Matters of Choice

  Woodfield sprawled over forty-two square miles of rugged country, and sometimes she was called into neighboring townships as well. Summoned by a boy who hiked three and a half miles to get to a phone, she went to a cabin on top of Houghton’s Mountain and strapped a sprained ankle for Lewis Magoun, a sheep farmer. When she came down the mountain and drove back to the office, she found Toby harried and anxious. “Seth Rushton has had a heart attack. They called you first thing, but when I couldn’t reach you, I telephoned the ambulance.”

  R.J. drove to the Rushton farm to find that the ambulance had already left for Greenfield. Rushton was treated and was resting comfortably, but it was a valuable lesson. The following morning R.J. drove to Greenfield and bought a cellular bag phone. She kept it in the car, and she was never out of touch with her office again.

  Now and then, as she made her way about the town, she passed Sarah Markus. She always sounded the horn and waved. Sometimes Sarah waved back.

  Whenever David brought R.J. to the log house while Sarah was home, she could feel Sarah’s watchful eyes as the girl analyzed everything that was said.

  Driving home from the office one afternoon, R.J. passed Sarah galloping Chaim the other way. She admired how well the girl sat the horse, how effortlessly she posted, her dark hair streaming behind her. R.J. didn’t toot a greeting, for fear of spooking the animal.

  A few days later, sitting in her living room, R.J. glanced out of the window and saw, through the gaps between the apple trees, that Sarah Markus was walking her horse along Laurel Hill Road very slowly while she studied R.J.’s house.

  R.J. was interested in Sarah in part because of the girl’s father, but also because of Sarah herself, and perhaps for another reason. Somewhere in the back of her mind was an amorphous picture, a possibility she didn’t dare to consider yet—the concept of the three of them together, she, David, and this girl as her daughter.

  A few minutes later, horse and rider came back down Laurel Hill Road the other way, the girl still taking in the house and the land with her eyes. Then, when they had reached the end of the property, Sarah kicked her heels and Chaim began to trot.

  For the first time in a long while, R.J. allowed herself to think of the pregnancy that had miscarried after Charlie Harris died. If that baby had been born, she would be thirteen years old, three years younger than Sarah.

  She waited by the window, hoping Sarah would turn the horse and ride past again.

  One day when she came home from the office at dusk, R.J. found that a heart-shaped rock, as large as her hand, had been left on her porch by the front door.

  It was a beautiful heartrock composed of two outer layers of dark gray stone and an inner layer of lighter rock that sparkled with mica.

  She knew who had left it. But was it a gift of approval? A signal of truce? It was too pretty to be a declaration of war, R.J. felt certain.

  She was happy to get it, and she took it inside and set it on the living room mantel next to her mother’s brass candlesticks, a place of honor.

  Frank Sotheby stood on the porch of his general store and cleared his throat. “I think they should both of them see a nurse, mebbe, Dr. Cole? The two of them live all by themselves with a bunch of cats in that apartment above the hardware store. The smell. Whew.”

  “You mean right down the street? How come I’ve never seen them?”

  “Well, because they don’t ever come out, hardly. One of ’em, Miss Eva Goodhue, is old as sin, and the other one, Miz Helen Phillips, that’s Eva’s niece, is lots younger but more’n a little dotty. They take care of each other after a fashion.” He hesitated. “Eva calls me Fridays with her grocery list. I carry ’em an order every week. Well … her last check was refused by the bank. Insufficient funds.”

  The dark, narrow stairway had no light bulb. At the top of the stairs R.J. knocked, and after she had stood there for a long time, she knocked harder. Again and again.

  She heard no footsteps, but she sensed slight movement behind the door. “Hello?”

  “Who is it?”

  “It’s Roberta Cole. I’m the doctor.”

  “From Dr. Thorndike?”

  Oh, baby. “Dr. Thorndike has been … gone … a good while. I’m the doctor now. Please … am I speaking to Miss Goodhue or Mrs. Phillips?”

  “Eva Goodhue. What do you want?”

  “Well, I’d like to meet you, Miss Goodhue, to say hello. Will you kindly open the door and invite me in?”

  There was silence behind the door. The moment stretched and stretched. The silence thickened.

  “Miss Goodhue?”

  At last R.J. sighed. “I’ve got a new office right down the street from you. Just down Main Street, first floor at Sally Howland’s house. If you should ever need a doctor, either one of you, just telephone or send somebody to fetch me, okay?” She took one of her cards and slipped it under the door. “Okay, Miss Goodhue?”

  But there was no answer, and she went back down the stairs.

  When she and Tom had made their infrequent trips to the country, sometimes they had seen an occasional glimpse of wildlife, rabbits and squirrels, chipmunks who nested in the overhang woodshed. But now that she lived in the house every day, she witnessed through the windows a variety of wild neighbors she hadn’t met before. She learned to keep her binoculars at close hand.

  From the kitchen window, one gray dawn, she saw a bobcat amble insolently across the meadow. From her home office overlooking the wet pasture, she saw four otter, up from the river to hunt in the marsh, running in a single undulating file so close to one another they appeared to be the curves of a serpent, a Loch Ness monster in her wet pasture. She saw turtles and snakes, a fat old woodchuck who ate the clover in the meadow every day, and a porcupine that waddled out of the woods to munch the early drop of tiny pale-green apples under the trees. The thickets and trees were full of songbirds and raptors. Without trying she saw a great blue heron and several varieties of hawk. From her front porch she witnessed a horned owl come down, fast as doom and soft as a whisper, and take a running vole from the meadow. Up, out, and away.

  She described what she had seen to Janet Cantwell. The town selectwoman taught biology at the university in Amherst. “It’s because your house is on a verge, a meeting of several different environments. Wet pasture, dry meadow, deep woods containing ponds, the good river running through the whole thing. Creatures find wonderful hunting.”

  As R.J. traveled the countryside she saw properties with names. Some signs were self-acknowledgments: SCHROEDER’S TEN ACRES, RANSOME’S TREE FARM, PETERSON’S REWARD. Others were droll: DUNROVIN and IT’S OUR PLACE; or descriptive: TEN OAKS, WINDCREST, WALNUT HILL. Some of the names were too precious. She’d have enjoyed calling her place Catamount River Farm, but for many years that name had been on a house a mile upstream; besides, it would have been presumptuous to call her property a farm nowadays.

  David, that man of many facets, had a basement full of power tools and had offered to make it possible for the new doctor to hang out a shingle.

  She mentioned it to Hank Krantz, who came roaring and clattering up her driveway one morning on his big John Deere tractor, pulling his manure spreader. “Get in,” he said, “and we’ll get you a log for your signpost.” So she clambered into the big metal spreader, providentially empty but redolent of cow shit, and held on in disbelief while he jarred and bumped her—a country woman at last—all the way to the river.

  Hank chose a healthy, mature black locust tree in a stand on the riverbank and felled it with his chain saw, trimming the log and putting it in the manure spreader to keep her company on the way back.

  David fashioned a stout, square-cut signpost from the log, approving Hank’s choice. “Black locust is just about rot-proof,” he said, and set it three feet into the earth. An arm extended from it, with two eyebolts on the bottom surface from which the sign would be suspended. “You want something besides your name? You want to call the place anything special?”

  “No
,” she said. Then she made up her mind, and she smiled. “Yes, I do.”

  She thought it was beautiful when it was done, painted the same yellow as the house, with the lettering in black.

  THE HOUSE

  ON THE VERGE

  R.J. COLE, M.D.

  The sign puzzled people. On the verge of what? they asked her.

  Depending on her mood she pleased herself by telling them the house was on the verge of solvency, on the verge of despair, on the verge of collapse, on the verge of answering the cosmic riddle of life. Pretty soon either they grew bored by her oddness or accustomed to the sign, and they stopped asking.

  20

  SNAPSHOTS

  “Who’s next?” R.J. asked Toby Smith late one afternoon.

  “I am,” Toby said nervously.

  “You? Oh … of course, Toby. Do you need a physical exam, or do you have a problem?”

  “Problem.”

  Toby sat by the desk and outlined the facts sparingly and clearly.

  She and her husband, Jan, had been married for two and a half years. For the past two years they had been trying to conceive a child.

  “No luck at all. We make love all the time, desperately and much too often, really. It’s ruined our sex life.”

  R.J. nodded in sympathy. “Well, give it a rest. It ain’t what you do, it’s the way you do it. And when. Does Jan know you’re talking with me about this? Is he willing to see me, too?”

  “Oh, yes.”

  “Well, we’ll do a semen analysis and run some tests on you, for starters. After we gather some information, we’ll be able to set up a regular drill for you.”

  Toby regarded her seriously. “I would appreciate it if you would use another word, Dr. Cole.”

  “Of course. Schedule? We’ll set up a regular schedule?”

  “Schedule is fine,” Toby said, and they smiled at one another.

  * * *

  She and David had reached the stage where they asked each other a lot of questions, wanting to know one another in every way. He was curious about how she regarded her work, and it was interesting to him that she had been educated both as an attorney and as a physician.

  “Maimonides was a lawyer as well as a doctor.”

  “A rabbi too, no?”

  “A rabbi too, and a diamond merchant, to bring bread into the house.”

  She smiled. “Maybe I should become a diamond merchant.”

  She found it possible to talk about anything with him, an unbelievable luxury. He felt the same way about abortion that he felt about God: he was undecided. “I think a woman should have the right to save her own life, to safeguard her health or her future, but … to me, a baby is a very serious thing.”

  “Well, of course. To me, too. Conserving life, making it better—that’s my job.”

  She told him how it felt when she was able to help someone, really score points to drive away pain, to extend life. “Like a cosmic orgasm. Like the world’s biggest hug.”

  He listened when she remembered agony too, times when she had made a mistake, when she realized that someone who had come to her for help had been harmed by her efforts.

  “Have you ever ended somebody’s life?”

  “Hurried death in through the door? Yes.”

  She liked the fact that he didn’t say the obvious things. He only looked into her eyes as he nodded, and took her hand.

  He could be moody. Real estate sales seldom influenced his spirits, but she was able to guess whether or not his writing was going well. When it was going badly he took refuge in physical work. Sometimes on weekends he allowed her to share his garden chores, and she pulled weeds and dug her hands into the soil, loving the gritty contact of earth with skin. Despite her supply of fresh vegetables from the gardens of others, she wanted her own. He convinced her of the wisdom of a couple of raised beds, and he knew where she could buy some used barn beams with which to make the frames.

  They removed the grassy topsoil from two rectangles on a gradual, south-facing slope in the meadow, block by block like Inuits building an igloo, and piled the sod upside down in the composter. They set flat stones in the ground in the shape of the beds, four feet by eight feet, using a bubble level to make certain the stones were even. On the stone base David built the bed frames, using two layers of the oak beams on each. The beams were difficult to handle and work. “Hard as death and heavy as sin,” David grunted, but soon he had shiplapped the corners and had driven long galvanized spikes to form the frames.

  He set down his sledge and took her hand. “You know what I love?”

  “What?” she asked, her heart pounding.

  “Horse shit and cow shit.”

  The manure available to them was from the Krantzes’ cow barn. They mixed it with peat moss and soil and overfilled the beds, and then piled a foot of loose hay on top.

  “It will settle some. Next spring, all you’ll have to do is pull the hay aside and plant your seeds, and then add more mulch as things grow,” David said, and she looked forward to all of that with the anticipation of a child.

  By the end of July she was able to see some financial trends in her practice. It became troublingly clear to her that certain patients ran up doctor’s bills without any serious commitment to paying. Payment for treating insured patients, although slow, was guaranteed. Of the uninsured, some were destitute, and without hesitation or regret she wrote off their treatment—pro bono. But a few patients were reluctant to pay even though it was obvious they were able to do so. She had treated Gregory Hinton, a prosperous dairy farmer, for a series of ulcerated boils on his back. He had been to her office three times, each time telling Toby he would “send a check,” but no check had arrived.

  While driving past his farm, she saw him enter the barn, and she turned the Explorer into his driveway. He greeted her pleasantly, if with curiosity. “Don’t need your services, glad to say. Boils are all gone.”

  “That’s good, Mr. Hinton. Glad to hear it. I was wondering … well, if you could pay your bill for the three visits?”

  “You were what?” He glared. “Good lord. Is it necessary to dun patients? What kind of a doctor are you, woman?”

  “A doctor who has just begun a new practice.”

  “You should be advised that Doc Thorndike always gave a person plenty of space about paying.”

  “Dr. Thorndike has been gone a long, long time, and I don’t have that luxury. I’d appreciate it if you could pay what you owe,” she said, and bade him good-day as pleasantly as she was able.

  That evening David nodded slowly when she told him about the encounter.

  “Hinton is a stubborn old skinflint. He keeps everyone waiting to be paid, so he can milk the last bit of bank interest out of every dollar. What you have to realize—what your patients must realize, too—is that you’re running a business at the same time that you’re doctoring them.”

  She needed to work out a system for collections, David said. Any dunning should be done by someone other than the doctor, so R.J. could keep her “image as a saint.” Collecting debts was pretty much the same no matter what the business, he told her, and together they mapped out a program that she explained the next morning to Toby, the delegated collector, who would send out bills once a month.

  Toby knew the local population well and would make the difficult decision about whether a patient truly was indigent. Anyone who couldn’t pay but who wished to barter work or goods would be allowed to do so. Anyone who couldn’t give money or barter wouldn’t be billed.

  For those whom Toby believed capable of paying, separate computer categories were programmed for accounts that were up to thirty days overdue, sixty to ninety days overdue, and more than ninety days overdue. Forty-five days after the first bill was mailed, Letter No. I was sent, asking the patient to contact the doctor with any questions about the account. After sixty days, Toby would make a telephone call reminding the patient of the outstanding balance and recording his or her response. After ninety days, Le
tter No. 2 was sent, a firmer request for payment by a specific date.

  David suggested that after four months the account should be turned over to a collection agency. R.J. wrinkled her nose in distaste; that didn’t fit her vision of the relationships she wanted to build in a small town. She realized she had to teach herself to be a businesswoman as well as a healer; still, for the time being she and Toby agreed to hold off on dealing with a collection agency.

  Toby came to work one morning with a piece of paper that she handed to R.J. with a smile. It was yellowed and crumbling and had been placed for protection in a clear plastic holder.

  “Mary Stern found it in the files of the Historic Society,” Toby said. “Since it was addressed to an ancestor of my husband’s—the brother of his great-great-grandmother—she brought it over to our house to show it to us.”

  It was a physician’s bill, made out to Alonzo S. Sheffield, for “Office visit, grippe—50 cents.” The name printed at the top was Doctor Peter Elias Hathaway, and the date on the bill was May 16, 1889. “There have been several dozen physicians in Woodfield between Dr. Hathaway and you,” Toby told R.J. “Turn the bill over,” she said.

  A verse was printed on the back:

  Just on the brink of danger, not before,

  God and the Doctor we alike adore;

  The danger passed, both are alike requited;

  God forgot and the Doctor slighted.

  Toby returned the bill to the historical society, but not before copying the verse and placing it into the computer with Accounts Receivable.

  David talked all the time about Sarah, and R.J. encouraged him to do it. One evening he brought out pictures, four fat albums that recorded the life of one child. Here was Sarah as a newborn, held in the arms of her maternal grandmother, the late Trudi Kaufman, a plump woman with a wide smile. Here was serious little Sarah in her Teeterbabe, gravely watching her young father while he shaved. Many of the pictures engendered an anecdote. “See this snowsuit? Navy blue, her first snowsuit. She was just a year old, and Natalie and I were making a big deal over the fact that we had been able to switch her from diapers to training pants. One Saturday we took her to A&S—Abraham and Strauss, the nice department store in downtown Brooklyn. It was January, right after the holidays, and cold. You know what it is to dress a little kid for the cold? All the layers you have to put on them?”