Authors: Renee Manfredi
“Anna,” Nick said, and waved her over.
“Howdy,” Anna said, and sat. “You’re early.”
Nick tapped his watch. “No, actually, you’re late. We said one o’clock.”
Anna rarely got meeting times mixed up, but it was possible that she had misunderstood. “Apologies,” she said.
“Perfectly all right. Amy and I were just reviewing what her role will be.”
Anna turned to her smiling, freshly scrubbed student. “And are you comfortable with it? Does it seem like something you can manage?” Anna asked.
Amy nodded. “I think so. I mean, yes.”
Anna listened as Nick spent a half an hour reviewing the objectives of this support group, and how to recognize when it was her job, as a moderator, to steer the discussion into a different direction if necessary. “You’ll do fine. Occasionally patients might ask you for medical advice, but you’ll remind them that you’re not a physician. The focus should be on living with AIDS, not dying from it. A chronic life-threatening illness, not an immediate death sentence.”
Amy said she understood.
“This is really just an overflow meeting, remember, at the patients’ request. So, your primary duty is to defuse the occasional outburst. Most of these group members have known each other for years. If there’s anything you’re unsure about, call one of us.”
Amy nodded. Anna looked at Nick. “Us? Who’s included in that pronoun?”
Nick said, “Me, Dr. Klein, the psych resident, and you.”
“Me? What kind of assistance would I be?”
“Oh, just in the capacity of Amy’s mentor,” Nick said.
Anna felt her temper flare a little; she’d told Nick from the beginning that she had little interest or belief in support groups. But, she turned to Amy. “That’s fine. I’m sure you’ll be terrific, but you can always call me if you need to.”
“And I was hoping you wouldn’t mind just sitting in on the first meeting, which starts at three. I reserved the conference room on the third floor for today and next week. Subsequent meeting places yet to be determined. Maybe here, maybe not. I’ll let you know.” Nick looked at his watch. “Okay, Amy, if you want to head upstairs, Anna will join you in a few minutes.”
Amy stood, gathered her papers. “Thank you, Mrs. Brinkman,” she said to Anna. “For agreeing to help me the first few weeks.”
Without missing a beat, Anna said, “It’s my pleasure, dear. This is a good opportunity for you.” She smiled, waited until Amy was gone, then turned to Nick. “You’re a jackass.”
“Anna—”
“I didn’t agree to anything other than to provide you with a student, who by the way, from what I can tell will be nothing more than a glorified babysitter.”
“Now, Anna—”
“My husband was a physician. I know how hospitals run. Risk management probably wouldn’t agree to let you have the extra time unless you provided them with a coordinator. Which is in name only.”
“That’s not true, Anna.”
“Someone from the janitorial staff would also qualify. Or one of the clerks in the gift shop.”
“Anna!”
She stopped.
“I did tell you that your student’s role would not be as an official mental health worker. It’s true that it’s hospital policy to have an appointed leader for any gathering, but it is certainly not true that I am using her as a glorified baby-sitter.”
Anna took a deep breath. “And is it also true that I’m sitting in on these meetings for the first few weeks?”
“Well, that was unfair of me not to ask you. I’m sorry. But I told you I wouldn’t be available Saturdays. I’d supervise today’s meeting except that I’m filling in for a colleague on hospital rounds. For which,” he said, and looked at his watch, “I’m late. Also, Anna, I do think Amy will be more likely to admit any problems or concerns to you than to me or Klein.” He paused. “I’ll make it up to you.”
“Oh? What did you have in mind?”
“Dinner?”
Anna snorted. “Pass. But I wouldn’t say no to five or six new Bausch & Lomb microscopes for my lab. Or a box of rare specimen slides of viruses from far-flung places.”
“Done,” Nick said.
Anna stood, turned to go.
“Oh, hey Anna.” Nick held out the book she had left on the table,
frowned at the title,
Women Who Roar: A Pride of Women Hunting in Africa
.
She took the book from him and headed upstairs.
The next hour was such a disaster that even Anna was tempted to walk out fifteen minutes into it the way Amy herself did.
How was she supposed to anticipate this? She’d been around medicine most of her life, had helped people, including her own husband, through sickness and dying. She’d softened the blow of bad news, and helped the convalescing, but this illness, apparently, didn’t gentle and humble most people the way something like cancer did. Anna was half-expecting exhausted patients propped up in chairs and their equally exhausted caregivers. Instead, she heard them from halfway down the hall when she first walked up. The room was filled with a riot of personalities and the sugar-saturated energy of a kindergarten class.
As soon as Anna walked in, Amy brightened and introduced herself. “Hello, I’m Amy,” she’d said, and the group of them, in unison, replied, “Hi, Amy,” as though it were an AA meeting. Things tumbled downhill from there. They interrupted her, talked over her, and ignored her attempts to moderate the discussion. Anna remained silent; she didn’t want Amy to feel undermined.
Then fifteen minutes into the meeting, Amy walked out. Anna stayed and finished out the hour, then went immediately to find Nick on his rounds.
“Hi,” he said, writing in a chart. “How did it go? Where’s Katie?”
“Amy. She had the good sense to leave.”
“Shit,” he said, and snapped the chart closed. “Was it as bad as all that?”
“Worse than all that. Those men gave her a hard time.”
“I’m sorry. They’re lively it’s true. I thought I told Allie that.”
“
Amy
. You did, but she’s out of her depth here.”
“Maybe I should have prepared her better.” He waved over a group of residents, who were huddled together at the nurses’ stations like a flock of starlings on a telephone line. “I have to finish rounds, but can we talk about this later? I’ll call you tonight, okay? We’ll sit down with the next student you give me for a few hours. I should have stressed one of the unique features of this illness. Assholes become complete assholes as they get sicker. This is the single most difficult thing the patient’s caregiver has
to deal with. Their partners were always a little demanding and obsessive, for instance, but now when they’re really sick, it gets out of control. I’ll call you later.”
“No,” Anna said. “Sorry, but I don’t think any of my students are adequately trained for this. Why don’t you ask one of your students to run it?”
Nick glanced over Anna’s shoulder. “Dr. Lee, start the rounds without me. Room 405, sixty-year-old Caucasian male who presented with abdominal pain. Hypertensive, previous M.I.” Nick waited for the group to walk past. “I told you, Anna. My residents are ridiculously overworked as it is. I can’t ask them to take on extra duties. Well, I did ask, but none of them agreed to help out. If you don’t want to commit another student, I’ll just tell my patients that there will be no overflow Saturday group until I can find another moderator. They’ll have to adjust. Sorry to have involved you in this.”
“Okay,” Anna said. “Good luck with finding someone. By the way, why did you come to me in the first place?”
He shrugged. “Hugh used to talk about how bright you were, how much you loved medicine and how good your instincts about people were.”
Anna caught her breath. “You knew my husband?”
He nodded. “We were on-call together a lot when we were residents. He talked about you all the time. We were all envious of him. Of how lucky he was to have a wife who understood the demands of the job.”
Anna leaned against the doorway of a supply closet. From inside, a panoply of odors reached her, the most prominent of which was Xylene, the chemical used to clean microscopes and slides. Hugh used to tease her about how much she loved the scent of it.
“Let me think things through. I’m not promising anything, though. But it seems to me that if I give you another student, I should give you a lion, not a lamb.”
Nick looked at her over the top of his glasses. “What do you mean?”
“I mean, you don’t need someone with a surplus of compassion, you need someone with an edge who can deflect all the insults. Edges, I understand. The touchy-feely-weepy instinct is one I never had.”
“You might be right,” he said. “Incidentally, was there one person in particular who drove Amy away?”
“Well, sort of. Two men. They were having a fight about blue socks.”
“Alan and Michael. I would have guessed that. I’ll speak to the two of them. They’re almost always keyed up.”
“Okay. Because if I agree to send in another student, I’d ask that you kick them out the minute they start with the personal insults.”
“Deal,” Nick said.
The two men had dominated the first fifteen minutes of the meeting. One partner accused the other of intentionally losing his lucky pair of socks, which resulted in three ensuing sleepless nights until the socks were found. The sleeplessness, he claimed, then further weakened his immune system. Anna’s head reeled from trying to follow the man’s logic.
“It’s this kind of carelessness that got me sick in the first place,” the man had said. “It’s recklessness. You either keep track of what’s important or you don’t. You didn’t, that’s why we’re here.”
Amy had stepped in at this point. “Let’s keep the discussion on one thing at a time.”
“There is no one thing at a time, sister. This is everything at once. That’s what you need to understand, but never will.” Amy burst into tears and stood to go. “That’s right, leave. Go back to your Girl Scout camp and toast marshmallows with your little flower friends. You can tell them all about your day with the big bad wolf who huffed and puffed and blew your house down.”
“That’s enough,” Anna said. “Stop it.” He was quiet then, but his words hung in the air. There was truth behind his rage. How could she or Amy—or any noninfected person, for that matter—understand how it felt to be assaulted by an illness like this? He was rude, certainly, but she thought now it might be more than that. Maybe it was the impatience that came with having a finite number of years left. Even small bits of time were weighted. Social niceties were wasteful, including the few seconds it took to introduce oneself. That was her hunch, anyway.
Anna turned to Nick now. “I need to get going. I’ll get back to you early next week.”
“Sounds good,” he said. “Thank you.”
She was halfway down the hall when Nick called her back. “You dropped these,” he said, and handed over her car keys. She really needed to sew the lining of her pocket.
It was still too early to pick Greta up, so she went into her office. She enjoyed working in the deserted building on weekends. She liked the emptiness of the offices, the absence of inhabitants echoing those Bible stories her maternal grandparents pelted her with during her girlhood summers where the virtuous were taken up to heaven, the world drained of all but the wicked. Their beliefs eventually made them a little pathetic to her, but she liked the peace and solitude and beauty of the Lancaster County farmland, spent hours wandering around the neighboring Amish pastures and properties.
Anna’s parents were eclectic in their religious beliefs. Her father was a Jewish convert to Buddhism, a professor of Eastern Studies at NYU. Anna’s mother worshipped only her career as a physicist. Once, Anna’s father had taken her to a Seder at his parents’ apartment in Manhattan. She remembered a gathering of women, though surely there were also men there. She was ten or eleven and fascinated by the women in their black dresses and lace mantillas, serving the hard-boiled eggs and salt water. Her father had sneered, before and during the meal. When he donned his yarmulke, he crossed his eyes and stuck out his tongue at her. Afterward, the two of them left early to get the train back to Brooklyn. Her father tossed his yarmulke into a trash bin on top of a crumpled newspaper.
“Sorry, dear,” he said. “I’m getting old and sentimental.” He shrugged, smiled. “Wanted a sampling of my boyhood, I suppose.” Anna had laughed with him at his mocking irony, but secretly she was enchanted. She thought the Seder was beautiful, though she wouldn’t admit this to him, and part of her never got over the disappointment in her father for shielding her from such reverence, for keeping this part of her heritage secret and out of reach.
She called home to check her messages. One from Greta to tell her she was already at home and didn’t need Anna to pick her up, and two more from her daughter. Anna would have to call Poppy back tonight, she knew, since unlike the first message when Poppy said she’d take Anna’s silence as a no, her daughter had called three more times.
Poppy must be assuming Anna was still trying to make up her mind, which she most certainly wasn’t. She never wanted to see her daughter again, period. There was no forgiveness big enough.
She turned on her microscope, slid one of the student-prepared slides
underneath the lens. It was waxy and opaque with stain, as were the next five she checked—all unreadable. She would have to repeat the lesson Monday. Anna picked out the slide for AIDS from her specimen box, focused it under the light. She thought about what Nick had said earlier, that patients’ unpleasant characteristics often became exaggerated. Part of her wanted to push aside the issues of psychology and empathy and all the man-made handholds and explain everything at this, the cellular level. There was something moving about retroviruses like AIDS, the fact that an individual’s DNA was scooped out like half-melted ice cream to be replaced with the virus’s own code. She found it inexplicably engaging, the notion that all the various personalities of the sick in that awful meeting harbored the same skewed viral coding, a bad science-fiction movie coming true, everybody slowly becoming the same person in the end. It was easier to forgive tantrums when one saw the devastation at this microscopic scale, the heroics of the battle being fought over each of the body’s cells.