Turn of Mind

Your mind is full of other fantastic images, some in lurid color, some in black-and-white. It is like watching a compilation of movie clips filmed by a lunatic. A heap of harvested hands on the white sands of a turquoise sea. Your parents’ house in Philadelphia, engulfed in flames. I am very far gone indeed. Here. So it was here. You can see the remains of the yellow chalk mark mixed with dust. What Amanda could never have abided.

Your filthy bare feet leave footprints. Shoes. You need shoes. Amanda was taller and heavier than you, but you wore the same shoe size. Eleven. Wearing boxes without topses.

You take the stairs to her room and find a severe blue dress with a belt and a pair of black flats. You try to wash your face, but the water has been turned off, so you spit upon a towel and scrub at the worst of the dirt. Then you lie down on Amanda’s bed.

But before you sleep, Peter visits. He stands by the window, blocking the moonlight. What did you do? he asks. Why did you do it? He has been digging in the garden. His knees are black with wet earth. He is holding one of Fiona’s most brightly colored snails in his palm. In the sweat of thy face shalt thou eat bread, till thou return unto the ground; for out of it wast thou taken. You are sweating. Enough, you say. But he is gone, replaced by Amanda. She sits on the edge of the bed. She takes your hand. Hers is whole, unblemished. You are relieved: It was all a dream, then. All a dream. And finally you are able to sleep.

You are awakened by a crack of thunder, the sound of drumming against the window, on the roof. Outside the window you see gray and wet, but it is still warm. You see that you are already dressed, shoes even. You must have been on call.

Those days as an intern, learning to jump up from the soundest slumber, ready to slice. No transition from oblivion to hyperawareness. You are aware of an empty stomach, but when you go downstairs the refrigerator is dark and empty, and a sour smell emanates from it. In the pantry some dry cereal, stale. Rat droppings on the shelves, holes chewed in the bags of pasta, the cracker box.

You catch sight of the clock still ticking above the sink. Eight forty-five. The clinic opened at 8 am. You are late. You stuff some cereal in your mouth, run to the front door. You do not have your car keys, you must take a cab. You walk swiftly down the street toward Fullerton, where the cabs stream past day and night.

You are already soaked from the warm rain. The first two cabs are occupied, but then you are in luck: The third one stops. To the New Hope Clinic, you say. Address? he asks, but you can’t remember. He punches the name into a small machine mounted on his dashboard. Chicago Avenue, he says. Okeydoke.

He is dark, handsome. A Palestinian flag is draped over the front seat. His cell phone rings and he spits out a string of guttural sounds, hangs up. You brush off the water as best you can and try to relax. Chicago the gray lady. You don’t mind.

Sometimes you want the outside world to match your interior reality, you said to James once, trying to explain why you loved thunderstorms. Another boom overhead and a streak of lightning on the right. Awesome, says the taxi driver, and catching your eye in the rearview mirror, he smiles.

The taxi pulls up in front of a low gray building. Seven seventy-five, the man says. You reach for your purse. You begin searching around the backseat, you pat your pockets, you are frantic. The man looks more concerned than alarmed. You work here? he asks. Or a patient? You are a doctor, you explain, and the man nods like he expected as much. Perhaps you can borrow it, he suggests. I will wait.

You run through the rain to the front door. The waiting room is full of people, many more people than there are chairs. Jean is at the front desk, checking in a woman with a crying infant. When she sees you she looks startled. Dr. White! she says. What a nice surprise! Aren’t I on the schedule? you ask. Then, without waiting for an answer, you say, No matter. Clearly you need me. I’ll be ready in ten minutes.

You walk into the back area and are surprised at all the strange faces. A medium-size dark-skinned man stops you. I’m sorry, he says, staff only here. His name tag says dr. aziz. It’s okay, you tell him. I’m Dr. Jennifer White. Apparently there was a schedule mix-up, but it looks like you could use the help.

Dr. White? he asks, but you are already at the back sink, washing up. You go to the wardrobe, take a white coat, button it over your dress. What do you have for me? you ask. The other doctor hesitates, then shrugs. Room three, a rash, could be shingles, could be poison oak, he says. The chart is on the door.

You give a quick knock for courtesy, then enter the room. The woman is perhaps thirty, African American, a fine strong frame. But she is holding on to her left side and her face is in pain. Let me see, you say, and she reluctantly lets go. You pull back the blue hospital gown to see an angry rash with raised red bumps and blisters that have erupted on the skin in a band that reaches across her belly and around her back.

Does this hurt? you ask.

Yes. It started out as a kind of tingling. But now it hurts. Badly.

You look. Some of them have become pus-filled, others are still in the early stages of formation. You motion for her to turn over. Nothing on the other side, just this broad swath down the right side of her body, her hip, thigh, and buttocks.

What is it?

Herpes zoster. Known more commonly as shingles, you say. I’m going to prescribe one of the antivirals. Acyclovir. It should decrease the duration of skin rash and pain. I hope we’ve caught it early enough. Also apply cold compresses to the rash three times a day. Above all, do not scratch or you risk infection.

How did I get this? You called it herpes. Did I get it from my boyfriend?

No, not at all. Shingles is caused by the same virus that causes chickenpox. You know, what you had as a child.

You are looking for your prescription pad. It’s not in your pocket. You excuse yourself and go out into the hallway.

Excuse me?

Yes, Doctor?

I have misplaced my prescription pad. Can you get me one? You turn and nearly bump into another woman wearing a white coat. She does not have a name tag on. She looks frazzled. She examines your face with curiosity. Are you Dr. White? she asks.

You nod, yes.

I recognize your photo. I didn’t realize you were still involved in the clinic. I thought you’d retired. Dr. Tsien still talks about how much you are missed at the hospital. She frowns, opens her mouth, closes it again.

You don’t follow all of this. I come here every Wednesday, you say.

But today’s Thursday.

You pause, think. I must have had a conflict this week, you say.

Everyone has been very grateful for your help. That a doctor of your caliber would work here pro bono has always meant a lot to us. Not to mention the other contributions you’ve made, of course. She still has a bemused look on her face, as if trying to remember something.

You turn to go. You face a bewildering mass of doors. Where were you? You pick a door at random and go in. An older man is sitting in his underwear. He looks surprised. Is something wrong, Doctor? You tell me, you say. What brought you here today?

The man looks uncomfortable. As I told the other doctor, I’m having trouble going to the bathroom.

Does it hurt? Or do you have urgency but no voiding?

The second one. I think. I try to piss and nothing comes out. It hurts.

Any erectile dysfunction?

Excuse me?

Do you have trouble maintaining an erection?

No, of course not. The man doesn’t look at you when he says this.

Liar, you think.

How long have you had this dysuria? you ask.

This what?

This urgency but no voiding.

About a month. It comes and goes.

Any blood in the urine?

He hesitates, then says flatly, No.

Any pain or stiffness in the lower back, hips, or upper thighs?

Maybe.

My guess is prostatitis, you say. Then, after seeing his reaction, you add: Relax, it’s not cancer and it will not lead to cancer.

Is it curable? he asks.

Sometimes. Sometimes not. But we can almost certainly relieve the symptoms, you tell him. We’re going to start by taking a urine sample to rule out bacterial prostatitis.

There is a slight knock at the door. A woman is standing there. Dr. White? she says. There is a cab driver who says you owe him money. He’s kept the meter running, so it’s up to sixty-five dollars now. What should I do?

I didn’t take a cab, you say.

He says he drove a doctor here, a woman, and he described you. Perfectly. What should I do? He won’t go away.

I’m busy here, I have roomfuls of patients to see, can’t you take care of this?

He’s really quite insistent.

Very well. You turn to the man. I’ll be right back.

You follow the woman out of the room and nearly bump into a dark-skinned man going in.

Doctor?

Yes?

Was there some reason you were in with my patient?

To examine him, of course. He needs to provide a urine sample, have some blood work done.

Yes, I know. I’m surprised you found it necessary to interfere. I didn’t ask for a consult.

There is a dark young man wearing a T-shirt and blue jeans standing at the counter, surrounded by people.

There she is, he says. He addresses you directly. You said you would borrow the money. Now the fare has increased. It would be even more if I were keeping the meter running now. I turned it off. Can you please pay me? It is now sixty-five dollars.

I don’t know what you’re talking about, you say.

I picked you up at Fullerton and Sheffield. In the rain. You left your purse at home. You said you would borrow the money.

The dark-skinned doctor is now standing behind you. Is there a problem? he asks.

This lady owes me sixty-five dollars. I don’t know why she is lying. If she really is a doctor, she can afford it. If I lose this fare my boss will take it out on me.

The dark-skinned doctor reaches into his pocket. I have fifty dollars. Will that be enough?

The cab driver considers. A phone rings, he picks up his cell phone and flips it open, and speaks in an unintelligible tongue.

Okay. Fine. But I am very upset with this. You’re lucky I don’t call the police.

I’m glad that’s settled, you say, and return to the clinical area.

You are examining a five-year-old complaining of a stomachache when someone knocks on your door. Come in, you call. In walks a heavyset woman, short dark hair. A blazer. She is holding something in her hand.

Dr. White.

Yes?

You are scribbling instructions to the lab, trying to concentrate. The child’s mother is asking questions in a language you don’t understand, the child is whining, and your stomach is complaining from hunger.

Please get the nurse. I need a translator.

Dr. White, you’ll need to come with me, please.

I’m not done.

You consulted the clock.

I’m here until four pm. I can see you then.

Dr. White, I am Detective Luton of the Chicago police.

Yes? You don’t look up.

You and I have met before.

Not that I can remember, you say. You finish writing, hand the slip to the mother, and open the door to usher her and her child out. Then you turn to face the woman directly. No, you say, we have never met.

I understand that you believe that. But we actually have what you could call a relationship. At least I consider it so. Her brown eyes are so dark that the pupils are almost indistinguishable from the irises. She seems to be on edge, yet is speaking in an even voice.

What is this about?

A number of things. The most immediate is that you’re practicing medicine without a license, since yours expired. Then there’s some other outstanding business.

Such as? You lean against the examining table, cross your arms and your ankles. A posture that inevitably intimidated your residents. This woman doesn’t appear in the least disconcerted.

There’s the fact that you went AWOL from your residence yesterday afternoon. Your children have been frantic. The police have been looking for you for more than thirty hours. Funny, we never thought of looking here.

Why the police? you ask. I am an adult. Where I go and what I do is my own business.

I’m afraid not, the woman said.

That’s ridiculous. I just saw Amanda this morning, you say. We had breakfast together. At Ann Sather’s, on Belmont. Every Friday, it’s our time.

Amanda O’Toole has been dead for more than seven months now, Dr. White.

Impossible. She was sitting opposite me eating Swedish pancakes this morning, you say. She complained about the coffee to the waitress, as usual. Then left an overly generous tip. A very typical meal on a very typical day at the end of a very typical week.

You need to come with me, Dr. White.

Faces are crowding up behind the woman’s from the hallway. Faces curious and not particularly friendly. You unfold your arms, stand up straight. All right. But you are interfering with some important work. A lot of the people you saw waiting in the front office won’t get seen today because of you.

To this the woman says nothing, but gestures toward the door. You hesitate before exiting the room in front of her. You feel her hand on your shoulder, guiding you. The people part as you walk silently out of the clinic.

You’re in the front seat on the passenger’s side of a small brown car with faded upholstered green-and-cream plaid seats. The seat belt is jammed, so you just hold it across your lap. The woman looks over and smiles. Hope we don’t get stopped, she says. That would be something. She puts the car into reverse, backs up, nudges the car behind, then puts the car into first and inches away from the curb.

Your daughter has been worried about you, she says as she pulls out into traffic. It’s now getting into late afternoon, rush hour has started, and Chicago Avenue is clogged in both directions.

Fiona? you ask. Why? She knows where she can find me. I’m here every week.

Nevertheless, the woman says. She is drumming her fingers on the steering wheel. She is in the right lane, behind a red Honda minivan when she puts her blinker on, sharply turns the wheel, and pulls into the left lane. Horns blare.

Are we going to the hospital? you ask. Have I received a page?

The woman shakes her head. No, she says. She picks up a small phone lying next to the gear box. She pushes a button and brings the phone to her ear, waits and then speaks loudly into it. Hello? Fiona? This is Detective Luton. I found your mother. The New Hope Clinic—she was treating patients. I need you to come to the precinct. Call me when you get this.

And she hangs up.

Fiona is in California, you say.

Not anymore, says the woman. Just Hyde Park.

This isn’t the way home, you say.

The woman sighs. We’re not going there. Just to the station. You’ve been there before.

The words make no sense. She is your sister, your long-lost sister. Or your mother. A shape-shifter. Anything is possible.

The woman is still talking. There’s no going back to your former facility. She gives you a quick sideways glance. You’ve deteriorated quite a bit since the last time I saw you.

There is such pity in her voice that you are jolted back into a more solid world. You look around. You’re on the Kennedy now, heading south. This woman drives too fast, but expertly, taking a long off-ramp that swings around to the left and straightens out before passing directly underneath a long stone building spanning the highway. Left, then right, then a glimpse of the lake before a sharp right turn, and down into an underground garage and into a parking stall with a screech. A sudden and absolute silence. A damp smell.

You both sit in the dim light for a moment without speaking. You like it here. It feels safe. You like this woman. Who does she remind you of ? Someone you can depend on. Finally she speaks. This is highly irregular, she says. But I’ve never been one for following the rules. Neither have you, by the sound of things.

She leads the way to the elevator, pushes the up button. Something just wasn’t right about this from the beginning, she says. Nothing fit.

When the elevator comes, she shepherds you inside and punches the number 2. The doors are dented and pocked, and inside it smells of stale smoke. The whole compartment trembles and shakes before slowly beginning its ascent.

When it opens, you blink at the sudden bright light. You are in a long, cream-colored hallway humming with activity. Pipes run across the ceiling and down to the floor. Posters and flyers are tacked to the walls, ignored by the people streaming in both directions down the hall. The woman you’re with starts walking, jingling a ring of keys, and you go on for some time, getting jostled by men and women, some in uniform, some dressed as if for the office, many casually, even sloppily attired. You wonder what you look like in your white doctor’s coat, but no one gives you a glance. The woman finally stops at a door marked 218, inserts a key into the lock, opens the door, and gestures you inside.

Cool gray walls. No window. A gray steel desk, nothing on it except a cylinder holding a number of sharpened pencils and some photographs. The subjects range from faded black-and-white daguerreotypes of grim-looking men and women in clothes from a century ago to contemporary men and women, many of them holding children and many in uniform. No pictures of the woman herself, except one in the exact middle of the collection, of her and another woman, slim, with long ash-blond hair, standing next to each other, their shoulders slightly touching.

Sit down, the woman says. She pulls out a hard wooden chair. She then opens a corner cupboard, pulls out two bottles of water. She hands one to you. Here, drink this.

You gulp it down. You hadn’t realized how thirsty you were. The woman notices the bottle is now empty, takes it from your hand, and offers you the other one. You are grateful. Your legs and feet ache, so you slip off your shoes, wiggle your toes. A long day of surgery, of holding steady, of not allowing your attention to flag.

The woman settles herself on the opposite side of the desk. Do you remember anything at all of the last thirty-six hours?

I’ve been at work. First surgery, then on call. A busy week. I’ve been on my feet for fourteen hours a day.

You bend your knees and lift up your feet as though presenting evidence. She doesn’t look at them. She is intent on what she is saying.

I think you’ve been at the New Hope Clinic since this morning. But before that you were having quite an adventure.

You’re not making much sense, you say. But then you realize that nothing much does. Why are you sitting here with a stranger, wearing clothes not your own?

You look down at your feet and realize even the shoes are not yours: They are too wide and the wrong color: red. You never wore anything but sneakers and plain black pumps. Still, you slip them back on, struggle to stand up, fight the comfort of having firm wood support your thighs and buttocks.

It is time to go. Home again, home again, jiggity jig. You have a vision of a train speeding past a small plot of parched earth, of a clothesline strung between wooden poles from which hang a man’s trousers, a woman’s housedress, and some frilly dresses that belong to a young girl.

A tall dark man, a sweet melancholy face, kneeling by your side as you dig a hole in the dirt. He puts his hand in his pocket, brings out a fistful of coins, opens his hand, and lets them fall into the hole. Then he helps you push dirt over them, pat it down so there’s no trace.

Buried treasure! he says, and laugh lines appear around his eyes. But you know what you need? he asks. A map. To remind you, so you can retrieve the treasure when you need it. I won’t forget, you say, I never forget anything, and this time he laughs out loud. We’ll come back in a year and see if you can find it, he says. But you never did.

It’s time, you say, and begin to push yourself up.

The woman leans over, puts a hand on your arm, and gently but firmly pulls you back to a sitting position. You went away for a minute, she says.

I was remembering my father, you say.

Good memories?

Always.

That’s something to be grateful for. She sits for a moment, motionless, then shakes her head.

There was a disturbance at your old residence last night. A neighbor reported an attempted break-in. Was that you?

You lift up your hands, shrug.

If it was you, you weren’t alone; the neighbor saw two and perhaps other people at your former house. By the time we got a car there, everyone was gone.

There is a burst of music. A sort of cha-cha. The woman gets up and retrieves a small metal object from a table, holds it to her ear, listens, says some words. She looks at you, and says something else. Then puts down the device.

That was Fiona, she says. She’s on her way.

Who’s Fiona? you ask. The visions come and go. You would prefer them to come and stay, to linger. You enjoy these visitations. The world would be a barren place indeed without them. But the woman isn’t listening. Suddenly she leans forward. She is focusing everything on you. She vanquishes the last remnants of your vision with her gaze.

It’s time for the truth, she said. Why did you do it?

Why did I do what? you ask.

Cut off her fingers. If I understand that, I can put the rest together. If you killed Amanda, I believe it was for a reason. But I don’t believe you would kill and then maim gratuitously.

Maim. An ugly word, you say.

An ugly business all around.

Some things are necessary.

Tell me why. Why was it necessary? Tell me. This is for me. Once I take you in, once you are committed to the state facility, that’s the end of it. Case closed. But not really. It will never be, in my mind, unless I know.

She didn’t mean for it to go that far.

What? What didn’t she mean?

It was coming a long time.

Sometimes things build up. I understand. I do.

There’s a knock on the door. The woman gets up, lets in a young woman with short hair.

Mom! She rushes over and hugs you, won’t let go. Thank God you’re all right. You had us all so worried. Detective Luton has been a godsend.

We’ve been going over things, says the older woman.

The young woman’s face tightens. Yes? Does she remember? What has she told you?

Nothing yet. But I feel we’re close. Very close.

That’s great, the young woman says mournfully. She has not let go of your hand. If anything, she is clasping it even tighter. Mom, shhh. You don’t have to say anything. It doesn’t matter anymore. There’s nothing worse they can do to you. You will not be judged fit to stand trial. Do you understand me?

A messy job.

The older woman speaks up. Yes, it was a messy job. How did you get rid of the bloody clothes?

Mom, you don’t have to say anything.

They were taken away.

Who took them away?

You shrug. You point.

Mom . . . The young woman puts her hands to her face, sits down heavily in a chair.

Jennifer, what are you saying?

Her. There. She took the bloody cloth, the gloves. Cleaned everything up.

Detective Luton—Megan—I don’t know why she’s saying this.

But it’s too late. The middle-aged woman has raised her head, the intelligence in her face aroused.

Three women in a room. One, the young one, deeply distressed. She has taken her hands away from her face and is clasping them tightly in her lap. Wringing them. Wringing her hands. A rough motion, this grasping and twisting of the metacarpal phalangeal joints, as if trying to extract the ligaments and tendons from under the skin.

Another woman, older, is thinking hard. She is looking at the young woman, but she is not seeing her. She is seeing images play out in her mind, images that are telling her some sort of story.

And the third woman, oldest of all, is dreaming. Not really present. Although she knows she is wearing clothes, sitting on a hard chair, that material is pressed against her skin, she cannot feel any of it. Her body is weightless. The atmosphere has thickened. It is difficult to breathe. And time has slowed. An entire life could be lived between heartbeats. She is drowning in air. Soon, scenes will begin appearing before her eyes.

The woman, the one that is neither old nor young, is opening her mouth. The words drop out, hang motionless in the congealing atmosphere.

At last, something is making sense, she says. A beat of silence. Then another. Perfect sense, she says. She stands up. She is working something out. Even if your mother were capable of killing, it’s unlikely that she would have been able to cover her tracks so thoroughly. Not without help.

The younger woman’s hands are now still, but they are gripping each other so tightly that all blood has drained from the knuckles. She closes her eyes. She doesn’t speak.

The middle-aged woman’s voice is getting louder. She is coming alive as the young and old women shut down. That’s one of the things that saved your mother from being charged for so long. Her capacity for that kind of act was so obviously not there. But if she had assistance . . . Yours . . .

When the young woman finally speaks, her voice is so low you can scarcely hear it. What are you going to do? she asks.

I don’t know, says the middle-aged woman. First I have to understand.

Understand? What is there to understand? The young woman is speaking faster now, agitatedly. Her voice is higher, pleading. She tugs at the edges of her shorn hair. Almost whining. You do not find it attractive. What does it remind you of ? Stop that. Stop it now. She did it, the young woman says, loudly. I found out. I helped her cover it up.

Not so fast, the middle-aged woman says. I need to understand. She picks up something from the table, runs her fingers across it, puts it down before continuing. Did she give you any indication that she was angry at Amanda? That she was thinking about doing something like this?

Absolutely not. The young woman almost interrupts, she is so eager to answer. She places her hands in her lap, one on top of the other, like stacking bundles of kindling. Willing them not to move.

Then how did you know to go over there? The older woman’s voice is rising. She is losing control even as the younger woman is regaining it. They are focused entirely on each other. One tamping down emotions, the other escalating them.

I went home to check up on her. I’d been worrying. And I couldn’t sleep that night. I thought I’d spend the night there, give Magdalena a break.

Why didn’t you tell us this?

Because one thing would lead to another and you would ask too many questions.

And so . . . ?

I pulled up into the parking space next to the garage. Behind the house. And saw my mother coming down the alley. She was spattered with blood. All I could get out of her was one word: Amanda. So I took her there. And found her.

Did your mother say why?

She said it was blackmail.

Blackmail?

Yes.

About what?

About me. The circumstances of my birth. That my mother didn’t know who my father was. Not for sure. Amanda was going to tell.

Tell who? Your father was dead. Who else would care?

Me. How ironic. My mother killed to protect me. Or some idea she had about how I wouldn’t be able to handle the truth. Or perhaps it was Amanda pushing things one inch too far.

And so you cleaned it up, the older woman says.

And so I cleaned it all up, says the younger woman. She is even calmer now. Almost relieved.

What did you do with the fingers?

I wrapped them up and tossed them into the Chicago River, off the Kinzie Street Bridge.

You did a good job of it. What about the scalpel?

You mean the scalpel blades? I threw them out with the fingers. I tried to take the scalpel handle, too. But my mother wouldn’t let me. She took it home, along with the unused blades. You know the rest about those.

The older woman has been pacing. Back and forth, between the wall and the desk. Yes, she says. We know the rest. She is now looking at you again. They are both looking at you. You are now visible again. You are not sure that you like that. You felt safer floating in the ether.

But the fingers, says the older woman, suddenly. What about the fingers?

The younger woman shudders. She turns away from you, as if she can’t bear what she sees. She answers the older woman without looking at her, either.

I don’t know, she says. I haven’t a clue about that. It was just the way Amanda was when I found her.

The older woman is quiet for a moment. Then she comes over, sits down next to you, and takes your hand.

Were you able to follow this, Dr. White?

There are pictures in my head, you say. Not gentle visitations. The other kind.

Is that the way it happened?

A horrifying tableau.

Yes. Indeed it was. Can you tell us now why you dismembered her hand?

She had something I needed. She wouldn’t give it up.

The woman is suddenly alert, her hand reaching out and taking hold of your arm. What did you say? she asks in a soft voice that belies the strength of her grip. What did she have?

The medal.

The medal? The older woman is not expecting this. The Saint Christopher medal?

The young woman sits up. She has a look on her face.

Mom.

You wave her away.

Amanda had the medal. She wouldn’t give it up, you say.

But I don’t understand. Why would she have your medal?

Mom . . .

There are voices outside the door, a shadow in the smoked glass at the top half of it. Then a loud knock—rat-tat-tat-tat. The woman gets out of the chair and reaches the door just as it is opening. She stops it with her foot, not letting whoever it is step inside. She speaks a few quiet words, then shuts and locks the door before sitting down again.

You were saying, she says. About the medal.

You do not know what she is talking about. The medal, you repeat.

Yes, the medal. She sounds frustrated. You were about to tell me about the medal. About Amanda and the medal. What did that have to do with the fingers? She gets up again, comes around the desk, reaches out as if to grab your shoulders. To shake it out of you. But what? You are no use to her. You shake your head.

The young woman opens her mouth to talk, hesitates, then speaks up.

Amanda had the medal clutched in her hand. She must have grabbed it from my mother’s neck during the struggle. Then rigor mortis set in.

The older woman backs away from you, faces the younger woman. Her face is a study.

And so she cut open her hand to get it back.

Fiona, you say.

Yes, Mom, I’m here.

Fiona, my girl.

The older woman’s voice is cold. A fine little actress. She pauses, addresses the young woman. You know, we could charge you as an accessory.

The younger woman is now trembling. It is her turn to get up, begin pacing the small room.

Continue telling me about the fingers, please. Please, Jennifer. Try to remember.

But you are quiet. You have said your piece, nothing remains. You are sitting in a strange room, with two strange women. Your feet hurt. Your stomach is empty. You want to go home.

It’s time, you say. My father, he gets so worried.

The young woman begins speaking again. I couldn’t pull the medal out of Amanda’s hand. She held it so tightly. Rigor mortis had set in. I panicked. I was certain someone was going to walk in. Then my mother just got to work.

Cutting off the fingers.

Yes.

She went back to the house, got her scalpel and blades. Washed her hands just as if she were performing a procedure in the OR. She found a plastic tablecloth and a pair of rubber gloves from the kitchen. The tablecloth she positioned under Amanda’s hand. Then she inserted the first blade in the scalpel and cut off the fingers, one at a time, changing the blade after each amputation was complete. She had to sever all four fingers before she was able to free the medal.

And then what did you do?

Took her home, washed her, put her to bed. Came back and cleaned up. It was easy—I just rolled up everything in the tablecloth and drove to the Kinzie Street Bridge. Then went home to Hyde Park and waited for the police to show up. I thought there was no way they couldn’t know.

The middle-aged woman doesn’t move for a moment.

Jennifer?

You wait for her to ask something else. But she seems to have run out of words.

Some things stick, you say.

Yes. Some things do. She looks miserable. Defeated.

For myself, I don’t care, you say. But Fiona.

The woman takes her hand away from you to watch Fiona, still pacing. Ten, twenty, then thirty seconds. A painful half minute. Then she makes her decision.

No. It’s not necessary to mention any of this. Not to anyone. The worst has happened. Nothing will make a difference for Amanda. Nothing will change what will happen to your mother.

Mom. The young woman is openly weeping. She comes over and kneels by your chair, puts her head in your lap.

Thank you, she says to the middle-aged woman.

It’s not for you. I have no loyalty to you.

No one is looking at anyone else. You reach out and touch the brightly colored head. You plunge your fingers into the hair. To your surprise, you feel something. Softness. Such silken luxury. You revel in it. To have regained your sense of touch. You stroke the head, feel its warmth. It is good. Sometimes the small things are enough.

FOUR

She is not hungry. So why do they keep placing food in front of her? Tough meat, applesauce. A cup of apple juice, as though she is a baby. She hates the sticky sweet smell, but she is thirsty, so she drinks. She wants to brush her teeth afterward, but they say, Not now, we’ll do that later. Then, much later, the sloppy hard scrubbing, the rasp of the bristles against her tongue, the cup of water brought to her lips and then taken away too soon. Rinse. Spit.

The bulky diaper, the shame. Take me to the bathroom.

No, I can’t, we don’t have the staff today, everyone’s on sixteen-hour shifts. Someone will change you later. Janice. I’ll send her in when she’s off break.

Jennifer, you are not eating. Jennifer, you must eat.

She shares her room with five other people. Four women and one man. The man sucks his toes like an infant. The nurses refer to them collectively as the Lady Killers.

There are no niceties. There are no soft edges. There is no salvation.

Once a day, they are let out of their room, allowed to walk around a cement courtyard. It is chilly, the season must be turning. Better than the suffocating heat. She takes care to stay away from the others, especially the contortionist, who is prone to bumping hard into people then daring them to complain.

She walks back and forth across the courtyard, head down, not seeing, not talking. It is safer that way. Sometimes her mother walks with her, sometimes Imogene, her best friend from first grade, chattering about monkey bars and ice cream. Mostly she walks it alone. She is having visions. Angels with flame-colored hair singing in that unending hymn of praise.

She’s doing it again. A voice nearby.

Stop it! Stop her! Another voice, a smoker’s voice accompanied by a cough.

The angels continue singing. Gloria in excelsis Deo. They are sending a savior. A very young man, but able. He will bring three gifts: The first gift she must not accept. The second gift she should give away to the first person who speaks to her kindly. The third gift is for her alone. This is the word of the Lord.

Her mother, her beauty known through five kingdoms, had three royal suitors. On Good Friday one brought her a rabbit, the symbol of fertility and renewal. Not to be outdone, on All Souls’ Eve the second suitor gave her a black cat, emblematic of the witches’ Sabbath. On the night before Christmas a donkey was found tied to a tree in the front yard. A donkey in Germantown! Let that be a lesson to you, her parents said. But she accepted none of these suitors because she was waiting. And then He came.

The laying of hands upon her, roughly. Now Jennifer, you have to stop that noise or we’ll have to put you in solitary again. Yes. What are you wailing about this time? Can you use your words? Not today, huh? Okay, then you can just stay quiet. That’s right. Shhh.

But when all is done, when the end is near, what is left? What is one left with? Physical sensation. The pleasure that comes from relieving one’s bowels under hygienic conditions. From laying one’s head on a soft pillow. The release of the straps after a long hard night of pulling and pushing. To awaken from nightmares and find that they were, comparatively, the sweetest of dreams. Now that it is over, now that it’s near the end, she can think. She can allow herself to drift to places that before she would not go.

It’s the visions that make the waiting possible. And what visions! In glorious color, all senses activated. Fields of blooming, perfumed flowers, gleaming sterile operating rooms ready for cutting, beloved faces that she can reach out and caress, and soft hands that caress back. Heavenly music.

Jennifer, your visitor is here. Time to get up. Let’s clean you up. You know the rules. Stay quiet, no yelling, keep your clothes on, do not grab or hit. That’s right. Here we are. Now I’ll just park you here. And look here is your visitor. You have an hour. I’ll be back.

She does not know this person. Is it male or female? She cannot tell anymore. Whoever it is, they are speaking.

Mom?

She doesn’t answer. She thinks something has happened, something important, but she can’t remember what.

Mom? Do you know who I am?

No, not really, she says. But your voice is comforting. I believe that you are dear to me in some way.

Thank you for that. The person takes her hand, tightly. It is reassuring. It is something tangible in a world of shadows.

She’s still not sure who this young person is, but she cannot stay here too long. There are a rabbit and a cat to feed and a donkey to ride.

How are things today? I’m sorry I’m late. Work’s been insane.

Yes, she knows how insane work can be. One patient after another, bones bursting out of skin, how fragile the human body is, how easily penetrated and broken, how difficult to put together again. But the work doesn’t need to be so sloppy. Who made this mess? She cannot believe it. She cannot believe her eyes. Who would do such a careless job.

You didn’t clean up the OR, she says.

It’s Fiona, Mom, your daughter. Here to say hello. Mark wants to come, but his work has been busy, too. He has a big case now, isn’t that exciting? They finally trusted him with an important one. He promises to come soon.

Mark is dead.

No, Mom, Mark, your son. He’s very much alive. He’s doing well. Much better. You’d be proud of him.

She can’t forget the OR. It is on her mind. Her vision of the day. A burning image.

You didn’t adequately prep for your procedure, she says. It was a mess from start to finish! Wherever did you do your training?

My undergraduate and master’s degrees at Stanford, Mom. You know that. And then back here for my doctorate at Chicago.

Sloppy. Sloppy and inexact. Have I taught you nothing? Skull base surgeries are delicate. Under the best of conditions you must be careful. But this is unsanitary, even brutal.

Mom.

That accounts for all the blood, of course.

Mom, please keep your voice down.

Then, louder, the man-woman person addresses the blue-suited woman sitting in the corner of the room. May we have a little privacy? We have some matters to discuss and it is difficult with a third party in the room.

It’s against rules.

I know, but just this once? Here. Here’s fifty dollars. Go have a smoke or a cup of coffee. No one will know. Nothing will happen. You can lock us in, that’s no problem. Just give us a little privacy.

Okay, but I’ll be waiting right outside.

The woman leaves the room. There is a rattling, then a click as the door is locked from the outside.

Mom, we’re alone, we can talk now.

She’s not sure what this person wants. She? He? has got both hands on her arms at this point, is squeezing too hard. It hurts.

Mom, are you remembering? Do you remember? What do you remember?

A botched job. Cruelty. You must never be cruel, however the temptation. And for many, it is a temptation.

What do you remember?

There is much pathology among surgeons. If patients knew, they’d be even more frightened of going under the knife than they already are.

Are you recalling that night?

I know some things.

What do you know?

I have these visions.

Yes? The person is growing agitated. Their green eyes are fixed on hers.

It can be difficult, she says. She is exerting herself, trying to break through the noise, trying to see past the blood. The clumsy job. The unmoving patient.

But you are having a vision now? Mom? Are you?

Quia peccavimus tibi.

What is that? Italian? Spanish?

Miserere nostri.

Mom.

My darling girl. Of course I had to help her.

The person is crying. Mom, please. The woman will be back soon. You must be careful what you say.

My darling girl. And yet I didn’t want her. I took one look and said, No, take her away. Get me back to work, fast. Give me my body back, free of this parasite. And she turned out to be the most important thing. The thing I’d do anything for.

Stop, Mom, you’re breaking my heart. The creature is now pacing up and down the room, beating its arms against its side, seemingly intent upon doing itself an injury. I would have told them everything if you had remembered. I would never have done this to you. Every day I think of turning myself in. No. Every hour. I’ll never have peace again.

It stops for a moment, takes a breath, and then continues.

Do you remember why? I want you to know why. I told you that night, but we never spoke of it again. I didn’t want to ask. I didn’t want to bring up something you may have put out of your mind. Do you want me to tell you again? It was for us, for the family. Amanda knew. She confronted me. She would have told.

Yes, I knew that she knew. That she would have figured it out. Too smart, my girl.

Mom, at first it was that I just couldn’t make the numbers make sense. But I didn’t know for a while exactly what Dad had done. Then it all became clear. The extent of it. It was a shock, I tell you. Dad!

The money was ours. James earned it.

You mean he stole it, Mom.

Yes.

And kept stealing. Until Amanda stopped him.

Yes.

And you told her that you had returned it. All of it. And were repaying your debt to society by working at the clinic. But you hadn’t. You managed to keep her from knowing.

It was our secret, yes, James’s and mine.

Then Dad died. And you were deteriorating. I found it all out when going through your papers. At first I thought you didn’t know about it, that it was all Dad. But then of course I realized you must have known. And ever since I assumed financial power of attorney, Amanda had been asking me questions. Probing. Somehow she found out there was money. Too much money. That she had been your dupe. That I’d been corrupted, as you had been. She couldn’t stand that.

James had been right to worry about Fiona. It was too much for her.

And then she kept harassing you. Wouldn’t give up. Despite your condition. That afternoon, you’d had a fight. Magdalena told me. You were terribly upset. She had to take you to the ER. They had to inject you to calm you down. Magdalena called me. She was furious. That woman has gone too far, she said. I wasn’t able to get there until late—I had a faculty event I couldn’t get out of. So I drove up around ten PM. I parked in front of your house, walked to Amanda’s. I can still see the expression on her face when she opened the door. Triumphant. No regrets. She had wormed what she needed out of you. And set to work on me. The things she said, horrible things. About you, Dad, and especially me.

Amanda told me, I put a stop to it back then, and I will not have you perpetuate it now. With your father dead and your mother the way she is, you can discover the past crimes of your parents and make restitution. Recreate yourself as an ethical citizen.

The person is deep into the story and startles when spoken to.

Keep an eye on Fiona, James told me when she was still very young. Not even ten years old. You know what worried him the most?

What, Mom?

All the caretaking. Of her brother. Giving it all away and leaving herself defenseless. She’s at risk, he told me. Watch her carefully.

Amanda was going to report me, Mom. It would have been the end of us, our family, what little was left. And she told me such things. About Dad, about you. Nasty things. Amanda at her worst, her supercilious morality on full display. She would recreate me in her image, she said. A righteous image. I was so distraught, so angry. I pushed my way past her into the house. I had no plans. But somehow I found myself shaking her by the shoulders—I had to reach up, she is so tall. She laughed at me— at my ineffectiveness, at my—my weakness. So I gave her a hard shove. And she fell backward, hitting her head on the corner of that oak table in her hallway. So much blood! And the world just stopped turning. I knelt down, tried to feel for a heartbeat: nothing. I was desperate. Bloodied and shaking with the chills and the horror of it all. I couldn’t think clearly. I just ran—got in my car and began driving home, driving too quickly. It’s amazing I didn’t get stopped. I was past Armitage when I realized I didn’t have my Saint Christopher medal. Your medal. It was there in Amanda’s hand when I got back, but rigor mortis had already set in. I must have been sitting there for some time when you found us. I was just out of my mind.

All my beloved, gone. Except the one, the girl.

I didn’t know you were there until you came up behind me, knelt down. You held me for a moment. Then you took me by the arm, pulled me up, and moved me away from the body.

A botched job. A cruel job.

I was out of my mind.

But that terrible tableau. There on the floor. All the blood. But worst of all, the look on her face. Horror, yes, but something else. Satisfaction.

You know the rest, and after, how I scrambled to remove any evidence.

An unwelcome vision. It keeps visiting me. But is it true?

The person covered its face.

The two people you love most in the world. And it’s not the death that matters, but the look on your darling’s face. The dark joy. Unbearable.

You never hesitated. You just set to work. No recriminations, no questions. You protected me. You saved me. The person is quiet for a moment. I guess you could say we managed to have a moment of grace in the midst of the horror. The person reaches out a hand.

Mom? What’s wrong?

No. I will not go that far. I am not that far gone.

The person is starting to cry again. Mom? What are you saying?

She thinks then. She can still think sometimes. She knows this person. She knows what this person is capable of. She now knows. So this is how it ends. So this is what it feels like to get beyond pain. You can get beyond it.

Mom, please.

So this is how it ends.

Mom. This is not how I imagined things would be.

Each day slower than the one before it. Each day more words disappear. The visions alone endure. The playground. The white Communion dress. Playing kickball in the streets. James burning toast. The babies. The one she had to learn to love. The one she thought she couldn’t love under any circumstances.

And that second one is all that matters now.

The large woman in blue is back, rattling her keys. Visiting hours are over.

Yes, I have to go anyway. The person is wiping its eyes. It is getting up. Mom, I’m going to have to skip tomorrow. You know it’s a teaching day. But certainly on Thursday. I’ll see you then.

What matters at the end are the visions. There is no one to hold up the books anymore, to ask if she remembers. But it doesn’t matter. She doesn’t need the photos now. Now they come directly to her. Her mother, her father. They have news for her, jokes. James, holding back at first, then allowing himself to be drawn in. And Amanda. Amanda is there, too, whole and strong. She is angry; who wouldn’t be? But after her anger burns itself out, there will be something left.

Nurse, she’s doing it again.

There is a good place here. It is possible to find it. With such dear friends. Even with the silent ones. Then there are the ones that have risen again. Sent by God.

Nurse, can you shut her up?

Accepting what you have done. Accepting the visions. Waiting it out in their company. In the end, that is enough.

ACKNOWLEDGMENTS

My heartfelt thanks to friends who commented on early drafts of this work, especially Marilyn Lewis, Jill Simonsen, Mary Petrosky, Carol Czyzewski, Christie Cochrell, Diane Cassidy, Marilyn Waite, Judy Weiler, Connie Guidotti, and Florence Schorow. I was thrilled to get the chance to work with Grove/Atlantic’s legendary editor, Elisabeth Schmitz, whose insight and generosity of spirit made this a much better book than it otherwise would have been. My thanks also to Morgan Entrekin for his encouragement and support, and to Jessica Monahan, who held things together through the editorial process. My special gratitude goes to dear old friend Dr. Mitch Rotman for his invaluable advice on medical matters; however, any errors there are mine, not his. I can’t thank enough my agent, Victoria Skurnick, of the Levine-Greenberg Literary Agency, whose utter professionalism was matched only by her extraordinary personal warmth: I know now why she is beloved throughout the industry. And of course I couldn’t have done it without my family, who, after much debate, let me have the comfy chair to write in: David and Sarah, much love to you.

Table of Contents

COVER PAGE

TITLE PAGE

COPYRIGHT PAGE

DEDICATION

CONTENTS

ONE

TWO

THREE

FOUR

ACKNOWLEDGMENTS