Arms Wide Open

by Patricia Harman

  “Shit, I forgot to tell you!” he explodes. “We were going to cancel the move to Russia if Rose had serious medical problems, but once we got the word that she’s genetically normal, it’s full speed ahead. We’ve been working like crazy to get ready. I never knew what a hassle it was to get visas.”

  “So . . . ? What did the geneticist say?”

  “Well, Rose is just a normal little girl with blind ear pouches, and we’re getting a bone-conduction hearing aid before we leave.”

  On Friday, I arrange to record, at a small studio on the edge of town, a CD of lullabies for Rose, so she can hear me sing when she gets her hearing aid. I’ll have copies made for Orion’s kids too, Lissie and Abraham.

  At first my voice is weak, but I don’t let myself cry, neither for joy or sadness. I close my eyes and pretend I’m singing in the dark to Mica, Orion, and Zen when they were little boys, and my voice gets stronger. Hush-a-bye don’t you cry. Go to sleep-y little baby . . .

  CHAPTER 3

  Healer

  “What’s up?” I ask as I come out through the open deck door.

  Tom sits with his feet up on the porch rail, staring across the lawn. “I’m just waiting for a call. A patient I did surgery on a few days ago came back to the emergency room this evening.” Two gray squirrels with curly tails are eating birdseed spilled by the careless blue jays, two feet away from his chair, but he doesn’t notice.

  His cell phone finally rings and he flips it open. “Dr. Harman.” I listen to the one-sided conversation, watching his face. There are circles under his eyes. He’s been harassed with phone calls two nights in a row. “Yeah, so how are her vitals? . . . OK, wait for the lab results. Type and cross her for two units and make her NPO.”

  “What?” I ask when he hangs up.

  “I’ve got to go back to the hospital.” His voice is low and discouraged.

  I tighten my lips. “Can’t you eat dinner first?”

  “It’s my patient Bobbie Boyd. The RN says she’s orthostatic, blood pressure’s way too low.”

  “Is she bleeding?”

  “Not on the outside, but she oozed all through surgery. I ordered a post-op hemoglobin and blood-clotting studies. They’re pending. I guess I can grab a bite.”

  Five minutes later, his cell phone rings again, a catchy salsa tune that belies my foreboding.

  “Dr. Harman,” he says again. “I’ll be right there. Call the nursing supervisor and alert the OR.”

  “What’s happening?”

  “Her hemoglobin is 6.”

  He doesn’t have to say more. Six is way too low, and he’s already heading toward the front door.

  It’s a warm evening, and I’m outside in the gazebo staring down at the lake. The air smells like lilacs, and even if I was blind, I could tell by the scent that it’s almost summer. The fireflies come out one by one, the first I’ve seen this year, but I don’t get as excited as usual. Tom’s still not home.

  Because of his specialty, pelvic pain, my husband takes care of many women who’ve been referred to him by other gynecologists, surgeons, and family docs, women with endometriosis and adhesions, women in delicate health or with autoimmune diseases that lead to poor healing, patients the other docs prefer not to mess with. Tom always accepts them.

  I think of the worst: what if Bobbie Boyd hemorrhaged and died? Tom’s never had a woman expire after surgery or childbirth and I don’t know how he’d handle it.

  Finally, the lights of the 4Runner come down the drive. “Tom, out here . . .” I call across the lawn. “How’d you do? She OK?”

  My husband sags into the deck chair next to me. “Yeah . . .”

  I think that’s all he’s going to say and I’m afraid to ask more.

  “We had to give her another two units of blood, four all together. By the time I opened her, I couldn’t find a bleeder, but there was one thousand ccs in her pelvis.” I picture the amount as almost a quart. “Her labs showed a coagulation disorder. I stayed a few hours longer to be sure she was OK, but her husband was pissed.”

  I imagine the man, skinny and tall, with a scraggly ponytail, wearing a tight AC/DC T-shirt. He sits on the edge of the hospital bed, tightens his jaw, gets out a pack of cigarettes, and then remembers he’s in a hospital and puts them back. When Dr. Harman comes in, weary and wearing light green scrubs, the fellow jumps up. “What did you do to her? Will she be OK? She better be OK.”

  “The vibes were heavy,” Tom continues, discouraged. “The guy’s an asshole. I’ve seen the way he treats Bobbie when he brings her to the clinic. He talks for her, bosses her around like she’s a piece of shit. I don’t think he trusts me.”

  I stand up behind my husband’s chair and run my fingers through his short gray hair and across his forehead, pull his head back until it rests on my stomach. He’s such a good man.

  It once seemed so easy. We wore our hearts on our sleeves and were here to serve the people, first by attending homebirths when there were no birthing centers or hospitals with humane protocols, and later as medical professionals who changed those protocols.

  When Laurel left the commune, Tom was my driver as we sped through the night to homebirths, down a hollow or on the top of a mountain. He boiled water and sat in the kitchen. The fathers appreciated having another man around, a reassuring presence in a sea of femaleness. I appreciated him because he was an EMT and available if we had an emergency.

  Now he is the captain of the ship, the one in charge, losing sleep over surgical complications and worries about malpractice litigation. When we step out of the gazebo and look up, heavy clouds have come in and the stars are wiped out.

  Summer

  CHAPTER 4

  Escape

  “You gonna be ready soon?” I pester, standing at the door to my husband’s pottery studio, inhaling the earthy smell of clay.

  “Bug off, Pats.” Tom is hunched over a table covered with pale gray vessels, mostly coffee mugs, and he’s not in the mood for my comments. The floor is sprayed with clay; even the windows are splattered. His glazed bowls, pitchers, teapots, and vases, in shades of blue, brown, and green, cover every surface of every shelf lining the walls.

  “Gotta move if we’re going to make the ferry,” I nag.

  “I have to get the handles on these mugs while the clay is still damp. There’s plenty of time.”

  I let out a long sigh, then stomp back upstairs to my office. It won’t help to push him. He only gets more stubborn. We take turns alternating who will be worried about being late. Apparently, this is my turn.

  On my silver laptop, a recent e-mail from Laurel is open. I run my fingers lightly over the screen. Our old commune friend is always sending some political announcement, some call to action or silly YouTube video. I forward the best ones on to Mara and Tom. It’s been two years since I’ve seen Laurel. Maybe three. She’s a physical therapist now, married to another physical therapist in Ohio, and has two kids.

  “Mica, Emma, and baby Rose are moving to Russia,” I type back. “I hate that they will be so far away. I’m trying to be brave, but it feels like a chunk of my heart was cut out.”

  Laurel, having been Mica’s stepmom, still asks about the little blond, blue-eyed hippie boy. She has teens of her own, with all the troubles I once had. Recently she e-mailed that she found marijuana in the oldest girl’s bureau. Been there. Done that. The mother-heart drops down a dark hole . . .

  You raise your kids with respect; teach them to think for themselves. You do your best and then they go wild on you. Though all of us were at least peripherally involved with grass in our youth, drugs are much stronger now and more dangerous, not to mention still illegal in most places.

  I glance again at my watch, send my e-mail, and snap my laptop closed. This afternoon we’re leaving for a long weekend at our summer cottage, Har
mony House, a five-bedroom yellow farmhouse with a barn on Pelee Island. The small landmass, about the size of Manhattan but with only three hundred year-round residents, is located on the Canadian side of Lake Erie.

  I laugh at myself. Once we lived in a log cabin, before that a barn with a dirt floor, then there was the butterfly tent. What yuppies we are, with two lakeside homes! I wait twenty minutes, then bug Tom again.

  Four hours later, just in time, we trot up the ramp of the old-fashioned red and white ferry. As the copper sun drops over the edge of the earth, we pull, with three long, low blasts of a horn, out of Sandusky Bay.

  Tom and I stand on the bow watching white sailboats pass in the dusk. “I’m so tense lately.” I let out my shaky air, indicating with my fist my upper abdomen. “Too tense.” Tom’s elbows rest on the deck rail and his face is impassive, but I want to talk.

  “For months, when your mom was sick, we had to go back and forth to Ohio. Our life has been in turmoil, and then she dies while you’re in the Dominican Republic doing your medical mission, and we go back for the funeral and then Zen comes home and our house isn’t ours anymore. Just when things are calming down, Mica announces that they’re moving to Moscow and then we find out Rose can’t hear. It’s like a beehive that won’t settle.”

  Tom puts his arm around me and squeezes but he doesn’t say anything, just stares at the swath of red sky turning lavender. A squeal on the bow of the boat interrupts the quiet. The captain, a slim man with short white hair, wearing a red plaid kilt and a crisp shirt with gold crests, tunes up his bagpipe. He squeezes a few times, then begins a Scottish drone.

  Amazing Grace, how sweet the sound . . . the words fill my head. The fist in the center of my abdomen opens. That saved a wretch like me. I close my eyes and am back in the Spencer Library community room at the Growing Tree potluck supper. We’re holding hands in a circle. I once was lost, but now I’m found . . .

  The tables are laden with hippie food, cornbread, pinto beans, and vegetables from our gardens. Mara is there, and Stacy. Rachel catches my eye. Laurel is leading the singing, with Ben playing his guitar.

  I used to think our life on the farm was so hard. Maybe all life is hard. I glance at Tom to see if the bagpipe music moves him too. Our eyes meet and I know he remembers.

  The piper plays to the water. He plays to the first star, the one that gave me courage when I lay on the ridge in labor with Orion. He plays for us.

  Through many dangers, toils and snares we have already come. ’Tis grace that brought us safe thus far . . .

  “Welcome to Canada,” a passenger laughs. And grace will lead us home.

  Regret

  In an hour, we’re sitting, with a bottle of wine, on our deck, which rests on top of the granite break-wall, protecting our summer home from storms. “Cheers,” I say, clinking our glasses. “Happy summer solstice.” To the south, on the U.S. shore, twenty miles away, distant lights twinkle in Sandusky and Lorain.

  A few years ago, when we were on vacation and feeling flush, before the economy went to hell, we bought this farmhouse with a barn and two acres, and now, to keep up with the mortgage, rent it to cottagers from May to November. We started coming to Pelee when the boys were little and Tom was in medical school in Ohio. We camped here at first, then moved up to cabins. The kids learned to drive on these dirt roads. Below the huge boulders, the waves measure time.

  Both of us let out a long breath together. Each August there’s more algae bloom and matted weeds as the water temperature rises. I lean forward to look down at the rocky beach and when I rest back, notice Tom’s eyes. ”Are you OK?”

  “Yeah. I was just thinking of my mom. She never got a chance to see this place. Her dying has really hit me. It’s been months since her funeral, but every day I think of something I want to tell her. I miss her. She was one of my best friends.”

  “Are you crying?”

  He swipes the eyes with the back of his hand. “A little . . .”

  How could I have not noticed? I reach over and touch his wet cheek with one finger, then take him in my arms. Just because Dorothy’s death had been anticipated doesn’t mean it wasn’t traumatic.

  Sometimes I wonder about myself, the sensitive midwife. Am I so wrapped in my work with women that I don’t even notice the pain of my own family members? How often have I walked past Tom or the boys, deep in thought about a patient, completely oblivious to the ones I love most?

  “I miss her,” my husband says again between sobs. “I miss my mom.” His chest shakes against mine. “She was an inspiration to me, even on her deathbed. So strong, facing the unknown. Even when speaking was exhausting, she was herself—demanding, compassionate, sometimes a pain in the ass . . . I just wish I’d been there to say good-bye. I wish I’d stayed home, not gone on that medical mission to the Dominican Republic.”

  He says that now, but at the time there were nurses, doctors, and impoverished patients needing his care, depending on him. His mother could have lasted for months . . . but she didn’t.

  It cuts you to see a grown man cry. In thirty years, I can count on one hand the times my husband has broken down. Now I’m crying too. We hold each other with the dark water splashing below.

  “Your mama’s OK,” I tell him, patting his back. “She’s probably in heaven dancing with your dad while Bing Crosby sings ‘Blue Moon’ . . .”

  Tom gives me a crooked smile. I pull him up and we slow dance on the deck, like teenagers, our arms locked around each other. Blue mooooon . . . . I sing.

  “Dancing in heaven?”

  “Well, she could be!”

  He squeezes me and runs his hands down my back and then lower. Our bodies fit together like an arm in the sleeve of a favorite soft shirt. He kisses me and rubs his two-day beard on my cheek.

  It’s not easy to let go when you’re used to gripping life with your fingernails. It takes a while, but I finally stop struggling, let my wings unfold, and we soar over Lake Erie together.

  Ruby Tuesday

  My first patient when we get back on Tuesday is Ruby Mott. I think of the Rolling Stones song “Ruby Tuesday” and smile. I’m in a good mood after our mini-vacation and hum a few lines while I look over her chart, then enter the exam room.

  “So, Ruby. How’s your pain this month?” The twenty-nine-year-old gives me a tired look, as if it’s too much to answer. She’s a tall, thin woman wearing sandals, fringed jean shorts, and a black tank top. She’s so skinny, it crosses my mind that she could have an eating disorder, like Nora, my patient who almost died of bulimia.

  Ruby holds her abdomen, looking like death warmed over, and I ask my question again. “So, how’s your pain?

  “Some days better. Some days worse. I’ve been under a lot of stress lately.”

  I hesitate. If I ask about her stress, I may be here for a while. I ask anyway . . . she wants to tell me. “What’s up?”

  “Money problems. My phone was shut off and my stepmom won’t lend me any cash. My dad’s in county lockup, so he can’t help. I need something for my nerves, can you give me some Valium?”

  I frown. This is the kind of social situation a lot of the chronic-pelvic-pain patients have. In-law problems, outlaw problems, kid problems, money problems, yet they faithfully show up, once a month, on Tuesday, for their support group and prescriptions.

  I remind myself that women like Ruby are not the average pelvic-pain patients. Most women with endometriosis or lower abdominal adhesions or fibroids or cysts get better with medical therapy or surgery.

  The chronic pain patients are the hard cases. They’ve been to multiple doctors looking for help. They’ve already had several operations, scopes, ablations, nerve blocks, even complete hysterectomies; still they have real pain.

  Tom decided on this specialty when he was in his last year of residency. He takes the patients’ prob
lems seriously. It’s common for women experiencing pain to have been told there’s nothing wrong with them . . . that it’s all in their heads.

  There are some, like Cindy Carlton, who are stable on their meds and never ask for more. Cindy’s an elementary school teacher who has massive adhesions from a pelvic infection after surgery years ago. She has two girls and a husband who’s a coal miner. One of their kids got married last spring and Cindy brought us pictures of the wedding. The pleasant patient takes narcotics as scheduled. Never asks for more. Without them, she couldn’t work, couldn’t take care of her family.

  If there were an adequate pain center in the area, one that cared about the patients and looked at their problems holistically, we would long ago have referred Cindy and Ruby, but there’s nothing like that, so our chronic-pelvic-pain program grows.

  “That’s tough about the money, Ruby. Maybe you could call the help line at United Way. They might be able to give you a loan.” I ignore the request for Valium, but ask her about her BMs, her bladder, her nutrition and activity level. The answers are brief and the appointment comes to an end when I give the young woman her Oxycontin prescription, a handout on stress reduction, and her birth-control pills.

  “Thanks, Patsy.” The forlorn face breaks into a grin and I watch as she almost skips down the hall and out through the waiting room. Sometimes I question how much she hurts. Is it all a big show? You hate to second-guess your patients.

  No one knows. She comes and goes. Good-bye, Ruby Tuesday.

  DESTINY

  Sun glints on the river. Blue sky overhead. There’s nothing like a free outdoor concert, and these guys are good. The drummer beats out a solo that sounds like a big Harley racing through the mountains and then the band breaks into Bob Seger’s “Against the Wind.” The crowd cheers, stands up, and sings.