The Cole Trilogy: The Physician, Shaman, and Matters of Choice

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The Cole Trilogy: The Physician, Shaman, and Matters of Choice Page 146

by Noah Gordon


  23

  A GIFT TO BE USED

  As a rule the hills were about ten degrees cooler than the valley, summer and winter, but that year the third week of August was sodden with heat, and R.J. and David sought the shade of the woods together. At the end of the trail they toughed it through the forest to the river, hard going, and made sweaty love in the pine needles on the riverbank, R.J. worrying about hunters. Then they found a sand-bottom pool and sat naked in the water, washing each other with their hands.

  “Heaven,” she said.

  “At least, the opposite of hell,” David said thoughtfully.

  He told her a story, a legend. “In Sheol, the fiery underground world to which all sinners go, souls are freed every Friday at sundown by the malakh ha-mavet, the Angel of Death. The freed souls spend the entire Sabbath soothing themselves by sitting in a cool stream, just as we’re doing now. That’s why in the old days some of the ultra-pious Jews wouldn’t drink water all during the Sabbath. They didn’t want to lower the healing waters occupied by the souls furloughed from Sheol.”

  She was intrigued by the legend but was having troubling thoughts about him. “I can’t figure you out. How much are you poking fun at piety, and how much is piety part of the real David Markus? Who are you to talk about angels, anyway? You don’t even believe in God.”

  He appeared to be mildly shocked. “Who says? It’s just … I’m not certain God exists, and if so, what he is—or she, or it.” He grinned at her. “I believe in a whole order of higher powers. Angels. Djinn. Kitchen ghosts. I believe in sacred spirits that serve prayer wheels, and in leprechauns and elves.” He held up his hand. “Listen.”

  What she heard was the complaint of the water, confident birdsong, the wind through megamultitudes of leaves, the velvet bee-drone of a truck on a far-off road.

  “I feel the spirits every time I come into the woods.”

  “I’m being serious, David.”

  “So am I, damn it.”

  She saw he was capable of spontaneous euphoria, of attaining a kind of high without swallowing alcohol. Or was it without swallowing alcohol? Was he safe from alcohol nowadays?

  How healed was the weakness that lurked within his strengths? The errant breeze continued to move the leaves above them, and his forest imps nagged at her, pinched at the most sensitive parts of her psyche, whispered that although she was becoming more and more involved with this man, there was much she didn’t know about David Markus.

  R.J. had called a county social worker and reported that Eva Goodhue and Helen Phillips needed help. But the county authorities moved slowly, and before the call brought results, a boy came to her office one afternoon and reported that the doctor was needed at once in the apartment over the hardware store.

  This time the door to Eva Goodhue’s apartment opened for her and she absorbed the full blast of air so foul she had to fight against gagging. Cats were underfoot, rubbing against her legs as she avoided their excrement. Garbage overflowed a plastic container, and dishes bearing rot were piled in the sink. R.J. had supposed the summons was because Miss Goodhue was in trouble, but the ninety-two-year-old woman, dressed and spry, was waiting for her.

  “It’s Helen, feeling very poorly.”

  Helen Phillips was in bed. Her heart didn’t sound alarming when R.J. listened with the stethoscope. She needed a good scrubbing, and there were bedsores on her back and buttocks. She had indigestion, belched, broke wind, and was unresponsive to questions. Eva Goodhue answered every question for her.

  “Why are you in bed, Helen?”

  “She enjoys it, it’s cozy. She likes to lie there and watch the television.”

  From the condition of the sheets, it was obvious Helen took all her meals in bed. R.J. was prepared to prescribe a new and stern regimen: out of bed early in the morning, regular baths, meals eaten at the table, and pharmaceutical samples for the indigestion. But when she took Helen’s hands in her own, she was afflicted with a flow of intelligence that filled her with sadness and terror. She was shaken. It had been some time since she had experienced the strange and terrible understanding, the certain knowledge for which there was no explanation.

  She reached for the telephone and dialed the town ambulance, willing the dispatcher to pick up the receiver. “Joe, it’s Roberta Cole. I have an emergency and I need an ambulance fast. Eva Goodhue’s, just down the street, over the hardware store.”

  They were there in under four minutes, a remarkable response time. Nevertheless, Helen Phillips’s heart stopped when the ambulance was halfway to the hospital. Despite frantic resuscitation efforts by the ambulance crew, she was dead on arrival.

  R.J. hadn’t received the message of impending death for several years. Now, for the first time, she acknowledged to herself that she possessed the Gift. She remembered what her father had told her about it.

  She discovered she was ready to believe.

  Perhaps, she told herself, she could learn to use it to fight the dark angel whom David called the malakh ha-mavet.

  She made certain she carried a hypodermic needle and a supply of streptokinase in her medical bag, and she contrived opportunities to hold her patients’ hands every time she saw them.

  Only three weeks later, making a house call to Frank Olchowski, a math teacher at the high school who was in bed with the flu, she took the hands of Stella, his wife, and felt the signals she dreaded to detect.

  She took a deep breath and forced herself to think calmly. The chances were highest that it would come either as a heart attack or a cerebrovascular accident.

  The woman was fifty-three years old, about thirty pounds overweight, and distraught and puzzled. “It’s Frank who is sick, Dr. Cole! Why have you called the ambulance, and why must I go to the hospital?”

  “You must trust me, Mrs. Olchowski.”

  Stella Olchowski went into the ambulance, staring at her doctor strangely.

  R.J. rode in the ambulance with her. She fixed the mask over Stella’s face and adjusted the flowmeter on the tank to deliver 100 percent oxygen. The driver was Timothy Dalton, a farmworker. “Make tracks. No noise,” she told him. He used the flashers as the ambulance careened away, but he didn’t sound the siren; R.J. didn’t want Mrs. Olchowski any more perturbed than she already was.

  Steve Ripley was troubled, too, after he took a set of the patient’s vital signs. The medical technician shot a puzzled glance at R.J. “What’s wrong with her, Dr. Cole?” he said, reaching for the radiophone.

  “Don’t call the hospital yet.”

  “If I bring somebody in with no symptoms and without submitting to the emergency room’s medical control, I’m going to be in deep trouble.”

  She looked at him. “Go with me on this one, Steve.”

  Reluctantly, he put the phone back on the hook. He watched Stella Olchowski and R.J. with increasing unhappiness as the ambulance made its way down Route 2.

  They were two thirds of the way to the medical center when Mrs. Olchowski winced and clapped her hand to her chest. She groaned and looked wide-eyed at R.J.

  “Take another set of vitals, fast.”

  “Jesus, she’s in severe arrhythmia.”

  “Now you can call medical control. Tell them she’s having a heart attack, that Dr. Cole is with you. Request permission for me to administer streptokinase.” Even as she spoke, the hypodermic needle was entering flesh, her fingers depressing the plunger.

  The cells of the heart muscle were perfused with oxygen, and by the time permission was given by medical control, the drug was beginning its work. When Mrs. Olchowski was off-loaded at the hospital by the emergency room staff, damage to her heart had been minimized.

  For the first time, R.J. had learned that the strange message she sometimes received from patients could save their lives.

  The Olchowskis told all their friends about their internist with the wonderful medical wisdom. “She just looked at me, and that woman knew what was going to happen. She is some doctor!” Stella said. The am
bulance crew agreed, and added their own embellishments to the story. R.J. began to enjoy the smiles that were directed at her as she went on her house calls.

  “This town likes having a doctor again,” Peg told her. “And they’re proud to think they have a damn good one.”

  It embarrassed R.J., but the message went out through the hills and valleys. Toby Smith came back from the state Democratic convention in Springfield and told her that a delegate from Charlemont had remarked that he had heard the lady doctor Toby worked for in Woodfield was a really warm, friendly sort of person. Always holding people’s hands.

  October brought an end to pesky insects and triggered incredible bursts of colors in the trees, a joyous streaking of the hills. The natives told her it was just a run-of-the-mill autumn, but she didn’t believe it. On an Indian summer day she and David went fishing on the Catamount, and he caught three decent trout and she caught two, gills brightly colored for mating. When they cleaned the trout they saw that two of them were females full of eggs. David reserved the trout eggs to fry with hen’s eggs, but R.J. avoided them, disliking all roe.

  Sitting with him on the riverbank, she found herself telling him details about the experiences she would never dare tell a medical colleague.

  David didn’t smile. He listened with great interest—even, she realized, with envy.

  “It’s written in the Mishnah…. Do you know what the Mishnah is?”

  “Some kind of Hebrew holy book?”

  “It’s the basic book of Jewish law and thought, compiled eighteen hundred years ago. It records that there lived a rabbi named Hanina ben Dosa, who could work miracles. He prayed over the sick, and he used to say, ’This one will live’ or ’This one will die,’ and it always turned out as he said. And they asked him, ’How knowest thou?’ And he said to them, ’If my prayer is fluent in my mouth, I know he is accepted. And if not, I know he is rejected.’”

  She was annoyed. “I don’t pray over them.”

  “I know. Your ancestors named it well. It’s a gift.”

  “But … what is it?”

  He shrugged. “A religious savant would say of both you and Rabbi Hanina that it’s a message you alone are privileged to hear.”

  “Why me? Why my family? … And a message from whom? Certainly not from your angel of death.”

  “I think your father probably was right when he guessed that it’s a genetic gift, a combination of mental and biological sensors that allows you additional information. A kind of sixth sense.”

  He held out both his hands to her.

  “No. Go away,” she said when she understood.

  But he waited with an awful patience until she took his hands in hers.

  She felt only the warmth and strength of his grip, and a weakness of relief, and anger at him.

  “You’re going to live forever.”

  “I will if you will,” he said.

  He talked as if they were soulmates. She considered the fact that he already had had a strong love, a wife he had cherished and now mourned. She had had Charlie Harris, an early lover who had died while their union was still perfect and untested, and then a bad marriage to a selfish and immature man. She continued to grip David’s hands, unwilling to let go.

  24

  NEW FRIENDS

  On a busy afternoon during office hours R.J. received a call from a woman named Penny Coleridge. “I told her you were with a patient and would return the call,” Toby said. “She’s a midwife. She said she would like to get to know you.”

  R.J. returned the call as soon as she was able. Penny Coleridge had a pleasant telephone voice, but it was impossible to guess her age over the phone. She said she had been practicing midwifery in the hills for four years. There were two other midwives—Susan Millet and June Todman—practicing with her. R.J. invited them to her house for supper on Thursday, her free afternoon, and after consulting with her colleagues, Penny Coleridge said all three would come.

  She proved to be an affable, stocky brunette, perhaps in her late thirties. Susan Millet and June Todman were about ten years older. Susan was graying, but she and June were blondes who looked enough alike to be mistaken for sisters, although they had met only a few years earlier. June had received her training in the midwifery program at Yale-New Haven. Penny and Susan were nurse-midwives; Penny had trained at the University of Minnesota, and Susan had trained in Urbana, Illinois.

  The three made it clear that they were happy to have a doctor in Woodfield. They told R.J. that some pregnant women in the hilltowns preferred an obstetrician or a family practitioner to deliver their babies and had to travel a good distance away to find one. Other patients preferred the less invasive techniques practiced by midwives. “In places where all the docs are men, some patients have come to us because they wanted a woman to deliver their baby,” Susan said. She smiled at R.J. “Now that you’re here, they have a wider choice.”

  Some years before, obstetricians in urban locations had worked to hobble midwives politically because they saw them as economic competitors. “But out here in the hill country, doctors don’t give us trouble,” Penny said. “There’s more than enough work to go around, and they’re happy we’re here, sharing the burden. By law, we have to be salaried workers, employed by a clinic or a physician. And although midwives would be perfectly capable of doing things like vacuum extractions and forceps births, we have to have a boarded obstetrician on call to do those things, just as you do.”

  “Have you made connection with an ob-gyn to act as your backup?” June asked R.J.

  “No. I would value your advice in that regard.”

  “We’ve been working under a good young obstetrician, Grant Hardy,” Susan said. “He’s smart, he has an open mind, and he’s idealistic.” She made a face. “He’s too idealistic, I guess. He’s taken a job with the surgeon general in Washington.”

  “Have you made a new arrangement with another ob-gyn, then?”

  “Daniel Noyes has agreed to take us on. The trouble is, he’s retiring in a year, and we’ll have to start again with somebody new. Still,” Penny said thoughtfully, “he might be just the ob-gyn to be your backup as well as ours. He’s grouchy and crusty on the outside, but he’s really an old dear. He’s far and away the best obstetrician in the area, and an arrangement with him would let you take your time looking for another ob-gyn before he retires.”

  R.J. nodded. “That sounds sensible to me. I’ll try to persuade him to work with me.”

  The midwives were discernably pleased when they learned that R.J. had had advanced training in obstetrics and gynecology and had worked in a clinic dealing with female hormonal problems. It was a relief to them that she was available in the event that a medical problem arose with one of their patients, and they had several women they wanted her to examine.

  R.J. liked them as people and as professionals, and their presence made her feel more secure.

  She dropped in often to see Eva Goodhue, sometimes bringing a package of ice cream or some fruit. Eva was quiet and introspective; for a few days R.J. suspected that was her way of grieving for her niece, but she had come to conclude that those qualities were aspects of Eva’s personality.

  The apartment had been thoroughly cleaned by the pastoral committee of the First Congregational Church, and Meals on Wheels, a nonprofit agency that served the elderly, delivered a hot dinner every day. R.J. met with the Franklin County social worker, Marjorie Lassiter, and with John Richardson, minister of the church in Woodfield, to talk about Miss Goodhue’s other needs. The social worker began with a blunt report of her financial status.

  “She’s broke.”

  Twenty-nine years before, Eva Goodhue’s only living sibling, an unmarried brother named Norm, had died of pneumonia. His death had left Eva sole owner of the family farm on which she had always lived. She had promptly sold it for just under forty-one thousand dollars and rented the apartment on Main Street, in the village. A few years later her niece, Helen Goodhue Phillips, daughter of
Harold Goodhue, Eva’s other dead brother, had divorced her abusive husband and come to live with her aunt.

  “They were supported by Eva’s money in the bank and by a small monthly welfare check,” Marjorie Lassiter said. “They thought they were on easy street, even sometimes indulging in a weakness for mail-order purchases. They always spent more than the capital earned annually, and the dwindling bank account finally has run out.” She sighed. “It’s not uncommon, believe me, for someone to outlive her money.”

  “Thank God she still has the welfare check,” John Richardson said.

  “That won’t support her,” the social worker said. “Eva’s monthly rent alone is four hundred and ten dollars. She has to buy groceries. She’s on Medicare, but she has to buy drugs. She has no supplemental medical insurance.”

  “I’ll look out for her medical care as long as she remains here in town,” R.J. said quietly.

  Ms. Lassiter gave her a rueful smile. “But that still leaves fuel oil. The electric bill. The occasional purchase of a necessary article of clothing.”

  “The Sumner Fund,” Richardson said. “The town of Woodfield has a sum of money left it in trust, the interest to be utilized to help needy citizens. The expenditures are made quietly at the discretion of the three selectpersons, and are kept private by them. I’ll talk to Janet Cantwell,” the minister said.

  A few days later R.J. met Richardson in front of the library and he told her it was all set with the Board of Selectmen. Miss Goodhue would receive a monthly stipend from the Sumner Fund, enough to cover her deficit.

  It was later that day, as R.J. finished updating the patient charts, that she realized a bright truth: as long as she lived in the kind of town that was willing to help an indigent old woman, she was content not to have shiny new plumbing in the Town Hall toilets.

  “I want to stay in my own home,” Eva Goodhue said.

  “And you will,” R.J. told her.

 

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