The Gretchen Question

by Jessica Treadway

  The Gretchen Question

  Jessica Treadway

  To Cassis and August Henry, with thanks and love—

  past, present, future

  She always had the feeling that it was very, very dangerous to live even one day.

  —Virginia Woolf, Mrs. Dalloway

  It was the simplest of tasks that lay before me: I was to move the bins.

  I looked forward to the pleasure of doing this favor for my friend. After my work meeting at the hospital, I would drive to Grettie’s house instead of my own. How many times have I made the trip between us? Too many to guess at. How many more times will I make it—that’s the question.

  It’s the solstice, the third week of June. The cusp of summer just outside Boston: impossible to overstate how pretty it is here, how filled with greenness and hope. When I saw the peacefulness of the morning, its beauty, my heart rose and wanted to stay there. But beneath the pleasure I anticipated, I felt nervous.

  It wasn’t just me. All the towns around here were nervous. On edge. That was far as you could go—you couldn’t say panicked or petrified. Nobody had gotten hurt. Nothing had been stolen except food. Someone was breaking into houses while people were away—for the day, for the weekend—and spending time in the family rooms. The owners would come home and find a blanket they’d left draped over the sofa lying rumpled across the cushions, as if someone had lain beneath it, then cast the throw aside. TV channels had been changed, the remote control in a place other than where the owners had left it. People started referring to the intruder as “the Snack Burglar,” and I guess to show that they were serious about catching him, the police went so far as to take fingerprints from the TV remotes and test them against what they had in their database. No match. No idea who was doing it. “A disturbed individual,” the police chief said in an interview on the local news.

  “We urge everyone in the community to be vigilant,” he added. “I know there’s a nickname floating around out there, that might lead some people to take this more lightly than they should. Criminals often start small and progress to bigger actions. Just because the situation might seem relatively harmless now doesn’t mean it will stay that way.”

  A sample item in the published police log looked like this:

  Officers responded to a call from a Birch Road address when the residents returned home from school and work to find that their home had been entered in their absence. The intruder had apparently watched television and eaten a sleeve of Ritz crackers and a container of leftover take-out food. Police have no leads at this time. The residents were advised to lock their doors from now on.

  They hadn’t locked their doors! I’m ashamed to say that when I read that, my sympathies shifted from the victims to what I know from crime shows is called the “perpetrator.” I know that an unlocked door is not the same thing as an invitation to enter. But I pictured the intruder, the perpetrator, merely looking for a place to rest, and something to eat. It would probably turn out to be a homeless or mentally ill person who could have stolen jewelry or something else to sell, but didn’t. Who would only go so far and not compromise his integrity. That was something in his favor, I thought.

  Also, who keeps such track of their crackers that they know when a sleeve is missing, for God’s sake?

  I always lock my door. I keep it locked even when I am inside.

  The first thing I did was check the weather forecast online. It’s been hot all week, and the temp was again headed upwards of eighty degrees, so I was a little worried—I used to do just fine in the heat, but lately, not so much. When I took Scout out for his early walk, the sun already warmed the top of my head like the palm of a gentle and giant hand. Afterward, I finally allowed myself to dig out my warm-weather clothes. I’d been superstitious about it, afraid to trust I’d see summer, but now here it was.

  It would be a full day, what with my work meeting, the favor for Grettie, and the appointment with the therapist at three o’clock. There was a time in my life, especially when my son was young, that every day was a full day, but lately they’ve been pretty light. I knew it was a good idea to pace myself. I’d better take things slow.

  First the work meeting, then the bins. Then. . .

  But I didn’t need to worry about that now. I was determined to delay feeling anxious about it until two hours before we were to meet. The therapist had once advised me to schedule “worry time,” during which I was allowed to think as much as I wanted about whatever agitated me. These thoughts could include all the what-ifs and fantasies my mind could conjure (no matter how outrageous), but aside from that specified block of minutes or hours, I must do my best to reject any worries that sneaked in.

  I was skeptical, I admit. But I also have to admit that it worked, at least a little.

  For instance, it helped me sleep on the night before my surgery two years ago. As I lay in the dark I told myself that when morning came, I could let my fear run away with itself, but not before then. The technique isn’t perfect by any means, but sometimes it works well enough to keep me from fretting all day about an afternoon appointment, like the one I had later. I would allow myself to begin fretting at one o’clock.

  As for the bins, Jack had planned a trip for his and Grettie’s twenty-fifth wedding anniversary without taking into account that they’d miss the trash and recycling day for their street. Their town ordinances dictated that they couldn’t leave empty receptacles in front of the house for more than a few days. But neither did they want to leave a full garbage barrel in the sealed garage for another week.

  A year ago, they could have just asked one of their neighbors to help out. But now, since they’re at odds with most of the people on their street, Grettie asked me to swing by and move the containers from the curb into the backyard.

  It’s not far for me; their town is right next to mine and only a fifteen-minute drive when it isn’t rush hour, and she knows I have flexibility during my day. But she still hesitated to request the favor, I could tell. She felt bad about taking the trip at all, right now, even though she didn’t know how far away they’d be because Jack had not told her: it was a “surprise destination” anniversary trip.“Are you sure you’re up for it?” she asked me before they left. “You know how fast a week goes, right? We’ll be back in no time. You’ll be fine.”

  I couldn’t help realizing that it would have been more than twenty-five years—nearly thirty!—if it had been Grettie and me celebrating the length of our lives together. And I tried hard, as I always did, not to resent Jack for taking her away at a time when I might really need her. I always suspected him of being at least a little jealous of my friendship with Grettie, even though she told me No, he didn’t feel that way at all.

  But never mind, I told myself. Never mind, as I have told myself so often during these years.

  The trash and recycle trucks made separate trips to the street but both routes were always finished by midday, Grettie told me. My work meeting was scheduled for noon. At ten, I clicked into the file I’d moved to the head of my queue in the hospital database, figuring that I would likely be finished within an hour. It was a case of the flu complicated by irregularities in the patient’s heart.

  PATIENT ID: 1998207

  DIAGNOSIS: Influenza, cardiac arrhythmia, atrial fibrillation

  INDICATIONS: The patient is a 47-year-old woman of average weight and otherwise good health who reports having suffered from flu symptoms

  (head and muscle ache, fever, congestion) two weeks earlier, self-treated with acetaminophen (Tylenol brand) and OTC cough medication. She reports the symptoms abated, then returned along with dizziness, shortness
of breath, and confusion. Examination indicates tachycardia and atrial fibrillation.

  RELEVANT HISTORY: The patient acknowledges use of cocaine over a period of about three months in her mid-20s. She reports that she experienced occasional symptoms of tachycardia during that time, but did not seek medical attention.

  DISPOSITION: Patient was admitted for overnight monitoring and observation.

  When arrhythmia continued, and in light of other symptoms indicating stroke risk, ablation surgery was scheduled. Patient signed consent.

  PROCEDURE: The patient was brought into the operating room and placed in the supine position on the operating table. An intravenous line was started, and sedation anesthesia was administered IV. The patient was monitored for cardiac rate, blood pressure, and oxygen saturation continuously.

  After 10-15 minutes several incisions were made in the chest and ultrasound energy was applied to create scar tissue in the heart to block abnormal electrical signals causing arrhythmia. Measurements were taken to ensure that the scar tissue now directed electrical signals through a controlled path to the lower heart chambers. Incision was closed and dressed. The procedure was completed without complication and tolerated well.

  FOLLOW-UP CARE: Patient was moved to ICU for observation and monitoring. Diuretics and anti-coagulants were prescribed. Patient was up and walking one day after surgery, discharged to home with instructions to continue diuretics for two weeks. Follow-up scheduled in a month.

  I knew this patient. Well, not knew personally (if I’d known her, I would have had to send the file to someone else), but remembered, from other case notes I had coded over the years. Her patient ID had caught my eye at first because 1998 was the year my son was born, and 207 had been the number of the triple-decker I lived in, on the outskirts of the city, when I gave birth to him. But over time, I had other reasons to pay attention to this patient’s file. We were the same age. The first time I coded her, she’d been treated for a septate uterus, which led to a miscarriage. I remember how sad I felt, reading this; my own son was two years old at the time. Since then, she had been treated for a nasal deformity (minor); appendicitis (more cause for concern, but caught in time); a successful pregnancy six years ago (I was so happy for her, to see that news!); and now this, the most serious of all.

  What had she been confused about when she came in with symptoms? And why had she done cocaine in her twenties, and what had stopped her after three months? I imagined a boyfriend who was what my mother would have called “a bad influence”; I imagined her coming to her senses, knowing that she had to leave him, fearing his reaction both because he was on drugs and because he did not want to lose her. I imagined the talk she’d had with herself and the decision she knew she must make: stay with this loser and lose myself in the process, or make a clean break, from him and his way of life. Of course, this was all a complete fantasy on my part. It was just as likely that she’d tried cocaine at a party, liked it, and would never have stopped using if her parents or a friend hadn’t intervened and forced her to get help. But I liked to tell myself stories about the patients I coded. It appealed to the English major in me.

  The patient’s name was Celia Santoro. I was not supposed to know it, but—through no fault of my own—I did. I also knew that the procedure she had undergone, ablation, was called a “heart maze.” It had been performed a month and a half earlier; was she all right now? Once I learned her name, I couldn’t help (or didn’t help, take your pick) looking up where she lived. Her address was in the town just east of mine, probably ten miles away from where I sat at my desk coding her medical file. Sometimes I was almost tempted to drive by her house, to see if I might catch a glimpse of her—to see if she looked anything like what I imagined.

  But of course, I would not. It would violate the ethics of my profession.

  “How can that possibly not be the most boring job in the world?” my son asked me once, when he was in fifth grade. “You sit at a desk and read about the boring medical procedures people had done to them. Then you sit in a basement and compare notes with people who do the same boring thing. You turn people into numbers, and for what? Insurance companies. How can that feed your soul?”

  He didn’t mean to be obnoxious, I told myself. It scared me, I admit, to hear that tone in his voice—I’d heard it before, I’d seen that look. But I convinced myself that it wasn’t the same tone or the same look; he was genuinely curious, he genuinely wanted to know. He must have heard someone use that phrase, “feed your soul,” in a sincere way—it’s the way people talk around here. When I was young it was Follow your dream.

  I bit back the impulse to inform him that it didn’t feed my soul. But it fed him. Kept him in this house in this town with its school district that might not be as fancy as the one Grettie’s kids went to, but was still pretty damn good. And in the clothes he liked to wear, the music he liked to listen to, and the games he liked to play. All those tai chi lessons! Now, it pays for his college—or some of it, the portion not paid for by the loans he’s taken out, which I try not to think about.

  My salary alone wouldn’t have been enough. I make thirty dollars an hour as a medical coder, and that’s now, after almost twenty years. I still think it’s better than anything I could have gotten with my degree in English, which is why I took the job in the first place. Coding was fairly new then, it was easy to stay employed. Property taxes alone eat up about a fifth of my annual earnings. Until this spring, I supplemented my salary by teaching a night class in coding certification at the community college. I can’t imagine what Will thinks I must be paid for my work. If he’s ever bothered to wonder, he’s never asked.

  But that’s kind of how it is, here. Ours used to be more of a blue-collar town, but then in came the bike path and now it’s literally an extension of Cambridge. Most kids are accustomed to their parents having enough money for whatever they want. I guess it’s not Will’s fault, those things he said to me.

  I told him: “I know it isn’t your idea of exciting. But somebody has to code those doctors’ notes.” I knew he would not understand it if I said what I really thought, which was that I thought of each file as a story. And that what I did for a living is the same thing we all do, all the time. When it comes down to it, anything one person ever says to another can be construed as code. “It’s the way the system works,” I said instead. When he smirked, my heart sank, but I kept trying. “I think of it as a kind of translation. From one language into another.”

  At this he laughed outright. “Yeah, right. It’s pure poetry.”

  Well, there was no way I could turn this into anything else in my head—the meanness, the disrespect. “I’m not saying it’s poetry.” If someone had told me what it could be like to be the single mother of a single son, I might never have had him. This was what I told myself sometimes—that it was because I was doing it all alone, because I had no siblings to offer him—to avoid believing it was my fault, the way Will acted and the things he said to me.

  But we got through it, thank God. He started taking tai chi classes in middle school, and they seemed to make him a little calmer, less likely to pester me about who his father was or anything else. Soon after that the emetophobia set in, though we didn’t call it that—we called it the trouble with his tummy—and we stopped arguing altogether, probably because he couldn’t afford for us to be fighting when he had that going on. He was vulnerable, he needed me. He became my sweet boy again, right up until he left for college last August. When we had the worst fight of all.

  He’s not a bad person—of course he isn’t! Or a mean person, or an unfeeling one. (Look at all the feelings he has for his girlfriend.) He’s just somebody who needs to recognize that he’s allowed his priorities to get out of whack. Isn’t it more important to keep loving the parent you know than to agonize about the parent you don’t? But try telling him that.

  After I finished coding and submitting Celia’s file, I logg
ed out of the system and shut the computer down altogether. As I reached for the switch, there came a memory I wasn’t sure I wanted. Was it the sight of my own arm, sleeveless because of the hot day? How Will, when he was little, would rub my bare arm up and down the way other children would rub a blankie. He’d do it in bed after his bath, when I picked him up from preschool, and whenever he felt nervous. I remember longing for it, the arm-rubbing, even as it was happening.

  How is it possible to miss a thing before you’ve lost it? And yet, I did. We do.

  After I logged out of my work program, I took Scout for another short walk around the block. He’s almost ten now; we’ve had him since Will was in fourth grade, when he asked if we could get a dog. It wasn’t my idea, I didn’t want one. Well, that’s not exactly true. I was happy to have a dog, I just also dreaded it because I knew what always follows having a dog, the dog has to die. I didn’t want Will to have to go through that. To be honest, I didn’t want to go through it, myself.

  He started bringing up the idea after we went with Grettie and her son Cam to one of the Harvard museums, where we saw a sculpture of a robed, reclining corpse with a dog at his feet. Fidelity beyond the grave, read the exhibit plaque, so I explained to Will what “fidelity” meant. I could tell that of all the art we saw during that visit, this piece affected him the most. “If you lie down or if you die,” he said to me solemnly the next day, “a dog will keep you company forever. Don’t you think that would be nice?”

  Not for that reason but because he wanted it so much I let myself be persuaded, and as it turned out, Scout became more of a companion to me than to Will, because he was at school all day and I was working at home. He was a beagle mix from the pound, nothing special. They didn’t charge us anything, we just went over one day and brought him home. Will said he liked having another boy in the house, which I thought was adorable. When he took up tai chi, Scout took to lying across the room and watching. Will said Scout’s eyes followed his every move. He said he thought it settled them both down—the dog, and him. I thought that was adorable, too.