Man with no nose

I am in the NIC–North Infirmary Command building today–from the name, you would think it was  a bustling tent-hub, efficiently run, filled with scurrying medics and jobs to be done. But, it isn’t. It is quiet here, even peaceful in a forgotten way. It reminds me of an abandoned Victorian orphanage or an insane asylum. The halls, five person wide, linoleum lined, are empty. Every heavy metal door is locked, opened with a medieval looking key that someone always has and someone else always has to find. This place is, in fact, an infirmary.  It is populated with hospital beds and inmates with amputated legs, inmates in wheelchairs, on dialysis, brittle diabetics, cancer victims, and, as a hold over to when it was a death sentence, a special ward for those afflicted with HIV. The dorms, spread across a football stadium of space, are cavernous. The whole place feels post-apocalyptic, but, at the same time, utterly normal. It is as if a nuclear bomb went off outside and everyone is dead, but the inhabitants never got the news, and just kept living their lives .

The man with no nose sits patiently on the exam table. He is about sixty, dough faced. In the place where his nose should be is a short stack of blood soaked gauze, held to his face with a piece of cloth tape. He tells me his story in measured tones. It is does not sound rehearsed, The facts are part of him. He has squamous cell cancer, it has spread. He has had surgeries, lots of them, but it keeps coming back. He had a PET scan. The tumor is behind his eye now, trying to go to his brain. He just had a biopsy, now it is constantly bleeding. He swallows the blood. It makes him nauseous. He tells me all this matter of factly, betraying a flicker of emotion only when I ask him if he has pain. Yes, excruciating he says. But even then his voice is  dulled, unwavering, as it must be. The facts are facts, but, he must be careful, the story, a thin tissue, is not yet healed to a scab.

The nurse pulls away the gauze. The man winces. She notices.  She is Russian-born, with a strong accent, competent but kind. She calls him “mister.” She tells him she will wet it and goes to fetch a bottle of water.  When she returns and the bandage is pulled back, neither of us gasp. His face looks as if it has been hit by a bomb, a bloody hole lies in its center. I have never seen this kind of thing before, but it does not disgust me. Nothing about bodies disgusts me anymore. This is what giving birth does to you, and getting old. I lean forward, and peer inside, slightly fascinated. It is a mangled cavern, and hard to make out features. He suggests that I might use a light. I thank him, and I do, but it doesn’t help. I do not know what I am seeing.

Later, when I have to examine another patient, the man gets off the stretcher, removing the white paper covering and pulling down a new sheet from the roll. You don’t have to do that, I say.  I do not say “you are going to die soon,” but he knows. “Son of a doctor,”  he replies with a smile. It makes as much sense as anything, so I nod. I could, perhaps, wink, but it is not a lie. Rather, we are making up a shared logic, a rubric for how we will go on. The hole is filled with this–  chit-chat, small talk, “good to meet you,” “goodbye.” They are everyday incantations for conjuring the illusion that it will be okay.

The profundity of this does not hit me until later. I can picture us now, the man, the Russian nurse and me, standing there, absolutely NOT horrified by the carnage. We are all looking at him, and he too, as if he were a statue in a museum. The Greek boy with no leg, a patrician woman missing an arm–something from antiquity, which,  through some miracle has survived. It is not time passing in the abstract that we see. It is a mystery–the mystery of how this man, now everyman and no man, can actually be. We are a little in awe. It is more sublime than any landscape. It is flesh we are honoring,  not sky or sea.   Jail is incomprehensible. But, right now, looking at him, no place on earth is home. This moment is transcendent and absolutely not transcendent, the way that death is.

I think about what it is to be human. How much of you could a cancer eat away, before you lost that honorific? A lot, I think. The body will fail, you will go to jail, the cancer make its way to your brain. All these things are true. In the face of it, we do not know what we ought to do. So we just stand there, all three of us: me, the Russian nurse and the man with no nose contemplating.

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