The Blue Cotton Gown

by Patricia Harman

  The sun shines down from the high window on my face. It lights the blue stained-glass mandala.

  I sleep all afternoon, smiling.

  CHAPTER 12

  ARAN

  On my first day back to work after the holidays and my two weeks of sick leave, I see Aran is an add-on at the end of the day, the reason for her visit listed only as gyn problems. I sit at my desk, checking my mail. Donna stops by. “How you doing?” she asks.

  I shrug. “Fine. I guess everyone has heard the cancer is gone. They just scooped out my insides, washed up my pelvis, and poof ’no cancer!” Donna squints, unsure what my sarcasm means, then leaves quickly.

  I’ve thought about this appointment with Aran all day, wondering how it will go, wondering if I’ll know what to say. Trish had called me at home three days ago to tell me Aran thinks she may have an STD. She also told me that Aran’s not coming home at night. The girl leaves her baby, doesn’t make any arrangements with Trish, and just disappears, doesn’t say where she’s going or when she’ll be back. When she’s not staying away from home she locks herself in her room. Trish is starting to wonder if her daughter is on drugs. I agree, this doesn’t sound right.

  When I enter the exam room at four, I find Aran sitting in her exam gown, her hands folded in her lap, looking as proper as a girl in a church choir, her short sandy hair shiny and clean, her face pale and without makeup. She wears nothing but thick green wool socks and the blue cotton gown, but she’s thinner than I remember. Black combat boots are pushed under the guest chair. I decide to play innocent and see what she says.

  “So how are you? I haven’t seen you for a few months.” I smile, staring into the girl’s large blue eyes. It’s hard to tell if the pupils are constricted.

  “Not so good.” The thin smile fades. “First of all, Jimmy and I broke up. I know we have before, but this is for real. I’m serious. For real. I took all my stuff and the baby’s stuff too, and moved home. Now he has chlamydia, and I’m afraid I might too. I want to be checked for everything. He’s such a dirtbag!” There are tears in her eyes, just floating on the edges, not flowing yet. She wipes them with a corner of the blue exam gown.

  “So when did you last have sex with him?”

  “Just a week ago. I thought we might get back together, but now it’s never going to happen. I’ll never forgive him! He’s such a liar, and I stood up for him all this time, stayed with him at the hospital. I feel like a fool.”

  “You didn’t use condoms, by any chance, did you?”

  “No.” Her eyes dart away.

  After the exam, I have Aran sit up. “I’ve checked you for gonorrhea and chlamydia,” I begin. “There’s no discharge or redness. There are blood tests we need to get for HIV, syphilis, and hepatitis.” Aran nods. “We’ll have to wait for the results, but I want to say very seriously, from now on you need to use condoms. It doesn’t matter how much you love a guy. It’s your body. The birth control pills will only protect you from one thing’babies! And as you know, they’re not even a hundred percent for that.” I’m glad to see the corners of Aran’s mouth turn up. The young woman got pregnant last time while taking the pill.

  “I know,” Aran says. “I really do know. And I will. I promise I’ll use them. From now on, I will.”

  “There’s something else,” I continue. “Trish says you’re staying out nights and not coming home. This concerns me, because I haven’t seen a new mother act like this before. I know you love Melody, and I wonder if you think you could have postpartum depression or something.” I’m winging it now.

  “She told you?” Aran’s steamed.

  “Yeah.”

  “Well, I’m not using drugs. That’s what they all think. My dad assumes I’m a crackhead.” She laughs bitterly, the blue eyes blazing. “I’m practically the only one of my friends who isn’t. If they only knew …”

  “So how come you stay out all night? Don’t you worry about the baby?”

  “No, my mom will take care of her. She’s real good.”

  I stop the questions for a minute, then go on. “So, do you think you could be depressed? You know, postpartum depression. Sometimes it starts months after the baby comes. Your life has changed dramatically, and there’s been a lot for you to cope with. So many changes can wear a person out. Stress can make a person feel like running away.”

  Aran is staring at the posters on the bulletin board. “No, I’m okay. So long as I am with my friends, I’m fine.” She’s still turned away.

  “What about when you’re alone?”

  Aran picks at her nails, which I notice are not as clean as they once were, and lets out some air. “I feel like crying. I just feel like crying all the time …” There’s the beep-beep of the laser in the next room, but no other sound.

  “So maybe it is some kind of postpartum depression.”

  Aran nods slowly, thoughtfully. “I’ve been thinking of getting out of here. Just loading up with the baby and going to my grandma’s in Philly, but I don’t have the money for gas, and my Escort’s not in great shape.”

  I roll my exam stool closer. “I had postpartum depression once. At the time I didn’t even know what it was, but I thought bad things. I even thought about killing myself. I don’t know why. It wasn’t like me. My life wasn’t that awful really. Do you ever have thoughts like that?”

  Aran sits up straight. “Killing myself? No, I could never do that. I think that this is the life God gave me and even if it hurts right now, everything happens for a purpose. I really believe that. I didn’t want to have a baby. I never wanted to be a mom. I don’t even like little kids very much. But I got one, for whatever reason. I would never kill myself. I would never.”

  “That’s good. I think everything has a purpose too, at least when you look at the big picture. Even if we can’t see what the purpose is.” We’re both silent, staring at the cream linoleum tiles with specks of dark green.

  I stand up and fill out a lab slip for the STD blood tests and write a script for antibiotics. “Do you think an antidepressant might help, Aran? I could give you some samples.”

  Aran shrugs. “I guess …” I can’t tell if the girl thinks medication is a good idea or is just going with the path of least resistance, but she takes the two weeks of samples I give her and shoves them into her purse.

  In a way I’m reassured. Aran’s probably drinking more than she said and using some drugs, but maybe nothing heavier than grass. She may be depressed, but she’s not suicidal.

  “Will you come back to see me in two weeks?”

  “Sure,” Aran says, zipping up her pre-maternity size 3 jeans, “and thanks, Patsy.” There’s not a stretch mark on her beautiful body. “Thanks for seeing me. I was really upset.”

  I give her a little hug. Just a small one around her waist.

  I’m surprised when Aran smiles widely, exposing straight white teeth, the kind that probably cost Trish a fortune at the orthodontist, and gives me a big hug back.

  Loss of Faith

  This is the last straw. I swear it is! Rebecca Gorham has finally replied to my e-mail and says that we have unfortunately underpaid our fall taxes by around fifteen thousand dollars. Okay, by $15,239. Now it’s early January, for God’s sake, and she’s just figured that out! I’ve been sick to my stomach all day. Where are we going to get that kind of money again? She knows we don’t have it. She should, anyway, she’s the accountant.

  Each quarter I’ve asked Gorham to get the IRS reports done on time so we don’t end up short, and each time she has an excuse. Last spring she was dealing with her predecessor Robert Reed’s screwed-up tax forms from two years before, a huge job and not her mess, so we didn’t say anything when she was late. It’s been less than a year since we dug ourselves out of the hole our pal Bob left us in. Then in late November, Rebecca went to Europe to visit her sick mother. How can you criticize that? And for Christmas, she traveled to Boston to be with her kids.

  “Getting an extension is no big deal,” she
’d informed me back then. “Businesses do it all the time. I’ll just fill out a form.” Apparently the form never made it to the IRS office, and now there are additional penalties. This is not the most money we’ve owed, but the well’s running dry.

  I suck in a heavy breath. Tom finally agrees with me that we need to get rid of Rebecca, but when is the right time, and how shall we do it? The woman, though a disappointment, did work her butt off through the earlier crisis. Still, we have to get a new accountant, and soon. The trouble is, I no longer have confidence we’ll make a good choice. We’ve been through this twice in the last three years.

  It’s three in the morning and I’m walking the floor again, carrying my jam jar of scotch. I wish we knew someone in business to guide us. When we’d finally gotten wise to Reed’s shady deals, I received Gorham’s name from a friend in my meditation group. Despite the glowing recommendation, Rebecca’s been a bust; not as disastrous as Bob, but bad enough.

  Tomorrow I’ll ask the secretaries to call other physicians’ groups in Torrington and find out who they use for accounting. If a name comes up twice, we’ll interview him or her. We’ll be expedient, but we won’t rush into a decision this time.

  I stand near the corner windows, staring into the night. The snow has drifted all day. Now the wind’s picking up and it’s coming down hard. And where will we get $15,239? There’s just enough in the account to make payroll. Tom has already borrowed from his retirement fund to pay the boys’ tuition.

  Breathe in. Breathe out. Things will probably resolve happily. Tom says they will, anyway.

  I lean back in the big white chair and curl my feet up. For a long time I rest there in front of the big corner window, watching the clusters of snowflakes shoot like sparks through the night.

  KASMAR

  As usual, I’m running behind in the clinic, but I stop short in the hall when a woman emerges from the restroom. She looks familiar, but for a minute I can’t place her. Then it comes to me. It’s Penny, the patient that picks.

  The blonde’s cheeks have a healthy pink glow. The pancake makeup is gone and the scars on her face have smoothed. “Hi, Penny,” I say, studying the patient. She stands with her shoulders back, wearing a wine-colored sweater with slim black pants, but her blond hair is what strikes me. It’s been cut short and curled, and the dark roots are gone. I hadn’t seen her for months and I had truthfully forgotten about giving her the free microderm treatments. For a while we’d done them every two weeks. “You look good,” I tell her.

  Penny grins. “Thanks, I guess. I just saw the other nurse-practitioner for a yeast infection.”

  I want to ask more: Have you stopped picking? Does your husband tell you how pretty you are? Who was the doctor that sexually molested you? But the hallway isn’t the right place. Nor the right time. “Well, I got to keep moving. You take care,” I call out as I tap on the door of exam room 2.

  “Hi, Kasmar.” I plunk down on the stool. Running late again.

  “You can call me Kaz.” The patient’s voice is lower now, and she has five-o’clock shadow on her square-jawed, freckled face.

  “That’s new,” I say, meaning the name, not the beard.

  “Yeah, like the sound of it? I introduce myself to colleagues and students now as Kaz Layton. Has a nice masculine ring.” Kasmar’s blue eyes twinkle and her voice goes up in a girlish way. I raise my eyebrows. She clears her throat and tries again. “Nice masculine ring,” she repeats, an octave lower. We both laugh. When we first started treatments I was worried how the nurses and secretaries would react to the idea of our assisting a woman in becoming a man, but Kasmar’s sense of humor has made her one of the staff’s favorite patients.

  “So, you feeling pretty good about everything, I take it.”

  “Yeah, I passed for the first time as a guy last weekend.”

  I glance at the dark gray Dockers-style pants, gray plaid shirt, and a red tie thrown casually over the back of the guest chair. On the floor are new men’s hiking boots.

  I push my stool back against the cool white wall and wait for the story. “Yeah?”

  Kasmar turns sideways on the exam table and leans forward, her hands on her knees. Her brown hair is cut shorter each time I see her. This time it’s shorter than Tom’s. “So we were at that new seafood restaurant. You know the one by the mall? Jerry and I were having dinner.” I nod. “And when the waitress took our order she called me sir. We almost lost it but I kept my voice low and ordered ‘for the lady and I.’ Seemed like a nice macho touch. ‘Very good, sir,’ the waitress said. That cracked us up.

  “So dinner went fine. Their food’s pretty good. But here’s the great part. I had to go to the restroom, so I stood up and walked toward the back. As I got close, I was nervous. I hadn’t given a thought to which john I would use.

  “I just kept striding through the tables, wondering if anyone was watching me but trying to be cool. Finally, I saw the signs and almost turned back. There were two doors: one with a shark wearing a top hat and one with a dolphin wearing a dress.” Kaz widens his blue eyes, clearly a guy now, telling this story. He wiggles his eyebrows.

  “I look to see if anyone’s watching.” He swivels his head back and forth, acting it out. “Which one should I take? An elderly woman in a polka-dot dress comes out of the ladies’ room and nods. I take a deep breath and go in with the sharks.”

  Kaz, the man, rubs the side of his face, feeling his two-day-old beard. “Yeah, it was a milestone.” He grins.

  I stand and give his arm an affectionate squeeze. “Hey, you’re getting muscles! That’s one of the side effects of the testosterone.”

  “Yeah, I’m taking some supplements and working out with weights too.”

  “That’s great.” I listen to his heart and lungs with my stethoscope. “The beard looks good. How ’bout everything else? You doing okay? Your labs are fine.” I hand over the copy of the patient’s results for cholesterol, testosterone, CBC, and liver enzymes.

  Kaz grimaces. He stares at the sheet of paper without reading it, then hands it back. “I guess I’m okay, but not really. I’ve had some problems at home.”

  “You mean Jerry?”

  “Yeah. She’s having trouble adjusting to me being a guy. We were always a lesbian couple, see? We hung out with other gay women. Now what are we? A heterosexual couple? I don’t think so. So who do we hang out with? Jerry misses her old girlfriend, Kasmar, but I want to be her husband, Kaz.”

  “Well, you’re still with her, right? You’re still working it out. You may have changed outside, but you are still you inside.”

  “Yes and no. I’m more confident now, more aggressive. I don’t put up with bullshit as much, expect more respect from people I meet. And women are starting to come on to me.” He grins suggestively. His straight teeth are even and white.

  “Women? Really. Like what? When?”

  “Oh, like at the agricultural conference I just went to in Syracuse. I had quite an entourage of female graduate students following me around.” The smile fades. “But Jerry, she’s still the love of my life. I don’t know what I’d do if I lost her.”

  “Have you tried counseling? Maybe you’re just in an adjustment phase. You have to admit, the situation is weird. I mean, to be in love with a woman who’s turned into a guy.”

  Kaz snorts and rubs his beard again. “Yeah, we’ll be okay. We have an appointment with our therapist next week. I’ll tell you how it goes when I come back next time.”

  He stands up to leave. “We’ll be okay,” he says again, convincing himself.

  I head for the lab. Did I do the right thing by helping Kasmar the woman become a man? I look back down the hall. As if sensing my thoughts, Kaz smiles and raises his hand in salute.

  Mutiny

  It’s 4:35, the last patient’s gone, and the staff is finishing up for the day. The receptionists file the labs, pushing the heavy sliding metal chart racks back and forth. I sit at my desk, staring bitterly at my last chart, running my fi
ngers over its shiny yellow surface.

  Our monthly meeting this noon had not gone well. The secretaries, nurses and practitioners, aware that we owe the Feds another fifteen thousand dollars, have voiced their concerns about the precarious future of the practice.

  “If you’re going to have to close, you ought to tell us. Don’t drag it out. We’ll have to find new jobs. We have families,” says Celeste. Her brown eyes single me out. I keep my face still but tighten my jaw. If I bite any harder I might crack a filling. Celeste doesn’t look away. “You should have realized a long time ago that Gorham was worthless.”

  She’s right, but Tom made decisions too, and yet somehow he’s always exempt from such criticism. A few heads nod, agreeing with Celeste, all eyes on me. I study the women in their blue checkered uniforms, which we provide for them, a different color for every day of the week. We pay the best wages around. Granted, we are struggling, but where is the gratitude? Where’s the support?

  On the other hand, I reflect, they all have families. They depend on their incomes to make mortgage payments and keep food on the table. They have a lot at stake here too. They need these jobs. Celeste is just the only one with the guts to say it.

  “If I were running this business, I’d hire an experienced office manager. Someone who knows what she’s doing,” Celeste goes on. I listen to her without expression, thinking that hiring an administrator would cost another forty-five thousand a year. Like we have that money!

  Though I resent being locked in the stocks before the whole village, I realize that there is frequently truth in hearing what you don’t want to hear. I have my bachelor’s degree in health-care administration, but I’m not an experienced CEO.

  What hurts most is that while I was being publicly lashed, no one came to my defense. No one, not even Tom. What was he thinking? If my husband were the victim of this kind of flogging, I’d have backed him up. I was being blamed for all the practice’s problems, while he sat picking his nails.