Still Life in Shadow (16)

"Excellent. Our anesthetist is in Lisbon this week. We can put you to work!"

Nothing like a working vacation, I always say.

We walked inside and directly to a radiology room, and a nurse with ultrasound equipment in hand was waiting for us. Maria took the hand unit as the nurse doused the area over Latham's groin and upper thighs with surgical jelly. When the machine was ready, Maria ran the wand over the area several times, looking at the screen as she did and nodding from time to time. When she was finished, she ordered an AFP test and called the operating room nurse to get the room ready. She told them that there was an anesthetist on the grounds now, and I heard her tell them that 'she would ask.'

"Ask what?" I said.

"There are about ten cases in need right now, but they are on hold until Doctor Avilas returns. They have asked if you would consent to help out while you are here."

"Well, whatever I can do to help. What about legalities, licensing and the like."

"Ah, yes, You are an American. I forgot. Don't worry about that. We practice medicine here to cure the sick, not to profit some corportate enterprise. And the lawyer on the other boat? He is a friend?"

I smiled, nodded understanding, but hated the implicit condemnation of America in her words.

◊◊◊◊◊

We scrubbed and went into the operating room. Most of the equipment was, by current standards at least, somewhat antiquated, but the procedures used weren't unfamiliar to me. I put Latham under, and after the nurse shaved away his pubic hair, Maria made a four inch long incision just above his penis on the wall of his belly. She retracted the skin and felt for the cord, then pulled the affected testis out of Latham's groin and felt along the cord. She held the swollen gland in her hand and turned it over in the light; theoretically, if it wasn't cancerous she could pop it back in and sow him up and after a few miserable days he would be free to resume a normal life. I looked at the white lesions that covered the orb and knew as well as she did: Latham had a vicious cancer...seminoma, teratoma, who could say?

"It is hard all the way up," she said to the room. "I was afraid of this." She snipped the cord and clamped it off, then put the shining pink orb into a shallow stainless steel bowl and walked it out of the operating room. It's standard procedure to do this, by the by. She was carrying it to the lab, where a waiting pathologist would cold section the testis and the cord to identify the cell types and classify the cancer, and therefore determine how far up the cord it had spread. With that information, a post-op treatment plan could be formulated.

She returned a half hour later.

"All three. Seminoma, teratoma, and granuloma. I'm sure it has spread into the lymph, but without a CT scan there's no way to measure the involvement. I suspect we should wake him and let him regain his strength for a few days. With more information we can decide how to proceed." She nodded to her nurse, "Okay. Let's close now."

I brought Latham out of the ether a little later, when he'd been moved to the hospital's little post-op ward, and I was there when he popped out of his fog.

"Howya doin', shipmate?" I said to him when it was apparent he could talk.

"So. How'd it go?"

"Well, David, you're alive. I'll let the doc tell you what she found."

"Not good, is it?'"

"No, not really, but I don't know the extent of it. She can better fill you in on your options. Right now, you get some rest."

"Am I gonna die, doc?"

"David, we're all going to die. Right now, we're all going to concentrate on getting you better. That's all. That's what you've got to concentrate on."

I smiled at him as he drifted back to sleep...

"Doctor Patterson? Doctor Patterson?..."

I woke with a start, saw Maria was standing over me.

"Yo!" I felt like I resident again, pulling forty-eight hour shifts in the emergency room.

"We have a critical cardiac case flying in right now; can you look over the equipment and see if you have everything you need?"

"Do you have a nurse that speaks English?" I asked hopefully.

"Sister Magdalena is on her way."

I shook myself awake and walked from the Doctor's lounge to the operating room and found the Sister waiting for me. She walked me through the hospitals best equipment - it was surprisingly up to date - and we set about getting the room ready for the arrival of our next patient.

A few minutes later I heard the helicopter beating the air over the town, and our patient came in a few minutes later, followed by Maria Louisa.

"What's the procedure? I asked. "And who's doing it?"

"I am," Maria said.

"Oh, come on! What kind of doc are you, anyway?" I asked incredulously.

"I was trained in Zurich, in cardiovascular surgery. I came to Horta afterwards."

"Alrighty, then," I said as I looked at her to see if she was serious. It wasn't unheard of, really. A top gun who opted out of the bright lights and the big city to get away from -- what? "So, what's the story with this guy?"

"His mitral valve is failing. We're going to replace it."

"No kidding! Who's going to assist?" I asked, knowing this was a grueling procedure for two well trained heart surgeons.

"You are, Doctor Patterson."

You know the feeling, I know you do. It's like when you were a kid and you knew better than to argue with your mother. You knew there was no way you were going to get out of whatever it was she wanted you to do.

I looked at Maria Louisa D'Alessandro and hoped to God this woman was the best heart surgeon in the world, because she sure as hell wasn't my mother...

◊◊◊◊◊

Well, four hours later and I was just about convinced Maria could walk on water. If the situation warranted, she could have given Jesus water-skiing lessons. And then, after finishing the heart we scrubbed again, then took out the appendix of a nine year old girl who was screaming in agony when her father carried her into the hospital in the middle of the afternoon. Exhausted, I went to the lounge to get some coffee and put my feet up for a minute, and was just dozing off when Maria came back in.

"We have a laryngeal growth to remove next. You are ready?" She was looking at me like I was the village idiot, and a lazy one, at that.

"Uh, listen doc, I was up all night sailing a boat and trying to take care of that kid," I said, pointing to the little post-op ward down the hall. "I'm a little tired."

"Alright, doctor. I'll go explain to Mr Vasquez that we can't operate on him today because you're tired." She turned to leave and I got up to follow. She walked right into the scrub room and started in on her hands, and I stood next to her while we scrubbed in. I think, but I'm not quite sure, she was smiling at me, measuring me -- for a coffin, I think.

◊◊◊◊◊

I might have slept in the Doctor's lounge that night, but wouldn't swear to it. I woke up curled up on a little vinyl covered sofa the next morning, but that's all I can say with any degree of certainty. I had been wearing the same shorts and t-shirt now for four days, and I was pretty sure I reeked -- like a pile of dead fish out in the sun. I sat up and took a tentative whiff of my armpits.

Yes.

Dead fish.

Time for a shower.

But all my clothes were still on Circe.

On the table in the middle of the lounge was a neat stack of green surgical scrubs and a couple of towels, along with a bar of nondescript soap. Wasn't that cute? There was a little map pinned to the towel indicating where I could take a shower, and a reminder that there were about ten cases lined up for the day.

I stood in the shower and let the water beat down on the back of my neck; I thought about Harry and Trina, and of course, the problem with Jennifer that I'd created.

Was I just middle-aged-crazy, just another balding cliché living out his fantasies?

Granted, I was married to one of the world's meanest women, and yes, granted, we'd been talking about divorce for more than a few years. The simple fact remained: I was married, and I had screwed my best friend's daughter.

Let's just ignore, for the moment, that I had really enjoyed the experience, and wanted to continue the relationship.

Circe and Bolero would arrive today, unless something untoward came of them, and with their arrival there would be a showdown. Another gunfight at the O.K. Corral. Harry was just too parochial to let this slip, and Trina was just too flaming mad to let me live another day without giving me a really nice piece of her mind.

Maybe what I needed was to bury myself in the O.R. and forget about all this crap for a few days.

Yeah, that was what I needed!

Escape!

◊◊◊◊◊

We finished the third case, a tonsillectomy on a six year old boy, right before lunch. Maria and I walked to the cafeteria and had a bowl of seafood soup that was simply wondrous. Not American hospital food, that much was certain. I could see the breakwater and the harbor down at the bottom of the hill, and tied up down there I could just make out the -- Circe.

"What's wrong?" Maria asked.

"Hmm? What makes you say that?"

"Your jaw is clenching, and your eyes hardened."

"Ah! My friends arrived. The boat is tied up down there."

"Oh? Which one is she?"

"There," I said, pointing to a black-hulled ketch along the middle of the breakwater. "That big black monstrosity there, by the flag pole."

"I can't see anyone down there; do you?"

"No."

"So, why are you so tense."

"Because it's my best friends' boat, and his wife and daughter are on-board. I, ah, was indiscreet, with his daughter."

"Yes, I suppose that would make me tense, too. Do you need to go and clear the air before we begin our afternoon's work?"

"No," I sighed. "I suspect it'll wait."

"I suppose so. But might that not be inadvisable? You need a clear mind, do you not?"

"I haven't had one of those in years, Maria." I looked at her; she was looking me directly in the eye. She knew me, I could see it in her eyes. She knew exactly what I'd done, and why.

"You know, Pete, we each make our own prison, yet we alone hold the key to our release. It is such a simple thing to tell the truth, is it not?"

"I suppose..."

She reached out and put her hand on mine. "You told me the truth, Pete, just now. And the pain in your eyes left you for a moment."

She squeezed my hand once, then stood and took her tray to the waste bin and left the room.

And I could still feel where her hand had rested on mine. My skin burned with electric impulses, as if I'd been touched by fire.

"So, what the hell was that all about?"

I looked down at the harbor, saw Harry and Trina sitting in the cockpit, and suddenly I knew. Knew what I had to do. I left the cafeteria and walked out the front door of the hospital and made my way down to the harbor. I saw Harry and Trina looking at me from a long way off.

They were ready for me. Ready and waiting by the time I arrived.

◊◊◊◊◊

I walked up to Circe and looked at my friend, and he looked -- tensely -- at me.

"Well, come on if you're comin'!" I hopped onto the deck and stepped into the cockpit.

"How was the sail in?" I asked, wanting to ease into this slowly.

"Oh, fine, fine. How's the boy?"

"Cancer, a bad one." They nodded their heads and looked sad for a moment, then Trina looked at me.

"You want to get your stuff off now?" she asked.

"I've been, ah, they've had me working round the clock since I got here. Done about ten surgeries since yesterday. Haven't had time to get a place to stay yet."

No reaction to that, but Harry began again:

"Well, we've got your stuff all packed up," he said. "Why don't you take it with you now." He was having a hard time looking at me, acting like this wasn't really his decision, but that didn't matter now. Almost thirty years of friendship down the drain. It hurt, but I should have thought of that before I let my hormones run away with me like that. Yet I thought, somehow, our friendship had been stronger than that. Oh well, that was -- as they say -- too bad. Water beneath the bridge. I went below and got my bags and walked off the boat. I never looked back, never said goodbye. They remained silent as I walked away.

I have to admit the whole thing hurt. Badly. No one walked away unscathed.

◊◊◊◊◊

I dumped my duffels in the lounge and went to scrub in for the next case. I was on automatic pilot now; when I hurt inside I usually just bury myself in work, do the next case, keep on keeping on 'til I can't.

Maria came in and started in on the next case, a hysterectomy, and she talked to the scrub nurse in Portuguese while I monitored the woman's vitals.

"So, how did your visit go?" she asked me -- out of the blue.

"Oh, it went."

"Well, I'm sorry for you. Wish it would have worked out better."

"I'm gonna need a place to stay, and need to find a way back to the States."

"That's not a problem," she said. "We can take care of that after we finish up this afternoon."

Later that afternoon she walked me up to a nice little hotel and I checked in -- and Maria insisted they give me a hospital discount - and after dropping off my bags in the room she told them I would be working at the hospital for a few days. We walked out and down to a little travel agency, which was closed, and thence up hill to the town library, where I could check my e-mail.

Trina had, bless her heart, already communicated all my sins to Sara, my wife, and the message in my in-box from her indicated that she would be forthwith filing for our too-long postponed divorce. Another note from a colleague at work telling me that news of my affair was all over town, and there was talk of suspending my privileges at the hospital.

Oh, this was just too good to be true.

Maria came over and sat next to me at this point.

"Must be bad news," she said. "I swear your face just turned scarlet."

"Oh, let's see. My wife, she's filing for divorce, the people at the hospital are going to dump my privileges, and that's just the first two emails."

"Are you sure you want to go back?" she said with a chuckle.

"Not sure where else I could go." I opened up the next email, from my bank. All my accounts were frozen. Well, I had some travelers checks with me, enough to get by for several months at these prices, but until I challenged this I was not liquid at all. I could see Maria reading my email over my shoulder, then saw her shaking her head out of the corner of my eye.

"Would you like me to see about getting you on staff here?" she asked. "The pay isn't the best, but you're a very talented physician, and we could use you. I see no issue getting around the legal obstacles."

"Hmm," I said, now very clearly distracted, "what did you say?"

"Stay here, Pete. Work here, work -- where you're needed. That's why I returned; the world back there didn't need one more high-priced chest surgeon, but I was needed here. So I stayed, I came back to my roots, but I came back because I was needed."

"Okay, yeah. Might as well," I said, but I was in a funk now, felt like I was drifting into clouds of unreality.

"Come on," Maria said after she looked at me for a while. "Let's go get some dinner."

◊◊◊◊◊

We walked away from the library up a long hill, winding through narrow winding streets as we climbed, then we took off down another long, narrow road that led to a small village in the distance. We walked for about a half hour, and I looked at the sun as it sped toward the western horizon. The sun even looked lonely to me. All alone up there, no one to talk to, no one to love.

She opened an old wooden gate and a dog about the size of the house came bounding up and stood on his hind legs and licked Maria once on the cheek, then noticed me and dropped back to the ground. He looked at me with his head cocked to one side, like he was taking my measure, and after a moment he came over to me and sat in front of me, blocking my way. He sniffed my legs, and I felt his cold nose on my hands as he sniffed there, too. He circled me, sniffed at my feet, then moved away as Maria led me into her house.

I sat where she told me and watched the sunset as she moved off to start a fire, then into the kitchen to prepare dinner. I sat quietly, and Max, her dog, sat between me and the kitchen. I was clearly an unknown to him, and he didn't, apparently, like unknowns in his house.

"That's okay, Max," I said as I looked at him sitting there on the floor. "If I was in your shoes, I wouldn't like me."

◊◊◊◊◊

I walked back to town after dinner, and I was pretty certain I could find my way back to the hotel on my own. It was very cool out, and the sky was clear. I looked up, could see Saturn overhead and the smoky band of the milky way rising out of the eastern sky. Huge volcanos rose into the sky, standing there, judging me.

What did I want? What punishment was just?

Did I want to go back, back to seething seas of innuendo and endless recriminations? Was money so important to me now? I looked around as I walked into the village, and darkness was complete as the sea came into view. From here I could look down to the harbor below; the lights of the village gave the scene a fairy-tale quality, almost of luminous expectancy, and I could still see a huge volcano across the water, on the next island. I could see the twinkling of lights of another small village, there, across the water.

This was a simple world. A simple life. A life for people like Maria and, perhaps, for people like me.

But did these people really need me? Someone like me? Could I really settle here, leave the complexities of that other world behind? I felt like I had damaged my world beyond repair, and felt totally helpless as I turned a corner and my tiny hotel came into view.

But someone was sitting on the front steps of the building, under the pale yellow glow of a streetlight near the doorway. I walked toward the building, toward the light, and saw a girl sitting there, quietly, almost lost in the shadows.

She looked like someone in a painting I had seen once, the painting of a sea witch on her throne. She looked like a still life in shadow, all fury pent up and lost.

As I walked closer, as the hotel grew steadily closer to me, I could see Jennifer sitting there in the cool night air. I could see her there, gently crying, and I could see a duffel bag by her side.

She heard my footsteps, I guess, because she looked up, then stood and ran to me.

"Oh, Pete, I love you. Don't let them take me from you. I want to stay with you forever."

I felt her tears on my chest.

Or were they mine?

A simple life, indeed.

◊◊◊◊◊

She was in her outlook a simple woman, and it had been said of her for as long as anyone on the island could remember that she had never shown an interest in men. Perhaps if I'd known that I would have been surprised by the attentions I presumed Maria Louisa paid me that first night with her. Or perhaps I would have thrown off my depression and acted on those simple gestures. As I walked back to my new 'home' that night, as I walked along under the stars, I thought about Maria and her simple life, but I had -- when I considered the notion -- no context for these thoughts. Maria Louisa was a mystery to me, and, as I would soon learn, she remained so to most people on the island. I didn't know that night she was regarded by everyone in the Azores as a Saint. She could just as easily have been -- so little did I know her then -- an alcoholic pedophile, or the proverbial axe murderer. I simply did not know her, understand her. She was a terrific surgeon; that I knew, that much was obvious. She was full of compassion for the sick, and people took comfort from her simple presence when she walked into their hospital room.