We were still living in the apartment over the store. The closest hospital was Beth Israel, on First and Sixteenth. In the taxi on the way there, Maggie asked my sister if her medical insurance was up to date. I mean, a person is burning up with fever, you figure she’s going to be in the hospital awhile, and you’re wondering if her HMO is going to take care of this.
“Oh yes, certainly,” Annie said. Her teeth were chattering. I was holding her in my arms. “Whenever I go away, I leave instructions with Sally Jean.”
“Who’s Sally Jean?” Maggie asked.
“My closest friend. You remember, don’t you? The UN translator?”
“Is she in Maine now?”
“No, I don’t know where she is just now. She moves around a lot. But she takes care of my HMO bills whenever they come in.”
“How does she do that?” I asked.
“She sends them the money.”
“How?” Maggie asked. “Cash? Credit card?”
“We have an arrangement,” Annie said. “My health insurance is in perfect order. Don’t worry, I’ll give the hospital this little card I carry in my wallet.”
When we got to the hospital and while Annie was being wheeled into the emergency room, Maggie asked me, “Did you ever meet this Sally Jean?”
“No. But Annie’s mentioned her before. They used to room together in Amsterdam.”
“So how come she pays Annie’s bills for her?”
“She used to do translations for the UN.”
“What kind of non sequitur is that?” Maggie asked, and kissed me on the cheek.
Our internist arrived a half-hour later, examined my sister, and asked at once if she had recently been in any country where she might have contracted malaria. Well, it so happened that the last country Annie had visited (and this was where she also ate yams and shat in the woods) was one that announced in big signs at the airport MALARIA IS ENDEMIC IN PAPUA NEW GUINEA.
I don’t know how Dr. Ernst knew at once that malaria was what Annie had. But upon questioning her further, it became apparent that not only did she have it, she also knew she had it.
“It comes and goes,” she told him. “The high fever, the shakes.”
Maggie and I stood by silently, listening. I was thinking, She knew she had malaria. She knew before she called from Maine. She came to us knowing she had malaria.
“How long have you been aware of these symptoms?” Dr. Ernst asked.
“Ever since I got back to the States.”
“And when was that?”
“In April.”
“You’ve had the symptoms regularly?”
“Well, on and off. I thought what it might be... you see, some fellow religious pilgrims and I...”
“Pilgrims?”
“I’m a Tantric adept,” she said. “In Papua New Guinea, I hooked up with some other followers of the religion, and we were singing and chanting in the jungle one night, in the dark, and it was a marvelous and wonderful experience, transporting, in fact. So when I developed a fever a few weeks later, I thought it was due to this very high level of consciousness we’d achieved. This absorption into the cosmic weave.”
Dr. Ernst looked baffled.
“Are you attributing malaria to some inspirational religious experience?” he asked.
Annie merely smiled at him as if she alone, and perhaps her guru, knew all the secrets of the universe.
“Why didn’t you check yourself into a hospital in Maine?” Dr. Ernst asked her. “If you knew you were sick...”
“Actually, I’m afraid of hospitals,” she said. “I don’t like medication.”
“Well, Miss,” Dr. Ernst said, “you’re in a hospital now, and I’m prescribing medication, and you had damn well better take it if you know what’s good for you!”
Annie looked surprised.
In the corridor outside, Dr. Ernst said to me, “Your sister seems rather childish, doesn’t she?”
On her second day in the hospital, when the quinine had brought her fever down, and she was no longer shaking, I told Annie that the hospital wanted to know how she planned to pay her bills, and asked if I could have the HMO card she carried in her wallet.
Annie looked at me.
“The thing is,” she said, “Sally Jean and I had a parting of the ways before I left for India. So she probably let the insurance lapse while I was gone.”
“I thought she was your closest friend.”
“Yes, she is. It’s just that she comes and goes a lot.”
“So what are you saying? You don’t have medical insurance?”
“You know I don’t trust the health care system.”
“Yes, I know that. But you’re in a hospital now, Annie...”
“Yes, Andy, thank you for informing me of that fact. I never would have guessed otherwise.”
“So how do you expect to pay for your stay here?”
“I thought you said you were going to take care of me.”
“I didn’t mean...”
“You said, ‘Don’t worry, Annie, I’ll take care of you.’ ”
“You were running a temperature of a hundred and...”
“It’s what you said.”
“I meant I’d get you to a hospital.”
“Where I’m supposed to pick up the bills, right? I have a little jewelry shop in Maine, you expect me to...”
“Annie, please, there’s no need to get upset about this. Just tell them you don’t have health insurance and can’t afford to pay for your stay here. They can’t kick you out, you’re a sick person. That’s against the Hippocratic Oath. Okay?”
“Sure,” she said. “Okay.”
When I went to the hospital the next morning, she was dressed in street clothes and sitting in a chair beside her bed, her face grim, her hands folded in her lap.
“What are you doing out of bed?” I asked.
“I’m leaving the hospital.”
“Why?” I said.
“Because you won’t pay my bills.”
“I can’t pay your bills, Annie. I can hardly afford to pay my own bills.”
“Oh, poor little school teacher,” she said.
“Don’t mock me, Annie.”
“Anyway, I don’t have to stay here. I’m cured already.”
“You’re not cured. Dr. Ernst says...”
“What does Dr. Ernst know?”
“His specialty is infectious diseases.”
“I don’t have an infectious disease.”
“You have malaria.”
“If I had malaria, it’s gone now. I don’t have any fever...”
“Malaria hides. That’s why you...”
“Hides?”
“Dr. Ernst says it hides.”
“From whom?” she asked, and grinned at me slyly.
“A characteristic of the disease is that the parasite hides. You can think it’s gone, but it isn’t. That’s why you have to take the medication for the full course. That’s what Dr. Ernst says.”
“Where’s Dr. Tannenbaum?”
“Who’s Dr. Tann...? Annie, Dr. Tannenbaum was our family doctor. We haven’t seen him in almost seven years!”
“He’d tell them to discharge me, all right.”
“I doubt that very much.”
“Oh yeah? I’m telling you he’d have me out of here in five minutes flat.”
“He’s probably dead by now. In any case, Dr. Ernst feels you should stay in the hospital until he’s sure they...”
“Dr. Ernst isn’t my doctor. Anyway, if nobody’s going to pay my bills, why would they want me to stay?”