Pyrexia

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by Judith Ford (December 2020)

The Artist and his Model, Edvard Munch, 1919

 

 

One Hot Night in July

        On the way to the hospital, Andrea thinks about an article she recently read on a Facebook post. Or was it Wikipedia? “10 Facts About Fever.” She’d printed it and pasted it into her journal.

        “John,” she says to her husband, “did you know another name for fever is pyrexia? Cool word, pyrexia, don’t you think? Better than just saying fever, or this other option, febrile response.”

        He glances at her, then back at the road. His jaw tightens; the only sign he’s heard her. He had a hard time convincing her to let him take her to the hospital, and he’s still annoyed.

        “Pyrexia makes a commonplace fever sound almost elegant, more scientific, don’t you think? More deserving of attention.”

        “Attention. Yup. That’s what we’re going for here,” John says. “I want your fevers to get the attention they deserve.”

        “They’re just going to tell me to take more Tylenol and go to bed. Wait and see.”

        The ER receptionist takes one look at Andrea’s flushed face and the way she’s clinging to John’s arm and immediately directs the couple to a triage room.

        A male nurse whose name tag reads “Randy” asks Andrea how long she’s been sick. Andrea says, “A few days.”

        John says, “No, it’s been a week, and every day her fever goes higher.”

        “Other symptoms?” asks Randy.

        “Not really,” says Andrea.

        John looks at his wife with a “what-the-hell” kind of look. “Not true,” John says. “You’ve had a rash all over your body for weeks. Plus,” he adds, to Randy, “she’s tired all the time.”

        Randy addresses all his other questions to John. Andrea doesn’t mind. In fact, she’s relieved to not have to talk. She is very tired. John and Randy discuss insurance, primary doctor, phone numbers. The pattern of symptoms.

        Huh, Andrea thinks to herself. Listen to them. When they say it all at once like that, it does sound pretty grim.

 

        Andrea is fifty-five years old. She teaches junior high English. She goes running before breakfast every morning. When she was forty, she ran the Boston Marathon. She keeps a journal in which she records odd bits of knowledge, poems she runs across and likes, bits of wisdom she wants to remember. She doesn’t write daily but often. She has a tall stack of novels beside her bed and is taking voice lessons. She has long-term, medium-term, and short-term goals that she keeps track of on an online organizing site. She keeps daily to-do lists and actually completes them most days. Andrea is not comfortable with weakness of any kind. She believes that pressing on through adversity is both admirable and effective. She has continued to press on through every day, despite her nighttime fevers, and every day—all day—she’s tired.

        Every night this week, while John was asleep Andrea’s body shivered itself into a fever; her eyes stung; her mind fogged over, and her face and hands felt like they were on fire. After an hour or so, the fever always went down, at least some, before the chills returned, followed by another fever spike. Every morning this week Andrea woke drenched in sweat but without chills or a fever and no mind fog. She got up, washed off the night’s sweat, and, because it was summer vacation time, went running or to her yoga class and after that to a bookstore or to her weekly breakfast date with her friend Jackie. It’s been fairly easy for her, during the days, to not think about her nights.

        In her journal this week, she’s written things like: Is this some kind of weird flu? Not flu season. Must drink more water, up the vitamin C. And this: I’m a little worried about the fever last night, 3 am – 101. Gone this morning, though. No big deal. And: Scary last night; okay again today.

        After several days of this pattern, Andrea told John she might have the flu. Or something. John is not a worrier; he nodded and asked if she was getting better. She told him she was, because at that moment—it was early morning—it felt like the truth. She hoped it was the truth.

        The next night’s journal entry: 102 tonight. Elizabeth had a temp that high when she was two. Got so sleepy and limp. Pediatrician said no emergency, give her lukewarm bath, Children’s Tylenol. She got better. Will I?

        Remembering Elizabeth’s long-ago fever, the next night when Andrea’s fever hit 103, she took a lukewarm bath, swallowed two grown-up Tylenols, and hoped for the best.

        Freshly bathed, she joined John in bed. He woke and asked, sleepily: “What’s up?”

        “Another fever.”

        “Mmmmm,” John mumbled. Then he fell back asleep.

        All night long Andrea worried about her fever, but when in the morning she was okay again—no fever but still tired—she told herself the worst was over. She did her scheduled run, eight miles. It was hard. Every day, it was getting harder.

        The following night, the night John insisted on taking Andrea to the hospital, her temperature was 104. It was 2:00 a.m. when they arrived.

 

        Now Andrea is lying on a narrow bed in a brightly lit exam room in the ER. A circular curtain surrounds her bed. She has begun to shiver. She shakes so hard the bed squeaks and rattles. Her chills at home have never been quite this bad. “Damn,” she gasps. “I should have stayed home!”

        John gets three warmed blankets from one of the nurses. He piles them on top of his wife. “That should help,” he tells her, and sits down on a metal chair near the foot of her bed. He pulls out his phone and stares into its screen. A thing he always does, Andrea can’t help but notice, when he’s worried.

        The chills subside. The fever rises. Andrea closes her eyes. She has managed all week not to look at this thing, whatever it is, straight in the face. Somehow it seemed like if she didn’t focus on it, didn’t name it, it would go away. Even now, her instincts are to pretend to be less ill than she apparently is.

        She tries to convince John she should go home. Home is where she will survive, she believes. Not here. Not here in this place where she can already sense the forces that will rob her of control, that will own her illness, will own her. She is more afraid of all that than she is of the fever.

        “I’m feeling better now,” she lies to John in a wisp of voice that says otherwise.

        “No, you’re not,” he says.

        “No, really. You should go get yourself a cup of coffee or something. Take a break.” Andrea feels her fever rising once again and doesn’t want to see her own fear reflected in her husband’s face.

        A nurse comes in with a rattling tray of glass vials. She will take Andrea’s blood and send it to a lab with instructions to rush the results.

        “Tell him it’s okay for him to leave me for a while,” Andrea says.

        “It’s fine,” the nurse replies. “Go home and sleep. We’ve got her now. I’ll call you if anything changes.”

        John shakes his head, looks worried, but leaves without argument.

        The nurse draws four vials of blood and tells Andrea to rest. It will be awhile before the lab will have any results. When the nurse leaves, the white curtain around Andrea’s bed billows out like a sail, then settles back.

        Andrea feels abandoned. She knows this makes no sense; she herself told John to leave. But once she’s alone, she finds it harder to distract herself from the mounting evidence that she does, in fact, belong here. That she is, goddamn it all, terribly sick.

        Concentrate on something, she tells herself. That Wikipedia page about fever. She’d looked up fever because, on some level, she was concerned about her own fevers. She pictures the page, the way it looked on her computer screen. There was something about how shivering raises body temperature. Heat kills germs. Like rhinovirus, streptococcus, and other common infections. She is pretty sure she doesn’t have any common infection. Just the damn fevers. What good, then, is the shivering?

        Does she have malaria? If she’d thought of that at home, she’d have Googled it, read the symptoms, worked on a home cure. Wouldn’t be able to do that now, though, even if she was at home. The fever makes it hard to think. Thinking seems crucial; letting her mind wander, dangerous.

        So, next she focuses on a wide cabinet opposite her bed. She is counting aloud the folded blue and green scrubs stacked behind its glass doors when a tall woman with a low ponytail, wearing a white lab coat, appears at her bedside.

        “Hi, I’m Dr. Bernstein,” she says as she reaches for Andrea’s hot hand. She holds it lightly in both of hers, as if Andrea is someone she knows and cares about. She makes unflinching, direct eye contact.

        “I read your lab reports just now,” says Dr. Bernstein. “I can see from the results that you’re very sick, but we don’t yet know why. Your white blood cell count is way too high, and your red cells are low.”

        Andrea’s throat tightens, her eyes fill, and the words I feel sick; I feel awful pop into her head. She’d written them down in her journal after her book club read The Sheltering Sky. A sad book. The young people in it, Kit and Porter, are lost, despairing. Like Andrea was when she was young, only these two aren’t just psychologically lost but lost on safari in Africa. Port falls ill with a high fever. As if the desert heat has seeped into his body and inflamed it from the inside. That’s how Andrea feels right now, inflamed from her very core.

        She looks up at the ER doctor, and all she can think to say is “I feel very sick. I feel awful.”

        “I bet you do,” says the kind doctor. “I think we should admit you.”

        Does this doctor know that when Porter says, “I feel sick. I feel awful,” he is near death? Am I near death? Andrea wonders. Does Kit die too? She can’t remember what happens to Kit. It seems important to remember.

        Dr. Bernstein says again, “I’d like to admit you. So we can figure out what’s wrong and make you feel better.”

        “No,” Andrea says, resisting out of habit, more than sincerity, her mind still wrapped up with Porter and Kit. Wrapped up and afraid. “I need to get back to my students.” This sounds wrong, but it’s the best she can come up with.

        “It’s summer,” the doctor reminds her.

        “Oh. Right. I meant, Timmy needs me.”

        “Your son?”

        “No, my dog. My kids are grown and gone.” Her pitch rises to a whine and she talks too fast. “I can’t stay here. I have things to do.”

        Part of her wants to give in and let somebody take care of her. But she doesn’t trust anyone but herself to take care of herself. Andrea doesn’t trust letting go of control. Letting go, she thinks, is dangerous. Like when you’re lost in a blizzard and your brain says, lie down and sleep in the snow, when sleeping is the last thing you should be doing. Really you should be running as fast as you can to a shelter. The snow looks so soft and cozy. So you lie down. And you die.

 

        When Andrea was eleven, the Asian flu swept through her school. So many students and teachers got sick that the school closed for ten whole days. Andrea’s parents had let her sleep with them in their big bed. Her father had brought cool washcloths for her forehead. Her mother brought graham crackers, warm lemonade with honey. They’d checked on her frequently through the day, maybe the night too. And she got well.

        A flash of a memory of her small self, waking well, in her parents’ life raft of a bed, makes her tell the doctor, “Okay. I’ll stay a day or two. But that’s all.”

 

        The hospital bed in her room on the third floor is hard. The pillow makes a crinkling noise when she rests her head on it. The room is fluorescent and glaring. It’s cold in here, and there’s a horrible framed print picture on the wall opposite the bed: faded fields with some nondescript grain—wheat?—bending in a limp wind, pale red barn in the horizon. The room smells of disinfectant.

        Andrea refuses to put on a hospital gown. Too institutional, she thinks, too like a uniform. A prison outfit. Instead she opts for her own underwear and the T-shirt she wore when she arrived in the ER, a souvenir from a recent running event.

        A square-shaped man in a blue lab coat arrives. Dark-haired, maybe early forties, with a smile, like John’s, that crinkles the corners of his eyes. He’s come to take more of her blood. David Something, Phlebotomist, it says on his name tag.

        “Do people call you Dracula?” she asks him.

        “All the time,” he says. “Whenever your fever rises,” he tells her, “call your nurse, who will call someone like me to draw more blood.”

        “Why?”

        “Whatever is making you sick might be more active when your fever goes up. Might be easier to identify. You’ll see a lot of me for a few days,” he says.

        “Maybe not,” she tells him. Thinking, I can leave tomorrow if I want to.

        Andrea sleeps for half an hour, but another rising fever wakes her. She is still awake when, a few hours later, the darkness outside her window begins to soften into dawn and a breakfast tray arrives. Andrea lifts the steel dome covering the plate. The plate holds a leathery mass of scrambled eggs, one piece of white bread toast that’s cold and bare, a wrapped pat of butter, and a small square of grape jam. She replaces the dome and pushes the tray table away.

        As she waits for John to return, she stares up at the TV, perched high on the wall, where a smiling woman in blue scrubs is welcoming her to Trinity Memorial and hoping Andrea will have a pleasant stay.

        John returns with her toothbrush, a book, clean underwear, a pad of paper, and a pen. He doesn’t say what Andrea expects him to say, that he was right to bring her here and she was wrong to resist. Instead, he says, “I’m relieved you’re here. I was so worried when you wouldn’t listen.”

        “I won’t be here long, do you think?”

        “As long as it takes, honey.”

        John stays for hours, reading something on his iPad while Andrea drifts in and out of restless sleep. When he leaves, he is careful not to wake her, but she wakes anyway, to the click of the closing door.

        “John?” she whispers. She feels battered and small; a fish washed up on a blazing beach.

        She knows she needs rest, but even if the fever cycle didn’t keep waking her, the nurses would. They come into her room over and over, turn on lights and check her temperature, her pulse and blood oxygen level. Her blood is drawn again and again as her fever continues to rise and fall. A seesaw. A bungee jump. A lethal roller coaster.

 

Day Two

        The early morning sun pours through the window, spreads itself across her white blankets, demanding to be noticed. She barely registers its warmth. In fact, by nine o’clock, she’s shivering again. More warm blankets are laid across her body until the shivering gives way again to a brutal heat surging outward from her navel, like a wind-driven wildfire.

        Andrea remembers how her son Josh, when he was barely old enough to walk, had what turned out to be a fever seizure, seemingly out of nowhere. She’d been folding laundry in the bedroom when Josh made a weird gurgling sound. His body sagged and his eyes rolled up, as he fell, unconscious, into the open closet, landing between her favorite red heels and John’s Allen Edmonds dress shoes. She ran to him, picked him up, and shouted at him, “Josh, wake up!” As if he’d want to wake up to someone screaming in his face. But he did, in seconds, and laughed at her expression, her furrowed brow, her tear-filled eyes. His doctor, when Andrea called him, said it was a fever seizure; “Take his temp.” It was 104.

        Andrea rouses from this memory and hits her call button; mumbles something to the voice that asks what she needs. Has to repeat it. “A nurse. Take my temperature. Call the blood guy.”

        Her temperature is again 104. Andrea looks for a pen, to record the time and date and the 104. Wanting the solid ground of a list. She opens her bedside table drawer, pushes herself onto her elbows, and clumsily moves her hand back and forth, bumping into a bottle of something, maybe hand lotion, her cell phone, a pen. She pulls out the Welcome to Trinity Hospital pamphlet, opens it, and writes the date, the name of the nurse, and 104, inside, next to list of hospital departments.

        A new technician, female this time, and younger than Dracula, comes to collect more blood. She doesn’t laugh when Andrea says, “Oo, goody. Bloodletting! Did you bring the leeches this time?”

        All day the chills and fever take turns occupying her body. She lies in bed watching reruns of Friends and Project Runway, not really following the dialogues or the plots. When there is a plot. On Project Runway, a tall, wasp-waisted young woman with a pale dead face struts along a narrow runway, walking so determinedly forward in those impossible high heels, Andrea expects her to walk right out of the TV screen and onto her bed.

        John comes around 6:00, after work. He is wearing his courtroom suit, navy blue and well tailored, no tie, and the button on his collar is undone. Andrea notices the dark circles under his eyes, but barely registers the fatigue that has probably caused them.

        Andrea has just finished a bout of chills and is hoping John doesn’t see how drained she feels. She needs him to buy into her story, that this illness (she no longer denies that she’s sick) is temporary; she’s going to be fine soon; nothing here is dire. She needs to read this reassurance in his face and body language and be reassured herself. Because she’s no longer sure of anything.

        “It’s good I’m here. I know. I feel better already.”

        John smiles and nods.

        “I’m keeping myself busy,” she tells him. “Look!” She holds up the “Welcome to Trinity Hospital” pamphlet. Its cover page sports orderly rows of hatch marks in bundles of five. “I’m keeping track of each time some medical person comes into my room. I started last night.” She tries to sound perky. She opens the pamphlet. “And here, I’ve written all their names and the beginning and end time of each of their visits, and when my temperature is taken, I write that down too.”

        John doesn’t answer at first. Then says, cautiously, as if addressing a crazy person, “You don’t need to do that. It’s all in your chart.”

        “It’s okay, John,” she says. “I want to. It helps me.”

        “Does your doctor know you’re doing all that?”

        “I don’t know. Why?”

        After John leaves, Andrea wonders why her record keeping didn’t impress him. He doesn’t get how important it is. Each entry of a name or a number is a marker, a road sign, a guide rope to hang onto in this unmappable place.

        She falls asleep. Within half an hour, a tight sensation on her upper arm drags her awake. Dracula is wrapping a strap and tapping for a vein.

        She can’t stop her mind from picturing bloodletting. While he slides a needle, into the back of her hand this time, she remembers a black-and-white photo of a thin man in a white nightshirt—was it in an old World Book, maybe—leeches plastered on his face and neck. She mumbles something to Dracula.

        “What? Sorry?”

        “I hate leeches.”

 

Day Three

        Dr. Alberts, Andrea’s primary physician, comes in the morning. Dr. Alberts is built like a twelve-year-old, short and flat-chested, her face crinkled like crushed paper, her voice, pinched, as if she’s ninety. She is not ninety, more like fifty. She offers guide ropes of a different kind. She tells Andrea that a squadron of specialists will be examining her. Only she doesn’t say “squadron.” “Squadron” is the term that occurs to Andrea. A platoon. The troops. Dr. Alberts writes down their names and specialties. Infectious disease specialty, oncology, rheumatology, hematology, gynecology, endocrinology.

        Andrea reaches for her pen and the Trinity Hospital Welcome pamphlet. She writes “infectious disease” in the margin of page two. “Oncology.” She will add names, dates, and times later.

        “What are all these doctors going to be looking for?” Andrea asks.

        “Everything,” answers the doctor. “Anything. Mostly ruling things out at this point. My opinion? I think this is some kind of autoimmune response, but I don’t know yet what to call it.”

        “It needs a name?” Andrea says. “Can’t you do something about the fevers without knowing the name?”

        “I wish we could. I know you’re uncomfortable.”

        “My whole body hurts.”

        “I can’t give you any medication. Drugs would mask your symptoms and then we’d never know what’s causing all this.”

        “I don’t care what’s causing it. I just want it to stop.”

        “Be patient; it won’t be much longer.”

        Andrea turns to stare at the wall.

 

Day Four, afternoon

        Her fever soars to 105. After an hour she begins to sweat, and her fever drops down to a mere 100. She draws a graph on a napkin, left over from lunch, to show herself the shape of the fever cycles. Lines that swoop high, swoop low, and back up, back down. Never quite reaching 98.6. A map as coldly ominous as a map of a minefield. Is this thing going to kill me, she wonders. No one seems worried about that. No one is bustling about making urgent sounds, doing urgent things, like…? Like what? What should you do if your fever goes to 105? What if it goes higher?

        When her fever rises again, she hits her call light and asks her nurse, Susan, to come.

        Nurse Susan brings bags of ice and lays them against the back of Andrea’s neck, armpits, and forehead. She places more bags along both sides of Andrea’s legs. Shocking cold at first and then Andrea feels a little better. The fever, she thinks, is raging just the same, but the ice distracts. A small relief. She will take what she can get.

 

Day Five

        The next morning, the doctors begin to troop in. They come one at a time, each with a theory. Cancer, cellulitis, lupus, Lyme disease, chlamydia. Cancer: that’s the one that scares her. “Cancer” stands out in her mind, as if lit by stage lights.

        Andrea puts a check mark next to each doctor’s name in the pamphlet’s list as she meets him or her. They all want her blood. The infectious disease doctor wants a chest x-ray. The oncologist orders a spinal tap. On the old TV show ER, people would scream and cry when they had a spinal tap. “No,” says the oncologist. “It won’t be bad.” When the time comes, he gives Andrea a mild sedative, and he’s right; it isn’t bad. And the sedative is lovely.

        Where is John? she wonders as the afternoon draws to a close. He should have called by now. She hears the supper cart being wheeled down the hall. She tells herself she’s pathetic, needing John’s strength as she does, needing to draw it from him and transfuse it into herself. Her ragged self. A teacher at Andrea’s school once referred to a difficult student, a needy kid, as an energy vampire. Andrea wonders if her need for John makes her an “energy vampire.”

        “I just need him,” she says aloud to the empty room and tears up. She has always hated helplessness in anyone, especially herself. She feels helpless now, but hasn’t got the energy to hate herself for it.

        She is unable to eat the gray meat and mashed potatoes cooling into glue on her tray. Smelling like her school’s cafeteria. She doesn’t want to write anyone’s name down anymore, nor make any graphs or hatch marks. She doesn’t want to do anything. She doesn’t want to do nothing. So she lies still, eyes closed, counting her breaths, until her phone rings.

        John’s voice pulls her back into herself.

        “Is it too late for me to come?” he asks.

        “Please come,” she tells him.

        And he does. He brings her a new journal and three pens, red, green, blue. He sits in a recliner beside her bed and takes her hand.

        “Whoa, hot,” he says.

        “How is the dog doing?” she asks. “Did you pay the electric bill?”

 

        The new journal becomes her newest anchor. She writes in red, green, and blue lines that she thinks are insightful, even brilliant, but later she’ll be surprised to see what is actually there: the short phrases, truncated ideas. Flashes of nightmares.

        “Blood taking,” she writes. “Gunshot wound. Barber, razor. Bad humors. Black bile means melancholy. Patient faints, bleeds more. Blood gone. Patient dies of blood loss.”

        The hours pass slowly. She never feels comfortable, not even for one minute. She can’t sleep; she can’t rest; she can’t focus long enough to read. The TV runs sit-coms quietly in the background. She looks at her lists now and then, but her eyes skim the paper, as if it were a train table on a day she’s not traveling.

        John visits every evening after work. He tells her stories about the dog, who seems to be looking for her, pacing the house. Tells her he himself is doing fine, eating out with friends. He misses her. He reads political blogs on his iPad while she sleeps.

        She writes in her notebook: “where am I? Lepers island. Land of the sick. Two-dimensional. Nothing moves, breathes. I breathe. How much longer.”

 

Day Six

        Right after lunch (Andrea manages to eat the innards of a sandwich, but not the bread), Jackie, who teaches math down the hall from Andrea’s classroom, knocks softly and lets herself in to Andrea’s room. “Look at you!” she says, “All skinny and pale! Time to get up and get back to work!” Jackie is dressed, as usual, impeccably, in unwrinkled khaki linen shorts and an equally unwrinkled pink linen shirt. In that other land, the land of the well and the strong, Jackie and Andrea have not only been colleagues but also best friends. They’ve traveled together, shopped together, held each other together through all manner of domestic disasters: Jackie’s husband walking out, Andrea’s son contracting meningitis, the sucker punch of the empty nest. Jackie could always make Andrea laugh till she cried.

        Not today. Today she hands Andrea a pink striped bag containing an embroidered white cotton nightgown and a box of chocolates. Andrea can’t imagine what she’ll do with either gift.

        “I have bad fevers,” she tells Jackie, who looks puzzled. “They come in all colors and kinds, did you know that?”

        “I guess. No. Not really. I’ve never really thought about fevers much.”

        “Yellow and scarlet. Hay, hemorrhagic, rheumatic, typhoid.”

        “You’ve been reading Wikipedia. Not a good sign.”

        “Doesn’t the word hyperthermia sound like fever? It’s not. It’s heatstroke. A low-grade fever used to be called a febricula.”

        “That’s a great word. Let’s bring it back. What do you think?” says Jackie.

        But Andrea has stopped listening. Talking this much has tired her. She closes her eyes.

        “We miss you, hon,” Jackie tells her. “I hope you appreciate my coming; you know how much I hate hospitals.”

        Jackie doesn’t stay long. When she leaves, Andrea is relieved. And then she cries. Because Jackie left; because Andrea doesn’t know if she can ever leave this room and go with her.

        After her dinner tray is removed, Andrea calls her nurse, whose name is Paige, to take her temperature, because it feels to her, she tells Paige, like her head is going to burst into flames. The thermometer beeps and displays three red numerals: 106. Not only is Andrea miserably hot, but now every muscle in her body is tensed, as if preparing to flee. In fact, if someone told her she could outrun this illness, she’d be up and sprinting down the hall, no matter how awful she felt.

        “Please,” she says to Paige. “Do something.”

        “I’ll get the ice,” says Paige.

        “Pyrexia,” Andrea manages to write in her notebook. “Febricula. Scarlet. Black. Multicolored fevers.” She sets her notebook down when Nurse Paige returns with the ice bags.

        “They don’t help much,” Andrea says.

        “Still,” says the nurse, “it’s all I’ve got. These and ice water.”

        She hands Andrea a tall plastic cup with a straw through the lid. The ice cubes rattle. The ice bags make a clinking noise. Someone in the hallway is refusing to go back to bed. He shouts, “You don’t understand!”

        “Close my door, please,” Andrea says as the nurse leaves.

        Later—hours? Minutes? —Paige returns with another batch of ice bags.

        Andrea asks, “Can one hundred and six cause a seizure? Can it kill me?”

        “High fevers that do those things are usually caused by infections; you don’t seem to have an infection.”

        “Are you sure?”

        “I’m pretty sure,” says Paige.

        But Andrea has read stories about people whose brains were damaged by high fevers and people whose high fevers were harbingers of imminent death.

        In her notebook, Andrea scrawls, “Nurse not sure.”

 

        On day seven, Dr. Alberts visits, first thing in the morning. Andrea is packed in ice, like the day before. She tries to make a joke about being a salmon ready for shipping. The doctor doesn’t laugh.

        “This is awful,” Andrea tells her doctor, who pushes her lower lip out in a sympathetic pout.

        “I am really sorry,” she says, “we still don’t have an answer. That’s good and bad; good because none of the test results revealed anything. The bad news is that now your spleen is enlarged, and the pain in your chest is from fluid building around your heart. And we still don’t know why.”

        Andrea begins to cry. Because it’s early morning, her fever is not yet as high as it will be, and she briefly has the mental wherewithal to notice her losses.

        “I’m missing my whole summer,” she moans. “I can’t live like this.”

        The doctor sits down on the bed. “Do you miss your husband?” she asks.

        “He comes nearly every day, but I miss being with him in real life, yes. I miss everything. I miss Josh, who lives in New York now, and Elizabeth in Salt Lake City. I miss the dog; I miss my pillow, I miss reading. I miss sleeping more than forty-five minutes at a time.”

        Dr. Alberts pats Andrea’s back. A gesture Andrea would have loathed in her real life, would have rejected as cliché. Now, the touch feels warm and well meant, if not exactly helpful.

        “We’ll get you out of here soon,” the doctor says.

 

        Late afternoon, the same day. The number is 106 again. Andrea can muster neither word nor sound. She is dazed. She lies still in her bed, as if she is glass, as if the smallest movement could shatter her. She stares up at the ceiling tiles. The lines of small holes in white squares. She remembers reading that Native Americans used wild ginger to fight fever. She thinks wild ginger would be a good idea, but she falls into a restless light sleep before she can push her call button to ask for it.

        She is running, panicked. There is lava flowing from the horizon. The wind scorches her clothes. The bottoms of her shoes are smoking. A hand rises up from an opening in the hot, melting street and grasps her ankle; a voice whispers, This way. Come this way. The manhole cover opens the rest of the way, and a small, naked man who glows red invites her down. Come with me, he says. Even his eyes are red. The lava stream getting very close to her feet. The man says, Trust me. I am your only hope.

        Andrea half wakes, cannot quite rouse herself, until she begins to sweat, waves of relief flowing over her, as if a huge water balloon hangs above her and someone has popped it; cool water rains down. Like blood. Bloodletting releases demons. Was the little man in the hot red world a demon? Or a guide? Or both? She sleeps before she can decide. The first real sleep in weeks. But only an hour. The fever begins to build soon after she wakes. She feels it building, even as she records bits of the dream in her notebook: lava, red man, heat, melting, terror, water, fire and blood. Trust?

        She’d hoped—she’d believed—between that big fever and this new one, that the worst was over. Hadn’t that been what her dream was about? Being saved. But, no, apparently not.

        Fever hallucination. Like Josh’s seizure. Caused by heat on brain, she writes in her journal, between fever spikes. Red man, a liar.

        When the chills stop and Nurse Paige takes her temperature, Andrea doesn’t care if this fever has risen higher than or not as high as the last. She doesn’t ask the exact number, as she usually would. She’s stopped recording the fever numbers. She’s stopped calling anyone when she blazes. She doesn’t make any more graphs or hatch marks. She knows now that she is dying of whatever this is.

 

Day Eight, Evening

        Andrea doesn’t tell John she’s dying when he comes to visit. He’ll figure it out soon enough.

        John is unusually quiet, staring down at his hands in his lap, no iPad or iPhone there.

        “What is it? Andrea asks him, thinking, He’s given up on me too, just like I have. “John?” she repeats. “Tell me.”

        “I lost my case today,” he says, not looking up. “Domestic abuse. The wife refused to tell the judge what she’d told me, about how her husband blackened both her eyes and broke her nose. How he knocked her unconscious another time. The guy went free and she went with him.”

        John usually limits his hospital conversations to the weather, the dog, news from their adult kids’ lives. Not ever anything worrisome and not anything, really, about himself. Andrea is surprised at this change of subject. It feels good. It feels more real. It pulls her down into her own skin, gives her back some of the substance the fevers have worn away.

        “Oh, awful,” Andrea says, meaning it.

        “I thought I could protect her, and turns out, I couldn’t. He’s crazy. He may well kill her.”

        John lowers his head; his shoulders shake. Is his temperature rising too, Andrea wonders, then realizes he’s crying. She slides out of bed, pushes the IV stand in front of her to stand behind his chair, she strokes his cheek, hugs him with her one untethered arm. It’s so good to be out of bed, good to feel John’s chest rise and fall, good to feel the warmth of his living body.

        Maybe, she thinks, I won’t die after all.

        “Get back in bed,” John says. “Please.”

 

        Later that night, when her fever shoots up to 106 again, she remembers she wants to live. She wonders if John is afraid not just for his client, but for his wife too.

        She makes herself think about cool things. White wine in a frosty glass on a hot summer night. Ice crystals on a windowpane. Her father with a cool washcloth for her forehead.

        In the morning, when her fever is low again, a few lines from Katherine Anne Porter’s Pale Horse, Pale Rider are running in her head. Pale Horse is one of Andrea’s favorite stories. The words she remembers now are about Miranda’s high fever. Before the day’s chills begin, Andrea writes the lines in her notebook: “There remained of her only a minute fiercely burning particle of being. Trust me, the hard unwinding angry point of light said. Trust me, I stay.

        John, she thinks to herself, trust me, I stay.

 

Days Eight to Ten

        Having ruled out the worst diagnoses, like cancer or liver failure or Lyme disease, the medical squadron finally takes aim at the fever. First, a day of high doses of aspirin. By midnight, the time her fevers often are highest, she’s only 101. However, her ears ring so loud, she barely hear Alberts tell her they have to stop the aspirin or she’ll lose her hearing.

        Next day it’s a drug called Indocin. Which makes her feel very strange. Because her fever no longer goes over 101, she has the will to walk. So, she walks the hospital corridors, pushing her companion, the IV stand, beside her. The walls have no mass; she could put her hand right through them. The floor is made of smoky glass. People’s voices echo in her skull as if everyone is inside a giant tin can. She isn’t in her body. She describes this to Alberts, who stops the Indocin.

        On Days Ten, or maybe Eleven, Dr. Alberts tells her she can go home the next morning. Andrea is shocked. Go home? How? She’s still having fevers, although not so high. She’s lost six pounds since her first day here and feels flimsy as a piece of Kleenex. Since going on with any kind of normal life, feeling as weak as she still feels, is unimaginable, she figures they must be sending her home to die.

        She does not want to die.

        “Nothing more we can do for you here,” the doctor says. She hands Andrea a prescription for prednisone. “We’re guessing you might have a rare inflammatory disease called Still’s. There isn’t a cure, but the prednisone can help manage your symptoms.”

        “Will I be well in time to go back to work?” Andrea asks.

        “I don’t know,” the doctor answers with graceless candor. “You will feel better than you do now. I don’t really know how long it might take.”

        Better not to have asked.

        Andrea gathers her few hospital possessions—books, a few T-shirts, her notebook, the several unread books, the embroidered nightgown, and the box of chocolates. Her street shoes, a pair of red Birkenstocks. Red. The color of real life, she thinks to herself.

        That night, she dreams of hatchling turtles. They tumble toward the sea, under the black eyes of hungry gulls and wild dogs.

        The following day, Jackie arrives to take her home. She strides into Andrea’s room, smiling, and hugs her hard. Jackie navigates the hallways with Andrea in the required wheelchair; two helium balloons with manic smiles bob up and down on their strings tied to one wheelchair arm. A closing elevator door almost clips one of the balloons’ strings, but Jackie tugs it inside in time. First floor, then, and out the door.

        Where, for the first few minutes, Andrea squints and flinches, pummeled by sunlight that ricochets off car bumpers and windows; the smell of roses, car exhaust, and melting tar; the rumble of traffic; the shredding noise of a bus; a wagon of chattering toddlers pulled by a daycare worker. She sits already exhausted, as she waits in Jackie’s VW bug, while Jackie returns the empty wheelchair to the hospital lobby.

        As Jackie drives, more slowly and carefully than her usual style, Andrea imagines herself sitting with John at the picnic table in the yard drinking chilled white wine from sweating glasses. She pictures the way the sunlight comes through the east window of her living room every morning; she’s smelling the cracker-y scent of Timmy’s paws, his long, furry body snuggled next to her in bed; she’s picturing the high white ceiling of the dining room with its curly plaster molding, the four posters of her tall bed, so high Timmy has to get a running start to jump into it. Her own pillow. Home. Where everything will be peaceful and healing.

        She forgets all about those things, other than the scent of the dog’s paws, when she gets home for real. She is too tired to notice much of anything. Timmy, however, will not be ignored. He throws himself, hysterically weeping, against her waist, her legs, covering her arms with sloppy kisses. He runs for the bedroom, jumps onto the bed, and waits for her to join him. Which she does for most of the next two days.

        On the third day, her fever is only 100 at noon. Her belief in her continuing life is rickety, a structure of straws and rubber bands. Each time she leans on it, it rattles and trembles. But on the fourth day, there is no fever at all. Not midday or late afternoon or any time in the night.

        She writes in her notebook: “Something that causes fever is called a pyrogen. Something that stops a fever is an antipyretic. Prednisone is one hell of an antipyretic.”

        She needs a lot of sleep, but after a week, she is able to get out of bed, still a bit weak and stiff. She dresses; adds a belt to keep her jeans from sliding off her bony hips. Wears warm socks even though it’s still summer. Her feet remember the fever chills. She opens her laptop, locates her school’s website, and discovers she is able to concentrate on it long enough to know when and where to show up for the school year’s first all-faculty meeting, a month away.

        She decides to risk taking a walk outside. It is a lovely August morning. The sky is a washed-out blue, cumulous clouds patching its edges. The sun on her shoulders is hot, but external hot, rather than internal. She likes this kind of hot; it caresses and softens her skin; it sinks into her and eases rather than inflames.

        She walks half a mile. This is pushing it. She’s trembling, both from tiredness and from a feeling of pleasure she is unused to feeling. Before she has a chance to tune in to what might have been the early signs of exhaustion, she is spent. She has gotten to the entrance of an urban park. She sits down at a picnic table, closes her eyes, lets her body go completely still, hoping it will recover enough to easily get home. She enjoys breathing the warm air. When, a few minutes later, she opens her eyes, a robin perches on a fence not more than one foot away. “Well, hello,” she says. He startles, and takes flight. He hadn’t realized she was living.

        I am a living thing, she says to herself as she walks slowly home. She must remember to write that in her journal. The oaks and maples along the road are sporting white haloes, like the coronas around a moon on a humid night. The daylilies in her neighbor’s front garden sing to her. She feels as if she’s wading in the earth, up to her knees in loose soil. This isn’t like the Indocin, dark and wrong, hollowing her out, stealing her soul. These images—prednisone hallucinations, she supposes she must call them—are the opposite: they fill her; they remind her she’s part of a living world.

        As soon as she gets home, she picks up her notebook, intending to write not just about being alive but also about the bird, the glowing trees. She writes, I am living, but can’t find words for the rest. She closes the notebook and lies down on the top of her bed, wondering what she’ll say to John when he comes home and asks, as he always does, “How was your day?”

        She will say, “I am alive,” and he won’t understand what those words contain. He will be glad with her, and that will be enough.

Table of Contents

 

__________________________________
Judith Ford‘s writing has been published in Caveat Lector, Clackamas Literary Review, Confluence, Connecticut Review, Evening Street Review, Hampden-Sydney Poetry Review, Jumbelbook, The Laurel Review, The Meadow, North Dakota Quarterly, The Paragon Journal, The Penmen Review, Pennsylvania English, Quarter After Eight, Rubbertop Review, Southern Humanities Review, Waxing & Waning, Willow Review, and many other journals. She coauthored a poetry collection with Martin Jack Rosenblum, Burning Oak, published by Lionhead Press (1986).

She is a retired psychotherapist and in the past have led workshops in the use of the arts in psychotherapy and has also taught creative writing to middle, high school, and adult students.

When she’s not writing I enjoy reading, hiking, dancing, strength training, yoga, and Words With Friends. She is the mother of three grown children, and grandmother to four wonderful grandchildren.

Follow NER on Twitter @NERIconoclast

 

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