The Pursuit of Alice Thrift (19 page)

“Hmm?”

“Dr. Hastings? The one who wanted to throw me out of the program? I told you about that—the cholecystectomy?”

“Right,” she said.

I said, “One of these days I'm going to have to work under him. And I have this fantasy where I'll say, ‘You owe me an apology, Dr. Hastings. What you said and did was inexcusable. I spoke to a lawyer, and she agrees. One more harassment and we're going to sock you with a lawsuit—you and all of your kind.' ”

Sylvie said, “What's gotten into you?
Lawsuits.
‘All of your kind.' Did you really consult a lawyer?”

“No. It was all Leo. He used to be the grievance chairman of the nurses' union, so we role-played until I got it right.”

“Good man,” she said, but wanly.

“Another lap?” I asked.

She said no, sorry. Couldn't. Had to read up on, well, stuff. Crohn's disease. For a talk. A stack of articles she'd clipped and never read. Besides, she was beat. Would probably have to nap before settling down with the journals.

I said okay. Exercise and confession now concluded. Back to medicine; back to
The Annals of Surgery.
And, likewise, back to sleep.

THE NEXT MORNING
I not only diagnosed a pneumothorax but also got the chest tube into the pleural cavity on the first try. No one applauded, but the senior resident said, after hearing lung sounds, “Very slick.”

Next day, still assigned to the ER: lacerated thumb belonging to fifty-two-year-old male, injury inflicted by lid of a tuna fish can. Same senior resident of the pneumothorax stepped aside; said, “Dr. Thrift is going to take over. As we all know, women are much better at sewing. And she's not just any old ER doc. She's a surgeon.” Eight respectable stitches were the easy part, but I also told a joke—“Next time you might want to consider peanut butter and jelly”—evincing bedside bonhomie and inducing a grumpy laugh from the patient as I wound gauze around my very good work.

Friday: A sixteen-year-old girl presented, complaining of severe abdominal pain, accompanied by a jittery teenage boy whose jeans hung below the elastic waist of his boxer shorts. Patient moaning; reported having taken Ex-Lax to dispel the pain with no relief. Instantaneous and surefooted diagnosis by me: pregnant, in labor, possibly in transition; certainly in denial.

Early morning hours of the next day: Forty-eight-year-old man in cardiac arrest arrived by ambulance. Flat line. Much hyperactivity all around me. I was asked by a third-year resident to take over for him after five minutes of CPR. I did. I continued for my five minutes until he signaled, Okay, I'm back. We alternated for close to thirty minutes as others tried drugs, defib, everything at our disposal. Despite heroic efforts, he was never resuscitated. I did feel sad—this young man, his wife and children waiting to be told—but above all I felt part of a team that had done its medical best, seamlessly, loss of life notwithstanding, and proud that I never missed a compression or a count.

I am not saying that I deserve a Nobel Prize in medicine for what were, essentially, feats of first aid. Not at all. I wouldn't even present them as evidence of professional advancement. All I'm saying is that in the span of five days, no one had a tantrum at the sight of me. No one looked up from a gunshot wound or a blunt head trauma or a seizing accident victim and barked, “Not Thrift. Not her. Get me someone else.”

MY SIXTEEN-YEAR-OLD PRIMIPARA
, Amber Quinlan, had the far bed in a double with a woman whose side of the room was a florist's bonanza. I asked the teenager if she remembered me from the emergency room.

“It was a girl,” she said.

“I know. I read your chart before I came in. Congratulations.”

“Yeah, right. Just what I needed.”

I asked how she was feeling.

She
asked if I was a doctor; brightened when I said I was, and asked if I could write her a prescription for OxyContin.

My ER antennae vibrated: A patient was asking for a controlled substance cited in a recent memo as being a fashionable street drug. I said, “What do you need OxyContin for?”

“Pain,” she said. “Wicked bad.”

I went back to the nurses' station, checked Amber's file, saw she'd been given Tylenol with codeine. I returned to her bedside and said, “Do you remember getting a pill about fifteen minutes ago?”

“No.”

I told her she'd feel better soon, and said good night. As I made my turn, I was jerked back by Amber's hand clutching the hem of my white jacket. “My baby?” she asked. “Is she okay? They said she had to go into the special nursery.”

“That's just a precaution. Because of your age and because you didn't have prenatal care.”

“I took vitamins,” she said. “I knew that I was supposed to do that much. And I drank chocolate milk, like, a lot.”

I borrowed a chair from the roommate's side of the double, and closed the curtains around us. “What about your parents?” I asked.

“What about them.”

“Did anyone notify them?”

“Someone had to call my mother about insurance and also 'cause I'm under eighteen. She left work and came here.”

“How was that?”

“Freakin' out. Hysterical. Like, ‘How could you do this to me?' And ‘I'm not raising no baby so don't get any ideas about bringing her home.' ”

“Is that what you'd planned? To bring the baby home?”

Amber said, “No way.”

“Then you've decided to give her up for adoption?”

Amber said, “I've heard you can get money for it.”

I said she'd have to talk to the social worker, but I doubted that very much.

“I knew a girl,” said Amber, “and the family who was getting her baby sent her these big thick steaks in the mail so she'd eat right. And after the adoption was legal? She got a car.”

I said, “Promise me you won't leave until you speak to a social worker.”

Amber took a swig from a bedside can of Coke. “Is she going to tell me to keep it?”

A head appeared through the curtains. “Excuse me,” she said. “I'm in the next bed so couldn't help overhearing. But do you mind if I ask if the baby's father is Caucasian?”

Amber said, “What?”

Before I could define
Caucasian
or compose a sentence suggesting that the woman mind her own business, the roommate continued. “I know people who are trying desperately to adopt. I could put the two of you in touch.”

I said, “This is a matter for social workers and adoption agencies and . . . and . . . responsible adults.”

“Not true,” said the roommate. “Private adoptions can be arranged through a lawyer.”

“Enough,” I said to her. “Please. She's sixteen years old.”

“He's white,” Amber said. “So's his mother. I never met his father.”

“What does his father do?” asked the roommate.

“Please don't confuse her,” I said.

When the roommate had receded back through the curtains, Amber said, “I was thinking maybe one of those open adoptions where the parents send you a letter and a picture once a year. And if I ever get my own place, she could come during school vacation.”

I said, “I'm sure they'll find a wonderful couple who will take all of that under advisement.”

“Go see her,” said Amber. “They'll let you in. You're a doctor, right? You can go right up to her.”

“You can go in, too,” I said. “Day or night. You're the mother.”

She shook her head.

“You want me to go for you and give you a report?”

Amber said, “Her face was kinda swollen. I want to know if there's anything wrong or if it's just from getting born.”

“Are you sure you don't want to come with me? They like to get you up on your feet.”

“I'll do it tomorrow. I have bad cramps, almost as bad as when I was having her.”

I said, “That's normal. The medication should be kicking in about now.”

“Come back after,” said Amber.

ON DUTY, TALKING
nonsense to Baby Girl Quinlan in her unflattering lavender cap, one big finger massaging her back, was Nurse Leo Frawley.

“How is she?” I asked.

“Fine. Just passing through on her way to the big-girl nursery,” he said.

“Everything normal?”

“Yup. Breathing on her own, eating by mouth, pooping nicely. She's shipping out in twenty-four hours.”

I told him I was in the ER when her mother came in complaining of abdominal pain, and had recognized it as labor.

“Good call,” said Leo.

“It wasn't as obvious as it sounds. I mean, she could have been a regular fat girl with appendicitis.”

Leo said, “And how clueless do parents have to be, or how absent or how wasted, not to notice their daughter's pregnant?”

I said, “That doesn't sound like the Leo I know.”

“I've seen too much,” he said. “The milk of human kindness dries up when you've taken care of as many crack babies as I have.”

I said, “She may have been hiding the pregnancy, but she told me she drank milk and took vitamin pills.”

“Over-the-counter One-A-Day—with iron if we're lucky—and no prenatal care,” he said. “Big fucking deal.” He smiled, though, as soon as he turned back to the baby. “She must have done something right. This one's lookin' good. Even her weight was decent.”

I bent down so that I was eye level with the baby. “Kind of ugly, though, isn't she?”

Leo shushed me.

“You're not suggesting that she distinguishes between flattering and unflattering adjectives?”

“I never take that chance,” said Leo. He turned back to the baby and crooned, “Right, sweetie-pie? All my babies are beautiful. Even the ones who are as homely as sin.”

Now I tried it, a kitchy-cooing of my own design. I said, “Little girl? Nurse Frawley didn't say ‘homely as sin.' What Nurse Frawley actually said was, ‘Isn't she going
home
soon?' ”

“She's not,” said Leo. “At least not with Miss Foulmouth Quinlan.”

“You know that?”

“I know everything,” said Leo. “It affects a bunch of stuff. Like none of us goes to the mother's room and gives the old breast-milk-is-best pep talk. Also, I was at the birth, or shortly thereafter. Let's just say a cursory evaluation of Amber's motherhood potential leads me to say, ‘Good riddance to bad rubbish.' ”

“On the other hand, she
did
ask me to check on the baby and report back to her.”

“Sweet,” said Leo.

“So can I tell her that everything's fine? Because she was worried about the baby's face looking swollen.”

“She was a little beat up coming out, but that's normal. She'll be totally adorable in a week or two.”

He moved to an incubator, which bore a child's drawing by what I deduced was an older sibling, and a second fanciful poster-paint sign proclaiming
MY NAME IS TYLER ANDREW.

I stayed by Amber's baby, who was tightly swaddled and propped on her side. Her face was red; a hematoma was blossoming under one closed eye. Usually I would introduce myself to a patient, but here I just whispered, “I'm sure you're going to have a great life, and that your adoptive parents will give you music lessons and orthodonture if you need it, and send you to college and even graduate school. Okay?” I looked over my shoulder to make sure Leo wasn't close enough to hear. “And in her own way your birth mother really loved you, because no teenager takes vitamin pills and drinks milk unless she has a pronounced altruistic streak.” I touched the worn flannel blanket that swaddled her tightly, then crossed to where Leo was rocking Tyler, still attached by tubes to various monitors.

I asked if that was part of the protocol—rocking the babies in rocking chairs.

Leo smiled. “Why, yes, Dr. Thrift. I think this might be considered a protocol—as well as calming a fussy baby. Not to mention soothing the nurse on call, especially when he's tired and his other customers are asleep.”

“I like that,” I said. “I mean, do I ever get to sit down in a rocking chair when I'm stressed? Maybe
I
should consider neonatology.”

“It's a gas. I mean, I see bad stuff, but now even babies weighing a pound and a half go home in a car seat wearing real baby clothes instead of doll outfits. Even when I'm in peds, I sneak back in to see my babies.”

His babies.
How could I not bring up the biological one in utero? I said, “You must be looking forward to sitting in a rocking chair with your own son or daughter.”

Leo looked down at Tyler and said after a moment, “I'm sure I will.”

“And Meredith must love babies, too, or she wouldn't be a midwife.”

“Meredith—” Leo stopped. “Well, no one can say she doesn't live in a world that revolves around childbirth.” He turned back to Tyler and said, “Okay, pal. How about a delicious snack?” And back to me. “He just started taking breast milk. You missed the party at lunch.”

He went to the refrigerator and I followed as he explained that it was an unusually quiet night here in special care. During the day, it was Grand Central. Some parents camped out here, which was actively encouraged. Good for the mothers, good for the babies.

“Am I supposed to talk Amber into keeping hers?” I asked.

“No! She's what? Fifteen?”

“Sixteen.”

“Why would you think it's a good idea for a sixteen-year-old single mother to raise her unwanted baby as opposed to some desperate couple who will worship her?”

“No sound reason. Just thinking of Amber down the road. She has this elaborate plan for open adoption and summer vacations when the baby's older.”

“Anything's possible. A healthy white infant? Let her negotiate.”

An inappropriate hypothesis passed through my brain: Might unwed Meredith give her out-of-wedlock baby to an infertile married couple? To mask the traitorous thought, I pushed it over the border into prepartum enthusiasm. “You'll be a wonderful father. Anyone who can appreciate these scaly, wizened preemies will certainly be a fabulous dad.”