A Little Life: A Novel

“I will,” he says.

January; February. He is busier than he has ever been. Willem is rehearsing a play. March: Two new wounds open up, both on his right leg. Now the pain is excruciating; now he never leaves his wheelchair except to shower and go to the bathroom and dress and undress. It has been a year, more, since he has had a reprieve from the pain in his feet. And yet every morning when he wakes, he places them on the floor and is, for a second, hopeful. Maybe today he will feel better. Maybe today the pain will have abated. But he never does; it never does. And still he hopes. April: His birthday. The play’s run begins. May: Back come the night sweats, the fever, the shaking, the chills, the delirium. Back he goes to the Hotel Contractor. Back goes the catheter, this time into the left side of his chest. But there is a change this time: this time the bacteria is different; this time, he will need an antibiotic drip every eight hours, not every twenty-four. Back comes Patrizia, now two times a day: at six a.m., at Greene Street; at two p.m. at Rosen Pritchard; and at ten p.m. again at Greene Street, a night nurse, Yasmin. For the first time in their friendship, he sees only one performance of Willem’s play: his days are so segmented, so controlled by his medication, that he is simply unable to go a second time. For the first time since this cycle began a year ago, he feels himself tumbling toward despair; he feels himself giving up. He has to remind himself he must prove to Willem that he wants to remain alive, when all he really wants to do is stop. Not because he is depressed, but because he is exhausted. At the conclusion of one appointment, Andy looks at him with a strange expression and tells him that he’s not sure if he’s realized, but it’s been a month since he last cut himself, and he thinks about this. Andy is right. He has been too tired, too consumed to think about cutting.

“Well,” Andy says. “I’m glad. But I’m sorry this is why you’ve stopped, Jude.”

“I am, too,” he says. They are both quiet, both, he fears, nostalgic for the days when cutting was his most serious problem.

Now it is June, now it is July. The wounds on his legs—the old ones, which he has had for more than a year, and the more recent ones, which he has had since March—have not healed. They have barely diminished. And it is then, just after the Fourth of July weekend, just after Willem’s run ends, that Andy asks if he can come talk to him and Willem. And because he knows what Andy is going to say, he lies and says that Willem is busy, that Willem doesn’t have the time, as if by delaying the conversation, he might delay his future as well, but early one Saturday evening he comes home from the office and there they are in the apartment, waiting for him.

The speech is what he expects. Andy recommends—he strongly recommends—amputation. Andy is gentle, very gentle, but he can tell, from how rehearsed his delivery is, from how formal he is, that he is nervous.

“We always knew this day would come,” Andy begins, “but that doesn’t make it any easier. Jude, only you know how much pain, how much inconvenience, you can tolerate. I can’t tell you that. I can tell you that you’ve gone on far longer than most people would. I can tell you you’ve been extraordinarily courageous—don’t make that face: you have been; you are—and I can tell you that I can’t imagine what you’ve been suffering.

“But all of that aside—even if you feel you have the wherewithal to keep going—there are some realities to consider here. The treatments aren’t working. The wounds aren’t healing. The fact that you’ve had two bone infections in less than a year is alarming to me. I’m worried you’re going to develop an allergy to one of the antibiotics, and then we’ll be really, really fucked. And even if you don’t, you’re not tolerating the drugs as well as I’d hoped you would: you’ve lost way too much weight, a troubling amount of weight, and every time I see you, you’ve gotten a little weaker.

“The tissue in your upper legs seems to be healthy enough that I’m pretty certain we’ll be able to spare both knees. And Jude, I promise you that your quality of life will improve instantly if we amputate. There won’t be any more pain in your feet. You’ve never had a wound on your thighs, and I don’t think there’s any immediate fear you will. The prosthetics available now are so infinitely superior than what they were even ten years ago that honestly, your gait will probably be better, more natural, with them than it is with your actual legs. The surgery is very straightforward—just four hours or so—and I’ll do it myself. And the inpatient recovery is brief: less than a week in the hospital, and we’ll fit you with temporary prostheses immediately.”

Andy stops, placing his hands on his knees, and looks at them. For a long while, none of them speaks, and then Willem begins to ask questions, smart questions, questions he should be asking: How long is the outpatient recovery period? What kind of physical therapy would he be doing? What are the risks associated with the surgery? He half listens to the responses, which he already knows, more or less, having researched these very questions, this very scenario, every year since Andy had first suggested it to him, seventeen years ago.

Finally, he interrupts them. “What happens if I say no?” he asks, and he can see the dismay move across both of their faces.

Hanya Yanagihara's books