Lilian was the only patient that morning. This was a change from the crowded waiting room she was used to in the days before Dr. Fenton began to charge an annual fee. “Concierge medicine” sounded like “bespoke chocolates” and would not have been Lilian’s natural inclination, and yet she stayed with the clinic. Looking for a new physician would require making calls, meeting strangers, and filling out medical-history forms, and that, even for a healthy fifty-one-year-old, could be complicated. Lilian might be able to omit the two miscarriages—not all experiences, thank goodness, left a trace—but could she also omit the two childbirths, the second by C-section? Small talk happened in doctors’ offices, sometimes about children.
A fee was a manageable price for not having to lie or explain. Lilian did not mind telling the truth, but truths could be startling and leave people uneasy—spooked, Lilian called that state.
The nurse, who introduced herself as Tina, was new. So, Eileen must have retired. For a few years, Eileen had been talking about travelling to County Clare, where her grandparents had lived before emigrating. That retirement plan had been a recurring subject, and Lilian welcomed the images of the coastal cliffs, the castle ruins, and the country lanes, a whiff of wild and poetic bleakness in the fluorescent-lit examination room. She wondered if Eileen talked about visiting her grandparents’ village with every patient. Lilian had been to Ireland many times but not to County Clare. Eileen had never been to Ireland.
Tina, between fifty and sixty, was not the chatty type. She seemed to have an unusual way of looking at Lilian, which reminded her of the way Elizabeth Bowen had described a secret agent in one of her novels—“using both eyes at the same time.” The association was perhaps unfair. Why shouldn’t Tina look with both eyes fixed harshly on Lilian’s face—the nurse was not a Cyclops or afflicted with exotropia.
Lilian’s right arm failed to provide any blood. Tina sighed. “Nope,” she said. “Nothing.”
“Huh, I drank plenty of water this morning,” Lilian said, a pointless statement because the outcome was the only thing that mattered in this circumstance.
“Not enough,” Tina said, and switched to Lilian’s left arm, which proved a success.
The veins in both her arms used to be coöperative for Eileen. Lilian was about to say something—like how odd that an arm could wake up one morning and decide to misbehave—but Tina held up a finger. “Listen. You can hear it if you stay quiet.”
It?
“The blood flow,” Tina said, nodding at the tube in her hand.
Lilian held her breath, and, in the stillness, made a mental list detailing the nurse’s appearance and movements. Her fingernails were painted lavender; her hair, shoulder length, thick, was dyed ink-dark; her green eyeshadow and pink blush seemed only to accentuate her angular face and hard stare. She favored her left hand, capping and uncapping tubes with it. There was a mole on the back of her right hand. Lilian had not taken such an inventory with Eileen, whose face had begun to fade from her memory, but Eileen had never asked her to listen to her own blood filling the test tubes. No nurse had done that.
Perhaps Tina had a propensity to seek unusual and aesthetic satisfaction from her work, Lilian thought, experimenting with generosity, but it was a cold generosity, assured by her sense that she herself possessed the ease of a chameleon: she could meet Eileen’s small talk with warmth and effusiveness, and she could also match Tina’s unsmiling stillness with her own stark impassiveness. She wondered if Tina asked all her patients to listen to their blood. It seemed unlikely. Someone would have complained, concierge medicine or not.
They sat through six large tubes’ and three small tubes’ worth of silence. Only once did Lilian catch what she thought might be the sound of her blood flowing. If asked to describe it, she would not have had any way to do it. Lilian was a writer, but words were limited. Once, at a zoo, she and her children had been invited to stroke a boa constrictor. Lilian, with a phobia of reptiles, nevertheless gathered the courage for her children’s sake, running a finger along the back of the boa constrictor. The sensation, unlike touching any other living creature or inanimate object, could not be described. Some experiences are exclusive, known only to those who seek or are afflicted by them.
Tina untied the tourniquet on Lilian’s arm and left with the tray of tubes. At that moment, two thoughts occurred to Lilian: she would be able to give a good witness’s description of Tina if they were characters in a detective story; and Tina, memorable in her appearance and her demeanor, would never be the murderer in a novel, only a decoy.
In real life, the probability of a nurse being a murderer in disguise, though not zero, was low, and Lilian did not believe that such a sensational turn was likely to occur to her. She had simply been reading too many mysteries recently, and those books tended to instill extra meaning in the commonplace. It was like the sky in a painting, which was often the first thing Lilian noticed and studied when she was in a museum. That must be what the painters wanted, their individual skies rendered unique by their perceptions and techniques. Lilian did not pay equal attention to the actual sky, which served as a background for other things she scrutinized: witch hazel in February, weeping cherry in May, autumn foliage, and icicles in the coldest days of the year. She was wary of giving the sky, which was vast and lofty for everyone, any metaphorical or transcendental weight, as Tolstoy was wont to do.
Lilian had begun to see Dr. Fenton seven years ago, three months after the death of her older son, Oscar. Dr. Fenton had dealt with that information professionally at their first meeting. She had asked about Lilian’s mood, and Lilian had replied with a joke about the ratio of her being vertical versus horizontal. Joking was her version of uncontrollable tears, but Dr. Fenton neither laughed nor pressed to see what was behind Lilian’s inane laughter. Instead, she wrote down the contact information for Lilian’s psychiatrist and therapist and turned her attention to Lilian’s body, which offered, Lilian supposed, the solace of the concrete: minor problems could be managed; anything major would be referred to specialists.
But, when a second death beset Lilian’s life, Dr. Fenton’s reaction took her by surprise. It was four weeks after Jude’s death, and Lilian had gone to the clinic because of a small gardening mishap. A rose thorn had pricked the back of her ring finger and caused an exceedingly painful but local infection.
Dr. Fenton explained that where the prick was, between two joints, was an enclosed space, like a small petri dish. Like an Eppendorf tube, Lilian said. It’s an occupational hazard for writers to always want to revise and edit; she could not help but offer an alternative simile. Dr. Fenton glanced at Lilian and said yes, exactly, and within that space the bacteria’s proliferation could cause acute pain, but it was a problem that was easy to solve with antibiotics. As Dr. Fenton washed her hands at the sink, ready to finish the visit, she asked about Lilian’s general health. Lilian hesitated and said there was something else that Dr. Fenton might want to know, which had nothing to do with the infection and was not the reason for the appointment.
This time, Lilian did not attempt any joke. She related the news in the simplest manner: like his brother, Jude had died by suicide. Dr. Fenton looked so stricken that Lilian, for fear that Dr. Fenton might faint, held her elbow and guided her to a chair. It was the first and the only time that Lilian had witnessed another person’s reaction to Jude’s death. Apart from two close friends, people had received the news by e-mail or by text or by phone call—not from Lilian and never in person. Dr. Fenton’s tears made Lilian feel that she had performed an unfair trick. She should have e-mailed the news before she arrived at the clinic with a pricked finger like a princess in a fairy tale.
Lilian had chosen Dr. Fenton because she had an unfussy, pragmatic way of looking at life. “My job”—she had often said at Lilian’s checkups—“is to keep you healthy for as long as possible. And then, when the time comes, hopefully, you’ll go out fast, no prolonged illness, minimal suffering.” The first time Dr. Fenton had said that, she had drawn a steady line in the air with her pen and then dropped it suddenly. Lilian laughed, but Dr. Fenton remained stern, only nodding at Lilian’s understanding.
When Dr. Fenton recovered from her tears, she asked Lilian how she was doing. Lilian, aware of both her hands now being held by Dr. Fenton, who was neither stern nor matter-of-fact in that moment, replied with what she had carefully formulated as an answer to people’s queries, making a distinction that only some would notice: “My life is never going to be all right again, but I’m doing all right.”
“But why . . . did he . . . do you know?”
Most people did not have the opportunity to blurt out that “why” question to Lilian, even though it must have been among the first questions that occurred to anyone. “I don’t think ‘why’ is the question for me to ask,” she said. “I accept Jude’s decision.”
“You must be a saint!”
It was an inexplicable exclamation, one that Lilian would later wonder about. What kind of saint, in what religion or tradition? Lilian was not a saint—just considering the idea made her feel ten times bleaker about her life than she did already. Nor was she a cold-blooded monster, though she knew that some people considered her precisely that. Why else would two children from the same family choose suicide? The unfathomable is unsettling, and that makes the most banal thought a shelter. Those who don’t think of themselves as monsters feel less uneasy if catastrophes can be explained as consequences. “I suppose it’s only natural for people to come to that conclusion,” Lilian had mused a couple of times with her therapist, and once, at a literary banquet in London, with an acquaintance.
The previous time Lilian had seen Imelda, who was sitting next to her in London, was ten years earlier, when her children were alive, but with some people mindless small talk would be an insult. Imelda pondered. “If you look around, it may be safe to say that most of the people here have not experienced the same level of difficulty as you have,” she said, gesturing to the well-dressed guests relishing the dinner and their conversations. “So, I’m afraid an average person might think, My gosh, those parents must be monsters.”
Lilian found that reply comforting. The world could not be made darker or rosier for her by the tinted glasses others chose for themselves. She would rather talk with a person who was capable of seeing the world as it was, hence capable of seeing her as who she was. “Sometimes I think about Ivy Compton-Burnett,” Lilian said, knowing that Imelda would understand the reference. Ivy’s two youngest sisters died in a suicide pact on Christmas Day of 1917, and they were not even the only children in that family to meet the fate of untimely death.
“A hundred years ago, the death of young people was a more common experience,” Imelda said. “But that thought doesn’t help you.”
“No,” Lilian agreed.
“I hope you don’t feel you need to beat yourself up for what happened.”
“Oh, I don’t beat myself up,” Lilian said. “Life has done that already.”
Tina came back to administer more tests. Though not a talkative woman, she had a range of ways of conveying her judgments: a heavy sigh, a quick gasp, or an emphatic shaking of her head. Thus Lilian learned that she did not ace the depth-perception test for both eyes, and her hand grip was suboptimal, which—as Tina refreshed Lilian’s memory, though she needed no such reminder—was an important measurement because of its correlation with the onset of dementia.
Just as Lilian settled into a chair for her auditory test, Tina paused and pointed to Lilian’s puffer jacket on a hanger. “Look,” Tina said. There was a tear on the back, about half an inch. Some downy fluff was about to leak out.
“Oh,” Lilian said, keeping her face and voice flat. She felt a convulsion, not because of this jacket but because of the one she had worn at twelve. That year, she had begun to commute to middle school, navigating the crowded buses in Beijing, an hour in the early morning and an hour in the evening. Public transportation in a metropolis was a reliable way to hasten the end of childhood. On those buses, a girl learned to watch out for the trespassing body parts of men, a hand probing purposefully, a leg pressing ignobly, but it was on a winter evening that the malice of the world was crystallized for Lilian. A stranger razored the back of her puffer jacket, crisscrossing lines that she did not feel. After she got off the bus, feathers started to escape behind her, swept up by the wind and turned golden orange by a nearby street lamp. A passerby exclaimed, and a circle of people formed around Lilian: worse than being beset by a disaster was to have it assessed by strangers. More than one person expressed disapproval of Lilian’s carelessness; someone wondered aloud about the financial burden she would cause her parents—a puffer jacket, in 1985, was a considerable expense. An acquaintance, who happened to have been passing, questioned the cost of unnecessary ambition. Lilian, the woman said, could have done just fine going to the middle school nearby instead of commuting a long distance to an élite school. Seen from decades later, that moment took on the fantastical air of a fairy tale, but it was one about Bluebeard rather than the Goose Girl, served up as a cautionary tale, not a happily-ever-after. What was the moral of the story? Years later, Lilian understood people’s fear of the incomprehensible: when something terrible happens to someone, surely that person must have erred in the first place. How else can people find security and reassurance in this senseless world?
Tina, as though offended by Lilian’s nonchalance, clicked her tongue and retrieved a Band-Aid from a drawer. “If you’ll allow me,” she said, and, before Lilian agreed, she placed the Band-Aid over the tear.
Lilian watched the lavender fingernails as Tina smoothed the Band-Aid, and remembered a quintessential Patricia Highsmith scene—or perhaps Lilian had only imagined it, for later she could not recall from which of the Tom Ripley books she had retained this memory: Tom, moving the body of a man he has just murdered into some woods, accidentally breaks off a branch of a young tree; while the body burns, Tom caresses the wounded tree, full of tender apology.
A puffer jacket does not sense its mutilation. A tree does not mourn a severed branch. Blood flowing into test tubes does not hanker for an audience. A rose thorn does not harbor any ill will, only blind stubbornness. If one were to tally the things and the people in life, Lilian thought, one would be bound to conclude that much of the world is unfeeling: incapable of feeling or unwilling to feel, though what difference does it make? And, in so many ways, an unfeeling world may be less horrendous than a world in which feelings, too narrow or too strong or too timid or too distorted, dictate life.
A pair of twins from the past often returned to Lilian’s memory. In first grade, Lilian had befriended the girls. Their family, unlike the families of most of Lilian’s schoolmates, lived not in an apartment building with central heating and running water but in a one-room cottage, which was no more than a shack. The windows were open squares pasted over with layers of newspaper, and the room was occupied mainly by a brick bed large enough for the parents and the four children to share. The twins, inexplicably to Lilian even then, kept a hedgehog as a pet, and once—only once—Lilian was invited to visit the hedgehog after school. The girls’ older brothers were out, and their parents were at work. The room, with neither enough natural light from the newsprint-covered windows nor a lamp lit, reminded Lilian of the word “medieval,” which she’d just learned, though she knew not to share this with her friends. The twins, in fact, were considered backward at school. They could not read and often failed the hygiene check on Mondays: their fingernails were dark, the skin on the backs of their necks and behind their ears looked sooty, and they could never produce a clean handkerchief from their pockets.
The hedgehog was retrieved from a cardboard box where it lived. (Why did it never think of climbing out of the box and running away when no one was home? Lilian would wonder after the visit.) The creature, with its small eyes, a pink, sniffling nose, and gray spikes that did not hurt but only tickled, did not have a name. Unlike a cat, it could not chase a piece of yarn, but it could do the neatest trick, which the twins were eager to show Lilian. One of them placed a pinch of salt in her palm. The hedgehog licked it up and then started to cough, an eerily human sound, as if an old man were coughing. Lilian, startled, looked around at the door, and that made the sisters laugh: Lilian, too, was tricked, just like the hedgehog.
Lilian felt obliged to laugh with the girls. Was that a form of small talk for children, when feelings that were too intense could be covered up more easily than articulated? Was that the beginning of Lilian’s habit of telling jokes instead of shedding tears?
A few weeks after that, the girls and their mother died of carbon-monoxide poisoning on a cold night. The father and the two boys survived. Nobody said anything about the hedgehog, and, long after Lilian had forgotten the girls’ faces and their names, she thought about the hedgehog. Lilian could be considered a sensitive child because the memory of the coughing hedgehog agonized her, and yet she was unfeeling, too, for she had not mourned her friends. Perhaps it is futility—more than pain, more than humiliation, more than death—that haunts one. Short of stealing the hedgehog from the girls, Lilian could do nothing to stop them from obtaining heartless pleasure from its helplessness, just as the world did nothing to save the girls or many other children. Perhaps Lilian should have told Imelda that it was not that children’s deaths were becoming less commonplace. Rather, the world was becoming more resourceful with its distractions: futility is easier to banish than death.
Once the auditory test got under way, Tina, for the first time, was approving. “My God, your hearing is good,” she said, looking straight into Lilian’s eyes as though challenging her to disagree. But she might be imagining these things by paying too close attention, Lilian thought, in the same way that Tolstoy gave meaning to the lofty sky of Austerlitz, or the painters of the past immortalized the sky as they had seen it.
Lilian made a noncommittal sound. She had not minded Eileen’s small talk, because it had required neither feeling nor attention from her. Tina demanded extra exertion from Lilian—it took an effort to look intentionally obtuse. Pretending can be a different form of understanding, or of withholding understanding.
About fifteen years ago, Lilian had travelled to upstate New York. Nabokov country, as she used to think of it, though on a recent trip she realized that it would be more fit to be called MAGA country. The literary organization that had invited her for the earlier trip had arranged a car service between the airport and the town, a two-hour ride. The man who came to pick Lilian up introduced himself as Noah.
It was neither the first time nor the last that Lilian had been a captive audience. People who knew her little tended to see in her a sympathetic listener, taking her quietness as attentiveness, viewing her questions—asked only to deflect people’s questions about her—as an invitation. Once, at a fund-raising party in San Francisco, a woman approached Lilian with a wistful look. “If my mother had had your career, she would not have killed herself” was the opening line, and Lilian felt obliged to stay for a long narrative and offer the appropriate response. Another time, someone else’s graduate advisee kept Lilian in her office for three-quarters of an hour with a monologue, during which Lilian did not say a single word. Afterward, the young man exclaimed, “You’re wonderful. Perhaps I should add a wise Japanese woman as a character to my novel!” For about two years, a hairdresser—an immigrant in New York who also had a master’s degree in theology from his homeland—talked at length about religion, philosophy, and his struggles with faith as he cut Lilian’s hair.
It’s astonishing, Lilian often thought, that people feel this urge to talk about themselves with a stranger, however much or little they have lived. But few people would look at their own lives and think they have had only a meagre portion of experience; they must feel that they have experienced more life than they know what to do with—why else would they insist on telling Lilian their stories? Only someone like Ivy Compton-Burnett would say, after the deaths of those young siblings, whom she had raised, “I have had such an uneventful life that there is little information to give.”
People are sometimes presumptuous, at other times predictable, but often they are both. Yet, even as Lilian bemoaned this to a friend, she knew she was partially responsible for repeatedly putting herself into these situations. Was she too passive, too polite, too sympathetic, too kind—was that what made people feel the ease of telling her about themselves? Was she too curious to resist a story—any story, good or bad or mediocre? Or was she, ultimately, too indifferent to her own dilemma of being held hostage by other people’s wishes and miscomprehensions?
The journey in Nabokov country could have been one of those familiar incidents. In her travels, Lilian had unintentionally collected many drivers’ stories: of a man from an Irish family in Boston who had escaped what he called his “Catholic guilt” by running west, all the way to the Pacific; of a Puerto Rican whose aspiration to become a champion jockey had been dashed by his weight gain during puberty; of a Pennsylvania grandfather whose tales about the talents and quirks of every single grandchild—seven of them—had made Lilian drowsy; of the hard luck and good dreams of many strangers. Lilian wondered if those men repeated their stories to all their passengers.
Noah, encouraged by the occasional and polite response from Lilian, talked, unsurprisingly, non-stop: about his previous position, as a school district’s superintendent; about his inheriting a fleet of vehicles two years earlier, when his father retired from his limousine firm; about the village in Central Europe from which his great-great-grandfather had emigrated, and the family get-together every other year, alternating between the village in the Old World and the town in upstate New York, where the latest reunion included two hundred and fifty family members, from both countries; about his three children, the youngest in high school, the two older ones in college; about his favorite grocery store, Wegmans, and his favorite purchase from the store, organic roast chicken. This tireless need for people to narrate their lives, Lilian thought, half listening, half sunk in amused despair.
Then Noah changed his subject. He asked Lilian if she had heard of the famous case of a local teen-age girl being abducted and chained in the basement of a farmhouse for seven years by a man. “The reason I want to tell you the story is that we’ll pass that part soon,” Noah said. “I can take a detour to show you the house.”
Lilian said there was no need, and Noah insisted that it was not inconvenient. Only two minutes off the road, and he would make sure to step on the gas so that Lilian would get to her hotel without any delay. Already, the air in the car seemed to take on a different quality. Lilian, keeping her face vacant, pretended that she did not see Noah’s eyes studying her in the rearview mirror as he went on to recount, with lurid relish, the girl’s abduction, her years in the dungeon, and, eventually, her escape.
Noah was not the man who had committed the atrocity, but how much better was he than the criminal, whose feat he must have admired, somehow, when he swerved off the local highway to a country road and then onto an unpaved dirt road? The farmhouse, unoccupied for some years according to Noah, stood in early-spring drabness, its white paint peeling, its dark windows staring blankly. Noah left the car idling and pointed out a path behind the house which led to a neighboring farm. When the girl had found the opportunity to escape, she had run on that path barefoot and naked, Noah said, describing the scene as though on that day he had been sitting in an idling car in the same spot, watching.
Perhaps Noah was no different than Patricia Highsmith, who had not murdered and yet must have found a thrill in watching her characters murder others. Was it a crime that Noah turned himself into a compulsive narrator, fondling details of gruesomeness because he was safe, free, and invincible, and because there was nothing Lilian could do but sit with him, listening?
Lilian, then and later, wondered if she had done the right thing by maintaining an inscrutable look when the car stopped at the farmhouse. After they got back onto the highway, she closed her eyes, pretending to have dozed off. Noah’s motive—timid in one sense and outrageous in another—was transparent, but there was no point in letting him know that she had seen through him. Her understanding was precisely what he hankered after: he wanted her imagination to be framed by his imagination; he wanted her undivided attention and intense feelings.
When they reached the hotel, Noah helped to unload Lilian’s suitcase and wished her a good visit. Until then, Lilian had not known how the drive would end. In fiction, there would have been many alternatives between the farmhouse and the hotel. Patricia Highsmith would have taken the story in one direction; Elizabeth Bowen, another; Ivy Compton-Burnett, yet another. But Lilian knew that there was nothing she could do but wait and see. In fiction, one can maneuver the time line to accentuate a drama or to defuse a crisis, but, in life, Lilian knew, then and later, the falsity of such maneuvers: there was nothing a mother could do when a child died or when a second child died; she could only wait for each day to arrive and then discover the meaning of that day.
Some writers rely on their techniques; some, their idiosyncrasies. All the same, there is consistency in each writer’s touch, Highsmith being Highsmith, Bowen being Bowen. Life, inconsistent, with little technique but with unpredictable idiosyncrasy, is always a superior storyteller.
When Tina came back into the room, Lilian was lying on the examination table, naked but for her underpants and a robe held closed by her hands, since she had been warned by Tina not to tie the belt. Tina wired the EKG machine and put cuffs around Lilian’s ankles for an ABI test, asking not once but twice whether Lilian had put any lotion on her body that morning.
Lilian shut her eyes. In a murder mystery, Tina could have injected something into Lilian, or she could simply have knocked Lilian out with blunt force, but life was not fiction. Whatever was going on behind Tina’s discontent that morning, or whatever had happened in Noah’s imagination, was only a small fragment in a vast reality. They were unlikely to rewrite an ordinary life. Few people could. Few people would.
When the tests were over, Tina disconnected the electrodes from Lilian’s body, taking care not to rip off the tape too abruptly. Lilian, her eyes still closed, nodded when Tina said that her heart looked fine. Then the room became quiet, as though Tina had left without Lilian’s noticing. She opened her eyes. Tina was standing right next to the table, looking down with both her eyes fixed on Lilian’s face. “Do you have children?” Tina asked.
Later, Lilian would call a friend whose father was a doctor to confirm that the question was unusual or at least unprofessional. Later, Lilian would wonder if in her file Dr. Fenton had notes about the deaths of Oscar and Jude, which Tina had seen, and if Tina felt compelled to ask the question because how Lilian chose to answer it would mean something. This, of course, was a conjecture; for once, Lilian was not interested in knowing the truth.
But at that moment, looking up from the examination table at Tina, her dark hair framing her unsmiling face, Lilian neither hesitated nor flinched. “No,” she said.
Tina nodded. “Neither do I.”
The unmistakable sadness in that statement took Lilian by surprise. Did Tina mean that it was too bad that Lilian, like Tina, had missed something essential in a woman’s life? Or perhaps Tina had expected Lilian to say, “I had two sons, and they died”—to which Tina could have responded with a revelation of her own: “The same happened to me. I’ve lost my children, too.”
Lilian would never know what was behind Tina’s sadness. After she left and Dr. Fenton came into the examination room, Lilian did not mention anything unusual to the doctor, just as, years before, she had not complained to the literary organization about Noah. Noah and Tina would stay in her memory, just as the twin sisters had, but they would do little to haunt Lilian, unlike the hedgehog’s coughing, unlike the feathers flying from her back, and unlike the lives and the deaths of her children. Had Oscar and Jude been alive, Lilian might have felt differently toward Tina. She might have asked questions, which might have led to stories. She might have even made up a story with a deeper complexity, featuring a villain named Noah. But her attention was limited, and her feelings were more exclusive these days. She did not seek to understand Tina or Noah, for understanding was not their due. ♦
