I turned to study the living room. Virtually nowhere were any personal touches. I drifted over to look at the framed diploma on the wall.
C. Agustin Ruiz, the name read. Above it, in larger letters, were the words Columbia University, College of Physicians and Surgeons.
“Holy shit,” I said, unable to censor myself in time. The heavy paper clearly marked the certificate as nothing you could make with a home-computer word-processing program. This guy was bona fide.
“Something wrong?” Cisco said.
“That’s a good school, isn’t it?” I asked.
He turned to see me looking at his diploma. “Most people would say so,” he said. “Didn’t I tell you to take off your shirt?”
I pulled my shiny pink sleeveless top over my head and sat down on the table, feeling self-conscious in a black half-cup bra. With my hands at my sides, resting on the edge of the exam table, I noticed something about the material underneath. It was cloth-covered, rounded, and cream-colored.
“Is this a massage table?” I asked Cisco, who’d come near to take a few objects from his footlocker.
“You must have made a wrong turn on the way to Cedars-Sinai,” he said dryly.
Some bedside manner, I thought. But he was right.
Cisco rolled to the side of the exam table and turned on the overhead light with an in-line switch in the cord. A stethoscope was draped around his neck, a blood pressure cuff in his lap. He held a yellow legal pad on his lap.
“Are you going to take notes?” I asked.
“All doctors do,” Cisco said. “What’s your name?”
I tensed. Cisco noticed it. “We can do this AA style, if you like,” he said. “First name and last initial.”
“Sarah P.,” I said.
“What do you do for a living?” he asked.
I gave him a dry stare ringed heavily with black eyeliner.
Cisco licked his teeth speculatively. “Right,” he said. “Are you taking any medications currently?”
“No,” I said.
“Do you use?”
“Use what?” I knew what he meant, but felt like giving him a hard time, like Sarah P. the hooker would have.
“Drugs.”
“No,” I said.
“Date of your last menstrual period?”
“I don’t remember,” I said, “but I’m regular.”
“Any chance you could be pregnant now?”
“If I were, could you fix it for me?” I asked.
“We’re going in circles. Do you think you might be pregnant?”
I shook my head. When he didn’t move on, I said, “No. I’m sure.”
“Okay,” Cisco said. “Let’s get started.”
He laid the cool surface of the stethoscope against my sternum. He nodded. “Breathe deeply for me,” he said. I did, closing my eyes. “Again.”
A shredding sound made me open my eyes. Cisco was unwrapping the blood-pressure cuff.
“You’ve got all the equipment,” I said.
“Not nearly what I’d like to have,” he said.
Obediently I held out my arm, and he pumped air into the cuff, then let it hiss out, watching his stethoscope.
“Hundred and four over seventy,” Cisco noted. “Nice.”
He’d surprised me. On my rare visits to doctors, I’d always had high readings. White-coat hypertension, they called it, blood pressure that was only high in medical settings.
But Cisco’s place was different. He acted like a doctor, and this was an exam, yet I was clearly in someone’s home. There was a faint scent of cooking in the air, instead of that disturbing antiseptic smell of a doctor’s office.
He took my temperature, read the thermometer in silence, and shook it out. He looked in each ear with an otoscope, felt the glands at the side of my neck.
“When did you first notice the symptoms?” he asked.
“Two days ago.”
“Any reason to think you might be immunosuppressed?”
“No,” I said.
“Are you prone to ear infections?”
“No.”
“Are either of your ears bothering you?”
“No,” I said again.
Cisco rolled backward slightly. “You can put your shirt back on,” he said, giving the shiny pink thing the honor of being called a shirt, something I wouldn’t have done. I pulled the top over my head, straightened my hair with my fingers.
“Here’s the deal,” he said. “You seem to be a person in good health, with a bad cold. It’s not the end of the world. Get plenty of fluids and rest, take some vitamin C, and treat the symptoms with some over-the-counter remedies.”
“All right.”
“There is one other thing.” Cisco’s tone had changed, sharpening my attention. “I’m not real happy with the way your left ear looks. We usually see infections in children, not adults, and you say it’s not bothering you, so I’m not going to worry about it too much. But if it starts to hurt you, go to a clinic. You may need antibiotics, and I can’t prescribe for you.”
“Okay,” I said.
He rolled back a few paces and retrieved something else from his chest. A red leaflet, which he came back to hand to me. It was an informational pamphlet from a walk-in sexual health clinic.
“I’m not making judgments here,” Cisco said. “But if you’re trading sex for money or drugs, then you need to get tested for HIV and other diseases. And if you test negative for everything, you need to talk to someone about how you can stay negative.”
The skin on my face felt warm and sensitized, the way it sometimes does when someone is kind to me for no good reason. I took the flyer.
“By the way, in answer to your earlier question,” he said, “I don’t do abortions.”
“Did that offend you?” I asked.
“No,” Cisco said. He did not elaborate.
I was free to go, but now that the hard part was over, my curiosity was rising. I said, “So, you went to medical school and everything?”
“Yes,” he said. He was putting away his instruments in the chest.
“But you don’t have a license?”
“I used to,” he said.
“What happened?”
“That’s a longer story than we probably have time for,” Cisco said, his tone measured. He was at his filing cabinet now, tearing the top sheet of paper off his legal pad, finding a place for it in the top drawer.
Dear God, the man kept files. When I made my report to Prewitt and we got a warrant, an extensive search wasn’t going to be necessary. Cisco was carefully documenting and organizing everything we needed to hang him.
Cisco rolled forward to collect the two twenties from the bookcase. When he didn’t take it anywhere, I understood that he didn’t want to put the money away while I was in his apartment, so I wouldn’t see where his stash was. He was careful.
“You know,” I said, “forty dollars doesn’t seem like a lot of money.”
“I don’t plan to get rich doing this.”
“Then why do it at all?” I asked.
“I fill a need,” Cisco said. “Believe it or not, people do fall through the cracks of the health-care system. Some don’t have insurance. Some are illegal immigrants. They’re intimidated by ERs, the crowds and the waits and tension there. I provide a service.”
“And, of course, they pay you,” I pointed out, playing devil’s advocate.
“I’m part of what the World Bank calls the informal economy,” Cisco said. “It’s accepted practice in many countries.”
“But you said you don’t have the equipment you’d like,” I pointed out.
“You’d be surprised what’s available from medical-supply houses,” he said. “No drugs, of course. But I’ve been able to get much of what I need for my practice here, which is mostly minor injuries, burns, things like that. I’m also able to give reassurance to people with small problems, like yours. And when people have more serious problems, I’m an early-warning system. When people come to me with symptoms that trouble me, or conditions that are beyond my capacity to treat, I tell them in no uncertain terms to get to a clinic or hospital.”