CHAPTER 2
Sin of Omission
“Didn’t you notice?” Rebecca had asked, scratching her head with a pencil. “Didn’t you check his figures?” Her red hair flared around her face, and her dangling earrings shimmered.
Now I turn over and pull the covers up to my chin, remembering the meeting with our new accountant from Pittsburgh. It’s 2:15 a.m. and I need to sleep, but I can’t. Rebecca Gorham had reviewed the letter we received from the IRS and told us that the practice owed the government twenty-one thousand dollars. The best I can understand is that our former accountant, Bob Reed, had been underreporting the corporate income for two years. “Didn’t you check his figures?” Rebecca had asked again in frustration.
“No,” answered Tom, pushing his wire-rim glasses up on his nose. “We trusted the man. It’s his job. He knows about numbers, I know about medicine. If I checked everything he did, I might as well be my own accountant!”
Gorham had tossed her head, and her earrings had tinkled. “You understand that you’re responsible for everything you sign, don’t you? Your signature is on the tax returns; you’ll be personally liable.”
It’s 2:25 a.m. I throw the covers back and crawl out of bed. In the bathroom I find my jam jar of scotch and pull my robe closer around me. I pad though the dark living room, moving by feel, past the sofa and love seat, dragging my fingers along the muted southwestern cream and blue upholstery. It’s the same Pine Factory furniture we bought when Tom was an ob-gyn resident. The cream Berber carpet is soft under my feet.
In the corner, in front of four tall windows, a ten-foot ficus tree grows in a pot. If it weren’t for the cathedral ceiling, there’d be nowhere to put it. I stand for a moment looking out, and then step through the glass door onto the wraparound porch. No peepers tonight. No stars.
This house, cedar sided, perches over Hope Lake. To the south, through the bare trunks of oaks, the water picks up light from cottages. Steep wooden steps lead down to the dock. I pace around the porch to the west.
Here two acres of grass spread gently uphill. In the moonlight I can dimly see Tom’s beehives, our oval vegetable garden, and beyond that the gazebo. When we first moved to Blue Rock Estates, the yard was just mud. Now there are peach, pear, and apple trees and a few pines.
There’s something about Rebecca that makes me uneasy. We’ve only been with her three months. Our failure with the previous accountant causes me to doubt my judgment. We’ve started with her now, so we’ll continue. Tom trusts everyone, and he hates change. I don’t much like it myself.
I take my first sip and swallow it down. The first sip is the worst … bitter and burning. There’s no movement down at the lake, no sound, only the little waves lapping.
Rebecca has promised she’ll contact the IRS and request an explanation of the bill. She’ll argue that the error in underpayment, if there is one, was an oversight of the previous accountant and apply for an extension to give us some time. We’ve never owed money like this before, and I don’t have a clue where we’ll get it.
I gaze at the half-moon as it slips back and forth between the clouds, an unhappy lady, then I say a small prayer. Twenty-one thousand dollars!
TRISH
“What’s wrong?” Trish catches my arm as I hurry out of the medical center and across the parking lot on my way to the car. I’m not sure I want to see her. Since the meeting with Rebecca Gorham, I’ve been walking around like a whipped dog. “You look awful. Are you getting sick?”
Trish is a nursing assistant in the Family Wellness office, two floors below the Torrington Women’s Health Clinic. We’ve been friends for ten years, maybe twelve. Tom delivered her third baby and did her surgery when she had an ectopic pregnancy. She left the university medical practice to join Dr. Wilson at Community Hospital about the same time we left the faculty ob-gyn practice to start out on our own.
“I’m having a meltdown,” I say grimly. Trish follows me to my car; her straight, cropped sandy blond hair blows across her face as she hauls her heavy satchel over her shoulder. I fumble with my keys at the Honda. “I feel like crying all the time.”
“What? What’s up? I’ve never seen you like this.”
I get in the car, take a deep breath, and rub my hand over my face as I settle behind the steering wheel. “It’s the IRS … We’re screwed. We thought our first accountant, Bob Reed, was fine, but what did we know? I mean, Tom and I can barely balance a checkbook. Not that we can’t, we just don’t get around to it, know what I mean? Anyway, to make a long story short, the guy wasn’t doing his job. We got a letter a few days ago saying we owe the Feds twenty-one thousand dollars!”
I let that sink in. Trish gets in the car, settles herself in the passenger seat, and pulls a pack of cigarettes out of her bag. Then, realizing we’re sitting in my vehicle, not hers, she puts it back with a sheepish grin.
“Our new accountant, Rebecca, says it looks serious. And we don’t have it, Trish! We don’t have that kind of money, not in the practice and not at home. Tom and I just live month to month. We’re paying off his student loans and the kids are still in college. We’ve never had much of a savings account and we’re up to our ears in debt. I know if you walk into our office we look successful’nice furniture, nice carpet, and new equipment’but since Dr. Burrows left and took all his patients, it’s been really tight. If this IRS thing is real, we could be ruined. I feel like such a screwup … Don’t tell anyone, okay?”
My friend nods but is silent, then finally says, “Maybe it’s a mistake.”
“Yeah, we’re praying.”
“You’ll work it out.”
“Think so?”
Trish smiles, then reaches into the depths of her quilted flowered bag and pulls out a red tin. “Know so! Want a homemade chocolate chip cookie? It’s better than tobacco. A patient brought them to the office, and my boss told me to take them home. The kids will never know what they’re missing.” Trish has a boy and two girls, Artie, Jennifer, and the oldest one, Aran.
“You know how to cheer a girl up.” We sit, munching. I sigh. “I’ve been trying to cut out sweets, but there’s a time and place for everything. Chocolate’s a blessing, almost as good as an antidepressant.” Trish shrugs. My friend is a perfect size 10 and never has to watch her weight. It might be because she smokes cigarettes. Whatever it is, I’m jealous.
Trish puts her hand over mine. “You’ll work it out,” she says again, glancing at the clock on the dashboard and gathering up her things. “I’ve got to run! I’m meeting Aran at the mall to shop for her prom dress. Can you believe she’s graduating from high school in a few months? I’m only thirty-five, and my baby is graduating.” I picture the slim teenager, so like her mother, same sandy hair, same blue eyes, only taller.
“Who’s her date?”
“This kid Jimmy. He’s from Pittsburgh. Dan doesn’t like him. Thinks he’s on drugs. Aran says she’s in love. Do kids really know at that age? I tried to tell Dan that my parents didn’t like him when we were seventeen either, thought he’d end up a bum, but we’ve done okay, been together almost twenty years.”
I picture Dan, a tall, sweet guy who works as a tree trimmer for the state highway department.
“Got to rush!” She slams the Civic door and waves back to me.
When Dr. Harman was twenty and a bearded hippie, no one thought he would amount to anything either. “Hey, your cookies!” I yell through the open window, holding out the red tin.
“They’re your cookies now!” Trish yells back.
REBBA
“My boyfriend told me I should ask you,” the twenty-six-year-old starts out. “He thinks there might be something wrong with me. I might be frigid.” I glance up from her chart. I’ve been seeing Rebba for three years, and this is the first time the young woman has mentioned sexual difficulties.
“Why would you say that?” I ask.
“Well, you know,” Rebba says, “I don’t find enjoyment like other women, and I’ve been with m
y fiancé for over a year. I’ve been with other men too. It just never happens.”
“Do you get excited?” I scoot the exam stool up against the white wall so I can lean back.
Rebba nods. I watch her face. She has a flawless olive complexion. Her nose is narrow and straight. Long auburn hair.
“Do you have an orgasm?”
Rebba shrugs. “I don’t know. Maybe … I like your gowns.”
“What?”
“I like these exam gowns. My other doctor had paper ones. They gave me the creeps. Sometimes they’d tear, and they stood out like a paper lantern all around so you felt more naked under them than if you had nothing on. These are nice.” She strokes the worn fabric.
I stare at the gown, frowning. It’s plain pale blue print with tiny darker blue diamonds, nothing fancy, the usual hospital type. There’s a tie at the neck. The utilitarian garment only comes in two sizes, large and extra large. That means it looks awful on everyone.
Even before we started our practice, I decided that the gowns had to be soft cotton to cover the delicate nakedness of our patients. “We rent them from the Mountain View Laundry so there’s no choice of style. Thanks for noticing. They cost more, but it’s worth it.” I grin. “You’re worth it.” There’s a pause while I try to find the tangled thread of the conversation. “You were saying … you aren’t sure if you have an orgasm?” Rebba shrugs. “Do you know what they feel like?” She shrugs again. “An orgasm can be anything from a pleasant twitching in the vagina to something more like a whole body seizure with complete exhaustion afterward. Does any of this sound familiar?”
Rebba shakes her head, puzzled.
I try again. “Do you want to make love? Are you in love with your fiancé? Do you know what I mean, like desire him, want to kiss him?”
Rebba brightens and her eyes shine. “Oh, yeah, he’s the best.” Her face is flushed just talking about it. “That’s why I had to ask you. I’m afraid he’ll get tired of me if I don’t … you know … learn to come. Do you have medicines or anything?” She trails off. There are tears in her eyes.
“Rebba,” I say. “It may not be that important. I talk to lots of women. Many don’t have orgasms but have happy lives. It may not be that important to everyone.”
“But it is to me,” the girl whispers.
“I know what you mean.” I let out a breath. “For me it is too. Let me ask you this: Do you ever feel frustrated after intercourse? Like you aren’t finished and want to do more?”
The patient’s hazel eyes lose focus as she tries to remember. “No, I guess I’m relieved when it’s over, because if he goes on too long it hurts … Sometimes I wish he’d keep going with his mouth though.”
This catches my attention. “Why does he stop?”
“I guess he gets bored. I never asked him.”
“Did you tell him to keep going?”
“No!” Rebba’s voice goes up, horrified, and she flashes a look at the ceiling.
“Why not?”
The young woman shakes her head. “Well, I’m wet then. He says that means I’m ready.”
I sigh. It’s time for the Chat. “Okay, Rebba, there are some things I think you and your partner don’t quite understand.” I wheel my stool closer. “The average woman needs about twenty minutes of very direct, steady, gentle stimulation of her clitoris to have an orgasm.”
I’m not sure where I came up with the twenty minutes, but it’s my standard recitation. “Some more, some less. And it needs to be steady, not this way and that, changing every few minutes.” I figure this covers everyone, and if a woman really gets twenty minutes, she’s lucky. If she has an orgasm in ten, she’ll just think she’s highly sexed.
“Unfortunately,” I continue, “the way God or Nature designed the female body, it’s hard to get that much stimulation from actual intercourse, even if the guy goes on all night.” I use my fingers, like Dr. Ruth does, to demonstrate. “In fact, if he goes on too long, you start to get dry and then you will hurt.”
I pause to let Rebba absorb what I’m saying. “So probably, if you continue on with the oral stimulation or if you use some kind of lubrication and show him what to do with his hands, you’ll get more and more excited and eventually come. That’s what your body was meant to do. You’re young and you’re healthy, and you’re already excited. I really think it will work.”
“I don’t know—” The girl starts to argue but stops when I peer over the top of my reading glasses. Rebba screws up her face.
“Really, this is what you have to do,” I continue. “If you aren’t comfortable asking’what’s his name?”
“Andy.”
“If you aren’t comfortable asking Andy to do it, show him with your hand what you like, what feels good. And make a moaning sound when he gets it right. Let him know. I guarantee it will drive him wild.”
Rebba shakes her head.
“What?” I ask.
“I couldn’t. I … I would be too embarrassed.”
“Well, then, you will have to practice by yourself.”
I purposely don’t use the word masturbate. So many women have learned it’s wrong, but I figure if God gave you something that feels that good, you were meant to use it. Before Rebba has a chance to further object, I leave the exam room and return with a small bag of K-Y samples.
Rebba is standing next to the door, dressed in jeans and a light blue tank top. She is tall and slim with good posture, a willow in spring. “I want you to try what I told you,” I say, “five times in the next two weeks, for at least twenty minutes each time. That’s just about two hours of your life, and it’s for a good cause. I guarantee if you do, eventually you and Andy will be very happy.”
I close the exam room door and head down the hall to my office. Sometimes I wonder where I get the balls to talk to women like that, as if I’m some kind of expert.
Sometimes I crack myself up.
Communion
When I’m horny, my legs are restless and I tighten my butt. I never noticed, but Tom teases me about it. We’ve been buddies so long, we know all each other’s moves, know all the moles on each other’s backs, and know before the tears come what will make each other cry.
It’s my own fault I get horny. I never think about having sex until after eleven, after I’ve played the piano, done laundry, e-mailed the boys, as I do every few days, and then lain with my husband watching a video or reading aloud. We kiss or mess around a little, but by then I’m so tired, all I want to do is sleep. A few hours later, I’m awake again, staring at the alarm clock, stretching my legs and tightening my butt.
I lie in bed now wondering if Rebba will practice what I told her. I smile in the dark and slide closer to my husband, trying not to wake him, moving my hand between my legs … just testing, smelling his sweet man smell. He’s so tired tonight. One of his post-op patients dropped her blood pressure, and he came home from the hospital late. He thinks that the woman is stable, but I anticipate the pager will go off through the night. I squirm closer.
Tom isn’t asleep. He rolls over to hold me. When I come, I draw him on me with a desperation I’ve gotten used to but still don’t understand.
Then we ride away together past the moon and back into dreams.
SHIANA
Before I open the door, I know the woman is young, a college student, not from Torrington, and scared. I get all this from the first line on the progress note, next to her vital signs.
The name, Shiana Rogers, possibly African American. The insurance, Pennsylvania Alliance, likely out of Philly. The age, nineteen, means she’s probably a student, since Torrington, West Virginia, is a college town. The presenting problem, written in Abby’s loosely legible scrawl, is Wants to discuss birth control, and other issues. Patient’s first gyn exam. First exam is how I know the patient is scared. At the first exam they’re always scared.
I tap on the door. Dum-de-dum-dum. It’s my usual friendly knock. Carrying the yellow chart under my arm, I greet the young
woman who sits on the gray guest chair in the thin blue exam gown. Her brown arms are folded and her bare legs hang down, not reaching the floor. She has on red socks. “Hi, Shiana, I’m Patsy Harman, nurse-midwife and gyn practitioner. How are you?”
“Good, I guess,” she responds in a small voice. I reach out my hand, and the girl takes it, hesitantly, with the tips of her cold fingers. She pulls back, but I hold on. Just for a second.
“This room’s a little cold. Your fingers are like ice.” The room is not really cold. The patient’s just nervous.
I lower myself onto the rolling gray vinyl stool that swivels like the ones at an old-fashioned soda fountain, then I stand, reach into the drawer at the side of the exam table, and pull out a clean white sheet. I wrap it around Shiana’s narrow shoulders then settle back down.
Shiana is small, about five foot three, and a little plump. She has smooth coffee-colored skin, dark almond eyes, and straightened black hair pulled away from her face in a ponytail. She’s kept her pink baseball cap on. Embroidered with Greek letters, it looks strange with the blue cotton exam gown, but I don’t smile. “So, what brings you here today? Is this just an annual checkup or are you having a problem?”
The tears come before the words. I reach for the box of tissues on the counter and scoot the stool closer. I don’t speculate, just wait. It could be anything. I’ve heard so many tearful stories. It doesn’t pay to guess.
She surprises me though. “I’m just so mad! I’m so mad and embarrassed. I really don’t want to be here. I don’t want to be anywhere.” Shiana catches my eye, then looks away.
I take a deep breath. “It must be pretty bad, but you know what, I’ve heard a lot of stories in the exam room and—”
“He pulled out and he left it in.”
It takes me a minute to figure it out. Pulled out … left it in? “A condom?”
“Yes.” Very quietly. “We were lying in bed, see, just talking, in the candlelight. It was our first time. I live in the dorm, but my roommate was gone. When I moved to get more comfortable, he rolled over and went to the bathroom. I didn’t think that was so strange that he went to the bathroom. I could hear him peeing, but when he came out with his clothes on I asked him, ‘Where are you going? Is there something wrong?’ and he said, ‘I just have to go now.’”
The Blue Cotton Gown Page 3