The Blue Cotton Gown (31 page)

“I still don’t feel right. I’m just so
tired.
I’m taking my vitamins every day, but I’m not myself. I was wondering if you could check some more labs. Maybe there’s something else wrong.” She trails off and stares blankly at the cupboards over the sink.

The woman, a ghost of her old self, cries quietly, this time for real, but then she takes a deep breath, embarrassed. “Don’t worry about me, I’ll get it together. With seven kids, you don’t have time for a breakdown.”

“Do you think you might be depressed?” Nila rolls her eyes, round golden brown marbles in her thin, flushed face. “Well, I know you’re
depressed,
but I mean enough that you need an antidepressant. Depression can make you tired, make you want to sleep all the time. What with losing the baby and then Doug leaving, it wouldn’t be a surprise.”

“No, I’m fine. I’ll be fine. Maybe I just needed to cry. I’ll just get my labs done. Put down every test you can think of. I lose my medical card next week.”

I hand the patient the slip.

“I’m sorry I kept you so long,” Nila says. “I know this was supposed to be a quick visit. You always have a way of getting me going. A sympathetic ear, I guess. I don’t have anyone else to talk to. Not Marnie or Gibby, that’s for sure.”

“I wish I could do something more,” I tell her. “I’ll call in a few days when the lab results come in.”

We stand at the door. Nila seems so tiny. I could pick her up and carry her out under my arm. Then she straightens her denim jacket, tucks a few strands of loose hair behind each ear, and plods res-olutely down the hall. At the corner she turns and raises one wilted hand.

Where,
I wonder,
where is the woman that one morning at dawn took

off with seven kids in a van?

Lost

It’s not just Nila. I’m still upset over the IRS pocketing our thirty-three thousand dollars. Don, our accountant, has a specialist in his office who’s filing petitions on our behalf, and Noelle is persistently working the telephones, but for the immediate future the money’s gone, and more is being withheld by Accordia every day. And then there’s the threat of Elaine Wright’s lawsuit. I can’t shake it, this sense that a terrible storm is coming. Tom acts like nothing has happened.

“What’s the sense in worrying?” he says when I bring up Elaine’s lawyers’ request for records. “I did nothing wrong. They probably won’t sue me. Most requests for records don’t make it to court. If

you worry about every little thing that might happen, you’ll be unhappy most of your life.”

I sit wrapped in a quilt, looking out over the dark lake, smelling the new-mown grass and the lilacs, and take a swallow of my sleep medicine. Until the IRS stole our money and Elaine’s lawyers requested her records, I was sleeping through the night at least once a week.

I think about quitting the practice all the time now and find my-self looking through
Homes and Land
magazine for a cheap farm. I dream of when I was twenty and planted my first peas. How awed I was to see them sprout. Life was so uncomplicated then, but Tom won’t even discuss it. As far as he’s concerned, we’ll live in Blue Rock Estates for the rest of our days. He’s a wolf that has pissed around the perimeter of his territory and he’s not budging. Not unless we go bankrupt.

I could, of course, resign on my own, leave him holding the bag, but what good would that do? Financially the practice would be in even worse shape with one less provider, and unless I actually divorced him I’d still be faced with the debts and vicarious worries. If we continued to live together, I couldn’t help asking each day how the nurse-practitioners’ schedules looked, what the checking account held, and if the IRS had coughed up the money they’d taken from us.

Even if I was able to persuade Tom to move away with me, how could we sell the practice? What ob-gyn in his right mind would want to move to West Virginia, where medical-liability insurance premiums are ninety thousand dollars and up? And where in the USA are providers protected from frivolous lawsuits? I’m digging myself into a hole here, but I don’t see any way out.

I finish the scotch and stand leaning backward over the porch rail, which Tom has finally repaired. The smell of apple blossoms loosens the spring air. There’s something comforting about the night sky, the wide stretch of stars. These are patterns I know,

Orion’s Belt, the Seven Sisters, and the Milky Way. They shine over my home here above Hope Lake, over the abandoned communal farm near Spencer, and over the cottage in Canada.

I scan the horizon, from the hills across the lake to the lights of the vehicles on the faraway freeway and back to our drive, but I can’t find the North Star anywhere. I step out on the wet grass in my bare feet and pajamas and look over the roof of the house but still can’t see it. I’m bewildered, disoriented. If I were a stranger in a strange land, I’d be lost . . . lost with no compass to guide me.

I am lost.

nila

At 6:30 a.m. my cell phone goes off. What the hell? The office will be open in an hour and a half. Can’t they wait? I shake my head and reach for the phone.

“Hi, this is Patsy Harman.” I grope for a pencil.

“Sorry to bother you so early. This is Ann at the answering service. Were you out of bed yet?”

“No, Ann. What’s up?” I ask without enthusiasm.

“We had a call from a Nila Wilson. She says it’s an
emergency
and she needs to talk to you. She said
you,
not Dr. Harman. And she couldn’t wait until the office opened at eight. I thought that was strange.”

“Did she say what it’s about?”

“No. I asked, but she wouldn’t tell me. ‘I need to talk to Patsy right away’ is all she would say. She sounds upset,
very upset.
”

“Okay, Ann, that’s fine. What’s the number?” I write it down, then dial. Tom’s side of the bed is empty. He leaves early when he has to be in the OR.

“Hello,” a woman softly answers. “Is that you, Patsy?”

“Yeah, Nila. The dispatcher at the
emergency
service said you called.” I always put a little emphasis on the word
emergency,
wanting patients to get the idea that this is not a chat line.

“Oh, thanks for answering. I have to see you this morning,” a breathless voice starts out. I frown. This is my day off.

“What’s up? Is it something Dr. Harman can take care of ? Or one of the other nurse-practitioners? I just saw you a few days ago. I wasn’t coming in. It’s my personal day.”

I planned to get my hair cut, go to the mall, buy a new pair of shoes, and go on a bike ride in the middle of the day. This was a new leaf I’d turned over, to take better care of myself.

“No, I really need to see
you.
It’s Tilly, my four-year-old. I think

Gibby’s done something bad to her, real bad.” She stops, and it sounds likes she’s crying.

“Is she hurt? Isn’t this something a pediatrician or the ER should handle?”

“No, this is something for a gynecologist.”

Now I’m awake.
“What are we talking about, Nila? Are you sure?

Where’s Tilly now?”

“Asleep. All the kids are asleep, but they’ll be waking up soon, so I can’t talk long. Can I see you at the office? I’ll be bringing Tilly. I want you to examine her.”

I hesitate. “Nila, I don’t have a lot of experience with pediatric gy-necology. There’s a specialist at the university. I could call him.” “No, just you. You won’t scare her. You’re gentle. Tilly won’t be afraid if it’s you.” She has a point; at the university the child would be examined by an attending, accompanied, at the very least, by a

resident and a medical student.

“Okay, Nila, can you get there by nine? I’ll call the office and tell them that I’ll meet you there. Will that work?”

“I have to get the kids on the school bus and find someone to take care of Josh and Danny, but I think I can make it.”

“Well, I have a haircut at eleven, so try.” I hang up, feeling selfish.

The woman’s having a crisis and I’m worried about my hair.

tilly

At 9:15 a.m., I’m staring out the window over my desk at the white quarter moon still high in the morning sky when Abby taps on the door. “Your patient is here. I thought you were off today.”

“Yeah, I am. But Nila called this morning and said there was some emergency, so I told her I’d come in. Do you think you or one of the staff from up front could go into the exam room and read to the little girl so I could talk to the mother in private in the conference room?”

I wait at the big table until Nila joins me. She’s dressed in blue jeans with a man’s brown plaid flannel shirt, way too big. “So what’s going on?” I ask, skipping the niceties. Nila sits down and wipes angry tears from her eyes with her sleeve.

“I’m just so
sick,
Patsy. I’m so
furious.
I’m almost sure Gibby has

been molesting Tilly, doing stuff to her. I don’t want to believe it, but I think it’s true. That’s why I need you to examine her.”

I glance around. Where are the tissues? I must remember to tell the staff that we need tissues in the conference room.

“Nila, I need to know exactly
what
we’re talking about and why

you suspect Gibby. Is she hurt? Did Tilly tell you something? These are serious accusations.”

Nila wipes her flushed face again and tries to take a deep breath. She stares at me, and her large light brown eyes tear over again. There are dark circles under them, and her hair is pulled straight back and held with a rubber band. “For the past few weeks, Tilly has been crying when she goes to the bathroom. I couldn’t figure out why. It didn’t seem to
hurt
when she urinated, she just didn’t want to go in there. I would have to insist because she started wetting her pants again and she’s been trained for years.”

I cut in. “How old is she?” I’m taking notes in the back of Nila’s chart.

“Four. Just turned four. I figured she was going through some kind of phase and I’d just drag her into the bathroom every few

hours to keep her from having an accident. I feel so bad now. You know what it’s like with a big family. That many kids are kind of a blur. You’re just trying to keep them all clean and fed and the home-work done. Tilly has always been a no-fuss child, but lately Gibby’s been paying a lot of attention to her, having her over to his house for sleepovers. I never thought anything of it. It gave me more time with the others.”

“I still don’t get it. What happened that makes you think Gibby has molested her?”

“Last night. Last night, when I was putting Tilly to bed, she was rubbing her tushy
.
That’s what we call it.
Tushy
for girls.
Pee-pee
for boys. And I asked if she hurt down there and she said, ‘No, Daddy makes it better.’

“I was freaked. ‘What do you mean?’ I asked.

“‘Daddy does it in the bathroom.’ That’s what she told me. ‘What? What does Daddy do?’

“‘Rubs my tushy.’ Oh, what does that mean? It can only mean one thing, can’t it?” Nila is crying again.

Where are the damned tissues? There should always be tissues in this

room!

“And then she says, and this really got me . . .” Nila tries to pull it together. “Then she says, ‘Daddy says he has to do it because you’re too busy loving Doug.’ I almost threw up. Oh, Patsy, has he been doing something to her? He can’t be fucking her. She’s too lit-tle. Could he have done it to the other girls too? Is it to get back at me because I won’t get in bed with him? It’s just so perverted. I’ll kill him if he did anything to her. I swear I will.”

I picture the small blond hairy man with a hard-on sitting naked on the toilet with the pink, naked child on his knee. Doing what? What could he do? Screw her? Finger her? I take a deep breath.

“Okay, Nila, calm down. Maybe it’s not as bad as it sounds. Get a hold of yourself. I’ll need you to help me. I want to approach this as a routine physical. What did you tell Tilly when you brought her here?”

Nila is wiping her face on her sleeve again, smoothing her light brown hair back into place. I reach over and tuck a loose strand be-hind her ear. “I just told her that Mommy had a doctor’s appointment and she could come with me.”

In the exam room Abby sits reading a Dr. Seuss book to Tilly. The small, fair girl is dressed in red elastic-waist pants with a yellow knit top that says
princess
.
Her white-blond hair is up in a ponytail, and there’s a gap like her mom’s between her front teeth. She’s as cute as a button. A miniature Nila.

“Hi, Tilly. How are you today? Did the nurse read you a book? Thanks, Abby,” I say as the nurse leaves the room. Then I get down to business.

“I already checked your mommy. Now it’s your turn. My name is Dr. Patsy. It’s nice to meet you, Tilly.” I lean down and shake the girl’s tiny hand. She wears a blue and green beaded bracelet with butterflies. “Why don’t you sit up here?” I indicate the exam table. Nila picks her up and puts her where I ask.

I start with the girl’s heart and lungs, letting her listen with my stethoscope. Tilly’s eyes get big and she smiles. I peer in Tilly’s mouth and feel her neck and shoulders, getting the child used to my touch, slowly working my way to her bottom. She’s a sturdy lit-tle person, well nourished, well cared for.

“Now I need you to lie down and I’ll check your belly button. I’ll give you a sheet to cover up, so you won’t be cold. Mommy can help you take off your pants.”

I have no clue what I’m doing. This is definitely not in the nurse-midwifery curriculum, probably not in the ob-gyn’s training either. I figure I’ll check the girl’s vulva and vagina for evidence of trauma. Maybe do cultures for sexually transmitted diseases. I get out the swabs while I’m waiting. If Nila’s right, the molestation may have been going on for weeks.

“How old are you, Tilly?”

“Four,” the girl answers in her baby voice, lying on her back and kicking off her pants. “I just had a birthday.”

“And what’s your favorite color?” I’m gently palpating her soft round abdomen.

“Blue, but I like red too.”