The Blue Cotton Gown

by Patricia Harman

  I used to believe my wakefulness came from delivering babies. For almost twenty years I was on call, and the phone would ring in the night. Someone would be in labor or in some kind of trouble. Sometimes I would lie awake just waiting for the telephone to ring or the pager to go off.

  In reality, the wakefulness started long before, in a small tract house in California where I would lie listening to my parents shouting and to furniture crashing. It was my mama screaming, my father throwing things. I was eight or nine then, huddled in a twin bed in a small bedroom I shared with my brother. My bed was against the wall, his by the window. I used to wonder if I could get him out that window if I had to.

  CHAPTER 7

  HEATHER

  I lean on the lab counter, skimming my last progress note. My teenage patient, Heather Moffett, has returned to the clinic. It’s a follow-up visit for the emergency D & C of her twins. I dread the visit, expecting to be grilled by the stern grandmother, Mrs. Gresko, and perhaps also by the angry young man, T.J.

  I’m surprised to find only Heather in the room, sitting in the visitor’s chair and reading Vogue. She’s dressed in worn blue jeans with a striped knit top. Her red curly hair is cut shorter, almost a buzz, and she sports a silver nose ring along with the stud in her eyebrow. “Hi, Heather,” I say, touching her arm. “How are you today?” I cringe at the slick magazine. Tom has asked me to get rid of the “trashy reading material” in the waiting room but I’ve argued that women enjoy reading the articles. When else do we have time to catch up on Tom Cruise’s love life or take quizzes on our sexual IQ?

  “So how are things?” I ask Heather. The smell of the periodical’s perfume advertisements fills the exam room.

  “Pretty good, I guess.”

  Four words in a row. It’s practically the most I’ve ever heard Heather say in her surprising soft alto voice. “Any bleeding or spotting?” I start charting her responses.

  “No.”

  “Any cramps?”

  “No.”

  “Have you thought about birth control?”

  Heather doesn’t answer, just turns a page. Then finally, “Do you think drugs could have made the twins die?”

  “What?”

  “Drugs? Can drugs kill babies if the father takes too much?”

  I stop charting. Tilting my head to one side, I envision the thin, long-haired T.J. “You guys into a lot of drugs?” I ask casually.

  “T.J. is. He was in the ICU last night. Overdosed … He’s got IVs in both arms and an oxygen thing up his nose.” Heather stares vacantly around the room. “I was there all night. They let me see him this morning, but mostly I was in the waiting room. I thought for sure he would die this time.”

  “It’s happened before?”

  Heather rolls her eyes and snorts, indicating this should go without saying.

  “So what does he use? Heroin? Cocaine?”

  Torrington is not the big city, but I’ve heard hard drugs are around. Some of my boys’ old high school buddies have been busted, and I suspect they were selling more than grass.

  The patient returns to the glossy magazine, contemplating an outfit that looks like it could be purchased at the Goodwill but is priced at six hundred dollars. Maybe Tom’s right: we should get rid of these magazines.

  “He uses some of everything,” the young woman answers.

  “And you?”

  She shakes her head. “Not much, a little weed. What about the babies, though? Could his using drugs make them die?”

  I have to be careful. I don’t want to exaggerate or minimize. I don’t want to create blame where there isn’t any. “Well, it might be possible, but not likely. It’s more dangerous if the mother takes drugs, of course.”

  “Can the drugs get in the guy’s sperm and kill the babies that way?”

  “No, I don’t think so.”

  Heather nods thoughtfully. “Okay, I just wondered.”

  “So how is T.J.? You must be tired. Did you sleep at all?”

  “He’ll go to a regular room tonight. He might even get out tomorrow. I’m wiped out and I’m pissed at him too. I don’t even care anymore. He can kill himself if he wants. It’s not my problem.”

  I don’t believe her. “Has T.J. ever tried to get counseling?”

  “Nah. He says he doesn’t need it. Says it’s not a problem.”

  “Well, he almost died …”

  Heather shrugs.

  After the exam, I sit down again. “So we’d better get you on some kind of birth control. Even if you want to get pregnant later, it sounds like T.J. needs to get his head together. What do you think? Have you ever been on birth control pills?”

  “I tried ’em before. I kept forgetting.”

  “Well, we have the birth control shot.”

  Heather shakes her head no. “I hate shots.”

  “Or the patch. The birth control patch is a method a lot of young women like. You don’t have to remember to take something every day. You just put this small patch like a Band-Aid on your stomach once a week. I could give you samples, enough for two months.”

  “I guess.” She doesn’t sound enthusiastic.

  I change the subject. “Heather, where is your real mom? Your grandma used to come with you, and she always seemed so mad.”

  Heather appears to study the advertisements for fur coats in Vogue. “She lives in Georgia.”

  “Have you always lived with your grandma?”

  “Nah, just this year. I could have gone with my folks when they moved, but we fought all the time and then there was T.J. … I used to think I loved him. So Grandma said I could stay, but then Gramps got sick and I got pregnant, so it hasn’t worked out so good. I thought maybe T.J. and me would get married after the babies came, but …”

  I see the tears and move closer.

  Neither of us says anything for a moment.

  “You think you’ll be okay, Heather? I mean it. Are you going to be okay? I’m worried about you. You’ve got a lot to deal with, and a lot of women, most women really, after a miscarriage … well, you know, they feel kind of down. Even if they didn’t mean to get pregnant, maybe they get excited for a while and then the baby’s gone. It’s hard.” I remember my own three miscarriages, the sadness and anger.

  “I’ll be okay,” Heather mumbles. She takes the samples of birth control patches I’ve laid out for her and then stands.

  “You going back to the hospital to see T.J.?”

  “Nah. He’s gonna live. He can sort it out on his own. I can’t carry his sorry ass around all the time.”

  I regard Heather. She needs hugging, but her emaciated shoulders warn me away. Then she surprises me. She leans over and gives me a hug. Her body is nothing but bones.

  MRS. TERESI

  Tom’s pager has been going off all day in the clinic. In a lull between patients, I follow him into his office. “Everything okay?” I can see that it’s not. His smooth face is blotchy and red.

  “It’s Dottie Teresi, my hysterectomy of yesterday. Her hematocrit is dropping, and she’s spiked a temp. I think she may have a hematoma or an abscess but I can’t get her a CT until late tonight. The nurses are freaking and calling me every few minutes. I’m going to transfer her to the ICU.”

  “Is she that critical? What’s her temp now? Did you get blood cultures?”

  “One hundred and three. Blood cultures are pending. Who do you think you are, the doctor?”

  I shut up. I was only trying to be supportive, but we’ve been through this before. When Tom’s hassled, he doesn’t want my suggestions. I back into the hall. “Will you make it home for dinner?”

  “I doubt it,” he snaps. “I have to stay around the hospital until I figure out what’s going on.”

  As I walk away, I realize that Tom’s upset not just because Mrs. Teresi is ill but also because he’s worried he may be responsible. The patient’s husband, Dr. Teresi, a neurologist from Delmont, had personally requested that Tom do his wife’s hysterectomy, and my hu
sband had been honored. Now this happens.

  Tom is one of the most skilled gyn surgeons in Torrington. He performs surgery on patients whom other physicians would refer out, women who’ve had multiple operations, women with adhesions and severe endometriosis, women who are malnourished or morbidly obese. Dottie Teresi had undergone three C-sections in her childbearing years and had a fibroid uterus. She’d been bleeding off and on for five months before she gave in and had surgery.

  “It took me two hours to cut through the layers of scar tissue,” Tom had told me at dinner last night. “The bowel and bladder were all stuck together; one of the most difficult hysterectomies I’ve done.”

  At 3:00 a.m. I’m still wide awake and wondering how Dottie is doing when my husband quietly opens the bedroom door. “Everything okay?” I ask. I watch him strip off his scrubs in the near dark, exhausted. He’s been up for twenty hours and has to go back at six thirty.

  “We gave her two units of blood. Her hemoglobin was five, now it’s up to seven.” I wince. This is still very low. “The CT shows that it’s a hematoma, a collection of almost two thousand ccs of clotted blood. I’ll try to have it drained by radiology in the morning.”

  Tom rolls on his side. I want to ask if Dottie is stable, if she’s awake. I want to ask how Dr. Teresi is taking it. Is he upset and angry, or does he, being a physician himself, realize that these things happen, no matter how good the surgeon is? Tom’s already asleep.

  Raising up on my elbow, I stare at him in the moonlight. My husband has aged. It’s the sag of the chin, the worry. Where before I hadn’t seen lines, I see now that he’s not twenty or thirty or even forty anymore, and his short speckled hair is more white than gray.

  I look down at my lover, a man I’ve known since he was younger than our boys are now. The weight of his work is pulling him down. He doesn’t say much, but he takes this so hard. Each financial problem, each complication, is another furrow etched in his face, yet inexplicably he sleeps like a baby.

  “Hallelujah”

  I open my eyes, and the light of the blue sun catcher is reflected on my arm, and “Hallelujah” by Leonard Cohen is still repeating on the CD player. I’m lying naked on the blue and white quilt with my husband curled around me. We’re at the cottage on Pelee Island for a four-day weekend, a welcome rest after the worries about Mrs. Teresi.

  This is the first time we’ve been away since June. It was hard to leave Torrington, and we almost didn’t. His patient is still on a cooling mattress with a temp of 103. She has three IV antibiotics running, and the hematoma, which is now an abscess, is shrinking, but Tom worries her infection may be caused by a resistant strain of bacteria. Dr. Hazleton is covering while we’re gone on this mini- vacation.

  We’d made love after lunch. Now the sun’s low in the sky, slanting golden across the lake and pouring in through the small window at the head of the bed. I lift up to look at Tom’s face, so relaxed, so at peace. I haven’t seen him looking like this in a long time, and I think of him as a young man and myself as a young woman, just starting our lives. I think of all the years we’ve been together and how much I still love him. Outside the open window, the waves of Lake Erie lap at the rocks. Tom reaches out for me in his sleep, smiling, adjusting our bodies together. This man is a metronome for my days. He’s what keeps our rhythm.

  Sometimes life is too beautiful and too sad. The cells of our skin interlock like the notes in the song. Hallelujah … Hallelujah … I wipe my tears with one finger and gently wet Tom’s cheek, but he doesn’t open his eyes. “I’m getting up. I have to write.”

  Tom squeezes me tight and says, “Hmmmm,” then lets me go.

  There are only a few hours left before dark. I pull on my jeans and T-shirt, forget the bra. In two days we’ll take the ferry home, go back to work, and meet woman after woman in the exam room. On the break wall, I sit on a granite boulder with my laptop resting on my knees. Writing the women’s stories has become a compulsion. If I don’t write them down, I’ll forget.

  I remember one story. It’s Penny’s story.

  PENNY

  “I like coming to you. I’d rather have a female doctor than a man. You’re nice,” says the thirty-seven-year-old when I return from the lab with her prescription and a handout about vaginitis.

  “Thanks, that makes me feel good.” I don’t say anything about the reference to me as a doctor. I just let it pass. I’ve learned that patients feel bad when I correct them, as if they’ve somehow offended me. I wear a name tag that says PATSY HARMAN, NURSE-MIDWIFE-OB/GYN PRACTITIONER. They can read. That’s good enough.

  Penny Simmons is a thin, rough-looking blonde who’s been, as they say, around the block a few times. Her pale skin is coated with pancake makeup, and she smells like cigarettes and perfume.

  “I like helping patients take good care of themselves and making their exams as easy as I can,” I respond and hand her the script for Diflucan. “The microscope confirmed it’s yeast. There was a lot of discharge. This medication should take care of it.”

  Penny takes the square piece of paper but doesn’t stand up to get dressed and leave. “I don’t like going to men. I had a bad experience with an exam once.”

  I’m at the sink washing my hands. I pull a paper towel out of the dispenser, taking my time. There’s probably a way to ignore such a comment, but I don’t know how to do it. “Was it a rough exam?”

  “No, just the opposite. This was a long time ago, when I was seventeen. It happened at the family-planning clinic maybe twenty years ago. Family planning is at the health department now. Used to be at Torrington State University Medical Center.” She waits to see if she should go on and takes her cue when I lower myself to the revolving stool.

  “What happened?”

  Penny stares down at her blue exam gown. “I went in for birth control pills. Me and Steve had just married and we didn’t want to have babies too soon; just a birth control visit, but you had to get examined anyway.” I nod. “He wasn’t even a real doctor. He was a …” The patient searches for the right word.

  “An intern? A resident?”

  “Yeah, one of them. He was young. Didn’t seem much older than me, but all dressed like a doctor in a long white coat. He kept saying he had to examine me. He made me come back three times before he would give me the pills. ‘I need to check your ovaries. They feel enlarged’ is what he told me. He would tear the paper exam gown open real slow. I didn’t want to keep going to him, but the birth control pills were free and I had to get them.”

  I’m beginning to feel uncomfortable. This doesn’t sound right.

  Penny goes on as if she’s merely the narrator of the story, not a participant in it. “So I came back like he told me. The last time he locked the door, and the exam took a while. I don’t know how long. The whole thing was so embarrassing. I just stared at the ceiling. He kept going in and out with his fingers. Touching me. I lay real still. Since I’d never been to a gynecologist before, or even talked to anyone about it, I didn’t know what the exam was supposed to be like. I should have stopped him, but I was so shy. Now I would just kick him in the balls.”

  A resident in his long white coat. It had to be a resident, not a medical student. The students wear short coats. I picture it: He’s standing between the girl’s legs, stroking her, watching her face. Penny is pretty then, with long, naturally blond hair and pale skin. She doesn’t try to get away. He smirks, convincing himself she likes it. Her legs are in the stirrups and he is standing so close. Now she’s breathing hard. He’s breathing hard.

  I’m feeling sick.

  Penny continues. “I don’t know how long it lasted. Maybe ten minutes, but I had an orgasm.” She slides her eyes over to see my reaction.

  I’m speechless at first … then finally: “Did you ever report it?”

  “Oh yeah, I was so upset I had to tell someone. I told my husband. He was only twenty, but he took me to the police. He said we had to do something, that the doctor should be arrested beca
use it was rape. I hadn’t thought of it like that. I’d felt it was my fault. So I went. It was awful. I had to tell the story over and over. More cops kept coming in and sitting with their little notebooks and writing things down. One cop told me it would be a hard case because it would be my word against the doc’s. He asked me if I had gone to the emergency room to be examined for trauma so there would be proof, but there wasn’t any trauma, so I hadn’t gone.

  “Steve had to wait downstairs. I don’t know why, just procedure, they said. I could hear them laughing out in the hall. They took my statement and said they’d talk to the doctor, but nothing ever came of it. This was a long time ago. There were no women cops then. We were just kids to them, really.”

  For once I have nothing to say. I know unprofessional and exploitive things happen in health care, but a patient has never told me anything personal like this. So finally I ask, “Do you know who this physician is? Do you know his name?”

  “No. I forget it, if I ever knew. I guess I wanted to forget.”

  “Did you ever get counseling?”

  “I never confessed it to anyone else before. Not even Ma. She would have blamed me. Steve’s been good, though. He talked me into getting my checkups again a few years ago.”

  “Did you ever see that doctor again?”

  “I would never go back there. I imagine he’s gone.”

  I want to know what the young doctor looked like, but I don’t want to dredge up bad memories. Maybe the guy’s still around somewhere, a pedophile stroking young girls, thinking they like it, thinking he’s helping them develop their young sexuality, justifying it in his warped mind. I feel my face flush with anger. “Do you remember what he looked like?”

  “Oh, I won’t forget. He was tall, with thick hair; brown, I think. He had long fingers, thin fingers like a girl. Very handsome. I can’t remember the color of his eyes. I don’t think I really looked into them.”