This morning the surgeon saws off her arm. No one stops him. No one comes to kiss her head. Perhaps she makes a joke of it before she falls asleep—but, of course she does—and they all laugh. Secretly, in her hospital bed, knees folded up, bleach-white sheets, palming a small mirror, she puts on a dab of lipstick before they wheel her in. That’s what she jokes about. All dolled up to go to the operating theater, darling! Don’t cut off the wrong one!

I have done this before, I will do this again

Sonia Almeida, L Shape. 2018, artist book, hardcover. 13¼ × 10¼ × ¼", 16 pages. Includes ink and permant pens drawings, oil on gessoed paper, transparencies, lithograph, woodcut and monotype. Courtesy of the artist and Simone Subal Gallery.

I remember every button, every button hole. I remember the smell. You do not forget the smell. Today, I forget my age. Last week, I put down the wrong year, off by two, on a form I filled out for my doctor. I have three small children of my own now. Today, I live in New York.

But that fractured, stark, bright, too-loud that is trauma in the child, that remains intact and living, loiters at the edges of each day like a vagrant on the stoop of a townhouse. It comes in pictures. It crosses an ocean. While I sit beside my asthmatic toddler, watching his body struggle to breathe, it finds me. When I scrub nail polish from a toe with an acetone wipe, and the alcohol scent of it fills the room, it brings me there again.

All along the corridor, very young men. Adam’s apples, naked shoulders, stubble on their scrawny necks. Nubs of half-limbs swaddled upon their beds like sacks of white flour. Others, legs suspended, screws and bolts and draining tubes sealed into their bodies with iodine and pus, hang like laundry from cables and pulleys and fluid-filled drips. Everywhere, construction sites of muscle and bone. They turn their heads to look at us, a band of four, two children, two adults. Look down at the floor. They arrive here by motorcycle, for the most part, says Mum—But, shhh! Don’t stare!—riding too fast, too violently.

Towards the bed we walk and their gaze follows only her. They could not see the tumors in her arm. They didn’t know because the doctors didn’t yet either. It had already shifted, morphed, crept silently down her spine. Watch them watching her, their eyes helping Dad help her off with her coat, eyes helping him undo the buttons down the front of her shirt, fiddling past the bra to her belly button. I draw the curtain partway around the bed. And they begin chattering.

Well, fancy that, we got a real lady in ’ere!

It’s about time, innit?

’ow’s your bike, luv?

Mahvelous to ’ave you, Madam.

Back and forth across the ward, up and down the aisle, cackling, caged baboons, jibing, impertinent, repulsive, confined to the white linens of their pens, tethered by central lines and intravenous shackles.

“The pleasure, gentlemen,” shoes slipping off, one, two, socks padding neatly to the edge of the curtain, she whips it closed the rest of the way. “Is all mine.”

A few more hours yet. Still graceful of body and wit. Before she had us, she was a woman.

And now, in our enclosure, her fingers begin to tremble, white and shaking, unfastening the buckle of her trousers. Dad brings the nightdress up around her shoulders.

“I should have brought one without buttons,” she says.

“Goddamn it. Goddamn it. How will I do this?” Her voice drops. A hush, clotted with tears. “How will I do this tomorrow?”

He reaches out for her hand and helps her up onto the bed as if into a carriage in the snow.

The things we’ve collected for her for good luck: A horseshoe, a marble, a George the Fifth penny, a four-leaf clover picked on Blackheath.

She takes the horseshoe like a steering wheel.

“Which way do you hang it?” I ask her.

“Well, look, if you put it like this, with the open side down, then all luck runs out. But if you put it like this,” her eyes open wide, “the devil sits in it.”

We prop it on its side, on the table like a “c.” Damned if you do, and damned if you don’t.

“Don’t say, ‘damn,’” says Mum. And I kiss her cheek because I am eleven and she tells me to, and my little brother throws his arms around her and holds her tight until her nightdress soaks through from his tears, and we have to pry him off.

We walk away. Through the small opening between the curtains I see her taking off her rings.

She sleeps on one side of the Thames. We sleep at home on the other. And late, very late, past two, the silence is raging in my room, so I come downstairs and turn on so many lights the filaments hum. Dining room lit up like noontime in July. A match to pilot light on the gas fireplace, and the little blue flame leaps around my bitten nails. The fingers of a child. Bread thick with butter, boil tea. The midnight callers on the radio, stories about the recession and the dole, the IRA, stories about the war in the Gulf.

Struck bright with inside light at three AM the old Victorian house creaks and settles, wet rot rotting, chimneys unkempt, rambling garden creeping with foxes and bats. Elderberry tree shuddering. Dad has no job, so here we were. White bread. Boiled potatoes from the can. Stains on linoleum from when Bessie was a puppy. Sickly wallpaper curling at the seams—white with red hearts. Greasy black dust clings to the painted bricks above the oven, quivering in the chimney draft. Large hole in the wall above the door where the plaster sometimes trickles down. Cupboards and drawers overflowing with hoarding. Props from the theater. Crisp packets. An old champagne bottle cigarette holder that plays music when you opened it. Teacups, Toby jugs, brass candlesticks, old corks. The one photo left of our granddad McNulty, standing next to our mum in her Irish dancing dress, little black shoes together. Just our granddad’s body, mind. The photo is torn off at the neck. He died when she was ten and we don’t talk about him. She changed her Christian name. The name he gave her, the Irish name, “Maureen,” became “Emma,” once he was dead. Perhaps he was a very bad man. Perhaps he drank, did evil things to her. All I know for certain is that he was fat and had no head.

The telephone! That three o’clock demon. So loud and sudden. Hands clamp shut my ears. Shaking, quivering, two hundred bones jangling like windchimes, humming a single note to blot out the telephone bell. And I’m waiting now, waiting to hear what I know I’ll hear on the other end of the phone: She is dead. But it rings just once.

Black sky softens to dark blue and then gray, but I’m broken so it doesn’t matter. One by one, the yellow streetlights up and down the road flicker off. The milkman will be by.

This morning the surgeon saws off her arm. No one stops him. No one comes to kiss her head. Perhaps she makes a joke of it before she falls asleep—but, of course she does—and they all laugh. Secretly, in her hospital bed, knees folded up, bleach-white sheets, palming a small mirror, she puts on a dab of lipstick before they wheel her in. That’s what she jokes about. All dolled up to go to the operating theater, darling! Don’t cut off the wrong one! She laughs, she charms them, one must, so they understand that you’re a person and do their best to save your life. And then the anesthesiologist sticks a needle deep into her vein, and fastens it with tape, covers her mouth and nose with gas. She can’t run now. Can’t change her mind. And perhaps she panics, but I’ll never know. No one knows it doesn’t matter yet. No one knows it’s already too late, it’s already spread. They might as well have left her with two arms. Painted yellow with iodine, a dotted line drawn across her skin like a tailor marking the hem of a dress. They begin to cut. Clamp vessels shut. The blood. The fat. Saw through the bone. Saw through it the way my dad saws through two-by-fours near the garden shed, fresh, beautiful white pine dust gathering in pyramids at his feet. Bone dust. And all the little ragged ends of her.

Sun rises behind a sky gray as paper. I watch from the window the clip-clop of a Clydesdale pull the rag-and-bone man’s cart up the road. “Old lumber! Rag and bone! Old lumber! Rag and bone!” Ancient foghorn in the mist, not like a man, but like the recording of a man who lived and died a hundred years before. Horseshoes beat a steady pace up the road and past our house, a mop of pale feathering around each massive hoof, rolling muscles in his back and neck, bristling with hair and sweat. All that rubbish on the back of the cart, for what. Rag and bone! Rag and bone! Mum rode horses as a girl, knows which way to hang a horseshoe for good luck. The silence comes roaring back. Because after they cut it off, what would they do with it? Would they just throw it away? But they couldn’t just throw it away. What would they do with her arm, with those fingers that I’d grasped so tightly ever since that moment many years ago in June, when the midwife first lay me on her chest? The hand that walked me safe across the road, brushed my hair and mopped my tears. It would fall into a heap of broken, useless things at someone’s feet, a specimen, a remainder, as if it meant nothing to anyone. I’m so terribly sorry, I tell it. I love you. Goodbye.

Time to go! Dad calling from the stairs. But how we linger with our cardigans. How long it takes for my little brother’s buttons, every one, pulling each slow sock up the eternities of our legs.

It rests beside her, bandaged like a knee. Unnatural and small, worse than I’d expected. She can’t sit up. And what they call it when they come by for their rounds to see how the wound is healing—a stump. The corridors fill with cloudy water to their ceilings, into my lungs, fluid in a tank to drown me. How could they. I see only that word when I look at her now. Why not just call it an arm? Just a little nub of an arm, but still an arm, though, still hers. What a horrible thing to do after cutting it off, to call it something so cruel. To brutalize it with a saw and then tease it with such names. They cut so high, only a few inches below her shoulder. Almost nothing of it left, almost no arm at all.

Her eyes find mine, she sees me looking. My concern, disgust, my fear. She sees my shame. And she tries to smile with all of her face in such a way as to draw my eyes up to her own and away from the stump on the pillow beside her. Her face is putty, not her own. And because I can see her trying, the desperation and the agony in her face, it makes me angry. Because I am eleven, which is old enough to know what she is trying to do.

“Could you?” She asks. Dad opens her lipstick from her makeup bag on the bedside table. Shaky, overcautious, dips his pinky into the color, dabs her lips, her cheeks.

“You’re letting him put makeup on you?”

He smears it with his thumb, gently and evenly, a sculptor working clay.

“I’m in the theater!” A raised eyebrow. “I’ve put more lipstick on than either of you ever will.”

White coats come by for the rounds. Clipboards, glasses, masks. Shooing the children away to the day room.

And here is the worst of it. We wait. Our high-backed vinyl chairs rubbed smooth from the heft of people since gone. A television—old-fashioned hermit crab, screen built into an ugly cabinet resting on the floor, splutters out the BBC in black and white.

And my heart, through the vessels by my ears, beats its two-syllable warning: She’s dead. She’s dead. She’s dead.

A young man hobbles in on crutches, great shimmering x-ray in hand.

He holds it up for us and we smile even though we’re not to talk to men who start the conversation. I look at it. And then I looked down at his legs. The smell of them like antiseptic, bleach, infection, disease. Precisely clean, irreparably broken.

“Take a gander at all those shiny pieces! That there’s metal, that is. In me!” His limbs. Held together with a million bolts and screws. I see them sticking out of the bandages on either side. And in the places between the gauze, those screws disappear right into bruises in his flesh, like arrows shot into red and purple bull’s-eyes.

“Will you look at that!” he says. So proud, so in awe. “Will you look at that. I’m part machine!”

And this is what I fear for my mum. That they turn her into something that isn’t herself, something that can’t love us and we can’t love back. Or that they take her away all together. But the only time I cry is over broken cups and plates or Oliver Twist singing “Where Is Love.” I refuse to cry over this because someone might see and confirm what I fear.

Here’s Dad to lead us back. And the ward awakens into chatter. The dinner cart’s silent wheels, stinking beef stew and onions. Little cartons of orange juice and milk. A tray, pills dispensed to each patient, communion. A young man cups the bottom of the nurse checking the level of his drip.

“Give us a bit of PT, love.”

“Oi, get off!”

A burst and clatter of a laughter. Someone snorts like a pig. They laugh and howl across the aisle, those weasels.

One, freed from his tethers, now crawls around the floor, barking and crying, howling up at the lights, bed socks slipping along beneath him. He grins at me as I walk behind Dad, and then he whimpers, rolls onto his back and bares his belly. My half-smile of shame.

A double amputee, a Spaniard with thick dark curls, hauls himself out of bed to lie stomach-down on his wheely bedside table. Strong muscled arms, but legless. I outweigh him. He pushes off like a swimmer, propels himself across the ward, flapping breaststroke through midair on his table, wind in his curls, a low-flying duck.

The nurses come by to give her morphine. Minutes later, none of it can keep her with us. A bubble creeps from the corner of her mouth, her eyes roll shut. A madwoman. Tubes draw her fluids out of her, down to a bag near the floor. My stomach curdles. We close the curtains around her bed. My little brother kisses her goodbye, clinging to her like a prawn, until we have to pry him off.

Side by side at the dining room table, her and me. Tea and digestive biscuits. A breeze picks up from the open window, tousling under the salmon-colored curtains which roll and billow like waves. I sit on folded knees, to make me taller beside her. There’s the smell of roses, bad luck. Breathe in, breathe out. Deliriously sweet and full on the breeze from the front garden, no one to prune them anymore with the shears. Yellow ones, the size of saucers, grow bigger than ever before, ungodly plump and haunted, like moons. They lean and droop on the weight of their massive heads and the scent of them blows through the room.

“Well, then. Let’s see if I can do this.”  She takes a pen in her left hand.

“I can.”

“Well, yes, I know you can.”

“No, I mean I can write with my right hand, too! Lemme show you!”

I snatch the pen. It falls away from her, weakly, too easy to grab. A wretched old woman, an infant, a corpse. Ice cold, I give it back.

A very small scrap of lined paper sits on the table before us. She puts the pen to it but the paper slips. Only one hand. Only one arm. She can’t hold it down and write at the same time. She fumbles, fails, paper skittering away under the pressure of the nib, shame moves down into my fingers, drops into my toes.

“Would you. . . ?”

I’ve waited too long, God help me. God help her. I am ashamed. And now I am ashamed because I have a mother who needs help just to write on a tiny piece of paper. And now I am ashamed for feeling ashamed of her like that. Filthy, horrible child.

Scuffling pen between her fingers and thumb, biting her lip as if in pain. High on my knees I sit, leaned in, my cheek to the warmth of hers, the powder-sweet vibration of our closeness. My heart follows the nib: lightly on the paper it moves, a trail of shaky ink behind it, the palsied line of a snail. As if it were cold, that line, the way it trembled. The way our whippets shake outside in the snow.


“M . . . Y. . . My! You wrote ‘My!’ It’s very good!”

But it isn’t very good at all. The letters crippled and wretched as if each one of them is afraid. She writes these lines:

My writing
looks like a drunken crane fly
stepped in the inkpot.

And then, one night, Dad is cutting up her brussels sprouts.

“I’m going to get my driver’s license!” She says.

Eyes raised over mealy potatoes from the can, sodden veg slick with butter and salt, soft French bread.

No one can watch us. The neighbors aren’t home. Morning bleak as twilight, a storm that smells of copper pennies. The car keeps on, I can’t get out. Through the traffic, through the rain, ever closer. My face against the glass, damp breath clouds up and recedes. Outside, the blur of London, a gesture painted with a brush, a sweep of white-gray smudges, buildings and monuments, marble, emerald-green ivy leaves clambering up red brick walls like soldiers clambering over an obstacle course; wet pavement, black, shocked and jagged with red-yellow light from the traffic, a tornado of pigeons clattering up. I chose a raindrop, and follow its jittery path down the windowpane. It meets with other raindrops, quivers into them and is gone. My broken heart.

Prostheses. Such a word.

Dad parks. The clinking metal of our seatbelts unbuckling, the dull unsticking of the doors, umbrellas flapping, the wings of frightened crows. So many nights without sleep. Every sound too bright to bear. Too much, just too much. And here we were, outmatched by the brightness, feet squeaking, high-gloss linoleum, fluorescent lights above, cruel-white, jingle-jangle.

I stand beside her as she sits at a table, hair smelling ever so slightly of cigarettes, her neck perfumed. Violets. Just perfectly herself. My comfort. Peter on her other side, alert, at heel, child-guard at palace door.

“It will be challenging,” says the doctor, “since the amputation’s so high, and the stump’s fairly small.”

The stump. Poor, sweet, sad little thing wrapped up in a white cap like you might put on a newborn.

“But, here, see what you think of this. It’s less functional, and more realistic-looking. More aesthetic, for going out and such.”

Puts it in front of her at the table.

That undead thing. A jointed tube of plastic polymer, a hand attached to its wrist, a rubber hand, humanesque, textured flesh and fingernail beds. Fingernail beds. The tiny pits and nooks for pores and hairs. Saw off a piece of person, replace it with a bit of plastic. Mum’s hand looks nothing like this. Don’t they care? Hers eggshell-pale, soft and white, elegant nails, fine blue veins below, the layering hues of Pre-Raphaelites. I know the width and color and weight of her hand. This abomination.

She picks it up, turns it over.

Her touch makes it all the more evil. Panic washes through me, the panic from the shopping center when I lost her grip in a crowd, and then, reaching, found it again, grasping it with all my heart only to look up and see the face of a stranger.

Another arm, another, lined up along the table, broken pieces of person.

“Now, this one’s the most functional,” says the doctor, “most useful for gripping—for, uh, driving, let’s say, and manipulating objects.”

A nightmare of a thing. Jointed, brutal, mechanical. Metal, wood, pulleys and levers. And where the hand should meet the wrist, come two long, hook-like pincers. Evil, glinting. Doesn’t this doctor have a mother of his own?

Pincers come together and apart like glistening claws. Silver hooks that snap and clutch for a screaming child in its most terrifying dreams. Her brushing my hair after my bath as I sit at her knees on a little stepstool, her hands warm and safe on my neck, on my shoulders, the damp smell of soap around us both, the care she takes sorting out the curls.

“Well! It’s not terribly pretty, is it?” she says.

“It’s like Captain Hook’s hook,” says Peter.

“Do you have parrots?” she asks the doctor.

Picking it up, moving it, putting it down again.

“I mean, I will need something like this, though.” She looks at Dad, then the doctor. “You see, I’m going to be learning to drive.”

She touches the silver tips of the hooks, runs her fingers along their edges. And pauses for a moment—we watch—she bows her head, thoughtful, rests her hand upon the metal, lightly, as if it were the arm of a friend. We watch. But her silence and her stillness. We noticed she is asleep, swept away by the lull of the morphine.

Dad and the doctor exchange a look. The doctor purses his lips. Dad nods.

It’s all a dream. They both know it, and now I know it, too—she will not sell her photographs, or return to university to study poetry, Victorian literature, and the Pre-Raphaelite brotherhood, she will not learn to drive a car, to pass her test, to ferry us to school. Yet she will plan these things, and we will discuss them so we never have to think about what will happen next.

Shortening days, the shadow of the wheelchair in the hall.

There’s Peter. Pale and chubby, dark-haired, one blackened front tooth that refuses to fall out. Nine-year-old fixer of things not broken, breaker of things already fixed in order that he can learn how they work and fix them again.

He digs around in the playroom for supplies, sorting through the cupboard under the stairs, lays out his findings across the dining room table. Out of balsa wood and string he constructs a prosthetic arm. Like one of those punch guns that shoots out a fist when you pulled the trigger, a crisscross latticework attached to a string. Pull it and a cardboard hand extends forward, cut out and reinforced from the side of a box of Rice Krispies.

And me. Lingering around him as he works, leaning too close over his shoulder, poking at this and that. I want to ruin it, discourage him, accidentally crush it or spill the glue. Yet still curious to see how it will work.

Meticulous, serious, he positions the wood and cardboard just so, waits for it to dry. And then I follow him up the stairs to Mum and Dad’s room, where he clambers up onto her bed to present it.

Pilled bottles lined up like tombstones.

She props herself to sitting, looks at his creation, and draws him close. Look how thin she is.

“It’s brilliant, Peter!” she says, “It’s just so clever, it really is. I can’t believe you made this for me! It’s just perfect!” she says, and she kisses him over and over again, buries her nose into his hair and draws a deep breath.

But it isn’t perfect. None of it is.

I can’t understand why he made such a thing, and why he would go up and give it to her. I can’t understand why she seems so moved by it, why she pulls him close and holds him tight.

When I come back here to this place, I am recast. I play the role of mother now, the scent of my child, a sweetness sickened by the shadow of loss. The constant threat of the body, an undiagnosed future: that I might ever be sawed up, like her, that I should die in pieces.

Or worse, that they should leave me first.

At this moment I am in the emergency room, yet again, my toddler on my lap, attached to the nebulizer. Chest x-ray, steroids. He holds me tight. The radiologist examines the imaging. The worst part. We wait.

Three children, two asthmatic. My headless Irish granddad died of asthma in his thirties.

But he will be fine, and I know it because I have been here before, in this room, or that room, I know the names and faces of the staff. I know how to read the oxygen levels at home, interpret the crackles and wheezing and stridor, the intercostal and substernal retractions, the tracheal tug. I know when to use which steroid. When to get a taxi uptown. When to go fast.

Because of that first time.

Black night, yellow-red streetlights, fogged up windows of the cab, sick baby strapped into his car seat, Harlem, sleeping buildings post-rain, neon zigzagging across water-slicked streets. We stop at a light. We wait we wait we wait. And there is my own voice, fraught and reedy, loud enough for the cab driver to hear it, loud enough so he would hear and would just fucking go.

“You’ll be OK, little love, we’ll get you there. You’ll be OK. I’ve got you, I’ve got you, Mummy’s got you!” Hear me, goddamnit, hear my voice and drive faster!

Just a cold, some sneezes, a fever that passed. And we leave the rosy light of evening for the floodlit sterility of illness.

Shuttled through triage, straight to the ICU.

From nothing—a perennial nervousness that has travelled with me always like a curved spine—to here. Says the brain: You see? You were right to be afraid. All this time you were right to be afraid. It comes full circle, says the brain. You see?

Because there he is, my first and only baby. Without him I have no child. I am not a mother. They don’t even raise the crib bars high, because he can’t move, can’t roll, can’t stand. No syntax or sentences left. So many monitors, so small a body. All beeping, always beeping. Oxygen desats to 85, 84, 83, alarms scream, nurses right there. They feed a slim red tube down his nose into his lungs, suction him like a vacuum cleaner. The longest I’ve gone without nursing him. His fluids come through IVs.

Try something else, it’s not working. They swab his fat little arm with antiseptic, insert a heplock into his vein. Magnesium sulfate. The bright smell of alcohol washes over me. Dizzying.

You see how we come full circle?

Machinery everywhere. He’s swelling up! His face has swollen up! Quick, someone, please look at him! His eyes seem swollen shut! No, they say, he’s not swelling up, it’s just the way the CPAP is attached—the tight gauze band around his forehead, see? But his poor little eyes seem bruised and bloated. He doesn’t look like himself.

“Will he be OK?” I ask.

“He’s a very sick little boy,” they say.

“But—will he be OK?”

“We just have to get him through the night.”

NewYork-Presbyterian Children’s Hospital. My own gray face staring back at me in the bathroom mirror of the pediatric ICU. So that’s what it looks like, the face of a mother about to lose her baby. Thirty-four years old and empty. Fear that comes in waves, and never stops, fear like a brutal nausea, the sickness of impending loss. Of going home without him.

But he lives, he continues to live. He smiles and his face is her face, her generosity, her wisdom, her calm. Six years old, but somehow eternal.

At this moment, a February in New York, I am in the emergency room again with my youngest child. The x-rays for pneumonia are clear, discharge papers on their way. I have done this before, I will do this again.

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