Brendan Costello's family gathered in half light at the hospital. He had overcome so much in his life, but the deep damage to his brain meant he would never become Brendan again. That was time.
Brendan had spent four months enduring three surgeries and long rehabilitation after the infection made his injured spine even more unstable. He returned to his Upper West Side apartment in late December and began regaining the life he had put on hold.
His sister, Darlene, stayed with him in the intensive care unit at Mount Sinai Morningside Hospital. She confirmed that his favorite music would play non-stop from portable speakers supported near his bed. The gravel revelation awaits Tom. Charles Mingus' “Ah” cool. I know the laughter of New Orleans jazz.
The music captured Brendan: a dark, popular Irish fatalism, covered in hope and wonder. And yes, he used a wheelchair, but whoever proposed this defined a man in some way to anyone.
A creepy decision was made after the test confirmed that there was no chance of regaining consciousness. Brendan's ventilator will be removed at 1pm on Sunday, January 19th, five days after the collapse. He was 55 years old.
It was now a Sunday, heavy, grey and terrifying. Some of Brendan's closest relatives rang his bed, including his sister and his aunt and uncle who raised him. The wait groaned, Mungas aahed and the clock was checked.
Then, just two minutes before the appointment, tears reached the final squeeze in her cheeks and hands, and the nurse stepped in at the moment and said Costello had called.
what?
phone. You need to take it. You need to take it.
The intense little sister left her brother's room and called. The immediate family watched, watching her listen and see her insisting, seeing the distortions in her face unbelievable.
Time paused as all emotional and spiritual guarding gave way to recognition to say goodbye: of course. Their beloved Brendan – witty, paradoxical, caring, undead Brendan had other plans.
of course.
Brendan came honestly to his gallows humor. Finding comedy in tragedy was a coping mechanism, a way of owning the pain he shared with his sister.
Their parents were deaf and ultimately incompatible. After her father left the family, her mother — a devoted, cheerful, troubled mother — seized her life in the basement of her Brooklyn apartment. Brendan was 8 years old and Darren 6.
They lived with Uncle Marty and Aunt Kathy Costello and two young girls in North Westchester. The couple decided to raise their four children the same way and did their best to alleviate the trauma that shadowed ne and nie.
Young Brendan entertained his family at Sardonic Azides, worked well in class and founded a Peace Group student at Yorktown High School. After graduating from college, he worked writing Wall Street-related news releases. He found a way to paralyze himself.
Late one night in August 1996, a very drunk Brendan fell on the subway truck at Lafayette Broadway station. The approaching D-Train cut his tie just below the knot, robbing him of his ability to walk, on a service measure of how close he had come and die. Devastating.
However, while he was rehabilitating in the spinal cord in-secretary program, he met a man in a wheelchair called Boris. “Boris told him when an accident like this happened, you wouldn't retreat from the world, you were leaning against the world,” recalled Marty Costello. “You're going out there, and that's what Brendan did.”
He did so with Brendanesque humor, occasionally wearing a blue Metropolitan Transportation hat and a black T-shirt decorated with the symbol of the Orange D train. He will explain to him to show that he doesn't have any difficult feelings.
“If you see your parents die, or if you're running away by train, you're at a deeper depth of what's funny,” his sister said.
Among the many things that united the two brothers was the 1986 Jim Jalmuch film Down by Law. That tragic sensibility resonated with the lines that were uttered by Roberto Benini, who played an Italian immigrant struggling to learn English.
“It's a sad and beautiful world.”
Brendan drove and refused to help in and out. We went skydiving. They co-hosted a radio program focusing on disability rights and culture. I taught creative writing at City College in New York. This work has been released on Harper's, The Village Voice, and more. He became president of the Irish-American Writer and Artist Organization. It belonged to St. Pat of all groups that arranged the annual Everybody Come Parade in Queens. He talked about his cousin Katie Odell's storytelling with elementary school students, and sometimes even let him sit in his wheelchair.
And he dominated trivia nights at the Upper West Side diving 106 bar, often helping him beat all corners, including the most delicious team of Columbia University students. “He was definitely the MVP of our team,” recalls Leland Elliot, his longtime friend and trivia teammate.
Brendan loved Faroa Sanders' saxophonic improvisation, James Joyce's literary riffs, and Kintugi's Japanese art. There, broken pieces such as devastated ceramics are reassembled with gold or silver lacquer, creating new and incredible things.
He disliked Disney, Apple, and in particular the suggestion that his obstacles somehow inspired him. “He wasn't the kind of person he wanted to be considered a man in a wheelchair,” said his cousin Maryne Canavan. “He wanted to be identified by what he brought to the table.”
And what he brought was quite a bit, she said. “His brain was his superpower.”
The call that stopped Brendan's death was not him, but it was to extend his life. Just like he planned.
The caller was from Liveonny, a federally designated nonprofit organization to coordinate organ donation in the New York metropolitan area. If a patient who meets certain clinical criteria appears to be at the peak of death at a donor hospital, the hospital should contact Liveonny and then check the person's name in the database of registered donors.
A few years ago, Brendan was signing up while renewing his driver's license. The caller, a family support advocate for LiveOnny, gently explained that this means he cannot leave the ventilator. At least not yet.
This news was almost too much to handle. Darlene Costello, who had been training herself to say goodbye to her loved one and brother a while ago, gushed out in anger. Why was she just listening to this now?
But gradually she began to embrace the import and beauty of what was unfolding. Until late that afternoon, Liveonny representatives were on the morning side of Mount Sinai, patiently taking the next step with Costello and her cousin Canavan (both nurse practitioners).
When Costello learned of the “guided donation” option, she felt a serious pull of fate, allowing families to point the organ to a specific recipient for the possibility of a match. Here I had the opportunity to make another whole using one broken body piece. Her mentor and friend, Dr. Sylvio Burcescu.
Dr. Burcescu was a psychiatrist and head of the Mensana Center, the Westchester clinic where Costello worked. Several of his patients had told her that his advice saved their lives. Now, a rare and debilitating kidney disease engulfed his own life, and he had registered for a transplant.
“I was completely neutralised by dialysis,” said Dr. Burcescu, 62, recalling the fatigue, pain and extreme limits of his liquid intake. “It's a very bad situation.”
When Costello called, he supported her for bad news about her brother. Instead, he said, she was excited, even brighter, and asked the question he took in breath: Do you want one of Brendan's kidneys?
As she described what unfolded, the doctor struggled to surround many of his emotions: sadness, shame, humility, gratitude, and so many of his feelings. Finally, he said: It would be an honor.
So many things changed suddenly, and yet many people had to fall into place. The chances of a match between Brendan and Dr. Brucesc were slim. Of the 2,052 kidney transplants LiveOnny has promoted over the past three years, only about 50 came from tutored donations.
“The sun, the moon and the stars need to be lined up,” said Leonard Achan, president and CEO of Liveonny. And if they didn't, he said, instead the organ would be offered to the most compatible people at the top of the national waiting list.
A series of tests, measurements and analyses determined that this is rare and is a consensus of ODDS. “A real miracle,” Achan said. “The case where someone says, 'I know someone.' And that actually works. ”
Nurse at Mount Sinai Morningside Hospital has never seen so many visitors. Some are stuffed into certain patients' rooms, with the rest of dozens of dozens of them spilled into the hall on the seventh floor of the intensive care unit.
However, after years of nursing experience, Cornelius Sublett knows to maintain his “ICU mind.” Be careful about the patient's oxygenation, blood pressure and comfort and be prepared to meet all the needs of a grieving family.
His mantra: “Providing Self.”
It was Wednesday, January 22nd, three days after Brendan's final wish postponed his death. He is in the 24th room, just as music wins the mechanical beeps of reality. Fiona Apple sings about seeing not just the crescent moon, but the entire moon. Sting summons the unforgettable Irish atmosphere of hundreds of years ago about his brave beloved heroes.
People alternately wear masks, gloves and yellow separate gowns before saying words, prayers and goodbye to enter the small room. Hospital guidelines allow only two visitors at a time, but accommodation is being made for love crashes.
The atmosphere changes when you call the operating room on the third floor to say that everything is set. It's time again. Sublett kicks the red lever at the base of Brendan's bed and releases the brakes.
With the help of another nurse, he leads the bed from the 24th room into the hall. Along the wall, family, friends and hospital workers are attracting attention in honor of those trying to give life in his imminent death. It is a ritual called the Honor Walk.
As you pilot the bed, two Teal Scrub nurses take care to walk slowly and at a uniform pace. Brendan's relatives are delayed one by one as his music washes them.
The queue turns left at a small command center in the intensive care unit and moves towards the shiny red exit sign above the automatic door. Beyond is a steel silver elevator that takes Brendan to the four-story operating room.
There, after a while, his ventilator is cut off and his breathing ends. His left kidney goes to Dr. Burcescu, a friend of his sister. His right kidney goes to a man in Pennsylvania, and a woman in Tennessee goes to the lungs. He also donates his constant search eyes.
A few weeks later, there will be a funeral Mass in his old parish on the Roman Catholic Church of Ascension, Upper West Side. Hundreds of people attend. The sacred jazz is played.
It'll all come first. But for now, Louis Armstrong is buzzing perfectly about the saint's march as Brendan Thomas Costello Jr. leads a sacred, slow procession through this sad and beautiful world.
Audio created by Parin Behrooz.