A History of the Present Illness

by Louise Aronson

  Over a salad of organic greens, heirloom tomatoes, and home-stewed chipotle black beans, Ricardo—who had turned seventy-six the previous month—lamented his family’s lack of longevity. “They all died by their late seventies, more or less,” he said, and then listed them. “Lupe at seventy-eight, José at seventy-five, Maria Elena at eighty-one, Tío Miguel just before his seventy-ninth birthday.”

  “Late seventies isn’t so bad,” Nick said. “It’s beating the average.”

  Jason asked what the average was.

  “It depends,” Marta said. But before she could finish answering the question, Mercedes—who wouldn’t consider even the latest barely visible in-ear hearing aid—interrupted.

  “Rico, te olvidas Juan Carlos.”

  “Oh, no,” Ricardo said. “I didn’t forget Juan Carlos. Just the opposite.” To Nick he said, “Juan Carlos Luis Manuel de Perez, my paternal grandfather. A self-made man like myself. He was not the sort to complain or ask for help. Thought people got where they were by their own strengths or failings and it was not anybody’s job to help them out.” He looked at Marta. “Juan Carlos was our only centenarian.”

  Nick nodded, but his attention was on Olivia’s plate. They were seated side by side. He reached over with his fork, picked out the orange and yellow tomatoes, then waved them at a grimacing, delighted Olivia before dropping them onto his own salad. Olivia could have done this for herself, of course, but Marta’s husband and youngest child were a mutual admiration society, each thriving on surprising the other with small, unnecessary kindnesses. If Nick—whose firm specialized in civil rights law and ethically ambiguous, often highprofile local criminal cases—noticed her father’s backhanded slight at his leftist predilections, he didn’t let on.

  “They used to call him El Luchador,” Ricardo continued. “The Fighter. And he was. Devil of a man, opinionated on everything from the proper length of ladies’ skirts to the history of Mexican-American relations. Even in his nineties, he was always getting into altercations, and not just the kind with words.”

  Marta refused to argue with her father about the relative influence of genetics and character as determinants of extreme old age. Between her exhaustion and his unshakable confidence, she’d be wasting what little energy she had left after a day of work and family and the latest Sophie drama. With chest pressure when he walked up hills and what the cardiologist called “a better than even chance” of needing bypass surgery, she worried that Ricardo wouldn’t reach seventy-seven, much less eighty or ninety or a hundred.

  With her patients, Marta considered herself skilled in the art of difficult conversations. It was only when people with options—not those with little money and no access to affordable, healthy foods, but her Glen Park boomer neighbors or her wealthy patients from Nob Hill or Pacific Heights—repeatedly and knowingly made unhealthy decisions that she felt helpless in the way dealing with Sophie made her feel helpless. Those conversations left her speechless—or almost. She went through the motions. She did her job. Often it seemed that her patients couldn’t tell the difference. She hoped Sophie couldn’t either.

  Her father would not only recognize insincerity, he would pounce on it. So rather than respond to whatever question may have been couched in his Juan Carlos story, she asked Olivia what a centenarian was.

  Olivia puckered her lips and moved her eyes from side to side. “Ummm.”

  “Try and figure it out.”

  The little girl rested her fork on the side of her plate and let out a world-weary sigh. “Cent-ten-a-rian. Cent, like a penny. Ten, that’s a number. A-rian. Arian. Ar-ian.” Her shoulders sagged. “Oh, boy, I’m in trouble now.”

  “What’s a librarian?” Jason asked his sister.

  Marta and Nick smiled at each other across the table.

  Olivia squinted at her brother, clearly concerned that this might be a trick question. Reluctantly, she said, “A library person.”

  “So if I tell you centum is Latin for a hundred,” Nick said, “what’s a centenarian?”

  Olivia sank in her chair until her eyes were just above her plate. Suddenly they widened, and she sat up. “A hundred-year-old person!”

  The adults clapped, Jason hooted, and Olivia climbed up on her chair for a bow.

  After a dessert of dulce de leche frozen yogurt and out-of-season, imported, and very expensive blueberries bought for the benefit of her father’s long-suffering arteries, Marta walked Ricardo and Mercedes down to their car. “What are you doing tomorrow?” she asked.

  “Monday,” Ricardo said. He pulled a slim black leather datebook from his back pocket. It had gold-rimmed light blue pages and a red ribbon place marker, and he’d had one just like it every year Marta could remember.

  Using his index finger as a guide, he read, “At eight, there is epilepsy update. At nine, irritable bowel syndrome, and for lunch, ocular emergencies.” He closed his datebook and smiled.

  “Tell me you’re at least going out for a nice dinner.”

  Mercedes studied the front of her already buttoned coat.

  Ricardo’s nostrils flared. “Tomorrow,” he said, carefully articulating each syllable, “I will have dinner at home, as always, at seven o’clock punto, as I would on any other Monday. And anyone”—he looked from Marta to Mercedes—“anyone who thinks I am in need of a last supper should not bother to come on Tuesday to the hospital.”

  Mercedes leaned her head against the sleeve of his coat. He pulled her toward him until they were side by side and Marta stood alone opposite them.

  “That’s not what I meant,” she said, though it was precisely what she’d meant. “You may have to stay overnight, and you know how hospital food is.”

  “And I know also what a fine cook Mercedes is.”

  Ricardo didn’t look at his wife as he said this, but it was clear to Marta from Mercedes’s reaction that he’d never uttered those or similar words during any of the twenty-six years of their marriage.

  She gave her father a quick kiss and hugged Mercedes. “Me llamas?”

  “Claro,” Mercedes said, and reached up to lay a hand on Marta’s cheek. “I will call as soon as he finishes.”

  The Perezes did not pry into one another’s affairs. They did not ask direct, obviously concerned, and conspicuously unasked questions such as, Why didn’t Sophie have dinner with us? And, I know you’re very busy, but won’t you talk to the heart doctor to make sure everything goes okay for your father? In fact, the Perezes were the sort of family that did not even say I love you. Not on birthdays or holidays. Not after pleasant family meals. Not even before angiograms or when confronted by a child desperately trying to get their attention.

  Seconds after her grandparents left, Sophie came downstairs and poured herself more cereal than Marta consumed in three days. None of the rest of them ate that particular brand, with its refined sugars, artificial coloring, and television cartoon tie-in. Sophie bought it for herself with money she earned watering neighbors’ yards and feeding their cats when they traveled. Because of their busy schedules, the Perez-Bartons had no pets, no indoor plants, and cactus gardens both front and back, facts that appeared at numbers five, twenty, and twenty-one on their elder daughter’s thirty-two-item list of complaints, a list Sophie made available to anyone—their friends, colleagues, random strangers—on her Facebook page.

  Nick confiscated both bowl and cereal box. “Dinner’s over,” he said. “And you missed it.”

  “No problemo. I’m having breakfast.”

  “No,” Nick said, holding the cereal out of reach. “You’re not.”

  And then it started. Red blotches covered Sophie’s round face. She picked up a heavy glass serving bowl and dropped it onto the floor. It cracked in two but didn’t shatter, so she lifted the largest piece over her head, prepared to throw it across the room. Marta reached for the half bowl and Nick grabbed Sophie by the wrists. A sharp sting seared Marta’s palm, then she felt a warmth, and all three of them watched as bright red blood rushed down
her arm.

  Nick let go of Sophie. “Get out of here!” he bellowed, shoving her with such force that she nearly tripped over her own feet. Marta put her hand under the tap and turned on the cold water. She lifted the flap of severed skin. It was a clean, relatively superficial cut. No glass fragments, no exposed tendons.

  “Should I do something?” Nick asked. “What should I do?”

  “A dish towel,” she answered. “A clean one.”

  Nick had the good sense to pass a towel well past its prime, and Marta wrapped her hand with it, then held the hand above her head. Regaining control, Nick led her into the den and sat down beside her on the couch, positioning himself so his shoulder was under her elbow and it was no longer any effort for her to elevate her arm.

  “What are we going to do?” he asked.

  “When the bleeding stops, I’ll put on a pressure dressing.”

  A window had been left open and the fog had come in. Cold air blew through the room. Marta shivered.

  “I mean about Sophie.”

  Oh, she thought. That. Marta ran the fingers of her good hand through Nick’s hair, blond waves increasingly giving way to gray. Every night, something different set Sophie off. One night it was Olivia, the next it was a look Nick might or might not have given her. The amount of milk in her glass, a t-shirt not yet washed since its last use, her science homework, the trill of her mother’s pager—any minor infraction could cause major chaos: screaming, flying objects, punching, scratching, and kicking. One evening a passing pedestrian had called the police.

  Marta had lost whole nights—weeks, months—of sleep, running through their parental decisions and actions, trying to uncover the source of Sophie’s overwhelming anger. She couldn’t figure it out. Not knowing why her child was such a mess was almost as agonizing as the hostility itself.

  “Boarding school?” she suggested, only half joking. They’d already tried therapy, first individual and now family, a change of school, and upward and downward adjustments in structure and independence.

  Nick frowned. “She’s not a chair or a coat. We can’t just send her away because she doesn’t suit us anymore.”

  “I know,” Marta said, but thought, Where’s that law written? People must do it all the time. They couldn’t be the first parents unable to cope with a child.

  “I pushed her too hard,” Nick said. “Way too hard.”

  “You were upset about me.”

  “No,” he said. “I mean, yes, of course, but that was only part of it. I wanted to push her even harder. I wanted to . . .”

  She could guess what he was reluctant to admit. She’d had the same feelings herself, moments when she didn’t worry whether Sophie was cutting herself or doing drugs or contemplating suicide, and instead imagined in cold, gratifying detail slapping certain expressions off her daughter’s ugly, hate-filled face. Once upon a time, they’d had a wonderful, happy family. She had loved her life. But in the last year, she’d begun coming home filled with trepidation. She dreaded dinners and bedtimes and mornings before school and even weekends, sixty hours without reprieve from a child who had painted the walls of her room black, rarely pulled up the shades, worshipped Kurt Cobain, hated school, and preferred plants and animals to human beings.

  Marta took Nick’s hand. “Tell me.”

  He closed his eyes. “I wanted to throw her onto the floor. Beat the crap out of her. Get back at her for all she’s put us through.” He took a sharp breath. “My own daughter, and I wanted to hurt her so badly I could taste it.”

  She kissed his palm, then closed her eyes too. The reddish darkness behind her lids seethed with minute speckles of light she couldn’t hope to organize into a useful clarity. Against that backdrop, Marta imagined Sophie as a smiling infant, a temperamental toddler, a pretty and charmingly precocious child, and finally, she pictured her daughter waddling into the kitchen, slumping down at the table, and shoveling bite after unwieldy bite of lavender and pink and lime-green cereal into her huge, sneering face, and she felt something inside her tighten, shut down, and turn off.

  *

  Everyone knows what to do for a heart attack. Everyone, it turned out, except Marta’s two useless half brothers, graduates of the nation’s leading universities, both of whom still lived at home and neither of whom called 911 when their father’s chest pain began later that night. Instead, they squeezed a pallid, sweat-drenched Ricardo and the invisible six-ton elephant on his chest into Carlos’s new chrome-and-silver Mini and drove him not to the closest hospital but, at Ricardo’s insistence, across town to the University Medical Center.

  “What were you thinking?” Marta yelled at Carlos in the waiting area outside the cardiac intensive care unit. And he and Jorge exchanged the look they’d shared as boys when she’d explained to them the importance of learning Spanish or flossing their teeth.

  Early the next morning, Marta went home to change her clothes and give her family an update on Ricardo’s condition. Nick hadn’t gone with her to the hospital, as they were no longer willing to leave Jason and Olivia at home alone with Sophie. After she explained to the kids that their grandfather had had a heart attack and then a surgery he barely survived and might not recover from, Sophie announced that she’d rather die than be a doctor.

  Marta said, “I can’t have that conversation right now.”

  Sophie smirked. “That’s me all over. The inconvenient child.”

  Jason was on the verge of tears. “Please, can’t we just talk about Abuelo?”

  “Inconvenient?” Nick turned to Sophie. “What about selfish?”

  “I’m going to be a doctor,” Olivia said. “I’m going to go work in Africa like Megan’s mom.”

  Sophie glared at her sister. “You can’t be a doctor. You can’t even kill a bug.”

  Olivia opened her mouth to protest, then glanced at her sister and closed it again without speaking. Jason turned on his Game Boy and began pounding the keys.

  Nick said, “Each of you can be whatever you like. But right now we should be thinking about your grandfather.”

  Marta nodded.

  “Oh, sure,” Sophie said. “We can be anything. As long as it’s the kind of job that makes people say, ‘Wow, you’re such a good person.’”

  Nick flinched. Marta looked at her daughter and tried to feel something other than exhaustion and a wish that they’d sent Sophie to spend the night at a friend’s.

  “We just want you to be happy,” Nick said. “All three of you.”

  Sophie cackled. “News flash! Plan not working!”

  Marta pictured her father tethered to a bed by tubes and wires and coma. “What would make you happy, Sophie? Tell us. Please.”

  Sophie threw her head back and slapped the table, as if her mother had just told a great joke. The performance stopped as abruptly as it began, and she glared at Marta. “Like you care.”

  “Do not,” Nick said, “speak to your mother that way. Ever. And you can do whatever you damn please. Just don’t hurt other people.”

  Sophie turned to her siblings. “But,” she said, “it’s A-OK to degrade and deprive yourself and your family for the sake of strangers.”

  Jason’s fingers froze above his toy.

  “Jesus, Sophie!” Nick said. “What the hell does that mean?”

  Marta felt dizzy. She had refused Jorge’s early-morning offers of vending machine cookies and soft drinks. “We have never degraded you, Sophie,” she said. “Never.”

  “I forget,” Olivia said. “What’s degrade?”

  Sophie’s eyes narrowed. “Try and figure it out, hot stuff. Start with the Latin root.”

  “Please,” Jason whispered.

  Sophie pushed back her chair and stood up. “You two don’t even like me,” she said, her eyes shooting from Marta to Nick and back again. “If that’s not degradation, what is?”

  “Like?” Nick protested. “I love you!” The usually unspoken words emerged too loud and with the unmistakable violence of an expletive.


  But his words were no match for Marta’s silence. The refrigerator buzzed. Outside, a car passed the house, its radio turned up so high that she felt the beat in her bones and gut before she heard the blurred scream of vocals.

  Sophie walked over to where her mother was sitting and leaned forward until her pimpled face was just inches from Marta. “And I’m supposed to be the problem around here,” she said. Then she turned and ran upstairs.

  In the cardiac intensive care unit, Marta and Mercedes spent the day sitting side by side in orange plastic chairs beside Ricardo’s bed. Machines hummed and beeped. Every six seconds, the respirator made a whoosh and Ricardo’s chest rose and slowly fell. Above his head hung bags of medications—the right ones at the right doses, Marta knew, since every time she left the cubicle, if only to use the bathroom down the hall, she checked them on her return. Below him, attached to the bedrail, other bags collected liquids from his bladder and chest tubes. Pumped with fluids during the resuscitation and operation, her father had put on twenty pounds overnight.

  “The children are okay?” Mercedes asked for the third time in two hours. Her face, usually round and decorated with powder and rouge, appeared ashen and deflated, as if she’d lost the pounds Ricardo had gained.

  “Nick picked them up from school,” Marta said again. “They’ll be here soon.” She looked out the window and watched an aide check the blood pressure of a patient in the next building. “And the boys will be back. They decided we needed real food for dinner.”