‘All set, Paul?’ Lesley inquired.
Fedorko nodded. ‘I’ve got the book,’ he said and turned to Laura. ‘Are you okay?’
‘No, to be completely honest,’ she replied. ‘I mean, I don’t know what I’m doing here in the first place.’
‘Well, if you’re going into pediatrics, this is something you’ll have to learn. Also, frankly, these things are always easier if there’s a woman present,’ Paul answered.
Shit, Laura thought, it’s my job to keep the mother from ‘acting like a woman’ – in other words, getting hysterical. What am I supposed to say – I’ve been through it, too? Or is there some special cliché that’s appropriate for ‘just us girls’?
She turned to her preceptor. ‘What’s in the book, Paul?’
‘You’ll see,’ he said, and then smiled. ‘Don’t worry, Laura, this is one of those occasions when we can almost guarantee a happy ending.’
Lesley knocked.
A man’s voice bade them come in. They entered, their number making the little room seem crowded. Mort Paley was sitting by his wife’s pillow, holding her hand tightly. She was clearly still more or less comatose, but her husband leaped to his feet the instant the doctors entered.
‘Hello, Mort,’ the obstetrician said, deliberately using the first name to reinforce the effective parent-child relationship that always gives a doctor the upper hand. ‘Congratulations.’
‘But there’s something wrong, I know,’ Kathleen called out. ‘I mean, I’ve been asking every nurse on the ward and they just keep saying “Wait till Dr Lesley comes.” Something’s the matter – it’s on your faces. All your faces.’
The obstetrician began again, ‘Let me introduce my colleagues.’
Mort listened impatiently as Lesley presented each member of the team by name and function. It was more obvious than ever that they were not there to bring glad tidings.
Laura empathized with him. Why are they taking so damn long? she wondered. Can’t they just tell the truth and calm these poor people? Christ, they must think the baby’s dead.
‘There’s a little problem,’ said Lesley finally, without emotion.
‘What? What’s wrong?’ Mort demanded. ‘I mean is he sick or something?’
At this point Lesley ceded the floor to the pediatrician.
‘Dr Fedorko will explain. It’s really his department.’
Paul coughed and put on a show of confidence as he began.
‘Now, Mort, I am sure you know that there’s a history of cleft palate on Kathleen’s maternal side—’
‘Oh, no,’ the father gasped. ‘You mean the kid is gonna look like Kathleen’s uncle? The guy is practically a freak. He can’t even talk normally.’
‘What is it, Mort?’ his wife asked. ‘Is our baby like Uncle Joe?’
He took her hand to comfort her as she began to moan. ‘No, no, please tell me it’s not true.’
‘Mort and Kathleen,’ the obstetrician interrupted, ‘this is 1962. We’ve got the know-how to correct this sort of deformity. Just let Dr Fedorko show you what wonderful work pediatric surgeons do these days.’
Once again he called upon – or rather, it seemed to Laura, passed the buck to – his colleague.
‘Look at these pictures,’ Paul said soothingly, opening the photograph album.
‘Oh, Christ.’ Mort Paley cringed.
‘But those are the “before” pictures,’ Fedorko insisted. ‘Look at those same children after they’ve been operated on. Aren’t they marvelous?’
Mort was not assuaged. He was still sick at the thought of what their baby looked like now.
He stared at the doctors and entreated, ‘Please don’t show these to her now. Can’t you at least wait a day?’
‘No, Mort,’ Lesley answered categorically. ‘This is something the two of you have got to face so you can start to deal with it right away.’
What for? Laura asked herself. What on earth could possibly be gained by giving bad news to this woman now? The poor girl’s been in labor half the night. They won’t be operating on the kid for weeks, so why don’t they let her rest a little longer?
But then, as the senior pediatrician continued to show photographs of malformed children before and after corrective surgery, Laura suddenly understood Paul’s haste: he had no tolerance for pain. He empathized too much and needed to unload the burden as soon as possible.
For the first time Laura understood why it was said that to be a doctor – or at least to survive as one – you have to build a fortress around your feelings to withstand all the assaults of emotional involvement.
You can try to help the suffering and mitigate their pain, but you must not feel it.
She wondered if she could ever be that strong.
An hour later Fedorko suggested, ‘Laura, why don’t you help Nurse Walker take baby Paley to his mother. She’s got to breastfeed him.’
‘Can she do it, Paul?’
‘Physically, yes. The kid’s able to suck. Psychologically – I don’t know. That’s where your bedside manner will come in. I’d really prefer not to use a Breck feeder. Why use a syringe when, from the baby’s standpoint, the best source is “Château Maman”?’
‘But, Paul, I’m so new at this I don’t know what the hell to say.’
‘Tell her the harelip will be perfect in six months. Anyway, if you can just get her to take the baby in her arms, Nature’ll do the rest.’
She stood outside Room 653, took a deep breath, and then said to the nurse, ‘You wait here. I’ll see what I can do to prepare her psychologically.’
‘But Doctor Castellano, that’s not our usual practice. I mean, we normally bring the baby right in.’
‘Well, if you don’t mind, I’d like to try it my way.’
‘All right, doctor,’ she capitulated.
Kathleen’s first reaction had been precisely what Laura had expected: ‘No! God! I don’t want to see it – take it away.’
Her husband was still there and gave a wordless gesture to Laura, seeming to convey, Can’t you stop torturing her?
A little frightened by the task forced upon her, Laura persisted. ‘Please, Kathleen, he’s a lovely little boy with a few … malformations that we can easily set right.’
‘But he’s like my Uncle Joe,’ she protested. ‘It’s my fault. When Mort sees him he won’t love me anymore.’
‘Please, honey,’ her husband whispered, ‘it isn’t your fault. And I’m certainly not going to stop loving you.’
To relieve the tension, Laura changed the subject slightly. ‘Have you chosen a name yet?’
‘We were going to call him Mort Junior,’ Kathleen began. ‘But now—’
‘We’re still going to call him Mort,’ her husband interrupted reassuringly.
Laura looked at him, as if to say, You’re a good guy. She’s damn lucky to have you.
‘I’m going to bring little Mort in now,’ Laura said gently. ‘He’s ready to be nursed, and I’d like you at least to give it a try.’
Kathleen could not answer. Instead, Mort, putting a hand on his wife’s shoulder, looked at Laura and said, ‘Go on, bring our baby in.’
There is an ironclad rule: As long as a doctor holds a baby it still belongs to him. The moment a mother actually touches it, the child is hers forever. And no matter what he looks like he is beautiful.
So it was with Kathleen Paley.
Laura put the newborn infant into Kathleen’s arms, and the mother lifted her son to her breast – and sighed.
‘Look, Mort,’ Kathleen murmured lovingly, ‘he’s feeding.’ With her free hand she stroked the baby’s fuzzy head. ‘He’s cute, isn’t he, Mort?’
‘The cutest baby in the whole world, darling,’ he replied, and meant it.
Laura thought to herself, Good thing you didn’t look inside his mouth – you could see practically to his nose.
‘Thank you, Doctor,’ Mort said with emotion. ‘Thank you very much. We’ll be seeing you again, I hope.?
??
‘I hope so, too,’ Laura answered sincerely, and made a mental note to follow up on baby Paley’s progress. And be sure that she was present when they made him really beautiful.
Johns Hopkins Medical School Baltimore, Md.
Dear Laura,
I was really glad to get your letter and very touched by your story of the cleft palate baby. If the pediatric teams are anything as good as they are here, that little boy will be fine.
My own surgical experience – if you can call it that – has consisted almost exclusively of holding retractors while other people cut. A second-year resident promised to teach me the trick of holding a clamp and sleeping on my feet at the same time. He claims it’s the only way you can get through the ordeal.
On the more personal front, there’s been a kind of change in my life. One night last month, I was on call with this really neat resident who’s married with two kids.
You know how it is when it’s very late and the rest of the world’s asleep – you find yourself saying things you otherwise never would. We got to talking about careers and marriage, and this guy said straight out, that if he had to choose between being Surgeon General with no home life – or being a GP in Greenland with his wife and kids – he’d go the family route without a second thought. By the time he had finished asking me why I wasn’t a wife and mother, he had me asking myself the same questions. And I couldn’t come up with any good answers. So I figured it was maybe time to stop being an adolescent and talk to somebody who could help me do it.
The upshot is that I’ve started seeing this really good psychiatrist – you may even have heard of him. Andrew Himmerman. He’s a really bright man who’s written half-a-dozen books and about a zillion articles. The only trouble is he practices in D.C. and driving from Baltimore to Washington three times a week at 5 A.M. may send me to an early grave. But, at least I’ll go with my act together. Anyway, I’m scouring the Washington area for a Surgical Residency so I won’t have to commute for shrinkery.
Your letter wasn’t very specific about married life. But then I guess since you knew Palmer so long it hasn’t made that much of a change. On the other hand, having seen what the long days (and nights) at the hospital have done to some interns’ marriages, I suppose there’s strain involved. But then I sometimes forget you’re Wonder Woman.
Got to run and scrub.
Please write soon,
Love,
Grete
Laura folded the letter just as Palmer appeared in their kitchen, yawning and unshaven. She rushed to kiss him.
‘Gosh, you look like you’ve been up all night,’ she murmured.
‘So do you.’
‘I was,’ she answered with a weary smile. ‘I saved two lives. And you can’t imagine how great that feels. So what’s your excuse?’
‘I was waiting for you to come home.’
‘Did you forget that I was on? I mean, I wrote it all down.’ She pointed to their ‘Harvard Through the Seasons’ calendar on which she had written out the timetable of her hospital comings and goings in green ink.
‘I can read, Laura,’ said Palmer, drowsily going through the motions of making himself instant coffee. ‘But being an old Army man, I construed 2300 hours to mean eleven p.m. and figured you’d be home by midnight.’
‘Oh, shit,’ Laura responded, tapping her forehead. ‘We got this emergency call from Manchester to pick up a pair of preemie twins and take them to Intensive Care. I rushed up with one of the interns. And you won’t believe this, we had a flat tire on the way back.’
‘No, actually,’ he replied coolly, ‘I don’t believe it.’
‘Lucky the respirators were on a generator or we would have lost the kids—’ She stopped abruptly when Palmer’s words finally sank in. ‘Are you calling me a liar?’
He tried to be nonchalant. ‘Laura, Manchester is in the sovereign state of New Hampshire and I’m sure they’ve got their own pediatricians—’
‘Of course they do. But you know why so many people move to New Hampshire – because there’s no state tax or anything. But that means their hospitals can barely afford a box of Band-Aids. There was no way of saving those twins except by putting them on the respirators at Children’s.’
She gave Palmer a pleading look.
‘Anyway, I know I should have called, but it was all such a rush. I’m sorry, darling.’
She went to kiss her husband, but he moved slightly to avoid her embrace.
‘Are you playing hard to get?’ She smiled affectionately.
‘I’d say you were the one who was doing that,’ he retorted.
‘Palmer, what the hell are you insinuating?’
‘Primo, though I’m willing to believe they’ve got spartan facilities in Manchester, I’m not prepared to accept that they don’t have an ambulance that could have transported those unfortunate infants.
‘Secundo, I have never heard of an ambulance being driven by two doctors – and certainly not one that had a flat tire.
‘Tertio, the way you’ve been waxing rhapsodic about your medical colleagues, I figured it was only a matter of time until you were, as the Bard puts it in Othello, “making the beast with two backs”.’
The rage center in Laura’s brain was sending the signal to explode. But the rest of her was too exhausted.
‘Primo, my loving husband,’ she began her rebuttal, ‘you should remember that Othello was wrong about his wife. Secundo, Manchester doesn’t have portable incubators and we were in a station wagon, not an ambulance. And, tertio, I think you are a paranoid shithead for not believing me. I mean, how the hell do I know you weren’t with some floozy last night? Now, get out of my way, I’ve only got four hours to sleep before I’m due back.’
As she was disappearing through the kitchen door, Palmer called after her, ‘That was a good idea you just gave me, Doctor Castellano, I might just start my own private Intensive Care Unit. To take care of me.’
At the heart of it all was the problem that Laura and Palmer each had different expectations from a marriage. Yet she had never found the courage to discuss it openly with Palmer.
He was still traditional enough to think his wife should be a companion, helpmate, mother of his children, and of course a sparkling hostess. After all, his own mother had been such a model wife to his father. And certainly Laura filled every one of his criteria.
She, on the other hand, had no paradigm for marriage. She knew only that she did not want a relationship like her parents’. The fact that Luis and Inez had lived together for more than twenty years before they separated certainly did not prove that they were ever welded as a couple.
Indeed, there had been a long time during her early Med School years when she doubted that she was fit for any kind of marriage. For the only thing her parents had succeeded in imparting to her was the quality of self-reliance. And wasn’t marriage a relationship of mutual dependence? Not out of weakness, but of two strengths fusing to become a greater force – two beams leaning on each other to sustain a greater weight.
But all through their courtship, what Laura had found most attractive in Palmer was the way he protected her. He seemed – though she could never see it that explicitly – so fatherly. And he had led her to believe that marrying would simply change her name, not her life-style.
They had honeymooned at the exotic Hotel Byblos in Saint-Tropez. Every morning they would walk along the water’s edge from the beach of Pamplon (Plage de la Bouillabaisse) to the beach of Tahiti – trying not to look selfconscious (or even look, for that matter) as they passed the nudist colony that lay in between.
Palmer did not disguise the fact that he enjoyed this kind of sightseeing and he tried to tease her into taking off her bra. But to his amusement he discovered she was not as uninhibited as either of them thought.
After lunch they would go to bed, and then siesta. Later, as the sun grew orange, they would sit in Le Senequier near the marina, and observe the bronzed and beautiful as they paraded by
.
They sipped Pernod, while a few hundred meters off, the fishermen were busily unloading what would be their dinner at Leï Mouscardins.
Their nuptial voyage had been a dream, but their return to Logan Airport was an uncomfortable awakening. For Laura, whose sensuality (even in a bra) had put the other women on the beach to shame, now donned a baggy white coat and drove off to Children’s Hospital at dawn.
Palmer was left with half a summer to burn, not knowing how to occupy himself till the fall term began. At first he tried to work on his Chinese. But he was driving himself crazy with the sound of his own voice trying to imitate the tones of pronunciation that differentiate the various meanings of the same word.
He would sometimes take a book and walk along the Charles to find a shady spot and read. And when he tired, he would watch the sailboats – like albino butterflies – dash to and fro across the placid water.
The dark would arrive with half the evening gone. He would then return to Beacon Street, defrost a dinner, open a bottle of Chablis, play Vivaldi on the stereo, and fantasize that he was on a date with Laura.
He was a patient man and Laura – still radiant and energetic from their honeymoon – made the nights she was off duty compensate for her absences.
But the internship weighed heavily on her shoulders and fatigue set in. Then she would come home, kiss him, take a shower, have a bite to eat, and then plunge like a deep-sea diver into many-fathomed slumber.
Gradually she started to give up the eating. After a few more weeks she would leave the shower for the morning, kiss him, throw off her shoes, and then go to bed in what she had been wearing.
But let the record show – she always kissed him first.
Once – miracle of miracles – she got the medical equivalent of a two-day Army furlough.
Palmer was delighted and proposed a little drive up to Vermont to see nature’s brushwork on the autumn trees, have dinner at a cozy inn, and then, as Edgar Allan Poe put it, love with a love that was more than love.
‘I’m up for the last part,’ Laura said, smiling wearily, ‘but couldn’t we do it a little closer to home, like in our own bed?’