by G. H. Ephron
Dr. Rofstein opened the door again. He shook my hand, looked me in the eye, and said the same thing he always said when we parted.
“Remember, no good deed goes unpunished—”
I finished saying it with him. “—but do good anyway.”
Late that afternoon as I was leaving to head home, I noticed Gloria and Emily sitting on the side porch of the unit. They were in chairs facing each other, heads together. Emily took a drag on a cigarette and offered it to Gloria.
Please don’t, I thought—Gloria had had a miserable time kicking the habit a few years back. For a long time she carried around an unlit cigarette that she used as a sort of pacifier whenever she felt the urge.
Gloria declined the cigarette. I wondered if Emily was complaining about me. I hadn’t come right out and said I didn’t want her working with patients until she sorted her head out, but I was sure she realized I was getting close.
Just then a black Range Rover pulled into the circular drive. It stopped. I recognized the large, dark-haired man who stepped out. It was Kyle, Emily’s ex. She waved at him and stubbed out the cigarette. So the white knight was back in Emily’s life.
Emily and Gloria stood. Gloria had her hand on Emily’s shoulder and they talked, their faces close to one another. They hugged and held the embrace, which surprised me because Gloria wasn’t a huggy kind of person. Then Emily pulled away, picked up her briefcase, and ran to the waiting Range Rover.
The next evening I made my way up the wide steps and across the broad courtyard plaza of the Charles Hotel where lights twinkled in the trees. Shands had called and suggested that I meet him for a drink. He was heading over to the bar after work anyway, and he’d had a chance to look at my scan results.
By the time I got to the dim, leathery, cigar-scented bar, I was more in need of a Maalox than one of their exquisite, pricey martinis. I’d spent most of the night before trawling the Web for information on how to interpret functional MRIs. The basic idea was simple—an fMRI showed you how blood flow was changing the brain. Beyond that, nothing was simple. I’d finally given up, frustrated.
At least there had been encouraging news about Uncle Jack. His fever was down and his lungs were starting to clear. They were talking about moving him out of the ICU and back into a regular hospital room. He might even be back at the Pearce in a few days.
I spotted Shands at a table in the corner. Handsome in his dark suit, his silver hair lustrous, he sat there brooding over his drink. As I approached, I wondered about him wanting to talk to me here instead of at the lab. Maybe he preferred this setting—first anesthetize the patient, fill his head with smoke, then whammo, deliver really bad news.
He rose and shook my hand. “Peter. Thanks for meeting me here.”
He gestured the waiter over. I ordered a club soda. He ordered another martini.
“I hope you don’t mind coming here. Things at the lab are a little…tense,” he said.
“I suppose that’s not surprising.”
“You know that detective who’s in charge?”
“MacRae?”
“He’s a pain in the ass.”
I laughed. “Yeah well, that’s his job.”
“You think they’re looking at this as murder?”
So was this why he’d wanted to meet me here—to get the inside scoop on the investigation? How the hell did I know, I wanted to yell at him. Of course he’d be clueless that I was tied up in knots about what he’d seen in my brain scan.
“If MacRae’s still there, you can be sure they’re considering it. If it was an accident, then why hasn’t that person who carried the oxygen tank into the scan room come forward?”
“Fear. Immaturity,” Shands suggested, his chin out. I was sure he wasn’t the only one who wanted to find a convenient scapegoat. “They keep coming back and asking questions. It’s taking a toll on everyone. Especially Emily.”
Our drinks came. Shands stirred his martini.
“Not that she was that stable to begin with,” he went on. “I never would have hired her if I’d known she posed for Playboy. Know what I mean?” He took out the olives, slid one from the toothpick into his mouth. “Now the board is breathing down my neck. Very bad timing. Just when we’re on the brink of a major breakthrough.” He squinted at me through the dark. “Well, none of this is your problem. Of course, you want to know about your test results.”
Finally. Queasiness knotted in my stomach.
“You mentioned that your father had Alzheimer’s. Anyone else in the family?” he asked. This wasn’t an auspicious beginning.
“My uncle.”
“Father’s brother?”
I nodded.
He cleared his throat. “One of the difficulties is that there’s so much variance across the sample. There are only shades of difference between the lower end of the normal range and the slightly abnormal, indicating that there’s a problem.”
Slightly abnormal? Maybe I could get myself a baseball cap with SA sewn onto it. “But you think there’s a problem.”
“I need to confirm it with a rigorous statistical analysis. Leonard used to do all of that.” For a moment he sounded like a petulant child who’d been asked to clean his room.
“But you think my scan shows some abnormality?” I wanted him to stop waffling.
“Your father. Was it a steady decline, or was it marked by a fluctuating state of consciousness?”
“My dad…” I began. I remembered the ride from Brooklyn to Cambridge after my father had been diagnosed with Alzheimer’s and he and my mother had agreed to come live in the other side of my two-family. Dad seemed to know where we were going, that we were on the Pike. We were having what felt like a normal conversation and then, somewhere around 495, the window shade came down. He became agitated, terrified that we were going to run out of gas. He kept trying to grab the steering wheel. I stopped to fill up but that did nothing to quiet his fears. Finally, my mother had to take over the driving and I got in the back seat with Dad to keep him from causing an accident. Only now did it occur to me to wonder about his agitation. Had he been hallucinating?
When we got to the house, Dad sat in an aluminum chair on the lawn, watching the movers. With perfect clarity he’d asked my mother, “Did you remember to bring my pipe? I left it in the bathroom.” Each week after that, the periods of lucidity had grown more sporadic.
Shands was waiting for my answer. “Both, really,” I said. “A steady decline with occasional periods of lucidity.” All that had been consistent with a diagnosis of Alzheimer’s.
“Movement disorder?” Shands asked.
“Tremors,” I said. “Periods of jerky movement.”
“I’m not surprised. I think your scan shows the markers for Lewy body dementia. When I’ve finished crunching the numbers, you can come down to the lab and we’ll go over the results in more detail. You’ll find it fascinating.”
Fascinating? What planet did this guy inhabit? I sat there, gaping at him, trying to absorb the verdict.
Belatedly he added, “I’m sorry, Peter.” He even seemed to mean it.
Hey, everybody dies, I told myself; so now you know how you’re going to do it. Could be another twenty years, could be forty. Could be you get hit by a bus. I was sure of one thing: This was one piece of information I really didn’t need to know.
Shands had one leg crossed over the other, his foot jiggling. He knocked back the last of his drink.
“So you’ll come to the lab and we can discuss treatment?”
My mouth dropped open, but I couldn’t even respond. Shands didn’t notice. He reached into his pocket and pulled out his beeper. He must have had it set on vibrate because I hadn’t heard it go off.
“I’m afraid I have to run.” He stood and pumped my arm. Then he was gone.
I felt as if I’d been hit by a tidal wave and bounced off the bottom of the sea. Only a minor part of it was the check that the waiter delivered as soon as Shands left, as if on cue. Twelve bucks apiec
e for martinis?
What a swell guy. ’Bye, Peter. By the way, you probably have Lewy body dementia. Anyway, see ya later, buddy, and don’t skimp on the tip.
17
I DIDN’T remember deciding to drive over to Annie’s, but twenty minutes later I found myself on her doorstep. Lights were on in the bay window on the top floor of the triple-decker. I was about to ring the bell when the lights went off. I waited. There was the sound of footsteps on the stairs. Annie opened the door. She had on her jacket, her backpack slung over her shoulder. Her face was streaked with tears and she was holding a fistful of Kleenex. For a moment, she seemed startled to see me. Then her face crumpled.
“You heard?” she said with a sob.
“Heard what?”
“Uncle Jack died.”
“He what?” I was stunned. “But I thought he was doing so much better.”
“That’s what I thought.” She wiped her nose and sniffed. “One minute they’re telling me they’re moving him back into a regular room, the next I get the call that he’s gone.” Annie swallowed. “Gone.” She repeated the word in a whisper.
I took Annie in my arms and held her. “I’m so sorry,” I said. I closed my eyes, feeling distraught, exhausted. If I’d only left Uncle Jack at home with his piles of old newspapers, decaying cat food, and moldy sink with its everyday garden-variety germs, he’d probably still be fine—or at least Uncle Jack’s version of “fine.”
“I’m going over there. I need to say good-bye.”
“Can I come?” “You’ll come?” we said simultaneously.
I kissed her head, overwhelmed with relief that she wanted me to be with her in this.
“He once told me he saw Ted Williams play at Fenway, the year he batted .406,” Annie said, leaning her head against the car window as I drove. “I was going to get us tickets for September.”
We passed through Union Square and took a right, heading toward the BU Bridge.
“I just saw him this morning and he was looking so much better,” she said.
“Sometimes that’s the way it is. People rally just before the end.”
“But his fever was down. White count almost back to normal. I just bought him two new pairs of pajamas.” Annie gripped a tissue in her fist as we came through the rotary into Boston. “I can’t believe it. It’s surreal.”
I pulled into the hospital garage and parked. It seemed like a very long walk through the connecting tunnel to the lobby. We took the elevator up. At the ICU they directed us to the room where Uncle Jack had been laid out.
The door was ajar and a curtain was pulled across the opening. In the hall just outside, a man in a white uniform was arguing with the nurse. “But we have the order right here. Supposed to pick up a Mr. O’Neill? I just need a signature.”
“You have to get a signature from his next of kin,” the nurse said.
“What’s this all about?” Annie asked. “I’m next of kin.”
The man showed her a piece of paper. “We just need you to sign this.”
“‘Postmortem Confirmation of Consent,’” I read over Annie’s shoulder. “Consent for what?”
The man in the white suit looked uncomfortable. “Autopsy and…Mr. O’Neill agreed to donate his brain.”
“He what?” Annie said.
“Let me see that,” I said.
Sure enough, there were orders from University Medical Imaging to pick up Uncle Jack’s body and transport him there. I remembered the room past Dr. Shands’s office, the one with the stainless steel tables and shelves of fixatives. That was probably where the autopsy and brain harvesting took place.
“I just need you to sign—” the man started.
I began to say something but Annie was right there, perfectly capable of putting this guy in his place. She glared at him.
“You’ll have to forgive me, sir, but my uncle just died. I haven’t even had a chance to see him, to say good-bye.” By the end, her voice was breaking up with emotion.
The man took a faltering step back. “Sorry, ma’am. It’s just that they like us to transport the deceased as soon as possible after death.”
“I’ll let you know when that is.”
“Want me to go in with you?” I asked Annie.
“Thanks,” she said, facing the curtained opening, “but I’d rather go in myself. I want to be alone with him.”
Annie put her fingers to her lips, squared her shoulders, and stepped inside. A moment later she burst out again through the curtains.
“Is this some kind of a joke?”
“Is there a problem?” the nurse asked.
“I don’t know who that poor man is, but he’s not my Uncle Jack.”
“Bureaucratic bullshit,” Annie said, giving a snort of disgust as we headed down a floor and to the opposite wing to find Uncle Jack. The body behind the curtain had been another elderly man who’d died in the ICU at the same time Uncle Jack was transferred to a regular room. Paperwork mixup.
“He’s not dead. He just moved to the fourth floor.” Annie was laughing and crying at the same time. Her voice had an edge of hysteria to it. “You ever read The Stupids Die?” she asked.
“I don’t know how I missed that one.”
“It’s a hilarious children’s book. It’s about this family that think they’ve died and gone to heaven. Turns out they’re in Cleveland.” Annie was moving so quickly I had to run to keep up with her. “I got it for my niece a few Christmases ago. Don’t know what made me think of it.”
We’d reached the door of Uncle Jack’s room. “Welcome to Cleveland,” Annie said as she entered. Annie was ebullient, her mood like a big bunch of red balloons filling the little room.
Uncle Jack had been sitting up in bed watching television. His color was good, and he seemed to recognize Annie. I watched the two of them together, my uneasiness over Shands’s diagnosis seeping back into my consciousness.
When Annie and I got back to her house an hour later, she was still elated. She sat in the car, her head tipped back against the headrest. Her curly hair was soft around her face, the edges tipped with light from the glow of an overhead street light. She reached for my hand, looking more relaxed than I’d seen her in weeks.
“Amazing, isn’t it, how much better things look when you realize how much worse they could be.” That was my mother’s credo: Expect the worst and you’ll never be disappointed.
Now Annie shifted over onto one hip and gazed at me. She ran a finger up my arm, sending a shiver down my back.
“You have to go home?”
Reluctantly I told her that I couldn’t stay, making up an excuse about unfinished work. It wasn’t so much unfinished work as unfinished business—I knew I’d be preoccupied with what Shands had said about my brain scan, and this wasn’t the time to tell Annie about it. She had enough of her own shit to deal with.
I walked her to the door and we kissed under the porch light.
I slept lousy that night, wishing I were in bed with Annie, spooned together, breathing her scent. Instead I was alone with worst-case scenarios galloping through my brain. In one, I was a patient on my own unit sharing a room with Uncle Jack. Annie was feeding me chicken soup through a straw and wiping the dribbles off my chin. When I finally dropped off to sleep, it was only to wake up from a nightmare in which Emily Ryan, wearing nothing but an open lab coat, was giving me a shot from a hypodermic syringe filled with some murky green concoction. As I watched the poisonous stuff drain into me, I heard Dr. Rofstein intoning, “Listen to your gut.”
I was awake when the phone rang at 6:30. “I can’t believe I didn’t read it more carefully,” Annie said. She’d been going over the consent form that she’d signed for Uncle Jack. “Says right here, consent for post mortem and retention of human material for diagnosis and research. Would’ve been nice if they’d put it in English.”
I pushed myself up in bed and shoved back the covers. I remembered the words that Emily had crossed out on Mr. Black’s consent. Most lik
ely it was that section. Mr. Black didn’t have Lewy body dementia, so Shands wouldn’t have been interested in his brain.
“Annie, the only widely accepted way to diagnose Lewy body dementia is by autopsy. Their research would be worthless unless they confirm the diagnoses.”
“But don’t you think he should have said something when I signed the form? I don’t think a brain donation clause should be slipped into the fine print. Isn’t that unethical? Maybe criminal, even?”
I thought Annie was overreacting but I didn’t say anything. The same clause had probably been in the consent form I signed. I hadn’t bothered to read the final paragraphs. When the white-coated medics arrived to collect my brain, I knew my mother would take it in stride—she’d shrug and mutter “typical.”
“Peter, did you hear what I said?” Gloria asked at morning meeting two days later.
“Of course he did,” Kwan said. “That’s why he has that deer-in-the-headlights look in his eyes.”
“I most certainly did,” I protested. “You said Mr. O’Neill is coming back this afternoon. I was about to ask you where we’re going to put him.”
“I just told you,” Gloria said, giving an exasperated look, “we’re putting him in his old room. It’s empty.”
I had zoned out. We’d been discussing a new patient that Emily had been evaluating. The woman had come to us because she kept getting lost in her own neighborhood. Her husband would find her wandering in some backyard, two blocks away. Was that me ten years from now? Twenty? When would my memory start to go? Was it going yet? I tested myself. Who’d been my kindergarten teacher? Mrs. Dreiwitz. First grade was Mrs. Lowe. Second, Miss Goldsmith. Third? I couldn’t remember, though I could picture the corner classroom on the second floor. When would I start to talk to my dead relatives?
“Wouldn’t hurt to put his things back there,” I said. “Make it feel more familiar.”
I’d visited Uncle Jack again yesterday. He was doing well. Still weak, but eating and moving around on his own. He seemed to understand that he was getting out of the hospital, though he couldn’t seem to grasp the fact that he was not going home.