The Baby Doctors
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“I wouldn’t call Rose a dinosaur,” Sarah said, slightly offended on her mother’s behalf. “Set in her ways about some things, but then she hasn’t had much exposure to alternative forms of practice.”
Curt smiled. “Yes, well, I encounter that resistance all the time. Even with my own family. Debbi knows quite well what works, yet if I’m not constantly reinforcing it, she’ll slip right back into going to the doctor for every little thing. Her asthma is a case in point. She knows how to control it but insists on carrying that bloody inhaler.”
“Well, I’m against taking unnecessary drugs,” Sarah said, “but asthma can be dangerous if it spins out of control.”
“Exactly. Which is why I teach her self-hypnosis.”
Sarah said nothing. Maybe it was the eyes, but there was something about him that made her vaguely uneasy. It was that whole balance thing, not swinging too far in either direction. She made a mental note to see if Matthew knew him.
FORTUNATELY, Curt Hudelson’s disapproval of her mu shu pork didn’t interfere with her enjoyment of it. Later, sitting on the living-room floor, cushions piled up around her, the take-out carton in easy reach and John Coltrane on the stereo, she started unpacking the boxes she’d brought over from her mother’s house. The first one contained half-a-dozen photograph albums documenting the first sixteen years or so of her life. The earlier photos were on black paper, stuck into tiny gilt paper corners that she used to buy in small plastic bags from the Bay Variety store on Lincoln. They predated the sticky white boards with plastic sheets that she’d discovered by the time she was twelve. Taking on the role of family archivist had been an act of desperation. After a stack of the shoe boxes Rose always dumped pictures in fell from the closet shelf, spilling all over the floor. Sarah had decided to impose order.
She speared a piece of pork with her chopstick and savored the taste.
A storm had blown in during the night and stuck around. Wind rattled the windows, and rain lashed against the glass. Northwest weather. She hadn’t realized how much she’d missed it. Missed everything from her past. Ted, who had left his native England as a child, seemed to have spent much of his adult life looking for a sense of place. She set the chopsticks back in the carton and carried it into the kitchen.
“I want to feel that kind of connection,” Ted used to say when she would talk about growing up in Port Hamilton, about the generations of Benedicts who had practiced medicine there. “I want to know, deep inside me, that this is where I belong. I want to feel a part of the community, of the land. I want to know the people, I want them to matter to me personally. I want the kind of life you had.”
As an adult, she had a less rose-tinted view of what that had been, but until she was fifteen, she really had thought everything about her life was perfect. The big red barnlike house on the bluffs above the Strait of Juan de Fuca. Her attic bedroom, with the window seat where she’d watch the Olympic Princess carry passengers and their vehicles back and forth between Port Hamilton and Victoria, British Columbia. Curling up under blankets at night, gazing at the lights across the water, imagining a Canadian girl just like her staring at the lights from Port Hamilton.
Rose would label it nostalgic yearning, but she had always felt so safe back then. Happy. Long golden summer days, perfumed by the red and pink roses that filled the backyard. Fourth of July parades and picnics on the beach. Time in endless supply, it had seemed. At Christmas, bundled up in coats and scarves, she would hold her parents’ hands as they walked into town for the Christmas-tree lighting on Main Street. Snowshoeing and skiing in the winter, bonfires on the beach in the summer and fireworks to light the dark sky.
Best of all, there was Matthew, the boy down the street. Matthew the star of her childhood memories. Racing their bikes along the jetty that protected Port Hamilton’s deep harbor from the choppy waters of the straits, screeching and whooping, the wind in their faces. Walking home from the beach together, wet hair and sandy feet.
On her thirteenth birthday, she’d scrambled over huge boulders to the rocky beach, Matt right behind her. With their backs against a rock, they’d watched the shorebirds and he’d told her the Latin name of the Black-bellied Plover.
“Pluvialis squatarola,” he’d said, and she’d burst out laughing because she thought he was making it up. She’d looked it up later, of course, and he’d been right.
If there was a time when Sarah hadn’t been in love with Matthew Cameron, she couldn’t remember it. It wasn’t puppy love or a crush or anything like that. She’d never carved their initials into tree trunks or scribbled intertwined hearts on her schoolbooks. They’d never talked about it, this bond between them, never even held hands. She could hardly even explain it to herself, the deep, certain knowledge she’d had that she loved Matthew with every fiber of her being and that they would always be together.
At least, she’d felt that way until Elizabeth moved into the house next door. Elizabeth, with her almond-shaped eyes and naturally rosy lips. Elizabeth, who knew how to talk and laugh with boys but still act like a girl. Her family was from Los Angeles and she wasn’t happy about moving to Port Hamilton, which she considered a hick town that she intended to leave as soon as she could. Elizabeth was always talking about how things were in Los Angeles: the way the girls dressed, the cool places kids hung out, the movie stars all over the place. And when Elizabeth talked, everyone listened, boys and girls.
Before Elizabeth, Sarah had never given a moment’s thought to her appearance, but Elizabeth’s long silky hair made her painfully self-conscious about her own unruly curls, about the freckles that spattered her cheeks and nose and her skinny, boyish frame. More than that, Elizabeth forced her to acknowledge there really was a difference between the way boys and girls behaved.
It was also while watching Elizabeth that Sarah first realized she lacked the ability to do what others girls seemed to do naturally. Elizabeth danced with her head at just the right angle to look up into a boy’s eyes. Elizabeth could walk into the Parrot Cage, where the kids hung out after school, and all the boys crowded round her, falling over themselves to get her attention. Matthew included.
Before Sarah realized what was happening, it was no longer just Matthew and Sarah, the way it had always been. It was Matthew, Sarah and Elizabeth. And then Matthew and Elizabeth. One night he’d started telling her about Elizabeth. “She’s sweet and pretty and…” He’d shaken his head as though words alone weren’t adequate to sum up Elizabeth.
“Wow,” Sarah had said, “sounds serious. Like you’re in love with her.”
“I think I might be.”
And Sarah had forced herself to smile.
“The thing is, I can’t talk to her the way I talk to you,” he’d gone on to tell her. “She doesn’t get my jokes.”
“Yeah, but she’s pretty.”
And then, safe in her own room, Sarah had cried herself to sleep.
By the time Matthew went off to premed in Seattle, he and Elizabeth were officially a couple. Sarah had immersed herself in her own studies and, for the first time in her life, days and weeks, then months went by when she didn’t think about Matthew. But never, ever, did she stop loving him.
The night he married Elizabeth, Sarah had wandered away from the reception out to the small patch of beach just past the hotel. Matthew had found her sitting on a piece of driftwood, staring out at the water. Allergies, she’d said when he’d asked about her red eyes. And then she’d hugged him. “I hope you and Elizabeth will be very happy.”
The following year, she’d gone off to medical school herself and met Ted, a fellow student. Ted, a gentle dreamer who wanted only to help. His death still haunted her dreams.
CHAPTER FIVE
LUCY CALLED just as Matthew was leaving the house to pick up Sarah.
“Daddy.” A pause. “Can I come with you to Frugals?”
“I didn’t think you liked it,” Matthew said. “You never want to go when I suggest it.”
“But I do this time.”
“How about tomorrow?”
“Daddy.” Her tone turned wheedling. “I’m hungry now.”
He laughed. “Well, I’m sure you can find something in the house to eat.” He glanced at his watch. “Listen, Lulu, I’m running late.”
“To see Sarah?”
“Right.”
“Why can’t I go?”
He frowned. “Lucy, what’s this about?”
“Nothing. I just want to go with you.”
“Not this time.” He could almost feel the sullenness of the silence on her end and, although she’d never shown any interest in the women he occasionally introduced her to, he sensed something different. “But I do want you to meet Sarah. You’re going to like her a lot.”
“Yeah, right.”
“Lucy?”
“What?”
“Come on, honey.”
“I gotta go,” she said.
He heard the disconnect, debated whether to call back, then decided against it. No real reason she couldn’t come along, but it had been years since he’d seen Sarah and, he reasoned, Lucy would be bored listening to them play catch-up.
THE TEST OF A TRUE FRIENDSHIP, he later decided was how easily you could slip back into a natural rhythm. Sarah looked like a slightly older version of the Sarah he’d always known. Skinny bordering on scrawny, the small triangular face and shrewd gray eyes that seemed to bore right through any kind of dissembling. Hair always dated people, but Sarah wore her reddish brown hair just as she always had, in a thick, heavy braid that came halfway down her back. The row of small silver hoops in her ears were new, as were a few lines around the eyes. He could imagine her squinting into the bright sunlight. No sunglasses for Sarah. He’d teased her about the sprinkle of gray and she’d done the same to him.
After they picked up the burgers, they’d driven out to the end of Forbe’s Hook, found a spot on the rocks and watched the sun dissolve into the water.
“So what are your plans now?” he asked as the sky turned to shades of pink and red. “Are you going to stick around for a while?’
Head down, Sarah picked at the threadbare knee of her jeans. “Actually, I am.”
He waited a moment. “And?”
“I have a plan.”
Matthew grinned. “You’ve always had a plan.”
“This is different. This is a grown-up plan. A huge plan. And it involves you.”
As Matthew dug around in the paper sack for more fries, he felt the shift in her mood. Whatever Sarah’s huge plan turned out to be, he wasn’t in the right frame of mind to hear it. Her presence had been a welcome distraction from the looming Compassionate Medical Systems crisis, and he felt a reluctance to be drawn into more serious discussion. He also knew that Sarah in full-steam-ahead mode could be nigh on impossible to stop.
She shot him a glance. “You want to hear it?”
“Do I have a choice?”
“You sound tired, Matthew.”
“I am.”
“Work?”
“Essentially.” In the gathering darkness, he saw the glimmer of a smile flicker across Sarah’s face. “Don’t tell me, your plan is the solution.”
“It could be.”
He gave in to the inevitable. “Tell me.”
“Okay.” She drew in a breath. “Remember when you first started medical school, you used to talk about the kind of medical practice you wanted to have? Not just treating disease and patients who were already sick, but patient-centered care that promoted wellness with traditional healing arts, home mind-body therapy—”
Matthew groaned.
“What?”
“Tell me I was never that hopelessly naive.”
Sarah turned to face him. Eyes gleaming, body tensed, she seemed a cat poised to pounce. He braced himself.
“Matthew,” she said, “listen to me. There’s nothing naive about that. It’s exactly what I want to do. What I want us both to do. An integrated approach that doesn’t abandon mainstream medicine. I mean, kids are still going to break bones or need surgery…”
Presumably where he came in, he thought, as he listened to her describe the practice they would set up together along with herbalists, hypnotherpists and an assortment of other practitioners.
“Ted used to talk about establishing that kind of practice,” she said. “And when he died, I thought that his dream died with him, but then—” her voice softened “—it was the strangest thing. I was going through a box of old letters that you had sent me when you were in med school and I found this one that almost spelled out word for word the same thing Ted and I were planning to do. That’s when I knew I had to come back.”
Matthew looked out at the water. The ferry from Victoria appeared on the horizon, its lights punctuating the darkness. “Sarah, I don’t know how to say this—”
“Please don’t tell me it won’t work, because—”
“I wasn’t going to say it won’t work. I think it could. I appreciate the fact that medicine is changing. I don’t believe one school of thought offers all the answers. It’s just not going to work for me.”
Sarah took a deep breath. “Why not?”
“For one thing, your timing couldn’t be worse. I’ve spent most of the day in meetings, listening to reasons why Compassionate Medical Systems is the only answer.”
“You don’t believe that.”
“I don’t not believe it. CMS has an excellent reputation,” he said, hearing the hollowness in his voice. “And, frankly, the peninsula needs an infusion of cash. We need more doctors, a new hospital, new equipment. That’s never going to happen the way things are now.”
Sarah began picking at the knees of her jeans again. Moments passed. “You’re not thinking of selling out yourself, are you?”
“It’s not selling out, Sarah,” he said, his voice sharper than he intended. “The bottom line is providing quality care. Olympic can’t do that under the existing structure. The money isn’t there.”
“Wait.” She cupped her hand to her ear. “That sounded suspiciously like an affirmative.” “I haven’t decided yet.” In Sarah’s world, he was remembering now, there were no shades of gray. Black or white. Good or bad. Right or wrong. Fair or unfair. Remembering too the impossibly high standards she expected, from others as much as from herself. There was Sarah’s way of doing things and there was the wrong way. “Just once,” he remembered shouting, after they’d argued about some high-school project they were working on together, “I want to hear you say that something is good enough, that it doesn’t need fine-tuning.”
“I know something about Compassionate Medical Systems,” Sarah said. “When I first left the peninsula, I made the mistake of going to work in one of their hospitals in Seattle. Ted had a similar experience. We both realized it would never work for us. That’s when we decided to go to Central America. I mean, these companies answer to stockholders. I won’t work in an environment where the real focus is money, not patients. Bottom line, money’s going to dictate which doctor you see, how many tests can be run, what medicine you should take. Patients wait months for appointments that used to take days—”
“I can’t decide whether it’s the Frugal burger or this discussion,” Matthew said, “but I’m getting a headache.”
“Sorry.” She stretched her legs out, wriggled her toes in her beat-up sneakers. “I get up on my soapbox and there’s no stopping me.”
“I noticed.”
“Well—” she wrapped her arms around herself “—it’s getting cold. I should probably get going.”
But neither of them moved. Out on the horizon a few stripes of pink cut through the indigo sky. “Things change, Sarah,” he finally said. “Sometimes that’s a good thing, sometimes it’s not so good. But it’s reality. The way things are now, I go to work. Get home, sometimes not till one in the morning. Sleep the night, if I’m lucky. If not, I get a call from the E.R. because they can’t locate the doctor who’s supposed to be on call. I end up spending time on call that I’d rather spend with my daughter—”
“But I don’t understand. You’re chief of staff. Why would they page you?”
He laughed. “We have a chronic physician shortage. No new people coming in, old ones dying off. Right after you left, the mill closed, so one huge source of employment shut down and, well, you know the peninsula. There weren’t that many jobs to begin with. A good percentage of my patients who’d worked at the mill lost their insurance, but I still see them. They’d pay if they had the money, but there are no jobs. All of that makes it harder to attract new physicians.” He picked up a pebble and tossed it into the dark water. “So if it seems like selling out to you, I’m sorry. Idealism is fine, but I also have to make a living.”
After that, they fell into silence again. Sarah, hunched into her windbreaker, her hair hiding her face. The mood had shifted, and he didn’t know what to do about it.
“Aw, come on,” he said, “it’s not that bad.” The sun had dissolved, turning the sky shades of pink and vermillion against the navy sea. “You don’t get views like this everywhere.”
THE FOLLOWING DAY, Rose stopped by the apartment and, as they were having coffee, announced she was selling the practice. “I was waiting for the right moment, but I didn’t want you to hear about it from someone else.” Sarah stared at her. “You’re not serious.”
“Yes, I am.”
“You’re retiring?”
“Compassionate Medical Systems is buying me out. For a very good price, I might add. And take that horrified look off your face.”
“I’m shocked.”
Rose took a deep breath. “Welcome to the real world. The handwriting is on the wall. Sure, I can hold on for a few more years, but it’s like those mom-and-pop stores—like McGregor’s. I remember when I used to do most of my grocery shopping there and I still drop in to pick up milk or something I’ve run out of, but that’s mostly out of loyalty. When I need a lot of groceries I go to Albertsons or Safeway. Everyone does, it’s a fact of life.”
Her hands suddenly icy, Sarah wrapped them around her coffee mug. Rose was going on about managed care being the wave of the future and encouraging her to apply to Compassionate Medical Systems. Sarah flashed back to the time as a kid when she’d saved her allowance to buy her mom a Norman Rockwell print: a country doctor’s office, the small boy baring his bum for the kindly old doctor’s injection.
She could still see Rose’s bemused expression as she unwrapped the gift. Years later, she’d understood. Too sentimental. Generations of Benedicts might have practiced medicine out of the same family home, but they’d never been a Norman Rockwell family. And now that the money was right, Rose was casually parting with tradition. Selling out.
“Sarah, I know this is a disappointment,” Rose said, apparently reading her expression, “but it’s honestly the only way to go. It’s getting harder and harder to make a living this way. More uninsured patients.”
“Someone has to take care of them.”
“Someone also has to make a living,” Rose said. “And if you think I’m being hardhearted, talk to Matthew—”
“I already have.”
“Uh-oh.” Rose’s mouth twisted. “And?”
“Take a wild guess.”
“Didn’t I try to tell you?”
After Rose left, Sarah stood in the kitchen, staring out at the gulls and the tankers on the water and the wind-tossed trees. Things did not look promising.
On the wall of her clinic in Central America, she’d tacked up a pain-assessment chart with six cartoonlike faces whose expressions ranged from happy and smiling to great discomfort and unbearable pain. Small kids couldn’t read the captions underneath—annoying, nagging, miserable, horrible, excruciating and so forth—but they knew that a furrowed brow, down-turned mouth and falling tears weren’t good things.
She’d stuck the chart on the refrigerator. Right now, she was definitely among the scowls and grimaces group. Coming back to Port Hamilton was supposed to be like completing a circle. A return to the place where she’d been the happiest, an opportunity to practice medicine with a doctor she admired for his ideals and who was also her best friend.
So much for that.
She made more coffee, carried her mug into the living room, back to the window. Tempted to just go to bed, pull the covers over her head and shut out the world, she was stopped by Rose’s voice in her head mocking her for doing that very thing. She pulled on her sweats and running shoes and jogged down to Francis Street Park, her favorite place in Port Hamilton.
The park was steeply banked with tangles of blackberries on either side and steps running down to the water. Even before she reached the steps, she could see the dark hull of a tanker at anchor, hear the seagulls screech. She felt an almost holiness, like walking into a church.
She took deep, slow breaths, tried to clear her mind. Minutes passed and, slowly, the turbulent thoughts began to subside. She would be all right. Things would work out. She would come up with a new plan. Maybe Matthew wouldn’t have fit into the picture anyway.
They hadn’t always seen eye to eye. Last night was a reminder of that.
In the silence that had fallen between them on the drive back to her apartment, she’d gone through all the things he would never actually say to her about why sharing a practice would never work anyway. He would never say them, because he loved her. Not the way she’d always wanted him to love her, but as a friend whose feelings he wouldn’t want to hurt. You’re too idealistic, Sarah. Too unpredictable. Too…much.
The wind picked up and blew in cold gusts that reached like bony fingers through the fabric of her sweats. She started to run. And this was the memory she wanted to run from now—she’d preached at him. Accused him of abandoning his ideals. Just thinking about it now made her run faster. His expression as he tried to explain was burned on her brain.
Her sneakers slapping the pavement, she continued down the trail. When she reached the ferry terminal, she stood for a moment trying to decide whether to run on to Lopez Hook or head back to the apartment and… what? Send out résumés? Return to Central America? She decided to continue for another ten minutes or so.
“THERE YOU GO.” Elizabeth set a platter of bacon and eggs down in front of the guy at the table by the window. “Can I get you anything else?”
He smiled up at her. “Maybe just a refill.”
She brought the coffeepot over and filled up his mug. If he hadn’t been reading the newspaper, she might have got him talking. She liked to do that, hear people’s stories. Chitchat about the weather. No big heavy stuff, just people being nice to each other.
Back in the kitchen, she stood with her arms folded, watching the gulls in the empty parking lot fight over a scrap of something. No one believed it when she’d taken the job as a waitress at the coffee shop down by the ferry landing. The ex-wife of a doctor, pocketing tips and getting paid minimum wage. But it wasn’t the money—Matt was good about making sure she and Lucy had enough. It was being appreciated. People smiled when she brought their food, they thanked her like they really meant it.
Trouble was, business had slowed down to practically nothing. Now she was the sole employee. Cook, waitress and cleanup crew and she still had time to stand staring out of the window. Time to start feeling sorry for herself, Pearl would say. She looked around for something to do, but the kitchen and all the tables were spotless, so she called home to talk to Lucy. The phone rang five times before the girl picked it up.
“Hi, honey.” Elizabeth smiled into the phone. “Watcha doing?”
“Sleeping,” Lucy said.
“Hon, it’s nearly noon.” As soon as she said it, Elizabeth wanted to take the words back. Everything she said these days made Lucy mad. Being around her was like walking on eggshells. “Why don’t you get dressed and come down here and I’ll make you lunch.”
“Can I come down without getting dressed?”
“Huh? No, I—”