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Volume 2, Issue 1
Spring 2006:

A Chance Pregnancy

Michael A. LaCombe

Cell 2 Soul. 2006 Spring; 2(1):a15

There is a time of day when the hospital itself sleeps, a time when nurses begin to whisper, when the strident paging is still, and even the babies are quiet. It is the time of comfortable settling in, as the hospital hushes its hive-like self to minimum hum. And for the doctor there is foreignness about this calm. Buffeted by conflicting demands, never permitted to finish one task well, the doctor is unsettled by this sudden ease. It shouldn't, he knows, be this way.

It is late. He should be home. He should be fathering. But his children sleep. Then he should play husband. But his wife will be tired and ready for sleep herself. Then he should read. He should catch up on his journals. He shouldn't need sleep. He should be able to endure anything, he should never feel tired, should always be filled with energy, and with the excitement of medicine.

He should love his patients, every one, should always be generous and understanding, should always be eager for the next consultation and its intellectual challenge. He should be all-knowing, well-read, well-rounded, academic — the perfect Renaissance man.

And so he is. He is a doctor after all — he has permission, an entitlement — and so believes he is all these things.

But he is not perfect, he readily admits from his humble position of supreme modesty. And he allows from his core a faint burn of resentment as he reads his day's last demand: a request for preoperative evaluation of a 96-year-old woman.

Because he is insightful (supremely so) and fully understands himself (completely so), he should not, will not, be troubled by this final intrusion. His anger, he knows now with perfect clarity, must be directed at the surgeon who would operate on one so ancient.

Very well. He will examine this body lacking any comprehension, this once-human repugnant with age. Because he has taken an oath, has been certified and recertified, because he holds the pedagogue's integrity, there will be no shortcuts here.

He enters the close, still darkness of her room. There is the soft glow of the night light, a smell of narcissus mixed with the scent of antiseptic solution. The drapes are parted and on the windowsill he sees the nodding paperwhites next to a stack of books. On the tray table at bedside there is a tumbler of water, a glasses case, a copy of Antaeus, and a magnifying glass. The bed contains a rumpled ball of bedclothes, too small to contain a human body certainly, and from which comes the musty smell of age. Holding his black bag in one hand and the patient's hospital chart next to his chest with the other, he pauses to take in this scene, when the rumpled ball speaks to him.

"Why Doctor! Yours is a face of Stygian gloom."

Startled by the sudden coherence, he answers, "I beg your pardon?"

"What have you been up to that you must beg my pardon?" she asks, laughing.

Almost midnight, he thinks; must he endure this wit? He settles down to business. He will start with a social history, he decides, and pulls a chair to the bedside. And in this way he begins yet another tedious workup — but perhaps there will be a curious murmur or some intriguing endocrinopathy, and that might prove interesting after all. And the night will not have been a total loss.

"How far did you go in your schooling?" he asks. He has in his voice a hint of the routine, and of condescension. He watches her reach for the thick glasses, watches her slowly put them on — first to one ear, and then turning her head, she hooks the other — now peering at him in the darkness. She smiles and drops her eyes.

"It may surprise you, Doctor, to know," she answers, "that I never went past primary school."

"That does surprise me. You are...well spoken." He feels himself getting involved — more than he should. He cannot help himself.

"I had a wonderful grandmother," the old woman continues. "You see, I had tuberculosis as a child and so they gave up on me. No sense wasting schooling on me. But my grandmother didn't give up on me. She sat out with me in the sun — it was believed in those days that sunshine was good for people with consumption. Do they still believe that? She sat with me in the sun and we read."

The doctor shifts in his chair impatiently. He has promises to keep and has no time for the adventures of a 19th-century Nancy Drew. He will ask her about prior hospitalizations, prior illnesses.

"Yes, we read a great deal," she continues. "We, my grandmother and I, read all of Thackeray, for one. Oh, forty percent of him isn't any good, but the most of him is priceless!"

She becomes animated, fixing her hair, straightening the bedclothes just so, darting quick glances his way. He had asked, after all.

"Have you read Thackeray, Doctor?" she asks.

He pauses. He had read something, but he couldn't remember just what...or whether it was even by Thackeray. It had probably been just a plot summary, undoubtedly something read for grades during that mad, headlong rush to medical school. But he cannot tell her that. He cannot confess, not even to this ancient woman. He should have read Thackeray. He would read Thackeray soon. He made a mental note to do that.

"No, I guess not," he answers. "We were all very busy with the sciences, of course."

"Of course. But...not even Vanity Fair, Doctor?"

The woman wouldn't give it up! "Vanity Fair is Bunyan, I think," he parries.

"No, no Doctor!" she giggles. "Christian passed through Vanity Fair on his way to Salvation in Bunyan's Pilgrim's Progress, but Vanity Fair, the novel, is most certainly Thackeray. You never met Becky Sharp?" she teases.

"Becky Sharp?" The doctor shifts again. The whole encounter is becoming painful.

"She's Thackeray's unforgettable whore, Doctor. You really must read Vanity Fair that is, if you haven't as yet. Such a fine exposition of man's egotism and infinite capacity for self-delusion."

The doctor looks up quickly at his patient. Had there been a message there for him? Her serene, wrinkled face holds her bright eyes, blue and innocent. In all of her wrinkles he can find no trace of guile.

"You really enjoyed that book, didn't you?"

"Enjoyed it? I lived it, Doctor. I lived all the books! How else could an infirm girl plot and pillage, murder, and burn at the stake, all in one day?

"Still, there are gaps in my knowledge, tremendous gaps, I know," she confesses.

The doctor leans forward toward her, hands clasped between his knees. He sighs, starts to speak, stops, then starts again. He has reached the edge of the path when the risk seems suddenly worth it, or when there is no risk at all.

"I'll tell you something. There are gaps...tremendous gaps...in my knowledge as well."

"I can't believe it," she says with all sincerity. "You are a doctor, after all."

"Well, I didn't mean gaps in medical knowledge." He begins to back and fill. "Although yes, I guess in medicine too. One can't know everything, I guess." (Why had that been so difficult to say?)

"But you know, I never read a darn thing other than medical journals these days. Can you believe it?"

"You're terribly busy," she soothes, "and you didn't have my grandmother. But you are a young man, Doctor. There's time. There's time. Make time."

"It's a terrible thing to say," he answers, "but I wouldn't know where to begin. I read book reviews. I make lists of books. I buy books. But I never read them. There just isn't time."

"Begin, Doctor," she whispers, "begin with Becky Sharp. You'll simply love her!"

He leans back against the chair, crosses his arms, and looks out the window into the night. It has begun to snow. The flakes, like down, sift quietly through the spruce. He feels a sense of sanctuary. There is no longer the urgency to flee. And then the insight comes as a wolf against the snow — at the one moment, nothing, and in the next, it is there, catching your breath with its truth. He sees the reason in priorities, the naturalness of the relative importance of things. He holds a newly focused sense of what is vital, and what is not. He looks at the old woman, and then out again at the snowfall. He wants to preserve this moment, photograph and frame it. But even as he holds fast to his truth, he feels it steal away.

It will slip away. These insights always do. It will be lost to him, to remain only as a pause, a thought, a sense of déjà vu. But it will lie within him like a seed, a kernel of life planted there by the old woman. And one day this chance pregnancy might still deliver him.

Now, his mind washed clean of trivialities, he moves to her without pretense.

"You know," he says, "you are the most remarkable woman I have ever met."

"Oh Doctor," she answers. "I'll bet you say that to all the girls."

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