The passage of time is an unavoidable detail of life. As such, its many consequences are felt by all of us. But none is more noticed than its final symptom: the inevitable end of our own existence and that of those close to us.

This ultimate end is examined in Douglas Bauer’s new nonfiction book, What Happens Next? Matters of Life and Death. He will appear at Prairie Lights, 15 S. Dubuque St., at 7 p.m. Friday to read from his new work.

"[It’s] a connected series of personal essays that examine issues of mortality," he said. "It’s about me and my life and speculations about my parents."

The book is a result of Bauer’s experience dealing with aging and seeing those around him age simultaneously.

"It was inspired by a coincidence I couldn’t ignore," Bauer said. "At the very hour I was in routine surgery having a cataract removed, my mother passed away in a hospital half a continent away. That moment, and its metaphor, was too powerful not to write about."

While this incident and the contents of the entire book are specific to him, those publishing the book believe that it will speak to nearly anyone who picks it up.

"Doug writes quite a bit about his mother’s aging in tandem with his own and how the love and need linking parent and child change together," said Catherine Cocks, the acquisitions editor at University of Iowa Press. "These two relationships — with his mother and with his own body — wring affection and exasperation from him. Those are emotions many of us are experiencing now and that all of us will experience eventually."

It’s not the subject matter alone, though, that makes the book a text worth reading, said James McCoy, the director of UI Press.

"It’s honest," McCoy said. "Doug strikes me as someone who can’t help but being ruthlessly self-aware without drama or pity. Doug is writing on a much higher level than even his most accomplished peers. It’s difficult work to create prose this thoughtful and seamless."

Published as a set of essays, the book was initially intended to be a single story until Bauer realized that the original structure could not support the book he had in mind.

"At a point, I recognized the form of the book should be a collection of essays," Bauer said.

The book then became something of a new experience for Bauer, who’d never written personal essays before. Still, by drawing from similar books while staying true to his own writing, he completed the book.

"It’s a model for how the personal essay should be written," McCoy said. "But his frank discussions of life and death really make it worth the price of admission."

With the topic of death and mortality at the heart of the book, it’s easy to imagine it as dark and unsettling. Bauer, however, hopes that the book lets readers explore the topic without running into any morbidity.

"You might think a book about growing up, going out in the world, then growing old and coping with your parents’ deaths would be depressing, but What Happens Next? is absolutely not," Cocks said. "I finished reading it with a big smile on my face. This is a book about people taking care of each other, about the pleasures of eating good food in good company, about remembering what matters and looking ahead to what will matter in the future."

"Live from Prairie Lights," Doug Bauer

Book Excerpt:

We stood, surrounding the gray marble gravestone. It was one of hundreds rising up out of the snow in long, straight rows like a bumper winter crop. There’d been no new storms for several days, the winter now refined to a wind that raked your face.

This cemetery was a spot of intimately familiar earth, where my brother, Bob, and I had buried our father almost seven years before and where we’d come as children for our grandparents’ funerals.

This morning, there were Sue and I, my brother and his wife and their three grown sons, along with the funeral director and the Methodist pastor, a thin, smooth-skinned, soft-voiced man named Reverend Riggle.

He was speaking of the certainty of my mother’s eternal reward, which she’d earned at least in part by her devoted service to the church. In the five days since her death, I’d been thinking off and on about the nature of her faith. By which I mostly meant that I’d been trying to imagine how she had imagined the stuff, the substance of an afterlife; that substance of the things she might have hoped for, that evidence of the things she’d not seen, as the letter to the Hebrews speaks of faith.

As I listened to Reverend Riggle’s version of the contract with eternity, I felt an easy scorn, quick as an adolescent’s for anything adult, and I wanted to be more generous than that. I was here, after all, on my dead mother’s, on the reverend’s, on the culture’s terms, and I should honor them.

Particularly since there had been a time when I did; when I was a boy and an ardent, humorless believer.

Sitting in church with my parents on Sunday morning, I repeatedly looked past the minister at the pulpit to the backdrop of a maroon velvet drape that hung from the ceiling to the floor covering the wall behind the altar. At some point I had come to understand that behind this drape was a secret, luxuriously furnished room and back there, in that room, was where God was. I knew, of course that His primary residence was Heaven, so I didn’t presume He lived in the room behind the drape in any daily way. I thought of it as a kind of pied a terre, a place He escaped to now and then, a relaxing weekend in rural Iowa.

But here’s the point: That God – the long, white beard, the long, white robe, the elegant wooden staff – that He was back there relaxing on His second-home throne was nothing I fantasized. It was the thrilling truth and I wouldn’t have dared to sneak up in the quiet of an empty sanctuary to pull the drape aside and take a peek. Not that I feared the crushing disappointment of looking at a naked wall. It was, rather, a matter of delicious intimidation as I carried the sense of God’s majesty, the wattage of His radiance, not to mention his Old Testament temper if you crossed Him.

So in thinking about my mother’s long Methodist life, I’d been wondering whether at the end of it she’d embraced some adult version – whatever that meant – of my early boyhood’s literal belief. Or had she come to an understanding, or maybe always held it, that led her to a more metaphorical faith? It was a conversation she and I had never had.

At the gravesite, the cold was posing us all like waifs, our bodies tightly clenched inside our heavy coats. Our eyes were watering; our noses were running. I looked past Reverend Riggle to the vast white landscape of fields fertile with winter and heard him pray, “We beseech thee, O Lord, to dispense your perfect kindness to those loved ones gathered here as we commend your servant, Maude, to your loving care.”

We all turned and started toward our cars to drive the short distance to the church. The sky was now a mist and the mist was crystalline, making the wind hurt even more. Still, I paused a moment at the stone sitting squatly in the snow, taken with the feeling, brief as a breath, that I was abandoning my mother, and my father, to this unspeakable weather, and the phrase came to the disrespectful adolescent in me: You could catch your death out here.

TEN days back in Boston, I left our condominium to take a fifteen-minute walk through my South End neighborhood and the edge of Chinatown to Tufts-New England hospital where I had an appointment for an echocardiogram.

My heart had been behaving somewhat oddly for a few months. It would, for no reason I could guess, all at once begin to beat with a particularly emphatic percussion. It didn’t happen often, but often enough, and when I felt it pounding most intensely I imagined a claustrophobic microbe beating frantically, metrically, on the walls of my heart.

Recently, my cardiologist had seen me to review the results of a heart monitor I’d worn for nearly 24 hours, during which my heart beat 89,219 times. In his office, he’d asked me to sit down and leaned toward me with a pencil and a drawing pad.

His name is Andrew Weintraub. He is fair-complected, bespectacled, in his mid- to late 40s I would guess, and his manner, which is brisk, is saved from being brusque because his hurrying intelligence is entirely friendly; it’s a knowledgeable energy he’s happy to dispense. Still, he gives the impression of being perennially en route and he quickly drew a kindergarten-simple sketch of the heart, getting its inverted-fat-acorn shape exactly right. Then he divided it into its four chambers, two upstairs, the atria, two below, the ventricles.

Technically, my mother died of congestive heart failure and it came to me as Dr. Weintraub drew and talked about the heart that he was inversely narrating the physiology of her death: the sequence of valves opening (as the orifice of hers inexorably narrowed) and blood flowing (as hers therefore couldn’t) from top (where hers was forced to stay) to bottom (where it couldn’t get.)

The day I’d worn the monitor, only 190 of my 89,219 heartbeats were irregular. But few as they were, there were enough of them to identify the beat as something called supraventricular tachycardia. Weintraub had explained what this was by returning to his drawing and inking a tiny button in the left atria. It’s called the sino-atrial node and in a normally working heart it’s from here than an electrical impulse is evenly, repeatedly sent out to start and keep the beat.

Sometimes, though, other heart cells, as though jealous, or bored, connive to intercept the node’s essential task and prematurely fire away. These impulses, once released, have no idea where to go or what to do so they zip around in the heart, producing a kind of wild short-circuiting. Little wonder that in such moments my entire upper body felt caught in a riptide of pulse, felt as if it were actually swaying to the strength of these renegade charges.

Walking to my echocardiogram appointment on this bright, cold January morning, I passed a small group of homeless men gathered on a street corner. One of the South End’s long established features is a scattering of shelters, notably the city’s largest, the Pine Street Inn – which is hardly the cozy auberge its name suggests, but an enormous painted-brick building that runs the length of a city block.

I worked for some years as a Pine Street volunteer. I stood at the receiving desk of the medical clinic for three hours, one night a week, and greeted the men and recorded their names as they stood in line for its various services. Several needed to take their medications, which the nursing staff kept for them. But many came for things I could dispense myself. Some stopped to receive a nightly packet of Tylenol and vitamins. Several came in and dropped, dead-weighted, into a chair while I drew plastic tubs of soapy water so they could soak their feet, which were lividly scabbed and stank unimaginably and as often as not were missing toes. Most of these men were drunk or high and hacking convulsively. Some, schizophrenic, were speaking to their voices, debating apparently contrasting accounts of what had happened to the pair of them that day. One night a man, his feet resting in their warm bath, his pants’ legs rolled up past his calves, broke off his private conversation, turned to me and calmly began, “ My name is Yves Saint Pierre. In Chicago, I am known as Jesus Christ. My inner fire is so strong, I can be with a woman who has VD and I won’t get VD.” He continued, still serenely instructive, “Everything is color and energy. White is the brightest on the side of negative energy. Forty thousand cosmic vibrations. Red is the highest positive energy. Eighty-five thousand cosmic vibrations.”

Over the years at Pine Street, I watched men get thinner and thinner. I noticed more and more of their teeth falling out. I saw faces altered by knife gashes and mashed-in noses. I observed their limps growing increasingly severe, until they needed canes, and after canes, crutches, and after crutches, wheel chairs. They lived, these men, dog years of illness and abuse: one year aged them seven.

As I passed the cluster of men this morning, I recognized quite a few of them, though none gave me a second look. I began to recall them individually – Bobby, whose entirely toothless mouth caused his face to collapse in on itself like a worn out shoe; Teddy, dark featured, swarthy, imperviously handsome, his eye-patch giving him the look of a silent-movie star playing a buccaneer; Eric, a cheerful man who always called me The Riddler, insisting I was a dead ringer for that Jack Nicholson character in the Batman movies. There were a couple of others whose names I’d forgotten but my thought about them as a group was, My god, how can you, and you, and you, still be alive? There I was, headed off to the hospital, my heart – as it happened right then – banging away in my chest.

And there they were, their faces weather-burnished, their camaraderie high, having spent the night on narrow cots in a crowded shelter dormitory, sleeping away the booze and the drugs of the previous day, and now well into their frigid Boston mornings.

IN the echocardiogram room I lay shirtless on my side while a technician, seated next to me, held the instrument’s sensor, which looked vaguely like a stethoscope’s medallion and was connected by a long cord to a console fitted with several dials and a fairly small screen. She’d applied some kind of jelly to the sensor to aid the transmission of images, and now she began to guide the sensor incredibly slowly over my heart.

This was at the same time an oddly intimate and deeply alien sensation – stripped to the waist, with this stranger of a woman tracing, more deliberately than you could imagine, some lubricant device all around my chest, while both of us watched the grainy moving images of my heart on the little screen; it was like impossibly cautious sci-fi foreplay.

I found the images enthralling, not least for the accompanying machine-amplified sound effects – the regular sloshing and flushing of my blood as it flowed up and down and in and out of my heart’s four chambers. I pictured someone in thigh-high waders moving through floodwaters.

“What a cool machine,” I said to the technician.

And she replied, “Jack Nicholson.”

“What?”

“It’s named ‘Jack Nicholson.’”

“ . . . Why?” I asked.

“We give them all a name,” she said, the sum and substance of her explanation.

What filled Jack Nicholson’s screen was gorgeously patterned, and grayly abstract unless you knew what you were seeing. It looked, with its lighter flecks among the gray and its smoky swirls, like the Milky Way. Or maybe it looked, with its beckoning cavities, like a series of caves, a spelunking world. Except that everything was moving, endlessly, regularly moving; valves opening and closing like saucy tongues lewdly flicking; dark holes pulsing primordially. So maybe it looked like a fetus with attitude from the Pleistocene Age, although if I were a Pleistocene mother, the fetus I was watching was not depending on me for its life; I was dependent on it for mine.

Viewing an echocardiogram, compared to looking at an X-ray, is like reality television compared to still photography, and I realized that part of the pull for me was voyeuristic. Even as this professionally decorous technician with her gooey probe was Geiger-countering her way all over my chest, I felt, for my part, a kind of peeping Tom, for what I was watching on the screen seemed to be behaving entirely on its own. The flow and gurgle and animation was completely independent of anything I was consciously asking my body to do, or was otherwise aware that it was doing, and it seemed as if I were catching these moving parts of me unawares.

As I lay there, a sense of great gratitude came over me. There was my heart, working away on my behalf without notice or complaint as it had without pause for more than sixty years; a self-assigned responsibility; an act of pure charity. Watching, thinking about all that time and its dumb routine, it seemed a marvel that its recent small mistakes were its first.

I felt particularly close to it, too, because I see it working practically. Or mechanically. It is of course a pump; life’s splendid pump, and there is magic to be sure in the idea of the electrical charge that gets it started and keeps it going. Still, given its elementary design and the sequential way it works, it suggests a device that someone like my father, someone tremendously clever at fashioning gadgets to solve a particular barnyard need, might build from spare parts he had lying around in his shop out in the garage. The heart seems to me just such a sublime contraption and in that spirit I imagined my mother’s — wheezing, sputtering, held together with caulking and patches of criss-crossed duct tape, until finally exhausted.

When the technician finished, she said, “You gave us some good pictures.” She pronounced it “pitchers”. I heard this as her applauding my heart’s commendable behavior, a quality of performance I might take some credit for. I ate healthily. I exercised vigorously. It only followed that my heart would be photogenic. Ready for her compliment, I asked, “What makes some people’s pictures better than others?”

She shrugged. “Some days they’re good, some days they’re not. Nobody knows.”

A few hours later, I saw Dr. Weintraub and he prescribed what he termed “a homeopathic dosage” of a beta blocker, a class of drug which, simplistically put, quiets those renegade short-circuit-causing cells. He also asked me to wear another monitor, and to wear it not for a day but for a month.

Compared to the first one, it was the size of an iPhone instead of an old VHS cassette, and more sophisticated in what it recorded, which meant more complicated to operate. If I felt my heart beating strongly, however slightly more than normal, I was to push a button to start the monitor recording. After that, I was to call an 800 number, where, like infomercial operators, technicians were standing by. Then I had to put the monitor up to the receiver to send what I’d caught on tape to their transcribing equipment. In other words, I would, for a month, be bugging my heart.