New Nonfiction from Karl Meade: “Knee-Capped”

We all live in a kind of delirium: as if we have control of our lives, while we know damn well something is coming. We don’t know if it’s coming from the inside or the outside—a disease or a rogue wave. We don’t know when or where. But we know it’s coming.

For me, I always thought it would be my stomach, or water. I nearly drowned at two, and that seemed to do something to my stomach—twist it into a sinuous time bomb. My dad, who never forgave himself for my near-drowning, always thought it would his heart, or his brain. But never his knees.

*

When he wakes lying on his back in the dark—he tells me later—his whole body throbbing, his mouth dry as sand, his tongue so swollen he can’t even lick his lips, he hears cockroaches scuttling, water dripping. He thinks he’s in a cave. He has to get out. He’ll never survive here.

He lifts his head slowly and looks around. A shaded window, a door rimmed with light. He tries to sit up but his arms and legs are strapped to something metal. Voices in the distance. He calls out, quietly: Lorna?

The door bursts open to a blinding light. God no, they’re back: two figures in white lab coats brandishing shiny weapons. One grabs his leg and stabs his thigh with a knife of ice. A woman’s voice says it’s okay, Ray, relax—but it’s a trick—she grabs his head and sears his eye with a laser. He thrashes wildly but they pin him down, voices barking orders, eight hands on his limbs now—where did the others come from? They strip him bare, rip off his underwear. A hand grabs his genitals.

No, he cries.

Finally they let go and slip out the door. Darkness falls. His heart pounds. Cockroaches ooze out of the walls. He counts his breath, like they taught him at boot camp: in two-three, out two-three. Stay calm. Survive.

*

“You see that, Karl?” Nurse Sandra leans her full weight on my dad’s wrist, his massive hand curled into a fist. “He’s trying to punch you in the face.”

I can barely hold his other arm down as his wild blue eyes glare up at me, his face glistening, his hair a frizz of grey, like he’s been zapped out of the sky. It takes two nurses to hold each leg—at seventy-eight, he’s as strong as the day he enlisted.

Sandra says, loudly: “It’s okay, Ray. You’re at the Ottawa-Carleton Hospital. I’m one of your nurses.”

“It’s Major Meade to you,” he says.

“More like Major Trouble.” She smiles, but Dad doesn’t react. “You had your knee replaced yesterday, Ray.”

Now he laughs, derisively. “Your comrades tried that one already.’

Yesterday he was clear and calm, couldn’t wait to get “back into action.” I flew in from Vancouver to help him through his physio, at home—drink a few beers, watch a few games—but now I watch, helpless, as they tear off his Velcro-ed diaper and take a urine sample.

“Hands off the bird,” he says. He starts giggling. “Stop, that tickles! You’re making me horny!”

They put on a new diaper and strap him down. I follow Sandra into the hall, my stomach a rope of fire. “What do I do?”

“Someone has to stay with him. Just go with it.”

“Go with what? What’s wrong?”

“You’ll have to ask his doctor.” An alarm sounds down the hall. She looks left and right, her forehead creased. “Betty!” she shouts down the hall. She glances at me—”The drugs should make him sleep now”—and rushes off.

In my dad’s cramped room of steel and plastic, I find him turned completely around in bed, his head at the foot, the IV cord wrapped around his torso. “Dad, how did you do that?”

“I don’t know.” He stares at his hands as if they belong to someone else—these blunt-fingered hands that taught me how to grip a golf club, how to flip an egg, even how to change a diaper. He looks at me, upside down, tears in his eyes, pleading: “Get me out of here.”

“They said you have to stay in bed, Dad.”

His face hardens. “It’s your country.” He reefs his arm sideways and rips out his IV. An alarm beeps and Sandra rushes in. I shrug—”sorry”—while she turns him around and tightens his straps. Someone walks by in the hall and Dad calls out: “Help! Help!”

“Shush, Ray, you’ll alarm the other patients.”

“Patients my arse! We’re prisoners!”

Sandra re-attaches his IV and injects oxy-something into it. Dad lies back and she smiles at me, but I see the fatigue in her eyes, the fear—unlike me, she knows what’s coming.

She rushes out and I settle into the chair at the foot of his bed. It’s past midnight, I’m exhausted from the long trip out here, and now this—whatever this is. But he keeps pulling me into his waking dreams: eyes open, swearing, laughing, crying. I’m his brother in Korea, his drunken father in Halifax, my mother Lorna before she died. Then I’m his guard and he’s a POW in Germany. Every time I close my eyes, he makes a break for it—yanking the arm straps, clawing his IV—and I pop up from my chair. He freezes—caught in escape—then plays casual: “Want some advice, Sergeant Pop-up?”

“Sure,” I say, to engage him.

“Stop jogging.”

All night he cries for help, calls me bloody Kraut, Sergeant Pop-up, Karl with a K. Born in Germany, eh? He laughs, wildly, derisively. Finally, at 5 a.m. his eyes close and he weeps, quietly, for my mother: Lorna. Help me, Lori. Even though she’s been gone for thirty years, her name on his lips grants us both the gift of sleep.

*

I wake to a weak winter sun through the window, with my dad staring at me—his youngest son—slouched in the chair in the corner, my coat over my lap. I see tears on his stubbled cheeks, fear in his glazed eyes. Or maybe it’s my fear I see.

Then his eyes narrow. He picks up a crust of toast from the tray across his lap and chucks it at me. “When the hell did you get here?”

I smile, relieved—his old self, the joker. I sit up and stretch my arms overhead. “Yesterday. Don’t you—?” I catch myself.

He nods at me, stares, as if taking me in. I know this look of his. For years he’s teased me that my mother said I was the daughter she never had, that I have her sensitive eyes, her slender fingers, even her mouth. I’ve caught him, over the years, looking comforted to see me, but also saddened, remembering Lorna.

I hear a deep, familiar voice down the hall. Ken, my oldest brother, strolls in carrying three coffees. He’s the epitome of tall, dark and handsome, with a quiet confidence I’ve never felt in my life. I feel my shoulders drop, as if the cavalry has arrived.

“Good morning,” he says, placing a coffee on Dad’s tray, studying his eyes to see if he’s there. “Feeling better?”

“Bright and chipper,” Dad manages, hesitantly. He looks from Ken to me. “I didn’t do anything bad last night, did I?”

I stand up, glad to hear him lucid. “The Major? Bad? Never.”

Suddenly he glares at Ken. “Who are you? You’re in one of those gangs, aren’t you.”

Ken and I trade glances. Adrenaline grabs my stomach. The day-nurse enters, a short Francophone woman named Genevieve, with dark hair and bright, friendly eyes. Dad gestures at her uniform. “That’s nice. Did you put that on just for me?”

‘Ah,’ she says, wagging her finger at him. “I heard about you.”

She takes his pulse, smiles at us, then at Dad. “Where did you get that nice tan, Ray?”

“Walmart,” he says. “Blue Light special.”

Genevieve looks at Ken and I. We both shrug, just as the doctor walks in, clipboard in her hand, hair pulled back in a severe bun. I can see she’s a hard-ass, which Dad will like. She doesn’t ask how he is, just gets right to it. “What day is it, Ray?” Her voice is loud, like he’s hard of hearing. I resist the urge to say he’s not deaf.

He blinks and shakes his head hard, as if trying to uncross his eyes. “Sunday.”

She writes on her clipboard. “It’s Thursday, March 11. Do you know the year, Ray?”

“1932,” he shoots back.

She nods. “That’s the year you born. So that’s good, but right now it’s 2011.” She flips to a new page and hands Dad the clipboard and a pen. “Can you draw me the face of a clock?”

Dad raises his hands in the air: it’s a trick question, an accusation. “I haven’t seen O’clock’s face in thirty years.”

She flips the page back on the clipboard. “Ok, Ray. How about this place? Where are we?”

He looks around the room, then blankly at me, then Ken. His eyes widen and he snatches at something in the air, like a fly.

“Ray,” the doctor says, firmly. “When did you last drink alcohol?”

He sits up straighter, tries to see out the window. “Where did the water come from? Is this a prisoner ship?”

Ken steps forward, calm and polite. “Ray stopped drinking two weeks ago, just as he was told to.”

“You, stop talking!” Dad jabs his finger at Ken. “He wants my pension. My own son, betraying me!”

“He’s not betraying you,” I say.

“Now it’s both of you?”

“He’s saying you stopped.”

“I never took you two for squealers.”

Ken and I look at each other. Genevieve touches my arm, then escorts Ken and I into the hall.

*

“It’s more confusing to him,” Genevieve says, in the hallway, “if there’s too many of us.” Her hand moves to the pager flashing on her belt, but she doesn’t look at it. Her eyes tighten, as does her demeanor. “Let’s stay out here and let the doctor do her job.” Now her pager rings aloud and she strides off down the hall.

As I watch her and two other nurses rush into a room, I feel like I might vomit: fatigue, fear, confusion. I glance at Ken, for big-brother guidance, but he has a deep crease down his forehead, staring at the door to Dad’s room.

“Do her job?” Ken says, shaking his head. “They always go to the alcohol. Blame the fucking patient.”

The doctor emerges, and Ken cuts her off.

“Excuse me,” he says, politely. I know he’s seething, but he sounds calm and cool. “But what’s going on with Ray?”

The doctor glances down the hall, then counts off her fingers. Her voice is as cold as the pale green walls: “It could be stroke, TLA, infection, anaesthetic reaction, electrolyte imbalance, alcohol withdrawal—”

“—I told you he stopped drinking two weeks ago,” Ken says.

“Look,” she says, “he’s getting the million-dollar treatment. Blood tests, urine, EKG, we’ve even pushed through an emergency MRI to see if there’s been a stroke.” She says it like that, as if the stroke is somewhere out there, rather than in Dad’s head. “You’ll have to trust me.”

Genevieve sticks her head out from a door down the hall. “Doctor.”

Ken takes the dayshift to sit with Dad, while I go to Dad’s to unpack and rest. But first I stop in the lobby to call my wife on Salt Spring Island, off the coast of Vancouver. When I say stroke, my voice buckles. “I truly thought he was gone,” I say.

Beside me, a youngish bald woman wearing a kerchief, sitting with a girl on her lap, hears my voice break and smiles at me, kindly. I glance at her daughter and my heart sinks. My mother died when I was seventeen, but this girl is more like seven. I try to smile back, but my throat squeezes into a sob. I shove it back down but I can no longer speak. My wife tells me to call her father, a retired surgeon. He’ll know what to do.

I steel myself and call. He doesn’t miss a beat: “I saw it all the time, Karl. It’s overhydration. Your dad’s drunk on water. Get them to turn the IV rate down.”

I search out Genevieve, the day-nurse, and tell her. She shrugs, apologetically: “Doctor’s orders.”

I see the doctor and literally chase her down the hall. She sighs, and says, flatly: “Drunk on water?”

My voice seethes—not calm, not cool. I’m the youngest, the hot-head. “My father-in-law was Chair of the College of Surgeons! He’s not just some quack with a theory!”

There are nurses and patients and visitors in the hall. Everyone stops. They’ve heard Dad’s cries for help.

The doctor looks me straight in the eye. “Sir, lower your voice, please.”

I manage to lower my voice. “He knows what he’s talking about.”

She does not waver. “I’m sure he was good in his time, but we have protocols now.” She looks at her watch. “I have other patients.”

I stand there for what feels like a long time. Patients and visitors walk past, trying not to stare. Finally, I shuffle out to the parking lot, sit in my rental car staring out the windshield at the hospital. I try to figure out which is Dad’s window, and what’s happening to him in that room. When my head bobs forward in sleep, I drive slowly, dreamily, to Dad’s house.

*

I should sleep, but instead I go for a long, slow jog through my childhood neighborhood, retracing the routes my dad and I used to run. After showering, I Google “overhydration,” print out my findings from McGill University Health Centre, and plan to hand a fait accompli diagnosis to the doctor:

“Overhydration can lead to dangerously low sodium levels in the blood, or a life-threatening condition called hyponatremia, which can result in brain swelling. Because the brain is enclosed in the skull, it leaves almost no room for expansion, which can cause headaches and brain fog, even cognitive problems and seizures.”

Then an email from my father-in-law says exactly the same: “This condition is well known and the causes were worked out in the 1960s. It is nothing new.”

I’m so angry I can hardly breathe. I try to calm down, get some rest. I spend the afternoon wandering the rooms of my childhood house studying the photos on the walls and dressers and tables. I even lovingly admire his duct-taped broom, his black-taped toaster—two of many testaments to his lifelong Air-Force Supply-Officer modus operandi: nothing gets junked.

When I return in the evening, to my relief I find a note from Ken saying Dad was “pretty clear” for most of the day—”fingers crossed.” I collapse into the chair beside Dad’s bed. I can’t believe it’s still Thursday. I’ve only been here for twenty-four hours, but it feels like a week. He smiles at me, a bit oddly, like I’m a stranger on a train. We begin the nightshift watching TV in his room. He’s laughing at Jerry Seinfeld, and I’m so relieved to see him lucid that I need to wipe away the tears.

“God, that’s funny,” I say, pretending my tears are because of Seinfeld.

A minute later, he tries to get up. “I have to go home. I have people expecting me. My son Karl is coming.”

“I’m Karl.”

“You’re not my son. My son would let me get up.”

He starts twitching and flinching. He folds his arms to keep them still. Then he swats the air, points at the wall: “That one’s tall!”

By ten o’clock he’s gripping the bed rails like an amusement ride, his wide eyes flicking from one wall to the other.

“You okay, Dad?”

“Watch out,’ he says, ‘those spiders are jumpers!”

Nurse Sandra arrives with a trolley of meds and needles. Dad settles down, plays calm for her while she chats away, taking his vitals, reading his chart. But when she jabs the needle into his IV, he says, “No more of that, thanks.”

Sandra chuckles. “It’ll help you sleep, Ray.”

“Please, no.” He looks at me, desperately. “Please.”

She glides her trolley out of the room and I follow her. I tell her about overhydration, hand her my crumpled pages of research, but she hands them back, gives me the same answer: “Doctor’s orders.”

I turn away. I think maybe if I had more sleep, or was a better person, a better son, I could be more useful. Every time I walk down that hall back to his room, I feel like I’m walking into death. I pull my chair closer to him and read Sam Shepard’s elliptical, almost drugged-out stories, and Dad loves it.

“When you come to Ottawa, you have to come visit me.”

“On Ogilvie Road?” I say, testing him.

“Good memory,” he says.

I close the book, pull my chair to the corner, and before I know it he’s sunk into a mime of drowning: back arched, hands gripping the steel rails, his nose in the air, trying to stay above water, trying to breathe. Later he says the IV shot him off a cliff into the sea. But right now he can’t close his eyes. I’m his mother, after her heart attack at fifty: she’s here, sinking with him through all those eyes lost in the Halifax explosion. I’m squeezing his hand, as his mother, then he’s my mother, Lorna, saying to me: “What a good boy you are, Karl. What a good boy.”

The water streams down my face. What am I supposed to do? What am I supposed to say?

Sandra appears as if from a dream, taking Dad’s vitals as he gazes up at her lovingly. “You’re being a good son to your father,” she says to me.

I can’t even say thank you.

She places her hand on my shoulder. “It’s hard to see your father like this.”

The night plays out much like the first. He takes me on his full tour of duty: Halifax, Moncton, Montreal (where he met Lorna), Germany, Manitoba, Comox BC, Ottawa, Greenwood Nova Scotia. His eyes wide open, he draws me into his Halifax childhood, his Air Force boot camp, his mother dying, Lorna dying.

At 3 a.m. his eyes finally close and I wander down the pale-green hall into the pale-green common room and stand in front of the muted television: a science documentary showing a strange ocean wave stretching along an entire coastline. My mind keeps expecting the wave to break and recede, like any wave, but it doesn’t. The wave crests a sea wall, hits the shore, and rolls through a town—buildings collapse, cars bob like toys—then continues into the countryside, swallows a road, rolls up an embankment, and engulfs an entire bridge full of cars and trucks. A woman and her son clamber onto their car roof, watching, helpless, as this wave out of nowhere just sweeps them off the roof and they’re gone.

A caption scrolls across the screen—LIVE: Tsunami Strikes Coast of Japan—and I realize, my God, it’s the news. I return to Dad’s room and sit in the chair, watching his chest rise and fall. My hands won’t stop shaking. All those people—that mother and son—gone, just like that. And Dad—where has he gone?

Finally, my eyes close and I’m caught in a wave of bodies and cars drifting through a recurring nightmare from my childhood: my mom and dad and I, trapped underwater in abandoned warships. I’ve had nightmares of water, been afraid of water, since I nearly drowned at two years old. My dad always blamed himself: he turned his back for a few seconds—”Seconds!” he cried—then found me face down in the water.

*

The next morning, Ken finds us both asleep—mouths open, faces pale. “I thought you were both dead,” he says later.

He quietly wakes me with coffee. We let Dad sleep while we talk. I tell Ken about my father-in-law’s theory, and my confrontation with the doctor. “I think you better be the one to talk to her,” I say, sheepishly.

Dad wakes, just as the doctor comes in on her rounds. She seems pleased. Her eyes almost smile. “Good news,” she says. “The tests all came back negative. We’ve ruled out the biggies.”

Adrenaline surges through me. “Then what’s wrong with him?”

“Time will tell. Be patient.”

I feel the tears rise and it angers me. “Time? He’s drowning! Turn the water down!”

She goes on about protocol and treatment. How do you argue with a doctor, once you’ve raised your questions and been dismissed? It’s my one hour of Google versus her seven years of medical school. I won’t win, and usually shouldn’t. But what if I’m right? How do I know?

Ken squeezes my arm, lets the doctor finish. When she leaves, Ken hands me a sheath of his own research. He and his son Conor have discovered Postoperative Delirium (PD), and Postoperative Cognitive Dysfunction (POCD). I quickly scan what he’s printed, and the frustration rages through me. Both are well-known syndromes, “a central nervous system dysfunction that complicates the recovery of elderly patients following surgery.” I read on, sweating. PD typically occurs on postoperative days 1 to 3 and is associated with prolonged hospital stays, increased risks for morbidity and significant health care expenditures.

I want to strangle somebody. But Ken talks me down.

I drive back to Dad’s, fall asleep on his couch. Delirium: Hippocrates called it brain fever, but all I see is fear. Fear in Dad’s eyes, fear in Ken’s forehead, fear in my stomach. Even in the nurses and doctors, hidden beneath their professional cool.

When I return that evening, Dad’s lying flat on the bed with his arms at his sides, wide-eyed and breathing toward the ceiling, mesmerized with “all the gibberish,” as he later says to me. I squeeze his hand and he squeezes back, but he won’t, or can’t, let go of what he’s watching on the ceiling. He tells me what he sees, like a romantic poet’s visionary work, his own Kubla Khan, all of his family and friends in a “great film,” as he puts it.

He’s crying and laughing. “I had a great life. Lorna was such an extraordinary woman.”

“You were a good man, too,” I say.

“I’ll take that, Karl, but I could’ve been a greater man.”

“We all could’ve been greater. That’s what keeps us going.”

“I’ll give you that.”

Sandra comes in, then stops dead. She sees Raymond’s eyes welled up and wide, and mine brimming with tears. Squeezing each others’ hands. She leaves, without speaking.

Raymond says: “Karl, thank you for that.”

“For what?”

“For the great film you made. That was a mammoth production.”

“I didn’t make a film. It was your mind.”

“They don’t let you make films like that anymore.”

I open my mouth to speak but he stops me with a raised hand.

“Look at that waterfall! Jesus, it’s just beautiful.” He looks from the left corner of the ceiling to the right. “I love my family so much. My boys. I never bragged about them, okay, I guess I did.” He laughs and looks at me. “So, am I going to die now, at 79?”

“No,” I say. “That’s just your birthday.”

“Who’s coming for me?”

“We all are.”

His “film” lasts fifteen minutes. I hold his hand, he squeezes mine so hard, eyes glistening, wide with horror, then glee. “There goes sister Rosie, there’s Bob in a tank. He was a great fucking hero he was!”

“And there I go, into the grave. A great fucking smash-up.”

All night he lives this monologue, sleeping, awake, narrating his visionary babel.

*

The third night, the fourth night, the fifth: Dad slowly rises out of the fog. On day five, our middle brother Dave arrives from Oklahoma and takes the nightshifts. On day seven, all four of us limp out of Admitting together, the walking wounded. We sit in Dad’s living room and watch the news, stunned: twenty thousand people gone. We feel angry at the doctors, but lucky that Dad’s still here.

In the coming months, he tries to tell us what it was like: the bugs, the cave, the dreams. Lorna right there in the room with him. Little do we know that the next seven years will play out like the past seven days, only in reverse, in slow motion. Next year he’ll lose his keys, the year after that his car, then his words. Five years from now, when the diagnosis comes—Vascular Dementia—he will blame his knees: that it all started here. The fog that never quite lifted, just thickened slowly through his brain.

But I can’t help but think of his near-drowning: what if I hadn’t turned my back on him, not for seconds, but for days? What if I’d been calmer, more skilful with the doctor? What if I hadn’t let him drown from the inside? Then, instead of checking him into a dementia floor this week, maybe we’d be walking together along the Halifax beach of his childhood, watching the waves roll in.