in the plains just west of Fort Worth, where cattle drives used to camp on their way to the transcontinental railroads and settlers laid claim to Indian lands with barbed wire. Now, a grid of pavement allots quarter-acre swatches of azaleas and scrappy live oaks to homeowners who coax green growth out of the dust. The lushly watered lawns invite barefoot play, until the Texas sun slaps you back inside.
