Dissection, p.7
Dissection, page 7
‘Will didn’t say anything to me about it. Was he hurt?’
‘He was upset, crying, but no, he hadn’t been hurt physically. I wanted to call you — he seemed quite distressed — but he said he didn’t want to bother you at work. He was quite adamant about it.’ Mrs Hammond looks at her pointedly.
‘I don’t know why he would say that.’
‘I suspect he was trying to protect you from something,’ the teacher says, shifting in her seat.
So this is what it’s about, this little tête-à-tête. Using my son to get to me, to get at me. ‘I don’t know what you mean,’ she says coldly.
‘My impression is that something was said in the playground — something unkind — and William reacted.’
‘Something unkind?’
Mrs Hammond looks uncomfortable. ‘Something about you, in particular.’
She suddenly understands. ‘About my court case, do you mean?’
‘Yes, I’m afraid so.’
It has followed me here, to this children’s playground, and found my son. She feels the blood drain from her face. As surreptitiously as she can, she grips the edge of the seat with both hands to steady herself. But surely she could have predicted this. If she had been thinking clearly, thinking of her son instead of herself, she might have taken preventive action. The trial has been in all the newspapers, will have been discussed at the dinner table of many a family in the neighbourhood. Everyone — those who know her well, even those who know her only well enough to greet her briefly at the school fence, or point her out to others when her back is turned — will feel entitled to their opinion. And of course they are entitled: it is a public matter, a civil matter, after all — though a shiver travels along her spine when she thinks of her name spoken, her actions dissected by those who stand behind her in the supermarket queue. If she put her ear to the pavements of this suburb, would she hear the whispering? As she walks her children home from school do the telephone wires above her hum with her name? She can easily imagine what children might make of those overheard conversations: someone’s leg was cut off. They probably have her wielding the saw. Your mother cut off a boy’s leg: that is how William would have heard it. My dad says she is a bad doctor. A witch doctor, perhaps: do children know of such things these days? She pretends she’s a doctor but she’s really a witch.
‘Who was it?’ she asks. ‘Who said this to William?’
Mrs Hammond sighs and names the child. ‘Please remember, we don’t know exactly what happened. I’ve already spoken to the boy, given him a warning. Maybe we should leave it there, for William’s sake.’
Mrs Hammond is right. She recognises the boy’s name. He is one of the school troublemakers: not the sort of child who will respond well to punishment, much less an appeal to his better instincts. Although, at this moment, she wants to grab the boy by the arm — by the scruff of his neck and push him up against a wall— it will be better for William, better for her, too, that she plays the incident down. It’s not fair, she wants to protest to Mrs Hammond, who sits there, watching her over her glasses, her ample hips squeezed into the ridiculously small chair. She wants to stride across the room, throw open the window and shout across the empty asphalted yard: Leave my son alone. It has nothing to do with him.
There is a knock at the classroom door. She turns to see Joe at the window, smiling impishly. Behind him stands William, white-faced, anxious. She nods and tries to smile reassuringly but he scowls at her and turns away. Does he know what this meeting is about? He has not asked why she was coming in today, but of course that means nothing. He is only ten years old. She is washed out, close to tears. My eldest son, my defender. My poor little boy.
‘I must go. The boys have swimming lessons now.’ She stands, stiffly. Her legs feel lifeless, unstable. ‘I’ll speak to William tonight about … everything. Thank you for letting me know.’
‘He’s a lovely boy,’ Mrs Hammond says again, standing, too, and smoothing her skirt. She waves through the glass at William. He does not wave back. ‘A sensitive, intelligent boy. I wanted to mention: we have a school psychologist who visits once a week — if you wanted William to see her.’
She bristles. ‘See her? For counselling, you mean? I’m not sure that’s needed at this point.’
Mrs Hammond stands her ground. ‘I understand it’s been a difficult time — for you and your family. Whatever we can do to help.’ She pauses expectantly, her face composed into an earnest, enquiring expression. Let’s get to the bottom of this, her expression reads. Let’s get things out in the open, shall we? Enquiring or inquisitive?
Do not use your teacherly ways on me, she thinks. Do not patronise me. ‘I appreciate your concern,’ she answers, as if to end the matter, ‘but I am sure we can manage.’ She starts to move away, afraid that Mrs Hammond might put a hand on her arm or, worse still, attempt to hug her.
At the door she turns back. ‘Just for future reference, I am always — have always been — happy for the school to contact me at work. I would never …’ She trails off. Whatever it was she was about to say — she is not quite sure herself — she cannot finish. She shrugs her shoulders and leaves, closing the door behind her.
April 14
Sophie tells her that she has consulted a naturopath for a breastfeeding problem. The naturopath has diagnosed the condition as candidiasis. ‘If she can’t fix it I will have to stop breastfeeding,’ Sophie says. ‘The pain is driving me crazy.’
She is surprised, even a little insulted, that Sophie has not asked her advice. Of course she does not want to treat her sister. Nevertheless, she might have advised her in general terms. Instead Sophie has transferred her problem from one paradigm to another, from Western medicine to that of alternative health. She understands that this is happening all the time, that many of her own patients also consult alternative health practitioners, that the complementary health industry is burgeoning — but that her sister would see a naturopath instead of a GP.
When she graduated from medical school, Sophie, then seventeen, gave her a boxed coffee mug decorated with the words: Congratulations! You’ve made it! The next year, during her country-hospital rotation, Sophie travelled by train to stay for a week in her poky hospital flat. Doesn’t Sophie remember those nights she was on call? Didn’t Sophie stir at the sound of the telephone, wake just long enough to glance at the clock each time she left her bed to go to the wards? The things she did on those wards at night. She had been a doctor for only six months. During the week Sophie stayed she performed a lumbar puncture, her first unsupervised, on a febrile infant who had just had a seizure. The emergency-room nurse held the small body still, tucking the child’s head into his drawn-up knees so that the tiny vertebrae, like knuckles, curved out towards her. The old man with terminal heart failure whose stuttering, suffocating death she intruded upon each time she entered his room to give him a little more morphine. A little more, no more. He had once been the town mayor. His son, the local policeman, had cried at the bedside as he held his dead father’s hand. Over breakfast, didn’t she tell Sophie of her nocturnal duties? But perhaps she had been too tired to talk. Perhaps Sophie had not been ready to listen.
Sophie argues that GPs do not give her enough time. She tells Sophie to stop visiting extended-hours, bulk-billing clinics where inexperienced doctors are under pressure to push patients through. Really, she is annoyed by Sophie’s double standards. While her sister complains about the quality of care she receives from a bulk-billing clinic, she is willing to pay for a forty-minute consultation with a naturopath. It is more and more a case of attaching value to something one has paid for and devaluing something one receives for free.
For five years before joining David and Rohan, she worked in a community health centre in a working-class area of the city. One evening a week, as part of her job, she saw patients at an outreach clinic; a converted shopfront in a down-at-heel shopping strip where the streetlights were often broken and the walls were splattered with graffiti of an artless and angry kind. Most of the time spent there she patched up social problems: drug use, alcoholism, depression — the ravages of long-term unemployment. Being a salaried government employee, she knew nothing of the costs of providing care: all she need do was ensure that each patient signed their Medicare form. Whether patients valued their care or not was all one to her then.
It is only since entering private practice in a more affluent suburb that she has begun to question her value. Despite the given wisdom that all patients deserve equal access and equal care — and philosophically, intellectually she adheres to this — she realises she makes a distinction between those who pay and those who do not. It is not rewarding, rather it is burdensome to see paying patients. She feels an extra pressure to perform, to provide value, once money has entered the equation. She spends longer with these patients, longer than she should, sits acquiescent as they bring out their checklists, and still feels she has not done enough. She is especially uncomfortable with seeing the children of paying parents, these children in their private-school uniforms who regard her coolly, who, she imagines, are asked by their parent on exiting the clinic: Did you like that doctor? Should we go back to her?
The concept of general practice as small business sits uneasily with her; that her skills are a commodity to which a monetary value is attached still seems, after eleven years in private practice, a little grubby. Paul has told her to be realistic. She is providing a valuable service and that, after all those years of medical training, she should in fact be charging more. And when the dishwasher repairman arrives at the house, demanding, somewhat rudely, a hundred dollars to set foot in the door, she can see Paul’s point. She cannot help but compare the service provided by the dishwasher repairman to that which she provides. Though, it must be said, the dishwasher man will leave with the dishwasher fixed, in running order. When it comes to her patients, she cannot always make such a claim.
The government pays her fifty-three dollars for a standard home visit; eighty-two for a longer one. Of course she is at liberty to charge what she likes, but most home visits are to elderly pensioners. She imagines Betty Cohn in her stained cardigan, or bony Celia Duffy with her colostomy bag, fumbling in their purses for a tightly folded hundred-dollar bill while she waits with palm outstretched. Grubby, very grubby. That is surely not what medicine is about. But increasingly it is. Whether or not to charge for one’s services is really no longer a philosophical or political question, rather it has become a question of survival. In the context of practising good medicine, universal bulk-billing is unsustainable. She knows this to be true. She has done the mental arithmetic repeatedly. But it is tiring and annoying and still somewhat demeaning that she has to factor money into her work.
Can she honestly say that money has never been a driving force in her life, despite the community stereotype, the fallback position of politicians: that doctors are greedy and self-serving? She wants to be able to say it. Her parents, both teachers in government schools, were motivated by intellectual rigour and a desire to do good. She believes she has absorbed these values so completely that the thought of being affluent seems almost immoral. She can see, now, how her parents’ values were so clearly reflected in her career choice, although at the time of choosing, at the age of seventeen, she would have resisted the notion of parental influence. But she was not, at that unformed age, resistant to the notion of doing good. I want to work with people, to help people, she would say, when asked about her reasons for selecting medicine. She was not alone in this: many of her peers, especially the young women, gave this as their reason, too. And what else could they say? I chose it for the prestige, for the comfortable living it will afford me. When they had opted for a caring profession, how could they give expression to such calculating ambition, even if it were true? When she asks herself now, as she often does, why she chose the way she did, the answer comes back as a question: What did you know, an unformed seventeen-year-old, about choice? But still she clings to the notion that, at a time in her youth, a time that can be reduced again and again, from a nebulous swirl of influences and experiences that began in utero, reduced down to one decisive moment, perhaps the moment she entered the number ‘1’ — a single, vertical stroke of the pen — against the word ‘medicine’ on the university application form: at that moment of choosing, she chose to do good.
But what use is it, this talk of good? She no longer knows the meaning of the word. It is an outdated word, stripped of its status as an abstract noun, now relegated to an insipid adjective, fast becoming an insipid adverb. Better to say she wanted to help; less lofty, more practical to help than to do good. In the scheme of things, she wants to be able to say that she chose to help. In preference to what? To standing by and doing nothing? To hindering? Being helped? Are these the choices she turned her back on? Would it have been better to choose neutrality or passivity? After what has happened, she can now say: yes, it would have been better to have chosen otherwise. Better for her and her patients. But increasingly she feels she must hold onto the notion of her seventeen-year-old self choosing to do good, even though she knows this to be a sentimental fancy, even though she knows the concepts of choice and goodness contained within her notion will not hold up to scrutiny of any kind, that she is incapable of defending them. Yet, if she does not cling to this one idea — this imperfect, hollow plank, torn from the sinking vessel — what, then, is there left to cling to?
In the evenings, when Paul is watching The 7.30 Report or Four Corners, she looks at him and wonders what it is that keeps them together. He must sometimes think the same about her. It is not that she feels they no longer have anything in common, or that they have drifted apart because of lack of interest. She would like to think they were less predictable than that. Her reflections are based more in the general than the specific. It is the nature of long-term relationships in general that she questions.
She usually brings a basket of washing into the room to fold while she watches television. She sits on the sofa with the basket at her feet and puts the washing on the floor in piles, one for each family member. She does not ask him to help her, but often, without a word, he will start taking clothes from the basket and folding them, his eyes still on the television screen. He takes a particular interest in matching the socks. Sometimes, when she looks at the folded socks piled between them on the sofa, the odd ones draped over the side of the basket (he matches them but does not know whose they are, apart from his own), she is struck by how far they have come.
When she met him all those years ago, at a student party, she had first thought him an artist. It might have been his long hair, falling over his eyes, or the angle at which he leaned against the wall in that Carlton terrace, as if he were aware of the line of his body, the figure he cut in the narrow hallway. Such self-awareness she might have construed as conceit in other men, but not in him. He was a final-year architecture student, he told her: an artist of sorts. She had worn her party dress that night — a vintage dress of red roses, with a square-cut neck and a fitted waist. Perhaps it had made her seem braver than she felt.
They were so young! Where did it go, their youth? Forfeited, nibbled away in daily, hourly increments. And with it, their hard-edged idealism, softened and yielded to the capacity for compromise. Their youth is gone, but, in its place, they have gained the skill of compromise. It is hardly a fair trade. They have also learned to read each other’s minds. She had once believed this to be a good thing, a sign of their like-mindedness. She would have even gone so far as to say they were made for each other. But if recent experience has taught her anything, it is that she can no longer simply accept things as given; that the paradigm can shift as quickly, as treacherously as desert sand, so that north becomes south, good becomes harm. Like the gradually coinciding menstrual cycles of women who live together, their telepathy might be explained away by geography and routine: shared roof, shared mortgage, shared childcare, shared chores. She, despite her scientific view of the world, was once moved enough to believe in destiny and affinity. Now, in a world that makes less and less sense, she scrabbles in the dirt for rational explanations.
April 16
She visits a periodontist at his sleek rooms in the city. He deftly probes each of her teeth, calling out a number every time to his nurse, who writes them down on a card. ‘You have moderately severe periodontitis,’ he tells her when he has finished. ‘You’ll need gum surgery to slow the advancement of the disease. Even so, with the very best care, you’re likely — almost certain — to lose one or two teeth.’
She hears his words and understands he is going through his patter — X-rays, review appointments, payment plans — but she can take none of it in. ‘How long have I had this problem?’
‘It’s difficult to say. Most people have chronic disease over years, but some — a few — have a more rapidly advancing form. At this stage I can’t say definitively which category you fall into.’
‘But it’s likely to have been present for a couple of years, at least?’ Is she putting words into his mouth? If so, let him be the one to reject them.
The periodontist glances swiftly at his watch; she is detaining him with her questions but she does not care.
‘A couple of years — yes, most likely.’
‘And my dentist should have informed me of it? And commenced treatment?’
‘Yes, if he or she had detected it. We’ve known how to diagnose and treat periodontitis for twenty years now — dentists included.’
Brian Leonard had been of the old school: superficially charming, urbane. He called her ‘gorgeous’ and tickled her under the chin as she sat in the chair, continuing this practice unabashed until she was well into her teens. He was an out-and-out flirt, a soft-skinned ladies’ man, manicured and scented, his dark, wavy hair becoming ever more streaked with silver over the years. She remembers how her mother, his contemporary, would laugh and blush at his comments, delivered with a suggestive smile, a flash of his square white teeth (all capped, she now thinks: those teeth were too white, too regular). As a child she was fascinated by the large signet ring, studded with a red stone, on his little finger and the heavy gold chain bracelet that slid up and down his bare forearm as he worked. No other men she knew wore jewellery. He must have been only thirty when she first visited him, yet how experienced he seemed to her then; experienced and self-assured. He never explained, never educated. Leave it to me, his manner implied. I am the professional here. He did not encourage prevention: he did not even show her how to floss. Why, then, did she put up with it — his patronising manner, his sexist remarks — for so many years, when all such traits had become unacceptable in her profession? Because he was of the old school and she forgave him for it. She tolerated his behaviour because he and his fusty waiting room with its tattered children’s annuals and humming fish tank were, for better or worse, a part of her childhood. She had first encountered him when she was willing to believe in the infallibility of adults. Her mother had delivered her to him. For these reasons she continued to let him get away with it.
