by Charles Bock
“You’re still the poor sonofabitch who’s got to stand strong.” Ruggles’s tongue flared, licked the foam from his lip. “You have to strap up for battle and take care of your family. You’re the one carrying the burden. It’s bullshit and it sure ain’t fair, but that’s the deal. The shitty business of being a man.”
—
During that most indulgent stretch of the eighties, in the wee hours of those wild nights, back when stockbrokers and club freaks had finished their cross-cultural tangles on the various dance floors of Limelight, or had tired of dry humping in the most impenetrable crannies of Tunnel, or had chopped out their final lines on Nell’s glossy tables; after the go-go boys of the Paradise Garage, the strippers from Billy’s Topless, the bears at Mineshaft, and drag queens of Jackie 60, to say nothing of the dominatrices from all those converted basements, and the chicks with dicks who were hooking for tricks on Little West Twelfth; once all of those beautifuls and their damneds had finished crawling through the darkness, done with their respective hobbies, predilections, and transgressions; when they were still strung out, still jittery, and needed a place to calm down, somewhere to hash out all those loose ends, relive the night, perform some more, or just grab some decaf, accepted wisdom—among those who knew—had it that no matter where you’d been, no matter whom on the West Side you might have done, someone else from your particular locale of debauchery would have made their way toward that street of deep grooves and broken cobblestones. The aquamarine-blue metal panels from a different era. Oversize steel letters provided a stylish signature: R & L RESTAURANT, the name of some disappeared Hopperesque diner. This decrepit neighborhood’s single safe haven for a fag to plop himself at such hours. The only place chic enough for a late-night countercultural epicurean to want to hang. The only open joint where there was passable coffee, let alone steak-frites, or the poached egg Caesar with goat cheese (legitimately inspired—you had to try it).
Breaking off a discussion with his liquor distributor, the restaurant owner hurried over, kissing Alice on each cheek of her mask. She looked radiant. How glorious it was to see her. His accent as glamorous as his dusty shag of hair. A moment of proper admiration for the bébé, then he hooked his arm in Alice’s—at which point something clicked. He was horrified, and withdrew what he realized was not a sterile arm—an arm that had put her at risk for infection. His apology was both obvious and implicit, although in Alice’s eyes no damage had been done, and nothing needed to be so much as implied; in this place there was only love.
Taking hold of the stroller handles, the wide-chested man Alice called Florent pushed the apparatus out ahead of them, thus allowing Tilda to guide Alice, the two friends progressing slowly, because Alice had to go slow (Careful, Tilda warned): down the gap of space between the lunch-counter stools and the row of square school-lunchroom-style tables; over linoleum slick with carried sludge and wet footprints. The above-the-fold, large-headline-famous artist, in his usual lunch seat beneath a map of the country that boasted his name, looked up at Alice; all the members of his lunch party did the same. The eyes of busboys consciously avoided Alice, as the owner had long ago ordered others to do with a generation of sickly patients.
—
“I pray every day for your wife to survive” came through the phone, Blauner pausing for effect. “And when she does get through this, in all candor, she’s got a lot to deal with. One little gem: she’s no longer going to be eligible for life insurance. So your parents, her parents, too—if they have any money—start putting it away for your daughter. Trust fund. College fund. Something.”
“I hadn’t even thought of that—”
“Right, why would you? Good I remembered. And when you file your joint return and itemize the deductions you’re allowed to take for medical expenses—which you should do, and are allowed by the law—all the co-pays, prescriptions, out-of-network costs, anything not covered by your policy and that you have to pay, soon as you report them on your Schedule A, one hundred percent guarantee, that number’s going to wave a red flag for the IRS.”
“You mean—”
“Your business and personal returns get audited. So keep those receipts.”
“You’ve got to be, shit, it’s not enough that—”
“You’ve got a while until that happens, though, so there’s more immediate problems. While we’re working to land some good new insurance, the ceiling on what you have is low. Three, right? Let’s do whatever we can to make sure your policy covers as much as possible, let’s stay on top of costs—”
“I just, I mean—”
“Bubbie, you’ve got to be with it. Every time a doctor comes into a hospital room, that’s a billed visit. Research doctors, no. Students on rounds, no. But each time the person in charge of your case comes in? Bill. Any test procedure? Different bill. People reading the results of that test?”
“Bill.” Oliver was with the program, even if he wasn’t happy about it.
“It gets nuts,” the lawyer continued. “Doctor visits get processed in a department specifically for doctor costs. Hospital costs get processed somewhere else. Lab costs, somewhere else. You’re going to get these different statements, all from different areas, sometimes different companies.”
“That’s already happening. Most say we don’t have preapproval, which is just bullshit—”
“Boychick, the only way to handle this is calm. You’ve got at least a month before insurance processes and approves. Until then you’re getting those bills. Don’t overreact. Just confirm: the doctor’s office sent insurance the precert.”
“Got it. Okay. I’ve been trying to read the statement sheets, but there’s no logic. It’s to where I have no clue—”
“That’s what I’m saying. And your doe-eyed case manager?”
“Culpepper.”
“Go over her head. Deal with her supervisor. Soon as you can. Today. You write a letter to the hospital finance office. Let that supervisor know you’re appealing everything with the insurance. Every single out-of-network charge. You request medical notes from the case, the case manager, the doctors. Date and sign that letter. Make copies for your file. You want that hospital financial office helping you. Right up until the second they have to start trying to get the balance of what your insurance didn’t pay.”
Oliver typed. “So pit the hospitals against the insurance companies?”
“Part of the process. You and your wife have to be in this for the long haul.”
“Goddamn long-term ground war in Russia.”
“It’s up to you to use the time. Lengthen out how long it takes to settle each appeal. That’s over, apply for financial aid—see if the hospital reduces the bill. Hospitals are like private schools in Manhattan: they have all kinds of money for aid; only the applications are huge, specifically to discourage people from applying. But, kid, you jump through hoops the right way, there’s aid. Still, even afterward, you want to elongate out the payment period for what’s left. Whitman’s going to be in business, so don’t you worry about them.”
“I know we have enough insurance to get through that consolidation thing—five days of chemo, we stay under the cap. Another induction, though—I mean, if Alice agrees to try….But thanks. What you’re telling me helps.”
“You’ve got to adjust how you deal with these people,” Blauner said. “Every time you call your health insurance company, make sure you get name and number of each operator. Take complete notes. Repeat important info back to them for confirmation. When that phone-automation system tells you they’re monitoring a phone call for quality control? Don’t kid yourself—they’re checking on employees to make sure they follow the company script. They’re also monitoring your response. So no yelling at operators. Ever. Don’t give anybody reason to claim you’re unstable, you’re violent, they can’t work with you.”
“Yeah, well…it may be too late for that, but it’s good you told me.”
“Kid, believe me, I understand. But cut that shit o
ut, pronto. Any rep, you’re as polite as with your sainted granny on her birthday. Soon as you wrap up a conversation, say the rep’s been very helpful. Ask for her name—because you want to tell her supervisor. Then send a thank-you letter for the information you were given. Put that information very specifically in the letter. This way you create a paper trail of what you’ve been told, by whom, and when. Keep your own copy of everything.”
“What’s the worst they’re going to do?” Oliver asked. “It’s not like insurance companies can seize property.”
“You’re funny.”
“What?”
“Boychick, you never heard of a court order to freeze accounts?”
“Fuck.”
“That’s down the road. But still—any way for you to hide assets? Do you have assets?”
“Fawck—”
“I had a client. She had cancer, is in for chemo. While recovering she gets pneumonia. They CAT scan her stomach before letting her come home. This at the start of the Christmas holiday weekend. Short staff, all senior docs away on vacation, residents and interns galore through the ward. Scan shows liquid around the gallbladder. Radiologist reads the pictures, sees the liquid, but also fuzz. He can’t make a firm deduction. He writes the risks are significant and could be examples of serious problems. This is what goes into the official report.”
Oliver started to ask what that meant.
“Attending reads the report, refuses to release the patient, naturally. My client complains to the daily resident. She wants to go home for Christmas.”
“I know that scene.”
“So the resident calls the radiologist. Off the record, the radiologist’s willing to admit the scans don’t look bad, whatever’s happening around the gallbladder isn’t such a kenahora. Besides, CAT scan results can be days behind what’s really happening.”
“So the radiologist’s just covering his ass.”
“Well—he can’t afford to have the patient released, and not have a warning in the paper trail. That happens, the radiologist’s legally liable. Client owns the hospital.”
“Why not fucking unplug the tubes with your hands?” asked Oliver. “Just take yourself out. They can’t keep her against her will.”
Blauner laughed. “Leave a hospital against medical advice? Insurance doesn’t pay for your stay, doesn’t pay for any procedures during that stay.”
A long breath outward.
“Exactly. There’s all kinds of angles.”
Another breath. Oliver said, “I just don’t see how we’re supposed to get through this.”
—
Alice raved about how scrumptious the seared strip steak had been, even if she’d only been able to eat a few bites, it had been no less divine; and she told Monsieur Florent how much she appreciated being in such a welcoming and lovely space, and the restaurant owner responded by kissing Alice’s hand as if the medically necessary rubber gloves were elbow-length silk, and he clasped into her palm a black business card, and told her that any time she needed anything, just call—didn’t matter if it wasn’t on the menu; they would have it for her, they could deliver to the loft. Bread baskets and water glasses were refilled; Florent told the women to take their time and he receded. Alice recounted for Tilda being in the blood cancer waiting room and meeting that man with the hump on his back, just what it had been like staring into his eyes, looking right at someone staring at his own death. Alice said she’d seen his death. She’d traveled into his void. Why should she get to live, she wanted to know, why should she get a chance, have everyone be so kind, all these people with their pity and their good wishes?
But staring at that man also allowed her to realize something. It was up to her to accept the void. She was the one who ultimately had to kill her God, kill her parents, kill herself, kill her identity, kill her personal narrative.
Interrupting, sheepish, apologetic, the creative director at a clothing house where Alice had never once set foot introduced himself, and asked if she needed any clothes, if he could do anything for her, anything at all. Alice thanked him for his kindness and accepted his hand in hers, and once he’d gone, she told Tilda that well before she’d ever fallen sick, she’d known about a form of Buddhism that prepared for death by having its practitioners chant: Every day, I am getting older, my body is decomposing, I am closer to my end. She used this chant while she was doing yoga, or chopping up celery and cleaning the sink.
Taking her time, catching her breath, in spurts and segments, with sips of cool lemon water now and then to refresh her, Alice told Tilda that she’d been reading, when she could, and there was another koan—this one about a mother monkey and her baby. The mother monkey swings through the forest, while the baby monkey clings to her. In this way the baby monkey is taken care of by her mother. “I’m supposed to be the mother and the baby. I’m supposed to let go of my worries, cling to the knowledge that the earth will take care of me. Which sounds all well and lovely. But maybe it’s just giving myself an excuse to not fight?
“Theory is theory,” Alice continued. “Every day I do try to believe there are all kinds of ways the earth can take care of me. But there’s still this black box, always pressing on my chest: the possibility that I’ll never know my child, that she’ll never know her mother. I’ll be leaving helpless little monkey alone in the world. I try to live by these—but I’m sorry. I’m sorry. I’m small. I’m selfish. I won’t give up my husband. I won’t give up my baby. I can’t.”
Tilda had risen from her seat, was on her way around the table, sitting next to Alice, visibly exhausted, ignoring her own tears. Tilda dabbed at the river flowing down Alice’s face. Alice did not have to give up anything. They were going to find a donor. The transplant would happen.
Alice murmured, placed her head on Tilda’s shoulder. Downy hairs were alight, standing along the length of her wan neck. Tilda stroked, down their side, pressing with a feather’s pressure.
“We live in categories,” she said. “You’re a mother. A wife. A patient. Lots of things, right? But categories don’t bring you to your soul, do they?”
Alice’s breaths arrived—each lighter, softer.
“Religion doesn’t have an answer for what’s happening to you. Maybe you really will end up being one of those impenetrable Zeny paradoxes. What I know is this: we can be here for you. We can love you. That is all we can do. You still have to go through this. You’re the one on the spiritual pilgrimage.”
Spent, Alice murmured again, nestling further into the safety of her friend’s bosom. Tilda kept stroking. Alice’s eyes stayed shut. She made a blissful, dreamy sound. Dishes clattered in the background, table conversations carried on. Undisturbed, Alice nodded off to sleep.
How to Save the Day
THE BATHROOM DOOR was ajar in case she needed to call for help. He could see plumes of steam, mirrors gone smoky. The effect was dreamy, almost mystical; a half-concealed, shimmering creature, her oval head ungainly, precariously balanced on the pale cord of her neck. She was looking down. Along the top of her head, nubs were nascent, rebirthed. No way she knew he was watching; otherwise she wouldn’t have remained so exposed, naked, absorbed in her private ritual: two spiderish fingers scooping into a tin, emerging with a viscous cream.
Oliver had traversed the terrain of her body more times than he could count; presently it was almost unrecognizable—alien in the sense of foreign, but also otherworldly: smooth, oddly shaped, glowingly pale; broad shoulders gone hollow. In the wiped-away streak of an otherwise steamed mirror, her breasts were still impossibly gorgeous with poisoned milk, her nipples lipstick pink. And then her leftover pregnancy weight, still somehow unaffected by the chemo; her papoose of a stomach jiggling, just a bit, while she placed the cream below the jut of her clavicle, a bright white smear now covering the cigarette burn of a bruise, where her intravenous port had been.
The skin hung loose across her buttocks, sallow flour sacks—he’d once loved spanking them, sinking his teeth into them. The si
ght unsettled him and he couldn’t look for long. In the mirror’s reflection, he caught her absence of pubic hair. Even after all this, he was shocked—both drawn to her cleft and repulsed by it.
She kept rubbing, smoothing the cream with her fingers until the white glop disappeared and her chest glowed. Flits of loose dead skin shed with her touch, flakes lifting into the steamy, wet air. Alice hardly noticed.
He came up behind her and nuzzled into the delicate architecture of her nape, resting his head on the safe side of her shoulder, where there had been no ports or surgery. Oliver planted a butterfly kiss on the middle of the back of her neck. Alice made a shocked, satisfied noise, let her head rest against his.
—
The phone kept ringing. She steeled herself, remembered that good old Doc Glenn had checked his service from the Burlington airport. She told herself her red-balloon-pig features had receded. For reasons logical and comprehensible and for no reasons whatsoever, every single time, improbabilities had indeed broken in her favor, a forged trail. Near and perilous misses. Improbable if minor successes.
Each ring was an opportunity; the chance to face that terror, to do something better than pee on herself. Alice exhaled, reached, and lifted the cool molded plastic. Bringing the receiver toward her ear, she managed a greeting, felt herself tensing, tried to relax her shoulders. Alice confirmed for the caller her date of birth. She then listened, and learned that her five percent mystery cells had come back decidedly clean. Her upcoming chemotherapy would not be reinduction.
The first molecules of air rushed into her lungs. Once again if became had became will. I will survive. We will find a way.
“There’s more to it,” Beth said. “Let me double-check the notes.”
A tandem of pigeons had landed en masse on the sill across the way from the apartment’s eastern windows. The wash of soot outside the window was substantial enough to make gray birds look mottled and filthy. Alice watched their little heads bob, their beaks peck; she listened.
