“If I want to,” Maribeth replied, acidly.
“Do you really think you’re helping yourself by getting so worked up?” he asked. Like he was the wronged party here.
“No,” Maribeth said flatly.
“Then don’t,” he said.
AT ELEVEN, THE buzzer rang. When Maribeth opened the front door and saw Luca there, she broke down in big, gusty tears.
“Oh, no! That’s not good,” Luca said, motioning Maribeth over to the living room. She sat down on the sofa. “What’s going on?”
Maribeth recounted the days since coming home. The sense of backsliding. Her family’s unrelenting dependence on her.
Luca listened patiently. “I wish I could say you’re the first woman who’s had this complaint,” she said.
“I’m not?” Maribeth said, feeling both heartened because it wasn’t just her and disheartened because, really?
Luca smiled wryly. “Would it surprise you to learn that one of the top fantasies for women is a prolonged hospital stay?”
“That’s absurd.”
“Not if you think about it. The exhausted, multitasking woman. A trip to the hospital, it’s like the ultimate vacation. A chance to be the nurtured one instead of the nurturer. Guilt free, no less.”
“But I have been in the hospital, for something really serious, and it hasn’t changed a thing.”
This wasn’t entirely true. It had changed everything, but not the way she needed it to.
“That’s why it only works as a fantasy,” Luca replied.
“I don’t know what I’m supposed to do. I don’t know how I’m ever going to heal this way. I feel like I’m healing backwards, the end result being . . .”
She couldn’t say it. Didn’t have to. Luca acknowledged it with a nod. Then she started to unpack her equipment. “Let’s take a look at you.”
Luca did the exam. “Your EKG looks great and your heart and lungs sound fine. Your pulse is a little weak and I wouldn’t be surprised if you were anemic so when you get your next blood work done, have them test for iron. But you appear otherwise healthy. You’re clearly run-down, but not in any imminent danger I can see.”
“That’s good, I guess,” she said before she started to cry again.
“It is good, Maribeth.” Luca squeezed her hand. “You can be happy about that.”
But how could she be happy when every day that she supposedly grew stronger—healthier—she felt more and more terrified? The specter of death had seemed abstract before, even after the heart attack, even as she was watching the image of her heart on the screen in the cath lab. But now it was real. It was a presence as physical and demanding of her attention as her twins. Maybe that was why she wanted to stitch Oscar and Liv into her body, and at the same time, she wanted to jettison them far away from her.
“Is there anything else going on?” Luca asked. By now, she’d been there more than twice the allotted time.
“No,” Maribeth answered. “I mean, I’m probably just run-down, like you said.”
Luca packed up. Before she left, she embraced Maribeth. Then she held her at arm’s length and looked at her as if deciding something.
“I believe you have a healthy heart,” she said. “The doctors have done their part. But if you want to get better, really better, well, you’re going to have to do that for yourself.”
Pittsburgh
13
It had been surprisingly easy.
Maribeth had walked downstairs and hailed a cab, carrying only a hastily packed duffel bag with a few changes of clothing and her medications. She’d left her cell phone, her computer—pretty much everything else—at home. None of that felt necessary anymore. She had e-mailed Jason. An apology? An explanation? She wasn’t sure. By the time she was in the cab, the details of her note had already begun to fade.
“Penn Station,” she told the driver. She had not known that would be her destination until the words came out of her mouth.
Twenty minutes later, she was at the train station. Across the street was a branch of her bank. Maribeth was about to pull cash out from the ATM but instead she wandered into the lobby and asked a teller how much she could withdraw.
Twenty-five thousand dollars turned out to be surprisingly portable. It fit snugly into her duffel bag.
Easy.
When she entered the mildewy cavern of Penn Station, she still hadn’t known where she was going. She’d thought maybe some quaint coastal New England town. And then she saw the departure board.
She bought her ticket for the Pennsylvanian and went to one of the cell phone kiosks for a burner phone (testing out a vocabulary acquired during that one season she’d managed to watch The Wire). The clerk handed her a pay-as-you-go flip phone with a 646 number. She paid for one hundred minutes of talk time. She went into a Duane Reade and bought a bottle of water, a pack of gum, and some lice shampoo, just in case. Then she boarded the train.
Easy.
When the train emerged onto the wetlands of New Jersey, Manhattan glittering in the afternoon sun, Maribeth thought it looked like something from a movie. Which was how it had felt. Like something happening to some actor on a screen. She was not Maribeth Klein, mother, leaving her two young children. She was a woman in a movie going somewhere normal, perhaps a business trip.
On the train, exhaustion overcame her, a different flavor from the dragged-down lethargy that had plagued her back home. It was the floppy satisfying tiredness one gets after a long day of doing nothing in the sun. Using her duffel bag as a pillow, she went to sleep.
Easy.
When she woke up and went to the café car to get something to eat, she found a discarded City Paper on one of the tables. Inside was a tiny real estate section, with not much advertised, but there was a one-bedroom in a neighborhood called Bloomfield. She called from the train and spoke to the landlord, an elderly sounding man with a thick accent (Italian? Eastern European?) who told her the apartment was available, and not only that, it was furnished. The rent was eight hundred dollars a month. For an extra fifty bucks, she could move in a few days before the first of the month. She took it sight unseen.
Easy.
She spent her first night in Pittsburgh in a janky motel near the train station. The next morning, she took a taxi to her new apartment and gave the landlord, Mr. Giulio, first month’s rent, one month’s deposit, and signed a month-to-month lease. There was no FBI-level background check required of a New York City rental. No broker fee amounting to 15 percent of a year’s rent. Just sixteen hundred dollars. When she paid in cash, Mr. Giulio did not bat an eye.
Easy.
As for leaving, leaving Jason, leaving her children, she kept hearing Luca’s words: You have to do that for yourself.
A task assigned to others, falling back to her. In some ways it was comforting.
So leaving them was not exactly easy. But it was something she already knew how to do.
14
The last thing she wanted was more doctors. But Maribeth needed a cardiologist. Or a surgeon. She would be missing her scheduled follow-up appointment with Dr. Gupta, so before checking out of the motel, she’d found a Yellow Pages in the dresser, right next to the Bible, and had ripped out a sheaf of pages. She’d felt a pang of guilt for destroying the book, but, really, who didn’t have a smart phone anymore? Well, who besides her?
She’d spent Halloween morning in her new apartment calling cardiology practices. There were several; Pittsburgh was a medical town. Her new neighborhood was sandwiched between two hulking hospitals, which Maribeth found equal parts comforting and alarming. Most of the doctors were booked out, but after a dozen calls, she found a practice that had just had a last-minute cancellation for Monday.
As she waited for the taxi to take her to the appointment she wished she’d thought to steal the entire Yellow Pages. She’d spent most of the weekend holed up, sleeping and watching TV, subsisting on minestrone soup and yogurt from the little Italian grocery on the corner. Now that she
was feeling steadier, there were things to figure out. Where was a proper grocery store? A pharmacy? Where might she get a nicer set of sheets than the stained ones the apartment had come with? Without Google at her constant disposal, she didn’t know how she would find anything.
A scrawny tabby cat sidled up to her, lost interest, and then sniffed at an artfully carved jack-o’-lantern that was starting to rot. The handiwork, she guessed, of her upstairs neighbors, a young couple who were the only other tenants in the small frame building. The top floor, she knew, was vacant. Mr. Giulio had offered to show her the studio apartment there, but she’d declined, saying she could handle the rent on the one bedroom. (What she could not handle were the two flights of stairs to the attic.)
The door opened and a young man with a swoop of platinum hair emerged. He bent down to try to pet the cat, which scurried away.
“Is that yours?” Maribeth asked.
“We aren’t allowed pets in the building,” he replied.
“Oh. I didn’t know. I just moved in to the ground-floor apartment here.” She pointed. “But luckily I don’t have a pet.” She heard herself babbling and stopped.
“Welcome to our beautiful neighborhood,” he said drolly, gesturing to the bleak, treeless block.
“Thanks. Hey, look, you don’t happen to have a Yellow Pages?”
“They still make those?”
Maribeth suddenly felt so very old next to this young man, as she waited for a taxi driver to ferry her to a doctor.
“Sunny,” he called over his shoulder. “Do we have a Yellow Pages?”
A young South Asian woman, Sunny presumably, appeared. She had deep dimples, a ponytail, and was wearing leggings and an oversized sports jersey. “Didn’t we use it as a doorstop last summer?”
And now Maribeth felt 482 years old. Mercifully, the taxi pulled up. “Maybe another time,” she said.
She arrived at the doctor’s ten minutes early, as instructed, to complete the paperwork. She sketchily filled out the health history and left the insurance forms blank. So far, she had managed to exist on an entirely cash economy. She hadn’t planned it that way—she hadn’t planned any of this—but after so many years of being constantly available to everyone, she wanted to keep it that way.
“Excuse me, ma’am,” the receptionist said after Maribeth had handed in her paperwork. “We’ll need your insurance card.”
“That’s all right,” Maribeth said. “I’m paying cash.”
“You’re paying cash?” She looked at Maribeth as if she’d just announced she would be paying with Pokémon cards.
“Yes,” Maribeth said.
“Don’t you have insurance?”
“I’ll be paying cash,” Maribeth said.
“If you can’t afford insurance,” the receptionist replied, “we can help you apply for it. It’s very reasonable if you qualify for Medicaid. And we also offer discounts for the indigent.”
Indigent? She’d showered for this morning’s appointment, even washed her hair, albeit with lice shampoo, which had dried it to straw. Also she’d forgotten to get conditioner so maybe she did look a bit finger-in-socket. But still, the grooming had taken some effort.
“I’m paying cash,” Maribeth said for the third time.
The receptionist had looked at the forms. “You’re coming for postoperative care and you’re paying cash?”
“That’s right.”
“How did you pay for your surgery? In cash?”
Maribeth was beginning to get flustered. But then she remembered Elizabeth’s advice in situations like these: Act like you own it.
She took a deep breath. “How I paid for my surgery is neither here nor there. I just need to see a doctor, and I can pay cash. Up front. You won’t have to bill anyone.” Her voice sounded haughty, completely unlike her.
It seemed to work. The receptionist went to get the office manager.
Maribeth sat down and waited, feeling like she was about to be busted. As if it wasn’t the office manager who was going to come out but her high school principal. Or Jason.
“Ms. Goldman.”
It took Maribeth a few seconds to realize she was the Ms. Goldman being addressed. M. B. Goldman was the name she’d listed on her forms. An old nickname, her mother’s maiden name.
“Yes. That’s me.”
The office manager, an attractive overweight woman wearing a red power suit, smiled. “I understand that you’d like to pay cash for your visits.”
“Yes,” Maribeth said.
“The thing is,” the office manager said, “it’s against our practice’s policy.”
“I don’t see why this is such a problem.” Maribeth knew from her C-section and Oscar’s ear tube surgery the paperwork jungle of insurance companies. Oughtn’t they be thanking her for saving them the trouble?
“The doctors might want to order tests. And with the Affordable Care Act, everyone should be insured. Particularly a cardiac patient.”
“Shouldn’t that be my concern?”
“I’m just trying to explain our policy.” She paused. “Perhaps you should visit the ER?”
“I don’t need an ER,” she said. “I have money. I can leave a deposit.”
The office manager looked genuinely apologetic. But she still shook her head.
“Can you at least refer me to a cardiologist who might see me?” She no longer sounded like someone who owned the world. She sounded like someone who was asking to borrow a teaspoon of it.
“What about Dr. Grant?” the receptionist asked.
The office manager frowned.
“Is Dr. Grant a thoracic surgeon?” Maribeth asked.
“A cardiologist. One of the founders of this practice,” the receptionist said at the same time that the office manager was saying, “No, no. Not Dr. Grant.”
“Why not? Will he take cash?” Maribeth asked.
“I bet he might,” the receptionist started to say.
“I’m just not sure he’s taking new patients,” the office manager interrupted. She shot a warning look at the receptionist.
“So you can’t refer me to anyone?” Maribeth asked.
“Not anyone who won’t require insurance,” the office manager said.
Maribeth looked at the receptionist who was now looking at the floor.
Well, so much for easy. She’d had a good run, she supposed.
Defeated, she gathered her things to leave. She was almost out the door when the receptionist tapped her back. “Stephen Grant,” she whispered. “Give him a call.”
15
When she got home, she pulled out her purloined section of the Yellow Pages. Many of the doctors and practices took out ads. Dr. Stephen Grant did not. He had a one-line listing. As the phone rang, she remembered the queer look on the office manager’s face, a look of warning almost. A receptionist picked up. She said they had an opening for the next day. Maribeth hesitated. It was one appointment. How bad could he be?
DR. STEPHEN GRANT’S office was in a neighborhood called Friendship, not so very far from Maribeth’s new apartment. In her old life, it would’ve been walking distance. In her new life, she could walk three blocks.
As she rode the bus, she stared out the window at the elegant brick homes that Pittsburgh seemed to have in blithe abundance, like an overripe tree dropping apples to the ground. A few days ago, in the taxi from the train station, Maribeth had been similarly amazed at how pretty it was here—she’d assumed Pittsburgh would be a, well, pit. But it wasn’t. All the graceful sweeping trees dappled in fall colors, all the handsome houses with their stained glass windows, elaborate brickwork, tidy gardens. When the taxi had dropped her in front of her building, drab and with vinyl siding, she’d been disappointed, but mostly relieved. To run away was bad enough, but to land somewhere she might enjoy living, that felt obscene.
Though Dr. Grant’s office was right next to one of the large hospitals, his practice was not in one of the adjacent modern buildings, as the first practice she??
?d tried had been, but attached to one of those large brick houses she’d admired. She walked past it twice—it was easy to miss, only a small plaque on the front door announcing the practice—and when she pushed open the front door, she felt as if she was about to barge into someone’s living room.
Instead she found herself in a tiny waiting room with two chairs and a desk manned by an older black woman, her hair done up in an elaborate tower of braids. She gave Maribeth the same stack of paperwork to fill out that the other practice had, and Maribeth handed it back, with both her family history and the insurance forms blank.
When the receptionist asked for her insurance card, Maribeth replied: “I’m paying cash,” steeling herself for an argument that never came.
“Payment due at time of service,” she said. “Hundred and fifty dollars.”
A hundred and fifty dollars? Maribeth had expected it to be at least three hundred dollars, maybe more for tests. To be safe, she’d taken five hundred from her stash (or stashes; she had secreted bills throughout the apartment, hoping that if someone broke in, they wouldn’t find it all and clean her out).
“I might need tests,” she said.
“Hundred and fifty dollars,” the receptionist repeated.
Maribeth counted out the money and handed it over. The receptionist printed out a receipt by hand and gave it to Maribeth.
“That’s okay,” Maribeth said. “I don’t need it.”
The receptionist raised an eyebrow. “I’ll go on and leave it in the file.”
“Thank you.”
Maribeth started to sit down but the receptionist stood up and beckoned to her. “Come on back.”
In a small examination room, the receptionist, who was also apparently the nurse, took her vitals. Then she handed her a blue examination gown. “Dr. Grant won’t be but a moment.”
While Maribeth sat shivering in the gown, she began to question the wisdom of going to this Dr. Grant, who had appointments open at the last minute, couldn’t afford a receptionist and a nurse, and, she now suspected, had probably done something to get himself ousted from the larger cardiology practice. She pictured the stooped, nefarious villain in every bad TV legal drama.