Public health, she understood, was about providing services to those who were least likely to be good patients. She took their blood pressure, listened to their leaky hearts, tested for STDs, dispensed condoms, instructions, advice. Then the same people came back again and again, with the same complaints, bad habits, and neglect. The name of God might be Truth, but surely his middle name was Patience, to put up with so much repetitive and avoidable folly.
On this Monday, Christie saw a woman whose chest X-ray showed lesions, and a Guatemalan man with an ulcerated leg. The immigrants were always the ones in the worst shape, given to doctoring themselves with their own remedies until things turned truly bad. They couldn’t afford to miss even one day on the job. There were children with pinkeye and earaches, sore throats and rashes. A man on crutches from an accident, and from what he claimed was botched surgery: “They had some beginner practice on me and it didn’t heal right. Then they tried again so he could get more practice.”
The clinic doctor made brief eye contact with Christie, a look that meant drug-seeking behavior. “And why is it that you think the surgeries were unsuccessful?”
“Because it feels like I got broken glass in my hip. Awake, asleep, sit, stand, lie down. Can’t you give me something?”
There was a hungry, calculating look to the man, as if he was telling the truth but it was a story he’d repeated too many times. The doctor said he should go back to the surgeon and tell him he was having problems.
“Like I’d want to have anything more to do with that clown.”
The doctor suggested physical therapy, a pain-management practice. “And tincture of time. We never heal as fast as we want to. You have to measure your recovery in terms of months and years.”
“It’s been almost a year.”
“It may take a while longer.”
“Funny how months can feel like years, depending on if the body in question is yours, not somebody else’s.” He wasn’t going to get what he wanted, and he was unhappy about it.
On his way out of the examination area he lingered, angling to speak to Christie.
“Man, that doc is a hard-ass.”
“So am I.”
He made a pantomime of amazement and mock fear, staggering backward on his crutches. You could still see the ladies’ man, the jokester, the good-time guy in him, underneath all his layers of trouble. His color wasn’t good, and the skin around his eyes and mouth was stretched and abraded, and his arms were ropy where the flesh had diminished. But still he had the remnants of what Christie thought of as ordinary good looks. This registered on her purely as an observation.
She said, “You need to back off on whatever you’re taking. OxyContin? Hydrocodone? After a while your body can’t tell the difference between pain and drug dependency.”
“Yeah, because plain old pain is so much better for you.”
“I’m sorry,” Christie said, taking a step to move past him. She had to attend to the next patient, whose medical history form had been filled out and fastened to a clipboard, waiting for her at the check-in desk. But he held out one of his crutches to block her, making another joke out of it.
“Didn’t used to be so hard to get a pretty woman to talk to me.”
Christie obliged him with a smile. He probably wasn’t a bad sort of guy. Just unlucky or dumb or both. She wondered about the accident he’d been in, if it had involved alcohol. “I think you should do what the doctor told you. Go back and see the surgeon who did the operations.”
He shook his head. He was wearing a baseball cap, that universal symbol of guy-dom, black, with a Raiders logo. “He doesn’t want to see me any more than I want to see him. Doctors don’t like people they can’t fix.”
She thought this was probably true. She was about to say, Excuse me, she had already said it in her mind, when his face spasmed, a quick folding-in on itself. “Ah,” he said, coming out of it. “More good old-fashioned pain.”
She hesitated, wanting to say something to this, but she had no more time to spend on him. On the other side of the door was the waiting room, with its linked orange plastic chairs and unfresh magazines and the play table in the corner for the kids. On the walls, a number of public health posters. The posters showed multicultural citizens looking pleased because they were following the recommendations for condom use, healthy diets, vaccinations. Beneath the posters, on the orange chairs, the crowd of patients waiting to be seen, the conveyor belt of bodily distress that must be kept moving.
And he was already headed for the exit. “Bye, Nursie. Think about me next time you hurt.”
The mind persisted in making thoughts, the thoughts had to be ordered, tamed, redirected. She sat before her little shrine, perfectly still, but it was one of those times when the mind would not allow itself to follow. On Wednesdays and Thursdays she worked in a general practitioner’s office, and though you saw fewer patients than at the clinic, there were gaps of boredom and irritation. The greatest achievement is selflessness. Mother Teresa regarded each of the afflicted poor she tended to as Christ in a distressing guise. But there was only one Mother Teresa, and she would not have been asked to provide diet pills to weight-obsessed Marin matrons. On Fridays and every other Saturday morning, she made visiting rounds to shut-ins and the frail elderly. So much in life was suffering, but nobody ever wanted to die. The name of God is Pain. Mofucker! No. Focus.
The greatest precept is continual awareness. And there were those times when she could sustain whole moments of this, seeing the familiar as if she were seeing it for the first time, with new eyes: the different moods and lights of ordinary concrete, depending on air and sky. A piece of gaudy, fire-colored cellophane trash. The greatest wisdom is seeing through appearances. Maybe she was too judgmental. Too quick to size people up by applying her own prejudices. She wanted to love them and she couldn’t. She had tried to turn that into detachment, into a virtue, but lately it only made her sad.
She gave up and got to her feet, disappointed with herself and her mood. Above her head, the indistinct sounds of Art and Linnea, talking to each other from different rooms. It must have been one of their good nights, Art finding something silly enough or harmless enough to get her to engage. Maybe getting to know a child wasn’t entirely unlike meditation. You kept going at it from all different angles, and once in a while something clicked.
Mrs. Foster was neither a shut-in nor, at present, frail, having recovered from her anxiety-induced heart arrhythmia and breathing difficulties. But she had grown fond of Christie and was willing to pay out of pocket for the home visits. There was really nothing wrong with her, and she might have learned to read her own blood pressure and monitor her pulse. She only needed attention, and sympathy, and who was Christie to say that these were not forms of medicine.
Since Mrs. Foster lived here in town, it wasn’t difficult for Christie to stop by, as Mrs. Foster called it, as if they were chatty neighbors given to sociable comings and goings. To get to Mrs. Foster’s house, Christie left her economy-class apartment next to the freeway and drove downtown, then up into the hills. This was where the celebrities, both current and mythic, lived. There had once been a good many rock musicians and artists, not as many at present. The place cost too much now. Back in the old days, Janis Joplin had lived in Mill Valley. Now there was a television chef.
Mrs. Foster’s house was a marvel of sleek redwood and expansive glass, arranged to take best advantage of the canyon views. There was some Asian-inspired landscaping Christie allowed herself to covet, with weeping cherry trees, peonies, ornamental maples, and bluestone paths. When she rang the front doorbell, it made a deep, bonging sound that was meant to be reminiscent of temple bells.
One of the furious captive cats appeared in the glass panel at one side of the door, hissed and spat and ran away again.
It took another couple of minutes for Mrs. Foster to open the door. She was wearing a spo
rty outfit with a nautical aspect, trimmed with red, white, and blue stars, brass buttons. There were certain looks that seemed to be associated with prosperous old ladies. “Come, come,” Mrs. Foster urged, and Christie did the quick side-step necessary to prevent the cats from bolting to freedom. Mrs. Foster slammed the door shut behind her. “How are you, dear? You look very pretty today.”
Christie said she was fine, and thank you, and followed Mrs. Foster back into the breakfast room, where Mrs. Foster had laid out teacups and teapot and a tray of thin wafer cookies and what looked like candied orange peel. In the center of the table was a bowl of peaches so perfectly formed and ripe and fragrant they might have been a magazine centerfold. “How does ginger tea sound?”
“That would be nice.” She noted that Mrs. Foster’s breathing was somewhat rushed and shallow, as if getting to the front door had winded her. “First why don’t you sit down, and let me check you out.”
Mrs. Foster’s pulse was elevated and her blood pressure into the 160s. “You’re a little speedy today,” Christie told her. “Did you take your pills yet?”
“I can’t believe those things are good for you. They make me feel like I’m a rag doll with the stuffing being pulled out of me.”
Christie said yes, but they were necessary to regulate the system that was not regulating itself, and they had to be taken on schedule. “Do you want me to go get them for you? I can put the kettle on too.”
Mrs. Foster agreed to this. Christie filled the kettle from the kitchen tap and set it on a burner. The medicine was upstairs in one of the bathrooms. As she advanced farther into the house, the smell of cat announced itself. Two adolescent kittens, one orange, one black, raced up the stairs ahead of her. A tiger-striped adult lurked on the windowseat, running off to hide as Christie approached. Cat noises, thumps and pattering feet, came from different rooms.
Christie retrieved the medicine, then took the opportunity to make a quick check of the upstairs. The guest bathroom had two litter boxes in it, neither of them entirely clean or entirely soiled. This meant that at least some of the cats were making use of them, rather than any handy section of carpeting. The bed was made, the laundry picked up. The cleaning service now came twice a week, which helped. The neglected medicine was a concern, as were the cats, which, although they were all supposedly spayed and neutered, seemed to have increased their population since her last visit.
Mrs. Foster was a widow and the cats were a project of her widowhood. First there had been Mr. Foster, all dead and tragic. Christie heard the story a number of times, because it was Mrs. Foster’s heart’s sorrow, the story she’d been left to tell. How she had screamed in disbelief when she’d come home and found him, had fallen insensible on the floor, awakening in the dark next to the dead man. How she had touched his knees and then his cold face, speaking to him in an ordinary way about the things she had done that day. It wasn’t the kind of conversation he had ever taken much of an interest in, and so she was used to talking to herself. It was only a little normal space before she had to get up, make phone calls, and get on with the business of death.
The panic attacks and cardiac symptoms began once the funeral was over. They sent her to the emergency room on three occasions. They came on without warning, and sometimes she had what she called “grayouts,” when her vision turned dim and her ears filled with roaring. Her daughter had come up from San Diego to stay with her, but she was either going to have to find some way to manage on her own, or else make the transition to some sort of sheltered, supervised housing. This was when Christie had first met her. She’d been sad and frightened, huddled in a quilted bathrobe and surrounded by Kleenex. Although her husband had been ill, she had insufficiently imagined his dying.
Christie organized Mrs. Foster’s medicine, checked her vital signs, and listened to her talk about Mr. Foster. He sounded rather disagreeable, or else Mrs. Foster was still carrying on their long-standing marital quarrel, in which he stood accused of insensitivity, sarcasm, and condescension. But she missed him, if only because now there was no one to argue back.
By virtue of her not dying, Mrs. Foster’s health gradually improved. Christie showed her some breathing exercises and brought her vitamins and calming teas. The daughter in San Diego sent a gift basket of spa products and the daughter in New York sent fancy cupcakes. One of them suggested that she might now acquire a small, companionable dog. Mrs. Foster was a great lover of animals, although Mr. Foster would never have put up with one in the house.
Instead the cats arrived. They were members of a feral colony in San Anselmo, and had been trapped by a group dedicated to feral cat welfare. “I thought,” Christie said, when the cats began to take up space with their carriers and food bowls and catnip toys, not to mention their clawing, biting selves, “that you managed feral cats by trapping them, spaying and neutering and vaccinating them, and then releasing them again?”
“Somebody was poisoning them,” Mrs. Foster said, her eyes and nose growing pink at the thought of it. “Putting out poisoned tuna fish. Can you imagine? There’s simply no safe place for them right now. Besides, some of the young ones could get used to people and find homes. They just need a chance.”
And so the lower level of the house, a place where Mr. Foster had retreated to practice his solitary hobbies (woodworking, the construction of remote-controlled rockets), had been turned into a cattery. There were a dozen feral cats in all, and supposedly only the tamest and most tractable were allowed upstairs and given names: Peanut, Handsome Devil, Lola, and Miss Priss. But more and more of them seemed to have migrated upstairs, where they shredded upholstery and hid under furniture, claws shooting out to inflict vicious ankle wounds. They seemed to make Mrs. Foster happy, in the same way that having a difficult husband had made her happy. The feral cat people came over on a regular basis to help with medications, or transport cats to the vet, so there was company in the house as well. “Some people go to the dogs. I’ve gone to the cats!” Mrs. Foster was fond of saying.
Christie came back downstairs with the blood pressure medicine and made sure Mrs. Foster took it. The kettle came to a boil and she filled the teapot, trying to ignore the thing in the corner of the kitchen floor that she was pretty sure was a cat turd.
Mrs. Foster poured out the tea and they drank, looking out to the backyard and its pleasing vista of formal plantings and fishpond and Mrs. Foster’s elaborate collection of bird feeders. The cats, able only to watch from behind closed windows, must have thought they’d died and gone to hell.
“How have you been eating?” Christie asked. “Are you getting enough protein?” Mrs. Foster could be a picky and irregular eater, given to things like cheese and crackers for breakfast.
The nautical outfit made Mrs. Foster look like a captain in some small, loopy navy. “Cooking is so much fuss in this weather. I like a nice salad, watercress if I can get it, goat cheese, toasted walnuts, dried cranberries. You try it sometime.”
“Add some cooked chicken.”
“And a little high-fiber cereal. And some calcium pills.” Mrs. Foster smiled in a way that was meant to be mischievous. She had once been a pretty woman, and there were still remnants of this in her coquettish manner. She had recently had her hair colored, so that it was no longer white but coppery gold. It poufed out thinly over her scalp like a tangled, vining plant.
“Seriously. You have to feed yourself at least as well as you feed the cats.”
“I don’t know how people get excited about cooking for themselves. Where’s the comfort in it?”
“I do every night,” Christie said, incautiously, because any such statement was likely to get Mrs. Foster started on one of her favorite topics, how Christie should find herself a nice man, marry, and have children before it was too late. But Mrs. Foster was listening to the sound of cat commotion in some distant precinct of the house: guttural war cries, attacks and retreats.
“I don’t
know why they have to fight like that,” Mrs. Foster complained. “There’s plenty of everything for everybody.”
“Cats don’t really like other cats. Most of them. They’re solitary hunters.”
Mrs. Foster waved this away. “Well they must get together once in a while. Or there wouldn’t be any kittens. Oh, if there was such a thing as ghosts, my husband would be haunting me day and night. He didn’t have any use for a cat. And he was so fussy about this house. It’s a beautiful house, of course. But it’s not a museum, it’s meant for living.”
Sooner or later, Mrs. Foster’s conversations all led back to her husband, if only to complain about him. Christie didn’t understand their marriage. But then, she hadn’t understood her own. Trying to be discreet, she checked her watch. She had another appointment this morning. She didn’t have much use for a cat herself.
Christie was about to make her final speech about better eating habits, when Mrs. Foster said, “He wasn’t the easiest man to live with. He wasn’t always sympathetic to different points of view.”
Christie murmured that people were, oftentimes, and understandably enough, partial to their own way of seeing things. As she was herself. Her prickly, unbending self. She wondered if she should get a cat. A nice tame cat, not one of the feral hellions. She could pet its rumbly fur, watch its pink tongue paddle in water, attempt to bond with the creature.
“Of course I got mad at him. So mad I’d cry. Oh he could be an aggravating man. I came to understand, it was just his nature. Like the poor cats. There were things he couldn’t help.”
The Humanity Project Page 11
