by Vincen Gregory Yu

My father’s eyes, wide open, glistened like black buttons. Doll’s eyes, my mother called them: a pair of pearls glued to alien sockets. A week ago, we’d rushed him to the emergency room. He had vomited fresh blood again, barely a day since coming home from his third hospital admission in a year. Now, in this near-arctic ICU, his breaths came by way of the machine humming on his bedside. His fingernails bore streaky stains the color of rust. Half smiling, my mother waved a hand before his face; he didn’t respond, as expected.

How could I tell her it’s blood that made his eyes appear that way? Doctors called it disseminated intravascular coagulation, which occurred in the wake of clinically overwhelming conditions, like severe infections or widespread burns. What it meant was that the body had essentially burned through its clotting material and had started bleeding in unusual places—hence, eyes that looked bigger and blacker, the pupils blotted with blood. Or, as I thought of them in med school, death’s eyes. 

The first time my father vomited blood, I was four years old. My mother said it was the first time she saw so much blood come out of one person, the bedroom floor suddenly a canvass of clumpy maroon and burgundy trails. When the doctors did the endoscopy, they found my father’s esophagus riddled with varices—extremely dilated veins—bleeding like burst pipes, consequence of his liver cirrhosis. Clearly, his days of youthful inebriation had come to settle debts. But he survived that episode, and many more episodes, in fact, and over time his bleeds became almost an ordinary occurrence in our household. Melena—dark, bloody feces resulting from internal bleeding—was a word that popped up in our conversations every couple of years. He would bleed, get better, then get on with life. 

Today, the cycle ended. His pneumonia had blown up, his gut bloated from accumulating fluid, his kidneys barely churning out urine. And he hadn’t stopped passing blood in his stool since throwing up again the other day—the last time I saw him conscious. When I entered the ICU and saw him like this, with his eyes wide open, I knew it was going to be no ordinary Sunday. Probably no turning back now. Was he even still here, I wondered—inside this pale, sunken body, hearing and feeling what little sound and movement there was in the room? 

The hardest part was telling my mother. Breaking the news to your own flesh and blood was the one skill they didn’t teach us in med school: how to be the harbinger of heartbreak to your own kin. Even my endocrinologist brother seemed to have clammed up—an odd sight, really, as if his habitual self-assurance and all his training from one of the country’s best hospitals had swiftly evaporated. After all, how could we expect our mother to accept immediately the inevitable end to a thirty-year marriage; to reconcile with no difficulty the gaunt but still jesting husband of few days ago with the man now before her, blank and unstirring?

It came as a surprise then, my mother’s reaction. In place of tears was a gentle, infectious calm, as if seeing my father bleed so terribly on and off through the years had steeled her for this day. From her bag, she took out a pearl, this miniscule, milky orb that could have been plucked from a random woman’s ear or an unremarkable necklace. She also took out a small Ziploc and placed the pearl inside. When the time comes, she said, put the pearl in his mouth and make sure it stays inside. Old Chinese lore had it that pearls were beacons of the soul, torches for the long voyage to a peaceful afterlife. Whether the soul would be lost or stuck in some form of limbo without the pearl, I never bothered to clarify.

The time finally came, late in the afternoon, with the family plus a couple of my brother’s friends gathered round the bed in the dialysis unit where my father was scheduled for a session. While the nurses were preparing the machine and my father’s IV catheter, I saw his heart rate begin to decelerate on the cardiac monitor. The inflections on the screen grew farther apart, while the beeps adopted a slower cadence. Everybody in the room stopped whatever they were doing and shifted all attention toward my father, his chest still rising and falling, his eyes clouded by stark blackness. When the monitor finally registered a flat line, nobody broke into hysterics. Nobody in my family, least of all my mother, was about to become one of those delirious characters in the evening soaps. My mother took out the Ziploc from her bag and handed the pearl to my brother, who asked the nurse to slacken my father’s lower jaw while he placed the pearl inside. Then we asked for some bandage to ensure my father’s mouth stayed shut. I borrowed a stethoscope from one of the nurses and, as I’d done countless times to patients I no longer remembered, laid the chest-piece right above my father’s heart. And heard only silence, pure and true and infinite.

For Greg


In the photo is the author’s father, credits belong to the author’s family.