Nonfiction

     We notice the brown spots first. Dried blood stains dotting our blankets and sheets, mystery droplets left overnight. I was the one to notice the black scap. Cast over one of the many soft pink fat deposits on Max’s belly, this was something different.

     The brown marks hadn’t stopped appearing, so Mom, freshly grieving her father’s loss, took Max to the vet, and this evidence of a cut was the only thing we had to go off of. At home, I prayed to anything to let Max be okay. Not another loss for Mom, I thought, because it had only been a month. Because Max slept beside Mom, nestled up beneath her comforter. And because, at best, Max and I were co-inhabitants. He sometimes slept in my bed if no one else was home or if my plush white blanket was folded neatly on top. He never kissed my face or gave me licks, even when I came home from school or vacation. But he let me sit next to him on the couch, liked when I rubbed his belly. We were known to lay out on the kitchen room floor by the sliding glass door when that first hint of sunlight shone through a winter day. But I knew he liked me the least, and I was fine with that.

     Hudson, my eldest younger brother, has a special bond with Max. They could look into each other’s eyes and communicate; I’d seen it. When Hudson left for college for the first time, Max was the last one he said goodbye to. He knelt down to the dog’s level, placed his hands over Max’s ears, and stared deeply at him. I love you, he said, bringing his forehead to touch Max’s.

     Max liked to wrap himself up in Hudson’s blankets when he was away at college, like now. He had been away for Grandpa, too.

     The vet takes Max’s blood and discovers his platelet count is dangerously low. They’re not sure why but it means that when he got cut, the wound was unable to begin the healing process. In other words, he had been bleeding internally. Much like, ironically, when Hudson’s wisdom teeth were removed and he spent three days falling asleep at home, tasting blood when he swallowed, returning to the hospital, and having the sores cauterised yet again.

     The boy and his dog: their blood was too thin, and wouldn’t clot.

     My Grandpa’s blood: found first in his kidneys.

      Grandpa gets sick for the first time in August of 2019. I’m away in Westchester with my boyfriend, finishing up an internship at a magazine there. I’m living with my Grandma, his ex-wife, and Grandpa Andy, his ex-best friend. I wake up to a call from my Mom.

      “Grandpa is being taken to the hospital, and I’m following the ambulance.”

      “What happened?”

       “He was hallucinating again, but this time he was up at 4 a.m., walking around the halls and yelling at some general he was seeing. Tim, the guy in the front office? Yeah, he called me and kept calling me. I didn’t see it until 6 a.m. when I woke up to get Zach ready for school.”

       “What’s going to happen?”

       A pause. A haggard sigh. I regret asking it as soon as I hear her response.

       “Jess, I don’t know. Just go to work this morning, and I’ll update you when I can, okay?”

       Jonny walks out of the bathroom to find me sat, half-dressed, on our bed, still gripping the phone to my ear. He asks what happened, and I tell him, falling into his chest as he comes to sit beside me. I start crying a heaving sob, and he keeps holding me, his arms wrapped around my body. When I’m able to control myself, he props me up against the pillows and searches for my work pants, finds them crumpled in the dresser. He places them gently by me, rubs my back as I shimmy them on without getting off the bed. Jonny walks through the whole routine with me because I’m fragile, because I might break again at any moment.

       But, like always, I do as I’m told. I arrive late to work and don’t tell anyone what’s going on. Not like we talk much anyway. I sit down at my empty desk and open tabs for research. For the first time this whole internship, I put headphones in and listen to music. I get up every half-hour to walk outside because if I stay here, among the dying spider plants and computer screens, as my entire life is swirling around me, and no one has any clue what is going on, and they all get to go about their days like everything is normal and no one they love is dying, and then I will scream.

       I walk out to the parking lot and stand below the stairs. I look out over the cars. I try to reach my mom each time, but she doesn’t always answer. When she does, I try to get answers out of her that she doesn’t have.

       “We’re waiting to find out.”

       “They took him in for blood tests.”

       “Aunt Michele is coming.”

       I just want her to tell me if he’s going to die. I want my mother to tell me if her father is going to die. But she can’t.

       That night I decide I’m going home. Jonny drives me to the train station the next morning, and I cry into his arms again. We hug until I really have to leave, and I get on the six-hour train ride with my phone, a needlepoint app, and my Dramamine.

​

       We’re still in the midst of the pandemic, so Mom wakes up early each morning to drop Max off at his vet. She waits for him in the car as he gets poked and prodded. After his blood has been tested, they bring him outside to her where they run over the news, if there is any. For the past few days, things have been consistent: his blood platelet count is going up consistently and holding, stay on prednisone and steroid. Every morning and night before he eats.

       Mom is thrilled Max is getting better, but hates the pills she has to force through his mouth, past his teeth, down his throat. He’s mastered the art of wrangling the cheese or ham from around the pill and leaving the white capsule on the ground, defeated. I’m not convinced it’s because he hates the pills. No, I think he’s just figured out we will keep trying, with more and more ham or turkey or cheese, until he swallows it.

       Dinner often falls to my jurisdiction when I’m taxed with heating up whatever elaborate meal Mom made for Max tonight. When he gets sick, even just a small stomach ache, we can always tell because he won’t eat his dog food. Tonight I’m making him pork chops with rice.

       I make the boil-in-a-bag kind of rice and let it cool down. I then chop up the meat into small pieces and mix it all, with his separate hip medicine, in a white porcelain bowl. Maizie, our smaller dog, gets a small sprinkle of rice in her food so she doesn’t feel left out.

       Somehow, my Dad had known Max was really sick this time around. He kept saying Max is acting weird, and we kept waving him off, just saying he was tired or it was his regular upset tummy from getting in the trash. Because Max didn’t act incredibly off, even as his platelets disappeared somewhere within his body. It was Dad who pushed us to take him to the vet, and it was him now saying Max shouldn’t be eating pork chops.

       But he ate them and eventually graduated to rice and pork chops and dry food, before waning off the fresh food entirely. The pills kept coming, though, and we soon realised they may never stop. If we wanted Max alive, wanted his platelets stabilizing, then the medicine would stay.

       When I get home, I go straight to the hospital. My Aunt is there, too, and together, we all pile into his room in the Intensive Care Unit. My grandfather hated it at the ICU. Of course, he would. He didn’t trust the doctors or nurses and took his own notes in a nearly illegible, scrawled script to keep track of what drugs he was being prescribed and when. If a nurse brought in something new, he would show her the notes and refuse to take the pills until someone confirmed it was correct. This habit carried on into the nursing home as well.

       We hold his hand and make small talk. To pass the time, we keep a keen lookout for the handsome cardiatric doctor handling my grandfather. My mom and aunt like this guy a lot more than the original ICU doctor, who was “all doomsday,” according to my mom. This one is a tall, thin Indian man who appears out of nowhere, striding into the room like a beacon of sunlight even as we inch closer to midnight. Whenever I’m not there, my aunt sends me updates and sneaks photos of him checking on grandpa.

       He says grandpa will need heart surgery, or rather should have heart surgery. Two things stand in the way: one, that my grandfather’s heart, at this point, simply can’t handle the strain and would not survive it, and two, that my grandfather vehemently disapproves of surgery.

       Mom keeps trying to tell him it isn’t even on the table. That’s how serious this is. So far, the swelling in his shins has gone down and the nurses who check his vitals on the clock seem pleased with how the numbers have reacted.

       He keeps taking the concoction of pills and, by the next day, stabilizes enough to be discharged. But he can’t go home, a truth he keeps attempting to fight. Even though I can tell he’s relenting, in his own way, to his situation. Instead, we move him into a nice nursing home in Livingston County, about forty-five minutes away, but my Mom works with them and trusts the nurses. We can tell he likes it there, even as he keeps his stubborn character and pill-taking notes. They let him garden in the planters when the weather’s nice; his favorite nurse there brings in new seedlings every morning. We visit him, and I come wearing my graduation gown. He texts me almost every day about new shows he’s watching or with garden updates. It’s nice, comfortable. I almost forget he’s still a man whose heart is failing.

       The second time Max gets sick, I’m away at school when my parents call me from the car. Max is incontinent, Dad says. I ask what they mean. He can’t hold his bladder. We’ve woken up to diarrhea in the room twice now, and he keeps getting sick. Again, I pray to something. I ask if he got into the trash, as he’s known to do, and they’re adamant he hasn’t. And his pee, his shit, it all has blood in it. This time, I want to make it home before he dies. That was the way we were talking, then, like he would die. Like there was no way he couldn’t die.

       When I get home, I sit next to him on the couch. He doesn’t move. Just slow breaths I can only sense by the movement of his chest. We gather the soft blankets up around him to rest on the couch. Mom had been weaning him off the prednisone herself before this happened, not happy to have Max living from pill to pill. She felt like she was depriving him of something. But now, as per the vet’s orders, we go back to his original dose to see if that will help handle the blood coming out of him.

       He isn’t eating, his pee is bright red from blood, we carry him up the stairs. Every morning I sit with Max on the floor, hand feed him slices of ham, spoon up cold rice and scrambled eggs into my palm, and lay it flat in front of his nose. Slowly, his soft tongue licks my hand clean. When I take him outside, I crouch down and watch his stream of piss, hoping for clear. I’ve convinced myself that he’s just getting rid of all the blood stuck in his body, from the low platelets and lack of clots, from the first time he got sick.

       I can tell Mom is nearly resigned to the idea of putting him down. He can’t keep living like this, she says. I make Mom promise me she’ll wait, and give him more time. He’s not himself, he’s in pain, she keeps repeating. And I know, I know he is. But I feel in my bones that if we give him just a few more days that he can pull through this. A broken record with no medical background, I repeat: It’s the blood from before, he’s just passing it through. All that blood had to go somewhere, right? Now it’s leaving.

       I return to my spot on the couch beside his body. He doesn’t stir, which is unusual. He doesn’t push his back legs against my thigh, either pushing me away or stretching out against me. I’ve never been sure. Instead, he keeps breathing deep, almost ragged breaths. Let’s watch some t.v.v., Max. What are you in the mood for?

​

       When Grandpa gets sick for the second time, they find tumors in his kidney. My initial reaction is, of course, disbelief, but because I am unable to understand how they went unnoticed this long. Where were they the first time he got sick? They couldn’t have just shown up in a year, could they? This prolific and pronounced? That seems like the work of silent, persistent years.

       “He made his decision,” dad says.

       And now they have to make one again. I know what will happen before they tell me. I know he won’t do chemotherapy.

       I know he wouldn’t have them removed if his body could handle the procedure. I know he doesn’t want the tests and the pills and the pain and the appointments and the doctors and the hospital visits. I know there’s nothing to do now but wait, and I am so scared for him because I know he must be terrified. Because I know his biggest fear is dying, just like mine, and I can’t bare to think about how he’s feeling. This grown man, my grandfather, reduced to sickness and fear and no-other-options.

       They take him off his medicine. Mom comes home. She’s an absolute mess, and I wasn’t expecting it. When my dad’s parents died, especially my Nana, who she was so close with, closer than she was with her own mother, my mom was a rock. I never saw her cry. And if I did, they were soft cries. Now, she comes home and sobs into my dad. Deep, heaving groans that I once mistake for laughs because they are so guttural. She puts on her black pajama pants and lays on the couch, wraps blankets around her. The dogs never leave her.

       It has happened so much faster than we thought, but we know that’s better. Easier. “He lived how he wanted to,” Dad says. “He didn’t want the doctors and the medications,” I say. “We can’t force him. He’s done everything the way he’s wanted to.”

       I can see my mom hurtling down country roads, moving through those forty-five minutes a ghost of herself. She used to come to this nursing home for work; now, muscle memory takes over. She passes the farm stand with fresh flowers and tomatoes and eggs that we used to stop at. Passes the horse farms. Passes through the town, past the burger joint we took grandpa to once before the pandemic started.

       I’m home because we can’t go see him. Because I think it’s better for us not to. But I feel stuck and helpless. I sit outside, let the bright sun beat down on my face. Sweat pools under my turtleneck, and I let it. For the first time of many, I send him a text message I don’t expect him to answer to, perhaps even know he won’t. But I just need to do something.

       “I love you, grandpa.”

       A beat. Six minutes pass. An eternity.

       “I love you, topp.”

       Max slowly gets better. He starts passing clots as he pees, and the remaining stream is a bright, healthy yellow. I feel unnecessarily proud that I was right in some way. That he just had blood in his system that was taking up space and needed to leave. The pills start working again. He makes his way up the stairs; slowly, yes, but he stops falling. His legs stay beneath him. We move the mat from the stair’s base.

       Grandpa passes away on August 23, a day before Hudson’s birthday. Mom wakes me up by sitting at the edge of my bed, and I know before she even says the words. This is how she always tells me bad news: like when Dad’s father fell for the first time, or when our dog before Max was put down.

       I sit up in bed and hold Mom. Surprisingly, I’m not crying. I move downstairs slowly, and sit on the couch beside Max slowly. Everything feels like moving through molasses. We’re all in the room: Hudson, Zachary, Mom, Dad, the dogs. Max scoots over on the plush blanket as if to say he sees me and wants me to share in what has soothed him. I lay my hand on his velvet nose and let the other rest by Mom’s side.

Jessica L. Pavia is an M.F.A. candidate in Sarah Lawrence College's writing program. She lives in Rochester, NY with her dogs and family. Her work has appeared in The Sheepshead Review and Barzakh Magazine.