by Susan Rieger
Nate decided in tenth grade he would be a doctor—not a surgeon with a grueling schedule, but a family practitioner. He wanted variety in his patients and their diseases, and he wanted to keep playing his bass. He was almost good enough to be a professional. “I can’t be in any kind of quartet,” he explained to his parents, “if I can’t practice with the others regularly.” Jim was pleased and proud his son wanted to go into the family business. He wanted Nate to go to Yale, and if not Yale, then Stanford or Harvard. Nate had other ideas. “I’m not the smartest guy in the room,” he said to his father, “but I’m the most determined. I’ll go to a small school for college. I’ll have a better chance that way getting into a good med school.” He went to Amherst, where two older Lewisohn cousins had gone, graduating in 2000. He took off a year to work with Paul Farmer in Haiti, then went to Yale for medical school. He admired the dean, David Kessler, who had been the scourge of the tobacco cartel at the FDA. “Maybe I’ll do public health,” he told his parents. “Yes,” Anne said. Jim nodded. His son was a Lehman; he wouldn’t have to make money. Jim had tried not to care that Rupert had been appointed to the Yale Corporation. He had money, I don’t; not my own at least, he told himself. He didn’t care about the money, only everything else, the prestige, the recognition, the honor, Eleanor. He wished she hadn’t married so well. He fantasized about Nathan one day joining the Corporation.
Anne’s parents adored Nathan. If they had a favorite grandchild, which they wouldn’t, he was it. The Cardozo grandparents were not fond. They had been counting on a beautiful grandchild, and Nathan disappointed, one more reason for Jim to keep the family visits brief and infrequent. The last years of Jim’s parents’ lives, he saw them only when they were in the hospital. He oversaw their medical care. He found he preferred his parents when they were ill. They were like all his other patients, helpless, needy, and afraid.
—
Anne’s news that she was pregnant had surprised Jim, but not in the way he would have expected. He was elated, ready to accept it as vasectomy failure. He knew there were vasectomies that failed—studies showed a one-in-a-thousand pregnancy rate. Like the Honduran murder rate, the highest in the world, he thought, to give the statistic more heft. And he hadn’t been tested after the procedure to find out if it had worked. He was, in this way, like many patients and most doctors. Most doctors were notoriously bad patients: they prescribed narcotics and stimulants for themselves; they never got flu shots; they thought checkups were a waste of time and money; they “watched and waited” while their PSA levels went through the roof. Their balkiness wasn’t entirely owing to professional cynicism or a sense of invulnerability. They believed in public health—potable water, vaccinations, pasteurized milk, seat belts, birth control—much less in medicines and surgeries. They knew many ailments would go away by themselves, sooner or later. They also knew they would die one day, at home if they were lucky. Hospitals were disease pits, more dangerous than highways, no place to be sick in. Jim often thought of having “Do Not Resuscitate” tattooed on his chest. He was struck how often doctors died of diseases in their specialty. “Best to be a pediatrician,” he’d tell medical students. “You’ll begin your practice having outlived the condition.” Jim suspected he’d die of heart disease. He never took a stress test.
Jim didn’t question Nathan’s paternity, beyond his first queries to Anne. He couldn’t imagine Anne cheating on him, and Nathan himself was the best proof. “Like father, like son,” the Lehmans always said. Father and son were both smart without being intellectual, practical without being plodding, analytical without being exacting. They liked working with their hands. Neither had much of a sense of humor, which they admitted privately to each other and came to regard as the secret to their success. Humor was socially useful, professionally distracting. Focus, doggedness, determination, drive, they were the right stuff. By the time there was routine DNA testing, Jim didn’t give it more than a minute’s thought.
—
Jim was liked and admired by the nursing staff at Presbyterian, a distinction rarely paid a surgeon who hadn’t previously been hospitalized with a grave and humbling illness. He treated nurses as colleagues and professionals, listening to their concerns, asking their opinion, taking their advice. Before he checked up on a patient on the ward, he would check in at the nurses’ station for an update. He believed he owed his success to the ward nurses and often said so, to them and to the other cardiac surgeons. His colleagues mocked him, calling him Dr. Kumbaya. They thought he was breaking ranks with the surgical knighthood by pandering to the yeomanry. “He has a wife with a PhD,” they’d say, as if marriage to an educated woman, always a mistake, made men red-eyed, weak-wristed feminists. To no avail, he would explain that his treatment of the nurses was strategic and practical. “I need them,” he’d say. Nurses were his early warning system of infections, bleeding, arrhythmias; they also had warmer, more comforting beside manners. His was cool, correct, and fleet: a hand on the shoulder, a nod, a smile. Seconds later, he was gone. He had the best outcomes in the department. Patients came from Rochester, Minnesota, Boston, and San Francisco to see him.
Two days after hearing that Rupert Falkes was dying on the sixth floor at Presbyterian Hospital, Jim dropped by his room. Eleanor was in the hallway, speaking with one of Rupert’s doctors. Catching sight of Jim, she smiled at him. “Do I need to introduce the two of you?” The two men nodded at each other, with the chill civility of silverbacks finding themselves in the same clearing: they’d fight it out when the females were gone. “Ah,” she said, “I see you know each other. Stephen is Rupert’s oncologist; Jim, a college friend.” Jim hated that she always added “college” or some other qualifier to her introductions, consigning him to her past. “I’m sorry,” she said to Jim, “I need to follow up with Stephen. It shouldn’t take long.”
Eleanor and Stephen stepped away. They spoke for several minutes. Jim began to feel conspicuously ridiculous. He looked in at Rupert, who was lying very still in bed, his eyes closed. The radio was playing: Bach, he thought. He resisted the urge to read Rupert’s file, tucked in a folder on the door. He guessed that Stephen was deliberately taking more time than necessary, to put him in his place, to keep Eleanor to himself. On the oncology wards at Presbyterian, the surgeons and oncologists achieved at best a shaky truce. They had moved past “slash and burn,” the tired war metaphors, to literary invective. The surgeons had started calling the oncologists the Brotherhood of Dracula; the oncologists responded by calling the surgeons the Sisterhood of Frankenstein. One morning, in the heat of their schoolyard tiff, mostly played out with plastic body parts and rubber bats stuck in coat pockets, lockers, and mailboxes, the staff found a large engraved metal plaque attached with dental adhesive to the main door of the oncology ward. It read: THE STOKER-SHELLEY MEMORIAL WING. It was too expensive a prank for the residents, the likeliest perpetrators, to have pulled it off; no one else came forward. The doctors, in a rare display of collective good humor, wanted to keep the plaque up. The hospital president ordered it taken down, to protect donors’ sensibilities. The chair of oncology decided to auction off the plaque, to raise money for the new children’s cancer wing. Jim got it after fierce bidding, for eleven thousand dollars. He knew Eleanor had put it up.
After waiting ten minutes, Jim signaled he was leaving. Eleanor called out, “Thanks for stopping by. Sorry we couldn’t talk.” Over the next three months, Jim dropped by Rupert’s room three or four times a week, hoping to find Eleanor alone. Every time, she was with someone, usually one of Rupert’s doctors, sometimes a son or two, occasionally a friend. She was always welcoming, happy to make introductions but never able to talk to him. He knew his behavior was indecent, even if no one but Eleanor knew it. He wasn’t there to help her. He was there to woo her, to make love to her, in the presence of her dying husband. Every time he left the oncology ward, he swore he’d keep away. A day later, he’d lost all resolve. He would find himself, in his open hours, drifting do
wn to the sixth floor. I’m only passing through, he’d tell himself. As a discipline and a restraint, he wrote letters to Nathan at college.
—
Eleanor and Jim met at Columbia summer school the summer before their junior year. He was taking organic chemistry, she was taking the Russian novel. He saw her having lunch in John Jay, bent over Anna Karenina. She’s beautiful, he thought self-consciously, the same way I am. When he was younger he’d been embarrassed by his looks and the attention they attracted. He had worried that people thought he was a girl. Strangers stopped his mother on the street to tell her what a beautiful child he was. One woman said he looked “just like Elizabeth Taylor in National Velvet.” He growled at her. Adolescent gawkiness took the edge off his prettiness, and by the time he was twenty, no one would take him for a girl. Women often still said he was beautiful, but not like Elizabeth Taylor, like Tyrone Power. When he approached Eleanor, he expected a smile, interest. Girls liked him.
“It’s better in Russian,” he said.
She looked up at him. “Oh, those Russians,” she said, unsmiling, “they think Shakespeare is better in Russian.” She went back to her book.
He persevered. She was smart as well as beautiful, plainly worth pursuing.
“Do you like it? Do you like Anna?” he said.
She looked up again, her good manners kicking in. “I like it. I don’t know if I like Anna. I can’t see dying for love. I liked War and Peace more. I like Natasha more.”
“Do men ever die for love that way, or only women?” he asked. He slid into a chair across the table from her.
Eleanor thought for a moment. It was a more interesting question than she had expected. “Not in novels, only in life.”
“I think I might die for love,” he said.
She finally smiled at him. “Heroically? Sacrificially?” she said.
“I’d like to think so, but that’s not what I meant. I meant dying from loss,” he said.
“How can you know that about yourself?” she asked. “Have you ever been in love?”
He shook his head. “Emotions are treacherous. I like to keep things cool.”
“I don’t know any other way,” she said.
They spent every day together that summer. She took him to movies at the Thalia: Bergman, Rossellini, Fellini, Renoir. He read her Chekhov plays and stories. They didn’t fall into bed heedlessly, carelessly, drunkenly, like so many young lovers. They planned their first time, with Lancers rosé wine, candles, and, on the bedside tables, a box of condoms. He undressed her slowly. They looked at each other naked. They started at four thirty p.m., after her class, and went on until midnight when she caught sight of the clock, threw on her dress, and caught a cab home. In the fall, she visited him every weekend at Yale. They didn’t introduce each other to their parents until the spring and then it all fell apart. They cried. “I’ll never get over you,” he said. “You must,” she said. “You will.”
—
Jim went to Rupert’s funeral at St. Thomas. He had ended his Episcopal surveillance of Eleanor’s boys after Nathan was born but he remained too curious about them. He took his old seat on the far edge of the far aisle. The boys looked less alike than they had as children but they were all still dark and lean, plainly Eleanor’s children, plainly brothers. There were four wives or girlfriends, all blondes, like Rupert; a sixth dark young man; and two small, white-haired granddaughters, who sat quietly in a front pew, reading books. There was a young woman sitting with the family who looked like the boys; he didn’t recognize her. Was she a sister? Had he missed her in his census? Eleanor looked tired and pale. Like a grieving widow, he thought with a start. It had been a mistake to come. The organist started playing. Half listening to the music, Jim plotted. For the last forty years, the boys and Rupert had stood in the way. With the boys grown and Rupert dead, those roadblocks were gone, Eleanor was free. I’ll get divorced, he thought, with a stab of pain. He would have to give up Anne.
The eulogies began. The two boys spoke well. Jim found himself wishing Nathan was with him, to hear them speak about their father. He missed his son, off in college, planning a separate life. He wondered what Nathan would say at his funeral. He hoped he would tell a life-with-old-Dad story, poignant and affectionate. Nathan was the gift of his life. He had never loved, could never love anyone else as much as he loved Nathan. The thought that he might have missed him by marrying Eleanor gave him a thump.
The penultimate speaker, John Earlham, made little impression on Jim. He spoke with a kind of lisp and talked about cricket in New York in the ’50s. Rupert was very good at cricket; his swing was deadly. “He held the bat at an odd angle,” Earlham said. “When it connected with the ball, the ball flew. When it connected with anything else, call an ambulance. Kidding, sort of.” The last speaker was Dominic Byrne. His eulogy made Jim sit up. He sensed a rival, another man with an engaging accent. Byrne spoke about Rupert but also about Eleanor and the way he saw his friends as husband and wife. “I’ve never married,” he said, “and Rupert and Eleanor’s marriage was the closest I came to seeing one close up. Eleanor, well we all know Eleanor, she would say, ‘Oh, Rupert,’ to him or about him, as if she were speaking about a limb or other part of her body. There was in her voice at those times an unembarrassed and unembarrassing intimacy that seemed akin to breathing. Rupert, to me, perhaps not to her, was more explicit and, not surprisingly, less expressive. He called her ‘my great good luck.’ He would look past me when he said it, as if eye contact might move him to tears.”
Jim thought of his wife, his great good luck. Did he love her? He was grateful to her. Did she still love him? He wasn’t sure anymore. Their love for Nathan was their strongest bond, but since he went off to Amherst, they seemed untethered. They had become careful with each other, as if a sharp word might sever the connection. Nathan noticed, as an only child will, and asked his mother what had happened. “We’re adjusting to a Nathanless life,” she said. “Don’t worry about us.” She wasn’t worrying. She had again come to a fork in the road.
For Jim, the adjustment was to a Rupertless life. He tried to imagine his life if Eleanor agreed to marry him, if he divorced Anne. Nathan would be angry, but he’d come around eventually; children always did. Eleanor’s boys would be angry too, but that would be more her problem than his. His married friends and colleagues would at first be shocked and disapproving; then they’d be envious. He’d miss the Lehmans. Most of all, he’d miss Anne. He wished he could give up the dream of Eleanor. He would, he knew, be less happy with her than with Anne, but happiness was no longer the point. He was stuck. From the deep recesses of his brain, the words of “The Charge of the Light Brigade,” memorized in eighth grade, clamored into consciousness: Someone had blundered. Theirs not to make reply, Theirs not to reason why, Theirs but…The congregation rose, stepping on the poem’s last line. The choir began singing “Jerusalem.”
—
Jim began to think he should cut back on surgeries. He was sixty-four. He’d been practicing for thirty years, since he finished his cardiology fellowship in 1972. He was tired of standing for five hours; his back, which used to ache the last hour of an operation, now ached almost from the beginning and then for hours after. His hands, swelling with arthritis, were clumsier, more likely to make mistakes; his eyes were seeing less clearly even with his magnifiers. He was sweating buckets, from all two million sweat glands it seemed; he thought the nurses shrank from him, repelled by his odor. He talked with Nathan about these changes. Nate had finished his first year of medical school and was itching to start rotations in July. The year had given him enough knowledge to have formed some set opinions. He had always been a boy who kept his eyes open, and in the last year, he had seen many older surgeons resisting assistance in the operating room, risking a malpractice suit, becoming more arrogant as their skills declined. “Two a week, Dad,” he said. Jim swallowed hard; he had expected Nathan to argue with him.
“Look,” Nathan said, seeing his
father’s dismay, “you’ve got a great future as Presbyterian’s second-opinion guru.”
“You’ll be a great doctor,” Jim said. “I asked. You answered. Balls.”
Nathan looked at his dad. “Are you sure the symptoms are age-related?” he asked. “Not from drugs or drink?”
“What made you say that?” Jim asked. “Has your mother said something to you?”
Nathan paused, giving Jim a start. They both sensed a tectonic shift. Jim wanted Nathan’s good opinion.
“Mom is loyal to a fault,” Nathan said. “I have eyes, Dad.”
Jim roused a small smile. “Don’t worry about me.”
When Jim made his announcement that he was cutting back on surgeries to do more consulting, he suggested that he thought his colleagues were too quick to operate.
“Why did you do that?” Anne asked.
“Better that they think I’m insulting them than losing my grip,” he said.
“When does it end?” she asked. “This chest beating.”
“In the grave,” he said, smiling at her. She looked blankly back at him. He felt a pang. From the beginning, Jim had counted on Anne’s obliging nature. She had said, half joking, not long after they were married, that she came with a lifetime warranty, only his to violate. He had believed her. He couldn’t remember an argument that had left either of them raw or jagged. He had always been able to make her see things his way. Her new, sharper edge gave him a feeling of dispossession. It wasn’t open rebellion, more like dogged resistance. She was becoming less agreeable and more polite. A note of judgment, hinging on criticism, tinged her conversations with him. She was cooler to him, not adoring, not even admiring. She went along without agreeing, as if the matter didn’t matter. “Oh, let’s agree to disagree,” she would say. She started sleeping in Nathan’s room when he went off to Haiti. It was clear Nate no longer needed his parents. Anne had never needed Jim, but she had wanted him. That was no longer clear.
