The night sky flashed purplish white: first zigzag of lightning from out beyond the marsh.
I counted one thousand six, one thousand… before the thunder started rolling toward me across the heat-stilled acres of cattails and brine, kettledrums leading into some doom-riddled Beethoven finale.
The fireflies winked out with the first fat drops of rain. One more bright flash with an instantaneous crack-and-bang and then the rain rushed earthward full-tilt, hot and wet and soothing.
I set my glass down on one of Julie’s delicate little side tables and clenched both fists, aching to pound the rest of Setsuko’s pearly teeth down her swan-like throat.
Skanky cunt.
My HMO’s wait for a new-patient pediatrician appointment was nine weeks, so I settled for one with a nurse practitioner two days later. I’d picked the office complex closest to our new house, which was an hour’s drive from Aunt Julie’s.
As we headed into the crush of Boston-driver morning insanity on Route 128 some butthead in a Camaro cut me off, and then traffic stopped altogether.
The Camaro pulled forward, and we were finally going slowly enough that I could read the sticker on its rear bumper:
NICE PEOPLE SWALLOW.
I hadn’t laughed that hard in a year, at least. Maybe five.
The windows were down and the sound of me laughing frightened a dozen crows into the air, flapping and cawing in panic, swirling upward like a chunky whirlwind of soot.
I’d picked out our new health insurance plan, and to tell the truth I’d probably done a crappy job of it. Dean’s new employer had mailed us jewel-toned pocket folders from three Boston HMOs, crammed with medical marketing fluff: large type, catchy bullet points, and big color photos of beaming, fit, and strategically ethnic catalog models. The fine-print stuff that actually mattered was tucked in behind on forgettable onionskin, extensively footnoted, and utterly impenetrable.
Figuring it would’ve been impossible to figure out which of these three meds-keteers was apt to screw clients over the worst until after one of us had thoughtlessly lost a leg to a passing express train or come down with a bad case of leukemia, I crossed my fingers and signed us up with Harvard Pilgrim.
Fuck it, if I ever needed chemo, maybe I could show them Great-Grandmother Fabyan’s Society of Mayflower Descendants certificate and ask for a discount.
Their Watertown medical center had a big parking lot with several hundred cars already jammed into it. Having forgotten the stroller Aunt Julie had found me at a garage sale back in Hamilton, I hoisted Parrish and India to my hips and started slogging across the acres of shimmering asphalt.
Pediatrics was on the fourth floor, and I was breathing hard by the time I deposited the girls next to a pile of plastic trucks and locomotives on the alphabet-carpeted waiting room floor. One of the ladies behind the chest-high reception counter took my name and co-pay before handing me a clipboard thick with triplicate forms and a ballpoint pen to which someone had affixed a large plastic daisy as an anti-theft device.
I kept a weather eye on the girls and attacked the blur of waivers, disclaimers, medical histories, state lead-testing requirements, vaccine schedules, and who-the-fuck-knows-what-Faustian-else for the next twenty minutes, stopping only to shake the cramps out of my hand.
I handed the forms back in and joined the girls on the floor for another half hour past our scheduled appointment.
Parrish had her thumb in her mouth and a plastic dump truck upside down in her lap so she could spin its front wheels with her free hand. India had unearthed one of those Fisher-Price wheel-of-fortune things that make different animal noises when you pulled the plastic cord.
After its ninetieth “moo,” I was thinking this plaything would make a deeply satisfying skeet-shooting target, but India was loving it and talking right along with the voice inside, so I gritted my teeth and let her keep cranking it up.
Twenty minutes later, a young nurse took us back to the exam rooms.
Another fifteen minutes later, the nurse practitioner walked in.
She was wearing big glasses with Life Saver–green frames, white clogs, and fuchsia scrubs with black-and-white cartoon cats and dogs on them. She flipped through the paperwork, reading the girls’ heights and weights aloud.
“Fraternal twins?” she asked.
“Yes,” I said, gently stopping India from bunching up the exam-table paper with her fists, telling the nurse each girl’s name.
“Full term?” she asked.
“Three days past the due date,” I said, knowing the drill. “India was Baby A—seven pounds. Parrish was six pounds, nine ounces. Vaginal birth, no complications. Good Apgar scores. Up to date on their vaccines.”
She smiled, jotting on her clipboard. “And you just moved here from Colorado? I hear it’s pretty out there.” Local chick—no r’s in her “heres” or “theres.”
“Couple of weeks ago. It’s nice to be back on a coast.”
“Massachusetts requires that all toddlers get a blood test for lead, okay?”
I winced, hating the idea of needles in my daughters’ chubby little biceps. “Okay, I guess.”
“We’ll send you down to the lab for that. Any other concerns?”
I took a deep breath. “Well, Parrish’s godmother Ellis saw some documentary on PBS a couple of nights after we stayed with her on our way east, and now she thinks Parrish might be autistic. I read up on it in a bookstore yesterday and to tell you the truth, the symptoms sounded more like me than either of my kids, but I told her I’d check it out.”
The woman looked up at me, smirking with a little shake of her head. “Trust me. If your kid’s not sitting in a corner spinning plates, you have nothing to worry about.”
I was starting to like her. Maybe she could call Ellis for me, deflate the hypochondria a little.
“For the first year,” I said, “Parrish hit all her developmental milestones before India did—rolling over, sitting up, standing. Our pediatrician back in New York got me all worked up about that. Now India’s pulling ahead a little. I figure maybe twins take turns.”
She nodded. “Kids do things at their own speed, in their own time. I get moms in here who have conniptions if they can’t tick everything off on a monthly checklist in some parenting book. You’ve got the right attitude.”
I thanked her.
“I mean it,” she said. “Half the women in here, I just want to tell them to relax, you know? Ninety percent of good parenting is patience. I get the feeling you’ve mastered that part of the job.”
“I don’t know if it’s patience so much as exhaustion, most days.”
She grabbed another form from a brown-plastic display thing screwed to the wall next to the cotton-ball-and-tongue-depressor cabinet, handing it to me along with her pen and clipboard. “Fill this out for Parrish, all right? You can tell your friend you covered all your due diligence. Any kind of screening starts with communication, at this age. Meanwhile I’ll get started with Miss India, here.”
I sat on a chair with Parrish and the clipboard balanced on my lap.
The form had a list of ten questions beneath the heading “Speech and Language Milestones, 18–24 Months,” with checkboxes for “yes” and “no.”
The first few questions seemed silly, starting with Do you know when your child is happy and when your child is upset? Well, duh.
But toward the middle of the form I had to think harder.
Does your child point to objects?
India was patting the animals printed on the nurse’s shirt, saying “Dog! Cat!” Parrish leaned into my shoulder, thumb still in her mouth as she hummed a little tune to herself.
About how many different words does your child use meaningfully that you recognize (such as baba for bottle; gaggie for doggie)?
I looked up at the nurse again. “This might be kind of a dumb question,” I said, “but what does it mean when they ask about words your child uses ‘meaningfully.’ Parrish uses a lot of words and phrase
s, but sometimes it’s like she just enjoys saying them, not like it’s for any particular purpose.”
The woman smiled at me, nodding. “It’s probably a good idea to make a note of that on the back of the form, okay? Just describe the kinds of things she says, give them an idea.”
She picked India up from the exam table. “All done, sweetie.”
I carried Parrish over to her, taking my seat again with India in my lap.
“Hi, Mummie,” she said, patting my cheeks with her hands.
“Hi, sweetheart,” I replied, kissing the top of her head.
The form’s next question made me grip the pen harder, my left arm tightening around India’s waist.
When you call your child’s name, does he/she respond by looking or turning toward you?
I checked the “no” box.
Does your child pretend to play with toys (for example, feed a stuffed animal, put a doll to sleep, put an animal figure in a vehicle)?
I thought about how the girls had just played in the waiting room, India interacting with the available toys, Parrish quietly spinning another upside-down truck’s wheels as it lay in her lap.
Another “no.”
Does your child follow simple commands without gestures?
I put the pen down.
Seven no’s.
The nurse pressed her stethoscope to Parrish’s bare chest and my daughter let loose a peal of laughter, kicking her bare heels with delight against the exam table’s vinyl-upholstered front panel.
“Is that ticklish?” said the nurse, smiling along with her.
“Ticklish!” cooed Parrish, kicking her feet again.
Nothing to worry about. Nothing at all.
“Beautiful, healthy girls,” said the nurse, when she’d finished up.
I gave her the clipboard back and thanked her.
She glanced down at the questionnaire at the top of the pile. “They’ll call you at the front desk with paperwork you’ll need for the blood test in a few minutes. And to make appointments for the girls’ next checkups.”
“Okay,” I said.
She tapped a finger against the edge of the papers. “Let’s make you one with speech and language, too.”
I must have blanched because she put a reassuring hand on my shoulder the moment she looked up.
“It’s just routine, honey,” she said, “and I think Parrish is absolutely fine, all right? Kids develop at their own pace—like we were talking about. But they’ll want to take a look whenever you answer ‘no’ to more than three of these questions. It’s a precaution, that’s all… test her hearing, things like that. I’ll see if I can get you in this week. Then you can call your friend, tell her everything’s checked out.”
I nodded.
“She’s gonna be just fine, I promise. And you can tell your friend that autism’s incredibly rare. Less than one case in fifteen thousand births. Then Rain Man comes out, right? Another thing for the nervous moms to obsess over. But we’ve never had an autistic child in this practice. I’ve been here twenty years, and I’ve seen just about everything else.”
“Okay,” I said, incredibly relieved.
“You’ve got two terrific kids here, and you’re doing a great job with them. I don’t want you to worry about this. You look exhausted, and Lord knows twins will run you ragged. Not to mention you just moved here, right?”
“I drove across with the girls, from Colorado,” I said.
Her eyes went wide. “Alone?”
I shrugged. “Yeah.”
“Now, that takes guts.”
“My husband still has some work to finish up out there. He’s due in tomorrow night.”
“My Teddy ever tried making me drive our kids cross-country without him, back in the day? He’d still be sleeping in the garage.”
“Actually it was kind of fun,” I said. “I blew bubbles for the girls to chase around on rest-stop lawns every couple of hours. And I didn’t have to do any dishes, which was totally awesome. The only bummer was when we got to Kansas City late at night during an undertakers’ convention. Wasn’t a motel room for miles—I had to drive all the way to Leavenworth.”
She laughed. “See? You’re one tough cookie.”
India decided this was the perfect moment to trot out her new favorite sentence: “Mummie farted!”
I bit my lip, trying not to encourage her by laughing.
“That India’s gonna be trouble,” said the nurse, shaking her head as she stifled a grin of her own.
58
Sometimes, the worst possible shit in life unfolds slowly, inexorably. And I think maybe that’s harder to take than sudden disaster—tornadoes, car crashes, spontaneous combustion. That kind of stuff, it slaps you into fight-or-flight instantly. You can’t even think about it. You’re just there and you have to dive in, no questions asked. You make it or you don’t.
The slow tragedies, though… suffering that inches forward just outside your line of sight, one appalling grain at a time, until it’s too late? You look back and can’t believe you didn’t know, didn’t appreciate the last precious, unsullied time while it was building all around you, eating away at the walls and the floorboards and your very marrow.
The most awful thing that’s ever happened to me took a month. Well, it was happening even before that month. The month was how long it took for the experts to weigh it and poke and pry and type up the reports.
First the nurse practitioner. Then an audiologist, who passed me on to a speech pathologist in the office next door.
That prompted a diagnostic panel, two weeks later: eight clinicians, a playroom with a one-way mirror, signing release forms so they could videotape the session.
Me and Parrish in that little room for two hours, people coming in and out. Colored blocks. Different toys. Tests. Questions. Play-Doh.
All of them trying to get her to look up, engage, speak.
Parrish did cheerfully utter what had lately become her two favorite phrases: “Happy Birthday!” and “Winnie-the-Pooh!”
Apropos of nothing in particular. Giggling. Not really looking at any of us.
And still, I didn’t know.
None of it scared me, and it fucking well should have.
After the little white room there was a big beige one. A round table, lots of chairs.
We all sat down. I had Parrish on my lap.
And they didn’t say anything, not at first.
Or look me in the eye.
I smiled. “So?”
The woman directly across from me put down her clipboard. Dark-haired, nice-looking. Maybe ten years older than me. Child psychiatrist.
“Madeline,” she said, leaning forward so her lab coat bunched up a little, hands clasped on the table in front of her.
She looked up at me.
“Yes?”
“Parrish is a wonderful little girl,” she said. “Gorgeous. Very sweet. And you’re wonderful with her.”
“Thank you,” I said.
“It’s… We’ve agreed on a diagnosis.”
“Okay.” I rubbed Parrish’s belly, jiggled her a little on my knees.
“This is what we classify as PDD-NOS,” the woman said.
I waited.
She smiled at me just a little, her eyes crinkling up. “That stands for ‘Pervasive Developmental Disorder, Not Otherwise Specified.’ ”
I nodded. “Um, okay… I don’t know what that means.”
“It’s relatively recent terminology, actually,” she said. “Describing a newly recognized, well, subtype of an existing disorder.”
“Of which disorder?”
I still didn’t get it, that her next word would be the poleax, whistling down toward the back of my neck.
Sharp enough to slice clean through a sheet of paper, a column of bone.
One word to cleave my life in two: before/after. Ignorance/devastation.
“Autism,” she said.
It was twilight out, when I carried Parrish up the stairs to ou
r new place. Everything soft outside, purple.
Dean was on the sofa in the living room, watching India play on the floor.
I stopped in the kitchen doorway, Parrish quiet, straddling my hip.
How the fuck do I even begin?
He looked up at me. His eyes were red, the lids swollen and puffy. He inhaled a ragged breath and I watched tears slide down his cheeks.
I walked over to the sofa, sat down beside him.
He knows already. Okay.
He reached for Parrish, pulled her over onto his lap, pressed her head against his chest. He rubbed her back and she started sucking her thumb, relaxing into him.
“Bunny?” he said.
I took his nearest hand, twined our fingers together.
His breath caught in his throat again.
“Shhhh,” I said. “It’s okay. We’re going to get through this.”
He shook his head. “Setsuko hung herself last night.”
I took my hand back, then got to my feet and reached for Parrish.
“Please tell me the bitch is actually dead,” I said.
Parrish wrapped her legs around my waist, laid her head to rest against my collarbone.
Dean slumped forward, and then he had the gall to sob.
“For fuck’s sake,” I said. “Tell me she got that right, at the very least. The suspense is killing me.”
He didn’t say anything, just nodded.
“Excellent,” I said. “Outstanding.”
Dean looked up at me, haggard.
“Oh, please,” I said. “You expect me to feel sorry for her?”
He didn’t answer that. Didn’t ask how it had gone with all the doctors that day.
More tears.
I shrugged. “News flash: Madame Butterfly had a happy ending.”
I turned away from him, lowered Parrish gently to the floor beside India. Stood up again.
“Bunny—”
“Tell you what,” I said. “I’m going to go to the kitchen. Pour myself a beer. So I don’t fucking punch you in the face right now.”
He had the grace to blanch, I’ll give him that.
I got my beer—last bottle in the icebox. Popped the top off. Carried it back into the living room.
Dean’s head was bowed, hanging low and slack from his shoulders. A bull resigned to the coup de grâce, one he richly deserved.
Valley of Ashes Page 31
