by Charles Bock
“Instead of fighting being here”—she sniffed—“probably it would be helpful if I told myself, This is where I’m going to get better.”
Oliver ran a hand along Alice’s arm. “If New York magazine spent all that time staking out the Black Tide,” he said, “they must have found an answer about the crabs.”
His face was blank, waiting for a response, which confused her. She easily could have fallen apart. Instead Alice swallowed a laugh.
“I couldn’t get through this without you.” She wiped at the corners of her eyes. “You know that? You know, tu esta?”
He kissed her hand. He whispered: “Tu esta.”
“Really though,” he said. “All those reporters? They had to find out something.”
—
What they found was that the three fresh, polite young people working behind the front desk were backed up to Duluth, and that the exam rooms were all occupied, and that whenever one of those doctors with the bright white lab coats and the expensive ties popped up from the back area, he’d grab a nurse for a quick consultation and scurry off somewhere else. One didn’t need a Ouija board to deduce it was going to be a while before Alice would get called for her bloods, let alone her appointment. She and Oliver filled the lag with hangman—Alice cruised in the first game thanks to blueberry (Oliver praising the word choice as excellent), to which Oliver responded with a feeble plop (Alice sussed it in a snap, a lonely oval marking her single misstep). Alice lifted and turned Doe around and smelled her rear. She wondered if they should try to hold out on changing the baby until they got into an examination room (one of those radioactive waste containers then could get put to good use, most likely). Oliver got up and used a hallway sink to wash his hands, as he’d been doing every nine minutes, even though he hadn’t touched anything since the last rinse except his own pen. He asked a nurse for some medical gloves and blew them up into balloons with protruding blue fingers. In New Hampshire this had worked to distract the baby, but here, the hypnotic effects wore off after a few minutes. In New Hampshire, Oliver and Alice had passed untold amounts of time lying together in her hospital bed and playing rummy; they would remember to bring cards from now on.
Between Oliver’s cleansing jaunts and parlor tricks, while he was getting his ass handed to him at hangman, he and Alice delighted in the sight of their little wonder charming everyone on the fourth floor’s eastern wing, and they further procrastinated about the diaper now sagging with a green slush that Oliver liked to call chana saag, and they reminisced about their shenanigans back in their room in New Hampshire, and they proclaimed themselves incredulous at having nostalgia for that insane time, and they proclaimed themselves thankful for even having the chance to look back, and they proclaimed themselves fortunate for this astounding relationship of theirs, having as much fun in that stupid room as they had, under such ridiculous conditions; and proclaimed they would get through this mess as well, they would survive and look back at all this. Alice also held up a spare issue of New York magazine she’d been leafing through in the waiting room. She told Oliver that the magazine’s spies had indeed learned about a special underground, speakeasy-era, trapdoor entrance to the Black Tide. Instead of printing the origins of those crabs, however, Alice reported, the journalists refused to reveal the answer.
“Hype for hype’s sake?” Oliver made a yanking motion. “The real issue’s whether the Black Tide purchased ad space from the magazine as a trade-off.”
“You honestly think anybody gives a rat’s rear if they flew those things in from Timbuktu?” Alice answered. “People want the mystery. It’s better that way.”
A man was limping—Alice had noticed him earlier, gnarled, with a small mountain rising from his right shoulder. He stopped in front of them. The gray skin covering his skull was stretched, all exterior layers of flesh having been burned away, so that it looked like the angles of his cheekbones threatened to break through. His eyes were freakish, hazel marbles sunken deep into their sockets. He focused on Doe. “What a beautiful, wondrous child you are,” he said. To Alice now: “She’s what—five months?”
“Six, yes.”
“You look at one at this age, it rushes up all the good memories from your own.”
The man said Alice looked superb, her attitude would make the difference. He thanked Oliver for his offer to scoot over on the couch but declined, explaining that couches were murder on his spine, he had a special ergonomic desk chair that he couldn’t sit in without discomfort. Volunteering his name as Cael, he asked which doctor Alice was seeing. “The staff here is excellent. They do everything they possibly can.”
Alice did her best to smile, but Cael picked up on her discomfort.
“Yeah. I know. I’m sorry. It’s a shitty thing being here. Six years now, on and off, I’m in twice a week from Syosset. They’ve done chemo. Radiation. Experimental drugs. Seed implants. Special magical beans.” He chuckled, grimaced. “Every time I was sure they’d got it. They tell you the treatment’s going well. You go into remission, start to get stronger, brick by brick, start to rebuild your life. Then something isn’t right. They do them tests. You get that call. Oh, the spot is back. The spot has spread. Stage four.” He caught himself. “You’re new, Jesus, the last thing you need is to be hearing my shit. I know better, I’m sorry—”
“Don’t be absurd.” Alice tried to smile, her stomach knotting on itself.
“It’ll be different for you, I can tell. You’ve got that beautiful child.”
His smile was trying to be generous, failing. This was a man who knew better than to keep talking, and could not stop himself. “Tumor’s wrapped itself around my kidneys. Who knew cancer could even do that? It’s ridiculous. You wish you could reason with it, explain that the more it grows the quicker that both of us are done. It can’t live and be a happy tumor without me. My only option left is this special surgery. Doc doesn’t even want to try. Honestly, I can’t blame the man. He’d have to remove one kidney, take out the part of the tumor that’s wrapped around that side of my body, and then use a vacuum to suck out the rest. He says surgery would kill me on the operating table. But if they don’t go in—”
Cael took a rolled paper from his back pocket, tapped it out in front of them. “I signed the waiver, absolved the hospital, whatever they want. With any luck today I can convince them…”
He was failing in his effort to be brave, and Alice felt her own failure as well. She breathed in, released outward. She willed herself still. Did her best to stare at this man, to meet him.
Cael swallowed. No longer smiling, his pupils black, fathomless.
This treatment we’re discussing
REQUISITE KNOCKS ACTED as both interrogative (Is it okay?) and warning (Because I’m coming in). The oncologist made sure the door was shut behind him, and joined the already crowded room. Where Alice’s New Hampshire physician had looked as if he’d been ordered from a doctor’s catalogue, this new one, the doctor now taking over her care and treatment, seemed to have been ordered from a more expensive catalogue, one with a glossy sheen and higher price points. A bit taller than six feet and robust, with a thick black field of hair slickly parted to one side, looking lightly wet or gelled, Howard Eisenstatt, MD, was neither as old nor as musty as his name suggested. His face oblong and pale, with a thin layer of baby fat; small brown eyes deeply set and hard with intelligence, his nose long and thin.
Acknowledging neither the nurses nor the other doctors in the room, he focused his attention on Alice, smiling in a manner neither welcoming nor insincere, his handshake strong without being warm. At the end of his lab coat’s sleeve, peeking out from beneath an ivory-white French cuff, half of a chunky, high-end titanium watch was conspicuous. The doctor moved toward Oliver and similarly introduced himself. He completed the formality of washing his hands and stepped toward the office desk, stiffly taking in the dormant baby stroller, the folding chair overflowing with coats and shoulder bags and hanging sweater arms and that single, tiny yell
ow unicorn.
Adjacent to that pile, perched on what Alice realized was the doctor’s prize—the sought-after stool—Oliver was using his toes for leverage, spinning himself and the little one in slow half circles, the child gurgling, holding her blanky, sucking with great affection on her pacifier; now aware of attention on her, she turned away from her father, checked out the nice new man in the lab coat.
Howard Eisenstatt, MD, once more extended those thin lips, revealing that tight smile. Scooting himself upward, he sat on the edge of the desk, stretched his pressed slacks diagonally out in front of him, revealing thin fine socks, perfectly matching his pants’ gray shade. A glance toward his clipboard; Eisenstatt removed a ballpoint from the chest pocket of his lab coat. Repeated pressing didn’t get the pen going. Licking the end was no help. The doctor looked down; fleshy folds of a double chin revealed themselves. Eisenstatt blinked at his pen, as if blinking were an expression of disappointment, as if expressing disappointment to a pen would somehow motivate the ink.
“We couldn’t get a sitter,” Alice said.
She sat, rigid, against the raised slab of the examination table, her left arm hanging straight down between dangling legs. A catheter was plugged in the soft of her elbow, and layers of clear plastic tubing were taped to her forearm. A quiet, head-scarfed woman down the hall was employed solely for the brutally tedious task of starting IV lines and getting blood from cancer patients, and she’d needed three sticks in order to penetrate Alice’s vein. The number remained unsettling to Alice for reasons she would not allow herself to think about (the vein had been found, onward). The catheter had been installed, Fatima had explained, “in case doctors want plasma transfusion. Line ready to go. No problem.”
Watching the doctor mess with his pen, Alice felt the urge to swing her feet, kick up her hot pink socks. Her boots were off so that a second nurse—Requita?—had been able to get an accurate weight. Her socks remained on so Alice’s bare feet wouldn’t come into contact with anything germish. Besides, the exam room was chilly.
“Are you okay?” asked Eisenstatt. “I know it’s been a long day. Maybe some water?”
A rustling behind them, Requita began searching for a paper cup. Now the nurse left the room. At the same time a new woman entered, middle-aged, frizzy-haired Hispanic, unfortunately jammed into a tightly fitting, generic-looking blouse and slack set. She handed Eisenstatt a functional and spiffy-looking felt-tipped pen from her own overcrowded breast pocket. Alice double-checked the laminated hospital ID dangling from that bright purple strap—Dantelle? Yes, Dantelle. She’d come in before. A nurse-practitioner, a kind of cross between doctor and nurse. She’d gone over Alice’s history, sympathized with Alice about childcare, hadn’t been condescending or overboard.
“Water would be wonderful,” Alice said. “Thank you, Doctor.”
Near the elevated cupboards and shelves in the back of the room the final member of this gathering lingered: an attractive Indian woman, almost as tall as Eisenstatt, but willowy in a manner common to Alice’s world, with lustrous long hair, hot-ironed to fashionable straightness, and cords in her neck from too much working out. Dr. Bhakti was a visiting fellow, training to specialize in cancer treatment. She’d been in earlier, introducing herself and going over cursory bone marrow transplant information. She’d also sized up Alice’s outfit. Her glance might have been innocuous; still, Alice had noticed.
At the moment, Bhakti was sitting on the edge of a counter, filing her nails. Her boots were the second pair to capture Alice’s fancy this morning—confirmation that someone needed to get herself new boots.
“We straightened out the problem with your slides.” Eisenstatt read with medium interest from Alice’s file. “So that’s progress.” He flipped a page on the clipboard. “Everything indicates Dartmouth-Hitchcock did an excellent job. Getting you here to this stage was no small achievement. But there are still a few matters that I’d like to review. Can we go back and begin with the first symptoms, before you—”
“The nurse didn’t write that down?” Oliver asked. “None of the three other people who took her history got what you want?”
“I don’t mean to be difficult,” Alice said. “We’re grateful to be here. But we seem to keep going over information your staff asked me ages ago.”
Eisenstatt tipped his forehead, the nineteenth-century gentleman conceding a thorny point. “It’s maddening. You’re going to get a lot of it. Standard medical procedure. We go over things repeatedly. This is our thinking: it’s possible you’ll remember something that deviates from what the nurse heard. You might add a detail that adds to Dr. Bhakti’s understanding of this case. Each time a staff member or doctor hears your story, it gives us a chance to consult with one another, and hear everything fresh in our own ears. It’s an inconvenience for you, I know—”
Dating back to the night of her admission to Dartmouth-Hitchcock, continuing all the way through the morning of her release, Alice had tracked her blood cell counts; she’d made it her business to memorize the names of the nurses, personalize herself to the nursing assistants. Here at Whitman, for the umpteenth time, she was more than capable of verifying that, upon her admittance to DHMC, she’d been given two drugs, Zithromax and ceftazidime, for her pneumonia. (“Lower left lobe,” Alice remembered. “I’m fairly sure that’s what they told me about the pneumonia.”) She had no problem naming which antibiotics she’d been given upon her admission (acyclovir, and also some sort of azole antifungal), or “cytarabine,” the first of her induction chemotherapy drugs, or following up with “the other one. The red drip. Dana Rubenson.”
“Daunorubicin,” the cancer fellow corrected.
“Dana Rubenson makes it easy to remember,” Alice said.
She was counting the days until all this was over and Tilda and a bunch of other girlfriends formed a shopping mob with Alice and made it their personal mission to liberate every sexy pair of boots being held in the clutches of SoHo’s boutiques. Accepting a paper cup—“Thank you, Dantelle”—Alice let herself soak in the relief of sipping lukewarm tap water. She allowed herself to enjoy watching visiting fellow Bhakti retreat back into her little corner.
The moment she answered the next question, Alice knew letting her guard down had been a mistake; she’d confused desonide—the ointment for the facial rash she’d gotten as a side effect of a platelet infusion—with triamcinolone—the ointment she’d been given for her postchemo chest rash.
By then Dr. Bhakti was alert, the nurse-practitioner was having her say, Eisenstatt, too—everyone correcting her.
“It can get confusing sometimes,” Dantelle said.
“You’re doing great”—Bhakti’s voice dripped with honey—“remembering all this.”
Alice half-expected a lollipop. Her own fault. “You are kind,” she said.
Then the vancomycin she’d been given for that nasty blister and skin infection following her IV infiltration. The catheter-port contraption that had required minor surgery to install in her jugular, so they could run the IVs. The heparin drip into the catheter-port thing for the blood clot in the infiltrated arm. The transition from heparin drip to Lovenox pills, which had changed to Coumadin shots, after it turned out her insurance would not cover the Lovenox. Plus her platelet transfusions. And how long it had been since she last had a fever, her ordeal distilled into a connect-the-dots trail of pharmaceuticals and procedures. As if she were speaking about the intricacies and design specs of a blouse collar that she had been struggling with, Alice was as specific as possible about how many minutes after eating two spoonfuls of wheat flakes with sliced bananas she’d felt the cramping along the side of her stomach. She pointed to the right side of her abdomen, explained the shifting, cramps becoming something else, a rush both sudden and desperate, the consistency of her stool becoming watery.
Howard Eisenstatt and the nurse-practitioner shared a look. Eisenstatt speed-read a note from off her chart reporting that, after her induction chemo, traces of a stom
ach virus had been present in cultures taken from high inside her nose and deep in her throat. “Normally the virus goes away with time and antibiotics,” he said. “I imagine that’s been the case here.” He ordered the nurse-practitioner to take more cultures. “If the virus has reappeared,” Eisenstatt continued, “we need to make sure it just stayed in your stomach. I don’t want you to worry. If it comes to that, we have a drug that eliminates the bug. You can take it through an IV.”
“Even if the bug did get in your bloodstream,” Dr. Bhakti said, stepping up. “There’s an experimental form of the drug that’s been testing to encouraging results.” She crinkled her nose. “Only one potential problem. A number of patients have had some side effects.” Realizing what she was saying, “The, ah, most problematic…being”—her voice slowed—“well…diarrhea.” She waited. Then, for emphasis, added, “Dangerously explosive diarrhea.”
Oliver snorted, looked at her as if she was crazy. “You’re going to cure my wife’s diarrhea with a drug that causes dangerously explosive diarrhea? If it comes to that?”
Almost as a reflex, he checked with Alice, meeting her eyes, anticipating unhappiness with his flippancy.
“We’re not letting them do that to you,” he said.
She emanated gratefulness, relief.
“We’ll try with what we have,” Eisenstatt answered, “if it comes to that.” The doctor leveled a gaze at Bhakti, his irritation obvious. “And you’re still taking the Coumadin shots every day?”
