I believe in anatomy, that the things we learn in school about the human body are generally true, at least for the most part. But I took the fact that I had internal organs on faith until I had an ultrasound a few months before my thirty-fifth birthday and saw my ovaries. The physician assistant running the cool jelly covered wand over my abdomen was looking for anything out of place and showed me the eggs. I’d been terrified of cancer. But here were eggs. It was shocking somehow even though I know we all have them. Meaning women. Female elephants or frogs. Inside or outside, organized in clumps that can haunt us. Then she told me I had a well-formed uterus. She said it like a compliment, but I had no idea what to say in return. It felt like it does when someone compliments my dog. “What a handsome guy,” they say at the park, “What a tail.” I say “Thank you” because “I know,” feels rude. But “thank you” doesn’t feel like the right thing either. I didn’t make the dog. I didn’t even choose him because he was cute. I chose him because of the way he leaned into the chain link fence of his cage at the shelter and I wanted someone to lean into me like that.
I’ve never seen it but I’m 99% sure I have a heart. The other 1% hopes that my circulatory system is powered by chipmunks running on tiny treadmills or that I’m really a robot like Vicky on Small Wonder—with real-girl hair and the ability to wear dresses and keep her feelings from unhinging her. I tried being Vicky, my kind of Vicky, for years. Till recently. But it doesn’t work. My heart kept getting in the way, the literal muscle of it unfathomable. It shouldn’t be that way. I’ve known what the heart muscle looked like ever since I was old enough to climb stairs by myself, up to the loft where my heart surgeon father kept his books from medical school and later, a model of the heart that had sat on the dark wooden desk in his office till he was forced to retire, at fifty-two years old, because it was too painful to stand without crutches long enough to do surgeries. I don’t know for sure, but I think he used the model to explain to patients—after they’d gotten dressed again—what their surgeries were going to be like. “First we…then we.… Like this,” motioning from across his desk, walking them patiently through the flow and back eddies of the body, the places blood pooled where it shouldn’t. I thought about the water pump at the farm where we lived—the hours he’d spend lying on his side in the dirt, trying to fix the pump that pushed water through the big plastic hoses to the small plastic drippers to every single tree. The clogs in the line he’d fix with surgical tools he brought back from the hospital. I thought too about how he liked to read rivers before sending us down in the driftboat with thick aluminum sides. The one he’d bought so we’d be fine when we hit the rocks, spinning in eddies, till he wedged us out again.
On my last trip to my parents’ place, I kidnapped the heart model and brought it back to Richmond to put on my own desk, the one that my brother built for me using our dad’s tools. I picked them both up at the same time. The desk and the heart, its wood and plastic molding painted in red and blue. Each part labeled with a number and a word in fine black script. As a kid I’d run my fingers over the aorta, the vena cava, the four chambers with doors that swing open on tiny bronze hinges. A strange toy house, a beating thing fixed, a model for something I didn’t understand yet. The heart—object and metaphor. Movement and memory of things that hadn’t happened, wouldn’t happen, for quite a long time. The steady drumbeat of advancing loss. The hopeful relentlessness of the muscle electric.
Every other Wednesday night for the last year, I’ve hung out with a group of grieving children in San Francisco. It’s called Josie’s Place, and we meet in a church basement with stained brown carpet and a heater we can’t turn on because it makes the room smell like an electrical fire. The groups are made up of five-to-fourteen-year-olds who’ve all had someone close to them die, usually a mom or dad, in car accidents, or suicides, but mostly of cancer or heart disease. Their parents were young—in their twenties, thirties, or forties. As group facilitators we avoid saying things to the kids like your mom “is in a peaceful place now,” or euphemisms like “passed away” instead of “die.” The founder, a wild-haired academic administrator in her fifties named Pat Murphy, told us that our job is to be empathetic witnesses to the kids’ grief, confusion, or joy, to play with them, and show them it’s safe to express themselves if they want to. Our job is not to tell them it’s all going to be okay, thank God. Because it’s not.
What has happened to these kids is sad and unfair and it always will be. Whoever wrote the dumb saying “Everything will be okay in the end. If it’s not okay it’s not the end.” on everything from dish towels to shitty tattoos, should be tried for treason of the human experience. It’s just not true. Some things are not okay and then they stay that way.
Hanging out with these kids isn’t sad though. It’s the opposite. It’s fun. I’m learning important lessons from them. Lessons I hope might help us all.
The knowledge that you can lose anyone you love at any moment, for no reason at all, is nearly unbearable. The kids at Josie’s Place learned this earlier than a lot of adults I know. They’re like little wizards who’ve seen behind the curtain of mortality. And yet, and still, so many of them run flat out at recess or pretend to be Elsa from Frozen singing till their voices are ragged. They throw a stuffed panda named Chubby at each other hard enough to leave bruises. Many of them are joyful. And that joy sits right along a big yowling sadness. These kids are resilient, but not in a vacuum. No one is.
Many Christians in medieval Europe believed that inside every one of us was a book. They called it the book of the heart and thought it contained the joys and betrayals, the sadnesses and exhilarations of their lives. Individuals could be judged by their hearts after death. Hearts were organs and texts. Written literally and metaphorically into them were the scars of deeds, good and bad, loves, losses, grace.
Sometimes my dad took parts of hearts home even though he wasn’t supposed to. Once I found a frozen aorta in our freezer next to a Ziploc bag of blueberries. Another time, while rifling for colored pens in his top desk drawer, I found a dried up heart valve next to a half smoked cigar. The valve was about the size of a quarter, white and stringy and looked a little like shark jaws without the teeth. I loved this medical flotsam and jetsam. I cut my Barbies’ hair with trauma shears and played doctor/patient with a basket of Ace bandages and shiny butterfly clips. To impress friends, I’d sneak upstairs to his cache of medical books and pull out the bright orange one on skin disorders. It had a special section on gangrene with full color photos. There was an entire page just of infected testicles. Elephantine black masses swollen to the size of grapefruits. We’d stare till we couldn’t stomach it anymore and then shove the book back onto the shelf and pull out my dad’s navy blue stethoscope, taking turns listening to the steady, watery beats of each other’s hearts.
It was only recently I found out that a heartbeat isn’t actually one thing. When people say beat, what they really mean is one contraction and one expansion in the space of about a second. The thu-whump you hear in the stethoscope, or when you lay your ear on someone’s chest, is a two-part thing. Every day this happens around 100,000 times, pumping roughly 2,000 gallons of blood through your lungs, out to the rest of your body, and then back again. A closed, circular river inside every one of us with its main arteries and tributaries—including all the small vessels that, if you laid them end to end, would reach about 60,000 miles. More than twenty times longer than the Amazon. Your giant watershed of one, powered by a single muscle the size of your fist.
Last month I visited the mothership for grief counseling for children in the United States—it’s in a beautiful craftsman style building in Southeast Portland called the Dougy Center. It was founded in 1982, on the belief that while therapy can be very helpful, most children reeling with loss could also use a place to be with other kids going through the same thing and that creative play and empathetic witnessing by adults is healing.
Inside, there’s a room where kids wearing smocks can hurl paint at wall-sized canvases like little Jackson Pollocks and another room the staff calls the “volcano” room where the kids can rage around—working out their anger on piles of brightly colored pillows, padded walls, and punching bags. A giant, bright volcano is stitched in red, orange, yellow, and brown vinyl onto the wall. Around the corner and halfway down the circular hallway, there is another room. It’s called the hospital suite. Inside there’s a real children’s hospital bed, tiny sets of scrubs, and white doctors’ coats for the kids to wear. There is even a light up X-ray table and X-rays of hearts and turtles. There are childsize stethoscopes and plenty of Band-Aids.
Joan Schweizer Hoff has worked at the Dougy Center for twenty-eight years. Since it was founded. She told me that the hospital room is one of the most popular rooms at the center. She’s proud of the hospital curtain mounted to the ceiling. “It was important that we had that sound in here,” she said, “the sound of the curtain being pulled back on the track.” It helps make it real.
“The kids come into this room to save the people they couldn’t in real life,” she said. They come in here to heal the people that no one could heal. And it works.
It’s not anything I’d recommend but you can learn a lot from growing up with terminal illness in the house—yours or someone else’s. Not that it saved me from messing up. It didn’t. But it did save me from certain hazards, even while it flung me right in the path of others.
Six months after my dad died, I graduated from high school—all frizzy haired and anxious about being good enough. I was just like the Max Fischer character in the movie Rushmore except fatter and into painting watercolor sunsets—such a good girl my friends called me Moral Laurel. After I walked off the stage, clutching my rolled up diploma, my mom gave me a small wrapped box. Inside was a note from my dad—and below that, a pen.
“Use this to sign your first book someday,” the note said.
It took me fourteen years but I did use that pen to sign my first book. And I’m going to use it to sign my second—the one you’re reading a bit from now.
A few years ago, my younger brother Jake met the new heart surgeon in our hometown, Dr. Dominic Tedesco. He said that patients my dad operated on thirty, even forty-five, years ago were coming back in to have their bypasses and other procedures redone. It happened often enough that he could tell without looking at their charts if they’d been our dad’s patients. Every time Dr. Tedesco opened up their chests, he’d see a neat scarred line where the stitches closed up the thoracic cavity. “It’s how he opened and closed,” he told Jake, “it was unmistakably your dad.” I love thinking about those men and women, all of them still walking around with my dad’s signatures on their hearts, the marks that allowed each of them to live so much longer than he did.
When I was eleven I had a succession of hamsters. La Fe was the first, a fluffy round snowflake with tiny pink toes who liked to eat peanuts in the shell. When she died, three weeks after coming home from the pet store, it hit me hard. I gave her a sky burial in the top of an avocado tree in our back yard—sliding her tiny body into an empty shoebox and climbing up to where the tree branches forked and I could stuff the box into a spot that no one would see. Then I wrote a poem. Bad poetry is how I’ve always grieved. Sometimes I write the poem before the dying is even happening. I imagine how it will be when they’re gone. Sometimes I can’t see the page, or the screen, through the messy carwash oftears. Anticipating.
It sounds like a circus-man’s memoir. But it’s what I wrote. About La Fe but also, of course, not about her at all. An eleven-year-old’s take on the world. A map of my raging heart.
This is what I know now: When we grieve we don’t just grieve one loss, we grieve every loss we’ve ever had. And not just the death losses. But the broken relationships, the betrayals, the people we loved who wouldn’t or couldn’t love us back, the ones who don’t want to talk to us anymore, or we can’t even stand to run into, the cats who left for days at a time and then just stopped coming home at all, the parents who didn’t see our hurting, or the ones who saw it too clearly, the people we hoped to be but aren’t. Birth life love death peanuts.
Many of the kids I’ve met over the last year or two use the permeable border between what they believe is real and what they don’t to their advantage. They choose to use the power of their imaginations to rewrite their scripts. The narratives that terrify us the most, the ones we can barely stand to touch: that we failed the person we loved, that we could have saved them if only we’d done X or Y or told them how much we cared. These are the stories to be rewritten. And if you’re eight and you still believe in the tooth fairy, you can also convince yourself that it’s possible to tell people who’ve died that you still love them and they’ll know. You can talk to them in your dreams. Or invite them in for tea with your imaginary friends. Or call them up from the fake phone in your fort and ask for their advice about how to deal with the parent that’s left behind, or just how to possibly endure the missing-of-them.
Living with uncertainty. Is awful. But it’s all we have. We can spend our time in this waiting room of a lifetime fearfully looking at the clock or we can throw stuffed pandas at each other or paint at the wall. Saving teddy bears is a way of saving ourselves. Playing when you are aware of death is an act of bravery. It’s not denial. It’s the opposite. Playing is an act of resistance.
As one young girl who comes to Josie’s Place said to her mom, “We can all be happy sad here.”
We don’t have to choose. We can’t. Thu-whump.
Laurel Braitman is a New York Times bestselling author (Animal Madness) whose work has appeared in the Guardian, the New York Times, Wired, and elsewhere. She is currently Writer-in-Residence at the Stanford University School of Medicine. Her next book is about family, medicine, and mortality.