No Respecter of Lines - Laura Maffei

Dr. Giannini never says no to anyone, which is why his waiting room is always packed and noisy. Every day I see and hear it from my desk in the tiny vestibule. Through a narrow doorway, two steps down, his wood-paneled waiting room is lined with orange bucket seats in which children squirm, or cry, or sit catatonically with their fevers, if they aren’t dashing back and forth across the floor or rummaging in the toy box in the corner. The parents—usually mothers but every once in a while a father—sit somewhat catatonically too: some resigned, some fuming with irritation at the long wait. Dr. G always overbooks. Or, more accurately, he makes the receptionist overbook. That’s me.

So this morning, when the phone rings as soon as I walk in the door, I hesitate for only a moment when they demand to come in immediately when the day’s already booked solid. Actually, the first thing I do is ask if they ought to call 911 instead, because they report, in urgent tones—the father mostly, but the mother beside him, interjecting something every few seconds—that their thirteen-year-old daughter suddenly cannot lift her arm. That she tried to start blow-drying her hair that morning and could not lift the hair dryer. But no, they don’t want to go to the hospital. Everything else about her seems fine. They want to see Dr. Giannini. Still in my coat, one hand holding the phone and the other opening the appointment book to today’s date, inked with back-to-back appointments in my handwriting, I tell them to come in.

I understand their insistence; I’ve been working for Dr. G for only three months, but already I can see that everyone loves him, which is why they put up with the crowds and the long waits, including the ones who fume about it. He deserves their adulation. The man works tirelessly and still has a smile and a warm word for everyone, even after eight hours of examining screaming children. He’ll phone a patient back at any hour of the day or night. He makes house calls. Besides all that, he knows what he’s doing: he goes to pediatric conferences and stays on top of everything. You wouldn’t guess he has such stature if you saw him outside the office, or without his clean white coat and stethoscope. He’s short and rotund, with a thin, nasal voice and a big nose that his glasses are always sliding down on. He’s walking proof that appearance is meaningless.

I know, of course, that appearance is not meaningless for the adolescents who come into his office, their long hair hanging like a curtain to conceal acne-ridden cheeks, or their shoulders hunched forward inside jackets, attempting to curve like folded wings around their changing bodies. The thirteen-year-old who can’t lift her arm, when she walks in with both her parents, is one of these. But then she turns her back and takes off her jacket, and I see that her round-shoulderedness is something more. 

Beneath her sweater, her shoulder-blades stick out in points and make a strange outward motion as she moves her arms. I smile at her parents and pretend not to see the suppressed panic in their eyes as I mark them in the book and send them into the waiting room, which, by the time they arrive, has already begun to fill up.  Dr. Giannini is already in with his first patient. I tell them they’re next.

But the first patient is a six-year-old boy whose mother never stops talking. Lately her son has been prone to throat infections, so whether or not he should have his tonsils removed is up for consideration, and I can imagine the endless questions she’s asking Dr. Giannini, and the endless anecdotes and descriptions of the boy’s symptoms she’s giving him, interrupting each phase of the examination. Every ten minutes, the father of the thirteen-year-old girl comes up the two steps from the waiting room. Tall, quiet but with a tightness in his voice, he looks at me from under his thick eyebrows and asks how much longer I think it might be, and whether I am sure that Dr. Giannini knows that this is an urgent matter. Each time, I assure him that the doctor knows (he does—I popped in to tell him) and that it shouldn’t be very much longer now. The man is intimidating, dressed in a good suit and overcoat—he must have been ready to leave for work when his daughter could not lift the hair dryer—yet right now he’s powerless, and I can see he hates that.

At last, the mother of the six-year-old, with her son in tow, comes down the hall toward me. Dr. G usually sends them out to me on their own like this—“See Anne on your way out”—while he finishes writing in their chart and getting the room ready for the next patient, whom he fetches himself when he’s ready. He does it quickly this time: just as the mother and the six-year-old reach me, I see the parents and the girl get up and leave the waiting room through the other exit, the one that goes straight to the exam rooms.

The talkative mother leans her elbows on the high counter in front of my desk and tells me about her son’s throat, barely pausing as I take a phone call and schedule an appointment and write down a message for the doctor. I make her follow-up appointment but she keeps talking. She’s always like this, and I usually don’t mind it—I sort of half-listen and nod most of the time—but today I feel on edge, probably because of that nervous family, and I wish she would leave. She doesn’t. She’s worried about the possible tonsillectomy, and she recites everything Dr. Giannini told her plus everything she has heard from her friends and family members. I can’t see what her child is doing, down below the high counter, but I imagine him standing there miserably with his sore throat. 

She stays and talks for longer than the thirteen-year-old girl’s examination, for suddenly I see the girl approaching, by herself, which I’ve never seen before. “Excuse me, I’m so sorry!” I say loudly over the woman’s voice, which is the only way to get a word in. “I need to speak to this patient.” I glance behind her, and she glances too, and finally gathers up her purse and tells me she’ll see me next time and leaves. The girl does not come up to my counter, but hovers by the wall. 

I smile. “Hi, dear. Are you finished with the doctor?” I don’t know what else to say. I can’t make a follow-up or do anything else until her parents are here.

“He said he wants to talk to my parents for a minute.”

“Oh, okay, well . . . you can sit in the waiting room if you’d like.”

She glances at the crowded waiting room, where just now a toddler lets out a screech. “Um, is it okay if I just wait here?”

“Sure,” I tell her. 

She stands sideways against the wall with her arms crossed, looking down at the floor. She looks so uncomfortable that I look down at my desk and straighten some papers even though I don’t need to. If she were a small child I could find ways of distracting or entertaining her, but with an adolescent girl I don’t know what to do. We’re both silent. I wish the phone would ring. I look up, and I can see again the strange angle of her shoulder-blades. I also notice that her mouth droops, but she doesn’t look like she’s frowning. It’s more like her face is expressionless. She frightens me.

Now the doctor himself is coming toward me, holding her file. The girl’s parents are just behind him. I stand up. As the three of them come closer, I catch a glimpse of the parents’ faces. The father’s is set and stern, the mother’s puffy with crying. The phone rings. I answer it, intending to take care of whatever it is as quickly as possible so I can attend to Dr. Giannini and this family.

But it’s for me. “Mrs. Riley?” the woman’s voice says, and even though I’m not a nervous type, my chest flutters a little bit. It’s the nurse at the elementary school, where my son James is in the second grade. For a moment I feel a weight bearing down, an irrational sensation of an evil thing impending that includes this family in front of me and the screeching toddler in the waiting room. But the nurse says only that my son has soiled his pants; otherwise, he seems to be fine, no fever, no pain, nothing else the matter. I breathe. “Oh,” I say into the phone, as Dr. Giannini reaches my counter and puts the file down. “He might not need to go home,” the nurse tells me, “but he definitely needs a change of clothes.”

 “Anne, hand me the Rolodex please,” Dr. Giannini says to me quietly.  I lift it from the desk up onto the counter, and then I turn away, to speak quietly into the phone, to let the nurse know that I’ll be there as soon as I can, but that I have to call a substitute and then drive home to get a change of clothes for James.

I stand waiting while Dr. Giannini flips through the Rolodex, because I need it to find the substitutes’ numbers. I know he would let me leave right away if I asked, leaving him to juggle everything on his own. But even though I’m worried about James, it’s not an emergency, and I’m only three months into a new job, my first since James was born, and I don’t want to cause a problem so soon. 

Also, I don’t dare interrupt. The family stands waiting while Dr. Giannini flips the little cards. “Ah, here we are,” he says. He isn’t smiling.

He writes a name and number on a piece of paper and hands it to the father of the family. They leave, and I want so much to ask him about them, but of course that wouldn’t be right, and anyway there’s James. Dr. G kindly suggests that I go as soon as I contact someone who can come in—that I don’t wait until the sub gets here. I accept.

The flash of white when I step out the door startles me—I had forgotten about this morning’s sudden snowfall. It has stopped, but the unshoveled sidewalks are slippery with footprints that have formed ovals of slush. The streets are slippery too, and I drive slowly, frustrated, thinking of James standing there in the nurse’s office in his soiled pants and waiting far too long, alone and probably embarrassed, knowing James, a quiet child who likes to stand back, who always seems to be taking everything in. 

I drive up Richmond Avenue past the wall of dirt that demarcates the dump, now a snow-speckled wall of dirt, and I think I smell it, the pungent smell of garbage that you would normally smell on a warm day but not on a cold day like today, with the car’s windows sealed tight.

In a part of my brain that I am trying to close off, because I don’t want to admit this to myself, I know I’ll look in the girl’s file when I am back at work, even if I have no legitimate need to, even if the sub does the billing and puts it away.

At home I hurry, thinking guiltily of James, grabbing pants, underwear, socks, shirt—I don’t know how much he might need—throwing them in a bag and hurrying back out. The narrow streets leading to the school are slushier than Richmond Avenue was, and I have to drive even more slowly, and circle the block to find a spot, before I can finally run into the red brick building with the bag of clothes.

In the nurse’s office, there he stands, my son, as I knew he would be, not wanting to sit down in his soiled pants. I immediately kneel in front of him and brush his hair back with my hand while I mumble something to the nurse about my job and the roads. I look into his big eyes. He hasn’t been crying, but he’s troubled. He’s never had an accident in school before, not even in kindergarten. I ask him if he ate something strange. He shakes his head no.

“Well, let’s get you into some nice clean clothes,” I say with a smile, but quietly. I never use forced cheerfulness on James, the way I do sometimes with children at the doctor’s office who automatically brighten at the sound of a high-pitched voice and forget whatever I’m trying to distract them from. That doesn’t work with James.

But he’s eager enough to get out of his soiled clothes and cleaned up, and once he is dressed again he exudes a palpable relief. And I’m relieved too. He seems fine—no lethargy, no symptoms of anything at all. A normal kid. Nothing wrong with him.

But should I leave him to this long day? It’s Wednesday and he has catechism class. Catholic kids leave school early for that, but it still makes the day longer. I ask him if he would like to come straight home. But this is James’s First Communion year and St. Stephen’s is strict about it—any missed catechism class must be made up on a Sunday afternoon. He doesn’t want to make it up on Sunday. He wants to go today. Okay then, I’ll pick him up at catechism, I tell him.

I leave the school and drive away alone. I could go home—should, really, since the substitute has been hired for the rest of the day—but I’m too restless.  I drive back past the dump, back to Dr. Giannini’s, and I dismiss the substitute, an older, semi-retired woman with a round puff of dyed brown hair. She’s annoyed but I don’t care—Dr. Giannini is generous and will probably pay her for the day anyway.

I take my chair with a sense of purpose. I answer the phone, I take messages and make new appointments, I do the billing for the files the substitute left on the desk—none of which belong to the thirteen-year-old girl—and I put them away. I collect files from the people Dr. Giannini sends down the hallway to me, and I make follow-up appointments and next-vaccination appointments. All the while I try to find an opportunity to find the girl’s file.

Finally there’s a lull, and I stand up and scan the thickly-packed shelves behind me, looking over my shoulder for Dr. Giannini, rehearsing in my head like a wayward teenager what I would say to him: I was just curious . . . No.  I was just checking that the substitute did the billing correctly . . . That would be better. As if he would bother to ask me what I’m doing with a file in my hands. I’m being paranoid. It’s unlike me.

At my desk, where I can quickly hide the file under other paperwork if need be—how stupid I’m being, I tell myself, I’m in and out of people’s files all day—I open it. Today’s exam is on top. Dr. Giannini’s scribbles respect no horizontal or vertical lines. Most of it seems to be a list—maybe of symptoms, because I think I can make out the word can’t more than once.  His handwriting, which I’ve been priding myself on learning to read, is much worse than usual. I can make out very little. It’s as if he made it unreadable on purpose.

But at the very bottom of the page, I can read two abbreviated words, musc dystr, and then directly underneath them, adolesc onset. He added a large question mark beside both sets of words. When I say the words to myself under my breath, I realize he thinks she might have muscular dystrophy. Like Jerry’s Kids? A chill goes through me. I didn’t know that could just come out of nowhere. Does it mean she’s going to be in a wheelchair soon? Does it mean that the girl who was standing right here in front of me this morning, does it mean she’s going to die young? 

How are her parents going to tell her?

In the bottom corner, he scribbled the abbreviation Ref, which I know means “Referred to,” but the last name is one I don’t recognize as any of the usual referral doctors. Not the ear-nose-throat guy or the tonsil surgeon or the allergist. I put the file away. I want to get it away from me.

Through the afternoon, I smile at patients, I answer the phone in my professional, reassuring voice. Inside, I am muted, subdued. At the end of the day, I decide to risk it. It is not my business, but I have to know.

“Dr. G?” I’m standing in my coat. He’s standing behind the desk, head bent over the day’s messages, eyeglasses sliding down his nose.

“Mm?”

“I was just wondering . . . that girl who couldn’t lift her arm, will she be okay?”

He does not look up. “I don’t know. I sent them to a specialist.”

“Oh,” I say. I stand there foolishly. Even more foolishly, I press on. “If they call, is there anything . . . is there anything specific I should tell them?”

Now he looks up at me over his glasses. “No, Anne. Just take a message.”

I feel myself flush. “Right. Okay. Have a good evening, doctor.”

Outside, the December dusk is lowering. The morning’s sudden snow has retreated off the sidewalks and streets and onto the grass, but it’s still sprinkled on the wall of dirt that hides the dump, the wall that I imagine keeps the rancid garbage from spilling out onto Richmond Avenue.

The parking lot of St. Stephen’s is filling with the cars of the mothers of kids in the after-school catechism classes. I pull into a spot toward the back, and I get out and walk across the asphalt, buttoning the top button of my coat against the damp and the chill.

The kids come out in a rush, as they always do, the younger ones first. And there is James, in his blue jacket, carrying his small bookbag. I can see right away that he’s still troubled, and I feel a deep pang—surely I should have taken him straight home with me from the school nurse’s office. What is wrong with me?

We walk across the lot and I wait until we’re in the quiet of the car to ask him, “James, honey? Did something happen today? I mean, besides what happened with going to the bathroom. Did anything happen that bothered you?”

He shakes his head right away.

“Did any kids hit you or say something mean to you?”

Head shake again.

“Okay.” I pause. “You know you can tell mommy anything, right?” Have I ever said that to him before? I really should have said that to him before.

He nods. His eyes are a deep liquid brown. I grin at him and make a crab-claw with my hand, our private game. He smiles a little. I go in for the tickle, and get a chuckle out of him. Just a small one. He’s still subdued.

“Okay, let’s go home,” I say, and I turn the key in the ignition and the car rumbles. Before I pull out, I look at James again. My serious boy. Who knows what’s in store for him? For any of us.

At home, I cook extra cheerfully, singing along with the radio, with Karen Carpenter—Why do birds suddenly appear—and when my husband gets home I run to the door and take him by the lapels of his overcoat and kiss him before he can say anything grumpy about his day. At dinner I must seem strange, talking more brightly and rapidly than usual to my two taciturn men. I smile down at the boiled potatoes flecked with parsley before I pass them, seeing them as beautiful, and then I chatter away again. And although I am nearly out of breath, I don’t want to stop, I want to keep it up, keep holding what’s here, keep warding off anything else.

Originally published in the print-only journal The Halcyone, vol. 3, no. 2, Summer 2020, pp. 17-20

Laura Maffei's fiction has appeared in The Westchester Review, Touchstone Literary Magazine, and other journals. She is the author of the poetry collection drops from her umbrella and was the founding editor of American Tanka. Raised on Staten Island, she received her MFA from the Michener Center for Writers at the University of Texas at Austin. www.lauramaffei.com