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“I don’t want to leave you with a false impression,” Holmer Toibb said.

“No,” Dorothy said.

“You’d have to undergo an evaluation.”

“Of course.”

“A medical evaluation.”

“You’re the doctor,” Dorothy said.

“I’m not a doctor,” Holmer Toibb said. “I’m not even a Ph.D. You have to see a physician, someone to do a work-up on you before I’d consent to treat you.”

“Specimens? Needles?”

“Well,” Toibb said, “whatever it takes to give you a clean bill of health.”

Mrs. Bliss looked concerned.

“What?” Toibb said.

“Nothing,” said Mrs. Ted Bliss, “it’s just. You know something, Doctor?”

“I’m not a doctor.”

“What do I call you you’re not a doctor?”

“Holmer. My first name is Holmer.”

“I can’t call you your first name. I won’t call you anything.”

“Suits me,” said Holmer Toibb. “So what were you going to tell me?”

“Oh,” said Dorothy, “Ted, my husband, may he rest, took care of all of the paperwork. Medicare, supplemental, Blue Cross, Blue Shield — all the forms. The year he lost his life even. You know something, I haven’t seen a doctor since. Isn’t that crazy? It ain’t just the forms. I can’t look at them.”

“Here,” Toibb said, “use these. Please don’t cry, Mrs. Bliss.”

She was crying because, in a way, it was the last straw. What was she, stupid? Frank and Maxine had shpilkes to get home, out of Florida, away from her. To ease their consciences they dumped her with Manny from the building. Speaking personally, she liked him. Manny was a nice man. Generous, a lovely neighbor. She needed him and he always tried to be there for her as they said nowadays, but you know what? He was a clown, Manny. He was putting on a show. Perhaps for Mrs. Bliss, or other people in the building, maybe even for God. But a show was a show and anyway every time Manny did something nice for her, every single time, Dorothy felt like someone too poor to buy her own being offered a Thanksgiving turkey. So of course, overwhelmed as she was by the prospect of paperwork, official forms for the government, and the supplemental insurance gonifs, of course she was crying.

“Mrs. Bliss,” Holmer Toibb said.

“I’m not Mrs. Bliss.”

“You’re not?”

“You’re not a doctor, my husband is dead, I’m not a Mrs.”

“Please,” he said, “please Mrs. Bliss, all right, I’ll see you. If you want me to see you I’ll see you.”

That was their first appointment.

“Just out of curiosity, Doctor,” she said, and this time he didn’t correct her, “just out of curiosity, I don’t look healthy?”

“I’m sorry?”

“I look frail? My color is bad?”

“That’s not what I said, Mrs. Bliss.” And this time she didn’t correct him either. “I’ve no expertise in these matters. It’s something else entirely. I don’t treat people if there’s a chemical imbalance. If they’re bipolar personalities, or suffer various mental disorders. I thought you understood that.”

“I was a little worried.”

“Well,” Toibb said, “worried. If you were only worried. Worried’s a good sign.”

“Well, when you said…”

“I have to be sure,” Toibb said. “Only if they’re at loose ends, sixes and sevens. Only if they have the blues or feel genuinely sorry for themselves. Otherwise…” He left the rest of his sentence unfinished.

Mrs. Bliss wasn’t sure either of them understood a single word of what the other was saying, but she felt oddly buoyed, even a little intoxicated by the sense she had that she was adrift in difficult waters. For all the times she had gone on picnics with Ted and the children to the Point on Lake Michigan, or out to the Dunes, for all the summers they’d been to resorts in Michigan City, Indiana, with their Olympic-size pools, or even, for that matter, to the one on the roof of the Towers building in which she lived, Mrs. Bliss had never learned to swim. She had taken lessons from lifeguards in the shallow ends of a dozen pools but without the aid of a life preserver she couldn’t manage even to float. Though water excited her, its mysterious, incongruous clarity and weight, its invisible powers of erosion and incubation — all its wondrous displacements. This was a little like that. The times, for example, Mrs. Bliss, giddy, alarmed, suspended in inner tubes suspended in life jackets, hovered in the deep end weightless in water, her head and body unknown yards and feet above drowning. This conversation was a little like that. She felt at once interested and threatened, its odd cryptic quality vaguely reminiscent of the times her Maxine or her Frank or her Marvin were home on vacation trying to explain to her the deep things they had learned in their colleges.

“…like the collapse of arteries under a heart attack,” Holmer Toibb said. “The heart muscle tries to compensate by prying open collateral vessels. That’s what we’ll work on. It’s what this therapy is all about — a collateralization of interests.”

“What heart attack?” asked Mrs. Bliss, alarmed.

“Oh, no,” Toibb said, “it’s an analogy.”

“You said heart attack.”

“It was only an example.”

There was little history of heart attacks in Mrs. Bliss’s family. What generally got them was cancer, some of the slower neuropathies. (Despite her sealed ear, Mrs. Bliss’s deafness was largely due to a progressive nerve disorder of the inner ear, a sort of auditory glaucoma.) Yet it was heart disease of which she was most frightened. It was her experience that things broke down. Lightbulbs burned out, the most expensive appliances went on the fritz. Washers and dryers, ranges, refrigerators, radios, cars. No matter how carefully one obeyed the directions in the service manuals, everything came fatally flawed. How many times had she sent back improperly prepared fish in restaurants, how many times were her own roasts underdone, the soup too salty? You watered the plants, careful to give them just the right amount, not too much and not too little, moving them from window to window for the best sun, yet leaves yellowed and fell off and the plant died. Because there was poison even in a rose. So how, wondered Mrs. Bliss, could a heart not fail? A muscle, wound and set to ticking even in the womb. How should it endure its first birthday, its tenth, and twentieth? And how, even after you subtracted those two or three years that the man in Immigration tacked on, could it not be winding down after seventy or so had passed? How could a little muscle of tissue and blood, less substantial than the heavy, solid, working metal parts in a courthouse clock, that you couldn’t see, and couldn’t feel until it was already coming apart in your chest, hold up to the wear and tear of just staying alive for more than seventy years of even a happy life? It was like the veiled mystery of the invisible depths between herself and her death in the water of a swimming pool.

He wanted to see her again later that same week, he told her, and sent her home with an assignment but, so far as Dorothy could tell, without starting her in on her therapy.

“Tell me,” Holmer Toibb said the next time she came, “what name is on your mailbox?” It was the first real question he’d ever asked her, and Mrs. Bliss, who thought it was for purposes of billing, which, since this was the third or fourth time they’d seen each other and he still hadn’t started to treat her, she rather resented. In fact, she was still stung by his heart attack remark.