Flashback
Michael Palmer
Michael Palmer
Flashback
If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men and for all time to come, if I transgress it and swear falsely, may the opposite of all this be my lot.
— Conclusion of The Oath of Hippocrates, 377 B. C.
Saint Peter don't you call me 'cause I can't go. I owe my soul to The Company Store.
— Merle Travis
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PROLOGUE
Toby Nelms lay on his back and counted the lights as they flashed past overhead. He was eight years old, but small even for that age, with thick red-brown hair, and freckles that ran across the tops of his cheeks and over the bridge of his nose. For a time after his father's job relocation from upstate New York to the T. J. Carter Paper Company of Sterling, New Hampshire, Toby's classmates in the Bouquette Elementary School had called him "dot face, " and "shrimp, " and had pushed him around in the school cafeteria. But things were better now, much better, since the day he had held his ground and absorbed a beating at the hands of Jimmy Barnes, the school bully. Five… six… seven … Toby rubbed at the lump at the top of his leg, next to his peenie, where the pain had started and still persisted. The doctors had said that the shot would take the pain away, but it hadn't. The music that the nurses had promised would relax him wasn't helping, either. The song was okay, but there weren't any words.
His hand shaking, Toby reached up and pulled the padded earphones off his head. Eight… nine… The lights turned from white to yellow to pink, and finally to red. Ten… eleven… Following the fight with Jimmy, the kids had stopped pushing him and had begun asking him to walk home with them after school. They had even elected him to be the class representative to the student council. After months of inventing illnesses to stay home, it felt so good to want to go to school again every day. Now, because of the lump, he would miss a whole week. It wasn't fair. Twelve… thirteen… The red lights passing overhead grew brighter, more intense. Toby squeezed his eyes as tightly as he could, but the red grew warmer and brighter still. He tried putting his arm across them, but the hot, blood light bore through and began to sting them. Softly, he began to cry. "Now, now, Toby, there's no need to cry. Doctor's going to fix that little bump, and then you'll be all better. Are you sure you don't want to listen to the music? Most of our patients say they feel much better because of it."
Toby shook his head and then slowly lowered his arm. The lights were gone from overhead. Instead, he saw the face of the nurse, smiling down at him. She was gray-haired and wrinkled and old-as old as Aunt Amelia.
Her teeth were yellowed at the tops, and smears of bright red makeup glowed off her cheeks. As he watched, the skin on her face drew tighter, more sunken. Her wrinkles disappeared and the spaces below the red makeup, and above, where her eyes had been, became dark and hollow.
"Now, now, Toby… now, now… now, now…"
Once again, Toby threw his arm across his eyes, and once again, it did no good. The nurse's skin tightened still further, and then began to peel away, until the white of her bones shone through. The red dripped like blood over her skeleton face, and the holes where her eyes had been glowed. "Now, now… now, now…"
"Let me up. Please let me up."
Toby screamed the words, but heard only a low growl, like the sound from the stereo when he turned the record with his finger. "Let me up.
Please, let me up."
The sheet was pulled from his body, and he shook from the chilly air.
"I'm cold, " he cried wordlessly. "Please cover me. Please let me up.
Mommy. I want my mommy."
"Okay, big fella. Up you go."
It was a man's voice, deep and slow. Toby felt hands around his ankles and beneath his arms, lifting him higher and higher off the bed with wheels, higher and higher and higher. That same music was in the room.
Now, even without the earphones, he could hear it. "Easy does it, big fella. Just relax."
Toby opened his eyes. The face above his was blurred. He blinked, then blinked once more. The face, beneath a blue cap, remained blurred. In fact, it wasn't a face at all-just skin where the eyes and nose and mouth should have been. Again, Toby screamed. Again, there was only silence. He was floating, helpless. Mommy, please. I want Mommy. "Down you go, big fella, " the faceless man said. Toby felt the cold slab beneath his back. He felt the wide strap pulled tightly across his chest. Just the lump, his mind whimpered. Don't hurt my peenie. You promised. Please, don't hurt me. "Okay, Toby, you're going to go to sleep now. Just relax, listen to the music, and count back from one hundred like this. One hundred… ninety-nine… ninety-eight…"
"One hundred… ninety-nine…" Toby heard his own voice say the words, but he knew he wasn't speaking. "Ninety-eight… ninety-seven …" He felt icy cold water being swabbed over the space between his belly and the top of his leg-first over the lump, and then over his peenie. "Ninety-six… ninety-five." Please stop. You're hurting me.
Please. "That's it, y'all, he's under. Ready, Jack? Team? " The voice, a man's, was one Toby had heard before. But where? Where? "Okay, Marie, turn up the speakers just a hair. Good, good. Okay, then, let's have at it. Knife, please…"
The doctor's voice. Yes, Toby thought. That was who. The doctor who had come to see him in the emergency ward. The doctor with the kind eyes.
The doctor who had promised he wouldn't… A knife? What kind of knife?
What for?
Then Toby saw it. Light sparked off the blade of a small silver knife as it floated downward, closer and closer to the lump above his leg. He tried to move, to push himself away, but the strap across his chest pinned his arms tightly against his sides. For a moment, Toby's fear was replaced by confusion and a strange curiosity. He watched the thin blade glide down until it just touched the skin next to his peenie. Then pain, unlike any he had ever known, exploded through his body from the spot.
"I can feel that! I can feel that, " he screamed. "Wait! Stop!
I can feel that!"
The knife cut deeper, then began to move, over the top of the lump, then back toward the base of his peenie. Blood spurted out from around the blade as it slid through his skin. Again and again, Toby screamed.
"That's it. Suction now, suction, " he heard the doctor say calmly.
"Please, please, you're hurting me. I can feel that, " Toby pleaded He kicked his feet and struggled against the wide strap with all his strength. "Mommy, Daddy. Please help me."
"Metzenbaums."
The blade of the shiny knife, now covered with blood, slid free of the gash it had made. In its place, Toby saw the points of a scissors pushing into the cut, first opening, then closing, then opening again, moving closer and closer to the base of his peenie. Each movement brought a pain so intense, it was almost beyond feeling. Almost. "Don't you understand? " Toby screamed, struggling to speak with the reasoning tone of a grown-up, "I can feel that. It hurts. It hurts me."
The scissors drove deeper, around the base of his peenie. "No! Don't touch that! Don't touch that!"
"Sponge, I need a sponge right here. Good, that's better. That's better."
The scissors moved further. Toby felt his peenie and his balls come free of his body. Don't do that… don't do that… The words were in his mind, no longer in his voice. Again, with all his strength, Toby tried to push up against the strap across his chest. Overhead, he saw the doctor-the man whose eyes had been so kind, the man who had promised not to hurt him. He was holding something in his hand-something bloody-and he was showing it to others in the room. Toby struggled to understand what it was that he was showing, what it was that was so interesting. Then, suddenly, he knew. Terrified,
he looked down at where the lump had been. It was gone, but so was his peenie… and his balls.
In their place was nothing but a gaping, bloody hole. In that instant, the strap across Toby's chest snapped in two. Flailing with his arms and legs, he threw himself off the table, kicking at the doctors, at the nurses, at anything he could. The bright overhead light shattered. Trays of sparkling steel instruments crashed to the floor. "Get him, get him,
" he heard the doctor yell. Toby lashed out with his feet and his fists, knocking over a shelf of bottles. Blood from one of them splattered across his legs. He ran toward the door, away from the hard table… away from the strap. "Stop him!.. Stop him!"
Strong hands caught him by the arms, but he kicked out with his feet and broke free. Moments later, the hands had him again. Powerful arms squeezed across his chest and under his chin. "Easy, Toby, easy, " the doctor said. "You're all right. You're safe. It's me. It's Daddy."
Toby twisted and squirmed with all his might. "Toby, please. Stop.
Listen to me. You're having a nightmare. It's just a dream. That's all.
Just a bad dream."
Toby let up a bit, but continued to struggle. The voice wasn't the doctor's anymore. "Okay, son, that's it. That's it. Just relax. It's Daddy. No one's going to hurt you. You're safe. No one's going to hurt you."
Toby stopped struggling. The arms across his chest and under his chin relaxed. Slowly, they turned him around. Slowly, Toby opened his eyes.
His father's face, dark with concern, was inches from his.
"Toby, can you see me? It's Daddy. Do you know who I am?"
"Toby, it's Mommy. I'm tere, too."
Toby Nelms stared first at his father, then at the worried face of his mother. Then, with an empty horror swelling in his chest, he slid his hand across the front of his pajama bottoms. His peenie was there right where it was supposed to be. His balls, too. Was this the dream?
Too weak, too confused to cry, Toby sank to the floor. His room was in shambles. Toys and books were everywhere. His bookcase had been pulled over, and the top of his desk swept clean. His radio was smashed. The small bowl, home of Benny, his goldfish, lay shattered on the rug. Benny lay dead amidst the glass. Bob Nelms reached out to his son, but the boy pulled away. His eyes still fixed on his parents, Toby pushed himself backward, and then up and onto his bed. Again, he touched himself.
"Toby, are you all right? " his mother asked softly The boy did not answer. Instead, he pulled his knees to his chest, rolled over, and stared vacantly at the wall.
CHAPTER ONE
Sunday, June 30, was warm and torpid. On New Hampshire 16, the serpentine roadway from Portsmouth almost to the Canadian border, light traffic wound lazily through waves of heated air. Far to the west, a border of heavy, violet storm clouds rimmed the horizon. The drive north, especially on afternoons like this, was one Zack Iverson had loved for as long as he could remember. He had made the trip perhaps a hundred times, but each pass through the pastureland to the south, the villages and rolling hills, and finally, the White Mountains themselves, brought new visions, new feelings. His van, a battered orange VW camper, was packed solid with boxes, clothes, and odd pieces of furniture. Perched on the passenger seat, Cheap dog rested his muzzle on the windowsill, savoring the infrequent opportunity to view the world with his hair blown back from in front of his eyes. Zack reached across as he drove and scratched the animal behind one ear. With Connie gone from his life, and most of his furniture sold, Cheap dog was a rock-an island in a sea of change and uncertainty. Change and uncertainty. Zack smiled tensely. For so many years, June the thirtieth and July the first had been synonymous with those words. Summer jobs in high school, four separate years in college, and four more in medical school, internship, eight years of surgical, then neurosurgical, residency-so many changes, so many significant Junethe-thirtieths. Now, this day would be the last in that string-a clear slash between the first and second halves of his life.
Next year, the date would, in all likelihood, slip past as just another day. Highway 16 narrowed and began its roller-coaster passage into the mountains. Zack glanced at his watch. Two-thirty. Frank and the Judge were at their club, probably on the fourth or fifth hole by now. Dinner wasn't until six. There was no need to hurry. He pulled off into a rest area. Cheap dog, sensing that this was to be a stop of substance, shifted anxiously in his seat. "That's right, mop-face, " Zack said.
"You get to escape for a while. But first…"
He took a frayed paperback from between the seats and propped it up on the dash. Instantly, the dog's squirming stopped. His head tilted. "You appreciate, I can see, the price that must be paid for the freedom you are about to enjoy. Yes, dogs and girls, it's time for"-he took the silver dollar from his shirt pocket and read from the page-"a classic palm and transfer, Italian style."
The book, Rufo's Magic with Coins, was a 1950s reprint Zack had stumbled upon in a Cambridge seconthand bookstore. Amaze your friends… Amuse your family… Impress members of the opposite sex… Sharpen your manual dexterity. The four claims, embossed in faded gold leaf on the cover, each held a certain allure for him. But it was the last one of the group that clinched the sale. "Don't you see? " he had tried to explain to a neurosurgical colleague, as he was fumbling through the exercises in Chapter One. "We're only in the O. R. -what? — a few hours a day at best. We need something like this to keep our hands agile between cases-to sharpen our manual dexterity. The way things are, we're like athletes who never practice between games, right?"
Unfortunately, although the principle behind that thought was noble enough, the implementation had given rise to a most disconcerting problem. For while Zack's hands were quite remarkable in the operating room, even for a neurosurgeon, he had as yet been unable to master even the most elementary of Rufo's tricks, and had been reduced to practicing before mirrors, animals, and those children who were unaware of his vocation. "Okay, dog, " he said, "get ready. I'm going to omit the patter that goes with this one because I can see you eyeing those birches out there. Now, I place the coin here… and snap my wrist like this, and… and voila! the coin it is gone… Thank you, thank you.
Now, I simply pass my other hand over like this, and…"
The silver dollar slipped from his palm, bounced off the emergency brake lever, and clattered beneath the seat. The dog's head tilted to the other side. "Shit, " Zack muttered. "It was the sun. The sun got in my hands.
Well, sorry, dog, but one trick's all you get."
He retrieved the coin and then reached across and opened the passenger door. Cheap dog bounded out of the camper, and in less than a minute had relieved himself on half a dozen trees, shambled down a steep, grassy slope, and belly flopped into the middle of a mountain stream. Zack followed at a distance. He was a tall man with fine green eyes and rugged looks that Connie had once described as "pretty damn handsome… in a thuggy sort of way."
He wandered along the edge of the slope, working the stiffness of the drive from his bad knee and watching as Cheap dog made a kamikaze lunge at a blue jay and missed. Do you know, boy? he wondered. Do you know that the rehearsal's over? That we're not going back to the city again?
He squinted up at the mountains. The Rockies, the Tetons, the Smokies, the Sierras, the northern Appalachians-an avid rock climber since his teens, he had climbed at one time or another in all of them. There was something special, though, something intimate and personal that he felt in the White Mountains and nowhere else, they seemed to be giving him a message-that the world, his life, were right where they should be. The demands of surgical training had exacted a toll on every aspect of his existence. But of all those compromises and sacrifices, the unavoidable cutback in his climbing was the one he had accepted the most reluctantly. Now, at almost thirty-six, he was anxious to make up for lost time. Thin Air… Turnabout and Fair Play… The Widow-Maker…
Carson's Cliff… Each climb would be like rediscovering a long-lost friend. Zack closed his eyes and breathe in the moun
tain air. For months he had wrestled with the choice of a career in academic medicine or one in private, small-town practice. Of all the decisions he had ever made-choosing a college, medical school, a specialty, a training program-this was the one that had proved the most trying. And even after he had made it-after he had weighed all the pros and cons, gotten Connie's agreement, and opted to return to Sterling-his tenuous decision was challenged. The ink was barely dry on his contract with Ultramed Hospitals Corporation when Connie announced that she had been having serious second thoughts about relocating from the Back Bay to northern New Hampshire, and in fact, that she was developing a similar case of cold feet over being engaged to the sort of man who would even consider such a move. Not two weeks later, the ring had arrived at his apartment in its original box, strapped to a bottle of Cold Duck. Zack sighed and combed his dark brown hair back with his fingers. They were striking, expressive fingers-sinewy, and so long, even for the hands of a six-footer, that he had taken to sending to a medical supply house in Milwaukee for specially made gloves. Early on, those fingers had set him apart in the operating room, and even before that, on the rock face. He gazed to the northwest and swore he had caught a glimpse of Mirror, an almost sheer granite face so studded with mica that summer sun exploded off it like a star going nova. Lion Head… Tuckerman Ravine… Wall of Tears… There was so much magic in the mountains, so much to look forward to. True, life in Sterling might prove less stimulating than in the city. But there would be peace and, as long as he could climb, more than enough excitement as well. And, of course, there would be the practice itself-the challenges of being the first neurosurgeon ever in the area. In less than twenty-four hours, he would be in his own office in the ultramodern Ultramed Physicians and Surgeons clinic, adjacent to the rejuvenated Ultramed-Davis Regional Hospital. After three decades of preparation and sacrifice, he was finally set to get on with the business of his life-to show his world, and himself, exactly what he could do. The prospect blew gently across what apprehensions he had, scattering them like dry leaves. Connie or no Connie, everything was going to work out fine. Homemade bread and vegetable soup, goose pate on tiny sesame wafers, Waterford crystal wineglasses and goblets, rack of lamb with mint jelly, Royal Doulton china, sweet potatoes and rice pilaf, fresh green beans with shaved almonds, fine Irish linen. The meal was vintage Cinnie Iverson. Zack was aware of a familiar mixture of awe and discomfort as he watched his mother, wearing an apron she had embroidered herself, flutter between kitchen and dining room, setting one course after another on the huge cherrywood table, clearing dishes away, pausing to slip in and out of conversations, even pouring water, and all the while, skillfully and steadfastly refusing offers of assistance from Lisette and himself. The table was set for eight, although Cinnie was seldom at her seat. The Judge held sway from his immutable place at the head. His heavy, high-backed chair was not at all unlike the one behind the bench in his county courtroom. Zack had been assigned the place of honor, at the far end of the table, facing his father. Between them sat his older brother, Frank, Frank's wife, Lisette, their four-year-old twins, Lucy and Marthe, and Annie Doucette, the Iversons' housekeeper, now a widow in her late seventies and part of the family since shortly after Frank was born. In sharp contrast to Cinnie Iverson's bustlings, the atmosphere at the table was, as usual, restrained, with periods of silence punctuating measured exchanges. Zack smiled to himself, picturing the noisy, animated chaos in the Boston Municipal Hospital cafeteria where, for the past seven years, he had eaten most of his meals. He had been raised in this house, this town, and in that respect, he belonged, but in most others, after almost seventeen years, it was as if he had packed up his belongings in Boston and moved to another planet. Of those at the table, Zack observed, Lisette had changed the most over the years. Once a vibrant, if flighty, beauty, she had cut her hair short, eschewed any but the lightest makeup, and appeared to have settled in quite comfortably as a mother and wife. She was still trim, and certainly attractive, but the spark of adventure in her eyes, once a focus of fantasy for him, was missing. She sat between the twins, across from Frank and Annie, and reserved most of her conversation for the girls, carefully managing their etiquette, and smiling approvingly when one or the other of them entered the conversation without interrupting. Lisette was a year younger than Zack, and for nearly two years-from the middle of his junior year at Sterling High until her one trip to visit him at Yale-she had been his first true love. The pain and confusion of that homecoming weekend in New Haven, the realization of how far apart just six weeks had taken them, marked a turning point in both their lives. For a while after Lisette's return to Sterling, there were scattered calls from one to the other, and even a few letters. Finally, though, there was nothing. Eventually, she moved away to Montreal and made brief stabs first at college, then marriage-to a podiatrist or optometrist, Zack thought. Pollowing the breakup of her marriage, she had returned to Sterling, and within a year was engaged to Frank. Zack had been best man at their wedding and was godfather to the twins. Like Lisette, Annie kept pretty much to herself, picking at, more than eating, her food, and speaking up only to bemoan, from time to time, the arthritis, or dizzy spells, or swollen ankles which kept her from being more of a help to "Madame Cinnie." It was difficult, and somewhat painful, for Zack to remember the wise, stocky woman of his boyhood, hunkered over a football then hiking it between her legs to Prank as he practiced passing to his little brother in the field behind their house. One of the curses of being a physician was to see people, all too often, as diagnoses, and each time Zack returned home and saw Annie Doucette, he subconsciously added one or two to her list. Today Annie looked more drawn and haggard than he had ever seen her. Frank, of all those in the room, had changed the least over the years. Now thirty-eight, he was in his fourth year as the administrator of Ultramed-Davis Hospital. He was also, if anything, slimmer, handsomer, and more confident than ever. "What are the possibilities,"
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