“Clean your hands here.” The sign, next to a pump bottle filled with clear gel, welcomes me to the hematology/oncology suite at this Boston hospital. Everywhere I go — grocery store, gym, elementary school — I am exhorted to do my part in the war against germs. Sanitized, I take the clipboard from the receptionist and fill out forms before moving among clusters of chairs, looking for a magazine other than Golf or Prevention. I study a hospital pamphlet that hyperbolizes hope. It irritates me. But I am often irritated by cheerful messages conveyed in institutional publications. It’s not hope I dislike. It’s the prescription of hope. These hospital pamphlets remind me of the churchy magazines for children that were stacked on the end tables in the waiting room of my childhood dentist. They often featured fictional stories of dying children who were promised a future with God, and they terrified me.
As a person with a chronic illness – I was diagnosed as an adult with Type 1 diabetes more than 20 years ago – I have spent a lot of time in medical waiting rooms. I have come to know their rhythms and reading material well. This one specializes in the treatment of cancer. I’m not really the intended audience for the services or messages. Unlike most of the other patients, I’m only here for iron-deficient anemia, persistent since my pregnancy with a third child, who is by now school age. It is a tiring condition, and having to stir up the energy to treat it exasperates me. Isn’t it enough that I have one serious illness? I wish there were a trusted listener I could put this question to.
Across the waiting room walks the old white-haired man with one ear. This is my third visit to see a blood specialist, and I have spotted this man in the same waiting room before. He consistently wears chino pants and a green sport shirt. As usual, a patch of medical tape covers his right ear hole. He’s one of those volunteers who bring food and comfort to patients who are very ill. Probably he was at one time a cancer patient. “A drink?” he asks me. I squint and shake my head: No.
I wait; I wait; and I wait. I decide to not care, to not ask the front desk people to hasten the doctor. There is nothing at work that cannot simmer untended for another hour. To sit in a quiet place and do nothing is a break from tasks to finish and people to respond to. I don’t even try to fill the time with reading.
Two rounded women and a smaller man sit abreast, coats still on, their relationships not obvious. All three are engrossed in catalogs they have brought along. A trim man and woman sit together, also silent; the man reads Golf while the woman looks around. I guess that they are married. At the reception desk, the clinic assistants – two women of color with long, curled hair, bright blouses, and white lab coats – talk about the challenges of commuting. There’s a giant tropical fish tank, full of fish and as clean as you’d expect anything in a hospital to be, and its filter bubbles the water. The wall-mounted television is turned to a sports channel with the sound muted.
Nearest to me is a female pair, talking. I listen and occasionally look. The younger woman, in her 40s like me, is the daughter. The older woman, though not elderly, has the look my old aunts did in the last months of their long lives when their skeletons, long concealed under flesh, gradually asserted themselves. Her bent knees push at the fabric of her pants like fists. The skin of her face is pulled over the rock of her head, giving her a look that is alert and grim. Once pretty, she wears red lipstick and has tucked her graying straight hair over her ears. Her body holds itself still, without the fidgets and adjustments that impatient people make. “Keep sitting up” is what I guess she tells herself. She looks exhausted yet resolved.
Yet, this mother and her adult daughter talk with quiet animation. The season is blossoming, and someone they know is readying a lake house for the summer: windows opened to air things out and dead mice and dust swept out. “And she has to get all the clean sheets unpacked from bags and make up the beds,” the daughter says with a tone that conveys the impressiveness of this task. The women discuss the decluttering of closets in their own homes and the buying of new pots and pans; the daughter’s kitchen needs them. Then the mother describes a dream she had, of waking up in a room of a house she hasn’t visited in a long time, another lake house from years ago. “Do you remember Auntie Pauline’s house?” The daughter shrugs. I listen to them and think, one at a time, of houses on water that I have known. Picturing bare floors and dried pine needles and slants of sun, I marvel at how these two, on the verge of losing so much, manage to linger on the quotidian. What would my mother and I talk about if this were our turn? Or, more painful for me to imagine, if I were in the place of the older woman sitting here with my son or my two daughters? Often what motivates me to care for my diabetes is the thought of living a long and able life so that I might enjoy my children’s adulthoods, not tethered to dialysis. I hold on to a belief that I have a great deal of control over my outcome. I have also believed – and I suddenly realize that this is folly – that, by having one chronic illness, I am somehow exempt from more threats to my well-being and longevity. My anemia is a sign, however, that my body is much more complex than a basic system, with inputs and outputs, I can understand and control. And this may be why a conversation about housekeeping – ah, the pleasures of order! — is so comforting.
The women talk not at all about why they are here; there is no mention of treatments, blood counts, and clinicians’ names. The daughter asks the mother, “Are you hungry yet?” The mother answers, “Just a little.” The daughter goes into a room off the waiting room and returns with a cellophane package. While eating the one cracker she will eat, the mother says to the daughter, “I think I’m cold.” As if on cue, the daughter retrieves a sweater from the tote bag behind the wheelchair. With effort, the mother leans forward as the sweater is draped over her shoulders and back like a shawl.
Because he’s in my sightline, I see the doctor emerge from a hallway and walk toward us, which is at least a few seconds before the women notice him. Tall, he wears pants, tattersall shirt, and white lab coat that show off his brown skin and dark, feathered hair. His gold-rimmed eyeglasses glint under the hall lights. Younger than me, the doctor moves with a kingly reserve that would prevent a person from calling him “young.” He is almost in front of the women when they hear his steps. Their faces turn up to his. Holding out his hands, palms up, he half bows to the mother and asks, “Would you like to dance?”
Putting her hands in his, she exerts herself to her feet, all the while keeping her spine straight. Now standing, she turns her face up to him again – he’s at least a head taller, a wonderful height for a ballroom dance partner, and I envy her touching him – and the older woman looks in his eyes and responds with a sureness that is a match for his allure. “Actually,” she replies, “I would like to die.” She has been waiting to say this.
I look at them openly. They are unaware of me, their audience. The doctor does not miss a beat; there is no hesitation, no startled stepping back. He smiles at his dance partner with affection that is both reserved and generous. They know each other well, I see, not as lovers but as people who have met many times, perhaps for only a few minutes before the nurse is called or paperwork for chemotherapy signed, and yet each time they learned a little more about each other, each time they adjusted their movements and responses to stay in step. Who would lead? At first, she wanted him to. Later, comfortable together they took turns.
My doctor, an older, white-haired hematologist in the same clinic, looked at the numbers from my recent lab work, unchanged after oral iron supplements, and recommended intravenous treatment. He promised me, “This one is easy.” And, for a while, he was right. The IV iron infusions I had later that summer gave me a noticeable boost. Life continued, with more zest.
But the dancers, the older, dying woman and her gallant doctor: In my memory of this waiting room scene — private, yet played out for me — the two of them turn away and face the hallway from which he emerged. The daughter quietly gathers up her mother’s things, placing them in the seat of the wheelchair. Looking down at the woman who looks up at him, the doctor lets go her hands, lifts his left arm like a wing, and offers an elbow to her. She takes it. The two walk, almost shuffling, into the passageway that leads into examining rooms. The daughter, a few steps away, follows.