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Authors: Carol Cassella

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BOOK: Oxygen
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I pull out some chicken and peel off the plastic wrap. “So why are you working so hard to remodel your kitchen when you haven’t even furnished your living room?”

“A better investment. Women are always more attracted to a man’s kitchen than to recliners and coffee tables. Besides, isn’t gourmet cooking the requisite hobby of the financially secure professional these days?”

“The last time you cooked for me you had to ask what
deglaze
meant. Besides, there’re no dishes if you eat out—that ought to appeal to you. Are you worried that’s what drove Claire off?”

He’s swirling his wine in the sunlight and doesn’t answer. “So are you getting out of town anytime this summer? I mean can you, with the lawsuit and all?” he asks.

“I’ll probably have to make a trip to Houston at some point.”

“What for?”

I sit up and lean over crossed legs, plucking up slender blades of new grass and weaving them into a fragile braid.

“Is it your dad?” he asks, after waiting through my silence.

“Yeah. I guess it’s coming to a crisis.”

“How much of his sight has he lost?”

“I’m worried he’ll be functionally blind before long. He was a medieval history professor for thirty-eight years.” I look up at him. “Did I ever tell you that?”

“I knew he taught history. You’ve been pretty quiet about him.”

“Hmm.” I cast for some memory or description that won’t tarnish this splendid day. “Well, my father is a man who’s built his entire universe on books—deciphering them, teaching them, creating them. And now he can barely see the words on a page. He’s losing the one thing that has ever really mattered to him—besides my mother.”

“Is he still living on his own?”

“Not only that—he’s still driving. I’m waiting to hear from the police that he’s wrecked his car.”

“Maybe you should have his license taken away.”

“I’d have to have his car taken away. Not having a license won’t stop him. But you’re right. Pretty soon we’ll have to force his hand.”

“Can you get him to move up here?”

A short laugh escapes me at this, struck by how very little I must have relayed to Joe about my father and myself. “Funny to think that after I move to the farthest corner of the country he could end up next door. My dad would never accept being dependent on me.”

I sense him pull back from the obvious question of why not. “It’s a hard thing to learn, asking for help.”

“Impossible to learn—for him, at least,” I answer. “I don’t think he’d ever let me take care of him, even if that’s just his own kind of passive suicide.”

“Yeah, but at least if you take his license away he can commit suicide without murdering a flock of pedestrians.”

I slap his hand for that comment, and he reaches up and brushes my hair back from my face. “I’m sorry. I shouldn’t have said that.”

“No, you’re right. I think it’s the first time in his life he’s faced a situation where he couldn’t rationalize or debate or write himself out of trouble. In fact ‘faced’ is exactly the opposite of how he’s dealing with this—he’s ignoring it.”

“Isn’t there anybody he’d talk to? A priest” He’s Catholic, isn’t he?”

I shake my head. “He used to be.”

“Why’d he quit?”

“Oh, it’s complicated. Like most family stories.”

“What about your sister?”

“I’m the doctor, I’m the logical one to figure out how to help him.”

“As a doctor, or as a daughter?” Joe asks in a quiet voice.

“Oh, I think it’s a bit late to fix the daughter role.” My lap is littered with tiny green braids of grass. I sweep them off to wither among the weeds and twist the cap off a soda, but it’s hard to swallow. I wait for the emotion to subside, then ask, “So what about you? Are you planning any trips?”

“I want to get some flying in, maybe down to California. Katz has been scoping out a bike trip, if he can talk his wife into it.” He squints against the noon sun. Droplets of sweat glisten on his forehead and upper lip. “So has it gotten any easier, since your deposition is behind you? Isn’t most of it handled between the lawyers from now on?”

I bite my lip and consider how much to lie. “I don’t expect to hear much until the mediation date is set. It could be months. I don’t know if that makes it easier or harder.”

“I thought it was all just a financial negotiation at this stage.”

I look him square in the eye and try to envision his expression if I tell him my concern about Jolene’s heart. Would I see shocked empathy? Academic curiosity? Pity? Blame? Then I take a deep breath and answer in the most neutral tone I can manage, “Well, Donnelly’s suggested that the more responsibility they can pin on the hospital and the staff—me—the higher the dollars will go. I know he wants to keep it out of court. I think he assumes a jury would slaughter me
and
First Lutheran, given the outcome.”

He’s quiet for a few minutes after this. He can hardly tell me it will all work out just fine.

I hear shouts and roll over on my stomach to look up. Four or five young boys are running across the field in front of us, dragging a newspaper kite along the ground, the string tangling in grass and twigs. It jolts and bounces into the air, then cartwheels down against the dirt as they clamor at one another to run faster, pull harder, let go of the string. Joe is propped up on his elbows and shades his eyes to watch. A second later he is up and running through the grass, circling the children and swooping the kite up from the earth. He hunches close to the ground and sweeps his hands across the sky. Now he’s up and sprinting, the kite held high above his head, rattling and teasing against the wind. He is loose and ageless and accepted in their midst, a child among children. I am reminded of the time we went to the Oregon shore in October and he took advantage of a rare sun break to race straight into the icy waves, coming up suitless—naked and blue and hollering—sending a nearby family tearing for their car.

I watch him run, holding the kite’s wooden cross and wheeling backward, shouting to a brown-skinned boy to let out the string more, more, and more again, until it breaks out of his grasp and arcs skyward. It is so obvious to me, here, at this moment, that we have had hopes for the same things in life: a family, a reason to come home from work. Why couldn’t we make that step? One of us, both of us, pulled everything back inside, back into neutral territory, where it has taken root and grown into what it is now, what it will always be—this lovely, multifaceted friendship, immutable in its maturity.

He comes back hot and happy, innocent in his momentary oblivion to all but the present.

“You’re drenched. Why didn’t you wear a T-shirt?”

“Need less sunscreen.” He looks at me and smiles, then falls on his back to stare at the infinite blue light.

“Hey, any idea what time it is? Should we be heading home?” I ask.

“Always back to earth, Marie. Always in control, aren’t you?” He looks at me fondly, acceptingly, for which I am thankful. Otherwise the remark would have stung. “OK,” he says, “we’ll find out the time.”

He rolls me onto my back and scoots around to lie head to head in a long line, then he tells me to lift my arms up and he grasps my hands so our four arms rise vertically, throwing a narrow shadow across the grass, a flesh-and-blood sundial. “There,” he says, “how much more do you need to know about time?”

Our arms drop and we lie in silence and warmth until I can almost slip away from here into sleep. Just as I begin to drift I hear Joe say quietly, “‘Time held me green and dying/Though I sang in my chains like the sea.’”

15

On the drive home
I glance in the rearview mirror and see that I’ve sunburned my nose and cheeks. I check my mailbox—overflowing as usual. The phone rings as I open my front door and I run to the kitchen, dumping the armful of magazines, newspapers, bills and solicitations on the counter.

It’s Lori. “Hi. Where were you? I’ve been calling all day. Sorry I left so many messages. Gordy’s out of town and the kids are at the club with Olivia. It’s my first moment of peace all week. How are you?”

“Better. I just got back from San Juan Island. We’ve had incredible weather the last few days—it’s been up in the eighties.” It relaxes me to be able to answer with something other than “Fine, and you?” “So where is Gordon this trip?”

“Dubai—trying to drum up investors. He’s missing Neil’s first Cub Scout hike.”

“Dubai? They invest in Texas shopping malls? Couldn’t you go with him?” She used to travel with him, but as their three children have come along, his schedule has become a burden she grudgingly accommodates.

“Even
his
plane ticket’s probably wasted money. And we’d have to hire another mother. Speaking of which, why don’t you plan a trip here soon? They’re growing up fast, Marie. Elsa’s got a better figure than I do now.”

I laugh. “Oh come on.” In our phone calls I still imagine her as the slender girl she was two years ago.

“I swear to God. You could fill me in on things. I’m tempted to eavesdrop outside her closet door one of these nights.”

I feel a twinge of disloyalty. “She’s a great kid—you know that. Should I be reporting more?”

I can almost hear her stand up straight. “No! Then she’d stop talking to you and start taking advice from her friends!” She sighs and adds, “I’ll get this figured out by the time Lia’s fifteen. You did pretty well by me after mom got sick.” She brightens again. “So why not come down later this summer?”

“Who comes to Texas in the summer?”

“You could come here and then we could drive down to Houston together, if I can get Gordon to watch the kids. I talked to Dad yesterday. He saw his ophthalmologist again last week and the news wasn’t good. I had to drag that out of him, though. I wish you would call him again. Maybe he’ll tell you more of the medical stuff than he tells me.”

As close as we are, Lori and I diverge around my father the way rushing water parts around a boulder. Instead of tempering our discrepant experiences with him, age has made them harder to talk about, at least for me. “Last time I asked whether he could still manage the house on his own he pretended the line was cut off and hung up on me. I don’t know which he values more, his independence or his sight.” I sort the mail as we talk, pitching Lands’ End and Nordstrom catalogs, Valpak coupons and platinum credit card offers into an overflowing recycle bin.

“He’s got to start making some plans. Are you going to wait until he shouldn’t drive at all, which was probably months ago?” There is a weighted silence on the line as she slides the responsibility for my father’s future into my lap. We’ve had this conversation numerous times, but always leave the painful conclusions unresolved. “Marie,” she adds when I don’t answer, her voice halfway between angry and sad, “I can’t keep translating everything between the two of you. We’re not that young anymore.”

“No. You can’t. At some point you may have to admit that some things just aren’t translatable.” I feel bad about the remark as soon as it leaves my mouth. “Look, I’ll call him later this week and try to get him to let me talk to his ophthalmologist. And I’d love to see you all if I can get away this summer. I just can’t plan anything until I know more about this legal settlement, OK?”

“I’ll turn up the air conditioning for you. Will you call me after you talk to Dad?” She waits for my response through a prolonged silence. “Marie? You still there?”

“Lori, my pager’s going off. I have to go.” I hang up the telephone and sink cross-legged onto the tile floor of my kitchen. In my hand is the last piece of the day’s mail, a thick white envelope with my formal name and title typed across the front and the return address of the King County Medical Examiner’s Office. My hands are shaking so, I knot them together on top of the envelope, wanting them to stop quivering like the heart of some small and terrified animal trapped in my lap.

Right now an identical envelope must be sitting in Don Stevenson’s hospital inbox, waiting in John Donnelly’s office, slipping through Darryl Feinnes’s mail slot, stacked with all corners rigidly aligned on Caroline Meyers-Yeager’s spotless desk. If the contents conclude that Jolene died from irreversible complications of anaphylaxis—a presumption I have propagated since the day of her death—they will file the pages into a cabinet or an overflowing cardboard box, along with the thousands of other pages to be reviewed by the mediator. Nothing will materially change for any of them.

But everything will change for me. Either way, no matter what the autopsy discovered, everything will change. I will be freed by the knowledge that Jolene’s death was a tragedy of nature, or awake in the nightmare that it was my fault.

I could wait until I get the phone call from Donnelly or Caroline and not go through this alone. I could drink enough wine to blunt the impact or celebrate the absolution. But even while I rationalize how to delay I slip my forefinger underneath the sharp crease and rip through the sealed envelope.

It is at least ten pages, thirteen when I actually flip to the back and see the final number. The first page is filled with known facts: the date and time of Jolene’s death, the date and time of her autopsy, her diagnosis at admission and the type of operation. The name and title of each participant is listed like the opening credits to a movie. Halfway down the first page, in bold type, is the section heading
Final Anatomic Diagnosis
. I’m almost thankful it is right here on the front page, too late now to pretend I don’t see the answer.

“Coarctation of the proximal aorta. Bicuspid aortic valve.” Time breaks into a thousand finite particles. I am here reading the words, I am above myself, watching myself. I am conscious that I only have a few more stunned seconds before everything falls apart.

I scan through the lists that follow, the weight of her heart and the congestion noted in the ventricles, the edematous fluid in the alveoli of her lungs, the color and texture of her liver, her kidneys, her intestines, her spleen, each quantified in grams and centimeters. Her ovaries are small and atrophic. Her physical stature is noted to be smaller than her age-matched norms. There is a subtle laxity of flesh at the nape of her neck, a nominal lowering of her posterior hairline. And the last bit of data listed, which explains the delay in her autopsy report: a chromosomal analysis confirms that many, though not all, of Jolene’s cells carried only one X chromosome. Jolene had Turner syndrome.

 

I have stood on crowded street corners and watched thyroid goiters ebb and flow above shirt collars when women swallow. I have waited behind men in espresso lines examining darkly pigmented flecks for the ragged edges and mottled coloring of melanoma. I’ve spotted the swan neck deformities of rheumatoid arthritis, the spidery broken blood vessels and yellowed sclera of liver disease, the fleshy nodules of neurofibromatosis, the broad, flattened fingernails and barrel-shaped chests of pulmonary disease, the butterfly rash of lupus.

I have lost the ability to look at a stranger’s face without estimating the ease or difficulty of intubating their trachea. I have forgotten what it was like to be ignorant of the telltale clues that failing internal organs and multiplying infectious organisms surreptitiously display. Physical diagnosis is the study of optical illusions, the art of seeing through what is expected in order to detect which part of the picture is changed, what hidden shape hides in the shadows and creases of familiar scenes. Since I began medical school fifteen years ago this second sight has seeped into me the way tea stains dental enamel or cigarettes color smokers’ fingers. To read Jolene’s autopsy report is to slap my forehead—my own moment of “Aha!” The lamp becomes a lady, the young woman an aged hag. The clues were minimal to be sure—I should be comforted by the fact that every other doctor who’s cared for her missed them as well. But if I’d recognized them, if I’d listened to her heart despite her crying, if I’d pressed Bobbie for more details, I might have caught it. I might have stopped it. I might have changed everything.

BOOK: Oxygen
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