Turn of Mind (35 page)

The woman stopped.
My turn to ask some questions,
she said.
Why did you
resist having children? Is it your career?

No. I suppose it comes down to control as well, you said. I like making my own choices. I always have. But with a child you have no choice. When it is hungry, you must feed it. When it has soiled itself, you must clean and change it.

But as a doctor, aren't you constantly responding to patients' needs? When something
happens during a surgery, you have no choice. You have to fix it. When an
emergency arises, you have to respond.

That's different, you said.

How?

You spoke slowly, trying to work it out.

It requires the best of you, you said. Something unique. Not just anyone can perform a transfer of an intercostal nerve into the musculocutaneous nerve to restore biceps function. Or an open carpal tunnel release, for that matter. Even other specialists mess those up. Yet a child can love anyone. Children
do
love the most horrible, depraved people. They attach to warm bodies. Familiar faces. Sources of food. To be valued for such base requirements doesn't interest me.

You'll change your mind when you have the baby. I've seen it happen time and
time again.

So people say. My anticipation is that I will hand it over to James and let him deal with it.

You interest me. Not many people would think this way, much less say so.

I usually say what I think.

Yes. I see that. And I suspect you don't have much patience for people who don't.

You're right. Not much.

Then suddenly your memory skips ahead to the birth, which was three weeks early. There were some problems with Mark's lungs. He came out furry, covered with lanugo. A small, red wheezing creature. He was your patient before he was your child, which helped the transition.

Naturally you breast-fed him, because of the antibodies. Did your duty in that regard, despite the inconvenience and pain. You didn't like being sucked dry multiple times a day, and the thought of it distressed you more than you expected.

You weaned him at three months and resumed your professional life once you no longer leaked milk at the slightest provocation. You hired Ana at that point—Ana who did all the things a good mother would do. You were not a good mother. And yet Mark clung to you. And, six years later, Fiona did the same. By then Amanda had stopped trying to conceive, even she admitted it was pointless.

When was the last time you saw Amanda? You cannot recall. You accept that she is gone. They are all leaving, every one of them. James. Peter. Even the children. A diaspora. But you are somehow drawing strength from that. With each loss, you are stronger, you are more yourself. Like a rosebush being pruned of extraneous branches so the blossoms will be larger and healthier next season. Sheared of this excess, what will you not be capable of ?

You have a vision: Amanda, here, on the floor, her heart violated, her eyes still open. You always thought the practice of closing the eyes of the deceased a silly one. It's for the living, of course, who would like the dead to behave, to have death approximate sleep. But there is no repose for Amanda. She's on her back, her hands clenched as if about to engage in battle. Her legs akimbo. Are you making this up? Because there are others in the room, shadows are flickering. Words are being spoken.
Must you do this? Yes, I must. Quickly then.

Your mind is full of other fantastic images, some in lurid color, some in black-and-white. It is like watching a compilation of movie clips filmed by a lunatic. A heap of harvested hands on the white sands of a turquoise sea. Your parents' house in Philadelphia, engulfed in flames.
I am very far
gone indeed.
Here. So it was here. You can see the remains of the yellow chalk mark mixed with dust. What Amanda could never have abided.

Your filthy bare feet leave footprints. Shoes. You need shoes. Amanda was taller and heavier than you, but you wore the same shoe size. Eleven.
Wearing boxes without topses.

You take the stairs to her room and find a severe blue dress with a belt and a pair of black flats. You try to wash your face, but the water has been turned off, so you spit upon a towel and scrub at the worst of the dirt. Then you lie down on Amanda's bed.

But before you sleep, Peter visits. He stands by the window, blocking the moonlight.
What did you do?
he asks.
Why did you do it?
He has been digging in the garden. His knees are black with wet earth. He is holding one of Fiona's most brightly colored snails in his palm.
In the sweat of
thy face shalt thou eat bread, till thou return unto the ground; for out of it wast
thou taken.
You are sweating. Enough, you say. But he is gone, replaced by Amanda. She sits on the edge of the bed. She takes your hand. Hers is whole, unblemished. You are relieved: It was all a dream, then. All a dream. And finally you are able to sleep.

You are awakened by a crack of thunder, the sound of drumming against the window, on the roof. Outside the window you see gray and wet, but it is still warm. You see that you are already dressed, shoes even. You must have been on call.

Those days as an intern, learning to jump up from the soundest slumber, ready to slice. No transition from oblivion to hyperawareness. You are aware of an empty stomach, but when you go downstairs the refrigerator is dark and empty, and a sour smell emanates from it. In the pantry some dry cereal, stale. Rat droppings on the shelves, holes chewed in the bags of pasta, the cracker box.

You catch sight of the clock still ticking above the sink. Eight forty-five. The clinic opened at 8 am. You are late. You stuff some cereal in your mouth, run to the front door. You do not have your car keys, you must take a cab. You walk swiftly down the street toward Fullerton, where the cabs stream past day and night.

You are already soaked from the warm rain. The first two cabs are occupied, but then you are in luck: The third one stops. To the New Hope Clinic, you say.
Address?
he asks, but you can't remember. He punches the name into a small machine mounted on his dashboard.
Chicago Avenue,
he says.
Okeydoke.

He is dark, handsome. A Palestinian flag is draped over the front seat. His cell phone rings and he spits out a string of guttural sounds, hangs up. You brush off the water as best you can and try to relax. Chicago the gray lady. You don't mind.

Sometimes you want the outside world to match your interior reality, you said to James once, trying to explain why you loved thunderstorms. Another boom overhead and a streak of lightning on the right.
Awesome,
says the taxi driver, and catching your eye in the rearview mirror, he smiles.

The taxi pulls up in front of a low gray building. Seven seventy-five, the man says. You reach for your purse. You begin searching around the backseat, you pat your pockets, you are frantic. The man looks more concerned than alarmed.
You work here
? he asks.
Or a patient?
You are a doctor, you explain, and the man nods like he expected as much.
Perhaps
you can borrow it,
he suggests.
I will wait.

You run through the rain to the front door. The waiting room is full of people, many more people than there are chairs. Jean is at the front desk, checking in a woman with a crying infant. When she sees you she looks startled.
Dr. White!
she says.
What a nice surprise!
Aren't I on the schedule? you ask. Then, without waiting for an answer, you say, No matter. Clearly you need me. I'll be ready in ten minutes.

You walk into the back area and are surprised at all the strange faces
.
A medium-size dark-skinned man stops you.
I'm sorry,
he says,
staff only
here.
His name tag says dr. aziz
.
It's okay, you tell him. I'm Dr. Jennifer White. Apparently there was a schedule mix-up, but it looks like you could use the help.

Dr. White?
he asks, but you are already at the back sink, washing up. You go to the wardrobe, take a white coat, button it over your dress. What do you have for me? you ask. The other doctor hesitates, then shrugs.
Room three,
a rash, could be shingles, could be poison oak,
he says.
The chart is on the door.

You give a quick knock for courtesy, then enter the room. The woman is perhaps thirty, African American, a fine strong frame. But she is holding on to her left side and her face is in pain. Let me see, you say, and she reluctantly lets go. You pull back the blue hospital gown to see an angry rash with raised red bumps and blisters that have erupted on the skin in a band that reaches across her belly and around her back.

Does this hurt? you ask.

Yes. It started out as a kind of tingling. But now it hurts. Badly.

You look. Some of them have become pus-filled, others are still in the early stages of formation. You motion for her to turn over. Nothing on the other side, just this broad swath down the right side of her body, her hip, thigh, and buttocks.

What is it?

Herpes zoster. Known more commonly as shingles, you say. I'm going to prescribe one of the antivirals. Acyclovir. It should decrease the duration of skin rash and pain. I hope we've caught it early enough. Also apply cold compresses to the rash three times a day. Above all, do not scratch or you risk infection.

How did I get this? You called it herpes. Did I get it from my boyfriend?

No, not at all. Shingles is caused by the same virus that causes chickenpox. You know, what you had as a child.

You are looking for your prescription pad. It's not in your pocket. You excuse yourself and go out into the hallway.

Excuse me?

Yes, Doctor?

I have misplaced my prescription pad. Can you get me one? You turn and nearly bump into another woman wearing a white coat. She does not have a name tag on. She looks frazzled. She examines your face with curiosity.
Are you Dr. White?
she asks.

You nod, yes.

I recognize your photo. I didn't realize you were still involved in the clinic. I
thought you'd retired. Dr. Tsien still talks about how much you are missed at the
hospital.
She frowns, opens her mouth, closes it again.

You don't follow all of this. I come here every Wednesday, you say.

But today's Thursday.

You pause, think. I must have had a conflict this week, you say.

Everyone has been very grateful for your help. That a doctor of your caliber would
work here pro bono has always meant a lot to us. Not to mention the other contributions
you've made, of course.
She still has a bemused look on her face, as if trying to remember something.

You turn to go. You face a bewildering mass of doors. Where were you? You pick a door at random and go in. An older man is sitting in his underwear. He looks surprised.
Is something wrong, Doctor?
You tell me, you say. What brought you here today?

The man looks uncomfortable.
As I told the other doctor, I'm having trouble
going to the bathroom.

Does it hurt? Or do you have urgency but no voiding?

The second one. I think. I try to piss and nothing comes out. It hurts.

Any erectile dysfunction?

Excuse me?

Do you have trouble maintaining an erection?

No, of course not.
The man doesn't look at you when he says this.

Liar, you think.

How long have you had this dysuria? you ask.

This what?

This urgency but no voiding.

About a month. It comes and goes.

Any blood in the urine?

He hesitates, then says flatly,
No.

Any pain or stiffness in the lower back, hips, or upper thighs?

Maybe.

My guess is prostatitis, you say. Then, after seeing his reaction, you add: Relax, it's not cancer and it will not lead to cancer.

Is it curable
? he asks.

Sometimes. Sometimes not. But we can almost certainly relieve the symptoms, you tell him. We're going to start by taking a urine sample to rule out bacterial prostatitis.

There is a slight knock at the door. A woman is standing there.
Dr.
White?
she says.
There is a cab driver who says you owe him money. He's kept
the meter running, so it's up to sixty-five dollars now. What should I do?

I didn't take a cab, you say.

He says he drove a doctor here, a woman, and he described you. Perfectly. What
should I do? He won't go away.

I'm busy here, I have roomfuls of patients to see, can't you take care of this?

He's really quite insistent.

Very well. You turn to the man. I'll be right back.

You follow the woman out of the room and nearly bump into a dark-skinned man going in.