Dr. Knox (7 page)

I'd left the shades up, and yellow light from the street fell on the bare brick walls and worn floorboards of my apartment and lit dust motes in the air. I dropped the duffels by the door, left the lights off, and tapped the thermostat. The A/C cycled up, and I walked through the big space that was living room, dining room, and kitchen, and grabbed a Stella from the fridge. It was icy on the back of my throat, and the cold ache spread through my sinuses and made a tiny dent in the mantle of fog around my brain.

I took slow, deep breaths between sips, trying for more oxygen. At the end of an endless day, I had all the post-call symptoms: I was wired, tired, jangly, underfed, overcaffeinated, and my attention span was flickering like a match at the beach. I drank some more beer and looked at the phone on the wall. The message light was blinking, but I couldn't bring myself to listen and wasn't sure I would comprehend it anyway. I kept moving, because to sit, I knew, was to sleep, and I wasn't ready for that.

My apartment spanned the floor, and there were windows and views all around, though the northern one was of the alley and the southern one of a potholed parking lot. To the west, glossy and glowing, were the towers of the ever-newer downtown, closer each time I looked. To the east, in daylight, I would've seen the cityscape flatten into warehouses, rail yards, and the concrete arroyo of the L.A. River. Now it was urban pointillism—yellow dots on black, picking out intersections, loading docks, the gated pens where trucks and buses slept. I walked to the bathroom and looked out the window into the alley below. There were no cars there but my own, and no people at all. I wondered which way Elena had run last Friday, and who'd been chasing her then—
los soldados
or the tattooed Russians. Maybe both.

I drank more beer and said her name aloud. My voice echoed, rebounding off the brick and boards and the few pieces of furniture I owned. A Formica table in the kitchen, a battered slab of maple that was more or less a desk, an armchair of synthetic suede, a doughy, slipcovered sofa, swaybacked bookshelves, a wrought-iron bed, and a clouded mirror with a chipped black frame—all bought at neighborhood secondhand stores that were gone now, or rebranded as
vintage.

Here three-plus years, and it looks like you're expecting evac anytime. On the off chance no helo's coming, why don't you hang a picture, or put a rug down?
Sutter had said that the last time he stopped by, but I didn't agree. I had dug in here—you just had to read closely to see it.

There were books on my shelves, and not just the rippled paperbacks that I'd picked up used at the bookstore on Spring Street. There were volumes older than I was, which had survived through med school, residency, marriage, a storage locker in New Haven while I was abroad, and then the trip west when I washed up in Los Angeles, with no plan of what to do and no idea of where else to go.

There was a copy of Guyton's
Textbook of Medical Physiology,
its cloth cover frayed and faded, that had been my father's when he was in med school, and a Mitchell-Nelson
Textbook of Pediatrics,
in even worse shape, that had been my grandfather's. By its side was my great-grandfather's Gray's
Anatomy.
It was much abused by time and humidity, stained with coffee, Scotch, and who knew what else, but his father's inscription was still legible in purple ink in front:
To the next Dr. Knox.

I was, on my father's side, the latest in a long line of Drs. Knox, who had tended to the ill and injured of Litchfield County, Connecticut, since before the Revolution. Until I came along, anyway. I was the first Dr. Knox not to settle in Litchfield County, or in Connecticut, or maybe not anywhere at all. I was also the first to go west to medical school, the first to divorce, the first to work in Africa, the first to be relieved of that work. So many milestones…In fact, the aberrant behavior had started a generation earlier.

My father, Wilton Knox, was the first Dr. Knox to marry another physician—to marry any woman who worked outside the home—and the first Knox to marry a Jew. Which had no doubt set his Anglo-Saxon ancestors spinning in their Litchfield graves. His living relatives weren't thrilled either, nor were my mother's—though I imagine her parents were by then long past being surprised by anything she did.

Marilyn Berg was their youngest child. Their other children had joined the family's scrap metal business in Buffalo, married within the tribe, and dutifully produced the next generation, and Marilyn was expected to do her part—was all but promised, the story went, to a local dry-goods prince—but she'd had another future in mind, and it didn't involve being anyone's hausfrau. It did include a full ride to Vassar, though, and afterward to the Yale School of Medicine, and she'd dared her parents to stop her. They didn't try. She was the first in her family to go beyond high school, and she was never other than first in any of her classes.

I took a long pull of Stella and took the Guyton off the shelf. There used to be a picture in here. It was tucked in back, a black-and-white snapshot taken when she was in college, and I held it up to catch the streetlight. She was on a bench, and a Gothic spire loomed behind her. She wore a skirt like a pleated horse blanket, a white blouse, and the impatient scowl she donned for every photo. There was a pile of books beside her. Behind the sour look, she was eastern European lovely—small, dark-haired, pale, awkward, and insubordinate, her eyes full of intelligence and banked anger.

She'd met my father in New Haven. He was two years older, but a year behind her in med school. She made extra money tutoring; he was having trouble with biochem. They took their residencies—his in internal medicine, hers in emergency medicine—in Boston. They married when he passed his board exams and she finished a post-residency fellowship in critical care. She was three months pregnant at the time.

It was back to Litchfield County then, to a white house behind stone walls, and to the eighty-bed hospital nearby, where my mother ran the ER and my father was an attending, and where they practiced side by side—old-school doctors, true believers in a notion of medicine-as-religious-calling that was dated even then. They worked there, twelve hours a day or longer, six days a week, until just past four on a December morning a dozen years later, when my mother died. She was coming back from a call, the road was icy, the embankment steep, and the river running fast. It was a single-car accident, a week before my birthday.

So went the family myth, anyway. But it was unreliable narrative, I knew: simplified, sanitized, improved for romance and tragedy—as if it needed any more. And, as family stories do, it left out the messy bits, the contradictions and cobwebs. So how to reconcile their tireless devotion to patients, their skill and confidence as doctors, with their absolute bafflement as parents? How to explain that my presence seemed often to astonish them, as if I'd been left just that moment at the doorstep? What to make of the chaos inside our house—the chronically unmade beds, unwashed laundry, dust, and filthy dishes—the neglect so nicely camouflaged by white clapboards? What to make of my father's fondness for drink, of my mother's moods, which swung without warning from manic to polar and remote? What to make of the whispers after her death about a Dexedrine habit? Family: unknown, unknowable, the most commonplace and obstinate of mysteries. I laughed aloud at my own melodrama, and my voice sounded strange.

I raised my beer and found the bottle empty. I went to the fridge for another and downed half of it on my way back to the bookshelves.

I had more photos, in a box on a shelf. I drank more beer and lifted the lid. There was a picture of the two of them on top, from when they were residents, on a rare day off. They were in the Public Gardens, by an ornate willow, and they looked like refugees—thin and pale and exhausted.

There were other pictures, but I didn't want to look—they did nothing to patch my fractured memories of my parents into anything coherent. My closest approach to that came from the smell of a certain industrial disinfectant, a synthetic pine that was sweet and stinging—my madeleine.

The doctor's lounge at their little hospital was awash in the stuff. The room had a green vinyl sofa, a card table and folding chairs, tin ashtrays, and two vending machines: one that dispensed ossified candy, and another that hissed and burbled and spit something warm and brown and caffeinated into a paper cup. I rode with them on night calls until I was ten or so, and they would park me on that sofa and disappear through the swinging doors, down the hall to the ER. Besides the disinfectant, the lounge smelled of cigarettes and burnt coffee, and the overhead lights made a noise like angry bees. One night the boredom became too much and I followed them.

There was a nor'easter, and a drunk had driven a pickup into a station wagon. The woman in the wagon had a broken leg and had gone into labor six weeks too soon, and the fetus was in distress. The drunk, it turned out, had also eaten lots of Seconal. It took a minute or two for anyone to notice me there. That was long enough for me to see.

In the nearest bay, my mother was delivering the baby. It was by C-section, and there was screaming and blood on the floor, and her gloved hands and gowned arms were wet and red to the elbows. In the next bay, my father was wrestling with the drunk, who was the size of a boxcar and who roared and bucked, despite the nurses holding him, as my father snaked a tube down his throat.

It wasn't the violence of it that I remembered best—the blood and shouts and physical struggle—or the terrible intimacy, or the grotesque slapstick—a nurse sliding on her ass through a pool of vomit, the drunk's trumpet flatulence. Rather, it was my parents' composure through it all. They were the only fixed points in the reeling chaos, the steady drums and baseline, the poles around which the globe swung—calm, sure, commanding, and, to me, never more real. Never more parental.

My second beer was gone, but I'd brought along a third and didn't break stride. I returned the picture to the box and made the mistake of glancing inside as I did. Margot smiled up at me, and I shuddered and put the lid back on.

Margot—blue-eyed, flaxen-haired avatar of Fairfield County privilege and entitlement—tall, slender, ever appraising. My ex-wife. I finished the third beer in a long swallow.

It was in San Francisco. I was in my last year of med school; she was working in venture capital. It was a drinks thing—a bio-pharma start-up looking to cultivate new doctors. I wasn't cultivatable, but I liked the view of the bay from the hotel lounge, and also the vodka tonics. Margot was sipping Stoli, neat. I don't know what I was thinking then—my father had died two months before, after a dozen years of steady drink and diminishment, and it's possible I wasn't thinking at all. I certainly wasn't seeing straight.

So I took in the dangerous cheekbones, the lanky grace, the wry line of her mouth, the knowing chuckle, the poise, and all the rest, and read it as cleverness, an irony that maybe masked a deeper wound, a generous heart, a love of beauty. I misread. Massively. What I thought cleverness was in fact a casual cruelty. The irony: no more than affectation. The warmth: practiced good manners. And the aesthetic sense: just a keen eye for everything that conferred status.

Gunfire punctured my beery musing, and I went to the kitchen window and took a look. There were just a few shots, widely spaced, and they weren't nearby. It wasn't a rare occurrence around here, and after the Central African Republic—the long bursts of full auto that would rip through the night—these pops were tame. I listened some more, but heard no shouts, no tires squealing, no sirens. A celebration, maybe, or somebody making a point.

I sighed and looked at the joint that had waited so patiently on the table. I reached for matches and struck one and opened a window. Warm air came in, and I lit up and took a hit. The smoke expanded, and I held it for a moment and coughed. The glowing ember lit the window orange, and made a jack-o'-lantern of my reflection. I laughed and found another Stella.

Margot had never pretended to be other than what she was; if I'd been fooled by anyone, it'd been by me. It had taken me the whole of my residency and longer to figure it out. In the meanwhile, we'd returned to Connecticut, I to work at Yale–New Haven, she at a private equity fund in Westport. We lived in Stratford, and I'd lost count of how many precious off-duty evenings I'd wasted watching boats on the Housatonic while her colleagues droned on about clients, bankers, real estate, golf handicaps, flying private, carried interest, private schools, and Republican fund-raisers. When I wasn't bored, I pitied them. How they deluded themselves that all that crap meant something, that it was anything but comforting fiction, protective distraction from the realities of life: the nasty, brutish, and short parts, the horribly random parts, the parts where we're powerless to protect our loved ones from anything. I mostly thought they were fools and cowards. In darker moments, I envied them.

I took another hit, then washed the rawness from my throat with beer. Margot was spoiled and her values were toxic, but she was never stupid. She saw the arc of things before I did—from the time I took my first gig with Doctors Transglobal. I was three years out of my residency when I began, and my initial assignments were just a week or two long. I was packing to leave on the second one, to Brazil, and she watched from the doorway.

“I've never seen your ER empty,” she said. “It's SRO whenever I've visited. So I guess this isn't about demand for health care suddenly collapsing in New Haven.”

She was cross-legged on the bed while I packed for my next assignment, a project in Guatemala. “Always somebody to help, huh? And always somewhere else. I thought a couple of trips would get those fantasies about saving the world out of your system. But they're in there deep, aren't they? Down in the bone.”