"My objective is to continue living"

This is something that hasn't stopped tripping me out: Periodically, I'll call my Tia L's cell phone, and when she answers it, I learn she's in the hospital.

That happened most recently when I called on Dec. 27, after I had been unable to reach her or my uncle, El Capitan, on Christmas. Tia L has a rare form of lymphatic cancer and has been hospitalized a couple times. Sometimes, she's in the hospital because she's getting chemo. Other times, she's there because the lymphoma has rendered her immune system too fragile and she gets sick.

When I called today, I learned she's in the ICU. That tripped me out. I mean, who answers their cell phone in the ICU? Because of the tremendous amounts of telemitry equipment in your typical ICU, they normally don't allow cell phone usage. But Tia L had hers on, and she talked to me for nearly an hour on it.

It seems she has been in the hospital without intermission since our conversation in December. She's been in the ICU for the past five days because she has become critically ill. On Friday night, while I was out dining with friends, one of them -- I think it was Bubba -- inquired about Tia L's health. While that conversation was going down, Tia L was battling a fever of 106.8, with "bone-rattling chills," that caused so much shaking that she began to hyperventilate.

"The fever was bad enough," she said. "I was freezing and they were covering me in ice packs, but the part where I couldn't breathe really annoyed me. I said, 'This just sucks.' "

She's always practiced the art of the understatement.

A month ago, she told me she thought she would be trying a new form of chemo, but her doctors disagree over whether it would help and whether she is strong enough to take it, so the past month in the hospital has been all about treating various symptoms while doing nothing about the cancer itself. She's frustrated and trying to figure out how to get the chemo, which is her shot at surviving.

"The insurance lady came in the other day and said, 'What's the plan?' And I told her, 'Staying alive.' "

Well, under the circumstances, there is no Plan B, I told her. I'd prefer if you stuck with Plan A.

"Yeah, yeah. Plan A," she replied. "You're right. There is no Plan B."

Then she added, "When you're in the hospital for like 7 or 10 days, after you get out, everything in the world is so *beautiful.* When the only thing you have to look at is four walls all day and night, you start to forget what the outside world looks like. Before I ended up in the ICU, I could at least go down to the end of the hall. The hospital has a lanai at the end of each hallway, and I could sit out there and look at the buildings. Oahu is a lot like Miami; there are all these skyscrapers, but in between them, from up high, you can look down and see the old buildings. I like those the most, especially the ones with the Spanish tiles. But in here, they won't let me get up because they've got all this shit stuck to me, and the only think I can see is all this equipment."

During the conversation, I kept hearing the equipment beeping and buzzing. The nurse came in, and Tia L paused the conversation with me to ask some questions about a CT scan she was having this afternoon. To me, she said, "I'm really hungry, and it's hard to get food in the ICU because most of the people are on feeding tubes. So it bugs me when they bring me something to eat but then won't let me eat it. I'm afraid someone's going to come take it away before I get back from the test."

Being in the hospital creates a whole different reality, a strange set of concerns. "I've been here so long," Tia L said, "that I'm starting to get all institutionalized. It's making me crazy."

That isn't easy for anyone, but I think it's especially hard for Tia L. Not only has she been a highly energetic, motivated person for most of her life, but when she served in the Peace Corps many years ago, she ended up transforming the experience of patients who were locked away in a Third World mental hospital. She knows the negative effects of institutionalization, and it's a pet peeve, to say the least.

For a while, though, our conversation turned to things outside of the hospital. I told her about my trip over the holidays. We talked about the upcoming wedding of one of my cousins. And I inquired whether El Capitan had finally sold a shuttle bus he had acquired when he thought he was going to start an adventure tourism company (before Tia L was diagnosed with lymphoma). She said he had. We also talked about The Notorious M.O.M., El Capitan's sister, and her decision to go to Kona later this week for some sight-seeing -- and how Tia L is wondering if some of that sight-seeing might happen on Oahu.

From a family-support standpoint, that's one really fucked up part of this story. Because the Big Island of Hawaii does not have adequate medical care, Tia L is in a hospital on Oahu. That means that El Capitan and my cousins have to take a flight to visit her in the hospital, so she is spending a lot of time without the presense of her family, with whom she is very close. It is a stress on all of them, coming and going. (Frankly, I can't imagine The Notorious M.O.M. would not make the flight to Oahu, but then, the depth of her emotional ineptitude never ceases to surprise me.)

Anyway ... yikes!

I was not expecting *any* of this when I called. I thought perhaps she might be back in Kona and perhaps getting chemo. Instead, she was telling me she had signed a DNR order, much to the dismay of my cousins.

Several hours after I hung up the phone, I felt the weight of anxiety settling in for a visit, but I was having difficulty determining why.

I talked to S2, who always finds her way to the heart of a matter. "You know, with all the things you've been thinking lately about attachment," she said, "I guess I want to tell you not to underestimate the power of this particular relationship. This one is huge."

When she said that, it felt like a thousand images of my life with Tia L flashed through my mind in an instant. My Christmas stocking. Peppermint tea on the counter. Mask-making. Mardi Gras parades. Chicory coffee. A sweat lodge with eucalyptus water. An old Suburban. Cathy Bell at the kitchen table. The sailboats. The conversations. Crawfish etoufee. The sleigh bed that inspired my own. Crab meat crepes. Dancing at Tipatinas. Showing my knockers on Bourbon Street. Portraits of my ancestors on the walls. The bouncing check I gave her once. Haircuts. Both of us in black evening gowns on New Years Eve. The fierce light of her eyes. All the hugs and kisses. The endless hugs and kisses.

It was a like a flash flood, the way it came upon me. She was a significant source of warm, unconditional maternal love that sustained me through adolescence and college.

And then, for 14 years, nothing. She and El Capitan set sail to South America for a couple years, and we lost touch. We reconnected in May of 2005, and things resumed as if they had never stopped.

I suppose it's because in some ways, they never did stop. Tia L is one of those people I have carried around inside me since the day I met her. Death, no matter how crushing, won't take that away.

As I fine-tune the voices in my head, hers is one I should turn up a lot louder. It has always been about love. For me. For others. For adventure. For life itself.

"My objective," she told me today, "is to continue living."