by Kate Ledger
The jumpiness wasn’t all in his head, either. He found himself unable to sit still, bouncing his knees, drumming fingers on the surfaces of tables. He was suffering from a little twitching around the edge of his eye—myokymia, he thought, putting a name to the quick ripple under the skin. Was it visible from the outside, or was he just feeling it? He leaned into the bathroom mirror, inspecting. It was a minor distraction, not terribly uncomfortable, but a sign that he was not handling the stress. He had become a jerking heap of involuntary impulses.
Time had passed since the raid, but he wasn’t sure how long. It was Wednesday. Maybe Thursday. He had not managed to drive to Bethesda on the night after the raid. The Ebberlys departed and he’d sat on the couch, only intending to rest a moment, fortify himself for the drive. Even he was surprised by the toll the events had taken on him. He woke in daylight from a sleep so encompassing, he was not sure where he was and he wondered for a moment whether he’d imagined some or all of what had happened. The phone rang with a tone he somehow knew was insistent. The details settled back into place all at once, the ripped-apart office, the quiet house, Jamie, in trouble. He heard Emily’s voice, a hello with edgy reverberation.
“I fell asleep,” he explained, feeling frantic. “I didn’t mean to. I’m coming right now.” He began looking for his shoes.
“Don’t tell it to me, tell it to her,” she responded coldly, righteously. “She’s the one waiting for you.”
He kept his voice steady, but he felt like crying. “Emily, I’m sorry I didn’t make it. I was going to get in the car, but I sat down. Kind of blacked out, maybe. You should have called me. I’m coming now.” There was an interruptive note of call-waiting and he remembered that Tory was intending to call as soon as there was news. To Emily he insisted, “Hold on a second. Just don’t go anywhere.”
“Simon,” Tory began as soon as he clicked over.
Then he had to ask Tory to wait. “It’s the other line,” he explained to Emily. “I have to take it. Don’t hang up.”
“Goddammit, Simon,” she said, and he knew exactly what her face looked like, her mouth slightly pulled down at the corners, her lips curled in. His heart ached.
He clicked back to Tory, who said, “I want to know of any other patients who’ve died. Anyone else that might raise flags. They’re combing through files with the forensic pathologist, but I need to know if you’ve got other cases that maybe you haven’t mentioned.”
“None that I can think of,” Simon said earnestly.
“Any accidental overdoses? Suicides?”
Simon recalled a woman named Helen Frieden, an older woman with an unenviable case of fibromyalgia, who suffered daily and who got only modest relief from the narcotics he offered. She was lovely, and he wished he’d known her before she was sick. By the time he met her, she’d arranged to have many forms of therapy in place. She meditated and did hypnosis, and counseling, and she still, somehow, was unable to keep the pain at bay. After some time, she didn’t want to fight anymore. “A long time ago, maybe ten years, I had a patient who helped herself to a lot of pills and died. I’d followed her carefully. Frieden, her name was. She suffered horribly, but I wasn’t her only doctor. She had a shrink even. Her death came as a complete surprise to everyone. Is it my fault if my patients exercise free will?”
“Her name was on their list. I need to know about absolutely everyone.”
“That’s it. I mean, I’ve had patients with cancer who’ve died and who were taking all sorts of pain medication at the end. Does that count too?”
“Listen, here’s what we need to do—”
“Um, Tory—” Simon interrupted, “Emily’s on the other line and my daughter’s in the hospital, and I’ve got to get to Bethesda.”
“I talked to the U.S. Attorney’s office—”
He was impatient all of a sudden. “Are they arresting me today?”
“No, but—”
“Then whatever it is can wait,” Simon said. “I gotta go.” He clicked back to Emily. He could hear her breathing. “You there?” He wanted to tell Emily everything, but he felt he didn’t deserve to. It was impossible to know where to begin.
Her voice had urgency, a kind of belligerence even. “Can’t you focus on us? Right here? Even for five minutes?” Emily demanded. “Are you getting ready to see patients already?”
“I’m not,” he insisted. “I’m coming now.”
“I’m here now,” Emily said. “I’m thinking she doesn’t need the drama. Our whole drama. She’s recovering. Maybe you should come this evening instead.”
“Let me talk to her,” he urged.
He heard Emily negotiating with Jamie, trying to hand over the phone. He began to feel more panicky. The myokymia flickered under his lower lashes, twitching and undermining, the wings of a little moth trapped next to light.
“Hi,” the little voice said. It was a little voice, but he was certain it had an edge of resentment, too.
“How are you feeling, little porpoise? I’ve been trying to get to you, but it’s been hard.”
“It’s okay,” she said. “I mean, let’s be honest. I’m almost better.”
“I was there on Monday night. Do you remember?”
“Yep.” She was shutting him out. He could feel it. It was like a door creaking shut that he had to jam with his foot.
He thought of all that had happened since he’d been standing at her bedside in the hospital. It seemed like weeks ago. “I think I’ve messed up, sweetheart,” he said.
“Yep,” she answered.
Her curtness irked him. Who was she to blame him? What did she know about the stresses he was facing? He responded, “What were you doing piercing yourself?”
“I wanted it,” she said.
“But you didn’t think it might get infected, did you?”
“Nope. I just wanted it,” she said again.
“Put your mother back on the phone,” he directed, and when he had Emily back, he announced, “I’m driving down there, Emily. I’m leaving the house now.”
“Come tonight,” Emily replied. “We’ll have a proper Changing of the Guard.”
But Tory called in the afternoon, saying that nobody had filed charges, and that the best thing to do would be to begin to formulate the appeal to the State Medical Board. That way, they’d be ready to address the suspension the very instant the charges were dropped, and he stood a better chance of reinstating his practice, possibly without too much interruption. They were entering patient names onto Tory’s laptop in the early hours of the evening. “Don’t stop, Simon,” Tory urged. “We’re going to be ready for them.”
When Simon called Emily to inform her he’d be just a little bit later, she said, her voice like ice, “I heard. Yes. From Betsy. Did you think you just wouldn’t mention anything?”
“Ah,” he sighed. “There wasn’t ever a good time,” and then confessed, “I didn’t know how to tell you.”
“Is it that treatment of yours?” she demanded. “Is that why you lost your license?”
He felt anger at her that she could simplify it so easily, but he didn’t feel like arguing with her. “Narcotics, actually,” he said with a sigh. “There was a man who died. It wasn’t my fault, though. Really had nothing to do with me—I hadn’t seen him for a long time. Sort of a bad coincidence. But there it is.”
“How could you have gotten yourself into this?” she asked quietly. “How is this happening?”
Julie McKinley, he thought quickly. If he hadn’t hired that nervous little girl, none of this would be happening. But then there were other answers. If he’d refused, like most of his colleagues, to give patients the medication they needed, he wouldn’t be in the same mess. Or if he’d just shrugged and referred patients to a pain specialist—or a psychiatrist. Or if he happened to be the type of person who wasn’t driven to find solutions. Or if he happened not to care. If he’d been a little less available to his patients. If he’d been busy. If she’d responded to the fact that he loved her
and that he still wanted her more than he’d ever wanted any woman. If he’d been making wine or growing orchids with his daughter instead of trying to be a hero. If he’d let someone else play the role of David to the Goliath of the great unknown. If he’d managed to recognize in time how sick Caleb was. If he’d managed to get his baby to the hospital earlier. If he’d chosen a different hospital. It was impossible to know where to begin.
They sat on the phone in silence. He had his head in his hands, and vaguely he wished she could see him like that, bent over, his head fallen. There was a time, right after Caleb died, when he’d felt like he couldn’t stand the pressure of every approaching minute, when he didn’t know what to do with himself or what to say. He’d entered their bedroom and sat on the edge of the bed with his elbows on his knees, his face sunk into the basket of his palms. He’d already cried; he was done crying. He was wasted from crying. She came out of the bathroom and she saw him. He knew she had entered the room, and he could feel her standing there, knowing all of it without uttering a single word as she stepped toward him. Unable to look at her, he opened his eyes and saw her feet on the floor in front of him, bony and sculpted, the color of sunbleached stone. He saw all of their contours, the magnificent arches, the crook of her big toe, the wide flat nail. Bare and vulnerable, rawly human, they were also sturdy and reassuring. He felt lost in the architecture of her feet. He stared at her feet, planted before him, unmoving, before she touched him. He didn’t move, didn’t breathe, and she put her fingers into his hair. Lightly at first, then deep, against his scalp, and then holding his head with kindness, her hands poised in a kind of priestly blessing of benevolence, and maybe even forgiveness.
He remembered that moment, and he yearned for it again. But she could not see him now. Probably she would not have guessed that his head was in his hands because she said something that he didn’t quite hear. What he thought she said was, “You brought this on yourself,” but he wasn’t sure and he didn’t want to ask her to repeat it. He smarted from the sound of it. “I don’t know how,” he stammered, his voice barely audible.
But he did know, and he did not go to the hospital that night because he was afraid to see them, his wife, his daughter, because all of the ruin around him pointed back to that night fifteen years earlier when the nurse at his side said, “I’m sorry.” Emily called later to say that Jamie was being discharged, that the antibiotics had worked, the wound did not need cleaning, and that she was taking Jamie back to her apartment. He answered the phone and heard the news as if from a stupor, and he felt relieved without quite knowing why. He didn’t ask the kind of medical questions he felt he should ask, and there was relief in that, too. There was mail on the floor in the hallway. He sifted through it with his feet, mostly bills, and he would not read them. Among the envelopes, he spotted a red one and recognized the jerky loops and triangulated curves of his mother’s handwriting. He took it to the living room where he ripped it open. “Simon,” began the letter in her spindly cursive, even more ragged than he remembered, and strangely, he felt his heart beating,I hardly know where to begin. I’m so astounded by your actions, I feel I do not recognize you. How dare you, is all I can say. How dare you? We raised you to respect other people’s property and especially privacy. We did not raise you to behave in such a reprehensible manner as you did in July when you went uninvited into your father’s things. I’m still angry when I remember how we caught you with the medication in your hand. All of that might have been forgivable, however. It might have been possible for me to understand your actions as a form of concern for your Father, who has done so much for you all of your life. I was sensitive to the fact that we might have done something dangerous not mentioning the medication to the doctors at the hospital. But regard for your Father did not ultimately seem to be your central concern.
I cannot understand your decision to write about him in the newspaper. Our friends in Baltimore were kind enough to send it to us, but when we read it we were wounded to the core. Isn’t there such a thing as patient confidentiality? Doesn’t your Father deserve at least that much respect? It is a terrible thing to open up the paper and see your personal matters laid out for everyone in the world.
I cannot imagine how such behavior makes you a responsible doctor. But even worse, I cannot respect your sense of what it means to be someone’s son. I do not understand why you subjected your Father and me to this public and very undeserved disgrace.
Your Mother
P.S. If anyone can be said to have “discovered” any sort of cure, the credit should go to Charles.
He couldn’t remember the last time he’d been on the receiving end of one of his mother’s famous missives, other than the occasional postcard. The last one might have been during his internship when he’d announced he wouldn’t come home unless she and Charles paid for his train ticket—and the familiar rambling weirdness charged him with a bizarre sense of delight. Emily would have gotten a good kick out of this one. His mother hadn’t called in months, but she’d taken the time to write an entire letter? How dare you, he read again, and tasted in his mouth the rising ire, that rage of being poked with a stick. He’d gone all the way down to Florida to help them, and they hadn’t appreciated a single ounce of the effort. His trip had only proved how dysfunctional his relationship with them was. They’d deserved his interference. They’d deserved their public disgrace.
But one line in the letter wounded him more than the others. I cannot imagine, he dared to read again, how such behavior makes you a responsible doctor. So it was true, then. People were looking, judging not just the self he put into the world, the self that dressed, went out to dinner, greeted neighbors on the street. People expected more of him just because he was a doctor. Who could live up to such standards? He’d acted in such good faith, tried desperately to make people more comfortable. He’d done everything he could to make them know their suffering was legitimate and assure them their needs were heard. And yet, after all of it, everything he’d done had been so wildly misunderstood. Where was the person in his corner? Who was watching his back as he’d been so concertedly watching everyone else’s? He put the letter on the coffee table and watched as it missed and drifted to the floor. He curled up on the sofa in a fetal ball and dozed.
He remained on the couch, disappearing deeply into caverns of sleep as though he were making up for years of exhaustion. Daylight turned into night, turned into a shale-gray dawn. He rose to go to the bathroom with the seam of the couch’s leather panels imprinted in a line down his cheek. The phone rang and he spoke to Tory, and except for being aware that he wasn’t going to jail that very day, he didn’t remember what they’d said. At one point he lifted his head from a pillow to the sound of a low rumbling. The noise seemed to be inside his head, and then he realized that the vacuum cleaner was running upstairs. It must have been Friday; Lorraine had let herself into the house. She must have passed him on her way upstairs. He was embarrassed at the state of the house, but he couldn’t bring himself to get up. He was filled with a vague hunger, and he wondered whether she’d made anything that was waiting for him in the refrigerator. He wasn’t sure whether Emily typically left instructions about what to cook. Finally, he heard her padding down the stairs, and he lifted his head when she seemed to be standing in the doorway of the living room.
She was a large woman with limp, straggly hair. The colorless, toughness of her skin, like caulk, made her look much older than she was, which was probably only thirty-five. She wore a T-shirt and wide black jeans while she cleaned. “Doctor,” she ventured politely, “I didn’t do this here room because I didn’t want to wake you. But I gotta be going. I got another job, and I have to get the bus.”
He sat up and squinted at her. “It’s Friday, isn’t it?”
“All day.”
“I don’t have cash. My wife—she’s—”
She was rushed, exasperated. “I can take a check, but just this once.”
He could tell by her tone that she
knew, and he was surprised to feel embarrassed. She must have heard that Emily was leaving. And here he was sleeping in disheveled clothes on the couch when he should have been seeing patients. He rummaged through the dining room sideboard to get a checkbook. She’d been coming to clean their house every week for more years than he could remember, and he had no idea where she lived or that she had another job or that she took the bus to get from one place to the next. She had cooked for them, folded their underwear, wiped flecks of their spittle from the bathroom mirror. And yet he knew nothing about her. How was this possible? He flipped through the checkbook until he found a blank one, and he considered telling her that she didn’t need to come anymore, and yet he couldn’t find a way to say it. Instead he said, “How much do we owe you?” and he added twenty dollars to the fee she announced.
When she was gone, he felt strangely infused with a new sense of what needed to happen, realizing that what he’d needed was sleep, a chance to let the body rest and sort through the tumult. He was refreshed, and he decided he would not succumb to the DEA’s charges. He would not be a victim. He would fight the medical board, maybe even write a book about the persecution of innocent doctors. Ravenously, he shoveled cereal into his mouth. He drank milk straight from the carton, finishing it off. He dialed Tory and left a message: “We’ve gotta talk. I’m not going to let this get me down. You’re right, I’ve worked too hard to play dead now.” When he didn’t hear back from Tory, he left another. “Call me, we need to talk strategy. I need to know what’s next.”
What’s next? he asked himself. What’s next? He went down to the basement and surveyed the disarray of the shelves, the battered wine-making kit. He bolted up the stairs and found a cardboard box in a closet, and dumping out the clothes that had been stored in it, decided it would do for trash. He picked up the broken pieces of the casks, swept the splinters. He’d heard about people like this, whose day-to-day lives careened like a car around blind curves. Mishap after mishap happened to them and they could no more get out from under the downward pull of events than they could escape gravity. He would not succumb to it. He would pick up the pieces, address the problems head-on and continue to do the right thing.
