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

by Noah Gordon

  Letty Gates had turned on the strong light above their barn door, and R.J. began seeing it through the trees while she was a good distance away. She drove into the barnyard and stopped the Explorer near the back steps. She had just gotten out of the car and was taking her bag from the backseat when the first sharp, loud report made her start, and something kicked up the snow near her booted foot.

  At once she made out the figure of a man just inside the barn door, in the darkened interior. The outside light reflected off the snow to gleam dully on the barrel of what she guessed was a deer rifle.

  “Get the fuck out of here.” He swayed as he called to her, lifting the rifle.

  “Your wife is hurt, Mr. Gates. I’m a doctor, Dr. Cole, and I’m going into your house to take care of her.” Oh God, she thought, not smart at all. She didn’t want to give him ideas, send him back into the house after the woman.

  He fired again, and the glass in the right headlamp of her car exploded in a shower of shards.

  There was no place where she could hide from him. He had a powerful weapon, and she had none. Whether she tried to duck behind the car or within it, all he had to do was take a few steps and he could kill her if that was what he wanted to do.

  “Be reasonable, Mr. Gates. I offer no threat to you. I just want to help your wife.”

  There was a third shot, and the glass in the left headlamp of the car disappeared. Then another shot blew away a chunk of the front left tire.

  He was making junk of her car.

  She was exhausted, sleep-deprived, and so terrified that she was past caution. The accumulated tensions of ripping apart her life and putting it together again in this new place—everything suddenly welled up within her and spilled over.

  “Stop it. Stop it. Stop it. Stop it.”

  She had lost control, abandoned reason, and she took a step in his direction.

  He came to meet her, holding the rifle low but keeping his finger on the trigger. He was unshaven, dressed in dirty overalls and a manure-stained brown barn jacket and a plaid woolen cap embroidered with “Plaut’s Animal Feeds” on the front.

  “I didn’t have to come here.” She listened to her voice in astonishment. It was modulated and reasonable.

  He looked puzzled as he lifted the rifle. At that moment they both heard the car.

  For just long enough, he hesitated, and Mack McCourtney sounded the siren loud and low, like the growl of a giant animal. In a moment the car lumbered into the driveway, and McCourtney was there.

  “Now don’t you be a horse’s prick, Philip. Put that gun down or it will be real bad for you. Either you’ll be dead or you’ll be in jail forever with no chance to get drunk at all.” The police chief was quiet and steady, and Gates set the rifle against the wall of the house. McCourtney handcuffed him and put him in the back of the Jeep, which was as secure as a cell, reinforced by heavy wire gridwork.

  Very carefully, as if she were walking over thin ice, R.J. went inside the house.

  Letty Gates had multiple bruises from her husband’s fists and what proved to be hairline fractures of the left ulna and of the ninth and tenth ribs on her left side. R.J. called the ambulance just as it returned from transporting the truck driver to the hospital.

  Mrs. Gates’s arm was splinted and placed in a sling and bound to her chest with a wide cravat to support the ribs. By the time she was taken away by the ambulance, Mack McCourtney had gotten the spare tire onto R.J.’s car. The lampless Explorer was blind as a mole, but she followed behind the police Jeep as McCourtney slowly drove down the mountain.

  When she got home, she managed to get only partially undressed before she sat on the edge of her bed and cried and cried.

  The next day she was busy with office hours, but Dennis Stanley, one of McCourtney’s part-time special officers, drove the Explorer into Greenfield for her. He got a new spare tire and the Ford dealer replaced the headlights and the wiring for the left lamp. Then Dennis went to the county jail and gave the bills to Phil Gates, explaining that the judge might take it kindly when he considered the possibility of bail if Gates could say he was sorry and had already made restitution. Dennis brought Gates’s check back to R.J. with the repaired car and advised her to cash it immediately, which she did.

  Things slackened in December, and she welcomed the breathing room. Her father had decided to visit friends in Florida for Christmas, and he asked if he could spend four days beginning December 19 with R.J., to celebrate the holiday early.

  The early celebration put Christmas on schedule with Hanukkah, and David and Sarah said they would be glad to come to a holiday dinner.

  R.J. cut a small tree from her own woods, which pleased her, and made a nice dinner for the four of them.

  They exchanged gifts after the meal. She gave David a small painting she had bought of a cabin doorway that reminded her of his house, and a family-size package of M&Ms. For her father she had bought a jug of the Roches’ maple syrup and a jar of I’m-In-Love-With-You Honey. For Sarah, she had a collection of Jane Austen’s novels. Her father gave her a bottle of French brandy, and David gave her a book of poems by Emily Dickinson. Sarah had wrapped a pair of mittens she had knitted of undyed yarn and a third heartrock for R.J.’s collection. She told R.J. that in a way her gifts were from Bobby Henderson too. “The wool came from sheep raised by his mother, and I found the heartrock in their barnyard.”

  R.J.’s father was growing older. He was more hesitant than she remembered, a little quieter and somewhat wistful. He had brought his viola da gamba. His hands were so arthritic that it hurt him to play, but he insisted that he wanted to make music. After the presents were exchanged, she sat at the piano, and they played a series of duets that went on and on. It was even better than the perfect Thanksgiving had been; it was the best Christmas R.J. had ever had.

  After David and Sarah had gone home, R.J.’s father opened the front door and walked out onto the porch. It was crispy cold, so there was a sheen of ice on the surface of the snow, and the full moon cast a path of light across the meadow as if it were a lake.

  “Listen,” her father said.

  “To what?”

  “To all the calm and bright.”

  They did, standing there together, breathing in the cold air for a long minute. The wind was still, and there was a complete absence of sound.

  “Is it always this peaceful here?” he asked.

  R.J. smiled. “Most of the time,” she said.

  27

  THE SEASON OF COLD

  David came to her place one afternoon when she was away and snowshoed over the cleared path through the woods three times, packing down the deep snow so the two of them could travel the trail on cross-country skis. The trail was too short, too quickly covered by a skier; they agreed they would have to finish it in time to have better skiing the following winter.

  The woods became a very different place in the cold season. They saw tracks that told of animals that in the summer would have passed through the woods unnoticed, spoor of deer, mink, coon, wild turkey, bobcat. One set of rabbit tracks ended in a broken place off the trail. When David stirred the snow with a ski pole he uncovered frozen blood and bits of white rabbit fur, where an owl had fed.

  Snow was a serious reality of everyday life in the hills. At David’s suggestion, R.J. bought a pair of snowshoes and practiced using them until she could make reasonable progress. She kept the snowshoes in the car, “just in case.” In fact, she didn’t have to use them that winter. But early in January there was a storm that even the town’s old-timers called a serious blizzard. After a day and a night of steady, heavy snowfall, her telephone intruded just as she was sitting down to breakfast.

  It was Bonnie Roche. “Dr. Cole, I have a terrible pain in my side, and I’m so nauseated I had to quit in the middle of milking.”

  “Do you have a fever?”

  “My temperature’s a little over a hundred. But my side. It hurts like hell.”

  “Which side?”

&
nbsp; “On the right.”

  “Low or high?”

  “High … Oh, I don’t know. In the middle, I guess.”

  “Have you ever had your appendix removed?”

  “No. Oh, God, Dr. Cole, I can’t go to the hospital, that’s out of the question! We couldn’t afford it.”

  “Let’s not assume anything. I’ll come out to your place right away.”

  “You can only get as far as the highway. Our private road isn’t plowed.”

  “Sit tight,” R.J. said grimly. “I’ll get there.”

  Their private road was a mile and a half long. R.J. called the town ambulance squad, which had a rescue unit that used snowmobiles. They met her at the entrance to the Roches’ road with two of the machines, and soon she was seated behind Jan Smith and hugging him, her forehead tucked into his back as they skimmed over the snow-buried dirt track.

  When they arrived, it was clear at once that Bonnie’s problem was appendicitis. A snowmobile wouldn’t ordinarily have been R.J.’s transportation of choice for a patient with a hot appendix, but under the circumstances it had to serve.

  “I can’t go to the hospital, Paulie,” Bonnie told her husband. “I can’t. Dammit, you know that.”

  “Never you mind about that. You leave that to me,” Paul Roche said. He was tall and rawboned, in his twenties and still looking too young to drink alcohol legally. Every time R.J. had come to their farm, he had been working, and she hadn’t ever seen him, out here or in town, when his worried boy’s face wasn’t creased with an old man’s frown.

  Despite Bonnie’s protestations she was helped onto Dennis Stanley’s machine, which moved off as slowly as Dennis could manage. Bonnie rode hunched over, guarding the appendix. At the plowed public road the ambulance and the crew were waiting, and they whisked her away, the siren splitting the silence of the town.

  * * *

  “About the money, Dr. Cole. There’s no insurance,” Paul said.

  “Did you clear thirty-six thousand last year from the farm?”

  “Clear?” He smiled bitterly. “You’re joking, right?”

  “Then you won’t be charged by the hospital, under the rules of the Hill-Burton Act. I’ll see that the hospital sends you the papers to sign.”

  “You mean it?”

  “Yes. Only … I’m afraid the Hill-Burton Act doesn’t cover doctor bills. Don’t worry about my bill,” she forced herself to say. “But doubtless you’ll still have to pay a surgeon, an anesthesiologist, a radiologist, and a pathologist.”

  It hurt her to see the worry flood back into his eyes.

  That evening she told David about the Roches’ predicament. “Hill-Burton was meant to protect indigent and uninsured people from disaster, but it doesn’t work because it pays only the hospital bill. The Roches are riding a fragile economic ship. The expenses that aren’t covered may be heavy enough to sink them.”

  “The hospital raises its charges to the insurance companies to cover what they can’t collect from patients like Bonnie,” David said slowly. “And the insurance companies raise their rates they charge for their insurance to cover their increased cost. So everybody who buys health insurance ends up paying Bonnie’s hospital bill.”

  R.J. nodded. “It’s a lousy, inadequate system. There are thirty-seven million people in the United States without any form of medical insurance. Every other leading industrial nation in the world—Germany, Italy, France, Japan, England, Canada, and all the others—supplies health care to all its citizens, at a fraction of what the world’s richest country spends for inadequate health care. It’s our national shame.”

  David sighed. “I don’t think Paul will make it as a farmer even if they survive this problem. The soil in the hills is thin and rocky. We have some potato fields and a few orchards, and some farmers used to grow tobacco. But the crop that grows best up here is grass. That’s why we had a lot of dairy farms once upon a time. But the government doesn’t support milk prices anymore, and the only milk producers who can make money are the big-business outfits, enormous farms with giant herds, in states like Wisconsin and Iowa.”

  It was the subject of his novel. “Small farms around here have popped like balloons. With fewer farms, the agricultural support system has disappeared. There are only one or two veterinarians left to treat the herds, and agricultural equipment dealers have gone out of business, so if a farmer like Paul needs a part for a tractor or a baler, he has to drive clear into New York State or Vermont to find it. The small farmer is doomed. The only ones left are those with personal wealth or a few like Bonnie and Paul. Hopeless romantics.”

  She remembered how her father had characterized her desire to practice rural medicine. “The last cowboys, searching for the vanished prairie?”

  David grinned. “Something like that.”

  “Nothing wrong with romantics.” She determined to do everything in her power to help Bonnie and Paul stay on their farm.

  Sarah was off on an overnight field trip to New Haven with the school drama club, seeing a revival of Death of a Salesman, and almost shyly, David asked if he could spend the night.

  It was a new wrinkle in their relationship; he wasn’t unwelcome, but suddenly he was in her living space in a more serious way, something that took getting accustomed to. They made love, and then he was there in her room, sprawled over more than half of her bed, sleeping as soundly as if he had spent the last thousand nights there.

  At eleven o’clock, sleepless, she slipped from the bed and went into the living room and turned on the television for the evening news, keeping the volume low. In a moment she was listening to a United States senator castigating Hillary Clinton as a “dreamy do-gooder” for vowing to gain passage of a universal health care bill. The senator was a millionaire whose every medical problem was taken care of, free of charge, at the Bethesda Naval Hospital. R.J. sat alone before the flickering screen and cursed him in furious whispers until she began to laugh at her own foolishness. Then she clicked him off and returned to bed.

  Outside, the wind screamed and moaned, and it was as cold as the senator’s heart. It was good to snuggle up to David’s warmth, one spoon fitting into another, and presently she slept as soundly as he.

  28

  RISING SAP

  The advent of spring took her by surprise. The fourth week of a dun and cheerless February, while R.J. still was in the dead of winter psychologically, she began to notice people working in the woods by the roadsides as she drove past. They were tapping wooden or metal spiles into maple trees and hanging buckets on them, or running plastic lines like a giant network of intravenous tubing from the tree trunks into large collecting tanks. Early March brought the requisite weather for sugaring—frosty nights, warmer days.

  The unpaved roads thawed each morning and were transmuted into canals of glue. R.J. found trouble as soon as she turned the car into the private road on the Roche place, and very soon the Explorer had churned into the gumbo up to its wheel hubs.

  When she got out of the car, her booted feet sank as if something were pulling her into the earth. R.J. dragged the wire cable out of the winch in front of the Explorer and slogged down the road with it until more than a hundred feet of line lay in the mud behind her. She chose a huge oak tree that looked as though it were anchored in the earth for all time, encircling it with the cable and then snapping the hook over the line so the tree was captive.

  The winch came with a remote control. She stood off to one side and pressed the button, then watched in fascinated delight as, gradually and inexorably, the cable was drawn into the winch and became taut. There was a loud sucking noise as the four tires were pulled from the thick ooze, and the car began to inch forward slowly, slowly. When it had moved about twenty yards toward the oak tree, she stopped the winch and got back in and started the engine. The wheels had purchase in four-wheel drive, and within minutes she had reclaimed the cable and was rolling toward the Roche barnyard.

  Bonnie, minus her appendix, was home alone. She
still couldn’t do heavy labor, and Sam Roche, Paul’s fifteen-year-old brother, came each morning before school and every evening after supper and milked the cows. Paul had taken a job as a shipper in the knife factory in Buckland in order to try to pay the bills. He came home every day after three o’clock and spent what was left of daylight collecting maple sap and boiling it in the sugar house until the wee hours of the morning. It was brutal work, collecting and boiling forty gallons of sap to get one gallon of syrup, but people paid well for the syrup, and they needed every dollar.

  “I’m scared, Dr. Cole,” Bonnie told R.J. “I’m afraid he’ll crack under the strain. Afraid one of us will get sick again. If that happens, good-bye farm.”

  R.J. had fears about the same things, but she shook her head. “We just won’t let it happen,” she said.

  Certain moments never would leave her.

  November 22, 1963. She had been going into Latin class in junior high school when she heard two teachers talking about the fact that John F. Kennedy had been gunned down in Texas.

  April 4, 1968. She had been bringing books back to the Boston Public Library when she saw a librarian crying and learned that an assassin’s bullet had found Martin Luther King, Jr.

  June 5, that same year. She had been kissing her date outside the apartment where she lived with her father—she remembered the boy was chubby and played jazz clarinet, but she no longer could recall his name. He had just touched the fabric armor, made up of her thick sweater and her bra, that enclosed her breasts. She was trying to figure out how to react to that when his father’s car radio reported that Robert Kennedy had been shot and was believed to be dying.

  She would add to those moments hearing that John Lennon had been assassinated and that the Challenger had exploded.

  Now, in Barbara Kingsmith’s house, on a rainy morning in mid-March, she had another terrible moment.

  Mrs. Kingsmith had a serious kidney infection; her fever hadn’t impaired her garrulousness, and she was complaining about the colors used by painters on the inside of the Town Hall when R.J. heard a few words of a bulletin from the television in the den, where Mrs. Kingsmith’s daughter was watching.