My twin brother, Danny, could say twelve words: Eh. Eh-eh. Hi. Yeah. More. Momma. Dada. I-an. Arra. Dayday. Annie. Eddie. The last time I visited him, I wanted just one.

“Say ‘I-an,’” I said.

We were in the intensive care ward at the Cleveland Clinic. It was Sunday. My parents had called me earlier that day to say that Danny’s pneumonia was getting worse and they didn’t know if he’d make it much longer. Danny was born with severe cerebral palsy and intellectual disabilities, used a manual wheelchair, and relied on caregivers for most things. He lived in our parents’ house for 23 years and then transferred to a group home, where in the last five years, his health had declined. He got a feeding tube to prevent bouts of pneumonia, but during a recent readjustment of the device, a doctor poked a hole in his intestine, giving him a severe blood infection that sent him into cardiopulmonary arrest. He was in the hospital again for what we feared would be the last time.

I rushed up from Cincinnati, where I was attending grad school, and saw my twin brother on the hospital bed, a square plastic facemask blowing oxygen into his lungs.

If this were any other day, he’d make fun of me, because I had gotten lost in this space station of a hospital. My mother would call me “directionally challenged” and he’d mock me with his version of my name: “I-an!” For my brother, joking was a barometer of health. If he didn’t make fun of me, I’d worry he was in too much pain, too distracted to find things funny. But today, behind the mask, his eyes were vacant. He looked like a fallen exterminator who’d walked through too many poisons.

I pleaded with him via twin-telepathy: Give me your last word and give it only to me. I pressed my nose against the plastic. “Say ‘I-an,’” I said.

Because there was a large gap between Danny’s receptive and expressive capabilities, we had to make what disability advocates call the “least dangerous assumption” and assume his communicative intent even when we weren’t exactly sure what he was trying to say. We had to co-construct meaning from his body language, context, and tone. We had to project ourselves into his mind. This might seem strange, but language is a flawed and limited instrument. We can never truly know what someone feels or thinks, even if they have a million words at their disposal. My brother just happened to have twelve. His disability helps us see the essential human truth of all communication acts: We all construct other minds through this imperfect mediation of language. No one speaks on their own. We are all twins—we all finish each other’s sentences. 

My name is a case in point. My brother multiplied its meaning with tone, context, and absence. He said “I-an” so I’d talk to him. In our family’s van, he repeated “I-an” every fifteen seconds to tease me, a kind of auditory torture. He yelled “I-an” into my voicemail to call him back. He said “I-an” in response to questions like: “Who’s ugly?” He yelled “I-an” at church, heckling the priest in the middle of a sermon, which might mean any number of things, both satirical and metaphysical. He said “I-an” softly before he nodded off to sleep, so that it might as well have been: I love you.

My name was the currency between us. When I said, “Danny, give me an ‘I-an,’” I was asking for a hand-slap, a bro hug, if everything was all right, if he loved me. When he refused, the “absence of I-an” could have as much meaning. The silence might mean: Dude, screw you. It might mean: I’m too tired. I’m in too much pain. It might mean: You have to talk to me more. You’re an asshole. Withheld at the right moment, it might mean: I resent you.

The next day, my brother was more alert. He scanned the room at the sound of our voices. When he saw my face, he smiled. I asked him, “Do you want to punch me in the face?”

“Eh,” he said. Maybe he was getting better.

“Say ‘I-an.’”

“Eh-eh.” I looked for a smile, but did not find one.

“Are you mad at me?” Danny said nothing. I listened to the wheeze of his breath, the click and hiss of tubes. Was he teasing me, as in Eh-eh, you loser? Was he angry that I hadn’t been there more, that I left him behind? Eh-eh, and go screw yourself. Why did you move four hours away and become just a voice on the phone?

Maybe I was reading too much into this “Eh-eh.” I could pick apart his words for hours. I tried to imagine what he was thinking and feeling, even at the risk of being wrong, even if I made him into a rough facsimile of myself. But the alternative was ethically unthinkable: not granting him a mind worth guessing at.

At midnight, the orderlies transferred him to the hospice ward. An IV went into his neck to keep him hydrated and to deliver pain medication. The bed slowly inflated and deflated, seeming to breathe.

There were no masks between us. I could touch my brother’s face. His diaphragm resumed its usual rhythm, three deep breaths and then a half-minute of stillness. His fever spiked, and we put a cool, damp cloth on his forehead.

Soon he’d lose consciousness. I became a beggar. I changed tactics, just going for annoying: “Say ‘Brian.’ Say ‘Brian.’ Say ‘Brian.’”

My mother said, “Daniel Trapp, you say your brother’s name.”

But my brother held firm, his face an iron curtain of passivity. He blinked, swallowed, and inhaled a gulp of air.

When my family left for the hospital hotel, I lay next to my brother and felt his hot breath on my lips. We both had the same long eyelashes, the same shaggy eyebrows that bled together into a unibrow, though I plucked. We did not have the same smile. His was dimpled, open, and wide. It stopped strangers in the street. Mine was closed-mouthed and tight, like I was in pain and hiding my teeth. He was right. Who’s ugly? I am. Me.

Danny blinked. He stared in my direction.

I asked him, “Are you ready to go?”

“Eh,” he said. He could have meant back to his group home.

“Are you ready to die?”

I feared what I’d have to do if he said, “Eh-eh.” Wheel him back up to intensive care and hope the doctors just went with it? But he did not test me. He didn’t answer. Maybe he didn’t know what was happening. Maybe he couldn’t conceptualize death. But perhaps that’s an unfair demand when I can’t comprehend my own death, my not-being. Maybe his silence was his response: You idiot. Who is ever ready?

A white film covered his tongue and his cough was wet. I put my finger in his hot hand. I asked my brother, “Do you love me?”

“Eh,” he said. He did not tease me. He knew.

I closed my eyes and held him to my chest. I pretended it was twenty-nine years ago, that we weren’t even born, still sealed in the womb. Where were our bodies? Were we like this, face-to-face? Were we turned around, back-to-back and rubbing spines? Was he upside down, his butt in my face? Where did I end and my brother begin? I pretended that his body wasn’t breaking down, that he never had a single surgery or procedure, never had a feeding tube or mask. There wasn’t even language yet. We hadn’t learned a single word. Our cells were still blooming, getting ready. We would do it all over again.

In the morning, Danny was still conscious, though he worked harder for air, his eyes closing for longer stretches. “Say ‘I-an,’ Dan. Please.”

“Come on, Danny Boy,” my mother said.

My father asked him the trick question. “Danny, who’s ugly?” With this kind of audience, my brother would’ve said my name on cue, but he just breathed in and out, his eyes fixed on the ceiling.

I resigned myself: He would never say my name again. What did I think it would accomplish anyway? It was just a word, one of twelve. Did I want to be reminded of who I used to be, not just “Brian,” some normal unremarkable sad sack, but “I-an,” his twin brother, his partner and protector and caregiver, the person who pushed him through the world from behind his wheelchair handles? Maybe through him saying my name, I could be that better self even after he was gone. Maybe when he was dying, I was the one asking him for comfort. Whatever I wanted, my twin brother would not give it.

The hospital air conditioner hissed, and Danny rose and fell with the breathing of his bed. 

Then my father leaned in and whispered: “Dan, if you tell me who’s ugly, the nurse will show you her boobs.”

“I-an,” Danny said.

We laughed. We cheered. We laughed again, which dissolved into something like sobbing. 

The nurse came to fluff his pillow and scribble in a notebook. When she left, we pretended she was still in the doorway. “He said ‘Brian,’” my father told the emptiness. “You know our deal . . . Oh! There she is, Dan.”

We gasped. He couldn’t see that far, so we all played along, even though our hearts weren’t in it. My brother probably knew we were liars, but he played along, too.

Later, at his funeral, we’d set his ashes next to a picture of his smiling face, and a priest would proclaim his new body in Christ, walking tall in a wheelchair-less heaven. Later, we’d admit that if we saw him on the other side without his disabled body, we wouldn’t recognize him; he would not be my twin brother.

Later, his last word would come back to me. Did he say my name to comfort me, to assure his twin who would soon not be a twin at all that it was OK? “I-an” as in Don’t be lonely. You can still be ‘I-an’ for the rest of your life. Or maybe it was a final dig, ”I-an” as in I will only say your name as part of a boob joke. Now let me die in peace. Or maybe his last word was less about me and more about performing himself one last time, building unbearable tension until he released it at the perfect moment, my brother orchestrating his last grand joke, the final reading of his barometer of health. “I-an,” as if to say, I’m still here. It’s been great, but I’ll take my bow. Goodbye. Goodbye. Goodbye. Maybe by saying my name, he was saying his own name one last time as well.