Sensing Light

by Mark A. Jacobson

  “Fuck yourself, Bartholomew.”

  The lawyer showed Kevin his extended middle finger.

  “Go back to law school,” Kevin said as he walked away, “You missed the part about murder. It’s not protected by the Bill of Rights.”

  XIX

  GWEN LEFT CLINIC EARLY that afternoon wearing capris and a tee-shirt. She drove to Noe Valley where her best friend, Nan, had just claimed a tennis court. Their bond, forged twenty years ago while sharing seats on the bench of the Stanford women’s varsity team, had endured despite the divergent directions their lives had taken. Nan married a lawyer right after college—they did have that in common. She became a suburban matron and didn’t work outside the home again. Her daily life was unaffected by the turmoil of the 1960s that so influenced Gwen. Nan’s three children were all older than Eva, and Gwen often thought of Nan as an older sister—except on the tennis court where her speed, powerful swing, and natural blond hair made Gwen feel like Nan’s doddering old aunt.

  They lost touch during Gwen’s years in medical school but reconnected when Eva was born. Nan would come to San Francisco and provide advice and support. A few years later, Nan’s youngest child was diagnosed with a kidney tumor. Gwen would drive to Menlo Park, their roles reversed.

  After volleying for ten minutes, they began a set. Gwen’s first serve nicked the net.

  “Let,” hollered Nan, shifting her center of gravity from one foot to the other.

  Where does that energy come from, wondered Gwen.

  She lost in short order by a double fault, two long returns, and another double fault. The second game started with Nan’s serve getting by her. It was one she would have been able to return a year ago. In college, she had been well-matched against Nan on the court. Not anymore.

  Gwen set her hands on her hips and shouted, “You may have to play the outer lines for this to be competition.”

  “It used to be about winning, Gwen. Now it’s about exercise.”

  “Uh-huh,” wheezed Gwen as she rushed the baseline and returned a serve over Nan’s head as she was creeping up to the net. Nan raced back. She had to lob her return, allowing Gwen to send a forehand smash which Nan could only watch. They both laughed.

  There was another bond they shared. Sophomores on the Stanford tennis team traditionally strengthened their forearms and got their art requirement out of the way at the same time by taking a studio course in carving marble. Their team mates were soon bored with the repetitive hammering, but Gwen and Nan were entranced by shaping stone blocks into human forms. They still made dates to visit local museums whenever sculpture exhibits were in town.

  As they walked off the court, Nan said, “We’re on for the De Young next weekend, right?”

  “Absolutely! I’m not missing a chance to see some of the Pergamon collection.”

  “Hey, how’s Eva?”

  “The same. At least she’s not pregnant or doing drugs. I guess I should be grateful.”

  “That’s for damn sure.”

  “Actually, if I can think objectively and ignore how she treats me, it does seem that for fourteen, she’s doing all right.”

  Nan slung an arm around Gwen’s shoulders.

  “There you go,” she said. “That’s a winning attitude.”

  XX

  FROM TENNIS, GWEN WALKED to a neighborhood Italian restaurant. Inside, Kevin was seated with an open bottle of Chianti on the table. He filled two glasses as soon as he saw her.

  “Sorry about your father,” said Gwen.

  “I’m not. Let’s talk about something else.”

  He had anticipated Gwen bringing this subject up and decided he didn’t have the stamina to sort through his conflicted emotions again today.

  “OK, we won’t go there. What’s happening with Marco’s mother?”

  “I just got a telegram. She’s finally out of the woods. He’s coming home the day after tomorrow.”

  “Yay!”

  “After four operations and a pulmonary embolism, she left the hospital with her mind and mobility intact. Can’t ask for more than that, can you.”

  “I guess what he’s gone through makes what we do seem easy.”

  Kevin showed her a little smile which quickly faded. He was still tense from the tantrum session at the health department. He told her about the debacle.

  “Did the director make a decision?”

  “He thinks there isn’t enough community consensus to force closure.”

  “Shit!”

  She had already given Kevin the short version of her meeting with the AIDS Action Committee. Now she went into the gory details.

  Kevin was sinking into pessimism. He realized they had to stop talking about work. He asked how Rick and Eva were doing.

  “Oh, he’s the good guy. I’m the witch.”

  Uh-oh, thought Kevin, this might be a mistake too.

  “He truly is the good guy. He doesn’t lose his temper like I do. Plus, he’s not the father who abandoned her. She can blame me for that.”

  Kevin winced.

  “Don’t worry. I’m not going to cry.”

  “Aren’t you being a little hard on yourself? Think about how much experience Rick has with kids. And he’s not her father. She can’t push his buttons like she can yours.”

  “I know. Rick has the clinical distance to see her as a patient with a treatable condition.”

  Kevin laughed.

  “So when did you say Marco is coming back?”

  “Wednesday evening,” he answered blithely.

  Hearing his blatantly counterfeit tone, Kevin shuddered. He couldn’t pretend not to notice it. Something was wrong between him and Marco. He didn’t understand it, had no desire to think or talk about it, but knew he needed to, that he should use this opportunity to get Gwen’s help.

  She looked at him with concern.

  “I’m worried…” he said.

  He couldn’t articulate the fear any further. It was too amorphous.

  Gwen turned pale.

  “I’m worried,” he faltered, grasping for safe words to hang onto, “about what…this academic status thing might do to us.”

  “Oh,” she said, the color returning to her face. “You think he’ll be envious?”

  Kevin was relieved. She had given a name to the distress, one he could handle.

  “Maybe. It’s not something we’ve ever talked about. But I see where you’re going. I do need to make sure things stay real between us.”

  “Right! Marco isn’t that competitive, is he? You two can work it out. Just don’t say anything he could remotely interpret as lording it over him.”

  “Me?” he exclaimed in mock offense, “Lord my status over Marco? Don’t tempt me.”

  Aware his back muscles were painfully taut, Kevin stretched his neck. Was that a panic attack, he wondered. Will that be the price of fame?

  Dishes of steaming osso buco and risotto, redolent with garlic, were brought to the table. Eating was an excuse for dropping the matter.

  As their plates were being taken away, Kevin asked, “Was Eva a Girl Scout?”

  “Girl Scout? Do you think if I had made her join Girl Scouts, she’d be better behaved now?”

  “No, no. I’m just curious. How about you? Were you a Girl Scout?”

  “Yeah…”

  Gwen recalled a muggy spring afternoon, the smell of chalk and starched clothes mixed with acrid sweat. She had been standing in a line of uniformed girls, waiting to march into the school assembly hall. She was adjusting the front of her Girl Scout dress. It didn’t seem right. She had forgotten how many buttons were supposed to show below the belt. She’d been told, repeatedly, how important it was that everyone look exactly the same when they filed onto the stage. Was her scarf completely under her collar? Her sash at the right angle? She could only see the back of the girl ahead of her. There was no way to check. Her anxiety turned into suspicion. Why was it so important that everyone look alike? What if she wanted to be different?

>   “When?”

  “In elementary school. It was part of Pasadena 1950s conformity. All the girls joined. The uniform was chic when we were ten. By the time we were twelve, it was passé, and anyone seen wearing it was ridiculed. So I quit. Sorry, Kevin. Girl Scouts wasn’t particularly meaningful for me. Was Boy Scouts for you?”

  “I’ve been trying to figure that out.”

  “Why?”

  “It’s about understanding where my values came from. All I got at home was ‘don’t waste money,’ ‘do your chores,’ ‘don’t lie.’ And the Church was mostly about not having evil thoughts or committing sins. But Boy Scouts actually had positive ideals. Some were even altruistic. I bought into it. There were these twelve values we had to recite out loud at troop meetings. I’m blanking on the first ones. The last four were ‘thrifty, brave, clean, and reverent.’ Brave is good. I’d like to have more courage.”

  “Interesting. Girl Scouts had same thing. I remember ‘respectful’ and ‘considerate’ were on their list. I couldn’t buy into it. I saw how well those values were working for my mother. She was so respectful and so considerate, and it made her so miserable.”

  Kevin folded his hands below his chin.

  “Now we are getting someplace,” he said in a parody of a Viennese accent. “The unhappy childhood that drives great accomplishment in adult life.”

  “Indeed. It was grist for my mill.”

  “You’ve been in therapy?”

  “Kevin, I’ve been divorced. It’s de rigueur. Have you?”

  “Once…”

  Gwen leaned forward conspiratorially.

  “So, tell me about it.”

  “You really want to hear this?”

  “Of course I do!”

  “OK…I guess things came to a head when I moved to San Francisco expecting to fall in love and leave my neuroses back in Boston. None of that happened. Residency was exhausting. Whenever I did escape from the hospital, I’d see all these men who were openly out and looked genuinely gay—I’m using the nineteenth century definition of the word. Big surprise, I sank into depression. I tried therapy because I was desperate.”

  “Did it help?”

  “Not at first. The therapist thought my problems stemmed from low self-esteem. He made me describe my strengths. That was round one—lukewarm results. Round two was examining values, what we were just talking about, and choosing which ones I wanted to direct my life. That’s when I began to believe the person I want to be—fair, empathetic, competent, not needing to control others—was in reach.”

  “And it worked?”

  “I wasn’t cured overnight, but it was a turning point.”

  “Impressive! Therapy wasn’t nearly so high-minded or transformative for me. Mostly it was about the anger—at my parents, at Daniel, at myself—that was poisoning my life. I needed to exorcise it or at least be able control it.”

  “But you’re so not an angry person.”

  “Aha!” she said, assuming the Viennese accent. “This is the result of years of hard work on the couch.”

  They were laughing as the waiter arrived with the check.

  “That’s what we like to see,” he said. “Happy customers.”

  XXI

  GWEN HAD A HANGOVER the next morning. The headache lingered into her mid-afternoon meeting in a hospital conference room. Thirty nurses, medical assistants, and laboratory technicians sat around the perimeter. They looked tired after finishing their eight hour shift and uneasy about the subject to be discussed. Gwen introduced herself and explained the specifics of what had been advertised in flyers posted throughout the City Hospital corridors. They could sign up here to get a blood test that would determine if they had been infected with the AIDS virus. In addition, they could opt to have the test repeated every six months.

  “It’s voluntary screening,” Gwen said. “I want you to be clear about three things. First, all results will be kept strictly confidential. Second, screening is being implemented for our protection, to learn how to make our jobs safer. Third—this hopefully is just hypothetical—if someone were to be infected from a needle stick or scalpel wound, the antibody results could be used to document it was due to the occupational exposure rather than…some other behavior.”

  Lilly, a Filipina nursing supervisor, exactly Gwen’s age, raised her hand.

  “Yes?” said Gwen, recalling a framed photograph of three children she had seen on Lilly’s desk.

  “How long before we know the result?”

  “We only have enough lab tech support to run the assay once a week, and we have to schedule a counseling session to give you the result. So right now it’s taking about two weeks from the time your blood is drawn until you can get the result.”

  “That’s a long wait,” objected a middle-aged black ICU nurse.

  “I couldn’t agree more, but regulations require a counselor to be present when you get the result, whether it’s negative or positive. Most employees at City Hospital want to participate, and there aren’t enough counselors to schedule it any sooner. Once we’ve completed this round of screening, we can spread out the follow-up testing. Then the waiting time will get shorter.”

  A young, blond woman with a Swedish accent said, “I have a friend who was tested in a research study. He says it’s very frightening, waiting to find out.”

  “Honey,” said an older gay man, “The folks I know who’ve been through it say the waiting is ice-cold terror.”

  There was a collective, introspective lull. Gwen looked around the room to see if anyone had an question. She saw doubt and vacillation, though no one appeared ready to articulate it. She invited comments and was met with silence.

  A few people walked out. The rest got in line to sign a consent form and choose a date for their blood draw. As the last staff somberly exited, a public health nurse hurried in. The woman was assisting Gwen in this project and held one of the manila folders they were using to keep each participant’s records.

  “Can we talk?” she whispered urgently to Gwen.

  “Sure, what’s up?”

  She didn’t speak until the room was empty and she had shut the door.

  “One of the stored samples is positive. It’s a woman. Her only risk factor is a needle-stick three years ago.”

  Gwen felt her chest pound. The pace of her breathing involuntarily sped up. She couldn’t remember the drill for dealing with an infected health care worker. After her own close call, she had never really believed it could happen to anyone else here. What was she supposed to do now?

  “Who is it?” Gwen asked.

  “You sure you want to know? Her post-test counseling visit is next week. We can’t tell her before then, can we?”

  “No!”

  Gwen considered the implications. If she knew who it was, that could help her prepare to handle the woman’s reaction. But what if it was someone she worked with in clinic? What if they interacted before the disclosure meeting? How could she not be tense and artificial? And afterwards, wouldn’t that be seen as a betrayal?

  “When’s the appointment?”

  “Monday, three o’clock. Can you be there?”

  “Of course I’ll be there.”

  Gwen deliberated, eyes fixed on the manila folder. She held out her hand.

  As soon as Gwen was alone in her office, she opened the folder. It slipped from her moist, shaking fingers onto the floor. She wiped her palms on her skirt, clenched and unclenched her fists, and tried again.

  It was a name she didn’t recognize—one small mercy—Laurie Hampton, an ICU nurse. Another was her age, forty-seven. Future pregnancies wouldn’t be an issue. Gwen read the account of a needle-stick exposure. The source patient had later been diagnosed with Pneumocystis pneumonia. The file was small, just the incident report, a behavioral questionnaire that had every box checked ‘No,’ a signed consent form, a phone number and address in Daly City, and a woman named Tanya listed as an emergency contact.

  Gwen noticed a page stap
led behind the report. It was a photocopy of a letter dated a month after the incident. Herb Wu had written to City Hospital’s head administrator demanding the hospital refer Ms. Hampton to a psychotherapist and pay all costs.

  She closed the folder and chewed on her ballpoint pen. Suddenly, the pen snapped. She watched in horror as a drop of black ink fell from her lip onto the file’s cover, obliterating Laurie Hampton’s identification number.

  XXII

  KEVIN’S HANGOVER, MILDER THAN Gwen’s, was gone by end of his morning clinic. He had a pleasant break in the early afternoon. A ward team presented their most interesting cases to him, and he did a little teaching. When he returned to clinic, he passed the waiting room where three of his suramin trial subjects sat fidgeting. Their study folders were in his exam room. He found a note on top from his research assistant alerting him to new lab test results inside. Kevin picked up one labeled HW.

  On his way to get the patient, he opened the folder. His assistant had highlighted three abnormal results with a fluorescent yellow marker—creatinine 3.5, blood urea nitrogen 40, urine protein 4+. Dazed by the bright halos encircling numbers that indicated imminent kidney failure, Kevin leaned against a wall. To fend off mounting dread, he concentrated on what he had learned about suramin toxicity. Individuals who had received the drug for sleeping sickness often suffered kidney injury as a side effect. It began with innocuous amounts of serum proteins leaking into urine. If suramin continued to be administered, it could lead to irreversible kidney failure.

  “That’s why we check a weekly urinalysis,” he complained aloud. “Kidney toxicity isn’t supposed to happen this fast.”

  This patient’s urine had shown a trace amount of protein last week, though not enough to meet the protocol criteria for stopping treatment.

  Kevin went to the waiting room.

  “Hubert?” he called softly.

  Mr. Wilson had requested Kevin use his first name. It wasn’t Kevin’s style, but he adapted to what his patients wanted. A slender, blond, twenty-eight year old man stood up. Hubert was a graphic artist for a downtown advertising firm and quite a success at the job from the rumors Kevin’s assistant had heard. Other than a birthmark on his neck, Hubert had remarkably smooth, unblemished skin.