by Alix Ohlin
He reinserted the oxygen in his nostrils and walked downstairs slowly and purposefully, carrying the oxygen line raised behind him like a king with his robe. Adding to this effect, his wispy hair stood up and waved, crownlike, above his balding head. By the time Marguerite showed up he was installed in the living room in his favorite armchair, his thick, veiny ankles visible between the cuffs of his brown pants and his brown socks.
“Hi, handsome,” Marguerite said.
She was wearing a flowing green pantsuit with gold buttons and smelled like roses. She and Walter had been dating for years. They'd met in the home, and Walter's moving back into his house, when Carl came to live with him, had given him the reputation among the residents there as a heartbreaker. But Marguerite came to see him faithfully—taking a taxi—every Tuesday and Thursday, and they drank weak coffee that Carl made, and played gin. Marguerite looked better than Walter did, in spite of being older, but she was delicate and getting a bit, as Walter put it, soft in the head. Sometimes she'd smile at Carl and say, “Oh, dear, my mind is going. If you see it anywhere, could you tell it to come back?” Other times she'd forget words and Carl, walking past the living room, would see her sitting on the couch with her hands up in the air like an agitated bird, saying, “I'm so stupid— what's the word I want?” Walter could never guess.
Carl put out the coffee, went downstairs to his office, turned on the computer, put on the headset, and listened.
GENERAL APPEARANCE: patient exhibits pedal edema. Earlier this evening patient was found by a relative who brought him in for examination.
He had started working from home a year ago, when he moved back in with Walter, in this house where he'd grown up. Walter didn't say anything to him about the first heart attack, just checked in to the convalescent home and then called to announce the change of address. Carl understood that this was Walter's dignity in action: the refusal, at all costs, to be a burden. But when he went and saw the place he felt sick. The fecal smell, the dim light, the wan, shrunken people like some alien and unfortunate race, all this had frightened Carl and pissed him off. He resolved to do whatever was required—including quitting his job, moving back home, and taking care of Walter himself—to get Walter free of it. While he was sitting in Walter's room, a man passed by the open door in a wheelchair, then back in the other direction, then again, and again. When he noticed Carl watching him, the man bared his gums and laughed.
“Walter,” Carl said, “we're getting out of here.”
“Don't trouble yourself, son,” Walter said, but he was clearly pleased.
Before setting up his own business, Carl was employed by a transcription service at a hospital, and he didn't realize how much he hated going to work every day until he no longer had to do it. Everything about it—the commute, the workplace banter, the fluorescent lighting and bad coffee—had filed him down into points. Carl had no ear for gossip, didn't tell jokes, was uneasy with the siege-like camaraderie of the office. He was not a people person. And now, away from those things, he was a great deal happier. He worked only with voices he turned into reports.
Transcription was a habit that could be mastered and even internalized. When he was watching television with his uncle or shopping for groceries, he would hear people's voices and almost unconsciously transcribe them, his foot tapping as if he were working the foot pedals. In medieval monasteries there was a room called a scriptorium where certain monks labored all day long transcribing the world into text, and it seemed to him there was an equivalent purity to the work he did in this bare basement room. Correct spelling and grammar, the unadorned finality of the perfect text, these had an astringency that pleased him.
VITAL SIGNS: steady and strong;
TEMPERATURE: 99.6 degrees
RESPIRATORY RATE: 20
Carl worked for exactly one hour. It took him forever to get through reports by Dr. Sabatini, who was his least favorite of all the doctors. Here was the height of rudeness: he ate while dictating. Chomps and smacks between words, slurps and molars grinding. It was disgusting and necessitated guesswork on the part of the transcriptionist, which Carl hated; but it was either that or ask him to clarify every other word. Sabatini sounded like a jerk, too, his syllables impatient and clipped. For some reason that Carl couldn't specify, he also sounded bald. This suspicion hadn't been confirmed, though, since they'd never met. Carl avoided the hospital as much as possible, which was very nearly completely. The world of technology made this miracle happen.
Most days he stayed downstairs until five, at which time he and Walter ate dinner while watching Jeopardy. Between the two of them they always did better than the contestants. If they could go on as one person, Walter sometimes said, pretending they were Siamese twins or with one of them hidden behind the other, well, they'd clean up. Walter was a game-show fanatic. The first summer Carl had come to live with Walter, when he was eleven, there was a guy on Tic Tac Dough who had a summer-long winning streak, and at the time, through childish superstition, he felt that as long as that guy could keep winning, as long as Walter cheered him on, then everything would be OK. He and Walter watched every day, and the tension was almost unbearable. This was years ago, of course, after Carl's mother died of what Walter liked to call “the rock-and-roll lifestyle.” In the stairwell there was a picture of her, Jane, from high school, smiling broadly, even crazily, as if she were drugged—a glimpse of the future, maybe. And there was a picture of Marie, as well, even though she and Walter had only been married five years before she left him for an army man and went to live on a base in Germany. She was still there, and every year she sent Walter a Christmas card. On the inside she crossed out the German words and wrote “Merry Christmas!” instead.
SKIN: unremarkable
HEAD: Atraumatic
CHEST: There are coarse mid-inspiratory crackles heard at the right lung.
FACTOR CONTRIBUTORY TO CONGESTIVE HEART FAILURE: smoking 30 years
At the end of the hour he went back upstairs. The television was on, sound turned up loud, and both Marguerite and Walter were dozing, their cards still spread on the table. Marguerite had gin. Carl stood behind the couch and coughed softly. Marguerite made a kind of low moan and her face sagged terribly in the second before she pulled herself into her usual cheery expression.
She glanced at Walter and then at Carl. “I guess I'd better be off,” she said.
“I'll call your cab.”
“Thank you, dear. You're a …” She looked down and turned the loose gold rings on her fingers, then said, as if to the jewelry, “What's the word I want?”
“Blessing?” Carl said, since this was what she usually called him.
Marguerite beamed. “Just so,” she said.
After he'd called, he took her elbow and they began the slow, careful walk out of the house and down the driveway. She leaned against him and clutched herself closely around the waist. They stood at the end of the driveway, waiting. Marguerite swayed a bit in the wind. “You know, dear,” she said, “he doesn't look too good.”
“Walter?”
“Dear,” she said, “of course Walter.”
“Well, he's sick,” Carl said.
“Has he been making his weekly visits?”
Carl began to tap his foot. “You know I take him, Marguerite.”
“I know you do, dear.” She looked at him, then took a tissue from her white handbag and dabbed a bit at her nose. “It's just … well.” She sighed. “At the home we get excellent round-the-clock care.”
“Walter hates the home,” Carl said flatly. Marguerite took a deep breath, drew herself up to her full height, which wasn't very high, and said, “It isn't anybody's first choice, dear.” The taxi appeared around the corner and crept toward them.
“He's fine,” Carl said.
When the taxi pulled up, he lowered Marguerite's fragile bones onto the ripped upholstery of the backseat. As the car pulled away he felt a flash of guilt and called, ridiculously, “Thanks for coming!” He could s
ee the white blur of her tissue in the window as she waved good-bye.
Patient has been prescribed
Walter was awake and watching Matlock, drinking a cup of coffee that by now must have been quite cold.
“Faking, Uncle Walter?”
“If I pretend to fall asleep, she falls asleep too,” Walter said, and slurped.
“That's not very polite,” Carl said.
“Well, Jesus. You know I think the world of Marguerite. But if I have to hear one more word about her grandchildren in Boca Raton, I'll fall asleep and never wake up.”
“She thinks you should go back into the convalescent home.”
“Convalescent home, my ass,” Walter said. His eyelids were heavy and he held his coffee cup loosely on the arm of his chair. “You keep convalescing and then you're dead. What day is it, son?”
“Thursday.”
“Thursday's bingo night in the home. I won once. Jar of cold cream.”
“They gave you a jar of cold cream?”
“That was the prize.” Walter put the coffee cup down on the table, leaned back, and closed his eyes. “I gave it to Marguerite. That's how the two of us got started.”
“Oh.”
“Yeah,” Walter said. “Don't worry. I'm fine.”
HISTORY:
That night Walter fell out of bed. What woke Carl up from a restless, dream-drenched sleep (since he never knew the people whose illnesses or accidents were described in the reports, and never saw the doctors who dictated them, his periodic nightmares were filled with faceless strangers undergoing unidentifiable medical procedures while Carl watched, helplessly) must have been the thud of Walter's body hitting the floor. He sat up in bed, not knowing why he was awake, and heard a ragged, whispery gasp from the other side of the hall. When he got to the bedroom, Walter was looking up expectantly from the floor.
“I fell out of bed!” he whispered.
“I can see that,” Carl said.
“I feel okay, though.”
“We should probably go to the hospital.”
“I said I feel all right.”
“I heard what you said,” Carl said. He knelt down and slipped one arm under Walter's back and pulled him to a sitting position. His uncle's back felt meaty and solid through his T-shirt. But he was unsteady on his feet, and in the car he closed his eyes and didn't seem to feel well enough to talk.
At the emergency room they put him under observation, since they couldn't decide exactly what had happened to him. At the foot of the bed, Carl stood facing the digital flickering of the medical instruments. He felt calm. It wasn't the first time they'd been to the ER and in all likelihood wouldn't be the last. He examined the screen and thought of all the tests he'd seen, the signals from inside Walter's body: the CT scans, X rays, EKG. How many people ever saw that deep inside anybody else? He was proud of it somehow.
“Sometimes people just fall out of bed,” the intern told him.
“Is that your actual diagnosis?” Carl said. “I want to see the chart.”
“I can't give you the chart.”
“I want to see the chart,” he said, and grabbed it from the intern's hand.
Walter grinned at the intern from his bed. “He knows everything.”
“You need to rest,” the intern said.
Carl took the chart out to the hall and sat down with it. The jangling noise of the hospital, even at three o'clock in the morning, and the spasmodic blinking of the fluorescent lights and the bad-smelling, recirculated air were making him claustrophobic and irritable. He rubbed his eyes and looked at the chart, the scrawlings of medications and symptoms. Everything about his uncle was here, Walter on paper, his body reconstituted as a record of its processes and ills. This, he thought, is a body of information, and there arose before him a brief image of Walter's naked body, made not of flesh and blood but of a shell of data like tattoos in the air. In this image the body was as fine and translucent as a moth, numbers running down the arms and separating into five fingers, diagrams banded across the chest: statistical, eternal.
“Mr. Mehussen?”
Carl looked up at a woman extending her hand.
“I'm Dr. Newman,” she said. “I'd like to talk to you about your uncle. And I'd like to have his chart back, please.”
Patient appears fragile but in good spirits. Is able to communicate symptoms and receive information.
Dr. Newman had straight, thin, slightly greasy blond hair that swung as she talked. Under her white coat she wore khakis and sensible brown shoes. She was in the middle of saying that falling out of bed, while a traumatic event, might not have meaningful consequences for Walter's condition when he realized who she was. He glanced at her sharply.
“Do you have a question?”
“I just—you're Dr. Newman.”
She ran a hand wearily through her hair and nodded.
“Dr. Amanda Newman.”
“Yes, that's me.”
“I do your tapes,” he said.
“My tapes?”
“Transcription,” he said. He watched her nod again, and smile politely, and then recalibrate her manner to the one she used while dealing with people employed, however tangentially, in the medical profession. She took a deep breath, moved her shoulder closer to his, and became at once friendlier and more professional.
“You have excellent diction,” he told her.
She raised her eyebrows. “Thanks,” she said.
Walter spent the night under observation. Carl spent the night in the hallway, drinking bad coffee from a paper cup. They were running some tests and awaiting results. Dr. Newman was still on duty, and at times he could hear her cool, clear voice giving orders and asking questions, and the sound of it was oddly soothing to him, reminding him of his office and his work. He closed his eyes to focus on it. Other people waited near him, flipping through magazines or whispering softly together. They were all quiet, dazed-seeming. A woman came through and began searching around all the seats, saying, “My bag. I know I left it around here somewhere.” Then a man came and put his arms around her and led her away, glancing back guiltily over her shoulder as if the bag were a shameful or deeply personal subject, not to be discussed. He heard one of the nurses say, “Dr. Newman!” and Dr. Newman say, “In a minute!”
Walter was asleep, wheezing rhythmically. The other patient in the room was groaning in pain, a sound as distant and constant as traffic. It didn't seem to be keeping Walter up. Carl wasn't sleepy, but he slipped into a kind of a trance in the hallway, slouched in his seat. He didn't know what to do except sit and not sleep, sit and be vigilant. Whatever happened, he would be awake and present for it. He thought about when his mother died, and someone—a teacher—came and said to him, “Your mother is dead,” and it seemed like because it had happened off stage, out of his sight, that it could not be real or true. He tried to feel sad but couldn't. He kept trying to grasp the fact of it, and would sometimes repeat to himself, “My mother is dead,” and though the words would make him cry, he still didn't really feel it. The fact was too big. It defeated him. The days around the funeral passed in a blur of dark mystery, adults wearing black, speaking in whispers, the sense of being pressed in by crowds, the smell of unfamiliar food. Instead of grief he developed a sense of irritation and injustice, of being unfairly put upon. More than anything he wanted to find someone to complain to, maybe a teacher or someone else at school. He wanted to say that if only he'd been given more information, more evidence, more time, then he would have been better prepared.
PROCEDURE: patient will be informed as to the likely future developments in his condition.
Early in the morning the shifts changed and new nurses came on, pouring themselves cups of coffee and bustling around the station. He was looking down at the floor when he saw Dr. New-man's brown shoes.
She sat down beside him. “You should have gone home and slept,” she said.
“Why?” he said.
She laughed shortly, on the exhale. “B
ecause you look tired.”
“So do you,” he said, and she did. The skin under her eyes had turned bluish and looked wrinkled and taut. She had pulled her hair back in an elastic band, but a few strands had escaped it here and there. He noticed that she was carrying a chart, and knew it must be Walter's.
She cocked her head in the direction of his room. “Let's go talk to your uncle.” She took a step, but when he didn't follow she paused and looked at him, waiting.
“Please,” he said. Meaning, Please be a good doctor; meaning, Help him. Dr. Amanda Newman stepped back and put her hand briefly on his arm, and the touch of it was shocking to him— though not as shocking as when, in the days to come, she began to say his name at the beginning of her tapes: “Hello, Carl. This is a preliminary report on …” and he would listen, fascinated, to this part, the intimacy of these four letters spoken by her clear voice, his name, for minutes at a time, before he could move on.
“Let's go,” she said.
He followed her to Walter's room and they went inside, and Walter looked first to her and then to Carl, who saw his uncle's worried eyes go tranquil because he was there.
“Hi, Walter,” he said.
“ 'Lo,” Walter said, and coughed with the effort. He lay stolid and unmoving, his arms exposed above the sheet. The skin there was blotched and veiny. The other patient thrashed uncomfortably in his bed while his visitor, a younger woman, tried in vain to quiet him. Dr. Newman began to explain that Walter could go home, that there would be observation and additional medication.
As she spoke, Carl saw the cool black letters of her report unfurling in his mind.
ASSESSMENT: the heart labors.
He stood still with the revealed truth of it—that in the end, the real end, Walter was not going to be fine—and a pain bloomed hotly in his chest, as if his body were offering Walter's sympathy of its own kind. The tape in his head clicked and rewound, whirred all the way back to childhood. What he heard then was Walter's voice, smoke-tinged and hearty; what he smelled was Aqua Velva and tobacco and sweat. They were standing in the doorway of the living room, looking in at it, Walter behind him. He felt Walter's big hands pressing a bit too hard on his shoulders, the weight of them forcing him to slouch, and he was eleven and his heart flew up when Walter said, “From now on, son, this will be your home.”