“Every month,” Bonnie Roche told her, “I have a veterinarian come in to give our cows their tests and shots, but we can’t afford medical insurance for ourselves. Until you came, my cows got better medical care than my kids.”
The Roches weren’t an isolated case in America. In November, R.J. went to the old wooden Town Hall and cast a ballot for Bill Clinton as president of the United States. Clinton had promised her patients that he would provide medical insurance to everyone who didn’t have it. Dr. Roberta Cole intended to hold him to that promise, and she cast her vote as if it were a lance she was leveling at the health care system.
26
ABOVE THE SNOW LINE
“Sarah has had sex.”
R.J. waited a beat, and then she said carefully, “How do you know that?”
“She told me.”
“David, it’s absolutely wonderful that she could talk to you about something so intimate. You must have a remarkably good relationship with her.”
“I am devastated,” he said quietly, and she saw it was so. “I wanted her to wait until she was ready. It was easier years ago, when women were supposed to be virgins until their wedding night.”
“She’s seventeen years old, David. Some would say she’s well behind the curve. I’ve treated eleven-year-old children who have had sex. Sarah has a woman’s body, a woman’s hormones. It’s true some women wait for sex until they marry, but they’ve become a rare species. Even in the years when unmarried women were supposed to be virginal, a whole lot of them weren’t.”
He nodded. He had been quiet and morose all evening, but now he began to speak tenderly of his daughter. He said he and Natalie had talked to Sarah about sex before and after she entered puberty, and that he realized he was fortunate she was still willing to talk to him openly.
“Sarah didn’t say who her partner was, but since she’s dating only Bob Henderson, it’s safe to make a supposition. She said it was in the nature of an experiment, that she and the boy are very good friends, and they thought it was time they both got it over with.”
“Would you like me to have a talk with her about birth control, things like that?” R.J. hoped very much he would say yes, but he looked alarmed.
“No, I don’t think it’s necessary. I don’t want her to know I’ve been talking with you about her.”
“Then I think you should talk with her about those things.”
“Yes, I will.” He looked more cheerful. “Anyway, she told me the experiment is over. They value their friendship too much to spoil it, and they’ve decided to go back to just being best buddies.”
R.J. nodded doubtfully. She didn’t tell him she had observed that once young people had sex, they almost invariably repeated the experience again and again.
She had Thanksgiving dinner at the Markus cabin. David had roasted the turkey and made re-stuffed baked potatoes, and Sarah had candied a panful of yams with maple syrup and made threeberry applesauce from their own berries and fruit. R.J. brought pumpkin pies and apple pies with crusts she bought frozen at the supermarket and fillings she had prepared from scratch at three o’clock in the morning.
It was a quiet, very satisfying Thanksgiving dinner. R.J. was glad that neither David nor Sarah had invited anyone else. They ate the good dinner, drank mulled cider, and popped corn over the open fire. To complete her picture of what Thanksgiving would be if it were perfect, the overcast sky turned almost black at dusk and produced fat white flakes.
“Surely it’s too early for snow!”
“Not up here,” David said.
By the time she went home, several inches of snow had accumulated on the road. The windshield wipers kept the glass free, and the defroster worked, but she drove slowly and carefully because she hadn’t had the snow tires put on the car.
During all her winters in Boston, R.J. had loved the brief, mystical time when things were quiet and white during and immediately after a snowfall, but almost at once plows and trucks and cars and buses would begin to roar and snort, and the white world quickly became a dirty, dreary mess.
Here it was different. When she got to the house on Laurel Hill Road she built a fire and then turned off the lights and sat close to the flames in the darkened living room. Through the windows she saw that all around her house an accumulating blue whiteness had taken over the woods and the fields.
She thought of wild animals hunkered down in their holes in the blanketed ground, in the small marble caves on the ridges, in the hollow trees, and she wished them survival.
She wished the same thing for herself. She had survived the easy first months as physician to Woodfield, the springtime and summer. Now nature in the mountains was showing teeth, and R.J. hoped she would be equal to the challenge.
Once the snow came to the high land it didn’t go away. The snow line ended about two thirds of the way down the long descent local residents called Woodfield Mountain, so that when R.J. drove down into the Pioneer Valley to go to the hospital or to a movie or a restaurant, she found a snowless landscape that for a few moments seemed as foreign as the far side of the moon. It would be the week following New Year’s Day before the valley received a snowfall heavy enough to remain on the ground.
She enjoyed leaving the snowlessness and re-entering the white world of the hills. Although dairy farms were dwindling in number, the town was accustomed to an old tradition that said all roads must be kept open so tank trucks could collect the milk, and she had little trouble reaching her patients for house calls.
One night in early December, she had gone to bed early but was awakened at 11:20 by the telephone’s ring.
“Dr. Cole? This is Letty Gates, over on Pony Road, and I’m hurt.” The woman was crying, breathing raggedly as she spoke.
“Hurt how, Mrs. Gates?”
“My arm may be broken. I don’t know, my ribs … It gives me pain to breathe. He did me bad.”
“He? Your husband?”
“Yes, him. Phil Gates.”
“Is he there?”
“No, he’s gone off for more drinking.”
“Pony Road is up on the side of Henry’s Mountain, isn’t it?”
“Yes.”
“Well, okay. I’ll be right along.”
First she telephoned the police chief. Giselle McCourtney, the chief’s wife, answered the telephone. “Why, I’m sorry, Dr. Cole, but Mack isn’t here. A big twelve-wheeler went off the highway on that icy stretch just past the town dump, and he’s been down there since nine o’clock, directing traffic. He should be back any time, I expect.”
R.J. told her why her husband was needed. “So will you send him up to the Gateses’ farm as soon as he’s free?”
“I surely will, Dr. Cole. I’ll try to raise him on the radio.”
She didn’t have to place the car in four-wheel drive until she started up Pony Road. After that the rise was steep, but the hardpacked snow made a smoother ride than the dirt road would have offered in the summertime.
Letty Gates had turned on the strong light above their barn door, and R.J. began seeing it through the trees while she was a good distance away. She drove into the barnyard and stopped the Explorer near the back steps. She had just gotten out of the car and was taking her bag from the backseat when the first sharp, loud report made her start, and something kicked up the snow near her booted foot.
At once she made out the figure of a man just inside the barn door, in the darkened interior. The outside light reflected off the snow to gleam dully on the barrel of what she guessed was a deer rifle.
“Get the fuck out of here.” He swayed as he called to her, lifting the rifle.
“Your wife is hurt, Mr. Gates. I’m a doctor, Dr. Cole, and I’m going into your house to take care of her.” Oh God, she thought, not smart at all. She didn’t want to give him ideas, send him back into the house after the woman.
He fired again, and the glass in the right headlamp of her car exploded in a shower of shards.
There was no place where sh
e could hide from him. He had a powerful weapon, and she had none. Whether she tried to duck behind the car or within it, all he had to do was take a few steps and he could kill her if that was what he wanted to do.
“Be reasonable, Mr. Gates. I offer no threat to you. I just want to help your wife.”
There was a third shot, and the glass in the left headlamp of the car disappeared. Then another shot blew away a chunk of the front left tire.
He was making junk of her car.
She was exhausted, sleep-deprived, and so terrified that she was past caution. The accumulated tensions of ripping apart her life and putting it together again in this new place—everything suddenly welled up within her and spilled over.
“Stop it. Stop it. Stop it. Stop it.”
She had lost control, abandoned reason, and she took a step in his direction.
He came to meet her, holding the rifle low but keeping his finger on the trigger. He was unshaven, dressed in dirty overalls and a manure-stained brown barn jacket and a plaid woolen cap embroidered with “Plaut’s Animal Feeds” on the front.
“I didn’t have to come here.” She listened to her voice in astonishment. It was modulated and reasonable.
He looked puzzled as he lifted the rifle. At that moment they both heard the car.
For just long enough, he hesitated, and Mack McCourtney sounded the siren loud and low, like the growl of a giant animal. In a moment the car lumbered into the driveway, and McCourtney was there.
“Now don’t you be a horse’s prick, Philip. Put that gun down or it will be real bad for you. Either you’ll be dead or you’ll be in jail forever with no chance to get drunk at all.” The police chief was quiet and steady, and Gates set the rifle against the wall of the house. McCourtney handcuffed him and put him in the back of the Jeep, which was as secure as a cell, reinforced by heavy wire gridwork.
Very carefully, as if she were walking over thin ice, R.J. went inside the house.
Letty Gates had multiple bruises from her husband’s fists and what proved to be hairline fractures of the left ulna and of the ninth and tenth ribs on her left side. R.J. called the ambulance just as it returned from transporting the truck driver to the hospital.
Mrs. Gates’s arm was splinted and placed in a sling and bound to her chest with a wide cravat to support the ribs. By the time she was taken away by the ambulance, Mack McCourtney had gotten the spare tire onto R.J.’s car. The lampless Explorer was blind as a mole, but she followed behind the police Jeep as McCourtney slowly drove down the mountain.
When she got home, she managed to get only partially undressed before she sat on the edge of her bed and cried and cried.
The next day she was busy with office hours, but Dennis Stanley, one of McCourtney’s part-time special officers, drove the Explorer into Greenfield for her. He got a new spare tire and the Ford dealer replaced the headlights and the wiring for the left lamp. Then Dennis went to the county jail and gave the bills to Phil Gates, explaining that the judge might take it kindly when he considered the possibility of bail if Gates could say he was sorry and had already made restitution. Dennis brought Gates’s check back to R.J. with the repaired car and advised her to cash it immediately, which she did.
Things slackened in December, and she welcomed the breathing room. Her father had decided to visit friends in Florida for Christmas, and he asked if he could spend four days beginning December 19 with R.J., to celebrate the holiday early.
The early celebration put Christmas on schedule with Hanukkah, and David and Sarah said they would be glad to come to a holiday dinner.
R.J. cut a small tree from her own woods, which pleased her, and made a nice dinner for the four of them.
They exchanged gifts after the meal. She gave David a small painting she had bought of a cabin doorway that reminded her of his house, and a family-size package of M&Ms. For her father she had bought a jug of the Roches’ maple syrup and a jar of I’m-In-Love-With-You Honey. For Sarah, she had a collection of Jane Austen’s novels. Her father gave her a bottle of French brandy, and David gave her a book of poems by Emily Dickinson. Sarah had wrapped a pair of mittens she had knitted of undyed yarn and a third heartrock for R.J.’s collection. She told R.J. that in a way her gifts were from Bobby Henderson too. “The wool came from sheep raised by his mother, and I found the heartrock in their barnyard.”
R.J.’s father was growing older. He was more hesitant than she remembered, a little quieter and somewhat wistful. He had brought his viola da gamba. His hands were so arthritic that it hurt him to play, but he insisted that he wanted to make music. After the presents were exchanged, she sat at the piano, and they played a series of duets that went on and on. It was even better than the perfect Thanksgiving had been; it was the best Christmas R.J. had ever had.
After David and Sarah had gone home, R.J.’s father opened the front door and walked out onto the porch. It was crispy cold, so there was a sheen of ice on the surface of the snow, and the full moon cast a path of light across the meadow as if it were a lake.
“Listen,” her father said.
“To what?”
“To all the calm and bright.”
They did, standing there together, breathing in the cold air for a long minute. The wind was still, and there was a complete absence of sound.
“Is it always this peaceful here?” he asked.
R.J. smiled. “Most of the time,” she said.
27
THE SEASON OF COLD
David came to her place one afternoon when she was away and snowshoed over the cleared path through the woods three times, packing down the deep snow so the two of them could travel the trail on cross-country skis. The trail was too short, too quickly covered by a skier; they agreed they would have to finish it in time to have better skiing the following winter.
The woods became a very different place in the cold season. They saw tracks that told of animals that in the summer would have passed through the woods unnoticed, spoor of deer, mink, coon, wild turkey, bobcat. One set of rabbit tracks ended in a broken place off the trail. When David stirred the snow with a ski pole he uncovered frozen blood and bits of white rabbit fur, where an owl had fed.
Snow was a serious reality of everyday life in the hills. At David’s suggestion, R.J. bought a pair of snowshoes and practiced using them until she could make reasonable progress. She kept the snowshoes in the car, “just in case.” In fact, she didn’t have to use them that winter. But early in January there was a storm that even the town’s old-timers called a serious blizzard. After a day and a night of steady, heavy snowfall, her telephone intruded just as she was sitting down to breakfast.
It was Bonnie Roche. “Dr. Cole, I have a terrible pain in my side, and I’m so nauseated I had to quit in the middle of milking.”
“Do you have a fever?”
“My temperature’s a little over a hundred. But my side. It hurts like hell.”
“Which side?”
“On the right.”
“Low or high?”
“High … Oh, I don’t know. In the middle, I guess.”
“Have you ever had your appendix removed?”
“No. Oh, God, Dr. Cole, I can’t go to the hospital, that’s out of the question! We couldn’t afford it.”
“Let’s not assume anything. I’ll come out to your place right away.”
“You can only get as far as the highway. Our private road isn’t plowed.”
“Sit tight,” R.J. said grimly. “I’ll get there.”
Their private road was a mile and a half long. R.J. called the town ambulance squad, which had a rescue unit that used snowmobiles. They met her at the entrance to the Roches’ road with two of the machines, and soon she was seated behind Jan Smith and hugging him, her forehead tucked into his back as they skimmed over the snow-buried dirt track.
When they arrived, it was clear at once that Bonnie’s problem was appendicitis. A snowmobile wouldn’t ordinarily have been R.J.’s transportation of cho
ice for a patient with a hot appendix, but under the circumstances it had to serve.
“I can’t go to the hospital, Paulie,” Bonnie told her husband. “I can’t. Dammit, you know that.”
“Never you mind about that. You leave that to me,” Paul Roche said. He was tall and rawboned, in his twenties and still looking too young to drink alcohol legally. Every time R.J. had come to their farm, he had been working, and she hadn’t ever seen him, out here or in town, when his worried boy’s face wasn’t creased with an old man’s frown.
Despite Bonnie’s protestations she was helped onto Dennis Stanley’s machine, which moved off as slowly as Dennis could manage. Bonnie rode hunched over, guarding the appendix. At the plowed public road the ambulance and the crew were waiting, and they whisked her away, the siren splitting the silence of the town.
* * *
“About the money, Dr. Cole. There’s no insurance,” Paul said.
“Did you clear thirty-six thousand last year from the farm?”
“Clear?” He smiled bitterly. “You’re joking, right?”
“Then you won’t be charged by the hospital, under the rules of the Hill-Burton Act. I’ll see that the hospital sends you the papers to sign.”
“You mean it?”
“Yes. Only … I’m afraid the Hill-Burton Act doesn’t cover doctor bills. Don’t worry about my bill,” she forced herself to say. “But doubtless you’ll still have to pay a surgeon, an anesthesiologist, a radiologist, and a pathologist.”
It hurt her to see the worry flood back into his eyes.
That evening she told David about the Roches’ predicament. “Hill-Burton was meant to protect indigent and uninsured people from disaster, but it doesn’t work because it pays only the hospital bill. The Roches are riding a fragile economic ship. The expenses that aren’t covered may be heavy enough to sink them.”
“The hospital raises its charges to the insurance companies to cover what they can’t collect from patients like Bonnie,” David said slowly. “And the insurance companies raise their rates they charge for their insurance to cover their increased cost. So everybody who buys health insurance ends up paying Bonnie’s hospital bill.”