“Damn!” Beata exclaims. “I didn’t notice how much it snowed during dinner.”
“There, there. Winter princess comes to your rescue.”
Brushing away the soft snow, they work fast to ward off the cold.
“Let me give you a lift.”
“It’s only a few blocks and I need the air.”
Beata hugs her. “You’re a stubborn one.”
“Take care!”
“You do the same, Doctor. Think about taking a break. You could skip the chapel part of the retreat and just wander around the snowy woodland and join us for delicious meals.”
FOURTEEN
March, 1997, Minnesota
Monica slips through the dim lobby, sets the steaming latte on her desk and closes her door, careful not to disturb any other early birds.
They all share exam space. Still, this room is her home base. Attached to the ceiling is a blue and red mobile from the Farmer’s Market which is particularly popular with women getting pap smears. Men rarely comment on it.
Sipping the latte, she opens the laptop, determined to catch up on the wretched computer system. As clinic director, Louise has persuaded everyone to standardize records. Her interview charts are labyrinthine. In another life, Louise designed torture instruments. Enough, she’s got to clean up her attitude toward “teammates” as Louise likes to call them. The woman is a hard worker; everyone has quirks.
She squints at multi-colored tables. God, she misses the intimacy of taking notes as patients talk. Conversation. Making eye contact. Asking intuitive questions. With this computer, she’s more of an admissions clerk than a physician, always waiting for the next item on the chart. OK, Louise is right in some ways. What if a patient has a crisis when she’s out of town? Who could read her shorthand? She’ll get this down. But not this morning because the clinic opens in twenty minutes.
Startled by Brewster’s radio, she finishes her coffee and closes the program. Their charming and ever-patient receptionist always begins mornings—before he thinks anyone has arrived—with NPR news.
She opens another program to confirm her schedule: a pretty average day. Three routine check-ups. One flexible sigmoidoscopy. Mrs. Polanski is worried about her memory again. Two people with flu symptoms, a follow-up on Roger’s broken arm, an anti-depressant consult, ear infection, skin cancer assessment. A crowded list—she hates how Louise limits consultations to twenty minutes—but still manageable.
Brewster turns off the radio. She hears him clicking on all the lights; his crepe rubber soles squeak on the clean floor.
She opens her door for air.
“Monica!” He looks embarrassed. “Did my radio disturb you? I thought…”
“No, it’s reassuring that someone pays attention to world news. I was getting a head start on that new computer program.”
He laughs knowingly. “Stunning how much work labor saving devices take.”
Her first patient is giggling. Monica remembers Clare was referred by three other lesbian patients. She likes a diverse roster. Wishes it were more ethnically mixed.
“Why so merry?” she smiles.
“Your assistant Gao was refreshing my health history on the computer.” She bursts into hysterics. “I guess you have to start from scratch with the new PC system?”
“Yes,” she answers neutrally.
“So she asked if I were sexually active.”
Monica sees it coming.
“Then she asked, ‘with a man or a woman or both?’ ”
She nods, waiting.
“I said I’ve been in a monogamous lesbian relationship for twenty years. Then she asked, ‘Do you use contraception?’ ”
Monica blushes at the system’s rigidity.
“I couldn’t help laughing. ‘What kind of question is that?’ I teased. Gao shrugged and broke into a small smile.”
“Gao has no other option. Our director requires her to ask all the prescribed questions.”
Clare laughs again. “It’s OK, really. But I can’t wait to tell Anita.”
*****
Monica hates running late. “Sorry to keep you, Mrs. Polanski.”
“Oh, Doctor, I thought they weren’t going to let me see you. That nice Chinese lady asked so many questions. I explained I had a doctor. But that didn’t matter.”
“Gao is my assistant, Mrs. Polanski. She meets with each person first.”
“Isn’t that nice. I’ve always liked the Chinese: such industrious people. Polite.”
No point in explaining “Gao” means “song” in Hmong; this would take them even further afield.
“How are you doing today? Gao notes that you still need a refill on the hypertension meds and that you have some questions about your memory.”
Mrs. Polanski’s list of concerns grows longer than either of them anticipate.
The patient’s real problems often get mentioned in passing. Clinical Practice 101. She unbuttons her lab coat, realizing this hot turtleneck is a mistake.
Knocking at the door.
“Excuse me.” A red-faced Gao delivers the note. From Louise.
Monica doesn’t need to unfold the green paper. She’s already gone over Mrs. P’s allotted time. As a Medicaid patient, Mrs. Polanski isn’t high on Louise’s triage list.
“Thank you, Gao. Please tell Louise I got the message.”
She slips it into her pocket to share with Alonso. Tonight they’ll do a “mental health session” over coffee. She’s lucky to have a colleague she can be candid with.
“Mrs. Polanski, please ask Brewster for an appointment in early April.” Normally, she’d wait for more questions. But she should get to this clinic meeting.
*****
Outside the conference room, she pauses for two deep breaths. Detach, Beata advises. Beata schedules transcendence into her weekly routine. On Tuesdays and Fridays, she eats lunch solo, reading her meditation books.
Louise pointedly consults her watch as Monica enters. Then she continues with the meeting. “We’ve got to streamline the rota more.”
Alonso raises a furry eyebrow to Monica, patting the adjacent chair.
“Yes,” Jill is agreeing. “It’s like the Peter Principle. The more minutes you have, the more time you waste. These radio spots teach me succinctness, minute by minute economy. If we spent less time, patients might take more responsibility for their own health.”
“But,” Monica leans forward, “isn’t coming to the clinic responsible?” She bites her lip, knowing she should have sat out the first couple of exchanges. She concentrates on her sandwich. The mustard tastes vinegary.
Louise’s gaze is frosty. “I believe our teammate is talking about self-sufficiency and not running to mama with each scraped knee.”
“Don’t you think that’s a little patronizing?” inquires Amber.
Monica watches her closely, glad for the comradeship, but concerned about her job security. The nurse practitioner usually keeps to herself at these debates.
Gabe leans forward, fiddling with a tuft of grey in his beard. “We mustn’t jump to a decision. We should consider the options prayerfully.”
Monica looks at the wall behind Louise where a chart of the human body reveals organs, bones, muscles in garish colors. They are all competent diagnosticians. What do they understand about healing?
“Colleagues,” Louise clears her throat. Monica is a little envious of this tall, handsome woman with straight silver hair. Louise’s nose crooks at a dramatic angle, yet it’s another of her pretty baubles. From the side, her face is magnetic because of the sculpted cheek bones and the pastel blue eyes.
“We have just ten minutes left to…” Louise begins.
She wields fragility and toughnes
s. Monica knows she’s as bright as Louise, but lacking strategic instincts. Beata and Alonso have adamantly confirmed that deficit.
“…come to a consensus on patient schedules.”
“It’s hard to cut off people when they’re anxiously talking,” Gabe sighs. “Especially older people.”
“Your empathy is admirable.” Louise’s jaw juts almost imperceptibly. “But we’re a team here.”
“That’s right,” Jill says sincerely.
Monica wonders.
“We share overhead costs,” Louise adds. “Remember the common good.”
Brewster raps on the door. “Sorry doc. Patient time.”
Seething all the way to the hospital, she warily concentrates on navigating her car through the new blanket of snow. As someone committed to preventive medicine, she should really avoid running over pedestrians. But, good god, the gall of Louise. The coy coolness of Jill. The ineptitude of Gabe. No, Monica, focus on the road.
Entering the enormous brick hospital, she shakes off her irritability. Realistic optimism is the foundation of successful bedside manner. Plus there’s reason to be cheerful about Robert. A fit, twenty-six year-old man is strong enough to overcome pneumonia, especially with a new course of anti-retrovirals. She stops at the restroom to brush her hair and splash cold water on her face. “Leave the forces of doomed efficiency behind,” she whispers to the mirror. “Let Gabe take care of them in his prayers.”
Refreshed, she hurries down the hall to her recovering patient. AIDS is a lottery. Chance and genes foil all predictions.
Robert lies, pale and drawn, staring at the ceiling.
“Hey, you,” she cajoles, “I thought you’d be shooting baskets when I arrived.”
“Not yet.” His voice is thick, soupy.
“The new meds haven’t helped yet?” She tries to remain upbeat.
“Which new meds?”
She inspects the chart. “What’s this?”
Robert, like most of her HIV/AIDS patients, closely monitors medication. “Insurance company nixed them.”
“What? We’ll see about that!” she explodes, then calms down for Robert’s sake. “I’ll be back.”
“I’m not going anywhere soon. I hope.”
Ben, one of her favorite nurses, is on the phone.
Settle down, she tells herself. Whatever happened, it’s not the nurse’s fault.
The short black man finishes his call, immediately turning. “Robert?”
“Yes. What happened with the new course of meds I prescribed?”
“Insurance company,” he shrugs irritably.
“Why wasn’t I called?”
“The resident said she phoned you. I know you were on her list. But we had two cardiac arrests…” He shakes his head. “This really sucks, you know.”
“I’ll phone the health plan, myself. Can you get the number?”
“Rightie here, Joan of Arc. Best of luck.”
She waits five minutes in the “physicians’ queue,” listening to the Goldberg Variations. Damn. She can’t tie up the nurses’ line. She needs to get back to Robert, then visit three more people at the hospital before returning to the clinic.
“I’ll call from home, Ben. Usually, I get through around midnight.”
“Go Doctor!” Ben grins. “Don’t wear yourself out.”
Lake Clinic is hopping: a typical late winter afternoon. After four patients, Monica forces herself into a time-out, carrying a half cup of coffee to the staff bathroom. Often five minutes are enough. She lets herself get too angry. Maybe she does need Beata’s serenity retreat, if only it came without droning priests.
The young man is literally wringing his hands.
“Sometimes SSRI’s stop working,” She checks his chart. “Five years on Zoloft?”
“No, Dr. Jill prescribed it last spring.”
“Really, oh, well, sometimes these computer records are unreliable.”
“I met Dr. Jill last April, after hearing an awesome radio program about depression.”
“Tell me how long the prescription worked for you?”
He fights tears. “I feel like such a wimp. I drag myself to work and just sit there. I’m going to lose my job. I’ve already lost my mind.”
“Don’t blame yourself,” she says fiercely. “Depression often has complicated physiological components too. Your therapist’s note says you’ve been in counseling two years. So you’ve covered the bases.”
He tugs a tissue from the box beside her laptop and blows his nose.
“For how long was the Zoloft effective?” she tries again.
“I’d say it lasted maybe a month.”
“A month? Why didn’t you check back with Dr. Jill?”
“She’s been busy. They couldn’t squeeze me in. I call every few weeks. Finally I gave up and told that nice guy Brewster that I’d talk to anyone.”
“I see. Let’s discuss alternatives, non-serotonins like Wellbutrin and Atavan.”
“Do they have side effects?”
“All pharmaceuticals have side effects. I was just about to discuss them.”
“First, Doctor, what do you think of flower essences? My herbalist wants to try sage.”
“I’ve studied alternative medicines, but flower essences aren’t in my repertoire.”
Brewster appears at the door in his down parka and woolen cap. “Just wanted to say I’ll lock the front door on my way out.”
“Sorry, Doctor, I’m keeping you. I can come back when Dr. Jill has an opening.”
“As you like,” she says, “or you could stay to see if we find another anti-depressant.”
“If you’re sure I’m not keeping you.”
“This is my job. Now, let’s consider those possible side effects.”
*****
What happened to her weekend? She steps on the gas, determined not to be late for dinner with Jeanne and Mom. Otherwise, Jeanne will snap that she’s too busy for her humble family. “Humble family,” she actually used that phrase last time. Wild traffic on 94 East! The sunny day has impelled thousands to head for the Wisconsin hills.
She zips off at Snelling, suffused with nostalgia. Summit Avenue—when she was a kid, she dreamed of living in one of the mansions on Summit. She’d marry a doctor and raise a girl and a boy. The poodle would be named Clarence. Most nights, she fell asleep decorating the imaginary house—overstuffed sea green sofa and chairs in the parlor. A grand piano. The shiny oak table graced with fresh flowers. Carnations—how she loved those flowers before the funerals started.
Summit Avenue fantasies evaporated with Dad’s disappearance. Realism was her mode now. They had watched TV westerns together. “Wouldn’t you love to gallop a wild horse across the mountains?” he’d ask. They studied the constellations on clear nights. “Nothing better, good buddy,” he once told her, “than to die under the stars.”
Jeanne, on the other hand, had always been Dad’s “baby doll.” When he left, his pretty doll began to eat and eat. These days, drink appeals more than food.
Easier to let go of being a buddy than being a baby doll. Monica dates her tenacity to those days. Sometimes she thanks him for a healthy dose of pragmatism.
Oakhill Road is five minutes and a world away from Summit Avenue: small wooden houses and carefully kempt yards. The exteriors haven’t changed much, but Mom’s new neighbors are Hmong or Somali. “Fascinating!” she tells Jeanne and Monica.
Guardedly, she climbs the slippery steps, resolving to salt them before she leaves.
Jeanne opens the door. She’s checking her watch.
“Busy at work, Doctor?”
She pecks Jeanne’s flushed cheek. “Sorry, I ran into unexpected
traffic.”
“Yeah, I saw lots of cars on the two-hour drive from Duluth.” She nibbles an olive from her martini.
Monica sighs. Her beautiful little sister is ten pounds heavier this month.
Jeanne notices Monica’s worried look. “Don’t get on my case. It’s Sunday. Some people go to church. I have a little drink.”
“What about church?” Mom appears, wiping her hands on a new flowered apron.
They each smile sheepishly.
“Has one of my daughters finally returned to Mass?”
Monica wraps her arms around this loving woman with curly blonde hair and a wide smile. She looks 10 years older than her 73 years, and Monica feels her fragility as they hug. She senses years of struggle, loneliness and hard work.
Gently withdrawing from the steadfast embrace, she winks. “Every Sunday…”
They speak in unison. “Every Sunday you light a candle for our safe return.”
“Two candles,” she says firmly.
The sisters smile at one another.
Mom shrugs, returns to the kitchen. “Come help me serve the food.”
The table is laden with mashed potatoes, turnips, glazed carrots, roast lamb, mint jelly, like the bounteous Sunday dinners of their youth.
Monica and Jeanne wait for grace, hands folded in their laps.
“Bless us, oh Lord, for these Thy gifts which we are about to receive,” Mom prays. “Thank you for bringing our wee family together on Your day. Amen.”
They fill their plates, eating silently, perhaps hungrily. Monica, for one, is grateful for the distraction of the food.
Mom turns to her, “Now what happened to that tiny baby—two months premature, I think—you mentioned last time?”
“I’m happy to report—for Mary Anne’s sake and for Mom’s—that Little Andrea has gone home from the hospital.”
Traveling with Spirits Page 13