by Nick Trout
I pull the Polaroid photograph of my family out of my breast pocket and with great care I insert pins into the existing holes at its corners and restore the centerpiece of the collage. Now I see how it fits, framed by images of a wife and son radiating from its core, drawing the eye to a focal point around which everything else revolves. I step back, take it in, and change my mind, unhooking the entire corkboard from the wall and carefully carry it upstairs.
Next on my “to do” list is a call to my landlord back in Charleston. I need him to get into my studio, raid my closet, and locate a certain framed certificate of graduation. After months of legal wrangling with McCall and Rand Pharmaceuticals, I’ve become a regular down at the FedEx office, three blocks from my apartment. This particular store closes at five, but if he hurries he can overnight it to Vermont.
Frieda remains parked where I left her, in front of the refrigerator. Given her predilection for this spot, this is where I set up her dog bed.
“Quick walk before supper?”
If it’s dark enough for stars it’s safe for us to go out, though this venture on the trails can’t take long, given the way the cold air burns my lungs with every breath. Frieda stays on leash, trotting to heel, my sentinel. The image of my mother’s graveside flashes through my mind and I wonder how many times I will have to replay my conversation with Lewis for it all to feel less raw.
“Why didn’t you call me?” I had asked Lewis as the two of us kneeled in the snow and I squeezed him tighter and tighter, in a vain effort to break the rhythm of my tears. “Why didn’t you tell me what really happened, before he died?”
Lewis broke my grip and pushed me back, wanting to be sure I saw everything in his answer. “If I had, would you have believed me? Would you have come? Before everything you’ve experienced since you took on Bedside Manor?”
And though I said nothing, we both knew the answer.
“Sorry, Frieda, that’s going to have to do it.” Quarter of a mile, if that, but Frieda doesn’t complain when I about turn. I read the same old contented smile on her face and it softens the pain. Then my inner demons get to work and I’m smiling too. More than anything else, Bobby Cobb wanted to be understood. He wanted to be forgiven. And here I am, back in Eden Falls, trying to do the exact same thing. Time to say good-bye to the man I have been for the last fourteen years. So long as I haven’t left it too late.
No doubt Amy will despise the word epiphany, but I want her to know what happened today, to know I was so very wrong about Bobby Cobb. It’s one thing to misjudge a person, it’s another to convict them and refuse them their day in court. I’m not deliberating about talking to Amy, I’m not weighing the pros and cons, I’m just following an innate desire to set the record straight with a woman I barely know. I’ve never been smitten or besotted, but if I was, Amy might be the first. That’s why I want a chance, and for a confident straight shooter like Amy, honesty seems like the best place to start.
Down at the diner, this time actually wanting to slide into my father’s favorite booth, I find it occupied by a familiar face—Chief Matt Devito.
“Hey, Doc, take a seat, I’ve been meaning to drop by and thank you.”
“You have?” I say, keeping my coat on for now.
“That thing with Mr. Greer’s dog and his neighbor. Could’ve gotten ugly. Appreciate the way you handled it. Buy you a coffee?”
“Uh … sure,” I say, my back to the door, scanning the booths and counter. I don’t see Amy anywhere.
Devito follows my gaze. “Looking for someone?” He cocks an eyebrow, like he’s on to me.
A waitress appears and it’s not Amy.
“Can I get a coffee, please, cream no sugar?”
I can’t tell whether the woman, in her sixties, hears my request. She gives away nothing—not acknowledgment, not pleasure, not disgust, but just traces her footsteps back the way she came.
“That’s Maggie. Bit different from Amy.”
I raise my chin, not touching this subject. I want to head back to the practice and call over to Harry Carp’s house, but I try to look interested in the rest of the clientele.
“You know,” says Devito, half-smiling, jabbing an index finger in my direction, “there’s something about you. Just can’t put my finger on it.”
Say hello to my little friend.
“Really? Tell me, Chief, any luck finding that missing golden retriever? I’ve seen the posters everywhere.”
My coffee arrives, sloshing over the sides of the mug as Maggie slides it across the table like a barkeep serving a beer. She tosses me a handful of tiny half-and-half containers, and even though Devito’s still picking at the remains of his French fries, she whisks away his plate without a word.
“Not yet. But I’ve had a couple of interesting leads.”
The Chief’s intonation begs me to ask. “Like what?”
Devito leans back into his pew, checks the coast is clear, leans forward. He really has been watching way too many TV police procedurals. “Being as this is still an ongoing investigation, all I can tell you is I’m interested in talking to a man, about your height, about your age, likes to wear a hat with fur earflaps and might be trying to disguise his victim as a male.”
“I see,” I say, pouring in three artificial creams. “And how are the family holding up?”
“Devastated. At least the mother and daughter are. Dad seems fine.”
“Why’s that?” I ask, trying to sound surprised.
“Anne Small was married to a friend of mine, her first husband, Brian. Great guy. Died about two years ago. Sources tell me the replacement is having a hard time adjusting to the fact that the wife came as a package deal with a daughter and a dog.”
“What do you mean by hard time?”
The Chief interlaces the fingers of both hands and cups the back of his bald head. “I’m saying he has motive, if it turns out the retriever is more than just missing.”
Devito winks, letting me know I heard it here first.
I reach for my coffee but get waylaid by my phone buzzing in my pocket. “Hello,” I answer.
“Cyrus.”
There’s something wrong in her voice. “Amy. You okay?”
The Chief’s hands drop to his sides, his ears on high alert, listening in.
“Not really. It’s Clint. I think she’s dying. Can you see her?”
“Of course, I’ll be right over.”
I’m on my feet.
“Too late,” she says. “We’re on our way over to you.”
She hangs up.
“I’ve got to go. Thanks for the coffee.”
I shuffle out of the booth, more than enough time for the Chief to fire off a jibe. “Word to the wise, Doc, and that word is unattainable.” He flashes his brows, creases rippling to the top of his crown. “Pretty sure she plays for the other side, if you catch my drift.”
Ordinarily, the old Cyrus would have let this go. But not this time, not after today, not with this woman. I beckon him closer, lean in, and say, “Pretty sure she doesn’t.”
Be damned with chivalry and southern politeness, I fix him with my best attempt at the smile of a man who can only refute his accusation thanks to carnal knowledge. And judging by Devito’s reaction, I think I did okay.
I want to be prepared—IV catheter and fluids to hand, X-ray machine warming up, last set of Clint’s X-rays on the viewing box. But what am I preparing for? How can I treat let alone cure what I’ve failed to diagnose? I replay Amy’s words. I think she’s dying. And that’s when I realize it wasn’t fear catching in her voice; it was defeat, resignation, the inevitability of failure, my failure to save her dying grandfather’s dog. Amy’s phone call wasn’t a cry for help, it was a plea for mercy. Perhaps I should be prepared with a needle and a syringe full of blue juice.
Headlights pull into the parking lot and the surprises keep coming.
“She’s in the backseat,” shouts Amy. She jumps down from the driver’s side of her SUV, glances at me
over her shoulder, like she barely knows who I am, and instead of joining me at the rear passenger door, she disappears around the hood, to the opposite side, attending to the other sickly patient in her life, Harry Carp.
“You okay, Grandpa? Take your time. I’ve got you.”
Why am I surprised? He’s here to say the good-bye to Clint, when what he most wanted was for her to be there to say good-bye to him.
I open the door to the backseat. Clint is sprawled across a plaid blanket. Her eyes are closed. She’s perfectly still. I’m too late. Frigid night air rushes into the truck, diluting the warm air, and I can’t see any smoky breath from her nostrils or her mouth. I grab her, and in one frantic and awkward motion, I scoop her into my arms. Stepping back, I keep both eyes on Harry. The pronouncement is forming on my tongue, but then there’s a faint whimper from under the blankets, a stirring, and my breath catches in my chest, inducing a reciprocal whimper of my own.
“Sorry to ruin your evening,” Harry says. “But she’s suffering. Can’t have that. Not this dog.”
Amy has a firm grasp of Harry’s arm, but I still worry about the ice underfoot and him falling and cracking a hip. Leave breaking his heart to me.
We shuffle inside, back to the work area, and I lay Clint and her blanket down on a table.
“Can I get you a chair, Harry?”
Harry frowns, shakes his head. “Thanks, but I need to be here by her side.” A liver-spotted hand reaches for the top of Clint’s head. The way Clint leans into his familiar touch is subtle, but important in a way I wouldn’t have understood just a week ago.
“She won’t get up,” Amy says. “Won’t eat, won’t drink. I tried to help her to her feet, and she moaned in pain. You’ve got to be able to find what’s wrong with her.”
It could be criticism. It could be encouragement. I can’t read her blue eye or her brown eye so I turn to Harry for guidance.
“Take one last look for me, Doc. But if you can’t give me an answer, I’ll let her go. You with me?”
I nod, which I think is enough for Harry to know that I understand and respect his decision.
Amy puts her arm around her grandfather. He’s watching me and she’s watching him and I know I must ignore them and focus on a funny-looking female dog named after a movie star.
Clint’s stats are not good. Her pulse is quick and thready, she’s dehydrated, her temperature is 103.5°F. She’s depressed, reluctant to stand let alone walk, and there it is again, that wince, that moan, when I press down hard on her spine behind her shoulder blades. I revisit her X-rays on the viewing box, once more scrutinizing her spine, her chest.
Nothing.
“What do I know? I know that if I touch her in a specific location I elicit pain. What sort of pain? Well, what types of pain are there? Gnawing, throbbing, burning, stabbing, pressing, postoperative, colicky, muscle, and … referred. Referred.”
“You do know we can hear you talking to yourself.” Amy sounds genuinely concerned.
“Referred,” I repeat, ignoring her. “Referred pain occurs when a painful sensation is felt in a site other than the one where it is actually occurring.”
I go back to the X-ray. I stand back. I move close. I squint, tilt my head this way and that.
Maybe.
“I need to take another X-ray of Clint’s chest. Amy, can you give me a hand positioning her?”
Carefully, I carry Clint over to the machine, Harry shuffling along at her side, his hand never letting go of her fur. Amy grabs a couple of sandbags, purely to help stretch Clint’s front legs forward for her picture. I clear the room (though it’s a struggle to pry Harry off his dog, even for a few seconds), snap a shot, and process the image.
“There,” I say, pointing to a fuzzy, fluffy patch of whiteness, “that’s a little different from last time.”
“What is it?” asks Harry.
I’m already on it, pulling out drawers and opening cabinets in the X-ray room. I’m looking for something Bobby Cobb would keep in stock—cheap, practical, and often a remedy in its own right. The fifth chemical element in Group Two of the Periodic Table—barium. “We’re about to find out,” I say, showing off a gallon container half full of a viscous white liquid.
“What are you going to do with barium?” asks Amy, and I sense she’s worried where I’m going with this and thinking this is getting a little desperate. Maybe she’s chalking it up to the clinical ramblings of a doctor who can’t accept failure.
“I’d like to give Clint a small dose by mouth, let her swallow it down, and take another X-ray.”
Where it comes from I don’t know—determination, conviction, lack of viable alternatives—but I’m lucid and calm.
Amy takes her time, as though she’s reading more into my state of mind than considering what I’m suggesting.
“Grandpa?”
I like the way this is Harry’s decision. Harry nods, and I draw up ten milliliters of the liquid barium in a syringe, and that’s when another piece of my past catches up to me. I flash to a postmortem examination from my days as a pathology resident, to the lungs of a dog that accidentally inhaled barium and subsequently died of pneumonia.
“You okay?” asks Amy, tuning in to my reverie.
“Sure,” I say, positioning Clint so she’s sitting upright as I gently open the corner of her lip, creating a pouch near the back of her mouth in which to squirt my chalky medicine.
Barium tastes bitter, and Clint squirms and gags, zombie drool dripping from her lips, but most of it goes down the hatch. Amy and I set up for another X-ray, take the picture, and four minutes later I have the two latest images side by side for comparison, before barium and after barium.
I stand back, but I don’t need to deliberate and I don’t need to work my imagination. The answer is right there, in front of my eyes, and with it comes a bigger, far more cogent question, one that eclipses any thoughts of celebrating a diagnosis. It begs me to ask whether or not it was there all along, before Clint got so sick, before she began to suffer, before it was too late.
“Well?”
Did I underread the original films? Did I fail to take in the big picture? Is Clint another milestone in a life being defined by an endless series of mistakes?
“Dr. Mills?”
This time it’s Harry, and I want to tell him but I also want to be sure.
“Amy, you bring home a meal for Harry most nights, right?”
“What’s that got to do with … ?”
“Yes, she does,” says Harry.
“Bear with me a moment,” I plead. “And, Harry, you told me you ‘sometimes’ feed Clint table scraps, yes, though I think you meant to say ‘always,’ right?”
Harry nods, though he looks lost. I turn to Amy. “What do you bring him from the diner?”
“What ever’s on special.”
“And does that vary?”
“On a daily basis, sure, but it’s pretty much the same week to week.”
“So what was it today?”
“Spaghetti and meatballs.”
“And yesterday?”
“Chicken parmesan.”
“And the day before?”
“Lasagna.”
I gesture for her to keep going.
“Chicken marsala. Pork.”
Pork. “What sort of pork?”
“Pork chops. Why?”
I take a deep inhalation, but it’s one of pain, not relief. Taking a step closer to the X-rays, I tap what was once a white fluff y cloud, that now, stripped of its cloak of invisibility thanks to a thin layer of barium, has been unmasked as a half-chewed piece of bone.
“Clint has a piece of pork chop lodged at the bottom of her esophagus. It’s stuck just in front of the opening to her stomach. Maybe it’s mainly gristle or cartilage, because I don’t see it properly on the plain X-ray, but the barium doesn’t lie. That’s why she has pain behind her shoulders. That’s why she was having a hard time eating and drinking.”
Harry’s movi
ng beyond the diagnosis, tuning in to the fact that I’m not pleased with what I’ve discovered. “Is this bad?”
“Potentially, yes.”
“Potentially?” snaps Amy. “What does potentially mean?”
Harry pats her arm, like he’s used to reining her in. I try to swallow. My mouth is dry gulch.
“If the bone or cartilage or whatever has been stuck in the same spot for the past few days, it could have caused pressure necrosis on the mucosa of the …” I stop myself and start over. “A rotting piece of wedged pork chop could have worn a hole in the esophagus, the tube from the mouth to the stomach, allowing saliva and ingested food and bacteria free access to the inside of Clint’s chest.”
Harry and Amy stare at the X-rays, as though they might discover the answer for themselves.
“Can you see a leak?” asks Amy.
“No, but it still might be there. We didn’t use enough barium to know for sure.”
“What can we do?” asks Harry, brushing past me to hug Clint around her neck, to put his face in hers, to whisper in her ear. I don’t want to eavesdrop but I can’t help but hear the strangled words “I’m so sorry. I’m so sorry.”
Amy and I glance at one another, powerless to stem Harry’s tears.
Not so long ago, I would have dismissed Harry’s connection to Clint as irrelevant to my diagnosis and superfluous to my cure. But here and now, embedded in this crisis, I can’t ignore the tremor in Harry’s grip and the insistent rhythm of Clint’s beating tail. If this is the end, then this must be a dog with no regrets, no wish for anything different in her life. And as these two best friends look into each other’s eyes, I am convinced that Harry and Clint know more about giving than most.
