Writer, M.D.

by Leah Kaminsky

  “I remember when Lily was a girl, maybe nineteen or twenty,” he said. “Well, at that time there was young men from all over that wanted to go with her. You remember that, Lily?”

  “I’m sure I do not remember.”

  “I remember very well, Lily. I remember one day in summer when there was two young men waiting in the yard in the morning to see you. You must remember that. Tony Nersesian and Gerald Volkmann—they were mad to see you. At that time you must have been out with both of them one or two times, to a dance or something. And then there they was one morning.”

  “That was a long time ago.”

  “Good-looking boys, they was, too. Good-looking and mad as bulls. Come down, Lily, they said, come down; we want you to choose between us, make one of us happy.”

  “Nothing special about either of them, neither.”

  “Well they was pretty strong for you, is all I can say. So you lean out of the window up here, like a princess, and look down on them and say, you’ll go with the strongest, they’ll have to fight it out. You don’t care for boys who can’t fight. You said that, and maybe you was kidding. But they took you on your word. All right, they said, so be it. Right down there in the yard, they pulled off their jackets and rolled up their sleeves, spit on their hands—and then they’re away. It’s nine o’clock in the morning, mind, and these two hammering away at each other, throwing punches. And Lily, calm as you like, is sitting up at the window laughing.”

  “You’re exaggerating, Anton.”

  “Not exaggerating anything. Then they both got a few good punches in and there’s some blood—and before you know it, one of them, I think it was Gerald Volkmann, was out cold on the ground, knocked out. The other one’s not looking too good either, but he stood down there rubbing his hands and called up that he’s yours. And cool as you like, you sat at the window and said that you’ve changed your mind, you prefer sensitive boys, not bloody fighters, because you’re a pacifist.”

  “I never said pacifist.”

  Lily did not smile, but Elsbeth could see that she enjoyed being talked about. She kept going at the task at hand, but weakening and slowing down, wanting to prolong the moment. She did not seem to be her father’s sister. They were more like acquaintances, talking freely with each other but showing no affection. This was another country way. And they looked different. Her father had big features, while Lily was fine boned with a small nose and mouth, made severe by her hair, which she pulled back in a bun. She wore no makeup and did not need any—her skin looked the same outside in bright light as it did inside.

  Elsbeth blamed Lily for what was not acknowledged. They went on as if everything were normal. The steroids made her father put on weight. He walked outside. It was early winter now, and the ground was frozen hard in the mornings, the earth black, sometimes dusted with fine drifts of powdery snow. He wore a woollen cap over his shaved head. The scar from the operation had become a fine red line, and the skin over this area dipped down like a crater. He walked slowly and repeated the names of things he saw as if they were new to him: “That’s the old barn,” “There’s the threshing machine,” “There’s the shed where we’d dress the hog carcasses.” Elsbeth followed him around the yard hanging on to his sleeve, kept close to him, but said nothing. Her mother spent hours talking to him in the morning, and was always cheerful, laughing—her normal self. There was no indication that anything lay in wait. No preparations made. No fear. Elsbeth sat at the dining room table in the afternoon, white cloud and black frozen ground visible through the windows, and read the anatomy textbook, as if there were solutions to be found in diagrams of the cerebral hemispheres, or the cerebellum (leafy bulbs the texture of ornamental shrubs), or the convoluted arterial channels. But knowledge was a burden and did not help. The pictures of the flesh-colored interior landscape were as foreign and threatening as a primeval forest, the shores of an uncharted new land where the natives practiced cannibalism.

  Very early one morning, Elsbeth heard her father going downstairs and outside before dawn. She dressed and went out after him. The car started in the shed. She kept out of sight behind the shed wall, and watched her father come out again and walk slowly back to the house. She went into the shed and got into the car, hunched down behind the driver’s seat on the cold floor, and waited. Finally, her father came back, panting, got into the driver’s seat heavily, and pulled out into the yard. He turned the heater up high and took off down the white road. It was still dark, a halo of light visible on the horizon. She kept low and watched the sky, power lines running past, listened to her father tapping the steering wheel, coughing. A few minutes later, the car bumped over some rough road and came to a stop. Through the window above her, she saw the black shapes of trees. Her father opened his window and she heard the rushing of water, and smelled the sour mud of the river. She waited for her father to get out, but he did not get out. He sat still in the front seat, not moving for five minutes, ten minutes. She heard him breathing. She crouched on the floor, her knees and ankles aching. Was he asleep? It seemed possible. She had decided to sit up and look around the seat, when he suddenly put the car into gear again and reversed back to the road. Twenty minutes later she felt the car run onto the sealed road, and in half an hour they were in town. A line of orange streetlights passed overhead, and then the car turned and came to a stop. Her father cracked open the door and got out. Elsbeth got out after him, coming to her feet suddenly. They were in the car park of Bruller’s Diner, headlights passing on the road, the morning cold and still around them, the lights of the diner shining brightly. Her father did not see her at first. He was breathing heavily after getting out of the car, standing with his arms by his sides, looking around. She tugged on his sleeve. He bent down.

  “Is that you, Tiger?”

  “I came in the car.”

  “Well, I can see that, clear as day.”

  “I woke up early.”

  “Are you keeping an eye on me, Tiger?”

  “I guess I am.”

  He took her hand and led her toward the diner. “I’m down here for breakfast, that’s all. Come down for breakfast like I used to come. Just wanted to do it again.”

  They went inside. It was warm and smelled of coffee. The counter had a chrome edge and stools with red seats on silver poles. Two or three men sat eating at the counter. Ted Bruller was serving, wearing a long apron and a white cloth hat.

  “Here’s a surprise,” he said.

  “Missing your pancakes, Ted. Guess I brought the young’un down, too.”

  “You want pancakes and coffee. What about the little miss?”

  “She can decide for herself.”

  “You allowed coffee?” Ted Bruller said to her.

  “Let her have whatever she wants, Ted. My treat today.”

  The pancakes were irresistible—dark brown and spongy with a large rectangle of butter in the center, two rashers of bacon along the side, and fried potatoes. She put a spoonful of strawberry jam on top, and then the thick, warm maple syrup. And she had coffee, too, milky with sugar. She couldn’t help but bolt it down, big mouthfuls of pancake and bacon and potato mixed together, and then mouthfuls of coffee as well. She wished she could have slowed down. Her father sat and took small bites with the tip of his fork; could not make headway. She watched him as he talked to Ted Bruller. In the harsh light of the diner, he looked sick; his skin white, his face and hands puffy. He did not take off his woolen cap—kept his scar covered. They talked about the price of corn and seed, the new machines that were coming in that year, the people he had known in school. Elsbeth felt as if this were a conversation she had heard many times before. The conversations would continue like this in the future, too, as monotonous and unending as the terrain. This was how people talked—in patterns. She cleaned her plate. Her father ate very little. He finally put down his fork and sat with his chin in his hands. He had drunk just half a cup of black coffee. Ted Bruller said there was no need to pay, it was on the house, but her father
refused. He had never taken a free meal, he said, never would. He left the money on the counter.

  “You thank Mr. Bruller, Tiger, for breakfast.”

  “No need to thank me, little miss. We’ll see you again.”

  “See you again,” her father said, and slid off the stool. “Keep well.”

  “You keep yourself well, Anton. Regards to Helen.”

  They went outside. The day had opened up, a beautiful fall day, clear and bright. Birds sounded loudly. The fields behind the diner were blanketed in a thin sheet of white frost. Elsbeth got into the car and found her father’s hunting rifle and a box of bullets on the front seat—this is what he must have gone back inside the house to get that morning. She pushed the gun to one side and held the box of bullets on her lap. Her father got into the car carefully. He did not say anything about the gun. He drove along the main road out of town, past the church. They picked up speed on the open road, and her father smiled at her—a real smile of release, of freedom. Anything was possible, he seemed to say. Death can be cheated. The stories told by fathers to daughters are true. Pumpkins can be turned into coaches, giants overcome, miraculous escapes engineered if you are prepared to believe. She tasted pancakes and syrup on her tongue, looked out at the fields covered in white frost. Stillness. Constancy. For a few minutes in the car she felt happy. There were places of safety and sanctuary in the everyday, she knew that: the warm brightness of the diner, the feel of the car seat against her legs, stalks of dry grass arcing in the wind along the side of the road, ordinary things. Things she could see and touch.

  She felt the weight of the bullets on her lap.

  “You going hunting?” she asked.

  “You never know,” her father said after a long time.

  The fall her father died, she walked around the house at night. Nighttime was the only time she felt calm then. As if events had been temporarily postponed. She walked in the dark. She listened at her father’s door. She pulled on her boots and jacket and went outside into the cold clear air. She walked out along the white road as long as she could stand it, and then back. One night when her father was very sick, she saw light coming from the dining room windows. The red velvet curtains had not closed properly and cast a knife-edge of light across the driveway. Elsbeth looked through the curtains and saw Lily undressing for bed. She watched her take off her uniform and underwear, then unscrew the cap of her bottle of skin cream and rub the cream in all over. She rubbed slowly, even sensuously, and looked quite different out of her clothes. Elsbeth recognized that she was beautiful. She had a different body from that of her mother—she was tall and lean and full breasted, with narrow hips and thin legs and a flat belly (horizontal scar from the hysterectomy barely visible). She was pretty, too, with her brown hair combed out. Beautiful. Lily pulled on the nightgown and the robe and knelt by the bed with her Bible. It made Elsbeth ashamed to see Lily as she was seen by those that she loved. A sister. Mortal. Flesh and blood. There were mysteries in Lily, she understood that, complexities. A person who concealed her own beauty, accepted poverty, denied herself. Here she was, tending her own dying brother, praying for him, showing a kind of restraint and courage that Elsbeth thought she would never have. She felt something expand inside her, a sadness, a yearning, something she could not define. Her father lay upstairs. The dew was falling; the hollow of the night surrounded her. The light from the window fell on the cold ground. That light would be seen for miles across the flat, hard country, from the frozen fields and from the forest on the distant hill, the light across the dark fields coming in patches through the shifting trees and falling on the still forest floor. Elsbeth turned from the window. She walked quickly down the long white road again, determined to go as fast and as far as she could before the cold became unbearable.

  About the Authors

  ETHAN CANIN has been the recipient of numerous literary prizes. He graduated from Stanford University with a degree in English, and then enrolled in the M.F.A. program at the Iowa Writers’ Workshop. After earning an M.D. at Harvard Medical School in 1991, he began an internal medicine residency at the University of California, San Francisco. He continued to write and to practice medicine, but following the publication of his book The Palace Thief in 1994, he decided to concentrate on writing. In 1998, he joined the Iowa Writers’ Workshop faculty. He is the author of two collections of stories, Emperor of the Air and The Palace Thief, and four novels, Blue River, For Kings and Planets, Carry Me Across the Water, and America, America. With his wife and three children, he divides his time between Iowa City and the woods of northern Michigan.

  PAULINE W. CHEN attended Harvard University and the Feinberg School of Medicine, Northwestern University, and completed her surgical training at Yale University, the National Cancer Institute (National Institutes of Health), and the University of California, Los Angeles, where she was most recently a member of the faculty. In 1999, she was named the UCLA Outstanding Physician of the Year. Her first nationally published piece, “Dead Enough? The Paradox of Brain Death,” appeared in the fall 2005 issue of the Virginia Quarterly Review and was a finalist for a 2006 National Magazine Award. She is also the 2005 cowinner of the Staige D. Blackford Prize for Nonfiction and was a finalist for the 2002 James Kirkwood Literary Prize in Creative Writing. She lives near Boston with her husband and children.

  NICK EARLS graduated in medicine from the University of Queensland. He worked in general practice and as a medical editor before becoming a full-time writer of fiction in 1998. He is the author of thirteen books, including bestselling novels such as Zigzag Street, Bachelor Kisses, Perfect Skin, and The True Story of Butterfish. Zigzag Street won a Betty Trask Award in the UK in 1998, and is currently being developed into a feature film. He was the founding chair of the Australian arm of the international aid agency War Child, and is now a War Child ambassador. He has also been a patron of Kids Who Make a Difference and Hands on Art, and an honorary ambassador for the Mater Foundation, the Abused Child Trust, and the Pyjama Foundation.

  ATUL GAWANDE, a surgeon and writer, is a staff member of Brigham and Women’s Hospital and the Dana Farber Cancer Institute. He is also a staff writer for the New Yorker, Associate Professor of Surgery at Harvard Medical School, and Associate Professor in the Department of Health Policy and Management at the Harvard School of Public Health. In addition, he is the director of the World Health Organization’s Global Patient Safety Challenge Safe Surgery Saves Lives. Gawande received his B.A.S. from Stanford University, M.A. (in politics, philosophy, and economics) from Oxford University, M.D. from Harvard Medical School, and M.P.H. from the Harvard School of Public Health. He served as a senior health policy advisor in the Clinton presidential campaign and in the White House from 1992 to 1993. His book Complications: A Surgeon’s Notes on an Imperfect Science was a finalist for the National Book Award in 2002, and is published in more than a hundred countries. In 2006, he received the MacArthur Fellowship Award for his research and writing. His book Better: A Surgeon’s Notes on Performance was a New York Times best seller and was one of Amazon.com’s ten best books of 2007. His newest book is The Checklist Manifesto: How to Get Things Right. He lives in Boston with his wife and three children.

  PETER GOLDSWORTHY was born in Minlaton, South Australia. He grew up in various country towns, finishing his schooling in Darwin. He graduated in medicine from the University of Adelaide in 1974, and worked for many years in alcohol and drug rehabilitation. Since then, he has divided his time evenly between writing and general practice. He has won major literary awards across a range of genres, including fiction, poetry, opera, and theater. These include the Commonwealth Poetry Prize, the FAW Christina Stead Award for Fiction, and an Australian Bicentennial Literary Award. He has published four collections of poetry, including This Goes With That: Selected Poems 1970–1990 and If, Then; five collections of short fiction, including Gravel and Little Deaths; and seven novels, including Maestro, Honk if You Are Jesus, Wish, Three Dog Night, Jesus Wants Me for a Sunbe
am, and Everything I Knew. He wrote the libretto for Richard Mills’s opera based on Ray Lawler’s play The Summer of the Seventeenth Doll. He has also written a comic novel, Magpie, jointly with Brian Matthews. He lives in Adelaide and has three children.

  JEROME GROOPMAN is Professor of Medicine at Harvard Medical School, Chief of Experimental Medicine at Beth Israel Deaconess Medical Center, and one of the world’s leading researchers in cancer and AIDS. He is a staff writer for the New Yorker and has written for the New York Times and the Washington Post. He is the author of The Measure of Our Days, Second Opinions, An Anatomy of Hope, and How Doctors Think.

  JACINTA HALLORAN, a general practitioner and writer, graduated in medicine from Monash University, Melbourne. She has written on medical topics for a wide variety of publications, including the Sunday Age and Inside Story. In 2005, her short story “Finding Joshua” won the inaugural Australian Doctor GP Writer of the Year Award. In 2007, her novel, Dissection, was shortlisted for the Victorian Premier’s Literary Prize for an Unpublished Manuscript; in 2008, it was published by Scribe Publications. She completed an M.A. in creative writing at RMIT University in 2009. She is currently writing her second novel, and lives in Melbourne with her husband and three children.

  SANDEEP JAUHAR is a cardiologist and the director of the Heart Failure Program at Long Island Jewish Medical Center. Before graduating from medical school at Washington University in St. Louis, he received a Ph.D. in condensed matter physics from the University of California, Berkeley. He writes regularly for the New York Times and the New England Journal of Medicine. He is the recipient of a SAJA Journalism Award for outstanding stories about medicine. His first book, Intern: A Doctor’s Initiation, was a US best seller, and has been published in many countries. He lives with his wife and their two children in Old Brookville, New York.