Healer: A Novel

by Carol Cassella

  Claire dials the number and waits through six rings, about to hang up when a woman answers. She listens for a moment and clicks the receiver down.

  “What is it?” Miguela asks.

  Claire shakes her head. “It was some company. A business.” She brushes her hand across the page, as if the numbers might magically appear more clearly or change altogether into an obvious solution she should have put together from the start. At least, she thinks, it’s unlikely a brothel or drug house would hire such politely professional office staff. “Maybe I dialed wrong. Or the phone number could have changed since Esperanza lived there.”

  She dials the number once more; this time the woman answers after only three rings. Claire’s finger hovers over the button ready to disconnect the call; she’s crazily embarrassed about disturbing this complete stranger again. But now, when the woman answers and states the name of the business, Claire recognizes it.

  She hangs up and walks back to the record shelves, this time hunting through the As until she finds Rubén Aguilar’s chart. She already knows the contact phone number and address are out of date, doesn’t bother to compare them to Esperanza’s. She is looking for the single, loose slip of paper she had scribbled his address and new number on, riffling through the pages, shaking the chart upside down with no luck. Miguela is watching her, visibly restraining herself from interrupting. Claire stops to think for a minute, tries to slow her mind down so she can remember.

  Miguela reads the name off this other patient’s chart. “Who is this man?”

  “I think he was there. At Optimus. I’m sure that’s who answered the phone.…” She stops, remembering at last where she’d put it. She pulls her cell phone out from the clutter of her purse and punches in the first three letters of Rubén’s last name. The same number they have just called pops up in the screen.

  She turns to Miguela again. “Tell me. One more time. Tell me what Esperanza said about the house.”

  Miguela begins to repeat what she has said before, glimpses of something like a hotel or a boardinghouse, confused with memories of medications and needles and blood, all of it mangled by Esperanza’s illness, by Miguela’s grief, by an imperfect translation between Spanish and English. It’s a senseless history if you listened to it rationally or considered it skeptically, degenerating more every time she tells it. Claire can see that Miguela is distraught.

  The computer screen has already gone dark, but jumps to life as soon as Claire touches the mouse. She clicks onto the Internet and types in Optimus; a dozen different companies fill the page. Then she refines the search, adding the words research and Wenatchee, Washington. The screen goes white while the slow clinic connection filters through to a new list—the top link connects directly to OptimusResearch.com, a blue and white scheme with the words Optimus Clinical Research in bold letters, slanting across a broad band of graduated color. Above the company name a man and woman in white coats consult over a clipboard. The man appears studious, handsomely graying with a stethoscope looped around his neck; the woman is blond and smiling. Underneath the logo a string of quotes float by, like banners pulled by a prop plane across a blue sky:

  Fastest track to FDA approval in the U.S. market

  Safe, Secure, Efficient

  Optimus brought our drug to patients in record time at half the cost.

  “What is it?” Miguela asks.

  “It’s a clinical research organization.”

  “I don’t understand.”

  “Research. Like a laboratory. Laboratorio. They help drug developers test new drugs.” She closes both charts and holds them in her lap, creases the empty cardboard folder labeled ESPERANZA RUIZ and puts it into the trash can under the desk.

  Miguela’s eyes are closed and she is sitting very straight and still, as if she is blinding herself to the world. As if she’s praying. Claire remembers the first night she saw her, how terribly cold she must have been. “Miguela, let me take you home. I’ll go see Dan. At least, maybe, we’ll find out what made her sick.”

  • 32 •

  By the time she drops Miguela at the house and drives to Dan’s it is after six thirty. She hesitates a minute, wishing she had stopped at the store for a gift—food or flowers. Then she picks up both Esperanza’s and Rubén’s charts and walks up the driveway, passing Dan and Evelyn’s old Buick, rusted in spots along the bottom from years in this climate. Evelyn’s purse is sitting on the driver’s seat. Claire lifts it through the open window and rings the doorbell. The lilacs are in full bloom now, exuding a sticky-sweet scent, swarming with bees.

  “Did I leave it outside again?” Evelyn asks, pushing open the screen door.

  “In the car.”

  “Yesterday it sat on the front porch half the day before I tripped on it going back out to the store. Lucky we live in a safe town. Come on in, he’s on the sofa.”

  “Is he up for a visit?”

  “Tired. We spent the last two days in Wenatchee getting a new stent—I try to stack up the doctors’ visits so we only have to make one trip a week. Really wears him out.”

  The usually neat gray weave of Evelyn’s chignon is feathered with wispy tendrils escaping the clasp of her painted leather barrette. The smells of the house have altered—something sharp and medicinal is in the air. Evelyn touches her shoulder and heads toward the small kitchen, murmurs something about tea. It takes Claire a moment to find Dan in the dimly lit room. She tries not to react to the change in him.

  “Hey there,” Claire says softly.

  Dan stirs and opens his eyes. When he sees her he pushes himself up on the sofa so that he approximates a sitting position, waves his hand at her, a gesture that should appear casual and lithe but instead looks like the static moves of a stick man. “Hey yourself. You’re starting to stop by pretty frequent. Should I be dusting off my black frock coat?”

  “Not unless you know somebody who’s getting married,” Claire answers, pulling a chair around to face him, determined not to let him see how alarmed she is by the weight he’s lost in five days.

  “You just getting off? Whole point of working in that podunk clinic is to get home at a decent hour.”

  “It’s Sunday. I was trying to clear my desk.”

  “Sunday,” he repeats, pausing with a shake of his head.

  “Anyway, Frida’s already ratted you out. I know you never got home before seven until you hired me.”

  Dan smiles at her and straightens up a bit, one hand guarding his abdomen. Evelyn brings in a tray with a porcelain teapot, cups already rinsed with steaming water in the English way, a saucer of ginger cookies, a pitcher of cream, and a jelly jar lid filled with pills and capsules. She pours tea for Dan and hands him the jar lid. He lifts his cup in a mock toast and throws the medications onto the back of his tongue one at a time, chased with a swallow of tea. He wipes his mouth with his sleeve and Claire sees his hand tremble.

  “I left a mess for you to clean up. My apologies.” He laughs once. “I always planned to get better organized.”

  “We’re making it, Dan. Rosa and Anita are both working part-time. We’ve told Anita she’s not allowed to have her baby till Christmas. And Frida can take care of most patients on her own, you know that. I just cosign her scripts.”

  He nods, his gaze fixed at some distant point out the window. Then he turns to her with a completely focused look, a resilient voice. “I want you to call me with any question at all. I’m leaving so much undone—that’s the worst of it all. Call me. At least I can tell you where to go for money when you run out.”

  Even with this perfect opening Claire finds it almost impossible to ask him about Esperanza. It sounds ridiculous when she starts piecing the questions together in her own head. Could Dan know anything about Optimus Research? Is it purely coincidence that two patients who used to work for Ron Walker had the phone number for Optimus listed in their charts and then turned up with liver damage—fatal in Esperanza’s case? She should call Optimus again herself, ask them flat out how l
ong they’ve even had that number. “I mainly need you to convince the men I’m trustworthy.” She looks down at her hands, running one thumbnail under the other, suddenly awkward about the transition, however tangential, to his mortality. When she looks up, though, she can see in Dan’s face that everything will be all right, whatever she needs to say to him. “We put an ad in for another doctor.”

  “’Bout time!”

  “Yeah. Anita wrote it as ‘salary commensurate with experience,’ but Frida said we should change it to ‘salary commensurate with the depth of your gullible, bleeding heart.’”

  Dan laughs with his head thrown back, a sound like something rusted breaking free. Claire feels lifted by the ring of it, risen to a place where she can see beyond her tense, circuitous guessing game with Miguela in that deserted office, over nothing more than a sketch of facts and her own dread that Ron Walker—Addison’s golden parachute—could be tainted.

  Dan wipes his eyes with a napkin from the tray, settles back on the sofa with a relaxed smile on his face. “I need to go to the bank Monday. I’ll do it during lunch, if you’ll meet me there. I need to make you a cosignatory on the account.” She would have trouble meeting his eyes now, except for the matter-of-factness in his manner, as if he were telling her where to buy new business cards or thermometers. “Ron will give you whatever you need.”

  It’s jarring to hear Ron’s name now, like Dan has been reading her thoughts all along. Another example of the multiplying coincidences that truly can occur in a small town. Claire wonders when Ron learned about Dan’s cancer. Before their dinner together? Was he so capable of separating his charity from his business he hadn’t given a clue away? Or was it pure professionalism, respecting her option to move in a different direction than her husband?

  After a few more minutes of conversation she sees Dan’s eyes begin to lag. “You’re tired. I’ll come back. Or I guess I’ll see you Monday, won’t I?”

  “It’s the morphine. I’d make a lousy addict.”

  Evelyn must have been listening. On that cue she comes out of the kitchen and walks Claire to the door, keeping the conversation roving around Jory and cooking and her garden, breaking off a heavily drooping branch of lilacs for Claire to take home. Only when Claire bends to kiss her cheek does she clutch Claire’s shoulder, fiercely, quickly, the flash of distress gone almost the moment Claire feels it. Then she stands with her perfect, elegant posture and tucks the lilacs into the top of Claire’s purse, hundreds of tiny purple petals scatter through her brush and wallet and loose change. Evelyn gestures with her clasped hands at the manila folders under Claire’s arm. “Do you always take patient charts with you when you visit your friends?”

  “Oh…” She gives an awkward laugh. “I had a question. It’s not important.”

  Evelyn puts one hand under Claire’s chin; her fingers are warm and soft. Claire remembers a moment a decade ago when her own mother had stroked her face in comfort after the last miscarriage, when she knew she couldn’t bear to try again. It was the last time she had truly felt like her mother’s child. “Claire? If you need to ask him anything, you should do it now.”

  Claire sits on the dining room chair again, with the two charts on her lap. “Dan?” She whispers his name with her hand resting lightly on his knee, sees him struggle to open his eyes.

  It takes him a moment to focus, but then he smiles. “Monday already, huh?”

  “I’m sorry. If you’re not too worn out, I do want to ask about a patient. You only saw her twice, I think. You may not even remember.” He grins, as though he remembers every patient who’s come through the clinic, year after year, a flood swelling and ebbing as they follow crops like a tidal current of human labor—anonymous, undocumented, infinitely replaceable.

  “What’s the name?”

  “Esperanza Dela Estrella Ruiz.”

  Dan is quiet. For a moment she thinks he has fallen asleep again. But then she sees him nod, just a tuck of his chin. He squeezes her hand once.

  “I found her chart. Charts, actually. She had two, under different names.” He waits for her, seems to want her to lead. “She’s Miguela’s daughter. I promised Miguela I’d try to find out what happened. That’s the real reason Miguela came to Hallum.”

  He sighs, a raspy shudder of breath. “What did you find in the chart?”

  “You thought she was pregnant. She had a little edema, nausea. Her period was late. You ordered some labs and a pregnancy test.”

  Dan’s blink is slow, drugged, or maybe just worn out, but he is quick in his response. “I ordered liver functions and a hepatitis screen.”

  Claire considers how to put the story together so Dan might comprehend how it’s impacted her. “She came back a couple of months later, weeks after you’d scheduled her follow-up.”

  “And the lab results showed a negative pregnancy test. Her liver enzymes were all high. Bad high. But her hepatitis screen was also negative. Albumin was down, platelets were down, red blood cells were low.” It’s as if Dan is reading the eight-month-old lab results from the page.

  “Your note says…” Claire starts.

  “It says she had hepatotoxicity. Liver damage. Probably drug-induced.” He stops again, a crease of worry between his eyes. Or maybe pain. Claire glances at his hands to see if he presses one against his abdomen, the way he had for so many weeks before she’d learned why.

  “Do you know what drug?”

  He frowns briefly, then looks at her and shakes his head. “I didn’t have a chance to run any other tests on her. Could have been anything from pesticides to Tylenol.”

  “I know.” Claire nods and licks her lips. “I know.” She takes the other chart in her lap and opens it on top of Esperanza’s. “But I had another patient, too—Rubén Aguilar. I told you about him a few months ago. He had the same picture—liver damage, viral hepatitis screen was negative. He must have moved away after I saw him; he missed his next appointment. The weird thing is, he and Esperanza had the same address for a while. Or at least the same phone number. I called—it’s a clinical research organization. Optimus Research. The kind of place that runs investigational drug studies. They both used to work at Walker’s Orchards. And then they both ended up at this Optimus place. Both ended up with liver damage.”

  After a long pause Dan says, “Maybe I’m not following you here. Are you trying to connect Ron to this research outfit? He’s the biggest employer in Hallum. Half the migrants in the valley work for him at some point.” He winces when he says this, a look that could be mistaken for annoyance if Claire didn’t understand what he was going through, didn’t fully comprehend how much he owes to Ron. He seems distracted by the pain for a moment, then scans Claire’s face, something deeply personal in his eyes. “Why did Miguela come to Hallum to find Esperanza?”

  “To find out what happened to her. Miguela’s convinced someone is to blame—that it was intentional. She thought Esperanza was pregnant when she got back to Nicaragua. I guess she had enough fluid in her abdomen—ascites—to look pregnant. From Miguela’s description, the bruising and swelling and confusion, I assumed it was toxemia. It was a miracle Esperanza made it back to Nicaragua at all.” She pauses, leans forward a little. “It wasn’t until I found the second chart with the lab results, found out she wasn’t ever pregnant, that I knew she’d died of liver failure.”

  The change in Dan’s face is immediate. Claire realizes that he has been listening to this story with some degree of hope, now completely upended. “Oh, Dan! I’m sorry. You didn’t know she died.”

  “No.” He covers his face with his long, thick-jointed fingers, pulls them down his cheeks so she hears the brush of his cracked skin across his beard. He lets out a small gasp and rocks back and forth once. “No. I guess I knew it on some level.” He sighs again and struggles to collect himself. “Esperanza didn’t get to Nicaragua through any miracle. When she came to see me the second time she was pretty sick. Jaundiced, swollen. Too sick for a clinic. I drove her to the emerge
ncy room. Stayed with her until they told me they were admitting her. I expected she’d be in the ICU within another few days if it didn’t turn around, she looked that bad to me.”

  “What happened?”

  “I went back the next day. To see her. They told me she’d left.”

  Claire sits up straighter in her chair at this. Dan almost seems to be waiting for her to tell the rest of the story. She tilts her head. “How could she have been discharged if she was that sick?”

  “You really don’t know? No guess?”

  Claire shakes her head.

  “They stabilized her and put her on a plane. They bought her a ticket back to Nicaragua because it was cheaper than hospitalizing her.”

  “I don’t believe it. They would send her home rather than treat her?”

  Dan pulls the blanket closer about his waist, shifts his torso like he can’t get comfortable. “My dear, the only positive thing I have to say is that I’m thankful such a thing still surprises you.”

  • 33 •

  The sun is already setting when she reaches the top of the long driveway. A forest fire has been burning out near Chelan and a south wind pushes the smoke their way, the sunset bleeds strange and thick with unnatural purples and reds.

  Claire parks and sits in the car, watching Addison move between the windows like panels on a movie screen. He’s getting dinner on the table, opening a bottle of wine, pointing to something Jory is reading. Nothing comes to Claire, no clear way to talk to him about Optimus. Not even clarity on the rightness or wrongness of Walker’s possible involvement.

  She picks up the medical charts and her purse and gets out; the air smells of burning wood and scorching earth, a primitive impurity in it. The silhouette of the old barn looks as if the first summer storm will knock it to the ground. But it has stood long enough—through a world war and polio epidemics and a burned-down aspen grove that has already grown back dense and strong. That barn had outlasted the Blackstocks and will outlast the Boehnings.