The essay, “No Pity,” by Maggie Kast tells the harrowing story of her 34-year-old son’s last days in the hospital. From the first words, I was gripped by the cascade of events told in Maggie’s spare, unflinching prose.

Day 1. For the last six months, my developmentally disabled
son, Stefan, has been trying to make himself throw up, sticking
his slender hand down his throat to the wrist, and he can’t tell us
why. He knows he shouldn’t. He will even tease us with a hand-to-mouth
feint, a crafty look in his eyes, but he can’t say what compels
him. Today we have an early appointment at the GI Clinic of a large,
teaching hospital, where he’s been under treatment for Crohn’s,
inflammatory bowel disease, for eight years. I’m apprehensive,
knowing he continues to lose weight.

“Hi, Pumpkin,” says a nurse. “How are you?”

“Hi,” says Stefan. “How you?” He steps forward to shake
her hand with a slightly uneven gait, one foot turned out more
than the other, then follows her into an examining room. Neatly
dressed in summer shorts and a T-shirt, he’s thirty-four years old
but less than five feet tall and beardless, his hair gelled into little
spikes. Suddenly he begins to shiver in a way I’ve never seen anyone
do before: deep, bone-shaking tremors that run through his
whole body, and I’m aghast. His gastroenterologist appears in the
doorway, takes one look and says, “ER—now.” We hustle Stefan,
frightened and screaming, into a wheelchair, grab the hands he’s
trying to put down his throat, and hurry down the hall. The doctor
explains as we go that chills called rigors (pronounced rye-gores)
are caused by an immune response in which the set point for body
temperature in the hypothalamus rises, and the body shivers in an
attempt to warm up.

“Can’t we go directly to Admissions?” I ask the doc, hoping to
avoid the busy, impersonal ER where no one knows or has time to
understand Stefan.

“It wouldn’t be fast enough,” he says, explaining that rigors are
a common symptom of septicemia, or blood poisoning, and require
immediate treatment. Blood tests soon confirm that diagnosis.

“How do you get septicemia?” I ask an ER nurse as she hurries
by our curtained cubicle.

“From infection in any part of the body,” she says. “Often from
hospitalization.” Vaguely I remember hearing about resistant organisms
living in hospitals, but I can’t stop to think that the help Stefan
needs might come bundled with lethal exposure. He’s trying hard
to put his hand down his throat, and it takes all my strength and
concentration to prevent him. We’re both scared, and sometimes I
think swallowing his hand has become a response to fear in addition
to whatever is going on in his stomach. Soon his heart races out of
control and an ER doctor comes in and starts massaging his carotid
artery, watching the wall, not looking at Stefan.

“I’m not trying to choke you,” he says, “I’m just trying to get
your heart rate down.” I don’t understand how this works, and Stefan
even less, but he lies fairly still, eyes searching for escape like the
eyes of a horse in a fire. His usual patter in the hospital—“Almost
finished? Go home soon?”—is oddly absent. The bottom falls out of
my stomach and my world as I realize that he’s sicker than he’s ever
been before.

From Maggie:

“No Pity,” my contribution to Gravity Pulls You In, deals with my son S.’s hospitalization and final illness, but in most ways this time was the polar opposite of his life. Sick, he was quiet, weak and depleted; well, he was enthusiastic, outgoing, and humorous. Despite limited speech, he loved to engage strangers in conversation and could easily persuade them to buy him a candy bar or a coke. His passions ranged from watching the clothes go round in a front-loading washer (at age six) to joining in rhythm jams with his brother’s rock band (as a teen-ager) to church, concerts and anything with music, the jazzier the better.

In the hospital, S. was isolated, connected to the fabric of his life only by me and the occasional music-loving nurse-tech. But most of his life he was enmeshed with others, first at home, where his closest brother taught him to walk by constructing a tricycle-wagon contraption that allowed S. to hang on, toddling behind while the older boy rode.  Always engaged in family ritual, S. learned at a young age to raise a glass for a toast and say, “Posit.” Though symbolic action was hardly his strong point, he watched when we acted out gifts in charades and tried to guess, enjoying our raucous applause when he got something right. Our other kids always looked out for him and included him in family life, from trick-or-treating to cooking to camping out. Stories about his early schooling, first communion and moral development can be found in my book, The Crack between the Worlds: a dancer’s memoir of loss, faith and family (Wipf and Stock, 2009).

S. loved to make his father’s favorite, Liptauer, a spread made with cream cheese, blue cheese, mustard and Worcestershire sauce, and he often asked for it after his father’s death. This love competed with his fondness for music, creating the conflict in “Joyful Noise,” the story anthologized in Love You to Pieces (Beacon Press, 2008). And he was uniquely skilled at finding remote items in our refrigerator, filled with leftovers and supplies of a six-person family. “Find me the mustard,” I’d say, and he would shift items carefully from side to side until he found the missing jar.

S. participated fully in his group home, El Valor, where he lived from age eighteen. At his funeral, his loving housemates mourned him by placing flowers on the coffin, shuffling or striding to the altar in an uneven line, erasing the isolation of his time in the hospital. And this tribute brought to mind the way he had burst into applause at my mother’s memorial the year before, reacting to a Dixie combo that played some of her favorite tunes. As we followed S.’s coffin out of the church where he’d loved and been loved, we clapped as well as wept, singing “This Little Light of Mine.” I could almost hear his excited yips of joy.

Maggie Kast is the author of The Crack between the Worlds: a dancer’s memoir of loss, faith and family (Wipf and Stock, 2009). Her fiction has appeared in The Sun, Rosebud, Nimrod, Paper Street and others and her essays in America, Image, Writer’s Chronicle and ACM/Another Chicago Magazine.  Her work has received two Pushcart nominations and a Literary Award from the Illinois Arts Council. Excerpts from her book can be found at www.maggiekast.com; links to reviews at ritualandrhubarbpie.blogspot.com.