Lie Still (52 page)

The thing about high blood pressure in pregnancy is it leads to inadequate blood flow to the fetuses, and they grow poorly and tend to curl up their toes and die under stress.

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Stress like labor and delivery or even getting big. Or, late in the pregnancy, blood pressure can shoot up suddenly and cause big ugly strokes in young mothers.

The thing about twins is they compete for blood flow.

They can be chronically stressed and ready to die. They are usually premature arrivals simply because the uterus is overstretched and good and ready to empty itself once it reaches a certain size. Then, if the grown-ups involved even attempt vaginal delivery, the first may come out okay, then the second gets locked into a bad angle while its pla-centa is leaving the building. If the uterus clamps down, the baby is stuck; if it relaxes, Mom hemorrhages like an outgoing tide.

If you cannot do a C-section on five minutes’ notice, you have no business attempting twins. If you don’t have someone ready to resuscitate two preemies, you have no business doing twins. I knew this town of nine hundred could not muster a C-section in thirty minutes, nor probably two hours, since there was no anesthetist available. And no one to tend to preemies if the good doctor was doing the section.

I don’t think there was lack of desire but surely there was a lack of modern resources.

It was all I could do to smile back at the young mother-to-be. I measured her uterus, checked her weight gain, checked her blood pressure, made sure she was taking her blood pressure pills and her iron and vitamins, told her alcohol or tobacco would kill her babies, patted her shoulder, and sent her out.

I dictated a lengthy chart note describing how I thought her management should go. I tried to drop huge hints that the woman and her future babies deserved to see a specialist.

Just as I hung up the dictation microphone the office nurse came in. I asked her if she thought there was any chance the doctor might possibly consider referring this smiling victim of circumstance on down the road to, say, at least an obstetrician if not a high-risk pregnancy specialist.

The nurse’s reply is still a classic of revealing—perfectly—

the unintended. She said emphatically, “Oh, no! Doctor is re-394

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ally looking forward to this. He hasn’t delivered twins in years!”

So that was my moral dilemma for the day. Should I have called back the hopeful girl and told her to find her way out of the 1930s and avoid a stroke or a baby with cerebral palsy or both? Or should I respect the doctor-patient relationship that I had only stumbled upon, an interloper, wet behind the ears, carrying assurance of neither success nor failure, only gross estimates of probabilities? Like betting a life on the turn of a card.

Or three lives.

“High risk.”

Since my aborted residency I have promised myself I would stop taking these things so seriously. But they pop up like corpses in horror movies.

Retelling, though, is reliving, and reliving is, in some small ways, getting to revise.

Two weeks ago, after my Wednesday in Othello, I came home and dug through old boxes until I found my bear’s face belt buckle. I took it to a Western clothing store in Ogallala the next weekend and bought an expensive hand-tooled belt for it to cinch around me. Been wearing it ever since. It reminds me to ponder—even to articulate to myself at times—a possible connection to the spiritual. To things Larger.

Last week I made an offer on twenty-nine acres along the Dismal River, thirteen miles out of town. A place I used to go for catfish as a kid. “Dismal” is an unfair name. Sure it’s muddy, but so is every other river in the state. The entire riverbank is covered by mature cottonwood trees, four of the biggest dead a few years from beaverkill. They house redheaded woodpeckers. There are morel mushrooms nearly every spring, wood ducks in the summer, and pheasants in the fall. In the winter there are bald eagles. I love it out there.

The acreage is mostly bottomland, prone to floods about every fifteen years or so, but there is an old dike running through the middle. The weed canes and grass are over eight feet tall in the open areas on the upland side of the LIE STILL

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dike. Best of all, there’s a small hillock at the northwest corner, sparsely covered with little cedar trees and a couple of juvenile cottonwoods. That is the area where the morels show up. There is a spot just beyond there, between trees, where I want to build a small house, if I can get the permits. From the front rooms I’ll be able to see the river.

Maybe Mom and I can get Dad to come sit there.

I couldn’t leave, anyway. Dad fell again a couple weeks ago. Mom saw the whole thing this time. She swears he was just trying to go too fast and tripped. She wants him home.

I’d be an ogre to argue again for a nursing home.

So with him on her hands she deserves whatever help I can muster. Which means Hooker will be home. Moving to Maine or Oregon or Tahiti is out of the question, for now.

Only since the second stroke have I realized how much they are part of the heart and soul of Hooker. People come to see Dad at least once a week. Old friends in from the ranches and patients from down the street. They bring food and plants and cookies and wine. The guests and Mom talk.

I guess he listens. I think I saw him smile once, but it could have been a reflex.

Seeing Mary Ellen again, after these years of oblivion, brought a tide of feelings from their supposed retirement.

We’d been the best of friends. We had been through all flavor of romantic choices together. She knew my weaknesses.

She had seen me pass up a guiltless but cheap encounter with an RN only because she was married—however un-happily—but take to a sex-for-sex’s-sake hookup with a fast-food manager I met at a party. She knew the desperado’s rules of engagement most of us used: Cheap sex would not hurt anyone if the consenting adults had identical and appropriately low expectations. And it might help.

Still, there had been no one like Mimi Lyle.

At first I gave Mary Ellen no clues because it didn’t come up. We were never ones to tap the other on the shoulder and say “Guess who I’m fucking.” Mimi, of course, quickly convinced me of the necessity—on her part more than mine—

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for absolute silence, even on the radar screens of half-formed suspicion. After Monty and Mimi had their toe-to-toe in the PICU, I thought Mimi might best remain my little secret. After my epic debauch with Madame Lyle in front of the fireplace in the canyon, I did not think I was completely outside Mary Ellen’s capacity for respect, but the hole I was in was pretty deep.

When I learned of Miriam Lyle’s operating inabilities, or more importantly, her refusal to act in her patients’ interests, it seemed that anyone who had ever been on Mimi’s side must surely burn in hell.

When I was not renewed in the residency I told Monty a skeleton version of the flap over Mimi’s inabilities. I left out sex and drugs. She could not believe that was sufficient to get me fired. I held out my own incredulity. She knew I was hiding something. But my hemming and hawing had become a habit.

When Henry Rojelio fell into my lap and I lost my paltry job in Glory, things swirled quickly out of control, but I mustered a passable lie for Mary Ellen; lying is easiest done to those who trust you. I told Mary Ellen the Glory Hospital had hung me out to dry when the story hit the press. All along I had good intentions for a full disclosure some night over dinner, but I never came through.

My passive acceptance of stasis on the plains became a passive choice. One I denied, for years, having made. Living away from Mary Ellen, working my itinerant’s jobs, schtooping Cheryl on the every-third-month plan and whomever else might understand and accept and in some cases welcome emotional distance as the foremost aspect of my character, it was easiest to pretend Mary Ellen did not want to talk to me.

But what I’d thought was hell turned out to be purgatory: Mary Ellen called three months ago to tell me about a message. The message was a reprieve, not by its contents, by its point of delivery.

Mary Ellen’s call came on a Monday morning. I’d just gotten home from a sixty-hour shift in a quiet little ER where, LIE STILL

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truly, nothing happened. Boring days and fitful nights in a saggy bed. I had read a mediocre spy novel and watched two baseball games. After shifts like that I feel like skiing for ten hours straight or running a marathon. That particular Monday, though, it was 104 degrees with 75 percent hu-midity, so neither seemed likely. When she called I was looking at baseline torpor with intermittent periods of ennui, ruined only by the need to mow the lawn at my rented house.

Mary Ellen said my mother had given her my number.

She told me there was a message for me on her answering machine. She said the caller had asked that she relay it on to me without listening to all of it. The caller said to tell me it was from “Robin.”

The small dorsal hairs on my neck stood up. I probably gasped. Here was one last shot at vindication. I said nothing.

Mary Ellen said, “Who’s Robin?”

After a pause I said, “Robin is dead.”

There was a long pause. I wasn’t picturing Robin; I was seeing Mary Ellen’s face.

She said, “Do you want me to mail you the tape?”

I thought. I said, “No.” There was a pause. “Keep it there.

I’ll be there by tomorrow night.”

It was summer; the days were long. I got to Mary Ellen’s just before sunset the following night. She seemed guard-edly happy to see me. I was barely out of the car when she came to me, threw her arms around me, and kissed my cheek. I was as emotionally stiff as a sixth grader.

“The message awaits,” she said. “Though I’m hoping you’ll be able to speak to me at some point.”

“Mary Ellen.” I looked at her. “I don’t know what I can say.”

She looked at me. “What’s it been? Three years since our last conversation?”

“About that.”

“How have you been?”

I smiled. “Stable.”

She smiled.

*

*

*

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Mary Ellen sat me in her den.

“I think I’d like a drink,” I said. She brought Scotch, studying me.

“I guess you’ll want to listen to it alone. I’ll be in the kitchen.” She left and shut the door.

The tape held a lightning bolt. An electric voice from the past,
vox ex machina,
though not a
deus ex machina
. Not my ticket out of limbo. It was evidence of the inadmissible sort—just like an unsigned letter, it could not be verified. No one would be coming forth to testify. There are no witnesses, only we perpetrators.

Hello, Dr. Montgomery. This is actually a message for a friend of yours, Malcolm Ishmail. I tried to get his address or phone number from the Medical Board in Phoenix, but it was like they never heard of him. So I asked for yours. I figure you two should be married by now, so, well, anyway, if you could get this message to him, somehow . . . And maybe he should just hear it himself, if you don’t mind. I’m sorry but there just isn’t any other way.

Just tell him it’s from Robin.

[A pause.]

Malcolm. It’s me, Robin, or I should say, the woman you knew as Robin. I guess you figured out I wasn’t really Robin Benoit, him being dead and all.

And you can figure of course that I can’t use my real name. I really wish . . . [A pause.]

Your old friend, Dr. Lyle, told me things would go different. God, was she wrong. She told me it was a super-short-acting drug, the resuscitation would go okay and the kid would be fine, but that we—she—the report! . . . [Her voice was trembling.] . . . the report I was going to file would be damaging enough to you to get you out of the state, maybe out of medicine, probably for good.

She . . . she said you were a bad doctor. You had bungled surgical cases, and lied and hurt people. She LIE STILL

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told me you had tried to destroy her reputation. She said you were out to get her because she had reported you and gotten you fired from the residency.

Oh, I hated you so much. At first. You never knew that, did you? When I heard what you had said and written. But ever since the boy totally coded in the ER, I wanted to explain to you that I never meant to hurt him, really. I wouldn’t have done that. If I had known.

Mimi . . . Dr. Lyle . . . is my mother.

You must think I’m so evil. That’s why I called. I’ve come to realize some things about my mother. She’s not the saint I thought she was.

I’m getting married, Malcolm. That’s what got me thinking about all of this again. We want to have kids . . . [She was sniffling.] Once in a while, I remember what I did. I have nightmares. Awful . . . [A stuttering deep sigh.]

I have to make up what I can. I thought about trying to see you, or writing you, to try to, I don’t know, tell you I never meant to really hurt that boy like that. But I have to be completely untraceable.

Mom may have problems, as a doctor. But I know she is really good. She has done so much good for so many people. You must not have seen. All the good things. You never saw that. How could you have said those things? About her? [Her voice trailed off.]

I never knew her when I was a kid. My dad’s parents raised me. They were always sort of vague about my mother, told me she was sort of . . . gone . . . like off in the wilderness, I imagined, doing these really great things to help people. Like a missionary in Africa.

When I was in nursing school, though, she wrote to me, then we finally met. It was so great. To finally know my mother and see that she really was doing great things for people.

She told me she was pregnant when she left my dad.

She told me she left him ’cuz he beat her. And why, 400

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when I came along, she had to give me to Dad’s parents to raise. She had nothing for a little girl.

She said her career was her life. Like it was her baby, you know, for some women.

You know she didn’t even know that the real Robin was a man until those detectives came to question her? Afterward she called me to tell me to be extra careful. She told me she rechecked the obituary from the paper and it just talked about a nurse, never used a “he” or “she.” The obit writer probably didn’t know either. [A laugh.]