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

by Noah Gordon

  He didn’t look at R.J. “Leave us alone.”

  R.J. went out into the waiting room. After a long while, Paula Simms came to her.

  “He insists that you go home. I think you’d best do it, R.J. He’s very … you know. Upset.”

  Consciousness hurt unbearably. Sarah couldn’t be gone forever like that, just … gone. It was hard for her to face. It hurt to think, even to breathe.

  Suddenly the ice cube in which she had lived after Charlie Harris’s death was back.

  She made the first call to David that afternoon. After that, she telephoned every fifteen or twenty minutes. Each time she got his recorded business voice, so professional, so relaxed, thanking her for calling the Woodfield Realty Company and inviting her to leave a message.

  Next morning she drove to his house, thinking perhaps he was sitting there alone, not picking up the phone. Will Riley, David’s far neighbor from down the road, was putting a new fence post into the ground.

  “He home, Mr. Riley?”

  “No. Found a note from him taped to my door early this morning, asking me to feed the animals for a couple of days. I thought the least I could do is fix the fence. Hell of a thing, isn’t it, Dr. Cole?”

  “Yes. Hell of a thing.”

  “That wonderful little girl.”

  Sarah!

  What was going on with David? Where was he?

  When she went into the house it was just as it had been when she and the ambulance crew had left it, except now the blood had dried to a paste a quarter of an inch thick. She stripped the sheets and the blankets from the bed and placed them into a garbage bag. She used David’s garden spade to scrape up the terrible pudding from the floor, then she carried it into the woods in a plastic bucket and buried it. She searched out David’s stiff brush and soap and scrubbed the floor until the successive rinse waters turned from red to pink to clear. Under the bed, she found the cat.

  “Oh, Agunah.”

  She would have liked to pet the cat, hug her, but Agunah stared at her like a cornered lion.

  She had to drive home fast in order to shower and get to the office in time to see patients. It was mid-afternoon when she met Toby in the hallway and learned what half the town already knew, that David Markus had taken his daughter back to Long Island for burial.

  For a little while she sat at her desk and tried to make sense of the next patient’s case history, but words and letters wriggled on the other side of a deep liquid glitter. Finally, she did something she had never done before. She told Toby to apologize and reschedule patient appointments. Sorry, terrible headache.

  When she got home she sat in a chair at the kitchen table. The house was very quiet. She just sat.

  She cancelled all appointments for four days. She walked a lot. Got out of the house and just walked, over the trail, over the fields, along the road, without knowing where, to start and look about her in surprise: How on earth did I get here?

  She telephoned Daniel Noyes, and they met for an uncomfortable, sorrowful lunch.

  “I gave her a good examination,” he said quietly. “I couldn’t see anything wrong with her at all.”

  “It wasn’t your fault, Dr. Noyes. I know that.”

  He gave her a long, searching look. “It wasn’t your fault either. Do you know that, also?”

  She nodded.

  Outside the restaurant, he kissed her on the cheek before he turned away and walked toward his car.

  R.J. had no trouble sleeping. On the contrary, at night she sank into a deep and dreamless place of refuge. Mornings she lay under the covers in the fetal position, unable to move for long periods.

  Sarah.

  Her mind told her to reject guilt but she understood that guilt was hopelessly intertwined with her sorrow and from now on would be part of her.

  She decided it would be better to write to David before she tried to talk with him. It was important to her that he understand that Sarah’s death might just as easily have occurred following an appendectomy or a bowel resection. That infallible surgery didn’t exist. That it was Sarah’s own decision to have had the abortion and that she would have had it even if R.J. hadn’t agreed to help her.

  R.J. knew it would be little comfort for David to be told that some losses are incurred even in the safest invasive procedures. That in electing abortion over pregnancy, Sarah had been increasing her chances for survival, because in the United States, one out of every 14,300 women who continue pregnancy will die, while of women who are aborted—even after fourteen weeks of pregnancy—one in 23,000 can be expected to die. And that since everyone’s chances of dying every time he or she enters an automobile are one in 6,000, both pregnancy and abortion are extremely safe risks.

  So Sarah’s death as a result of a legal abortion was a rarity. A rarity.

  She wrote letter after letter, until finally she finished one that satisfied her, and then she drove to the post office.

  But instead of mailing it, she tore it up and threw the pieces in the Dumpster. She realized she had written it as much for herself as for David. Anyway, how could it make a difference. What did he care about statistics.

  Sarah was gone.

  And so was David.

  33

  INHERITANCES

  Day after day passed, and R.J. didn’t hear a thing. She called Will Riley and asked him if he knew when his neighbor was coming home.

  “No, I don’t have any idea. He sold the Morgan, you know. Did it by phone. I got a letter from him, overnight mail, asked me to be there yesterday at four o’clock so the new owner could pick up the horse.”

  “I’ll take their cat,” R.J. said.

  “That’ll be good. She’s out in my barn. I’ve already got four cats.”

  So R.J. picked up Agunah and brought her home. Agunah minced through the entire house, every inch a visiting queen, inspecting with disdainful suspicion. R.J. hoped David would come home and claim her soon. She and the cat never had established a meaningful relationship.

  She was chatting with Frank Sotheby at the general store a few mornings later when he wondered whether some other real estate person would move into town to take Dave Markus’s place.

  “I was surprised to hear he put his house on the market,” he said, regarding her closely. “I understand Mitch Bowditch is handling it, over in Shelburne Falls.”

  She drove down the Mohawk Trail to Shelburne Falls to have lunch and dropped in at the real estate office. Bowditch was a pleasant man, relaxed with people. He sounded truly regretful when he told her he had neither an address nor a telephone number for David Markus. “I just have a letter authorizing me to sell the place fully furnished, as is. And a New York bank account to send the check to. David said he wants to unload it quick. He’s a very good real estate man, and he set the price on the low side of fair. I should sell it pretty soon, I expect.”

  “If he should call, would you kindly ask him to contact me?” R.J. said, and handed over her card.

  “I will be happy to do that, doctor,” Bowditch said.

  In three days the cat ran away.

  R.J. roamed up and down Laurel Hill Road and walked the trail through the woods, calling.

  “AAGUUUUNAAAAAH!”

  She thought of all the critters that would consider a housecat a meal—bobcats, coyotes, mountain lions, large winged raptors. But when she got back to the house there was a message on the answering machine from Will Riley’s wife, Muriel, saying the cat had made her way through the hills back to their barn.

  R.J. picked her up again, and two days later Agunah left again and returned to the Rileys.

  Three more times the cat ran away.

  By that time it was late in September. Will grinned at her when she showed up to claim her unwilling guest. “It’s okay with us if you just leave her here,” he said, and R.J. agreed at once.

  Still, she felt a reluctance. “Shalom, Agunah,” she said, and the damned cat yawned at her.

  On her way back down the road, as sh
e passed the log house she saw that a new blue Jeep with New York registration plates was parked in the drive.

  David?

  She pulled in behind it, but when she knocked on the front door, Mitch Bowditch opened it. Beyond him was a man with a tanned face, thin graying hair and a brushy mustache.

  “Hi, there. Come on in and meet another physician.” He introduced them, “Dr. Roberta Cole. Dr. Kenneth Dettinger.” Dettinger’s handshake was friendly but brisk.

  “Dr. Dettinger’s just bought the place.”

  She controlled her reaction. “Congratulations. Will you practice here?”

  “Oh, God no! I’ll just use it for weekends and vacations. You know.” She knew.

  He had a practice in White Plains, child and adolescent psychiatry. “Very busy, long hours. This place, it’ll be like heaven to me.”

  They all three moved out into the backyard toward the barn, past the half dozen hives.

  “You going to keep bees?”

  “No.”

  “Want to sell the hives?”

  “Well. You can have them, glad to have you take ’em away. I’m thinking of putting a pool and a deck out here, and I’m allergic to bee venom.”

  Bowditch cautioned that R.J. didn’t want to try to move the hives for another five or six weeks, until they had a serious cold snap that would put the bees into dormancy. “Actually …” He consulted an inventory list. “David owns eight more hives that he’s rented out to Dover’s Apple Orchards. You want those too?”

  “I suppose I do.”

  “Buying the house the way I’m doing raises some problems,” Kenneth Dettinger said. “There are clothes in closets, bureaus to be cleaned out. I don’t have a wife to help me get the house shipshape. Only just divorced, you see.”

  “I’m sorry.”

  “Oh.” He grimaced and shrugged, and then he grinned ruefully. “I’ll have to hire somebody to clean everything out of the house and get rid of it.”

  Sarah’s clothes.

  “Do you know anyone I could hire to do a job like that?”

  “Let me do it. No money. I’m … a friend of the family.”

  “Why, that would be fine. I would appreciate it.” He was studying her with interest. He had chiseled features. She didn’t trust the strength she saw in his face; perhaps it meant he was accustomed to getting his way.

  “I have my own furniture. I’ll keep the refrigerator, it’s only a year old. Anything you want, just take it. What’s left … give it away or ask someone with a truck to haul it to the dump, and mail me a bill.”

  “When will you need the house emptied of things?”

  “If it can be done by Christmas, I’ll be grateful.”

  “All right, then.”

  That fall in the hills was especially beautiful. The leaves turned wanton in October, and the rains didn’t come to buffet them off the trees. Everywhere R.J. drove—to the office, to the hospital, to make a house call—she was struck by color viewed through a prism of cold, crystal air.

  She tried to go back to living her life normally, concentrating on her patients, but it seemed to her that she was always one step behind. She began to worry that her medical judgment might be affected.

  A couple who were near neighbors of hers, Pru and Albano Trigo, had a sick kid, Lucien, ten years old. They called him Luke. He was off his feed, without energy, had explosive diarrhea. It persisted, on and on. R.J. did a sigmoidoscopy, sent him for upper GI X rays, an MRI.

  Nothing.

  The boy continued to fail. R.J. referred him to a gastroenterologist in Springfield for a consult, but the Springfield physician couldn’t find anything wrong, either.

  Late one afternoon she crunched over dry leaves on the trail. Just as she reached the beaver pond she saw a body flash away underwater like a sleek, small seal.

  There were beaver colonies up and down the Catamount River. The river ran through the Trigo property, just downstream from R.J.’s.

  She hurried to her car and drove to the Trigos’ house. Lucien was lying on the couch in the living room, watching television.

  “Luke, did you go swimming this summer? In the river?”

  He nodded.

  “Did you swim in the ponds made by the beaver dams?”

  “Sure.”

  “Did you ever drink the water?”

  Prudence Trigo was paying very close attention.

  “Oh yeah, sometimes,” Lucien said. “It’s real clean and cold.”

  “It does look clean, Luke. I swim in it myself. But I just happened to think that the beaver and other wild creatures defecate and urinate in it.”

  “Defecate and …”

  “Shit and piss,” Pru said to her son. “Doctor means they shit and piss in the water, and then you drink it.” She turned to R.J. “You think that’s it?”

  “I think it might be. Animals infect water with parasites. If somebody drinks the water, the parasites reproduce and form a lining in the gut, so the intestine is no longer capable of absorbing nourishment. We won’t be sure until I send a stool sample off to the government lab. In the meantime, I’ll start him on a strong antibiotic.”

  When the test came back, the report said that Lucien’s digestive tract was laden with Giardia lamblia protozoa and showed traces of several other parasites as well. Within two weeks he was eating again, and his diarrhea had disappeared. Several weeks after that, another test revealed that his duodenum and jejunum were free of parasites, and his pent-up energy had found such release that he was getting on his mother’s nerves.

  He and R.J. agreed that next summer they would swim in Big Pond instead of in the river, and that they wouldn’t drink the lake water either.

  The cold came down from Canada, the kiss of death for all the flowers except the hardiest chrysanthemums. The hayed fields, close-cut as the heads of convicts, turned brown under the lemonish sun. R.J. paid Will Riley to bring the beehives to her place in his truck and stand them in her backyard in a row, between the house and the woods. Once they were moved, she completely ignored them, being occupied with treating humans. She had received advisories from the Centers for Disease Control warning that one of this year’s influenza strains, A/Beijing 32/92 (H3N2), was particularly virulent and debilitating, and for weeks Toby had been summoning aging patients to the office for flu shots. The vaccine didn’t make an appreciable dent in the epidemic when it came, however, and suddenly R.J.’s days were too short. The telephone ring became hateful. She prescribed antibiotics to some whose infections appeared to be bacterial, but mostly all she could do was tell them to take aspirin, drink lots of fluids, stay warm, get plenty of bed rest. Toby caught the flu, but R.J. and Peg Weiler managed to stay healthy despite the workload. “We’re too ornery to get sick, you and I,” Peggy said.

  It was the second day of November before R.J. could make time to bring cardboard cartons to the log house.

  It was as if she were closing out not only Sarah’s life, but David’s as well.

  While she folded and packed Sarah’s clothing, she tried to shut off her mind. If she could close her eyes too while she packed, she would have done it. When a carton became full, she took it to the town dump and placed it in the bin for Salvation Army collection.

  She stood for a long time over Sarah’s collection of heartrocks, trying to decide what to do with them. She couldn’t give them away or discard them; finally, she packed them all carefully and carried them out to the car as if they were jewels. Her guest room became a rock room, trays of heartrocks everywhere.

  She threw away the things in David’s medicine chest, ruthlessly dumping Sarah’s Clearasil and David’s antihistamines. Inside her there was a growing coldness at him for making it necessary for her to do these hurtful things. She saved the letters she found on his desk without reading them, placing them in a brown paper bag. In the lower left-hand drawer of the desk, she opened a typing paper box and found his book manuscript, which she took home and placed on the high shelf in her closet next
to old scarves, mittens that didn’t fit anymore, and a Red Sox cap she had had since college.

  She spent Thanksgiving Day working, but the epidemic already had started its downward curve. The following week she managed to take two days in Boston for an important occasion. Her father was ten months beyond the university’s mandatory retirement age of sixty-five. Now he had to leave the chair at the medical school that he had occupied for so many years, and his department colleagues had invited R.J. to join them at a dinner in his honor at the Union Club. It was a mellow evening, full of praise, affection, and reminiscences. R.J. was very proud.

  The next morning her father took her to breakfast at the Ritz. “Are you all right?” he said gently. They had already discussed Sarah’s death at length.

  “I’m absolutely fine.”

  “What do you suppose has happened to him?”

  Her father asked timidly, afraid to cause her more hurt, but she had already faced the question squarely, and she realized she might never see him again.

  “I’m certain he’s lost in a bottle somewhere.”

  She told her father she had paid off one third of the bank loan for which he had co-signed, and both of them were relieved to change the subject.

  What lay ahead for Professor Cole was a chance to write a textbook he had been planning for years and the teaching of several courses as a guest professor at the University of Miami.

  “I have good friends in Florida, and I thirst for warmth and sunshine,” he said, holding up hands that arthritis had made gnarled as apple tree branches. He told R.J. he wanted her to have the viola da gamba that had been his grandfather’s.

  “Whatever would I do with it?”

  “Perhaps learn to play it. I don’t play it at all nowadays, and I want to travel light.”

  “Are you giving me Rob J.’s scalpel, as well?” She had always secretly been very impressed by the antique family scalpel.

  He smiled. “Rob J.’s scalpel doesn’t take up much room. I’ll hold on to it. You’ll be getting it soon enough.”

  “Not for a very long time, I hope,” she said and leaned over the table to kiss him.