Dr. Alstadt made a grimacing noise with the corners of his mouth. Dr. Kimberley shook his head. “You see,” he said. “This is what happens when you skip your follow-up appointments.”
“But I didn’t skip my follow-up appointments. I had a follow-up appointment last week. I have another follow-up appointment on Thursday.”
“Oh. Well. Then sometimes these things happen.”
The rest of it seemed to transpire very quickly. Once again she was given a shot in the crook of her elbow, and once again her skin began to tingle, and once again she had the sensation that all her life until just that moment she had been falling toward the ground and suddenly, instead, she was floating above it, and the world looked so handsome, and the light so sweet and welcoming, and she cried as she lay there waiting for the orderlies to take her into the strange, blue, humming, capacious elevator. When she woke up and tried to wipe the grit from her eyes, she found that there was a boxing glove on her hand, and then her mind cleared and she realized that the boxing glove was a bandage, wrapped so tightly that it had fixed her fingers together into a sort of trowel. A machine beeped next to her left ear. A woman in dark green nursing scrubs came in to check on her. When Carol Ann asked her how the operation had gone—where was her glove? could she go home now?—the nurse looked at her chart and said, “Maybe we should wait for the doctor to explain things to you,” and then, “Calm down, now, Miss, calm down. There’s no need for us to raise our voices, is there?” and finally, “I’m sorry to tell you this, but your thumb has been amputated at the knuckle.” It took almost a full minute for Carol Ann to understand that the schools of fish swimming in slow spasms across her vision meant that she was holding her breath. The nurse opened a water bottle, placed a pair of the blue pills on her tongue, and helped her swallow them. Then came the long hours of careless assent and easy reminiscence she had dreamed about while she was sitting behind her desk at work. Memory after memory leafed open in her mind like buds on a tree. The time she found her babysitter rubbing one of her mother’s bras against his cheek. The night she spilled her popcorn on the usher at the movie theater. The Matisse and Duchamp posters with which her college roommate had decorated their dorm room. The fountain outside the library where someone had arranged the coins to spell Mike Rules! Her recovery suite had a single bed this time, and she could run the lamp or change the position of her mattress without fear of disturbing anyone. She did not recall turning the television on, but on it certainly was, and she watched two men in cheap suits debating how the Illumination had affected our duty toward animals, or “the lower creatures of the world,” as they kept calling them. One of the men’s ties was sending irritated little glimmers up his neck. An abscessed tooth was radiating from the other’s mouth. Every so often there was a film clip of a stack of poultry pens in the bed of a trailer, the wire cages giving off innumerable white flashes; or a jockey hieing a horse around a track, its knees and shoulders burning with the strain of the race; or a gang of children flinging gravel at a stray dog, beads of light opening on its body as it tried to twist out of the way.
Dr. Alstadt must have gone home already, because the girl who came to replace her bandages that night could not have been older than twenty-five, fresh out of medical school, her hair held back with a pair of tortoiseshell barrettes. At first Carol Ann was too apprehensive to look at what remained of her thumb, and she kept her eyes fixed on the ceiling until the girl was finished, but a few hours later, when the same doctor returned to change the dressing again, a nurse had fortified her with a second dose of the blue pills and she was able to investigate the amputation. It was not as gruesome as she had imagined it would be. She had a neat little half-thumb now, homely but not repulsive, the crease along the center sewn so tightly together that the stitching looked like one continuous black thread. The injury shone like a penlight where the tendons had been sliced apart, and she was aware of the pain, but she did not mind it nearly as much as she suspected she should. The doctor swabbed her thumb with a clear, sharp-smelling liquid that evaporated almost immediately, then cushioned and rewrapped it. She was saying something about the importance of keeping the area disinfected when Carol Ann drifted off to sleep.
She woke with a start. It was three in the morning. For a moment she thought she had left the television on, but the flickering she saw from the corner of her eye turned out to be her own arm, flung haphazardly over the pillow. Waves of light were following each other all the way from her hand to her shoulder, a display she might have found hypnotic if it hadn’t hurt so much. Her head ached, and so did her back. She was grinding her teeth, and there was an awful tightness in her stomach. Obviously, the pills had worn off, and with the sickness came the desperation—it had always been that way. The serenity she had accepted so naturally just a few hours before was gone now. She could hardly remember what it felt like. Here, in this place, her life seemed like one long litany of wounds, ending in these sweat-drenched sheets with half her thumb missing and stretching back through time in an unbroken sequence of bone fractures and muscle strains, sunburns and concussions, black eyes and canker sores. There was a light in her hand, and a light in her head, and doubtless a light in her memories, too. She had known days of happiness and beauty, rare moments of motionless wonder, but trying to relive them after they had vanished was like looking out the window at night from a partially lit room: no matter how interesting the view, there was always her own reflection, hovering over the landscape like a ghost. That face, it was the problem. Those eyes and that skin. She wished that she could throw the glass open for once and see things as they really were.
If she remained absolutely still, she thought, then maybe, just maybe, she would fall asleep again, and she lay on her side for a while watching the bands of light travel up her arm. When she realized the cause was hopeless, she got up to use the bathroom. After she was finished, she made the mistake of reaching for the faucet with her left hand and was hit by a jolt of pain so severe that her legs locked upright and she had to Frankenstein-walk back to her bed. It took a long time for her knees to loosen up, and even longer for the glow in them to subside.
Shortly after the sun rose, an orderly brought her a breakfast of orange juice and scrambled eggs. A nurse followed behind him with a chaser of blue pills. A few hours later, Dr. Alstadt found her staring out the window at the cars on the freeway, just sedated enough to be comfortable but just sober enough to be clearheaded. “Hello, Carol Ann,” he said. He reached out as if to take the loop of hair that was dangling over her eye and brush it back with his fingers, then thought better of it and dropped his hand. “How are you holding up?”
“Where’s Dr. Barrettes?”
“Dr. Barrettes?” He looked at her chart. “You mean Dr. Clovis. ‘Dr. Barrettes’—that’s good. Dr. Barrettes has gone home for the day. So, Carol Ann, I want to talk with you about what you said to me after the operation,” which made no sense, none at all. She would have remembered if she had seen him after the operation, and she hadn’t.
He gave her a quizzical look and pulled a chair up to her bed. “You don’t remember, do you? That happens sometimes when you’re still shaking off the effects of the anesthesia. Carol Ann, I sat here in this room with you for almost an hour yesterday. You were only half-awake, but you said something that implied your ex-husband had caused your injury. I’d like to know if that’s true.”
“What did I say?”
“Well, you were in kind of a daze. You kept talking to him about your alimony check. You said, ‘You didn’t love me. You didn’t even like me,’ and then, ‘Are you happy now, you sad—?’ You repeated the word sad a few times. I think you were trying to say sadist. ‘Are you happy now, you sadist? It nearly lopped my thumb off.’ ”
She felt her face coloring—something that hardly ever happened to her now that she was an adult. She told him the story of the carving knife and the tape-sealed package and how she had found her alimony check buried beneath a pile of wood curls. “So
I guess he did cause my injury, yes, in a roundabout way, but really it was my fault. One stupid mistake, and …” She made a sound she did not think she had ever made before, a sigh like the beginning of all sighs.
“Well, concerning that,” Dr. Alstadt said. He told her about the physiotherapy she would need after her wound had healed—“not a lot, but some. The thumb is important. You can expect to lose about twenty percent of the function in your left hand. Twenty percent might not sound like much, but you’ll probably have to learn a new way to tie your shoes, for instance. Brush your teeth. Trim your garden—do you garden? Hold a knife and fork.”
The prospect of resuming her life after she left the hospital depressed her. Dr. Alstadt perched his glasses on his eyebrows and rubbed his eyes with his index fingers. He still wore a barely visible aura of emotional turmoil. She wondered where it came from. “Yesterday in the gas station you said you were having a bad day at work. You look like you’re having another one.”
“That’s nothing you need to worry about. I’d rather talk about you.”
“I’ve been learning how to tie my shoes and use a fork without my thumb for two weeks now, remember?”
He paused, made a decision, nodded. “Right. Well. The situation is that the hospital is facing a budget crunch. We either have to cut hours or cut jobs. I’m supposed to make the decision for the A&E.”
“Arts and entertainment?”
“Pardon? Ah. No. Accident and emergency.”
“So what are you going to do?”
“Make life a little harder for everyone, as opposed to a lot harder for someone. The staff won’t be happy about it, but I’ve weighed all the options, and it seems like the one that will do the least harm. You know, ‘First do no harm’ and all.”
“That sounds like the responsible choice.”
“Yes. Well. Nobody can say I’m not conscientious. It might be my one shining virtue.”
“What’s your one shining vice?”
He amused her by pondering the question. “Nostalgia,” he answered eventually, and a few seconds later, “Self-pity.”
“I think we share a shining vice.”
She spent another day lost in pain and reverie, staring at the patients bearing their light past her door and dozing off between outbursts of noise from the television. Every so often someone would arrive to feed her, medicate her, or change her bandages, and if she was sleeping she would rouse herself, and if she was hurting she would try to hide it. The tip of her thumb was gathered together in a smart little pucker around her stitches. She could only presume that, like a sausage, it had been hollowed out to make room for the skin to close. There was a fairy tale that had disturbed her when she was a child, too young for school, and she thought about it now, the one about the quarreling couple who waste all their wishes attaching sausages to each other’s noses. Her mother used to read the story out loud to her, and whenever she reached the illustration of the poor wife tugging at the sausage on her nose, a look of cross-eyed fury on her face, Carol Ann insisted that she turn the page. She always rushed to put the book away the second the story was finished. There it would stand on its shelf, giving out an aura of indignation and menace, just as her teddy bear gave out an aura of sleepy affection, her toy box an aura of cheerful excitement, but the book was fixed against the backdrop of her room, and it had been for as long as she could remember, and it never occurred to her that she could simply get rid of it. She must have fallen asleep while the nurse was working over her because she seemed to spend the next few hours locked in a small stone house with her husband, the two of them trading wishes like insults. She woke up just in time to see the same orderly who had watched her claim the journal a couple of weeks ago take a few steps into the suite, shake his head as he realized who she was, and say, “Perfect. Just great. Wrong room.”
That evening, before he left for home, Dr. Alstadt stopped by to ask her how her day had gone—and also, she could tell, to allow her to ask about his. Somehow, without trying, over a scant few conversations, they had transformed themselves in each other’s eyes from doctor and patient to two fragile human beings, both afflicted by nostalgia and self-pity. When she asked him how everything had gone in the field of arts and entertainment, he said, “About how I expected it would. Everyone hates me a little, but no one hates me passionately.” He reached up to grip his shoulder, rolling his head in a slow circle. She saw a dozen vines of light swaying on the back of his neck. They were thicker than the ones she had noticed before, and he said, “Ah, yes, my neck. It always gets like this by the end of the day.”
“Turn around.”
He must have thought she wanted to take a closer look at the spot because she surprised him by using her good hand to work the tension out of his muscles. Each white tendril grew brighter as she bore down on it with her fingers, then much softer as she eased away. When she was finished, Dr. Alstadt made a tiny halting sound of pleasure.
She was in the hospital two more nights before he allowed her to go home.
I love the photograph of you your parents keep by the front door, that little girl in her glasses and her Holly Hobbie dress. I love the way you kiss. I love the way you shake your head when you yawn. I love the “magically delicious” doodles you make when you’re talking on the phone: stars, moons, hearts, and clovers. I love to look up and see you sitting beneath the lamp in the living room—reading a book, or staring out the window, or chewing the end of a ballpoint pen. I love how soft your hands are, even though hand lotion is disgusting goop and you’ll never convince me it isn’t. I love the way you line your brushes up on the vanity like silverware. I love knowing that if there’s a restaurant I want to try, I’ll get to try it with you; if there’s a movie I want to see, I’ll get to see it with you; if there’s a story I want to tell, I’ll get to tell it to you. I love your giggle fits. I love the names you’ve had picked out for 25 years: “Mira” if it’s a girl, “Henry” if it’s a boy.
The journal lay on the walnut table by Carol Ann’s sofa, and though she had finished nearly a quarter of it, she still had to remind herself that it was not a continuous outpouring of unbroken passion, that every sentence represented a small, isolated profession of love, separated from the ones that came before and after it by the hard line of a night’s sleep. The book was like the row of squares on a calendar: each piece held nothing more than the bare outline of a single day. It seemed to reveal the couple’s marriage as fully as any diary, though, and the further she read, the more intimately she felt she knew them. The husband’s name was Jason, and the wife’s name was Patricia, and their relationship was as open and playfully chiding as it had been on their wedding day. They drove to the lake to picnic and swim, and they rented Woody Allen movies on the weekend, and though she liked spicy food and he did not, they took turns cooking meals for each other on their old gas stove. Carol Ann had seen the light fade from the woman’s body but had failed to learn her name until she reached the journal’s seventeenth page, when she came across the line, I love sticking your name in songs where it doesn’t fit the rhythm: “Patricia Williford, why don’t you come to your senses?” The fact that the two of them were no longer kissing each other’s shoulders, or taking their rings off when they did the dishes, or dancing but only from the waist up—it seemed like a frightening mistake. And even if there was a Heaven, she thought, and even if they were together in it, that would not make it right.
She was finding it difficult to concentrate at work. In part it was the weather, a sudden string of gentle blue days that had lured thousands of birds into the air, but mostly it was her thumb, which still throbbed with pain, throwing up obstacles around even the easiest tasks. Answering the phone, punching the space bar on the keyboard, opening the window, retouching her makeup, maneuvering a bag of chips through the sliding gate of the vending machine—every hour presented her with another puzzle to solve. She knew she was in trouble the moment she got home from the hospital and found a pile of newspapers scatter
ed on her welcome mat. Right away she realized she could not pitch them up to herself with one hand while she held on to her pocketbook with the other, as she ordinarily did, so she slipped off her shoes and spent an aggravating few minutes trying to kick them inside. The glass door kept swinging shut in the wind, though, and the papers came bounding back at her with a terrible banging noise, and finally she had to give up, put her purse on the accent table, and kneel down to collect them one by one. As soon as her wound finished healing, she knew she would be able to use her left hand again, but until then she would just have to keep bobbling through her days like a steel marble in a tilting maze game.
On Tuesdays and Fridays, she left work early for an appointment with her physical therapist, a briskly competent but slightly abstracted woman who seemed to view human beings as a simple collection of joints, muscles, and nerve bundles. At the beginning of each session, she would greet Carol Ann with a short conversation like—
“How are you doing this afternoon?”
“I’m all tangled up inside.”
“Super! Now let’s focus on that hand of yours.”
—then lead her through a series of exercises designed to improve the strength and dexterity of her thumb, or what was left of it. There was the “thumb press,” which involved flattening a barrel-shaped lump of clay into her palm. The “thumb abduction,” a maneuver resembling a leg lift with her hand filling in for her body. The “isometric thumb extension,” in which she made a hitchhiking gesture while her therapist applied pressure with an index finger. And then there was the “putty pinch” and the “prayer position” and half a dozen others. Her therapist had her repeat each of the exercises in three sets of ten, counting off the repetitions—one, two, three, you’re doing good, five, six—while Carol Ann nodded along and pretended she thought it was helping. The glow that had been concentrated in her thumb would gradually spread across her entire hand, following the extensor in a long line up her forearm, and by the time the hour was over, anyone who saw her stealing through the back hallway to the parking lot, balancing her palm before her like a waiter carrying a bowl of soup, would know immediately how much her hand hurt. But then that was true of everyone now. Everyone, everyone, everyone, and all the time. The world had changed in the wake of the Illumination. No one could disguise his pain anymore. You could hardly step out in public without noticing the white blaze of someone’s impacted heel showing through her slingbacks; and over there, hailing a taxi, a woman with shimmering pressure marks where her pants cut into her gut; and behind her, beneath the awning of the flower shop, a man lit all over in a glory of leukemia.