“It’s her father. He had another heart attack and is over in the hospital. She didn’t really want to be here but says working keeps her mind off what’s going on with him.”
“Shit.”
“Yeah, it’s bad …” Celeste lowers her voice. “What’s up with Dr. Harman?”
“It’s Mrs. Teresi. They took her back to the OR this morning. It’s the third time. Her blood pressure was dropping and the general surgeon wanted to go back in. Tom won’t even talk to me about it.”
Celeste sighs, sweeps her dark hair away from her face, and clips it to the top of her head in an asymmetric ponytail. “I hate to see him this way.”
“Are you doing okay?” I ask her.
She wrinkles her nose like something reeks. “Sometimes this place gets me down … the weight of it.” A chime rings from Tom’s exam room, signaling he needs a nurse. “Gotta go,” Celeste says.
I press my lips together and stare out my office window. The leaves at the tops of the maple trees are just starting to turn red. Dark clouds in the west threaten rain. At least when I was in the birthing room with Caroline, there was nothing to worry about but one mother, one baby.
Yeah, I think, sometimes this place gets me down too.
TRISH
“Did you hear about Trish’s daughter?” Donna whispers, pulling me aside as I enter the clinic, ten minutes late, on Wednesday morning.
“What?” I swing around.
“Aran’s boyfriend, Jimmy, lost his job and ended up in intensive care after overdosing on Oxycontin.” She bends in close, says conspiratorially, “Aran spent the whole night in the reception area by herself, waiting to see if he would pull through.”
I lay my canvas briefcase down in the hall with more care than it deserves and go very still. “How did you hear that? Are you sure? Aran hasn’t been seen in the office since she transferred to the teen OB clinic at the university, weeks ago.”
“Vi, the receptionist in family medicine, told me. She heard about it when Trish called to tell them she’d be coming in late because she had to go to the hospital. Aran didn’t even telephone her folks to let them know what was happening. Just sat up all night, alone.”
“Thanks for telling me, Donna. Is Trish in yet?”
“I’m not sure. Want me to call down there?”
“No, that’s okay. I’ll wait.” All morning, women come in for annual exams, abnormal periods, and OB visits, but I’m thinking only of Trish and Aran.
By late afternoon Trish sits in my office, smoothing her daisy-print scrub jacket and crying. Her oval face is mottled and wet. “Well, Dan was right. Remember, he thought Jimmy was into drugs? But it’s not just marijuana. It’s needles and pills. He’s out of the ICU and he’ll survive, but he’ll be hospitalized for another twenty-four hours. Of course, he feels terrible, apologizes for causing us trouble, tells us he loves Aran, and in his way I know he does. He promises he’ll stop using, but he has no insurance and the bill will probably be fifteen thousand dollars.” She wipes her nose with the back of her hand. I sit facing her, my knees touching hers. Trish pulls back her sandy hair with both small hands, staring out the window and watching her hopes for her pregnant daughter whirl away like the leaves off the autumn trees.
Finally I ask, “Where’s Aran now?”
“She’s sleeping. She called off work. Told them she was having contractions.” Trish lets out a sad breath. “I don’t know what to do anymore. Dan isn’t speaking to anyone. He’d just like to lock Aran in her room. Keep her under house arrest. This craziness is tearing our family apart.”
I gaze at my friend. I’m amazed that Trish manages not only to function but to do her job well in the midst of this chaos. She’s such a steady, good person. “I don’t know how you do it, Trish. What keeps you going? You feel like your family is falling apart, but you just keep on trucking.”
My friend shrugs and raises one eyebrow. “What choice do I have? We’re raising two other kids besides Aran, remember? They need some kind of life.”
We stare at each other.
“Did I tell you when things were really out of control at our house, when the boys were getting into trouble, how I ran away from home?” I ask her.
Trish nods sadly. Yeah, she’s heard the story.
Run Away
I share pretty much everything with my patients. I tell stories about myself. I tell stories about other women, about friends and patients. I’m always careful to change the place and time of the encounters because in a small community, you never know who knows who. I disguise the details, saying, “I had a patient once, this was quite a few years ago,” or “This was when we lived in Ohio …”
Sometimes I tell mothers about the troubles Tom and I had when the boys were teenagers. I tell them how I wanted to run away. I was so tired of feeling afraid for them and feeling guilty that I’d screwed up. Sometimes I tell them that I did run away. This is the truth. It was around the time Orion was picked up downtown by the paramedics.
He was sixteen, I think, and was late for his twelve-o’clock curfew … the details blur after a while, fifteen or sixteen. Tom and I were in bed, but neither of us was sleeping.
The phone rang. Tom picked up. “Dr. Harman,” he said in his doctor voice. The phone ringing that late didn’t particularly alarm me. We were still doing deliveries and were often called in at night. What scared me was the way my husband sat up in bed and dropped his feet to the floor.
“When? … How are his vitals?” There were long gaps in the conversation. “I’ll be right in.” I felt nauseated. The word his was the tip-off. Our patients are female.
“What? What’s happening?” I switched on the bedside lamp.
“It’s Orion. The squad brought him into the university hospital’s ER.”
“An auto wreck?”
Tom pulled on his jeans. “No, he’s in a coma.” Our eyes met, saying everything. “Could be head trauma. Could be booze. His blood-alcohol level is real high. They found him in one of the row houses in the university student district. Someone called the squad, but no one was there when the paramedics arrived, so they don’t know what happened. They’re taking him in for a CT now.”
“Should I come?” I started to get up.
“No, I’ll call you.” My husband left and I stayed in bed, praying.
When Tom returned, five hours later, he told me what’d happened. Someone had called the squad, but when the paramedics got to the Clifton Street address they found Orion abandoned on the floor of a trashed-out living room, hip-hop music blaring and a keg of beer on the kitchen counter.
Orion was in the hospital unconscious for seven hours before anyone knew whether it was an overdose or a head injury, maybe from a fall or an intentional blow to the head. It turned out to be alcohol poisoning. I think this was the same year Zen was expelled for having ten little baggies of marijuana on the high school campus after a basketball game.
During this time, I was insane with worry. The only one of the boys who seemed to be doing all right was Mica, in college in Connecticut. There’d been that incident when he’d worked as a pizza delivery man and was kidnapped by a group of thugs who’d forced him at knifepoint to drive to his ATM and take out money for them and then stole his car, but that was earlier. If he was in trouble now, we didn’t know about it, and that was okay with me.
Those were the years when I began walking the floors. I stopped sleeping with Tom, camped in my study, and prayed on my knees, but I never missed work. I smiled and was nice to the patients. I told no one what was going on at home, that we were losing control of our children and that I was afraid if they didn’t end up dead, they would end up in prison. I had no one to tell, no friends or colleagues who had kids being hauled in by the police or found almost dead by paramedics. The only thing that soothed me were my fantasies of flight.
Whenever I was alone, I would imagine a cozy home free of fear and fighting, some safe, calm haven. I would visualize myself packing the Civic, go
ing into detail about what I would take: a few framed photographs, my favorite blue quilt, books, CDs. I pictured myself packing my guitar, my cameras, some kitchen things, a suitcase of clothes, a book of poetry. My escapist plans gave me peace, and I reviewed them over and over.
And then one day, something, I can’t remember what, pushed me over the edge. It might have been Zen’s acid trip when he thought he was God and we had to drive to Philadelphia to get him, or maybe it was when he stood in the TV room and called me a bitch. Whatever had happened, I went to the phone, found an apartment, wrote Tom a note, and left. I’d spent so much time thinking what I would pack, it was easy.
In the halls of the faculty OB clinic, Tom and I saw each other daily. We were professional and polite, but looked at each other with eyes like wounds in our faces. Sometimes Tom would visit my little furnished studio, which was as sweet and quiet and lovely as I’d imagined. There was a fold-down bed like in the old movies, a kitchenette, and a small dining table. I smoothed my patchwork quilt over the sofa and put up a few pictures on the white walls. Outside the front window I hung a bird feeder, and in the evenings, I would watch purple finches fight over millet and flax seeds.
“I want to move here too,” Tom complained after we made love on the blue and white quilt. But we couldn’t both run away at the same time. Someone had to be responsible and stay with the boys. I was gone for three months, and then one night after work I moved home and cooked dinner.
Now, when a patient confesses to me that her son is in jail or her daughter is out on the streets, I’ll roll my stool closer and tell the mother my story. I tell it because there was a time when I told no one.
I told no one because I knew no one who I thought would understand.
NILA
“Hi, you didn’t expect to see me back so soon, did you?” Nila looks about like she always looks: tidy, with her midlength blond-brown hair tied back in a ponytail. Her clear skin is now tanned from the summer sun. She wears size 2 jeans and a blue T-shirt that says WORLD—S BEST MOM on the front of it.
“I am surprised. So, how are you doing?” It’s been months since Nila Wilson transferred to her new nurse-midwife, and I’d assumed she was settled in mid-pregnancy.
Follow-up gyn problem, the note on the chart says. Must be some mistake; Nila ought to be five or six, maybe seven months pregnant by now. I glance at the woman’s belly, checking for the swelling that should be there.
The patient meets my eyes, placing both hands on her abdomen protectively. “Well, you probably heard. I lost it.”
“No, I’m sorry, I didn’t know. I guess the other ob-gyn practice didn’t think to tell me … I’m really sorry.” Nila begins to spill tears. I grab the box of tissues and slide my stool closer. “So what happened? How pregnant were you? Are you doing okay?”
“I lost it,” Nila says again. That’s all she says.
“But what happened, did you just start bleeding? What happened?”
“Yeah, I’m sure it’s my fault. Doug told me to slow down. But you remember, I never had problems with my first seven pregnancies, and I kept working as hard as I could. We got that old place on Weimer Road. I told you about it, the big farmhouse? Well, it was a dump, but perfect for us, six bedrooms, two baths.
“No one had lived in it for years. The kids and I started with three rooms, the kitchen, the living room, and the one bathroom that worked. We got those livable and then we just camped out, cleaned and painted another room every few days. I mean serious cleaning. Some of the windows were broken, so there were leaves and bird nests everywhere, all kinds of shit.” She checks to be sure her language has not offended, and when she sees that it hasn’t, she goes on. “Literal shit! Bird poop, mice poop, some bigger stuff, maybe raccoon. It was hard work, but fun. The kids and I slaved all day and half into the night for two weeks. Of course, I was working harder than anyone through the heat of August. I was obsessed. Nesting instinct, I guess.
“All that time we were bringing in furniture, whatever we could scrounge or get at yard sales and flea markets. We got cheap paint at the discount place out on Bobtown Road and whitewashed everything. I couldn’t ask Gibby for any of my old things, you know, my ex-husband, so we had to outfit the whole place. We worked our butts off, me and the kids. Doug was at Select-Tech ten hours a day, and I applied for food stamps.
“The first night Doug and I got settled into our new bedroom we made love. That’s when the bleeding started. Doug blamed himself. I’d spotted once before, with my fourth pregnancy, so I told him it would be all right.” Nila stops for a minute. I picture a stocky, good-looking guy in his early forties who hasn’t had much to do with childbirth staring down at the streak of red blood on the sheets.
“But it wasn’t all right. When I went to my midwife she couldn’t find a heartbeat. They did an ultrasound, and the baby was dead. It wasn’t the intercourse. I’m sure of it. It was all the hard work. I should have known better. I was four months along. I just thought I was superwoman. Now I know that I’m not. Eventually, I had to tell the kids. They didn’t even know miscarriages happened, since all of my pregnancies had gone fine before.”
Nila is quiet for a moment, remembering. She just sits there, a deflated balloon. “Then my sister, you know, Marnie?” I shake my head no. “Yeah, you do. She was at my last birth. Anyway, she’s real Christian and she told me the miscarriage was punishment from God for adultery. You know how she is.
“If I was a drinking woman, I swear, I would have started right in. Doug was crying and blaming himself because the miscarriage happened right after intercourse. And Marnie was telling me it was some kind of holy curse, and the kids were looking all worried. I had to go into the hospital for a D and C. My doctor told us that miscarriages just happen sometimes, that it wasn’t anyone’s fault, but I don’t know … I was working too hard.” Nila studies my face, waiting to see what I think.
“I agree with the OB,” I tell her. “Sometimes the baby’s not forming right, or the placenta comes loose. It hardly ever has anything to do with what you did or didn’t do. One out of five pregnancies ends in miscarriage. Some say one out of two if you count the real early ones. You’ve just been lucky before. Will you and Doug try again? I know you were happy about the baby.”
Nila shrugs her narrow shoulders. “Maybe, but I want to get the kids settled first, and then we’ll see. School is just starting. And I want to get a divorce from Gibby. He’s driving me nuts. When he heard about the miscarriage he sent me flowers, started calling, wanted to get together again. He says I wasn’t meant to be with anyone else. He keeps going on that our babies always came out good, and I can’t have one with another man … I gotta get a divorce. I’m thinking of going to some kind of legal aid. He’s driving me nuts.” She says it again.
I’ve never seen Nila so distressed. “Maybe I can help you with that. Didn’t you tell me that Gibby had been hitting you after his head injury? Wasn’t there something about that?”
“Not really hitting. He always stopped short.”
“What, then?”
“Just picking on me. Telling me I was lazy, that the house wasn’t clean, that I wasn’t taking care of the kids. He’d get real angry but he never hit me. One time I thought he was about to. He shoved me against the stove and it was turned on. I burned my arm. He didn’t mean it to happen, but I took the kids and went to Marnie’s that night. A few weeks later, I left in the van.” I remember Nila’s impressive dawn getaway with the six kids.
“So did he threaten you with violence? Did he do anything else?”
“Oh sure, he threatened, but it was all hot air. He’d mouth off, say he’d kill me if I ever left. I didn’t believe him. We’d been together forever. I know he loves me in his own way.”
“Nila, I’m going to give you the number for the Rape and Domestic Violence Center. They may be able to assist you. There are lawyers in town who volunteer at the shelter to help abused women get a divorce.”
Nila frowns. “I
wouldn’t want to get Gibby in trouble. I wouldn’t want that. We were together for so many years and he’s the kids’ father.”
I stop the discussion. I’ve heard this before. “Well, I’ll give you the card with the phone number. At least you think about it. Gibby sounds potentially dangerous to me. If a man threatens you with death, it’s serious.”
“I’m okay now,” Nila reassures me. “He sent me flowers, and I have Doug.”
I smile resignedly. No use pursuing it, but I’ll give her the card. We always keep a stack of them in the restrooms so women can take them without having to tell us their problems. “So what brings you here today? Have you had a period since the D and C?”
“Yeah, I’m fine. I just had a few days of spotting but I think I need to get some kind of birth control. I’ve never used any before. I read you shouldn’t take contraceptives after the age of thirty-five if you smoke cigarettes, but I gave up the fags when I was in South Dakota. Could I get the birth control patch I’ve been reading about?”
“That’s great. You quit? Not easy to do.” I check Nila’s blood pressure and write her a script for the patches. Then I give her a long hug. “I’m sorry about the baby,” I say gently, patting the woman’s flat stomach. Nila peers down at my hand. She takes my fingers and puts them up to her cheek.
“Thanks,” she says. “Thanks for listening to me.” There are tears in her eyes again.
Nila is scheduled to return in three months for a birth control check.
Superwoman.
HEATHER
“Hi, Heather, how’re you doing?” I touch the slender young woman’s shoulder as I enter the exam room. I’m mildly surprised to see T.J. standing in front of the mirror that’s mounted on the wall in the corner, staring at himself. His long hair is gone and his head is now shaved. There’s a tattoo of an eagle on the back of his neck, and two wooden plugs in his earlobes.
A few months ago, I’d written the patient a prescription for birth control patches; now her urine test is positive for pregnancy. “Hi, T.J.,” I say, wishing he weren’t here but obliged to include him. “Did you guys get a frost out your way this morning?” I have nothing against the boy, but the only time I’ve had any real communication with Heather was the time she came to the clinic alone. My conversational gambit flounders.
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