My Favorite Midlife Crisis (6 page)

“No, I would not. I plan on becoming a nun in an order that prohibits photographs,” Fleur deadpanned.

“A nun,” the girl said breathily. “My great-aunt is a nun. That is so cool.”

Outside in the brighter lights of the mall, Fleur said, “I must have been crazy to think this was a good idea. There is no way in hell I’m going to put any one of those pictures on the Internet.”

“But you have to,” Kat said. “People want to see what they’re getting into. Would you buy a pig in a poke?”

I slid her a lacerating look. Kat is splendid with visual images, not quite as adroit with words.

“Then I’m not going on. Forget the Internet. Forget The Plan. Fuck The Plan.”

I’ve seen this sudden stalling out in patients before they’re wheeled into surgery. Second thoughts before undergoing the experience that might save their lives. “Fine, but if you don’t do the project, it will be the only thing being fucked. Think about it.”

“Think about this.” Fleur shot an elegant, well-bred middle finger at me.

The final word. For now.

Chapter 6

“Hello, Doc,” my father said to me at six o’clock that evening as I let myself into his tiny East Baltimore row house. He waved at me from the hollow of his chair, a behemoth of a brown corduroy La-Z-Boy that nearly swallowed him up.

I leaned over to kiss his forehead, and he reached out a bony hand to stroke my hair. Dark and small, he was the antithesis of your typical Scandinavian stereotype although he came from unadulterated Norwegian stock. He used to brag he never weighed more than 135 pounds in his life. For the last few years, he’d been tipping the scales at 115. He hadn’t cared for red meat when red meat was in favor, had no taste for sweets back then, and so, I thought, eyeing him sadly, he will live on forever, his heart ticking merrily, his brain slowly but inexorably disintegrating.

Sylvie was the latest in a succession of round-the-clock caretakers, Caribbean ladies of infinite patience who did the job that should have, by rights, and would have, in another era, fallen to me.

“He’s been very good today,” she reported, putting down her copy of the
Caribbean
Voice.
“Not agitated at all. And he cleaned his plate for lunch. He does like that chicken I do.” She talked about him in front of him as if he weren’t there. I wanted to pretend he was, so we had discussed this, Sylvie and I, but to no avail. “It don’t matter I tell you,” Sylvie had insisted. “He don’t know. And if I have to take you in another room to tell you t’ings, you lose your time with him.”

“Dad,” I said, “it’s Gwyn.”

“I know who you are.”

“Who am I?” I challenged him to repeat it. Numbers were still remembered. Phone numbers. Bank balances. But names disappeared as they were uttered.

“You’re Doc,” he said.

“And who is this?” I pointed to Sylvie, hoping the new medication Dan found for him might have kicked in, kicked away some of the tangles.

“Ah, that’s my hon.”

All women, except for me, were “hon.” All men were “captain.”

He didn’t know us, but he did appreciate us. Some days he stood for hours in front of the wall my mother had decorated with family photographs, a documentary of our survival under her demented dictatorship. At least pinned to the wall, we were still and quiet which was all she’d ever asked of us. In spite of her, or because of Dad or who knows what interplay of forces, my brother and I grew up to stay out of jail and pay our taxes. Rolfe, who looked stunned until adolescence and then stoned in his portraits, managed to become a chemical engineer, marry Nadine, and father three kids. He moved to California decades ago and made it east to see Dad twice a year. My father’s maintenance fell to me. Fair enough. I’d sopped up most of his attention as a child.

While Rolfe stayed under my mother’s radar, I was the thorn in her side, the bee in her bonnet, the fly in her ointment. I looked like her which for some reason galled her, and from the time I was four I talked back to her in polysyllables she didn’t understand. She hammered away at me with everything she had.

I was eight when she went into Springfield State Hospital for the first time. Eleven when she made her first suicide attempt, by overdosing on Thorazine. The shrinks diagnosed schizoaffective disorder. There were short pre-hospitalization periods when she heard voices and spun delusions. But most of the time she was just dreadfully depressed and over-the-top angry. Principally with me who, in her muddled mind, was always out to get her. So of course I deserved every slap, every pinch, and in adolescence, the occasional slug.

Dad did what he could to protect me, and when the opportunity presented itself for my escape, he made sure I got out. Rolfe went to the University of Maryland for its low tuition. To pay my way at Barnard, Dad drove a cab at night in addition to his day job working a furnace at Bethlehem Steel. Three hours after I called home to report my acceptance to medical school, my mother took a bus downtown and leapt off the top of the Bromo-Seltzer tower.

Up and out of his chair, remarkably sprightly for an Alzheimeric eighty-two-year-old, my father shuffled over to stand beside me. He clasped my hand. We stared together at these pictures that took up so much space in his minuscule living room, and I realized they were as meaningless to me as they were to him.

“Who is this?” I pointed to my mother. Dan said to keep pushing him to remember. Every cell retrieved is a small victory.

“That,” my father said confidently, “is the USS
Arizona
. A grand battleship before they sunk her in Pearl Harbor. Terrible tragedy.”

Indeed. What a fabulous place, the human cerebellum.

“You know what?” I stroked his hair. “I’m in the mood for a Big Mac, how about you? A nice fish sandwich?” We did this nearly every Sunday, a treat for him. “McDonald’s. What do you say?”

“Oh, my. That’s a good one,” he laughed. “McDonald’s.” That name he remembered.

At dinner, he tore off pieces of the fish and cheese sandwich and fed himself while keeping a careful eye on his dessert, a fried apple pie. After my mother’s suicide, he’d developed a sweet tooth.

“Eat your fries,” he instructed me, briefly lucid. “Enjoy yourself, it’s later than you think.”

Not so crazy.

When I dropped him off, I reminded Sylvie to hide the phone so he couldn’t call me at five o’clock in the morning.

Then, feeling guilty since he asked so little of me, I changed my mind. “Let him call,” I told her. “I can always go back to sleep. It’s no big deal.”

She shrugged at me as if I were just another neurotic American white lady, which I am, and steered my father toward the La-Z-Boy. Two steps in, he shook her off and turned to me.

“Okay, Doc,” he tipped an imaginary hat. “Give my regards to Broadway.” A song he used to sing to me when I was nine or ten and couldn’t fall asleep because of some hissy fit my mother had thrown earlier in the evening. “And remember me to Herald Square.”

I had already kissed him good-bye when I handed him over and I was just going to wave from the door, but now I ran back and kissed him again on his soft, paper-dry cheek. For my reward, he returned the kiss, the first kiss from him in a long time. Then he patted my cheek, moved back a step, and surveyed me, his nearly colorless eyes sparking with some emotion. As if he were really seeing me.

Two years before, the American Association of Gynecological Oncologists had awarded me the Turnbull Prize for my work at the Women’s Free Clinic. A great honor.

This was better.

I arrived home to find a message on my answering machine. Harry Galligan, finally making good on his promise. He was at a conference in Topeka, but he didn’t want me to think he’d forgotten me. He hoped I was doing okay after my FRESH sharing.

Not a word about seeing me or even phoning me when he returned. So much for fantasies of being wrapped in his warm, pipe-tobacco-scented embrace.

The next morning, I was steady-handed and absolutely focused as I prowled through the reproductive organs of my uninsured patient, Freesia Odum. Ms. Odum, age forty-six, had a huge fibroid tumor hunkered down in her uterine wall. This, and three other sizeable tumors, were the cause of her excessive bleeding. I’d tried everything short of surgery to shrink these four big mamas. But now we’d come to the end of the line. Freesia Odum had a six-month-old granddaughter, LaTanya, to raise, and she certainly didn’t want any more children of her own. So I went about removing her uterus without my normal reluctance, leaving her healthy matched set of ovaries intact.

I don’t like to perform unnecessary surgery, but when conditions call for it, I do love to cut. In those horrendous weeks after Stan made his confession and knocked my world out of orbit, the only place I could find a semblance of peace was in the OR. There is something empowering and, I think, healing to the surgeon as well as the patient in slicing deftly through live tissue, dicing and splicing as Neil Potak calls it, and putting everything to rights. Funny, I have always been a lousy housekeeper, but I’m a skillful surgeon.

Of course, there are times when nothing you do is going to make it well, and those are the days you think you should have been a marketing major. But Freesia Odum’s pelvic cavity offered no surprises, and when she came around in recovery I could tell her honestly, “You’re going to be fine. You’ll probably live to be a hundred and be around for LaTanya’s grandbaby.”

She was too groggy to speak, but her hand crept out to grab mine and press it to her lips. I thought of my father working that second job to get me through Barnard and blessed his currently addled soul.

Case closed, I thought. But in fact it wasn’t. Every week, the staff of Potak, Berke, and Bernstein gathers for our medical review conference. We cover all the challenging cases on the docket, sharing experiences and getting instant consults from our colleagues.

In the middle of reviewing Freesia Odum’s procedure—“Six millimeter squamous cell. Highly impacted. One three millimeter—” I was interrupted. Interrupting a colleague mid-review is considered bad form, and I wasn’t surprised that this breach of professional protocol was executed in the exquisitely grating voice of Bethany McGowan, MD.

“This Freesia Odum is your uninsured?” she asked. As if she didn’t keep a running tab on my billing.

“Freesia Odum has no medical insurance, that is correct.” I’d been leaning over the patient chart on the conference table. Now I drew myself up and inquired with lavish politeness, “May I continue?”

“I thought it was settled that we weren’t going to absorb any more uncovered cases.” Someone had given her leave to say this, I realized, or she wouldn’t have dared press on. She darted a glance at Seymour Bernstein (likely culprit), who continued staring at the table, and then at Neil Potak (wouldn’t have put it past him, either), who was furiously retracting and reloading his ballpoint pen.

“I’m sorry,” I said, my voice thick with sarcasm, “I don’t think you qualify as my monitor. You’ve been associated with this practice for what, a little over a year? I was present at the creation. In your place, I would not presume to chastise a senior partner for her professional choices.” Deservedly tough.

The little ferret’s face turned bright red but she didn’t lower her gaze. I slashed on. “I don’t know if they taught medical ethics at Harvard,” as a child of blue-collar Baltimore, Johns Hopkins-trained, the Harvard thing had always rankled me, “but we have an obligation here to treat patients. True, we cannot treat every patient without regard for ability to pay, and these days we seem to be guided less by the Hippocratic Oath than by the bottom line. Nonetheless, when we see a patient in severe distress, it is our social and moral responsibility to at least consider whether we can afford to absorb that patient’s fees.”

“We’re not a nonprofit, Gwyn,” she had the temerity to back talk me.

“Jesus,” I said.

“Besides, that service area has Covenant as a safety net hospital.” She made “service area” sound like downtown Baghdad. “Covenant absorbs these cases. I don’t know why we—”

“Covenant takes only uninsured emergencies, as you know.” I was seething. “They don’t do routine care or non-emergency surgeries.”

“But,” she smirked as if she’d got the goods on me, “Covenant just got bought by UltaMed. That’s a major corporation. Who’s to say they won’t increase community outreach? Which, we need to remember, is not part of our mission.”

Cold. Very cold. I wanted to slap her. Neil glanced at my face and said quickly, “Let’s move on please. This is sidetracking us.”

“Why don’t you do a study on this, Bethany?” Seymour interjected. I figured him to be the lead horse in the field of possible coconspirators. Divorced and always on the make, he’d come on strong to Bethany when she joined the practice, but I thought she’d rebuffed him. Now I wasn’t so sure. Was this a setup? “See how many pro bonos we’ve all done. Cost to the practice. Then we’ll be able to balance it against goodwill in the community, PR, abstract stuff like that.”

“Fine,” Neil said. “Do the numbers, Bethany, and we’ll take a look at them.”

I steamed silently.

As we drew to a close, Neil said, “I was supposed to go to London for the IAGSO meeting, but Cheryl is having back surgery. Anyone want to fill in?”