Before and After
PART I
CAROLYN
She wasn't on ER, never was during the day when she had patients, but they called her in on it. She was feeling around Jennifer Foyle's neck and groin for tenderness, talking over the girl's curly head, speaking for some reason about smallpox, Jennifer's mother insisting that one of these days they'd all pay for discontinuing vaccinations--the mother rolled up her blue flowered blouse sleeve and showed off a large mark, very badly done. She speculated that AIDS might be the result of this generation's having missed their vaccinations. Maybe, Carolyn thought, she just wanted everyone else to have a crack at a scar like that, which was as large as the gold locket she wore around her neck, and pebbled.
Then Karen poked her head in without knocking and told her she was needed downstairs. "Really right away," she added with mock sternness, because she knew Carolyn's propensity for thoroughness, the fetish she made of finishing consultations neatly and carefully so that everything was understood, every question answered.
Grudgingly, Carolyn wrapped things up. "Okay, kid," she said direct to Jennifer, who giggled. "Nothing wrong that a little preventive antibiotic won't take care of." She wrote the prescription, smiled at the child and touched her sweet bare shoulder reassuringly, and hurried out the back way because the waiting room was full and the mothers there would, when they saw her heading out, either stop her for one quick question or simply be offended, in spite of reason, thatshe was running out on them. The only departure a group of mothers would countenance without muttering was that of an OB-GYN on the way to a delivery. "Make my apologies," she called to Karen as she went. "See if you can push everything back an hour."
She had listened so often to her own squishy footsteps along the corridors--the professional building was attached to the hospital, and all of it was paved with the same dark brown composition flooring--that sometimes she thought the sound of hurrying feet was the doctor's real heartbeat. There was snow outside, it had been falling all morning, so it was going to be a car wreck, some kid wrapped around a pole or plowed into, at the bottom of a long slide down a hill. She had a faint pang of anxiety about Jacob, out there after school, at large like all the others. (Judith would have been home by now, off the bus and straight into the warm kitchen.) But she had mostly learned to quash those: there's no way for a pediatrician to try out every catastrophe on her own children. Anyway, the statistics were with them, for what they were worth--were with anybody, one by one.
Teenagers in car wrecks, she thought, pushing through swinging doors. They were bad enough for anybody, of course--the unexpectedness, the terrible instant consequences--but they were worse for teenagers. Worst case, there'd be a death or a maiming so heartlessly premature. But even if no one is hurt, even if it's just angry parents and a draw on the deductible, she had seen so much still-fresh confidence shattered that way, had seen such nasty psychological fallout. You might think it would be chastening, maybe get the boys especially to learn a little care and self-control. But an accident rarely seemed to yield more good than bad.
She thought this as she made the last turn to the emergency room, and already she could feel the anxiety rolling toward her in waves. She had passed two nurses and an orderly rushing the other way, and their nods had something in them of a familiar tension reserved for the awful days, the shocking injuries. This was a small town, a small hospital--everyone saw everything, or heard about it in a minute and a half. Not good, she thought. Distinctly not good.
The curtains were pulled around the far bed but she could see an unholy number of pants legs showing out underneath. Actually, thecurtains weren't entirely closed--too late to bother protecting anyone's privacy; if anything, there was anger in the parting of the protective drapes, the sloppiness of a furious assertion: Look! See what we're dealing with in here! She saw an elbow, gesturing, protrude from the opening as she approached--Trygve Hanson's, it looked like, the oldest doctor on the staff, the one who had delivered and doctored three-quarters of the town before the OB-GYN newcomers and the cardiac and thoracic men and she and the other pediatricians moved in to split things between them.
Carolyn ducked in without disturbing the curtains. It was steamy inside the little tent and all of them were sweaty. But when she focused in, she understood that it wasn't the heat that was making them uncomfortable. Still on the gurney on which she'd been wheeled in was a girl with her skull stove in. It was bashed, collapsed like a beer can, one of the younger doctors indelicately put it. Her hair was almost entirely bloody, one side of her face yellow to purple to brown--she was the kind of sight that renders a doctor an amateur, innocent of every hope of therapy or repair. She wished she could simply swoon and be carried out like any ordinary witness.
Carolyn took a deep disciplined breath. "Rape?" she asked, though the preferred phrase, borrowed from the law, would have been less loaded, softened by terror and anger to "sexual assault."
"Unlikely," said Tom McAnally. "She was fully dressed, just as you see her. In Tuttle's field--you know, over there where they keep the horses, behind that split-rail fence on Poor Farm Road?"
"No coat, no hat?"
"Looks like not." He cleared his throat like a reluctant boy asked to recite. "She was lying in the snow. Melted the snow down to the ground, they said."
Carolyn saw it obediently, a large pink circle, as if someone had spilled punch on ice. "You think this--happened--somewhere else."
Tom McAnally was looking at the girl's ankles. Her socks were drenched; he peeled them down delicately. "Clearly, somebody dumped her," he said sullenly to her feet. "But she died en route. Had a little pulse when they found her." The girl's jeans were bloody. It was only her head that had been mauled, though, and incidentally her neck, and her ear torn, but that was more than enough. A few suggestionswere made of where to probe, what to look at. Tom said, standing, "Well, the coroner will have to go over her with a fine-toothed comb. We can't poke around under her fingernails to see if she scratched the bastard or anything." He glanced away as if the whole thing made him ashamed to look straight at them. He was a very large man with an impassive face; clearly his emotions caused him trouble he didn't like to talk about.
"Do we know who this is?" Carolyn asked, her voice almost gone.
"Martha Taverner," Tom said furiously, as if he might be challenged.
"Martha Taverner! I know--you know her, don't you?"
"Me, you mean?" Trygve asked, and cleared his throat. "I did a section on her mother for this one. Early, I remember, maybe thirty-five weeks. Don't remember why, but we had to. She was big as a full-term." He stared at a pleat in the no-color curtain. "God, was there cheering. They only had boys, generations of boys, the Taverners. They finally got their girl." He pulled in one long, shuddering breath. "Hell of a sight for me to see just before I retire." He said that softly. "Nobody ever taught us how to deal with barbarians, and forty years of medicine sure as hell never brought me any closer." He turned and pushed out into the room, as if he'd had enough of all of them.
Carolyn stood staring at the mess of the girl's head--here and there you could almost see, though you'd be guessing, that she was blond, that she was maybe sixteen or seventeen. She knew that because the girl had been in Jacob's class all the way along. When he gave a birthday party in first grade, still full of the flush of excitement at having a whole classful of new friends, he'd made them invite everybody, there must have been fifteen or twenty of them! And Martha had been there, still very blond, almost white-haired, and embarrassed to smile because she had so few teeth. They hadn't gone on being friends--class, or who knows what, had sent them in different directions. The Taverners didn't have it easy. Carolyn had last seen her packing ice-cream cones after school down at Jacey's. Her hair had darkened up a little but she was still a round-cheeked pretty girl, with an ironic look to her, as if she didn't take much at face value: Show me, her expression seemed to say. She had a cool, amused shrug.
Carolyn picked up her wrist, on which a fine-linked silver braceletflopped. Her arm was already heavy with its absolute immobility. It was a small-boned wrist, frail as a cat's leg, entirely breakable, but unbroken. All of her was healthy, all eager, all wasted.
Someone had shown her.
She had to go back up to her office after that, though all she wanted was to sit down alone somewhere and grieve and be angry. "Doctors," she said to Tom as they started down the corridor, "are expected to be machines at times like this, going about our business without a dropped half hour for despair. Then we're criticized for not showing enough feeling in the hard moments."
"You're sure right there," Tom agreed. "They want you to stop on a dime, turn around, and suddenly you're the pastor with warm hands to lay on their foreheads."
Trygve had said he didn't know how to deal with barbarians. The thing, both good and bad, was that working in this town wouldn't prepare you for atrocities either--they had those car wrecks, they had occasional abusive live-in boyfriends who beat up on women and their women's children, but that was often subtle, rarely gross: the bruises were hidden and had to be probed for. Tractor accidents, falls from rooftops, every kind of bone break, and sometimes some sad, random, undisguisable maimings. But not murder--they didn't have murders in Hyland, population five thousand, give or take a few. Shopkeepers still walked down the street to the bank with their money visible in its canvas bag and no one had ever been hit on the head for it, as far as she knew. When burglaries took place, or car thefts--when bikes disappeared off lawns or mowers out of the work shed--they still tended to get blamed on outsiders, Massachusetts vandals passing through. Gossip, here, did the damage between antagonists that guns did in cities. It made doctors' ER duty tolerable and let them sleep most nights. But it left them, she thought this afternoon, more vulnerable, maybe, than they ought to be.
She looked for a broken bone on a very little boy then, barely able to make her usual friendly chatter with the child and the babysitter who'd brought him in, an older woman with pepper-and-salt hair, bowl-cut. The woman was in great distress over her responsibility for letting the child fall off a big round rock in his back yard, his favoriteplace to play. Ordinarily, Carolyn would have asked for a lot of detail to try to set the sitter's mind at ease, but now she felt, buzzing like a veil of bees around her head, the distraction of a dozen questions. Had they told Martha's parents yet? Who had done the telling? Probably the police, with their velvet touch. Ought she to have volunteered? Good God, they would want to see the girl. They would want to die at the sight of her--die or kill. She took refuge in examining the little boy's head and eyes for damage. He was very sweet, had stopped crying a long time ago and was looking around with an unquenchable stare at everything in the room. His eyes were so black they seemed all iris; she feared they might be dilated unnaturally. "We've been looking at his legs and his back," she explained to the sitter. "But he did fall a distance and there could be more subtle damage." The sitter's own eyes widened, alarmed. Carolyn reassured her; she had no reason to assume there were problems. "I'm just being careful," she said, staring into the child's marvelous face, his eyebrows frail as Oriental brushstrokes, getting him to track her light.
"Careful is what I guess I'm not," the sitter went on. She stood up and paced. Carolyn, less patient than she usually managed to be, told her to stop it. Her sternness was unpredictable, and when it emerged, it tended to surprise its object. Was it her blondness that seemed to promise softness (against her will), her perfectly modulated bedside manner with its slight hint of conscious control, the frequency of her laugh? She did think a pediatrician owed it to her patients to make visits to her office as stressless as possible. "It isn't good doctoring," she had said in public situations, "if the child puts up such a fuss about coming that it's easier to stay home."
But when she looked at the boy she saw how little it would take to mangle that strong square back, its vertebrae pushing through flesh like bent knuckles. She saw Martha Taverner as a young teenager, or not quite--eleven or twelve, maybe--in her own house. Carolyn was locally famous, had even been the subject of a story in The New York Times that she thought absurd for calling her heroic because she made house calls. RETURN OF OLD-TIME MEDICAL CARE, the story announced. "Dr. Reiser believes the multiple factors at work in the making of illness can only be discovered by attention to a patient's entire living circumstances, and that ideally includes where he lives." The girl'sshirt was off, she remembered, her tiny breasts like tweaks of dough to cover the apples in a pie. They rose and fell on her narrow chest; she had pleurisy and might need to go to the hospital. Or was that her cousin (Donna? Denise?), who lived with them, who was always sick, her nose always running? It might not have been Martha at all ... One way or another, she imagined a young girl just on the edge of what probably had brought her to this--a child with a body still pure, free of touch, free of wanting. Sentiment was such a dangerous draught, she rarely let herself have more than a drop of it. But today, now, the body that was her art and instrument seemed too frangible to be worth much. It was nothing but vulnerable, eaten from within or broken from without by some hostility that could as easily change directions like the wind and blow on elsewhere, leave a girl like this another sixty, seventy years to make a life. Or crumple it up, bones and lovely flesh and carefully tended hair, and fling it out, you could do that too. Someone had opened the door of a car and rolled out the remains of somebody's daughter.
"You can get him dressed now," she said to the babysitter, trying for softness. "Just keep an eye on him and call me if he complains of a headache, if he's nauseated, if he seems to be sleeping more than usual. Understand?"
The woman, looking deferential and relieved, picked up the boy's blue-checked cowboy shirt. It was so small, Carolyn thought, it would fit one of Judith's dolls.
Copyright © 1992 by Rosellen Brown.
