Now, here I am again, looking out at the cold, grey water. The kids were right. This is Midlife with Dr. Horton.
And it’s beginning to look like a crisis.
5
Attachment
When you’re a doctor, it’s tough not to take a history everywhere you go. It’s a default mode. You’re on an airplane, and there’s a person next to you. Soon you’re instinctively grilling them. Where are you going? What’s in Houston? How long have you lived there? What do you do? Questions tumble out, and before you know it, you’ve got enough for a clinic note.
At supper, we ask each other questions. We’re taking histories, trying to figure out soft hierarchies and groupings. I gravitate towards other internists. We immediately start talking about our practices. Do you do acute care? Inpatient? Where did you train? We’re searching for things we have in common, but also looking to assert ourselves relative to who else is here. We find some common threads, limp connections to people we went to school with. Names of old classmates come up, names I haven’t heard in twenty years.
Why didn’t I keep in touch with more of those people? I may not show it, but there’s a raw, unfinished edge inside me, like a knife homemade for a street fight. I use it to cut most cords. I’ve never gone to a class reunion. I say it’s because I don’t like goodbyes, but the truth is I also don’t like hellos because they lead to goodbyes. I’ll let patients get close, but they usually sort out the logistics for me by disappearing after discharge, or dying. But with most of my friends, I tend to fade over and out, to evade, to never be available for a call, to pass through town without meeting for supper, preferring to be cocooned in a hotel in silence. It’s not indifference; it’s the opposite of indifference. It’s an abundance of emotion, too much resonance, the strain of the memory of love. I’ll do anything to avoid that sting, the sharp bite of grief, the anxiety that this might be the last time I’ll ever see them. A risk I’m constantly managing.
Where did that come from? When I first left for university, my parents drove me there, leaving Wendy in the care of a tenuous patchwork of respite workers, setting off on the thousand-mile trek through the Canadian Shield via Michigan and along the unforgiving shores of Lake Superior. Getting there, settling in, buying sheets and a fruit bowl and pillows and a silver kettle, things I’d need in my new life. A wave of dread rising, rising, until it was time to say goodbye to my parents. My mother, wearing dark glasses, only the second time in my life I could ever remember seeing her cry, the three of us forming a little circle in the hallway, me regretting everything about this plan, wishing I’d never won a scholarship to this stodgy, faraway place. Then watching from my dormitory window as their Oldsmobile pulled away from the curb, sobbing into my hands and thinking, What kind of person does this? What kind of person leaves her parents under these circumstances? My sister Heather knew that feeling; she tried to go away once too. She came back after only a year.
Or the summer Wendy moved out of the house for the first time, to a rural hospital that promised to build a small brain injury unit for other young people. Wendy was having none of it. This is my home! I grew up in this house, and this is where I intend to die. That’s what she said. When moving day finally came, we loaded everything into the van, her clothes, her doll collection, her little china cups. Her jewellery. Her pictures. Her records, her radio, her television. She couldn’t grasp any of it, saw it as an utter betrayal. Wendy, incredulous, trying to grab onto my dad’s leg as he disconnected the wires to her stereo. Why do things have to change? she screamed, the look on her face permanently seared in my memory. Why can’t things just stay the same?
No wonder goodbyes were a land mine for me. They initiated a cascade of complex emotion that left me drowning. Better to slip out in the night, disappear from people’s lives altogether.
* * *
THE WOMAN ACROSS from me is wearing her nametag. Jodie. She strikes me as a hybrid of other people I’ve known and loved: short, sinewy, curls like corkscrews. Soft-spoken but intense, a person whose attention puts you on notice: prepare to get real.
I lean towards her.
“I’m Jill.”
“Jodie.”
“You remind me of some people I know.”
“My condolences to them.”
“That’s exactly what one of them would say.”
“Well, why don’t you tell me what they’d say next, and you can manage the whole conversation by yourself?”
“Love how introverted you are.”
“Good pickup.” She takes a bite of some kind of fleshless rice dish. She doesn’t look up.
“Why are you here?”
“I’m looking for peace.”
“Like, world peace?”
She chews silently for a minute. “Yeah, world peace, idiot.”
We grin at each other.
“What’s with the blue hair?”
“It’s an act of protest.”
“Against what?”
“Conformity in medicine.”
“Look at you. A rebel with claws.”
“What are you? Besides totally disinhibited?”
“GP. You?”
“Internist.”
“Outpatient?”
“Inpatient.”
“What’s that like?”
“Busy. We never turn anybody away, though.”
“Neither do we, as long as they have insurance.”
“What’s that like?”
“It’s like bullshit.” She pushes her plate away. “It’s like violence to my soul.”
“Have you ever done anything like this before?” She looks at me blankly. “Like, this place.”
“Bunch of times. You know about Omega?” I shake my head. “Omega’s a good one. Retreat centre. You can go for days.”
“Did it help?”
“Help what?”
“Anything.”
“Oh, it definitely helped. But you have to want it.”
“Well, obviously if you go somewhere like that you want to be helped.”
She smiles. “Is that obvious?”
A sudden, urgent thought crosses my mind. “There’s coffee here, right?”
“Nope.” She watches my face transform into a mask of panic. “Relax, Bluebell. It’s by the side door.”
“Not funny to joke about coffee.”
“Nothing’s off-limits here—don’t you know that yet?” She squints at my nametag. “Horton?”
I’m starting to figure that out.
6
Sherry with Tutors
Everyone has drifted from the dining hall into their rooms for the night. The complex is quiet. Doors occasionally open, feet pad on the carpet down to washrooms and showers. The lamp on the table casts a small, tidy disc of light. Rain hits the window in staccato bursts. I sit on the bed and lean against the wall, pulling the rough wool blanket over my legs. I’m exhausted, but not ready to sleep. I take a pad of paper and a pen out of my backpack and write, Why am I here? But then I cross it out, and instead I write, Why I am here, because it sounds more confident and less whiny.
Because I’m not the best mother I can be. When I’m with my boys I’m always thinking about medicine, students, etc. Not present.
Because I’ve lost what’s best about me and I have to get it back.
Grief I’ve never processed.
Something frozen/broken/blocked.
Meet other screwed-up doctors who look normal.
Stuck in state of hatred of entitled students.
Sleep in room with weird wool blanket.
Have online shopping delivered to American address to avoid paying duty.
Start writing again.
Start writing again. I lay my pen down on the paper. Those words sting.
Plenty of people think they’ll be writers. I know that. I loved science, and I was serious about playing piano, but it was literature I chose to study as an undergraduate and then master’s student; Plath and Larkin and Ishiguro constan
tly whispered in my ear for me to come join them. I wanted to live and breathe their craft. I thought about my life in terms of books I’d write, words as a way to change the world. I ended up in a competitive writing studio in the Department of English, surrounded by people who were really, truly serious about writing. The professor, Stan, was an editor at one of the major publishing houses. One day I went to see him during his office hours. I worked up the courage to ask him if he thought I had enough talent to be a professional writer.
“Yep,” he said.
I clung to that “yep” for the next twenty-five years.
But Wendy needed me. My parents needed me. And I knew there was something about me that patients needed too. I’d spent two summers working in nursing homes. Playing old songs on an old piano, belting out “The White Cliffs of Dover” for a bunch of people in their nineties and noticing the difference in the room, before and after. And later, drinking tea with them, my hands holding one of theirs, my face up close to their papery ears, that tender intimacy, the same way I leaned in to talk slowly to Wendy so she could hear me. People told me things, confided in me, poured their hearts out. Heather and I had watched M*A*S*H obsessively as kids. Secretly, I thought of myself as a carbon copy of Hawkeye Pierce. Just like Hawkeye, even when I didn’t know how to ease my own pain, I knew instinctively how to do it for others.
I thought I could still be a writer if I went into medicine. My journals and study notes all have quotes and plots scribbled in the margins. Funny lines, tragic lines, images, moments I never wanted to forget. For the first few months of residency, every day when I wasn’t on call, I got up at 5 a.m. so I could write for thirty minutes before work. But soon, those thirty minutes represented a disturbingly large portion of my sleep budget, and scraps of unfinished stories began piling up on the side of my desk until it looked like a paper junkyard. Things got so hard so fast that I just had to focus on living and getting through each day. And before long I was lucky if I could write a postcard. There wasn’t a way to be everything to everyone in those years, and the easiest dreams to abandon were my own.
The irony is I might have made the final decision to choose medicine because of a girl I barely knew. She was the type of friend who draws you close so she can cradle you while she tries to slit your throat. We were students in the same faculty of Graduate Studies. One day she asked me what I was going to do after grad school, and I said I was thinking about applying to medicine. McMaster was only a couple hours away, and at the time they had a reputation for taking people like me, people with colourful backgrounds relative to the usual pre-med, degrees beyond the sciences. Their philosophy was that people like me brought a different perspective to medicine—that academic gene pools need students who look at problems in totally different ways. My experiences with Wendy had also given me a particular way of relating to patients and families, a reason for wanting to be a doctor that I thought could make me a strong applicant. But the truth is, I might have just carried on in English if that girl in Graduate Studies hadn’t said to me, in her sweet-as-a-poisoned-drink voice, “Maybe you should be careful who you tell you’re applying to medicine.”
Why? Would people think I was selling out?
There was a beat of silence, a smug, expectant look spreading across her face. I realized: This witch doesn’t think I can get into medical school.
I could get into med school.
Couldn’t I?
I could. I would. I did. But there was a complicating factor. Right after a thick acceptance letter arrived from Mac, another envelope came. This one had a postmark from the U.K. I was being offered a full scholarship to go to Oxford for a PhD in English.
The medical school acceptance letter was printed by a computer; the package from Oxford included a personal invitation on crinkly yellow paper to drink sherry with tutors. I could picture my new Oxford life: I’d have a bike with a basket, and spend hours at the Bodleian. The real white cliffs of Dover. Weekends in Paris. Wool sweaters from the highlands, and a hearth and a stone fireplace older than anyone I had ever met. Bookshelves full of Yeats and Tennyson, and a room of my own, like Virginia Woolf’s. A place where the words could pour out of my heart and onto the page, and maybe someday those pages would find their way onto other shelves, maybe even the Bodleian itself.
But lying awake on those tortured, miserable nights, working it all out as if it were a formula with an elusive right answer, the “Go” or “Stay” columns were really “tutors with sherry” versus my sister in her wheelchair, bent over at a forty-five-degree angle, holding her head in her hands and asking if I could please take her to the summer fair. Those tutors wanted to know my interests within postmodernism. My sister had a more basic question for me: When are you coming home?
Home. My mom and dad at yet another gate in the airport, watching, waving this time as I boarded the plane that would carry me across an ocean for a year and then another and another. Maybe to marry an Englishman. Maybe never to return.
I didn’t need to study English at Oxford to learn the power of words. I’d already had my most important teacher. It was that doctor, yelling at my parents, There’s no brain left. He taught me that people with power have a duty to speak with care, because they have been entrusted with something fragile they have no right to break. He helped me understand that medicine itself was a very specific kind of power, one I would never, ever abuse, because I knew it was sacred. And anyway, I wasn’t drawn to power. I was drawn to medicine because it was my calling, the way a bird is drawn to the song of its own kind.
That was the only contest Wendy won in her whole life. She drew me home. Not out of pity, but out of love and its attendant duty, and a sense there might be things in life that would matter more to me in twenty years than whether I had a PhD from Oxford or had seen the Bodleian. So one day that summer, I was able to look Wendy in the eye and tell her something she would forget a few minutes later: because of her, I was going to be a doctor. And in a few years, I’d be coming home.
Two
7
The Step You Don’t Want to Take
Next morning I consult the schedule, which says we are starting in the Zendo at 6:30.
Have I read this right? 6:30?
It’s 6:10, and I’m only awake because I got up to go to the bathroom. But now I’m aware that around me, doors are opening and closing. The Zen beehive is coming to life with little doctor worker-bees all doing as they’re told.
The washroom consists of a white sink and a toilet. Just a canvas of white wall, primed. In the corner, I find a tiny mirror on a stand, about as useful for looking at your reflection as a Tiffany locket. I comb my fingers through my hair. My head looks like a blue toilet brush. But there’s no time to wash it unless I want to be late for the Zendo. Despite not even knowing what a Zendo is.
I go back into my room and look at the map. Zendo is at the back of the centre. Okay, I can find that. I pull on a tunic and some leggings and join the stream of people padding slowly up the stairs.
Zendo appears to be a place where you don’t actually do anything. It’s not a great hall so much as a spacious room, with four long rows of seating platforms separated by wide aisles. It’s dimly lit. A thin strip of windows runs along the top of all the walls, reminiscent of the tiny ones in my office at the hospital. Outside it’s still pitch black. Square, oversized meditation cushions are piled on the seats. There are already people in meditation poses, sitting along the walls, legs crossed, eyes closed. Mick and Ron are up front. There’s a metal bowl between them. I want a metal bowl like that filled with coffee.
I find an empty cushion and ease myself up onto the raised platform. The space between the platforms is big enough for a streetcar. Nobody is speaking. I can’t share any of my stupid jokes. I always have to be saying something clever.
Something I think is clever.
I lower myself onto the cushion, folding in my legs. Jodie is across from me. She’s wrapped in a very cool wool shawl and seems to hav
e her hands tucked inside some type of hidden pockets, like it’s a meditation straitjacket. Her eyes are closed. She looks like an ad for enlightenment. Meanwhile I still look like a blue toilet brush.
Where am I supposed to put my hands? I let them rest on my quads. Was there an email I missed about bringing your own straitjacket? This actually kind of hurts my back.
“Beginning with the breath.” Mick. His words are a surprise in the silence.
“Noticing the breath.” Does he have a lisp?
Why am I always with the jokes, even when there’s nobody else in here with me?
Is there somebody in here with me?
Mother, is that you?
“The mind will wander. This is what a mind does. When you notice your mind wandering, gently bringing it back, focusing your attention on the breath.”
My mind only wanders. Something happened to it. I used to be able to learn a Mozart sonata by memory in a week. I had this focus like a laser. Now my mind is more like a Roomba.
“When you’re ready, coming into a standing position.”
Okay, I like standing, I’ve got standing. Jodie looks blissed out. She opens her eyes. She nearly caught me looking at her.
Mick says we’re going to start walking through the Zendo, forming a line. Hello, comrades! He tells us to go behind the person on our right. I’ve noticed this guy before; he was at one of my tables last night. He said he was here because he was burnt out. I think his name is Greg. He’s older than me, with a little grey goatee like Sigmund Freud, and a North Face sweatshirt.
We start following each other through the Zendo, in a line that moves slowly, then quickly, depending on Mick’s instructions. He has us walk purposefully, shifting our weight from left to right, then hurriedly, staying close to the person in front of us. It’s funny, noticing the weight shifting from foot to foot, all those small bones able to support the rest of me. How is that even possible? Why didn’t I ask that question in medical school? Why has no student ever asked me that, and yet I get ten emails a month demanding to know why the university no longer pays for sandwiches at interest-group nights?
We Are All Perfectly Fine Page 4