Rembrandt’s ‘Return of the Prodigal Son’

In the course of conversation today a man said, ‘My doctor showed me a painting by Rembrandt. It was the Prodigal Son. Do you know it?”

I didn’t know it. 
I pulled Mister Google from my pocket as the man continued: ‘My doctor showed me the painting. I looked at the painting, wondering. I looked back at my doctor. He was looking at the painting and I saw his eyes in a sea of tears.’

It was my turn to gaze at the painting. I was right: I’d never seen the image before. My own eyes stung. 

Dinner with Some Old Teenagers

Word reached me, and when it came, it came obliquely. My writer friend in England, Hilary Custance Green, forwarded a letter that had reached her by way of one or another of the virtual media. ‘I wasn’t certain what to do with this,’ she wrote, ‘I thought it might be spam, but I decided to forward it, just in case.’ The writer of the letter asked Hilary if she could forward it to her old doctor. The letter bore strong feelings that had brewed and bubbled within the writer over years.
‘Dear Dr Goldenberg, I don’t know if you remember me but I remember you and I have wanted to contact you for a long time.’ There followed the remarkable declaration that my actions had saved the writer, now aged fifty-five, when she was a girl of seventeen. She owed her present happy life, she wrote, to my intervention, as well as the help of some others around that time. 

The letter, and the memories it evoked, thudded, jolted within me. Yes I did remember the girl, firstborn of three, trapped in a hell where her violent alcoholic father abused all in the home. I remember the face, fair skinned, the coronet of fair hair. And her brave, fugitive smile. 

I read on, and as I read the girl’s name came to me, a diminutive in the Australian way, never Anna but ‘Annie.’ Annie’s father was a helpless, hopeless drunk, and when drunk prone to unpredictable extremity. Annie would await his return from the pub with dread, hoping he’d keep away, hoping helplessly her mother and sisters would be safe. She’d have fled the family home long before but father had screamed and waved his gun at her. His words – ‘If you try to leave I’ll shoot you and the others and myself’ – shocked me. Uselessly, helplessly, I trembled for the child. The child confided she never brought a friend into that house, for fear of the shame. She told me these things, forty years ago, and I recognised a further shame, even deeper, Annie’s self-disgrace to be ashamed of her own father.    

In her letter Annie reminded me of the Saturday night she finally escaped. Father had drunk all that day and into the night. Annie sheltered in her bedroom but when father burst in she ran from him, wearing only her nightclothes. Father screamed behind her, ‘You’ll never come back into this house, girl!’ The girl walked through the early hours, avoiding exposed places. She found herself in the deep dark of a railway culvert and, terrified in that blackness she decided, ‘This is where I’ll have to sleep from now on.’
Annie wrote, ‘I walked to the clinic and laid down and waited there for you to arrive. You’d always been kind and understanding. I knew you worked the Sunday mornings. I didn’t have anywhere else. You took me in when you arrived and after work you drove me home so I could safely collect some clothes. Then you drove me to a refuge.’

Annie’s account of that last-first morning was only dimly familiar. I felt small stirrings of pride, and a tenderness for the girl in the nightdress. Much stronger was my shock as I realised I had not thought of her since the ‘rescue.’ Annie had disappeared from the days of those busy years. She had lived, thrived, suffered reverses, sought salvation, recovered, blossomed, become the assertive woman her mother could never be, married happily and raised children, good citizens, and now saw grandchildren. Forty years and no thought by her wonderful caring doctor. That child had come into her own and that doctor had reached his prime and passed it.
Perturbed, I wrote to Hilary to thank her for sending word, for her gift.
The word found me in the outback. I wrote to Annie, giving my phone number and told her I was anxious to speak to her. My phone rang as I rode my bike across the railway line. I dismounted and answered and the voice said it was Annie and for twenty minutes I listened to her narration of the events of a turbulent life. We agreed we’d meet after my return from the outback.
In the exchange of emails that followed a second voice entered, followed by a third, then a fourth. Later a fifth and a sixth made contact. The writers, all roughly contemporaries, had been my patients in their teenage years. Each bore a burden of recollection which pressed now to be discharged.

Three women, matrons now, waited for me at the restaurant. I opened the door to faces that shone. I saw three faces of girls in their teens. I stepped forward and found myself clasped. Lined faces kissed mine, ample bodies held me close.

We sat. The women said how young I looked, I said how good they looked. The past was with us, the past with its beauty and its horror. The past, reverberating with friendships I had forgotten and the three had remembered. 
How had I forgotten?
The waitress came, hovered, departed. Again she came and we promised we’d soon choose and order. It was not soon. Forty years here, twenty there, so much event, so much life. Babies – it turned out I had delivered them – were now adults, some even parents.  
The waitress returned. Jerked into the present we ordered.

Girls Numbers Two and Three are sisters. I asked after their parents, immigrants, older than me by ten years, proud people, beavers in the general community and within their own. Mum was alive, still vibrant – ‘and fat, like all of us!’ Shrieks of laughter. And Dad?

‘Dad’s fat too, and dementing. The grog; it’s Korsakov’s.’ The speaker is Number Two, now a nurse. In the care of their aging parents she’s the officer commanding Number Three and their brothers. 

Both Three and Two were married when I last knew them. They’d married matching buffoons, agreeable blokes when sober, not often sober, not often enough agreeable. Three spoke: ‘Even before we married I saw how my father in law treated his wife. He’d tell her she was stupid, shout at her to shut up when she spoke. One time I saw him belting into her – he was full as usual. I froze. We never saw that. Mum and Dad would drink a couple of gins after work but they never got nasty. Not like that.’ 

Memories returned to me of the mother in law. A tall trembling lady, her face pink and scarred, she’d address me in a soft trembly voice, describing symptoms I could never fathom, never cure. Now I understood.

‘It wasn’t too long before Robbie was getting aggressive like his Dad. He’d go to the pub after work, get full, drive home drunk. I had my first girl, then the second. I thought, “No. This isn’t what I want for them, not what I want them to see.“ I rang Robbie and I said, “Don’t hurry home you drunken bum. Your wife and your kids have split.”’ Peals of laughter from Three, far the widest at our table. ‘Did he ever hit you?’ – I wondered. ‘Lot’s of times, but I’d belt him too!’ More jolly mirth. Three sits opposite me, her great arms a gallery of art in brilliant reds. Finer tattoos crawl upward from her bodice, another spiders around her neck.

‘Weren’t you scared, leaving him?’

‘No.’ The thought is a stranger to Three. She stares at my unexpected question. ‘There was no future there. I got up, took my girls and went.’

Did I raise an eyebrow? I certainly wondered at her resolve, her clarity. Her fearlessness. ‘Yeah, money was tight. I got a job and I worked and I looked after my girls. They’re good. Their blokes are lovely. And the three of us, we’re very close. Like me and sis here.’ The two women looked at each other and smiled.

Two reminded me: ‘I was a mother at nineteen. Got married. You delivered my babies, Howard. I was in labour, terrified, not knowing anything. You got up on the bed beside me and stroked my back.’ Did I? Nowadays the Medical Board would caution me for this sort of thing. They’d require me to undergo Education.

Two continued: ’You know everything about us. You’ve seen all our vaginas!’ Careless in their merriment the girls showed none of the self-consciousness that saw me look down and blush. ‘I’m diabetic now,’ continued Two. ‘But I’m good. After I left my husband I worked as a nurse, you know, State Enrolled. When my kids were adult and near-adult my partner encouraged me. He said, “You’ve always wanted to study. Do it.” So I did. I studied nursing at Melbourne University. Boy that’s a gap – from Victoria Uni to Melbourne. But I did well…’

‘Got Distinctions’, Three’s voice was proud.

‘I did all of it on scholarships. I had to perform. They can take the scholarship away if you get bare passes. Now I’m specializing in Mental Health, in charge of the ward. I love it.’

Three told me how she too had always worked in health, in administration. She described without bitterness how, after eighteen years, her institution had managed her out of her job and into retirement. ‘Now I write poetry. I go to Creative Writing classes. And every Wednesday I post a poem on Facebook. Wednesday is the hump of the week. I call my readers, my “humpies.” Here’s this week’s poem’. Three handed me her phone where I read her tidy quatrains. The verses spoke in anticipation of this gathering, in praise of the poet’s doctor, his kindness, his understanding. Blushing again I came across a ‘Like’ in response. The author of the Like was Four, another ex-teenager whose family I’d been close to. Four wrote, ‘I remember how Dr Howard comforted me when Karen died.’ Another thump. 

I remembered Four, a striking girl with olive skin, tight black curls, a smile that made you feel like singing. I remembered Karen, Karen who was lost, that sparkling child. Karen was in the car that drove to the pub in the bush hamlet twenty kilometres distant from my country practice. The pub filled the young driver up with grog and watched him drive the carful of friends home. How many died when the car missed the bend? Four? Five? Karen was extinguished in that crash. I remember speaking afterwards with Four. Was she the only one I was trying to comfort? I think I was trying to comfort myself too. A year or so later another young driver killed himself driving home from the same pub. His passenger suffered a fractured neck, became quadriplegic. From that time until left I doctored the human wreckage. And my rage burned against that pub. I nursed a futile wish to close it down.
*** 
The girls spoke of the men in their present lives. Annie had formed a lasting union with Ian that prospers still. She showed me the album her family made for her fiftieth birthday. Here were Annie’s mum, Annie at fifteen, Annie’s own grown children, Annie with Ian. I saw a tall man, angular and strong-looking, with a craggy face. Two and Three spoke warmly of their own blokes. All three had known some duds but the ‘girls’ bore no hostility to the male race. When, at the conclusion of the evening, Ian turned up to drive Annie home he towered over me. My not-small hand was lost in his handclasp. Instantly likable, solid as a wall, he smiled and I felt gladdened for Annie.

Two asked Annie: ‘Have you ever seen your father again?’ Quietly came the reply: ‘I always vowed I never would. Then four years ago he wrote to me, to all of us, Mum, my sisters. He said he was dying, in Mallacoota. His heart was failing, from the grog. He wanted to see us. Mum wouldn’t come, neither would my sisters. But I thought, “He can’t hurt me now.” So I went. He talked and he talked, poured out his side of our lives. He lay on the bed and asked me to lay by him and cuddle him.’ 
I looked at Annie, my eyes wide. 

‘I thought, “He can’t hurt me now. He’s old and he’s dying alone.” He’s got a partner but she’s not his blood. It’s not the same. I climbed up beside him and I held him. We laid there together for a good while. After a couple of days I went home. He died two weeks later.’

Do You Have Children? 

She was the first patient in my day.
She was sent to this city in North Queensland by the foreign mining giant that employs her. 
I had never met her before. We introduced ourselves.
 She said: ‘I was woken by awful pain in my bladder. It’s an infection, I’ve had them before. I couldn’t sleep for the pain. It was four in the morning, but I got up and went out and walked the streets until I found a 7- eleven. I bought some Nurofen tablets for the pain.’
‘Did they help?’
‘A little.’
Her urinalysis was positive.
‘I think you’ll need an antibiotic. Antibiotics famously render the oral contraceptive pill inoperative. Maybe. So during this cycle you shouldn’t trust the pill… unless you want a baby.’
A smile and a shake of the head. The smile is not that smile that says, ‘Tread with care.’ She is a mature woman at peace with herself. Excepting for her hostile bladder. The smile licensed me:
‘Do you have children?’
‘No.’
Another smile as she sat and formulated a response to my silence.
‘I never thought I would. Now I realise I really have to decide – this month in fact. You see I’ll turn thirty-nine next month. I wouldn’t want to have a baby after forty.’
‘Why the late uncertainty?’
‘It hit me I might come to regret never experiencing that.’
 

She talked about childbearing and childraising, describing the contrasting experiences of her sisters. I agreed it was a momentous question. We talked about bladders and we parted.

 At home I asked myself how I’d describe my own experiences. I’d be unable to resist describing – at clear risk of malicious misinterpretation – the intense pleasures of bathing or changing soft bodies, the satiny skin, the small weightiness in arms or lap.
I thought about my feelings and the word that came was ‘intensity.’ Had she asked I might have said, ‘Becoming a parent deepened me. I believed I was tender towards children, but my firstborn taught me how I had tiptoed through mere shallows.’
I recalled an early piece of Martin Flanagan in the Melbourne ‘Age’. He described nursing his small daughter through a night of torrid fevers. From memory, I recall him writing, ‘I know I will never feel closer to this child than I have this night.’
I might have quoted an early patient who became an enduring friend. Her asthmatic sons struggled night after night for breath. She told me how she’d walked the floors, holding them, counting breaths, weighing ambulance against a dash in her own car.
Inevitably I was visited by verse.
I have walked and prayed for this young child an hour
And heard the sea-wind scream upon the tower,
And under the arches of the bridge, and scream
In the elms above the flooded stream….

(W B Yeats, ‘A Prayer for My Daughter’)

I might have described the common and uncommon thrill of feeling a newborn curling her fingers – by reflex – around the finger that I rest on her palm. I might have said, ‘The unearned trust of my child makes me know – as I have never known before – I am significant.
 

I might have said, ‘My children gave me a clarity that was visceral: I knew through them my task, the meaning of my being alive. I knew I would give my labour without question or measure or thought of recompense.

I could never have dreamed the reward that would follow – grandchildren. And of course, with grandchildren comes the renewal of mission, of labour, of redemption of my aging. Feeling anew that deep significance I stride towards my latter end with head high.’

 

Had she asked, that’s what I might have said. But of course we will not see each other again.
Postscript: But we did see each other again – the next morning. With her consent I read aloud the words you just read. I looked up. Her face was suffused, on her lips the widest smile, from her eyes a flow of tears.
She thanked me and in answer to my question she said, ‘Sure, you can publish that.’

Jeremiah Jan

She sits in the waiting room, reading. Any patient who enjoys a good read will enter my consulting room in a good mood. I do allow my patients time for a very good read.
The book she reads from is thick, with old-fashioned morocco covers and red-tipped pages. Looks like the Bible! She doesn’t look mortally ill. Perhaps she’s mortally afraid of the new young doctor.
‘Good morning, my name’s Howard.’
We shake hands. Her hand is fair, a youngish hand. The owner of the hand says, ‘Hello, I’m Jan.’
‘You’re reading the Bible? Which book?’
‘Jeremiah.’
Jeremiah the cheerless, prophet of doom, a man willing to be jailed for speaking truth to power. Serious reading. Might have been worse, could have been Job.
The serious reader sits down. She speaks: ‘Howard, I’ve come for a talk. I don’t need a diagnosis; if I want a diagnosis I’ll see Doctor Don. I don’t need a diagnosis, I need a talk.’
We have our talk.

Another visit by Jan, another long period in the reading room. Eventually I show her in. We are only about ten minutes into today’s talk when the phone interrupts us: ‘Howard, Doctor Don needs you in the Treatment Room. Now!’
‘Gotta go, Jan. Sorry.’
I go.

When I return, after about twenty five minutes, I resume: ‘So, Jan, you were about seven when…’
‘Howard, you can’t just do this.’
‘Do what, Jan?’
‘Take up our conversation without a break, as if nothing terrible or significant has just happened.’
‘Can’t I? Why not?’
‘You need time, some space. You need to come to terms with whatever it was that was so urgent. You are a person too, Howard.’

In my consulting room, situated at the furthest end of the building from the Treatment Room, Jan would not have seen the frantic mother, the pale plump doll that was the baby, the child inert, lifeless. She would not have felt the body still warm, not seen two adult males breathing desperate air into a new body that would not breathe again. She would not have seen the face of the mother passing through shock to grief to the start of lifelong self-accusation.
Did she perhaps hear sounds of stifled sobs?

Many chapters of Jeremiah and of Job have been read in the thirty-five years since that day. I remember the child, I have not forgotten the mother.
Nor have I forgotten Jan’s instruction.

Virgin from Christmas Island to the Mainland

A man walks into my consulting room with a bouncing limp. He is tall and upright. He bows slightly and shakes my hand. The familiar courtesies.

I greet him: Salaam Aleikhum.

He responds: Aleikhum Salaam.

We exchange names. His name is Ahmed. He says: “My foot is painful. Please excuse me. I am afraid I must remove my shoe.”

His problem is visible through an opening in his sandal: the left great toe is infected. The flesh of the nail bed is hot and red, a crescent of swollen skin surrounding a sunken island of nail. The skin is shiny, stretched to bursting. A promising eyelet of pus peeps from beneath a corner of the cuticle.

The infected nail bed is about to burst in a flow of laudable pus. The pus will stink, Ahmed will feel better and so will I. Finally, a patient telling me a straightforward story. Finally a patient I can cure.

I treat the infection, dress the toe and ask Ahmed to return tomorrow to renew his dressing.

“I cannot come tomorrow.” His manner is politely regretful. “I will leave here tonight.” He speaks softly, practicality competing with swelling happiness: “I have my visa.”

Ahmed’s smile is a field of waving daffodils.

As it happens I will fly out tonight too. After three weeks of seeing patients here, Ahmed is the only one I meet to win a visa. The remainder reside in trailer parks of hope and despair.

Continue reading

On Gradually Losing my Hearing – part II

A trip to the ear doctor is preceded by an examination by the audiologist and by the dimness of conversation with my patients. So quiet and restful are their remarks that I have been able to remove the notice in my consulting room that read:

Patients are kindly requested to speak softly and to leave quietly to avoid disturbing the doctor’s nap during your consultation.

In addition to increasing hardness of hearing, there have been frequent episodes of vertigo over the past 12 months. During these interludes a twist of the head is followed by a swimming sensation; the world moves, sliding ever to my right; images swarm, kaleidoscope-like, chasing each other endlessly, clockwise, around my visual field. It is an intriguing symptom, drunkenness without alcohol. Remarkable cheap, really. People pay good money for bad chemicals to achieve these experiences. It makes my ENT surgeon jealous, resentful, motivated to act.

And when the ENT saw an 11% discrepancy in acuity between the failing right ear and the failed left, he mentioned an MRI. When he heard of my increasing vertigo over the past 12 months, he wrote out a request slip. The request slip might be paraphrased as follows:

1.   The patient is deaf, ie old; this condition will worsen but will, like all things, pass.

2.   The patient is a doctor, ie hypochondriachal. He requires an MRI in order to cure him of his hypochondriachal fears, and as a punishment for having symptoms.

3.   During the procedure, please confine his head in a shoebox, then slide that head into an extremely confined space and assault his damaged ears with mechanical sounds at high volume. During this time, so confine him that he is entirely unable to move. If he has never suffered claustrophobia before this, please assure him that the days of calm inside his head are over.

4.   Do not warn him that during his MRI he can expect to wet himself in sheer terror.

5.   Ensure that the young technician who asks him to disrobe is female, charming and attractive. Tumescence will then fight against incontinence.

As you will appreciate the MRI represents the Himalayas of medicine where peak ethics gaze across at the highpoint of patient autonomy and comfort.

Before the scan you fill out a form in which you declare your body’s absence of internal metallic items. The list is long and the list of patients who can say “no” to all these is a shrinking one. Nowadays it is as difficult to qualify for MRI as for cremation. In my unserenity, I might prefer the latter; at least you don’t have to hang around waiting nervously for the report.

“Please take off all your clothes excepting your underpants.” It is not every day that a 67 year old gentleman receives an invitation of this nature from an attractive young woman. I am happy to oblige. She permits me to retain my kippah (skullcap – “no bobby pins please) and my socks. A gent in his socks is the epitome of the sexless vertebrate.

I might just as well wear a chastity belt. Continue reading

My Doctor My Self – A Fiction

A very old doctor?

A very old doctor? (Photo credit: revger)

Washing myself in the shower, it suddenly registers that I haven’t farted this morning. Straight away I know I am in trouble. A tummy ache is a commonplace, tummy aches come and go, but this one is different. My bowel has fallen silent. No wind music. Big news, bad news.

I dry myself, lie down and palpate my abdomen.

Is it distended?

Hard to tell.

Is it tender?

Decidedly.

Listening with the stethoscope, I hear nothing.

I listen harder, longer.

Silence. A clamorous silence, speaking in clinical tongues of bowel obstruction, of an absence of vomiting, of a pain that has been colicky in nature, and is worsening.

I am 64.

A person of that age with a large bowel obstruction most probably has bowel cancer.

That can’t be me. I don’t do cancer. I eat, I run, I work, I fart, I tell fart jokes.

I am large with life, I don’t have cancer.

And yet I hear myself observe that this patient is an Ashkenazic Jew. He has no comforting past history, of diverticular disease, of ulcerative colitis, of Crohn’s Disease.  And his aged mother had a pre-cancerous bowel polyp.

This old bloke, this rationalising self-deceiver has bowel cancer.

I feel a surprising, deep calm. I have cancer, I have ignored two decades of advice to undergo colonoscopy, and now I have bowel cancer.

I will die. Continue reading