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“Roger, it would be highly inappropriate. You’re the picture of health.” That was a lie, but I was trying to encourage him. At least he wasn’t fat. “In this state, assisted suicide is murder. Roger, I wouldn’t murder you under any circumstances.” That wasn’t true. I don’t think there was a doctor in our clinic who hadn’t dispatched someone to the happy hunting ground. Roger was weeping.

Send me to Diana.

“I can’t, Roger, and I won’t.”

“What about that woman you took care of? You seem to be able to help your old girlfriends, don’t you? Well, Doctor, I’m afraid I’m not one of those.” Roger got to his feet and, plucking a tissue from the box beside my examining table, turned to me with a transformed face, an expression of lofty annoyance. “You tin-pot sawbones. I’ll find someone who will do as I ask.”

“I’m terribly sorry…”

“Oh, no, you’re not. Let’s not part on that note.”

As he left, I heard him addressing people out in the hall. He would no longer support the clinic, he would put in a call to Washington, he would yield to the pressure of his lawyers, and so on. He was furious and probably knew that his wish for assisted suicide was wholly focused on the potions I might use to bring it about. He had really ruined his little wife, who was not a bad sort. She had a gesture of slinging her shoulders to get her hair off her face, something preserved from girlhood no doubt, since her hair had grown light as air. She arrived in our town, according to my father, full of gentle cultivation, only to be transformed into a dazed barfly by her husband, whom my father called “a vicious nonentity.” For good reason, Roger was friendless. “When he dies,” said my father, “they’ll have to screw him into the ground.”

Many of the problems I treated were related to overeating. Almost everyone these days was wholly focused on his or her stomach, what Dante called “that miserable sack that makes shit of what we eat.” I also got a good many women complaining of stress, and the stress often turned out to be the thug they’d married. Some of the women put up a good fight, but the effort took it out of them. The wife of a big-game hunter who came home from a bear hunt in Canada two months late, bringing by way of propitiation a Canadian souvenir, was told by this spunky woman to “take the little Mounty and shove it where the monkey hid the peanut.” This precipitated a battle wherein the bear hunter offered to cut off her head and defecate down her neck. After reciting each of these tales, she smiled, upper teeth resting on lower lip as if the smile had to lean on something to stay upright. She withstood these barrages, but in a matter of days she came in to see me, asking me for tranquilizers. I prescribed an SSRI instead and, as they are slow to work, gave her a pile of Xanax samples and advised her to stay half gaga until the SSRIs elevated her serotonin level. “I don’t suppose you’d consider dumping Big Boy, which would be best, so we’ll just medicate you so you can go on until the next catastrophe.” She said it was a beautiful bear and they were having it mounted.

On days like that, I saw this as a town spoiled by God’s displeasure.

But that never lasted and I came to love the sight of ordinary activity once again, the thing that had sustained me most of my life. When I had the Oldsmobile serviced, I spent time with the mechanics. I began to frequent the breakfast cafés again, even the clubby ones where the farmers and ranchers huddled like conspirators. In the happy years between the steam-cleaning service and the post office — that is, before my father lost his dream ground to foreclosure — we would make the short drive into town on our winding road through walls of chokecherry and hawthorn past bounding deer and the occasional bear to arrive just as the bicycles were wheeled out in front of their shop and awnings were cranked out, or the aged were taking their constitutionals and the flags were being raised and groggy children were heading out to their schools and the train could be heard down in the valley. Nowadays, experiences came at me like bugs hitting the windshield. I wasn’t sure I could keep up. Of all the mysteries of life, nothing was more mysterious than the return of happiness. I was willing to wait.

I drove a little over a mile outside town to the place my parents had lost. It may have been absorbed into larger property around it, but in any case the house was long abandoned. I pulled into the yard and got out of the car. Then I walked across the footbridge that replaced the creek ford of a century ago, carrying my drink and making a desultory effort to recognize the birds around me. I followed the trail through a small forest of aspens, the dense canopy only here and there revealing the bright clouds and blue sky just then taking on the scrim of evening. I finished my drink and left the glass beside the trail.

The creek turned sharply toward the north as I left the aspens and they followed its bank. This created a tiny meadow protected from all normal winds, and in this meadow stood the oldest cottonwood I knew of. I’d been visiting this tree all my life. I didn’t think it was unusual for children to hit upon a favorite tree, and I believed that this early affinity came from a memory of a time when trees could be sacred; I felt no need to shake off this conception. Perhaps it sheltered Crow people. There was something too about this tree as an aerial being held from beneath the ground by the grand starburst of roots, life and death, with the earth as the threshold between worlds. I’ve courted this state at times all my life — comparing bones to the stones around the tree, breath to the wind, eyes to sunlight, head to the moon, and so on. I’m not sure what I got out of it, but I have always found in nature something of a cosmic liturgy.

The old tree stood alone, but to the east a few strides away its seed-bearing flowers dispersed by insects and wind had created a forest of smaller trees. I sat at the base of the cottonwood, my back against its deeply furrowed gray bark, and looked up into the world of its branches toward its top, which might have been a hundred fifty feet away. The clouds of leaves and catkins blocked my view not far above my head; I knew that by midsummer fledgling birds would venture to the ends of its branches to begin their first attempts at flight, a skill that would take some to the sea, some to the pampas. Then all the leaves would float to earth and against a darker sky the somber outline of the great cottonwood would emerge and brace itself for the long winter; a willful crookedness of its limbs, defiant and imploring, suggested the long fight ahead. Here and there on our old place, one of these giants lay on its side, several tons of earth reared up around the tangled root ball, a few branches half a story high trying to live on. I used to hear them go down in windstorms all the way from the house and the abrupt subsidence, a welter of sounds, spoke certainly of the surrender of a great soul. It had been a long time since any of this was ours. I guess we couldn’t afford it.

The dispute with the board was finally resolved when Wilmot suddenly found other interests, something about a ski resort he’d invested in, and without his egging them on, the rest of the board slipped back into their customary status as airheads and boobs. Still, I found myself in bad odor with some of my colleagues for having continued to go to work as though there was no problem. That there turned out to be in fact no problem seemed to have little bearing on my situation, and so my discomfort was not alleviated. There was to be a staff meeting in the morning, and I think it was my dread of it that encouraged me to hook up with some old school chums and go on a bit of a bender at Pine Creek Lake. It was wonderfully just like high school. We had girls and a campfire, s’mores and an old M1 rifle to fire tracer shells into the night. One of my friends, a chiropractor from Miles City, was rolling blunts of high-octane BC bud, and I ended up sleeping in my Oldsmobile. Sad to say, I had to go straight to the dreaded staff meeting at the clinic, still half asleep, though not sleepy enough to relieve my apprehension at the sight of the reserve parking entirely occupied by the cars of doctors. My hair was filled with excelsior or some other packing material from a box of Christmas lights that had been in the backseat of the Olds for a couple of years, and it was clear that a number of the fastenings to my clothing had not made the trip back to town. I was late but I was also a doctor.