by Toby Devens
Not a word about seeing me or even phoning me when he returned. So much for fantasies of being wrapped in his warm, pipe-tobacco-scented embrace.
The next morning, I was steady-handed and absolutely focused as I prowled through the reproductive organs of my uninsured patient, Freesia Odum. Ms. Odum, age forty-six, had a huge fibroid tumor hunkered down in her uterine wall. This, and three other sizeable tumors, were the cause of her excessive bleeding. I’d tried everything short of surgery to shrink these four big mamas. But now we’d come to the end of the line. Freesia Odum had a six-month-old granddaughter, LaTanya, to raise, and she certainly didn’t want any more children of her own. So I went about removing her uterus without my normal reluctance, leaving her healthy matched set of ovaries intact.
I don’t like to perform unnecessary surgery, but when conditions call for it, I do love to cut. In those horrendous weeks after Stan made his confession and knocked my world out of orbit, the only place I could find a semblance of peace was in the OR. There is something empowering and, I think, healing to the surgeon as well as the patient in slicing deftly through live tissue, dicing and splicing as Neil Potak calls it, and putting everything to rights. Funny, I have always been a lousy housekeeper, but I’m a skillful surgeon.
Of course, there are times when nothing you do is going to make it well, and those are the days you think you should have been a marketing major. But Freesia Odum’s pelvic cavity offered no surprises, and when she came around in recovery I could tell her honestly, “You’re going to be fine. You’ll probably live to be a hundred and be around for LaTanya’s grandbaby.”
She was too groggy to speak, but her hand crept out to grab mine and press it to her lips. I thought of my father working that second job to get me through Barnard and blessed his currently addled soul.
Case closed, I thought. But in fact it wasn’t. Every week, the staff of Potak, Berke, and Bernstein gathers for our medical review conference. We cover all the challenging cases on the docket, sharing experiences and getting instant consults from our colleagues.
In the middle of reviewing Freesia Odum’s procedure—“Six millimeter squamous cell. Highly impacted. One three millimeter—” I was interrupted. Interrupting a colleague mid-review is considered bad form, and I wasn’t surprised that this breach of professional protocol was executed in the exquisitely grating voice of Bethany McGowan, MD.
“This Freesia Odum is your uninsured?” she asked. As if she didn’t keep a running tab on my billing.
“Freesia Odum has no medical insurance, that is correct.” I’d been leaning over the patient chart on the conference table. Now I drew myself up and inquired with lavish politeness, “May I continue?”
“I thought it was settled that we weren’t going to absorb any more uncovered cases.” Someone had given her leave to say this, I realized, or she wouldn’t have dared press on. She darted a glance at Seymour Bernstein (likely culprit), who continued staring at the table, and then at Neil Potak (wouldn’t have put it past him, either), who was furiously retracting and reloading his ballpoint pen.
“I’m sorry,” I said, my voice thick with sarcasm, “I don’t think you qualify as my monitor. You’ve been associated with this practice for what, a little over a year? I was present at the creation. In your place, I would not presume to chastise a senior partner for her professional choices.” Deservedly tough.
The little ferret’s face turned bright red but she didn’t lower her gaze. I slashed on. “I don’t know if they taught medical ethics at Harvard,” as a child of blue-collar Baltimore, Johns Hopkins-trained, the Harvard thing had always rankled me, “but we have an obligation here to treat patients. True, we cannot treat every patient without regard for ability to pay, and these days we seem to be guided less by the Hippocratic Oath than by the bottom line. Nonetheless, when we see a patient in severe distress, it is our social and moral responsibility to at least consider whether we can afford to absorb that patient’s fees.”
“We’re not a nonprofit, Gwyn,” she had the temerity to back talk me.
“Jesus,” I said.
“Besides, that service area has Covenant as a safety net hospital.” She made “service area” sound like downtown Baghdad. “Covenant absorbs these cases. I don’t know why we—”
“Covenant takes only uninsured emergencies, as you know.” I was seething. “They don’t do routine care or non-emergency surgeries.”
“But,” she smirked as if she’d got the goods on me, “Covenant just got bought by UltaMed. That’s a major corporation. Who’s to say they won’t increase community outreach? Which, we need to remember, is not part of our mission.”
Cold. Very cold. I wanted to slap her. Neil glanced at my face and said quickly, “Let’s move on please. This is sidetracking us.”
“Why don’t you do a study on this, Bethany?” Seymour interjected. I figured him to be the lead horse in the field of possible coconspirators. Divorced and always on the make, he’d come on strong to Bethany when she joined the practice, but I thought she’d rebuffed him. Now I wasn’t so sure. Was this a setup? “See how many pro bonos we’ve all done. Cost to the practice. Then we’ll be able to balance it against goodwill in the community, PR, abstract stuff like that.”
“Fine,” Neil said. “Do the numbers, Bethany, and we’ll take a look at them.”
I steamed silently.
As we drew to a close, Neil said, “I was supposed to go to London for the IAGSO meeting, but Cheryl is having back surgery. Anyone want to fill in?”
Bethany’s hand shot up. She was that dorky kid everyone hated back in junior high for being first with the answer. Call on me, call on me. Ugh.
I cut her off at the pass. “Actually, I’m going, Neil. There’s a session on adjuvant therapy for stage 1B1 ovarian they asked me to chair.” Lie, lie, lie. He could check the program. “Last-minute fill in.”
“Well, that settles that then,” Neil said.
Our policy is never to have more than one doc at a time absent from the practice if we can help it. Bethany did not look happy. Play with the big boys, take your lumps.
After the meeting, Neil crooked a finger at me and I followed him into his office.
“You okay?”
“Sure,” I answered, “why do you ask?” Knowing.
“Well, you seemed somewhat emotional in there with Bethany. Don’t you think you came down a little hard on her?”
“Oh, for godssakes. She’s a pompous pain in the ass. And out of bounds. Where does she get off telling me who to treat? It’s not like I’m standing on North Avenue handing out coupons for free hysterectomies.”
“You’ve done five procedures without charge so far this year, Gwyn. Look, I know the Clinic was close to your heart and you feel we should take up the slack now that it’s shut down. But we’re not a free clinic, and we do have to keep an eye on the numbers.”
“This is a highly lucrative operation. It wouldn’t hurt to give a little back.”
“The times they are a-changing,” Neil said. “We cannot afford liberal largesse. We are not a welfare provider.” I’d heard this too many times before. Neil is way to the right politically. “You’re how old? Fifty-four? You’ll be retired in a decade.”
“Not necessarily,” I said, shocked. This was the first time either of the partners had brought up the age issue.
“Give or take a year. And Bethany is thirty. She has thirty-five years left to work. Look at her background: Harvard and Hopkins. We don’t want to lose her. Let me also remind you it’s in your best interest to have the practice continue to be a solid moneymaker since it’s going to support you in your retirement. Think about it.”
And back off, was the unstated sentiment. Back off, old gal. You’re nearly history.
After I left, pulse racing but head held high, I called my travel agent to book my f
light to London.
Chapter 7
Tuesday didn’t get off to a promising start.
While I was still chomping on my breakfast bar, my secretary put a call through. The director of the senior center where my father spent his Tuesdays apologized profusely for bothering me at the office, but Dad was about to flunk out of adult day care. “We’re very concerned because Mr. Swanson refuses to interact with our A-Team,” her cutesy-poo name for the Alzheimer group. “He wouldn’t participate in music therapy, personal expression, or the reminiscence activities designed to stimulate memory.” Apparently all he wanted was to sit with three of the fully cognitive senior women and snooze to the clacking of their knitting needles.
Well, that sounded like a good choice to me, like my father was using what was left of his noodle. But if he got expelled, I’d have to scramble for coverage for Tuesday, one of Sylvie’s two days off, so I said, absolutely, I understood the benefits of socialization and stimulating his synapses and I’d speak to his doctor and get back to her.
Three patients later, the receptionist ambushed me with the morning mail. On top of the stack was a response to one of my grant applications for the Clinic. We regret to inform you… the letter began, as if reporting a death. I was getting down to the last funding sources on my list, but I refused to even consider abandoning hope for the Clinic. I’d think of something. I had to.
At least my afternoon lecture to first-year medical students went well. But their youth, their brightness, their eagerness to take on the world with its smorgasbord of options left me mildly depressed. And late. Late was a problem because Fleur and I were going to dinner and she took tardiness as a personal affront.
Therefore I was distracted and hustling when I barreled through the door to her shop and crashed into her former longtime squeeze Jack Bloomberg barreling out. The thing is, I should have recognized him instantly from the smell of his cologne. Then again, it had been a while since I’d been engulfed in Jack’s eau de Pine-Sol and I hadn’t gotten a look at him when we collided, so I had to hear the “Sorry” he tossed back over his shoulder in his unmistakable gargle before I thought, Oh, my God, could it be? I spun around to see him trotting down Pratt Street into the setting sun as fast as his Florsheims could carry him. Even from the back, he looked thinner. And, oh Lord, he was wearing a toupee. But there was no denying that splayfooted gait, the rolled shirtsleeves, and the open vest flapping like wings. My heart sunk. Fleur’s ex was back. For—believe me—no good reason.
Inside there was no Fleur in sight, but I spotted her manager, Quincy Dickerson, exiting her office wringing his hands. When he saw me, he broke out one of his fabulous magenta-tinted smiles and strode my way, arms spread wide for an embrace.
“Kiss, kiss,” he said and did just that, first on one cheek, then another, European style. He backed me up to arm’s length. “Now you’re a sight for my gorgeous brown eyes. Love the hair. The blonde is blonder, right?”
“Just a few highlights around the face. It’s supposed to add a youthful glow.”
“You could pass for thirty-five.”
“Liar.”
“Well, yes, but didn’t it make you feel better for just a teensy second?”
Quincy rocked with delight at his own wit. He was a big man and a bigger woman, but man or woman, he always looked stunning. By day, he wore replica Armani suits a tailor in Cherry Hill whipped up for him. Three nights a week and on weekends, he was Queenella LaBella down at the Rhinoceros Lounge, a gay nightclub on South Charles Street, parading in fabulously glitzy evening gowns he ordered at discount through Madame Max.
“Quincy, tell me I didn’t see Jack Bloomberg coming out of here.”
His face fell. “Husband of Bambi, father of bambino in the flesh, though I have to admit a lot less flesh than he used to lug around.” He pursed his lips. “And how did you like the dead possum on his head? Anyway, there was much activity behind closed doors which I assume didn’t end with hugs and kisses from the looks of Madame. And just now, when I tried to give the tiniest bit of advice to the lovelorn, she snapped my head off. Um-um-um,” he said as we both turned to watch Fleur emerge from her office. “Look at that face. Not a happy bunny. Make sure she orders two martinis at dinner.”
“Sake,” I said. “We’re going to the Kyoto Inn.”
“Oh, God, raw fish. Eating like seals. What is wrong with you people?” As Fleur drew closer, her fake customer-smile fading, Quincy hoisted his bulk from the banquette. “Good luck, babykins. Take care and beware. And don’t make it another hundred years before I see that fabulous face.” With an air kiss, he was off.
“About time he got his fat ass back on the floor,” Fleur growled after he had skittered away. “I have had more than my share of fat asses for one day, sitting or standing or trying to squeeze themselves into Vikki Vi capri pants three sizes too small. Let’s get out of here.”
At the Kyoto Inn, she took her mood out on her diet, ordering about thirty dollars worth of sushi and a mountain of tempura. When the diminutive Japanese waitress bowed away, leaving six plates behind, Fleur said, “Don’t give me that look. I’m on Atkins. Or South Beach. I can never remember which, but fried is allowed. Okay, not the rice, but I deserve it. It’s been a rough day.”
“I can only imagine. I ran into Jack on his way out. Or he ran into me. Don’t worry, he didn’t stop to chat. I don’t think he even knew who I was.” Fleur swirled her California roll furiously in the soy sauce. “Ah, poor baby. You want to talk?”
“No, I do not. Not to you and not to Quincy Dickerson who’d better keep his nose out of my business or he or she is history. And I’m not a poor baby, Gwyneth, although I know you mean well. I’m a big girl in every sense of the word and I do not need anyone, not a transvestite Dear Abby, not even you to tell me how to run my life.”
Feelings hurt, I fiddled with my napkin. “We don’t want anything bad to happen to you, that’s all.”
“Nothing bad has happened. Nothing at all will happen. Look, Jack stopped by to return something of mine. No big deal. Case closed. Let’s eat.”
That was an order so I snared a shrimp dumpling. She speared a Dragon Roll stuffed with shrimp tempura and crowned with slices of lobster.
“Umm. Why does trayf taste so good?”
“Trayf?” I’d never heard the word before.
“It means unkosher in Yiddish. Meat from animals that oink and wallow in mud and creatures that scavenge the sea floor. The lowest of the low.” She popped another pinwheel of solid cholesterol into her mouth and chewed blissfully.
Fleur, whose family had funded the Talbot Memorial Window at Trinity Episcopal Cathedral in Roland Park, fancied herself an expert in all things Jewish. She’d learned all about Torah and Talmud, kosher and non when she converted five years back thinking it would goose Jack into marriage. His mother was still alive when the romance got serious, and the old lady planned a fatal heart attack if he married out of the faith. So Fleur took instruction from a rabbi thinking if Mother Bloomberg approved, Jack would propose. She even went through the mikvah, the ritual bath, and became an official nonshiksa. Except Jack never gave a rat’s ass about religion. He only went to synagogue to please Mama. When she died, all bets were off.
“You still go to temple?”
“On the high holidays. And I can still turn out a mean potato pancake at Hanukkah. But do you remember how Jack loved Christmas? I can still see him on the ladder hanging decorations. He really had a hard-on for that tree. It made him feel like Jimmy Stewart in It’s a Wonderful Life.” Jack again. And she’d brought him up. “Fine,” she continued, “if you must know, he came over to return a bracelet I lost. When they moved out of his townhouse a few months ago, Bambi found this under the bed.” She rolled up her sleeve, tugged a gold bangle over her broad wrist, and handed it to me. “Under the bed, isn’t that priceless? Oh, I wish I coul
d have been there when she saw the inscription.”
“Jack and Fleur, forever and a day,” I read aloud.
“Yeah, his watch never ran on time either.”
I handed back the bracelet. “And he had to bring it over in person? Why, because he wanted to show you his wig? We have mail service in this country. What’s wrong with UPS? Or he could have just dropped it off at the Waterview desk. And if Bambi found it months ago, why did he take so long returning it?”
“All wonderful questions. And the final Jeopardy answer is, I don’t know. I didn’t ask. I don’t care. I took back my bracelet and said thanks and good-bye.”
“Yes, but did you say good riddance?”
“Oh, for godssakes, I knew I shouldn’t discuss this with you. Let’s please change the subject. Lighten this up. Talk to me about cancer.”
By dessert we’d had enough rice wine to mellow us out. “So what’s happening with The Plan?” I asked, wanting to make sure that after Jack’s visit, the project was still a go.
“It’s coming along,” she said. “I was thinking, maybe I’ll register with Jewlove.com.”
“Jewlove.com. You’re kidding!” I laughed, snuffling tea up my nose.
“See what you’re missing? There’s a matchmaking site for everyone and anyone. Blacks, Jews, black Jews. People with every interest. Every twisted sexual practice. Every body type. I’m going on Fabulousfatties.com and Lusciousnlovely.com. You ought to go on Ivydate.com. It’s restricted to people from the top colleges. Connie deCrespi met a droolworthy Princeton lawyer on there.”
Constanza deCrespi, who was supposedly descended from Italian aristocracy, was Fleur’s attorney and the woman she held up as the epitome of upper-class cool. I’d met Connie and she had everything Fleur credited her with: charm, brains, a laid-back elegance. Just fifty. Divorced with a ball-breaking settlement. Looking around for husband number two. Online, yet.
“When she found out he had a shoe fetish, Connie dropped him. But still.”