The Gretchen Question Read online

Once, my family was stuck in our car on the George Washington Bridge. We were driving from Worcester to New York so my mother could ask her aunt for money; my sister and I weren’t supposed to know that, but we did. It was February, very cold, with snow spitting on the windshield, and traffic was standing still. My father was smoking with the windows closed, and it was all Steph and I could do to hold back coughing, but we managed because it would have made our father mad. I was also wondering what would happen if I had to pee, and for a few minutes the wondering about it made me have to clench my legs, until I saw the dog and the woman and forgot what my body felt.

  The woman was holding the dog, which was brown and shivering, as she stood in the middle of the bridge next to a little Fiesta with its emergency blinkers on. We watched, waiting for her to cross the halted traffic to the other side, but she didn’t move from where she just stood in the snow swirls, stroking the dog’s small ears.

  “We couldn’t fit her in,” my mother said, as if answering a question my sister or I had asked. “We don’t have enough room.” It would have been easy enough for that small woman and her dog to slide in next to my sister and me on the back seat, but neither of us pointed this out.

  “A funny thing about Beetles,” our father added after a few more minutes, reaching for his pack of Pall Malls on the dash. “Their engines are in the trunk.”

  I waited for someone in another car to get out and tell the woman she could sit inside until the snow let up or the traffic jam was over, but nobody did. Ahead of us, all I could see was the stretch of fenders all pointing toward the same place; I could not tell where it ended—or was it where it began? The woman put her nose close to the dog’s neck and held him tighter, and I saw the dog squirm and hoped the woman couldn’t tell he was trying to escape.

  Why wasn’t she moving? Why didn’t anyone at least roll down a window to talk to her, to see if she was all right? To ask if they should call somebody for her once they made it over the bridge?

  But I didn’t really want to know the answer, so I closed my eyes. When finally I felt the car begin to move, I opened my eyes again and watched my father steer straight ahead, never turning to look at where the woman stood inches away from his window, until we had passed her, and then through the back windshield I watched until we were far away from where we’d been stuck, and the dog and the woman were lost through the fogged-in glass. My sister mumbled, “That wasn’t nice.” But it wasn’t clear if our parents heard her, or, really, what she meant, or even whom she was speaking to.

  On my way to the hospital the honking around me had ceased, because the kids in wheelchairs were finally out of the way. I passed through the light and into the lot, glancing at the marquee board outside the Methodist Church across the street. Don’t be afraid that your life will end. Be afraid that it will never begin. It took me a surprisingly long time to read the message, as if it were in a foreign language I’d understood when I was a child, but then forgot.

  We meet once a month for a working lunch—Lily, Susannah, Dee, and I—in the basement conference room of the hospital that employs us to do its medical coding. De Coder Ring, Dee calls us. I almost hesitate to confess that, it’s so corny, but on the other hand I love being part of this group; we’ve been working together for fifteen years now and we’re not just colleagues, we’re friends. Susannah and Dee and I all work from home, so the meetings are our only chance to see each other in person, since we don’t get together very often outside of work.

  Lily’s our team manager, and she schedules the meetings so we can go over new procedures or protocols, and also do postmortems on any problems or mistakes that come up between sessions. After the work part, we talk about what’s going on in our lives. One of us asks for advice and the others give it, one of us tells a story about a kid or a bad date or a parent’s illness, and the others respond to that, too.

  Sometimes one of us is feeling vicarious trauma over a certain file; we get to know these patients, even if it is only by their ID numbers, and over the years we’ve followed certain ones through different procedures we can’t help having feelings about: fertility treatments, miscarriages, cancer surgery, end-of-life care. We get attached to them. We feel invested in their stories, we want them to survive. For me, that patient is 1998207—Celia Santoro. But as coders, of course, we never get to meet them the way their doctors and nurses do, we never get to say how sorry we are when things don’t work out. So the four of us talk about that, too.

  When I got to the hospital, I took a parking spot and then noticed Dee pulling in right across from me. I could have sworn she saw me in her rearview, and I waved, but she didn’t respond. Well, she’s the spacey one out of all of us; sometimes she’s preoccupied by thinking about her five kids—five kids! I could never do it, but she has a husband to help—and I figured that’s what was happening when she stayed in her car, with her phone at her ear. I waited for her to finish talking so we could walk in together, but it was obviously a long call, I didn’t want to interrupt or distract her by hanging around, so I headed toward the entrance alone.

  There were two young women nurses walking shoulder to shoulder toward me, on their way to the lot. They were dressed in identical smocks, decorated with brightly colored birds—toucans, maybe, or parrots—which made me think they might work in pediatrics. Were the women lovers? I wondered. Then I wondered, What makes me think that? Just because they wore matching smocks, that didn’t mean anything. But no, it was something else, something about the way they leaned toward each other as they spoke and didn’t seem to see me until I was right next to them. Right before they noticed me, I heard one of them say to the other, “I wish I had it in me to break his heart again.” Okay, so they probably weren’t lovers. It was a different kind of intimacy, then.

  Suddenly, the pavement shimmered in front of me and I had to steady myself against the hood of a car. The nurse closest to me put a hand out and asked, “Are you okay? Do you know where you’re going?” She gestured behind her at the hospital building. The other one shaded her eyes with her hand and squinted at me, looking concerned.

  “Of course I know where I’m going.” I tried to lift the bag on my shoulder that contained my files, as if this was evidence of some kind, but it was a little heavy; it flopped back against my side. “I’m not a patient, I work here.”

  “Oh, sorry,” the nurse said. To take away from the awkwardness, her friend added, “Happy solstice! Hope you have a great summer.” They started walking a little faster, and I saw the first one glancing back at me as I stepped through the sliding door and into the lobby’s cool air.

  I sat down for a moment to savor the relief of it. The old woman who operates the convenience kiosk by the elevators was singing, as she always did. In all the years I’d been coming to the hospital, I hadn’t learned her name, even though I often stopped to buy something from her—Lifesavers, a pack of gum. Her voice was frail and she didn’t sing loud enough to disturb anyone in the lobby, so it’s possible not everyone heard her. But I always made it a point to listen. The woman moved me, somehow. How she was still in that spot, singing and selling things, I could not fathom; she’d seemed ancient to me when I first started coming here, and that was fifteen years ago.

  In the past, though I’d tried, I never managed to decipher her words or the exact tune. But now I heard clearly that she was singing “O Holy Night,” despite the fact that it was morning and the first day of summer. Was she singing more loudly than usual, or was I just hearing things better than I ever had before? Had she made it a point, when she saw me, to make sure I understood?

  The idea made me shiver. Usually I walk down the stairs to the Crypt, but today I took the elevator. For the first time in all the years I’d been coming to these meetings, I was glad to be going down instead of up. I didn’t mind that the Crypt had no windows, because that sun was just too bright.

  Of course it’s not an official listing in the hospi
tal directory, the Crypt. That’s just the name we came up with for the basement conference room where we meet, a few feet down from the maintenance office. It’s really just a big supply closet they took the supplies out of so they could fit in a round table and some chairs. We understand that nobody really cares about us coders—our work isn’t medical in any way, and my son was right, back then, when he said it was boring. The décor doesn’t matter, we’re about as far from the public face of the hospital as you can get.

  It was just about noon. Lily and Susannah were in the Crypt already, talking about something. When I entered, they stopped talking and looked up, both appearing surprised. “What?” I said. “It’s today, right?”

  “Oh, yes. Of course it is.” Lily got up to pull out a chair for me. She always wears jewelry that jingles when she moves, so I heard her earrings, her necklace, and her bracelets as I sat down. “We just weren’t sure you were going to make it.”

  “Why wouldn’t I?”

  They didn’t look directly at each other, but I could tell they wanted to. “Roberta,” Lily said. She shook her head, and there went the earrings again. She had to sweep a piece of hair from a dangling hoop. “We’re so sorry.”

  “You didn’t tell us,” Susannah added, coming over to cover my shoulder with her hand. I couldn’t read what was in her tone—blame, or sympathy? Probably both. I didn’t like the weight of her hand on me, and I didn’t like being so close to the smell of the lotion she used for her eczema, but I resisted shrugging her off.

  Well, this was exactly what I had been trying to avoid—my colleagues, my friends, finding out before I could tell them. Last month they’d noticed that I’d lost some weight, but I explained that I’d been exercising a lot. “I was going to tell you today,” I said, though this wasn’t true, I’d planned to hold off as long as I could. Until it was absolutely necessary. For one reason, I needed to keep working, I need the money. For another, if I’m being honest, a part of me believed that until I had to tell them, it might not be that bad.

  “Let me get you some water,” Susannah said, and left the room.

  “I don’t need any water. Coffee’s fine.” But she was already gone, and it was only Lily who heard. I waved off her serving me, walked over and poured myself a mug. On the table was the usual plate of sandwiches from the cafeteria, and she asked if I wanted one. I knew I should say yes, because I usually did, but the idea of putting anything solid in my mouth made me feel sick. I told her I’d had a big breakfast and maybe I’d be hungrier when we were done.

  Dee bustled in, apologizing for being late. I told her I’d seen her in the parking lot, but she hadn’t seen me. “Oh, sorry,” she said, spilling her purse and notebook and files on the table a moment before they would have all dropped to the floor. “Too many balls in the air, you know?”

  I did know. There was a time when this was true for me. Now, I wanted nothing more than a few balls to toss up there, even if I wouldn’t be able to watch them land.

  Susannah returned, setting the cup of water in front of me. We sat down and went through our agenda. I was the only one who’d screwed up this month, an audit had been triggered on one of my files. I saw where I’d made the error—well, errors—but it didn’t seem like that big a deal to me. I was surprised they all seemed to think it was. I waited for one or more of them to say that they understood how it could happen, that they could have made the same mistake themselves, but they didn’t. I decided I’d just shut up for the rest of the meeting and then leave as soon as the business part was over, if that’s how they were going to be.

  But when the business part was over, Susannah and Dee said they had to check on something together. When they closed the door behind them to leave me alone with Lily, I knew what it meant.

  “Roberta, I really am very sorry about this.” She looked paler than usual, and when she reached to knead her temple, I saw that she’d returned to her habit of biting her fingernails when she felt stressed. “We’re going to have to—suspend—sending you any more files, at least for the time being. It’s not me, I promise, it’s Corporate”—(she made her bracelets ring by pointing at the ceiling; the hospital’s administration was on the top floor, ten stories above where we sat)—“they’re concerned your—faculties—might be compromised, they’re afraid they can’t take that chance.”

  I was going to try to make a joke, about Corporate having some nerve suggesting that my faculties might be compromised, but I knew I didn’t have what it took to pull it off. “That’s a pretty cold way to put it,” I said instead. “And what, no warning? No probation, just pffft, I’m fired?” I made a slicing motion across my throat.

  Lily looked away from me, at a prehistoric filing cabinet whose drawers had rusted shut long ago—we know because we tried them once. Was she thinking about how nice it would feel to go outside when her shift was over, and how glad she was that she had many summer days beyond this one?

  After a moment, she forced herself to meet my eyes again. “Not fired,” she said quietly. “They’re not firing you—you’ll still be on the payroll. And if things get better, if your health—resolves—well, then they’ll have no problem sending you files again.”

  But we both knew what this was all shorthand for. We both knew what it meant.

  “I really wanted to resign,” I told her.

  “You can still do that. They’ll let you.” She seemed eager to grant me the wish I had expressed. “Whenever you think it’s time.”

  “Can I at least finish the files in my queue?” Thank God I’d coded Celia Santoro’s before I came. I’d seen hers coming and skipped others to get to it. I would not have wanted to miss knowing what was going on with her.

  “I’m sorry,” Lily said again. “I was instructed to amend your access, just before you came in.”

  Well, I appreciated that, at least—she could have said restricted. Or cut off, or blocked. Amended was less harsh. Theoretically amended can move in both directions, for better or worse, whereas with blocked or restricted, there’s no doubt about where you stand.

  I said “Thank you,” though I didn’t mean it. I said, “Is that it?” meaning, if I’m not going to come to these meetings anymore, does that mean I won’t see you guys again? But I couldn’t bring myself to ask the real question.

  She seemed to understand. “We should plan a time to get together, the four of us, outside of here.” She gestured around us at the Crypt and the larger hospital grounds. “That was so fun, the dinner last year for your—” She stopped herself.

  She’d been going to say “anniversary,” I knew. Last summer Grettie hosted a dinner party to celebrate the one-year mark of my surgery, which we believed had cured my cancer. She invited some of the women friends we had in common, and Lily and Dee and Susannah came, too. It was nice, they all seemed genuinely happy for me, and I was touched by their toast. I even tried a variation of the old joke, which suffered a little because I’d rehearsed it in my head a few too many times, about how the surgeon had told me that beginning eight weeks after my surgery I could lift heavy items, perform strenuous exercise, and have intercourse, and how I’d said back to her, Oh, that’s good, because I wasn’t having intercourse before. All of the women laughed as if I’d delivered it like a pro, and I was touched by that, too.

  It had been a good night, one of the best since my diagnosis. I could see that Lily hesitated to remind me of it now, as if maybe I’d forgotten that my situation had changed so much—become so amended—between then and now. “I’ll call you soon,” she finished, then seemed to regret that, too.

  Discreetly (but I noticed), she sent off a text, and within a few seconds Dee and Susannah returned to the room. Susannah was crying. Dee’s jaw was set in the way it is just before she objects to something. As cheesy as it sounds, the four of us in De Coder Ring had a group hug, and the guys in the maintenance office seemed to know what was going on, because they didn’
t come in and try to highjack the leftover sandwiches as they usually did. I don’t remember leaving the room, though I’m sure I must have said good-bye to the guys—I’d known them all those years, too. I don’t remember taking the elevator up to the lobby or hearing the old woman singing for the last time. I don’t remember going out to my car or getting inside it. I only remember that the air was hotter than when I came in, and that the sun, or something, was in my eyes. I drove out of the hospital parking lot in the direction of Grettie’s house, where I was counting on the bins having been emptied, so I could return them to where they belonged.

  Was it only because my job had just been “amended” that I felt even more unsure of myself, driving, than I usually did? Maybe I should have taken some time at the hospital, or in the parking lot, after Lily gave me the news and before getting into my car. But I realized this too late. Instead I squinted until my eyes hurt, trying not to make a wrong move.

  Sometimes I catch myself thinking that if I’d been a different kind of person—more relaxed, not such a nervous Nellie about driving and everything else—maybe I wouldn’t have gotten cancer in the first place. And even if I had, the first time, maybe it wouldn’t have come back now. Was it my being afraid that caused it to happen? I try not to think so, but sometimes it’s hard to resist the suspicions that pop into my head.

  PATIENT ID: 4559362

  DIAGNOSIS: Grade II adenocarcinoma of the endometrium

  INDICATIONS: The patient is a 45-year-old woman in otherwise good health who sought medical intervention after vaginal bleeding other than at the time of menstruation. Referred to gynecology for examination and biopsy.

  HISTORY: Onset of menstruation age 12, periods have been regular to this point. Patient likely in pre-menopause. She carried one pregnancy to 36 weeks 17 years ago, premature but successful emergency C-section due to fetal distress from placental abruption.

  (Is it any wonder Will suffers? He was literally in distress when he came into the world.)