The hacking cough is dry this morning – as it was last night and the full and mirthless day before. It is a brittle tapping, meted out in brutal increments from a virgin chest cavity – the thinning rap like that of a taut drum prattling in a cold vacuum. My son is eight years old, and he is in his fifth day of fever and pneumonia. It is the last week of December, and the days and nights everywhere else are dancing in the smiling lights and the happy tick toward another new year.
When the cough comes it does so to wake him and to buck him apart. It has been with us now for a long enough time for it to be referred to as “his cough.” His cough is unproductive. His doctor tells us this. We are given the character of his cough and what we are to expect from it. His cough is a protest and a noise; it is a compression and an irregular release of compressions; it is a thoughtless hammering-on; it is hungry and it is wanting in its hunger.
His cough has made his eyes seem pinned in their darkened lids, and he looks at me with the hesitant knowledge that I hold a combination of everything and nothing in my bottles of antibiotics and Mucinex and cough suppressant and Advil. I am a shuffling pharmacy and an amateur scientist. I am a small dispenser of public knowledge and nervous humor and I am the universe. But we are living through the question – what is this bug that resists the syrups and the coated pills and the remedies?
“Dad,” he asks between the kick of unexpected half-coughs.
“Don’t talk.”
“Am I getting better?” His hair is greasy, slick now with new sweat. His lips are cracked – layered in dead lip debris, dusted in white crust, with lasting orange markings at the corners of his chapped mouth from the few ounces of Gatorade that was forced into him.
“I don’t know,” I say.
He gives me nothing because I have given him nothing. I am raising him in nihilism, and the blank vapid ether that we are both breathing needs noise and color and shape. We seem to realize this together and accept it together. It may be that we can draw on facts, be comforted in the most uncomfortable facts; that we can pull on this full breast together and find inebriation in its nourishment.
“You need to drink,” I tell him.
“I am drinking.”
“Water doesn’t count. The Gatorade has sugars and things called electrolytes. Your body needs these things. Your cells – the little cells that you are made of – need these things.”
“I don’t like the Gatorade. It smells like wax.”
“That’s the pneumonia tricking you. Don’t listen to it.”
He does not look at me when he says this next thing, and I can see ruinous thoughts settling in his face. “Why is it so mean?”
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My son has a red belt in Shotokan karate. It is an achievement that has come after repetition and correction – over and again – correction and repetition, like an ocean smoothing a stone. The Shotokan discipline strives for perfection through repetitive action and the incorporation of diverse katas, which are themselves an increasingly complex series of movements that demand still more repetition in order to be fully understood and mastered.
Over the course of this schooling, he has been asked to break a variety of pine boards, each new one thicker than the last. When the wood does not give, he is asked to throw another strike and then another, his knuckles at times pinker and fleshier in their swelling – the knock of his small bones against the unforgiving square thwacking in a tight echo across the length of the dojo. It is a physical world in need of breaking.
I think of the times he has been stopped there and steadied there in his simple white gi – the times he was asked to imagine a different plane and could not see it. He had been there and not been there – it had been suggested that he be beyond there. And it is the same now. The thing that needs to be broken is not tangible – and yet it is the truer obstacle.
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I am sitting on his mattress in the dark, listening to his short breathing. He is curled up and baking in the hot wrap of his skin. I have forgotten why I am holding a towel, but I have wrapped it around my forearm as if I intend to repel some aggressive animal. Little makes sense – and horribly most of it does. The drugs are not working. I have taken the time now to learn more.
His cough has an identity. It is known in medical circles as Mycoplasma pneumoniae.
According to the CDC, Mycoplasma pneumoniae sends 100,000 Americans to the hospital every year. Its incubation period is one to four weeks, so it is carried quietly. It is the leading cause of pneumonia in school age children, and its trends are unknown.
It is a very small bacterium – one that lacks cell walls. Mycoplasmas are members of the class Mollicutes, which means soft skin. Without a cell wall the organism is resistant to the effects of penicillin and other beta-lactam antibiotics, which disrupt bacterial cell walls. The genetic code of Mycoplasma pneumoniae is more similar to mitochondria than to other bacteria. According to The American Lung Association, “Mycoplasmas are the smallest free-living agents of disease in humankind, unclassified as to whether bacteria or viruses, but having characteristics of both.”
The bacterium causes what is known as atypical pneumonia – a longer fevered sickness with unproductive coughing and general malaise as key features. On a website created for Middlebury College to better understand the Mycoplasma pneumoniae bug, Katherine Howard writes, “There are 5 recently proposed (and controversial) associations between mycoplasma infections and human disease: AIDS, malignant transformation, Gulf War Syndrome, Crohn’s Disease, and Rheumatoid arthritis.”
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I find paper and draw characters that represent white blood cells and characters that represent bacteria. They face each other – in my crude animation – prepared as they are to fight. The fight is demonstrated in violent scribbling lines, irregular slashes and arcs, wide and unstable loops and scores and strikes and stabs. Each white blood cell wears a gi. They drink Gatorade and eat toast, slurp soup and down spooned medicine. At first, the white blood cells lose and die in numbers – and the darker and uglier bacteria cheer. But then the nourishment kicks in, and the white blood cells are awarded red belts. There is a conclusive re-gathering, and the bacteria are routed. This is the storyboard that plays out.
He coughs through his nose, lets me fill another plastic cup with orange-flavored Gatorade. He cracks a small smile. This is all he has, all I can give him. We play it out together and again, repetition and correction – again, correction and repetition.