First, Do No Harm

First, Do No Harm

The past comes rearing up to bite the next generation when a son digs too deep into his family's past…. Martin Firestone can't figure why his father, the eccentric painter ...

About The Author

Larry Karp

Larry Karp grew up in Paterson, NJ and New York City. He practiced perinatal medicine (high-risk pregnancy care) and wrote ...

Read an Excerpt

Chapter 1

In the light of blue moons, certain doctors appear and blaze into legend, medical sports of nature with diag- nostic acumen beyond uncanny, healing powers just this side of miraculous. I’m not talking about the likes of Pasteur, Semmelweis, Walter Reed, healers whose heroic campaigns against the double-headed dragons of disease and human stupidity won them seats as Knights of the Hippocratic Round Table. Legendary docs are not knights, but Merlins, watching over fiercely bubbling cauldrons full of dark ingredients. Dark ingredients, strong magic. Darker ingredients, stronger magic, but greater risk of the pot boiling over—disaster. Unspeakable ingredients…

My grandfather was one of those Merlins, though I didn’t know it until just a couple of days ago. I didn’t know anything about my grandfather until a couple of days ago, and I’m twenty-eight years old. Dad never would talk about his father, strange, but Dad is Leo Firestone…yes, that Leo Firestone. The painter. Refusing to mention his own father’s name is way down on the list of Leo Firestone’s oddities. Way up on that list is Dad’s art. Nightmarish, bizarre. A teddy bear with barbed-wire fur next to a small disembodied hand, fingers gouged, bleeding. Couples embracing through jagged shards of glass. Doorknobs shaped like grenades. Spring-loaded knives poised to fly up through the seat of a well-used armchair. A mother putting her baby to her breast, the nipple a minefield of tiny blades. Worst are the faces, never shown directly, features shadowed and indistinct, a compelling ambiguity that never fails to pull me, resisting, into the damn paintings, to be slashed and stuck and gouged.

Dad first caught notice in the Fifties, one of  those stormy young postwar artists in New York who somehow managed to find time to work despite a full schedule of brawling and carousing. Some of Dad’s early companions flamed out in alcohol; some went out on the wrong end of a hypodermic needle. Others gave  up,  bought  a  suit and tie. But Dad prospered. Critics pronounced his work as brilliant as it was troubling. Gallery owners fought to feature his canvases. The more Dad called them leeches and vultures, the more they pursued him. Brilliant timing, the perfect Sixties artiste, he left a legacy of angry insults and bloodied faces that may never be matched by any painter,  sculptor, writer, or musician.

By the early Seventies, Dad could call any shot he wanted. He sold his little place in the Village, bought a piece of property on Peconic Bay, way out on Long Island, and built a house and studio for himself and his pianist-friend, Tanya Rudolph. Maybe music really does soothe savage breasts, but more likely Tanya just had what it took to stand up to my father. Early on, their fights were the stuff of tabloid headlines, but the only people who ever came away injured were those who tried to get between them. A year after they moved to Peconic, Tanya became Mrs. Firestone, and two years after that—following some loud and serious discussions—I made my appearance. Mother wanted two children. Dad finally agreed to start with one and see what happened. The fact I remained an only child speaks for itself. That, Dad would talk about. My grandparents, never.

Our house was a white stucco-coated Chinese puzzle, all intersecting acute angles, lots of glass. Inside, teak and mahogany-paneled walls covered with paintings, Dad’s, his friends’. My favorite was a five-by-four canvas of Mother, hung directly above her Steinway grand in the living room. Typically cryptic face, but Mother, no doubt. Dad really caught that particular way she angled her hip when she stood, the familiar tilt of her head, her flowing platinum hair. Mother went white in her twenties, had the great good smarts to never dye it.

Personality encounters were frequent at our house, artistic skirmishes routine. But space wars, never. Mother’s kitchen was immense, bright with copper and steel. Her Steinway seemed dwarfed in its corner of the massive living room. I had both bedroom and private playroom. At one extreme of the house stood Dad’s airy painting studio, at the other, his den, a small room with no windows. Dad kept that room locked whether he was inside or not, and Do Not Disturb was understood. No one but Dad went in there, ever. Not Mother, not the cleaning lady, not me.

Wild…first word to mind for my childhood memories. Winter nights, wind-whipped sheets of water against floor-to-ceiling windows, heavy percussive beat of waves slamming into the shore. One weekend when I was seven or eight, Norman Mailer came to visit. Picture me under the round glass coffee table, watching two  men  with dark raging eyes, beefy faces, crowns of wild black curls, going nose-to-nose, at least half-crocked, over some artistic particular I couldn’t begin to understand. Mailer was no pygmy, but Dad was three or four inches taller, with more muscle and less fat. Mother sat at her piano, hands gliding over the keys, white hair dancing around her face. Every now and then she stopped playing long enough to sip at a drink and study the combatants over the rim of the glass. Laugh lines traveled from the corners of her light blue eyes, then she tossed out a line that stopped Dad and Mailer cold. They all laughed, laughed, laughed.

I was no honor-roll student, worked only at what interested me, responded with equal indifference to carrots and sticks. I refused to learn anything by rote, accepted no givens—a pesty kid, always with a “Why?” or a “How?” Dad called me Professor Skeptikos, used to tell Mother they should’ve used birth control on that trip to Greece the year before I was born. “He drives me nuts. Asks a question, I give him an answer, here come ten more questions.”

One Saturday when I was eleven, Dad came back from a day in New York carrying a carton and wearing a smile straight off the Sphinx. He set the carton on the kitchen table, kissed Mother, then turned to me. “Well? Aren’t you going to open it?”

Christmas in March? I tore into that carton, and when  a thick manual fell out I thought I’d burst. “A computer. For me?” I ran over, hugged my father.

“Atari-ST,” he growled. “Supposed to have the best color graphics. And some new system where you can compose music, then hook up a synthesizer—”

“MIDI,” I hooted. “Oh, wow!” I scanned the room, a little man trying to spot a cab in a downpour. Dad jerked a thumb toward the front door. “Rest is in the car, you can help me schlep it in. Monitor, printer, bagful of books. It’s a kind of kit. You’ve got to put it together.”

I drew in a breath. I’d been a model-builder since the age of four, when I got a Lego set. At eight I built a model car that ran, at nine, an airplane that  flew.

“Maybe that’ll keep him out of my hair for a little while,” Dad muttered at Mother.

Mother smiled, slipped me a  wink.

Dad got me out of his hair, all right. He clearly knew nothing about computers, no point asking him questions. But if he was trying to nudge me toward a career in the arts with that Atari, he failed miserably. Color graphics and

MIDI ports were fun, but the computer itself was a whole new world. I found out about bulletin boards, spent a chunk of my savings on a 1200-baud modem, tied up our phone for hours, equal parts software and smut. Not long ’til I began to tinker with the software, putting together programs that by all rights should’ve blown higher than Everest, and sometimes did. But more and more often, they performed as I intended, usually pointing the way to a new challenge. Add, upgrade, ad infinitum. My childhood playroom became a jungle of wires connecting components set on shelves among books, floppies, tapes, CDs. I worked after school, weekends, and summers to support my habit. When I finished college, I signed on as program designer with Custom Softies, a company in a little office on the tenth floor of an old office building on East Fifteenth, near Union Square. Took a week to move all my stuff into my new apartment in Manhattan.

Five years, no problems, but then my bosses overextended. A couple of weeks after employees voted to accept an across-the-board pay cut, Dad came in to New York  to supervise an exhibit setup. Afterward, he took me to dinner. When he asked what was new, I told him about the salary cut. He shrugged. “You’ll get  by.”

“I suspect,” I said. “But just in case, I took a night job.” Dad looked amused. “What kind of night job?”

“At Bellevue…” I paused as Dad’s face settled into a scowl, clay hardening. “Bellevue’s Cardiology Department is one of Custom Softie’s biggest accounts, so I spend a lot of time there. Last week, I saw an ad on a bulletin board for part-time nurse’s aides. O.J.T.—”

Dad sprang to his feet roaring. “Jesus Christ. A nurse’s aide? At Bellevue? Most ridiculous goddamn thing I ever heard.” He reached into his pocket. “How much do you need?” Wallet out, open, fingers pulling at bills. “Shit, Martin, I’ve got more money than I can ever spend.” He held out five hundreds. “Here. Quit that fucking job.”

People around us turned to look. I brushed the money away. “Thanks, Dad, but I’d rather try to do it on my own.” The rest of the meal was a disaster. I don’t think Dad spoke ten words. After that, I always took care to avoid mentioning my second job, and Dad never brought  it up. I worked three partial shifts a week at Bellevue, and a full shift on Sunday. I checked vital signs, gave medications, made sure charts were up to date, emptied bedpans. I even met a girl at Bellevue, married her last year. When I introduced her to Dad and Mother, I told them we’d met at a party.

I watched the Bellevue doctors carefully, listened just as hard. Sometimes they took me aside to explain points. Dr. Charles Donovan, an internist, kept encouraging me to apply to medical school. I talked it over with my wife. Helene gave me that soft smile, the one that had sent me out to  buy an engagement ring. “I think that’s wonderful, Martin. I do. We’ll have no trouble managing on my income.”

“But we’ve talked about children—”

“We’ll just keep talking for a while. Do it, Martin.”

So I took the M.C.A.T., had an interview at N.Y.U. Med School, and got accepted. Helene was thrilled. “Let’s go to Palais Royal. It’s Friday, but maybe we can get a late table…oh, wait. Your parents?”

“I never told them I applied,” I said. “If I didn’t get in, easier to not have to explain why.”

Funny look. Helene handed me the phone. “Well, now you don’t need to explain. Just call them. See if they’d like to come in and join us.”

No way around it. Three tries before I punched the right numbers into the phone. Dad answered. “Firestone.”

“Dad? Martin. I’ve got something to tell you.” “Somebody’s a little late this month?”

“Not that, no. Dad, I applied to medical schools this year, and I’ve just been accepted.  N.Y.U.”

Silence…well, not quite. Better, no words. I heard a choking sound, almost strangling. “You what?” Dad finally said.

I wished time into rewind. “Got accepted to medi-  cal school. I’m going to be a doctor. Start the day after Labor—”

Dad cut me off with a volley of language as foul as I’ve ever heard, made steelworkers sound like sixty-year-old schoolmarms. I tried a couple of times to break in, but it was like holding a sheet of cellophane up to the stream from a firehose. Finally, Dad barked, “You know where Manny’s is? Restaurant.”

“Well, sure. You’ve taken me there a lot. Second, near Fifty-fourth.”

“Meet you there tomorrow, one-thirty. Lunch.” Not a question, not even a statement. “I…I’ve…”

First sign of weakness, but I knew better than to take advantage. Just waited.

“Got a story to tell you.” Slam.

Helene looked up, brows together, as I set down the phone. “Martin, what on earth happened?”

“I walked into an ambush, that’s what. For some reason, Dad’s more than unhappy. Sounds like I’ll get the score tomorrow. Lunch, command performance.”

“Your father’s very strange, Martin. Sometimes he scares me.”

The words were out of my mouth before I completed the thought. “The scariest people are scared people.”

This was not like Dad, not at all. A story to tell, barely able to contain it? Dad never told me stories, not about birds and bees, not about anything. Aphorisms were more his style, one-line zingers, right to the heart of the matter  and the gut of the listener. As I waited outside Manny’s, I couldn’t imagine what was coming.

One-thirty sharp, there was Dad in his favorite gray work shirt, splotch of bright green paint above the pocket. He nodded, motioned me inside, not a word.

Lunch hour waning, several highbacked mahogany booths empty. Dad motioned to one all the way in back. “We’re going to be here a while,” he told the headwaiter. “We’ll order, then I don’t want anyone bothering us.” He pulled a fifty from his wallet, handed it to the maitre d’, who slipped it in one smooth motion into his shirt pocket. “I understand, sir. I’ll let your waiter know.”

As we slid into opposite seats I snuck a look at Dad. Cheeks finished with rough sandpaper, skin slack over the bones. Fatigue lines etched at the corners of his eyes. Dark eyes bloodshot, muddy. Hair tumbling over his forehead and ears. How much sleep did he get last night? How much did he drink? Seventy-six years old, still knocking down the sauce from dark to dawn, then going all-out the next day. He flipped the menu open, scanned it, set it down, looked around.

The waiter, a slim young man in white shirt and snappy plaid tie, caught Dad’s eye, scurried over. “Yes, sir? You want to order already?”

Nod. “New York steak sandwich, rare. And a Manhattan, heavy on bitters. Martin?”

I tried not to think about Dad’s liver. “Same sandwich,” I said. “And iced tea.”

The waiter scribbled. “Got it.” He slipped his order pad inside his cummerbund. “Headwaiter talked to me. I’ll bring your orders soon’s they’re ready. Then, you want something else, you call me. Right?”

Dad allowed himself the tiniest trace of smile, not pleasant. “Right.”

The waiter left quickly. Dad drummed fingers on the table top, looked one way, then the other. Slowly, those black eyes turned toward me, focused, locked into  place.

“All right, Martin. What’s with this crap about medical school?”

I learned as a young boy, flinch and I was a goner. “No crap,” I said. “I applied, I got accepted, I’m going. If there’s crap, it’s coming from your side of the table, and I don’t understand. I’m not asking you to pay my way. I’m not asking you for anything. What the hell’s your  problem?”

“What’s my problem? I’ll tell you what’s my problem.” Head cocked, left eye half-closed, mouth twisted like a badly healed scar. “I ask my son a simple fucking question and he won’t give me an answer. Martin, why…the…hell… do…you…want…to…go…to…medical school?” Every word punctuated with a sharp nod of his head. Then the ultimate shrug, hands extended toward me, palms up.

Where was he going, my crazy father? I cleared my throat. “All right. Computers are exploding in medical use. Horizon’s endless. In ten years doctors will use them every day. Diagnosis, treatment, consultation. Research, devising new paradigms—”

Dad’s huge fist hit the table so hard I jumped. “God- damn, Martin, you’re not at an interview and I’m not a dean, so spare me the bullshit. First, you take a lousy night job for peanuts to work at a hospital. Now, all of a sudden, at twenty-eight, you’re going to medical school. I’m asking you why, and I want an honest answer. Is that too much  to expect?”

Dad watched me like a hawk taking aim at a poor salmon, flopping its way upstream in shallow water. “Dad… I’m not sure I can tell you exactly why. All those years I played with computers, I thought I was making science fiction real, and then I started working with the cardiac team at Bellevue. I saw them put new valves into hearts. Dad,   I watched a heart transplant—they put a new heart into a man’s body, he was dying. Three weeks later he walked out of the hospital. What could I ever do with a computer to match that? If a computer crashes, no big deal, just start over, but a doctor gets just one chance, and he’d better do it right…no, he’s got to do it right. I felt hollow, Dad, trivial. Like the big game’s going on, people pitching, batting, catching, throwing, the crowd’s cheering…and there I am on the bench in the dugout, a lousy batboy. When I saw that ad on the bulletin board, I had to take it. And you were right. Nothing to do with my pay cut.”

All of a sudden, Dad looked like a man just told the governor had declined to issue a last-minute stay. “I’m going to tell you a story, Martin.” Voice like a ghost’s. “Should’ve long ago, maybe, but I thought…hoped… June, 1943, I was sixteen. Finishing my junior year of high school. Summer before, I worked as a soda jerk, Ransome’s Confectionery, a few blocks from our house. But Mr. Ransome enlisted  in the Navy that spring, closed the store, sold the property.”

Dad, a teenaged soda jerk? I must’ve smiled, because he stopped talking, stared at me. “Hell’s so funny,  Martin?”

“Sorry, Dad. I just can’t picture you behind a soda counter with a little white cap on your head.”

Lines around his mouth softened. He seemed to be looking at something far away. “Neither could   Samuel.”

“Samuel?” “My father.”

“You called your father by his first  name?”

“My mother too. Part of your grandfather’s way of teaching me self-reliance. As far back as I can remember, it was ‘Count on yourself. Trust yourself.’”

Dad’s eyes, black ice. His story hardly begun, already enlightening. “Didn’t people think that was strange?” I asked. “Especially in those days?”

“If it were anyone else…but your grandfather was Samuel Firestone, and Samuel Firestone’s son calling his parents by their first names was the least…” Again, that massive fist, bang, on the table top. Silverware clattered.   “Martin, God damn it. Would you kindly shut up for a minute and listen to me?”

The waiter set down our drinks, glanced at Dad, left in a hurry.

“Sorry, Dad. I’m all ears.” I gave him the go-ahead.

He glared just a bit too long, almost smiled, managed not to. He coughed, knocked down half his Manhattan in a swallow, then turned back to me.

All right, then. One evening at dinner, a week before school was out, Samuel asked whether I’d found a summer job. I told him no, but I had a couple of leads.

He jumped in, both feet. “You can use this summer to see what being a doctor is really about. I’ll make you my extern. Take you to the office, to the hospital on rounds, into surgery. House calls, emergencies. Where I go, you’ll go.”

I couldn’t answer. Sixty years ago, doctors were revered, trusted without reservation. People cracked jokes about lawyers, bankers, politicians, even ministers, but never about doctors. But even more than that, there was something about my father…when he walked into a room, people stopped talking, stopped whatever they were doing, turned to him. He defined center stage. Where he’d go, I’d go? I might still be sitting there wordless at the dinner table if my mother hadn’t said, “Samuel, do you think that kind of work would be good for him—staying up all hours, going to some of the places you go? He’s only sixteen, still a growing boy. And with all the men who’ve been drafted, he shouldn’t have any trouble finding a job.”

Samuel laughed, pointed at me. “He’s six-four, a hundred-eighty. If he grows any more… All right, Ramona, I won’t overwork the lad, promise. If I keep him out at night, he can sleep late the next day. But it’s time for him to stop being a soda jerk. Next year, he’ll be going to college, and the sooner a college student declares for premed, the better his chances of getting into a medical school. Or, if Leo’s drafted, he could choose the medical corps.”

“If that’s what he wants.” Ramona tried to keep her voice even, didn’t come close. The thought of her son, her only child, being drafted and going off to Asia or Europe to be shot at, was her special nightmare. “Do you want to be a doctor, Leo?”

“I don’t know,” I said. “Maybe, if I’m good enough. But I also like to paint.”

Samuel leaned toward me across the edge of the table, then started to smile. When your grandfather smiled, the room   lit. Tanned face, perfect white teeth, black wavy hair, neatly trimmed. The most alert blue eyes imaginable. I could never read The Great Gatsby without seeing my father. Now he turned that smile on me full blast. “You can still paint, Leo. Painting’s a great hobby, good relaxation, but you need to live your life in the world. I say you’re plenty good enough to be a doctor, and this summer you can learn firsthand what being a doctor is all about. What do you say? Think you can handle it?”

He was some piece of work, my father. Not “Do you want to?” or “Would you like to try it?” “Yes, I can handle it,” I said to Samuel, with all the offended dignity a sixteen-year-old could muster.

Samuel stuck out his hand. “Shake, Extern.” Ramona, pale, silent, watched me shake.

“You start first day after school’s out,” Samuel said. “Hospital rounds, eight o’clock.” That was it. All employment formalities taken care of. In 1943, a doctor didn’t need anyone’s permission to give a student a summer externship. Especially if the extern was his son. Especially if the doctor was Samuel Firestone. He was a legend in Hobart.

Hobart, New Jersey, where Dad grew up. One of those metropolitan Jersey cities still struggling to recover from the disasters of the Sixties, but in Dad’s youth, Hobart was a textile town with a busy central business district surrounded by vibrant ethnic neighborhoods, families going back three, four generations under the same roof.

So that summer I carried my father’s big black bag. It took me no time to see he was a great doctor, an outstanding diagnostician, but there was something else. The minute your grandfather walked into a room and caught the patient’s eye, that patient knew he was going to get better. You could read it all over his face. I watched Samuel treat sore throats, heart disease, diabetes, learned how to set broken bones. I assisted at gall bladder surgery, went along on post-op visits. Then one night, after I’d been on the job for almost a month, Samuel shook me awake just a little after twelve. “Come on, Leo, up, move it. Sick kid Down-river.”

I threw on clothes, charged after Samuel, outside. He had the ’thirty-nine Plymouth started before I was onto the passenger seat. We backed out of the driveway, Samuel’s face glowing in streetlamp light. Gasoline rationing stickers on the rear windows flashed into view, a black-and-white A, good for three gallons a week, for ordinary persons to make do. But Samuel Firestone was not an ordinary person, and he never just made do. Next to the A was his C sticker, doctor’s guarantee of fill-up on demand. The day I watched him put on that sticker he winked at me and said, “Every job’s got bennies.”

Not much traffic at twelve-thirty in the morning. We shot down Roosevelt Avenue at fifty-five, never mind the wartime thirty-five-mile-an-hour speed limit. No cop in town would’ve stopped Samuel Firestone’s car, not even for an air-raid drill, not for any reason. Windows wide open, mid-July, a real Jersey summer night, temperature about eighty, humidity in the nineties. Samuel wheeled a sharp right off Roosevelt onto Straight Street, then across to Fulton, finally a right onto River Street. A couple of blocks up, he pulled to the curb, killed the motor, set the brake.

I grabbed the emergency bag off the back seat where Samuel always kept it, jumped out, paused long enough to lock the doors. Not many people in Hobart locked cars in 1943, but in that neighborhood you did. Down-river was Hobart’s equal- opportunity neighborhood, big fat zero for everyone. Mazes of crooked little streets squished between the shopping district and the Passaic River, tumble-down coldwater shacks only real estate agents would call houses and no one would call homes. Bars, brothels, dollar-a-night hotels. Down-river was jagged bottle-edges, knives, guns. You tried not to let the sun set on you Down-river.

Not easy to keep pace with Samuel. We ran past Marvin’s Bar, music blasting into the street over drunken shouting and laughter. Artie Shaw, “Perfidia.” Samuel danced along, double-time. He motioned me past a couple of sorry little houses into a narrow open doorway, then up a flight of stairs to a small landing. Air like a blanket soaked in piss, sweat, and months-old cabbage stew. Wall plaster yellowed, chipped. Samuel motioned toward an iron handrail, lower end hanging loose. “Careful, Leo.” Then he took off up the steps, three at a pace. By the time I hit the second-story landing, he was knocking at the door. “Lou, Lena,” he called. “Samuel Firestone.”

The door flew open. Samuel strode in, me on his heels, trying to look a hell of a lot surer than I felt. Just one room, curtain pulled across the back to make a bedroom, tiny kitchen off to the left. From behind the curtain came loud sobs, now and then a whimper. Couple of windows up, but not a stir of a breeze off the river. I could taste the stench of rancid cooking fat, shit, human secretions. A short chunky man in an undershirt and boxer shorts stood near the curtain, bloodshot eyes glaring at me. The man swiped the back of his hand across his nostrils. Samuel smiled. “Lou Westcott, my son Leo. He’s learning to be a doctor.”

Lou raked stringy black hair back off his forehead, then nodded at me, almost a bow. “Welcome.” One word, couched in respect. No argument if Dr. Samuel Firestone wanted to bring his son along to learn the trade.

Samuel flipped his Panama onto the post of a ratty stuffed green chair, then turned to a stocky, coarse-featured redhead in a nightgown that barely covered her breasts above and her crotch below. “Lena, you’re looking good. Little guy’s in back?”

Lena pointed toward the curtain. “He’s got pain, Doc, don’t know what’s the matter.” I heard generations of hardscrabble Appalachian farmers in Lena’s twang. “Just rolls around, pullin’ at his shoulder. I wanted to do a mustard plaster before I called you, but he wouldn’t let me put it on.”

Samuel glanced toward the curtain, where the sobs were slowly developing into howls. “How long’s he been hurting, Lena?”

She glanced at Lou, who let out a low growl like a threatened animal. “Just about an hour, Doc. Not even.”

Samuel looked at his watch. “Little before midnight,  then.

Was he asleep? Woke up with pain?”

Again Lena looked at Lou, but before she could say anything, Samuel moved toward the curtain. “Let’s have a look.” He pulled the curtain aside, and there on a filthy uncovered mattress sat a two-year-old version of Lou, pasty face mottled from crying, making frantic grabs at his right shoulder. I could’ve painted him onto velvet, straight from life. “Hey, Bub,” Samuel said. “Shoulder bothering you, is it? We’ll take care of that.”

He walked to the low bed, sat on the edge, talking all the while, eye to eye. He had that little boy mesmerized, only an occasional snuffle. But when he reached for the injured shoulder, Bub pulled away.

Lena said, “Bub, now you let Doc Firestone look at your shoulder,” but Samuel didn’t seem to hear her. He took the doctor’s bag from me, snapped it open, fumbled around inside, came out with a New Year’s noisemaker, one of those little blathorns where you blow paper out, then it rolls back. He blew. Bub jumped six inches. Samuel blew again. The kid started to laugh, reached for the noisemaker, then screamed and clutched at his shoulder. Samuel nodded, put the mouthpiece between Bub’s lips. “Blow,” he said. The boy just stared at him. “Blow!” The kid blew a short blast, laughed again, then blew harder. Lena let out a sloppy giggle.

“Keep blowing, Bub, that’s right,” said Samuel, all the while fiddling gently with the boy’s shoulder and upper arm.

“Dislocation,” he mumbled in my direction. “Subcoracoid, most common kind. Elbow’s displaced out from his side, see? And that bump in his armpit—head of the humerus. No crepitus, so probably no fracture.” Samuel stood up, took us all in with a look. “I’ll need your help,” he said. “The three of you.”

“What’s wrong?” Lena, anxious.

“Shoulder’s dislocated. Must’ve happened when he fell out of bed.”

Lena went white. I thought Lou might hit the deck. Samuel didn’t seem to notice, just kept talking. “We’ve got to get the bones back into place, then keep them there. Only take a few seconds but it’ll be painful. We’ll put him on the floor, on his back. Leo, you kneel across him, right below his stomach, rest your hands on his chest. Lena, sit above his head, hold it down. Lou, keep his left shoulder on the ground. None of you let him move, not a muscle. That’s important. Understand?”

One yes and two yeahs. Samuel smiled. “Boy’ll be fine, don’t worry.” He shrugged out of his jacket, slung it onto the chair, sat on the edge of the bed, winked at Bub. Then he unlaced his right shoe, slipped it off, dropped it. Bub started whimpering again.

“Come on, Lena,” Samuel said, very gently, then stood up. “Sooner we get started, easier it’s going to be on everyone.”

As Lena bent, I could see all the way to China down the front of her nightgown. She picked up the boy as if he were made of eggshell, lowered him to the floor.

“Now,” Samuel said. “Everyone in place, fast.”

Lena cradled the boy’s head between her hands. Lou fell onto the boy’s left shoulder. I flopped across his belly. The kid started to howl, legs kicked wildly under me. Samuel scampered to the floor at my left, shot his stockinged right foot into the boy’s armpit. “Look at the shoulders,” Samuel whispered to me. “See the difference?”

“Right one’s sunken on top,” I said.

“Sure is.” Samuel grabbed the boy’s flailing hand. Slowly, firmly, he pulled downward, then pressed the arm against the boy’s body. “Watch the shoulders,” Samuel whispered again.

The kid let out a screech that could’ve shattered glass, as the lump in his right armpit slid up and out of sight. The shoulders looked symmetrical.

“Okay, done.” Carefully, Samuel laid the boy’s arm across his chest. “Leo, go get some gauze strips out of my bag. Lena, Lou, relax, just a little. Let him sit up.”

By the time I got back with my hands full of rolled gauze, the war zone had pretty well cleared. Bub was snuffling but calm. “Start unrolling,” Samuel said, not letting go of the boy’s hand. “Still hurt, Bub?” The boy shook his head. The way Lena looked at my father made my cheeks flame.

Calmly, slowly, Samuel wrapped gauze around Bub’s arm and shoulder. When the boy started to cry again, Samuel picked up the noisemaker, stuck it into his mouth and blew. He kept blowing, loud, then soft, long and short, as he worked gauze round and round, splinting the boy’s arm against his chest. “Dislocation means you’ve torn a ligament,” he muttered to me between noisemaker blasts. “Move the arm before the ligament heals, it dislocates again.”

Finally Samuel stood up, stretched. “Sit in a chair with him, Lena. Hold his arm just like we’ve got it. He’ll need a little medicine.” Samuel grabbed his jacket, slapped the Panama into place on his head. “Back in a few minutes.”

I could hardly contain myself. Soon as we got into the car  I asked Samuel how he knew the boy had hurt himself by falling out of bed. Samuel smiled, this time not pleasantly. “Most common cause of shoulder dislocation is a fall on the outstretched hand or elbow. Did you look around that place? Where does the little boy sleep?”

“I didn’t see any—”

“Other bed? No, there isn’t one. The kid sleeps with his parents. Did you smell the booze on them?”

“I smelled something. But there were so many smells in there—”

“All right. Here’s what happened. Lou and Lena left the kid in the bed asleep, went down to the bar, had a few shots, came back ready for some business people usually like to conduct in private. But they’ve got no privacy. Probably they woke the kid, he got in the way, and one of them gave him a shove or just out and pitched him off the bed.”

“Are you going to call the police?”

“The police?” Samuel sounded weary. “Leo, think. Those poor red-earth southerners came up here looking for jobs in the silk mills, didn’t know silk’s been on its uppers for the last ten years. If they can squeeze out a couple bucks a week they’re doing well. Look where they live, for Christ’s sake, look how they live. Children are the last thing they want or need, but their creator gave them an irresistible urge, and their priest tells them contraception’s a mortal sin.” Samuel was shouting now, any momentary fatigue blown away. “They have a few drinks to take the edge off their pain, then go home to do just about the only thing two people in their situation can do to forget it all, if only for a while. Kid wakes up, starts crying. A little impatience, little thoughtlessness, and there’s your dislocated shoulder. Next week they’ll go to confession, be forgiven, and drop money they can’t spare onto a plate so the Pope can buy another gold cup for a cathedral. You want me to call the cops, Leo? Who for?”

Samuel wheeled onto East Sixteenth, pulled to the curb near the corner of Seventh Avenue, snapped off the ignition as if he were angry at the car. “Suppose I call the cops,” he said. “Suppose they lock Lou and Lena up. You think that kid’d be better off at the county orphanage?”

He threw the car door open, jumped out, slammed it shut. I did the same, then followed him to the door of a pharmacy. Dark inside. Samuel rang the buzzer, once, twice. A man’s head poked out the second story window. “We’re closed,” the man bellowed. He jabbed a finger at his watch. “It’s nearly two in the goddamn morning… Samuel?”

“Get your fat ass down here, Jack,” Samuel shouted back. “Emergency.”

A couple of minutes later, a light went on inside the drugstore, then the door opened. A big man wearing only green and white striped pajama bottoms stood in the entryway, peppering Samuel with silent anger. He ran fingers through a meager crop of greasy reddish hair, as if that might stimulate it to grow. “You and your fucking emergencies,” he growled at Samuel. “What is it this time? Some nigger got watermelon withdrawal?”

My father didn’t say a word, just stared. When the man began to shuffle in place, Samuel started talking. “Few things, Jack. I need a pediatric sedative, phenobarb elixir. A tonic, yeast, B-C vitamins, iron. Cod-liver oil. Oh, and roller gauze. Ten packs.” He nodded toward Jack’s black woolly chest. “Don’t get any hair in the medicines.”

Jack stomped off behind the counter, muttering. He pulled bottles from shelves, measured, mixed solutions through funnels into small brown bottles, all very meticulous. That impressed me. Never mind his nasty talk, no matter how he really felt, if he had to do that job he was going to do it right. Samuel strolled through the pharmacy, aisle by aisle, hands behind his back. Finally Jack waddled up to him, a bag full of bottles in one arm, bag of gauze rolls in the other. “Be six eighty-five, Samuel.”

“That’s with the doctor discount?”

Samuel’s voice was calm and level, not so Jack’s. “Doctor discount?” the fat man bellowed. “Shit, Samuel, this isn’t for your own use. Or your family’s.”

“That sick baby with no watermelon is my nephew,” Samuel said, and now there was an edge to his voice that put me on ready alert. “You can extend my courtesy that far, considering…”

“Aw right, aw right.” Jack waved a hand of surrender back and forth in front of Samuel’s face, then stormed to the cash register and rang up five dollars and forty-eight cents. “Christ Almighty,” he grumbled. “Get waked up middle of the night to lose money.”

“When you start with a sixty percent markup you don’t lose by giving twenty,” Samuel said. “If your brain were half as smart as your mouth, you’d say thank you and mean it.”

Jack gave Samuel a sour look with his change. Samuel tipped his hat as we left. I felt like the invisible boy—all the time we were inside no one said a word to me. I wondered what Samuel meant for Jack to consider, but didn’t dare ask.

As we pulled away from the curb Samuel said, “She’s going to have to keep that shoulder immobilized a while.” “She,” I noticed, not “They.” “Kids heal faster than adults, but if he moves his arm before the ligament’s had a chance to grow together, his shoulder’ll come apart again. And a kid like that needs tonics and vitamins because he doesn’t get anything like proper food.”

Back at Lou and Lena’s, the little boy didn’t even whimper while Samuel and I wrapped his chest and arm into a sling. As we put him into bed, Samuel’s hand slid under the dirty pillow, a fast out-and-back like a lizard’s tongue. Lena looked at the bottles and gauze, then at Lou. She worked a button at the top of her nightgown. Finally she said, “Doc, how much’s all this gonna—”

“Part of the call,” Samuel said. “I’ll put it on the tab.” He pointed to the bottles of tonics. “Teaspoon of each with breakfast and supper every day. And he can’t move his shoulder at all for a couple of weeks. Don’t take off that gauze, not for anything. Bring him to my office in the morning, ten o’clock. We’ll see how he’s doing, take a couple of X-rays. Write it down if you have to, Lena, because if you aren’t there—”

Lou, all this time slumped against the far wall like a prisoner waiting for sentence to be passed, suddenly went stiff. Lena jumped forward. “I’ll be there, Doc.”

The two of them nodded like Oriental windup toys. Samuel smiled. “Good.”

“I’ll be there,” Lena repeated. “And I promise I’ll give him his medicines, just exactly like you said. I won’t let him out of my sight, not for a minute.”

Lou came forward, grabbed Samuel’s hand. “Hey Doc, thanks. You’re the only—”

He was going to say my father was the only doctor who’d come Down-river at one in the morning to see an injured kid with stone-broke parents. Who’d not only come, but would make sure the kid had all the medicines he needed. Who’d know the parents had caused the disaster but would treat the kid anyway, and not call the cops. Samuel cut him off with a handshake and a quick pat on the arm.

Right then the wall phone in the kitchen rang. Lena picked off the receiver, listened, then held it out toward Samuel. “For you, Doc.”

Samuel said hello, then, “Go ahead, I’m listening.” Could’ve been anything from a stroke to the sniffles, no clue from my father’s face. After about a half-minute, he said, “They think it looks like a heart attack? Call them back, Ramona, tell them I’ll be right over.”

“Another patient.” Lena’s tone suggested she herself was being put upon. Samuel smiled as he gave her back the phone.

We were away from the curb, flying up River Street, before I’d slammed my door. I shouted above the wind whipping through the open car windows, “What’d you do right before we left? Your hand, under the pillow?”

Quick glance sideways, little smile. “You don’t miss much, good. Five-dollar bill. Lena’ll find it soon as she goes to look after the boy. Maybe she’ll buy a little decent food.”

“You don’t think she and Lou’ll just spend it on liquor?” Street lamps made a strobe show of Samuel’s widening smile.

“No, I don’t. At least until that kid’s shoulder is healed, every time the two of them turn around they’re going to see my face. And Leo… Sometimes it won’t be their imagination.”

Mystery Delivered Monthly

The Poisoned Pen Press Newsletter

FacebookTwitterEmail
Goodreads