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CHAPTER ONE

THE FLESH BLEW OFF HER BONES underground. That’s how the waxy anchorman put it; you could feel his lips loving to make the shape of the word blew. The reason they knew? They’d had to exhume her. He sighed, going for horror, but conveying pleasure, maybe not accidentally.

I was sitting in front of the TV that afternoon—three days ago—on an orange chair in the waiting room of a clinic for breasts, so I happened to be turning questions of tissue over in my mind anyway. In some chambers, the idea of this poor dead girl’s body exploding and being dug back up seemed like more than I could stand, the last click in a game of thought roulette. I waited for the release of a bullet that might knock me flat. But in other chambers, it felt acceptable, predictable, a revelation that I, as a sane adult, should be able to tolerate.

I imagined the anchorman, that plastic action figure, digging her up with bare hands himself, a spray of dirt and decay blowing into his open mouth. My husband had dated the now-wife of the anchorman in college (a coincidence), and so I imagined her, too, married to the salacious half-rhymer of blew and exhume. She had to listen to his voice and watch his face stretch into approximations of human expressions every night at dinner. Did graphics run underneath him as he brushed his blinding teeth? Did she suspect him of the perversions I did? Or know his actual ones? Maybe she shared them.

It wouldn’t have surprised me. One disappointing aspect of middle age was how few perversions remained shocking. I did feel a jolt, though, at learning that in addition to dying and liquefying, we also explode after being buried.

A NURSE CALLED my name, “Samantha Baxter,” and I leapt up, nodding like a doll on a dashboard, and followed obediently. A light-green hall became a light-green room on the right. The nurse weighed me, then stunned my arm with a pressure cuff and said, with her eyes cast down sorrowfully, that my blood pressure was elevated.

“I’m not surprised,” I told her.

“No,” she said, staring as if trying to determine whether I was slow, joking, or both. “I mean, it’s significant. The doctor will have to retake it later.”

She handed me the usual life-sized paper towel I was to wrap around my waist with a plastic ribbon and turned to go.

“Please put this on, open to the front.”

I shed my jeans and shirt, folding them into a miniature stack on the light-green chair before placing my bra and socks in my purse. I lined my ankle boots up, not wanting to appear unruly. I learned when my mother was diagnosed with breast cancer twenty years ago that I shared the gene that predisposed us to particular cancerous outcomes. It had letters but no name, and sounded to me like bric-a-brac, some country kitchen pattern on a quilt. I had been diligent about climbing into magnetic tubes for MRIs and making my breasts go horizontal in mammogram machines. From the moment I learned about the gene, someone had his or her hands up my shirt constantly. Meanwhile, a chorus of advice rose around me about prophylactic surgeries, but those seemed strange and medieval to me when I was young and spry and busy having, nursing, and raising my daughter. So I kept vigilant until now, when, as it turns out, I wasn’t vigilant enough and I should’ve done the prophylactic lopping when I had the chance. Because now it doesn’t look like it will be prophylactic anymore. Now I’m in some trouble. But just for the sake of honoring my own risky former self, I let myself be happily catapulted back to a time when even the word prophylactic suggested a tiny raincoat of pure, impending fun.

The nurse returned and took my blood pressure again. I stayed quiet, knowing it wasn’t going to matter who took my blood pressure where or when. Goat, boat, mouse, house, here, there, anywhere. Something was building in me like applause or lava, about to shoot out of my head—a sound? A bolt of sci-fi light? Actual brain matter or blood? I felt as bubbly and unpredictable as a cartoon. I found it tricky to calibrate my blood’s panic when its container was in peril.

My body knew it was in danger; every cell in me, including the Judases who were dividing, replicating, partying, knew this next news would be bad. That what we—all the parts of me—were waiting to discover was a question of margins. How dire? Catastrophic? What story would I be telling Charles at dinner—a hopeful version, a euphemistic one? Or telling Leah, if I took that wild route instead?

Leah! See? I was already contemplating it before I got the full impact of the diagnosis. Maybe this whole cancerpalooza is no excuse.

A “spot of calcification” had shown up on my most recent MRI. The deceptively maternal-seeming Dr. A was the one who told me this, holding my slide onto one of those backlit boxes I’d only seen in movies before. She flicked a switch and pressed the picture of tissue up onto that box of light, her broken nail pointing out a spot of white. She spit slightly when she said the word “dense” in her incredible sentence, “because your breast tissue is especially dense”—all those slobbery and disgusting s’s crowding out the verb, the nouns, the actual meaning of the sentence. I never heard what the clause modified, or understood what this especial denseness foretold.

Instead, I watched her spray of spit like a shadow puppet show across the lit slide, wondering whether the white spot was a presence or an absence, a small pearl in a dark sea of tissue or something removed by a mini hole punch. Either way, corrosive cells were coursing through my marrow.

Even before that appallingly alliterative appointment or the one three days ago, when I heard about the dead girl and my own body’s prospects veered toward worse, I had stopped watching television shows that only featured women either naked or dead. That sounds like a pretty low bar, but it eliminated everything. It excluded especially whatever my husband loved, including the pilot episode of a detective show he and the rest of the world were particularly rapturous about. The only character in whose story I could invest my energy was a corpse, hogtied to a tree before the series even got started. How luxurious would it be to find myself among the chorus of men in cop costumes circling that bloodless, naked body, taking notes, aroused, distressed? Furrowing my brow with the concentration of the artificially living, I would vow to avenge whatever also-man had done this heinous thing, all while untying the girl and stretching her out on the grass.

It was less fun, even as a viewer, to identify with the decaying victim. At least for me. And probably every other woman watching.

My husband, Charles, joked good-naturedly with our many friends—also good-natured—about how fussy I was. He had to screen anything we were going to watch together to make sure there was at least one female character who was clothed, alive, and competent enough to speak reasonable sentences.

He found almost no shows suitable for a tyrant like me, although he liked what he called the “Baxter test” and seemed to cherish the task of pre-screening and eliminating anything sci-fi, macho, politically reprehensible, or indifferent to the perspectives of women. We had very little time for television anyway. He was helping corporations defend themselves against whatever litigious clients or environmentalists sued, and I was teaching poetry.

I was alone in the waiting room when I heard about the body. This was right before my body divided into versions I had to work to keep separate, before I betrayed Charles in a fury worthy of some tragic Greek character. Before I made a devastating choice right at the end of my life. Except my choice was tawdry and banal. And even now, it’s only been a few days since I made it, like I said, so I don’t know if it’s the end of my life and won’t until at least a few weeks from now. Maybe my mind has begun to take over, marching my body straight out of my own life, even as I try to save that body, that life. What’s the difference between a body and a life?

After watching the news in the waiting room, I sat on the paper-wrapped table, wrapped in paper myself. Dr. A came pounding in, and right away she said, “I’m afraid I’ve spoken to the pathologist, and the tumor we found on the MRI and biopsied in the core biopsy did, in fact, turn out to be malignant.”

Dr. A is a big waster of syllables. There’s nothing lyrical or efficient about the way she speaks. The sound of blood rose up around and inside me when I heard the word malignant. I wished Charles had come with me, could hear the rest of whatever she said, could ask reasonable questions, could try—as he was wont to do—to statistic me back to the good kind of oblivion, the kind where we pretended numbers were in our favor.

During the core biopsy she mentioned, someone in a lab coat and surgical mask had drilled a screwdriver so deep into my body that I’d had the sense it might impale me, nail me straight to the table. My entire side had remained purple for two weeks, making a carnival mask out of the bruise against the dire pale skin on the rest of me.

Now Dr. A was yammering away about de- and reconstructing, asking questions to which apparently neither of us had answers: Which parts of my skin would they spare? How close to my chest wall would they have to scrape their scalpels, dig with trowels? I never knew chests had walls. I thought of the date again, November 1st. A calendar fell open in my mind: How long would it take me to get over whatever horrors awaited me here? Should I wish the time away, or would these weeks be my final romp on the planet?

Dr. A was explaining that she would do the surgery. She said, “I take the tissue,” and when I didn’t respond, added, “I do the removal.”

“Do” seemed an odd word to me, spinning into all of its forms, due, dew, doo-wop.

I asked, “All of it?”

“All of what?”

“My tissue.”

“We try to get as much of the breast tissue as we can. Of course, we can’t be certain we’ve gotten all of it. Some cells may remain.”

Some cells sell seashells. Maybe I’d write a tongue twister or a limerick. There was once a woman with cancer / who frolicked and—well, what rhyme, answer? Dancer? Prancer. Enhancer. Breast enhancer? Oh my God. Okay, so maybe—There once was a woman with breasts. Whose doctor put both to the tests. She spared her some nipples, but—triples, stipples, ooh, how about a subtle internal rhyme, dimples? Leaving the cutest of dimples?

Dr. A was talking and talking.

Pay attention, I reminded myself. Yes, yes, I gestured with my bobblehead while she said the words, “Depending on what we find, we would either cut under your breasts or across them.” I imagined the knife. A box cutter? A steak knife? How much like a regular thing did it look? Incision here, incision there. She began to draw on the paper table, and I watched. She drew grimaces, one underneath a blob; the other straight across its twin blob. I had an almost overpowering urge to color in the drawings, hear the metrical, waxy click of crayons on paper.

Would the incisions end up hidden under my breasts, or straight across them—real badges of damage? I wasn’t certain which I preferred, to what extent I’d want to hide that this had ever happened. If I survived. And might my preference also depend on how long I survived? Maybe I’d wish to mask the experience in the short term, but then want my body to bear the marks of it later.

In any case, I didn’t know how or want to discuss this aspect with Dr. A, armed as she invariably was with a barbed comment veiled as care. The first time I met her, before she’d examined me and done the slideshow of my dense tissue and calcification, she’d said (in front of Charles), “Well, since you have implants, you’re at least familiar with parts of the process, should you choose mastectomy and reconstruction.”

I had not had plastic surgery, was not familiar, stopped breathing because I was so stunned by this remark. On what basis had she concluded this? Something in my chart?

“I don’t have implants, I—” I said, shaking in my sweater. It sounded like I was lying.

“Well,” she said, glancing and clucking at me, “You have very large breasts, then, for your frame.”

Absolutely incredulous, I responded, “Yeah? Well, all this can be yours.”

And Charles had the audacity to shoot me a look.

IT STILL AMAZES me, which I guess doesn’t mean that much, since it happened only three weeks ago. But is it possible for a breast surgeon to say to someone who has a genetic certainty of getting cancer, and is about to learn there’s a spot of calcification on her especially-dense-very-large breast scans, “Well, since you have implants,” without knowing whether that’s true? It seems impossible to me, even now, after it happened. That night, Charles gently implied that if I were less abrasive and crazy, my conversations would go awry less often, less reliably. I railed back at him that it was her fault, said I hadn’t done anything to prompt her idiotic comment about the surgery she’d assumed I’d had. I said, how dare she? I didn’t want her as a surgeon; how could anyone who said such insane and inappropriate things to her patients be a reasonable doctor?

Charles calmly recycled the word “reasonable;” she was the best breast surgeon in the state, I should “be reasonable,” it wasn’t important to like her, we just needed her to save my life was all. As long as we could count on her to do her job, it hardly mattered whether she was “likable.” I shut his voice out. I teach poetry, like I said, and I don’t let my students use the word “likable” when describing the work they read or write. I don’t care whether characters—or even people, really—are “likable.” Can they just not be unbearably tedious?

But here, I clung to the word, because it seemed to me that if a surgeon was that insensitive, she lacked the capacity to care about my life enough to save it. I considered giving her a copy of my first collection of poems, many of them about bodies, but I haven’t yet. She doesn’t strike me as a reader of poetry. And if she is cleverer than I think, and understands the embedded criticism or even the title, Temporary Conditions (which now seems like a joke), will her understanding make her more likely to leave something dangerous inside me? To scrape less close to my chest wall? Save me less?

“Let’s schedule a nipple-sparing mastectomy for as soon as we can.”

“Oh, okay, yes.” Nipple-sparing! I saw a double “r” instead of just one, sparring, not sparing, nipples in fencing costumes, jabbing at each other. From there I got sparking, nipples with flashing metal tassels, chips of flame flying. Dr. A was staring at me. She could tell something, but I didn’t know what.

“Do you have any questions?” She sighed, maybe bracing herself for whatever unpredictable social fireball I might lob at her next. She struck me as the sort of doctor who resented being asked anything at all. She was already halfway out the exam room door, and who could blame her? She got to escape each of us and our miserable fear and questions over and over in that lime-green hallway, and then at the end of each day.

Look how normal I was, though! I wanted to prove her wrong, to make this conversation okay. After all, there was still one day left before I gave up pleasing anyone ever. I asked, “How long is the recovery? I mean, before I’m okay?”

She dared to look bored by this. What had she been expecting? Hoping for?

Then she asked, “Do you mean how you look? Or how you feel?”

Ah, so Dr. A thought I cared too much about what I looked like. I had felt the vicious undercurrent of this judgment every time she spoke, from the aggressively frumpy pedestal of her own cancer-free body.

“How I feel, obviously,” I defended myself. “When I can be up and about, when I can teach.” See, I’m smart!

“Well.” She surveyed me, made some vague and slurring sounds about two weeks, three weeks, depends, blah blah, drains, oh, and fluid. Fluid? She clapped a black folder shut fast—what doctor carries a black folder?—and left. She was a Disney villain. About to save my life. Or not.

“Thank you!” I cried out, hoping to inspire love in her, make her want to rescue me.

She glanced back over her shoulder, a lemon look on her face. “I’m going to send you over to Dr. B, our plastic surgeon now. He can discuss reconstruction options with you.”

The door clicked. I was alone, free of her. I stripped off the paper towel, folded it, and put it in my purse because I didn’t want to open the dead-gown bin. Then I slowly and carefully returned my body to its own clothing—inappropriately tight jeans, a silver T-shirt, a scarf, and bronze ankle boots. It was, I guessed, my hideous, visible vanity that made Dr. A so scornful of me.

I walked from Dr. A’s office to Dr. B’s office across the hall, zig-zagging to avoid the quickest route between any A and B and looking dizzily at the other women sitting in the waiting room. One in three of them would, at some point, find herself where I was. I felt such gutting sorrow at that fact that I swayed and sat, nauseated with our collective misery, as fearful for a moment for those strangers as I was for myself. Back in another orange chair, I realized the news was still on, a different anchorman now, his voice eerily similar to the first one’s.

“According to the autopsy reports, whoever killed the seventeen-year-old high school senior peeled off her skin. Meticulously,” he reported.

Meticulously? How did they know? And did they discover the peeling after she had already decayed? How was that possible? Forensics? What did they do, test the dirt and bone and skin cells? What skin cells? And how, from such testing, could they get peeling, let alone meticulously? Something involuntary and metrical inside me was leading me from subjects of the flesh to other subjects of the flesh, as if my mind and I were bouncing down enjambed lines. I landed on my own skin, being peeled away, tissue taken from underneath, replaced with what? Something plastic, something lasting.

Once I was in Dr. B’s office, he drew pictures of breasts, too, teardrops versus perfectly round planets. They were lovely; he was a much better artist than Dr. A, which I guessed made sense. He was wearing a lavender bow tie and looked meticulous. Oh, his waxy, prettily ageless face! Had he done his own work? Put himself half to sleep and reconstructed his neck, backspaced wrinkles off the page of his face? And when he peeled people’s skin back (mine, for example), when he worked on our faces or breasts or whatever construction site needed injecting, stretching, or implanting, did he move “meticulously?” His hands looked precise and graceful, instruments of poetic care. I imagined them coming into contact with my skin, tracing lines down my body, tickling my back, playing “X marks the spot” and then burrowing under my skin, into the blood and tissue—or absence of tissue—beneath.

When I stopped thinking about his clothes and fingers and the cartoon breasts he’d drawn, I realized we had moved on and the words coming out of his mouth were “fat grafting” and “grades of silicone.” He had asked me something, something about where he’d farm fat from elsewhere on my body and which of the various gummy shapes he was pointing to on his desk I’d like him to implant under the muscle wall of my chest.

He looked at me expectantly, as if I might have a response to any of this.

Banshee

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