Four of a Kind (12 page)

The mother asked, “Is it cancer?”

“When did you notice the bumps?” asked Carla, taking a closer look.

“A few months ago,” the girl whispered. “Can I put my shirt back on?”

The mother added, “I didn’t know anything about them until last night.”

Okay, Mom
, thought Carla.
No one’s accusing you
. “Do they itch?” asked Carla.

“A little,” admitted the girl.

Carla gave the girl a brief exam, confirming her immediate diagnosis. “You can put your shirt on.” To the mother, she said, “Selina has
molescum contagiosum
. Wartlike legions caused by a virus. She
might’ve caught it anywhere, at school, from a friend who had no obvious symptoms. It’s common and
not
life-threatening. There’s no way she could have prevented it.”

“Why are there so many?” asked the mother.

Carla nodded, good question. “Selina spread the bumps across her chest and shoulders by scratching them, and then touching an uninfected spot.” To the girl, she asked gently, “Do you have the lesions anywhere else?”

The horrified look said it all. The girl probably had lesions on her thighs and vulva.

The mother asked, “Is it curable?”

Carla pursed her lips. None of the treatment options were pleasant. Surgical removal, or chemically burning off the lesions. And even if every lesion were removed, more would crop up.

“It’s not systemic,” Carla answered, “so pills or any drug you swallow won’t help. You could either wait for the virus to run its course, after which the lesions will fall off on their own.”

“How long will that take?”

“Two years,” said Carla. “Otherwise, I’m sorry to say that the lesions have to be removed individually.”

“Will it hurt?” asked Selina, her eyes big with the beginning of panic.

Why hadn’t the girl told her mother about the lesions sooner? No
, thought Carla,
don’t blame her, she’s obviously ashamed and afraid. You can’t fix the patient, only treat the disease
. “You’ll get topical numbing cream, or a little shot in each lesion before the dermatologist removes them,” said Carla.

“The dermatologist? Can’t you do it?” asked the mother, eager to get the problem taken care of right here, right now.

It would take at least an hour to excise the scores of lesions, besides which, it was hospital policy for the pediatric clinic doc to refer patients to specialists. Carla might take a risk and scrape off a few lesions, but Selina had too many to count. “I’m so sorry, I can’t do that
for you,” she said. “You want a dermatologist, anyway. Dr. Fein has much more experience with this and he’ll do a better job than I could.”

“So we have to see another doctor?” asked the mom.

Carla understood her frustration, but she could do nothing to help. This was how the system worked. Tina entered the exam room, giving Carla the “hurry up” look.

“Tina, would you please call Dr. Fein for Selina and her mom and help them get an appointment today?”

Still upset, the mother said, “I can’t wait for an hour at another doctor’s office
today
. Sometime next week maybe.”

Empathy
, Carla thought. “I know your time is valuable, and I’m sorry to have kept you waiting.”

The woman muttered, “A lot of good that does me.”

To Selina, Carla said, “You’ll be okay. Don’t worry.” The girl tried to smile, but she was on the verge of tears. Carla would have loved to give her a reassuring hug, but that was way against hospital policy. No touching for any reason other than the medical exam.

Back at the hallway sink again, Carla again scrubbed her hands. So far, her patients this afternoon were presenting with topical issues. But even surface problems could be painful and upsetting. Carla thought there was a metaphor for life in there somewhere, but she didn’t have time to contemplate it.

Her cell phone vibrated in the pocket of her white coat. She checked the caller ID.

“Hey,” she said to her husband.

“Glad I caught you,” said Claude. “I’m on the Turnpike.”

“How’d the meeting go?” she asked. He’d been in Livingston, New Jersey, attempting to sell medical supplies to the buyers at St. Barnabas Hospital.

“Not great,” he said dismissively.
Doesn’t want to talk about it
, thought Carla. Lately, Claude didn’t want to talk about his work—or the boys, or her work. He was having a dry spell, and was frustrated to the point of remoteness. It didn’t matter that, due to cutbacks, the
entire industry was under water. Claude held himself to a higher standard. If he didn’t make a sale, he got mad at himself, and that translated into sulkiness at home. He’d slump on the couch, and leave the cleaning, cooking, and shopping to Carla.

“You there?” asked Claude.

“I’m here,” she said.
Still here
, she thought.

He said, “The traffic is murder, and I have to stop at the office to unload supplies.”

“You were supposed to pick up the kids after school,” she said, looking at her watch. She’d have to run over to Brownstone and bring the boys back here to do their homework in her office. She’d lose half an hour. Her schedule was a train wreck.

“Not going to make it,” he said.

“It’s my card night,” she reminded him. “Will you be home by sevenish to babysit the boys?” Babysit his own sons.

“Card game? Not again,” he said. “How much longer are you going to waste time with those women?”

Those
white
women, he meant. Carla asked, “Will you be home or not?”

“I don’t get why you’re doing this,” he said, avoiding the question.

“I’ll take the boys with me,” she said. Robin would be okay with it. Alicia was bringing Joe, and Bess’s daughter, Amy, was also coming to oversee the younger kids. Two more wouldn’t be a problem. She’d confirm with Robin, of course.

“They’ll wind up watching TV all night,” he said. “It’s okay at your
friend’s
house, but not at home? That’s a double standard. They’re smart enough to call attention to it.”

“I’ve got to go,” Carla said. “Patients.”

Patience
, she thought. Carla snapped her phone closed. Claude was right. The boys would probably watch TV at Robin’s. It was a double standard and—surprising herself—Carla didn’t care. She felt a flash of guilt. Was she giving in to temptation? Maybe playing cards
was
slowly eroding her resolve. Claude had criticized her, several
times, about drinking on the porch—in full view of all their neighbors. He said that was just as bad as drinking in the house.

He would make her pay for tonight. His weapons of choice would be exaggerated signs of disappointment and stony silences, examples of his passive aggression that had become glaringly, laughably obvious since Robin had pointed them out.

The Black Queen wouldn’t feel conflicted about indulging her pleasure. She’d claw and scrape and demand every last drop of what she wanted, when she wanted it.

“Wake up, Mommy,” said Tina sharply, standing behind Carla at the sink.

“I’m fine,” said Carla, drying her hands, moving toward exam room three.

“You have to
talk
to the mothers,” said Tina, blocking her way. “Tell them to bring in the babies at the first sign of trouble. They wait too long! Make them get it. They don’t listen to me. I’m just the
nurse
. They need to hear it from the
doctor
.”

When Carla was in med school and imagined her professional future, she’d cast herself in the Hollywood role of “family doc.” Being personally involved with her patients, serving as their trusted ally, treating them from infancy to young adulthood, being invited to graduation parties, confirmations, even bar and bat mitzvahs. Carla realized her dream of a huge extended family of patients was a response to the loneliness of her own childhood. She also knew it was a fantasy. The reality? In her fifteen years at LICH, Carla had treated thousands of patients, but hadn’t felt a close connection to any of them. Her job was to walk on eggshells, live in fear of hospital reprimands, follow the rules, bite her tongue rather than speak critically to a parent who might make a formal complaint. It wasn’t worth the risk. She’d diagnose, inform, and treat. The personal touch was against hospital policy.

Tina said, “I feel like I’m doing all the dirty work here.”

“It’s a dirty job,” said Carla.

“We have to start betting,” said Alicia later that night in Robin’s kitchen. “Hold ’Em is a betting game. Tim and I have been playing at home, and all the fun is in the risk.”

“Poker with just two people?” asked Bess, dealing the cards.

Alicia said, “Three. Joe plays with us. I’m proud to say the kid is a genius at poker. He wins more pots. Of M&M’s.” Seeing Carla’s reaction, she added, “You think it’s wrong to teach a nine-year-old to gamble?”

Carla shrugged. “I’m not telling anyone how to raise her child.”

Robin raised her wineglass. “Drink up, Carla. I’ll make a meddlesome yenta out of you yet.”

“Do you end up eating all your winnings?” asked Bess.

“What winnings?” asked Alicia. “Every night, I get shellacked.”

Robin said, “I hope that’s a euphemism for sex.”

“Not yet,” said Alicia, “but I’m ever hopeful. I do feel like Tim and I are getting closer. Moving in the right direction.”

As always, Carla felt uncomfortable when the conversation turned to Alicia’s marital woes. Robin could probably make some pronouncement about what her discomfort means, in terms of Carla’s own marriage. She hoped to avoid the subject of her own sex life. Although she’d weakened a few weeks ago when the card game was at her own home, and let a sliver of light shine on her problems with Claude, Carla felt uneasy talking behind her husband’s back. It violated their privacy, was a betrayal of trust. Whatever her problems were with Claude, they were not for public consumption.

Carla studied her cards. King of hearts, ace of spades. A high percentage hand. If she were playing on the computer, she’d raise. But, at her own insistence, the women didn’t bet.

Bess dealt the three flop cards, and said, “Amy came back from London, decked out head to toe in Stella McCartney. She looked incredible.
The transformation was complete. She’d gone across the pond a slacker slob and came back a fashionista.”

“We’re unhappy about this?” asked Robin.

“I’ve
begged
to take her shopping,” said Bess. “I tried to force my Visa card on her, and she refused. But when
Simone
offers, Amy not only agreed, but they have a great time together.”

“So your two main problems in life are that your gorgeous husband wants you too much, and that your daughter and mother have a beautiful relationship?” asked Robin.

Bess said, “Yes!”

Alicia and Robin laughed. Carla shook her head. None of them had real problems. They weren’t poor or hopeless. Their children weren’t sick or hungry. Bess, Alicia, and Robin had no perspective, no idea how blessed and privileged they were. How long could Carla continue to hang out with these people?

Bess dealt the last two cards. Carla won with a pair of kings, but the victory was hollow. No pot to claim. Alicia was right. It wasn’t satisfying to play with nothing at stake.

It wasn’t satisfying to sit here and listen, if she was putting her problems into the pot, too. Tonight seemed to be about minor gripes. Complaining for the sake of it and expecting others to care seemed outrageously indulgent. Carla was not a decadent person.

But she knew someone who was.

“From now on, while we’re playing, I wish to be referred to as the Black Queen,” announced Carla.

“Your
nom du poker
?” said Robin. “Love. If you’re the Black Queen, Carla, then I must be the Red Queen.” She tossed her flaming frizz of hair.

Bess said, “That’s good. Call me … White Diamond.”

Carla couldn’t help smiling at how spot-on that description was for beautiful Bess, with her sparkling eyes and blond hair. And Robin was the Red Queen, absolutely.

Alicia, the pint-sized brunette, said, “I guess that leaves me with Wild Heart.”

The others nodded admiringly. “Nice,” said Robin.

Carla let her back rest against the kitchen table chair, felt herself relax and then her spine lengthen. As the Black Queen, she fisted the deck. With each shuffle, she felt her alter ego gain dominance over her hands, her arms, her chest, and her thoughts.

“We
should
bet,” said Carla before she dealt. “But not money. And not M&M’s. Something valuable, but noncaloric.”

Robin said, “Cigarettes? Like we’re in prison?”

Bess said, “I’m never smoking again! That cigarette I had last time gave me a sore throat for a week.”

Alicia said, “We should play with poker chips. The woman with the most chips at the end of the night wins things we actually need. Like a night of babysitting.” Alicia turned to Carla and added, “Or a house call.” To Bess: “Or an outfit to borrow.” To Robin: “Or advice.”

“I give that away for free!” said Robin.

Bess said, “Anytime anyone wants to borrow clothes or jewelry, all you have to do is ask.”

“Same for house calls,” said Carla.