Fire & Water (29 page)

“Thanks for—”

Burt placed his huge hand over his heart, quieting my words. “My pleasure.” He turned to Ryan. “Come on, little one. Let’s go face those pussycats.”

* * *

Three weeks after Jake’s breakdown, I decided to go back to work full-time. I had patients and surgeries scheduled, and my uselessness with Jake was a vulture feeding on my flesh. I needed to feel effective at something. At my urging, Burt went to back to New York to complete the publication of a collection of photographs of Jake’s work on beaches. “It should generate some income, Katie.”

He pulled me into an embrace, engulfing me in his massive chest. I leaned against him, thankful for his sturdiness. “No one but you could have been here for Jake. For me,” I said. “I’m just so embarrassed. The money. My family—”

Burt looked down at me. “Not to worry. You take care of yourself and that little one. Let me worry about the business bits. Jake, well, he’ll pull out of this. I know it.”

As Burt’s cab pulled away from the house, loneliness and shame crept over me, viscous and honey-thick.

Later, I found myself sifting through childhood photographs feeling in my gut a tangle of anger, foolishness, and rage. Jake was right. My blindness had been voluntary. The mirror had told me the truth my whole life. Its reflected image bore no resemblance to Elyse Ryan Murphy, with her petite frame and delicate features. Now, looking at the mirror, my every feature—my coarse, dark hair, my height, the paleness of my skin—mocked my denial of the facts. Alice’s reflection, stripped of its heavy makeup and bleached hair, looked back at me. I had accepted without question the myth of who I was. Jake had recognized it the first time he’d walked into Murphy’s when he’d assumed Alice was my mother’s sister.

The hospital was the only place where I felt normal. The needs of my patients gave me a heroic excuse to leave the house. I assuaged my guilt by telling myself that my patients needed me.

Allison Bennett, four months old, provided ample distraction. A combination of birth defects and a twisted bowel had left her in constant pain. Surgery was risky. But a shortened life with a colostomy bag didn’t seem much future for her.

Once in my scrubs, I prepped for surgery. Fingertips, knuckles, between each digit, palms, wrists, arms, elbows. Each body part, fifteen strokes with antimicrobial soap. The counting of strokes was my pre-surgery mantra—a rosary-like ritual that allowed me to block whatever thoughts followed me into the scrub room.

On this day, the ritual brought special comfort. I was winning a war against unseen bacterial enemies, foiling their planned attacks before the first strike and finding their hiding places. With each stroke, I annihilated thousands of microscopic adversaries, like some allopathic superhero. In the OR I was a warrior, strong and fearless, vanquishing my enemy.

It was so simple. I only had to open bodies and repair the broken parts—correct an evolutionary mishap with established protocol. The outcome could be measured. During surgery, nothing else existed, only the beeps and buzzes of monitors and the voiced instructions for instruments and updates on readings. The rest of the world fell away. No broken husband. No debt. No lying family members. There was not even a Ryan. Had I flown to the moon, I could not have been farther away from my life.

As I stepped out of the OR, the baby’s family rushed toward me. “It went well,” I reassured them. “We removed the malformed section of bowel. Now that there’s a healthy connection, her digestive tract looks good. We’ll have to watch really closely for infection, so it isn’t all over yet.” I pulled off my surgical cap and shook my hair loose. “With any luck, though, you’ll be up to your elbows in poopy diapers before you know it.”

Allison’s dad wiped tears from his eyes while her mother nearly collapsed from relief. “Thank you, Dr. Murphy,” the exhausted mom warbled through her tears. “How can we thank you?”

“Just bring me some cake from her first birthday party. I’m partial to cream cheese frosting.” As I walked away, I longed for the usual feeling of elation I had after giving a family good news. Parents of a sick child normally filled me with gratitude for all that I had. I’d go home and hold Ryan’s perfect little body close to mine and say a prayer of gratitude to a god I wasn’t sure I believed in. But on this day, all I could feel was a pathetic kind of jealousy. Even with the enormous hardship they were facing, this family was lucky: their problem could be fixed.

* * *

Finally, I could avoid the conversation with Dr. Gupta no longer. My fear eventually trumped my arrogance, and I went to see the gentle doctor. “I’ve never seen him like this,” I explained. He poured tea for both of us from the filigreed teapot I’d seen the first time I was in his office more than five years before. “He’s so… dead.”

“Does he respond when you speak to him?”

“Only in groans and complaints if I open the shades or turn on the lights. When I talk, he barely looks up, and when he does, he looks like an animal that’s been beaten senseless. He eats almost nothing. Hardly speaks. He’s lost weight.”

“As have you, Dr. Murphy.”

I pulled my jacket around me, avoiding the deep black pools of his eyes.

“Can you get him to come to my office?” Dr. Gupta asked.

“I consider it a major coup when I get him to take in some liquids. I’m desperate here. Can you please come to the house?”

“I’m not being confident that would be the best thing.” The musical inflection of Dr. Gupta’s Indian accent again made me think of Yoda—wise and comical at the same time. If only he had Yoda’s powers.

“If it’s a matter of money—”

“Please, Dr. Murphy. Money is not at issue. I’m reluctant to be indulging this depression. There’s an ethical issue as well.” He held up the sugar bowl, and my nod cued him to add two lumps to my cup. “My services are voluntary, and he has declined them. If I come to him, he will have no reason to pull himself forward the next time he suffers an episode of depression.”

“The
next
time!” The shriek in my voice surprised me. I breathed to steady myself. “Dr. Gupta, I’d like to prevent a next time.”

“Yes, I see. Dr. Murphy, please be hearing me. This will be much more manageable if you begin to view your husband’s manic depression not as a series of single, surprising events, but as a chronic illness. It can be managed with consistent medication. This will make these episodes more infrequent and less severe. But recurrence is likely, if not inevitable. While it has been nearly six years since his last serious episode, we should view this as a period of dormancy—a remission, of sorts—for his mental illness.”

Dr. Gupta’s words were a flock of bats, dark and menacing.
Manic Depression.
Chronic Illness. Recurrence.

“I’m sure you have seen families who have a member with a chronic illness—diabetes or multiple sclerosis. It is challenging to see a disorder like your husband’s illness in the same light as physical illness. Maybe even more challenging for a physician. It seems to us that the patient is not really ill when his body appears healthy. It takes a great deal of support and treatment for families to weather mental illness together.”

Mental illness
. Those two words were smoldering lumps of coal that I was forced to swallow. Those were the words that people used to describe the rag-clad people—toothless, unwashed, and smelling of urine—pushing shopping carts on Market Street like Mary K’s Irene. I felt sucker-punched by this recurrence of Jake’s illness, infuriated that I’d allowed myself to be lulled into the illusion that it had simply disappeared, and more furious still that Ryan’s world had been irrevocably altered by the waking of the sleeping lion.

Dr. Gupta continued, but his voice became only a distant hum in my ear. I thought of Jake, his scraggly beard and his thin body curled in the twisted sheets. He had been a loving husband and doting father for more than five years. How could I reconcile that with what waited for me at home?

“Why does he go off of his medication? He’s brilliant. He’s got to know this will happen.”

“Many creative people with this disorder believe they lose their creativity when they are medicated. The mania, as awful as it can be, is a wild party that they once enjoyed and to which they want to return. After long periods of stability, they trick themselves and think that they can manage without the medication. Not unlike an alcoholic who, after a long period of sobriety, begins to think that he can handle a drink now and then.”

Tully’s sweet face popped into my mind. How many times had he gone on the wagon? How many times had he sworn that he was done with liquor? And Mary K, but for her smoking, had done everything to manage her diabetes, only to be outwitted by it.

I left Dr. Gupta’s office with the feeling that I’d just been issued a life sentence to a prison I’d chosen myself—with Ryan as my cellmate.

* * *

That night I slept, or tried to, on the suede chaise in front of the fireplace. I could no longer bear sharing a bed with Jake, so unresponsive, so dead to me. As I lay and watched morning’s light spill into the room, a pounding came from the front door.

When I opened it, Mary K stood on the stoop, her expression a mixture of anger and concern. Mary K was just another one of the people I’d been avoiding. She’d been right about him, and I couldn’t face her.

She held up a large bag of bagels and a cardboard carton containing two cups of Peet’s coffee. “I come bearing breakfast.” She scanned me from head to toe. “From the looks of you, a meal is long overdue.”

I wrapped my arms tighter around myself and watched a car pass on the road.

“You gonna let me in, or are we going to stand on the stoop all day?”

I followed her to the kitchen. The prosthesis that Andra had developed for her left her with a near-perfect gait, no obvious sign of a limp. Saying nothing, Mary K practically pushed me into a chair and began slicing bagels. The smell of toasting bagels made my stomach growl. I couldn’t remember the last time I’d had an appetite. Her silence let me know that Mary K had not just dropped over for a social call.

After she’d spread cream cheese and lox on two bagels and sprinkled capers onto mine, she brought two plates to the table and sat across from me. “So, Alice called.” Suddenly I felt hollow, and my appetite faded.

“She’s worried about you. Wondered if we’d talked.”

I pushed my plate to the center of the table. “Yeah, well, I’m sure she gave you quite an earful. You can just take your I-told-you-so bagels and go.”

“Really, Murphy? That’s what you think I’m here for? I left a couple of messages last week, but figured you were busy. I was up to my ass in stiffs, so until Alice called, I hadn’t really noticed that it was so long since we talked. Your dad and Alice are worried sick. You need to call.”

Rage made all my muscles clench. “I don’t need you to tell me when I should talk to my family.”

“Apparently you do. Of all of your many annoying traits, this withdrawal thing you do is by far the most annoying. Are you so dedicated to being a superwoman that you can’t let people help you? Jesus, I thought I was a prideful pain in the ass. But you take the cake. But never mind all that. Your dad’s been trying to reach you for three days. Did you listen to any of the messages?”

“I unplugged the phone.”

“It’s Dr. Schwartz.”

Her words were a spear that pierced though my defensive shield. I covered my mouth with my hand.

“I know you’re going through a lot right now. But I—”

“They told you all of it, then? About what happened with Jake? Alice?”

Mary K nodded, and I was oddly relieved at not having to tell her everything.

“That’s some tough shit, for sure. Timing sucks, but I thought you ought to know about Dr. Schwartz. I think you really need to see him. I don’t think there’s much time.”

An image of Dr. Schwartz’s tremulous limbs and his valiant fight against Parkinson’s flashed in my mind. “Where is he? At UC?”

“At his house. Your family is there with him.” It was hard to read the expression on Mary K’s face. Was she hiding the worst from me? Of course Dr. Schwartz would stay in his home. That would be his way.

“Ryan’s at an overnight. Thank God. The home nurse is here. Let’s just go?”

“Done,” Mary K said. “But first, you need to eat a bagel with me. You won’t do anybody any good if you pass out. Eat, then take a shower. Then we’ll go.”

My friend’s kind smile quelled my anger. She pushed my plate back toward me. “Come on. It’s the seedy kind. Your favorite.”

“Thanks,” I said.

“Skip it, Murphy. This spread set me back twenty-two-fifty, so eat up.” She took an enormous bite of her bagel. Her cheek bulged as she chewed.

Before I knew it, the bagel on my plate had disappeared.

Promises Kept

Mary K drove me to Lincoln Avenue and parked her car in front of Dr. Schwartz’s house. With dread for what I’d find, I climbed the stairs to my mentor’s flat where I’d spent so many afterschool hours as he quizzed me for chemistry and biology exams and prepped me for my SATs, then my MCATs. The thought of losing this sweet, humble, brilliant man made me feel hollow inside. I turned to Mary K on the steps behind me, trying to will myself to ring the bell.