SARAH MANGUSO

Blood and Shit

My shoulders still allowed my arms to rotate behind me, but my hands were too weak to resist even the slightest pressure. I couldn’t wipe my ass.

It’s hard to wipe someone else’s ass. After asking for a few extra swipes, I’d feel embarrassed, and then I’d say to hell with it even though my ass would itch like hell later and I wouldn’t have the strength to scratch it.

One of my nurses was a year younger than I was. She was the kind of person who would visit her brother and his family and see the house wasn’t clean and then clean the entire house. And she really knew how to wipe an ass. With a washcloth soaked in hot water, and then with a dry towel.

I thanked her so profusely the first time that she was moved to explain. I could wipe shit all day, she said, smiling.

Even blood didn’t bother her. Blood is for life, she’d said another time, when a line had popped out of my arm and I’d shot a blood geyser all over my bed.

I watched her clean up messes that horrified me, and she was cheerful, always.

One day she told me about the phlegm that formed in cancerous lungs. Sometimes she had to suction that phlegm. And sometimes it was black with necrotic tissue.

The young nurse said she’d never got used to the odor of that phlegm.

Sometimes I could hear people being suctioned. And sometimes above the slurping sound I heard the people yell in pain or in fear at seeing their own dead selves being sucked out of them.

Cavities

One day, while I was mostly paralyzed and my muscles were atrophying repulsively, two nurses scooped me up into a hammock attached to a scale and told me how much I weighed.

I’m half an inch shy of six feet, and in the hammock I weighed a hundred and ten pounds, and that wasn’t even my skinniest.

People brought me rich foods to eat, but there was no point. Extra food would turn to fat in me, as I couldn’t move to stimulate any muscle growth.

And the fatter I got, the harder it got for my muscles to move my body.

Not all of the nurses understood this. Particularly not the tubbier ones.

Still, I wasn’t avoiding rich foods. I ate french fries all day. I ate as much as I wanted, which still wasn’t much.

I did care about my teeth, though. Having my teeth drilled seemed an avoidable inconvenience.

And so at night, after my teeth had been brushed, when I was offered a cup of soda for my bedside table, I always asked for diet instead of regular.

And sometimes I got the look. The look that says Oh you goddamned malingering brat, starving yourself to get attention while in the next room there are people dying.

For a while I explained that it was to keep from getting cavities, as I was unable to manipulate a toothbrush to clean my own teeth after drinking a syrupy sugar drink, but then I gave up because of course an anorectic would say that.

Corticosteroids, which I took for a long time, eat away at the skeleton, and it’s not uncommon for the teeth to rot a little. And that’s not even taking into consideration that my teeth weren’t being brushed very regularly or very well.

But it’s been twelve years since my diagnosis, and I still don’t have a single cavity.

More Medicine

Before the diagnosis I had had intercourse with only one person, the man I call my college boyfriend. Which sounds as if we loved each other all through college, but we didn’t. We slept together for eleven weeks, and then he broke up with me.

I was very sad, but I enrolled in five classes the next semester and made a list of goals including run at least twice a week and avoid all time-wasting social engagements.

Two months into the semester, I got sick. And for a long time, I regretted I might die having had intercourse with only one person.

Like many freethinking college students, I thought intercourse was the greatest thing in life. And it just about killed me to hear of everyone’s rambunctious affairs while I was in the hospital.

So when a medical student came into my room alone, after his rounds were over, with a book to lend or a mix tape he’d recorded, I thought about which medical students I’d invite to have intercourse with me if I got to the end of the road there, in the hospital.

But I went back to college still sick, with my central line, not having had intercourse with any medical students, and every month or so I went back to the hospital to sit in the Oncology Outpatient ward to have my plasma replaced or to have a bag of gamma infused. And the only people there were the hem-onc nurses, who were women.

My line was implanted in June 1995, and in May 1996, after eleven and a half months, it was pulled.

I wasn’t well yet I was taking steroids and gamma globulin. But those treatments kept me healthier than plasma replacement had. Those treatments actually slowed down the rate at which my immune system secreted the poisonous antibodies.

I would still relapse, but it was clear that the steroids and the gamma would keep me at least as well as apheresis would, so it was decided I wouldn’t have my plasma replaced again. The gamma from March had already lasted three months. My neurologist believed I’d turned a corner.

I believed, though, that I would stop secreting anti-bodies forever only after I had intercourse. And though I looked worse than I ever had in my life— thanks to the steroids I was fat and swollen, covered in acne, and had a gruesomely round face- I knew I would have to go through the humiliation of finding a man who would agree to have intercourse with me.

I thought my friend Victor, who was legendarily promiscuous and who had shown interest in me shortly after my college boyfriend dumped me, might still be interested.

So I called him and invited him to have a drink with me that night. We had our drink and walked back to our dorm and sat down in the courtyard, just talking.

It was two days before Commencement. Early June. He was graduating, and I was graduating, too, sort of, but the envelope I was getting wouldn’t have a diploma in it. It would be empty, because I had another semester of classwork to complete.

Since it was two days before Commencement, only the seniors were left at school, and everyone was awake, and most of them were in the courtyard with us. It was a party that had been going on all week.

And so I felt exposed- I felt too shy to seduce Victor in front of the entire senior class of Dunster House, even though I knew no one would notice or care.

Finally, Victor said, Your place? getting up from the bench we’d been sitting on.

And we went to my dorm room, which was a single suite I had all to myself, with my own living room and my own bathroom, because my neurologist had written a note to the university explaining I needed my space.

And we sat on my futon, taking turns drinking out of a plastic bottle of cheap vodka.

I was still unable to put the plan into motion.

Eventually Victor said, Do you have any other rooms in this place? and walked me to the bedroom, and lay me on my bed, and had intercourse with me.

Then he asked me about the scabs on my chest from where the line had just been pulled out of me, and listened to the things I told him, and held me very tightly.

Two mornings later, when we were in the courtyard again, seated in rows, about to receive our diplomas, he was wearing a buttoned shirt and sweating, because his neck was covered with bright red marks.

Almost seven years passed. Victor and I wrote every day. I lived in New York and he lived in Chicago.

He told me some of his secrets, and I told him some of mine.

Our letters were intimate, but I didn’t get around to explaining to him that I’d recovered from my disease only because he had selflessly had intercourse with an ugly version of a girl he’d once had a crush on.

A little less than seven years after I was cured of my disease through the mystical power of intercourse, Victor had an aneurysm and died.

The End

There are two kinds of decay: mine and everyone else’s.

This is the usual sort of book about illness. Someone gets sick, someone gets well.

Those who claim to write about something larger and more significant than the self sometimes fail to comprehend the dimensions of a self.

Most people consider their own suffering a widely applicable model, and I am no exception.

This is suffering’s lesson: pay attention. The important part might come in a form you do not recognize.

You might not know to love it.

But to pay attention is to love everything.

To see the future as brightness.

Everything that happens is the last time it happens. We see things only as their own fatal brightness, and there is nothing after that brightness.

You can’t learn from remembering. You can’t learn from guessing.

You can learn only from moving forward at the rate you are moved, as brightness, into brightness.