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Volume 2, Issue 3
Autumn 2006:

Left-handed Favor

Michael A. LaCombe

Cell 2 Soul. 2006 Autumn; 2(3):a2

The heavy rain formed road-side streams, washing away the sandy shoulders, undermining the macadam. The doctor, picking his way carefully along in the dark to avoid driving his Chevy into a wash-out, slowed at the dirt-road right-hand turn and read the sign in a flash of sheet lightning. He saw the deep ruts in the dirt road, like a potato field on a bad day in April. He would have to walk it. Edging the Chevy onto the dirt shoulder, he parked, reached down to buckle his galoshes, then buttoned his slicker about him. Black bag in hand, he headed up the road in the storm. He was young and strong. This was still high adventure. He leaned into the driving rain and made for the light ahead.

The woman held open the door. She was thin, with a straight, hard mouth and no bosom to speak of. Her dress hung from her shoulders in a straight line to her ankles. Her cotton dress snapped in the wind. Glancing up through the rain, the doctor could see her bare feet stuck in oversized black leather shoes.

"Nice day," he said to her as he crossed the threshold.

"Thank you for coming out, Doctor," she whispered, closing the door behind him. She took his coat, heavy with the rain, and hung it with his felt fedora, dripping, on a nail next to the door. "She's in the next room."

The doctor surveyed the kitchen as he walked through to the adjacent bedroom. Rough pine boards, wide, warped, and slivered, formed the kitchen floor. The cook-stove at the left of the room, sporting a dull, rusted Katahdin Iron Works emblem on its bulging front, held assorted pots and a small, heatless fire. The day's wash hung over and to one side of the stove. Through a door off the kitchen to the right, he could see three dirty children quietly peering at him, minding someone's orders. This, he thought to himself, is definitely a left-handed house. Definitely. He headed through to the bedroom straight ahead.

The room held three people. Off in the far corner, set apart from the only bed in the room, sat an old woman knitting. She kept her eyes to the task, as though she might be sitting on a sunny porch somewhere, minding the dog. Her knobby fingers worked away at an afghan patterned in mismatched, garish colors of seconds and end-bits of yarn. She never looked at the doctor, did not acknowledge his arrival. She was, the doctor thought, the family's Final Arbiter, and would pass judgment upon whatever it was the doctor decided was wrong. In the near corner, to the right of the bed, stood a short, balding man with beer-belly and black suspenders. Arms folded across his chest, he held a can of Carling's Black Label in one hand and squinted against the smoke of the hand-rolled cigarette in his mouth. He might have been at a pig auction, except that in his face the doctor could read considerable quiet rage.

In the bed among the covers lay a young teenage girl who, in spite of her illness, was uncommonly beautiful. Sizing up the scene, the doctor knew without hearing a word, the diagnosis.

"She's in a family way," whispered the girl's mother.

"Knocked up," spat out her father.

The doctor placed his bag on a chair, leaned at the bedside, smiled at the poor frightened girl, and stood tall.

"I would like you two to leave," he said, nodding to the old lady and to the girl's father. "You will need to stay," he said to the mother, "because I will need some help."

The old woman clucked her tongue, sent a stare straight through the doctor, and made to gather up her knitting as though she were moving West, once and for all. The girl's father pushed himself away from the wall with a heave of his shoulder, gave his daughter a murderous look, and left the room with the old woman.

"How far along do you think you are, sweetheart?" the doctor asked the young girl.

"We don't know, Doctor. She just told us yesterday," said the girl's mother.

"When did you last...make love?" the doctor asked his patient.

"I only did it once...two months ago," sobbed the girl.

The doctor nodded to her kindly, as if to say 'that's okay', and gently pulled the covers down to examine her. Her belly was flat, and slightly tender above the pubis, and her thighs were parted. There was a pile of blood between her legs — 'products of conception' in the vernacular. He instructed the girl's mother to get soap, water and fresh sheets to help him clean her up. While the woman was gone about her assignment, the doctor whispered to the girl.

"You've had a miscarriage, honey. You lost the baby, but you'll be all right. You can have another baby someday just fine. But make that someday a long time away, okay?"

"I'm never doing it again," said the girl.

"Yeah, well, when you do, use some protection, okay?"

"I'm never going to do that again," she repeated.

"Okay," said the doctor. He smiled at her. Her old man, he thought, will bar the door against this one.

The girl's mother returned and together they washed the girl's thighs and changed the bed.

"She has a slight infection...in her womb...I'll give you these few pills for her, but you'll need some more. You can get them at the drug store in town day after tomorrow when the road's better," he said. He wrote out the prescription with his left hand, tore it off and handed it to her.

"What do we owe you for the call, Doctor?" asked the woman.

He sized her up. Poor and proud, he thought.

"You'll be getting a bill," he said.

The rain had stopped. He draped his coat over an arm, hat in hand, and nodded to the girl's father and to the old woman, both still sulking in the dark sitting room. He let himself out and walked his way through the mud back to his car. He chuckled to himself over his 'system'. When the doctor, who was ambidextrous, wrote his prescriptions and his medical notes with his left hand, the druggist would recognize his left-handed script and charge for drugs at cost only, and the patient would be sent no doctor's bill. Right-handed notes and 'scripts were handled in the usual way. And from what he could read of her father's character, this poor girl would already have paid enough for her illness. The furor in that house for the next few weeks would erase any thought of a medical bill coming due. He headed home.

Thirty years passed.

It was thirty years of progress and medical achievement, thirty years of antibiotics of every description treating every known infection and some as yet to come, thirty years of CAT scans and ultrasonography and magnetic resonance imaging, thirty years of electrocardiography and pacemakers and laser-directed coronary surgery, thirty years of Medicare and Medicine-as-Big-Business and third-party forms and the myth of the perfect result and lawyers wanting a piece of the action.

Percy Davis, the old pharmacist in town, had passed away, and with him went the doctor's left-handed 'scripts, with him the left-handed-written fictitious bill, because all patients were now insured, as the politicians liked to believe, and everything had to be documented. The doctor had attended Percy's funeral, on a sunny day in June, and stood apart at the hillside plot, recalling the old days, and their 'system'.

The days were growing shorter for the doctor as well. His worsening heart condition, the energetic competition, the age of the specialist, and his own out-dated knowledge, meant fewer hours for him, and fewer patients. He had some patients who played it both ways, who went down to the City to the specialists, and still came to him from time to time out of loyalty. He knew about it. They would let slip, mention a drug he hadn't read about or a procedure he hadn't sent them for — and he would know. He was a weathered old caboose shunted to a siding grown up with weeds and alders.

Most days he would round at the hospital, making social visits to the older patients who now had other, younger doctors' names on the door. He would joke with the older nurses, then go over to his office. There he'd see a few patients — blood pressure checks mostly — and then come home for lunch with Ethel, and tend his irises in the afternoon. The arrival of the mail was a big event in his day, but the mail held mostly advertisements for magazines he had never heard of and investment opportunities he hadn't the inclination or the money for. He had out-lived his usefulness and knew it, was no longer important, yet still wished to be — a McCormick Farmall forgotten in the field.

On one of these afternoons a car pulled in the drive. Out of it crawled old Nestor Tikkanen. Spying the doctor knelt among his irises, Nestor proceeded up the path in his peculiar way, elbows bent like a jogger, legs bowed out from the years, head quickly looking down at the path, then up at the doctor, then down again, like a chicken deciding upon a course of action. He might, in this manner, cover a city block in about three hours.

"You gonna enter them?" asked Nestor.

"Hi, Nestor," said the doctor. "What's up?"

"You puttin' your irises in the show this year?" asked Nestor.

"Haven't for years, Nestor. No sense to." The doctor resigned himself to playing the game, paying his dues in conversation before coming to the point of Nestor's visit. "I just do it for fun these days."

"Phyllis Teeples has got good ones," said Nestor. "Her boy stove up their pick-up, you know, but he ain't hurt. He's been out on compensation anyway. I ain't feeling too good."

"What's the matter?" the doctor asked Nestor. He stood up in the flower bed, wiped his hands on his trousers, and squinted against the sun at the old Finn.

"Worthless. No energy. Can't feed, can't milk. Don't care if the cows come in."

"Maybe you need some tests," said the doctor. "Don't you go to the group in town now? Have you talked to one of the doctors there?"

"Yeah, well I ain't going back there."

"I thought they were your doctors now, Nestor...after your heart attack, I mean," said the doctor.

"Doc, they don't even talk to you. Doctors don't talk to you any more. It's just tests, and more tests, and x-rays, and then the bill. Never say what's wrong, never say what the tests showed. Just these forms to fill out and then the bill and letters from the government. So I ain't going back there," said Nestor.

"You're my doctor, Doc," Nestor continued. "That is, if you'll take my case.

"I'll pay you," he added.

"Come on in the house, Nestor," said the doctor, leading him in and rolling his eyes at his wife on the porch.

" 'Lo, Ethel," said Nestor.

"Hi Nestor," said Ethel.

Inside, the summer coolness of the parlor enveloped them. The sun slanted through porch and window, diffused, dispersed. A grandfather clock ticked in the corner. The doctor sat his patient in a chair and sat opposite him.

"Let me see your hands," he said, taking Nestor's gnarled, arthritic hands in his own. He sat there wondering what he should do, where to start with this patient, and, for a moment, lost himself in a daydream.

There was a large medical ward fully occupied, filled with iron beds of chipped white enamel. Drapes separated bed from bed and at a table in the center of the ward, four patients played pinochle. The attending physician, tall, lean, patrician, with moustache and three-piece woolen suit led his group of students to the bedside. Three capped nurses quickly rose from the charting desk in abrupt attention and smiled to the senior physician, politely nodding to him. The students, seven men and one woman, stood in rapt attention. The attending, fingering his watch fob, lectured to them about the disease, then took the patient's hands in his own, showed them the coarse skin, the cool palms, the slow pulse. Shoving up his own sleeves and getting excited about the case himself, the physician tested the man's reflexes, asked the 'young lady' student to do the same, had them feel the man's coarse hair, and demonstrated to them his goiter. The students all nodded and smiled nervously to one another, and rushed back to the great library to read.

The doctor found, when he had awakened from his daydream, that he had completed his examination of the old Finn. He chuckled to himself, shook his head, and then spoke to his patient.

"I know what's wrong, Nestor. It's nothing serious. You have an under-active thyroid gland, that's all. You need thyroid for energy and your body isn't making enough of it. But you can take it in pill form and pretty soon, you'll be good as new."

"Goddammit, Doc," said Nestor. " I knew you could figure it out. I knew it. You're better than all the other doctors put together. Goddammit. What do I owe you, Doc?"

"Nestor, I'm the one should be paying you. This one's on the house. Thanks for calling on me." The doctor gave the old Finn the prescription for thyroid and walked him back to his car. On his return to the house, in a flood of nostalgia, he realized he had written the prescription with his left hand.

This story first appeared in MD magazine in different form.

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