“I like Pilar,” he says, putting the end of his cigar under his nose to smell it better, spinning it around between his thumb and forefinger. Pilar says the same thing about him. She likes Kepa. Abaitua remembers the day the three of them got together to sign a bank guarantee for the bookstore. He warned Pilar they might end up losing money, but she didn’t mind. Pilar answered exactly what Abaitua was thinking: Kepa would do anything for them. As well as signing the guarantee, Abaitua gave him some cash for him to cover any initial bureaucratic incidentals. It was around midday, and Kepa said that he’d heard about a little bar in the neighborhood of Antigua that had good seafood. He’d booked a table for them to go and celebrate, but Abaitua couldn’t make it, he had an operation scheduled to remove a uterine fibroid that afternoon. But in the end it wasn’t a long operation. He got home by mid-afternoon, and Pilar still hadn’t gotten back. She arrived quite late in the evening, with red cheeks and bright eyes, and seeing her like that, he half-jokingly asked if she’d had a good time, to which she replied so seriously that it was comical. She said, with great conviction, that he’d treated her like a queen. He’d taken her to a very normal looking bar, and they’d been served wonderful oysters and barnacles and an unimaginably good Chablis Grand Cru. Pilar knows how to appreciate good seafood and a good Chablis Grand Cru. One of the things he most liked about her was that she knew how to appreciate products of the land and the sea, and just then, he allowed himself to indulge the not very probable idea that those red cheeks were holding the warmth of a pillow. He’s not sure why, but he didn’t think she would betray him, and probably because of that he thought it would be completely bearable to him if she’d gone to bed with Kepa, it wouldn’t be more significant than the dessert she’d had after the seafood they’d eaten and washed down, as she specifically pointed out, with Chablis Grand Cru. Perhaps the worst thing would be that it was his money that paid for all the fun. Pilar used her toes to take off the high-heeled shoes that she so seldom wears and lay flat out on the sofa with the amused look of bliss that good wine gives you. It didn’t occur to him that she might want a bit of fun in bed after the banquet, and in any case, it wasn’t part of his routine to make love before dinner. At the time, he didn’t know just how alone she felt and how much she needed to be treated as a queen.
“I’m amazed by how much influence luck has in our lives.” They’re on their way back now, in the car, at the three-way intersection on the road that runs from the hospitals to Hernani, and Abaitua, wanting to know if he’s said that grand-sounding sentence in all seriousness, looks at Kepa. There’s no indication that he was speaking with anything other than total seriousness, and he adds, “I find the influence of luck fascinating, I really do.” And Abaitua, without having to ask him what he’s talking about, knows it’s a reference to his breakup with Edurne. The thing is, if that woman hadn’t offered him a Harrods bag, perhaps they wouldn’t be splitting up. He thinks that’s what set the whole thing off. If it had been a bag from another store, or better still, from a bookstore, or just a bag, nothing would have happened. Or if the Foyles bag hadn’t burst. Or if he hadn’t bought anything. Abaitua makes him keep his window open even though his cigar is out. He finds it hard to keep up his ban on smoking in the car, but he’s firm. He knows he has to be strict with Kepa, like with dogs, if he doesn’t want him to invade his territory. “Or if you didn’t smoke,” Abaitua says, and Kepa nods his head. “Or if I didn’t smoke,” he mumbles.
At the last moment—he’s tired, and he wants to be with Pilar—he decides to go straight home without stopping at the hospital. He pulls over across the street from the hospital, without turning the engine off, so that Kepa can get out. But he doesn’t seem to want to, even though he’s opened the door. He holds his arm out to keep the door open, as if not knowing whether to say something or not, and afraid that he might be about to start talking about money, Abaitua prepares himself. But there’s no reason to worry. After a long silence, he says that he’s completely convinced that when the woman in the plane conditioned his fate by giving him the Harrods bag, she also determined hers, and Abaitua calms down when he hears that but then feels guilty for having thought ill of his friend. When he asks him why he says that, Kepa replies it’s just a hunch. The last time he saw her, she looked full of anxiety. That’s what he says, and Abaitua steps on the accelerator a little to encourage him to go. Eventually he gets out. He’ll do what he can to arrange for Kepa’s mother to remain in the hospital for another week, that way he’ll be able to get everything in the house ready for her. He also says the two of them haven’t gone out together in ages. There’s a long weekend coming up soon, and they agree to talk about getting together.
Pilar is sitting on the sofa, leaning down over the newspaper that’s laid out on the coffee table, her usual unergonomic position, arms folded and her chest almost resting on her knees. She’s doing a Sudoku puzzle, giving it all her attention, she’s very, very good at them. If a particular type of intelligence is required to do Sudoku, then Pilar’s is very highly developed. Abaitua, on the other hand, doesn’t like games involving math, they require a lot of effort and he doesn’t find them gratifying, because he’s not very quick-minded, he’d say.
Hello. She replies with the same word after looking at him for a moment. She hardly lifts her head from her Sudoku. No more than a look—she could be thinking about something else or be bored—a look that starts at Abaitua’s face and goes down, evenly and quickly, to his feet, and then goes up again, quicker, without stopping anywhere, but then it does stop, on his face, for an immeasurably short moment, and although she seems more uninterested that inquisitive, he gets the impression she’s seen him on the inside as well as on the outside. He normally keeps still in that type of situation, feeling as though he’s being scanned, until she looks back at the newspaper and away from him. Then, when she’s no longer looking at him, she tells him he has a little smudge of toothpaste on one side of his mouth that he missed when looking in the mirror, a loose thread on his pants, and his shirt collar is sticking out over his jacket. And she normally tells him about things like that, but he’s sure she sees other things that she doesn’t tell him about, as well.
So she’s staring at her Sudoku puzzle again when she answers hello. It isn’t a happy hello or a sad one, just neutral—a little curt, perhaps. He decides to ask her how her day’s going. Nothing special. After leaving the notary’s office, she helped her father with some papers. He hardly has any operations scheduled. At one time, the clinic had plenty to go on with just maternity cases, but the fall in birth rates from the sixties onward, the ever greater costs required for the new type of care that an increasingly well-informed society demanded, and advances in the public health system put an end to the old man’s days of making a living off births, and he had to look for new ways to keep the business afloat. To do that, he relied on his other son-in-law, Yago Alzola the neurosurgeon, and the latter’s brother, the ear, nose, and throat specialist. He sent them to the United States, and when they came back, they were able to promote the techniques they had learned there quite successfully, to the point of securing a virtual monopoly on them, which allowed them to stay in business. Kepa says you can’t turn your back on Abaitua’s brother-in-law without him slicing it open for you. He’s operated on each and every slipped disc there’s ever been, the operable as well as the inoperable ones, and even ones that didn’t exist, and his brother’s laryngectomized half of Gipuzkoa; they’ve really amortized the techniques they learned. But they didn’t pass those techniques on, or keep their skills and procedures up to date, and their good run is over. When Pilar tells him that things are going worse and worse, he doesn’t point out to her that he had long ago predicted as much himself. In fact, she doesn’t give him much chance to say anything about it, and maybe her “and what have you done?”—which she asks without raising her eyes from her Sudoku—is a way of avoiding the subject. He prefers it that way. He says he’s had lunch with Ke
pa, tells her where and what they’ve eaten—she pays more attention to that, he thinks—and that they’re thinking of going up to the mountains on the next long weekend, which is a way of giving her forewarning, if not of asking for her permission, but he doesn’t mention the fact that he’s split up with his wife. Now it seems too late for him to do that, it was a piece of news to tell at the beginning, when he first came into the living room, saying, “You know what? Kepa’s left home.” But he remembers his absurd idea—absurd because he doesn’t think she would actually ever say it—that she might say “and why don’t you leave, too?”
Obviously, he himself could be the one to say, “Kepa’s left home, and I’m going to do the same.”
He tells her about his day at the hospital, about the psychiatrist who keeps prescribing tricyclic antidepressants, the sixty-year-old woman with breast cancer who’s refused to have a mastectomy because she’s afraid her husband might reject her. Pilar listens to him while she does her Sudoku, and as if to let him know that she’s listening, she says something from time to time. She classifies the woman who doesn’t want to lose her breast as an idiot. “Although I guess I’d have to see what her husband’s like,” she lets slip. He thinks of María Amor and, wanting to inject a bit of humor into things, says she’s lost her pimp, but Pilar doesn’t remember that story, even though he reminds her about the Dominican prostitute’s drug-pushing pimp with AIDS who let his brother get killed. “I would remember that.” But Abaitua is sure that he did tell her about them, and also about himself and his friend the infectious disease specialist talking about their theoretical moral dilemma, and above all, he remembers that when he told her about the Dominican woman being dominated and then said that some women have a weakness for psychopaths, Pilar hadn’t liked it one bit. He wants to remind her of it, so that she’ll say he’s right—some women confuse the characteristics of psychopaths with the marks of a person being energetic, daring, and resolute when it comes to decision-making, and that’s why they like psychopathic men, because they make them feel secure. “Do you really think us women like psychopaths?” She said exactly the same thing to him last time. He leaves it at that, without taking the trouble to insist that he said “some women” and not all of them. He sees that the skin on her neck has loosened a little, but he still finds her beautiful. Seeing her looking so beautiful, so close, and also so far away, he thinks, as he used to in the past, that he’d like to ask her what she’s thinking. “As if I’d tell you!” she used to answer. Sometimes he thinks he can read her mind. He wants to play at that. “I bet you you’re thinking about this or about that,” and he has the sensation he’s got it right, even though she always denies it. “Poor man, you always think I’m thinking about you,” she once answered, and he had to admit she was right—all the thoughts he imagined were about him, he never imagined any other possibilities. Now, he could say to her, “You know what? When I was having lunch with Kepa, it occurred to me that you might have slept with him.” What would her answer be? She’d probably tell him not to be stupid. And she would have said just that to him—“Don’t be stupid”—if he had ever mentioned, back in the day, that he suspected her of having done the same thing with the young neurosurgeon, whom he felt such solidarity for, because he was being shut out at the clinic, too. And yet later on, he found out that he had been right about that all along.
He decides to retire to the studio. Before, when Pilar used to do crosswords instead of Sudokus, and with great skill, as well, at least she used to ask him for help from time to time, mostly when some word about sports came up; it’s a subject she doesn’t know much about. He, in turn, would ask her for clues, such as how many letters there were in the word, whether she had any of them already, and Pilar would make room for him on the sofa for him to sit next to her, letting him see the crossword. He thinks Pilar liked doing things together—crosswords, at least. Sudoku doesn’t give you a chance to lend a hand. It’s a more autistic activity, to put it that way.
So he says he’s retiring to the studio. He’s taken on the responsibility for coordinating a perinatal survey that’s going to be carried out by various hospitals. His MD thesis was about something similar, although on a different scale. He tells her a bit about it, and although Pilar does seem to be listening, she doesn’t ask him any questions (“What hospitals? Spanish ones? Foreign ones?”), and he deduces from this that she’s not very interested in the subject.
They call the small room with the glass-doored cherrywood bookcases all around it “the studio.” There’s a simple table there—a board resting on two trestles that he’s used since he was a student. His MD thesis is on the table, leather-bound in two volumes with gold lettering: “Descriptive Study of the Perinatal Area.” In the more than one thousand pages of each volume, he tried to describe the then-current situation of care during pregnancy, childbirth, and the immediate postnatal period, a situation so terrible that death rates were two or three times higher than the rates in the rest of Europe. He worked nonstop on it, day and night, throughout 1975 and 1976, with innocent passion, truly believing that his research would be a real wake-up call to people and that, thanks to his influence, essential changes would be implemented to prevent such absurd deaths and grave accidents for newly born children.
He’d been on a work placement several years earlier at Port-Royal Hospital in Paris, and there he had met the neonatologist Alexandre Minkowski. Professor Minkowski was Jewish, the son of a Jewish psychiatrist, and according to his memoires, not a very good Catholic—Un juif pas très catholique was the title had had given them. He was highly educated and a decent yachtsman, had white hair, was swarthy, as elegant-looking as an Agnelli, and he had a good figure. He was very smart, and fierce and demanding when it came to denouncing the appalling lack of good care in matters connected with childbirth.
Abaitua will never forget the day he met him. Abaitua was part of a group of foreign resident doctors Minkowski had brought together in order to show them the services he provided. The professor appeared wearing a high-necked, short-sleeved white jacket with buttons up one side. Without saying a word, he took them across a wide, luminous hall to the intensive care ward, where there were dozens of premature babies, some looking like fetuses, with white caps on their heads, connected to wires and tubes. An assistant explained the various devices to them and the jobs of all the people around who looked after them. It was all flawless and transparent white—the hum of the respirators, the beeping of the control panels, the silent caregivers wearing isolation suits—and it looked like something out of a science fiction movie. It was an excellent setup, there was no doubt about that, one of the best ICUs for newborns in the whole of Europe, if not the best. Minkowski, who had not said a word until then, stood in front of the group and pointed at the incubation ward behind him with both thumbs. “Some of the children here are about to die; others will survive and be disabled with incurable brain damage for the rest of their lives. But no more than half of them should even be here connected up to these excellent, expensive machines at all; the other half should have come into the world without having to face any particular risks.” Those words were like a revelation for Abaitua, he’ll never forget them. He knew, of course, that ignorance about how to care for pregnant women (everyone’s ignorance, people’s in general and doctors’ in particular), negligence (everybody’s, once again), and malpractice had consequences in the birthing room, but he had never seen it so clearly, in such a tangible way.
To coin a phrase, he saw the light. If you think about it, not paying attention to a pregnant woman’s blood pressure, for instance, is more than just average negligence, it is also a terrible crime, as terrible as watching a child playing on the roof of a ten-story building without doing anything about it. Abaitua learned that from Minkowski. He spent the rest of his time there reading the professor’s works and often met up with him. He was a man it was easy to talk and get on with. He used to say that medicine progressed in opposition to
common sense and equality and that in the same way that greater priority was given to the Concorde’s record times—these were the blissful days of super-aviation—at the expense of the daily public transport that thousands of normal people needed every day, adventurous medical explorers were rewarded while sectors that were of more importance to people’s health were ignored.
This was his message: instead of putting your trust in scientific and technical formulas to miraculously cure illnesses, humbler but more efficient measures to prevent those illnesses from occurring should be applied. Minkowski was familiar with the state of pregnancy and birth care all over the world, and he often spoke about China, where rest was prescribed just as seriously and precisely as medicines were—all pregnant women had their blood pressure taken every eight days, and complete rest was ordered if their readings were above 120/80. With that measure alone, which eradicated eclampsia, they reduced their previous mortality rate, which had been similar to nineteenth century Europe’s, to the same level as Sweden’s, which was the lowest in the world.
He’s never in his life been as fanatical about anything else. He dedicated himself heart and soul, making a great effort with his descriptive research of the lamentable situation: there was no system in place to detect problematic pregnancies, women had fewer than half the number of checkups as in other European countries, had a third of all European cesarean births, mortality statistics were suspiciously connected with the time of birth and the particular medical establishment in which it took place, and there seemed to be a strict following in the public sector of the Biblical stricture “in sorrow thou shalt bring forth children,” leading to a lucrative market for addressing the resulting problems in the private sector . . .
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