Authors: Sara Paretsky
“It is clean, except for suburban scum who come and dirty it with their minds,” Mara yelled.
She turned back to the homeless woman, who was rubbing a crumpled newspaper over the dark blotch left by the man’s urine. Mara found a five-dollar bill in her wallet and handed it to her.
The woman interrupted her work to pocket the bill. “Thank you, ma’am, thank you. The Mother of God thanks you, too. Her face on the wall will smile at you. Her blood will cleanse you.”
The woman finished her work and stuck her fingers against the crack in the bricks where water, stained red by the rusting pipes behind it, oozed out. She laid damp fingers on Mara’s lips, then on her own. Mara tried not to grimace or draw away, but she couldn’t help gagging at the woman’s touch, and the taste of the chalky-sweet rust on her mouth.
As she walked back past the garage the manager was standing with the outraged couple, watching her. “Hey!” the manager yelled. “You! Do you know that woman?”
Mara scrunched her face into its most evil scowl. “She’s my mother, dickhead. What’s it to you?”
Made rounds early, ordered blood workup on Mrs. Herstein before her discharge, told her to come to clinic next week for results. She asked what would happen
if
she took the Prozac: “Will I have deeper insights?”
Into what, I asked. “The nature of life.” Not one of the side effects ever reported in the literature—told her I didn’t know, but that the drug might make her feel calmer, less like weeping. At that she got angry.
“I want to weep. Weeping gives you insight if you do it right.”
Too tired to try to understand what’s going on with her. Told her to come to clinic next week if she wanted to discuss further treatment when we have results of blood work.
Strange dream right before I woke up. Walked into room—large, light, empty, like a music room in a rich man’s house, thought at first I was alone, then uneasily aware of presence, pulled a screen aside and saw Mrs, Herstein dressed in surgical scrubs, large butcher knife in one hand, stereo receiver
in
the other. She was going to do surgery on my brain, plant the receiver in it. I turned to run and found door blocked by Hanaper, smiling, saying, just let her do it, it will keep her happy.
Woke in sweat before she could begin operating. Is this some kind of substitution for my parents? What did I think Mom wanted to plant in
my brain? But Hanaper as a stand-in for Dad doesn’t make sense—I dislike H, dislike his bullying, his lack of interest in patients, while Dad was a peace-at-any-price kind of guy. Or does that equate to lack of interest in children—in me? Hanaper called me into his office this morning….
“Dr. Tammuz. You’re always complaining that we are more attentive to the needs of the hospital than we are the community.”
Hector, the dream still heavy on his mind, eyed the department head warily. “Yes, sir?”
“An opportunity has come to me—to the hospital—to give something back. I think you would be ideal for the position.”
“And what is that, sir?”
“The Lenore Foundation has designated a fund to send a psychiatric resident into the homeless community one day a week. As you know, since the mayor closed community mental clinics, all hospitals in the city have experienced a greatly increased load of mentally ill homeless patients.”
Hector thought of the man who wanted to prove he was a chicken at the State of Illinois building, the one Hanaper had bullied into leaving the hospital so that he wouldn’t add to their uninsured costs, and said, “I hadn’t realized that, sir.”
Hanaper squinted to see if he could read irony in his resident’s face. “The man in charge of finding the right resident is Angus Boten. I think you met him when you came out for your interview. Unfortunately he wasn’t able to stay with the department here, but he called me yesterday to see if I could recommend anyone. Of course I thought immediately of you.”
Hanaper stared at me with a kind of cocky maliciousness. Does this mean he’s aware of my disappointment at not being able to work with Boten? But if that were the case he wouldn’t give me the opportunity to have even this modest association with B: H knows I am more interested in talking therapy than pharmaceuticals, and thinks it’s his job to ridicule that nonsense out of me, wouldn’t deliberately send me into a
clinic where the emphasis would be on Boten’s approach to treatment. More likely H has some knowledge about—poor—conditions of Lenore clinic: perhaps a cold cheerless room where an endless progression of smelly, psychotic men and women rant at me, much like Mrs. Herstein, only without benefit of soap.
Hector could see himself, ever shorter on sleep, writing prescriptions for Ativan, Prozac, Haldol, flinging drugs at the mentally ill the way GIs threw candy to children in wartorn countries. “I presume this means I can cut back on my on-call rotation, sir, since I’ll have to be out of the hospital one day a week.”
Hanaper was disconcerted, although only briefly. “The clinic will meet on Fridays, starting a week from today. We’ll move your on-call rotation permanently to Friday night through Saturday, Tammuz. That way you can dictate your notes on your homeless clients while you’re in the on-call room, save you some time so you don’t have to be away from home any more than necessary. Although you don’t have a wife yet, do you?”
Wanted to pick up the Steuben paperweight the bastard keeps on his desk and brain him with it. Wanted to sing, “Take this job and shove it.” But of course I just meekly said, “No, sir,” and got directions on when and where to start. Orleans Street Church has offered use of a room, since they run a homeless shelter there in an old coal basement. Hagar’s House. Wasn’t she the woman sent into the wilderness? So a fitting name: women out of the wilderness into the coal cellar.
Hard to remember why I wanted to become a doctor. Even if I finish my residency at this hellhole it will only mean signing on with some managed care group elsewhere and doing more of the same: relying on drugs, not therapy, having an average of fifteen minutes to spend with every patient, having to justify every admission to a committee of administrative baboons who know nothing about mental illness!
About to leave when Hanaper’s secretary buzzed him; Luisa Montcrief had arrived. The diva Stonds told us about on Tuesday, whose family is worrying. Completely forgot about her, as H obviously had,
too, but he was glad to sweep me along on his coattails, have secretary page Melissa so he could have bigger audience on his great therapeutic methods.
Bad news from the secretary: diva has no health insurance. Coverage lapsed after eighteen months of not paying premiums.
On first sight, Montcrief very striking—dark hair swept back from strong cheekbones, expensive-looking crimson dress. Another woman with her, sister-in-law we later learned, face tight with the kind of worry all caretaking relatives get after a while.
“Ms. Minsky? I’m Dr. Hanaper. Your brother says you’ve been having a few problems lately.”
The diva turned mocking brows toward her sister-in-law, who said sharply, “He’s speaking to you, Janice.”
“But my dear Karen, I am not Ms. Minsky. You are the only person with that name in the room. Unless you have Becca concealed behind the arras?” Her voice was rich, like fresh coffee, and her laugh tingled the blood of the men in the room.
“She likes to think of herself as Madame Montcrief,” Karen Minsky told Hanaper.
“I’m here in the room, Karen, and able to speak for myself. I like to think of myself as Madame Montcrief because that is my name. I paid a fee to a judge when I was twenty to have it legally changed. Not to ‘Madame’ of course; to Luisa Montcrief. ‘Madame’ is a courtesy title out of respect to my eminence in the world of music. So it is really never appropriate to call me anything else.”
“Except when you want to use the Minsky money,” Karen said sharply.
“Even though I changed my name I didn’t have a DNA transplant: I am still Miriam and Herschel Minsky’s daughter. I’m entitled to my share of their estate.”
“She squandered her share of the inheritance—”
“Which included half the money our parents had to leave, but nothing from the profits of the scrap iron empire. I don’t think I’m beyond my rights in wanting some of that cash flow.”
“Harry has worked every day of his life since he was fifteen in that scrap yard. He’s earned that money. You’re ashamed to have anyone know you’re a Minsky, even by DNA.”
“When Harry sold my home in Campania—”
“To pay the debts you’d built up around the world—”
“Ah, ladies,” Dr. Hanaper broke in, “you may both have valid points here, but let’s try to see what is bothering Ms. Montcrief.”
“There’s nothing wrong with me that a better agent wouldn’t cure,” the diva said. “Harry and Karen are nervous about my not working, but they have no idea how I feel, a world-class opera star, not to have had an engagement for almost three years.”
“People covered up for your drinking as long as they could,” Karen said, her face flushed. “Longer than I would have. I don’t know what hold you had over Piero Benedetti at the Met, but he brought you to New York to play Desdemona even after you were arrested in London for assaulting a member of the audience.”
“Assault?” Hanaper asked. “With a weapon?”
“She threw a decanter at a woman. From the stage.”
“The ridiculous creature was talking so loudly during the first act of
Tosca
I could barely hear my cues. I have perfect pitch, but I do need to know when someone else has finished singing so that I can time my entrance. By the time Scarpia was forcing me to sign my lover’s death warrant the woman was so loud she spoiled my approach to Vissi d’arte.’ After the performance my fellow cast members bought me dinner in gratitude for silencing her.”
“Was that before or after the police came for you?” Karen asked with heavy sarcasm. “If you hadn’t drunk most of a bottle of Scotch before going on in the second act you might have been more aware of the production than of the audience. Anyway, I don’t think it was the woman’s speaking—it was the boos from the balcony that interrupted your performance.”
Karen turned to Hanaper. “Even then Piero Benedetti brought her back to the Met. That’s where the end really came.”
“Karen, it is pathetic that you are so resentful of me you have to slander me in front of total strangers.” The diva smiled at Hanaper.
“Her life has revolved around the house Harry built for her in Highland Park and her only child Rebecca. She’s always been jealous of Becca’s attachment to me: the poor child isn’t exposed to culture, or glamour, and I provide her with both.”
At this point I thought poor Karen Minsky was going to strangle Montcrief. Same thing must have occurred to Hanaper—not always lacking in insight: he suggested Karen wait outside while he finished talking to Madame Montcrief. The interview went on for half an hour, with the singer denying that she was anything but a social drinker, talking of the jealousies in the opera world that led to slanderous reports of her drinking.
“Your brother says you stole his credit cards and ran up quite a hotel bill this last month. That doesn’t sound like slander, does it?” Hanaper said.
“Harry and I are twins, but we’re not identical.” She laughed heartily at her own joke. “We’ve never seen eye-to-eye on anything, even as children: he always preferred Queen Esther to Vashti, so that’s who he married. Now he wants me banished.”
Hanaper pounced on this, thinking he was getting a first true sign of delusions.
The diva threw up her hands—a theatrical gesture, yet somehow, from her, genuine as well. “Oh, dear: you really haven’t heard of the Book of Esther, Doctor? There was a time when you could expect to carry on a cultivated conversation with a man of medicine. That’s still true in Italy, you know: the most devoted fans of opera there are often in the medical ranks. Or the clerical. And if I had made such a statement to one of them, they would instantly have understood all the relationships in my brother’s life. But I suppose with drugs and machines to rely on American doctors acquire a technician’s approach to problem solving.”
Wanted to applaud her, but engrossed myself in notes while Hanaper stared at me suspiciously. He summoned the sister-in-law, said “Tough
love” the only thing to do in cases like this. Of course
if
diva had insurance he could recommend Midwest Hospital’s in-patient alcohol dependency program, but if Mrs. Minsky wasn’t prepared to pay the bill? Mrs. Minsky emphatically not ready to pay a twenty-thousand-dollar hospital bill.
Then, H advised, don’t let her sponge off the family, give her one last chance, if she blows that then don’t pick up the pieces again. And by the way you can give my secretary a check for two hundred fifty dollars. Melissa and I choked: poor Karen Minsky paying a seventy-five-dollar premium because Hanaper never read the Book of Esther.
After we slunk out as fast as we could Melissa said, “I would give up my residency if I thought I could ever dress and move like Luisa Montcrief.” I’d give up my residency if I could find another way to pay my medical school debts, I said,
and
we all went off to our respective patients.
Dr. Stonds pounced on me as I was writing up my last orders at the end of the day. What had happened with Mme Montcrief? He and his granddaughter used to enjoy her performances at Lyric Opera, Told him she seemed to be an alcoholic without any medical insurance, so tough love seemed to be the indicated treatment.
Stonds looked at me bleakly. Tough love is often the best treatment even in the presence of medical insurance, Dr.—Tammuz, is it? As you gain more experience you will be less willing to cry over the manipulators, the users, the abusers in the patient population. You
need
to develop a thicker skin, or you will be torn apart by your patients’ woes.
Advice I’ve been hearing since I was five, I think, Mom telling me not to be a crybaby. Develop a thicker skin. Instead, over time, my skin gets sandpapered to translucence.