Author's Note: Keep in mind, these essays are supposedly publicly available in Ichigo's world. So no ghosts will be directly referenced.
Part One: Life of a Strawberry
The Unlucky Thirteen Essay Collection
Essay One: The Intensive Care Unit
It wasn't called hospice. It was called the intensive care unit. This was a lie. It was essentially hospice, a place for the slowly dying. Statistically, if one was looking at ten intensive care patients, maybe two would survive to leave the unit.
Until very recently in history, human death has been relatively quick. We did not have the medical advances and technology necessary to prolong life. Now we do. This does not mean that nobody dies; rather, it means that dying people die much more slowly, and thus have a much worse quality of life while they're dying.
Consider a patient of my father's: by the end of all the surgery he'd had to do to keep her alive, she had dry gangrene of the foot which would have to be amputated, a large open abdominal wound with leaking bowel contents, she could not eat, she needed a tracheotomy, her kidneys were gone, and she would have to spend the rest of her life on a dialysis machine. To top it all off? What he'd originally treated her for was not getting any better.
Was she close to death? Maybe, but with constant dressing and the help of dialysis machines, feeding tubes, and amputation, it was hard to tell. She could live for years in that horrific in-between state. That's where hospice care comes in. People who work in hospice and intensive care try to make slow death as livable as possible. They can do nothing to save their patients, but they can comfort them in their final years.
My father ran a small family clinic from the bottom and front part of our house. He was a doctor. "Ichigo," he told me once when I was in junior high, "I want you to spend six months providing hospice care for people in the intensive care unit. I want you to emotionally, spiritually, and physically counsel and care for them through dying."
My father insisted that all three of his daughters do nursing duty shifts at his hospital. I was supposed to be born a boy. I was born five days late, on July 20th, and came out a girl instead. The ultrasound had made a mistake; a fraction of limb had been mistaken for a penis in the photograph. I often wondered how my life would have been different if I had been born a boy. Would my father still have mandated shifts at the hospital clinic?
"Dad, I'm not even religious or spiritual myself," I said, bewildered and kind of angry and thirteen years old and uncomfortable with facing the dying for some very personal reasons. "I'm no good at talking about emotions. What the hell am I supposed to say?"
"You'll figure it out," he said simply.
"What about school?"
"I'll take care of the unit while you're at school. You'll take care of it before and after school. Six months, Ichigo. You can do this!" He clapped me on the shoulder and walked off to take care of a patient. "I have faith in you!"
I have often speculated since about why a father would make his preteen daughter handle people in hospice care. He was a macho "tough it out" sort of guy, but I didn't think that was it. I'd always had a strange connection with death. My mother died when I was nine. I'd faced the back end of death. Maybe my father wanted to see his growing daughter face and accept the front end. And maybe, just maybe, he wanted his growing daughter to accept that nobody could save everyone.
I was also well aware of the studies that indicated hospice care, far from hastening death, sometimes prolonged life. I might be prolonging life for some patients by caring for them and being there for them. In the state they were in, was that a good thing? That was a matter up for debate.
I sighed. "Fuck," I muttered, and put down my school book bag to go put on my white nursing uniform. I would do this every day after school, without fail, for the next six months.
The Kurosaki Clinic hospital was separated into two wings: standard care on one side of the main hallway, intensive care on the other side. Intensive care consisted of two long rows of dying people hooked up to machines in white hospital beds, separated by curtains. There were TVs on each end of the room, always turned on.
For the six months I was working in the wing, the hospice care consisted of a young mother with stage four lung cancer, a highly drugged eighty year old woman with congestive heart failure, a middle aged woman who had refused treatment with metastasized bone cancer and a fungal pneumonia that had arisen in the final stages of her illness, and an old woman with end-stage respiratory and kidney failure who had been forced into the clinic by her children even though she didn't want to die slowly like her husband had. There was only one man, and he had senile dementia and no living family.
I had my physical duties: I settled people into wheelchairs and took them walking around the block in the sun, I served them bland but safe food and helped feed them, I changed and cleaned their sheets and their bedpans. I took the best care I could for their various illnesses, from administering drugs to making sure they took their medicine. I had to take special care of the man with dementia; I was required to keep his whole life scheduled for him, remind him of things and explain things to him over and over again, reintroduce myself every time I met him, keep him from wandering off. I brought in therapy dogs once after making sure no one had any allergies, smiling sadly as I watched the delighted patients play with them and pet them.
Strangely? This was the easy part. I was better at keeping calm and nursing the dying than I thought I would be. Other parts of working hospice were much harder. The entire wing reeked of death and antiseptic, a smell entirely impossible to describe, and it was full of long rows of passive, quiet people - not only waiting to die, but wishing for it.
That was the worst part. Somehow, it would have been easier if they were hysterical and unaccepting.
The emotional and spiritual aspects of hospice were the hardest. I've always had a Resting Bitch Face, and I had to work hard not to look like I was about to punch somebody's head off. But I also had to talk to the patients, counsel them, and this was entirely uncomfortable because for as long as I was around the clinically dying, I was constantly angry and upset.
Each patient required individualized care. I had to sit with them as they worried about their families, try to talk them through periods of depression and anxiety. They asked me whether or not death would hurt. I would be woken in the middle of the night to talk them through horrific nightmares of things to come. They told me that they felt lonely, alone. They asked about their health state, and I had to answer honestly while also trying not to upset them. It was emotionally exhausting and required a level of tact I didn't always have, but I didn't feel like bitching - my discomfort was nothing compared to the pain they were going through. I tried to make them feel cared for, schedule meetings with priests of varying religions, ordered more therapy dog visits.
Mostly I felt useless. Like I could do nothing of real significance. And that frustrated me.
"What do you think happens to us after we die?" the middle aged woman who had refused treatment asked me once in my first week. The young mother looked over curiously.
I replied without thinking: "I think it depends on what kind of person you were in life. There is the Hell realm, the Ghost realm, the Rebirth realm, and the Enlightened Realm."
"Ah. You're a Buddhist," said the woman, but I could see her sagging sadly.
"Not a terribly religious one, but yes." I looked at her for a long moment. "But do you know what the great thing about Buddhism is?" I said at last. "You can always change your karma around by being a better person. No matter who you used to be, if you become a compassionate person that cares for others, you can reverse any damage you might have done to your soul. Anyone at any stage of their cyclical existence can start trying to be a better person, and their rebirths will be better and they'll work closer towards Enlightenment.
"It's not about what kind of person you were. It's about what kind of person you choose to be."
The woman stared at me. "You know a lot about death for someone who's only thirteen."
"I've had a lot of time to think about it," I admitted.
The two women smiled. Somehow, with my crippling bluntness, I seemed to have comforted and pleased them. "What is your name?" said the middle aged woman.
"Ichigo," I replied. "Kurosaki Ichigo."
"Ichigo. It means 'strawberry.' What a sweet name…" said the woman with quiet, hoarse longing.
Usually I got annoyed when people called my name cute. Not this time. I was too sad and sympathetic to be angry or cruel.
"My name also means 'one who protects'," I said smoothly instead, turning back to her IV. "That's why I'm here."
"You care a lot about death," the young mother observed, and I paused. "I can see it. You're upset when you see us, because death affects you personally. Why do you care so much about death?" she asked me.
I stepped away from the IV and said quietly: "Because even I can't save everyone."
I was there when my mother died.
She was walking me back home from karate class. I was nine years old. We were holding hands, me in my rain jacket, her with her umbrella. It was pouring rain, a summer thunderstorm, and it had been raining for days.
Suddenly, a truck zoomed past us on the road, splashing me with water. I was closest.
"Oh, what a mean truck!" my mother said softly, leaning down to wipe my face with her handkerchief decorated with floral perfume. "Here, we'll switch sides. I'll walk by the road."
"No, Mommy. I'll walk closest, because I want to protect you," I said earnestly. Ever since learning my name was a guardian's, I had entertained fantastical daydreams of protecting everybody I loved: my friends, my Dad, my Mom, and my little sisters. It was why I had entered karate class.
"Well, I feel much safer now, don't I?" she said, a smile in her voice. "But until you can beat Tatsuki in a karate match, I think I'll be the protector."
My mother was always the protector, the nurturer. She filled her children's world with love, and laughed at my father's jokes and goofy antics, covering his world in light. I think she wanted our first memories to be happy ones, and tried hard to make that happen. When I grew up, I wanted to be just like her - a great protector.
I shouted now into the muffled cloth.
"What is it? I can't hear you!" she said with singsong humor, and removed the handkerchief from my face.
"I said I'll beat her someday!" I shouted indignantly. Tatsuki was the only other girl in my karate class, but don't take that as a sign of her weakness - she was the most vicious of any of us. She beat me in every spar, and at the end of every spar I cried, a humiliating tendency.
"That's the kind of spirit I like to hear!" said Mom cheerfully, still amused, and she stood closer to the road, switching the umbrella to her other hand and taking my hand in hers. "Now. Time for home. Tonight I think I'll make -" Mom was part nurse for Dad, part homemaker. We'd begun walking again.
But I don't remember anything else, because all of a sudden I looked across the street full of zooming cars and I saw something. The river across the street was swelling, flooding, with rain, and a girl was standing on the edge of the flood, as if she was about to dive into it, as if she was waiting for the rain to swallow her. She was pale with short black hair and silvery eyes.
Remember, I had a hero complex. I wanted to save her. I've had a complicated relationship towards the idea of being a hero ever since.
I snatched my hand out of my Mom's grasp and darted toward the girl across the street full of cars, ready to pull her back. "Ichigo, no!" I heard my Mom shout, and I heard her footsteps running after me. I'd reached the edge of the riverbank unscathed. There was a screech of wheels, something hit me from behind, and I blacked out.
When I woke up, the girl had gone. Nobody else had seen her.
I squirmed, coming to, underneath a heavy weight. I was soaked with something warm, and my face was in the wet, sticky mud. With effort, I turned around to see what was on top of me.
I saw my mother's dead face.
To describe what that moment felt like is impossible. So I'll just describe her face. She was smiling. Her eyes were glassy and blank. Her face was a cold whitish blue. Her brown curls were messy around her. The warm something was her blood. She was bleeding all over the riverbank.
I screamed.
I screamed and screamed and I kept screaming, as I dug for purchase and my nails dug into her skin, as I dragged myself out from under her, covered in mud and blood.
"Oh my God!" passing drivers who had stopped were gasping. "Her daughter is still alive!"
I was covered in mud and blood. I clutched myself and screamed.
For days afterward, every afternoon, I went to that riverbank. I paced, sat down, then paced some more. I pretended to my Dad that I was going to school, but I wasn't.
I don't know what I was waiting for. Eventually I just stopped going.
I think I was different, after that. Not as idealistic. I stopped pretending I was some kind of hero. Weirdly? I also started beating Tatsuki in karate matches. I stopped crying. It was as if, after all that hysterical screaming, the tears were just… gone.
The following months were strange. I'd be going along just fine, and then some weird thing would remind me of her. Once I was out shopping and I caught a whiff of the perfume she used to wear. And I completely lost my shit. I ended up sprinting out of the shop and across the parking lot, but it was as if my knees weren't working properly. I barely made it a block before collapsing against a pole, shaking. Not even crying, just… shaking. Gasping for air, like I was having a panic attack. I didn't feel like crying. Actually, I felt a little like I wanted to throw up.
I was angry for days afterward. I would go to gym and viciously punch and kick a punching bag until I was too tired to feel the choking fury anymore.
Moments like that happened a lot.
Stranger still were the days when nothing really seemed to have a point, when I just lay in bed all day and couldn't find the will to do anything. My thoughts raced. You have to understand… our family was a solar system. And Mom was the sun. Everyone, Dad, Karin, Yuzu, me, we all revolved around our mother. She was the one I had most wanted to protect. And she was the one I had failed. I had taken her from them.
Every time I saw Karin refuse to cry, every time I saw Yuzu actually cry, every time I saw my father looking much more tired than usual… it reminded me of that. Those were usually the days when I couldn't get out of bed. Then I'd feel even more useless. Or if a nightmare of her death would come? Maybe I wouldn't get out of bed for days.
It was my fault, you see. If I hadn't run across the road, my mother never would have been hit. And I may not have been a hero, but I knew that if I ever saw someone I loved die again, I would really lose my shit. Completely. For mostly selfish reasons, I swore that would never happen.
No one yelled at me. That was the hardest part. Nobody was angry with me. It would have been easier, I think, if someone had yelled at me. My father, one of my sisters, anyone. If someone had been angry with me. But no one was. Not openly, anyway.
I remember in middle school, I was at this school play, and they started talking about grief and loss, death and depression. All the blood drained from my face as the words echoed through my brain, and I started trembling. Guilt. Anger. Loss of energy. Loss of life force. Suicidal thoughts.
I barely made it halfway through the play before sprinting out of the theater. This is my great secret: In the end, I'm always a coward.
I lost my first hospice care patient two months in.
It was the old man, the one with senile dementia. When I came in to check on him, brushing back the curtain and announcing myself in a sing-song voice - I knew immediately he was dead.
I rushed forward, checking his pulse, frantically calling his name. There was no response.
My father found me crying half an hour later out in front of the intensive care unit. He sighed and sat down beside me.
"Someone died, didn't they?"
Unable to choke anything out, I nodded.
"It happens, Ichigo," he said simply. "People die. There was nothing you could have done, and at some point you're going to have to accept that."
I knew we weren't just talking about hospice care anymore.
"He had a brother who brought him in here," I choked out, furious but sobbing nonetheless. I still got teary when I was angry, and it was still a humiliating tendency. My hand was bunched running through my hair. "What the hell am I supposed to say to him?"
"Tell him the truth," said my father. "His brother was sick. Now he's dead. It's the same thing with your mother. She made the choice to cross the road. A car hit her, and now she's dead."
I looked up at him through my crying.
Suddenly, a little old lady wheeled herself out into the hallway in a wheelchair. I paused in surprise. It was the lady I'd always thought was so drugged-up.
"I want to talk to her." She pointed my father mercilessly down the hall. "You go somewhere else."
My father shrugged, smiling cheerfully enough. He nodded and left.
"He died and you're crying?" the little old lady snapped.
"You can talk," I said in surprise.
"Of course I can talk!" she shouted, and I jumped a little bit. "I just didn't want to!
"Look," she said flatly. "You make everyone in that room happy. You even made that old man happy."
"But… he didn't even know me," I said, confused. "I had to reintroduce myself to him every time I walked in there."
"Maybe he didn't remember you consciously. But every time he saw you, his whole being brightened. It's not his fault if you were too stupid to notice." She glared at me. "You made him happy. Sometimes, that has to be enough."
And she wheeled herself back into the intensive care unit.
The funny part? She had heart surgery a month later. She was the only patient I knew who made it back out of the intensive care unit.
I cared for the rest of them as they died, one by one. Died just like my mother had.
Tell the truth. Something happened, and now they're dead. You made them happy. Sometimes, that has to be enough.
People die. There was nothing you could have done, and at some point you're going to have to accept that.
The trick, I suppose I have learned, is to know when you can do something and when you can't. When making them happy is enough, and when it isn't.
I recommended that old lady to heart surgery. It's why she survived.
