Matters of Choice Read online

  On Wednesday it was announced that Allen Greenstein, M.D., had been appointed associate chairman of the department of medicine at the Lemuel Grace Hospital, to succeed Maxwell B. Roseman, M.D.

  For the next several days there were newspaper and television interviews with Dr. Greenstein about the fact that in a few years newborn infants would be genetically screened, making it possible for parents to know the health dangers their children would face in the course of their lives, and perhaps what they would die of.

  R.J. and Sidney Ringgold found themselves thrown together on Grand Rounds and at a departmental meeting, and passing each other several times in the corridors. Each time, Sidney looked into her eyes and greeted her warmly and pleasantly.

  R.J. would have liked him to stop and talk. She wanted to tell him she wasn’t ashamed of performing abortions, that she was doing a difficult and important job, one she had taken on because she was a good doctor.

  So why did she feel hangdog and furtive as she walked the corridors of her hospital?

  Damn them!

  On Saturday afternoon she made certain she came home early enough to shower at her leisure and dress slowly and carefully. At seven o’clock she entered Alex’s Gymnasium and walked into the lounge. Alexander Manakos was standing at one end of the bar, talking to two men. She sat on a stool at the other end of the bar, and presently he came over to her. He was even better looking than she remembered.

  “Good evening.”

  He nodded. He was carrying a newspaper. When he opened it, she saw it was Monday’s edition of the Globe. “Is it true, what this says? That you, you know, provide abortions?”

  This wasn’t to be an accolade, she knew. Her head went up; she drew herself erect so she could look him in the eye. “Yes. It’s a legal and ethical medical procedure that’s vital to the health and lives of my patients,” she said levelly, “and I do it well.”

  “You disgust me. I wouldn’t do you with somebody else’s dick.”

  Very nice.

  “Well, you certainly won’t with your own,” she told him calmly, and she got off the stool and walked out of Alex’s Gymnasium, passing a booth in which a motherly person with white hair was applauding, tears in her eyes. It would have been more comforting to R.J. if the woman hadn’t been drunk.

  * * *

  “I don’t need anyone. I can live my life by myself. By myself. I don’t need anybody, get it?

  “And I want you to get off my back, friend,” she told Gwen fiercely.

  “Okay, okay,” Gwen said, and sighed, and escaped.

  8

  A JURY OF PEERS

  The scheduled April meeting of the Medical Incidents Committee of the Middlesex Memorial Hospital was postponed because of a springtime blizzard that covered the grimy snow and old ice with a clean white layer that would have been cheering earlier in the season. As it was, R.J. grumbled about still more snow. Two days later the temperature rose to seventy-four degrees, and the new spring snow and the old winter snow disappeared together, the gutters flowing with the runoff.

  The Medical Incidents Committee met on the following week. It was not a lengthy session. In the face of clear evidence and testimony that Elizabeth Sullivan was dying and in terrible pain, they decided unanimously that Dr. Thomas A. Kendricks had not acted unprofessionally in heavily sedating Mrs. Sullivan.

  A few days after the meeting Phil Roswell, one of the committee members, told R.J. there had been no debate. “Damn it, let’s be honest. We all do that to hasten a merciful end when death is close and inevitable,” Roswell said. “Tom wasn’t trying to hide a crime, he wrote the order honestly, right there in her chart. If we punished him, we’d have to punish ourselves and most of the doctors we know.”

  Nat Rourke had a discreet chat with the district attorney and came away with the knowledge that Wilhoit did not intend to bring Elizabeth Sullivan’s death to the grand jury.

  Tom was exultant. He wanted to turn a page in his life, anxious to get on with the divorce and begin his new marriage.

  * * *

  R.J.’s mood was exacerbated by the beggars who were everywhere. She had been born and raised in Boston and she loved it, but now she couldn’t bear to look at the street people. She saw them throughout the city, sifting through the trash cans and Dumpsters, trundling their few possessions in shopping carts stolen from the supermarkets, sleeping in shipping crates on cold loading docks, lined up for free meals at the soup kitchen on Tremont Street, taking over the benches in Boston Common and other public places.

  To her, homeless people were a medical problem. In the 1970s, psychiatrists had lobbied to phase out the massive stone public asylums where the insane had been stockpiled under shameful conditions. The idea was that patients would be returned to freedom to live in harmony alongside the sane, as was being done successfully in several European countries. But in America the community mental health centers set up to serve the freed patients were underfunded, and they failed. Patients scattered. It was impossible for psychiatric social workers to keep track of someone who slept in a cardboard carton one night and miles away over a steam grate the next night. All over the United States, alcoholics, drug addicts, schizophrenics, and every variety of the mentally ill made up an army of the homeless. Many of them turned to begging, some soliciting on subways and buses with loud speeches and pitiful stories, others sitting against a building with a cup or overturned cap next to crude signs making their pleas: “Will work for food. Four children at home.” R.J. had read a study estimating that 95 percent of America’s beggars were addicted to drugs or alcohol, and that some begged up to three hundred dollars a day, money they promptly spent on substance abuse. R.J. thought with great guilt of the 5 percent who weren’t addicted, merely homeless and jobless. Still, she steeled herself against giving and was furious when she saw someone dropping a dime or a quarter into a cup instead of pressuring politically to get homeless people off the streets and into adequate care.

  It wasn’t only the homeless; all the ingredients of her existence in the city got on her nerves—the ending of her marriage, the depersonalization of her profession, the daily paperwork grind, the traffic, the fact that she hated to go to work now in a place where Allen Greenstein had beaten her out of a job.

  Everything merged into a bitter cocktail. Realization slowly dawned that it was time for her to change her life drastically, to leave Boston.

  The two medical communities where there were programs into which someone with her hybrid interests might fit were Baltimore and Philadelphia. She sat down and wrote letters to Roger Carleton at Johns Hopkins and Irving Simpson at Penn, asking if they were interested in her services.

  Long ago she had arranged for her spring calendar to be clear for a week, dreaming about St. Thomas. Instead, on a warm Friday afternoon she got away from the hospital early and went home to pack a few things she could wear in the country. She had to dispose of the Berkshires property.

  She had left the house and was getting into the car when she remembered Elizabeth’s ashes, and she went back inside and took the cardboard box from the top of the bureau in the guest room, where she had put it when she brought it home.

  She couldn’t bring herself to put the ashes into the trunk with her suitcase. Instead, she placed the small box on the seat next to her and put her folded raincoat in front of it so it wouldn’t roll off if she had to stop short.

  Then she drove to the Mass Pike and pointed the red BMW west.

  9

  WOODFIELD

  Even before the Georgian house on Brattle Street had been restored and furnished to their satisfaction, her marriage to Tom had begun to unravel. When they had found a charming property on a Berkshires mountainside in the township of Woodfield, in western Massachusetts near the Vermont line, they bought it and used the project of a vacation home to try to reinvent their “togetherness.” The small yellow frame house was about eighty-five years old, surviving sturdily next to an old tobacco barn that had begun to sag badl
y, like their relationship. There were seven acres of fields and thirty-nine acres of tangled old New England woods, and the Catamount, one of Woodfield’s three small mountain rivers, ran through both the forest and the meadow.

  Tom had hired a contractor to dig a swim pond out of a wet place in the pasture, and the bulldozer unearthed the small, stubborn remains of an infant child. The connective tissue had long since disappeared. What was left could have been mistaken for chicken bones save for the unmistakably human skull, like a delicate hardened mushroom, in three sections. There was no grave marker and the land was too marshy to be a cemetery. The find had caused a local stir; nobody in the town knew how the fetus had gotten there.

  Maybe the buried child had been Indian. The medical examiner said the little bones were old. Not eons, but certainly they had been buried long ago.

  Found in the earth above the bones had been a small earthenware plate. When it was washed, a series of rust-colored letters came into view, now terribly faded. What had been written on the plate couldn’t be read. Most of the letters were gone, but a few remained: ah, and od. And o, and again, od. Despite the sifting, a few of the small bones never were recovered. The county medical examiner had pieced together enough of the tiny skeleton to determine that it had been almost but not quite full-term, but the sex was unknown. The coroner took the bones away, but when R.J. asked if she could have the plate, he shrugged and gave it to her. She had kept it ever since in the breakfront in the parlor.

  The Massachusetts Turnpike is unexciting over most of its length. It was only when she had left the turnpike near Springfield and driven north on 1-91 that she first saw the low, worn-down mountains and began to feel happy. I will lift up mine eyes unto the hills, from whence cometh mine help. In another half hour she was in the hills, climbing roads that twisted and undulated, passing farms and forest, until she turned onto Laurel Hill Road and then drove down the long and winding driveway to the wood-frame farmhouse, the color of butter, that hugged the fringe of woods at the far end of the meadow.

  She and Tom hadn’t used the country house since the previous fall. When she opened the door the air was heavy and slightly bitter. There were droppings on a windowsill in the parlor, like mouse feces only larger, and with a quick return of the bad feeling that had plagued her for days, she told herself there was a rat in the house. But in a corner of the kitchen she found the desiccated remains of a bat. The first job she gave herself was to fetch the dustpan and broom and dispose of bat and droppings. She turned on the refrigerator, threw open the windows to let in fresh air, and carried in her supplies, two cartons of groceries and a cooler with perishables. Hungry but unambitious, she made a supper of a hard and tasteless supermarket tomato, a kaiser roll, two cups of tea and a package of chocolate cookies.

  Brushing the crumbs off the table, she realized with a pang that she had forgotten about Elizabeth.

  She went outside and brought in the box of ashes from the car, setting it on the fireplace mantel. She would have to discover the beautiful place Elizabeth had trusted her to find, and bury the ashes. She was drawn outside again and took a few steps into the woods, but they were dark and tangled. There was no way to explore them except by climbing over or under downed trees and bulling through brush and brambles, and something in her wasn’t ready for them, so she beat a hasty retreat and walked down the gravel driveway to Laurel Hill Road. It was an oiled gravel road, almost three miles long, rising and falling in several hills. She was glad to walk. A mile and a quarter down the road, she approached the small white farmhouse and enormous red barn of Hank and Freda Krantz, the farmers who had sold Tom and her their place. She turned around before she reached their door, for the moment not wanting to answer questions about Tom and explain the end of her marriage.

  The sun was down when she got back to the house, and the clear air was sharply cold. She closed all the windows but one. There was dry wood in the shed, and she built a small blaze in the fireplace and took away the chill. As dusk fell, the shrill of peepers in the pond spillway came through the open window, and she sat on the couch and drank hot, black coffee that was sweet enough to guarantee weight gain, and watched the fire.

  The next morning she slept late, had eggs for brunch, and then indulged in a frenzy of housecleaning. Because she so seldom was required to do housework she enjoyed it, and now she gained satisfaction out of vacuuming, sweeping, dusting. She washed all the pots and pans, but only a few dishes and utensils, just the things she would need.

  She knew the Krantzes ate midday farm dinners promptly at noon, so she waited until 1:15 and then walked up the road and knocked on their door.

  “Well, look who’s here,” Hank Krantz boomed. “Come in, come in.”

  They welcomed her into their kitchen, and Freda Krantz poured her a cup of coffee without asking and cut a wedge from half a white cake that was on the counter.

  R.J. didn’t know them that well, really, seeing them only on her infrequent visits, but she saw honest regret in their eyes as she told them about the divorce and asked their advice about the best way to sell the house and land.

  Hank Krantz scratched his face. “You could go to a real estate agent in Greenfield or Amherst, of course, but nowadays most folks sell through a fella named Dave Markus, right here in town. He advertises and gets good prices. And he’s a straight shooter. Not a bad sort at all for a fella from New York.”

  They told her how to get to Markus’s house. She drove first to the state highway and then off it and down a series of very bumpy gravel roads that didn’t do her car any good. In a clover field a lovely Morgan horse, brown with a white face blaze, ran alongside her car on the inside of the fence and then passed her, tail and mane streaming. There was a real estate sign outside a handsome log house looking out on a splendid view. A second sign made her smile:

  I’M-IN-LOVE-WITH-YOU

  HONEY

  Jars of amber honey were stacked in two old bookcases on the porch. Inside, radio rock music blared: The Who. A teenaged girl with long black hair came to the door. Freckled, heavy-breasted, angel-faced behind thick glasses, she was dabbing a cotton ball against a bloody pimple on her pointed chin.

  “Hi, I’m Sarah, my father’s away. He’ll be back tonight.” She scribbled R.J.’s name and telephone number and promised her father would call. While R.J. bought a jar of honey, the horse whinnied behind the fence.

  “He’s such a damned busybody,” the girl said. “Want to give him his sugar?”

  “Sure.”

  Sarah Markus got two cubes of sugar and gave them to her, and they walked to the fence together. R.J. presented the cubes timidly, but the big square horse teeth missed the flesh of her palm, and the lapping rough tongue made her smile. “What’s his name?”

  “Chaim. He’s Jewish. My father named him for a writer.”

  R.J. was beginning to relax as she waved good-bye to the girl and the horse and drove back down the road lined with tall trees and old stone walls.

  Main Street in Woodfield contained the post office and four businesses—Hazel’s, an establishment that couldn’t make up its mind if it was a hardware store or a gift shop; Buell’s Expert Auto Repair; Sotheby’s General Market (Est. 1842); and Terry’s, a modern convenience store with a couple of gas pumps out front. R.J. was partial to the funky general store. Frank Sotheby always had a wheel of sharp aged cheddar that made her mouth water. He sold maple syrup, cut his own meat, and made his own sausage, sweet and hot.

  There was no lunch counter. “Would you make me a sandwich, cheddar on a roll?”

  “Why not?” the storekeeper said. He charged her a dollar, and fifty cents for an Orange Crush. She had her lunch sitting on the bench on the store porch, watching the village go by. Then she went back into the store and recklessly cast aside her usual low-cholesterol approach to food, buying a sirloin steak, sweet sausage, and a wedge of the good cheese.

  That afternoon she put on her oldest clothes and some boots and braved the woods. Just a few
feet in, it was another world, cooler, dark, quiet with only the wind through billions of leaves, a gentle accumulated rustle that sometimes became as loud as surf and made her feel holy, and also a little scared. She was counting on the supposition that large animals and monsters would be frightened off by the disturbance she was making without trying, stepping on branches that snapped and generally moving clumsily through the close-grown forest. Now and again she came to a tiny clearing that gave respite, but there was no inviting place to rest.

  She followed a brook to the Catamount River. She estimated she was close to the midpoint of her property, and she traced the river downstream. The bank was as overgrown as the woods and the going was hard; despite the spring coolness she found that she was sweating and exhausted, and when she came to a large granite rock that projected from the bank into the water, she sat on it. She studied the pool and could see small trout hovering at mid-depth in the shelter of the rock, sometimes moving in unison like a squadron of fighter planes. The water at the tail of the pool was rushing and high with snowmelt, and she lay full-length on the warm rock in the hot sun and watched the fish. Once in a while she felt a spray like a whisper of ice on her cheek.

  She stayed out late until she was exhausted, then she struggled back through the woods, flopped on the couch and napped for two hours. When she woke up she fried potatoes and onions and peppers, and pan-fried the steak medium rare, and gobbled everything in sight, finishing with honey-sweetened tea. Just as the last light was squeezed out of the sky outside she was settling down for coffee before the fire and listening to another peepers concert, when the telephone rang.