A Life in Medicine

Home > Other > A Life in Medicine > Page 21
A Life in Medicine Page 21

by Robert Coles


  “I’ll be talking to you later in the day,” the doctor was saying to Howard. “There are still some things that have to be done, things that have to be cleared up to our satisfaction. Some things that need explaining.”

  “An autopsy,” Howard said.

  Dr. Francis nodded.

  “I understand,” Howard said. Then he said, “Oh, Jesus. No, I don’t understand, doctor. I can’t, I can’t. I just can’t.”

  Dr. Francis put his arm around Howard’s shoulders. “I’m sorry. God, how I’m sorry.” He let go of Howard’s shoulders and held out his hand. Howard looked at the hand, and then he took it. Dr. Francis put his arms around Ann once more. He seemed full of some goodness she didn’t understand. She let her head rest on his shoulder, but her eyes stayed open. She kept looking at the hospital. As they drove out of the parking lot, she looked back at the hospital.

  At home, she sat on the sofa with her hands in her coat pockets. Howard closed the door to the child’s room. He got the coffee-maker going and then he found an empty box. He had thought to pick up some of the child’s things that were scattered around the living room. But instead he sat down beside her on the sofa, pushed the box to one side, and leaned forward, arms between his knees. He began to weep. She pulled his head over into her lap and patted his shoulder. “He’s gone,” she said. She kept patting his shoulder. Over his sobs, she could hear the coffee-maker hissing in the kitchen. “There, there,” she said tenderly. “Howard, he’s gone. He’s gone and now we’ll have to get used to that. To being alone.”

  In a little while, Howard got up and began moving aimlessly around the room with the box, not putting anything into it, but collecting some things together on the floor at one end of the sofa. She continued to sit with her hands in her coat pockets. Howard put the box down and brought coffee into the living room. Later, Ann made calls to relatives. After each call had been placed and the party had answered, Ann would blurt out a few words and cry for a minute. Then she would quietly explain, in a measured voice, what had happened and tell them about arrangements. Howard took the box out to the garage, where he saw the child’s bicycle. He dropped the box and sat down on the pavement beside the bicycle. He took hold of the bicycle awkwardly so that it leaned against his chest. He held it, the rubber pedal sticking into his chest. He gave the wheel a turn.

  Ann hung up the telephone after talking to her sister. She was looking up another number when the telephone rang. She picked it up on the first ring.

  “Hello,” she said, and she heard something in the background, a humming noise. “Hello!” she said. “For God’s sake,” she said. “Who is this? What is it you want?”

  “Your Scotty, I got him ready for you,” the man’s voice said. “Did you forget him?”

  “You evil bastard!” she shouted into the receiver. “How can you do this, you evil son of a bitch?”

  “Scotty,” the man said. “Have you forgotten about Scotty?” Then the man hung up on her.

  Howard heard the shouting and came in to find her with her head on her arms over the table, weeping. He picked up the receiver and listened to the dial tone.

  Much later, just before midnight, after they had dealt with many things, the telephone rang again.

  “You answer it,” she said. “Howard, it’s him, I know.” They were sitting at the kitchen table with coffee in front of them. Howard had a small glass of whiskey beside his cup. He answered on the third ring.

  “Hello,” he said. “Who is this? Hello! Hello!” The line went dead. “He hung up,” Howard said. “Whoever it was.”

  “It was him,” she said. “That bastard. I’d like to kill him,” she said. “I’d like to shoot him and watch him kick,” she said.

  “Ann, my God,” he said.

  “Could you hear anything?” she said. “In the background? A noise, machinery, something humming?”

  “Nothing, really. Nothing like that,” he said. “There wasn’t much time. I think there was some radio music. Yes, there was a radio going, that’s all I could tell. I don’t know what in God’s name is going on,” he said.

  She shook her head. “If I could, could get my hands on him.” It came to her then. She knew who it was. Scotty, the cake, the telephone number. She pushed the chair away from the table and got up. “Drive me down to the shopping center,” she said. “Howard.”

  “What are you saying?”

  “The shopping center. I know who it is who’s calling. I know who it is. It’s the baker, the son-of-a-bitching baker, Howard. I had him bake a cake for Scotty’s birthday. That’s who’s calling. That’s who has the number and keeps calling us. To harass us about that cake. The baker, that bastard.”

  They drove down to the shopping center. The sky was clear and stars were out. It was cold, and they ran the heater in the car. They parked in front of the bakery. All of the shops and stores were closed, but there were cars at the far end of the lot in front of the movie theater. The bakery windows were dark, but when they looked through the glass they could see a light in the back room and, now and then, a big man in an apron moving in and out of the white, even light. Through the glass, she could see the display cases and some little tables with chairs. She tried the door. She rapped on the glass. But if the baker heard them, he gave no sign. He didn’t look in their direction.

  They drove around behind the bakery and parked. They got out of the car. There was a lighted window too high up for them to see inside. A sign near the back door said THE PANTRY BAKERY, SPECIAL ORDERS. She could hear faintly a radio playing inside and something creak—an oven door as it was pulled down? She knocked on the door and waited. Then she knocked again, louder. The radio was turned down and there was a scraping sound now, the distinct sound of something, a drawer, being pulled open and then closed.

  Someone unlocked the door and opened it. The baker stood in the light and peered out at them. “I’m closed for business,” he said. “What do you want at this hour? It’s midnight. Are you drunk or something?”

  She stepped into the light that fell through the open door. He blinked his heavy eyelids as he recognized her. “It’s you,” he said.

  “It’s me,” she said. “Scotty’s mother. This is Scotty’s father. We’d like to come in.”

  The baker said, “I’m busy now. I have work to do.”

  She had stepped inside the doorway anyway. Howard came in behind her. The baker moved back. “It smells like a bakery in here. Doesn’t it smell like a bakery in here, Howard?”

  “What do you want?” the baker said. “Maybe you want your cake? That’s it, you decided you want your cake. You ordered a cake, didn’t you?”

  “You’re pretty smart for a baker,” she said. “Howard, this is the man who’s been calling us.” She clenched her fists. She stared at him fiercely. There was a deep burning inside her, an anger that made her feel larger than herself, larger than either of these men.

  “Just a minute here,” the baker said. “You want to pick up your three-dayold cake? That it? I don’t want to argue with you, lady. There it sits over there, getting stale. I’ll give it to you for half of what I quoted you. No. You want it? You can have it. It’s no good to me, no good to anyone now. It cost me time and money to make that cake. If you want it, okay, if you don’t, that’s okay, too. I have to get back to work.” He looked at them and rolled his tongue behind his teeth.

  “More cakes,” she said. She knew she was in control of it, of what was increasing in her. She was calm.

  “Lady, I work sixteen hours a day in this place to earn a living,” the baker said. He wiped his hands on his apron. “I work night and day in here, trying to make ends meet.” A look crossed Ann’s face that made the baker move back and say, “No trouble, now.” He reached to the counter and picked up a rolling pin with his right hand and began to tap it against the palm of his other hand. “You want the cake or not? I have to get back to work. Bakers work at night,” he said again. His eyes were small, mean-looking, she thought, nearly
lost in the bristly flesh around his cheeks. His neck was thick with fat.

  “I know bakers work at night,” Ann said. “They make phone calls at night, too. You bastard,” she said.

  The baker continued to tap the rolling pin against his hand. He glanced at Howard. “Careful, careful,” he said to Howard.

  “My son’s dead,” she said with a cold, even finality. “He was hit by a car Monday morning. We’ve been waiting with him until he died. But, of course, you couldn’t be expected to know that, could you? Bakers can’t know everything—can they, Mr. Baker? But he’s dead. He’s dead, you bastard!” Just as suddenly as it had welled in her, the anger dwindled, gave way to something else, a dizzy feeling of nausea. She leaned against the wooden table that was sprinkled with flour, put her hands over her face, and began to cry, her shoulders rocking back and forth. “It isn’t fair,” she said. “It isn’t, isn’t fair.”

  Howard put his hand at the small of her back and looked at the baker. “Shame on you,” Howard said to him. “Shame.”

  The baker put the rolling pin back on the counter. He undid his apron and threw it on the counter. He looked at them, and then he shook his head slowly. He pulled a chair out from under the card table that held papers and receipts, an adding machine, and a telephone directory. “Please sit down,” he said. “Let me get you a chair,” he said to Howard. “Sit down now, please.” The baker went into the front of the shop and returned with two little wrought-iron chairs. “Please sit down, you people.”

  Ann wiped her eyes and looked at the baker. “I wanted to kill you,” she said. “I wanted you dead.”

  The baker had cleared a space for them at the table. He shoved the adding machine to one side, along with the stacks of notepaper and receipts. He pushed the telephone directory onto the floor, where it landed with a thud. Howard and Ann sat down and pulled their chairs up to the table. The baker sat down, too.

  “Let me say how sorry I am,” the baker said, putting his elbows on the table. “God alone knows how sorry. Listen to me. I’m just a baker. I don’t claim to be anything else. Maybe once, maybe years ago, I was a different kind of human being. I’ve forgotten, I don’t know for sure. But I’m not any longer, if I ever was. Now I’m just a baker. That don’t excuse my doing what I did, I know. But I’m deeply sorry. I’m sorry for your son, and sorry for my part in this,” the baker said. He spread his hands out on the table and turned them over to reveal his palms. “I don’t have any children myself, so I can only imagine what you must be feeling. All I can say to you now is that I’m sorry. Forgive me, if you can,” the baker said. “I’m not an evil man, I don’t think. Not evil, like you said on the phone. You got to understand what it comes down to is I don’t know how to act anymore, it would seem. Please,” the man said, “let me ask you if you can find it in your hearts to forgive me?”

  It was warm inside the bakery. Howard stood up from the table and took off his coat. He helped Ann from her coat. The baker looked at them for a minute and then nodded and got up from the table. He went to the oven and turned off some switches. He found cups and poured coffee from an electric coffee-maker. He put a carton of cream on the table, and a bowl of sugar.

  “You probably need to eat something,” the baker said. “I hope you’ll eat some of my hot rolls. You have to eat and keep going. Eating is a small, good thing in a time like this,” he said.

  He served them warm cinnamon rolls just out of the oven, the icing still runny. He put butter on the table and knives to spread the butter. Then the baker sat down at the table with them. He waited. He waited until they each took a roll from the platter and began to eat. “It’s good to eat something,” he said, watching them. “There’s more. Eat up. Eat all you want. There’s all the rolls in the world in here.”

  They ate rolls and drank coffee. Ann was suddenly hungry, and the rolls were warm and sweet. She ate three of them, which pleased the baker. Then he began to talk. They listened carefully. Although they were tired and in anguish, they listened to what the baker had to say. They nodded when the baker began to speak of loneliness, and of the sense of doubt and limitation that had come to him in his middle years. He told them what it was like to be childless all these years. To repeat the days with the ovens endlessly full and endlessly empty. The party food, the celebrations he’d worked over. Icing knuckle-deep. The tiny wedding couples stuck into cakes. Hundreds of them, no, thousands by now. Birthdays. Just imagine all those candles burning. He had a necessary trade. He was a baker. He was glad he wasn’t a florist. It was better to be feeding people. This was a better smell anytime than flowers.

  “Smell this,” the baker said, breaking open a dark loaf. “It’s a heavy bread, but rich.” They smelled it, then he had them taste it. It had the taste of molasses and coarse grains. They listened to him. They ate what they could. They swallowed the dark bread. It was like daylight under the fluorescent trays of light. They talked on into the early morning, the high, pale cast of light in the windows, and they did not think of leaving.

  Timothy J. Fisher

  PIES

  This piece was written in response to Raymond Carver’s story “A Small, Good Thing” in a literature and medicine course offered at Dartmouth Medical School. Students were asked to write about “a small, good thing” they had experienced during their four years of medical school; this story is one result of that assignment.

  A fourth-year medical school student recalls his second year of medical school, when he is intent on demonstrating his competence and skill as he takes an “H&P”—a history and physical. The medical student’s seriousness is delightfully undermined as a ninety-three-year-old man from Vermont’s Northeast Kingdom offers his own diagnostic story about living so long a life.

  TIMOTHY J. FISHER is an Ob-Gyn resident at the U.S. Naval Hospital in San Diego.

  My white coat still had the wrinkles in it and hadn’t yet developed the indelible ring-around-the-collar grunge that it has today. I was a second-year medical student, an impostor of the worst sort, sent out to prey on an unsuspecting inpatient to perform one of my first “H&P’s.” With clammy sweat on my brow and palms, I introduced myself in my best “I’malmost-a-doctor-can’t-you-tell?” voice and began my interrogation of the ninety-three-year-old man from the Northeast Kingdom. It seemed he had all the time in the world on his hands, while I had a precious, frantic hour in which to gather a history of present illness, to inquire about hemastochezia and tinnitus, to probe and prod, percuss and anscuctate.

  “So tell me about your family,” I said, doing my best to act as if I, too, had all the time in the world.

  He started in, and the beads of sweat started to drip down my temples as I realized he wasn’t meeting my agenda. I looked up from my cheat sheet to see him looking straight at me with what could only be described as a glimmer in his eye. It was a startlingly beautiful winter day, frigid and cobalt blue. A little part of me conceded, so I sat back to listen.

  “I had four brothers and I was the youngest.”

  Long pause.

  “Oh, the trouble we used to get into.”

  Pause. Chuckle.

  “My mother used to bake pies for the Saturday-night potluck dinner at church. When they came out of the oven, she would put them out on the porch to cool. Each one had a little hole in the top, and my brothers and I would take turns peeing right in that little hole. You should have seen the faces of the people at those church suppers! Oh how they complimented my mother on them pies . . .”

  Tears rolled down my face and I almost wet my pants from laughing. We both looked out the window for a long time, and he turned to me and said, “You know, I feel the same inside as I did back then. This body is just failing me.”

  Sarah Lentz

  COMMUNION

  This piece is another student response to Raymond Carver’s “A Small, Good Thing.” Here, a routine examination by an earnest medical student anxious to demonstrate her skill becomes a moment of poignant communion between doctor and
patient during, of all things, a rectal examination for cancer.

  SARAH LENTZ is a surgery resident at Emory University School of Medicine.

  Cardiovascular Surgery Elective. Two weeks of suturing—or so I thought. Within the first two days, Mr. T—returned for rehospitalization following a bivalvular replacement procedure. His first operation had not been entirely successful for he now had regurgitation around one of his new valves. A suture had pulled through, the valve had been defective or his aged tissue could not keep the valve in place—whatever the cause, he could not live in his current state: shortness of breath, fatigue, only being able to play with his grandchildren for minimal periods of time. And so he returned to the surgeons: whatever the risks, he was willing.

  I met him the night prior to his surgery. I completed the requisite history and physical. However, the attending inquired whether or not I had performed a rectal examination. “No,” I replied, since I had not wanted to put the patient or myself through the embarrassment. Later, I performed the examination, but only after I was sure he and his family had finished dinner and spent some time together.

  When he was alone, I timidly entered the room with latex glove and lubricative jelly in hand. He welcomed me in true northern New England style. He had been through this many times and so had no qualms. I talked, questioned, and listened to pass the time and make this easier—for both of us.

 

‹ Prev