The Cole Trilogy: The Physician, Shaman, and Matters of Choice

by Noah Gordon

  Max Roseman faced a long convalescence and had decided to retire. R.J. didn’t get the news from Sidney Ringgold; indeed, Dr. Ringgold made no official announcement. But Tessa came in with the intelligence, beaming. She wouldn’t reveal her source, but if R.J. had to bet, she’d have placed her money that Tessa had been told by Bess Harrison, Max Roseman’s secretary.

  “Word has it that you’re among those being seriously considered as Dr. Roseman’s replacement,” Tessa said. “Whoo-eee! I think you have a real good chance. I think that for you the job of associate chief would be the first rung of a tall, tall ladder. Would you rather aim at becoming dean of the medical school or director of the hospital? And whatever you end up doing, are you going to take me with you all the way?”

  “Forget it, I’m not going to get that job. But I’m always going to take you with me. You hear so many rumors. And you get my coffee every morning, you damn fool.”

  It was one of many rumors that floated all about the hospital. Now and again someone would say something sly and knowing, sending her a message that the world was aware of her name on a list. She wasn’t holding her breath. She didn’t know if she wanted the job enough to accept it if it were offered.

  Soon Elizabeth had lost enough weight so that for a brief time R.J. was able to get a faint inkling of what she had looked like as the slim young girl Tom had loved. Her eyes seemed larger, her skin grew translucent. R.J. knew she teetered on the brink of gauntness.

  There existed between them a curious intimacy, a world-weary knowledge that was closer than sisterhood. Partly, it was due to the fact that they shared memories of the same lover. R.J.’s mind wouldn’t allow her to imagine Elizabeth and Tom having sex. Had his lovemaking habits been the same? Had he cradled Elizabeth’s buttocks in his hands, had he kissed her navel after he was spent? Elizabeth must have some of the same thoughts when she looked at her, R.J. realized. Yet there was no jealousy in them; they were drawn close. Even burdensomely sick, Elizabeth was sensitive and astute. “Are you and Tom going to split?” she asked one night when R.J. had stopped to see her on the way home.

  “Yes. Very soon, I think.”

  Elizabeth nodded. “Sorry,” she whispered, finding the strength to console; but clearly, the confirmation came as no great surprise to her. R.J. wished they could have known each other for years.

  They would have been wonderful friends.

  4

  MOMENT OF DECISION

  Thursdays.

  When R.J. was younger she had made a great many political statements. Now, it seemed to her that she had only Thursdays.

  She placed special value on babies and disliked the notion of canceling them. Abortion was ugly and messy. Sometimes it got in the way of her other professional activities because a few of her colleagues disapproved, and for public relations reasons her husband had always feared and hated her involvement.

  But there was an abortion war waging in America. A lot of doctors were driven from the clinics, intimidated by the ugly and unsubtle threats of the anti-abortion movement. R.J. believed it was a woman’s right to make decisions about her own body, so every Thursday morning she drove to Jamaica Plain and sneaked into the Family Planning Clinic the back way, avoiding the demonstrators, the placards shaken at her head, the crucifixes jabbed at her, the thrown blood, the bottled fetuses stuck into her face, and the name-calling.

  On the last Thursday in February she parked in the driveway of Ralph Aiello, a neighbor who was paid by the abortion clinic. The snow in the Aiello backyard was deep and new, but he had earned his money by shoveling a narrow path to the gate in the back fence. The backyard of the clinic property was on the other side of the gate, where another narrow shoveled path led to the rear door of the clinic building.

  R.J. always made the walk from her car a quick one, afraid that demonstrators would burst around from the sidewalk in front of the clinic, and angry and illogically ashamed that she had to sneak to her work as a doctor.

  On that Thursday there was no noise coming from the front of the building, no screams, no curses, but R.J. was particularly troubled, having stopped to see Elizabeth Sullivan on her way to work.

  Elizabeth had traveled beyond the point of any hope and had entered the realm of intractable pain. The button she was allowed to press for self-medication had been inadequate almost from the start. Whenever she regained consciousness she suffered terribly, and now Howard Fisher had begun to give her very heavy doses of morphine.

  She slept in her bed without moving.

  “Hi, Betts,” R.J. had said loudly.

  She had placed her fingers against Elizabeth’s warm, faintly pulsing neck. In a moment, almost against her will, she had enclosed the other woman’s hands in her own. From somewhere deep within Elizabeth Sullivan information had flowed into R.J. and found its way into her consciousness. She had sensed the smallness of the reservoir of life, depleting steadily in incremental amounts, with infinitesimal slowness. Oh, Elizabeth, I’m sorry, she told her silently. I’m so sorry, dear.

  Elizabeth’s mouth had moved. R.J. bent over her, straining to hear.

  “… green one. Take the green one.”

  R.J. had mentioned the incident to one of the ward nurses, Beverly Martin.

  “God love her,” the nurse said. “Usually she never wakes up enough to say anything.”

  That week it was as if the screws suddenly were tightened on all the torture vises that brought stress to R.J. An abortion clinic in New York State had been set afire in the night, and the same sick passion was alive in Boston. Large, turbulent protest demonstrations, manic at times, had hit two clinics in Brookline, one run by Planned Parenthood and the other by Preterm. They had led to disruption of services, a large police response, and mass arrests, and it was expected that the Family Planning Clinic in Jamaica Plain was next.

  In the staff room, Gwen Gabler was drinking coffee, uncharacteristically quiet.

  “Something wrong?”

  Gwen set down her cup and reached for her purse. The sheet of paper was folded twice. When R.J. opened it, she saw a wanted poster, the sort displayed in post offices. It bore Gwen’s name, address, and photograph, her weekly schedule, the fact that she had left a lucrative ob-gyn practice in Framingham “to get rich performing abortions,” and the crime for which she was wanted: murder of babies.

  “It doesn’t say dead or alive,” Gwen said bitterly.

  “Did they make up a poster of Les, too?” Leszek Ustinovich had practiced for twenty-six years as a gynecologist in Newton before joining the clinic. He and Gwen were the only full-time physicians at Family Planning.

  “No, I’m the chosen goat here, apparently, although I understand Walter Hearst at the Deaconess Hospital has been similarly honored.”

  “What are you going to do about it?”

  Gwen tore the poster in half, and then in half again, and dropped the pieces into the trash basket. Then she kissed her fingertips and gently slapped R.J.’s cheek. “They can’t drive us away if we won’t let them.”

  R.J. finished her coffee thoughtfully. She had been doing first-trimester abortions at the clinic for two years. She had had postresidency training in gynecology, and Les Ustinovich, a superb teacher with a lifetime of experience, had trained her in the first-trimester procedure. First-trimester procedures were absolutely safe when done carefully and correctly, and she was careful to be correct. Still, every Thursday morning she was as tense as though she had to spend the day doing brain surgery.

  She sighed, threw her paper cup away, got up and went to work.

  * * *

  The next morning at the hospital Tessa gave her a very solemn stare along with her coffee and bagel. “It’s getting down to the crunch. Serious stuff. The word we have is that Dr. Ringgold is discussing four names, and you’re one of them.”

  R.J. swallowed a bite of bagel. “Who are the other three?” she said, unable to resist.

  “Don’t know yet. I heard only that every one is a heavy hitter
.” Tessa gave her a sidelong glance. “Do you know there has never been a woman in that position?”

  R.J. smiled less than joyfully. Pressure was no more welcome because it came from her secretary. “That isn’t a surprise, is it?”

  “No, it isn’t,” Tessa said.

  That afternoon R.J. was walking back from the PMS clinic when she met Sidney in front of the medical office building.

  “Hiyuh,” he said.

  “Hi there to you.”

  “Have you decided anything concerning that request I made of you?”

  She hesitated. The truth was, she had pushed it from her mind, not wanting to deal with it. But that was unfair to Sidney. “No, I haven’t. But I will in a very short time.”

  He nodded. “You know what every teaching hospital in this city does? When they need somebody to fill a leadership job, they look for a candidate who’s already created interest in himself because he’s a hotshot bench scientist. They want someone who’s published a number of papers.”

  “Like the young Sidney Ringgold, with his papers on weight reduction and blood pressure and onset of disease.”

  “Yes, like that long-ago young hotshot Sidney Ringgold. Research is what got me this job,” he agreed. “It’s no more logical than the fact that search committees looking for a college president always choose someone who has been a distinguished teacher. But there you are.

  “You, on the other hand. You’ve published a few papers, and you’ve created a couple of stirs, but you’re a doctor, not a bench science investigator. Personally, I think this is a good moment in time to have a physician of people as the assistant chief of medicine, but I need to make an appointment that will win a consensus of approval from the hospital staff and the medical community. So if a nonresearch type is going to be appointed associate chief of medicine, she has to have as much professional leadership in her résumé as is humanly possible.”

  She smiled at him, aware he was her friend. “I do understand, Sidney. And I’ll get back to you very soon with my decision about chairing the publications committee.”

  “Thank you, Dr. Cole. Enjoy your weekend, R.J.”

  “You too, Dr. Ringgold.”

  A weirdly warm storm blew in from the sea, pelting Boston and Cambridge with heavy rains and defrosting the late winter’s snow. Outside, all was puddles and dripping, and the gutters were awash.

  She lay in bed Saturday morning, listening to the downpour and thinking. She didn’t like her mood; she was increasingly morose, and she knew that kind of thing could affect her decisions, if she allowed it.

  She wasn’t enthusiastic about being Max Roseman’s successor. But she wasn’t enthusiastic about her medical life as it existed at the moment, and she found herself responding to Sidney Ringgold’s faith in her—and to the fact that again and again he had given her opportunities that other men would have denied her.

  And she kept seeing the look on Tessa’s face when she said that no woman had ever been associate chief of medicine.

  Mid-morning she got out of bed and put on her oldest sweat suit, a windbreaker, her most disreputable running shoes, and a Red Sox cap that she pulled down hard over her ears. Outside, her feet squished through the water, soaked before she was twenty yards from the house. Despite the thaw it was winter in Massachusetts, and she was wet and shivering, but as she jogged her blood began to sing and she warmed quickly. She had intended to go only to Memorial Drive and back, but the running was too good to cut short and she loped alongside the frozen Charles River, watching the rain on the ice, until she began to tire. On the way back cars splashed her twice, but it hardly mattered; she was wet as a swimmer. She let herself into the house through the back door and left her drenched garments on the tile floor of the kitchen, wiping herself with a dish towel so she wouldn’t drip on the rug on her way to the shower. She stayed under a very hot spray for a long time, until the mirror was so fogged she had no reflection when she got out and rubbed herself dry.

  She had just begun to dress when she made up her mind to go for it, and to chair Sidney’s committee. But not to replace anything in her schedule. Thursdays would stay Thursdays, Dr. Ringgold.

  She had gotten only as far as underpants and a Tufts University sweatshirt, but she picked up the portable phone and called his home number.

  “It’s R.J.,” she said when he answered. “I didn’t know if you guys would be home.” The Ringgolds owned a beach house on Martha’s Vineyard, and Gloria Ringgold insisted they spend as many weekends as possible on the island.

  “Well, but the lousy weather,” Dr. Ringgold said. “We’re stuck here for the weekend. You’d have to be a complete idiot to go out on a day like this.”

  R.J. lowered the back of the seat and sat down on the toilet and laughed. “You’re absolutely right, Sidney,” she said.

  5

  AN INVITATION TO THE BALL

  On Tuesday she taught an iatrogenic illnesses class at the medical school, pleasing to her because it was fiercely debated for almost the entire two hours. A few students still came to medical training in the smug expectation that they would be taught to be gods of healing, educated into infallibility. They resented discussion of the fact that in the course of trying to cure, doctors sometimes cause their patients injury and harm. But most of the students were aware of their place in time and society, sensitive to the fact that an exploding technology hadn’t obliterated the human ability to make mistakes. It was important for them to be acutely aware of situations that could cause harm or death to their patients and waste their hard-earned incomes on malpractice settlements.

  A good class. For the moment it made her more content with her lot as she made her way back to the hospital.

  She had been in her office only a few minutes when Tessa told her Tom was on the line.

  “R.J? Elizabeth went early this morning.”

  “Ah, Tom.”

  “Yes. Well, she hurts no more.”

  “I know. That’s good, Tom.”

  But he still hurt, she realized, and she was surprised how profoundly she hurt for him. What she felt for him was no longer a blaze, but undeniably a live spark of emotion remained. Perhaps he needed company. “Listen. Do you want to meet me some place for dinner?” she said impulsively. “Maybe go to the North End?”

  “Oh. No, I—” He sounded embarrassed. “Actually, I have something I can’t get out of this evening.”

  Comfort from somebody else, she thought wryly and not without regret. She thanked him for letting her know about Elizabeth and went right back to work.

  Late that afternoon, she received a call from one of the women in his office. “Dr. Cole? This is Cindy Wolper. Dr. Kendricks asked me to tell you he won’t be home at all tonight. He has to go on a consult, to Worcester.”

  “Thank you for calling,” R.J. said.

  But the following Saturday morning Tom asked her to brunch in Harvard Square. It surprised her. His usual Saturday routine was morning rounds at the Middlesex Memorial Hospital, where he was a visiting surgeon, and then tennis, with lunch afterward at the club.

  He was buttering pumpernickel very precisely when he told her. “An incident report has been filed against me at Middlesex.”

  “By whom?”

  “A nurse who was on Betts’s ward. Beverly Martin.”

  “Yes. I remember her. But, why on earth …?”

  “She reported that I administered an ‘inappropriately large’ injection of morphine to Elizabeth, causing her death.”

  “Oh, Tom.”

  He nodded.

  “What will happen now?”

  “The report will be considered at a meeting of the hospital’s Medical Incidents Committee.”

  The waitress came by and Tom stopped her and asked her to bring more coffee.

  “It’s no big deal, I’m certain. But I wanted to tell you about it before you heard it from somebody else,” he said.

  On Monday, in accordance with the wishes she had expressed in her will, Eliz
abeth Sullivan was cremated. Tom, R.J., and Suzanna Lorentz went to the funeral home, where Suzanna, as the attorney handling the estate, was handed a square box made of gray cardboard, containing the ashes.

  They went to lunch at the Ritz, and Suzanna read parts of Betts’s will to them over salads. Betts had left what Suzanna described as “a considerable estate” to support and encourage the care of her aunt, Mrs. Sally Frances Bosshard, a patient at the Lutheran Home for the Aged and Infirm of Cleveland Heights, Ohio.

  Following the death of Mrs. Bosshard, the remaining money, if any, would go to the American Cancer Society. To her beloved friend Dr. Thomas A. Kendricks, Elizabeth Sullivan had left what she hoped were good memories and an audiotape of Elizabeth Bosshard and Tom Kendricks singing “Strawberry Fields.” To her new and valued friend Dr. Roberta J. Cole, Elizabeth Sullivan had left a six-piece silver coffee service of French design and eighteenth-century manufacture, silversmith unknown. The silver service and the tape cassette were in storage in Antwerp, along with other items, mostly furniture and artwork that would be sold, the proceeds to be added to the monies going to Sally Frances Bosshard.

  Of Dr. Cole, Elizabeth Sullivan requested one last favor. She wished her ashes to be given to Dr. Cole for placement in the earth, “without ceremony or service, at a beautiful place of Dr. Cole’s choosing.”

  R.J. was stunned, both by the bequest and by the unexpected responsibility. Tom’s eyes glistened. He ordered a bottle of champagne, and they drank a toast to Betts.

  In the parking lot, Suzanna took the small square cardboard box from her car and gave it to R.J. R.J. didn’t know what to do with it. She put it on the passenger’s side of the seat in the BMW and drove back to Lemuel Grace.

  On the following Wednesday morning she was awakened at 5:20 A.M. by the loud and shockingly intrusive sound of bell chimes announcing that someone was at the front door.

  She struggled out of bed and into her robe. Unable to locate her slippers, she padded into the cold hallway in her bare feet.