by John Updike
“I have no idea.” Irritably he adds, “Why bother to talk to me when you’ve got Charlie back advising you, to say the least?”
She flares a little; her lips pinch in and her face comes forward. “Advising me is all he’s doing and he’s doing that because you asked him to. Because he loves you.”
She wouldn’t have spoken this way before going to Florida and those women’s groups, of “love” as something that is all over the map, like oil drips from speeding automobiles. She is trying to stir him, he dimly recognizes, back into life, into the fray. He tries to play along. “Me?”
“Yes, you, Harry Angstrom.”
“Why would he, for Chrissake?”
“I have no idea,” Janice says. “I’ve never understood what men see in each other.” She tries a joke. “Maybe he’s gone gay in his old age.”
“He’s never married,” Harry admits. “You think he’d be interested in coming back to work for Springer Motors?”
She is gathering up her things - a black leather pocketbook packed like a bomb, the old-fashioned round kind people used to throw and not the flattened Semtex that terrorists smuggle into suitcases in airplanes, and her real-estate textbook and photocopied sample documents stapled together, for her class tonight, and a new spring coat she’s got herself, a kind of jonquil-yellow gabardine with a broad belt and wide shoulders. She looks girlish, fluffyhaired, putting it on. “I asked him,” she says, “and he says absolutely not. He says he’s into these partnerships with his cousins, rental properties in the north end of the city and over toward the old fairgrounds, and a rug-cleaning business his nephew started up with another boy and they needed backers, and Charlie says that’s enough for him, he couldn’t stand to go back into a salaried job and all that withholding tax and the aggravation of being expected somewhere like at the lot every day. He likes his freedom.”
“We all do,” sighs Rabbit. “Hey, Janice. I was thinking just the other day we ought to get the wall-to-wall carpets in our house cleaned. No fault of yours, but they’re filthy, honey.”
Dr. Breit comes in Sunday morning and tells him, “Harold, you’re looking A-1. Ray does beautiful work. They say around the OR, `He could tickle a tapeworm under the chin with that catheter.”’ Breit looks up through his furry eyelashes for the expected laugh, doesn’t get it, and perches on the edge of the bed for extra intimacy. “I’ve been reviewing our own films plus the stuff the jerks down at Deleon Community finally got around to sending us. Your lumen in the LAD has gone up from fifteen per cent of normal to sixty. But I can’t say I’m crazy about your RCA, the right coronary artery; it shows I’d put it at about eightyper-cent blockage, which is fine and dandy as long as the welldeveloped collateral is supplying the right ventricle from the circumflex. But a lesion is developing at the bifurcation of the circumflex and the LAD, and a lesion at a bifurcation is tougher to treat with angioplasty. Same thing - I assume you’re interested in this - if the lesion is too long, or in a hyperkinetic AV groove, or in a situation where in the middle of the procedure you might get stranded without enough collateral circulation. In those kinds of cases, it can get hairy.”
His legs are a little short for sitting on the bed comfortably; he bounces his ham a little closer to Harry’s legs, and Harry feels the blood inside his supine body sway. Breit smiles and his voice grows confidential, like when he was murmuring over Dr. Raymond’s shoulders. “The fact is, Harold, PTCA is a pretty Mickey Mouse treatment, and what I want you to seriously consider as you lie here these few days, even though as I say this procedure appears to have produced good results for the time being, is, now that you’ve tested the waters, going ahead with a CABG. Not right away. We’re talking four, six months down the road before we go in again. We’d bypass both the RCA and the CFX, and the LAD depending on the restenosis, and you’ll be a new man, with damn close to a brand-new heart. While we’re in there we might want to look at that leaky aortic valve and think about a pacemaker. Frankly, we may have had a little postoperative MI; your electrocardiogram shows some new Q waves and there’s been an elevation of the CPK isoenzyme, with positive MB bands.”
“You mean,” Harry says, not totally snowed, “I’ve been having a heart attack just lying here?”
Dr. Breit shrugs daintily. All his gestures have a daintiness that goes with his milky-pink skin. His voice is a bit squeaky, piped through his blistered-looking lips. He says, “PTCA is an invasive procedure, nobody said it wasn’t. A little trauma is to be expected. Your heart shows myocardial scarring from way back. All a heart attack is is some heart muscle dying. A little can die without your noticing. It happens to all of us, just as everybody over a certain age has some emphysema. It’s called the aging process and there’s no escaping it. Not in this life.”
Harry wonders about the next life, but decides not to ask. He doubts that Breit knows more than The National Enquirer. “You’re telling me I’ve come into this hospital for I don’t know how many thousands of dollars for a Mickey Mouse operation?”
“Rome wasn’t built in a day, Harold, and your heart isn’t going to be rebuilt in a week. Angioplasty does some good, at least for a while, in about eighty per cent of the cases. But bypass is up to around ninety-nine per cent initial success. Look. It’s the difference between scrubbing out your toilet bowl with a long brush and actually replacing the pipes. There are places you can’t reach with a brush, and deposits that have become chemically bonded. A man your age, in generally good health, shouldn’t be thinking twice about it. You owe it not only to yourself but to your wife and son. And those cunning little grandchildren I’ve heard about.”
The faster Breit talks, the more constricted Harry’s chest feels. He gets out, “Let me see if I understand it. They rip veins out of your legs and sew them to your heart like jug handles?”
A frown clouds the young doctor’s face. He is overrunning the allotted time for his visit, Rabbit supposes. With visible patience he licks his sore-looking lips and explains, “They take a superficial vein from your leg and in some cases the mammary chest artery, because arteries hold up better under arterial pressure than veins. But you don’t have to worry about any of that. You’re not the surgeon, it’s our bailiwick. This operation is done tens of thousands of times in the United States every year - believe me, Harold, it’s a piece of cake.”
“You’d do it here?”
Breit’s eyes behind his flesh-colored glasses are strange furry slits, with puffy pink lids. “The facilities don’t exist yet in this physical plant,” he admits. “You’d have to go to Philadelphia, I doubt we could slot you into Lancaster, they’re booked solid for months.”
“Then it can’t be such a very little deal, if you need all these facilities.” Since childhood, Rabbit has had a prejudice against Philadelphia. Dirtiest city in the world: they live on poisoned water. And Lancaster is worse - Amish farmers, overwork their animals to death, inbred so much half are humpbacks and dwarfs. He saw them in the movie Witness being very quaint, Kelly McGillis wiping her bare tits with a sponge and everybody chipping in to build that barn, but it didn’t fool him. “Maybe Florida would be the place,” he offers Dr. Breit. Florida always seems unreal to him when he’s up here and having the operation there might be the same as not having it at all.
Dr. Breit’s sore-looking mouth gets stern; his upper lip has sweat on it. Why is he selling this so hard? Does he have a monthly quota, like state cops with speeding tickets? “I haven’t been that impressed by our dealings with Deleon,” he says. “But you think about it, Harold. If I were in your shoes, it’s what I’d have done - without any hesitation. You’re just toying with your life otherwise.”
Yeah, Rabbit thinks when the doctor is gone from the room, but you’re not in my shoes. And what’s life for but to toy with?
Mim phones. He takes a moment to recognize her voice, it is so dry and twangy, so whisky-and-cigarette-cracked. “What are they doing to you now?” she asks. She has always taken the attitude that he is a lamb am
ong wolves in Diamond County and he should have gotten out like she did.
“They’ve got me in the hospital,” he tells her. He could almost cry, like a boy. “They stuck a balloon up through my leg into my heart and pumped it full of saltwater to open up an artery that was plugged up with old grease I’ve been eating. Then afterwards they put a sandbag on the incision down at my thigh and told me not to move my leg for six hours or I’d bleed to death. That’s how hospitals are; they tell you what they’re going to do is about as simple as having a haircut and then midway through they tell you you might bleed to death. And then this morning the doctor comes around and tells me it was a Mickey Mouse operation and hardly worth bothering with. He wants me to go for broke and have a multiple bypass. Mim, they split you right open like a coconut and rip veins out of your legs.”
“Yeah, I know,” she says. “You gonna do it?”
Rabbit says, “I suppose they’ll talk me into it eventually. I mean, they’ve got you by the balls. You’re scared, and what else is there?”
“Guys I know out here have had open-heart and swear by it. I can’t see it made that much difference, they still spend all day sitting on their fat asses getting manicures and talking on the phone, but then they weren’t such dynamite before either. When you get to our age, Harry, it’s work to stay alive.”
“Come on, Mim. You’re only fifty.”
“For a woman out here, that’s ancient. That’s cow pasture. That’s hang-it-up time, if you’re a woman. You don’t get the stares any more, it’s like you’ve gone invisible.”
“Boy, you did use to get the stares,” he says proudly. He remembers her when she was nineteen - dyed-in blonde streak, big red cinch-in belt, sexy soft sweaters, skinny arms ending in a clash of bangle bracelets, buck teeth she couldn’t help revealing when she smiled, lips smeared with lipstick like she had eaten a jam sandwich, a leggy colt of a girl dying to break out of Brewer, to kick or fuck her way through the fence. She made it, too. Rabbit never could have made it out there. He was too soft. Even Florida bakes the spirit out of him. He needed to stay where they remembered him when. “So when are you coming east?” he asks Mim.
“Well, how bad are you, Harry?”
“Not that bad. I just complain a lot. All I have to do is stay away from animal fats and salt and don’t get aggravated.”
“Who would aggravate you?”
“The usual,” he says. “Nellie’s been having some problems. Hey, you’ll never guess who’s back on the scene squiring Janice around while I’m laid up. Your old boyfriend, Charlie Stavros.”
“Chas was not what I’d ever call a boyfriend. I took him on that time to get him off your wife’s back. Around here you’re not a boyfriend until you at least set the girl up in a condo.”
He is striving to keep her interested. People who’ve made it like she has, they get bored easily. “How the hell is Vegas?” he asks. “Is it hot there yet? How about you coming east to get away from the heat for a couple of weeks? We’ll put you up in the guest room above the den and you’ll get to know your great-niece and -nephew. Judy’s a real little lady now. She’s gonna be a looker not like you, but a looker.”
“Harry, the last time I came to Pennsylvania I nearly died from the humidity. I don’t know how you people do it, day after day; it was like being wrapped in warm washcloths. It’s that heavy climate is doing you in. That pollen is off the scale.”
“Yeah,” he weakly agrees. The phone receiver feels soggy in his hand. His own capacity to be interested isn’t what it should be. He’s free to wander the halls now, and you see amazing things: less than an hour ago, an amazing visitor, a young Brewer girl, she couldn’t have been more than fifteen, all in black, black jacket, tight black pants, pointed black boots, and her hair dyed yellowy white and cut short and mussed every which way so her skull reminded him of a wet Easter chick, plus a little flowery cruciform tattoo pricked right beside her eye. But his heart couldn’t quite rise to it, he felt he’d seen even this before, girls doing wicked things to themselves believing their youth would shine through and all would heal.
“Maybe l’ll come in the fall if you can last it out,” Mim tells him.
“Oh I can last,” he says. “You aren’t going to get rid of big brother so easy.” But the connection feels strained, and he can sense Mim groping, in the little pauses, for what to say next. “Hey, Mim,” he says. “Do you remember if Pop complained of chest pains?”
“He had emphysema, Harry. Because he wouldn’t stop smoking. You stopped. You were smart. Me, I’m down to a pack a day. But I don’t think I ever really inhaled.”
“I seem to remember him complaining of feeling full in the chest. He’d sneak his hand inside his shirt and rub his chest.”
“Maybe he itched. Harry, Pop died because he couldn’t breathe. Mom died because of her Parkinson’s. I suppose their hearts failed in the end but so does everybody’s, because that’s what life is, a strain on the heart.”
His little sister has become so dogmatic, everything cut and dried. She’s mad at something, too. Just like little Roy. “Hey,” he says, not wanting to let go however, “and another thing I was wondering about. Remember how you used to always sing, `Shoo-fly pie and apple pan dowdy?”’
“Yeah. Kind of.”
“What’s the line that comes after `Makes your eyes light up, your tummy say “howdy” ‘?”
In the silence he can hear chatter in the background, beautyparlor chatter, and a hair dryer whirring. “I have no fucking idea,” she says finally. “Are you sure I used to sing this song?”
“Well, I was, but never mind. How’s your life?” he asks. “Any new irons in the fire? When’re we going to marry you off?”
“Harry, come off it. The only reason anybody out here’d marry an old bag like me would be as some kind of cover. Or a tax dodge, if the accountant could figure one.”
“Speaking of accountants,” he begins, and he might have told her all about Nelson and Lyle and Janice, and the voices on the phone, but she doesn’t want to hear him; she says hurriedly, in a lowered voice, “Harry, a real special customer has just come in, even you’ve heard of her, and I got to hang up. You take care of yourself, now. You sound on the mend. Any time they get to be too much for you, you can come on out here for some sun and fun.”
What sort of fun, he would have liked to ask - in the old days she was always offering to get a girl for him if he came out alone, though he never did - and he would have liked to have heard more of why she thinks he is on the mend. But Mim has hung up. She has a life to get on with. His arm hurts in its crook from holding the phone. Ever since they invaded his arteries with dyes and balloons, he has aches and pains in remote and random joints, as if his blood is no longer purely his own. Once you break the cap on a ginger-ale bottle, there is never again as much fizz.
The nurse with the round pale face - a country kind of face comes in Monday evening and says to him, “My mother is having to drop something off for me tonight. Should I ask her to come up and see you for a second?”
“Did she say she’d be willing?” When 1 think of you thinking she’s
your daughter it’s like rubbing her all over with shit, Ruth had said the
last time they talked.
The young woman in her folded cap smiles. “I mentioned the other night, casual-like, that you were here, and I think she would be. She didn’t say anything rude or anything.” There is on her face a trace of a blush, a simper, a secret. If something does not soon happen to her, it will become a silly empty face. Innocence is just an early stage of stupidity.
This has not been the best day for Harry. The sounds of traffic and work resuming on the street outside reminded him of how out of it he still is. Janice didn’t visit, and now her evening class has begun. All day gray clouds packed the sky, in long rolls of nimbus, and trailed black wisps above the brick chimneys, but no rain has actually fallen. The view from his window consists of several intricately notched bands of ornamen
tal brickwork capping the third stories of narrow buildings that hold at street level a coffee shop, a dry cleaner’s, an office-supplies store. The corner building is painted gray, the middle one blue, and the third, with the most ornate window framing, beige. It has slowly dawned upon the people of Brewer that you can paint over brick with any color you choose, not just brick red. People live behind the upper windows across the street, but though Harry faithfully stares he has not yet been rewarded with the sight of a woman undressing, or even of anyone coming to the window to look out. Further depressing him, he has not been able to have a bowel movement since entering St. Joseph’s three days ago. The first day, he blamed the awkwardness of the bedpan and his solicitude for the nurses who would have to carry what he produced away, and the second day, the change of diet from what he usually eats - the food the hospital dieticians conjure up looks pretty good but tastes like wet cardboard and chews like chaff, so bland as to shut down his salivary glands - but on the third day, when he can wander the halls and use the bathroom behind a closed door in his room, he blames himself, his decrepitude, his drying up, the running down of his inner processes. Running out of even gas.