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Authors: Carol Cassella

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BOOK: Oxygen
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And I can’t let go.

There is a wail in the background, and Lori shushes a child. “I need doctorly advice. Lia fell on her arm about an hour ago—jumping on a pogo stick wearing roller skates. Go figure! How can I tell if it’s broken?”

And here is my alibi. Everything that hurts is instantly swallowed inside the emotional vacuum of logic and professional advice. “Is it swollen? Does it look crooked at all? Can she wiggle her fingers? Bend her elbow?”

I have Lori splint Lia’s arm in a rolled-up magazine, give her Tylenol and call her pediatrician in the morning. Lori wants to know if it matters whether she chooses
Rolling Stone
or
Harper’s
. From there she glides into descriptions of a disagreement with one of the teachers, how unusually rainy it’s been in Texas, “as if we lived in Seattle,” the fact that my father’s birthday is approaching and we should plan something together for him. The telephone is wedged between my face and shoulder and tears flow down my cheek along the hard plastic receiver until it becomes slick. I wonder if it is possible to cause a short circuit should they flood the tiny holes that carry my voice over fifteen hundred miles between here and Fort Worth.

6

It’s easy to get
the information about the funeral. I call up the medical examiner’s office on Saturday, when only a low-level assistant is likely to be on duty (even so, I’m tempted to alter my voice, ready to conjure a pseudonym). She perfunctorily tells me which funeral home received Jolene’s body; the funeral director consolingly tells me the date, time and place. Half my closet is on the floor by the time I’ve chosen a simple navy skirt and sweater, having given up on composing an outfit at once somber, tasteful and capable of making me thoroughly invisible.

The first truly springlike day of April, cherry trees quaking with proud blossoms, the air a purified blue, is the day Jolene is buried. I park across the street from a small chapel attached to Massins’ Funeral Parlor and grip the steering wheel while I reiterate all the reasons I’m justified in being here: funerals are a chance for resolution, a chance to seek peace; funerals are events where wealth, power and status acquiesce to equalizing fate—events where cautionary legal prudence should hold no ground. I’ve come here to show respect for Jolene’s life, for Bobbie’s loss—to acknowledge that even if we end up in adversarial roles in lawyers’ suites, I can grieve with her. I can do something to make her feel less abandoned. I have come here because I could not stay away.

A few minutes after the service is scheduled to start a man in a black suit walks onto the porch, checks his watch and closes the doors. I slip into the chapel and let my eyes adjust to the dim light. It is the simplest of rooms, no crosses or stars, everything cut to square without peaks rising up to point at God. I have no idea whether Bobbie is a religious woman. Is she having her daughter memorialized in this allegorical sanctuary because she is godless? Or just because she is poor? Did she raise Jolene to pray each night before sleep, begging the Lord her soul to keep? And when she did not wake, would never wake, was Bobbie prepared for God to take her child’s soul? Sunshine spills through the dusty panes of a high row of windows in shining bundled blades. Only seven or eight other people are scattered through the pews.

In the absolute stillness all I can hear is my heart pounding. It’s to be expected, I tell myself—so much guilt to work through. Of course I feel anxious about seeing Bobbie. I’m more ashamed to admit that I’m scanning the room for anyone here from First Lutheran who could recognize me. I slide onto the farthest edge of the last oak pew, as distant from the other guests as I can get.

Bobbie is sitting in the first row. Her hair is gathered into a loose bun at the nape of her neck, exposing the vulnerable bones of her cervical vertebrae, a rippling ladder from the collar of her black sweater to the curving base of her skull. She looks so much smaller than I had remembered. Jolene’s child-sized white coffin is directly in front of her on a raised platform, a bouquet of star lilies and white roses draped over the half-closed lid. There aren’t any other flowers—two large urns at the sides of the central stage stand empty. The teddy bear Jolene was clutching when I met her in the preoperative holding area must be lying on her breast—I can see the pink nylon of its stuffed belly curved above the wooden rim.

A middle-aged man and woman sit in the same pew with Bobbie, though not close to her. She seems isolated here, among the people I would assume she knows best. I glance at the faces I can see and try to guess at any family resemblance. The door swings open again and sunlight slices across the stone floor. Backlit by white light, two men, both dressed in dark suits, are silhouetted against the entrance. They’re coming toward me, looking right at me. I know them—Phil Scoble and Frank Hopper. They must be here to represent the hospital. I should have anticipated this. It would be the politically smart thing to do—to show up in a gesture of sympathy. Smart for First Lutheran and foolish for me. I’m about to stand and face them both when they cross out of the light and I see they are complete strangers. My head falls into my hands as if I were praying; I’m enraged at my relief.

The man who closed the chapel doors stands up at a lectern, clears his throat and opens a notebook. He drops his chin to survey his meager audience over his glasses, then welcomes us to this service honoring the life of Jolene Marielle Jansen. He reads a touching, generic eulogy. I wonder if they have prewritten speeches at a place like this, abbreviated psalms for children. Bobbie doesn’t look up. She doesn’t even move.

The speaker takes his seat and the chapel is quiet except for a few stifled coughs. The silence builds to an awkward shifting of weight and creaking of benches until people gradually begin to drift outside. The woman nearest Bobbie stands up and walks over to her, touches her shoulder and says something too low to hear. I gather my purse and a small spray of iris and daisies tied with a pink ribbon. I recognize now that I chose pink because of the bear—guessing that was Jolene’s favorite color. She was at an age when girls like to have a favorite color, I think. And the blue iris because her eyes were so blue, almost a cornflower blue, but I couldn’t find any cornflowers.

I have it all planned out, how I will walk up to Bobbie at the end of the service and hand her the flowers, tell her how sorry I am for all she’s going through, maybe touch her sleeve and then go before she feels like she has to talk to me. Nothing, certainly, that would upset my malpractice insurers or any lawyers. She might not even recognize me, dressed in normal clothes with my hair down. I can’t introduce myself to her again here—the thought of it paralyzes me.

The two men I mistook for Phil and Frank stand up and approach her. One kneels down, blond and boyish-looking, out of kilter somehow with anyone who might be a relative. He talks to her for several minutes, eventually helps her up and guides her down the aisle. They pass me and I can’t even stand up to intersect her. My heart turns over when I see her face-on. I’ve seen the same deserted eyes on trauma victims in the emergency room, a mask of stunned incomprehension as they struggle to recognize their exploded world. I am obviously invisible to her—we all are.

Walking out to my car, I see the three of them standing together under the boughs of a massive cherry tree, pruned into stubby wings bisected by a power line. A gusting breeze frosts them with a snowfall of petals. The blond man pulls a white business card out of his suit pocket and folds it into her hands, holding them in his own for a moment much as a minister might bless a parishioner after services. He escorts her down the street to an older beige Ford sedan with one mismatched blue panel on the passenger side. Then the two men walk to a black Lexus and chat together. In the daylight the balding man looks more juvenile, almost obsequious in the way he chuckles and agrees with the blond. There’s an abrasive self-confidence about their posture that makes it clear they’re used to choosing who stays excluded. Whatever they’re discussing, it couldn’t be the death of a little girl. It is suddenly as obvious to me as if I had read this man’s business card. He’s not a minister. He’s a lawyer.

 

In the evening, after I’ve showered and changed into a nightgown, I pick up the strewn contents of my wardrobe. I hardly ever wear anything but scrubs or jeans or running shorts anymore. I bought most of these dresses in the first few years after First Lutheran hired me, when I could finally afford to treat myself occasionally. So many of them look dated now, if I paid much attention to fashion. There was another spurt of consumerism at the end of my last student loan payment, this condominium and some furniture. It was the first time I owned an entire refrigerator, not just one borrowed shelf. The first time I could sit up late reading a novel in my own living room and not worry which roommate would come stumbling in from a party. And a new car—at last. No mismatched door panels in my life these days.

The purchases almost seemed part of the rite of passage of becoming a full-fledged physician, like framing my medical degree, licenses and board certifications—documents I was expected to display, status symbols I was expected to crave. I think I mainly desired the proof that I could provide for myself. I put so much on hold.

I ended up never hanging the certificates on any wall. Instead I filled the blank spaces with family photographs—my nieces and nephew at christenings and birthdays; my sister and me at the beach, at a rodeo, doubled up bareback on the sagging spine of her pinto mare; my mother in her rose garden, still as slender and fresh as one of the unopened buds gathered in her gloved hand, an age before my clear memories of her. And one formal portrait of my father taken for his retirement announcement, propped up in the center of a bookcase from which he can judge the wealth and security I’ve accumulated without his help.

I arrange the wilting iris and daisies in an orange juice glass and set them on my bedside table, scribble a note to Gary apologizing that I have to attend a conference the week he’s planned to visit, begging him to reschedule. Then I call Lori.

“It wasn’t broken—only a sprain. Her doctor loved the magazine idea. We went with
Rolling Stone
in the end. How was your day?”

“Not so great,” I answer. Then I take a deep breath and add, “I went to a funeral.”

“Marie, I’m sorry. Who was it?”

I sit down on the bed and knot the phone cord in my hands. The iris hangs limply over the rim of the glass—I turn out the light so I can’t look at it anymore. “It was a patient. Someone I took care of.”

Lori is soothing and sympathetic. She’s heard me talk about the lingering, often painful deaths of cancer patients who may undergo multiple surgeries before letting go. “Ah. That was kind of you to be there. Had you gotten close to the family?”

“No.” I stop. A soft cry escapes me; I can almost feel Lori’s tension at the other end. “It was a little girl. Eight years old. She died on my operating room table.”

Lori lets out a low groan. “Oh God. What was wrong with her? What kind of operation?”

“Nothing. She was a healthy patient having a completely routine surgery.” My breath reverberates against the mouthpiece; otherwise there is complete silence. I curl down onto my pillow with the phone snuggled under my cheek. “We were in the middle of her operation and suddenly I couldn’t ventilate her. Her airways closed.”

“There wasn’t any reason? I mean, nothing you could predict?” She sounds almost panicked, and I know she’s talking to me as a mother right now, not a sister. How can she help that? I hear another, smaller voice murmur in the background; Lori whispers, “Shhh, shhh, everything’s OK, baby,” and there is a rustling of fabric. Then she speaks into the phone again. “Lia’s in my bed. She had a nightmare.”

“I’m sorry. I should let you go.”

“No, it’s OK. She’s back to sleep. I can’t believe you’re up there going through this all alone. Do you want to talk about it?”

The tug of loneliness stretches the continent between us. “They’ve told me I’m not supposed to talk about it. That’s almost the worst part right now.”

“But you know it wasn’t your fault, right? I mean, do things just go wrong sometimes?”

“In sick people. Old people. Not in eight-year-olds. At least not very often. I think she had an anaphylactic reaction to one of the drugs. Maybe latex. And I treated her for that, but…it all happened so fast.”

“Is that like an allergy?”

“The worst kind. The kind that kills people.”

“But you couldn’t have predicted that, right? I mean, that isn’t your fault.”

I don’t answer her. How can I explain that blame is only one part of guilt when something goes wrong in a doctor’s work?

“Do you want me to fly up? I could ask Olivia to help Gordon with the kids. I could be there tomorrow.”

“Uh-uh. Don’t even think of it.” I try to force my voice to relax. It sounds hollow in the cove between my face and my pillow. “I’ll be OK. I guess at some point I was bound to have a bad outcome, just based on statistics.”

“Oh, Marie. I know you took wonderful—perfect—care of her.”

I roll onto my back, brushing damp hair from my temples onto the pillow. “If I’d taken perfect care of her, she wouldn’t have died. She was an only child, Lori. Her mother’s only child.”

 

Lori and I lost our mother twelve years ago this month, when I was twenty-five. I was in my third year of medical school. After twenty-four months bent over microscopes and cadavers and textbooks that broke the spine of my bookcase, my classmates and I all felt ready to apply our memorized Latin terms and lists of symptoms to flesh-and-blood patients. Finally we graduated to the hospital, and began to wear the emblematic white coat of a physician—pockets crammed with rubber stethoscopes, reflex hammers, tourniquets and antibiotic tables. We were the lowest tier of patient caretakers at that stage—even nurses’ aides smirked at our flailing efforts to mesh aced exams with the practical realities of illness. No textbook can teach you how to insert an IV catheter into a vein or a nasogastric tube into the stomach, or to suture a kicking child. Egos collapsed under the weight of bedpans and Band-Aids taped over our botched efforts. Still, for most of us, that white coat implied some mastery not only of medical knowledge, but of medical morals—the ethics of life and death. At some point, though, we all had to face humanizing reality. I had to face it inside my own family’s private crisis.

My mother had rheumatic fever as a young child, which damaged her heart valves. Over the five and a half decades of her life, her heart strained to push blood through a shrinking portal, building up its thick, muscular wall like the oil-slicked biceps of a weight lifter. Her heart strained and thickened while she ran with girlhood friends in her rural Texas school yard, fell in love with the older graduate student who lived in her mother’s boardinghouse, worked as a waitress to buy her husband’s books, tried for years to conceive a child and then bore my sister and me within fourteen months of one another. Her heart struggled and strained during all of this, quietly compensating for the misshapen valves so that all along she believed herself healthy, believed she would live to see her daughters marry, hold her grandchildren, help her husband into the infirmity of old age.

BOOK: Oxygen
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