The Blue Cotton Gown (20 page)

he was working, spending his money on drugs, and I was busting my butt to pay rent.” She takes a breath. “I found his pay stub one day, and I let him have it.

“Well, that was the last time I saw him . . . He stormed out, slammed the door. I just sat there and cried.” She pauses to blow

her nose and clear her throat. “I was working so
hard
and all that time he had a cake job, getting ten dollars an hour at an auto-body shop and spending his money, money we needed,
on dope.
I never even got to say good-bye—”

Someone from a distance says, “Heather?”

“I’m all right, Mom.” Then the girl’s voice breaks again. “I blame myself. I
knew
it would happen, but I just couldn’t stay. With a baby coming, I just couldn’t live with him anymore.” There’s another silence.

“Oh, Heather,” I say, cradling the phone as if I held her, “I know you feel guilty. Anyone would. But it wasn’t your fault. You know that. You
have
to forgive yourself.”

We talk some more. “I have a good doctor,” Heather tells me. “He’s the same one that delivered me. I just feel so sad that T.J. will never see his baby. I think it will look like him. It’s a boy, by the ultrasound . . . I just feel so sad.”

I take a deep breath and let it hang.

Celeste comes into the office quietly and sets the timer on my desk for three minutes, alerting me that a patient is ready in exam room 2. She pats my shoulder, noticing my tears and knowing by the chart open on my desk to whom I’m talking.

“Well, I gotta go. They have a patient waiting.” I wipe my eyes. “Heather?”

“Yeah.”

I want to tell her that the pure light within her will guide her way on, but instead I say, “Will you call me when the baby comes? Or anytime. Tell the nurses I said you can interrupt me if I’m seeing patients. It’s okay.” We say good-bye and there’s no way I can hug the young woman.

On the way home from work in the Civic I sing the song I learned on the commune. I sing it to Heather:
May the long time sun shine upon you, All love surround you, And the pure light within you, Guide your way on.

Circle

I have my women’s meditation group at five and end up leaving a pile of charts stacked in the corner of my desk again. I’ve attended this group every other Monday for more than a year and it means a lot to me. Until we stopped delivering babies, I didn’t have time to make friends. Now I sit in silence for twenty minutes every other week with women my age who wear Birkenstocks and jeans or long skirts and sandals. Half of us grew up in West Virginia. The rest moved here when we were hippies. Two of the women remember visiting our communal farm near Spencer, but that was twenty years ago. Zari and Carolyn have a homeschool consulting business, and Jean is a therapist with her husband. Mandy is a technical writer and Alice an artist. Three of us are nurses of one kind or another. Two are retired social workers. Almost everyone but me works part-time. After our meditation we discuss books on Buddhism or radical Christianity. We eat bran muffins and carrots, or maybe a fancy souf-flé or scones, if someone feels creative. And
chocolate.
Can’t have a

meeting without chocolate!

Today I keep thinking about motherhood. When you have children, you unlock yourself to pain. Not just the contractions of childbirth, which split a woman open like a seed, but the pain that will inevitably come later, the pain of a son’s broken arm or his broken heart. The pain of his loneliness, rejection, or failure. Sometimes the pain of his death.

I shift in my seat, flashing on Heather, all the hurt and grief she’s had in her young life already, losing the twins and now T.J., all the pain she still will go through. I shut my eyes tight and pray a strong prayer, directing the energy from this group of women toward her. And toward T.J. too. May he find peace.

Then I focus my attention and follow my breath. Breathe in again slowly. The universe breathes too. The tide rises and falls. An acorn sprouts, grows to an oak, then dies and nourishes another kernel of

life. The puddles of yesterday’s rain evaporate and come down again as a cloudburst. I pray for my sons, that the stars will dance with them, that the sun will befriend them, that the radiance of the full moon will enfold them . . . Breathe in and breathe out . . .

The women are stirring. “Let us come back to the room,” Zari says.

At the end of the meeting we hold hands, then bow to each other like Buddhist monks, with our palms pressed together in front of our chests. I am so honored to be with these women, all of whom glow.

“Namaste,”
we say, looking into each other’s eyes.

“I greet the light within you.”

holly

“You know these medications are habit-forming, don’t you?”

Holly Knight slouches in the guest chair, stretching her long legs out across the exam room. She has puffy dark circles under her eyes and looks like hell. I continue my lecture. “Not physically addicting, but habit-forming. If you use them too much you won’t be able to go to sleep without them, not even nap.” I don’t tell Holly how I know this. I don’t tell her about the forty-eight sleepless hours I went through downstairs in our guest room one weekend to get them out of my system. I don’t tell her about the sleep medicine in the lit-tle jam jar I use now.

It’s a quarter to twelve, and a drug rep is serving us luncheon in the conference room today. I don’t care about the food, but it’s bad form not to show. We like getting their samples of birth control pills, hormone replacements, and antidepressants for our patients. We accept their lasagna, tossed salad, and cheesecake in return for a five-minute lecture on why their products are better than others.

“So except for sleep problems, you doing okay?” I soften. “How are the hot flashes?” The patient’s not herself today, seems distracted and frazzled, and I decide to slow my inner clock and pay attention. “Are the hot flashes worse?”

Holly shrugs. Her usually coiffed hair is pulled back in a low ponytail; she wears no makeup. I’ve never seen Holly without makeup. Her face is blotchy and lined, making her green eyes look bigger, like they’re swallowing her face, and there’s a yellow pallor just under the skin. “Are you doing
okay?
”

I glance at her vital signs on the chart. Blood pressure and weight look good, pulse is fine, everything’s stable. “So what’s going on? Is it menopause, what?”

“It’s the night sweats. They’re happening again. And the mood swings. I’m losing it . . . I’m not sure if it’s hormones or stress.” I wait, let her tell it. “Nora’s in the ICU again. It’s the same old thing. I knew when she started spitting up blood that I had to do something. John says she has to
choose
to stop being bulimic, that she has to choose to live. But she has to be in her right mind to choose, doesn’t she?” I nod. I’ve never seen Holly like this before. She pulls her hair back from her face, adjusts the ponytail holder, and wipes her tears with the back of her hand.

“It was awful last week. Nora was beside herself. She would run in and out of the house screaming, ‘It’s
my life!
I can do what I want with it.’ I couldn’t calm her down. Nothing seemed to work.” Holly stares at her clenched fists. “We never did anything to hurt her, al-ways helped her. Sometimes I’m so angry. This hurts me so much

. . . but I know she hurts more. I just don’t understand it. John says it’s out of our control now.”

Holly shakes her head. “She has to
want
to live. I know he’s right,

but a few nights ago, after I thought she was sleeping, I went to her bedroom, just to check, and there was blood all over the pillow. She was hemorrhaging. They think it’s her esophagus. She looked so white in the dark, for a minute I thought she was dead. Then I saw

she was breathing, and eventually she opened her eyes. I was on my knees and her breath smelled so bad. Old blood was all over her teeth. I took her face in my hands and I whispered, “We have to go. I have to take you to the hospital.
I can’t let you die like this.
I wanted to shake her.”

I can see it. Holly is crying. Nora is crying.
All right, Mom, I’ll go. I’ll go if you want me to.
Then the long-limbed mother crawls on the bed and holds her leggy daughter. Holds her like a baby, and rocks her too. The girl is so weak from starving herself and raging against the world that she doesn’t resist. Outside the bedroom window the first flakes of snow fall in the dark.

Holly continues. “I didn’t beg her to eat like I usually do. I just cleaned the blood off her face with a warm cloth and took her to the hospital. They’re giving her hyperalimentation, electrolytes, pro-tein, and fluids by IV. They think they’ll be able to save her. They have to.” She stops. “I just don’t know what we did to make her this way.”

I take out my pad and write scripts for the sleep medication and a slight increase in Holly’s hormone therapy. She’s waiting for me to say something, but I don’t know what to say.

I reflect to myself that
we are not such screwups,
she and I. Holly

was just an ordinary mom doing what she thought was right. We both love our children. Did we give our children too much? Did we give them too little? The exam room fills with our collective guilt and mother love. We are drowning in it. Finally I struggle to the surface.

“Okay, John might be right,” I tell her. “Nora has to want to live. She has to want to live and get well. But it’s in your nature to try to save her. That’s what a mother is programmed to do. It’s what we have to do, if we can.”

*

chapter 11

patsy

“You bleeding?” Tom asks as we get ready for bed a few days after Thanksgiving. He stares at my pink cotton underpants in the laundry basket.

“Off and on. Not that much. It’s just spotting. It doesn’t happen every month.”

“Why didn’t you say something?” He’s brushing his teeth and the foam dribbles out as he talks. “We should do an ultrasound and an endometrial biopsy. You know being on unopposed estrogen can cause endometrial hyperplasia.”

“It’s probably just a period. I’m cramping a little.” I reach around him for my hairbrush. “My periods used to be irregular. It hasn’t been that long since I stopped.” I’m thinking it’s no big deal. “Did you call Rebecca Gorham today?”

Tom shakes his head, no, but he’s not diverted. “You’re on estrogen replacement without progesterone, you have to get regular ultrasounds. Tomorrow get an appointment with me, and I’ll do one. We should have done it months ago. And no, I forgot to call Rebecca. Why don’t
you
talk to her? You have more time.” He’s crabby tonight. He pulls back the quilt and adjusts his pillows.

“I already left two messages. She hasn’t returned my calls. She better not be in Europe again. If you telephone her, it might have more clout.” I jump out of bed to blow out the prayer candle, placing my hand on the round wooden box. “Peace be with you,” I whisper. Orion, Zen, Mica, Heather, Aran, Trish, Holly, Nora . . . everyone.

“Will you
please
help me out and do it tomorrow?” I ask again. “We haven’t had a meeting with her in months.”

Tom mumbles something and then he’s asleep. As usual lately, I lie there resenting him. I’m weary of worrying about the practice problems while he sees patients and sleeps like a babe. I remember Mrs. Teresi and take back my malicious thoughts. The man works his butt off, what can I say. I’ll try to call the accountant again my-self in the morning and be more insistent with her little cat of a receptionist.

My ultrasound doesn’t happen the next day or the next week, and neither does the meeting with Rebecca. I’m busy seeing patients and getting ready for Christmas, and then I stop spotting.

Most women do fine on a combination of estrogen and progesterone. I’m one of the exceptions. The progesterone makes me so depressed I can’t stand it. When I finally have Donna pull my gyn chart, I’m surprised to see that my last ultrasound was ten months ago.

Now it’s six in the evening, already dark, and Tom and I are the last ones in the clinic. I lean on the open door to his office. “Hey, want to do an ultrasound on me tonight?” I ask, as if inviting him out on a date.

He turns slowly from his computer. “Tonight? You still spotting?” His white shirt is rumpled and his tie is pulled loose.

“I wasn’t, but it started again. Really, it completely stopped so it just slipped my mind.”

Tom throws down his pen. “
Give me a break, Patsy.
You’re really

being irresponsible here. You’ve got to take care of yourself. We talked about it, what, a week, two weeks ago?” I feel like a schoolgirl reprimanded by her favorite teacher. He’s right and I know it. “Okay, come on.” He stalks past me.

We go back to the exam room. I’ve already turned on the ultrasound machine and typed in my name. I skip the blue exam gown and sheet, just pull off my slacks. Tom puts on gloves and gently inserts the vaginal transducer.

“Ovaries are fine,” Tom says. “The endometrial thickness is excessive, though . . . way over.”

I can see that he’s right by looking at the monitor screen. My pear-shaped uterus is lined with white. “How much?”

“Fifteen millimeters. It should be under five.” This is not good. “So, a biopsy?”

“Yep. Should have had one months ago.” He shakes his head. Tom’s not pissed anymore, just worried. He carefully inserts a small pipelle the size of an IV tube into the opening of my cervix and withdraws bloody tissue to be sent to the lab. It hurts, but I do my childbirth breathing and it’s over in minutes.

“So I guess I better get started on the progesterone, huh? Make myself have a period and get rid of that stuff ?”

“I’d say so,” says Tom. “But I don’t want to be your doctor on this.”

“You don’t want to be my doctor?” I’m shocked and a little hurt. “No, this is potentially serious. You need to see someone else. I can’t take care of you. If you need something done, I can’t do it.” “Like what? Like surgery?” I frown. “It won’t come to that. I’ll start the progesterone tonight. I know I should have been doing it