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 condo 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 perpetually.
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 realizing chuckle of New Orleans jazz.
The music captured Brendan: the dark-humored Irish fatalism flecked with hope and marvel. 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 choice 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 members 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 palms 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 a must 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 non secular girding to say goodbye gave method 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 actually. Discovering the comedy in tragedy was a coping mechanism, a method of proudly owning the ache, that he shared along with his sister.
Their mother and father had been deaf and in the end incompatible. After their father left the household, their mom — their devoted, hilarious, troubled mom — took her life within the basement of their Brooklyn condo constructing. Brendan was 8, Darlene 6.
They went to dwell with Uncle Marty and Aunt Cathy Costello and their two younger daughters in northern Westchester. The couple resolved to lift the 4 kids the identical, doing their greatest to ease the trauma shadowing their nephew and niece.
Younger Brendan amused the household along with his sardonic asides, did properly at school and established a College students for Peace group at Yorktown Excessive College. After school, he took a job writing Wall Road-related information releases that didn’t swimsuit his skills 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 minimize his tie just under the knot, in sartorial measure of how shut he got here to demise, and took away his means 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 informed him that when you’ve 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.
“For those who’ve watched your mother and father 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 sure 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 study English:
“It’s a tragic and exquisite world.”
Brendan drove a automotive, and refused any assist getting in or out. Went skydiving. Co-hosted a radio present targeted on incapacity rights and tradition. Taught artistic writing on the Metropolis School of New York. Revealed items in Harper’s, The Village Voice and elsewhere. Turned 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 college 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 group to beat all comers, together with, most deliciously, squads of Columbia College college students. “He was undoubtedly the MVP of our group,” recalled Leland Elliott, his longtime good friend and trivia teammate.
Brendan favored the saxophonic improvisations of Pharoah Sanders, the literary riffs of James Joyce and the Japanese artwork of Kintsugi, by which a damaged factor, akin 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 person 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 scientific 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. A minimum of not but.
The information was nearly 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?
Regularly, 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 subsequent steps with Ms. Costello and her cousin, Ms. Canavan, each nurse practitioners.
When Ms. Costello discovered of the “directed donation” choice, by which a household can direct an organ to a selected 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 complete: her mentor and good friend, 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 informed 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 intense limitations on his liquid consumption. “A really unhealthy state of affairs.”
When Ms. Costello known as, he braced for unhealthy information about her brother. As an alternative, he mentioned, she sounded excited, even upbeat, and requested a query that took his breath: Would you like one in all Brendan’s kidneys?
As she defined what had unfolded, the physician struggled to corral his many feelings: disappointment, embarrassment, humility, gratitude. Lastly, he mentioned: It might be an honor.
A lot had all of the sudden 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 govt 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 appropriate 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 person 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. Just a few 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 satisfy 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 previous, a few 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 less than 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 flooring calls to say that all the pieces is ready; 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, associates and hospital employees 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 sluggish, even tempo. Brendan’s family members 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 concerning the march of saints as Brendan Thomas Costello Jr. leads a procession, sacred and sluggish, by this unhappy and exquisite world.
Audio produced by Parin Behrooz.
