We Are All Perfectly Fine

by Dr. Jillian Horton

  Brian was friendlier than most of the other guys, and he never seemed to be trying to make himself look good at other people’s expense, which was unusual. Roy liked him. Sometimes they grabbed soup and sandwiches together in the cafeteria. Brian always said he had a headache, swiping at his eyes like a kid who just woke up from a nap, because all that light and dark could be hell on your eyes.

  It’s hard to put a finger on when people start to change. Roy agrees when I say it’s like the story of my children walking out into Lake Winnipeg as far as they can. It’s not always clear they’re in too deep when you watch them from the shore. Sometimes it’s only clear after their heads slip under the water, and if you’re standing on the shore watching, by then it’s too late.

  As their third year progressed, Brian became more withdrawn. Roy would ask him to go to the cafeteria, but Brian would stay in front of those huge lightboxes in the reading room. Roy heard a rumour that some staff were saying Brian was too slow. One staff member grumbled to Roy that Brian should go back to helping his parents make egg rolls, because he was missing so many diagnoses.

  Roy regrets that he laughed at that joke. He wants me to know that on the list of regrets he has about his entire life, not including paying more attention to his marriage, his second-biggest regret is that he didn’t tell the staff doctor Brian was his friend, his comments were racist, and he was an asshole.

  One day, Roy walked into the reading room. He was looking for a folder of films he’d left on one of the desks. Brian was sitting in front of the lightbox. There were no films on it. He was staring at the lit panels.

  Roy said, “What are you doing, trying to set your eyes on fire?”

  Brian didn’t answer him at first. He was rocking the tiniest bit in his chair, moving rhythmically, as if he were listening to music.

  “Brian?” Roy said uncertainly. “Hey, you okay?”

  “I’m fine,” said Brian.

  This moment is Roy’s biggest regret. Roy wishes he had pulled up a chair. He wishes he had sat down next to Brian and asked him what was bothering him. He wishes he’d gone to get Sally, who was nicer, and warmer, and had a better way with words.

  Instead Roy just said, “You should go home on time today.”

  “Soon,” Brian said to him.

  Roy found his stack of films in the corner and left.

  That was on a Friday. Roy had the weekend off, a prospect he’d been savouring for days. He planned to sleep in on Saturday, then go shoot hoops with one of the surgery residents who lived in his building, then do his laundry with a thermos of coffee, sitting on a beach chair by the coin-operated machines, smelling heat and bleach and fabric softener and catching up on his reading.

  Saturday came, and it was exactly as he’d planned, except at night he went out with the friend who played basketball and they drank too much and stayed out too late, and so the next day Roy didn’t even open his eyes until close to noon, when the sound of his phone ringing woke him from a deep sleep. He fumbled for the receiver on his bedside table, disoriented, rolling over on his freshly washed sheets.

  “Roy, it’s Sally.” She was crying.

  He could hardly understand what she was saying. Something about Brian. Something about the river behind the hospital parking garage. Something about Brian not swimming, and a security guard who saw the whole thing. Roy couldn’t piece it together, not yet. His brain still wasn’t working.

  Then it clicked, the sickening truth illuminating, as with the flick of a switch. Brian staring at the lightbox. Brian going under the water, in too deep, nobody realizing it until his head disappeared under the surface. Everybody thinking he’d come up for air any minute. Even though by then it was already too late.

  I sit with my face propped on my hands, watching the dining room empty out around us.

  “You know what I’ve wondered, over the years?” Roy says after a long pause. “Why him and not me?” Roy’s voice cracks, and he pauses for a moment. “That day when I saw him . . . I just wish I had done something.”

  We sit across from each other at the polished table while the light reflects onto it, his last bit of oatmeal long since gone cold. We look at each other for a long time. He must have downloaded it and read it last night, because he mouths one mournful, deliberate word.

  Differently.

  19

  Washing the Bowl

  Failure to cope. It sounds like a hashtag, not a diagnosis. Yet it’s what we’re taught to write on the charts of people with cancer pain that hasn’t been adequately managed, or elderly men who are mixing up the twenty medications that eight different physicians have prescribed for them in the last sixteen months. It’s pretty judgmental, something that girl in my graduate program might have said to me when she thought my plan to go to medical school had me tied with Quixote.

  It’s particularly cruel when the thing we say you failed to cope with isn’t a hangnail but your own imminent mortality. How will any of us cope when that moment arises? And is it failure to cope if you drink to get through the worst years of your life or take drugs to suppress memories of abuse or trauma that refuse to go back in the box?

  What does it even mean to cope? My mom managed to keep us all clothed and fed. My dad showed up at work every day no matter how broken he felt inside. It might have looked like we were all coping, but everything seemed so fragile, like it hung from a filament that could never bear the weight of all it carried, the love, the entanglement, the grief and injustice. We were in a desperate state. There wasn’t much between us and that cliff in my dream, the one I sometimes wanted to plunge over with my family.

  A story my dad told me: when my brother descended abruptly into psychosis as a teenager, when he was seeing animals in his empty closet and convinced that someone had poisoned him, when the regular hospital said the only place he could be helped or managed was a psychiatric facility, one weekday morning Dad took him there, for “assessment and treatment,” both of which would turn out to last for the next twenty years. He coaxed him inside the front entrance, my brother trembling and afraid. He gave the clerk at the front desk my brother’s name. They were expecting him.

  My poor brother was crying; he didn’t want to go. Dad told him he needed help. But before he had the chance to say anything else, two men appeared, just like in the movies. Each took one of my brother’s arms, and they dragged him screaming through two large doors that locked behind him, his cries eventually fading into silence.

  My dad taught at a community college. He had to go to work that day. He went to work no matter what was going on in our lives.

  That morning, on the way to his office, Dad ran into his boss in the hallway. A close talker, a man who always punched everybody in the arm and massaged their shoulders and shouted motivational platitudes.

  “Having a good day, Bob?” He slapped him on the back. “C’mon, smile, man! Aren’t ya having a good day?”

  They stood at the top of a staircase.

  Dad said in his whole life, he had never come so close to hurting someone, to grabbing his boss and throwing him down the stairs. That moment, forever preserved in his memory, the scene so real to him in retrospect that he sometimes wondered if he’d actually done it.

  He told his boss his day was going fine.

  He walked away.

  So what does it mean to say you’re coping? It’s what I’m thinking about as I leave Roy at the table, fill my mug with coffee, stop in my threadbare room to pick up the schedule for the rest of the day. Is coping doing what you have to do to get the job done? Or is it about something more than hauling yourself through misery? And how do we determine how much any one of us can take?

  * * *

  “‘YOU DO NOT have to be good.’”

  “That’s a relief.”

  “Stick a sock in it, Jodie.”

  “Everyone heard her talking to me like that, right?”

  Greg points at me. “‘You do not have to be good.’” He stops. “Actually, you two do h
ave to be good, or I’m not going to finish ‘Wild Geese.’”

  Jodie rolls her eyes at him. “We’ll behave ourselves.”

  You do not have to be good.

  You do not have to walk on your knees

  for a hundred miles through the desert, repenting.

  You only have to let the soft animal of your body

  love what it loves.

  Tell me about despair, yours, and I will tell you mine.

  Meanwhile the world goes on.

  Meanwhile the sun and the clear pebbles of the rain

  are moving across the landscapes,

  over the prairies and the deep trees,

  the mountains and the rivers.

  Meanwhile the wild geese, high in the clean blue air,

  are heading home again.

  Whoever you are, no matter how lonely,

  the world offers itself to your imagination,

  calls to you like the wild geese, harsh and exciting—

  over and over announcing your place

  in the family of things.*

  Joss leans back against the wall. God, she is effortlessly cool. Her blond hair drops in front of her face like a window blind.

  “That line . . . ‘the soft animal of your body.’”

  Jodie puts her fingers on her lips, makes a kissing gesture. “Magnifico.”

  My children. Skin smooth as soapstone. Their little rib cages, arms above their heads, tussling with pyjama shirts. Orange soap and lavender oil. The clean, simple lines of their small forms.

  Greg turns to me. “What do you think that bit is about walking on your knees?”

  “Why’d you ask her?” Jodie’s irritated. “I think she’s the least likely of the four of us to have done that.”

  I stick my tongue out at her.

  Joss’s vintage necklace is no less excellent today than it was yesterday morning. She has a cup of tea in a mug she must have brought from home that says Bernie Sanders Was Right About Everything. She pulses the bag into her cup, finally lifts it out, dripping tea all over the floor.

  “Why do you think they chose this poem?” she says.

  “You’re dripping,” Jodie warns her. “They chose this poem because we have to be good.”

  I correct her. “We have to be perfect.”

  “Obviously not possible.”

  Greg is milking his goatee again. “Where did that idea even come from? Like, that you have to be perfect at a hard job?”

  Joss likes this point. She wags her finger at Greg. “You know, that’s brilliant. Like, you have to be perfect doing the hardest job . . . shouldn’t the hardest job have the lowest expectation of perfection and vice versa?”

  “Yeah, like, ‘Make my coffee perfectly.’”

  “No one joke about perfect coffee.”

  “By the way, I heard somebody smuggled in a French press.”

  “Find out who. I’m transferring to that group.”

  “Even making perfect coffee is a way to practise, right?” Jodie likes this tangent; she’s excited. “Have you heard this Zen thing, ‘Wash your bowl’?” We shake our heads, no. “The student asks the master, ‘How can I become a master like you?’ And he says, ‘You like to eat breakfast?’ Student says, ‘Yes.’ Master says, ‘So wash your bowl.’”

  Joss’s not buying it. “That’s a bullshit story.”

  “How so?”

  “Condescending.”

  Jodie shakes her head defiantly. “Totally disagree!”

  “If a monk talked to me like that, I’d kick him in the nuts.”

  I wave a hand between them as if they’re about to brawl. “Guys, you’re both right. There’s wisdom in it, and it’s condescending if the person who’s saying it thinks they’re better than you. Like all the doctors from another era telling us how much worse they had it, but meanwhile they had like ten treatments to choose from and couldn’t have imagined anything as evil as a bad electronic health record.”

  “That’s exactly what I meant,” Joss says, placated. “As if our generation are all slackers.”

  “Oh God, but the students today!” Greg’s hand moves from his goatee to his temple. “They’re a mess. They want it all, and you can’t have it all.”

  “Okay, wait, but isn’t that what our teachers said about us?”

  “Yeah, but we didn’t want it all. I didn’t anyway. I just didn’t want my life to feel like a bomb went off in the middle of it.”

  “Man, no kidding.” Joss parts the hair in front of her face, revealing a deep frown. “My life is a serious shitshow.”

  “So, tell me about your despair.”

  “Fuck off, Jodie.”

  Jodie sits up straight, looks affronted. “I want to hear it!”

  Joss pauses. She pulls her knees to her chest. “Medicine tore me to pieces.”

  “In what way?”

  She laughs ruefully. “In what way did it not tear me up? That’s the shorter list.”

  “Okay, let’s hear that list.”

  “Well,” Joss says. She doesn’t seem able to decide whether she wants to hold her tea or put it down.

  Greg sniffs. “Is that green tea?”

  “It’s, like, an oolong or something.”

  Jodie presses her. “The list.”

  The tea is set down on the hardwood. Joss crosses her legs, props her elbows on her knees, lets her chin rest on the back of her hands.

  “You know how after strokes people get hemiparesis and they don’t recognize some part of their body, right? ‘Alien hand’ syndrome?”

  Jodie lets her hand float up towards my face in slow motion, preparing to strangle me.

  “I told a shrink I had alien life syndrome.” She shakes her head. “Like, is this my life?”

  Greg is nodding like a madman. “Yes. Yes. Or, like, is real life only when you’re in the hospital?”

  “I’ve thought that too.”

  “One day on the way home from a shift where I had to pronounce a teenager dead from meningitis, I walk by this lady screaming on her porch.” I shake my head at the memory. “I run over to her ready to, you know, protect her from an assailant, and she’s like, ‘Somebody stole my fucking bike!’ And I’m like, ‘I thought it was an emergency,’ and she gets in my face and screams like a poltergeist, ‘It IS an emergency!’”

  “It’s like we’re constantly shuttling between two planets. I read that somewhere.”

  “I don’t want to be all geeked out, but isn’t that kind of what the poem is about? Like this line.” Greg squints at the handout, clears his throat. “Meanwhile the world goes on.”

  “After the ecstasy, the laundry.”

  “We think we’re so terminally unique.” Jodie shakes her head wistfully. “Like we’re just uniquely screwed.”

  “Why would we be different from every other person on earth?”

  Greg interjects: “This is what she’s saying in the very last line! ‘No matter how lonely, the world offers itself to your imagination, calls to you like the wild geese . . .’”

  “Calls to me like my pager going off over and over . . .”

  “‘Harsh and exciting . . .’”

  “Isn’t anybody else here lonely?” Jodie looks at us expectantly. “I mean, didn’t medicine make you lonely?”

  “Or sick and crazy?”

  “Or dead inside like zombies?”

  “Order!” Jodie pounds her fist like a gavel.

  “One problem with this place is zombies need flesh foods.”

  “Oh, fuck. How is a person supposed to get anything done around here?”

  “We don’t have to be good! The poem said so!”

  Laughter. Joss’s mug tips over. The remnants of her oolong spill onto a cushion. Greg and I put our arms in the air like zombies and start shuffling towards Jodie on our haunches.

  I notice something, a feeling in my chest. Lightness. Joy. Or something that tastes like it. That flicker you get, of a déjà vu. A place you were once, even though you can’t say
where or when.

  I used to feel like this. Some parts of training were good. Besides Joni Mitchell and the chapel and crying by the lockers, and the crushing despondency, there was also laughter. Laughter with my friends. Fake-paging each other to call the morgue or the gift shop, writing prank consults for our crushes and our enemies. Endless jokes about the staff doctors and their idiosyncrasies. Holiday shifts dressed like elves. The patient who asked if he could borrow my phone to call my friend, his doctor, so he could tell him he was an asshole. Laughing ourselves sick as schoolkids when a kind, dignified, elderly attending told us solemnly we should always remember that beer was a powerful vasodilator.

  We drank a lot, probably too much. I suspect this is a scourge of more residency programs than is generally known. We drank to escape the constant fear of screwing up, to facilitate the laughter. We drank to let go of deep inhibition, the overdeveloped capacity for delayed gratification that so often epitomizes the medical personality. Sometimes we drank to find connection with one another in short, futile affairs. In a state of chronic sleep deprivation and ongoing high-grade stress, we looked for comfort in places we wouldn’t normally go to find it. We made a lot of mistakes at work, then those mistakes spilled over into our personal lives. Doomed relationships, failed marriages, the long, humiliating tail of flings we never would have had if we were really in our right minds.

  But Joss and the others have reminded me that I used to laugh more. With colleagues, with patients. Belly-laughing to the point of tears. The elderly woman who told me she lived with a granddaughter who called her “the cockblocker,” because young men were creeped out by the idea of sleeping over at her grandma’s, me so surprised to hear these words come out of her mouth that I nearly fell out of my chair, her laughing so hard I had to turn up her oxygen. The funny gifts from patients, our little inside jokes. The humour I developed reflexively, growing up in a home where there was a cloying sadness, where the bridges from crisis to crisis were short and unsteady. What a crucial skill, to be able to make people laugh on those bridges, lifting everyone up, higher, away from the water. The one thing I can still do when there is nothing else to be done.