I finally found my daughter in her black gown, with her blue sash around her waist and a small green and yellow ribbon pinned to her chest. She gave me a hug and a kiss, said she would call my cell phone so we could arrange to meet after the ceremony and then disappeared into a throng of her classmates.
I liked the speeches and enjoyed being surrounded by people full of optimism and dreams about the future. After the ceremony, I accompanied Mariana to her dorm room so she could change, and from there we would go to lunch.
She wanted to go to an Italian restaurant named Gino’s. It was far from campus and didn’t accept credit cards. If it had been up to me, I would have gone somewhere closer. But because she had expressed a desire to go there, and since I wanted to please her, we went to Gino’s. I knew why she had chosen this particular restaurant.
Neither of us remembered the exact location on Lexington Avenue. We got out of the cab two blocks too soon and walked down the right side of the avenue until we found the restaurant’s dark green door.
A notice was pasted on top of a padlock informing us that the restaurant had closed its doors at the end of April.
(“Out of business” was what the notice read. Afterwards, I learned that they had failed to renew their lease, and the owner, who had had enough, decided to give up and retire.)
“Imagine, it had been here since 1945. It was almost as old as I am,” I said to Mariana.
“It was Mom’s favorite, remember?”
“Yes, I remember,” I said solemnly.
“Where should we go now?”
We went to a restaurant on the eighth floor of a nearby department store. I liked my main dish (spaghetti alla carbonara) and the dessert (tiramisu). After lunch, I convinced Mariana to let me buy her some clothes, and this did me good.
We said good-bye in the late afternoon. She agreed with me that I had no business being at her “prom.” She returned to her dorm and I to my hotel. It looked like it might rain so I took a taxi.
I went to bed early. I fell asleep filled with a sense of pride. The next day I would feel ashamed, but, on the other hand, I would manage to learn more about Sergio Y.’s life and my real involvement in his death.
I woke up very early. Before leaving the hotel, I looked up Cecilia Coutts’s address on the Internet so I could find it on my map. To my surprise, I realized the townhouse she worked out of was on the same block as Sergio Y.’s. The restaurant he would open was also very near Grove Street. The cooking school was a subway station away. Apparently, Sergio wanted his life to be concentrated in this neighborhood.
But why an apartment in the West Village? I came up with several explanations, but I think all of them underestimated Sergio’s motives, which were anything but obvious. I speculated on his reasons nonetheless. One could be the fact that the apartment where Sergio lived belonged to his family. Oliver Hoskings informed me a Brazilian company was listed as the owner of 12 Grove Street, owned by Salomão, I imagine. Staying at a townhouse belonging to his family would have been much easier than renting an apartment on his own.
Confused, I thought of the neighborhood’s history as the birthplace of the gay rights movement. But Sergio had already given me plenty of proof that he was nothing if not a pragmatist. His choice would have been based primarily on practical reasons. Some of the most beautiful streets in Manhattan were in this neighborhood. His doctor’s office was there, too. It was also close to his cooking school. It was a good place to open a small restaurant. It was perfectly understandable that he would want to live there. I myself would love to live there.
The West Village had a tradition of counterculture and projected a bohemian aura, but it was also a neighborhood for the rich. Not just anyone could afford to live here. One needed money. The best houses, such as the one Sergio lived in, belonged to famous artists and lawyers and Wall Street bankers. Therefore, the only clear signal conveyed by Sergio Y.’s address was that he was still surrounded by the class from which he came.
To my surprise, what I later learned was that when Sergio told his parents he wanted to study in New York, Tereza and Salomão flew there and chose the Grove Street apartment themselves. They took advantage of what might merely have been a whim on their son’s part to buy a pied-à-terre in the city. But the apartment was much more in keeping with the son’s tastes than the parents’, I think.
Salomão’s lawyer handled all of the paperwork directly with the real estate agent after they had decided to make an offer on the townhouse’s two upper floors. This was all told to me by Tereza in a recent conversation.
For Sergio, the walk to Cecilia Coutts’s office was a very short one. He would leave the house, walk down the stoop, turn right, walk to Bleecker Street, turn right, then walk another block before turning right again on Barrow Street. He never even had to cross the street. Along the way, he would pass a vitamin shop, a stationery store and a small cinema showing independent films, which he enjoyed watching on occasion.
Dr. Coutts’s office was also in a townhouse, on the ground floor. As I stood in front of the building, I could see Sergio Y. standing at her door. His finger would have touched the same intercom button that I would press. His hand would have grasped the same brass doorknob my hand would grasp; he would have pushed that same cast-iron and glass door that I was now opening. Exactly the way I was doing.
We were together in the same place, separated by time.
After opening the iron and glass door, I walked along a dark, carpeted corridor. I pressed the black button under the number 3 and felt Sergio Y.’s finger under mine.
VANITY ALMOST PUSHED ME
INTO THE ABYSS
Cecilia Coutts was much more attractive than I had imagined. Her lips were thin and her smile appeared sincere. She was approximately 1.70 meters tall and had straight black hair that framed her handsome features. She must have been about 40, which also surprised me. Perhaps I felt that since we shared the same patient we might also share the same age.
She greeted me with a handshake. Probably because it was supposed to be a hot day, she wore a sleeveless T-shirt and—impossible not to notice—no bra. After greeting me, she asked me to follow her. She turned and walked down a corridor. I accompanied her. On the way, she asked if I would like a coffee. I was never much of a coffee drinker, but I gladly accepted the offer. I felt it was expected of me.
We entered a large room with tall windows. This must not have been where she saw patients. I imagined it was a large office, where she read, made calls, wrote and I presume received guests.
In the corner, by the door, was a small couch facing two armchairs. A bookshelf took up the entire side wall. Near the window at the other end of the room, there was a wooden desk. On it were some books, scattered papers and a white laptop, which was on with its screen open.
Cecilia gestured for me to sit in one of the armchairs in front of the sofa, which I obediently did. Without a word, she disappeared into the hallway, returning with a mug of coffee and packets of sweetener. Instead of a spoon, she offered me a wooden stick wrapped in a paper napkin. She sat in front of me and crossed her legs.
I started by thanking her for making the time to see me.
“Ms. Yacoubian sent me an email telling me about you,” she said with a smile.
She continued: “Sandra was always talking about you. It’s a great pleasure to meet you. ‘You’re one of my heroes,’ was what she told me when we first met.”
I had enough presence of mind not to reveal that our patient’s name change still sounded foreign to me. I did feel a certain discomfort, though, which, rationally, I tried to conquer. I policed myself not to use Sergio, only Sandra. For me, it was like speaking in code.
According to Cecilia Coutts, Sandra’s was a clear case of sexual dysphoria. “A typical case. What was striking was that there was no inner conflict on her part in understanding her clinical condition. She very naturall
y accepted the fact that she was a human and medical outlier,” she said.
She explained how Sandra had made an appointment to see her the same month she had arrived in New York. In her first session she identified herself as ‘transgender’ and declared a readiness to transition. “She told me she didn’t want to waste any more time.”
Sandra had told her that, at age twelve, while reading an article about transgender individuals in a magazine, she realized that she might be transgender herself. That’s how she first identified what she felt about her own body.
“She tried to talk to her parents, but they became upset. Sandra acknowledged the embarrassment she had caused. From that day on, she vowed she would no longer raise the subject. Tereza and Salomão also never mentioned it again. That’s what she told me. Perhaps she felt the feeling would go away with time. She might have thought that she would eventually surrender to what was expected of her. Or she could have just as easily committed suicide. But none of that happened. Angelus’s example opened Sandra to a feeling of existential possibility that Sergio had never known existed. She became aware of that feeling of possibility thanks to you,” she said.
I did not feel comfortable enough to confess my ignorance then and there to that beautiful woman who was calling me a hero. Everything she had said was news to me. But I didn’t want to disappoint her. I decided that I would listen to more of what she had to say, because, after all, I had come to her office to listen. She knew much more about Sandra’s case than I did. At the appropriate moment, I would ask questions that could clarify my doubts but without making my ignorance patently clear.
Cecilia Coutts explained that the psychological aspects of Sandra’s dysphoria seemed to have stabilized by the time she had met her. They had eight evaluative sessions. It was around then, she said, that Sandra made the most references to me. With the initial diagnosis confirmed, she continued her treatment and then moved on to hormone therapy. Gradually, she fulfilled every stage of the process until, finally, she underwent her reassignment surgery.
“The process wasn’t easy because it’s not an easy thing,” she said. “But with Sandra things were easier than with most patients. She understood very clearly what was happening to her, her condition.”
Coutts went on: “She came to me already very well adjusted. She spoke about you with respect, admiration. She said nothing would have been possible without your help.”
Emotionally, hearing all the good I had done Sandra brought back those feelings I had had when I ran into Tereza in the supermarket and learned Sergio had moved from São Paulo. Almost like someone trying to avoid a subject, I asked Coutts what Sandra’s life was like in New York.
She said she was extremely confident and took her cooking classes very seriously. She had taken a basic cooking techniques course and then other more specific and shorter ones. In total, she attended the school for a little over four years.
“She had very high grades and received excellent comments from her teachers. They were unanimous in recognizing that she had a unique talent for cooking, and with their help she landed internships at the restaurants of her choice. By the time those internships began, she was already dressing and living as a woman, though she was still transitioning and had not yet formally changed her name. My opinion is Sandra did an excellent job at avoiding the sexism and prejudice present in the kitchens where she worked. The prejudice she could have faced as a transgender individual was neutralized by the enthusiastic support of her professors and the chefs in the kitchens where she worked. Sandra would arrive early, leave late and work very hard. She experienced no problems to speak of. In the end, the fact she was transgender was only further evidence of her uniqueness. It was just one of the many rare things about her. It was almost a comparative advantage.”
As I listened to Cecilia Coutts talk, I heard echoes in my head of Sergio’s voice describing Areg.
“Sandra received offers from all of the restaurants where she’d interned. They were the best in New York. Surprisingly, she preferred opening her own business. She had the money and the support of her family. ‘Why not go for it?’ she must have asked herself. That’s what she tried to do. It was what she was doing when she died. Sandra was a person of courage.”
Earlier, she had mentioned “Angelus’s example.” I imagined she was speaking of Sandra’s determination to open her own business. Pretending to know what she was referring to I said: “I know. She named the restaurant Angelus.” To which, to my surprise, she replied: “Yes, Angelus, for the book you managed to get into her hands. It brought about the most important epiphany in her life.” She looked at the bookshelf behind her and pointed to the spine of a yellow book on one of the shelves, face level.
Cecilia Coutts’s use of “epiphany” in her testimony raised my confidence level. But my fear of seeming ignorant in her eyes also increased. At this point in my life, I know that not all epiphanies are positive. Some, paradoxically, show us the wrong way, the one we should not follow.
Cecilia Coutts did not detect the stiffness in my lips. Neither did she notice that for a moment I lowered my eyes, feigning a deep sigh. While she described the hormone therapy she had prescribed, I looked at the shelf, just above her eyes, trying to find the book that had unleashed this revelation in Sergio Y. I almost wished our meeting would end so I might get closer to the books as we were saying our good-byes.
I could not make out the word “Angelus” on the spine of any of them. From where I was seated, I really could not get a good look. I knew that the book I was looking for was there, but my eyes betrayed me. Against my will, I kept returning to the outlines of Dr. Coutts’s nipples visible through her sleeveless white T-shirt.
Just then, the intercom rang. A patient had arrived. Our meeting had come to an end. We exchanged business cards, cell phone numbers, and she said she would be available to clarify any doubts I might have.
I left Cecilia Coutts’s office not having had the courage to tell her the truth. I was not able to confess that I had been unaware of our patient’s transsexualism. I never managed to ask the questions I had intended to ask. My vanity had prevented me from revealing my ignorance. I was intimidated by her beauty. As a man, I felt physically attracted to her. As a doctor, I think this attraction disarmed me, it weakened me.
Sandra might have referred to me with great respect and admiration, as her doctor was now revealing, but this was never apparent to me. She never said anything to me that hinted at this. Even when she thanked me on the day she told me she would be stopping the therapy. Why?
If it were true that Sergio Y. was aware of his transsexuality from the time he was twelve, he did not mention the topic to me because he did not want to. Maybe he was not ready. The fact is, he did not. It is no use asking why.
He never told me anything. But, from what I could deduce, I had played an important role in his accepting his transsexuality and owning it. For some reason, I had been instrumental in his choosing his life’s course. Was I therefore equally responsible for his death?
The question remained unanswered in my mind. Still, I left Dr. Coutts’s office relieved.
I had been acquitted by one judge, Dr. Cecilia Coutts, who knew about me and the transsexuality, said I had done “a good job” with Sandra. Given that Sandra and Sergio were two identities of the same person, the good I had done to one could compensate for the damage I had done to the other. I could not help but feel flattered and feel the guilt lift from my shoulders, even if momentarily.
That night, I ate sushi with my daughter in the hotel’s Japanese restaurant. Back in my room, I took a shower and went to bed, but the sushi did not sit well.
I woke up a little after 2 A.M. I lay in bed, thinking, motionless, waiting to fall asleep again. I mention this little bout of insomnia because, if not for it, I would not be here writing this. It was during those many minutes of sleeplessness that I arrived at the conclusions that
made me feel obligated to leave a record of Sergio Y.’s story.
That night of insomnia confirmed for me the importance of humility. Pride had prevented me from admitting my ignorance to Cecilia Coutts. I had been unable to confess my professional failure. I did not mention my ignorance. I chose to stay in the shadows.
But I am a doctor. And ignorance, to a doctor, can be death. I learn in order to save lives. It is what I do. If I stop learning, my usefulness in the world comes to an end. I must accept that I do not know everything. I have strived to learn as much as I can. But I have to continue learning. I must see ignorance as an advantage. Learning what one does not know expands life’s possibilities.
While I lay awake in bed I had a revelation. That same night, beneath the sheets that were tucked firmly under the mattress, I, who never pray, prayed for my parents’ souls. Without them, perhaps I would not value honesty as much as I value it today. There would be no reason for me to tell this story.
At 4:07 in the morning, I sent the following email to Cecilia Coutts:
Dr. Coutts,
Thank you for seeing me in your office yesterday morning. It was a pleasure to meet you. The conversation we had about the patient we have in common was very illuminating. However, I have to confess that I have not been completely candid about my knowledge regarding Sandra’s clinical picture.
I fear I am abusing your time and your patience, but I would like to meet with you once more. If you can see me today, Friday, for five minutes, I would be very grateful. I leave for the airport at 2 P.M. Before then, any time that is convenient for you is good for me.
A.
At 7:30 A.M., my alarm clock went off. I got up and went directly to the computer to check whether Cecilia Coutts had responded. At 6:56 A.M., Cecilia had written the following message:
Dr. Armando:
I have a busy day today, but could meet you at my office before 11 A.M. At noon I have a conference at Beth Israel Med Center. Let me know by email if that works for you.
Sergio Y. Page 6
