by Kate Ledger
“Here you are,” Lucille said, putting the paper down and standing to kiss him on the cheek. “They’re supposed to discharge him today, whenever the doctor comes around. I told you, you didn’t need to come all this way.”
“What did they say this morning?” Simon asked, as Emily felt herself bristle at his forcefulness. “Did they round?”
“Hello, Lucille.” Emily pressed her cheek against her mother-in-law’s. “Hello, Charles. How are you? What a terrible thing to have gone through.” The fluorescent bulbs above the bed gave off a depressing yellow sheen, and the heavy smell of sleep hung in the air, unmoving. She felt the urge to rush to the window and fling open the curtains, let the light in, but she refrained.
“We brought this,” Jamie announced, holding up the plant wrapped in vermilion foil they’d bought in the airport.
“Here, Jamie.” Emily pointed to the windowsill. “Do you remember what happened?” She addressed the question to Charles, but Lucille took part in the answer. Charles let her. This surprised Emily, and moved her. Somehow their separate stories—two completely different experiences from two distinct locations—spun into one narrative. Lucille told of how she’d been waiting at the apartment for Charles to get home. He’d been driving down the street at a perfectly reasonable speed. The dog bounded from between two parked cars, and with only an instant to react, he’d steered toward the opposite sidewalk. A mailman witnessed the accident and called 911. The paramedics took six minutes and eighteen seconds to arrive from the time of the call. Charles phoned her from the ambulance, and he berated their driving the whole way to the hospital. A neighbor drove her to the emergency room, and she stayed with him through the night. “It wasn’t on a leash,” she concluded.
“Next time I won’t be so charitable,” Charles said.
“Oh, Charles.” Lucille patted the sheet that covered his leg.
“I want to know what the doctors said,” Simon said.
“They said he looks good,” Lucille replied. “The X-ray showed a broken rib, but nothing else. He’s stable, and he’s feeling good so they say he’ll probably go home this afternoon.” She looked at Charles as he flipped again through the channels of the television. “I think they were trying to cover their asses, if you’ll pardon my French,” she added in a whisper.
“Are you comfortable?” Emily asked gently, politely. It seemed to her the most important questions had not been asked yet. “Does anything hurt?”
“No problems,” Charles said. “That’s what I keep saying.”
“You’re allowed to complain, you know,” Simon said with an uneasy chuckle.
“I don’t hurt. I’m a little stiff, kind of like I was lifting weights or something. But nothing hurts.”
“You don’t have to be macho, Dad.” Simon was shaking his head. “It was an accident.”
“Nobody will think less of you,” Emily added helpfully.
“They offered him morphine. That’s what’s in the bag.” Lucille pointed at the IV. “But he hasn’t needed it once.” She sounded almost proud. “He’s got a button he can use if he wants some, but he doesn’t need it.”
Charles did look good—vibrant and fleshed out, certainly not as haggard as Emily had imagined. Even his eyes were clear. “Doesn’t hurt at all in your chest, where you got hit?” Emily asked. “It’s amazing.”
“They asked him if he feels numb, but he doesn’t feel numb either, do you, Charles? No numbness at all.”
Simon, at that point, had helped himself to a clipboard that was tucked in the bottom of the bed. “Why’d he have a chest CT?” he wanted to know. It didn’t seem right to Emily for him to be digging into the records.
“They’re just being thorough.” Lucille waved her hand. “They don’t want to leave any stone unturned.”
“They must’ve been concerned about something if they ordered a CT,” Simon said. “Didn’t you ask what it was for?”
“I feel fine, damn it. How many times do I have to say it?”
“Dr. Smitts said there was a tiny hazy area on the X-ray,” Lucille explained. “Nothing serious, he said, but Charles should have the test so they could have a peek.”
Lucille patted Charles again. Emily found herself unable to look away from where the age-spotted hand rested on his leg with so much quiet kindness.
But Simon shook a finger at his mother. “This is why we had to come,” he said. “You need a network around when you’re dealing with health issues. You need to be able to ask all the questions—not just the right questions—all the questions.” Emily looked at him. He looked notably tall and explosively broad next to the hospital bed. His nostrils flared as he lectured. “And it helps if your network includes a doctor, too.” He strode to the door and poked his head into the hallway. “Where is everybody in this hospital?”
Within an hour of stepping off the elevator on the fourth floor, Simon had immersed himself in Charles’s care. Graciousness didn’t occur to him, and Emily didn’t even have a chance to run interference. He badgered the staff to take Charles’s blood pressure twice in a single hour, and he insisted on checking the thermometer himself, as if the technician couldn’t read. He went around introducing himself to the nurses on the floor, and shortly after, he was using their names as if he worked with them: “Matthew, can someone call down to radiology to see if the CT’s been read yet?” In particular, he couldn’t get off the topic that his father wasn’t experiencing the appropriate amount of pain. “It’s just not proportionate,” he insisted.
“Yes,” Emily reasoned in a voice she hoped would help calm him, “but he says he feels fine. Haven’t you always said that listening to the patient is—”
“He broke a rib. Do you have any idea how painful that is? I’ve had a world-class athlete in my office crying, bawling over a broken rib you could barely see on a chest X-ray. Just a hairline fracture and he couldn’t stand up. All the surrounding muscles are affected. That guy couldn’t take a breath. I’m not making up that it’s a painful injury. It just is.”
“Maybe his pain tolerance is higher than other people’s. Being a veteran and all.” Charles had served in the Marines on a special mission deployed by battleship in the early 1960s. It wasn’t a typical tour of duty for a marine, as she understood. When he enlisted, the Korean War was over; troops had not yet been sent to Vietnam. He’d participated in some kind of seafaring brigade that fought “pirates,” as Charles had once explained, “before they were called terrorists.” He claimed to have helped rescue a hijacked Portuguese passenger liner in the South Atlantic and to have been among the troops providing reinforcement at Gitmo when Castro threatened to overtake the base. She believed his stories might be somewhat exaggerated—pirates?—and she didn’t know anything about the injury that had sent him back to the States and forced his military retirement. Simon had once said Charles had been shot in the ass, but she hadn’t been certain whether her husband was being facetious.
About the apparent lack of pain, Simon was adamant. “We can’t just brush this off,” he insisted. “He could have some bleeding in the brain, for all we know.”
He procured the names of the consulting doctors in orthopedics and neurology, and he requested the nursing staff check Charles’s pain medication machine, to see if it might be malfunctioning, somehow delivering morphine without revealing the dosing on the digital display. He asked the nurses for the physicians’ rounding schedule. Emily suggested that maybe they should just wait like everybody else for Dr. Smitts to round. This struck Simon as possibly the most terrible idea in the world. “In the hospital it’s the squeaky wheel that gets oiled,” he responded. “Believe me, I know.”
The worst came when Simon informed them he wanted to review his father’s complete medical chart himself. At that, the nurse’s eyes widened. She was young and prissy-looking, with a pattern of ducks on her scrubs. The nurse said she wasn’t allowed to give the charts to family members. It was a violation of patient confidentiality, she said, and a leg
al issue for the hospital. She said she could arrange for someone from hospital administration to come to the floor to review the chart with him. “But I’m a doctor,” he answered, as if that were code to employ another set of rules.
“Maybe you should head down to the cafeteria and get a drink,” Emily said finally. “Some coffee? You’re very wound up.”
“Something’s strange,” Simon insisted.
“Maybe a walk will help you sort it out.”
He paced outside the room, on the lookout for Dr. Smitts. Emily sat politely in the stale-smelling Room 417 with Lucille and Charles and Jamie, chatting about the weather, comparing the heat in Baltimore to the heat in Fort Lauderdale and speculating about Jamie’s plans for the rest of the summer (they’d made the trip to visit, after all). She caught another glimpse of Simon every few minutes when his Ping-Pong course took him past the open door again, and she began to feel despair that he wouldn’t listen to her. Charles was clearly fine and ready to be discharged. The trip had been excessive after all. What Charles needed most of all was to go home and have everybody leave him alone.
Emily had not known Simon before his medical career, his training, his title. Secretly, she believed that he was not one of those people who became a doctor because he was a natural, intuitive helper. Instinctive healers understood nuances in human actions, sometimes extracting themselves from the center of the stage simply to let events unfold. She believed that Simon was smart, but that he’d learned to be a helper because such skills were necessary in order to be a successful doctor. He’d cultivated the right kind of personality. Did this make him a fraud at the core? she sometimes wondered. He had a way of overcompensating that made her embarrassed for him. You could see it in almost everything he touched. When he’d planned to grow a whole array of orchids, he’d insisted on cultivating them from the bulb. “If you buy them grown,” he stated, “it’s not raising them. You’re just sort of babysitting them. What’s the point?” A simple trip to the Baltimore Museum of Art one afternoon had given him the idea to hire a metalsmith to build a sculpture garden in their own backyard. All of the energy, the loftiness of his ideas, that had intrigued and inspired her (and that had once reminded her of her father) seemed to be based not on actual talent or creative genius, but on impulse, something flighty and hopeful and not well informed, as if he were propelled by sentiment that he didn’t know how to manage.
A solid fifteen minutes passed without a sighting of her husband. But just as Emily stood and peered into the hallway, Simon trapped Dr. Smitts emerging from the elevator. She watched Simon gesticulating with wild hands, his white oxford shirt untucked on one side. Dr. Smitts listened, apparently agreeing. He was a bland-faced doctor, pale as a sand dune, clutching a folder. Hold your ground, Emily was thinking. As she approached them, she heard Simon suggesting an additional test.
“Isn’t a brain CT in order, considering everything?”
“Not necessarily,” Dr. Smitts was saying. “We ordered the chest CT to rule out pulmonary contusion, any kind of bruising on the lung, which would be possible, considering his broken rib. Plus his oxygen was low, which concerned me a little. But he’s got no chest pain, so I think there’s no sign of a contusion.”
“It could develop twenty-four hours after the accident,” Simon argued.
“I think we’re in the clear. No hemothorax, no pneumothorax.”
“Which means what—?” Emily asked.
“No bleeding in the chest cavity. No fluid in the lung cavity,” Dr. Smitts explained. “The CT was normal.”
“But what about his head?” Simon asked.
“We don’t usually do brain CTs unless there’s a clear sign he hit his head and we’re concerned about bleeding.”
“I’d say a brain CT is in order.”
“I’d agree if he had head pain, but he doesn’t.”
“Is it possible there’s something, a brain lesion maybe, that’s keeping him from feeling pain sensations?”
“Possible, of course, but highly unlikely. I can’t explain what your father’s experiencing, but I’ll tell you he’s a fortunate man.”
Simon would not be deterred. “Did it occur to anyone to check for signs that he might have blacked out before the accident? I mean, did anyone talk to the mailman who called 911? Anybody confirm there was a dog in the first place?”
At that moment she felt with a shock wave that his whole take on the accident, on Charles’s well-being, was out of control. Just then, Emily wanted to go home. They’d made the trip. They’d proved they cared. It was clear to Emily that Charles and Lucille wanted as little fanfare as possible. No doubt her father-in-law was embarrassed to have been in an accident in the first place. Now, what an indignity to have his judgment called into question, to be told that he couldn’t possibly feel the way he felt because this or that test showed some result. Who were these doctors? Emily listened, her heart raging like a knocking fist, as Simon argued for the need for additional tests, a brain CT, an electrical nerve stimulation test, something to explain the impossible absence of pain sensations. Charles’s healing called for privacy, for normalcy, for the opportunity to shrug it off and get on with life—not the kind of helping that Simon was trying to impose. Couldn’t Simon see that? Leaving was how they could contribute.
“The neurologist would know better than I about those tests,” Dr. Smitts was saying with deferential, agreeable diction. “But pain is highly subjective. It can be highly influenced by emotions and environment. That’s what makes it difficult to define and treat.”
“I’m just concerned that something else might be going on here,” Simon urged. “He broke a rib. Anyone can tell you that’s a helluva painful injury.”
“I agree, your father’s absence of pain, in light of his injuries, is unusual.”
“Warranting a closer look,” Simon said.
Emily listened for a moment, then interjected, “I don’t understand. Whatever happened to ‘if it ain’t broke’? Nobody’s listening to Charles. Can’t anybody listen to what he says he needs? He keeps telling everyone he’s feeling okay.”
“He shouldn’t be.” Simon turned to her, loud and didactic. “He’s got a significant break. Even if there’s nothing that can be done about it. It hurts, understand? So either he’s faking it, and there’s a pain issue to be addressed, or there’s some underlying problem keeping him from feeling it.”
“Darling,” Emily said, as delicately as she could in front of the slow-blinking doctor, “I think it’s possible you might be too involved.”
“Yes,” Simon agreed, much to Emily’s surprise. “That’s possible. But isn’t that my responsibility as his son?”
She hit a breaking point. She could not bring herself to stay even one night. All the posturing and the arguing and the indeterminacy. The numbers seemed to mean nothing, all the tests they’d conducted. It was impossible to know whom to believe or how to feel certain about any of the results. And Simon. The way he wouldn’t listen. What it reminded her of, what she preferred not to think of, was the night they’d rushed Caleb to the emergency room. She returned to Room 417 to sit with Lucille and Charles, as Jamie asked for a dollar for a vending machine. She watched Jamie hesitate in the doorway, uncertain which way to turn. All she could think of was that night and how they’d been so lost. So many tests—so many questions—that amounted to nothing. Made you think that medicine was just a lot of lucky guesswork and that having faith in the doctors was just that—faith. You put yourself in their hands and you hoped everything they found was simple and that they didn’t encounter any surprises.
At first she and Simon had clung to Caleb, holding his hands, caressing his head, as the doctor examined him in the ER. Then the staff suggested they leave the room, as the equipment careened around the corner for a spinal tap. Simon wanted to stay, but she felt she’d crumple if she was forced to watch a single needle enter that tiny body. All her senses were on edge and yet she felt unable to focus, unable to talk. She sat,
trembling, in the waiting room. What kept coming back to her was that knowing look that had been in Caleb’s eyes when he was only hours old. Me and you. Rocking her body, she clasped her hands together—she couldn’t remember what Jews did with their hands, whether you were supposed to put them together or not—and whispered a single word, please, into her knit fingers. The results of the spinal tap showed a raging infection. Meningitis, they said. There was even a rash on his body. There were antibiotics and IV fluids, and everyone seemed to be moving as swiftly as possible. Then there was nothing anybody could do.
No, she did not want to spend another second in a hospital. And whatever Simon was trying to prove, she didn’t want any part of his overblown quest for pathologies when it was clear there was nothing wrong with Charles other than a broken bone. Twenty minutes and a single phone call later, Emily had arranged tickets for herself and Jamie to return that evening to Baltimore. Simon didn’t want a ticket, and she didn’t book one for him. Instead, Simon insisted that he should stay over in Fort Lauderdale, just in case, and in fact he’d managed to sway Dr. Smitts, who’d gone ahead and recommended Charles have the nerve test because the indications were, indeed, baffling. “I’d feel terrible if I didn’t recommend it and then it turned out there were some sort of lesion,” Dr. Smitts reasoned.
Lucille looked pale at the word “lesion.” “Maybe one more night, just to be safe.”
That’s what it was, Emily thought. You looked for as many problems as possible just so you could say to yourself that you’d left no stone unturned. Because how could you go on otherwise? No, she didn’t want to spend another second there. She wanted to go home.
“Our flight’s at nine thirty,” Emily told him, as they stood in the hallway outside Room 417. She slipped her cell phone back into her purse.
“You know,” Simon pointed out, “it’s possible that if he’s not feeling pain—and I’m not convinced he’s telling the truth—but if he’s not, he could injure himself more just getting in and out of bed. He could jar that broken rib right out of place and possibly puncture a lung this time. The truth is, a little pain would probably serve him well. It’d keep him from moving around like a person who doesn’t have an injury.”