Tooth and Nail

by Linda D. Dahl

  * * *

  “Dr. Marsh, is this your new associate? I heard you hired someone from the Bronx program, and I had to see her for myself.” A middle-aged Indian man I didn’t recognize approached us. His face, with large eyes bulging under highly concave lids and an openmouthed, permanent smile, reminded me of that Muppet on TV who always laughed at his own jokes. When he held out his hand to greet me, I was surprised there was no fur or invisible string. “I’m Dr. Patel. We’ve never met. I trained here, in the city,” he said, emphasizing his geographic superiority.

  This was the first holiday party I’d attended since joining the practice. My boss, Dr. Marsh, insisted I subject myself to more hospital functions to get to know my colleagues. Ten minutes in and it was already clear I didn’t belong.

  Dr. Marsh, at least twenty years my senior, was tall and lanky, with a white scruffy beard and glasses. He was detached and calm, yet somehow magnetic. His conversations easily drew people in, creating an intimacy that made even simple exchanges feel like shared secrets. He primarily treated children, and their parents loved him, as did every one of his colleagues.

  I shook the moist and too-tight grip of Dr. Patel as he sized me up. I wanted to tell him not to worry because I was no match for him, especially in this hospital system. After residency, my colleagues scattered to other boroughs and the suburbs, so I had no connections in the city. But he seemed desperate to find that out for himself.

  He introduced the woman standing next to him as his wife, a cardiologist. She wore enormous diamond earrings. I could barely make out her eyes from behind the reflection of her glasses, whose frame bore the interconnected Cs of affluence. She spoke slowly, waving her perfectly manicured fingernails in front of her face as her lips moved. “You must be new. Are you a resident? I usually know everyone at these functions, since we are so involved in the hospital.” She looked me up and down, stopping with raised eyebrows at my neckline, which was obviously too low for her taste.

  I slowly crossed my arms over my exposed chest, hating myself for yet again taking fashion advice from my mother. But I couldn’t help it. Over the years, her criticism of my physical appearance had evolved into an art form, so convincing I believed in it like a religion.

  When I had mentioned the party, she had insisted I buy a designer dress to impress the other doctors. To her, the word designer meant expensive and fancy, neither of which could be used to describe the black, V-neck Spice Girl’s wardrobe malfunction she had found for me at TJ Maxx. Although she had pointed out that I was a little too old, fat and frumpy for the style, she had insisted I buy it anyway, reminding me I needed her guidance to learn how to be more feminine. According to her, my sense of style was only made worse by all those years of surgical scrubs and clogs, not that I had any idea how to look good before that.

  In the sixth grade, my mother had decided I should get a haircut like Princess Diana. Instead of offering her usual homemade do, she had splurged on a cut at the expensive JCPenney salon. She had been convinced that flipped bangs and a shaggy bob would somehow make me prettier. At the very least, they would soften my harsh Arabic features. Once, when I had complained that a classmate had said my nose was uglier than my moustache, she had assured me there was no sense in thinking I would grow to love myself. “If you want to feel better,” she offered, “you need to become a rich doctor so you can afford to fix your face.”

  “Uh, are you sure this will work with her hair?” the hairdresser had asked, lifting my coarse, wavy locks through spread fingers.

  “Oh yes, her sister had that haircut last week, and it was perfect,” my mother had insisted. My sister had the same delicate features and blond hair as my mother. In fact, she bore such little resemblance to me, people often questioned our relationship.

  The hairdresser had gone to work, chopping away hair, trying to even out one side, then the other, until she could do no more. Literally. In the end, she’d left me with a Frankenstein-like crew cut. I was no Lady Di.

  On the way home, my mother had tried to hide her horror. “You look mature,” she said. “I’m sure no one else in your class has the same haircut.” That part was true. The only children who had haircuts like mine were in military school.

  The next day, I received the most attention I’d ever had in my life. At first I was proud. My father had told me if people stared, it meant they were jealous. It wasn’t until lunch, when a first grader had pointed out to the whole lunchroom that I looked like the ugly duckling, that I realized what the stares really meant. I was a freak, and trying to be like everyone else made me stand out even more. I’d spent the rest of the day hiding in the bathroom, coming to terms with my place as a darkie, but still appreciative that my mother had tried to help.

  One of the servers, wearing practically the same dress as me, carried a tray of drinks to where we were standing. I grabbed a glass and took a sip of the red liquid. “I haven’t been in practice that long,” I continued, wishing the wine could inebriate me on contact. “So, do you live in the city?” I asked, to no one in particular.

  Dr. Patel could barely contain his excitement. My question set him up perfectly for his next segment. “Yes, we just bought in the Belvedere, a few blocks from here. The chairman of the board is my patient, so they approved us right away. Which is great, because our nanny has a shorter walk to our son’s preschool. He goes to the Town School, with the granddaughter of the president of the hospital.” He went on, dropping so many names and titles I wanted to offer him a suitcase to carry them home. “Where do you live?” he asked.

  Quickly recalling his comments, I tried to piggyback on some of them with my credentials. I had nothing. I didn’t have a nanny or know any chairs of any boards. I didn’t even know why knowing a chairman mattered for an apartment. The Town School was apparently important for some reason, but I didn’t know why a grown man would care about preschool. And I didn’t know any presidents.

  Since there was nothing even remotely impressive about me, I chose a different strategy. I tried to be purposefully vague. New York was so big I could just give him a general area, and the questioning would stop. “I live on York Avenue,” I said and took another gulp of wine.

  He frowned, and his Muppet face instantly changed to the grumpy one that looks like an eagle. “You mean near the hospital? Those are great units.” How was it that he knew every single street and apartment building in the area?

  “No, farther north. Ninety-First Street,” I said, certain he would be satisfied with that. Little did I know, he was slowly giving me a rope long enough to hang myself.

  “Oh, the Barclay. I know that rental,” he said, visibly relieved. “A lot of people start out there when they first move to the city. It can take years to save up enough to buy a place. I’ve been in practice close to seven, and we’ve finally bought something.”

  “Yes, dear, but it’s just the penthouse,” his wife said, tucking her hair behind her ear.

  Seven years? We? Anywhere else in the country, my salary alone would have been enough to buy a small mansion. In New York I was barely making it. After the divorce, I downsized to a one-bedroom near the projects so I could afford luxuries like utensils and sheets. My living situation was more college dorm than real home, eating leftover pizza on the floor until I could afford a couch. I was still waiting for the rich-doctor part to kick in, when my sacrifice and hard work would pay off. But from the sound of it, it wasn’t happening anytime soon.

  Pleased at my discomfort, Dr. Patel continued his line of questioning, moving on to a more personal subject. “So what does your husband do? Is he also a doctor?”

  There was no way out of this one. I could either continue to try and weasel my way out or just buck up and take it. I remembered watching a movie about a guy who had to do a rap-off against a popular, more confident opponent. Every time he tried to battle, he choked and lost. In the final scene, he decided to own his own weaknesses
up front, stealing the thunder from his opponent’s rebuttal and winning the contest. I figured What the hell? I had nothing left to lose. It worked for Eminem, and he was from Detroit.

  “I’m divorced,” I said. “My husband was an artist who had even less money than me—can you believe it? I was lucky he even wanted to marry me. I mean, I grew up in North Dakota with crazy immigrant parents, so that doesn’t exactly make you popular, you know? I trained in the Bronx, so I’m really good at dealing with gangsters and huge, fungating tumors, if you come across any of those. Needless to say, I don’t know any chairmen or presidents of anything, but if you know any single ones, send them my way. I’d love to get out of my rental apartment.” I uncrossed my arms, drained the last bit of wine and fought back the urge to mic-drop the empty glass.

  Unfortunately, my words had the opposite effect I’d intended. Dr. Patel’s expression changed to one of pity, suddenly aware that he’d wasted his arrows on such meager game. His wife grimaced and excused herself to use the powder room. Dr. Marsh shook his head and chuckled, enjoying the absurdity of the whole situation. He leaned in close and whispered, “Nice job.”

  * * *

  I was just as awkward in the office. The practice I joined catered to the wealthy, and by wealthy I mean ultrarich. Not like North Dakota, where wealthy meant you owned a Ford pickup truck with a second row of seats and your wall-to-wall-carpeted house wasn’t in a trailer park. These patients owned things like grocery-store chains and small countries. I had known that the ultrawealthy existed because I read about them in Vogue and the Style section of the New York Times. What I didn’t know was that, by joining this practice, I would have to live and work among them in their native habitat. I felt like a zebra in a gilded jungle. And all the hyenas were dressed in Gucci.

  * * *

  “Good morning, Dr. Dahl. Your first patient is in room one. Dr. Marsh isn’t in today, so we put Jimmy on your schedule. He’s in there with his mom.” Because I hadn’t yet developed a following, the staff filled my schedule with overflows from the other doctors. It was hard to pick up where they had left off, but it was better than an empty schedule.

  I read through the patient’s chart. He was three years old and had persistent fluid in his middle ear. He also had speech delay, probably because the fluid muffled his hearing. Dr. Marsh had been treating him for six months, and today was just a follow-up. The stakes were low, but I still had a knot in my stomach. Even simple encounters were ripe with opportunities for humiliation.

  Jimmy was seated on the exam chair in the lap of a woman who had the tan skin and dark hair of someone who came from the islands, possibly Puerto Rico, and spoke to him in Spanish. In the corner of the room, a blonde woman was focused intensely on a magazine I had never heard of. On the cover was a glossy picture of a model dressed in clothing no one actually wore.

  “Hi, I’m Dr. Dahl. What can I do for you today?” That was my standard line, somewhere between flight attendant and telephone operator. Years working as a fast-food cashier in high school had permanently imprinted customer service into my psyche. It took everything I had to stop from asking if they wanted fries with their diagnosis. Without thinking, I looked straight up at the adult occupying the exam chair.

  “That’s Rosa, James’s nanny. I am his mother,” said the blonde, standing up in the tallest stilettos I had ever seen. Thick gold jewelry hung in strands from her neck and around her wrists. Her white pants were tight and unforgiving, but her body had nothing to beg forgiveness for. She looked at me through dull, expressionless eyes, pursing her artificially full lips before speaking. “You are the doctor?”

  “Yes, I’m Dr. Dahl. Dr. Marsh isn’t in today. I thought they’d explained that when they made your appointment.” Although her face barely moved, she was visibly annoyed, I assumed because she was expecting to get what she’d paid for. My bosses took the paradoxical approach of charging cash up front for medical services. The way they explained it, when you are really rich, the more money you spend, the more elite the experience. To the very wealthy, it is more important to have something that no one else can afford than it is to have the best care.

  She stared at me. “I wasn’t expecting someone so...inexperienced. I hope you know what you’re doing.” She huffed and turned to pick up the child.

  “No, no, no! Wosa, Wosa!” Jimmy screamed, squirming in protest and batting at his mother. As she reached for him, he lifted his arms, then went limp, using his dead weight to prevent the exchange of laps.

  After thirty seconds of struggle and almost losing her balance, his mother finally relented. She took a step back and smoothed the edges of her hair again, nearly blinding me with the largest diamond I’d seen since Dr. Haven’s. Instead of making me angry like it had back then, it served more as a reminder of who was actually in charge.

  “Okay, James. I know you’re tired because we’ve been waiting so long for Dr. Dahl. You can sit there with Rosa,” she said.

  I glanced at the clock. It was only ten minutes after his scheduled appointment.

  “Can I check your ears?” I asked Jimmy, slowly approaching him like a zookeeper circling a wounded animal. As I neared his head with my otoscope, he screamed and batted at me. Rosa impotently tried to calm him by patting his head.

  “Can you hold his arms so I can take a look?” I asked, again misdirecting my question to Rosa.

  His mother had returned to her seat in the corner, arms crossed. “I do not restrain my son,” she said. “His therapist says it causes more anxiety. Strangers, like you, also make him nervous.”

  I was at a loss. I had to check him, but his mother was doing everything she could to reinforce my insecurity. I didn’t know why she hated me so much, but her disapproval only made me want to impress her more.

  “You really have no idea how to handle children. You’re obviously not a mother. Did Dr. Marsh interview you himself, or did he let one of his lackeys hire you?” She shook her head, barely able to roll her eyes under heavy eyelids. Her skin was so smooth she looked like a talking sculpture with a horrible case of Botox. I wondered if the poison had leaked out of her face to her insides, freezing her heart like it had frozen her face.

  Awkwardly, I grabbed the moving target of Jimmy’s left ear and managed to peek inside with my otoscope. Behind his eardrum, the fluid had congealed into a glue-like substance that was unlikely to resolve unless I poked a hole through the membrane and drained it. In other words, surgery. I groaned internally, doubtful I had the courage to make that recommendation to his mother.

  “Did you see anything?” she asked.

  “Um, Jimmy still has fluid in his ears. He can’t hear well, but if we remove the fluid his hearing will go back to normal.” I ended the last syllable on a higher pitch, instantly transforming my statement into a question. I couldn’t believe that, after all the hazing I’d endured in residency, I could still be so easily intimidated by this woman.

  “You’re saying you want to do surgery on my son? I told Dr. Marsh I don’t believe in surgery! Didn’t you read his chart?” I had read the chart, but Dr. Marsh hadn’t written anything about how insane this mother was.

  “James has been working with a homeopath. He’s also getting acupuncture, speech and occupational therapy, and he has an aide in preschool. I can’t believe your only suggestion is surgery! How can I be paying for this? I want to speak to the office manager!” She raised her voice so loud that the medical assistant peeked in to see if everything was all right.

  Moving past the assistant, Jimmy’s mother stormed out of the room to the main desk, leaving me alone with Jimmy and Rosa. Both stared down at the floor, like prisoners in an invisible jail cell. Seeing that there was nothing left for me to ruin, I went to my office to hide.

  Through the closed door, I could hear Jimmy’s mother screaming about my incompetence, loud enough for the entire waiting room to hear. After what seemed like an etern
ity, her voice died down, and everything went quiet. There was a knock at the door.

  “Come in,” I said, my voice barely above a whisper.

  It was Janet, the office manager. She was a tall woman in her fifties, who had worked for the practice for nearly a decade. I knew very little about her personal life, but her loyalty to the practice rivaled the fidelity in a solid marriage. She was direct about where everyone stood and didn’t try to sugarcoat anything. “Well, she wasn’t happy, but I managed to calm her down. I don’t know what you did to her, but her husband runs a hedge fund and owns a lot of real estate on Park Avenue. I set up Jimmy to see Dr. Marsh later this week for a complimentary visit, but he won’t be happy to hear about it.”

  In other words, I better learn how to behave, or my job would be in jeopardy. Any more mess-ups and Jimmy’s mother would go down the street to another practice. And since the wealthy move in packs, she would take all her rich friends with her.

  “I’m sorry. It won’t happen again,” I muttered. Those words felt too familiar. I’d spent half my life apologizing for what I didn’t know instead of benefiting from what I did know. Ironically, moving from the Bronx to Manhattan had felt more like a step back than a step forward. Nothing I had learned from the hood helped me out in the jungle. I had to start all over again.

  * * *

  “Are you ready to go? Amber should be at the restaurant by now,” Dr. Larson said, urging me out the door. He had been hired by the same practice a few months after me. Slight of stature and build, he carried himself with an air of entitlement. Other than the fact that we were around the same age and newly single, we had little in common. But he was the closest thing to a friend I had so far.