The Cole Trilogy: The Physician, Shaman And Matters Of Choice Part 135

After David and Sarah had gone home, R.J.'s father opened the front door and walked out onto the porch. It was crispy cold, so there was a sheen of ice on the surface of the snow, and the full moon cast a path of light across the meadow as if it were a lake.

"Listen," her father said.

"To what?"

"To all the calm and bright."

They did, standing there together, breathing in the cold air for a long minute. The wind was still, and there was a complete absence of sound.

"Is it always this peaceful here?" he asked.

R.J. smiled. "Most of the time," she said.

27.

THE SEASON OF COLD.

David came to her place one afternoon when she was away and snowshoed over the cleared path through the woods three times, packing down the deep snow so the two of them could travel the trail on cross-country skis. The trail was too short, too quickly covered by a skier; they agreed they would have to finish it in time to have better skiing the following winter.

The woods became a very different place in the cold season. They saw tracks that told of animals that in the summer would have pa.s.sed through the woods unnoticed, spoor of deer, mink, c.o.o.n, wild turkey, bobcat. One set of rabbit tracks ended in a broken place off the trail. When David stirred the snow with a ski pole he uncovered frozen blood and bits of white rabbit fur, where an owl had fed.

Snow was a serious reality of everyday life in the hills. At David's suggestion, R.J. bought a pair of snowshoes and practiced using them until she could make reasonable progress. She kept the snowshoes in the car, "just in case." In fact, she didn't have to use them that winter. But early in January there was a storm that even the town's old-timers called a serious blizzard. After a day and a night of steady, heavy snowfall, her telephone intruded just as she was sitting down to breakfast.

It was Bonnie Roche. "Dr. Cole, I have a terrible pain in my side, and I'm so nauseated I had to quit in the middle of milking."

"Do you have a fever?"

"My temperature's a little over a hundred. But my side. It hurts like h.e.l.l."

"Which side?"

"On the right."

"Low or high?"

"High ... Oh, I don't know. In the middle, I guess."

"Have you ever had your appendix removed?"

"No. Oh, G.o.d, Dr. Cole, I can't go to the hospital, that's out of the question! We couldn't afford it."

"Let's not a.s.sume anything. I'll come out to your place right away."

"You can only get as far as the highway. Our private road isn't plowed."

"Sit tight," R.J. said grimly. "I'll get there."

Their private road was a mile and a half long. R.J. called the town ambulance squad, which had a rescue unit that used snowmobiles. They met her at the entrance to the Roches' road with two of the machines, and soon she was seated behind Jan Smith and hugging him, her forehead tucked into his back as they skimmed over the snow-buried dirt track.

When they arrived, it was clear at once that Bonnie's problem was appendicitis. A snowmobile wouldn't ordinarily have been R.J.'s transportation of choice for a patient with a hot appendix, but under the circ.u.mstances it had to serve.

"I can't go to the hospital, Paulie," Bonnie told her husband. "I can't. Dammit, you know that."

"Never you mind about that. You leave that to me," Paul Roche said. He was tall and rawboned, in his twenties and still looking too young to drink alcohol legally. Every time R.J. had come to their farm, he had been working, and she hadn't ever seen him, out here or in town, when his worried boy's face wasn't creased with an old man's frown.

Despite Bonnie's protestations she was helped onto Dennis Stanley's machine, which moved off as slowly as Dennis could manage. Bonnie rode hunched over, guarding the appendix. At the plowed public road the ambulance and the crew were waiting, and they whisked her away, the siren splitting the silence of the town.

"About the money, Dr. Cole. There's no insurance," Paul said.

"Did you clear thirty-six thousand last year from the farm?"

"Clear?" He smiled bitterly. "You're joking, right?"

"Then you won't be charged by the hospital, under the rules of the Hill-Burton Act. I'll see that the hospital sends you the papers to sign."

"You mean it?"

"Yes. Only ... I'm afraid the Hill-Burton Act doesn't cover doctor bills. Don't worry about my bill," she forced herself to say. "But doubtless you'll still have to pay a surgeon, an anesthesiologist, a radiologist, and a pathologist."

It hurt her to see the worry flood back into his eyes.

That evening she told David about the Roches' predicament. "Hill-Burton was meant to protect indigent and uninsured people from disaster, but it doesn't work because it pays only the hospital bill. The Roches are riding a fragile economic ship. The expenses that aren't covered may be heavy enough to sink them."

"The hospital raises its charges to the insurance companies to cover what they can't collect from patients like Bonnie," David said slowly. "And the insurance companies raise their rates they charge for their insurance to cover their increased cost. So everybody who buys health insurance ends up paying Bonnie's hospital bill."

R.J. nodded. "It's a lousy, inadequate system. There are thirty-seven million people in the United States without any form of medical insurance. Every other leading industrial nation in the world-Germany, Italy, France, j.a.pan, England, Canada, and all the others-supplies health care to all its citizens, at a fraction of what the world's richest country spends for inadequate health care. It's our national shame."

David sighed. "I don't think Paul will make it as a farmer even if they survive this problem. The soil in the hills is thin and rocky. We have some potato fields and a few orchards, and some farmers used to grow tobacco. But the crop that grows best up here is gra.s.s. That's why we had a lot of dairy farms once upon a time. But the government doesn't support milk prices anymore, and the only milk producers who can make money are the big-business outfits, enormous farms with giant herds, in states like Wisconsin and Iowa."

It was the subject of his novel. "Small farms around here have popped like balloons. With fewer farms, the agricultural support system has disappeared. There are only one or two veterinarians left to treat the herds, and agricultural equipment dealers have gone out of business, so if a farmer like Paul needs a part for a tractor or a baler, he has to drive clear into New York State or Vermont to find it. The small farmer is doomed. The only ones left are those with personal wealth or a few like Bonnie and Paul. Hopeless romantics."

She remembered how her father had characterized her desire to practice rural medicine. "The last cowboys, searching for the vanished prairie?"

David grinned. "Something like that."

"Nothing wrong with romantics." She determined to do everything in her power to help Bonnie and Paul stay on their farm.

Sarah was off on an overnight field trip to New Haven with the school drama club, seeing a revival of Death of a Salesman, and almost shyly, David asked if he could spend the night.

It was a new wrinkle in their relationship; he wasn't unwelcome, but suddenly he was in her living s.p.a.ce in a more serious way, something that took getting accustomed to. They made love, and then he was there in her room, sprawled over more than half of her bed, sleeping as soundly as if he had spent the last thousand nights there.

At eleven o'clock, sleepless, she slipped from the bed and went into the living room and turned on the television for the evening news, keeping the volume low. In a moment she was listening to a United States senator castigating Hillary Clinton as a "dreamy do-gooder" for vowing to gain pa.s.sage of a universal health care bill. The senator was a millionaire whose every medical problem was taken care of, free of charge, at the Bethesda Naval Hospital. R.J. sat alone before the flickering screen and cursed him in furious whispers until she began to laugh at her own foolishness. Then she clicked him off and returned to bed.

Outside, the wind screamed and moaned, and it was as cold as the senator's heart. It was good to snuggle up to David's warmth, one spoon fitting into another, and presently she slept as soundly as he.

28.

RISING SAP.

The advent of spring took her by surprise. The fourth week of a dun and cheerless February, while R.J. still was in the dead of winter psychologically, she began to notice people working in the woods by the roadsides as she drove past. They were tapping wooden or metal spiles into maple trees and hanging buckets on them, or running plastic lines like a giant network of intravenous tubing from the tree trunks into large collecting tanks. Early March brought the requisite weather for sugaring-frosty nights, warmer days.

The unpaved roads thawed each morning and were trans.m.u.ted into ca.n.a.ls of glue. R.J. found trouble as soon as she turned the car into the private road on the Roche place, and very soon the Explorer had churned into the gumbo up to its wheel hubs.

When she got out of the car, her booted feet sank as if something were pulling her into the earth. R.J. dragged the wire cable out of the winch in front of the Explorer and slogged down the road with it until more than a hundred feet of line lay in the mud behind her. She chose a huge oak tree that looked as though it were anch.o.r.ed in the earth for all time, encircling it with the cable and then snapping the hook over the line so the tree was captive.

The winch came with a remote control. She stood off to one side and pressed the b.u.t.ton, then watched in fascinated delight as, gradually and inexorably, the cable was drawn into the winch and became taut. There was a loud sucking noise as the four tires were pulled from the thick ooze, and the car began to inch forward slowly, slowly. When it had moved about twenty yards toward the oak tree, she stopped the winch and got back in and started the engine. The wheels had purchase in four-wheel drive, and within minutes she had reclaimed the cable and was rolling toward the Roche barnyard.

Bonnie, minus her appendix, was home alone. She still couldn't do heavy labor, and Sam Roche, Paul's fifteen-year-old brother, came each morning before school and every evening after supper and milked the cows. Paul had taken a job as a shipper in the knife factory in Buckland in order to try to pay the bills. He came home every day after three o'clock and spent what was left of daylight collecting maple sap and boiling it in the sugar house until the wee hours of the morning. It was brutal work, collecting and boiling forty gallons of sap to get one gallon of syrup, but people paid well for the syrup, and they needed every dollar.

"I'm scared, Dr. Cole," Bonnie told R.J. "I'm afraid he'll crack under the strain. Afraid one of us will get sick again. If that happens, good-bye farm."

R.J. had fears about the same things, but she shook her head. "We just won't let it happen," she said.

Certain moments never would leave her.

November 22, 1963. She had been going into Latin cla.s.s in junior high school when she heard two teachers talking about the fact that John F. Kennedy had been gunned down in Texas.

April 4, 1968. She had been bringing books back to the Boston Public Library when she saw a librarian crying and learned that an a.s.sa.s.sin's bullet had found Martin Luther King, Jr.

June 5, that same year. She had been kissing her date outside the apartment where she lived with her father-she remembered the boy was chubby and played jazz clarinet, but she no longer could recall his name. He had just touched the fabric armor, made up of her thick sweater and her bra, that enclosed her b.r.e.a.s.t.s. She was trying to figure out how to react to that when his father's car radio reported that Robert Kennedy had been shot and was believed to be dying.

She would add to those moments hearing that John Lennon had been a.s.sa.s.sinated and that the Challenger had exploded.

Now, in Barbara Kingsmith's house, on a rainy morning in mid-March, she had another terrible moment.

Mrs. Kingsmith had a serious kidney infection; her fever hadn't impaired her garrulousness, and she was complaining about the colors used by painters on the inside of the Town Hall when R.J. heard a few words of a bulletin from the television in the den, where Mrs. Kingsmith's daughter was watching.

"Excuse me," she said to Mrs. Kingsmith, and went to the den. The television was reporting that in Florida a Right-to-Life activist named Michael F. Griffin had shot and killed Dr. David Gunn, a physician who worked at an abortion clinic.

Anti-abortion activists were raising money to buy Griffin the best defense lawyer available.

It made R.J. weak with fear.

When she left the Kingsmiths' she went straight to David's house and found him in the office.

He held her, comforted her, listened as she talked about the distorted faces she had pa.s.sed on so many Thursday mornings in Jamaica Plain. She told him of the eyes filled with hate, and revealed that now she knew what she had always expected on Thursdays: a gun pointed at her, a finger pulling the trigger.

She visited Eva more often than was necessary from a physician's perspective. Eva's apartment was just down the street from R.J.'s office, and she had come to admire the old woman and to use her as a means of knowing what the town was like when it was younger.

Usually she brought ice cream, and they sat and ate it and talked. Eva had a clear mind and a good memory. She told R.J. of the Sat.u.r.day night dances that used to be held on the second floor of the Town Hall and that everybody in town came to, bringing their children. And of the days when there was an ice house at Big Pond, and a hundred men at a time swarmed out on the ice and cut it up into blocks. And of the spring morning when a loaded ice wagon and a team of four horses went through the ice and down, down in the black water, and all the horses and a man named c.h.i.n.k Roth were drowned.

Eva became excited when she learned where R.J. lived. "Why, I lived only a mile or so from there most of my life. That was our farm, that place on the upper road."

"Where Freda and Hank Krantz live now?"

"Yes! They bought from us." In those days R.J.'s land was owned by a man named Harry Crawford, Eva said. "He had a wife named Rosalie. He bought your land from us, too, and built your house on it. He had a small mill on the banks of the Catamount, with a millrace to supply power. He took logs from your forest and made and sold all kinds of wooden things-buckets, b.u.t.ter molds, paddles and oars, ox yokes, napkin rings, sometimes furniture. The mill burned down years ago. You should be able to see the foundation on the riverbank, if you look carefully.

"I remember, I was ... oh, perhaps seven or eight years old, and I used to walk down there all the time and watch them sawing and hammering, building your house. Harry Crawford and two other men. I don't remember who the other two were, but I recollect Mr. Crawford made me a little ring out of a two-penny nail." She took R.J.'s hand and smiled at her warmly. "This makes me feel you and I are neighbors, don't you know."

R.J. questioned Eva closely, thinking that the history of the Crawfords might shed some light on the tiny bones found when her pond was dug. But she learned nothing that was any help at all.

A couple of days later she stopped in at the old frame house on Main Street that was the Woodfield Historical Museum and sifted through the historical society's records, some of them yellowed and musty. The Crawfords had had four children. A son and a daughter, Tyrone Joseph and Linda Rae, had died young and were buried in the main town cemetery. Another daughter, Barbara, had died in adulthood in Ithaca, New York; her married name had been Sewall. A son, Harry Hamilton Crawford, Jr., had moved to California many years ago, and his whereabouts were unknown.

Harry and Rosalie Crawford had been members of the First Congregational Church of Woodfield. They had buried two children in the town cemetery; was it likely, R.J. asked herself, that they would have placed another infant into mucky, unconsecrated ground without a headstone?

It wasn't. Unless, of course, there was something connected to that birth that the Crawfords were overwhelmingly ashamed of.

It remained a puzzlement.

R.J. and Toby Smith had developed into more than employee and employer. They were becoming close friends who could talk in confidence about the things that counted. It made R.J. more vulnerable in her failure to help Toby and Jan achieve a pregnancy.

"You say my endometrial biopsy was fine, and that Jan's sperm is okay. And we've been very good about doing exactly what you've advised us to do."

"Sometimes we just don't know why there's no pregnancy," R.J. told her, feeling somehow guilty that she hadn't been able to help them. "I think you should go to Boston to see a fertility specialist. Or up to Dartmouth."

"I don't think I could get Jan to go. He's tired of the whole thing. We both are, d.a.m.n tired," Toby said peevishly. "Let's talk about something else."

So R.J. spoke frankly to her about David.

But Toby said little in reaction.

"I don't think you like David all that much."

"That isn't true," Toby said. "I think David's just fine. Most people I know like him, but n.o.body I know has become close to him. He kind of ... lives within himself, if you know what I mean."

R.J. did.

"The important question is, do you like him?"

"I do, but that's not the important question. The important question is, do I love him?"