by Tara Conklin
It was the same frustration she felt with Joe. His drinking, the drugs. How does a man genetically predisposed to heart disease justify the regular use of cocaine?
Last week they’d met at a coffee cart outside the hospital. Recently Joe had suffered some chest pains. A moment when he felt his heart buck. That’s how he’d described it to Renee: “Like a horse, like a horse kicked me right here”—he placed his palm in the center of his chest. She’d immediately called a cardiologist friend and arranged for Joe to have a workup.
But the tests came back normal. No cause for concern.
“Just stop, Joe. Just stop using,” Renee said, holding her coffee in two hands, blowing the steam into the frigid autumn air. “It’s a risk.”
“I don’t do it that much,” he replied. He ate a glazed doughnut in three bites, licked the sugar from his fingers. “It’s fun. It helps me stop thinking about work. You know, unwind.”
“I’d like to get you into some kind of treatment.”
He laughed. “Renee. I love you. But come on. You heard your friend. The tests were normal. I just got freaked. That’s all. I have it under control.”
“I wish you would stop hanging out with Ace.”
“Ace? He’s harmless.”
“He’s a drug dealer.”
“That’s a bit of a stretch. He’s got some connections, that’s all. He’s a good person to know.”
“Well, I wish you didn’t know him.” Renee paused and then asked gently, “And, Joe—have you seen Dad again? Or any other hallucinations?”
Joe looked up at the sky and then down at Renee. “It wasn’t a hallucination,” he said.
“Okay, fine. But have you seen him?”
“No, Renee. I haven’t. I’ll let you know next time it happens. Okay?” He gave Renee a tight smile.
Renee took hold of Joe’s elbow and pulled him toward her. “Hold out your arms,” she said. “Please.”
“What? Why?” said Joe, but he did it, he held out his arms.
Before he could pull them away, Renee grabbed his left arm, pushed up the shirt cuff and examined the interior forearm. She saw a smattering of small purple bruises, each no bigger than a dime, with a vicious point of red in the center. Renee inhaled sharply. “Joe,” she said.
“Renee. Relax. It’s not heroin. Coke is so much better when you inject it. I’ve only done it a few times. It’s okay. Really.” And then, suddenly contrite, “I’m sorry you saw that. Listen, I’ll stop. Okay? I will. I promise. I can stop the coke. It’s not a big deal.”
Joe’s phone had started to buzz then, and he’d angled away from her to answer it, mouthed a good-bye, and turned down Lexington Avenue.
Afterward Renee had been so agitated she’d walked and walked, from New York-Presbyterian on East Sixty-Eighth all the way downtown. What could she do? Stage an intervention? He was working, he was in love, he was getting married, he was living a responsible, productive life. Maybe she was overreacting. Maybe she was being hysterical. But no autopsy had ever been conducted on their father; they never knew why he suffered the sudden cardiac arrest that killed him. Cardiomyopathy was one possibility, or ventricular fibrillation. Renee made sure that Joe had routine physicals; the tests had all been normal. Still, she worried.
From behind the blue curtain came another moan from the pregnant woman. Her husband wept softly.
“She’s going to be okay, right?” the man asked. No one answered.
Jaypa spoke low into the phone on the wall and caught Renee’s eye but did not smile. And then a tall, formidable nurse sheathed in the peach scrubs of the delivery room arrived and took charge. The curtain swiped open, and the whole enterprise, woman and man, doctors and nurses, gurney and IV, moved swiftly down the hall toward the elevators like an urgent traveling circus. The massive swinging doors that separated the ER from the hospital proper shut behind them with the slightest sucking noise—Renee always thought of a submarine pulling closed its portal—and they disappeared.
The ER returned to calm. The electronic blip of a blood-pressure monitor. The soft chatter of the triage nurses.
* * *
Renee never considered herself a prude. She liked to think about sex. She masturbated, each orgasm a small, perfect miracle, and found herself aroused equally by the sight of Mr. Quigley’s firm, round buttocks in math class and the kissing scenes in Top Gun. And yet by the age of eighteen she had never had a boyfriend, never dated, had kissed only one person—a pimply high jumper at a postseason track conference—and found it pleasant but not pleasant enough that she wished to repeat the exchange. She didn’t blame the man in the car for her ambivalence, not exactly. The line of causation was not so straight. But an unease rose up in her throat, the slightest taste of disgust, whenever she felt herself the subject of male sexual attention. Plus, she was busy. So busy! Track meets, academic decathlon, four AP classes, part-time work at the lab in New Haven, tutoring on Saturday afternoons, volunteering at the soup kitchen on Sunday nights. This was the reason she didn’t date, Renee told Noni, who offered her wholehearted approval.
“There’s plenty of time for dating,” Noni said. “High-school boys are Neanderthals anyhow.”
But then, toward the end of Renee’s senior year, Brett Swenson asked her to prom.
At eighteen years old and 205 pounds of pure muscle, Brett had been the star of the high school’s championship wrestling team. Thick, dark brows, a full, sensitive mouth, ears flat to his square head. Brett was cute, at least that’s what her friends said, and Renee appreciated certain aspects of his physique: the wide shoulders, the hard, flat stomach that he displayed often—in the lunchroom, in biology class, passing in the hall—by lifting the hem of his shirt to wipe his face or lips as though the simple task of carrying his prodigious muscles was enough to raise a sweat.
Yes, Renee liked the flash of that stomach. But she did not particularly like Brett. He laughed too loudly and too often and strode the halls as though the high school were his home and all the other students and teachers merely guests enjoying the whims of his hospitality. Stories circulated about Brett: the college girl he’d dated, the night he slept with two girls at the same time. Jennifer Garrit had slept with him, Renee heard, and Sarah Cooper and even a freshman, coltish Julie Farley, with her long legs and braces. All of these girls became marked by him, carrying with them through the halls a badge of experience and allure and tawdry knowledge. Brett never had a girlfriend. Such official couplings generally happened within the school band or the chess club, involving people without the wealth of opportunities that presented themselves to young men like Brett. He had a social obligation, it seemed, to spread himself around.
It was a distinct surprise when Brett asked Renee to the senior prom—a shocking event, thrilling to her friends but nausea-inducing for Renee. Weeks of back-and-forth communications ensued: his friends talking to her friends, handwritten notes, chats beside her locker. He called her once at home to detail the limousine his parents had rented, its long sunroof, its television and white leather seats. Renee had been swayed, almost, by these shows of consideration, but in the end she said no—Renee always said no—and spent prom night at the movies with her friend Gabby watching Pretty Woman and eating sticky Raisinets.
Two weeks later she passed Brett in the hall on her way to class, her arms full of books, hair unwashed and pulled up in a ponytail. He said, looking straight at her, his voice an undertone but the words distinct, “What a fucking waste.” He shook his head. Gone were the affection and attraction that he’d put on display during those fervent weeks before prom. The look he gave her was dismissive, with a whiff of disgust.
Renee pulled back as though slapped and did not reply. She kept walking.
What a fucking waste.
Later that night, at home in bed, Caroline snoring faintly in the bunk below, all Renee’s life choices arrived for her in stark relief. She was eighteen years old, six weeks away from high-school graduation, five months from starting
at the University of Connecticut in an accelerated premed program for which she’d won enough scholarship and grant money that Noni would pay nothing. Renee had worked so hard to excel academically, to keep her body lean and strong for cross-country, to keep an eye on Joe and her sisters, to watch Noni for signs of relapse into depression. Had she expended so much energy and time on these pursuits that something precious had slipped away? Her adolescence was nearly over—what did she have to show for her teenage years?
Caroline, Renee knew, had not wasted a minute of her time. She and Nathan were practically married already. They held hands in the hallways and on the street. They went to movies together, Nathan driving the ratty green Volkswagen Bug he’d been given by a dying uncle, Caroline installed in the passenger seat like a queen. Caroline had been on the pill for a year now. All the nights Renee had stayed in to study, all the parties she’d missed, all the beers she had failed to drink—these choices struck her now as safe and, yes, wasteful. And whatever it was she had wasted, she would never get it back.
That night Renee thought about the tan, smooth stomach of Brett Swenson and the senior prom that she did not attend and the ways in which she had already closed herself in. One small voice in her head wished she could go back and say, Yes, Brett, bring me to prom and feed me schnapps and vodka and take my virginity in the slippery, heated backseat of that rented limo. But the louder voice wished she could go back to that hallway and punch Brett Swenson in the face for making her question herself like this.
* * *
A buzz came from the triage nurse: a new walk-in patient designated urgent but not life-threatening. A thirty-eight-year-old white male in overall good health. No medications. Laceration on the left palm with persistent blood loss.
“Sorry, Renee, you’re the last doc standing,” the nurse said.
Renee groaned. “On my way.”
When Renee pulled open the curtain, the patient was sitting on a gurney holding his left hand with his right. His name was Jonathan Frank and it was the tenacity of his bleeding that struck her first.
“What happened?” Renee asked. Jonathan’s left hand was wrapped in a dish towel soaked with blood. Brilliant drops of red fell to the floor as Renee unwound the cloth to get a better look at the cut.
“Just a bread knife. Newly sharpened,” Jonathan answered. He looked pointedly at the woman standing beside the gurney. “No one told me.”
The woman rolled her eyes. She wore a long green dress under a longer black coat. A large diamond sat on her ring finger, throwing a tiny rainbow onto the blue curtain that divided this examining space from the one beside it. “Who decides to have a bagel after five courses at Jean-Georges?” she said. “Who?”
“Are you on any medication?” Renee asked Jonathan.
“No.”
“No blood thinners?”
“No.”
“And when did this happen?”
“Thirty minutes ago.”
“More like an hour,” said the woman. “I’m worried about him. He’s such a bleeder.”
“When have you seen me bleed, Simone? When, in the last ten years?” Jonathan Frank’s face was tight and neat, with short dark hair that rose in a little crest over his forehead. He was tall, over six feet, Renee guessed by the length of thigh that extended past the gurney’s edge, and thin as a pole vaulter. His whole person seemed drafted by an architect: it was precise, efficient, self-contained.
“Maybe your wife should step outside,” said Renee.
“She’s not my wife. She’s my sister. My older sister.”
The woman sighed dramatically. “Fine, bleed to death, see if I care. I’ll be in the waiting room.”
Renee continued working on the cut. The sister was right: Jonathan bled copiously. Renee was concerned about his inability to clot, and so she recommended he be admitted for further tests.
“Admitted?” he said.
“I’m afraid so.”
“I’m sure you’re very good at your job. But I’ll be fine.”
Renee released his hand. “Hold it up like this,” she directed. “Listen, at the very least you’ll need stitches. Quite a few. And probably physical therapy so you can keep full mobility. A wound like this can cause the hand to curl inward as it heals.” Renee made her hand into a horrible claw shape. She was exaggerating, but she hated this brand of skepticism. Sometimes male patients asked how old she was or if her superior was available to give his opinion.
“What do you do for a living?” Renee asked.
“I’m a carpenter. I make furniture,” Jonathan answered.
“So you work with your hands.”
“Yes, but I have an assistant. A really excellent assistant.”
“Tennis, then?”
“Do I look like a tennis player?”
Renee stepped back. “You do, actually.”
“No tennis. I box.”
“Box?”
“I’ve broken my nose twice.”
Jonathan’s nose was straight as a blade. “Doesn’t look broken to me,” Renee said.
“Okay.” Jonathan smiled. “But I’ve always wanted to be a boxer. Real tough-guy stuff.”
“You don’t look like a tough guy.”
“I do have a bleeding hand.”
“True,” said Renee. “But it’s from cutting a bagel.”
In six months’ time, Renee would learn that Jonathan liked to pretend, to put on characters the way other people put on clothes. He wore a fake mustache three days a week. He entertained casual friendships with at least a dozen people who knew him as Fodor Leyontiev, an émigré from the former Soviet Union, a poor violinist who still longed for the borscht of his childhood. This was not to say that Jonathan was dishonest. To the contrary—he was honest to a fault, and this was precisely the sort of complexity that later Renee would value so highly in him. Renee arrived at honesty through the usual route—a good heart, a sensible mind, a fear of making mistakes—while Jonathan’s route meandered, stopped to photograph the view and buy some candy. But their ultimate destination remained the same.
After Renee’s jab about the bagel, Jonathan quieted down. He coughed into his good hand.
Renee regarded the bloom of blood on his trousers. The frayed laces of his running shoes. The wound was his own doing, yes, but not one of reckless disregard. A hunger pang, a newly sharpened knife, a wily bagel. Simply an accident. No one was to blame. Certainly not Jonathan. He wasn’t the sort of person to act carelessly. Already Renee knew this about him.
She pulled Jonathan Frank’s chart from the slot at the end of the bed.
“You may have reached a tendon,” she said. “I’m going to hold off on the suture until we know if you’ll need surgery.”
“Trust me,” he said. “I don’t need anything.”
Renee had been writing in his chart, but now she stopped. “Nothing?” she said. “There’s nothing you need?”
“Not a thing,” said Jonathan Frank. He blinked. “Except your phone number.”
Renee had been hit on many times in the ER. The place had an air of perpetual disorder and diminished expectations, and there were some people who believed that such conditions also required sexually inappropriate behavior. These kinds of people always ended up in Renee’s care. She’d been mooned, flashed, asked out, grabbed by patients more times than she could count. Never before had she reacted to it with anything other than a quick shake of the head or, on a few notable occasions, a call to security.
But with Jonathan Frank she hesitated. He was holding his injured hand up as she’d instructed. The discarded dishcloth was stained a deep red and edged with little yellow ducks.
On the day she met Jonathan Frank, Renee was thirty-four years old, a fellow in general surgery with top marks from the attending physician, already in talks for a transplant fellowship next year. Brett Swenson was sixteen years behind her, the man in the car twenty-one. Jonathan was attractive and intelligent and had asked for her phone number. The fact that he
was her patient should have prompted Renee to answer with a simple, straightforward no.
Instead she wondered if there was any Chinese food left in the staff fridge. She wondered if Jaypa’s girlfriend, the nurse from Arkansas, had ever wanted to be a doctor. She wondered if she wasn’t the kind of person who did better on her own, someone who was meant to lead a solitary life. Someone for whom a profession, the most noble of professions, would provide a vast, singular joy. She realized that this man here was not Brett Swenson or the man in the car, but someone else entirely. Someone who perhaps, with his neat, clean hands and dark, intelligent eyes, might widen her world, not because it needed to be wider but because the opposite, a narrowing, might otherwise be inevitable. And she did not want that. Alone or not, Renee wanted to expand. She had always wanted more than herself. Medicine gave her that; maybe this man could, too. One did not necessarily preclude the other. For a brief, blazing moment, she hoped that this was true.
Without looking at Jonathan, Renee ripped a scrap of paper from the chart and wrote down her name and phone number.
“A nurse will take up you up to X-ray,” she said, and handed him the paper.
* * *
It had been a Sunday morning in April when Joe called Renee from the Alden College dean’s office. Renee was a second-year medical student and had slept four hours the night before. She’d been studying for the national board exam, a punishing full-day test.
When she picked up the phone, Joe said, “Renee, I need your help.” His voice was rough and low.
Renee did not speak. Briefly she considered hanging up on him, turning the phone off, returning to her books. Her roommate Lydia was still asleep; Renee could hear faint snores emanating from the closed bedroom door.
“What is it, Joe,” Renee said without inflection. “What’s happened?”
Joe explained the situation: the party, the alcohol, the police. Renee said very little. She whispered, “Okay, okay, I understand,” trying not to wake her roommate.
“You need to come here,” Joe said. “They wanted to talk to Noni, but I told them you.”
“Yes,” said Renee. “That was the right thing to do. Don’t let them call Noni. I’m leaving now.”