Patient, Female
I don’t let them forget anything. I tell them to remember it alphabetically: breasts, cervix, ovaries, uterus. Lying on my back, I take them through it, one exam at a time.
Because he lives near the hospital where I work, I spend every Wednesday evening at the apartment of a 78-year-old man who has emphysema. He waits for the sound of my key in the lock. As soon as I step through the door it begins: harassment, jokes, evasions, lies.
“What did you do today?” I ask him, dropping my bag and kicking my shoes off onto the rug.
“I walked the dog.” He sips at the air and exhales while he talks. I know he hasn’t left the apartment. His dog has been dead for several years.
I head for the kitchen and line up the pills he’s supposed to be taking: the alpha-blocker for prostate, the blood-pressure meds, the simvastatin for high cholesterol, the vitamins, the baby aspirin. This last is a challenge: he’s insulted to have been prescribed a children’s chewable.
“You’re later than usual today,” he says. I hear him shuffling from the rug onto the linoleum behind me. His apartment consists of two small bedrooms, a kitchen, a bathroom, a living room, and a carpeted hallway that smells of smoke. He used to smoke. “Busy day at the clinic?”
I pull the plastic off two microwave dinners and refuse to answer.
“I used to lose track of the days,” he says. Both his hands shake as if he were trying to open a pair of jars. “But not anymore. You probably never lose track. I bet you always know when it’s Wednesday.”
“Are you asking me about my job?”
“No,” he says. “That’s not a job.”
I pour him half a glass of Ensure, which he ignores.
“It’s vulgar,” he says.
“It isn’t vulgar.” Of course we’ve been over this before but because of his age and his selective memory I revive all the usual arguments: Mechanics take their own cars apart. Dental students rehearse in each other’s mouths.
“It’s not your mouth they’re staring at, is it?” He picks up his pills and swallows the first one, his spine as stiff as a crochet hook. “I hope you aren’t doing it for the money. How would that be different from prostitution?”
During an earlier and more experimental period of my life, I briefly dabbled in prostitution, but he doesn’t know that.
“Hey. What’s the difference between deer nuts and beer nuts?” he asks.
The microwave dings.
“Deer nuts,” he says, beginning to laugh without making noise, “are under a buck.” I open the refrigerator and locate a beer. I try not to think about the evening ahead of us.
“Ever seen mothballs?” he asks.
“No. The food’s ready.”
“It isn’t easy,” he says. “You have to lift those tiny wings.”
I put the two dinners and two forks on the enamel tabletop, then drink at least half of my beer before sitting down.
He gradually eases himself into his chair. His expression sours. “You don’t need to come here anymore if it’s so unpleasant.”
“Fine. I won’t.” I put my napkin on my lap. The Salisbury steak in its rectangular compartment is completely tasteless; I chew it as if it were a piece of gum. “Are you going to eat anything?” I ask. “Or are you just going to sit there?”
A couple of his thick, blunt fingers reach for my beer. “When your mother died,” he says, “you apparently lost your sense of humor.”
“I never had a sense of humor, Dad,” I say.
It isn’t exactly hard work, being a professional female patient. Every Wednesday at 3:15 I finish my classes (Introduction to Biology, Writing 2, and Family and Consumer Science) at the community college, then drive across town to the medical school/hospital complex, where I park in the visitors lot, flash my ID badge at the entrance, and head for the clinic. I strip off my clothes and stash them in a locker. I wash up. Then I put on a blue gown printed with shooting stars, and take my place on the paper-covered table in Exam Room 9.
The students and interns trickle into the room in groups of two or three so they can learn from each other. They’re training in OB-GYN, in family practice, internal medicine, emergency medicine, even pediatrics. Some, as soon as the door closes behind them, are nervous laughers (where’s the hidden camera?), as if they suspect they might be the objects of a joke. Others, usually the women, are annoyingly reverent. I’ve seen plenty of hands tremble when they reach for the cotton bow to untie my gown.
There is a proper order to these things, a protocol.
“May I look at your breasts?” Against the protocol. (“I’m going to examine your breasts” is preferred.)
Eye contact with several fingers in the vagina? Against the protocol.
Icy speculum? “Take that out right now and warm it under water,” I say.
It’s my job to teach them and to correct them. They’re the ones with the knowledge, the brains, the future salaries. But for now, in a marvelous one-of-a-kind reversal of roles, I’m the one in charge. “Introduce yourself,” I say when they forget. “Start again. Shake my hand, then wash your hands—not the other way around.” I remind them to ask me about my allergy to latex. I tell them to describe what they’re doing and to be straightforward, even to imagine that the patient, who can’t see what they’re doing (I have a mirror but I don’t always use it), might be blind. “Now I’m going to guide your left foot over here. Let your knees fall apart. I’m going to cover you with a drape, across your thighs.”
I don’t let them neglect or forget anything. I tell them to remember it alphabetically: breasts, cervix, ovaries, uterus. Lying on my back, I take them through it, one exam at a time. “You’re pinching,” I say. “Move your left hand.” Some of them are half-asleep on their feet. They work like dogs.
My mother died of ovarian cancer. My father called me (I was living several hours away with a friend) to say she wasn’t feeling well; she was dead a month later. My father and I spent the week in which she was nearly comatose on morphine arguing in the hall outside her room.
I told him I was going to move back home. But my father and I couldn’t live together, so I would find my own apartment. I had decided that I wanted to take some classes, maybe go to college. “I’m hoping you can pay for my education,” I said. “I know you set some money aside.”
“You’re standing here asking me for money,” my father said.
A woman in scrubs steered a gurney around us.
“What happened to your other plans?” he asked. “What happened to traveling around the country, doing drugs and getting arrested?”
“It was a misdemeanor,” I said.
On the other side of the door, which was ajar, my mother’s head was thrown back; her mouth was open. She appeared to be swallowing daylight, filling her body with as much of it as she could hold.
“She’ll want to know what you’re up to,” my father said. “You could go ask her what she thinks.”
Through the half-open door I watched my mother summoning radiance from all four corners of her room: from the window and the tile floor and the diaphanous hanging curtains and their silver rings, all the light in the world assembling itself and funneling toward her.
“It’s too late for me to ask her anything,” I said. A thin wire of rage lit up within me. “You should have known she was sick.”
“I’m not doing so well myself,” my father said.
My best friend, Cheryl—former shoplifter, co-delinquent friend of my youth—was the one who hooked me up with the professional-patient job. She was a professional female patient (the doctors called us “teaching patients”) at two different hospitals for several years. Then she had a baby and resigned. Too many hands is what she said. She couldn’t stand any more people touching her. Even her husband. Especially her husband, she said. He gets a look in his eye, Lissy, and I swear …
Cheryl used to tell me it was like acting, on a tiny stage. So I try to vary the experience in case the students—standing with their backs against the wall and waiting their turns—are comparing notes. I can be belligerent one minute, slow-witted the next. Sometimes I put the gown on backward: let them decide how to handle it. “You’re the undress rehearsal,” Cheryl used to say.
“Why are you sitting in the dark?” I ask him, the next week after work. I have brought him some groceries. I turn on the overhead light in the kitchen, noting that its cake-shaped glass bowl is full of dead moths.
“Wednesday,” he says. He’s got his oxygen on, the portable tank next to him on the rug like a faithful dog. He was supposed to die before my mother, but life is full of little surprises.
I set the groceries down by the sink. We buried my mother nine months ago, but her “to do” list is still taped to the windowsill. “Did you get out for a walk?” I ask.
My father rouses himself—he must have fallen asleep on the couch—and slowly stands up. “The world wasn’t prepared for me today,” he says. “I had too much potential.”
“Wednesday used to be your day for playing cards with Martin.” I open the freezer. “Have you seen him lately?”
“Martin’s dead.”
“Martin’s not dead. He lives at Longview. Why do you have so much ice?” The freezer holds one ancient package of sausage (I look at the date, then throw it out), one bag of peas, and half a dozen plastic containers full of ice. Additional cubes overflow their holding tank in the corner.
“Your mother liked ice,” my father says.
I put the peas on the counter and shut the freezer, remembering my mother dropping ice cubes into her coffee, her orange juice, her milk. “You know you could visit Martin at Longview. Assisted living isn’t contagious.”
“If you want to see him so much you go visit him,” my father says. “I didn’t think you were coming tonight. I thought you said you were going out.”
“Cheryl was busy.” I shrug. “She had to cancel.”
Standing on the threadbare carpet runner in the hall, my father blinks. His scalp is spotted like the skin of a rainbow trout. “You thought you were going out with Cheryl?” He raises his eyebrows. “Cheryl has a baby. She’s going to be busy for 20 years.”
I put two pots of water on to boil.
“You want to know what bothers me?” my father asks.
“No, I don’t.”
“What bothers me,” he says, “is that there’s no such thing as a professional patient. People in hospitals are always amateurs.” His slippers are held together with electrical tape.
“I’m training doctors,” I tell him.
“That’s not why you’re doing it,” he says.
I open a package of spaghetti, then lift the W for Wednesday in the weekly row of my father’s pills. “Are you embarrassed for me?” I ask. “Is that it? Are you embarrassed because I’m not modest?”
“When you embarrass me, I’ll tell you,” my father says.
I watch him attempt to pluck his pills from their narrow compartment, but his hands are shaking and his thumb is too big. I take hold of his hand, turn it over, and dump the pills into his palm, his skin as thick and smooth as polished wood.
“A guy walks into a bar with a duck on his head,” he mutters, concentrating on the pills.
I give him a coffee mug half-full of water.
“The bartender looks at the guy and then at the duck. He says, ‘What can I get you?’”
“You’ve already told me this one,” I say.
“The man says, ‘Nothing for me.’ But then the duck on his head pipes up: ‘Can you get this guy off my ass?’”
I feel as if the air in his apartment has gotten thinner, or as if someone has siphoned most of the oxygen out of my lungs. “I definitely can’t come next week,” I say. “You know, telling jokes isn’t the same as having a conversation.”
My father puts the first pill on his tongue. “Your mother died on a Wednesday,” he says.
“She died on a Friday. At four-fifteen.”
“Well. Same difference,” my father says.
During clinic the following week I try to establish an efficient pace. I’ve got 15 interns and students in groups of three, each student having been lectured about my pedagogical purpose and my superiority to the plastic torso down the hall. (I put my fingers inside it once; the vagina was long and narrow, like a garden hose.) Because I’ve been coaching a petite East Indian woman through what she clearly feels is a humiliation for us both, I haven’t noticed the fair-skinned, dark-haired would-be doctor waiting his turn at the side of the room. Only when he steps toward the table do I remember his face. I know him. Jerry Tomo. I knew him in high school. Not well—we didn’t exactly travel in the same circles—but he was the kind of person everyone knew.
I’ve got enough time to straighten my gown and say, Sorry, personal acquaintance, but any objection would seem belated, since he’s been watching the other exams from three feet away. Also, he hasn’t said anything. Which means I could be mistaken. If he was Jerry Tomo, he probably would have excused himself. Instead, sure-footed and graceful, a Gene Kelly of the exam room, he steps toward me and smiles.
“I’m Dr. Tomo. I’m here to do your exam.”
Perfect form. A+. We shake hands.
“Do you have any questions or particular concerns today?”
I open my mouth, then close it.
He strides to the sink. “Any allergy to latex?” He turns off the faucet with a paper towel.
I let him guide me into position on the table and open the top half of my gown, the little bow giving way with a hiss. Again the brief, reassuring smile, and then Jerry is all business. The other students crane their necks to observe as he palpates my breasts, a privilege I would have paid a hundred dollars for in high school.
“Any tenderness?”
Not coming from you, I imagine saying.
“Slide down to the end of the table,” he says. “You’ll feel my hand against your thigh.”
He warms the speculum in water, then snaps on the gloves. Cervix, ovaries, uterus. I examine a stain on the tile ceiling.
“Everything seems normal. We’re all done now,” Jerry says. He helps me up. The East Indian woman bows to me, by way of thanks. Jerry holds the door for her as they leave the room.
"Guess who I saw today.” My father and I are eating dinner: tuna casserole with olives. I added the olives on a high-calorie whim at the last minute, and they crop up, bleak and oily surprises, among the noodles. “Jerry Tomo.”
My father nudges a couple of olives toward the edge of his plate.
“From high school,” I add.
“I don’t remember. Did you go out with him?”
“No.” The only people I went out with in high school were Cheryl and her older brother, Dale, who is now safely tucked away from the public eye somewhere in Texas. “He was on the baseball and basketball teams.”
My father is squinting down at his plate as if trying to understand its contents. “And now he’s a doctor. And you saw him where?”
I reach for the bag of potato chips we opened for hors d’oeuvres and fill my mouth with a few of them.
“Tomo. Jerry Tomo.” My father puts down his fork. “That’s where you could have been,” he says. “That’s the life that passed you by. The one you passed up. Jerry Tomo.”
“Jerry Tomo isn’t a train I was supposed to catch.” I brush some potato-chip crumbs off my lap. I can almost see my father’s thoughts as they take shape. He is imagining a different daughter, a perky, Rollerblading creature who might have married the surgeon next door instead of flunking out of 11th grade and taking 15 years to claw her way back.
“Cheryl had the sense to quit,” he says.
“I’m not going to quit.”
We stare at each other for a while. Someone has cheated me, I think. Someone has leaned over the game board of my life and removed my mother when I wasn’t looking, leaving me alone to march through a series of pointless colored squares with this irritable old man, plague of my teenage years.
“You’re determined to humiliate yourself,” my father says. He stands up, then slowly shovels his dinner into the sink. “You know your mother would never have asked you to do it.”
I feel as if someone has opened a door in the side of my head. “She never asked us to do anything. She didn’t even complain until it was too late, because going to a doctor was too much trouble.”
“She was always nervous about doctors and hospitals.” My father stands with his back to me, at the sink. “But Dr. Chang was good to her,” he says. “He was very good to her at the end.”
I imagine myself jerking the window up in its sash and picking up our plates and our food and our forks and hurling the whole mess into the dark brick void between apartments. “She didn’t ask him for anything, either. Nothing. She never expected him to help her.”
My father turns toward me, eyebrows lifted in surprise. “That’s because she knew right away. She knew there was no help coming.”
This is what I will never understand. How can no help be coming? How can we live in a world in which no help arrives? “I’m not humiliated,” I tell him.
He turns on the water to wash the dishes. “Then what are you?” he asks.
A few weeks later I get to the clinic early and am put to work restocking the linen closet with drapes and gowns. I’m wheeling a metal cart full of clean linen toward the elevator when I turn a corner and nearly pin a white coat to the wall. Surprise: it’s Jerry Tomo. He tries to work his way around me, but I wedge the cart across his path. Better to get this moment over with, I think. My nose almost touches his ID badge.
“I didn’t remember you were so tall,” says the talking crotch.
“I had a growth spurt,” says Gerald Tomo, M.D. “While I was in college.”
“So you remember me. I thought you might.”
“I wasn’t sure at first. Then I thought … ” He shrugs, a handsome gesture.
I understand what he was going to say. There are people on this floor who are turning on spits in mechanical beds. There are people whose every orifice is occupied by a whirring machine. Embarrassment and awkwardness are low priorities.
I ask him what kind of doctor he’s planning to be.
“A neurologist. But I haven’t started neurology yet.”
I tell him I’m thinking of becoming a nurse, but I’ll need a few more years of college. I watch his face while he accounts for the past decade and a half of my life, a period during which he was probably spending his summers in Europe.
“My mother died in this hospital,” I explain, as if we’d been talking about our parents. “And now my father has emphysema.”
“Emphysema is treatable,” Jerry says. “I’m sorry about your mother.”
I stare at his ID badge. I want to pluck it from his coat and plunge it, voodoo-style, into his chest.
“I think it’s great that you’re willing to serve as a patient,” Jerry says. “Most women probably wouldn’t do it. But we need the training.”
“Especially in neurology,” I say.
Jerry makes his way around my cart and pushes the button for the elevator. I wait beside him while the doors open. He is headed for a lifetime of stressful days and long hours, softened by weekend golf and a second home perched on a glittering body of water. He steps into the elevator and nods.
“You’re welcome,” I say.
A few hours later I’m back at the door to my father’s apartment. Holding a grease-stained bag of Chinese food in one hand, I jiggle the key in the lock, which always sticks, as if forcing me to pause and collect my thoughts before I go in. When the door finally opens, I catch a glimpse of my father on the couch. He is watching TV, the screen casting its lurid blue light across his face. Even before I kick off my shoes and walk toward him, I understand that, against my will, I will miss him terribly, that my grief will make the sadness I felt when my mother died seem trivial and small.
Her death was the practice run, I think, a preparation for his. The injustice of it makes me press my forehead, hard, against the door.
“I thought you weren’t coming,” my father says.
I notice how bony his shoulders look despite the double layer of flannel shirts. “Wednesday,” I tell him. “I brought you some takeout. Are you hungry?”
He doesn’t answer. On the screen in front of him, a woman in high-heeled black boots clicks up a driveway toward a darkened house while glancing fearfully over her shoulder.
“That looks kind of sleazy.” I head for the kitchen, but I can still see the TV. “Is it a movie or what?”
Tethered to his oxygen, he shrugs. “A little sex, a little violence. It’s a mixed grill.”
I put our take-out food on two plates and set the plates on the coffee table in front of the couch, which is cluttered with badly embroidered pillows—my mother’s final, misguided hobby.
“Did you take your meds?” I ask, sitting down.
He barely nods.
Still wearing her heels, the TV actress tac-tacs noisily through a series of rooms and ends up trying to hide in a bathroom—probably the only place in the house without a window or a working phone.
“Idiot,” I say, my mouth full of rice. “She left the front door open.” The camera lingers on the woman’s breasts. I point toward the TV with my chopsticks. “She’s standing there waiting to be strangled.”
“It might not be strangling,” my father says.
The music swells as the woman, cleavage glistening, steps into the tub and draws the curtain. Despite the movie’s predictability, fear rises in me like a wave of nausea. Is there nowhere to go but toward the future? I find myself clutching my father’s sleeve.
Two minutes later the woman is dead. The station cuts to a commercial.
“You aren’t eating, Dad,” I say. I’m still holding his sleeve. When my father and I screamed at each other and fought—I used to wish he would drop dead—my mother invariably would tell me that he loved me. I swore that I hated him, that he didn’t love me at all; she said his feelings were complicated.
“She should have, locked the door,” my father says, nodding toward the TV. He speaks in small phrases, catching his breath. “Next time she goes out, she’ll know better.”
Next time, I think, is what I am waiting and practicing for. Next time my mother and I will be sitting here on the couch and she will be embroidering another unfortunate pillow, and because my mother has always loved me—and because her love is uncomplicated—I will let my father sit on the couch with us as well. In this alternate life, in this improved version, I make the decision for the three of us: I let him live.
I’m late to work the next Wednesday because the hospital parking lot is occupied by religious protesters. I park on the street a few blocks away, then elbow my way through the fervent throng, whose members chant and sway and gnash their teeth in prayer. One woman grabs my arm and insists that I save my baby.
“I’m not having a baby,” I tell her. George, the security guard, arrives and detaches the woman’s fingers from my arm.
In the locker room I pull off my clothes and take a one-minute shower. The water is cold, and by the time I reach the exam room I’m out of breath. The first three med students are ornery because they have been waiting for 11 minutes. I climb up on the table and apologize.
I try to gather my thoughts, to compose myself, but one of the students is already opening my gown. He is short and good-looking and scores particularly high on the arrogance scale, perhaps not wanting to take instruction from a living pelvis.
I’m not feeling well. My arm is sore where the protester grabbed me, and my heart is beating out a frantic rhythm in my chest.
Everything is moving too fast. The next doctor-in-training has hands like a butcher’s, short muscular fingers and spatulate thumbs. I want to pull him down by his white lapels and shout in his face: Radiology! Hematology! Geriatrics! But I can tell by the look in his eyes when he grazes my pubic bone with his wristwatch: this is it. He has some warped idea about the mystique.
I imagine I can hear the protesters chanting, pressing toward us with their ragged anger and despair. “Please,” I say. “Wait.”
The students look stunned when I stagger up and away from the table, cinching my gown closed with a fist. Are we not pretending anymore?
One of them suggests that I should sit down but I have nowhere to sit except the table.
“I’m not ready,” I say.
In their matching white coats they appear as blank and unconcerned as three sheets of paper. They are younger than I am and know almost nothing about what is bearable and what isn’t, about the evanescent line between simple mortification and an unendurable, impossible joke.
We wait for what seems like forever, for the sounds of the people coming to save us.