My husband stands at the front of the bus, one hand clutching a rail, the other gripping a strap, his hospital gown floating below a puffy blue winter jacket. It’s early April in Iowa City. For two weeks the dogwoods and cherry trees have been in bloom, but last night the temperature dropped to twenty-seven degrees, and this morning the wind shakes the trees, loosening the buds. Pink and white blossoms scatter across lawns and onto sidewalks as the bus maneuvers from the university hospital through neighborhoods of two-story clapboard houses that sit regally on sun-bright yards. My husband’s black-checked pajamas are hiked up at the waist and safety-pinned to his hospital gown so that the elastic in the pants won’t touch his wound or the two drains (which look, when full, like big plastic teardrops of Kool-Aid) left in after the surgery. For the past eight days at home David’s worn nothing but faded hospital gowns, the back left wide open — “Your butt to the air,” I’ve cheerfully noted — but to take the bus to and from the hospital today he’s made a stab at respectability.

Each time the bus stops and students get off and on, David holds one hand out, warding off backpacks or a purse swung carelessly. I notice the tension in his face: his jaw tight, his eyes wary, his demeanor forbidding. Almost no one looks directly at him. Eyes track him for a second or two, sly, curious glances — they’ve seen it all on Grey’s Anatomy and House — and then look politely away, releasing him back into irrelevance. What’s one more man in a hospital gown? When the doors of the bus close, David turns to me and grins. “Almost home,” he says, touching my hand, his eyes showing a sweetness I haven’t seen for days.

It’s 1 PM and we’re on our way back from David’s first post-operative checkup. In truth, we’re both tired and tense and tired of being tense; tired of the logistics of getting around after the operation; tired of cancer’s demands, its bullying style.

“You won’t be able to lie on your back or your left side for six weeks,” the surgeon said in a quiet, serious voice the morning after the operation to remove a malignant tumor just above David’s left buttock, a surgery that required a fancy procedure called a “perforator-plus flap” to cover the wound, which was too large to close with stitches. Then the surgeon delivered the whammy: “And you won’t be able to sit for six weeks. Any pressure on the wound can compromise the blood supply. Right now it’s very fragile.”

We were both too stunned to do more than nod assent, my husband lying on his right side, drugged by a morphine drip, and me standing at the foot of his bed, numbed by all that had happened so quickly. The doctor’s hands were beautiful and slender, like those of a musician. I wondered if he played the cello. Those hands had done meticulous work, reattaching blood vessels the thickness of a hair, shaping for my husband a new left buttock to match the right, moving tissue and skin and creating a delicate scar that looked like a lopsided smiley face. Of course we’d do what he said, as if a happy ending required only an act of will.

And yet, once home (after four days in the hospital), we were daunted by the physical reality of what it meant for David not to sit for six weeks. “Don’t sit, don’t sit,” I kept murmuring. Immediately I airbrushed away a persistent thought — You are the most sedentary person I know — and replaced it with You are a sixty-three-year-old man who must stand or lie on his side for most of the day. After one week David could stand up long enough to eat, pee, and even answer his e-mail at a raised desk in his study. He could get in and out of the rented hospital bed in our living room, half sliding, half pulling himself into it like a large, damaged animal seeking shelter, and then getting out with a number of awkward knee and elbow bends and a scrambling push with his heels. Each time, as he grunted and grimaced, it was all I could do to keep from offering help. Instead I acted the sentinel, watching and taking notes as if I were part of an anthropological survey:

D. looks like a man trapped in a Francis Bacon painting, minus the religious iconography.

D. struggles, rising onto his knees, panting, his stomach swollen and sagging, his eyes closed as if to say, “No more, no more.”

D.’s scrotum is a bulging bag, enlarged by edema, like a low-hanging . . .

I stopped, ashamed, and tried to erase the image, to protect my husband’s privacy, if only from my own thoughts. But the idea of privacy had been smashed in the hospital, where the surgeon had said bluntly, “He’ll have to be very creative with number two,” his tone devoid of irony at the use of a child’s term. I’d laughed like a schoolgirl and then felt embarrassed while David pushed the button for more morphine.

Later that day, when I sat alone in the car in the hospital’s parking lot, I wondered how exactly my husband was supposed to “be creative” about going to the bathroom. We’d been married for thirty years, and though I immodestly yanked down my pants and used the toilet while carrying on a conversation, my husband remained private, always closing the door. We rented a raised seat with handrails that fit over our toilet. “You’ve been cast in a Beckett story,” I told him, trying for lightheartedness because we’d always made fun of the intolerable. “Remember all those cranky old men stranded in bed, exiled from the world and trapped in the unspeakable?” Surely standing up to relieve one’s bowels was unspeakable. To my surprise, David didn’t laugh. He was busy trying to tie the back of his gown, and it seemed to require all of his concentration.

After a week at home, David could walk down our street and say hello to the neighbors, though his gait was slow and shuffling due to his incisions. When he went to bed, I stuffed firm pillows behind his shoulders and upper back (as the nurses had done in the hospital), and at night I checked on him every two hours to make sure he hadn’t turned in his sleep. Although the surgeon had prescribed a special air mattress, he’d warned that it wouldn’t protect the wound should David shift in the night. One morning, during my usual 3 AM wake-up, I walked quietly down the stairs and stood beside David’s bed, relieved to see him stretched out on his side, his right hand cupping his face. I’d never seen him sleep like that before. He looked so peaceful, almost serene — his brows relaxed, his face softened. I wished I could crawl in beside him and draw his arms around me. Instead I pushed the curtains aside and stared out at the dark, silent street, eerily empty and oddly beautiful, the ash trees thickening with leaves, the nearby houses huddled in sleep.

At 5 AM I woke again, startled and tired, my legs aching, mind muddled. Determined to get two more hours of sleep before I began critiquing manuscripts for my graduate class, I decided to do just a quick check from the stairs. Halfway down I saw David with the covers pulled snug to his chin. He seemed to be facing the ceiling, and that meant he’d rolled over. I raced down the stairs and shoved at his shoulder. “You can’t sleep on your back,” I rasped.

“What?” His eyes flashed open, but he was incoherent with sleep.

“You can’t sleep on your back,” I said, still shoving at his shoulder.

“I’m not,” he said, but fear made him suddenly obedient, and he shifted onto his side. “I’m not.”

I saw, to my relief, that he hadn’t fully turned — the pillows had partially prevented him — but it was enough to scare us both. After wedging another pillow onto the stack, I brought my blanket down to the couch and set up camp.

The next day we were both hollow-eyed as I checked the wound, lightly touching it with the handle of a pair of nail scissors, as I’d seen the plastic surgeon do. (If two white circles showed, the blood supply was intact.) “It looks OK,” I said. We both tried to smile, but David had had enough. He tossed aside the pillows, wrapped two high-density foam rollers (used for exercise and rehabilitation) in blankets, duct-taped them together, and secured them to the bed, making a more formidable barrier.


Getting David to the hospital for his follow-up appointment today was a new challenge. He couldn’t sit down to ride in the car. He couldn’t walk the five miles. The surgeon suggested I rent a van and put an air mattress in the back, allowing my husband to lie on his side for the trip, but David couldn’t get in and out of a van. Frustrated, David said, “Jesus, just tie me to the top of the car like Romney’s dog!”

In the end the solution was simple. David could stand up on the bus. To get to the university hospital we had to take two buses, walking three blocks from our house to catch the first one, transferring downtown at the corner of Clinton and Washington, and then walking thirty-eight steps from the bus stop to the hospital’s main entrance.

Now we’re on the way back. When the bus stops at Clinton and Washington, we wait for all the students to get off first, most of them talking or texting on their cellphones. The bus driver lowers the step, and, like a Secret Service agent, I leap ahead to clear the way. (“Ain’t nobody gonna touch your bum,” I’ve been teasing my husband.) “He’s been in surgery,” I announce to the two men waiting to get onto the bus. Their faces look blank, and white iPod cords dangle from their ears. But when they see my husband’s hospital gown, they each reach out and grab an arm, easing him onto the sidewalk. Though I know he could have done this alone, I am so moved by their help that I almost cry. “Oh, thank you,” I gush. Many people have offered good wishes, but modern life has become so hectic and myopic that almost no one has come forward with literal assistance. During David’s recovery I have been the sole caretaker: changing his dressings, emptying and measuring his drains, getting him in and out of the shower, massaging his legs while he stands in a tub of hot water, and shifting his feet so that they don’t ache.

We stand on the sidewalk in the middle of Iowa City, waiting for our next bus and enjoying the sun’s warmth as girls in pastel coats and leggings and gangly boys and other townspeople hurry past. I feel a sudden childish excitement: For the first time today this seems like an adventure. We do not have to hurry.


When the lump developed near David’s tailbone six months ago, in October, we were both almost certain it was a pilonidal cyst: a subcutaneous knot of hair and skin. An internist suggested that surgery would eventually be required, but David, who hates a fuss, kept putting it off. He had work to do — photographs to take and websites to maintain — and this surgery, we’d heard, required daily dressing changes and a slow, difficult healing process. Even as the lump’s growth accelerated, we never once thought of cancer. Instead we joked about the “cyst.” David called it his “tail,” harmless and comic.

“Bumped into your tail last night,” I said one morning as I poured water in the kettle for tea. “Last night you turned over, and it rubbed against my hip.” I got out my favorite cup.

“You leave my tail alone.”

“But it’s getting hard.” I tried to keep the concern out of my voice. Though he made fun of it, he didn’t want me to look at it; he hated having anything wrong with his body. “Mind on a stick,” I call him, because the body, to him, is merely functional, an adjunct to the brain.

“Hey, don’t try to sexualize my tail.” He gave me a mock-lascivious look and then fixed himself an espresso.

We both laughed to keep the uneasiness at bay. Nothing to worry about.

A few days later David lay on the examining table at the Family Care Center while a doctor with close-cropped white hair and stooped shoulders put on his blue plastic gloves. He pulled them on slowly, almost ritualistically, and I wanted to say, Hurry up! because David looked anxious lying on his stomach, his pants around his knees, his buttocks exposed. The lump was huge. How had this happened? When David had first begun wearing loose-fitting exercise pants to bed, I’d thought they were for warmth — it had been a cold January — but of course he’d been covering up the cyst, hiding it from himself and from me. Well, I saw it now: a round mass the color of bruised fruit. It didn’t look like a tail at all. It looked like a mangled peach embedded in his skin.

“I think it’s a sebaceous cyst,” the doctor said as he massaged the lump and palpated the area around it. “It’s probably filled with a thick fluid that will look like toothpaste. You need a surgeon to remove it.”

I was barely listening. I was staring at my husband, whose face was turned toward me, his eyes holding mine. I felt, at that moment, as deeply married to him as I did in the heat of sex.


Marriage is what I’m thinking about now as I look at my husband, who is standing apart from the other riders at the bus stop where we’re making our transfer. I notice that his hospital gown is uneven, tucked up beneath his coat on one side, the back dangling and fluttering in the wind. I have an impulse to straighten it, to tend to him, but his face looks strained and cautious and tired. Aware of how many times in the past week he’s said, “Don’t help me,” I stay where I am. Since the surgery, we’ve been like two people dropped onto an unknown trail, wandering together along a route we didn’t choose, uncertain of the dangers, wary of brief pleasures, forced to make up rules we don’t quite understand. The one thing we know is that we’re unprepared. Some days we cling to each other obscenely in our dependence. I find myself standing at the counter to eat alongside David, as if I were required to be with him in every function, including the “creative” one. Other days we simply wander aimlessly together, surprised by our intimacy. Familiar tasks, such as preparing and eating a dinner of pan-seared salmon, pull us so close there’s no need for words.

But then there are the frazzled days when each of us feels lost and alone — more alone, I think, than we’ve ever been. Before we boarded the bus to the hospital this morning, I called to David from upstairs, “Did you get your coat?” The temperature had dropped more than twenty degrees the night before.

“Why are you always hurrying me?” he yelled back.

Surprised by his defensive tone, I stood at the top of the stairs, thinking, I don’t know you at all. Then I realized that every part of me was equally unknowable to him.

On such days I can’t talk to him, can’t make him understand what I mean. I say one thing, he hears something else, and instead of solace or understanding, there’s resentment and anger between us. How can he distort the simplest question? I never know what to do. I confess that my first instinct is to flee, some voice in my head yelling, Go, go, go! My second instinct is to inform him of what I mean, to make it perfectly clear so that he will get it and comply with what I want. My third instinct is to say, Oh, forget it, shutting him out of my world in retaliation. I race through them all, the irrationality of each response rarely sinking in. Resolution comes only after the hurt feelings and anger and twisted rhetoric make one of us, exhausted and forlorn, break down and communicate with some degree of honesty.

I step into the sun, shading my eyes. There it is: the Seventh Avenue bus, our final one, turning the corner.

Usually I sit next to where my husband stands, but on this bus I have to take a seat opposite him, several feet away. I am relaxed because the pathology report revealed no metastasis to the lymph nodes, and thus no recommendation of chemotherapy; relieved because the oncologist was pleased with David’s rate of healing; and secretly excited that we’ll be home in time for me to fix a cup of tea and review my notes for an afternoon thesis defense.

I can see my reflection in the bus window: I might even be smiling. I imagine pumping my arm and shouting, We did it! like someone in a movie. Then I glance around, embarrassed, as if I’ve actually done this, and meet the eyes of a young man in a North Face jacket seated about two rows away. Blond and blue-eyed and probably in his thirties, he smiles a sweet, shy smile. I nod, then stare out the window. As the bus shifts gears and turns, I see David wince at the bumpy ride, his grip on the strap tight, but I know my sympathy wouldn’t be welcome. The man in the North Face jacket is now grinning at me, and I smile back. There’s something needy about him. On another day I might pull out a book to signal distance, but today — maybe because of the good news at the hospital — I want no such defenses.

“It’s finally getting warmer,” he says, as if we’ve been having a conversation. “It was cold this morning, but now it’s OK.”

“I had to put a sheet over my fern last night,” I say.

“The flowers don’t usually bloom this early,” he continues, referring to the unusually warm spring we’ve had. “But they seem to be doing OK.” Each time he says something, he smiles like a child asking for a lollipop.

“Let’s hope the tulips didn’t get killed by the frost last night.” I never know how to disentangle myself from such conversations, and yet I’m oddly enjoying getting to chat with someone without worrying about being misunderstood.

To my surprise, the man gets up and moves to my row. Though he looks normal, I think he might be mentally challenged. His sentences are simple statements of the obvious. His face is open and guileless, and I can see that he’s lonely and wants to be acknowledged, if only by an older woman on the bus — at least, that’s the way I interpret his loquacious spirit, his persistent smiles.

“I like tulips,” he says.

My husband turns, readjusting his hold on the strap, and glares at the man with open disdain. “My husband and I have just come from the hospital.” I nod toward David to defuse the situation. “This is our first time on the bus.” By now I’ve adopted the man’s short, declarative sentences.

“It’s a good bus,” he says, ignoring my husband’s gaze. “I take it every day.” He leans closer, and for the first time I see something mischievous in his blue eyes, a flash of desire, perhaps. I’m not sure what he wants, but I can sense he’s about to move again and sit right next to me.

I reach to pull the cord one stop early. Then I gather my purse and book and stand up. “Enjoy the ride,” I say, giving the man a wave as the bus comes to a halt. My husband moves slowly, slowly down the steps. Each footfall jars his incisions, and for a moment at the bottom he pauses with one foot in the air, half in and half out of the bus.

Following David onto the curb, I say, “Thank God, we’ll get home in time for me to get something to eat and go over my notes for the defense.”

No sooner has the bus pulled away than David turns to me, his eyes burning with accusation.

I expect him to complain that I’ve somehow hurried him. “What is it?”

“What do you think you were doing?” he demands. “You let that man sit by you. You talked to him, but you don’t talk to me.”

“What?” I’m incredulous at the absurdity of this outburst. If he hadn’t just come from the hospital, where he was poked and prodded, I would laugh. “Oh, please. There was something not quite right about that man. Surely you could see I was just being kind.”

David’s gown blows in the wind, and his blue coat makes his eyes look brighter. His hair, clean for the first time in a week, lifts in the wind and then frames his face, making him seem boyish. I think of how anxious and drawn he looks each night when he’s standing in a tub of hot water while I knead his calves, massaging the knotted muscles, stroking them then wrapping them in hot towels, tucking in the ends at the top. It’s only when I’m done that his face softens and his eyes close, and I have the impulse to press my head against his thighs, just to feel him.

“I don’t care.” He is still aggrieved and refuses to look at me. “I didn’t want you to talk to him.” He fiddles with the zipper on his coat. “It made me jealous.”

I’m married to a jealous man. A sick, jealous man. Perhaps I should welcome his feistiness, be relieved that he can feel this emotion, but I’m irritable. I did nothing wrong! In truth, this feels like an old fight we have about loyalty. We never doubt that we love each other, but there’s always the question of how much and how willingly that love is given. Who wants more attention? Who feels slighted?

“We talked about flowers,” I say. “You heard it all.” And yet even as I say this, I realize that I was flattered to be chosen by a lonely man. How absurd, but there it is: me, a desirable woman, a girl on the bus.

The traffic light changes to green, and we cross the street: just two more blocks to go before David can crawl into the hospital bed and lie on his side, and I can sit at my desk.

“But you talked to him,” he says, “and you walk three paces ahead of me.”

As he says this, I realize I am walking three paces ahead of him. He has to walk so slowly, it’s hard to regulate my stride. I can for a little while, but then, impatient, I push past him. Now I stop and think how quickly we move to defend ourselves. Haven’t I taken good care of you? I might say. Haven’t I been the most solicitous, the most dutiful of wives? And, given this, don’t I have a right to the insignificant pleasure of chatting with someone on the bus?

I can imagine his response: I’m the one who’s been critically ill, the one who’s had to suffer doing the most ordinary things, sleeping only on one side and waking with leg cramps and pain. I’m the one who has to shit standing up.

He’s right. That last part alone will win the contest of hardships. And yet, though it’s true he has the high ground, in marriage the high ground doesn’t always matter. I feel a fresh flash of irritation and long for us to be once again the couple joking in the kitchen: the half-asleep woman pouring her tea; the man teasing her, slapping her butt as he brews his espresso. Instead we are two people on the sidewalk, trapped in this uncertainty. I glance away from him, and that’s when I see it: just beyond a wooden fence, near a set of narrow gray steps, a tulip blooms, red and languid in the sun. And suddenly my irritation dissipates.

My husband too has stopped. He looks so fraught, so fragile in his anger over the fact that I have gotten too far ahead. “I always wait,” I say, but his eyes remain distant, wary. His posture says he still wants to fight. I walk to him and take his arm in mine. He gives it grudgingly, his body stiff. We walk silently for the rest of the block until we turn the corner and see our house, a beacon of comfort and relief: Rest. Food. Sleep.

“We’ll be OK,” I say, patting his arm and hugging it tighter.

He says nothing. I keep my steps aligned with his as we turn onto our walk, where, on each side, the hostas shoot up in green bursts. Carefully we climb the steps, stopping to rest at each one. As I move ahead to unlock the door, I hear the radio of a passing car and the drone of a distant lawn mower. I see our neighbors’ dogs chasing each other in their backyard.

“Thanks for getting the safety pins,” David murmurs as I put the key into the lock.

I remember how conscientiously he bunched together the fabric of his pajamas and gown this morning, how carefully he fastened the pin, how he looked up at me and beamed at this small success.

“Oh, honey,” I say, “you’re welcome.” And we step into our house.