EPILOGUE
FAMILY MEDICINE
THESE DAYS HE goes home on weekends. He likes to spend time with his new nephew, whom his mother refers to as Angel, as though that was the name on his birth certificate rather than Graham Alexander Hausmann. Kate alternates between (in third person) The Baby and (in direct address) Guh-ram. Guh-raham she says, prodding his belly until he farts or smiles or both. Guh-rahahahaham.
Erich calls his son Alex, the name he would have preferred to use, in honor of his maternal grandfather, Alexander Schlierkamp. Throughout the latter half of the pregnancy, Erich campaigned for Kate to move “Graham” to second place; that is, if anything Erich does can be described with a word as effervescent as campaign. What was wrong with Alexander Graham Hausmann? Airily Kate pointed out that Erich had chosen Gretchen’s name; by rights, she had dibs. Not to mention that “Alexander Graham” conjured Alexander Graham Bell, and she didn’t want people calling the child “Baby Bell”; or, for that matter, her “Mama Bell.”
For the life of him, Jonah’s father cannot understand why anyone would name a child one thing and then call it another. He has moreover observed that the baby’s eyes are a light, sandy shade that could very well be described as graham; the doubled accuracy gives him added pleasure in calling his first grandson by his propers. He tells Jonah that it’s intriguing how Kate (brown) and her husband (gray) have produced a child with golden eyes. Then again, genetics aren’t what they teach you in high school, when every phenotypic outcome can be plotted on a Punnett square. Any number of complex interactions…and besides, everything changes as the baby grows; Jonah, for example, had blue eyes for the first six months of his life, after which new marching orders roused enzymes and proteins that would leave him his legacy of muddy green. Jonah knows all this already but the conversation feels nice.
Gretchen doesn’t call her brother anything. She remains in denial, behaving as though the cranky lump that occupies an increasing amount of her parents’ energy is a temporary inconvenience rather than a genuine infringement of her sovereignty. She has earnestly suggested that they put It back in Mommy’s tummy, a concept Kate finds both delightful and revolting. Babies don’t work that way. And neither does Mommy.
As for Jonah, he hasn’t yet settled. For a while called the baby by his initials, GAH. Graham-Man, elided to Gramman, sounded too much like Gramma. Grambo, Gramcracka, Conan the Grammarian, Jean-Claude Van Graham. For a while he took to speaking to the baby in a Scandinavian accent, à la the Swedish Chef. Ja de fürden blurden bårdy førdy firk. Under this schema, Graham became Sven. When Kate threatened to revoke his visitation privileges, he switched over to G—wassup, G?—a hopelessly déclassé choice he doubts will last more than a few weeks.
Erich asserts that the child is going to be confused. Out loud, Jonah agrees, though he’s not terribly worried. This is a decision worth thinking about. What you call something determines its shape in your heart.
FROM PAGE FORTY-TWO of the Guide to the Third-Year Clerkships:
Your third year will be a time of emotional and intellectual growth. Becoming a physician is a gradual process, a forging of knowledge and compassion that comes with experience. Most students learn more about themselves than in any other academic context previously encountered.
From page sixty-seven of the Book:
CONCLUDING THOUGHTS
or
HOW I LEARNED TO STOP WORRYING AND
LOVE MEDICAL EDUCATION
Okay, seriously now, you’re going to have the time of your life. Third-year can be kind of a whirlwind, but that’s what’s so much fun about it!! Think about all the times in college you put off going to a party so you could prepare for orgo. Think about the girl- or boyfriend who called you a loser and went off to hook up with someone else because you had to stay at home and study. Think about all the loans you’re going to have to repay. You made those sacrifices in order to be a doctor. So now that you have the chance to actually be a doctor, take advantage of it. See? Doesn’t that make you feel better?
We didn’t think so. It makes us want to barf also. But how can you appreciate the good things in life unless you want to barf at least some of the time?
Instead, think of this: fourth year is a breeze, and then internship, and residency…in no time you’ll be a real doctor, probably no older than fifty. It has to start somewhere, and it may as well be here. Not in college; not during the Boards. Here, on your first day of your first rotation. Welcome to a world of hurt, and a world of healing. We got through it, and so will you.
HE WASN’T THROUGH IT.
“Christmas break” devolved into a haze of taped statements and tendered sympathies. He felt like he was making the rounds of the talk shows, like he was a celebrity sharing big news: interviewing with the Great Neck PD, the NYPD, three different ADAs. Scottie Vaccaro read the brief item in the Times—he was moving up in the world, it seemed—and phoned to ask what had happened. A reporter turned up at his parents’ house, where he went to hide out in the immediate aftermath. Friends e-mailed. Vik and Lance came, separately, to visit. And then there was a series of shouting matches with George.
Six months later, all he retains is a sense of displacement and a noxious sort of relief: feeling terrible for feeling better.
His parents—and the HUM administration—believed strongly that it would do him good to take time off. At the time he’d been too shell-shocked to argue. He’d lacked the presence of mind to reply that, if he missed the beginning of second semester, the rotation in question would have to be repeated—during his fourth year, at the expense of vacation time then; and that this arrangement would result in greater misery. Plus he had to make up the psych Shelf. His record was going to look suspiciously lazy. He didn’t want to present on paper as somone who’d slid by, not after years of work. And he would recover in a few days, he knew he would, once panic released him, once he could sleep again; Hannah’s open mouth, flashbulbed in his memory.
January was bad.
THE VIDEOTAPE OF that night is in the possession of Detective Luther Van Voorst of the Great Neck PD. Jonah has seen it once, the week following, when he drove over to the station with his parents and Chip Belzer.
Van Voorst wanted to use the tape to guide his questions. If you’re okay seeing it.
I saw it in person Jonah said.
For five minutes the shot shows the living room. The focus is lousy. Eve passes in and out of the frame, moving furniture around. Always the auteur. Then she disappears upstairs.
Why was she going up there.
To see Hannah.
Do you have any idea why she wanted to see Hannah.
Jonah said She was jealous of her.
Over you.
After a while, he said I don’t know how much it had to do with me.
What the detective wanted to determine was Hannah’s state of mind; it bore on whether or not she could be charged with a crime. He paused the tape. You sure you’re okay seeing this again?
Jonah nodded.
The struggle lasts at most six seconds, and its plainest interpretation is an act of aggression by Hannah. They both hold the knife. Eve pulling away, although Jonah thought that what she was really doing was pulling Hannah toward her. The blade glints before disappearing into Eve’s neck and drawing a huge, wide leer. Hannah’s hands on the blade. Eve’s hands on Hannah’s hands. Or—the other way around. Eve’s hands controlling; Hannah, a cover, a proxy, a puppet.
The pressure of moving blood varies throughout the human body. It is highest near the heart. When rent in unison, the vasculature of the neck—the common carotid and the internal jugular, as well as smaller vessels such as the inferior thyroid artery and the vertebral artery—forms a geyser of almost comical force. The carpet and the litho on the wall and the floor, all soaked; Hannah, too, poor Hannah, looking electrocuted, falling in tandem with Eve, swimming in her open throat.
Jonah knew what the detective was thinking; he was thinking the same
thing. Could he honestly believe that Hannah had lacked agency, had not provided at least part of the push. Could Eve, could anyone, hate herself enough to cut her own head halfway off.
He overestimated himself; he had to get up and leave the room. He knelt in the hallway. Moments later he felt a hand on his back.
Take as much time as you need.
When he reentered the room with the chair and the table and the lawyer and the detective and the cup of water, the TV had been switched off. Van Voorst handed him a napkin, which he used to dry his face.
You know, there’s a significant time lag before you—I mean, I can see you were dealing with, things.
He’d dealt with Hannah by dragging her away from Eve’s body, scuffling through pools, she kicking, kneeing him in the groin as he crawled. She was so strong.
When did you go to phone the police?
A few minutes later.
Do you remember how long?
Three or four minutes.
The detective nodded.
It had been more than three or four minutes. Jonah knew, because when he went to the kitchen to phone (he would not recover his cell, which had fallen and slid under the loveseat, until May, when the police mailed it to him in an evidence bag), the microwave clock said four twenty-four.
I was he said. I was—
He’d waited in the kitchen, the phone in his hands. Hannah on the floor near the front door, lighting up the house with her shrieks.
The ambulance took a while to get there he said.
Bad weather said the detective.
He’d waited eight minutes. By that time Eve was still. He dialed for help.
The detective said I forgot to ask: what were you doing at the house in the first place?
Jonah said Good question.
HE DOES NOT visit Hannah. The institution where she’s sojourning indefinitely is several hours upstate. When he called, he was told that in order to be granted permission to speak with or see her, George had to put his name on a list. This is something Jonah is fairly confident won’t happen. George faults him generally, as well as for any legal woes that might accrue to Hannah over the death of Carmen Cove.
By March, the district attorney still hasn’t made a decision. By June, Jonah infers that one might not be made for a while. Van Voorst believes that Hannah may have acted of her own volition. The DA tells Jonah that they’re juggling several competing truths. There is Hannah’s hand on the knife, Eve’s hand on the knife. There is the soft focus. Self-defense? Act of will? If so, whose? There is history: Raymond Iniguez and the threats against Jonah, which now seem very relevant. He is asked, in tones of voice that indicate a low opinion of his common sense, why he didn’t notify the authorities days or weeks earlier about Eve’s behavior. Hannah is mentally ill; are they going to charge her for criminal activity when most sane people…and so on.
Reading the article in the Times, one discerns the hovering specter of a civil suit. Carmen Cove’s parents are an accountant and a schoolteacher from Lauraville, Maryland. They are puzzled and angered by what became of their Ivy League–educated daughter.
HANNAH’S VERSION OF the story remains a mystery; since that night she has not spoken. The last time Jonah heard her voice was as the police put her in an ambulance and took her to Great Neck hospital. She said No.
He calls in April, on her birthday, but the nurse will not put her on. He sends a card a few days later. It shows a monkey in a party hat. IT’S YOUR BIRTHDAY, GO APE!!!
George tells Jonah that he has betrayed him. Jonah never found out if George had hired a sub for Christmas.
HE HAS MOVED out of the East Village and found a studio, uptown, in a large building on Third Avenue. Lance understood; he was getting ready to close up shop anyway, having discovered an awesome international-relations program in Amsterdam, the future of worldwide diplomacy, starting in September.
In his new neighborhood—which isn’t new, he’s been commuting up here for close to three years—Jonah has once again taken up running. He wants to train for the marathon. With four and a half months to go, he might get there.
He runs along the East River promenade, designated John Finley Walk by a black iron sign whose cutout design of a windblown man wearing a bowler shows the Queens waterfront. He runs around Central Park, the whole of it, twice. He runs to the Brooklyn Bridge and back, to the footprint of the World Trade Center. He gets dehydration headaches that feel great when they go away.
At home he gorges on pasta. Summer, full-throttle, has stripped legs bare, and he looks down from his sixth-floor apartment at people walking north, cars shooting south; listening to the unplaceable low-grade sonic presence that never shuts off in New York City. It’s the sound of movement, the sound of speech behind closed doors, the aggregate output of public living and private dying, dramas that he will never watch.
TUESDAY, JUNE 21, 2005.
FAMILY MEDICINE, WEEK ONE.
“Kiddo, long time no speak.”
The clinic, in Jamaica, abuts a half-completed housing development. All around the neighborhood are scrunched, discarded pamphlets inviting people to a sales office in Kew Gardens. 1, 2 & 3 BEDROOM UNITS. En route from the subway he passes the construction site, where enormous color sketches on posts promise a community of faceless, racially indeterminate folk inhabiting a building that, save its fresh brick, looks pretty much like any other metro-area craphole.
The erection of a retaining wall has turned the alley behind the clinic into a dead end. Someone has taken advantage of the newfound quiet by setting out a suite of plastic furniture: five folding chairs and a table varnished with soot. He lunches there with his fellow students or, as today, alone.
“You have to take a look at this letter, kiddo. It’s unfuckinbelievable. While my client and I remain convinced that our action was and is in the right…blah blah to insist blah blah Raymond Iniguez was a blah blah under blah blah blaaaah boldface however, comma. However. Continued pursuance of…blah blah…quote a source of undue stress to the surviving members of the Iniguez family unquote. ‘Surviving members,’ for crissake, like you’re a plague of locusts ate their crops. This guy is such a bullshit artist he belongs in a museum. Give the man a megaphone. ‘Undue stress’? They dropped cause they can’t win. That, if any, is the source of the Iniguez family’s stress: lawyerly incompetence.” Belzer snorts. “I think I’m going to have this framed. The guy’s prose is choice. He manages to sneak in that he believes they would have won, in front of what he says he expects to have been a biased jury. I relish that construction. What he expects to have been. Insane. Somebody musta called him bad names during childhood. But let’s not dwell.”
“…I—”
“Sound happy.”
“I’m surprised.”
“There’s nothing to be surprised at. I told you they’d bend. Now you can get back to more important work. Go save some lives. How’s that other thing. They charge her?”
“No,” Jonah says. “Not yet.”
“They won’t. Trust me. Everything’ll work out. My love to your folks.”
Jonah hangs up. His appetite is gone. He dumps his sandwich in the trash and heads back inside.
LATER, MUCH LATER, he gets a mailer with a Bronx postmark. Inside is a CD. He puts it in his computer, puts the computer on his knees, feels the optical drive spin. Through his headphones seeps a familiar melody, sly guitar and gentle bass, clutching each other. He remembers its ascending, descending solo.
He puts the song on his MP3 player and adds it to the mix he uses while running. It’s not a good choice—too slow to motivate—but he’ll leave it on for one day, it can’t kill him to think about it for one day.
That afternoon he heads north, past the projects where DeShonna lives. He does this often. His path skirts near the swing set, although he has yet to find her out there. Most likely he won’t ever see her. If he does, she might not see him. If she does, she might not recognize him, or might not respond to his wave. It woul
d hurt pretty bad if she didn’t. But she also might smile and wave back. He thinks it’s worth running there, on the off chance.
Acknowledgments
ONCE AGAIN I owe an enormous debt of gratitude to those whose expert advice has helped me mask the ignorance that, by and large, defines me. However many errors I may have let slip through, there would be substantially more without the wisdom of Michael Rosen, Michael Strapp, Dr. Daniel Stein, Ehud Waldoks, Stephen Provine, Dr. Michael Seider, Phil Figueroa, Frank Skrelja, Rabbi John Keefe, Dr. Benjamin Galper, Dr. Robert Adler, Dr. Cathy Ragovan, Dr. Derek Polonsky, and Dr. Alexander Stein. Thanks also to Debbie Brindley of the late, great Café Repast.
Five people deserve special mention for donating inordinate amounts of their time, and for allowing me to shamelessly plunder their stories. On matters of law: Ben Mantell and Wes Shih, Esqs. On matters of medicine: Dr. Jon Kessler, Dr. Eli Diamond, and Dr. Elena Resnick.
Thanks to my superb agent, Liza Dawson, and my magnificent editor, Christine Pepe, whose cheer and guidance pushed me to the finish line. And then beyond, to the concession stand.
Thanks to Amy Brosey and Eve Adler.
Thanks to my siblings and grandparents.
Thanks to Ema, Abba, Mom, and Dad.
The primary inspiration and source for this book is, of course, my lovely wife, the doctah.
«——THE END——»
Table of Contents
TROUBLE
Dedication:
Epigraph
ONE
• 1 •
• 2 •
• 3 •
• 4 •
• 5 •
Trouble Page 31