Her phone rang and she picked it up and got involved in a conversation with someone named Janine who’d just had a baby and wasn’t that great, and she was sure he was cute, just the cutest, when could she stop by with the baby gift she’d bought thecutestlittlebootieandjammy set.

21

The psychiatry secretary phoned Jeremy, and said, “You’re requested on Six West.”

It was Wednesday, well past his late-night supper with the old eccentrics and but for occasional surreal remembrances, the experience had been expunged from his head. Arthur Chess was out of his head, as well. He couldn’t believe he’d actually cared about the old man’s well-being.

Over the past few days, he’d seen Angela once- half an hour for coffee and hand-holding before she rushed off. During that time she talked more about her lung cancer patient, who was not doing well, and said, “For the rest of my chest rotation, I’ll be shifting from lung to heart. That should be good.”

“Absence makes the lungs grow fonder?”

“Ouch,” she said.

“Sorry.”

“No, I like it. Another side of you.”

“What side is that?”

“Regular. Not so… composed.”

“Happens all the time,” he said.

“Well, I haven’t seen it before. I like it.”

She squeezed his hand, left to talk to dying people.

He said, “Who requested me?”

The psych secretary said, “Dr. Dirgrove.”

“Don’t know him.”

“Well, that’s what it says, here. ‘Dirgrove.’ He’s a surgeon.” A redundancy; Six was a surgical ward. “He wants you to evaluate a preop patient.”

“For what?”

“That’s all I’ve got, Dr. Carrier.”

“He asked for me personally?”

“Sure did. Guess you’re famous.”

He found Dirgrove in scrubs, charting in the Six West physicians’ room.

The pale, blond man he’d seen demonstrating some sort of technique in the dining room to Mandel the cardiologist and the dark, mustachioed surgeon.

The trio Jeremy had believed Arthur to be observing, only to have Arthur shift his attention to the daily paper. And ask Jeremy to supper.

Seated, Dirgrove had appeared tall. On his feet, he was of medium height, no larger than Jeremy and ten pounds lighter. One of those rangy men who seems to be moving even while standing still. He greeted Jeremy with a warm smile and a hearty handshake. “Dr. Carrier. Great to meet you. Thanks so much for coming, I’m Ted.”

The photo on his badge was a good likeness- a rarity. A thumbnail shot of Dirgrove smiling just as he was now.

T.M. DIRGROVE, M.D. ATTENDING, CARDIAC SURGERY.

“Jeremy. What can I do for you?”

Dirgrove put the chart aside, leaned against the desk, rubbed one paper slipper against the other. His eyes were deep blue, thatched with laugh lines, clear, earnest, tired. Faint yellow-gray stubble dotted his angular face. Hands pinkened by frequent washing fluttered restlessly. His surgical scrubs were wine red. Jeremy found himself thinking: The better to hide the blood.

“I’m slated to operate on a young woman with a ventricular septal defect. On the face of it, routine.” Dirgrove smiled. “You know what they say: Routine is when it’s happening to someone else. Anyway, this girl worries me. She’s highly anxious. We cutters generally don’t pay much attention to that kind of thing, but I’ve learned to be a bit more careful.”

“Careful about anxiety?” said Jeremy.

“About the whole mind-body connection.” Dirgove tented his spidery fingers. He’d indulged in a beautiful manicure, but the rest of him seemed put together casually: short, spiky, uneven haircut, and the scrubs were wrinkled. Careless shaving had left a grid of longer, pale hairs at the juncture of his jaw and neck. “A guy like me can do all the right things technically, but if the mind’s not cooperating, it can be a problem.”

“You’re concerned about an anxiety attack during surgery?”

“About any significant sympathetic nervous system reaction. Even with the premedication, I’ve seen it happen. Patients who are ostensibly out and you cut them open and for some reason their adrenaline kicks in and their S.N.S. spikes and their blood pressure goes through the roof. When the anesthesiologist has his hands full, I can’t do my job optimally. That’s why I play mellow music in my O.R., and everyone shuts up. My instinct on this girl is she needs calming down. I’ve heard you’re the man for that, so if you don’t mind, could you see her? The family’s got good insurance.”

“What can you tell me about her?”

Dirgrove rummaged in a pile of charts, found one, flipped it open, passed it to Jeremy, and crossed to the door. “Everything you need to know is in here. Thanks. And I’d appreciate if you’d do it ASAP. We’re scheduled for tomorrow, first thing, in the A.M., so if you think we need a delay, try to let me know by 5 P.M.”

A brief wink, and he was off.

Merilee Saunders. The chart had lots to say about her congenital heart defect and her family’s ability to pay (excellent private insurance, indeed) but nothing about her psyche. None of the nurses had recorded any untoward anxiety, and Dirgrove’s only assertion to that effect was a neatly printed addendum to yesterday’s notes: Poss hi anx. Call psych.

Jeremy went to see her.

Dirgrove hadn’t told her about the consult.

She was a chubby young woman with grainy skin and unruly dark hair tied up in a knot. Her hospital gown had bunched around her shoulders, and she lay propped uncomfortably. Coal-nugget eyes aimed at Jeremy the moment he entered the room, and she glared but said nothing. Cheap silver rings banded eight of her fingers. Three pierces in one ear, four in the other. A tiny rosy dot above her left nostril said she’d changed her mind about the nose stud.

The chart said she was twenty years old, but the reading material on her bed table was all teen zines.

Jeremy introduced himself, and she frowned.

“A shrink? You’re kidding. What, someone thinks I’m crazy?”

“Not at all. Dr. Dirgrove would like you to be as calm as possible before the surgery, and he thought I might be able to help you with that.”

“If he wants me to be calm, he shouldn’t cut me up.”

Jeremy pulled a chair up to her bed. “May I?”

“Do I have a choice?”

“Sure.”

Merilee Saunders rolled her eyes. “What the hay. Park.”

“So,” he said, “surgery wasn’t in your game plan.”

She turned sharply, regarded him as if his skull had split open and his brain had tumbled out. “Sure,” she said. “It’s a fun thing for me, I can’t wait to be sliced. What a rush.”

“Has the reason for the surgery been explained to-”

“Blah-blah, blah-blah, blah-blah, blah-blah. Yeah, Freaky Dirgrove told me the facts.”

“Freaky,” said Jeremy.

“He’s a stiff. Roboticon. Except when he wants to turn on the charm. My mom loves him.”

The chart said the Saunders family was intact.

“What about your dad?” said Jeremy.

“What about him?”

“Does he like Dr. Dirgrove?”

“Sure, why not.” Merilee Saunders looked over at the TV suspended from the wall. “The channels here suck. Home shopping and Spanish crap and other crap.”

“True,” said Jeremy. “We’re a bit behind the times.”

The young woman shifted position under her covers. “Dirgrove tell you I’m nuts?”

“Not in the least. He just wants to make sure you’re in peak shape for-”

“Maybe I am,” she said. “Nuts. So what? And what does that have to do with getting my heart sliced open? And why now? All these years I’ve been fine and all of a sudden… I’m twenty, I don’t have to do something I don’t want to do.”

“If you have doubts about the-”

“Look, I’ve had this”- she patted her left breast-“since I was born. They tell me it’s a hole in my heart, but I don’t feel any different from anyone else. Not until some docko slips me the old steth and he hears it and everyone starts freaking out.”


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