“Shoot, they can’t handle me. I need me a real man!”
She waved as they pulled away. She turned once and smiled at me through the rear window.
Every time my path crossed hers, we bantered like this, sparred with each other, the sexual innuendo not far below the surface. It had become our ritual, a ritual now several years old that was never acted on. Was she really coming on to me? What if I ever did make a move, what if I took her up on one of her invitations? Would I find that I had made a horrible faux pas? But meanwhile, this tension, this never knowing, was titillating in itself.
Was it this complicated between men? Would two men in the same situation, feeling the same attraction, have danced around each other like this? Or would they have made their meaning crystal clear, perhaps consummated the relationship promptly? Why was it that anonymous sex, not just casual sex, rarely happened between men and women, only between men? Was it because the woman was the gatekeeper? Because she was less inclined to anonymous or casual sex? But a man, whether gay or straight, given his druthers, was quite capable of anonymous sex, could find it thrilling. I had never known a bar or club in any country that I had lived in where I could go and be sure of a sexual encounter with a woman—not without a monetary transaction. Did the prolific sexual activity of a gay bathhouse in its heyday, the anonymous sex, the multiple partners, the group sex, simply represent what all men were capable of if they had willing partners? Was this what a man would do if the gatekeeper were removed?
A cab drove past me and the driver waved. I recognized him as a cabby who often drove me to the airport. It was the first of the month, and all that day and late into the night an armada of Diamond Cabs would shuttle past our quarters, carting the domiciliary veterans to downtown Johnson City. There, in the cluster of bars that propped up the pawn shops, the shoe shops, the used-furniture stores, the flophouses and the liquor stores, another generation of veterans spent their pension and disability checks. And, there in downtown, they sought female company. Most of the time they had to pay for it.
Ahead of me now, the Miracle Center was flood-lit and pushed up at the sky like a giant lingam. Its smooth, concrete, multistory, multipronged silhouette was so different in mood and feel from the VA. The fringe of city land around it had been blacktopped into parking lots. The building, adorned as it was with a weather vane, satellite dish, and helipad, seemed to stand as a rebuke to my timeless Mountain Home.
I WOULD NORMALLY have waited in the doctors’ lounge for the admission office to page me. But this evening I walked over to tell them Will Johnson was coming. I wanted to check on the status of rooms and ask that they hold one for him on 5500 wing. I wanted to minimize any paper obstacles to his admission.
As I walked in, I saw a well-dressed man, gaunt under his fedora, approach the admission counter. He was in his early fifties, wearing a light overcoat, which he was now taking off with his wife’s help. Beneath it he wore a jacket and tie. The tie was much like what my father would wear: dark and unmemorable; men of that generation do not use ties to make statements. When he took off his hat, I saw he had a buzz cut, his sideburns shaved almost above his ears, the flesh at his temples looking red and angry. He was slightly stooped over, fatigue more than age. He took one last step to reach the counter.
The woman with him was the same age and was wearing a tweed suit with leather pumps. Her hair was gray, curly, and down to her shoulders; a pale, almost invisible lipstick was the only makeup she wore. She draped his jacket over her arm. She stood close behind him, both feet together, her shoulders back, her head held firm, an unaffected elegance in her manner. Only her chalky white knuckles, wrapped around the handle of a Gladstone, as if its contents were too precious to put it down, betrayed her anxiety. She now stepped closer to her husband, as if they were physically connected and the cord between them had been stretched.
He was not as yet aware of me, though she had glanced at me and smiled. I was not wearing my white coat.
He braced one hand against the counter, the other reaching for his wallet. He took a deep breath as if steeling himself for the laborious process of registering and proving he had insurance.
How difficult it must have been to pack that bag. Did they pack for a day or for a few weeks? As they pulled out of their driveway and made the long lonely drive to Johnson City, what falsehood did they invent for their grown son and daughter, for their grandchildren? How much dread must have filled their hearts when they entered the grand lobby of the Miracle Center, a hospital so different from their familiar little community hospital where, but for the disease they had, they could have been received like royalty?
I heard him tell the admission clerk that I was his doctor; I heard him pronounce my name carefully. The way they stood there, husband in front of wife, dwarfed by the high ceiling and the imposing foyer, they looked quite forlorn and forsaken, having only each other. It was a heart-wrenching sight. I stepped forward quickly.
Will Johnson turned to me. He seemed to instantly know I was the doctor he had come to see. He grasped my hand in both his. I was looking for signs of surprise or disappointment: Was he expecting a foreign doctor, was he prepared for my relative youth? Since Dr. Sarah Presnell had never set eyes on me, she couldn’t have told him very much about me, except that she trusted me with his secret. Will Johnson had blue eyes, spaced closely together, and now he fixed them on me and said he was delighted to see me. These words were not merely a figure of speech: his face broke into a warm smile. Crinkles formed all around his eyes and the strain and worry I had seen in his expression dissipated. A gap between his two upper incisors gave him a Huckleberry Finn impishness.
While still holding my hand, he turned, drawing me to him, and said proudly, as if he had just discovered me, “Bess, this is Dr. Verghese!” She shook my hand, the natural smile on her lips now deepening. I decided that in her youth she had been a very beautiful woman.
Less than thirty seconds had elapsed since I set eyes on them. And whatever preconceived notions I might have had about this patrician couple, whatever grudge I was nursing about the interruption to my evening and the caveats and admonitions that Sarah had given me, disappeared. I was drawn to the Johnsons in their plight, touched by the sight of them in the bright lights of the Miracle Center admission office, determined already to do everything in my power to ease their distress.
I asked the admission clerk to assign them a room on 5500. I told her she could come up later and fill out the forms she needed.
I took the bag from Mrs. Johnson’s hand and she surrendered it to me willingly. I led them to the staff elevator. Will Johnson held the back of my arm, walking slowly, leaning on me from time to time, while Mrs. Johnson walked on his other side. As we made our way down the corridor, I felt as if these were my parents or a favorite uncle and aunt who were sick and needed my help.
“How was your ride down?”
He contemplated the question seriously. I was merely making small talk, trying to break the ice. But he addressed the question as if it was the most important thing he had ever been asked. “It’s a ride that Bess and I have always enjoyed, coming down to Johnson City. But it was difficult tonight, given the reason for the journey.”
We made our way to 5500. I saw Mary, one of the nurses who had taken such good care of Gordon, come down the hall to meet us; I was sure the Johnsons would be well taken care of tonight. I introduced Mary and then left them in the room to get settled and to allow the admission clerk, who had dogged our tracks and now hovered in the doorway, to get her paperwork done.
Half an hour later, when I returned to do my history and physical, Will Johnson had changed into his own pajamas and a comfortable red robe. He was in bed with the head of his bed up. Mrs. Johnson was sitting patiently in the recliner, which she had pulled close to the bed. The TV was not on. It struck me that unlike Clyde, and very much like my parents, the thought of turning the TV on did not occur to the Johnsons. Every other hospital room I walked into, one of th
e first things I had to do was turn the TV off so as to pursue a conversation. In all the time I spent with the Johnsons, I never saw the TV on. Now, as I walked in, both of them broke into smiles, as if seeing a long-lost son.
Will Johnson patted a spot on the mattress indicating I should sit by him. He held my hand and inquired about me. Where was I from? Yes, of course, they were familiar with doctors from India. But how, if I was from India, did I have a name like Abraham? When I told them I was a Christian, told them the story of St. Thomas and his landing on the coast of India in Kerala, the Johnsons turned to each other and exchanged looks as if to say: Look how God works!
“Abraham,”. Will said, “I want to tell you everything that has happened to us, the living hell we have been through.”
IN MARCH OF 1984, Will Johnson lost his good friend Chuck Hoover to a heart attack. The funeral for Chuck was in Bluepark, Virginia. It was a dank winter morning. When Will Johnson stepped out of the church with the other mourners, the cold seemed to penetrate through the layers of his clothing. The retinue of cars, their headlights on high beam, snaked down to the cemetery. Will Johnson had controlled his emotions in the church. But now, riding alone in his pickup truck, he wept over the loss of his best friend.
Chuck Hoover had been a mining engineer just like Will. One of the first jobs Chuck ever did was an underground mining survey for Will Johnson. That had been the beginning of a long professional and personal association. Chuck’s firm had grown to be one of the largest engineering firms in Kentucky, while Will had seen his own firm grow from a single-owner-operated mine to a management company: Johnson Mining Consultants. They served five major mines in the surrounding area as well as a host of smaller mines. He and Chuck sat on many state and federal boards.
“Abraham, have you ever visited one of these mining towns in the Cumberlands?” Will Johnson leaned forward in bed to pose this question to me. It was surprising to me that as gaunt and tired as he looked, his speech was animated and his eyes glowed like a visionary.
“I’ve been close by,” I said, picturing Essie’s house outside of Blackwood, Virginia.
“You’ve seen the dingy row houses crowding the mountain roads? You know how they’re always subject to flooding? You know how miserable it can get? Well, a year before Chuck’s death, he and I had talked about building a planned coal community—a first in the country!” Here he smiled and paused, to let it sink in.
“This is what Chuck and I had in mind: Instead of the big coal trucks thundering through town, dropping coal debris as they go up and down the mountain, why not let the miners enjoy the same peace and quiet that the more affluent in a community seek? Why not let them have the spectacular views, beautiful parks, the opportunity to live in a community whose construction enunciates dignity? Abraham, who knows to what heights people can rise if given the best living circumstances instead of a hellhole built on a slag heap? I believe that geography is destiny, and Chuck and I had in mind a new kind of geography, a different destiny for the people of our county.”
Here Will Johnson was, having traveled over two hours to see me, and instead of talking about his symptoms, we were talking about a project that in the telling made him young again, a project that seemed to take away his stoop, take away the worry lines from his face. I listened carefully, determined to let him have his say.
Chuck Hoover and Will Johnson had staked their own money and borrowed heavily. The community would be called “Wilkishire,” a striking contrast, I thought, from appellations like Stonega or Osaka or Roda—the camps near Essie’s house—or even cruder ones like “Hunk Town” or “Nigger Town.”
Will Johnson now described the layout for me in detail, making little trails on the bedsheet with his index finger and pushing the sheet into a small mound in places to simulate the mountain. He went on for five minutes and then stopped abruptly:
“But when Chuck died, I knew ‘Wilkishire’ was doomed. It would never come about. The financing had been tenuous and tricky and had depended on Chuck’s being around. Work had already started when Chuck died.”
At Chuck’s funeral, after the graveside service, after the last prayer and as the crowd slowly dispersed, Will Johnson climbed up the slope to where he had parked his Chevy pickup truck.
As he stepped into the truck, he began to experience massive chest pains.
A few minutes after burying his friend, a second after starting the truck and shifting out of park, William Johnson’s heart stopped.
When his brain failed to receive oxygen, it protested: an explosive seizure focus formed in his cortex. It raced through his brain, sending his limbs and trunk flailing violently and repetitively. His now practically dead body was snapped back and forth in the confines of the driver’s seat. The force of these convulsions snapped two vertebrae in his back, a fact that would be discovered only many months later. There were even bruises on his feet.
During one of these convulsions, Will Johnson’s chest smashed the steering wheel with enough force to jump-start his heart. (Will smiled mischievously as he told me this and leaned forward to say: “That was God waking me up only to put me down.”)
The other funeral attendees rushed to the truck. Chuck Hoover’s wife, a nurse, pushed through to Will Johnson and saw that he was in extremis, that he needed to be in a hospital as soon as possible.
The hearse, now empty, seemed the logical means by which to take Will Johnson to the hospital in Bluepark. But the driver of the hearse balked—he was in the business of transporting the dead, not the near dead. When he mumbled something about liability, Will’s friend Matthew Elliot, who had played offensive lineman at the University of Kentucky, grabbed him by the collar and convinced him that he was liable to lose his life if he didn’t get moving. And so Will Johnson arrived at the Bluepark emergency room in a speeding hearse, Matthew Elliot riding shotgun next to the driver.
In the ER it quickly became apparent that Will Johnson’s seizure was secondary to a heart attack. (Will now showed me a copy of the ECG—he pulled it out from a thick folder. He did not hand me the whole folder; I was going to hear the story—medical and otherwise—chronologically and at his own pace.) When I saw the ECG, I was amazed that Will Johnson had survived. The ECG showed the telltale signs of acute ischemic damage to the heart: instead of the up-and-down deflection representing the normal electrical activity of the ventricle, this segment was now bowed—“coving”—in a classic pattern of injury. The heart attack involved the entire anterior wall of the heart, crippling the left ventricle, the heart’s main pumping chamber. It was the worst kind of heart attack.
Hour to hour, Will Johnson’s condition deteriorated. His blood pressure was low and it was easy for me to imagine why: so little muscle of the left ventricle survived that the heart was functioning inefficiently as a pump. Blood was backing up behind the failing pump and accumulating in Will Johnson’s lungs, causing him to be short of breath. The increased work of breathing, in turn, put more demands on his heart.
“Did you have any warning of heart disease in the years prior to that?” I asked.
“I used to smoke.” He gave me a sheepish grin. “And six months before my heart attack, a routine stress test by my doctor in Pikeville suggested I had ischemia. I never touched a cigarette since. I was referred to the cardiology division at Duke University Medical Center; they did a thallium stress test. They told me that my heart was perfectly normal, that I could go run a marathon. They said the rudimentary stress test done in my community hospital must have been erroneous.”
Will had clearly had a false-negative thallium stress test. Short of a catheterization with injection of dye into the coronary arteries, no test was infallible in determining the presence of coronary artery disease.
The doctors at Bluepark decided that since Will already had a chart in existence at Duke, this was the place to try to transport him.
“As luck—if you can call it that—would have it, Duke had just begun an emergency helicopter service to tran
sport patients in my situation. The helicopter was summoned to Bluepark.”
Mrs. Johnson spoke up now: “You can’t imagine how bitterly cold it was the night they flew Will out. There were snow flurries in the mountains and the wind in the hollows was shrieking something awful.”
A catheterization of his heart at Duke University, shortly after Will arrived, showed narrowing of short segments of the coronary arteries. Will was lucky: It would be feasible to surgically reroute blood around the obstructions using pieces of a leg vein. Perhaps this would allow the heart muscle to receive more blood and once again function efficiently as a pump.
In the early morning, a big black man came into the room to shave Will Johnson’s body from neck to foot. Will Johnson chuckled as he related this: “In the months to come, this shaving of my body was huge in my memory, perhaps because I remember nothing of the operation. It recurs to me in nightmares. In one dream, the doctors told me that the surgery would be fine but the body shave was going to be touch-and-go!” He laughed with delight, as if this image was hugely funny, and he turned to look at his wife. She reached for his hand.
“The surgery began at about four in the afternoon. When they were done they kept me in recovery because I was still bleeding. They poured blood into me. At one point they told Bess that they might have to go in again and open me up, stop the bleeding. I got a lot of blood, a lot of blood, didn’t I, Bess?”
Mrs. Johnson nodded and said, “My daughter Lee Ann and I would go in and stand around the bed whenever they would let us in. We were staring at him lying there with all these tubes and things in him and blood pouring into him. This intern—this black intern whom I can never forget—was so kind and attentive to us all night. At the end of the night, he held my hand and said, ‘It’s all right now. Looks like he’s okay and they won’t need to open him up again. The bleeding is finally quitting.’ ”
Mrs. Johnson paused, and stared at the bedsheet, as if trying to remember exactly what transpired next. “Then the intern says to me: ‘He’s gotten a lot of blood, lots and lots of blood. If he doesn’t recover fully, or afterward if strange things happen, please remember what I just told you. He’s gotten a lot of blood. Tell that to any doctor that he goes to see.’ ”
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