The household of Brendan Costello gathered within the hospital half-light. He had overcome a lot in life, however the profound injury 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 condominium 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 ceaselessly.
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 understanding 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 instructed this by some means outlined the person.
After exams confirmed no likelihood of regaining consciousness, a wrenching determination 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 family 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 fingers reached for one final squeeze, a nurse stepped into the second to say that Ms. Costello had a telephone name.
What?
A telephone name. You need to take it. You HAVE to take it.
The flustered sister left her brother’s room and took the decision. Members of the family 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 means of proudly owning the ache, that he shared along 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 condominium 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 boost the 4 youngsters the identical, doing their finest to ease the trauma shadowing their nephew and niece.
Younger Brendan amused the household along with his sardonic asides, did nicely in school and established a College students for Peace group at Yorktown Excessive Faculty. After school, he took a job writing Wall Road-related information releases that didn’t go well with his abilities or pursuits. He discovered methods to numb himself.
Late one evening in August 1996, a really drunk Brendan fell onto the subway tracks on the Broadway-Lafayette station. The oncoming D prepare reduce his tie slightly below the knot, in sartorial measure of how shut he got here to demise, and took away his capability 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’ve got 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 prepare image. Simply to point out there’s no exhausting emotions, he’d clarify.
“If you happen to’ve watched your dad and mom die, otherwise you’ve been run over by a prepare, you’re at a deeper depth of what’s humorous,” his sister mentioned.
Among the many many issues that certain the 2 siblings collectively was the 1986 Jim Jarmusch film “Down by Regulation.” Its tragicomic sensibility resonated, as did a line uttered by Roberto Benigni, who performed an Italian immigrant struggling to study 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 centered on incapacity rights and tradition. Taught inventive writing on the Metropolis School 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 staff to beat all comers, together with, most deliciously, squads of Columbia College college students. “He was undoubtedly the MVP of our staff,” recalled Leland Elliott, his longtime buddy and trivia teammate.
Brendan favored the saxophonic improvisations of Pharoah Sanders, the literary riffs of James Joyce and the Japanese artwork of Kintsugi, during which a damaged factor, similar 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 any individual who needed to be seen as a man in a wheelchair,” his cousin Maryanne Canavan mentioned. “He needed to be recognized by what he delivered to the desk.”
And what he introduced was appreciable, she mentioned. “His mind was his superpower.”
THE TELEPHONE CALL that interrupted Brendan’s demise 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 medical standards appears on the cusp of demise at a donor hospital, the hospital is required to contact LiveOnNY, which then checks for the individual’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. At the least 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 expensive and solely sibling, erupted in anger. Why was she solely now listening to about this?
Progressively, 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, during 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 chunk from one damaged physique to make one other entire: her mentor and buddy, Dr. Sylvio Burcescu.
Dr. Burcescu was a psychiatrist and head of the Mensana Middle, 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, mentioned, recalling the exhaustion, the ache and the acute limitations on his liquid consumption. “A really dangerous state of affairs.”
When Ms. Costello known as, he braced for dangerous information about her brother. As a substitute, he mentioned, she sounded excited, even upbeat, and requested a query that took his breath: Would you like considered one of Brendan’s kidneys?
As she defined what had unfolded, the physician struggled to corral his many feelings: unhappiness, embarrassment, humility, gratitude. Lastly, he mentioned: It will be an honor.
A lot had out of the blue modified, and a lot nonetheless needed to fall into place. The possibility 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 must line up,” mentioned Leonard Achan, the president and chief government officer of LiveOnNY. And in the event that they didn’t, he mentioned, the organ would as an alternative be provided to essentially the most suitable individual on the prime of the nationwide ready listing.
A battery of testing and measuring and analyzing decided that right here was a uncommon, against-the-odds match. “A miracle, actually,” Mr. Achan mentioned. “A case of any individual saying, ‘I do know somebody.’ And it really 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 strain 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 demise. 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 bunch of years outdated, a few gallant darling hero.
Folks 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 pointers permit for less than two guests at a time, however lodging have been made for the crush of affection.
The air adjustments when the working room on the third ground calls to say that the whole lot is about; it’s time, as soon as once more. Mr. Sublette kicks the pink 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, relations, pals and hospital staff stand at consideration, in somber respect for somebody who, in his imminent demise, 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 family 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 heart and strikes towards the glowing-red exit signal above the automated doorways. Past is a steel-silver elevator that can take Brendan 4 flooring right down to the working room.
There, in a short while, his ventilator will likely be disconnected, and his respiration will finish. His left kidney will go to his sister’s buddy, Dr. Burcescu, who will quickly drink as a lot water as he needs. 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 will likely be a funeral Mass on the Roman Catholic Church of the Ascension, his outdated parish on the Higher West Aspect. A whole lot will attend. A holy jazz will play.
All that can come within the days forward. However for now, Louis Armstrong is singing full-throated concerning the march of saints as Brendan Thomas Costello Jr. leads a procession, sacred and gradual, by means of this unhappy and exquisite world.
Audio produced by Parin Behrooz.