I’ve told Bess that, given the current circumstances, my job is easier than hers: all I have to do is die. She has the hard part; she has to live and figure out how to go on. Death’s severing of connections feels particularly acute for the people who are most attached to other people, and especially the person most wired into the person dying. Bess is most wired into me, and she’s also more anxious than me, such that I’ve been comforting her. Maybe this seems odd, for the person dying of cancer to be comforting the one who isn’t, but it works for us.

Last night, while I was sitting on the couch reading Paved Paradise: How Parking Explains the World,* Bess was holding my leg, weeping as a wave of anticipatory grief crested on her in the sudden, unanticipated ways it often seems to, and I observed that I’m facing my end with more equanimity than she is. She enthusiastically agreed, and at least I got her to laugh for a moment and abort the crying (though she’s welcome to cry as much and as often as she needs to).
What had started these tears was a realization that, if Bess has a hard time writing an essay after I’m gone, I won’t be here to help her organize it—a truth that, I keep reminding her, isn’t a good excuse for her not giving me pages now. But it’s not just editing that I won’t be here to do. A bunch of mostly overlapping worries haunt me, because I feel like Bess and I have gone long past “complementary skills” (though we do have those) and into “utter enmeshment that can only be broken with great damage.” In life I try not to damage Bess, and yet in death there’s little choice. I’m trying to find ways to preemptively comfort her and support her now, while I still can, so that she can call upon my love to help her through the coming darkness—but I still can’t choose not to die of cancer.

Over time, some couples grow into each other such that their minds partially merge; I read a spiritual dimension into this, but you don’t have to. “Grow into each other” is doing a lot of work in that sentence: words or phrases like “merging,” “conjoined minds,” “interdependence,” “co-dependence” (though without its usual negative or pathologic connotation), or, my favorite, “connected by an eternal golden braid” work too. Even before Neuralink allows brain-to-computer and eventual brain-to-brain interfaces, Bess and I know each other’s minds without a physical cable running between us, and so I’m worried that the impending loss of me will be like the loss of part of Bess’s brain. For most people, the loss of a spouse or partner is devastating.** For Bess, I fear the loss will be worse than average, and her recovery will be harder.

To be sure, I think recovery will happen for Bess, and that she’ll find love again (as I’ve instructed her to do, for her own sake), but I worry about complicated or prolonged grief. There’s an intellectual dimension of loss, too, because Bess so often thinks by talking to me. Some people think by writing, or walking, or sitting still and concentrating. Bess’s preferred thinking method seems to be chatter. She has friends and family she chatters with, but I’m her primary target. She’s almost physically hurt when I can’t listen to her ideas right then and there, in the moment. So I try to be open to listening as much as possible, though sometimes work or the need to execute my own writing gets in the way. Soon, it’ll be death that gets in the way.

These are some of the things that worry me:

* Writing and editing. I’ve been Bess’s writing coach and editor, particularly as of late. When Bess is writing, I’ve been telling her that, rather than getting in her own way, she can just write what she’s thinking. Whatever she’s thinking, she can write that down. Admittedly I find this statement and advice a little peculiar, because what does she write about if not what she’s thinking? Is she supposed to write what she isn’t thinking? That’d be a neat trick and if she can write what she isn’t thinking, I’d encourage it purely from a novelty perspective. I confirm that she can in fact write what she thinks, and that people will be interested in what she’s writing—or they won’t. No one is interested in everything. No piece of writing appeals to everyone. But Bess’s potential capabilities are enormous, and, if she can get out of her own way enough to execute, she’ll do great. A lot of what I do regarding encouragement is simply encouraging her to get out of her own way. Her process is like the bike-fall meme:

My job is to get her to stop stopping herself by putting that stick between her spokes. Who will do that job when I’m gone? Sasha Chapin is one answer, and he’s not the only editor out there. But the solution when I’m gone probably won’t be sitting on the couch with her or going on walks with her.

* Memory. I seem to remember things more, or better, or at least differently than Bess. Names of people or of places. Things we’ve done. Her memory is partially stored inside me. My memory of her is stored inside me, and by that I mean that I see her as others can’t, because of our long shared history:

But when Jake looks at me, he sees me at 25, showing up to our first date in a grey mini-dress, black boots and red lipstick. He sees me at 29 in a striped bra and panty set in our 35th story Seattle hotel room, pressing me against the cold glass. And he also sees me as I am now. I’m all these ages at once, as he is to me. Love isn’t just blind to ugliness, but to decay. Look at two 80-year-olds gazing at each other like teenagers and you’ll know what I mean. When I lose Jake, I’ll lose someone ever seeing me throughout all my ages again. I’ve said that parts of me will die with him, and I don’t just mean parts of my heart and the parts of my personality that act in relation to his. I mean entire eras of my life, all the views he was privy to, and therefore, much of my youth, goes as well. No one—even if I find love again one day, as Jake has urged me to do—will ever look at me at see me at 32, skinny dipping on a trip to Gunnison nude beach in New Jersey with a group of friends, laughing at how cold the water is under the sun of a hot summer day.

There are trivial things, too. The other night, we were watching the TV show Invasion (which is pretty good so far, and there should be more stories about alien contact, and more stories with hardware programmers as heroes), and there’s a character named Caspar. Almost all of you will probably have no idea what I’m talking about when I say that I joked to Bess that Kaspar Juul should be covering the alien invasion, with help from his sidekick Katrine Fønsmark. Juul and Fønsmark are characters on the Danish TV political show Borgen, which isn’t bad, but sadly the mothership never lands and no massive antenna dishes play major roles in the show. No one does any heroic programming. Still, it’s a show we watched a decade ago, and we’ve had so much time to build up this dense knowledge of each other.

* Ergonomics. Bess has had chronic problems with typing, because her arms hurt her. Looking closely at her, I see that she tends to contort herself like a circus performer or perch like a buzzard when she’s trying to write. She has a sit-stand desk but rarely stands. When she does stand (usually at my urging), she stands like a human flamingo, perched on her left leg with her right leg bent at the knee, which is pointing to the right, with the sole of her foot pressing against her upper inner left thigh. I believe, in yoga, this is called “tree pose.” Paula Tursi, our favorite yoga teacher from New York City, would be proud, but I don’t see how tree pose can possibly be ergonomic. To Bess’s credit, sometimes she switches legs. I encourage something more stable, but who will tell her to stand, and then tell her not to stand like a flamingo, when I’m gone?

Now that she’s been writing a lot, she’s been struggling again. So I helped her get and set up a Kinesis split keyboard. The split keyboard reveals some of her bad typing habits, like never typing with the pinky finger on her left hand. Now she sits with her elbows at a slightly greater than 90 degree angle. She’s got an external monitor. Adding these little things up seems to ameliorate many of her problems. She’s thrilled to be introduced to these tiny changes that seem second-nature to me. She says she’d’ve never discovered them on her own. She would have kept on suffering, like one of her patients too stubborn to see a doctor. I’m concerned about her extensor tendons. No one else will be, she says sadly, inciting more tears.

What other things do I know that Bess will need to know one day, and that I won’t be able to say to her, or help her with?

* Cooking. I do more cooking, even now, and Bess is too prone to forgetting to eat. She’ll not eat all day and then let pasta be dinner. To be sure, Bess can and does cook—she prefers to make elaborate, amazing meals, of the sort I can’t fully appreciate any more because I can’t chew, but she tends to ignore a lot of the day-to-day cooking that I’ve specialized in. She jokes that she brags about my cooking to her colleagues, whenever she hears someone complain about a spouse who doesn’t do their share of the housework.

“I know what you mean,” she’ll say. “Sometimes I get home after a shift and it takes Jake an extra 15 minutes to get dinner on the table.” Then she’ll sigh exaggeratedly. Another way our minds have merged: we both enjoy entertaining ourselves by sometimes inciting very minor agitation in others.
Since losing my tongue and ability to eat solid foods, I’ve evolved into making a lot of Instant Pot slow-cooker meals. The Indian slow-cooker cookbooks I’ve found are very useful.

When I was in the hospital recovering from the massive May 25 surgery, and then, when I first got home and could barely function, Bess later admitted that she barely ate anything because I wasn’t able to eat. Even though she knew I didn’t begrudge her, she didn’t want to eat in front of me, flaunting her ability to do a basic human action that I’d lost. And, besides, she didn’t have an appetite. She seemed to melt right along with me, losing 20 lbs over in a month. Only when I began cooking for her, and to blend my own food in a Vitamix, did she began eating. She said she felt like I was giving her permission to eat in front of me. And with me. I could only eat via tube.

And then there are beans. Bess was never a bean person: she didn’t love the smell or texture of canned beans, and making beans on the stove is too much a hassle and time commitment. She’s prone to forgetting whether gas stoves are on, though the excellent induction stovetop we’re using now reduces that risk. Plus, the induction stove doesn’t produce noxious indoor fumes like archaic gas stoves. On our first date, we were going to a movie, and she nervously confessed that she couldn’t remember if she’d left the stove on. Later, she told me that she struggled between two warring mental states: concern that I’d think she was crazy to think that she thought she was going to burn her apartment down, and concern that she actually might burn her apartment. In the end, lack of renters insurance motivated her confession. We turned around, missed the showing we’d planned, and checked her stove (it was off). But that was okay. Being a little scattered is one of her numerous charms. I’m getting off topic, because this paragraph started off talking about beans, but the point is that she didn’t love beans until I started buying from Rancho Gordo, which specializes in quality and heirloom beans (they also sell an amazing red popping corn); I was so enthusiastic that I signed up for their quarterly bean club. A friend calls me “bean man.” The Instant Pot cooks them fast. And they taste and smell better. Maybe they’re more nutritious, too, and they don’t have whatever chemicals are used to seal a can’s lining.

* Outdoor drying. The other day, Bess washed a new blanket. I suggested she leave it on the deck, since we live in Arizona and leaving wet garments or blankets outside will leave them rapidly dry, especially in the summer. She wanted to use the dryer instead and had to run it through three times, delaying her ability to go to bed. At the end she said she should’ve left it outside.

* Lifting heavy objects or opening jars: This is a standard male-female issue: I’m considerably better and more able to lift heavy objects and open jars, but, instead of asking for help, Bess often struggles and sweats then stares at me with wide-eyed wonderment when I casually pop open the jar. Sometimes I will please her by telling her that she loosened it for me. Mostly, I just like the way she looks at me as if I’ve returned to the cave fire dragging a mastodon behind me and she’s about to show her gratitude when we get under the deerskins.

* Gadget discovery: The Instant Pot, induction stovetop, and Kinesis keyboard have already been mentioned. I’d be remiss to miss the Zojirushi rice cooker, though. Perfect rice or lentils, every time, with no effort. One and a half cups water to one cup brown rice. One a quarter cups water to one cup green or black caviar lentils. It’s great. She’d have missed the sit-stand desk revolution if I hadn’t nudged her towards a sit-stand desk—which she doesn’t use in standing mode as much as she ought to, but I bet that will change.

* Sleeping at night. Bess is a bad sleeper and she sleeps better when she’s next to me. Five or six years ago, I discovered that reading to her in bed helps her fall asleep. I read her the entirety of The Deptford Trilogy and The Lord of the Rings, as well as multiple Elmore Leonard books (Get Shorty is the best one) and Lonesome Dove. I did all the voices, too, which sometimes made her laugh too hard to sleep. I can’t read Bess to sleep effectively anymore, but she says that being beside me helps her sleep. Even if she seems wide awake and busy near bedtime, if I say I’m going to bed, she’ll hop up and be under the covers, awaiting a cuddle before I’ve managed to get my shirt off. She likes sleeping next to me so much so that she resists sleeping in the office bed, despite me making more noise snoring than I ought to. She insists that Bose Sleep Buds completely solve this problem.***

* Love and affection. Bess thrives on both and I yield them up to her. Sometimes, if I want to let her feel like she’s had a little struggle, I let her think she’s forced me to yield them up, which gives her a sense of accomplishment.

* Geography. Thanks to the advent of universal GPS—a tremendous scientific and engineering triumph that almost no one steps back to appreciate today—geography sense isn’t as important as it once was, but Bess’s sense of direction is peculiar, and one might say close to altogether absent. Even with the phone speaking directions, she’s prone to missing turns or not knowing where to walk. I once asked her if she likes not having anybody else in the car because she’s just come to absolute peace with getting lost all the time. She didn’t even hesitate when she said yes. She calls me her GPS. She will never know which way is north.

* Medical questions. She’s done four years of med school and three years of residency and a decade of being an emergency medicine attending physician, but she’ll often ask me medical questions. Should she use the liquid bandage? Does this thing look serious to me? Do you think (insert symptom here) means I’m getting sick? My medical education consists of listening to her do questions for medical exams, listening to her stories and our friends’ stories, and sneaking into some drug rep dinners by pretending to be a doctor (the one about TPA, a stroke medication, is particularly vivid because Bess claims I raised my hand at the wrong time). She’s performed a thoracotomy—a rare, Hail-Mary procedure in which the doctor cuts open a person’s chest and attempts to use their hands to beat the heart:

With a fifteen blade, I slice deeply from his nipple all the way down to the bed. I grab the scissors, cut through his intercostal muscles, take the rib-spreaders, put them between his ribs, and crack his chest open. There’s a huge gush of blood. And then a moment of stillness, like the second after a lightning strike. Even his blood smells metallic, like ozone. I reach into his chest and put my hands around his still heart and begin pumping it for him, feeling for damage.

Then I slip my fingers down the length of his aorta and it is so riddled with holes that the frayed pieces disintegrate in my hands.

She treats pneumothoraxes and the obstructive shock they cause, also by cutting through the patient’s chest wall to puncture the patient’s pleural space to insert a chest tube. With all that medical experience, she has not internalized that I don’t know if she’s getting sick. I never know. I tell her that and she still wants my opinion. Despite her wealth of medical knowledge and my paucity of it, I’m still her second opinion about many medical issues.

* Book judgment. Bess has shaken off most of her bad MFA interests and habits, but she’s still prone to buying books that have no plot, or are political statements rather than novels, or otherwise aren’t any fun. Bad books affect her writing negatively; good books, positively. I’ve told her that, the next time a book from the McSweeney’s book-of-the-month club arrives, she’s to chuck it and read the first Elmore Leonard novel she can get her hands on.

* General comfort. Bess has said: “The only person who can comfort me over everything happening around your cancer is the person it’s happening to.” Right now, I can (and do) comfort Bess. She nods her head when I ask her if she feels that I’m doing a good job. After I’m gone, friends and family will try to comfort her. I’ve told her as much, and she replies that they won’t be me, and that the only person who can comfort her then will be a person who is gone. I hope that the many ways I’m showing her love now, and trying to prepare her now, will be enough. I’ve been making videos for her, so that when she needs my comfort, she can pull those videos up on her phone, and have a sense memory of me holding her and petting her head while I tell her it will be okay. It will be okay. If there turns out to be any way of reaching her, she knows I’ll do it. She has said she’ll look for me in dreams, since she’s a lucid dreamer.

* Eye masks, dishwashers, and ear plugs: This group is unashamedly a grab bag; Bess didn’t use eye masks for sleep until she saw me using them. Eye masks turn any room into a dark room. Dishwashers reduce the time wasted on dishes, but Bess’s parents apparently don’t believe in efficiency and so they’d never used one, and neither did Bess until she saw me using one. Ear plugs make noisy bars and restaurants tolerable. All three are quality-of-life improvements.

Some of these are minor and merely illustrative, to the point where the reader may be rolling his eyes; suggesting Bess leave a blanket outdoors isn’t on par with editing her work or functioning as her memory. Small actions add up. Small inconveniences and annoyances can become large problems, such as the wrong keyboard turning into a tendonitis and turning into her not being able to write or work. Fun fact: the most important part of a doctor’s life and career hasn’t, for years, been patient care—it’s actually keeping the electronic medical records (EMR) up to date. Kill a couple patients? Frowned upon, but also, eh, it happens. Screw up the computerized record keeping that allows hospitals to bill insurance? That’s a crisis and fireable offense. I exaggerate only slightly.

Not everything I show Bess takes. She wisely eschewed the Vibram Five Fingers (“toe shoes”) when I went through a period of misplaced enthusiasm. She did show me how to pick up a pen from the ground with my toes, a trick I could execute in those shoes, to the horror of students. She likes to travel and wisely ignored my arguments for travel being overrated. There are probably others that I can’t think of right now, but the overall trend is for us to show and share things to one another and for those things to be incorporated into and enhance our lives. When I’m gone that process will break down, and, with it, I worry that Bess will live a worse life, not just from loneliness but from not continually being exposed to the process of discovery that I automatically undertake.

The physical stuff matters, sure—the keyboards or the induction stove—but the loss of processing power and future growth are worse. She helps me grow and I help her. My own growth trajectory is going to be shut off by death, but hers will, I hope, continue. Without me, I worry that growth trajectory will be truncated.

This essay is nominally about Bess, but it’s really about how to have and grow a relationship. How to have and grow a life. No, come to think of it, not one life—two.

* What? Even while dying, I’m allowed to have some intellectual and policy-wonk inclinations.

** There are obviously exceptions, like the people planning to divorce anyway, or the people who stay together out of convenience or habit or lethargy or any number of other sad, if common and practical reasons.

*** Bess says that the keys to saving a (sleeping) relationship in the bedroom takes two things: Separate blankets and some kind of quality personalized white-noise-maker.