* * *
Pat has a hard job. Our office of six surgeons is in Children’s Hospital in Oakland. Every day each surgeon has a packed schedule. Also every day some get canceled, others put in their place and several emergencies added as well. One of our doctors is on call every day for the emergency room. All kinds of traumas, chopped-off fingers, aspirated peanuts, gunshot wounds, appendixes, burns, so there can be six or eight surprise surgeries a day.
Almost all of the patients are Medi-Cal and many are illegal aliens and don’t even have that, so none of our doctors are in this for the money. It’s an exhausting job for the office staff too. I work ten-hour days a lot. The surgeons are all different and for different reasons can be a pain in the butt sometimes. But even though we complain we respect them, are proud of them too, and we get a sense that we help. It is a rewarding job, not like working in a regular office. It has for sure changed the way I see things.
I have always been a cynical person. When I first started working here I thought it was a huge waste of taxpayers’ money to do ten, twelve surgeries on crack babies with weird anomalies just so they could be alive and disabled after a year spent in a hospital, then moved from one foster home to another. So many without mothers, much less fathers. Most of the foster parents are really great but some are scary. So many children who are disabled or with brain damage, patients who will never be more than a few years old. Many patients with Down’s syndrome. I thought that I could never keep a child like that.
Now I open the door to the waiting room and Toby who is all distorted and shaky, Toby who can’t talk, is there. Toby who pees and shits into bags, who eats through a hole in his stomach. Toby comes to hug me, laughing, arms open. It’s as if these kids are the result of a glitch God made answering prayers. All those mothers who don’t want their children to grow up, who pray that their child will love them forever. Those answered prayers got sent down as Tobys.
For sure Tobys can crack up a marriage or a family, but when they don’t it seems to have the reverse effect. It brings out the deepest good and bad feelings and the strengths and dignity that otherwise a man and a woman would never have seen in themselves or the other. It seems to me that each joy is savored more, that commitment has a deeper dimension. I don’t think I’m romanticizing either. I study them hard, because I saw those qualities and they surprised me. I’ve seen several couples divorce. It seemed inevitable. There was the martyr parent or the slacking parent, the blamer, the why-me or the guilty one, the drinker or the crier. I’ve seen siblings act out from resentment, cause even more havoc and anger and guilt. But much more often I have seen the marriage and the family grow closer, better. Everybody learns to deal, has to help, has to be honest and say it sucks. Everybody has to laugh, everybody has to feel grateful when whatever else the child can’t do he can kiss the hand that brushes his hair.
I don’t like Diane Arbus. When I was a kid in Texas there were freak shows and even then I hated the way people would point at the freaks and laugh at them. But I was fascinated too. I loved the man with no arms who typed with his toes. But it wasn’t the no arms that I liked. It was that he really wrote, all day. He was seriously writing something, liking what he was writing.
I admit it is pretty fascinating when the women bring in Jay for a pre-op with Dr. Rook. Everything is bizarre. They are midgets. They look like sisters, maybe they are, they are very tiny and plump with rosy cheeks and curly hair, turned-up noses and big smiles. They are lovers, stroke each other and kiss and fondle with no embarrassment. They had adopted Jay, a dwarf baby, with multiple, serious problems. Their social worker, who is, well, gigantic, has come with them, to carry him and his little oxygen tank and diaper bag. The mothers each carry a stool, like a milking stool, and sit on the little stools in the exam rooms talking about Jay and how much better he is, he can focus now, recognizes them. Dr. Rook is going to do a gastrostomy on him so he can be fed by a tube through an opening in his stomach.
He is an alert but calm baby, not especially small but with a huge deformed head. The women love to talk about him, willingly tell us how they carry him between them, how they bathe him and care for him. Pretty soon he’d need a helmet when he crawled because their furniture was only a foot or so high. They had named him Jay because it was close to joy, and he brought them so much joy.
I am going out the door to get some paper tape. He is allergic to tape. Look back and see the two mothers on tiptoes looking up at Jay, who is on his stomach on the exam table. He is smiling at them, they at him. The social worker and Dr. Rook are smiling at each other.
“That is the sweetest thing I ever saw,” I say to Karma.
“Poor things. They’re happy now. But he may only have a few more years, if that,” she says.
“Worth it. Even if they had today and no more. It’s still worth all the pain later. Karma, their tears will be sweet.” I surprised myself saying this, but I meant it. I was learning about the labor of love.
Dr. Rook’s husband calls her patients river babies, which makes her furious. He said that’s what people used to call such babies in Mississippi. He is a surgeon with us too. He somehow manages to get almost all the surgeries with real insurance like Blue Cross. Dr. Rook gets most of the disabled or totally nonfunctioning children, but not just because she is a good surgeon. She listens to the families, cares about them, so she gets a lot of referrals.
Today there is one after another. The children are mostly older and heavy. Dead weight. I have to lift them, then hold them down while she removes the old button and puts in a new one. Most of them can’t cry. You can tell it must really hurt but there are just tears falling sideways into their ears and this awful unworldly creaking, like a rusty gate, from deep inside.
The last patient is so cool. Not the patient, but what she does. A pretty red-faced newborn girl with six fingers on each hand. People always joke when babies are born about making sure it has five fingers and five toes. It’s more common than I thought. Usually the doctors schedule them for an in-and-out surgery. This baby is only a few days old. Dr. Rook asks me for Xylocaine and a needle and some catgut. She deadens the area around the finger and then she ties a tight knot at the base of each extra little finger. She gives them some liquid Tylenol in case the baby seems to be hurting later, tells them not to touch it, that pretty soon, like a navel, the finger would turn black and fall off. She said her father had been a doctor in a small town in Alabama, that she had watched him do that.
Once, Dr. Kelly had seen a little boy who had six fingers on each hand. His parents really wanted the surgery but the child didn’t. He was six or seven years old, a cute kid.
“No! I want them! They’re mine! I want to keep them!”
I thought old Dr. Kelly might reason with the boy, but instead he told the parents that it seemed to him the child wanted to continue having this distinction.
“Why not?” he said. The parents couldn’t believe he was saying this. He told the parents that if the boy changed his mind then they could do it. Of course, the younger the better.
“I like how he sticks up for his rights. Put her there, son,” and he shook the kid’s hand. They left, the parents furious, cursing at him, the child grinning.
Will he always feel this way? What if he plays the piano? Will it be too late if or when he changes his mind? Why not six fingers? They are weird anyway and so are toes, hair, ears. I wish we had tails, myself.
I am daydreaming about having a tail or leaves instead of hair, cleaning and restocking the exam rooms for the night when I hear a banging on the door. Dr. Rook had gone and I was the only one there. I unlock the door and let in Amelia and Jesus. She is crying, shivering as she speaks. His hernia is out and she can’t push it in.