Wednesday, March 28, 2012


If you were to visit North Philadelphia, you would see that its streets are a naked, forsaken gray. What you might not see, if you haven't lived here, is how deeply that gray penetrates below the obvious surface of things. Beneath the gray gutter water and the matted gray pulp of morning newspapers crushed into sidewalk crevices, below the gray clothes of druggies stretched like shadows across late afternoon sidewalks, beyond the gray wails of evening sirens, lies the grayer reality of despair accepted as fact-of-life, even embraced as destiny.

Up these gray streets I walk each morning on my way to work as a resident in Internal Medicine at Temple University Hospital, and down them I return in the evening or late at night. As I walk from the bus stop to the hospital and back, I try to look beyond the grayness of streets and above the facelessness of buildings into the tunnel of sky that opens like a bloodless gash overhead.  That, too, is often gray. Even if I had a naturally sunny disposition, the relentless gray would eventually discolor my spirit. As it is, I vacillate between despair and annoyance, with an enervated numbness stretched across the long spaces between.

Just yesterday, I took the subway downtown during lunch hour. Several subway-car windows were open, as they often are in hot weather. The car stopped at a station, briefly as usual, while stragglers ran from turnstiles to the still-open doors. Across the aisle from me sat a young man, a boy of perhaps fourteen, with short cropped hair, a well-washed face, and neat clothing. As the door slid shut, a group of five boys about his age ran up to the car. I thought they were trying to catch the train as the door was closing. Then three of them reached their arms through the open window behind the sitting boy and hit him on the head and shoulders. The boy looked up in bewilderment. The train began to move. He looked over his shoulder to see who had done it, but the gang had already run down the platform, whooping and chattering as in a primal war dance. When the train slid out of the station, he turned his head back around and looked down at his hands as if ashamed. An advertisement for Marlboro cigarettes, festooned with swirls of red and black spray paint in some indecipherable script, flashed through the window behind him before we went into the dark tunnel. I asked if he had been hurt. He didn't answer or look at me.

Since that encounter I have felt giddy and skittish, vaguely confused and threatened. On my way to and from work, I usually pass a fortune-teller's shop with a sign in the window showing a red hand painted on a yellow background. The name "ROSA" is hand-printed in pink block letters above it and "FORTUNES" below. After leaving work today, I feel more dispirited than usual. The bright sign catches my eye, and, on impulse, I walk up the cement steps to the door.

When the doorbell chime isn’t answered quickly, I start back down the stairs, but then hear the door open behind me. I turn to see an old woman in an oversized gray sweater and brown skirt peering through the partly opened door.

"What you want?"

"Is this Rosa's fortune telling place?"

"You want your fortune?"

"I guess so," I reply, no longer sure I do.

"Come in then." says the old woman, and lets me into a dim, inner room. Covering half the floor is a faded and frayed oriental rug; a round table and two chairs stand idly atop it. At the back of the room, a dingy green curtain hangs along one wall by rings strung on a dark rod. The old woman calls out.

"Rosa!" There is no answer. She calls again: "Rosa!"

"Huh?" comes a drowsy voice.

"Rosa. Is someone here to see you."
"What do they want?"

"They want to see you. A fortune."


A frowzy woman in her late twenties, perhaps slightly older than I, draws the curtain aside and saunters unenthusiastically into the room. She sits down slowly in one of the chairs by the table.

"You can sit," she says, nodding toward the other chair. I sit down and adjust my purse strap securely on my shoulder.

She looks me over with a detached air and says, "You want the ten dollar fortune or twenty dollar?"

"What's the difference?" I ask.

"The twenty dollar fortune is longer. More complete."

"Ten dollars," I say.

"You pay me now."


"You have to pay me first," she says.

I lift my purse off my shoulder, pull out a ten dollar bill, and put it on the table. She puts it in her pocket. I settle the purse securely in my lap. She asks me to show her my hand and I extend one hand tentatively across the table. She takes it, glances at the palm, lets it go, then pulls a deck of cards from a small drawer in the table and cuts them once.

"What’s your question?"

"What do you mean?"

"What is your question? What do you want to know?"

"Oh. I didn't know I was supposed to ask a question. Let me think."

She looks at me with narrowed eyes. I divert my glance to the pattern of swirls on the table cover. I had expected her to tell me something interesting or amusing. I have to think for a moment about what I really want to know.
She is stares at her hands with a bored, impatient expression. Finally, I ask, "Will my life be significant?"

An undecipherable expression flits across her face, an amalgam of surprise and annoyance. "What do you mean?"

"Will I do something that others will consider of real and lasting value?  That will be remembered?"

She lifts the top card off the deck, looks at it, looks toward me with a self-satisfied air, and says, "No."

She puts the cards back into the drawer.

"Is that all?"

"You wanted the ten dollar fortune. You get only one question."  

She rises from her chair; the interview is obviously over. She walks slowly toward the curtain. I hoist my purse strap securely onto my shoulder, walk toward the door, open it, step down the stairs, and walk out onto the dun-colored sidewalk.

 [This was written in the mid-'80s as I recollected my two post-doc years at Temple Health Sciences Center in Philadelphia. It intends to capture the spirit of what I felt while there]

Saturday, March 3, 2012


The call came at 10:30 that night. She had just gotten back to her room from a long, late dinner with two former fellow graduate students whom she hadn't seen for almost a decade. She had turned off her cell phone during the conference sessions and had forgotten to turn it back on during dinner. When the hotel phone rang, she answered in two rings.  It was her husband, David.

"Lynn, I've been trying to get hold of you. Jamie's in the hospital."

She answered in the controlled tone she used automatically during a crisis. "What's the matter?"

"I'm not sure. Appendicitis. The pediatrician saw him and told me to take him straight to the emergency room. I'm here right now. In the hospital. They're going to operate." David's voice sounded tense and disconnected.

"When are they going to operate?"

"As soon as they can.  As soon as the surgeon gets here.  It may have burst. The appendix."

She gasped to herself, but said quietly, "I'll come home as soon as I can. I may not be able to get out tonight, but there should be a flight early in the morning."

"Your mother's with him right now."

"Who's the surgeon?"

"I don't know."

"I'll call you and Marjorie as soon as I make plane reservations."

"All right. I'll pick you up at the airport.

As soon as she hung up the phone, she called the airline, made a reservation on the earliest plane she could take out of Dallas the next morning and canceled her Thursday flight. She had to transfer in Atlanta, and wouldn't arrive home until 1:20 the next afternoon. It was the best she could do. It was after 11:00 at night when she called Marjorie, a neighbor and the closest friend she had, to give her the flight schedule.

The phone rang five times before Marjorie finally answered. "Oh Lynn! Where are you?" she asked in a slightly hoarse voice.

"Still in Texas. Did David tell you about Jamie?"

"Yeah, he called from the hospital. I saw the poor kid before he went to the doctor. He was doubled over in pain. Screaming and crying like mad. David called me and asked me to come over and take a look at him. Guess he figured a mother would know what to do."

"Wasn't my mother there?"

"Yeah, your mom was there. She looked kind of upset. I believe she'd just given him an enema. Thought he was constipated. I told David he ought to get the kid to a doctor. Quick."

"Well, I'm coming back. I won't get in until tomorrow afternoon, though. David will call you in the morning. My plane gets in at 1:20 in the afternoon. Flight 1322, Delta."


"Where's Melinda?"

"Right here. She's sleeping on the couch."

"Good. Can she stay there overnight?"

"Sure, Lynn. Of course."
"You've got a key to our house. Send her over in the morning to get clean clothes for school. She can take lunch money out of the vase on my dresser. She knows where it is."

"She'll be all right, Lynn."

"Thanks, Marjorie."

"Don't worry about it. Have a safe trip back."

Still in the grip of her compulsive calmness, she called the front desk of the hotel and left a message for a colleague saying she couldn't have lunch with him the next day. Having taken care of the necessary practical details, she sat in the chair next to the bed, put her head in her hands, and wept.

Jamie had been complaining of a stomach ache for nearly a week before she left. She and David thought it was a bid for attention. He'd been out running and playing with other children in the neighborhood just the evening before she took the plane to Dallas. He always had some complaint before she went to meetings or conferences. Usually his stomach; he'd always had a sensitive stomach. Even when he was a baby, she and David often took him on long drives in the car to quiet him when he (and they) suffered from his attacks of colic.

'Why did Mother have to give him an enema?' Lynn asked herself. Her mother was one for keeping children's bowels moving, especially if they had a stomach ache. Every childhood illness could be blamed on constipation. The enema was exactly the wrong thing to do.  'My poor baby,' she chanted to herself. He wasn't exactly a baby, anymore. He was six years old, in first grade and learning to read. How far behind would this put him in his school work?

Mother, of course, would blame her. Mother had never understood why she went back to work in the first place. When Jamie was two and Melinda had started kindergarten, Lynn took a job as a research associate at the University. She tried to justify her decision to her mother.

"We can really use the money."

"Well, Honey, you've managed so far. You could scrimp a little. Tighten your belt. That's what I'd do. Why do you have to go back to work?"

"It's not just work, Mother. It's a career.  I've had years of training. I don't want it to go to waste! I can't stay out much longer or I'll forget everything I was trained for. I'll never be able to go back."

"But who will care for the children?"

That, of course, was always the question. Lynn had made the necessary arrangements. Nursery.  Baby sitters.  A part time housekeeper for a while.  She managed to juggle everything so the children were always supervised, always in somebody's "care."

Now that they were both in school full time, it was a bit easier. They took the bus to school in the morning and another bus dropped them off after school at the day care center. Either she or David picked them up in the evening on the way home from work.

Why did David have to wait for Marjorie to suggest taking Jamie to the doctor?  Why couldn't he just look at the child and know he was sick? At least, palpate his abdomen. But then, David had never bothered to learn which side of the body the appendix or gall bladder or spleen was on. He was an engineer; machines were his specialty. The body was a deliberately sustained mystery to him. He, too, would blame her, though he wouldn't say it in so many words. Why wasn't she there when he needed her? Why should he have to call a neighbor?

And she, too, would blame herself. Why wasn't she there when her child needed her? Could she have forestalled this crisis by paying more careful attention to his pain? Why had she left the children in the charge of two people who knew nothing about medicine or even biology? But then, who else should she leave them with?  What if he died from her neglect?  From her preoccupation with preparing her talk and packing for the conference?

She changed into her nightgown, called the front desk and asked for a 4:00 a.m. wake-up call and for a cab at 4:30, and then got into bed. She set the travel alarm she always brought with her, just in case.

As she lay in bed, she enumerated her losses. Of the $700.00 plane fare, she had paid $300.00 out of pocket. That was irretrievable. She had presented her talk that morning, the first day of the conference. So at least that wasn't a loss. But she had been looking forward to three more days of worry-free learning. That was gone.  She would not have the opportunity to talk with Ryder and compare techniques and results with him. He had confirmed some of her anomalous data using a different method, and now people were beginning to take her work seriously. All the top people in the field were here. She would miss hearing their papers, miss talking with them, miss developing a collegial rapport with them. She'd miss learning new techniques and new approaches to her research area. There wouldn't be another gathering like this one for a long time. She'd have to do it all the hard way—in the library, on her own.

On the morning plane ride to Atlanta, high above the clouds, she felt utterly cut off, isolated from everything—home and family, profession and colleagues. She could not know how her boy was doing, even whether or not he was still alive. Somewhere in her subconscious, she believed he was, but she also knew that he was in danger.

By the second leg of her flight back, her sense of suspension in a web of dichotomies had settled into her being. Home and profession. Husband and children. Reason and an almost mystical appeal to the power of will. Determination and resignation. It seemed as though ambiguity lay at the very center of her soul; in it was her only security and peace. She felt a numbness that no tears penetrated.

David met her at the airport.

"How's Jamie?" were the first words out of her mouth.

"They operated last night. Apparently his appendix was ruptured. They're worried about peritonitis."

"I was afraid of that."

"What is it, exactly?"

"It's inflammation in  the abdomen. It's caused by bacteria that get into the peritoneal cavity and spread and multiply around the intestines. If it doesn't kill you, you may get internal adhesions, scars where internal organs stick together and can cause trouble for life."

"Good heavens!"

They got into the car and drove silently to the hospital. She followed her husband into Jamie's room. Her mother, in the far corner of the room, looked up from her book when they walked in. Jamie lay flat on the bed in a white hospital gown, his left arm strapped to a board, an intravenous tube bound to the arm with tape. A plastic bottle filled with clear fluid was suspended high above his head and drained slowly into the tube. He turned his head toward them and gave his mother a weak smile as she entered the room. His face was feverish and his eyes listless and half-lidded. She went over to him and kissed his forehead, then laid her cheek against his. His face seemed to be burning.

"Hi, Mom," he said gallantly.

"How did you get yourself into this predicament?" she asked.

"It wasn't my fault," he answered, as if taking her question seriously.

"I know, Dear." She turned to her husband. "What did the doctor say?"

"He was in earlier this morning. Didn't say much. He said he'd be back in the afternoon. I guess we just have to hang in there and wait."

"They're giving him antibiotics in his veins," said her mother. "He can't eat anything but clear liquids."

He looked so small and frail, lying there. What would several days of clear liquids do to that already slight body? He had never been as solid as his sister. Now he would be even thinner. 'Thin people are supposed to live longer.' she thought, as if telling herself a cruel joke.

Her mother turned to David. "Since Lynn's here, I can take the car and drop you off at work, then go to the house and pick up Melinda. We can come back about 5:30 this afternoon."

"O.K., Mom," David said.

"Thanks, Mother."

Lynn was left with the listless boy. They were both helpless, at the mercy of forces neither had much control of. The battle of organisms and antibiotics. The battle of Death against the Will-to-Life. She could not will his life for him; she could only be there and try to help him will it for himself.

When the nurse came in to change his dressing, Lynn left the room and walked down the hall to a small sitting room for parents. A petite, dark-haired woman, apparently younger than Lynn, sat smoking a cigarette. She looked up. Lynn smiled and nodded toward her; the woman nodded back. Lynn sat in a nearby chair.

The woman put out her cigarette and asked, "Do you have a child here?"

"Yes, a little boy."

"Me too. Seven years old."

"Mine is six."

"Really? What's he here for?"

"Appendicitis. They took out his appendix last night."

"I wish mine had something that simple."


"Robert has leukemia." She lit another cigarette. "He was in remission for six months. It's back again. They're giving him chemotherapy and transfusions."

"How long has he been in the hospital?"

"Over a week now. They're trying to get his blood count right. Something like that."

"Yeah, they try to kill off the cancerous cells and replace them with normal cells."

"How do you know about that?"

"I do research in the area."

"Really!"  She paused. "What's your child here for?"


"Oh, yes. You told me. Where's his room?"

"Down at the other end of the hall. The last room."

"That's next to my Robert's room. I guess I heard them bring your boy in last night."

"Have you been staying in the hospital?"

"Yeah. I've stayed overnight in his room all week. Don't get much sleep, though."

"I guess I'll be staying here tonight, myself." Lynn couldn't resist asking the question. "Do you work?"


"Do you have a job? Are you taking time off from work to stay with your boy?"

"Oh, no, I can't work. I've got a little girl three years old at home besides Robert to take care of."


"Do you work?"


"Isn't it hard? Working and taking care of a family?"


"Well, I'm glad I don't have to," the woman said slowly, taking a long drag on her cigarette. "My husband earns enough to keep us going. His insurance should cover most of the hospital bills. But we'll still have plenty to pay, I'm sure. We'll worry about that when the time comes."

Lynn didn't know what to say. She wanted to get back to Jamie. As she stood up to go, she said, "I hope your boy gets better and can leave the hospital soon." She knew that, even if the child did improve and left the hospital, there was a real possibility that he'd be back, and that he might eventually die of that insidious, malignant disease. She hoped her horrible knowledge didn't show on her face.

"Same here." The woman had a smile on her lips, but her eyes were sad.

When Lynn got back to the room, Jamie was crying.

'What's the matter, Baby?"

"It hurts, Momma. It hurts."

"I know, Darling."

That evening, Jamie's fever was still high. The doctor came in briefly and said the child seemed better but wasn't out of the woods yet. David and Melinda came during visiting hours, then left. Her mother stopped by briefly and went from the hospital back to Camden that evening. "Dad needs me, Honey. I'll come back in a day or two."

After they all had left, Lynn made up the small cot beside her son's bed. She lay down on her back and listened to his fitful breathing and the occasional short cries of pain emitted in his sleep. Silent tears ran down the side of her face. Through the wall that separated them, she could hear the woman in the next room sobbing loudly.

'She's in even greater despair than I am,' Lynn thought. 'Staying home with her child hasn't protected him from serious illness or the specter of Death. Why this eternal female despair? Men get angry and lash out at those things that threaten or frustrate them. Or they run away. We women are bound to all that causes us pain. We remain to weep for the wounded and helpless. Is it necessary, somehow, for the begetting and sustaining of life that women weep?'

She remembered another time in another hospital, three days after Melinda was born. Lynn wanted to nurse her baby, but the milk had not come in. That lovely, placid child had, with each succeeding day, become increasingly fretful. Every time Lynn went to the nursery, the baby was crying. When the nurse brought Melinda into her room, Lynn would give the baby the breast—first one, then another—but there didn't seem to be anything there. Finally, that night, she sat in the rocking chair in the corner of her room, the baby in her arms, rocking and rocking, letting her suckle. When the nurse came to take the baby, Lynn said, "Please leave us alone."

She sat there in the darkened room, holding her child at breast, weeping, rocking, weeping, for an hour, perhaps longer. She lost all track of time. Finally, exhausted and hopeless, she took the baby back to the nursery. The next morning, her breasts were engorged and painful—so full that, at the thought of her child, they began spouting little fountains of milk that ran down her sides and abdomen like tears.

[This was written during the early eighties, at a time when I was stressed about work and child-care responsibilities. Although it has been submitted several times, it has not been published]