The Resurrectionist (2 page)

“Fine, thanks. Except that there isn't much doctoring in Administration. I'm ready to get back into practice.”

“Of course you are. But the cravings?”

“Nearly gone.”

“Nearly?”

“There are times . . .” Jacob says, his voice trailing off. “There are times when I think about it. That freedom from anxiety.”

Reithoffer nods. “Understandable. But you fully realize that this freedom is illusory?”

“Yes.”

“That is the key to avoiding relapse, you know. And the craving is the key danger of Xanax, why every course of medication should be carefully monitored.” Reithoffer waves one hand in the air, the gesture casually European. “Only in America would we imagine life without the bother of anxiety. And that is why these tranquilizers are so completely overprescribed here.”

There is an awkward silence; they both know that Jacob never got his tranquilizers from a prescription. As if to break the tension, Reithoffer begins flipping pages in the chart spread out on her desk. “How about alcohol?” she asks.

“Same as before. Just the social drink.”

“Fine. But remember that it's all of a piece with addiction. Alcohol is the prime avenue of relapse for those in tranquilizer recovery. It's cheap. Easy to come by. Similar effects on the nervous system. Be careful.”

“Right. I've got you.”

Reithoffer rises and takes a blood-pressure cuff and stethoscope off the coat tree behind the office door. She sits on the edge of her desk and motions for Jacob to raise his arm.

“And the Klonopin? How long have we been off that?”

“Three months now. I started tapering it in March.”

“Which you will remember I advised against.”

Jacob nods. “I remember. But I'm not a junkie, Kirstin.”

Reithoffer shoves the cuff up over Jacob's bicep and cinches the strap tight against his arm. “No. Not a junkie.” She breathes through her nose as she arranges the strap to her satisfaction. “No junkie could have finished a residency here at Carolina. If one ever does, the school will have my resignation promptly.” She smiles. “What you are—were—was a resident under great strain, working long hours. A resident who made a mistake. I am under strict confidentiality regulations from the Physicians' Task Force, but I can tell you that you are not the only one to make such a mistake.”

“That's good to know.”

Reithoffer slips the stethoscope under the cuff. It is steely cold against Jacob's skin. “Let's review it once more, the error. Tell me again why you broke your oath.”

Jacob shifts in the chair, but Reithoffer grips his arm more tightly and begins pumping the bulb of the blood-pressure cuff. Her fingers are long, delicately tapered, but strong.

“Again? What's the point?”

“To know your weakness. To face down the wolf so he doesn't come again.”

Jacob takes a deep breath. He knows that Reithoffer will take at least three readings of his blood pressure as he talks. There will be time.

“The last year was the hardest,” Jacob begins. “I had a lot of debt, just piling up, and the moonlighting was the only way out of it. I was getting stretched too thin. I was getting tired.”

Reithoffer studies the gauge of the cuff. Jacob can hear the starch in her white coat crackle when she moves. She nods for Jacob to continue.

Jacob takes a deep breath, closes his eyes, and remembers.

That third year of his residency, something had slipped, some cog in the turning wheels of his ambition had sprung loose. He'd been working like a dog at the little county hospital out in Newberry in between shifts at Memorial, trying to stay ahead of his rent and the enormous student loans. Some weeks that meant two to three days with no sleep, the seven-to-seven shift in Newberry sandwiched between his schedule at the university and his ancient Honda overheating on I-26 as he floored the pedal to make it from one ER to another. It had started out as hard as he could imagine. Then it had gotten harder.

It was especially bad in Newberry that fall. He lost three patients in November—two of them goners that he could have let go easily enough, but the third a woman of thirty-two whose breast cancer had metastasized at a rate beyond any even the oncologist could comprehend. Jacob had diagnosed the tumor and consulted with the oncologist throughout her treatment. Everyone knew it wasn't his fault and couldn't have been. But still there were her eyes, sinking into her skull in the last two weeks she was alive, which would never accuse him. And that, somehow, was the worst of it, the last indictment of his incompetence as her physician.

Her chemotherapy had been aggressive and it had taken its course on her body. A week before Thanksgiving he had stuck his head in a door on rounds and apologized to the woman in the bed.

“Wrong room,” he said. “Sorry.”

“No, right room, Doctor Thacker,” she said as he looked down to recheck the name on his chart. “Wrong life, I guess.”

Jacob froze. He felt that he could never again look up from the clipboard, so great was his shame, his disgust with himself.

“It's all right,” she said softly from the bed. “It's okay.”

When he looked up, she was smiling. Her weary face wore an open expression, already past this latest indignity. Not as though she were anticipating some long-shot good news from this visit, but simply that she was glad to see him. Her expression was simply, impossibly human.

He understood then that she knew this Friday afternoon to be her last, and tomorrow's Saturday afternoon to be her last. He sat down on her bed and they did not talk about the cancer or her regimen but simply talked. Yet her approaching death was in every unspoken word, fusing the conversation and charging it with meaning, with a new significance of the mundane. Later it would strike him that it was something like grace in the room, but then he could see it only as death, a thing she had somehow transcended while it crippled her healer.

After that it was as though his horizon had shifted, then dimmed. The bright goal was still there but now with less luster. The woman died on Thanksgiving Day. Jacob was at the hospital, midway through his twelve-hour shift, when he heard. He had eaten a Thanksgiving meal of cold turkey and store-bought dressing without tasting any of it.

Later that evening, a farmer had come in with his hand mangled to hamburger from attempting a thresher repair after too much holiday cheer. The man's wife was hysterical to the point of shock, so once Jacob got the farmer stabilized he went to the supply closet to get her a Xanax. And there in the supply room, his hand paused with the bottle of sedatives in it, as if by its own will. He knew the dose was .5 milligrams. He had shaken out two pills and swallowed one of them dry.

Reithoffer shifts on the desk and turns the valve of the blood-pressure cuff. The bulb hisses as the air drains from the cuff, and Jacob feels the pressure loosen against his arm.

“So where was the error, Jacob?”

He attempts a joke. “Not sending a nurse to the supply room.”

But Reithoffer does not smile, only fixes her flinty eyes on Jacob as she pulls the stethoscope from her ears.

“The error was a confusion of compassion,” Jacob says, sighing. They have been over this same ground for months.

“Exactly. Patients die, Jacob. They die when they should not, when we are unprepared and when their medical records indicate any other feasible outcome. College athletes in the prime of health suffer massive infarctions. Twenty-year-old mothers die of postpartum stroke after routine deliveries. And young women get cancer.”

“Her name was Varina Payton.”

“Let it go, Jacob. Our concern is with the survivors. The living.”

Jacob thinks to tell her again about the woman's eyes, the depths of suffering and endurance in them, but knows it is no use. He suspects Reithoffer has witnessed too much of it to really see it anymore.

“You cannot be a doctor without achieving the proper distance from your patients. Every physician must face the terminal cases and move on. Some are beyond our reach. Move on.”

Jacob nods. Reithoffer pulls the cuff off his arm and hangs it on the wall. When she turns back to him, the flinty eyes seem to have softened a degree.

“Jacob,” she says, “how did you lose your mother?”

He looks up more quickly than he had intended. “Not breast cancer. Emphysema. Dad too, three years earlier. They both worked in the mills all their life.”

Reithoffer nods, bends over her desk to make a notation in Jacob's chart.

“Last week I had to reply to a memo on conserving printer paper, Kirstin.
Office supplies
. I should be handling charts, seeing patients. Some days I look up from that computer, that desk, and I don't even know who I am anymore.”

“Blood pressure is one-thirty over ninety-two. Not too good. You need to be getting more exercise.”

“I haven't gotten down to the gym much lately.”

“Make it a priority. We are all busy.” Reithoffer closes the chart and puts it into a filing cabinet behind her desk.

“How is everything otherwise? We're at the midpoint now, right? Will I get a good report?”

Reithoffer locks the filing cabinet and drops the key in her pocket, checking her watch as she does it. She steps around the desk to where Jacob sits and rests a hand on his shoulder; Jacob can just make out the neatly manicured fingernails in his peripheral vision.

“These things take time, and the task force feels it can never be too careful. Get some exercise. Get some rest. You look tired.” The hand grips his shoulder. “Recovery is one day at a time. And today I have a long line of patients to see.”

Then the hand is gone and Jacob can hear the office door opening. Before it shuts, Reithoffer speaks again.

“You left a urine specimen with the technician?”

Jacob drops his head. “Not yet, ma'am,” he says.

T
WO HOURS LATER
he is back in the office, finishing a set of interview questions for Miss Nasir's profile in the next issue of the alumni magazine. Interviewing the new med students is usually awkward for him, but he feels a bit of genuine anticipation this time. He prints the document and sits back while the printer whirs.

Something is happening downstairs. The old building's central stairwells and open banisters cannot hide much from one story to the next. The racket of the construction has been building steadily for nearly a week, but now its timbre has changed; there is still noise, but not machinery, no hammering or sawing. Only voices charged with a current of intensity beyond the daily banter.

Below him, three black men emerge onto the front lawn clad in the khaki uniforms of the physical plant, their legs slathered with clay. One of them slings his hard hat back toward the building and stomps off toward the crosswalk at Gervais Street, and the others look after him for a moment before lighting cigarettes. They gesture expansively as they talk and drag deeply on their smokes. He recognizes one—Lorenzo Shanks—as a familiar face from the gym on Beltline Avenue, Jacob's occasional spotter on the bench press. He has never seen Lorenzo's face so intense, almost frightened.

A few minutes later, Jacob is down on the main floor, brushing aside the plastic sheet that has guarded the presidential offices from the dust of the foundation work in the cellar. His loafers sound emptily on the wooden stairs as he descends to the droplights that gleam against the red walls hewn from the dirt of the cellar. The foreman, Bowman, stands near one corner of the basement, shaking his head over the raw clay and smoking a cigarette of his own—an express violation of code inside a state building.

“You should know there's no smoking in here,” Jacob says as he approaches, but the man seems not to hear as he kicks at the dirt and a small collection of ivory fragments upon it. Bones.

“What I've got to work with,” he says. “Jesus Christ. If you-all had let me bring in my men, we'd be half done by now.” Smoke billows from his nostrils as he grunts. “White crew wouldn't have spooked at no pile of cat bones.”

Jacob squats at his feet. He prods at the bones until he arranges them into the metacarpus and phalanges of a small hand, human. He cradles the bones in his palm and rises with them in his hand like porcelain, until he is toe-to-toe with Bowman.

“Turns out your crew is smarter than you thought,” Jacob says, breathing evenly. “This is a second-shaft metacarpus and a first-row phalange. Which to you means the pointer finger of a small child, maybe five years old.”

Bowman backs up a step. “Shit,” he says.

“No shit. How many have you found?”

“They're all over the place. One of the boys looked in that vat yonder and just about ran out of here screaming. Rest followed him.”

Jacob looks where Bowman has nodded and sees an ancient cask of wooden slats bound in iron bands at the edge of the electric light. It is half buried in the dry earth of the cellar, like something that has washed up on a beach, then been partly reclaimed by tides. He's heard stories of old times, of the school contained in this single antebellum building, anatomy lab and all. He thinks he knows what might be in the cask. The old familiar smell in here underneath all the other odors, beneath the scents of raw earth and dry rot, is formaldehyde.