Fang had stronger ties to China than I did and knew more people at the funeral. Born in Shanghai, he was raised by my parents until age six and then by my mother’s side—her own parents and siblings—after she and my father left for America. Common of many families at the time, that only the parents went first, and the phrase “it takes a village” has never sounded hyperbolic to me but the truth. Plan was to send for him sooner, but by accident I was born and a few more years had to pass. From Oakland, my parents and I moved to Kansas. Then one grandparent died, followed swiftly by the other. There was a day in Wichita when I didn’t know I had a sibling, and within twenty-four hours, an older brother appeared. To curious neighbors, he was simply a relative from China, visiting for a little while. Odd and obvious. A twelve-year-old boy who looked so much like my mother and half like me.
At Pudong, I went to the ticket counter to trade my first-class seat for coach. The airline clerk squinted and asked if this was what I really wanted. Once I switched to economy, I wouldn’t be able to switch back. The seats in economy didn’t recline into beds, I would be without L’Occitane kits and Veuve Clicquot, no more pretty flight attendant with white teeth.
Economy isn’t a good time, she said in English, and if I was doing this to experience poverty or connect with the masses, it wasn’t a well-conceived idea.
Clearly, she thought I was insane. While holding my blue US passport, she told her colleague beside her in Shanghainese that I probably had a disease. The colloquialism she used can be said in jest, can be well-meaning or serious. It means that something is not right about this person, that literally she has mismanaged one or two of her nerves.
The flight back was shorter, fourteen hours with a tailwind. In coach, I slept most of the way and woke up to find that I had missed both meal services included with the price. My father hated waste, so I asked the average-looking flight attendant with yellow teeth if I could have a snack.
You see, my father, I said to her, he would’ve been hungry, and I still need to respect his wishes.
She said not too happily that she would see what she could do.
Before landing, we hit a long stretch of turbulence that prevented anyone in coach from moving freely in the aisles. From a distance, she threw me a bag of apple slices and a shrug. The slices weren’t crisp but grainy and wet. Still, I ate them all and saved the bag.
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A COMMON CONFUSION IS between intensive and emergency care. The latter is chaotic, usually on the first floor near the ambulance drop-off, in a room without dividers or enough beds. Someone might scream, Doctor! and because no one answers, that person screams on. Intensive care is just the opposite. It’s the best care that a hospital can give, and the room is quiet except for machine sounds, alarms that go on and off.
Just as radiologists know their imaging, ICU doctors know machines, ones that push oxygen into you, the all-mighty vent; ones that clean your blood, dialysis; the pumps, aka drips, that deliver medication and sedation through a central line directly to the heart. With many machines come many tubes. The endotracheal tube down the throat and to the vent for air, the nasogastric tube to the stomach for food, rectal tubes for stool, a foley for the bladder, etc. Fluid control was imperative. Too much fluid in and the body would swell. Too much fluid out and it would desiccate.
At my interview three years ago, the director asked why I chose intensive care, and I said I liked the purity of it, the total sense of control. Machines can tell you things that the people attached to them can’t, I said. I liked that the sick didn’t stay with us long, but for the stint that they do, we give it our all.
A sprinter, I described myself. The idea of longitudinal care wasn’t for me.
My director praised my honesty and offered me the attending position right then. More so than any authority figure I’d met before, he seemed to believe in me and agreed with my point about machines. From then on I knew that we were a match.
In any specialty, an attending is expected to lead and guide her interns and residents along in their careers. To become an attending, I had trained for twelve years. The job was to teach machine readings, and a question I liked to ask was how is this patient interacting with her machine, what’s the dance there like? If a patient fought, machine and patient became dyssynchronous. If they danced, the two were synchronous. Usually, the patient fought. Our innate drives to breathe and to dance alone are strong.
I taught on average three to five hours a day; the other hours were spent supervising. Procedures that I did in half the time pre-attending, I watched someone else do in double. If learning required mistakes, then teaching required watching different people make the same mistakes. Teaching was relentless déjà vu but grounding. It cemented the idea that we are all the same—height and weight did not matter, and the possibility of failure （or success） for anyone was never too far off.