The household of Brendan Costello gathered within the hospital half-light. He had overcome a lot in life, however the profound harm to his mind meant he would by no means once more be Brendan. It was time.
Brendan had spent 4 months enduring three surgical procedures and a prolonged rehab after infections additional destabilized his broken backbone. He had returned to his residence on the Higher West Aspect in late December to start reclaiming the life he had placed on maintain — solely to enter cardiac arrest three weeks later and lose consciousness eternally.
His youthful sister, Darlene, stayed by him within the intensive care unit at Mount Sinai Morningside hospital. She made certain that his favourite music streamed nonstop from the moveable speaker propped close to his mattress. The gravelly revelations of Tom Waits. The “ah um” cool of Charles Mingus. The figuring out chuckle of New Orleans jazz.
The music captured Brendan: the dark-humored Irish fatalism flecked with hope and surprise. And sure, he used a wheelchair, however woe to anybody who recommended this by some means outlined the person.
After assessments confirmed no likelihood of regaining consciousness, a wrenching resolution was made. Brendan’s ventilator could be eliminated at 1 p.m. on Sunday, Jan. 19, 5 days after his collapse. He was 55.
Now it was Sunday, heavy and grey with dread. A number of of Brendan’s closest kinfolk ringed his mattress, together with his sister and the aunt and uncle who had raised him. Waits growled, Mingus aahed, the clock ticked.
Then, simply two minutes earlier than the appointed hour, as tears dampened cheeks and arms reached for one final squeeze, a nurse stepped into the second to say that Ms. Costello had a telephone name.
What?
A telephone name. It’s important to take it. You HAVE to take it.
The flustered sister left her brother’s room and took the decision. Relations watching from a brief distance noticed her listening, noticed her arguing, noticed her face contort in disbelief.
Time paused, as all of the emotional and religious girding to say goodbye gave strategy to a realization: In fact. Their beloved Brendan — witty, contrarian, compassionate and not-yet-dead Brendan — had different plans.
In fact.
BRENDAN CAME BY his gallows humor truthfully. Discovering the comedy in tragedy was a coping mechanism, a approach of proudly owning the ache, that he shared together with his sister.
Their dad and mom have been deaf and finally incompatible. After their father left the household, their mom — their devoted, hilarious, troubled mom — took her life within the basement of their Brooklyn residence constructing. Brendan was 8, Darlene 6.
They went to stay with Uncle Marty and Aunt Cathy Costello and their two younger daughters in northern Westchester. The couple resolved to lift the 4 youngsters the identical, doing their greatest to ease the trauma shadowing their nephew and niece.
Younger Brendan amused the household together with his sardonic asides, did nicely at school and established a College students for Peace group at Yorktown Excessive Faculty. After school, he took a job writing Wall Avenue-related information releases that didn’t swimsuit his skills or pursuits. He discovered methods to numb himself.
Late one night time in August 1996, a really drunk Brendan fell onto the subway tracks on the Broadway-Lafayette station. The oncoming D practice reduce his tie just under the knot, in sartorial measure of how shut he got here to dying, and took away his capacity to stroll. Devastating.
However whereas rehabbing in a spinal-cord-injury program, he met a person in a wheelchair named Boris, who recommended others about this new chapter of their lives. “Boris instructed him that when you may have an accident like this, you don’t withdraw from the world, you lean into the world,” Marty Costello recalled. “You go on the market. And that’s what Brendan did.”
He did so with Brendanesque humor, typically carrying a blue Metropolitan Transportation Authority hat or a black T-shirt emblazoned with the orange D practice image. Simply to indicate there’s no onerous emotions, he’d clarify.
“In the event you’ve watched your dad and mom die, otherwise you’ve been run over by a practice, you’re at a deeper depth of what’s humorous,” his sister stated.
Among the many many issues that certain the 2 siblings collectively was the 1986 Jim Jarmusch film “Down by Legislation.” Its tragicomic sensibility resonated, as did a line uttered by Roberto Benigni, who performed an Italian immigrant struggling to be taught English:
“It’s a tragic and exquisite world.”
Brendan drove a automobile, and refused any assist getting in or out. Went skydiving. Co-hosted a radio present targeted on incapacity rights and tradition. Taught inventive writing on the Metropolis Faculty of New York. Printed items in Harper’s, The Village Voice and elsewhere. Grew to become president of the Irish American Writers and Artists group. Belonged to the St. Pat’s for All group that arranges an annual everybody-welcome parade in Queens. Talked about storytelling with the elementary faculty college students of his cousin Katie Odell, typically even letting them sit in his wheelchair.
And he dominated on trivia nights on the Dive 106 bar on the Higher West Aspect, typically serving to his workforce to beat all comers, together with, most deliciously, squads of Columbia College college students. “He was positively the MVP of our workforce,” recalled Leland Elliott, his longtime good friend and trivia teammate.
Brendan appreciated the saxophonic improvisations of Pharoah Sanders, the literary riffs of James Joyce and the Japanese artwork of Kintsugi, by which a damaged factor, corresponding to a shattered piece of pottery, is reassembled with gold or silver lacquer to create one thing new and wondrous.
He disliked Disney, Apple and, particularly, any suggestion that his incapacity by some means made him inspiring. “He was not someone who wished to be seen as a man in a wheelchair,” his cousin Maryanne Canavan stated. “He wished to be recognized by what he delivered to the desk.”
And what he introduced was appreciable, she stated. “His mind was his superpower.”
THE TELEPHONE CALL that interrupted Brendan’s dying was about extending lives, although not his. Simply as he had deliberate.
The caller was from LiveOnNY, the nonprofit group federally designated to coordinate organ donations within the New York metropolitan space. When a affected person who meets particular scientific standards appears on the cusp of dying at a donor hospital, the hospital is required to contact LiveOnNY, which then checks for the particular person’s identify within the database of registered donors.
Years earlier, Brendan had registered whereas renewing his driver’s license. The caller, a family-support advocate for LiveOnNY, gently defined that this meant he couldn’t be taken off the ventilator. A minimum of not but.
The information was virtually an excessive amount of to course of. Darlene Costello, who moments earlier had been steeling herself to say goodbye to her pricey and solely sibling, erupted in anger. Why was she solely now listening to about this?
Steadily, although, she got here to embrace the import, the sweetness, of what was unfolding. By late that afternoon, the LiveOnNY consultant was at Mount Sinai Morningside, patiently going over the following steps with Ms. Costello and her cousin, Ms. Canavan, each nurse practitioners.
When Ms. Costello realized of the “directed donation” possibility, by which a household can direct an organ to a particular recipient for a doable match, she felt the gravitational pull of destiny. Right here was an opportunity to make use of a bit from one damaged physique to make one other entire: her mentor and good friend, Dr. Sylvio Burcescu.
Dr. Burcescu was a psychiatrist and head of the Mensana Heart, the clinic in Westchester the place Ms. Costello labored; a number of of his sufferers had instructed her that his counsel had saved their lives. Now a uncommon and debilitating kidney illness had upended his personal life, and he was on the registry for a transplant.
“I used to be utterly incapacitated by dialysis,” Dr. Burcescu, 62, stated, recalling the exhaustion, the ache and the acute limitations on his liquid consumption. “A really unhealthy scenario.”
When Ms. Costello known as, he braced for unhealthy information about her brother. As an alternative, he stated, she sounded excited, even upbeat, and requested a query that took his breath: Would you like certainly one of Brendan’s kidneys?
As she defined what had unfolded, the physician struggled to corral his many feelings: disappointment, embarrassment, humility, gratitude. Lastly, he stated: It might be an honor.
A lot had abruptly modified, and a lot nonetheless needed to fall into place. The prospect of a match between Brendan and Dr. Burcescu was slim; of the two,052 kidney transplants that LiveOnNY has facilitated over the past three years, solely about 50 resulted from directed donations.
“The solar, moon and stars need to line up,” stated Leonard Achan, the president and chief government officer of LiveOnNY. And in the event that they didn’t, he stated, the organ would as an alternative be provided to essentially the most suitable particular person on the high of the nationwide ready record.
A battery of testing and measuring and analyzing decided that right here was a uncommon, against-the-odds match. “A miracle, actually,” Mr. Achan stated. “A case of someone saying, ‘I do know somebody.’ And it truly works out.”
THE NURSE AT Mount Sinai Morningside hospital has by no means seen so many guests. A couple of dozen, simply, with some crammed in a sure affected person’s room and the remaining spilling into the seventh-floor corridor of the intensive care unit.
However after a number of years of nursing expertise, Cornelius Sublette is aware of to maintain his “ICU thoughts.” Pay shut consideration to his affected person’s oxygenation, blood stress and luxury, and be prepared to fulfill each doable want of the grieving household.
His mantra: “To supply self.”
It’s Wednesday, Jan. 22, three days after the revelation of Brendan’s final want had postponed his dying. He lies in Room 24, as music triumphs over the mechanical beep of actuality. Fiona Apple sings of seeing not simply the crescent however the entire of the moon, whereas Sting summons a haunting Irish air, a whole lot of years previous, a couple of gallant darling hero.
Individuals take turns donning masks, gloves and yellow isolation robes earlier than getting into the small room to say a phrase, a prayer, a goodbye. Hospital tips enable for under two guests at a time, however lodging have been made for the crush of affection.
The air modifications when the working room on the third ground calls to say that every little thing is about; it’s time, as soon as once more. Mr. Sublette kicks the purple lever on the base of Brendan’s mattress, releasing the brake.
With the assistance of one other nurse, he guides the mattress out of Room 24 and into the corridor. Alongside the partitions, members of the family, pals and hospital staff stand at consideration, in somber respect for somebody who, in his imminent dying, is about to provide life. It’s a ritual known as the honour stroll.
Steering the mattress, the 2 nurses of their teal scrubs take care to stroll at a gradual, even tempo. Brendan’s kinfolk fall in behind, one after the other, as his music washes over them.
The procession turns left on the intensive care unit’s small command middle and strikes towards the glowing-red exit signal above the automated doorways. Past is a steel-silver elevator that may take Brendan 4 flooring all the way down to the working room.
There, in a short while, his ventilator might be disconnected, and his respiratory will finish. His left kidney will go to his sister’s good friend, Dr. Burcescu, who will quickly drink as a lot water as he desires. His proper kidney will go to a person in Pennsylvania, his lungs to a lady in Tennessee. He’ll donate, too, his ever-searching eyes.
In a few weeks, there might be a funeral Mass on the Roman Catholic Church of the Ascension, his previous parish on the Higher West Aspect. A whole bunch will attend. A holy jazz will play.
All that may come within the days forward. However for now, Louis Armstrong is singing full-throated in regards to the march of saints as Brendan Thomas Costello Jr. leads a procession, sacred and gradual, by way of this unhappy and exquisite world.
Audio produced by Parin Behrooz.
