The Cole Trilogy: The Physician, Shaman, and Matters of Choice (205 page)

Sarah wore her hair that year in the fashion of dozens of smart young models and film actresses, in long, tangled ringlets. Her tender, troubled eyes were made larger and more luminous by the thick glasses. Her full-lipped mouth trembled slightly, and her hunched, tense shoulders seemed to expect the vengeful blows of a punishing God. The pimples on her chin were back, and there was another in the crease at the side of her nose. Even now, while carefully damming up her despair, she looked like the dead mother whose pictures R.J. had studied so covertly, but Sarah was tall and had inherited some of David’s stronger facial features; she held the promise of a beauty more interesting than had been evident in the snapshots of Natalie.

Under R.J.’s careful questioning, what Sarah had described as “several” missed periods turned out to be three.

“Why didn’t you come to see me sooner?” R.J. asked.

“My period is so irregular anyway, I kept thinking it would come.”

And then too, Sarah said, she hadn’t been able to make up her mind about what to do. Babies were so wonderful. She had spent lots of time lying on her bed, imagining the sweet softness, the warm helplessness.

How could this be happening to
her?

“You used no contraception?”

“No.”

“Sarah. All those programs in your school about AIDS,” R.J. couldn’t keep from saying with ill-disguised bitterness.

“We knew we wouldn’t get AIDS.”

“How could you possibly know a thing like that?”

“We hadn’t ever gone all the way before with anybody, either of us. Bobby used a condom the first time, but we didn’t have one the next time.”

They didn’t know zilch. R.J. fought for calm wisdom. “So … have you talked about this with Bobby?”

“He’s scared stupid,” Sarah said flatly.

R.J. nodded.

“He says we can get married, if I want to.”

“Is that what you want?”

“R.J. … I like him a lot. I even love him a lot. But I don’t love him … you know, for always. I know he’s way too young to be a good father, and I know I’m too young to be a good mother. He has plans to go to college and law school and be a big shot lawyer in Springfield like his father, and I want to go to school.” She brushed a lock of hair from her eyes. “I want to become a meteorologist.”

“You do?” Somehow, because of her rock collection, R.J. would have guessed at geology.

“I study the television reports all the time. Some of those weather assholes are just comedians who don’t know a thing. Scientists keep learning new stuff about the weather, and I think a smart woman who works hard can go places.”

Despite what she was feeling, R.J. found herself smiling, but only briefly. She could see clearly where the conversation was heading, but she was waiting for Sarah to take them there. “What are your plans, then?”

“I can’t raise a baby.”

“Are you considering adoption?”

“I thought about it a lot. I’ll be a senior in the fall. It’s an important year. I need a scholarship to go to college, and I won’t earn one if I have to deal with a pregnancy. I want to have an abortion.”

“You’re sure?”

“Yes. It doesn’t take long, does it?”

R.J. sighed. “No, it doesn’t take a lot of time, I guess. So long as there aren’t complications.”

“Are there often complications?”

“Not very often at all. But there can be complications with anything. It’s an invasive procedure.”

“But you can bring me someplace good,
really
good, can’t you?”

The freckles stood out in the pale face and made Sarah appear very young and so vulnerable that R.J. found it hard to speak normally. “Yes, I could bring you someplace really good, if that’s what you end up wanting to do. Why don’t we talk it over with your father?”

“No, he’s not to know a damned thing! Not a single word, do you understand?”

“That’s such a mistake, Sarah.”

“You can’t tell me it’s a mistake. You think you know my father better than I do? When my mother died, he became a falling-down drunk. This could make him drink again, and I won’t risk it. Look, R. J., you’re good for my father, and I can tell he thinks a lot of you. But he loves me too, and he has … an unrealistic picture of me in his mind. I’m afraid this would really do it for him.”

“But this is a terribly important decision, Sarah, and you shouldn’t have to make it alone.”

“I’m not alone. I have you.”

It forced R.J. to say four very hard words. “I’m not your mother.”

“I don’t need a mother. I need a friend.” Sarah looked at her. “I’m going to do this with or without your help, R.J. But I really need you.”

R.J. looked back. Then she nodded. “Very well, Sarah. I’ll be your friend.” Either her face or the words revealed her pain, and the girl took her hand.

“Thank you, R.J. Will I have to go away overnight?”

“From what you’ve told me, I believe you’ve entered the second trimester. An abortion in the second trimester is a two-day procedure. Afterwards, there will be bleeding. Perhaps no more
than a heavy menstrual flow, but possibly more. You’ll have to plan on being away from home at least one night. But, Sarah … in Massachusetts a female under eighteen needs the written consent of her parents to have an abortion.”

Sarah started. “You can give me the abortion, here.”

“No.” No way, friend. R.J. took her other hand too, feeling the reassuring youthful vigor. “I’m not set up to do an abortion here. And we want you to be as safe as possible. If you’re absolutely certain you want an abortion, you have only two choices. You can go to a clinic in another state, or you can request a hearing before a judge who can grant you permission to have an abortion in this state without parental consent.”

“Oh, God. I have to go public?”

“No, not at all. You would see the judge in the privacy of his chambers, just the two of you.”

“What would you do, R.J.? If you were in my place?”

She was cornered by this direct question. No evasion was possible, and she owed the girl an answer. “I’d see the judge,” she said briskly. “I could set up the interview for you. They almost never refuse permission. And then you could go to a clinic in Boston. I used to work there, and I know that it’s very good.”

Sarah smiled and wiped her eyes with her fingertips. “That’s what we’ll do then. But, R.J. … what will it cost?”

“A first-trimester abortion costs three hundred and twenty dollars. A second-trimester abortion, the kind you need, is more complicated and more expensive, five hundred and fifty dollars. You don’t have that kind of money, do you?”

“No.”

“I’ll pay half. And you must tell Robert Henderson that he has to pay half. All right?”

Sarah nodded. For the first time, her shoulders began to shake.

“But right now, I have to arrange for you to have an examination.”

Despite what she had told Sarah, she already half thought of her as … not her daughter, exactly, but at least someone with whom she had a strong personal connection. She could no more do an internal examination of Sarah Markus than if she herself had
suffered the labor pains of Sarah’s birth, or been there in the department store elevator when Sarah had made water on the carpet, or brought her to the first day of school.

She picked up the telephone and called Daniel Noyes’s office in Greenfield and made arrangements to bring Sarah in for an office visit.

Dr. Noyes said that as near as he could tell, Sarah had been pregnant for fourteen weeks.

Too long. The girl’s firm young stomach was barely convex, but it wouldn’t stay that way much longer. R.J. knew that with each passing day cells would multiply, the fetus would grow, and abortion would become that much more complicated.

She arranged a judicial hearing before the Honorable Geoffrey J. Moynihan. She drove Sarah to the courthouse, kissed her before leaving her in the judge’s chambers, and sat on the hard bench of polished wood in the marble corridor, waiting.

The purpose of the hearing was to convince Judge Moynihan that Sarah was mature enough to have an abortion. To R.J., the hearing itself was a conundrum: if Sarah wasn’t mature enough to have an abortion, how could she be mature enough to bear and raise a child?

The interview with the judge took twelve minutes. When Sarah emerged she nodded somberly.

R.J. put her arm around the girl’s shoulders, and they walked that way to the car.

30

A S
MALL
T
RIP

“After all, what is a lie? ’Tis but the truth in masquerade,” Byron wrote. R.J. hated the masquerade.

“I’m taking your daughter to Boston for a couple of days, my treat, if it’s okay with you, David. Girls only.”

“Wow. What’s in Boston?”

“There’s a revival road company production of
Les Misérables
, for one. We’ll pig out and do some very serious window-shopping. I want us to get to know one another better.” She felt demeaned by the deception, yet she knew no other way.

He was delighted, kissed her, and sent them off with his blessings, in high good humor.

R.J. telephoned Mona Wilson at the Jamaica Plain clinic and told her she would be bringing in Sarah Markus, a seventeen-year-old patient who had entered the second trimester of pregnancy.

“This kid means a lot to me, Mona. A whole lot.”

“Well, R.J., we’ll offer her every amenity,” Mona said, a little less warm than she had been.

R.J. got the message that to Mona every patient was special, but she persisted doggedly. “Is Les Ustinovich still working there?”

“Yes, he is.”

“Could she have Les, please?”

“Dr. Ustinovich for Sarah Markus. She’s got him.”

* * *

When R.J. picked her up at the log house, Sarah was too bright, too cheerful. She was wearing a loose two-piece outfit on the advice of R.J., who had explained that she would only have to disrobe the lower part of her body.

It was a mild summer day, the air clear as glass, and R.J. drove slowly and carefully down the Mohawk Trail and Route 2, making Boston in less than three hours.

Outside the clinic in Jamaica Plain there were two boredlooking policemen R.J. didn’t recognize, and no demonstrators. Inside, the receptionist, Charlotte Mannion, took one look at her and let out a whoop. “Well, hello, stranger!” she said, and hurried from behind her desk to kiss R.J.’s cheek.

The turnover had been high; half the staff people R.J. saw that morning were unknown to her. The other half made a fuss over seeing her again, which she found especially gratifying because it visibly gave Sarah confidence. Even Mona had gotten over her snit and hugged her long and hard. Les Ustinovich, rumpled and grumpy as always, gave her the briefest of smiles, but it was warm. “How’s life on the frontier?”

“Very good, Les.” She introduced Sarah to him and then took him aside and told him quietly how important his patient was to her. “I’m glad you were free to take care of her.”

“Yeah?” He was studying Sarah’s forms, noting that Daniel Noyes had done the pre-clinic physical instead of R.J. He looked at her curiously. “She something to you? Your niece? Or a cousin?”

“Her father is something to me.”

“Oh-ho! Lucky father.” He started to turn away but came back. “You want to assist?”

“No, thank you.” She knew Les was being gracious, a stretch for him.

She stayed with Sarah through several hours of first-day preliminaries, taking her through admitting and medical screening. She waited outside, reading a two-month-old
Time
during the counseling session, most of which would be a repeat for Sarah because R.J. had gone over every detail with her as carefully as possible.

The last stop of the day was in a procedure room for laminaria insertion.

R.J. stared sightlessly at
Vanity Fair
, knowing that in the room next door Sarah would be on the examining table, her feet in the stirrups, while BethAnn DeMarco, a nurse, inserted a two-inch twist of seaweed, like a tiny stick, into her cervix. In first-trimester abortions, R.J. had dilated the cervix with stainless steel rods, each one larger than the last. A second-trimester procedure required a larger opening to enable the use of a larger cannula. The seaweed expanded as it absorbed moisture overnight, and by the next day the patient didn’t need further dilation.

BethAnn DeMarco accompanied them to the front door, telling R.J. the whereabouts of several people with whom they had worked. “You might just feel a little pressure,” the nurse told Sarah casually, “or the laminaria might give you some cramps tonight.”

From the clinic they went to a suite hotel overlooking the Charles River. After they registered and went up to the room, R.J. whisked Sarah off to Chef Chang’s for dinner, thinking to razzle-dazzle her with sizzling soup and Peking duck. But razzle-dazzle was difficult because of discomfort; halfway through dessert they abandoned the ginger ice cream because the “little pressure” DeMarco had mentioned was rapidly becoming cramps.

By the time they got back to the hotel, Sarah was pale and racked. She took the crystal heartrock from her purse and placed it on the night table where she could see it, and then she curled up like a ball on one of the beds, trying not to weep.