The Cole Trilogy: The Physician, Shaman And Matters Of Choice Part 134

She had inserted herself into a culture that was remarkably unfamiliar to her. At times she had to swallow hard as she adjusted to traditions that were foreign to her experience.

A number of families had been in the town for many generations-Jan Smith's ancestors had walked all the way to Woodfield from Cape Cod in the final months of the seventeenth century, driving their cows in front of them-and they had intermarried, so everyone seemed to be everyone else's cousin. Some of those who came from old families in Woodfield were welcoming to newcomers, while others were not. R.J. observed that individuals who were more or less happy with themselves, secure in their own souls, usually opened themselves to new friendships. It was those whose ancestry and native status were their only hopes for distinction who tended to be critical and cold toward "new people."

Most of the town's residents were happy about the presence of the doctor. Still, the environment was largely unfamiliar to R.J., and often she got the feeling that she was a pioneer on a new frontier. A country practice was like doing high acrobatic work without a net. At the Lemuel Grace Hospital in Boston, labs and diagnostic technology had been at her fingertips. Here, she was alone. High-tech science was available, but she and her patients had to make an effort to reach it.

She didn't send patients away from Woodfield unless she had to, preferring to depend on her own skills and capability. But there were times when she contemplated a patient and a silent warning bell rang starkly in her head, and she realized that she needed help; then she referred the patient to Greenfield or Northampton or Pittsfield, or even to the greater specialization and technology in Boston or New Haven or Hanover, New Hampshire.

She was still feeling her way but she had come to know many of her patients intimately, to see into the corners of their lives that affected their health, in a way that was possible to a small-town doctor.

One night at two a.m. she was awakened by a call from Stacia Hinton, Greg Hinton's wife.

"Dr. Cole, our daughter Mary and our two grandchildren are visiting us from New York. The littlest one, Kathy, she's two years old. She's an asthmatic, and now she's come down with a bad, bad cold. She's having a terrible time trying to breathe. She's all red in the face, and we're frightened. We don't know what to do."

"Hold her over a steaming kettle and make a little tent around her with a towel. Just keep her there, and I'll come right over, Mrs. Hinton."

R.J. made certain a tracheotomy kit was in her bag, but when she got to the Hinton farm she saw it wouldn't be necessary for her to do a trache. The steam already had done some good. The child had a barking cough, but she was getting air into her lungs, and the redness was gone from her face. R.J. would have liked an X ray to tell her whether it was epiglott.i.tis, but a careful examination indicated to her that the epiglottis wasn't involved. There was a mucosal inflammation of the lower larynx and trachea. Kathy cried all through the examination, and when it was over R.J. remembered something she had seen her father do with pediatric patients.

"Would you like me to give you a tricycle?"

Kathy nodded, sniffling. R.J. wiped the tears from her cheeks, then she took a clean wooden tongue depressor and drew a tricycle on it with her ballpoint pen. The little girl took it and looked at her with interest.

"Want one with a clown on it?"

Kathy nodded again, and soon she had a clown. "Big Bird."

"Oh-oh," R.J. said. Her television memory was weak, but she managed to draw an ostrich with a hat, and the child smiled.

"Will she have to go to the hospital?" Stacia Hinton asked.

"I don't think so," R.J. said. She left some pharmaceutical samples and two prescriptions to be filled in the morning, when the drugstore opened in Shelburne Falls.

"You keep her breathing that steam. If she has any more trouble, call me right away," she said. Then she walked woodenly to her car, drove sleepily home, and fell into her bed.

The next afternoon Greg Hinton came to the office and told Toby he had to speak to the doctor personally. He sat and read a magazine until R.J. was able to see him.

"What do I owe you for last night?"

When she told him, he nodded and wrote out a check. She saw that it covered everything he owed her for his past visits.

"I didn't see you last night," she said.

He nodded again. "I thought I'd better stay out of the way. I've been a stubborn fool. I guess I didn't feel comfortable, getting you to my house in the middle of the night after the way I've talked to you."

She smiled. "Don't worry about that, Mr. Hinton. How's Kathy doing today?"

"Much better. And we thank you for that. No hard feelings?"

"No hard feelings," she said, and shook the hand he held out to her.

With his 175-cow herd, Greg Hinton could more than afford to pay for a doctor's services, but R.J. also took care of Bonnie and Paul Roche, a young couple with two small children, who were struggling to survive with an eighteen-cow dairy farm.

"Every month," Bonnie Roche told her, "I have a veterinarian come in to give our cows their tests and shots, but we can't afford medical insurance for ourselves. Until you came, my cows got better medical care than my kids."

The Roches weren't an isolated case in America. In November, R.J. went to the old wooden Town Hall and cast a ballot for Bill Clinton as president of the United States. Clinton had promised her patients that he would provide medical insurance to everyone who didn't have it. Dr. Roberta Cole intended to hold him to that promise, and she cast her vote as if it were a lance she was leveling at the health care system.

26.

ABOVE THE SNOW LINE.

"Sarah has had s.e.x."

R.J. waited a beat, and then she said carefully, "How do you know that?"

"She told me."

"David, it's absolutely wonderful that she could talk to you about something so intimate. You must have a remarkably good relationship with her."

"I am devastated," he said quietly, and she saw it was so. "I wanted her to wait until she was ready. It was easier years ago, when women were supposed to be virgins until their wedding night."

"She's seventeen years old, David. Some would say she's well behind the curve. I've treated eleven-year-old children who have had s.e.x. Sarah has a woman's body, a woman's hormones. It's true some women wait for s.e.x until they marry, but they've become a rare species. Even in the years when unmarried women were supposed to be virginal, a whole lot of them weren't."

He nodded. He had been quiet and morose all evening, but now he began to speak tenderly of his daughter. He said he and Natalie had talked to Sarah about s.e.x before and after she entered p.u.b.erty, and that he realized he was fortunate she was still willing to talk to him openly.

"Sarah didn't say who her partner was, but since she's dating only Bob Henderson, it's safe to make a supposition. She said it was in the nature of an experiment, that she and the boy are very good friends, and they thought it was time they both got it over with."

"Would you like me to have a talk with her about birth control, things like that?" R.J. hoped very much he would say yes, but he looked alarmed.

"No, I don't think it's necessary. I don't want her to know I've been talking with you about her."

"Then I think you should talk with her about those things."

"Yes, I will." He looked more cheerful. "Anyway, she told me the experiment is over. They value their friendship too much to spoil it, and they've decided to go back to just being best buddies."

R.J. nodded doubtfully. She didn't tell him she had observed that once young people had s.e.x, they almost invariably repeated the experience again and again.

She had Thanksgiving dinner at the Markus cabin. David had roasted the turkey and made re-stuffed baked potatoes, and Sarah had candied a panful of yams with maple syrup and made threeberry applesauce from their own berries and fruit. R.J. brought pumpkin pies and apple pies with crusts she bought frozen at the supermarket and fillings she had prepared from scratch at three o'clock in the morning.

It was a quiet, very satisfying Thanksgiving dinner. R.J. was glad that neither David nor Sarah had invited anyone else. They ate the good dinner, drank mulled cider, and popped corn over the open fire. To complete her picture of what Thanksgiving would be if it were perfect, the overcast sky turned almost black at dusk and produced fat white flakes.

"Surely it's too early for snow!"

"Not up here," David said.

By the time she went home, several inches of snow had acc.u.mulated on the road. The windshield wipers kept the gla.s.s free, and the defroster worked, but she drove slowly and carefully because she hadn't had the snow tires put on the car.

During all her winters in Boston, R.J. had loved the brief, mystical time when things were quiet and white during and immediately after a snowfall, but almost at once plows and trucks and cars and buses would begin to roar and snort, and the white world quickly became a dirty, dreary mess.

Here it was different. When she got to the house on Laurel Hill Road she built a fire and then turned off the lights and sat close to the flames in the darkened living room. Through the windows she saw that all around her house an acc.u.mulating blue whiteness had taken over the woods and the fields.

She thought of wild animals hunkered down in their holes in the blanketed ground, in the small marble caves on the ridges, in the hollow trees, and she wished them survival.

She wished the same thing for herself. She had survived the easy first months as physician to Woodfield, the springtime and summer. Now nature in the mountains was showing teeth, and R.J. hoped she would be equal to the challenge.

Once the snow came to the high land it didn't go away. The snow line ended about two thirds of the way down the long descent local residents called Woodfield Mountain, so that when R.J. drove down into the Pioneer Valley to go to the hospital or to a movie or a restaurant, she found a snowless landscape that for a few moments seemed as foreign as the far side of the moon. It would be the week following New Year's Day before the valley received a snowfall heavy enough to remain on the ground.

She enjoyed leaving the snowlessness and re-entering the white world of the hills. Although dairy farms were dwindling in number, the town was accustomed to an old tradition that said all roads must be kept open so tank trucks could collect the milk, and she had little trouble reaching her patients for house calls.

One night in early December, she had gone to bed early but was awakened at 11:20 by the telephone's ring.

"Dr. Cole? This is Letty Gates, over on Pony Road, and I'm hurt." The woman was crying, breathing raggedly as she spoke.

"Hurt how, Mrs. Gates?"

"My arm may be broken. I don't know, my ribs ... It gives me pain to breathe. He did me bad."

"He? Your husband?"

"Yes, him. Phil Gates."

"Is he there?"

"No, he's gone off for more drinking."

"Pony Road is up on the side of Henry's Mountain, isn't it?"

"Yes."

"Well, okay. I'll be right along."

First she telephoned the police chief. Giselle McCourtney, the chief's wife, answered the telephone. "Why, I'm sorry, Dr. Cole, but Mack isn't here. A big twelve-wheeler went off the highway on that icy stretch just past the town dump, and he's been down there since nine o'clock, directing traffic. He should be back any time, I expect."

R.J. told her why her husband was needed. "So will you send him up to the Gateses' farm as soon as he's free?"

"I surely will, Dr. Cole. I'll try to raise him on the radio."

She didn't have to place the car in four-wheel drive until she started up Pony Road. After that the rise was steep, but the hardpacked snow made a smoother ride than the dirt road would have offered in the summertime.

Letty Gates had turned on the strong light above their barn door, and R.J. began seeing it through the trees while she was a good distance away. She drove into the barnyard and stopped the Explorer near the back steps. She had just gotten out of the car and was taking her bag from the backseat when the first sharp, loud report made her start, and something kicked up the snow near her booted foot.

At once she made out the figure of a man just inside the barn door, in the darkened interior. The outside light reflected off the snow to gleam dully on the barrel of what she guessed was a deer rifle.

"Get the f.u.c.k out of here." He swayed as he called to her, lifting the rifle.

"Your wife is hurt, Mr. Gates. I'm a doctor, Dr. Cole, and I'm going into your house to take care of her." Oh G.o.d, she thought, not smart at all. She didn't want to give him ideas, send him back into the house after the woman.

He fired again, and the gla.s.s in the right headlamp of her car exploded in a shower of shards.

There was no place where she could hide from him. He had a powerful weapon, and she had none. Whether she tried to duck behind the car or within it, all he had to do was take a few steps and he could kill her if that was what he wanted to do.

"Be reasonable, Mr. Gates. I offer no threat to you. I just want to help your wife."

There was a third shot, and the gla.s.s in the left headlamp of the car disappeared. Then another shot blew away a chunk of the front left tire.

He was making junk of her car.

She was exhausted, sleep-deprived, and so terrified that she was past caution. The acc.u.mulated tensions of ripping apart her life and putting it together again in this new place-everything suddenly welled up within her and spilled over.

"Stop it. Stop it. Stop it. Stop it."

She had lost control, abandoned reason, and she took a step in his direction.

He came to meet her, holding the rifle low but keeping his finger on the trigger. He was unshaven, dressed in dirty overalls and a manure-stained brown barn jacket and a plaid woolen cap embroidered with "Plaut's Animal Feeds" on the front.

"I didn't have to come here." She listened to her voice in astonishment. It was modulated and reasonable.

He looked puzzled as he lifted the rifle. At that moment they both heard the car.

For just long enough, he hesitated, and Mack McCourtney sounded the siren loud and low, like the growl of a giant animal. In a moment the car lumbered into the driveway, and McCourtney was there.

"Now don't you be a horse's p.r.i.c.k, Philip. Put that gun down or it will be real bad for you. Either you'll be dead or you'll be in jail forever with no chance to get drunk at all." The police chief was quiet and steady, and Gates set the rifle against the wall of the house. McCourtney handcuffed him and put him in the back of the Jeep, which was as secure as a cell, reinforced by heavy wire gridwork.

Very carefully, as if she were walking over thin ice, R.J. went inside the house.

Letty Gates had multiple bruises from her husband's fists and what proved to be hairline fractures of the left ulna and of the ninth and tenth ribs on her left side. R.J. called the ambulance just as it returned from transporting the truck driver to the hospital.

Mrs. Gates's arm was splinted and placed in a sling and bound to her chest with a wide cravat to support the ribs. By the time she was taken away by the ambulance, Mack McCourtney had gotten the spare tire onto R.J.'s car. The lampless Explorer was blind as a mole, but she followed behind the police Jeep as McCourtney slowly drove down the mountain.

When she got home, she managed to get only partially undressed before she sat on the edge of her bed and cried and cried.

The next day she was busy with office hours, but Dennis Stanley, one of McCourtney's part-time special officers, drove the Explorer into Greenfield for her. He got a new spare tire and the Ford dealer replaced the headlights and the wiring for the left lamp. Then Dennis went to the county jail and gave the bills to Phil Gates, explaining that the judge might take it kindly when he considered the possibility of bail if Gates could say he was sorry and had already made rest.i.tution. Dennis brought Gates's check back to R.J. with the repaired car and advised her to cash it immediately, which she did.

Things slackened in December, and she welcomed the breathing room. Her father had decided to visit friends in Florida for Christmas, and he asked if he could spend four days beginning December 19 with R.J., to celebrate the holiday early.

The early celebration put Christmas on schedule with Hanukkah, and David and Sarah said they would be glad to come to a holiday dinner.

R.J. cut a small tree from her own woods, which pleased her, and made a nice dinner for the four of them.

They exchanged gifts after the meal. She gave David a small painting she had bought of a cabin doorway that reminded her of his house, and a family-size package of M&Ms. For her father she had bought a jug of the Roches' maple syrup and a jar of I'm-In-Love-With-You Honey. For Sarah, she had a collection of Jane Austen's novels. Her father gave her a bottle of French brandy, and David gave her a book of poems by Emily d.i.c.kinson. Sarah had wrapped a pair of mittens she had knitted of undyed yarn and a third heartrock for R.J.'s collection. She told R.J. that in a way her gifts were from Bobby Henderson too. "The wool came from sheep raised by his mother, and I found the heartrock in their barnyard."

R.J.'s father was growing older. He was more hesitant than she remembered, a little quieter and somewhat wistful. He had brought his viola da gamba. His hands were so arthritic that it hurt him to play, but he insisted that he wanted to make music. After the presents were exchanged, she sat at the piano, and they played a series of duets that went on and on. It was even better than the perfect Thanksgiving had been; it was the best Christmas R.J. had ever had.