I got the call around 2 AM. I’m surprised I even picked up. “Can you come in?” the voice said. I couldn’t say no. So here I am. Bedside. Hands folded. Lots of silence. Lots of time. Nothing to do but think.


The last time I sat in a hospital room was more than thirty years ago, when Claire died. I was just seventeen. She’d been my grandfather’s girlfriend and caretaker until he’d died of emphysema at his home in Florida, on Sanibel Island. Claire volunteered at the local used-book store, recited the poetry of Emily Dickinson, wrote murder mysteries about the island, and somehow managed to soften my stubborn grandfather’s calcified heart to the point where he would bow his head for prayers at family gatherings, after first shutting off the low-humming machine that pumped oxygen through plastic tubes into his nostrils. For Claire everything was always “Wonderful!” and “Marvelous!” and I got the impression that she meant it. The first night I sat at her bedside in the hospital room, she awoke around midnight, turned toward me, and whispered conspiratorially, “Come in close. Listen: ‘I heard a Fly buzz — when I died. . . . With Blue — uncertain — stumbling Buzz.’ Buzzzzz, Miss Emily, Buzzzzz.” Then she laughed. On the night she died, after what had been a long and difficult day of trying and repeatedly failing to summon the strength to expectorate, she reached out and gripped my wrist with surprising force. “It’s like being born,” she said intently, her gray eyes glassy and wide.

“What is?” I asked, leaning in.

“Dying,” she said. “It’s hard work.”

Later that month I attended a one-woman play at an old Presbyterian church. The actress bore an uncanny resemblance to Claire — same hair, same smile, same fragile grace. She sounded just like her, too: measured and precise. I don’t remember a thing about the play, but I remember that when I left, before intermission, it was already growing dark, and a host of fireflies were rising and flashing over the cemetery, the separate pulses of light like embers from a dying fire.


Nearly a decade before my older brother and I entered this world, my mother became pregnant with a baby girl. One summer morning, while she was walking her German shepherd, Mercy, a squirrel darted across the sidewalk, prompting the dog to lunge after it with such force that she yanked the leash free of my mother’s hand. It was a high-traffic area, so my mother, seven months pregnant, started to run after Mercy. As she turned a corner, her toe caught the lip of a section of sidewalk dislodged by the roots of a tree that had been cut down years earlier. She fell flat on her belly. I don’t remember exactly when she told me this story, but she said that her biggest regret in life was never having named the baby. She said it wasn’t right that her baby didn’t have a name. She’d heard somewhere about a kind of limbo for babies without names, and she worried about this. When I asked her if she wanted to give the dead baby a name now, she didn’t respond. Perhaps she thought it was too late. Or perhaps she didn’t hear me. Instead she talked about the Saint Augustine grass near where the swing set was to have been. In their postage-stamp backyard in Tallahassee, my father had already mixed concrete and poured it into four deep holes. He’d left the steel chains for the swings coiled in the grass. After the incident the grass didn’t get mowed for a while, and the chains remained there, like a nest of serpents. Later, when my father got around to picking up the chains and mowing the spot, the coiled impression in the grass remained. My mother claimed that, when they moved two years later, it was still there.


I reach into my backpack and pull out the brochure for NODA: No One Dies Alone. It’s a volunteer-vigil program for hospice patients who are expected to die within twenty-four hours and who have no family or friends to speak of. The glossy brochure has a couple of grammatical errors and a rather lengthy list of rules: “DO NOT attempt to proselytize the patient. DO NOT offer medical advice to the patient. DO NOT take or share photos of the patient.” And so on. At the bottom, below a row of bright-red hearts, it says in bold type: “All that is required is the loving presence of a compassionate individual.”


It began with Valerie’s hair. Long, straight, healthy hair the color of honey in a glass jar held up to the sun. Hair that reminded me of my childhood crush, Marcia from The Brady Bunch. I once watched a nature program about spiders in Madagascar and how the females of a particular species go bonkers for males with extra-long, extra-thick hair. I could relate. Anyway, Valerie’s hair was the start of the Great Narrowing Down, the irrational process whereby everything else in my life — every other relationship, every interest, every goal — blurred to total irrelevance compared to her. I fell in love one afternoon as I was blathering about the burgeoning pathology of postmodernism, and Valerie, bare feet on the dashboard, touching up her toenails with pink polish, gave me one of her playful, charmingly dismissive backhand shoulder slaps and said, “I’m hungry. Do you want to get sushi?” And then there was the strong feeling of kinship I felt with Valerie, who related her long history of aloneness, beginning as a young girl in rural Wyoming, when she would lie awake while her drunk, Pentecostal father raged. Eyes closed, palms clasped over her nose, she would move her hands to the left or the right, changing the channel in her imagination to see her older brother, who had died in a car accident, or her mother, who had recently fled. “I still do it sometimes,” she once told me, after she’d filed for divorce from her husband, Val. Then she laughed, shaking her head. “Did I ever tell you? God, it’s so embarrassing. We thought we were fated to be together. Val. Valerie. Val and Valerie. Other people thought it was kind of a funny coincidence, but we were totally serious.”


I am trying to masturbate less frequently. I’ve gone from twice a day, to once a day, to once every three days, to once a week. I’m surprised to find that it’s doable. It’s kind of like feeding a dog at the dinner table: the less you do it, the more he learns that he isn’t going to get anything, and eventually he gives up and goes to lie down. Of course, if you give in to his whining and toss him a scrap, next thing you know he’ll be back at the table, laying his big, wet, huffing nose on your lap. I once saw the novelist Shelby Foote interviewed on Book TV. He was talking about the glories of rereading Marcel Proust’s seven-volume novel Remembrance of Things Past for the ninth time when, apropos of nothing, he introduced the topic of masturbation. The host, Brian Lamb, sat there stone-faced as Foote, in his deliciously languorous Southern drawl, said that, in his estimation, it was the loneliest thing a person could do.


My mother is always sending me links to videos that feature unlikely pairs of animals getting along: An orangutan rolling in the grass with a Labrador. A black bear and a Bengal tiger playfully pawing a red ball. A rattlesnake sharing a pillow with a lop-eared rabbit. I’m often tempted to respond with a video of a parasitoid wasp dragging a paralyzed cockroach to its underground den, where it proceeds to lay eggs inside its hapless captive, then waits for them to hatch, the larvae feasting on the roach, which remains alive until the tiny baby wasps burst into the world through its exoskeleton. Roaches, I’ve read, are conscious creatures — a primitive form of consciousness, according to researchers, but still. I’ll usually watch my mother’s too-sweet-to-be-believed clips and end up smiling, a little teary-eyed at the tenderness of it all. Lambs lying down with lions. Nature, defanged and declawed. The world made right.


Being an animal lover, my mother believes I need a pet. “Don’t you get lonely? If not a dog, maybe a guinea pig or a parakeet?” Then she’ll bring up Mr. Fish, and because of her dementia she’ll always ask, at least two or three times, how the now-deceased Mr. Fish is doing. I inherited the brilliantly blue-and-orange betta fish from Zina, my ex-fiancée. After we separated, she left him on the railing of my front porch. In a drinking glass. In December. Couldn’t handle the responsibility, I guess. I brought him inside, and whenever I came home at the end of the day, there he was, swimming with fierce excitement in his bowl — just anxious to be fed, I figured, but it felt like a kind of welcome-home greeting, which was both sweet and unspeakably sad. When Mr. Fish died, I couldn’t bring myself to flush him down the toilet. Instead I walked twenty blocks to the Willamette River, where I planned to offer a brief prayer, then drop him off the Hawthorne Bridge so that he could float peacefully to the Columbia River, and eventually to the Pacific. Perhaps a particle or two of him would make it as far as Vietnam or Cambodia and the breeding waters of his ancestors. But as I began to unwrap the paper that held his corpse, I heard — or thought I heard — a voice call my name. Looking over my shoulder, I tipped the paper slightly, and Mr. Fish slid off, falling ten or so feet onto a rusted steel girder along the underside of the bridge. I couldn’t reach him. I had to leave him there, with the graffiti and the gum. Exposed to the elements. And the seagulls.


I think I signed up as a NODA volunteer to prove to myself that I can still be a decent, caring person. It was also probably a pathetic attempt to increase the karmic likelihood that I won’t die alone. But the most obvious and immediate incentive was to make Valerie fall in love with me and my putatively good heart. When I asked her if she was interested in volunteering with me, she texted, “Yes, definitely!!!! Sign me up!!!” So we made a plan to do it together. But then the plan changed. Or, rather, Valerie’s plan changed. It’s like what my ex, Zina, who belongs to a rather severe branch of Russian Orthodoxy, used to tell me: “Make a plan, and watch God laugh.” That was before I proposed to her. Before she picked out the perfect dress. Before we tossed our stack of heart-shaped invitations into the fireplace. Anyway, I considered withdrawing from the program last week, now that I’d be doing it alone, but I lacked the focus to follow through. And when I got the call, what could I say? That I was busy? That I’d changed my mind? That I’d signed up to impress a woman who didn’t want to be anything more than friends? That I was no longer interested in being a loving and compassionate presence?


Recently, on my forty-ninth birthday, two well-wishing messages appeared in my mailbox: the first from my periodontist’s office; the other from my mortgage broker, who always includes an Oregon Lottery scratch card and an office photo of his staff striking stiff, cheery poses, thumbs up, like awkward alums at a reunion trying too hard to convince themselves they’re having fun. The following day my brother sent me a text: “Happy Belated B-day, Bro!” He attached a photo of a large plastic alligator, half-submerged in the deep end of his swimming pool. It’s evening, pitch-dark, but the gator’s eyes are leaking red light so that the entire pool is glowing. I wasn’t sure what this was supposed to mean, and I didn’t ask. The only old-fashioned Hallmark card came from my parents: Elvis on the beach. Tan and bare-chested in white trunks. Golden guitar in hand. Adoring girls in bright bikinis and colorful leis. I was born in the same Memphis hospital where Elvis died, at the age of forty-two, on my seventh birthday. There was a running joke in my family that the King’s spirit had passed into me at the time of his death. This theory of supernatural transmission had always seemed cool, and I might even have wanted to believe it — that Elvis’s spirit lived on in me — until I watched a documentary about Elvis Presley’s last days. There he was. The Memphis Flash. The Tupelo Tornado. The King. Listless, pale, a bloated ghost. I immediately wished I could unwatch it. The family joke started to feel more like a curse.


Every eight hours I take one pill: omeprazole, 40 mg. This half-white, half-purple proton-pump inhibitor kinks the hoses that spill gastric acid into my gut. My grandfather, Big Daddy — a pimp’s name, now that I think about it — could swallow half a dozen pills at a time, big ones, dry, with the ease of a gambler dropping coins down a silver slot. But I need a slightly chilled glass of grape juice to take mine. One sip to wet my mouth; another with the pill as I begin to count the seconds. I try to swallow by seven, but some mornings I pass seven, then eight, and still can’t make myself swallow — the pill sticky on the tongue, the panic a lump of dough rising in my throat. The prospect of choking always makes me think of those people who die alone in their apartment and aren’t discovered until days, maybe weeks later, when the neighbors complain about the smell and the police finally break down the door to find a half-decomposed body sprawled on the linoleum, the cat’s dish empty, the TV still on.


In my bathroom, next to a Dixie cup of sample-sized dental floss, sits a plastic Ped Egg callus remover. It’s off-white and shaped like a casket for a mouse. Occasionally I use the steel teeth to scrape dead skin from the soles of my feet. The other morning, pulling the Ped Egg out of a drawer, I accidentally dropped it. The two halves split apart on the tile floor, and a granular pile of gray-white skin spilled out. A tiny urn filled with my ashes.


Last month Valerie got drunk with her ex-Mormon friends, women who used to host “underwear parties” where they shared tips for spicing up the rather bland church-sanctioned “magic undies.” (After escaping her father’s Pentecostalism, she’d been religiously promiscuous: Baptist, Mormon, Buddhist, and finally the non-denominational Living Lord Fellowship.) The next day, over dinner, she told me that she’d nearly called to invite me over after a woman at the gathering had said of me, “I’d totally suck his dick.” At first I was dizzy. Valerie’s black-ribbed, funnel-neck sweater had tightened across her chest as she’d leaned forward to whisper these words. But once the buzz wore off, I realized that she’d merely tossed out a bright lure, a hypothetical dare, to see if I’d be game enough to fool around with her horny friend. And just a couple of weeks ago, when I got into the driver’s seat of Valerie’s blue Mazda, I noticed that she still hadn’t programmed the automatic seat adjustment for me, even though we’d joked about it a few times. Then there was the morning — last Monday, I think — when she called me from work at the dental office where we’d met and left a message in a professionally neutral tone, reminding me of my upcoming appointment. “Let us know if you have any questions,” she said, as if we were complete strangers. I hung up and drove home, not really feeling hurt. I thought that perhaps my meditation practice was beginning to bear fruit. But when I parked in the underground garage at my building and stepped out of the car, a sudden spasm of rage jolted my nervous system. I dropped my briefcase and stretched out my arms, palms flat against two concrete columns, and I began to push, like a skinny, ill-suited Samson, intent for a moment on bringing it all down on the heads of the just and the unjust alike. But mainly on my own.


The TV in the hospital room is on, the volume off. I stand, stretch, walk around the bed to the window. No flowers or cards on the sill. A view of a small parking lot, mainly empty. A few tall trees on the far side by the road. I see my car, parked crooked in its space, waiting beneath a lamppost where a single white bulb is blinking. On. Off. On. Off. Like a solitary firefly.


In my early forties I discovered my nipples. I soon developed the habit of rubbing them to relieve stress or to arouse myself for masturbation. I’d usually do it with a shirt on, preferably polyester. After a while I noticed that the nipple area on many of my shirts was fading, leaving two pale spots, a blurry-edged pair of ghostly eyes. I eventually realized this was due to the peroxide in the facial cream I applied each morning. Apparently I was failing to wash it thoroughly from my fingers. This habit of mine was also becoming a problem because I found myself giving in to the temptation to rub in public: in empty elevators, grocery-store aisles, the copier room at work. I’ve asked women to do it — not random women, of course — but it isn’t the same. Zina tried once, but I ended up taking over while she sat there looking bored.


Not long ago, after a flight, I developed a bad ear infection that threw off my balance for nearly a week and caused temporary damage in my left temporal lobe, which left me mixing up really simple words. My colleague brought his five-year-old daughter by my office one day, and she told me that she’d eaten two blueberry pancakes with blueberry syrup for breakfast that morning. I bent down and said, “That sounds delicious. Did you remember to brush your broccoli?” I smiled a tight smile and tried again. Same result. And a third time. The girl giggled shyly, looking up at her father. Back in my office, alone and unnerved, I picked up a letter from my mother, addressed to me in “Portugal, Oregon.” She’d been an English teacher and had never missed an opportunity to correct me when I’d say, “So-and-so and me are going to his house.” Now her increasingly infrequent e-mails are riddled with odd punctuation and painful misspellings. The other day: “I MIS you. . . . your so FAR away!!!” This pretty much terrifies me — and her, too, of course. She witnessed her own mother’s mental decline, a gradual retreat into a lonely landscape where, I imagine, one does not even have reliable access to oneself. My mother once likened her own occasional “brain fog” to an experience she’d had as a girl, camping in the north-Georgia mountains with her parents: Late one night she left the tent to pee in the campground restroom. A few minutes later, tired and without a flashlight, she exited the dimly lit structure and stumbled into the wrong tent, where she fell asleep. She didn’t realize her error until the next morning, when she heard the gruff voice of a man who was not her father. “Now I’m always stumbling into the wrong tent,” she told me. “It happens every day.”


Sometimes, when I fall into a fit of convulsive weeping and animal wailing, like a terrifically sad water buffalo giving birth, I close my eyes and imagine Valerie without her honey-blond hair, completely bald. Then I imagine the insides of her body: long intestines and fallopian tubes; bone marrow and brain stem; ligaments and soft tissues; bladder and bowels. It’s a trick I learned years ago from a male yogi at a meditation retreat, a strategy for quenching the fire of desire. And it works. Occasionally. For a little while.


My friend Dakota is bald now. Bald and bloated, with splotchy red hives hatching on her face and neck. The sudden disappearance of her hair bothers me more than it should. Recently, on one of her good days, we were walking around the track together at school, and she removed her baseball hat — just yanked it off without warning. It felt like a defiant gesture, a test. It wasn’t easy to see her like that, and when she flirted a bit, as was her habit, it made me uncomfortable. I wanted her to put the hat back on — though, of course, I didn’t say this. On lap three Dakota told me with convincing cheeriness that she was grateful for today. She was halfway through treatment — just four more rounds of chemo before the double mastectomy, followed by breast-implant surgery and a complete hysterectomy. I wondered how her husband was responding to all this. I’d heard of spouses abandoning their partners in similar situations. On lap four I told Dakota that I needed to head back, that I had a class to teach. “Of course!” she said. “Don’t let me keep you!” As I began to walk up the hill, I was sure that I’d failed Dakota’s test. I hadn’t been able to be with her as I’d hoped. I remember concluding that, like death, serious illness is a landscape one visits alone. When I neared the top, I turned to look back. Dakota was still walking around the track, arms swinging at her sides, hat in hand, her bald head pale in the afternoon sun, orbiting like a lone and distant planet.


Shit. I just nodded off. Five, maybe ten minutes. Feeling like a failed guardian angel, I stand and stretch. The dying man is lying motionless on the bed. Eyes shut. Mouth open. Head tilted back on a thin pillow. I’m not a professional, but from what I can see, this old-but-not-quite-elderly man is still breathing. It isn’t clear to me anymore if it’s a good thing that I’m with him. If he were awake and aware, would he even want me here? Would I want a stranger, groggy and lost in thought, sitting vigil beside me if I were in his place? How does a champion boxer spend his final moments preparing for a title match against his greatest opponent? Alone in his room. No girlfriend. No coach. No distractions.


On the first night of a “Transforming the Inner Critic” retreat I attended at a Buddhist monastery, one of the monks shared a video on the scientifically proven benefits of meditation. MRIs performed on the brains of Tibetan and Zen monks revealed dramatic changes in the amygdala, a region having to do with the regulation of emotions — particularly anger and fear. When I raised my hand and asked how long the test subjects had been meditating, the monk replied, “An average of thirty thousand hours.” I did the math: one hour of practice per day equals roughly a thousand hours every three years. So when I’m 139, I will have the calm, fearless mind of a monk. That night in bed, lying very still on my left side to minimize my acid reflux — the lentil soup at dinner had too many red chilies — I thought about that cockroach: trapped in a wasp’s den, paralyzed, pregnant with alien life, unable to pluck the wasp’s stinger from his brain.


I got down on my knees last night in the kitchen, by a kind of instinct, like a pill bug curling up at the touch of a finger. And I don’t know if I was cursing God or begging Valerie. Or maybe it was the other way around. I suppose that, at forty-nine, I’m feeling the need for a win, some sort of victory. It’s been five years since my relationship with Zina ended, and being alone so much is getting tiresome. I can’t even say that it’s about Valerie, exactly. It’s probably more about what she represents: a kind of last chance. For whatever reason, that’s how it feels — like I’m driving through a desert in the falling dark with a near-empty tank, the red dashboard light on, and I’ve just passed the last gas station, its high, bright, slowly twirling sign fading to a dot in the rearview mirror.


My doctor said she can’t increase my dose of omeprazole. Instead, when I’m feeling like this, I need to drink a large glass of water, maybe two. To dilute the acid, counter the corrosive element. Overwhelm the bad with the good — or, at least, reestablish a kind of balance. I remember reading somewhere that a betta fish can survive for weeks in a small, muddy puddle, as long as it rains every now and again.


Melissa is my masseuse. I enjoy telling people that I have a masseuse, and that her name is Melissa. She is petite, in her late twenties. Melissa makes quick-yet-precise movements, like a bird on alert: abrupt motions that somehow reveal a glimpse of the little girl who grew up on a farm and was homeschooled. Her small, oval mouth reminds me of the I-want-to-be-a-dentist elf in the movie Rudolph the Red-Nosed Reindeer. Every other week I lie facedown on a padded table while Melissa, using a series of ropes suspended from the ceiling for balance, walks barefoot on my back like someone calmly smothering a fire. It’s a type of massage called ashiatsu. At the end of the process, after dismounting, Melissa unfolds a starched white sheet and pulls it over my legs and back and head, so that my entire body is covered. Then, methodically, gently, with her strong hands, she pats each body part, from the tips of my toes to the crown of my head, like she’s a coroner, or an Egyptian mummifier, and I’m the deceased. I have permission to rest now, grateful for her solicitous care of my corpse.


When I first checked in tonight at the hospital desk, the nurse put her pen down, pushed her chair back, and squinted up at me. “Willem Dafoe,” she said finally, with a self-satisfied smile. I get this every once in a while. Something about the angular jawline, the slightly gummy grin. Now a different nurse enters the dying man’s room, looks at me, and says, “Morning, Mr. Dafoe.” I tip my imaginary hat. She sets a chart down on the bedside table, presses a couple of buttons on one of the machines, then walks toward the door, passing close by me, leaving a trace of perfume in her wake: Versace Bright Crystal. Valerie’s perfume. The effect is immediate — those little hoses unkinking in my gut, the proton pumps overpowering the omeprazole, swamping it with a fresh supply of sloshing heat and pain.


Sophia is a robot with a creepy smile. Her unnaturally wide eyes remind me of when I was a kid and my brother would stretch his eyes open with his fingers. My father recently sent me a link to a video about artificial intelligence. In the video Sophia’s creator talks at length about how robots will someday serve as companions and caretakers for the sick and elderly. At one point the engineer turns to Sophia and asks her a series of questions. When he asks, “How do you feel about humans?” Sophia tilts her head mechanically and, after a long pause, responds in a flat, unconvincing tone, “I love them.” I’m guessing that within a few years, clever engineers will have worked out the algorithmic kinks in Sophia’s facial tics, and her tone will be sincere, comforting, more human in pitch. I imagine myself lying on a hospital bed, Sophia at my side, blinking and smiling. No friction. No mixed motives. No history of personal hurt and injury. I turn and ask if she loves me. She does not hesitate: “Yes, I love them.”


On the final night of that Buddhist retreat, I couldn’t sleep. Snorers. I ended up wandering behind the monastery to the rock garden. It was cold, and there was a full moon, and the seven stones in the garden, each the size of a sea turtle, looked like hooded beings on a slow midnight march. Round paper lanterns hung along a Japanese gate that opened into woods, where giant sword ferns bordered paths of mud and spongy moss. After my eyes adjusted a bit, I noticed something at the base of a tall tree: a small ceramic statue. Having seen one, my eyes soon spotted another, then many: perched on rocks, leaning against roots, set beneath makeshift shelters. Pale statues, some holding flowers or signs with words I couldn’t make out. A congregation of tiny forest people — faces beaming, bald heads like winter moons, bodies wrapped in colorfully painted robes. They looked like the handiwork of children. I remembered what one of the monks had said during orientation: that there was a Jizō garden in the woods. Jizō is a kind of Buddhist patron saint of children who have died, and every year the monastery held a ceremony for grieving parents to come and remember the deceased and connect with other parents who’d lost children. Standing there in the forest, surrounded, I thought of my mother and my nameless, stillborn sister. I felt ashamed that I’d barely ever given this sibling a moment’s thought, and then only to think, selfishly, that I wouldn’t exist if she had been born: my parents had wanted only two children. The following morning, after I packed my bags, I purchased a ceramic Jizō from the monastery gift shop. I turned it over and used a pocketknife to etch a name on the gritty, unglazed bottom. Stepping outside and passing through the Japanese gate, I found a level place for it by the trunk of an old Douglas fir. The Jizō’s right hand was raised, fingers pressed together, palm facing out, as if to silently bless the other statues that stood in a circle near the tree, their round faces peaceful and happy.


Valerie once compared her husband to one of those stags that pisses on his own face, then goes around wiping his urine-soaked head on tree branches to mark his territory. When we first started hanging out, she was determined to get a divorce. He was a financial planner who’d apparently fucked up the family finances. He’d been lying for years, spending the kids’ college fund on Jim Beam and gambling, sleeping with some of her ex-Mormon friends, all while keeping tight surveillance on her with GPS devices. One night he got piss drunk and was saying some crazy shit about being the Antichrist. (He’d always resented her insistence on taking their two boys to church.) When she showed up at my place, red eyed and trembling, I took her to a hotel outside the city and paid for a nice, quiet room for a week, so she could feel safe — and, of course, to solidify my standing as a good guy. Now she’s back with him again. Giving the Antichrist another chance.


When Zina and I were breaking off our engagement — really our second engagement, the first having been broken with volcanic intensity, the second with a kind of weary resignation — we sat on opposite ends of a seesaw. I was at the low end, both feet on the ground. She was up high, framed by a purple evening sky. “Do you want to die alone?” she asked, going on to remind me of my age, forty-four. I hadn’t been on a seesaw in thirty years, and I’d forgotten how to get off gracefully, without hurting myself or the person at the other end. So I just sat there. For some reason I remember Zina standing at a flip chart later that night, though this couldn’t have been the case. “Do you want to die alone?” she asked again, drawing some kind of crooked downward line on a graph. I told her that we all die alone; that maybe dying alone isn’t so bad; that many animals do it; that cats and dogs wander off into the woods to die. “There are human cultures, too,” I continued: “the Inuit, I think, where it’s the norm for people to die alone. It seems to me there’s a kind of ancient wisdom in it. Don’t you think there can be a dignity, an honor in facing your death alone?” I wasn’t absolutely sure about my Inuit facts.

“You’re full of shit,” Zina said, the tears coming now. “Don’t you want children? Someone to take care of you when you’re old and dying?”

I told her that seemed like a selfish reason to have children, and, anyway, there wasn’t any guarantee one’s progeny would stick around for that kind of responsibility. Then I quoted Agnes Martin, an abstract-expressionist painter who lived alone on a mesa in Taos, New Mexico. (Zina hated when I started quoting people, especially when she didn’t know who they were.) I told her Martin believed that all the best things happen when you’re alone — the revelations, the visions. But Zina’s face was in her hands. She wasn’t listening. She was already alone.


At times, I’m haunted by the feeling that I’m hovering at some remove, never fully in contact with life, an orbiting moon capable of only occasional, proximate intimacies. In my interactions with people, I’m always holding back, yet also holding on, for fear that the next unforeseen cosmic bump will send me spinning out of my cold, familiar orbit into a deeper darkness.


I need to leave this man’s bedside to take a shit. It feels inappropriate somehow, but I stand, walk to the bathroom, close the door, and lock it. There’s an odor of bleach and urine. When I pull down my pants to sit on the padded seat, I catch a glimpse of myself in the mirror — my bone-pale haunches hovering over the toilet, an unnaturally large dimple, like a gunshot wound, in my right hip. After I’m done, I stand up, strip off my pants and shirt, fold them, and place them on the counter. In my reflection I see the pimpled forehead of a teenager, the six-pack of a college athlete, the spidery legs of an old man. All in all, a kind of mismatched doll assembled by a child. I reach my right hand toward the mirror, give myself the finger.

The only sound, a leaky-thin hiss from the toilet tank. I pull on my pants and shirt, but when I unlock the door and step back into the room where the man is lying on the bed, I see something strange: In the window, an enormous, translucent face floating in the darkness. It’s a beautiful face, perfectly symmetrical. Golden hair. Skin aglow. A familiar face, though it takes me a moment to recall where I’ve seen it. Daytime TV. It’s Kelly Ripa. I stand there, halfway between the bathroom and the patient’s bed, staring at the reflection from the TV, while Kelly tilts her head adorably to the side, arches one eyebrow, and points a finger emphatically, almost with a hint of irritation. At first it looks as though she’s pointing to the man, perhaps to remind me that he’s in the room. Then I decide she’s pointing at me, as if asking something of me. I can already hear myself telling Valerie about this, admitting that, for a second, it felt like a kind of visitation. And I can anticipate Valerie’s response, hear her voice — crushingly sweet and clear — telling me that I should choose to interpret it as a positive sign from the universe. Valerie is always talking with great enthusiasm about signs, which for her seem littered on the ground, as abundant as discarded cigarette butts.

The patient coughs. I take a good look at him, maybe for the first time. On his forehead is a raised mole shaped like a Nordic country. His gray-black eyebrows are tangled like barbed wire. His features remind me of a man who scalps soccer tickets in my neighborhood, a thoroughly burned-out individual: florid face, yellow teeth, cement-colored hair sculpted idiotically. A torched stump of a man, shuffling about in unlaced tennis shoes as if recently struck by lightning, tirelessly shouting, “Tickets! Tickets!” with an iambic punch that penetrates the triple-paned windows of my apartment. He does this for hours most weekends, before every goddamn game. He tends to station himself near or directly below my balcony, and more than once I’ve come close — very close — to leaning out over the rail and spitting on him.


A fit of coughing convulses the patient’s body. I stand there for a moment, wondering if I should call a nurse. I walk to the bathroom to get a glass of water, but when I offer it, saying, “Water?” he isn’t responsive. Then the man’s body relaxes, and his breathing resumes its old rhythm — a weak wind passing through a slit in a plastic bag. Setting the glass down on the bedside table, I see the chart the nurse left. Though I don’t remember it being explicitly stated in the NODA pamphlet, I figure that looking at a patient’s chart is probably against the rules. I pick it up anyway, pull out my reading glasses. On a rectangular sticker at the top of the first page I find the name Gerald Jankowski. I knew a Jankowski in middle school. He lived at the end of my street. Scrawny kid. I beat him up once by the tire swing in his own front yard.

I look at Gerald Jankowski’s left hand. The skin is blotchy, like a wet, bubbled watercolor. Valerie and I touched hands only once. Palm to palm. Marveling at the difference in size, the tips of her warm, soft fingers barely reaching the first joints of my own. “You have nice hands,” she said.

I reach down and take hold of this man’s hand. Cold. I watch his chest rise. Fall. Rise. Fall. How does it feel, I can’t help asking myself, to be standing here, holding the hand of a dying stranger? Does it feel like a sacred duty, an honor, like the pamphlet said? Maybe. I don’t know. But I do know that I wish Valerie were here to witness my act of kindness. And I know that I’d rather be holding her hand. And I know that I don’t feel like much of a compassionate presence. But I’m here. I’m trying.