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“Boychick, the only way to handle this is calm. You’ve got at least a month before insurance processes and approves. Until then you’re getting those bills. Don’t overreact. Just confirm: the doctor’s office sent insurance the precert.”

“Got it. Okay. I’ve been trying to read the statement sheets, but there’s no logic. It’s to where I have no clue—”

“That’s what I’m saying. And your doe-eyed case manager?”

“Culpepper.”

“Go over her head. Deal with her supervisor. Soon as you can. Today. You write a letter to the hospital finance office. Let that supervisor know you’re appealing everything with the insurance. Every single out-of-network charge. You request medical notes from the case, the case manager, the doctors. Date and sign that letter. Make copies for your file. You want that hospital financial office helping you. Right up until the second they have to start trying to get the balance of what your insurance didn’t pay.”

Oliver typed. “So pit the hospitals against the insurance companies?”

“Part of the process. You and your wife have to be in this for the long haul.”

“Goddamn long-term ground war in Russia.”

“It’s up to you to use the time. Lengthen out how long it takes to settle each appeal. That’s over, apply for financial aid—see if the hospital reduces the bill. Hospitals are like private schools in Manhattan: they have all kinds of money for aid; only the applications are huge,
specifically to discourage people from applying
. But, kid, you jump through hoops the right way, there’s aid. Still, even afterward, you want to elongate out the payment period for what’s left. Whitman’s going to be in business, so don’t you worry about them.”

“I know we have enough insurance to get through that consolidation thing—five days of chemo, we stay under the cap. Another induction, though—I mean, if Alice agrees to try….But thanks. What you’re telling me helps.”

“You’ve got to adjust how you deal with these people,” Blauner said. “Every time you call your health insurance company, make sure you get name and number of each operator. Take complete notes. Repeat important info back to them for confirmation. When that phone-automation system tells you they’re monitoring a phone call for quality control? Don’t kid yourself—they’re checking on employees to make sure they follow the company script. They’re also monitoring your response. So no yelling at operators. Ever. Don’t give anybody reason to claim you’re unstable, you’re violent, they can’t work with you.”

“Yeah, well…it may be too late for that, but it’s good you told me.”

“Kid, believe me, I understand. But cut that shit out, pronto. Any rep, you’re as polite as with your sainted granny on her birthday. Soon as you wrap up a conversation, say the rep’s been very helpful. Ask for her name—because you want to tell her supervisor. Then send a thank-you letter for the information you were given. Put that information very specifically in the letter. This way you create a paper trail of what you’ve been told, by whom, and when. Keep your own copy of everything.”

“What’s the worst they’re going to do?” Oliver asked. “It’s not like insurance companies can seize property.”

“You’re funny.”

“What?”

“Boychick, you never heard of a court order to freeze accounts?”

“Fuck.”

“That’s down the road. But still—any way for you to hide assets? Do you
have
assets?”

“Fawck—”

“I had a client. She had cancer, is in for chemo. While recovering she gets pneumonia. They CAT scan her stomach before letting her come home. This at the start of the Christmas holiday weekend. Short staff, all senior docs away on vacation, residents and interns galore through the ward. Scan shows liquid around the gallbladder. Radiologist reads the pictures, sees the liquid, but also fuzz. He can’t make a firm deduction. He writes the risks are significant and could be examples of serious problems. This is what goes into the official report.”

Oliver started to ask what that meant.

“Attending reads the report, refuses to release the patient, naturally. My client complains to the daily resident. She wants to go home for Christmas.”

“I know that scene.”

“So the resident calls the radiologist. Off the record, the radiologist’s willing to admit the scans don’t look bad, whatever’s happening around the gallbladder isn’t such a kenahora
.
Besides, CAT scan results can be days behind what’s really happening.”

“So the radiologist’s just covering his ass.”

“Well—he can’t afford to have the patient released, and not have a warning in the paper trail. That happens, the radiologist’s legally liable. Client owns the hospital.”

“Why not fucking unplug the tubes with your hands?” asked Oliver. “Just take yourself out. They can’t keep her against her will.”

Blauner laughed. “Leave a hospital against medical advice? Insurance doesn’t pay for your stay, doesn’t pay for any procedures during that stay.”

A long breath outward.

“Exactly. There’s all kinds of angles.”

Another breath. Oliver said, “I just don’t see how we’re supposed to get through this.”

—

Alice raved about how
scrumptious
the seared strip steak had been, even if she’d only been able to eat a few bites, it had been no less
divine;
and she told Monsieur Florent how much she appreciated being in such a welcoming and lovely space, and the restaurant owner responded by kissing Alice’s hand as if the medically necessary rubber gloves were elbow-length silk, and he clasped into her palm a black business card, and told her that any time she needed anything, just call—didn’t matter if it wasn’t on the menu; they would have it for her, they could deliver to the loft. Bread baskets and water glasses were refilled; Florent told the women to take their time and he receded. Alice recounted for Tilda being in the blood cancer waiting room and meeting that man with the hump on his back, just what it had been like staring into his eyes, looking right at someone staring at his own death. Alice said she’d seen his death. She’d traveled into his void. Why should she get to live, she wanted to know, why should she get a chance, have everyone be so kind, all these people with their pity and their good wishes?

But staring at that man also allowed her to realize something. It was up to her to accept the void. She was the one who ultimately had to kill her God, kill her parents, kill herself, kill her identity, kill her personal narrative.

Interrupting, sheepish, apologetic, the creative director at a clothing house where Alice had never once set foot introduced himself, and asked if she needed any clothes, if he could do anything for her, anything at all. Alice thanked him for his kindness and accepted his hand in hers, and once he’d gone, she told Tilda that well before she’d ever fallen sick, she’d known about a form of Buddhism that prepared for death by having its practitioners chant:
Every day,
I am getting older, my body is decomposing, I am closer to my end.
She used this chant while she was doing yoga, or chopping up celery and cleaning the sink.

Taking her time, catching her breath, in spurts and segments, with sips of cool lemon water now and then to refresh her, Alice told Tilda that she’d been reading, when she could, and there was another koan—this one about a mother monkey and her baby. The mother monkey swings through the forest, while the baby monkey clings to her. In this way the baby monkey is taken care of by her mother. “I’m supposed to be the mother and the baby. I’m supposed to let go of my worries, cling to the knowledge that the earth will take care of me. Which sounds all well and lovely. But maybe it’s just giving myself an excuse to not fight?

“Theory is theory,” Alice continued. “Every day I do try to believe there are all kinds of ways the earth can take care of me. But there’s still this black box, always pressing on my chest: the possibility that I’ll never know my child, that she’ll never know her mother. I’ll be leaving helpless little monkey alone in the world. I try to live by these—but I’m sorry. I’m sorry. I’m small. I’m selfish. I won’t give up my husband. I won’t give up my baby. I
can’t.
”

Tilda had risen from her seat, was on her way around the table, sitting next to Alice, visibly exhausted, ignoring her own tears. Tilda dabbed at the river flowing down Alice’s face. Alice did not have to give up anything. They were going to find a donor. The transplant would happen.

Alice murmured, placed her head on Tilda’s shoulder. Downy hairs were alight, standing along the length of her wan neck. Tilda stroked, down their side, pressing with a feather’s pressure.

“We live in categories,” she said. “You’re a mother. A wife. A patient. Lots of things, right? But categories don’t bring you to your soul, do they?”

Alice’s breaths arrived—each lighter, softer.

“Religion doesn’t have an answer for what’s happening to you. Maybe you really will end up being one of those impenetrable Zeny paradoxes. What I know is this: we can be here for you. We can love you. That is all we can do. You still have to go through this. You’re the one on the spiritual pilgrimage.”

Spent, Alice murmured again, nestling further into the safety of her friend’s bosom. Tilda kept stroking. Alice’s eyes stayed shut. She made a blissful, dreamy sound. Dishes clattered in the background, table conversations carried on. Undisturbed, Alice nodded off to sleep.

How to Save the Day

T
HE BATHROOM DOOR
was ajar in case she needed to call for help. He could see plumes of steam, mirrors gone smoky. The effect was dreamy, almost mystical; a half-concealed, shimmering creature, her oval head ungainly, precariously balanced on the pale cord of her neck. She was looking down. Along the top of her head, nubs were nascent, rebirthed. No way she knew he was watching; otherwise she wouldn’t have remained so exposed, naked, absorbed in her private ritual: two spiderish fingers scooping into a tin, emerging with a viscous cream.

Oliver had traversed the terrain of her body more times than he could count; presently it was almost unrecognizable—alien in the sense of foreign, but also otherworldly: smooth, oddly shaped, glowingly pale; broad shoulders gone hollow. In the wiped-away streak of an otherwise steamed mirror, her breasts were still impossibly gorgeous with poisoned milk, her nipples lipstick pink. And then her leftover pregnancy weight, still somehow unaffected by the chemo; her papoose of a stomach jiggling, just a bit, while she placed the cream below the jut of her clavicle, a bright white smear now covering the cigarette burn of a bruise, where her intravenous port had been.

The skin hung loose across her buttocks, sallow flour sacks—he’d once loved spanking them, sinking his teeth into them. The sight unsettled him and he couldn’t look for long. In the mirror’s reflection, he caught her absence of pubic hair. Even after all this, he was shocked—both drawn to her cleft and repulsed by it.

She kept rubbing, smoothing the cream with her fingers until the white glop disappeared and her chest glowed. Flits of loose dead skin shed with her touch, flakes lifting into the steamy, wet air. Alice hardly noticed.

He came up behind her and nuzzled into the delicate architecture of her nape, resting his head on the safe side of her shoulder, where there had been no ports or surgery. Oliver planted a butterfly kiss on the middle of the back of her neck. Alice made a shocked, satisfied noise, let her head rest against his.

—

The phone kept ringing. She steeled herself, remembered that good old Doc Glenn
had
checked his service from the Burlington airport. She told herself her red-balloon-pig features
had
receded. For reasons logical and comprehensible and for no reasons whatsoever, every single time, improbabilities
had indeed
broken in her favor, a forged trail. Near and perilous misses. Improbable if minor successes.

Each ring was an opportunity; the chance to face that terror, to do something better than pee on herself. Alice exhaled, reached, and lifted the cool molded plastic. Bringing the receiver toward her ear, she managed a greeting, felt herself tensing, tried to relax her shoulders. Alice confirmed for the caller her date of birth. She then listened, and learned that her five percent mystery cells had come back decidedly clean. Her upcoming chemotherapy would
no
t be reinduction.

The first molecules of air rushed into her lungs. Once again
if
became
had
became
will
. I will survive. We will find a way.

“There’s more to it,” Beth said. “Let me double-check the notes.”

A tandem of pigeons had landed en masse on the sill across the way from the apartment’s eastern windows. The wash of soot outside the window was substantial enough to make gray birds look mottled and filthy. Alice watched their little heads bob, their beaks peck; she listened.

—

Vintage board games dug up from obscurity; metal lunch boxes celebrating science-fiction shows; odd dolls manufactured to monetize a moment’s quirky breakout star. Each item miraculous, preserved against time. Love Saves the Day. Alice and Oliver let the window display distract them. The passing sounds of the East Village vague behind them, the air thick and cold. She laid her head against the warmth of his shearling. From the stroller, the child reached toward the finger puppets and stuffed animals on the other side of the glass.

Doe would be every bit as entertained by the tumbling clothes in the dryers of the launderette next door, and the family would continue—meandering on the lightly frosted pavement of Second Avenue, passing into the junkies, hoodlums, and creative entrepreneurs who’d started laying out a veritable thieves’ market. Oliver picked through record albums and cassettes that lay next to a disemboweled car stereo. Alice enjoyed guessing at the logic behind a tapered leather jacket with hugely padded shoulders, a lining of cowboy fringe. “The eighties,” she said.

Their trek was incremental, but steady. Doctors’ orders be damned, she wanted her last meal outside to be special. And no way Oliver was going to stop her from sitting at the common table at the vegetarian restaurant where she’d been ordering since freshman year. Soon, long deep breaths allowed Alice to ingest the steamy swirl of hot green tea. She managed to down the entire cup. For old times’ sake, she and Oliver shared a dragon bowl of piping hot tofu, sea veggies, and rice.