Mom slumped, largely out of it, occasionally jolting up. She now blinked at the two large men laboriously, excruciatingly, hoisting her from the wheelchair into an airplane seat; could she decode reality from dream? She had cracked her skull in Sicily and undergone urgent surgery. For weeks, my sister and I had been desperate to get her out of Palermo’s Civic Hospital, an impossibility without legal permissions. These were now bundled in my purse like the Holy Grail.
There are journeys you never plan, journeys counter to beauty. They deliver you deep into your bowels. The pain you’ve been prized is an awakening you didn’t ask for. And the trip is indelible. Because you—in this case we—get turned inside out, bowled over, crashing into the fray.
Flight attendants draped Mom in freshly clean blankets and surrounded her with little blue pillows. They maintained a courteous distance, though their sidelong glances suggested they dreaded the worst. I guarded Mom with my stare, pleading with the fates. Throughout that long sleepless night, the attendants kindly plied me with wine. I asked for it, strangely immune to tipsiness. We had twelve hours to go: Palermo – transfer in Munich – Chicago/Northwestern Memorial Hospital.
Mom had been vacationing with my sister at our family home off the western coast of Sicily, on the tiny rugged island of Favignana. There, my sister watched Mom’s hand abruptly reach for the kitchen island—and miss it, careening skull-first onto the ceramic tile floor. A torrential flow of blood was all that moved. If you are on an island without a hospital, the only hope for medical intervention is an emergency medevac helicopter. Mom was fortunate to get soared unconscious over the glittering Mediterranean Sea to Palermo’s Civic Hospital.
Thus began our confounding weeks in a distraught dilapidated neighborhood, navigating the bitter stench of piled garbage and the urine waft of slumped addicts. Graffiti scoured the hospital’s exterior walls. Indigent families lived out of their cars in the front parking lot, spilling olive oil grease into the redolent August heat; tossing aside flecked newspaper wrappings and crumpled pizza boxes. These coated the asphalt. Cigarette butts paved the way to the hospital. The one ridiculously small garbage can was always overflowing. More to the point, all of us were hostage to the hospital, its windows facing multiple funeral homes displaying leering caskets.
Mom lay semiconscious on the fourth floor. We climbed the stairs frequently, bringing ordered medical and general care supplies: bed pads, skin salves, washcloths, toothpaste. This was the ICU floor, blistering in the August heat, four sweltering patients to a room. One side of the long hall housed female patients; the opposite side, recovering men. Rotting produce and gasoline pulsed from the street through the open windows, muting the ever-present nostril-scorching floor bleach. Each blue-gowned patient was hovered over by sisters, mothers, aunts.
Scotch-taped to the red fire extinguisher in the hall, calling cards advertised revolving short-term room rentals. My sister had grabbed one in anticipation of my arrival. We settled in our Spartan bedroom with its plank-hard twin beds overlooking a barb wire-fenced courtyard stacked with construction debris. At night, we encountered our beleaguered housemates returning from different hospital wards, exhaustedly scarfing down sandwiches or cookies, anything not requiring utensils; we had a woefully undersupplied kitchen. Early morning, waiting in line outside the one communal bathroom, eager to hear a flush, impatient to resurrect ourselves with shampoo, towel, toothbrush, we doused each other in grief. One mother was recovering from her kidney donation to her daughter who remained comatose. The mother wept: “With my own body I cannot save her?” Another waited to learn whether her son’s eyesight could be salvaged, face lacerated in a motorcycle accident. Relatives came and went, spilling gruesome stories. When we weren’t agitated by cries and moaning in the ICU, we heard muffled weeping through the apartment walls.
Later, I would learn that Palermo’s Civic Hospital is under the Mafia’s thumb, as is much of Sicily’s hospital infrastructure. While that fact lay largely unmentioned, everything else got contracted at full volume; the staff’s shrill commands, agonized screams, clanging wheels, pounding feet. The poorest Sicilians must depend on understaffed, overcrowded national care, ever mistrustful, knowing they’re cheap fodder in a system that can barely sustain them, discreetly living under the radar until an emergency takes them public. It turns out, however, that in close quarters, Sicilian women are uninhibited investigators. I was asked my age, my family status, how I kept my weight, why my sister has no children. These women kept vigil every night, all night, perched on the hospital room’s flimsy plastic chairs. Mom’s eliminations and ingestions were reported to us in the morning with a precision rarely received from the male nurses and doctors. In short, catch-as-catch-can, they insisted we were in this together.
The entrance to the ICU ward featured a large sculpture of the Virgin Mother Mary in a glowing halo of star-shaped lights, her feet tickled by bouquets, her arms festooned with anguished supplications and grateful ex-votos for blessings granted. For Mary and her cadre of saints, postmortem powers are the shiny silver lining of martyrdom. Forgoing worldly attachment, they’ve achieved power from beyond the grave. None of us in the ward aspired to that status, but we gender-identified with Mary, our courageous precursor to suffering and loss.
When a priest wandered in, sprinkling holy water, murmuring intercession, aunts, sisters, and daughters waited a little while before overtaking him in a full-throated chorus of prayer to Holy Mary, Mother of God.
I was being reminded how specifically Sicily is hell on women. Shrines to the Virgin Mary, meticulously tended unlike so much else, are everywhere—on roadways, stairwells, in fast-food joints. Each asserts the indubitable primacy of motherhood. Other jobs or roles are hard to come by, now more than ever with the island’s economy ravaged. Motherhood offers ancient validation, and remains the prevailing economic model. It’s the 24/7 ineradicable obligation to accept being requisitioned without pay. The aunts, sisters, daughters, mothers fought and cajoled the medical establishment, rising in rank when one of their members—and this meant any patient in our shared room—was neglected: repeating, insisting, developing into an Occupy movement, a critical mass railroading reluctant nurses to pay sudden attention to a leaking urine bag, a non-dispensing IV drip, an arm swelled twice its normal size and turning purple from an intravenous malfunction (Mom’s). One wife gathered a group from across the hall of male ICU rooms, to witness her assertion: “Not even Christ on the cross would be left to suffer thus,” loudly describing the clotted catheter engorging her husband’s testicles, until a doctor appeared.
Sicilian sisterhood is ferocious. As was my mother’s condition. She had fractured her skull by collapsing from undiagnosed internal bleeding. Gastro-intestinal surgery revealed a complex rupture due to advanced peritonitis. Sliced mid-abdomen, she now eliminated through a stoma to which a colostomy bag was attached. Intermittently, she was whisked to Neurology on a rattling wheelchair for CT brain scans. She had come inside out in more than one way. The residual effects of anesthesia had her hallucinating the doctors were Nazis trying to saw off her limbs. She claimed spies parachuted from the ceiling intent on throwing her out the window. During her second night, Mom ripped out her IVs with surprising supernatural strength, tumbling herself out of the bed, crawling her way to escape. Two dozing aunties in plastic chairs quickly awoke and formed a protective cordon around her. They knew when staffing was lax. In the morning, they helped us hire nighttime caregivers, Rosalba and Toti. The aunties watched them like hawks, reporting back to us, worrying over every detail.
Days passed, and Mom’s sub-cranial hematoma wasn’t shrinking. Medical prognoses veered wildly, though the larger problem was a dire lack of thoughtful coherent communications. One doctor we begged for advice cut to the chase: “Prepare for death.” Meanwhile, Neurology and Gastroenterology warred like old nemeses hunkered down in competing forts. When Mom fell into another coma, the gastroenterologist who began pinching her nipples repeatedly—to no reaction—lunged for the ICU emergency phone to reach Neurology. He got no response, once, twice, three times. He grabbed his cell phone—the ward in thrall—and scorched the hapless receiver: “Get here on the double or I’ll devote my life to making yours a fucking hell.” It did not improve interdepartmental relations that Mom spontaneously came out of her coma. Nothing was predictable, not even the blessings. Our grand not knowing held us in a state of terror. Here was not where we wanted to be. Not on this trip.
Even Sicily’s conservative Catholicism acknowledges double X chromosome power. At least three powerful female Catholic martyrs are historically authenticated Sicilians, from birth to horrific death: Agata of Catania, Lucia of Syracuse, and Rosalia of Palermo. They remain resonating presences, held close to the heart and venerated. The church’s firm grip on the Sicilian imagination is apparent in the elaborate processions mounted annually for these patron saints in their natal cities, their impassioned tragedies enacted, their bravery resurrected. Agata, a devout beauty from a noble family, refused the amorous advances of the Roman prefect Quintianus. Lucia distributed her patrimony and jewels —intended for her betrothed—to the poor. Rosalia, a descendant of Charlemagne, refused worldly goods and suitors, fleeing to a mountain cave to live as a hermit. These proclamations of independence resolve into a familiar trajectory. She asserts control of her body and finances, refuses men and marriage, speaks her defiant truth, and is met with either mutilation, imprisonment, or torture to the death, usually all three. This lesson is not lost on contemporary Sicilian women, who are highly attuned to the hazards of a solitary stand, and the cost of forgoing motherhood. The martyrs’ purity endures as dramatic inspiration—now appointed healers of breast cancer, sexual assault, blindness, the plague- stricken, and more—and as real testimony to the perils of bucking the patriarchy.
Sicilian religiosity—mobs falling to their knees, crying in ecstasy, arms outstretched, as spectacular fireworks and elaborately costumed scenes of death and glory are mounted—was well known to my family from our years of visits. But we had not encountered equivalent eruptions of passion in intimate quarters. Fueled by a liturgy born of ineradicable wounds, our shared hospitalization unleashed dramatic protestations and saint-worthy devotion.
How immature they must have thought us, clearly mystified by our strange resistance to the safe barricade from the world the hospital represented for them, crisis having given way to a reprieve they did not in any way take for granted. The ward women patted our hands: “Stay calm. Give her time. She’s safe here.” Bumped ahead of other thousands needing care, each patient here had won the equivalent of a prize-winning lottery ticket. But as, each day, we began our mission to waylay doctors hurriedly smoking cigarettes, begging them for information only to have them rush away, safe was not how we felt.
It’s not that there weren’t fathers, sons, nephews, and sons-in-law visiting their brothers or mothers, but their gender was controlled. They were continually banished: “Out now! Out, Out! Out!” by medical staff. We women remained to witness the ablutions administered to iodine-tinged, stapled, foot-long scars. Tenderly exposed organs spilled feces between colostomy bag changes. We observed the insertion of catheters to spread crotches, got caught in the crossfires of vomit. Somehow, I was reminded of the ritual cleansing at a Moroccan hammam; not only were the veils off, so was every speck of societal decorum. The unstated reason behind our presence was that we were being trained for our future as long-term nurses.
The women celebrated the tiniest indication of any patient’s healing: clapping, grinning in unison. One day we arrived late from buying supplies at the pharmacy, to another patient’s daughter gently spoon-feeding Mom chicken broth with rice. Mom ate like a bird, and the ward showered her every bite with praise. They called her nonnina americana, American granny. Another day, a sister-in-law wheeled her charge into the bathroom to blow-dry an elaborate coiffure. When a male nurse reprimanded her, she sniffed: “It’s not human to leave her otherwise.” She couldn’t be moved as she raised the can of hairspray. We closed rank around her.
Sitting with the ward women, waiting interminable hours every day for the miracle of a doctor visit, we heard almost daily, “How I wish I could see America.” As if it were a trip to the moon, which was exactly how astronomical that expense was for them. One night, back at the apartment, settled into our pajamas, the twenty-something older sister of the daughter who’d received her mother’s kidney, came out onto the sliver of un-scenic balcony where we stood vaguely gathering our wits, and opened her heart. For two weeks she had not spoken, only ever wringing her hands, eyes lowered behind thick glasses, sticking dutifully by her weakened mother’s side. “I’ve worked in a hair salon since I was twelve. Fourteen years, without benefits or security. What else can I do? Our costs are so many.” Her sister’s transplant had been deemed risky for her congenitally weak heart, categorized by the nationalized health-care system as elective, and performed at the family’s expense. And her young sister was not coming out of her coma. “How could my mother not try to save her?” she asked us. Women lean hard on one another in a failing economy that strafes the poor to give everything they have and more.
My sister and I resolutely continued to accost the revolving door of doctors, aggressive sentinels that we were, demanding the discharge permissions that would enable Mom’s transport to the United States, doctors most of whose names we did not know. They rushed off to other urgent surgeries, shaking their heads as we challenged them with our insistent, and to their minds, hysterical mission. It took three weeks to wear them down into diffident submission, as they weighed the risks of moving her, delivering stern warnings and arguing with us in frustration. We would, however, free up a desperately coveted bed.
Throughout the interminable journey home, I prodded my mother like a pincushion, checking if she could be woken. I could smell her; there’d been no way to get her to the bathroom, and her insides had clearly not held. But finally, now we were stateside, and the waiting Chicago ambulance’s medics leaped to action, inserting IVs, fitting Mom with an oxygen mask, wiping her down as best they could, rushing us from O’Hare to Northwestern Memorial Hospital. While they settled her shortly in ER, then to her reserved room, I stepped away to make the necessary urgent calls. I returned to Mom lying in a fresh gown, all washed, a new colostomy bag applied, dirty towels and washcloths disposed out of sight. A cup of ice chips with a straw, and a tissue box were next to her. In an hour, she was sleeping in a spotless cocoon of thoroughly monitored privacy.
The air-conditioned room’s large windows overlooked shining skyscrapers, and a slice of cerulean Lake Michigan. Cheerful nurses sanitized their hands with each entry and exit, checked monitors, IVs, and Mom’s vitals, slipping on purple medical gloves as needed. They were constantly refreshing her bed with extra thick white pillows and crisp white sheets. They layered her with soft heated blankets, quick to change them when they cooled. They urged her to rest, rest, rest. The daily updated dry-erase board provided the schedule of nurses and doctors’ rounds, names provided. We had reached medical paradise. We had bought it, privileged to have such means.
I watched relatives arrive down the sound-muting vacuumed carpets, visiting the rooms of other patients, gently closing their beloved’s room door to seal in their close-knit consolations. In any case, the ward rooms were designed in a broad square lined around a busy central nurses’ station, seconds away from immediate medical care. Almost no visitors stayed overnight, most leaving after a couple of hours to tend to their own lives. I found myself reflecting on our fervent determination, our insistence, on fleeing Palermo. Northwestern’s study of the sub-cranial hematoma CAT scans and the peritonitis operation DVDs I had been provided by the Palermo Civic Hospital, showed Mom’s hematoma had been dutifully monitored and her emergency operation had been a lifesaver. The reigning theory was Mom had dodged catastrophe. But I wondered.
In the luxury of retrospection, those doctors who saved Mom had appeared forlorn and exhausted, supporting themselves on less-than- impressive government salaries—not among the select paid under the table by the Mafia for preferential medical treatment. In an underfunded, undersupplied, and overscheduled environment, the Hippocratic oath had to be, more than anything, what compelled their overtaxed, woefully uncommunicative, but determined professionalism. I had to give them that. I finally entertained gratitude. They safeguarded lives, laboring in excruciating conditions.
None of the wives or sisters who had encircled us knew a word of English. But they had known how and when to consider themselves lucky. They refused to allow one lax second to upend the scales newly tipped in their favor. They enacted the internal vigilance so ingrained in Sicilian women. They counted on their families with their lives. Daughters monitored IVs and medications. Sisters proffered morsels of home-baked cannelloni. And, all night long, the women kept vigil. They weren’t letting the medical system collapse; they’d remain, fighting until the bitter end. Gathering strength in numbers.
They had insisted on our belonging, the entire time we insisted on pulling out. Their conspiracy may have been born of necessity, but their spontaneous inclusion was pure generosity. In this way, without question, they made us theirs, and them ours. The willfulness of their concern sticks with me, having been born and bred to believe in community as a convenience with a volatile impermanent shell. Our lack of conviction confounded them, they who lean on a stern stubborn faith to survive feckless circumstances and institutions. We never got to explain our world to them, but they unhesitatingly wrapped us in theirs.
Anne Calcagno’s first novel, Love Like a Dog, set in Chicago, won 1st place award from the “New Generation Indie Awards.” She is at work on a second novel, Struck By Dina, about the Italian colonization of East Africa. For stories in her feminist collection Pray For Yourself, Calcagno won the San Francisco Foundation Phelan Award, an NEA Fellowship, and two IAC Artists Fellowships. She edited Travelers Tales: Italy, which won Foreword’s Silver Medal for Best Travel Book of the Year. Her features have been published in the New York Times, the Chicago Tribune, the Washington Post and other publications. She teaches in the MFAW/BFAW at The School of the Art Institute of Chicago. She is euphoric to be in Hypertext Review! www.annecalcagno.com.