by Matthew Iden
Chapter Four
My modest Cape Cod in Arlington, Virginia, has been my home for more than twenty years and, when I wasn’t raking leaves, I’d been undertaking a room-by-room renovation since the previous year, when Amanda—as she’d reminded me—had pronounced that every visible surface required removal or replacement. The kitchen wallpaper, with its Amish-buggy-and-iron-frying-pan motif, had been the first to go, quickly followed by the colorless linoleum I’d stepped on since the eighties. Sage-green walls now complemented a blond, faux-birch wood floor I was proud to say I’d put in myself. New appliances would have to wait, but I’d watched a few Sunday-morning, do-it-yourself renovation programs and felt competent enough to refinish the cabinet doors.
I’d resisted the projects at first—I wasn’t anyone’s idea of a handyman—but now I secretly looked forward to making the trips to the home improvement store and battling the other maniacs in the parking lot for the closest space to the front door. I never thought I’d needed a hobby, but scraping off wallpaper with a razor blade or filling nail holes with spackling compound seemed like a dream when I thought back to the days—not that long ago—when I sat and stared at the TV, waiting for my oncologist to call.
But those days had come back in a rush the moment I’d read the cheap paper postcard from Dr. Demitri. Dear Mr. Singer, it began, Please call our office at your earliest convenience to schedule your annual preliminary checkup. There was Demitri’s name, a phone number, and the good doctor’s address in Old Town Alexandria. That was it.
But it had been enough. I’d sat on the letter since, unable to lift the phone and make the simple call.
“Why?” I asked out loud, sitting at the table in my recently face-lifted kitchen the day after Paul Gerson’s call. The only audience was my cat, Pierre, who was curled on the table like a nautilus shell, though this shell weighed nearly thirty pounds and, even curled in a ball, was bigger than a bread box. I survived chemo, surgery, and I feel great. Why does a simple checkup make me feel like I’m on my way to the gallows?
Pierre opened one sleepy eye then, unmoved, closed it, and wiggled in place, tucking himself into an even tighter ball of fur, with the tip of his tail covering his nose. I scratched his back and he gave a low, growling burble. We’d shared a house for five years and I still didn’t know if he liked the heavy petting or was going to sink his claws into my neck the second I turned my back.
I sighed and headed for the basement to get my bucket of tools. I needed to stay busy. Actually doing the intelligent thing and calling Demitri’s office to schedule the appointment was out of the question. No reason why; I just couldn’t do it. I’d know when I was ready.
So I dragged a stepladder, paint bucket, scrapers, and toolbox up the basement stairs, set everything down in the dining room, and started prepping the walls for some big-time scraping. No rinky-dink, amateur-hour DIY, let’s-just-wash-the-walls-and-paint work ethic here. No sir, I was all-in on the distraction thing, so before I even thought about painting, I was going to have to strip the walls down to the drywall, patch ’em, then put on a primer coat. This would keep me busy for at least a week, even taking into consideration time for back aches, feeding Pierre, and checking on Amanda. I lined up my tools, put some music on the stereo, and got to work.
I quit twenty minutes later.
I couldn’t stop thinking about the appointment. Every time I moved around the dining room, I caught myself peeking into the kitchen to look at the postcard stuck to my refrigerator. It was like a neon sign without the neon, glowing white and accusing from the fridge door.
I finally threw down the scraper I was using and pulled out my phone. I dialed Demitri’s number from memory, then asked for Leah, the nurse who’d been along for my whole ride and had helped me keep my sanity more than once. The receptionist put me on hold, where I listened to a garbled version of classic hits from the eighties, nineties, and today. Leah answered a minute later.
“Oh, hey, Marty,” she said. “How are you doing?”
“Lousy. And I’m not calling to schedule my checkup.”
“Um, okay.”
It took me a second to get to it, but then I explained to her how weird I was feeling and how reluctant I was to even make the call, let alone come in for what was surely just a routine visit, and how stupid could it be—
“Oh, yeah,” she interrupted. “That’s super common.”
“What?”
“Feeling listless, angry, sad, worried?”
“Yes.”
“Having a hard time thinking about the appointment but you can’t get it out of your head?”
“Yes.”
“Happens all the time. Post-remission depression. Nothing special.”
I tried to punch down my irritation. “Do you think maybe you could’ve given me some kind of warning? Say, after the surgery?”
She clicked her tongue. “Have you ever heard the story about the mother who told her little boy not to stick rocks up his nose?”
“No. Did he have cancer?”
“So, a mother sends her son off to his first day of school and tells him not to stick rocks up his nose. He says, I never would’ve thought of that, Mommy.”
“Uh-huh.”
“An hour later, the school nurse calls to tell her that her son is in the principal’s office for sticking rocks up his nose.”
I was quiet.
“So the moral of the story is,” Leah continued, “don’t tell your patients to watch out for post-remission depression…”
“…or they might develop post-remission depression. Or stick rocks up their nose.”
“Exactly. So now you feel blue. You seem to be through the worst of the cancer. Maybe you’ve beaten it. But maybe you haven’t, right? And a checkup is going to tell you one way or another, but as long as you don’t try to find out which, both possibilities exist. Kind of like Schrödinger’s cat.”
“Did he put rocks up his nose?”
“No. Didn’t you take physics in school?”
“I was more of a history buff.”
“Schrödinger was a physicist who said that a cat in a box can’t be known to be either alive or dead until you open the box. As long as the box stays closed, both possibilities have an equal chance to exist. I mean, a real cat would eventually starve, but for the purposes of quantum physics, that’s the setup.”
I glanced over at Pierre and envisioned somebody trying to stuff him into a shoe box. I had an easier time imagining how much blood they would lose in the attempt. “Can I point out that that’s a shitty cancer analogy?”
“Sorry. Let’s just put it this way—avoiding the doctor may seem like no news is good news, but the truth of the matter is, you need to find out sometime. If it’s good news, you get to move on with your life. If it’s not as good, we can take steps to tackle it. But paralysis never leads to a positive outcome. You’re not Schrödinger’s cat. You have to come in for that checkup.”
I took a deep breath. “I understand that logically. But I’m not feeling it.”
“That happens. It’s okay. I can put you in touch with a patient advocate who specializes in this kind of depression.”
“I’m not going to therapy.”
“Okay. It’s not for everyone,” she said, backpedaling at the tone in my voice. “Some of our patients have helped themselves, too.”
“Any tips?”
“Well, most of them start with an anxiety diary.”
I paused. “An anxiety diary.”
“Yep. You jot down how you’re feeling, analyze what you can do about it, and recognize what you can’t. We have a guide we hand out sometimes. I’ll drop it in the mail to get you started.”
I scratched my nose. “I read this thing, then just write down my inner feelings?”
“It’s more in-depth than that,” Leah said, “but yes. And be honest with yourself. No one’s going to see this except you, so there’s no reason to fib.”
I grunted.
“One other thing I can tell you from what other patients have gone through. Watch out for the news.”
“The news?”
“If you hear some celebrity has been diagnosed with cancer or even some other disease, you’ll be tempted to conflate their diagnosis with your own, even if it’s a totally different kind. You’ve got to remember that they’re not talking about you. They’ve got their situation and you’ve got yours. Your job is to do the best you can to take care of yourself. Same thing goes for taking on someone else’s burdens until you address your own. Even the non-cancer, non-medical things. They can send you into a tailspin if you aren’t ready for them.”
“What if doing that for other people actually helps?”
“Well…okay. Just don’t kill yourself.”
Good advice anytime, I thought. But easier said than done.
Leah tried one more time to get me to schedule the checkup, I balked, and we ended the call amicably. I grabbed the paint scraper and went back to work, thinking about what she’d said. It made sense theoretically, but I cringed at the idea of pouring out my feelings and fears, whether it was in person or on paper. It was still on my mind an hour later when I took a break and grabbed a drink in the kitchen. Leaning against the sink, I sipped water as I watched my tree drop more leaves into the yard.
“An anxiety diary?” I asked Pierre, who opened one eye again, then closed it and went to sleep.
Chapter Five
Emergency calls don’t often come at noon. They seem reserved for the middle of the night, after you’ve fallen asleep, when the jolting ring of a phone in the darkness instills instant panic—something is wrong, someone is hurt, someone is dead. But there’s really no rule that says it always has to be that way, it’s just that the sense of dread and helplessness is stronger when you’re unprepared for it. Bad things can happen in the day, too.
I was walking to Java Hut—a daily routine that got me out of the house and put a large French roast in my hands—when my phone buzzed in my pocket. I pulled it out and sized up the number. Not one I knew, although that didn’t normally stop me.
I hit the little green button. “Hello?”
“Mr. Singer?” A woman’s voice.
“Yes.”
“This is Diane Brown, down at FirstStep. I’m Amanda’s supervisor.”
“Okay. Everything all right?”
“Yes. Well, no. No one’s been hurt—permanently, I mean—but Amanda was taken to the hospital about an hour ago.”
“What?”
I turned on my heel and jogged back to my house while Ms. Brown explained that, while manning the front desk, Amanda had tried to stop a masked man from coming into the clinic right after a delivery guy had been buzzed in. He’d been waiting for the opportunity and attempted to sprint past the desk to get into the back rooms of the shelter. The delivery guy and three staffers were able to stop the guy from making it any farther into the shelter than the foyer while someone else called the cops. The guy ran back out of the building, but Amanda, irate, chased him across the street to confront him, where he turned and shoved her hard enough that she fell to the sidewalk, breaking her arm.
“Did they get a hold of him?”
“I’m afraid not,” she said. “He ran away after pushing Amanda and we were busy helping her.”
“But Amanda’s okay?” I asked. I was almost back at my house and had my keys out. “She landed on her arm, not her head or anything?”
“I don’t think so. One of our staffers took her to the Capitol Hill Medical Center, but she asked me to call you. I just finished giving my report to the police, which took some time. Otherwise I would’ve called you sooner.”
“Don’t worry about it. You did okay. I’m heading out to the hospital now, but put the shelter on lockdown. If this guy is as crazy as he sounds, then he may just wait until the cops leave and try it again.”
“God, I hope not. We don’t have any volunteers to spare.”
I hung up, then hopped in my car and headed for Capitol Hill at speed. Fast enough, in fact, that I realized I was driving sixty in a thirty-five zone, and had to make a conscious effort to slow down. I wouldn’t be helping anyone if I got pulled over and had to sit through a lecture and a ticket from a local traffic cop.
Twenty minutes later, I pulled into the parking garage at the hospital, handed over a wad of cash to park, and headed in. A quick check-in at the ER desk and some back-and-forthing with one of the nurses I knew from my Homicide days got me a pass to the back where thin green curtains separated kids who had fallen off bikes, gangbangers with gunshot wounds, and staffers who tried to stop lunatics from breaking into women’s shelters.
As I walked into the heart of the clinic, however, a wave of queasiness washed over me. Too many hospital visits as a cop combined with my appointments for my cancer meant flashbacks, even a year after the worst was over. At this point, it was just a bit of nausea and a hard tightening the size of a walnut just behind my breastbone—nothing like the full-on sweats I’d experienced before. But it was enough to make me pull over to the side of the hallway and take a minute to collect myself. A nurse asked if I needed help back to my bed. I smiled and said, no, I could make it on my own. She left and I took a deep breath, then continued the search for Amanda.
I found her in the last bay, her head on the crinkly hospital pillow with her eyes shut, resting. Her left arm was wrapped in a blue cast from her thumb to near the elbow. She looked thin and pale, with smudges under her eyes. I watched her breathing for a second, then slipped in and took a seat as quietly as I could in the chair next to the bed. I didn’t have to be so careful. A steady white noise of nurses and doctors consulting, monitors bleeping and blooping, and the rattle of wheelie carts in the hall covered any amount of noise I made.
I’d been watching her sleep for about twenty minutes when a nurse pulled back the curtain and poked her head in. I raised a hand and she waved me out into the hall.
“Are you her father?” the nurse asked.
“Ah, yes,” I lied, feeling weird saying it. “How’s she doing?”
“A simple fracture. Painful, but nothing too serious. No plates or pins. We doped her up, put the cast on, and let her sleep.”
“Can she go home?”
“Oh, sure. No need for an overnight. In fact,” the nurse said with some emphasis, “she could go home anytime.”
“You need the beds?”
“There was a stabbing down near the waterfront and we’re the best, if not the nearest. Ambulance is on the way.”
“Okay, give me a second with her.”
“Thanks,” she said. “I’ll send someone over in a minute to check her out and get payment.”
“Payment? Like a copay?”
“Not exactly.”
“Sorry?”
“She needs to pay for treatment.”
I did a double take. “You mean, like, pay for the whole thing? Didn’t her insurance cover it?”
She shook her head. “She didn’t have a card when her friend brought her in, but we were too busy stopping the pain to process her correctly. Maybe she’ll give you the insurance information.”
Another nurse called for her and she sketched a short wave of apology and hurried down the hall to another bed. I went back to Amanda and called her name. Her eyes opened after a moment.
“Hey, kid,” I said. “I heard you had a rumble.”
She smiled weakly. “You should see the other guy.”
“I plan on it,” I said. “First things first, though. Let’s get you out of here. Can you walk?”
“I think so.”
I helped her sit, then steadied her as she swung her legs over the side of the bed. Together we put on her socks and shoes. One, two, one, two. I sat back and looked at her. The cast was ridiculous, a big blue block where her arm should be. “I hate to bring this up,” I said, “but the nurse out there said you didn
’t give them any insurance for this.”
She looked down at the floor.
I paused. “Is that because you don’t have any to give them?”
Her mouth pressed in a firm, bloodless line. She nodded.
“FirstStep doesn’t give you any because they’re on a shoestring budget?”
“No,” she whispered.
“And you don’t make enough to pay for a good plan, but too much to qualify for subsidies?”
A nod.
“And you were across the street when this guy pushed you, so no worker’s compensation?”
She nodded again. One fat tear rolled down her nose and dripped onto her jeans.
I took a deep breath. “Okay. We’ll deal with it.”
The codeine or Demerol or whatever it was that numbed the pain gave a her bad case of the wobbles, but with a hand on my arm, she was able to make it down the hall and out of the main body of the ER. I left her in the waiting room with a cup of water, then went back to check in at the admissions desk.
A prim white lady in her fifties, wearing thick-rimmed glasses on a beaded chain, gave me the rundown on Amanda’s bill. It was enough to put me in the ER. There were bed charges, X-ray fees, biohazard disposal costs, charges for the nurse’s time, charges for the doctor’s time. Everyone but the janitor had made it onto the list of line items, which was almost a page and a half long. The total bill was nine thousand dollars.
“You’ve got to be kidding,” I said, unable to help myself. “She was here for ninety minutes. That’s a hundred bucks a minute.”
“I’m sorry, sir,” the woman said in staid, uninflected tones. She was used to doing this. “That’s the price of modern medicine. We do have an installment plan.”
She reached behind her and plucked a brochure from a rack, then handed it to me. I looked at the cover stupidly. “You can finance your hospital bill?”
