“Thank you,” Devon said, genuinely touched.
“Shoes to go with it are in the closet. Size eight and a half, Christian Louboutin.” She looked at her watch. “Hurry.”
During the twenty minutes it took Kenji to drive them to the W Hotel on Union Square, Ruby fell silent, just as she had en route to Emmett Browne’s office. It had snowed through the night, and the snow was still coming down hard, swirling in the fierce gusts. Kenji negotiated the unplowed streets expertly. When they were a block from the hotel, Ruby roused herself and drank a glass of champagne.
At the W, as they approached Banquet Room B on the mezzanine, Devon was taken aback by the buzz of a large crowd. She had expected a gathering of anesthesiologists to be a quiet, staid affair. The reality was two hundred fifty doctors chatting loudly at twenty-five tables. There were centerpieces of red orchids and bowls of fruit. A lectern with a microphone stood behind the head table. Waiters were bringing in trays of iced tea and mineral water. Ruby had been vague about the scale of the luncheon, and she had neglected to mention—no small thing—that she was the only speaker. Other doctors would speak that evening before a holiday reception. But she wasn’t planning to attend. “I make my speech and we’re gone,” she had told Devon, who didn’t find this reassuring.
The doctors were about evenly divided between men and women. They had come in from around the country. All were conservatively dressed. The only flashes of real color were an occasional bright scarf or loud tie. Ruby drew a lot of stares and not a few whispers as she and Devon walked to their table, her purple positively luminous in a sea of grays and blues. She paused to shake some hands, but had trouble remembering people’s names. One doctor, a much older woman, took Ruby’s arm, as if wanting to detain her, but didn’t seem to know what to say.
Waiting to greet her was the president of the American Anesthesiology Society, a tall, starchy, no-nonsense woman named Margaret Finley. She wore a black dress and modest gold stud earrings. Her musky perfume made Devon want to sneeze. Dr. Finley in turn introduced the nine other doctors at the table, including two acquaintances of Ruby’s: Hiram Lake, a bearded doctor from Fort Lauderdale, and Karen Park, a Korean émigré who practiced in Seattle. Noting Dr. Lake’s bemusement over Ruby’s outfit, Devon could tell he hadn’t seen her lately.
Devon had been worried from the first about Ruby’s making a public appearance. But until they entered the banquet room, she hadn’t really grasped—maybe hadn’t wanted to—how much Ruby could damage her reputation there. She wondered if this was the true reason, unclear even to Ruby, that she had insisted Devon accompany her from Miami: to save her from herself before it was too late. A kind of human circuit breaker. If so, I’ve failed, Devon thought.
At twelve o’clock Dr. Finley went to the lectern and welcomed the group. Her remarks were cool and correct. No witticisms, no anecdotes. Not a wasted word. This was a woman who would anesthetize you with dispatch, Devon thought. Had these doctors elected her their president because they found her dryness appealing, or did no one else want the job? Ruby was unfazed by Finley’s coldness. In fact, as Lake and the others noted, she literally paid no attention to Finley as she rummaged in her lizard handbag and casually gazed around the room.
Watercress salad and shrimp cocktail were served, then chicken cutlets, which Devon declined. Hardly anyone was drinking, but when Ruby suggested to Dr. Lake that they order wine, he agreed, no doubt figuring she was nervous.
“I’ll keep you company, Ruby,” he smiled.
Ruby told the waiter to bring them a bottle of 1988 Chateau Latour; when told they didn’t have one, she asked for champagne.
Devon was seated between Dr. Park and Dr. Finley. Dr. Park talked about her own daughter, a Fulbright scholar in Prague—maybe the girl Ruby had wanted her to be, Devon thought ruefully. Dr. Finley didn’t speak to Devon at all after watching Ruby put away two glasses of the champagne. Ruby ignored her food, eating only a single shrimp and two apricots—a fair-sized meal for her these days.
At 12:45 sharp, Dr. Finley introduced Ruby. It was more laundry list than introduction. Increasingly anxious, her eyes glued to Ruby, Devon heard it piecemeal: “… Phi Beta Kappa at Radcliffe … Tallman Scholarship from Penn … Heckman Award in Anesthetic Studies … winner of the Forrester Medal … UNICEF volunteer in Peru … currently senior anesthesiologist at Gehring Memorial Hospital in Miami …”
Ruby took a last sip of champagne.
“I know we are all eager to hear Dr. Cardillo’s talk,” Finley concluded. “The subject is postoperative cognitive disorder. Please join me in welcoming her.”
To polite applause, Ruby walked to the lectern, carrying her laptop. She scanned the audience. Devon knew she had planned to read her speech from the laptop, so alarm bells went off when Ruby placed the laptop on a table behind her and clasped her hands on the lectern.
“Good afternoon. Thank you, Dr. Finley. And thank you all for inviting me to speak.” She paused. “POCD. I call it amnesia by anesthesia. What are we, each of us, but our memories? Just as our bodies are ninety percent water, our lives are ninety percent memory. There are moments when we are fully alive in the present. But, as time passes, those moments become scarce. Perhaps because the weight of our memories, ever multiplying, pushes up against the present, diminishing it, eventually crowding it out.”
So far, so good, Devon thought.
“Memory is our terra cognita,” Ruby said emphatically. “No matter if the memories are good or bad, if we try to cling to them or escape them. Let’s be honest: postoperative cognitive disorder is a euphemism for the fact that, if we’ve done our jobs as we were trained to, all of us here have erased patients’ memories.” She paused. “That may sound harsh. But maybe not harsh enough when you consider that, because of us, these patients are exiled to terra incognita for the rest of their lives.”
There was a murmur in the room, and Dr. Finley winced, exchanging glances with Dr. Lake.
“Brace yourself if you’ve never encountered the facts, which isn’t likely, or if you’ve blocked them out, which is.” Ruby paused again. “After surgery, forty percent of our patients experience long-term memory loss. Four in ten,” she emphasized. Another pause, this one longer. “Let’s assume one of those four suffers this loss solely due to surgical side effects: severe reduction of body temperature, neural trauma, postoperative inflammation. That still leaves three in ten patients whose memory loss can only be accounted for by the anesthesia administered.” Longest pause of all. “I know most of you don’t believe this. And I’m making it personal because for these patients it’s as personal as it gets.”
Though Devon recognized bits and pieces of the prepared speech she had heard before, she knew Ruby was winging it—and evidently wanted to wing it. At the same time, Devon thought, she still sounds lucid, and for all I know, what she’s saying may be completely true.
“I believe we can solve this problem by eliminating certain substances from our procedures,” Ruby went on. “Isofluran, for example, which we know erodes brain function. And desflurane combined with oxygen. And the low levels of CO2 applied during extended procedures. What are the moral implications if we pretend there is no problem?” She paused several seconds, then said, “Permit me a digression.”
Devon groaned inwardly. The pauses Ruby was inserting for dramatic effect were increasingly out of sync with the ideas they punctuated.
“Psychogenic fugue,” Ruby declared, lowering her voice as if she were sharing a confidence. “Psychogenic, as in ‘to originate in mental or emotional conflict.’ Fugue, as in ‘fleeing one’s own identity, seemingly self-aware, but later remembering nothing.’ From the Latin fuga, flight. Fleeing reality. Wandering off after splitting off. Aka, an amnesiac gone AWOL after a shock to the system. In Dade County this year we had four reported cases of postsurgical psychogenic fugue, all of them missing persons.” She paused one last time. “And then there is a case I learned of yesterday,” she continued. “One winter nig
ht, years ago, a man fled New York for New Hampshire, drove into the woods, and died of hypothermia in his car. Was it a psychogenic fugue?” She looked around the room, as if expecting a show of hands, oblivious to the perplexed looks on some faces, the anger in others, and the astonishment of colleagues from Florida who had known her as a model of probity, a quiet, cautious physician. Some members of the audience were already heading for the door. “We’ll never know. The police declared it a suicide. Did they look into the man’s medical history? What had been the shock to his system?” Five, ten, fifteen seconds ticked by. Ruby couldn’t speak. Ten more seconds passed. She stood frozen, staring out.
The audience no longer had to wait for an implosion—it had occurred—and more people were whispering among themselves or leaving their tables.
That’s it, Devon thought, standing up.
“What have you been waiting for?” Dr. Finley muttered.
Devon walked over to the lectern, trying not to wobble on the four-inch heels, and touched Ruby’s arm. “Mom,” she whispered, “it’s time to go.”
Ruby looked dazed.
“Please, come on.”
She managed to get three words out. “I didn’t finish.”
“Yes, you did. You finished.”
Ruby’s face fell, but when Devon picked up the laptop and took her arm, she didn’t resist. Leading her back to their table, Devon felt how unsteady she was. Dr. Finley remained seated, scowling at them. Dr. Lake was gone. Dr. Park and two other women came over to them.
“Can I help?” Dr. Park said to Devon.
“You could put the laptop in her bag and slip the bag over my arm.”
“Okay. And I’ll walk out with you.”
For Devon, the walk to the door with Ruby on her arm felt interminable. Ruby was slumping against her, growing heavier by the minute. Dr. Park took Ruby’s other arm. The doctors at the door parted to let them through.
The three of them rode the escalator down. They walked through the lobby and out the glass doors. Kenji pulled up in the limo.
Devon turned to Dr. Park. “Thank you.”
She gave Devon her card. “If you need me, call my cell.”
Within minutes, Ruby dozed off in the car.
Devon leaned forward and said, “The hotel. And after that, we won’t be needing you anymore, Kenji.”
Ruby slept for six hours and twenty minutes, on her back, in her bathrobe, on top of the covers. When she woke, she found Devon sitting on the side of the bed, watching her nervously.
“I know what happened,” Ruby said. “I’m sorry.”
“You scared the hell out of me.”
“I know.”
“Do you really remember what happened?”
“I remember enough.” She looked around. There was an ice pack and a bottle of water on the night table. “I’m so thirsty,” she said.
Devon poured her a glass. “You want to talk about it?”
“Not now. Please.” She spotted Dr. Park’s card beside the lamp. “Karen?”
“She came by. You were lights-out so fast, I wanted her to check your blood pressure, your heart. I’m not a doctor.”
“Oh god.”
“It wasn’t cool.”
“I said I was sorry.” She sat up. “I’m fine now.”
“You’re not fine.”
“I am a doctor. You think I’m not aware of my condition?”
“What condition is that?”
“Please.”
“You can’t keep going like this.”
“Devon, come here.” Ruby embraced her. “Thank you for watching out for me. Why don’t you send for some food? A sandwich would be nice. And coffee.”
Ruby took a cold shower. Her head was aching. Her tongue felt numb. She had no idea how she had gotten a bruise on her hip the size of a plum. Accustomed to Florida humidity, her skin was dry from these overheated rooms. She rubbed cream onto her hands and face. She strained to focus her thoughts. Remembering her speech was like watching a film clip that skipped frames, with no continuity and huge gaps. Under other circumstances, it might have been funny that she couldn’t remember what she had said about memory loss.
She put on a bathrobe and combed her hair. She didn’t want to look in the mirror. It wasn’t just that she appeared tired and ragged: there was a vacancy in her eyes that she couldn’t ignore so easily now.
Twenty years of professional integrity out the window in twenty minutes, she thought, burying her face in her hands. Who among her colleagues would hear her name now without mentally penciling crazy beside it? In Miami, when she had felt herself losing control, unable to steer a straight line, she tried to convince herself she was in fact adopting a more demanding sort of control that required you to negotiate zigzags, loop-the-loops, and curlicues previously unimaginable. A psychiatrist friend at a dinner party had once told her that some patients simultaneously attempt to conceal and announce the onset of madness—itself an act of madness. He had likened it to a construction crew’s unfurling one of those cosmetic trompe l’oeil banners down the side of a building: the pictorial representation made the building appear vividly intact even as it concealed demolitionists gutting the actual structure.
Devon ordered up a pot of coffee, three egg salad sandwiches, a plate of cookies, a glass of lemon juice, and some cayenne pepper, which she sprinkled into the juice.
When Ruby joined her on the sofa, Devon handed her the juice.
“What’s this?”
“Just drink it.”
“Whoa.”
“All of it.”
“Cayenne?”
“Uh-huh. I know something about hangovers.”
The pepper went down Ruby’s throat like fire. Then she surprised Devon, picking up a sandwich without a word and taking a healthy bite. When the sandwich was gone, she started in on another one.
“I was hungrier than I thought,” she said.
Devon started pouring her coffee, but Ruby stopped her. “I need more sleep. I’m already tired again.”
“Good.”
“You know,” Ruby said, “I always wanted to believe something my grandmother told me. She was a businesswoman, pragmatic, not formally educated, not given to big pronouncements. She waved a finger at me and said: ‘If your life is a story that begins when you’re born and ends when you die—and what else could it be?—you can write it yourself, or let other people write it. If you write it, you have to accept that sometimes something outside of you, that you can’t explain, will push the pen this way or that, and suddenly your story becomes someone else’s story—a person you love, or hate, or haven’t even met—and all you can hope is that eventually you take it back and get to finish it the way you like.’ ”
“Do you believe that?”
“I do now,” Ruby replied softly. “I just want it to be my story again. Not your father’s, not my father’s or mother’s, not anybody else’s.” She stood up and headed for her bedroom. “Please don’t wake me.”
It was 8:00 P.M. on Thursday night. Ruby would sleep through to 1:00 P.M. on Friday afternoon, seventeen hours straight, twenty-three hours out of twenty-four. Longer than she had slept during the two previous weeks combined.
Even so, Devon couldn’t let go of something Dr. Park had told her.
“Your mother ought to be put in the hospital, Devon.”
Devon was taken aback by her bluntness, but not by the suggestion itself. “That could really push her over the top.”
“She is over the top. This isn’t something you just sleep off. At least let me give you the name of a friend in Miami, a doctor your mother would trust. She’s going to need to see someone. If you want me to tell her this, I will.”
“No, you can give me the name.”
Devon didn’t mention any of this to Ruby. She thought that what had happened at the conference was the end of something, not the beginning. If that wasn’t the case, if Ruby doubled down on her denial and attempted to pick up where she’d left off, Devon wo
uld take Dr. Park’s advice.
NEW YORK CITY—DECEMBER 23, 8:40 P.M.
Devon traveled up the West Side Highway in an overheated taxi. It was slow going. The snow had finally tapered off, but twenty-six inches had fallen on the city. Some drifts were ten feet high. The plows and salters were out in force now, but even the parkway, one rutted lane in either direction, was thick with ice. The road divider was buried. The exit ramp at Seventy-ninth Street was blocked by abandoned cars. The high-rise windows overlooking the Hudson were intensely bright, as if, through the frigid air, those thousands of rooms blazed with fire, not lamplight. The temperature had dropped to 10 degrees. Chunks of ice were sailing down the river. Some were large, like mini-icebergs, shot through with sapphire light. Devon wondered how long they would remain intact when they were swept out to sea.
The taxi pulled up before a tall, well-kept building by the park. The bare trees in front were festooned with Christmas lights. The lobby was decorated with a fully trimmed evergreen, wreaths, and potted poinsettias. There was a basket of candy canes on the doorman’s desk. Devon stepped into the elevator and was whisked to the twelfth floor. A maid in a pale blue dress ushered her into a spacious apartment. The ceilings were high and the darkness deep down the two hallways off the foyer. The scent of incense wafted from a distant room. Devon was careful not to step on the nightingales in the mosaic tiles. The maid took her coat and led her into the living room. The lighting was dim, but the fireplace was alive with flames.
“Mrs. LeMond will be with you in a moment.”
Devon had been thinking so much about this apartment that she felt as if she had been there before. The oil portrait over the mantelpiece closely matched the image she had conjured of Sammy LeMond: a handsome man in a white suit, with a trumpet under his arm, a white carnation in his lapel, and a wry smile beneath a carefully trimmed mustache. Many of his possessions remained in place after all those years: the white grand piano, a set of tropical landscapes with flame trees and toucans, the African masks on the opposite wall that stared back at her.
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