Besides the five hundred American dollars, we have almost no money left. We have spent it all on our trip. So instead of taking a cab or the subway we walk from Penn Station across Manhattan.
Dr. Caine’s office looks like it has not changed in fifty years. In the sublevel waiting room, already full at eight in the morning, the midcentury end tables are cluttered and clustered with magazines and sculptures and braided mahogany lamps. The frame around the current receptionist’s window is painted toothpaste green. Here in New York, I think, the doctor could make a lot of money renting out the space for a movie scene in a doctor’s office circa 1969.
He already makes a lot of money, though. When the receptionist calls Aaron’s name, I take out the billfold and count out the five bills. The office accepts no insurance, and only cash. How many patients does he see a day? Ten? Twenty?
The internet gives the doctor mixed reviews. One five-star reviewer calls him a “genius.” A one-star reviewer calls him a “quack.”
So I am in a heightened state of my usual state of alertness when the doctor appears in the waiting room and hustles us into his ancient-looking, high-ceilinged office. He is a small, old man with a blunt face and a full head of silky white-blond hair. He has received no records (the office neither emails nor faxes), knows nothing about Aaron’s history, so Aaron fills it in, the abbreviated version. The only other parasite testing he did—the stool sample we sent off to Colorado—came back rather inconclusively, showing a very small amount of two types of protozoa.
How long have the symptoms been with you? the doctor wants to know.
“Eight years,” Aaron says.
Nothing else could cause those symptoms for eight years, the doctor says. Nothing bacterial. Certainly nothing viral. Some parasites can live, very contentedly, for up to twenty years inside of us.
I see Aaron actually gulp. It is exactly what he wants to hear and the last thing he wants to hear.
Dr. Caine reaches—he doesn’t have to reach far—for a book on his desk. It is his own book, on tropical medicine, though parasitic infections are not limited to the tropics, he tells us, paging through the book. We nod. We know, but it is good to hear it from him. Then he reads us a paragraph from his book. I can’t really focus on the words he’s saying. I can only pay attention to the fact that he is reading to us from his own book.
In the exam room next door, Aaron puts on a gown, open in back. Is there a sweeter and more vulnerable sight than a man in a hospital gown? I sit in the corner, holding his clothes folded in my lap. We make jokes about the anal swab to come, because when you’re about to get an anal swab, there is nothing to do but make jokes. When the doctor comes in, he puts on a pair of gloves and asks Aaron to turn to the wall.
“Which wall?” Aaron asks.
The doctor laughs. In all his years of doing this, he says, no one has asked that question.
Bravely, he turns over. My husband who does not like to turn his back to anyone. He’s had colonoscopies before, but he’s been blessedly unconscious. What I think of, cringing, is a pap smear. The speculum, the gel, the specimen, the strange feeling of having your cells scraped from some hollow place inside you. I hold my breath while the doctor narrates what he’s doing. The only reliable way to test for parasites, he says, is to look for evidence in the rectal mucosa. By the time a stool sample is processed, parasites and their eggs are often dead.
“What are these?” the doctor asks, looking at the purple scars on Aaron’s thighs. “Injection sites?”
He says it casually, as if he’s not really curious, just making conversation. He says it while his hand is inside my husband.
Aaron lies still. He couldn’t move if he wanted to. He says, “No.”
“No,” I say, sitting up straight. “No, they’re scars. From lesions. From the skin disease we mentioned?”
Why don’t I tell him that half the doctors we’ve seen look at Aaron’s skin and ask if he’s using drugs, that it is the last possible question he needs to hear, with or without a hand up his ass? Why don’t I explain that it’s not the accusation that he’s a drug user that’s so insulting, but the accusation that he has somehow caused this disease himself?
When the doctor is done, he leaves the room, and Aaron sits up slowly, as though waking up from a sedative. I don’t even want to acknowledge the question that has just been asked, the question that erases every step we’ve taken toward this office, every one of those five hundred-dollar bills. None of it matters. Now this doctor will be in a pile with the rest of them.
On the walk back to Penn Station, Aaron grows heavy. He shuffles slowly, as though into a wind, but it is not windy; it is a beautiful July morning in New York, still early, the city still waking. All along Central Park South, we walk arm in arm, and I remember our time here eighteen years ago, this path I walked every evening that summer, the joy I felt putting my new cell phone to my ear to call Aaron after a day at work. That summer before the world went wrong, the park was full of magic. The yellow construction cranes reminded me of wild animals, giraffes reaching up into the treetops. Now Aaron stops to rest on street corners, on benches. For a while, we don’t speak. Then the light turns. We pause on a corner. “Did he really say that?” he mumbles. “Did I make it up?”
I hold him around the waist. The yeasty heat of his body rises. His body tenses. “He said it,” I say. “I’m so sorry.”
The rest of the walk, I have to hold him tight to keep him upright, to keep him from stepping into the street. I can feel his body muscling toward the traffic.
Come on, I will him. Let’s keep going.
* * *
When we return to Ithaca, a package is waiting for Aaron. His uncle, his mother’s brother, has sent him a batch of family photos and letters. Aaron thumbs through them, holding them at an arm’s length. There are photos of newborn Sandra, Sandra at her first communion, Sandra with her first two children, Sandra hugging Aaron’s father in a park. There are class photos of Aaron and one of Aaron and Ashmat sneaking into a room where the grown-ups are clowning, out-clowning them.
Then, there it is: the photo of Aaron in front of the news column! He looks to be twelve or thirteen. He wears sunglasses, a baseball cap, a tight polo shirt, short shorts he calls “nut huggers,” and the tall striped socks every American boy wore from 1980 to 1985. He leans with one foot on the ground, one bent back against the newsstand. On the back, in Aaron’s preteen handwriting, are the words “Me in France.”
He shows me, mouth dropping open. “I was in France.”
He must have sent the picture to his mother, we conclude. Which probably means he went to France with his father. There is no one to ask, to confirm.
“How could you forget that?” asks Henry. We have just spent two weeks in Europe precisely to “make memories.”
How can he have no memory of this trip? What explanation is there, other than the tricks his brain learned to perform at this very age, to survive?
* * *
I suppose it was kind, the beast, to let us have our trip. The moment we return, it does, too.
Aaron is sick and I am sleeping when Dr. Caine calls the next week and leaves me a message. I catch the words “inflammation” and “crystals” and “negative serology.” What I gather is: evidence of a parasitic infection, but no particular parasites identified. He prescribes a new antiparasitic.
I call back, leave a message. Should he continue to take the other antiparasitics? Is this new one supposed to better than the others?
The next morning, at 5:32 A.M., he leaves another message, this time, for some reason, on Aaron’s phone. “I can’t really answer your question about medicine,” he says. “One of the problems we have with parasites is we don’t have the technical capacity to know which medicines are better.” He goes into a brief lecture on strep throat, bacteria, cardiology, efficacy rates. All of it sounds very familiar, and then it comes back to me: it’s the paragraph he read to us in his office. I wonder if he is sitting there on the phone in the
dark of Manhattan, reading again from his own book, a little script he repeats on autopilot. “I can only say that with the amount of medication that you’re taking, it’s going to be very difficult to define what is working or what is not.” The recording garbles a few words. “I think you should stop the medication that you’re taking, even three-four days off, then take the other medications, you might well be resistant to the other medications you’re taking right now, so that’s my answer. I see patients very early, I’m sorry, I call very early, but that’s the nature of my practice, so hopefully that will give you a path forward, stop the Ivermectin and Alinia, etc., wait three-four days, start the drugs which I prescribed, and I don’t know if they’re going to work any better!”
The click is loud. He doesn’t say good-bye, take care. He is of course hanging up a real rotary phone.
Aaron saves the message on his phone. Later, listening to it again, we’ll laugh at the absurdity of it. Much later.
I’ll fill the prescription, but Aaron won’t take it. He’s done with meds. It will sit in the cabinet, next to a big bottle of vodka.
* * *
On my fortieth birthday, Aaron wakes me up to ask me to look at the sores that are blooming over his body. He is naked and manic, standing at the end of the bed, talking to himself. He is standing in his own little weather system. I can almost see its borders around him, the way you can see the edge of a rainstorm from far off. I lie in my bed. I look. I know that, if I lie here, the weather will pass. When he leaves, I turn over and go back to bed and sleep until noon. When I wake up, the children are fed; Aaron is clothed. It’s not that I don’t feel guilty; it’s that I’ve shielded myself with a poncho for the day, waterproof. “What I want for my fortieth birthday,” I say, figuring it out as I go, “is to sleep until noon and go to the pool by myself.” Later, when I ask him, he will not remember waking me up. He will apologize.
At the college pool, I lounge on one of the good lounge chairs, under a hat with a book. I swim the breaststroke like my mom, keeping my head above the water. I don’t have to take anyone to the bathroom or coax a clinging child to swim to the stairs. The worry is a gentle nibble in my ear. “You guys good?” I text Nico. “Yes,” Nico replies. I turn over on my belly to sun my back. It is a dizzyingly sunny day. In Ithaca, I tell myself, such days are not to be wasted.
What I want for my fortieth birthday, I decide, is to throw myself a party. I text my friends. On Saturday, Aaron is moody and sick. His skin has erupted. We get in a fight in the afternoon. He does not want to be at the party. Fine. He spends the day in the bedroom. I spend the day scrubbing the house, then put on a black jump suit. Aaron emerges from the room to say, “You look nice. Have a good party.” He gives me a kiss.
One friend brings sangria, another guacamole, another a bottle of prosecco, which burps lavishly when we open it and makes us laugh. Amy Winehouse is at the top of the playlist and Henry dances with me while Nico gives VR tours in his room. The house is warm with bodies, none of them Aaron’s, and my happiness is almost enough to fill the house.
* * *
I know it before I admit I know it: Aaron’s not coming to Vermont. The trip has been there on the calendar, first week of August, for months. Three days at our family camp, three days in Burlington for my dad’s overdue memorial.
“You have to understand,” he says. “I have to protect my health.”
The trip to Europe: he rallied for it. But when we got home, he crashed. The stress of taking another trip, of seeing my family, saying good-bye to my dad, camping at the lake with no privacy, no provisions: it would be too much.
I do understand. But I’m disappointed. “I’m saying good-bye to my dad, too. I need you there.”
I do and I don’t. I wake the boys early and we drive the six hours to the lake. I haven’t been there since my mom’s memorial seven years ago, and the kids don’t remember it. When we get to the dirt road, I roll down the windows and the smell of the woods floods into the car, the branches brushing the windshield. I’m practically standing in the driver’s seat, a kid on a bike. In the road, my nephews greet us wet-haired in towels. Nico and Henry tumble out of the car to greet them. There’s Sam and Pete and Cameron and Keri and Aunt Marty, who looks so much like my mom I have to try not to cry when I hug her. Where’s Aaron? Not well? Their faces are sad; then we move on. The old cabins my grandfather and uncles built are shells of their former selves, but there’s the beaver dam, the stone fire pit off the deck, the old wooden raft we threw rocks at, where another aunt got married in a white bikini. There’s the loon on the water, its plaintive howl; only one this year; where’s its mate? Sam has strung a new REI hammock in the place where the rope one used to hang. He’s brought a new forest-green canoe. The path to the privy I can still navigate with my eyes closed, my bare feet finding the same root steps and moss carpet that were here thirty years ago. We set off on a hike before we can even settle in. Watch for nettles! Where’s the old Long Trail cabin? Didn’t this streambed used to have water in it? Mom, have you ever seen a bear? Pete gives Henry a boost. Sam and I quote Stand by Me and Goonies and The Neverending Story. When we get to the caves, the temperature drops: a new space here in the woods. The stone walls rise above us. The boys scamper ahead with their cousins into the ravine. Mom! Look at this! The oldest cousin appears wearing a grisly mask: a skull with antlers. Is it a deer? A moose? Was he dragged here by a bear? Did he slip and fall? Later, when we get cell reception, Nico and Henry will tell their dad about it. They’ll tell him about scaling Bare Rock, about chasing frogs and playing poker and swimming to the raft and whittling wood. Now, there is no way to contact him. He might as well be on a different planet. Sometimes the ghost of him hikes behind me, a brush in the bushes, an empty space. My worry, though—there is no space for it here.
For three days, I walk the dirt road around the lake. I paddle out into the middle of it. I swim in it. I bathe in it. I follow the path down the Point between the blueberry bushes where Henry is picking blueberries to the place where the same pair of thirty-year-old snakes are mating on the rocks, past the place where the moss gives way to slippery rock, where the rock gives way, gives out, so the only thing to do is push off into the water, all of you. Underneath the dark surface are fish and frogs and who knows what? A lake monster? I wouldn’t say no. Once, swimming together in this lake, my parents passed directly over a beaver. My mother screamed, jumped onto my father’s back.
When my mother was a teenager, she complained to her father about not having been baptized. He walked her to the Point, dunked her in the lake, and said, “Look—there’s God in the sunset.”
Now I am here, treading water, forty, safe, surrounded, alone, in the church of the lake.
At Bare Rock, looking down at the lake, Sam and Pete and I scatter some of Dad’s ashes into the wind. We try to make jokes, about the ashes scene in The Big Lebowski, about Dad’s ashes being eighty percent tobacco, but our voices catch. In the canoe, Nico and Henry and I scatter more, a little here in this corner, on that shore. Mom is here, her ashes, too, and her brother’s, and her mother’s. When Dad’s ashes meet the water, they dissolve, a chalky spirit. Fish food. The boys are a little weirded out. Shh, Nico tells Henry, and they let me sit and cry in the bow.
* * *
When we get home from Vermont, Aaron is okay.
He has not broken out. He’s meditated, exercised, cut his own hair, eaten from the garden, washed the dishes, fixed the upstairs toilet. In that bathroom, on the mirror, are a dozen yellow Post-it notes he has affixed, notes about letting go of resentments, about self-care and solitude and serenity. “Very Al-Anon, babe,” I compliment him. I don’t want to take them too seriously. I can’t let myself. They are the same kinds of notes, I try to remember, that I saw on his mirror his first time in the psych ward. Still, they’re elevated. If those were the notes of a man telling himself to live, these are the notes of a man telling himself how.
“I’m sorry I wasn’t there,�
� he says. “I’ll always regret it.”
I close my eyes. “Don’t tell me that,” I say. But I don’t really regret it, not completely. I can see he needed the space as much as I did, that he didn’t waste it.
One more thing, Aaron says. While we were in Vermont, he took a Seroquel. Just 200 milligrams, a third of his regular dose. An experiment. “I freaked out so bad. Nell. It was insane. I was seeing things, hearing things. I’m telling you. That drug was making me psycho.”
* * *
It’s still afternoon, but I’m tired after the drive, so we get into bed. The new sheets are white. A risk. Is it stupid to invest in white sheets? Or is this how we choose to live in the present, to stop waiting for a cure?
Aaron is tired, too. He can’t catch his breath; his stomach is distended. His eyes roll back in his head for a moment. He struggles to get under the covers, puts on a dumb voice, makes fun of himself. I laugh hard. I tuck the duvet up over us. He says, “You make me feel like a person.”
Immediately I start to leak mascara on the white pillow.
“What?” he says.
I shake my head. He rests the tissue box on the nest of our bodies. The late summer light taps through the window. We half-sleep for a while, two mismatched spoons in a drawer.
SINGULAR MONSTER
No more doctors, Aaron says. Then, okay, he’ll see the neurologist. His name is Dr. Queen. We’ve been referred here by the doctor at Urgent Care, who told Aaron “I really feel like you have Bell’s palsy” a few weeks ago, hours before we boarded our flight to Europe.
He has an East Texas accent and a kind face that has seen too much sun, though he looks about Aaron’s age. He shines a light in Aaron’s eyes, watches him walk up and down the hall. I mention the lesions, trying to ward off the doctor’s inevitable question. But he doesn’t ask about drug use. Instead, he nods knowingly. “Morgellons?” he says.
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