—
Anne’s news that she was pregnant had surprised Jim, but not in the way he would have expected. He was elated, ready to accept it as vasectomy failure. He knew there were vasectomies that failed—studies showed a one-in-a-thousand pregnancy rate. Like the Honduran murder rate, the highest in the world, he thought, to give the statistic more heft. And he hadn’t been tested after the procedure to find out if it had worked. He was, in this way, like many patients and most doctors. Most doctors were notoriously bad patients: they prescribed narcotics and stimulants for themselves; they never got flu shots; they thought checkups were a waste of time and money; they “watched and waited” while their PSA levels went through the roof. Their balkiness wasn’t entirely owing to professional cynicism or a sense of invulnerability. They believed in public health—potable water, vaccinations, pasteurized milk, seat belts, birth control—much less in medicines and surgeries. They knew many ailments would go away by themselves, sooner or later. They also knew they would die one day, at home if they were lucky. Hospitals were disease pits, more dangerous than highways, no place to be sick in. Jim often thought of having “Do Not Resuscitate” tattooed on his chest. He was struck how often doctors died of diseases in their specialty. “Best to be a pediatrician,” he’d tell medical students. “You’ll begin your practice having outlived the condition.” Jim suspected he’d die of heart disease. He never took a stress test.
Jim didn’t question Nathan’s paternity, beyond his first queries to Anne. He couldn’t imagine Anne cheating on him, and Nathan himself was the best proof. “Like father, like son,” the Lehmans always said. Father and son were both smart without being intellectual, practical without being plodding, analytical without being exacting. They liked working with their hands. Neither had much of a sense of humor, which they admitted privately to each other and came to regard as the secret to their success. Humor was socially useful, professionally distracting. Focus, doggedness, determination, drive, they were the right stuff. By the time there was routine DNA testing, Jim didn’t give it more than a minute’s thought.
—
Jim was liked and admired by the nursing staff at Presbyterian, a distinction rarely paid a surgeon who hadn’t previously been hospitalized with a grave and humbling illness. He treated nurses as colleagues and professionals, listening to their concerns, asking their opinion, taking their advice. Before he checked up on a patient on the ward, he would check in at the nurses’ station for an update. He believed he owed his success to the ward nurses and often said so, to them and to the other cardiac surgeons. His colleagues mocked him, calling him Dr. Kumbaya. They thought he was breaking ranks with the surgical knighthood by pandering to the yeomanry. “He has a wife with a PhD,” they’d say, as if marriage to an educated woman, always a mistake, made men red-eyed, weak-wristed feminists. To no avail, he would explain that his treatment of the nurses was strategic and practical. “I need them,” he’d say. Nurses were his early warning system of infections, bleeding, arrhythmias; they also had warmer, more comforting beside manners. His was cool, correct, and fleet: a hand on the shoulder, a nod, a smile. Seconds later, he was gone. He had the best outcomes in the department. Patients came from Rochester, Minnesota, Boston, and San Francisco to see him.
Two days after hearing that Rupert Falkes was dying on the sixth floor at Presbyterian Hospital, Jim dropped by his room. Eleanor was in the hallway, speaking with one of Rupert’s doctors. Catching sight of Jim, she smiled at him. “Do I need to introduce the two of you?” The two men nodded at each other, with the chill civility of silverbacks finding themselves in the same clearing: they’d fight it out when the females were gone. “Ah,” she said, “I see you know each other. Stephen is Rupert’s oncologist; Jim, a college friend.” Jim hated that she always added “college” or some other qualifier to her introductions, consigning him to her past. “I’m sorry,” she said to Jim, “I need to follow up with Stephen. It shouldn’t take long.”
Eleanor and Stephen stepped away. They spoke for several minutes. Jim began to feel conspicuously ridiculous. He looked in at Rupert, who was lying very still in bed, his eyes closed. The radio was playing: Bach, he thought. He resisted the urge to read Rupert’s file, tucked in a folder on the door. He guessed that Stephen was deliberately taking more time than necessary, to put him in his place, to keep Eleanor to himself. On the oncology wards at Presbyterian, the surgeons and oncologists achieved at best a shaky truce. They had moved past “slash and burn,” the tired war metaphors, to literary invective. The surgeons had started calling the oncologists the Brotherhood of Dracula; the oncologists responded by calling the surgeons the Sisterhood of Frankenstein. One morning, in the heat of their schoolyard tiff, mostly played out with plastic body parts and rubber bats stuck in coat pockets, lockers, and mailboxes, the staff found a large engraved metal plaque attached with dental adhesive to the main door of the oncology ward. It read: THE STOKER-SHELLEY MEMORIAL WING. It was too expensive a prank for the residents, the likeliest perpetrators, to have pulled it off; no one else came forward. The doctors, in a rare display of collective good humor, wanted to keep the plaque up. The hospital president ordered it taken down, to protect donors’ sensibilities. The chair of oncology decided to auction off the plaque, to raise money for the new children’s cancer wing. Jim got it after fierce bidding, for eleven thousand dollars. He knew Eleanor had put it up.
After waiting ten minutes, Jim signaled he was leaving. Eleanor called out, “Thanks for stopping by. Sorry we couldn’t talk.” Over the next three months, Jim dropped by Rupert’s room three or four times a week, hoping to find Eleanor alone. Every time, she was with someone, usually one of Rupert’s doctors, sometimes a son or two, occasionally a friend. She was always welcoming, happy to make introductions but never able to talk to him. He knew his behavior was indecent, even if no one but Eleanor knew it. He wasn’t there to help her. He was there to woo her, to make love to her, in the presence of her dying husband. Every time he left the oncology ward, he swore he’d keep away. A day later, he’d lost all resolve. He would find himself, in his open hours, drifting down to the sixth floor. I’m only passing through, he’d tell himself. As a discipline and a restraint, he wrote letters to Nathan at college.