Oxygen

by Carol Wiley Cassella

  My answering machine gradually fills up with messages I barely listen to, invitations I won’t accept. Anyone who knows about the suit wants to ask if I feel prepared, if I’m completely confident in my lawyer, if I’m sleeping all right. Anyone who doesn’t know can’t tolerate my silences, the puzzled stare I give to their jokes, the full plate of food I push away at the end of dinner. Lori coaxes me through sheer persistence. She threatens to get on a plane within the hour if I don’t pick up, then fills our short conversations with stories about her children instead of questions.

  And Elsa. I always answer Elsa. I recognize her calls by their late or early hour, only when her parents are sleeping. Her adolescent self-centeredness is a gift, a secret room where time rolls back and I am me again. Sometimes I huddle on my own closet floor when we talk, a long-distance comaraderie of solitariness. “Why don’t you think she believes you?” I ask her, my knees folded against my chest, curtained between my wool coat and flannel bathrobe.

  “I can just tell. With both of them. They tell me how great I am and then they watch every little thing I do, like they think I’m a juvie. It’s driving me crazy.”

  “They watch you because they love you, Elsa. You know that. In your heart. Don’t you? Learn to trust that voice inside yourself.”

  I wonder if she knows that the lifeline I’ve been holding out to her has become my own.

  My first official deposition falls one month to the day after Jolene died. I arrive so early the janitor has to unlock the conference room door for me. The room has one tall, thick-paned window looking out over Puget Sound where an early spring fog floats the Olympic mountain peaks like a grand ship. My palms are so damp I wish women still wore the short white gloves my mother used to put on my sister and me for Easter.

  Men arrive lugging scuffed briefcases weighted with papers. The room takes on a jovial atmosphere, a breakfast outing away from the office routine. Everyone seems to know one another, regardless of which side of this suit they represent. Donnelly shakes my hand and pulls out a chair in the middle of the polished table. As people take their seats along either side, the divisions of loyalty split: defense team over here, plaintiff’s over there.

  After I am sworn in, Bobbie Jansen’s lawyer, Darryl Feinnes, smiles at me cheerfully and waves at a video recorder set up in the corner, pushing the bridge of his glasses higher on his nose with a stubby index finger. “You don’t mind the video, do you, Dr. Heaton? It just helps us all be sure we get the information right.” An assistant punches the silver button on the recorder down with a sharp snap that abruptly shifts the convivial mood.

  I answer and reanswer the questions Donnelly has prepared me for, but now my answers feel false and overrehearsed.

  “How long have you been an anesthesiologist, Dr. Heaton?”

  “Have you ever completed a fellowship in the specialty of pediatric anesthesia, Dr. Heaton?”

  “How many children have you anesthetized? Fifty? Two hundred?”

  “When did you last study pediatric resuscitation?”

  “What were your board scores, Dr. Heaton?”

  He keeps rocking back in his armchair and sucking his lips in between his teeth, as if he is tasting my vulnerability. The video camera’s steady red light reminds me that every hesitation in my voice, every stutter over my career statistics, is being seared onto a permanent record.

  After a few hours Feinnes suggests we all break for coffee, and there is a general scraping of chairs and loosening of ties. He is a short, puffy man with back-combed hair and blushed cheeks better suited to an English schoolboy. Feinnes leans forward over his Styrofoam cup and makes a chuckling remark to Donnelly, who throws his head back and laughs. I use the moment to go to the bathroom, where I sit silently in the stall, holding my forehead against tight fists.

  After the break another lawyer, some junior partner, repeats all the same questions. Every time I answer I look at his face to see if I have missed a date, a number, given some inconsistent answer that will damn me. The court reporter, a shrunken, osteoporotic woman, hunches over the muffled keys of her steno machine like a muted pianist.

  During the final three hours of the deposition the lawyers dissect every moment of the day Jolene died.

  “Which drug did you give first?”

  “Why did you choose that drug?”

  “How much did you give?”

  “Are you sure you gave that amount?”

  “Was that the correct dose?”

  “How many patients have you anesthetized in the prone position?”

  “How much sleep did you have the night before?”

  “Did you have anything to drink the night before?”

  “Do you tend to drink very much? How much is not much?”

  Donnelly objects to this and I shrink as if I’d been scolded. He tells me that I’m still required to answer the question, but at least his objection will be on record. I shift my clasped palms into my lap and see a damp outline of their shape on the tabletop.

  Near the end of the deposition Donnelly does his best to piece me back together. He reassures me that I’m doing fine, turns me by the shoulders to face his groomed graying hair, his creased, authoritative face. “Try to keep to the facts, tell the truth, stay calm. Just tell them exactly what steps you took in the operating room that day, to the best of your knowledge.”

  To the best of my knowledge I let a healthy eight-year-old girl entrusted to my care, my medical expertise, die. But until we have a pathologist’s report and a final settlement, who could tell me this was not my fault? Forgiveness can only come from myself.

  Donnelly reassures me that once we have the autopsy results Feinnes’s case for negligence will be even weaker. Still, he warns, the discovery phase of the mediation will probably take months. He walks down the hall with me after my deposition listing the records he’ll need to pull from my medical school and residency and years of work at First Lutheran, discussing the expert witnesses he plans to hire, explaining the tedious seesaw of haggling and bartering between legal teams that will finally affix a price tag to Jolene’s life.

  We wait for the elevators opposite another plush room, nearly identical to the one in which I’ve just been deposed. The door swings farther back and a young woman carries out a tray of dirty coffee cups and crushed sandwich boxes, leaving me a clear view of the gleaming conference table, the walls hung with paintings of flowers and fruit and English hunting parties. Bobbie is sitting at the table. If she looked up now we would be facing each other for the first time since Jolene’s surgery.

  Darryl Feinnes pushes a stack of papers in front of her marked with red stickers. I can hear snatches of their conversation—accounts and fees, funeral costs, pain and suffering, lost companionship—as he calculates the final tally of her tragedy. He twirls a pen in his fingers with a pinched mouth that suggests he finds her exasperatingly slow to comprehend. She watches him curiously, as if she’s hearing a foreign language dribble out of his mouth, the concrete details and dollars irrelevant. The bones of her face seem more angular than I remember, disproportionately prominent, her eyes and cheeks hollowed in purple shadows as if she’d forgotten to eat. The top buttons and holes of her blouse are misaligned. The fluorescent panel lights wash the flesh tones from her face and highlight gray strands seeded through her brown hair as her hand mechanically fills in the signature lines. I feel like I’m spying on her own private wound. We are coupled, she and I, through this lost child who has skewed the orbits of our lives.

  The elevator door buzzes and I turn to see Donnelly holding it open, patiently waiting for me to follow.

  It is almost dark by the time I get home. I should have left a lamp on—something, if not someone, to wait up for me. I call Lori but she doesn’t answer and I don’t have the heart to talk to a machine. I pick up the phone again intending to call my father, then put the receiver down before I dial.

  I pull a leftover wild rice salad out of the refrigerator, pour a glass of wine and
sit in my study watching the last light give up the day. Downtown city windows scatter just enough glow to cast everything in the room gray or black, familiar in shape instead of detail. My father stares at me from his picture frame, ghostly in the low light, nailed square in the center of a wall of books—a suitable setting for him. Maybe this is how the world looks to him right now as he loses his sight.

  After twenty-two years of sharing only the most neutral and essential information with him, of studiously living without his advice, I suddenly wish I could repeat to him the perfect summary of Jolene’s anesthetic, memorized after days and days of telling it to lawyers. Maybe we are far enough away from each other by now that he could listen and reassure me, convince me that I missed nothing, overlooked nothing, did nothing that might have precipitated her death. There was a time in my early life when he would have done that for me. But the woman I am today is too remote from the favored child I once was, and if forgiveness is what I need, he taught me well not to look to him.

  For the tenth time in a month I pull my pediatric anesthesia textbook off the shelf and read about anaphylaxis and cardiac resuscitation, convincing myself once more that nothing could have made a difference, hoping I find enough peace to sleep.

  9

  I’m sitting on a beach, and a breeze combs the fronds of three coconut palms rising into the cloudless canopy of sky; they ruffle like frayed emerald sheets. I hear the rattling crescendo before my hair lifts in the cool wash of air. The ocean stretches taut against the world’s curve, bright and blue, striped light and dark above hidden hills and valleys. The clean sweep of the horizon is notched by a dark scratch, a bobbing boat filled with three or four children. They are singing. Words ripple to me on gusts of air:

  The Owl and the Pussycat went to sea

  In a beautiful pea-green boat.

  I walk into the blue, and cold creeps up to my ankles, my knees, my thighs. My abdomen contracts and then relaxes as my skin shunts blood back to my core, warming my heart, my lungs, my gut, my womb. A wave lifts me, buoys me up to swim across the sea to the boat. The children’s voices beckon, their flushed faces shaded by sun hats; light and shadow cleave their bodies as the boat rocks and they stretch over the gunwales to splash the sea. I reach up to the polished wooden railing, the shadow of my hand splayed across it like a glimpse into the future, ready to grasp hold.

  I push my torso up and over the edge, poised, when a sucking tug in my pelvis, a vortex of gravity, pulls me, drags me below the water, beneath the boat. Salt washes into my nose and stings my open eyes. I hear the swallowed sound of the children’s singing over the humming pressure of the ocean, see the barnacled bottom of the boat above me, swaying on the water in the sunlight, marking the sharp break between air and ocean.

  The sea is so beautiful I don’t struggle at all, even as the water gets colder, heavier around my skull. Only at the last minute do I think of breathing, only just before the burning in my chest reminds me. Miles of ocean stretch over me and I am still swirling down, down until the evolutionary root of my brain, planted long before the higher fluff of my frontal lobes—site of all the judgments that make me unique among humans—forces my diaphragm down, gasps in whatever substance surrounds me, reflexively inhaling any possible source of oxygen.

  The breath wakes me up. In the disoriented space of near dreams I’m only aware of my heart pounding, rocking inside my skull, racing with the panic of impending catastrophe. My heart—the central organ of immediate survival that links all organs together through the oxygen-rich bath of circulating blood. It is as sensitive as a precision-tuned Ferrari—contracting and accelerating, throttling blood and oxygen and life ahead at the first physiological inkling of disaster.

  Jolene Jansen’s heart should have been racing when her body plunged out of the controlled and level plane of anesthesia into the strangling spiral of anaphylaxis. Her heart rate should have sped up before terminal oxygen deprivation checked it. Something was wrong with her heart. Something was wrong with Jolene’s heart even before I put her to sleep.

  I rest the tips of my fingers against my carotid artery and count my pulse as it slows down from one hundred to ninety to seventy to sixty. Outside I hear the last of the revelers leaving Pioneer Square as the street transforms from night to day, from bars to businesses. Circling red lights on my ceiling reflect the city’s sweep to bustle drunks off to emergency rooms or jails before the Starbucks and French patisseries open. In another two hours, pale-skinned baristas clothed all in black, silver rings ladder-stepping up the curves of their ears, will begin picking their way through the broken glass and oil-sheened puddles to turn on their espresso machines. It has been thirty-two days since Jolene’s autopsy, and the report is still not back. I creep down the hallway in my nightgown, padding on tiptoe as if there were anyone else here to awaken. My alarm is set for five. I have an hour to begin reading about congenital heart defects.

  Karen Leece, one of the gynecologists, pages me during my first case to say she has an extra ticket to the symphony at Benaroya Hall tonight. Her husband, Rick, travels a lot as a manager for Alaska Airlines, and she often adopts me as her spare date.

  “There’ll be eight of us—Glenn and his wife from my old practice, and some of Rick’s colleagues. We’re coming back to my house after for a drink. Please come, Marie—it’s Ravel. We’d all love to see you getting out again.” There is a brief moment of awkwardness as she realizes where she has trod.

  The thought of making small talk with strangers feels ludicrous. But she’s right, I’ve cloistered myself since Jolene’s death. So I accept.

  Benaroya Hall’s arcing glass wall fractures into glistening panels that rise three stories above the symphony patrons. Karen meets me at the front entrance with my ticket just before the auditorium lights go down so I won’t have to socialize until after the concert.

  “Do I look OK?” I ask her. I threw on a gauzy summer dress just before the taxi came, and couldn’t find the right shoes.

  Karen kisses my cheek and guides me past the usher with an arm around my waist. “Gorgeous. Are you eating anymore? Your belt is slipping off. How come I only gain when I’m stressed?”

  There is a swell of applause, and the pianist bows and sweeps the tails of his coat over the piano bench. Notes gather and swirl into imagined shapes; Ravel’s minor chords and runs stir a communion of unresolved pathos that cuts to my core. We are two thousand strangers revering music composed almost a century ago, discovering emotion evoked through vibrations of air. I close my eyes and let the piano crescendos wash over me, penetrate me, sweep me into a universe where these last weeks of my life could dissolve into inconsequential bits of fallen stars.

  After the concert we share cars to Karen and Rick’s house in Madison Park, a boxy glass and stucco structure plunked between two pastel Victorian-style mansions, its front porch overhung with evergreen clematis, the fading white blossoms fluttering like small ghosts against the dark leaves. Karen pops some fancy hors d’oeuvres out of the Sub-Zero refrigerator and pours champagne into gold-rimmed flutes. Glenn builds a fire of pressed-wax logs, unnaturally colored flames incinerate the paper on the fake wood, and we pull armchairs and kitchen stools around a pink marble coffee table. I’m hungrier than I’ve felt in days, and the champagne feels like it’s untangling something inside me.

  Louis, one of Rick’s trainees, and his wife, Jeanne, are over from France for a year. Their fourteen-year-old daughter is enrolled in the public high school.

  “She wants me to drive her everywhere,” Jeanne says. “At home she walked to school. If she wanted to see friends, she took the bus or the subway. Now she says she would be too embarrassed—her friends would laugh at her. Be glad you have boys, Karen. It is too difficult raising a teenaged girl.”

  “Well, don’t trade her away too quickly.” Karen shakes her head. “You should have been here to clean out the washing machine last summer when they forgot to take all the tadpoles they’d caught out of their pockets.”<
br />
  The conversation circles around the myriad trials of parenting until Glenn includes me with a remark about the financial freedom I’ll have without a college savings account to worry about. And then, as always in a gathering of physicians, we debate the U.S. health-care system. Glenn’s wife, Sharon, a public health physician, talks about funds redirected from a community clinic so her hospital can create a bioterrorism office. “They want me to prepare for smallpox while my older patients are dying of the flu.”

  “I’m always reading that America has the best health care in the world, yet you give new hips and knees to eighty-five-year-olds, and nothing to millions of children,” says Jeanne, crossing tanned legs so one high-heeled sandal dangles from a scarlet-nailed toe.

  Glenn deflects the medical criticism back onto the legal system, pointing out the outrageous malpractice premiums driving obstetricians out of the state.

  “I’ve heard about this. And Marie,” Jeanne says turning to me, “it sounds like hell what you are going through with the lawyers. Do they really videotape your testimony?”

  I rise and pick up plates and crystal from the table. “Hell would be a close approximation. Next year you must find me a job in France, Jeanne.” A hot flush floods my face and I tip my head so my hair falls forward in a veil.

  In the kitchen I run steaming water into the sink and pour in an iridescent blue soap. Laughter and competing voices rise and fall through the half-closed doors. I jump when a hand rubs my back. Karen has put on an apron covered with dancing black and white cows. She stands a head taller than me, with wide gray eyes pregnant women must find soothing. Her front teeth overlap. I suspect her parents couldn’t invest in nonessential dentistry, that Karen must have worked hard for scholarships and living wages so her children could grow up in a well-padded lifestyle, a lifestyle that would safely assure them long and happy lives. She grabs a dish towel and plucks wet stemware from the stainless rack beside the sink.