A History of the Present Illness (23 page)

I learned all this a few days later, when she called Josette about the things she'd left in the apartment and got me instead.

“I guess it was a really bad night,” I offered.

“You don't get it, Rey,” she said. “It wasn't about the kid or the shift or any of that.”

“Explain it to me, then. Because you're right, I don't get it.”

Perla sighed. “I don't know that it was any one thing exactly. Not the job, or the train wreck that was my living situation, or the fact that no way could I seem to keep a guy around for more than a couple of weeks. It was more like there was one person I thought I ought to be, and then there was the real me and what I really want from my life. I know that sounds trite and selfish, but I think that's it.”

“I don't know,” I said. “Sounds like you did what you felt you had to do.”

I'd been lying on Josette's bed studying for part two of the medical board exams when Perla called. Now I sat up and closed the book. Although there were three good texts with slightly different formats, I'd made my selection based on the painting on the cover. It was by Joan Miró, one of my idols way back in college.

“It's okay,” Perla said. “You don't have to be nice. I don't expect anyone to understand.”

The painting showed a stick figure with huge eyes, one red and one blue, looking surprised and anxious. Surrealist or not, it was a portrait of every sick patient I'd ever taken care of. Maybe the painting got to me, because I didn't mean to say what I said next.

“Back in med school, I almost quit too. Twice.” My roommates at the time had known, but I hadn't told most of my friends or my parents, not then or since. And I'd never mentioned that phase of my life to Josette.

“No way,” Perla said. “You're like Mr. Doctor.”

“Not then. It was first year. I wasn't flunking out or anything, but I hated it. Felt like I was being squeezed into a tiny little box. What I really wanted to be was an art historian or a painter or some shit like that.”

“What happened?”

“Are you kidding? No way did my parents immigrate to this country, then work their asses off so I could make art. I got over it. These days I might buy an art book or go to a museum now and then, but mostly I don't even think about that stuff anymore.”

“Reymundo Bautista, I totally underestimated you.”

“Yeah.” I laughed. “I get that a lot.”

We spent the next hour and a half talking—our first real conversation. I didn't hang up until Josette got home.

Josette still can't believe Perla left, not so much because of what she did to her career, but because of what she did to us, her supposed friends and co-interns. The program couldn't find a midyear replacement worth taking, so for the last five months of internship, when we all would have become toxic anyway, the remaining nine of us took on Perla's call nights and ER shifts in addition to our own. Since residency is equally about machismo and teamwork, Josette never complained, but she never forgave Perla either. Their friendship basically ended with Perla's departure, which was ironic, as it was only after she left that Perla and I really got to know each other. We talked often, generating huge long-distance bills during
the months she was gone, and we began going to art shows and museums together when she moved back to San Francisco the next summer. Josette joined us sometimes, but she usually made some snide comment about Perla not really being the sort of person she wanted to hang out with in her scant spare time. I thought Josette was just being petty and maybe a little jealous, until seven years later, when our first child was born and I suggested Perla as godmother. Josette asked if I'd lost my mind. Surprised but still not understanding, I explained that Perla, unlike our other mostly medical friends, had time for parenting. Josette said there was no way a woman with so little integrity would ever be any kind of mother to her children. She called Perla unreliable and selfish and accused her of living in a perpetual state of adolescence, choosing jobs that allowed her to bypass the rites and obligations of normal adulthood. After that, I tended to see Perla when I knew Josette wouldn't be around.

Until the boy's fall, I had never considered that Josette might be at least partially right about my friend. Listening to Perla tell the story of that Wednesday on Bernal Hill, I was sure the rest of our group—Althea and Sumita are still around (and still together), Lamar was recruited to Stanford as the youngest department chair in that institution's history, and the others, though spread across the country, keep in touch—would be as shocked as I was by Perla's choices. They would wonder what physician, former or otherwise, wouldn't immediately step forward to help an injured child. They would argue that the basics of resuscitation—airway, breathing, circulation—are like riding a bike, and even if Perla couldn't remember how many compressions or how many breaths to give the kid, she at least should have started some kind of
CPR. In other words, just like me, they would have missed the point.

* * *

It's funny how random things can impact your life. Sometimes I wonder whether Perla would have told me about Dylan Hunter's accident, much less gone into such detail, if we hadn't had long-standing plans to hang out at my house that Saturday evening. Josette and our boys were spending the weekend with cousins in Fresno, a road trip that I, attending on the wards, had to miss.

Perla sat across from me at my kitchen table as she told the story, a bottle of Napa Valley cabernet and a plate of artisanal cheeses between us. I tried to picture the characters and events she described so vividly: the dogs and the scream, the injured boy on the road, the cell phone woman and the man with twins, and, of course, Perla herself. When she finished, I felt certain she wanted me to find out whether the boy had survived, and if so, how he was doing. Because she had hesitated initially and then done little to help, I assumed that she didn't feel comfortable calling the hospital.

“I'll check the ER log for you tomorrow,” I offered. “Or, better yet, I'll swing by the peds ICU.”

“Tomorrow's Sunday,” she said.

“I'm on inpatient this month, so no days off.”

“Lucky you,” she said, laughing as she did each time I mentioned some of the less glamorous aspects of my work. “Anyway, there's no need. I saw him this morning.”

I put down my wineglass. “You're kidding.”

“The dad posted a ‘Did you save my son?' sign on the hill's
upper gate. I called the number, and he asked me to stop by. The kid looks like hell, but they say he'll pull through.” She smiled.

“You called?”

“Well, yeah. They wanted to be called. That's why Tom put up the sign.”

“Tom?”

“Dylan's dad.”

So now she was on a first-name basis with the family. I couldn't think of anything to say that wouldn't sound accusatory. How could Perla not see how badly she'd behaved? Didn't she know that dogs can never be put before humans? That once again she'd failed to follow through?

She poured herself more wine. With her trim, toned body and sun-bronzed hair, she looked as if she belonged in an advertisement for our new black leather barstools and the marble table Josette had said she couldn't live without.

“Actually, I think I've seen them around. They have a sheltie mix.”

“You did recognize the boy!”

Perla laughed. “It's the dog I recognized, of course. And probably also Tom. He's seriously cute.” She grinned. “But get this. Turns out the parents separated about two months ago, and Dylan was supposed to be going to his father's new apartment. He forgot what day it was. He shouldn't even have been on Bernal Hill!”

“Wait. You've met the father?”

She grinned again and tossed her hair. It caught the light from the colorful glass diffusers on the Italian light fixture I'd bought in exchange for agreeing that Josette could buy the table. Looking up at me through her bangs, she seemed relaxed and very happy. “In certain circles—mostly those where it's
normal to walk around carrying one or more plastic bags of dog shit—I have quite the rep.”

She just didn't get it.

“You have a medical degree,” I said as calmly as I could, “and you knew what to do, but instead of starting the resuscitation, you checked on dogs and waited for the paramedics. It's entirely possible that you cost that boy part of his brain and some of his function.” She could make up some bullshit story for herself if she wanted, but those were the facts.

Her face fell. She looked suddenly smaller and nothing like her usual brash self. She traced the rim of her wineglass with one finger, and I could almost feel her mind turning over what I'd said.

A moment earlier, I had felt angry at Perla and scared for her. Now I saw that if I could get her to face what she had done and not done on Bernal Hill, she could face everything else in her life too and things would finally come together for her. I put my hand on her forearm. “I'll help you with this. I'll be there with you every step of the way.”

She removed my hand. “There's nothing I need help with,” she said, her voice hard and so quiet I almost couldn't hear her. “All is good in my world of dogs and regular, predictable work schedules and people who understand that sometimes in life bad things just happen.” She took a deep breath. “You, on the other hand . . . did you really never ask yourself why you stayed friends with me when no one else did?”

I decided to handle her as I would a difficult patient. I walked around to her side of the table and used my most empathetic facial expression and tone of voice. “You don't have to pretend with me. We could talk through it together, review the protocol, and then next time—”

“Rey!” she interrupted. “Stop. I'm done talking about the boy. I didn't tell you the story so you could diagnose and treat me. I told you because it was a horrible experience and you're supposed to be my friend. So, since me getting sympathy obviously isn't happening, let's move on to something more interesting and not ruin our Saturday night.” She topped up our glasses and squinted slightly as she handed me mine. “Remind me. What sort of painting was it that you wanted to do after college?”

As my faithful companion at art shows for more than a decade, she knew the answer to that question as well as I did. “That's not what we're talking about.”

“Isn't it? C'mon, Rey, you want to talk motive, means, and opportunity. Well all right, mister big shot doctor. But don't pretend you don't know what's really going on here.”

I took her glass, placed it carefully on the table, and grabbed her arms. Then I pulled her toward me until her face was just inches from mine.

“Rey!” she screamed. “What the fuck?!”

Her lips and tongue were purple from the wine, and her breath smelled sharp from cheese and alcohol. I couldn't tell what I wanted more: to punish her or to devour her.

We stared at each other, breathing hard. She tried to wriggle free, but I wrapped her arms behind her back and held on tight. I could feel her, hot and rigid and foreign, along the length of my thighs and torso.

“Rey,” she said. “Get off me.”

My younger son often used the same words when the older one had him pinned. I imagined my boys bursting through the front door, home a day early and eager to see Daddy, with Josette following close behind.

I let go. Perla grabbed her purse off the floor. I sat down in what had been her chair. “Oh shit,” I said. “Oh my God.”

Seconds later, the front door banged shut.

* * *

Over the next few weeks, I caught sight of Perla several times at the general—in the cafeteria she'd always griped about, on the pediatrics unit I loved and she dreaded, and in the stairwell we'd both always preferred to the elevators. If she saw me, she didn't let on. But apparently Althea also ran into Perla at SFGH, and the two of them rekindled their friendship. Althea said that Perla visited the boy most days around lunchtime—between her morning and afternoon dog groups, I figured—even though Dylan was too impaired to recognize his parents, much less appreciate a stranger's attentions. Eventually Perla admitted to Althea that her presence at the hospital had more to do with the father than the son; she and Tom Hunter were dating.

For a while I worried that Perla would say something about what happened that night in my kitchen, but I don't think she will. Knowing Perla, she probably just put the whole thing behind her and moved on.

Not me. After she left, I cleaned up, finishing off the bottle of cabernet. Then I went into the den and looked up at my art books. I keep them on the top shelf of our huge built-in bookcase, just under the ceiling's polished, naked beams and well out of the children's reach. They all have moved with me, my painters and sculptors, from East Coast to West, from apartment to starter house to the three-bedroom Potrero Hill home Josette and I recently bought, with its views of downtown and
the East Bay. It's a beautiful house, and I am very pleased to provide such a home for my family.

Over the winter holidays, Josette noticed that I was spending more time with my art books, and she bought me a drawing pad, charcoals, and watercolors. Now I occasionally steal away from work, drive up to Bernal Hill, and plant myself on a patch of grass or red rock. Then, for thirty or forty minutes, I capture some piece of my world, upping the ante on the challenge to my fledgling skill set and offering a slight nod to modernism by using charcoal when watercolor might be best, and vice versa. So far I have rendered a giant ant colony against a tiny downtown San Francisco skyline; the famous Bernal coyote slouching in the high winter grass, her eyes as sentient as any human's and the backlit sky framing Mount Diablo in the distance; and a pack of dogs running down the pedestrian-only portion of Bernal Heights Boulevard alongside a trim, athletic woman, the wind blowing fur and hair, and their bodies loose and carefree, as if they might keep running forever.