Grief is the virus
that surges and retreats
without cure.

It lingers dormant
in the dark recesses
of memory.

Tears are the vector
that spread its contagion
among us.

It seems I’ve beat it
then there’s a welling up
in my throat.

I feel the tremor
and then a convulsion
that chokes me.

There is something sharp
tugging like a barbed hook
of regret.

I can’t escape when
every cell remembers
how things were.

At some point I will let go

Pain meds wore off around 4:30 am. Inched out of bed.

Stepped out into the courtyard to gaze at a brilliant tapestry of Winter stars. Caught the lingering sweetness of night blooming jasmine from the garden. Made a cup of ginger tea.

Turned on BBC, caught up on e-mail from the US for a couple of hours. Medicated, meditated. Back to bed for an hour.

Woke to the sound of squeaky kid’s shoes worn by Nam’s one-year old nephew as he toddled after the dog. Cooking smells. Got up again. Slowly.

Two young cousins batted my swiss ball around the pool. Nam’s aunts and parents chatted around the table. Good morning’s in Thai and English. Sunlight flooded the kitchen.

Bacon & eggs, fresh papaya, hot cocoa.

Opened e-birthday cards. Kissed Nam as she came out. Kissed her some more.

Serenaded with Happy Birthday by my Thai family. Presented with a bouquet of roses. First time in my life to be given flowers. Brushed my teeth. Cried.

Piled into two cars. Went the village temple where a monk performed a brief blessing for Nat. Gave him a shrink-wrapped plastic bucket filled with a bag of washing powder, instant ramen noodles, toothpaste, a jar of ovaltine and a rolled up hand towel. He seemed pleased.

Back into the cars. Lunch. Homemade sausage, coconut curry, noodles.

Family headed back to Bangkok. Seven hours driving. Mom & Dad hugged me and told me how much they loved me as a son. And how proud the whole family was. Couldn’t think of what to say. Held them tighter.

Went with Nam to the district registrar’s office to apply for Nat’s death certificate. A local farm couple waited on the bench beside us. Each held a perfect newborn twin girl.

Went to the hospital to pay the balance of our medical bills. In cash. Had a follow-up blood test. Cholesterol too low, otherwise fine. Doctor removed two sutures from my liver drain incision & changed all my dressing. Told me to eat more eggs. Like 4 eggs per day. Asked him if it was worth raising several chickens. Took him a second to get it.

Went to the market with Nam. Admired her Bodhisattva-like composure as she drove, taking calls from friends who hadn’t heard about Nat.

Rimping supermarket. Just the essentials. And a one litre tub of Cherry Garcia. For the first time I let the bag boy carry our stuff out to the car.

Home to change before heading back out for Italian. Played with our dog Maggie while Nam smoked a cigarette in the garden. Remembered that she hadn’t smoked in over a year. Happy to see how much she now enjoyed it.

Garlic pasta at Giorgio. Nam had the t-bone steak but gave half to me.

Back home. Nam expertly changed my dressing. Thoroughly enjoyed a sponge bath. Wrote this diary in bed as Nam drifted off. I soon followed.

Postscript:

Dreamed of flying low over the Andaman Sea. For hours.

In the fog of first awakening from surgery, I recall seeing a masked ICU attendant hovering above me. “When does the operation start?” I croaked.
“The surgery already finished.” Said the attendant, writing down something on a metal clipboard. “It’s 5pm, everything goes smoothly.” I smiled big, both for Nat and at having no recallection of how the last 8 hours passed. I remember telling him my shoulders hurt when he asked me how I felt. “I will give you something for that,” he assured.

The transplant had gone perfectly and my liver was already working in Nat with no sign of rejection. My wife later told me the baby’s skin had begun to return to pink for the first time since she was born, her eyes white again. She was stable and I drifted off peacefully as the drugs began to course through me.

The next time I awoke, I was in a hospital room with the surgeon who told me that everything looked good for both of us, though Nat’s frailty meant she was not out of danger. When he asked, I told him I felt fine, though I could feel something stuck in my throat that made me hoarse. I slept as attendants came in and out to monitor me.

The next afternoon ICU doctors noticed Natalie had some cranial swelling and ordered a CT scan which revealed a small burst blood vessel in her brain, so a neurosurgeon came in to stem the bleed and relieve pressure. Despite maximum dosages of coagulation drugs, her brain continued to swell to the point where her skull needed to be opened to allow it to expand. But as it did, pressure on her brain stem caused a seizure, and within hours she fell into coma. By late the next morning her doctors declared her brain dead.

With no humane options at this point, Nam and I decided to disconnect her from life support and to prepare her organs for donation.

There’s no way to sound the depth of our grief from losing Natalie, who despite her illness, was the most joyful little person. I know now that she was just visiting, teaching me how to be a selfless father and nothing we did could get her to stay longer.

For those of you who cared for her, we are grateful and hopeful that Nat’s passing will bring new blessings to our family.

The next journey begins

Oh Compassionate Ones, you who possess the wisdom of understanding
The love of compassion, the power of doing divine deeds
And of protecting in incomprehensible measure, Natalie is passing from this world to the next.
She is taking a great leap
The light of this world has faded for her
She has entered solitude with their karmic forces
She has gone into a vast silence
She is borne away by the great ocean of birth and death.
Oh Compassionate Ones, protect Natalie who is defenseless
Be to her like a mother and father
– a Buddhist prayer for the dead

It all started in the womb apparently;
A random confusion of signals
That triggered the cellular mutiny.

Jaundice was the warning
And then pain that brought
Howling fits late into the night.

Don’t blame yourself, the doctor told us;
This condition arises without clear cause
And is as rare as a Tahitian black pearl.

Somewhere in an entanglement of code
When the errant command is given to attack,
The body complies without question.

It starts as fibrosis in the liver;
Bile pooling and poisoning the blood,
Turning white eyes a ghoulish yellow.

The belly swells and limbs shrink as
The body slowly starves. Mother’s milk
Will not save her.

I learn the language of disease;
Lymphocytes, atresia, bilirubin,
But they don’t help me understand.

Now begins the countdown to rescue
And I will be there next to her,
Silently guiding her home.

Hold on, baby

Natalie will undergo an emergency liver transplant on December 8th at Suandok Hospital, Chiang Mai Thailand. The 12 to 14-hour operation will involve over 30 medical staff and will make Natalie the youngest child to receive a transplant in Northern Thailand. Her father will be the living donor.

Blood knows what it knows.
It talks to itself all night, like a sliding moonlit sea
– Anthony Hecht

After our baby’s recent Kasai procedure (liver duct bypass surgery), my wife and I are optimistic about her chances of full recovery. While we love seeing Nat as her active and cheerful self these days, we also know that there’s a strong likelihood that she will soon need a liver transplant. While most people would look upon this as a catastrophic, I feel a sense of serenity. It’s as if I waded out into a violent surf, was knocked down, tossed around pulled out into the calm beyond the breaking waves, where I can now contemplate the nature of the ocean without drowning in it. (more…)

When most of us think of success, it’s about the things we have accumulated; knowledge, money, seniority and achievements. We derive our satisfaction and happiness from these things based on how favorably they compare to cultural measures. I think about success in terms of who I am becoming, and for me to become the person I envision myself to be, ultimately, my measure of success has as much to do with achievement as it does with what I give up. Wisdom does not come from what we have gained; it comes from what we have lost. (more…)

Physics dictates that we do not feel speed. It is only our perception of acceleration and deceleration that give us any indication of our relative velocity. Here we all are, hurtling through the universe but we feel as if we’re standing still. So it’s not at all strange that as our lives gain a certain momentum, we become increasingly complacent. In our rush of daily activity, it’s easy to forget that this momentum is our own creation. When we allow ourselves to slow, things come into focus. At a dead stop, we realize just how beautiful each moment truly is. (more…)