The Good Father (2 page)

Alex had always had a quick wit and a sharp tongue. I suggested he sign up for debate classes, where he could learn to beat his opponents with words.

He shrugged, but I could tell he liked the idea. And over the next few months, Alex became the top debater in his class. Now he turned every request to eat his vegetables or help with the chores into an Aristotelian voir dire.

I had no one to blame but myself.

This was our nuclear family. A father, a mother, and two sons. Daniel, the son from my first marriage, had lived with us for a year during his sullen teens, but had departed as impulsively as he’d arrived, waking me one morning before dawn to ask if I could drive him to the airport. His mother and I had split when he was seven, and he had stayed with her on the West Coast when I had come east.

Three years after his brief stay with us, Danny, eighteen, had started college. But he dropped out after less than a year, climbing into his car and heading west. Later, he would say that he just wanted to “see the country.” He didn’t tell us he’d left. Instead, I sent a card to his dorm, and it came back unopened, with a stamp
OCCUPANT NO LONGER AT THIS ADDRESS
. This had been his way since childhood. Danny was a boy who never stayed where you left him, who popped up in unexpected places at unexpected times. Now he called infrequently; sent e-mails from Internet cafés in the flat states of the Midwest. The occasional postcard scrawled in a moment of summer nostalgia. But always at his convenience, not mine.

The last time I saw him was in Arizona. I’d flown in for a medical conference. Daniel was passing through on his way north. I bought him breakfast in a hipster coffee shop near my hotel. His hair was long and he ate his pancakes without pause, his fork moving from plate to mouth like a steam shovel.

He told me he’d been doing a lot of camping in the Southwest. During the day he hiked. At night he read by flashlight. He seemed happy. When you’re young there is no more romantic conceit than freedom—the boundless certainty that you can go anywhere, do anything. And though it still bothered me that he had dropped out of college six months earlier, knowing him as I did, I can’t say I was surprised.

Daniel had grown up traveling. He was a teenage gypsy, shuttled between Connecticut and California, living partly with me and partly with his mother. Children of joint custody are, by nature of the divorce settlement, independent. All those Christmases spent in airports, all those summer vacations shuffling back and forth between mom and dad. Unaccompanied minors, crisscrossing the nation. Daniel seemed to survive it without major trauma, but I still worried, the way any parent does. Not enough to keep me up at night, but enough to add a layer
of doubt to each day, a nagging sense of loss, like something important had been misplaced. And yet he had always been self-sufficient, and he was a smart, likable kid, so I convinced myself that wherever he went, he was fine.

Last fall, sitting across from each other in that Arizona coffee shop, Daniel teased me about my coat and tie. It was Saturday, and he said he didn’t see the point.

“It’s a medical conference,” I told him. “I have a professional reputation to uphold.”

He laughed at the thought of it. To him all these grown men and women acting and dressing in a manner that society deemed “professional” was ridiculous.

When we parted I tried to give him five hundred dollars, but he wouldn’t take it. He said he was doing good, working odd jobs here and there. He said it would feel strange carrying that much money around with him.

“It’d throw off the balance, you know?”

The hug he gave me when we parted was full-bodied and long. His hair smelled unwashed, the sweet musk of the hobo. I asked him if he was sure about the money. He just smiled. I watched him walk away with a deep feeling of impotence. He was my son and I had lost control of him, if I’d ever really had it. I was a bystander now, an observer, watching his life from the sidelines.

When he reached the corner, Daniel turned and waved. I waved back. Then he stepped into the street and I lost him in the crowd. I hadn’t seen him since.

Now, in the kitchen of our Connecticut home, Fran came over and kissed me on the mouth. Her hands were covered in flour and she held them up the way I had held mine up a few hours ago walking into the ICU.

“Alex got in another fight,” she said.

“It wasn’t a fight,” Alex corrected her. “A fight is where you hit someone and they hit back. This was more like a mugging.”

“Mr. Smart Ass has been suspended for three days,” she told me.

“I plan on being furious,” I told them. “After I have a drink.” I took a beer from the fridge. Fran had returned to the pizza stone.

“We figured pepperoni and mushroom tonight,” she said.

“Far be it from me,” I told her.

Apropos of nothing Fran said, “Yes, the seven-fifteen flight to Tucson.”

Tucson? Then I noticed the blue light.

“Yes, he’ll need a car.”

I started to speak, but she held up a finger.

“That sounds great. Will you e-mail me the itinerary? Thank you.” The blue light went off. The finger came down.

“What can I do?” I said.

“Set the table. And I’ll need you to take it out in ten minutes. That oven still scares me.”

The TV was on in the corner, playing
Jeopardy!
It was another ritual in our house, this watching of game shows. Fran thought it was good for the kids to compete with contestants on TV. I had never understood why. But every night around seven our house became a cacophony of barked non sequiturs.

“James Garfield,” said Wally.

“Madison,” corrected Fran.

“In the form of a question,” said Alex.

“Who is James Garfield?” said Wally.

“Madison,” said Fran.

“Who is James Madison?”

I had gotten used to the nightly confusion, looked forward to it. Families are defined by their routines. The pickups and drop-offs. The soccer games and debate clubs, doctors’ appointments and field trips. Every night you eat and clean. You check to make sure homework is done. You turn off the lights and lock the doors. On Thursdays you drag the Toters to the curb. Friday mornings you bring them in. After a few years, even the arguments are the same, as if you are living out the same day over and over. There is comfort in this, even as it drives you mad. As a virtual assistant, Fran was militant about order. We were her family, but also her ground force. She sent us e-mails and text messages almost hourly, updating calendar events in real time.
The dentist appointment has been rescheduled. Glee club has been replaced by ice-skating
. Armies are less regimented. Twice a week in the Allen household we synchronized our watches like a special-ops team tasked with blowing up a bridge. The occasional annoyance this raised in me was tempered by love. To have married once and failed is to realize who you are in
some deep and unromanticized way. The veneer of personal embarrassment about your weaknesses and idiosyncrasies is lifted, and you are then free to marry the person who best complements the real you, not the idealized version of you that lives in your head.

This is what led me to Fran after eight years of marriage to Ellen Shapiro. Though I had long thought of myself as a spontaneous and open person, I realized after my marriage to Ellen fell apart that I was, in fact, a creature of rigidity and repetition. I cannot stand living with uncertainty and forgetfulness. The bright-eyed, hippie ditziness that seemed charming in Ellen at first glance quickly became infuriating. Similarly, all the qualities that made me a good doctor—my meticulousness, my love of redundancy, the long hours I worked—proved to be qualities that Ellen found oppressive and dull. We took to fighting at every opportunity. It wasn’t so much what I did or what she did. It was who we were. And the disappointment we voiced to each other was disappointment in ourselves for making such poor choices. This is the learning process. And though our marriage produced Daniel, it was a union best dissolved before any real damage was done.

I took a glass from the cabinet, poured the remainder of my beer into it. I was thinking about the patient who had kept me late at the hospital today, Alice Kramer. She had presented herself to me two weeks earlier complaining of leg pain. It felt like her legs were on fire, she said. The pain had started three months ago. A few weeks later she’d developed a cough. At first it was dry, but soon it became bloody. She had been a marathon runner, but now even a short walk exhausted her.

I was not the first doctor she’d seen. There had been an internist, a neurologist, and a pulmonologist. But a valid diagnosis remained elusive, and despite their best efforts, the weakness and shortness of breath had persisted.

Other than the cough she seemed healthy. Her lungs sounded clear. She had some mild weakness in her right hip, but her joints, skin, and muscle were all normal. The symptoms she presented with suggested that her illness involved the nervous and pulmonary systems. This was unusual. Could it be Sjögren’s syndrome? This was a disease where the body’s immune system mistakenly attacks its fluid-producing glands. Except patients with Sjögren’s usually complain of eye pain and dry mouth, and she had neither of these.

Or maybe it was scleroderma, which is caused by an overproduction of collagen. The condition causes a thickening of the skin and can affect other organs of the body. I ordered blood tests. While I waited for them to return I went back over the patient’s medical files. As the doctor of last resort it is the rheumatologist’s job to reexamine every detail with fresh eyes. I reviewed her CAT scans and MRIs. On the chest CT, I saw faint cloudy patches on both lungs. By themselves they didn’t mean anything. It was the context in which I read them that gave them meaning. Looking at Alice’s film, another piece of the puzzle fell into place.

I’d ordered a lung biopsy. The pathology report showed evidence of inflammation. When the tissue came back I sat with the pathologist and reviewed the slides under a double-headed microscope. And there I saw the pivotal clue: a granuloma, a cell formation made up of groups of cells up to one hundred times the size of normal cells. They are found in the lungs only in a few diseases. The most common are sarcoidosis and tuberculosis. And since the patient showed no symptoms of tuberculosis, I was certain she suffered from sarcoid, a chronic disease characterized by tissue inflammation.

This afternoon when I told her I had a diagnosis, Alice had started crying. It had been months since the onset of her symptoms. She had been to dozens of doctors, many of whom had said her disease was all in her head. But it was my job to believe the patients who came to see me, to take pieces that didn’t seem to match and solve the puzzle.

On TV, the game show was interrupted by a newscaster. Banner headlines. Crisis colors. None of us noticed at first. We were deep in the ritual of pizza. The dough was rolled. The cheese and sauce applied. Children were scolded for an overly liberal application of toppings.

“I’m no structural engineer,” I told them, “but nothing round can hold up under that kind of weight.”

Wally told us about what he’d learned that day. Frederick Douglass was a freed slave. George Washington Carver invented the peanut.

“I don’t think he invented it,” Fran told him.

“Discovered it?”

“I think you need to go back over your notes,” I told him, finishing my beer and getting another.

Fran was the first to notice. She turned to the television and instead
of toothy hosts and eager guests found shaky camera footage of some kind of rally.

“What’s this?” she said.

We turned to look. On-screen were images of a political event in Los Angeles. We saw pictures of a crowd. Red, white, and blue banners hung on the walls. A presidential candidate stood onstage making a speech. The words were lost in the commercial mute of the TV. It is something the kids do when the ads come on, cutting the volume, letting the hucksters pantomime their sales pitches to the walls. As we watched the politician flinched, staggered back. Behind him two Secret Service agents pulled their weapons.

“Volume,” said Fran.

“Where’s the remote?” I asked, searching around.

It took precious seconds to find the remote, then many more to locate the mute button. All the while the children yelled at me to push this button or that one. When we finally got the volume working we heard the newscaster saying, “… reports of at least two shots fired by an unknown gunman. Seagram has been taken to a nearby hospital. No report yet as to the extent of his injuries.”

On-screen the footage played again. The candidate onstage, the sound of shots fired from the crowd. This time the frames played slower, the camera pushing in.

“We are trying to find a better angle,” the newscaster said.

I turned the channel. CNN had it. So did ABC and NBC.

“To repeat, thirty minutes ago Jay Seagram, a Democratic senator from Montana and the presidential front-runner, was shot by an unknown gunman.”

Back on CNN we found a female reporter standing in front of a hospital. Wind whipped her hair sideways. She spoke with one hand on top of her head.

“Ted, we’re hearing that Senator Seagram is in surgery. He suffered at least two gunshot wounds, one to the chest and one to the neck. No word yet as to his prognosis.”

This is how it happens. There is nothing and then, suddenly, something. A family is making dinner, talking, laughing, and then the outside world muscles in.

Fran sent the kids into the living room. They were too young for this. She was upset. She had gone to Seagram’s rally the last time he came to town. She had even gone so far as to stuff envelopes for him one weekend last month. He was young and handsome and spoke with authority. She had come to believe he was what she called “the real deal.”

“Who would do such a thing?” she said.

As a doctor I knew that Seagram was in for a long night. Reporters said that the first bullet had punctured a lung and the second had severed the carotid artery. Paramedics had gotten him to the hospital quickly, but those injuries would cause extensive blood loss. The loss of blood would depress his circulation, hindering his already compromised breathing. It would take a skilled surgeon to fix the damage in time.