Heart Failure

The morning I met you, I locked my elbows and threw my weight against your chest. What conspired beneath the shroud of your skin was familiar: an inscrutable trigger struck your ailing heart; blood laid stagnantly in your vessels and acid built up from circulatory failure, further diminishing your heart’s contractions. An injury spirals and cascades until you’re swept away in a current only vaguely resembling the ripple that bore it. I understood this because for weeks the undertow had gripped me too, but working to keep you here that morning saved me.

Your mother wore zebra print pajamas and slept fitfully on a daybed, which she motioned for me to sit on beside her. She diligently recorded every word I said even though none of it was important because what else was there to do. She stockpiled cafeteria apples in a basket by your bed and rushed to mop up the water you spilled until I stopped her. As the days wore on, her hair became knotted and her face so furrowed with exhaustion that I barely recognized her when I walked in. I brought you a document to sign forgoing resuscitation (“Allow Natural Death”); your mother signed too, and I signed as witness to her pain.

One morning I told your mother that this was not working and we should turn off the drips, and the look on her face is one I hope I never forget because it was unmitigated devotion and devastation and strength eclipsing pain: a compilation that transcended grief. Because I imagined she was angry with you for succumbing to the addiction that lethally remodeled your heart, angrier with the institutions that damned you to it, and terrified of the expanse of nothingness she saw stretched out beyond your grave, but at that moment, she thought only of shepherding the son she never imagined burying towards compassionate death. Because the root of my pain is love betrayed, while your mother pulled from the bowels of suffering an unrelenting, enduring, self-effacing love. She turned to you: “Whatever you want.”

I kept our visits short each morning because even though I've always known that life has been better to me than I deserve, when I think of you and your mother, I know it in a way that hurts. I can’t figure out how to thank her for enduring as everything around her decays, how to tell her that the look on her face has kept me going.

This post was written by Mariam Nawas, MD.