Horror and Wonder
by Clara Bosak-Schroeder
The day they installed my mother’s catheter was the day of her defeat. Mine too, as would be revealed in time. It still amazes me that such a small device could undo us both; could reveal the limits of care and point the way, for me at least, to a new sensibility.
A few days before the catheter, my father calls me and says, “come now.” My mother’s decline, held back by radiation and hope, has become precipitous. It is less than two months since her diagnosis and only one week until her death.
I make the long drive from Michigan to New York. It is fall, the beginning of my fifth year of graduate school, and the highway gives me some of the same peace as the ocean— an endless corridor of the colors of the sun. When I arrive, the driveway is empty of visitors and I hope the house will be too. I wander the rooms, touching my mother’s things, trying to sense whether she is sleeping. For a moment, I am enveloped in the silence and held by the cool white paint of the walls. What lies before me is a person I love in terrible pain, but also a set of problems. These I can confront.
She calls out from the middle bedroom. I come in and lie down next to her, spooning, and kiss her neck, rub the scar below her ear like a lucky stone. Her eyes are drowsy and I expect her to sleep again, but she surprises me, speaking suddenly and clearly for the first time, “Let’s take a bath.”
We stand in front of the mirror and she sponges herself slowly. I don’t touch her breasts, denied to me since childhood, hands and lips batted away, but am allowed to spread lotion on every other part of her. She needs a new nightgown, so I choose one, bright pink. And she says, I’m ready, and gets into the hospital bed, erected in the bedroom at the far end of the house. This was the master suite and it feels almost like a separate apartment, a separate world, a destination at the end of dark turnings. There at the juncture to the main house, she has arranged the oldest family photographs; their unsmiling faces made softer by the brown tones of a lost process.
That was a day of dignity because she chose it–she took to her bed, she graciously agreed that this part of her life was over. But several days later when the hospice nurse ordered a catheter, I could see her eyes shadow with real despair. Now no more pretense that this wasn’t her final illness, that she wouldn’t ever rise from this bed again. But also the catheter in particular— a symbol of total powerlessness, total inability to care for her private needs. The fear in her eyes and the relief in ours when the nurse suggested it—the moment when the balance of power shifted irrevocably to us, to making our lives more convenient.
Different nurses come, but the one who installs the catheter is young, maybe even younger than me: a cheerful brunette. As she circles the hospital bed she chats to me alone, my mother’s silence now taken for absence.
“That was very easy!” the nurse says. “As we get older, the urethra slips down and can be hard to find. But your mom’s is right where it should be.”
I take a hazy mental trip through my urinary system. I can’t quite picture this—the urethra seemed like a rather fixed thing—and what comes to mind (but this can’t possibly be right) is a dimmer switch, its knob falling imperceptibly downward. I read later that the nurse is describing urethral prolapse, or urethrocele. If the urethra isn’t well supported by surrounding musculature (as is common postpartum), it can fall into the vaginal wall and cause the opening of the urethra itself to fall downward.
I learn about the catheter the way I learn about her drug regimen, in a brief moment between one visitor and another, after consulting my father about our next meal and before fielding a phone call from my uncles, each vying to avoid the other as they schedule a final goodbye.
I don’t want to tell you what happens next.
What happens next is that I don’t change the catheter, I mean. I don’t clean it. I didn’t know. Maybe the nurse told one of us and we forgot, or maybe she forgot too, or thought it was self-evident, and so three days pass before she comes back and we realize what we have done. In that time, my mother slips beyond the reach of communication. She is uncomfortable and can’t tell us why; she shifts; she gestures. Was it the catheter? Or bed sores beginning? Was it the start of the pain that would, in those final days and hours, moan out of her in a horrifying rhythm, prompting one friend to suggest I “end” it? I have gone over these memories so often, they are hardly there now.
When I tentatively raise these feelings of guilt, my father says, “We did our best.” Among the myriad pains she suffered, this one did not stand out to him. But to me, there is something so pathetic about not being clean down there. And ironically, this feeling of sadness and shame that caused me so much guilt afterwards: this particular shame was what had caused me to fail her. Because although I was overwhelmed in those final days and perhaps not properly instructed, I know how attuned we were; how closely I was watching her body and trying to anticipate her needs, and I think I forgot about the catheter because at some level, deep down, I didn’t want to think of it. It was disgusting.
This, despite the fact that we had always entered bathrooms together, chatted there. Whoever needed to pee the most would go first saying, “I’m warming it up for you.” The other would comment on how long she was taking, how copious her flow, and together we evaluated the décor, often with malice. I would marvel again and again at her lack of underwear when I, like a leaky bucket, required panty liners every day. At home she sometimes went to the bathroom with the door open and I would wander in to ask a question, or say hello.
When she was dying, this pattern altered. My presence in the bathroom was no longer optional—a chance to connect—but instead a necessary aid to her growing weakness. Conversation ceased between us, and instead there was only her slow, determined struggle to sit, to stand, to wipe, and me watching, tensing to take over. Those were moments in which she was not embarrassed, I like to think, because we had unknowingly laid the groundwork for this encounter. Perhaps it helped that she was a very fastidious woman, so that her body had never seemed unclean to me. Or so I thought. I failed her terribly at the end, when my defenses were down. My disgust, buried or unacknowledged, obscured by a lifetime of easy intimacy, had a hidden cost.
Human beings experience horror and disgust for good reasons. Decay, disintegration, rotten food, feces: all of these pose dangers to survival. We are bodies composed of disgusting matter and we have evolved to evade this matter; I know I should forgive myself for an aversion hardwired. But disgust and horror have their opposite—wonder—and this emotion is just as powerful. Both wonder and horror feel like reactions beyond our control, beyond our responsibility, but this is an illusion. I have learned that we can urge ourselves towards wonder, away from horror, and back again, with the proper education. This, too, is a matter of our survival.
After failing my mother at the crucial moment, I take stock. I had thought I was a strong person, a conscientious person. I had thought I was in control of my mind; that I could exclude disgust by willing it, hold simultaneously the dying body and the person at its core. I learn instead that I am also a collection of involuntary responses. I do not want to be betrayed by these responses again. I decide to retrain.
***
Two years after my mother dies, I beg my friend Evan to see a fistulated cow. As a graduate student at Michigan’s land grant university, he teaches a lot of Agricultural majors; they assure him that if we come to the research center, we’ll find what I am looking for.
A fistula is a permanent hole between the outside of a body and the inside, or two inner parts. An anal fistula, for example, often forms at the site of an abscess: an infection of the anal gland. The gland is drained, but leaves behind its tunneled structure. The anus— itself a tunnel between outside and inside—develops side channels, tributaries. Fistulae can also be induced by injury (either accidental or deliberate), and sustained without pus or bleeding. In animal husbandry, the stomachs of cows and sheep are fistulated all the time, then plugged until their insides are needed.
It is such a quiet day; the spring blue of the sky stretching out like a road before us. I pick Evan up in town and at first, East Lansing looks a lot like Ann Arbor, or maybe Ypsilanti, its poorer neighbor. We pass Old College Field and the Red Cedar River, going far south until even the idea of the city has been forgotten. We arrive and stretch, stand still and allow the sun to bathe our faces. There are no other cars, neither cows nor people in sight, but finding signs for a self-tour, we obediently wind a path through the outbuildings and along fences; listening hard for mooing, but seeing only flies. I feel silly, dragging Evan on a goose chase for monsters. Too easy to just show up and expect satisfaction.
The main office is not on the tour, and who would keep cows in there? But we are out of options. I hold my breath and open the door, then lead us farther inside. We peer around corners and peek into locked rooms, searching for bells, signs, any indication that we should not be there. I am beginning to lose hope when we catch sight of a young man. He is hurrying between rooms, and doesn’t spare us a glance. “Excuse me!” I shout. “We’re looking for a fistulated cow!” And he points to a door and says, “Oh there are lots of them! There’s one right in here.”
The room he indicates looked like an office from the outside, but inside is fitted out like a barn. Instead of humans in cubicles, there are cows, each eating hay in a separate stall. The boy comes with us, enters the room, and lays his hands on a broad black-and-white shoulder; its hide interrupted by a graying rubber plug. He tells us about the fistula, how it’s put in and maintained; how sometimes the stomach needs to be reinflated. “Someone’s got a flat tire!” he says.
Face-to-face with my quarry, I am suddenly shy, tongue-tied. Evan helps me and asks, “I don’t suppose we can get any closer?”
“Sure,” he says, and ushers us into the stall. “Do you want me to try to get it off for you?” meaning the plug where skin used to be.
And Evan says “Yes, we’d like that very much.”
“The rumen is the biggest of the stomachs,” our guide says, “it holds fifty gallons.” I am nodding along to this explanation, which I have read before.
When he pauses I blurt out, “I guess you need gloves to touch inside?” (In pictures, the children are always gloved.)
“Nah,” he says, “there’s no acid—it won’t hurt you.” This hadn’t occurred to me; I was worried about the germs on my hands! Am I foolish to assume that the inside of a cow’s stomach is a safe space? That I am the foreign body? Later, I will look back on this moment and see something stirring. Fool or no, my senses are re-tuning themselves.
He is a beautiful specimen of a boy—blond-haired and blue-eyed, just about to graduate from college and easy in his confidence. “What do you do here?” I ask.
And he says, “I’ve done everything. I live here too, you know.” The wonders around him are mere background noise to a working life.
The fistula is high on the cow’s torso and smaller than I expected. It takes a lot of effort for him to unplug it, then we can see the hay roiling around inside, surging back and forth and up and down, oozing like a washer on high. It is greenish-yellow and smells grassy, bright. There is a lot of heat coming off it, like compost.
I don’t probe too deep and, looking back, I’m sorry; I hear you can feel the stomach squeeze you, far down. The majority of what I do feel is the hay; it is very warm and the liquid is nice and warm, like a bath when you first sink in. I wiggle my fingers until I can touch the stomach itself, and it is quite firm and a little nubbly, like carpet.
I rest one hand on the exterior of the cow, one hand on the interior, and measure the space between. Immediately afterwards, I will look for a bathroom, but the smell is like sex: no amount of soap can wash it off.
I am telling a group of friends about the fistula and the cow’s stillness through the whole thing—or not stillness, because she had been eating and just kept eating—and one of them interjects that we don’t know how the cow feels, when I say how comfortable she seemed.
“But we can’t know anything,” I say, about how they feel, while being milked, while being slaughtered, and there’s no reason to think that this is worse than everything else we do.”
“Exactly,” my friend says, still irritated.
The more I learn about fistulation, the more it concerns me, and yet I allowed myself to enjoy the consequences of what I would not choose, or do. The fistula (the hole itself) can leak, the cannula (the port) can become dirty and cracked, the animal’s appetite and condition can decline, lesions—wounds—are more or less expected. Animals are injured in this way so they can heal others whose grain and antibiotic-rich stomachs no longer produce the proper juices. The sick cow drinks the “rumen liquor” harvested from the fistula of the healthy cow. Transfaunation, it’s called: animals crossing bodies.
All I can say is that when I put my hand inside the fistulated cow, I feel pure delight. I feel myself changing to experience delight instead of disgust, wonder instead of horror.
***
After Mama’s death, after I see the cow, as I am in the final throes of my dissertation and preparing to try my luck on the academic job market, I find for the first time in my life that I am no longer hungry. Not just not hungry, but nauseated by food. I begin to lose weight, and at first this is a great pleasure. I am disgusted by my body and relish any chance to see it diminish. But as my bowel movements slow and become more painful I realize I should get myself checked out.
I don’t see the x-ray my doctor orders but I archive the image of her astonishment in my mind. “Poop up to here!” she says, tapping her hand to breastbone. “I’ve never seen someone so full.”
I like this doctor. I like how she expresses concern that I am losing so much weight instead of congratulating me. Her wonder is infectious, and I feel strangely proud of myself for the accumulation in my abdomen. I feel big in a good way, like a house with many rooms.
I survive this event. Several courses of laxatives flush me out, leaving nothing more than a new attention to my digestion. I become a custodian of fiber intake and feces output. I learn the Bristol Stool Chart by heart and linger over the toilet bowl, hunting and hoping for type four, the ideal, “like a smooth soft sausage or snake.”
In 1848, Dr. R.P. Harris of Philadelphia performed an autopsy on a young “lunatic” woman who died of feces buildup at the age of thirty-eight. In addition to chronic constipation, she lived with melancholy, hemorrhoids, and a leaky bladder—just like me. When she died and they excavated her body the matter inside was “as hard as brick clay is when ready for the mould.”
I wonder if my constipation is hereditary, a gift of my father, or an aftershock of my mother’s death. I am only eight years into my melancholy, while the lunatic woman lived twelve. What brought it on, I wonder? What did her parents think was going on? Were they surprised that the disorder of their daughter’s mind had physical presence; did they correlate her psychic and intestinal blockage?
For all I know, this young woman was perfectly aware of her danger; could sense, if not see by x-ray, her storage filling up. But in my imagination, her lunacy prevented this, her lunacy, in fact, consisted of this alienation from her own body; a turning away from the body and into the mind. I could have easily become her, I realize. My attitude of horror or wonder, of being disgusted or being amazed, applies to my own body as well. My own fate.
***
When my mother dies, my father and I aren’t in the room. It is easier, I’m told, to slip away if your loved one is elsewhere. Her co-workers come quickly to get us, but by the time we rush into the room it is already over. Her mouth, so long open and moaning, makes no sound. I laugh. I laugh in wonder to see death so close.
Then everything happens very quickly, and my plans to undress her slowly, wash her carefully, dress her again a final time with precision, with music, with prayers perhaps and also flowers, are all torn away. The nurse who comes to help is brisk and efficient, and how can I blame her? But I wince as we force the bird-like limbs into their final garb. The nurse removes the catheter and wipes my mother’s butt and comments on how little there is to clean. I am jealous then. But I don’t know how to say: I want to do that. That task is mine.
Clara Bosak-Schroeder (she/they) is a writer and academic in Champaign, IL. She has published creative nonfiction in Zone 3 and a scholarly book, Other Natures, with the University of California Press. You can follow their work on Twitter @thaumatic and on the web at theburningboy.com