Healer: A Novel

by Carol Cassella

  They hired an architect. Claire collected file drawers full of magazine pages and tile samples and paint chips. Their dinner talk lingered over notions of how a house can affect productivity and mood, how space and light can transform the language of private life. As the stock rose and split and split again they luxuriated in unfettered choices about windows and ceiling heights, curved walls and arched doorways—stone and plaster and wood made intimate, plotted out in blueprints and billed by the hour. Jory had been only four at the time, but they’d bought Lego sets and doll furniture and encouraged her to build the bedrooms and play spaces and closets of her fantasies while the architect took notes. They ended up taking the house down to the studs. The whole remodel took two years and cost more than any new house in the neighborhood. And now it was owned by someone else.

  On the last night before the movers came to haul their belongings away, with boxes stacked so high the house looked like a cubist representation of family memory, Claire had walked out onto the dock that jutted into Lake Washington from their stone retaining wall. She stood under the cold, fixed stars and listened to the silence, felt the cold, damp air, as fresh as any wilderness lake. She had promised herself, when they’d moved in, that she would do this every night—take ten minutes, five minutes, two minutes, to walk from her warm house onto the dock, taste and smell the water and sky that she had paid millions of dollars to “own.” She tried to remember the last time she had opened the doors to the porch after dinner, stood suspended above the lake and looked into its black mirror for falling stars. It had been years.

  She hunts down her hot chocolate one final time—gone cold with a skin of milk floating like an island in a brown pond. The kitchen sink is still hidden under boxes; she walks out the front door and steps barefooted into the snow, taking a queer pleasure in the stinging cold. There is no lake at this house, no dock to allow her to walk over the water. But there are stars, even more brilliant in the middle of winter, in the middle of nowhere. She cranks her neck back and searches for the north star. The cassette tape hisses between songs and then Joni Mitchell is singing, “Still I sent up my prayer/Wondering who was there to hear/I said “Send me somebody/Who’s strong and somewhat sincere.’”

  She listens until her feet hurt too much to stand it any longer, and flings the contents of her mug across the snow. Then she pulls her arm all the way across her body and hurls the cup out as hard as she can, hearing no sound when it sinks into the snow.

  • 16 •

  “How is Gretta?” Jory asks from the backseat. She is dancing a small hand mirror in front of her face trying to put mascara on as the car jounces up the rough driveway.

  “If you want me to drive you, you need to get up on time. You’re going to put your eye out with that thing.” Then, with a sharp glance over her shoulder: “She’s fine. What makes you ask?”

  “I heard you talking to her last night.” Jory snaps the compact shut and stuffs it in her backpack. “It’s a small house.”

  A truck loaded with cattle is grinding up the long hill at the junction with the main road, the animals calling out in low, plaintive wails. Claire clears her throat. “She sends her love.” Then, after a pause: “What did you overhear?”

  “Mainly you promising we’d be back in Seattle soon. So am I meeting you at the bakery again? You’ll get there before they close tonight?”

  “I’ll try, babe. I think we need to split the week, half on the bus, half I drive you.” She waits but Jory is staring out the window, silent until they reach the school. “You know, you could take a friend with you—to the bakery or home in the afternoon. I could drive them back to town after dinner.”

  Jory hikes her backpack onto her shoulder and unlatches the door. “Yeah. Well. We’re just moving again. Aren’t we.” She pauses with the door cracked open, looking at the crowd of kids through the fogged window. Claire turns toward her, sees her glossed lips tense for half a second before she steps out. “Love ya, Mom.”

  It distresses Claire that Gretta is the only example of a grandparent Jory will clearly remember. Her love is genuine enough, but it is, somehow, always… waiting. Waiting for the best moment to show itself. Waiting until times are better. Claire’s father had tried to explain his leaving with many words, all forgiving and hopeful and reassuring. But it was a single sentence about Gretta in his very last letter to Claire that finally caught it: “She’s worn a rut of worry in her mind so deep and comfortable she doesn’t know how to be happy anymore. Nothing’s ever good enough.”

  Anita is finishing her coffee when Claire slips in the back door. “Frida’s looking for you. Waiting room’s already packed. Drink up quick.” She rinses her cup and pours one for Claire but pauses with the coffee suspended between them. “You okay?”

  “Yeah. Just… a teenager.”

  She studies Claire’s face, maybe assessing how much consoling is needed, balancing it against the schedule. “Like they say, toddlers step on your feet. But teenagers, they step on your heart. Dan wants to see you before you start—back room.”

  The door to the urgent care room is half closed; Claire hears Dan talking with another man, a conversation interrupted at moments by a soft laugh, and the voice of a woman, too, all in the rising tones of friendship more than business. She raps on the wood and steps in.

  “Hey! There she is.” Dan leans forward to push himself up from his chair, an arrested instant as he transfers his weight that makes Claire wish she could see his face, want to grasp his arm. And then he is introducing her, though she could have guessed who both people are.

  Evelyn Zalaya looks like her name, tall and lithe, like her body has never gotten in its own way; a narrow, slightly arched nose and finely wrinkled skin that must have been flawless in her youth. Her eyes are a clear, unflinching blue. She must have heard a lot from Dan already; she holds Claire’s hands as if she’s known her for months, asking about Jory and Addison and the old house.

  The man with them is Ron Walker. He’d been in a tux when Claire had met him at the fund-raiser, of course, and even then she could tell that he was not a formal man, uncomfortable in his starched collar and stiff patent leather shoes, as if maybe he had dressed up only to earn more money for the cause. It had made her feel at ease with him, and the wrinkled khakis and somewhat ratty sweatshirt he’s wearing today make him look more like a patient than a donor. He takes her hand, loosely at first, with a question that she sees catch and connect the second he places her, then grips with a firm shake until the bite of his ring pinches. He is taller and thinner even than Dan, but with a soft fullness to his ruddy face, a dense, glowing web of veins over his cheeks and bulbous nose that gives him a perpetually happy look—which could be a hindrance or a convenient ruse in locking up a business deal, Claire decides.

  “Boehning, Boehning. Eugena, right? Addison Boehning—went to Harvard before he came back for his doctorate.”

  “How do you remember that?” Claire asks.

  Walker breaks into a wide grin. “I remember the Newsweek article. I like talent.” He focuses more closely on her then, like he’s separating Claire from his memory of her husband. “How’d we get lucky enough to hook you up with Dan here?”

  Claire flushes at this, her ease abruptly discomfited by a scramble to explain why she is now in Hallum as a resident instead of a tourist. She feels Dan watching her and he taps Walker on the arm. “That phone call you made hit a gold mine, by the way. Got enough antibiotics to purify the whole valley. Come take a look.” He escorts them all into the tiny pharmacy where unopened boxes of sulfonamides, penicillins and cephalosporins are stacked high enough to block the window, and, after some general talk about the clinic and a suggestion for dinner together, Claire slips away, back to the packed exam rooms.

  The hallway is filled with green flags, needy people in disposable paper gowns hoping for experienced advice. Claire looks at the charts propped in clear plastic bins beside each room, wondering if the thickest, most frayed folders would be harde
r because they are stuffed with recurrent illness and unsolved complaints or easier because the patient might speak English. Frida walks in from the waiting room, the swinging gate whapping against the wall with her determined stride. She takes one look at Claire’s face and says, “Start in two. White girl, first time here. I brought a spinach lasagna for lunch.” Then, under her breath: “Sick of damn peanut butter.”

  The girl is eighteen. She sits on the edge of the exam table fully dressed in clothes that are a size too small, wearing pancake makeup so thick it’s impossible to judge the natural color of her skin. Her eyes are ringed with black liner; Claire focuses on the play of light reflecting in her iris and pupil, trying to read her reaction to Claire’s greeting, to her white coat. It takes twenty minutes of oblique questions about vague complaints—headaches and dizziness and fatigue—to maneuver the girl into saying why she’s here, allow Claire to touch her body and see what’s hidden.

  By the time Claire finishes her exam and steps into the hall they are so far behind the waiting room has run out of chairs. She pulls Dan into the office and shuts the door. “I don’t know if I should call the police? Or send her to a women’s shelter?”

  “The nearest women’s shelter is two hours away. The police won’t touch the boyfriend unless she wants to press charges.” He takes a folder out of the file cabinet and hands Claire a page with two names and addresses typed on it. “These are the counselors in the valley who’ll see her for free, but good luck getting an appointment this month. Or next.”

  Frida comes into the office, looks at the names in Claire’s hands and says, “I figured—soon as I saw her. Tell it to me.” She drops a stack of lab slips on her desk and listens with her arms crossed and her head bowed, then takes the piece of paper, scans it quickly and gives it back. “Too young for Medicare, too rich for Medicaid, too broke for Blue Cross. Totally sucks.” She walks out to get the next patient ready, but stops with her hand gripping the doorjamb, turns to look at Claire with her lips in a set line over her bold white teeth. “Get her to make a regular appointment with you. Keep her talking.” She looks uncharacteristically depressed by the girl’s plight, even though Claire knows she’s seen the same or worse a dozen times—like she’s as sad for Claire as for the girl herself. “You’re not going to save them all. You know that, don’t you?” She tilts her head slightly to the side when she asks this, letting Claire understand it is not a rhetorical question, that she will wait here until she gets a response.

  By the close of the day her feet are aching but she has nearly kept up with Dan, thanks to a run of bilingual patients. She finds him sitting at the table in the urgent care room, bent over his knees so the ripple of his spine shows through his thin shirt. He looks up when she comes in, maybe just startled, but she sees a glint of discomfort before he changes his face for her. “Hey,” she says. “Everything all right?”

  He smiles. “Old age. Things start to hurt. Put it off—that’s my advice.”

  Claire laughs. “Yeah. I’ll do my best.” She sits next to him and leans on her elbow, holding his eyes long enough to test him. “You’re sure? You’d let me know if you needed anything, wouldn’t you?”

  “You’re doing it. You’re here.” But now it is his turn to test, and she finds it hard not to look away. He puts his hand over hers with a sound of dry leaves. “Just give what you can. While you can. That’s what I need.”

  Frida raps on the office door and hands Claire another chart with a blank progress note page in it. “Hey. Last one—that lady who only comes in before we’re open or after we’re closed. Only wanted to see you. Room two.”

  The mild irritation Claire feels at having to interview even one more person disappears when she sees Miguela sitting on the end of the exam table. “Hello! I was thinking about you the other day—something on the news about Nicaragua. Did you find any other work? Outside of Walker’s Orchards?”

  Miguela looks puzzled and holds her thumb and first finger up an inch apart, as she had done the night Claire first saw her outside the grocery store. “Más despacio, por favor. Slower.”

  Claire tries her Spanish. “¿Encontrado trabajo?” Miguela shakes her head, but Claire can’t tell if she’s referring to the work or the words. She decides to start fresh, doctor to patient. “¿Cómo puedo ayudar?”

  “Ha encontrado,” Miguela gives her a clear, encouraging smile. Her teacher’s smile, Claire imagines. “Es más correcto. A better way to say. ” They finally settle into a mix of slow, clearly pronounced Spanish and English, a blend and rhythm that works for both.

  She has come with a variety of complaints—a sore throat, a mild stomachache, a cough, blurry vision. Claire’s questions only bring up more disparate symptoms instead of narrowing the possibilities down, until she finally asks when Miguela last had a complete physical exam. “Todo? Nunca. Never.” She shakes her head, raising her eyebrows as if to express that even visiting a doctor could be considered a luxury. Claire is struck, again, by the sweep of her brows, the large, almond-shaped eyes—so disproportionate within her otherwise diminutive features they verge on anomalous, but instead combine to a strangely distinctive beauty. There is something else there, too. Something irrevocable and determined behind the lush lashes, the rich brown irises. The thought flashes through her mind that Miguela is a woman rarely surprised by life anymore, or—worse maybe—beyond disappointment. Like she has no more trust to let go of.

  “Well,” Claire says, after a moment’s pause. “Why don’t we do that today?”

  She runs through the long list of standard questions that builds a record of a patient’s physical life: when Miguela was born, her childhood illnesses and immunizations, when she began menstruating and with what regularity, how many pregnancies she has had and how many children borne. A list of injuries and surgeries and broken limbs, eating and exercise habits, allergies and medications. And throughout, Claire laces in questions about Miguela’s parents and siblings and partners, her schooling and jobs and interests, almost forgetting the late hour of the day, forgetting that Frida and Jory are both waiting.

  Then she begins the physical exam, starting at Miguela’s head and gradually moving down, studying her body in systematic sections—the texture of her hair, the clarity of her lenses and reactions of her pupils, the pearly surfaces of her eardrums, the size of her thyroid gland and the hollows of her neck. Her throat is slightly erythematous—probably a minor virus. Claire listens to the sounds of her heart and pounds her fist down Miguela’s spinal column and over her kidneys. She looks at her nail beds and skin and the straight, true lines of her long bones. She helps Miguela lie flat on the table with her knees slightly bent and presses gently on her abdomen, hunting for the edge of a swollen liver or spleen. Then Claire asks her to wait while she gets Frida in to observe her pelvic exam.

  She guides Miguela’s feet into the padded stirrups and warms her hands and the speculum under water before inserting the blades, then twists the metal stem of the gooseneck lamp to illuminate the cervical os, readjusts the light and looks again.

  Claire starts to ask Miguela a question but stops herself, glances at her notes open on the counter beside her—pregnancies: zero; gestations: zero; abortions: zero; wondering if their mixed languages have gone wrong. “I’m sorry. You said you’ve had a baby? Tiene niños?”

  The answer is the same, stated slowly and clearly pronounced in English and again in Spanish. “I have no children.” But the opening to her uterus is in the shape of a linear slit, rather than the tight circle of a nulliparous woman. It is obvious that Miguela has delivered a child.

  Frida leaves the room after Miguela sits up. Claire asks a few random questions again, only so she can repeat the questions about pregnancy more innocuously, leaving room for different answers that still don’t change. She strips off her gloves and gives Miguela her blouse before labeling the swab and slide from Miguela’s Pap smear.

  “Dr. Boehning, how do you think when you are afraid?”

&nb
sp; “What?” Claire turns around. Miguela hasn’t moved; the blouse lies creased across her lap. It’s such an oddly personal question—it flusters her, coming out of the blue. From the sound of her voice Miguela could be asking about something as simple as where she grew up, what food she eats or books she reads. She puts the glass slides and cultures carefully into a plastic lab bag and sits on the stool. There are hidden problems buried inside many patients’ questions—it is hard enough to tease through them without the barrier of language. “When I’m afraid of what?” she asks.

  “Well, only you can know.”

  Claire thinks about it for a moment. She had been afraid the night Addison finally told her the truth about vascumab, but, really, that had been less fear than a slow, sinking despair. She had been afraid for Jory when her labor came too early, when she had just finished her pediatrics rotation and seen the consequences of premature birth. There had been a car accident in a rainstorm once, the weightless instant of spinning across the wet pavement until time stopped at the moment of impact. She shakes her head, turning the question around to discern Miguela’s need, the root of her fear. “Are you asking how I make a plan when I’m afraid?”

  “No. When you feel danger—for your life. What do you think then?”

  When her life is in danger. How can she answer that? No one has ever shot at her, she has never run from traffickers, or rationed water in 120-degree heat, or struck back at an abusive boyfriend. An answer comes out quite spontaneously, before she can thoroughly consider, but she knows it’s true. “My daughter. My daughter and my husband.” She would think about how much she loved Jory and Addison, and how much she would miss them, how much more she has to do for them before the end of her life.