The Law of Similars

by Chris Bohjalian

  But something--no, some things--were beginning to bubble beneath the surface of my world. I could feel it. Something in Phil's head. In Whitney's. No doubt in Carissa's, too. Soon one of those somethings was bound to erupt, and the mess was going to be monstrous.

  And so I decided I would visit the man in the coma. I would go that very day, and I would witness, if only through glass, the way Richard's whole world had shrunk to a bed and some tubes and his wife's fingertips on his shin.

  Chapter 18.

  Number 276

  Excessively large doses of an accurately selected homeopathic medicine, especially if frequently repeated, are, as a rule, very destructive. Not infrequently, they endanger the patient's life or make his disease almost incurable.

  Dr. Samuel Hahnemann,

  Organon of Medicine, 1842

  .

  I was back from my ten o'clock by ten-twenty, having agreed that justice would be served if Teddy Paquette endured a year on probation for two counts of possessing marijuana. I told myself that the little hustler had learned his lesson, but I didn't really believe it. I just didn't hear a whole lot of contrition in his voice when he told the judge he understood well he had made some mistakes.

  And he certainly wasn't the physical wreck I was; he certainly didn't look like he felt any guilt. My body, on the other hand, had become a mass of tingles and bowel spasms, my stomach a fishbowl on the seat of a speedboat.

  When I returned to my office I placed my last two tabs of arsenic in separate envelopes and then licked and sealed them. One I would open when I got to the hospital that afternoon, and the other I'd have before bed. Tomorrow, I was positive, I would see Carissa. And while we were together, I'd be sure, somehow, to get more.

  "Do you remember the name of the woman you first met at the health-food store?" Phil asked me near the water fountain just before lunch.

  "No," I lied.

  "It's Patsy. Patsy Collins. Just think of how much it sounds like that old country western star, and you'll never forget it again."

  "Thank you."

  "Happy to help," Phil said. "She seems like a very nice woman--also all too happy to help."

  When I neared Margaret's office early that afternoon, I heard her talking on the phone. Something--a word, a phrase, perhaps the anxiety in her voice--led me to believe she was talking about me. And so I paused just before the doorway, just beyond her vision if she should happen to look up from her desk.

  Quickly I realized the concern in her tone was indeed for me, but at that moment she was actually talking about Carissa Lake.

  "I know Phil would like to subpoena her notes, medical records--I think he'd cart away half her office if he could get a court order," Margaret was saying, and I could tell she was sharing the news with her husband.

  "Oh, he definitely thinks Leland's involved," she said a moment later. "He just hopes the involvement isn't criminal. You know how fond he is of Leland. He really cares for him."

  I turned around and went straight back to my office. I didn't want her to worry that I'd overheard what she'd said.

  In my truck in the parking garage at Fletcher Allen Hospital, I ripped open one of the envelopes with arsenic, and I heard myself sigh when I slipped it under my tongue. I leaned back against the seat and closed my eyes, bracing myself for a vision--raw, real, unabridged--of Richard Emmons. Maybe Jennifer, too.

  No, not maybe. If I got Richard, I got Jennifer. I'd been afraid to call ahead, fearing that she wouldn't want me to come because I hadn't told her I knew that homeopath, and so I had no idea if she was actually at the hospital that moment. But I assumed she was.

  I wondered if another reason I hadn't called ahead was because deep inside I was hoping there'd be no family members present in the ICU, and the nurses would keep me away. Far away: no family, no visitors. I'd never have to see the man in the coma, yet I could tell myself that I'd made a good-faith effort.

  But I didn't really think that was the case, either. I honestly wanted to see Richard. I honestly wanted to be a presence for Jennifer.

  I'd always been pretty good with the dying, including, of course, my own parents. But I wasn't half-bad with elderly neighbors and distant uncles, either, or with the few acquaintances my own age who'd died young. Leukemia. AIDS. Lou Gehrig's disease. With them, I had discovered that I was fully capable of sitting passively in a chair by a bed, listening to the raspy breathing and the incom-prehensible murmurs--witnessing the twitches and spasms and seizures--that marked a body in shutdown. Some people found it difficult to brush the back of the hand of a man in a deep morphine sleep, but I wasn't among them. A hypochondriac, I'd realized, actually had a very great deal to offer the authentically sick: a profound empathy combined with genuine vitality.

  I climbed from the truck, adjusted my suit jacket under my overcoat, and started across the cement of the parking garage. The sun was about to set, and the garage had the feel of night. I wondered if Jennifer, too, sat alone in her car in this lot, trying to find the grit to go in.

  Madame Melanie Hahnemann, Samuel Hahnemann's much younger wife, was tried in Paris for practicing medicine without a license, and she was found guilty.

  Her mistake? She'd gotten too brazen with her business cards. And she'd placed an announcement in the newspaper, advertising her practice.

  Samuel had been dead for about three and a half years at the time, and some people said his widow was being prosecuted because she was a woman. But certainly she was being prosecuted as well because she was a homeopath.

  Even then--1847--orthodox medicine was apprehensive when it came to alternatives. Even in Paris, where the Hahnemanns had settled within a year of their meeting in Kothen.

  Yet it was clear the court didn't see Melanie as a villain. They were merely enforcing the exact letter of the law. She wasn't a doctor, but she had patients. Her only accreditation was from an American academy, and it had been granted simply because Samuel had written the school's founder, insisting that his wife was a brilliant healer and deserved recognition. As a courtesy to Hahnemann, they'd sent Melanie a diploma.

  And while the French medical authorities might have recognized the diploma had she submitted it to them for consideration, she'd never bothered. After all, she explained during the trial, she was a woman. Though there was a female obstetrician in Paris, obstetrics and medicine were then viewed as wholly separate universes: There were certainly no female medical doctors at the time in the City of Light.

  There were no medical schools in Europe that even admitted women.

  Melanie's sentence? She was asked to pay a fine of one hundred francs. About what she was paying for her annual newspaper subscription. Or what she charged a patient at a first consultation.

  And she was asked to stop practicing medicine.

  Apparently she paid the fine in full.

  And then continued her practice.

  She was simply more discreet than before the trial.

  But, much to her patients' relief, she continued to heal them, treating them without poisonous doses of mercury, or strychnine, or opium. Without subjecting them to venesection.

  She merely stopped passing out business cards.

  Jennifer Emmons smiled when she saw me in the windowless waiting room outside the ICU, and for a second I was surprised. I hadn't expected a smile. But there it was, that small but sincere, close-lipped little grin I had gotten before from the partners and children of the not-quite-dead: the smile of thanks. Thank you for coming. Thank you for remembering us. Him. Me. Thank you for not making me do this alone.

  I surprised myself by giving her what I'd come to call my friend-of-the-family hug--arms around the shoulders instead of the lower back, a scapula pat to signal separation--and she surprised me by staying there a second longer than most people, her arms against my chest in a variation of what my friend the M.E. described as the pugilist's pose: her fingers balled into fists, her elbows bent and pressed flat against her ribs. It was one of the basic postures of d
eath.

  "How nice of you to come," she said when we finally parted, her voice soft and hoarse.

  The television on the wall behind her was tuned to the Weather Channel, although the sound was all the way off. A pair of elderly women in slacks and scarves had been playing gin rummy on a couch when I'd arrived, occasionally looking up at the screen. I'd offered to turn up the volume for them--I was standing, after all, and they were sitting--but they'd passed. Then a nurse had come in and told one of the women that her brother was cleaned up and they could resume their visit.

  "I wanted to come sooner," I said. "But I let the...the awkwardness get in the way."

  "You shouldn't have felt awkward. Vermont's a small state."

  "Still..."

  "We all know people. You know Carissa Lake, so what? I must have three or four friends who know Carissa Lake."

  "They're not prosecutors."

  "No. But you won't be prosecuting her, either now, will you?"

  "Nope."

  I noticed most of the doctors and nurses who passed between the ICU and the waiting room were wearing surgical scrubs.

  "Probably nobody will be," she continued, just the tiniest hint of frustration in her voice. "Phil Hood told me it isn't likely you'll ever file a criminal charge."

  "The case is still open. It's only been three or four days. An information--an indictment--often takes months."

  "I don't expect anything. There isn't even much chance of a civil suit, I'm told. My Richard just...he just did this to himself. Made a mistake. I wanted to blame that woman because I wanted to blame somebody--God, wouldn't you?--but it doesn't seem like she did anything wrong."

  On the radar map on the TV screen, a swirl of clouds was stretching in a wide band through Minnesota, the Dakotas, and most of Iowa. It looked like we'd be getting more snow in Vermont in another day or two.

  "It must all seem pretty complicated," I murmured.

  "It did. It doesn't anymore. At first, we all thought for sure she was responsible. I did. Richard's allergist did. The state psych board did," she said, and then gave me that thin little smile once again.

  "What do you do, Jennifer?"

  "I'm a veterinarian. But I went part-time after our second child was born. Timmy. So now I only work Thursdays and Saturdays."

  "In Bartlett?"

  "Uh-huh," she said, adding, "I guess I'll be going back full-time as soon as I can."

  "How is he?"

  She puffed out her cheeks for a brief second. "He flexed his arm this morning when they knuckled his chest."

  "That sounds like progress."

  "It is. It means he's dying."

  I nodded, and tried hard not to blink or look away. "I'm sorry," I said.

  "Me, too."

  "And they know this...for sure?"

  "They do."

  "Because he moved..."

  "He's posturing. Isn't that a great word?" she said sarcastically. "It sounds like he's putting on airs."

  "It's a terrible word," I agreed.

  "Yup. The decorticate posture. Poke him or prick him or knuckle his chest, and his arm flexes." She flexed her own arm. "Like a spring. It means the brain is malfunctioning. It means he's probably lost his cerebral cortex."

  "I am so sorry," I said again. "I'm so very sorry."

  "I talk to the doctors and nurses, and I know they're doing all they can. But it doesn't do any good."

  I thought of all the things the doctors had done for Elizabeth in the four hours she'd lived, unconscious, after the accident, and what I gathered had been the Herculean efforts of two volunteer EMTs just to keep her alive long enough to die in an operating room. Doctors had sewn her spleen and re-inflated the lung that had collapsed. They'd set her broken arm. They'd given her blood, at least seven pints I believed, and then a powerful cardiac potion to help her heart pump blood to her brain.

  I realized I didn't know which lung had collapsed.

  "Do you want to see him?" Jennifer was asking.

  "May I?"

  She nodded, and motioned toward the shut double doors with an imposing list of visitor regulations.

  Although my father had died in a nursing home, my wife and my mother had died in this hospital. Neither, however, had ever spent a day or a night in either of the two adult ICUs. Elizabeth had never even made it to post-op.

  But my mother's death, at least, had lasted so long that I'd been able to behold all kinds of long-term interventions: Heart monitors and bladder catheters. Bags of blood and nutrition dripped into her veins through the sorts of tubes I saw every spring linking maple trees in the woods. A big hole with a plug in her chest to pump in the food when it became impossible for her to swallow because the esophageal radiation had so badly burned her throat.

  The difference that struck me most between the ICU and the regular hospital rooms in which my mother had wasted away--a feature even more evident than the rustling from the respirators, a sound like the wind--was that the walls facing the massive nursing station were made largely of glass. There wasn't a lot of privacy in those high-tech little chambers, but if you were sick enough to be there, it probably didn't matter.

  "Now, I know you two never met," Jennifer said when we finally stopped, and I realized that if she were to move her body a bit to the left or the right, I would glimpse Richard in his room. I noticed a lump under the sheets that I assumed was the fellow's feet, and I could see the bed rails were up. "But...well, he looks different than he used to."

  "I understand."

  "He looks older."

  "Thank you."

  When she entered the room, I saw Richard for the first time. Only his feet and his shins were under the sheet; the rest of his body was covered solely by a short hospital gown and a filigree of fat and thin tubing. And he did indeed look old, as if his body were collapsing in upon itself: He could have been the father of the Richard Emmons I had glimpsed in church a couple of times, a wrinkled and shrunken and pale version of the fellow I'd seen in the sanctuary.

  On his forehead was a flat silver circle.

  "Richard, I've brought a visitor," she said, and she leaned over the thick respirator tubes covering his mouth to get close to his ear. "Leland Fowler. He lives up in East Bartlett."

  "Hi, Richard," I said, hoping my voice sounded friendly and warm. I glanced around the room: Although I'd expected a fair amount of hardware, I was still unprepared for the mass of hoses and wiring and monitors. I could only guess what most of the screens were tracking and what most of the tubes were draining. All I could tell for sure was that one large box--a ventilator, I assumed--was breathing for Richard, and that the screen on the wall mount over the bed was shadowing his heart rate and rhythm.

  "Leland's a lawyer," Jennifer said. "He's Bob Fowler's son."

  "He knew my father?"

  "Not well. But Richard's ad agency did a little work for Green Mountain Grizzlies a few years ago."

  "I see," I said, nodding.

  "Some brochures, a catalog. The annual poster."

  "I'm sure my dad was a very difficult client. He really loved his bears."

  "Oh, Richard's had worse."

  "Thank you."

  "How's your little one? Abigail?"

  "She's fine."

  "Bonnie will be bringing my kids by a little later," she said, and then lowered her voice: "Bonnie's my sister. I don't know how I could have gotten through this without her."

  "Do you and Richard have big families?"

  "No, small. Tiny. I have Bonnie, that's all. And Richard's an only child."

  "What about your parents?"

  "My mother's alive, but my father passed away."

  "Richard's?"

  "Both of his parents are gone."

  "Who's taking care of the kids right now?"

  "Kate's thirteen, so she doesn't need much supervision. And it's been mostly my mother or Bonnie looking after Timmy. He's eight. It'll get a little easier for the kids next week when school starts again."

 
"I'm sure," I said. I wondered how much time Richard had left. I wondered if next week those kids would be at their father's funeral.

  "Your room got a lot of sun today," Jennifer said to her husband, including him once more in the conversation. "It was nice and bright around noon."

  I half-expected the body in the bed to respond. I wondered if Jennifer still fantasized about such things.

  "Don't you think you can already feel the days getting longer?" she asked, and it took me a second to realize she was now speaking to me.