Authors: Carol Cassella
Tags: #Fiction, #Literary, #Medical, #Contemporary Women, #General
Anita knocks on the door, ready to put the next patient in this room. Claire watches Jim cautiously making his way toward the waiting room. Something nags at her, something learned or heard too long ago to say why it has inserted itself into this man’s particular set of symptoms. She goes in to see her next patient, an asthmatic woman who seems offended at the suggestion that she has been cooking over an open fire, though her clothes reek of woodsmoke and scorched corn. She’s printing a label for the woman’s inhaler when Dan walks into the pharmacy and it comes to her. She puts her hand on his sleeve. “I don’t think it’s Parkinson’s. I think it’s PSP—progressive supranuclear palsy. He’s falling
backward.
And his tremor—it’s not a Parkinson’s tremor.” Dan’s face changes from confusion to disappointment and then, gradually, to something near camouflaged pride. “I mean, I could be wrong. There are other possibilities, too. But I don’t think it’s Parkinson’s.” She lets her hand fall to her side. “I’m sorry.”
“No, no. There’s no contest here.”
“Oh, I meant I’m sorry it’s PSP. It’s a worse diagnosis.”
Dan nods, studying her like he’s weighing it all. “No. I’ve not seen
that disease. But he’s lucky, at least he has a good doctor.”
She feels a small rush of pride when he says this. But by the end of that afternoon, when she has seen more patients than Dan, and thought more about the quiet sobriety she’d seen in his thinning face, she feels only concern. And when he doesn’t come in on four days over the next week—running to Wenatchee for some meeting with their banker, once saying he had to go to Seattle for more clinic supplies—Claire knows it is more than the natural slowing of age.
• 28 •
On Saturday Claire drives to Dan’s house. Evelyn is outside working in her garden. Her lilacs, their leather-smooth limbs as thick as a man’s wrist, are lush with purple flowers, just splitting apart a million tiny green pods. Evelyn stands and takes off a gardening glove to hold Claire’s hand. “You’re good to come by. It’s a busy season for just one doctor. Are you handling it okay?” Claire doesn’t answer her because the question itself is not what she hears. She hears Evelyn’s admission that Dan will not be working at the clinic much more.
“Is he up for visitors?”
“For you? Always. Come on in.” Evelyn scrapes the mud from her boots and drops her gloves into a plastic crate filled with garden tools and bulbs, some already sprouting as if ready to walk into the ground. Claire sees her square her shoulders when she opens the front door. “Dan? Claire’s here. You decent?” Claire can’t hear his answer, but Evelyn holds the door open and waves her inside the house.
The living room is dim; sun stripes shine through the half-closed blinds across the dining table where they had shared dinner just a few months ago. There is a new odor in the room, something faded and organic. Or maybe it’s the absence of what she expects—the smell of Evelyn’s southwestern cooking, the smell of pine and woodsmoke that has always followed Dan, even into the clinic. He is on the couch, covered with an alpaca throw, and hails her with a firmly raised hand, swings his legs to the floor.
“Hey. Don’t get up.” She pulls a chair out from the table and turns it to face him. Evelyn sits on the arm of the couch. “How are you?” Claire asks him. As soon as she says it she wishes she’d chosen any other words:
We miss you, your patients send their best, Frida’s coffee is worse than yours.
He turns on the table lamp and she sees it immediately, is astounded, even as a doctor, at how rapidly his skin has changed from an aged, sun-spotted ivory that has always jibed with his Hispanic name to the yellow of an aging bruise. The scleras of his eyes are the color of lemon pulp.
He watches her face change as she recognizes the most likely diagnosis. “I hate the itching. Even after all these years practicing medicine it caught me off guard. Need to wear mitts or something,” he says.
Claire smiles but feels tears coming. She concentrates on keeping her face still—if she knows Dan at all, he does not want to put up with her sympathy. She starts to talk about her patients, or ask about his walk by the river, but the falseness feels insulting. There is nothing to do but address it outright and let Dan guide her. “It doesn’t hurt, I hope?”
He winks at her, and that more than anything threatens to make her cry. “Good thing about being a doc is that you can write your own scripts.” He chuckles at himself. “I’m seeing Will Hesston in Seattle. He’s generous. Probably try a celiac plexus block next week.”
“So it’s pancreatic?” It is a moment when knowing too much about medicine imposes its toll. Hesston is the best in the region for pancreatic cancer, and if surgery had offered any hope Dan would have already had it.
“They put in a stent last month, kept the jaundice down until last week. Gonna have to change my wardrobe now. Evelyn says I should stick to yellows so I look like a reflector. I told her with a red hat and green shirt I could be a stoplight. Hallum’s first.”
Claire breaks out in laughter at this and hopes he thinks the tears streaming down her cheeks are from his pitiful joke. Evelyn cannot seem to stop herself and picks up a Kleenex box from the end table, plucks out a single white tissue and puts it in Claire’s hand; it relaxes the tension among the three of them, in a way.
Dan tells her more about his cancer; it has spread into his liver. The symptoms had been so nominal at first he had ignored them. “I got to live in blissful ignorance that many more weeks.”
Evelyn excuses herself to start dinner, though Claire suspects it is really to give Dan time alone with her. She sits quietly for a minute, rolling the tissue between her fingers. “You knew when you hired me, didn’t you. That’s why you called.”
He lifts one hand feebly off his stomach, reaching for another excuse, maybe, then lets it drop again. “I got the CT scan results a couple of hours after you left.” He moves his tongue along his upper teeth behind his lips and then smiles at her again, a gleam of a dare in his eyes. “I’ve put you in quite a bind now. Are you mad at me?”
She tilts her head to the side and tries to look like nothing more than an exasperated parent. “Well, I would have been picking your brain a lot faster if I’d known.”
He is quiet for a minute, serious at last. “You’re better than you know you are, Claire. You love it more than you know.” She feels blood rush into her face. Dan is watching her closely. “So once Addison makes his bazillions back, don’t walk away again. Even if you don’t stay in Hallum.”
She wishes that she had already told Dan about Walker. The fact that he has guessed so much makes her feel false with him now, at a point when there is too little time to fix it later. “I guess I still think of myself as being ‘in training.’ Waiting to see what happens.”
“You’ve been a curiosity to me in some ways, you know,” Dan says. Claire lifts her eyebrows, half expecting him to finish with one of his jokes again. But looking at him she thinks he is only taking advantage of his mortal diagnosis—if there can be any advantage at all—to say exactly what is on his mind. “You never seemed to me like the kind of woman who would quit on something you’d worked at for so long. Not out of convenience, anyway. Not for money. Not unless you had some reason to think you’d made the wrong choice in the first place.”
Claire looks down at her hands; she has rolled the Kleenex into dust. She fills her chest and holds her breath for a moment, releases it in a sigh. “It was more than money. More than Jory, even.” He waits for
her to go on, waits until she is ready, almost as if he needed to hear this to fully understand his decision to hire her. “I missed a diagnosis.”
“That’s part of learning medicine. Will be through your whole medical career,” Dan says, his voice totally calm, his yellow eyes without judgment.
“I missed an ectopic. A heroin addict who came to the ER every week with one pain or another. I discharged her and she bled to death underneath a bridge.” She sees Dan take a breath. “I never checked a pregnancy test.” She doesn’t take her eyes from him when she says it, sees the quick pull of muscles at the center of his face. She is grateful that he makes no effort to console her.
Evelyn comes out of the kitchen to walk Claire to the door. From the look on her face, the careful placement of her palm on Claire’s back, she knows Evelyn is thinking less about her own well-being at this moment than Claire’s. “He wouldn’t even consider chemotherapy,” Evelyn says.
“You’ll call me for anything, won’t you? Anything you need.”
Evelyn doesn’t answer. She wraps her strong slender arms around Claire and hugs her fiercely. When she pulls away she keeps both hands fixed on Claire’s shoulders and says, “You know what he wants you to do.”
Claire feels something wind up in her chest again, tries to keep it out of her face. Her voice is lost now; all she can do is nod.
“You need to think about it carefully.” Evelyn smiles, a bit weakly. “You’re a little young to give everything up for a charity mission.”
Jory and Miguela are not inside when she comes home. She scans the field and walks around the back of the house to look in the apple grove. The craggy overgrown boughs are massed with blush-colored buds nested in young green leaves, it takes her a moment to realize the electric hum in the air is ten thousand bees. She calls Jory’s name and listens, almost glad for the solitude before she has to pretend everything is fine. A gust of wind carries their voices to her and she follows the shoulder of the hill down below the aspen grove, farther onto the land than she’s explored in years, to an escarpment cut by a shallow stream where they’ve waded across to a bank of flat rocks still lit by the nearly horizontal rays of evening sun. When Miguela sees her she gathers
beach towels, shoes, an empty box of Ritz and starts up the path of trampled grass toward the house, ahead of Jory.
“We found some flowers.” Jory has a mayonnaise jar filled with lupine and balsamroot, the first of this spring. She puts an arm around her mother’s waist and Claire is suddenly overtaken by a sob. She pulls Jory tight against her chest and feels her body yield like a kitten lifted at the scruff of its neck, suspended and trusting; and then Claire turns it all into a game, squeezing her in tight bursts until she laughs and twists free. They are almost back to the house before Jory stops talking about her suntan and the highlights she wants to add to her hair. “Mom? Are you okay?”
The sun is dying in Jory’s face, a gasp of red and orange that burnishes her skin an Indian bronze. “Sure, baby. I’m just a little sad about a friend who’s sick.”
“One of your patients?”
“No. Not someone I take care of. Someone I care
for.
” Claire smiles. “I guess those are the same sometimes.”
Jory studies her face for a moment, then looks down at the jar of flowers, as if she’s consciously sparing her mother’s privacy. They start back through the damp grass and her hand slips into Claire’s. She says in a near whisper, “I’m sorry, Mom.”
Addison comes home that weekend, and Claire sees a visible change in him: the burn of self-confidence in his eyes that had been so much a part of him when they had fallen in love. More than what
she
loved in him, it was what he loved in himself—the application of his mind to a task he was uniquely designed for, witnessing the manufactured products of his dreams change flesh-and-blood lives.
Claire leads him into the kitchen to introduce Miguela, but the flowered bedsheet has been pulled over the alcove entrance with not a breath of movement stirring the folds. They go upstairs, careful not to talk in full voice until the bedroom door is closed. He drops his bag and waits for her to come to him and rest her forehead against his chest before he places his hands at the small of her back. Some of the sexual ease they had rediscovered at the Mayflower has already slipped away,
she can tell, like a pendulum rocking back toward the centering force of gravity.
“Where’s Jory?” he asks, breaking away to heft his bag onto the bed and pull out his toilet kit.
“At a dance class, believe it or not. A friend is driving her home after. She likes the teacher—at least she hasn’t said she
doesn’t
like her. Three classes so far.”
“I thought about buying her new pointe shoes in Seattle.”
Claire sits on the bed and crosses her legs. “Buy her modern dance shoes. A lot cheaper.”
“Can you get them over the Internet?”
“You get them from God. Modern is done in bare feet. So is this a sign you’re still optimistic?”
“No reason not to be.” He is putting his razor and toothbrush away and catches her face in the bathroom mirror, turns around and stands in the doorway, watching her. “You haven’t talked to Dan about it yet, have you?”
Claire shakes her head. “Not Frida or Anita, either. We’re advertising for another doctor—maybe we’ll get lucky and find two.” She sweeps her hair back from her face and presses her fingertips hard against her temples. “I don’t want to say anything yet. What’s the point of saddling Dan with this, too, until we know?”
The front door slams and Jory calls out, having seen her father’s car in the driveway. His face changes instantly and he is down the stairs, scoops Jory into his arms and spins her in a fast Lindy pretzel. She is wearing gym shorts and a V-neck tank top; her hair catches in her mouth every time she spins. But even in play she is all dancer, sensing Addison’s moves before he knows them himself, as if her muscles alone could calculate the laws of physics.
Claire stands on the bottom step and flashes back to the first week they’d had Jory home from the hospital, barely weighing four pounds. They had bought a food scale and every day Addison would dress her in a single dry diaper and baby blanket and balance her in the middle of the plastic tray with his hands hovering on each side, waiting, his face frozen with anxiety until the flashing orange LED display settled
and stopped. The day she broke five pounds he had carried her down the hall of their apartment building, knocking on neighbors’ doors with the news.
Addison flops onto the couch, sweating, but Jory seems to have barely warmed up. She plugs her iPod into the stereo receiver and pushes the table against the window. “Okay, wait a sec. I’ve been working on something.” She puts her hands on her chest to catch her breath and bends over her knees with a singular self-conscious laugh. Then she dials to the song and counts a beat of eight with her eyes closed before she pushes Play and begins to move in slow, fluid turns, long lines of arm and leg and neck.