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Muse 5

the healing muse, volume 4

These are just a few excerpts from the many inspiring selections in Muse 5. To order a copy and read the entire issue, please visit our Support the Muse/Order Copies page.

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B.A. St. Andrews, Your Breast a Unicorn

Uncut and unsewn my breasts nuzzle
yellow silk secure as two fauns nestled in
Debussy's dream, sun-dappled and safe,
finding solace singly and together.   My heart
beats staccato under slumbering glands of
these breasts and I think about the milk
of human kindness and my friend who, unaware,
suckled an abomination which curled inside her
softness and betrayed her.   Like Cleopatra's asp
awakening on compassion's mound,
on passion's curve, at consolation's center
one aberrant cell metastasized, stirring
from slumber to pierce with death that
tender sweetness it had dreamt upon.

She hates that phrase "lost a breast"
with its insinuation of carelessness.
"It's not as if the three of us went off
to market," she says, "my left breast,
my right breast and I and one zipped off
to ice cream while the other darted to
bottled dressings and me just meandering
beside vegetables stacked and clotted
like a painter's palette with apricot,
celeriac, eggplant, muscadine.   It's not
as if I realized suddenly one of my breasts
had gone missing and charged the courtesy
counter breathless on the PA system
announcing: I'm waiting on aisle nine
for my right breast, my recalcitrant child
who has spent her full, fragile, throbbing
life with me so please return please
and help me push the cart piled high
with treats for her: my other darling,
my rose-tipped girl, my comfort."

Breasts make money, cut or uncut.   We
speak of capital "B" breasts as if
they were priceless organisms to be
mined or culled or caught in the teeth
and so they are. The Breast is a bronze
pendant, a cocoa fruit lopped from
its emerald vine.   Breast is an apricot
moon pinned to the vineyard of night
a pool mirroring the love-sustaining needs
of women and men, women and women,
mothers and sucklings. Breast, tumescent
and detumescent as any male part, is
mystical and defiled, swollen and confined,
life-giving and powerful as Africa's Nile.
The Breast reigns: Queen of Solace, Empress
of Amazons, Priestess of Pleasure.   We all
worship the Breast, ripening or withered:
first pillow, first nation, first food.

Your breast is gone, medically incinerated
before we could place it among stars.
Lost as the unicorn, that ancient sigil
of innocence, your legendary breast is
extinct and wandering in fields of praise.
Like the Unicorn's, let your struggles be
woven into tapestries and hung in halls
of queens and heroes.   Let your face be
fashioned of herbs and flowers; let your
courage be emblazoned in golden thread
so light-yielding, so steadfast that fragile
sister ships may, by your radiance, glide
unperturbed past shoals and reefs of fear
and anguish which lay siege on every heart.
By your burning may ships heavy laden,
carved with busts of mermaids and deities
who tame wild seas, deliver safely their
cargo of women brave and beautiful as you.

Catherine V. Caldicott, Combing

Concerned for your image
You asked for a comb.
As it eluded your reach
I took the old pink plastic

And fanned out gleaming silver threads
Against the hospital pillowcase
The last time I combed your hair
You opened your eyes

Rare as alexandrite
Or sparkling Stella Maris
Under platinum waves
You held court

Our sweetly smiling Amphitrite
Framed by your silken sea spray
The last time I combed your hair
Before I dressed you reverently in black

Before your daughter's daughter
Pushed you in a matriarch's argent chariot
Queenly under glistening crown
Rendered pale by your dignity.

The last time I combed your hair
You told us it was late
You said time was of the essence.

Mirrored in your aqueous
My bewildered sisters and I
Laughed nervously
But how were we to know

That while silvery silk still clung to pink teeth
Your sands ran through our fingers
Your tresses a low tide against a cotton beach
The last time I combed your hair?

Bruce Bennett, Anodyne

To live from day to day
with what each day will bring
won't make pain go away.
It will not do a thing

For grief that chills the bone
or tremors of distress
that case the heart in stone.
Yet one can murmur, yes.


Michael D. Burg, Juan

About ten people have already been briefed, but as more flood into Trauma Room #1, each wants an updat. e"Blunt trauma, full arrest," I repeat as each new physician, nurse, tech, or other healthcare provider enters. "That's all we know. We'll learn more when the paramedics arrive."

Looking around the room, I see my team members getting ready: strapping on goggles and masks, tying on gowns, and snapping into gloves—preparing for battle. As they don their medical armor and talk, the room hums with an electric buzz. It's the pre-game jitters.

The paramedics had radioed in moments before. "This is RA 147, working a scene with a man down outside his car. On our arrival he had agonal respirations and a thready pulse. He’s 1144 now, intubated, CPR started, IV wide open. ETA two minutes, code 3."

Agonal breathing reminds me of a fish out of water, gills open, straining to suck in oxygen. A thready pulse means shock, cells suddenly starved for sustenance, the heart's efforts insufficient for the body’s needs.

As an emergency physician at a busy teaching hospital, with fourteen years of post-residency experience, I get it . . . instantly. I can picture the incident. Rescue ambulance 147 paramedics are providing medical care to a man lying on the ground by his car. He was barely alive when they arrived. Now he has no signs of life. One intravenous line is in and flowing, a tube has been inserted into the throat to provide oxygen and ventilation, and chest compressions are ongoing. Driving top speed, they'll be arriving at my hospital in two minutes, sirens howling, lights flashing.

The short, hurried call has brought the trauma team running. Moments later the paramedics wheel their patient into the trauma room, CPR in progress. Their report is terse. "Approximately forty-year-old male found down outside his vehicle in near cardiopulmonary arrest after his car hit a pole. IV, oxygen, intubation, CPR, transport," intones the paramedic, her flat voice carrying the emotional impact of typewriter keystrokes. "No response to therapy. Front-end damage to the vehicle, no seatbelts, no airbag, unknown closing speed, no other medical history available."

Paramedics primarily care for patients, which is different from "working a scene." Sometimes a human-to-human connection is made. Caring happens then. Sometimes it's just a job; that's "working a scene."

The paramedics—no matter how seasoned or how tough—are often tender, almost lovingly so, with patients. This is especially true for the infirm elderly and children. The paramedics seem to bond with them, even during their brief time together. I often overhear comforting words as the medics transfer patients from the hard, narrow ambulance gurneys to ours. "The docs and nurses here are great. They'll take good care of you. Everything will be all right."

This one's different. From the beginning it seems as if this patient is nameless and faceless to the field personnel. Perhaps it's because he never spoke to them. The paramedics didn't have time to check his wallet, so he's come in as a "John Doe" and is assigned a trauma number. I notice that he's young, maybe mid-thirties, about the same age as many of the paramedics. Possibly it's too painful for them since they identify with him. They don't want to see themselves as he is now, found down, lifeless, after a car crash. Distance may be a way to avoid painful thoughts of mortality. I can't dwell on it, but it strikes me as odd, atypical, and sticks in my head.

In the same way, the emergency department workers—nurses and doctors alike—treat this "found-down-full-arrest" not like a human being but like a spent biological object. Alive moments ago, his heartbeat, thoughts, and speech made him one of us. Suddenly he's been relegated to another, lesser, category.

He's unceremoniously moved from the paramedic gurney to the resuscitation bed, deposited there with a rough thump. Most in the room set to work on him like miners digging into a seam of ore. A workaday atmosphere exists; but there's something more, an unusual sense of disrespect that sets me on edge.

As the emergency department attending physician, I head half of the trauma team, the part concerned with managing the patient's airway. I’m also responsible for directing the overall care of the patient, for running the resuscitation and making sure that the team follows a priority-driven approach. I've been an attending for fourteen years, the last six of which have been spent in academia, teaching doctors in training. I now work at a trauma center, one that sees much of the horrible medical stuff that gets splattered across page two of the newspaper in the "Your Community" section.

Resuscitations are supposed to be orderly. An organized approach benefits the patient. Many medical interventions happen simultaneously. There is, after all, plenty to do when someone arrives all but dead in the emergency department. But chaos shouldn't rule. The most important things should happen first, then those of lesser import, and so forth. Practically, however, a well-ordered trauma resuscitation is more often the exception than the rule.

The surgical portion of the trauma team, headed by an attending surgeon, consists of medical students, physician assistants, interns, residents, and nurses. Simply fitting all those bodies into our trauma room and around the patient's bed is nearly impossible. The emergency department personnel are involved too, so we need a place to stand. Respiratory therapists, X-ray techs, hospital supervisors, EMTs, ward clerks, and others with a role in the proceedings crowd in also. Finally, anyone else who feels he or she would like to play along comes in to watch. There's always an overabundance of nervous energy crackling in the room. With that many over-amped people packed into a tight space the scene sometimes degenerates.

Many surgeons—even the budding ones—like to yell, their raised voices demanding attention for their every action, no matter how trivial. Cacophony is the result; minor and major merge and overlap. "Hand me a glove and some lube," bellows the surgical intern charged with doing the rectal examination.

"I need a line set-up here, now," screams another, frantically trying to establish an intravenous infusion.

"Catheter tray, stat!" squeaks the lowly medical student. He may be putting in his first urinary catheter, but he’s learning from his superiors.

As long as the important parts of the resuscitation are going smoothly, I let all this and more wash over me, ignoring much of it, so long as the ABCs—airway, breathing, and circulation—are being attended to. In this case they are, as are other potentially life-saving procedures and interventions. I can block out the bedlam swirling about the bedside. Even the attending surgeon's voice shrieking, "5, 4, 3, 2, 1, X-ray!" or "Move it or lose it!" in an overly dramatic and unnecessary effort to clear the room of those not wishing to be repeatedly irradiated, fades into the background.

I float above the scene, feeling as though I'm looking down on a gang fight. I'm slightly detached from some of the minor details of the battle for life but hyper-aware of how the overall effort is going. I’m focused on the big picture. It's a skill I learned as a senior resident. I can tell if we’re winning or losing. We're losing this time.

This detached approach also allows me to teach my resident during the chaos. We stand side-by-side at the patient's head, our masked and goggled faces kissing distance apart, hemmed in by the respiratory therapist and her ventilator to my left and the ever-present lookyloos to our right.

Alexis Choi, the resident, is a vibrant, intelligent woman in the throes of "senioritis," that end-of-residency-training languor that takes hold after four years of one hundred-hour workweeks and innumerable taxing encounters. I had senioritis once myself, a really bad case. Only sex and dreams of graduation kept me sane as I plodded through the final few months of my senior-resident year. I don't know how Alexis is coping with her burnout. I suspect she has her own strategy, but I don't know her well enough to ask.

When I was an intern, a senior resident pushed me toward a horribly mangled patient as he outlined the man's multiple life-threatening injuries. When we reached the patient’s bedside, he slapped me on the back, turned and strode off, cheerily quipping over his shoulder, "This bud's for you." That offhand line was his attempt to spark confidence in the struggling neophyte physician under his command. I never felt more alone or scared in my life, until the next time.

As a senior resident myself, I often flippantly suggested that patients in their death throes "only had the flu." I considered myself a great wit at these moments. Many on my team apparently agreed, since my line, "It’s only the flu," routinely elicited peals of laughter and many similar comments. With an attitude like that I'm sure I abandoned my junior residents during their moments of greatest need.

I have since emerged from my affective anesthesia, but I was deeply under at one point in my career. I lived there once, but I never want to return to that emotional cocoon.

Keeping our voices low, Alexis and I discuss medications, the need for various interventions, diagnostic strategies, airway management, whatever is relevant to the situation at hand. Thinking and performing properly under pressure are necessary skills for emergency physicians. I quiz Alexis so she can learn to process vital information during times of extreme stress. I can do it; I learned it as a trainee myself. It’s likely that Alexis will eventually work at a smaller hospital. She won't have a tremendous trauma team to sweep into her department every time a dead person is brought in. She'll have to prioritize and use her more limited personnel wisely. We thrash all this out and more.

Sometimes, during resuscitations, a sense of reverence or respect (or perhaps awe) pervades the room; sometimes a party atmosphere ultimately prevails. In this case it's the latter. It's unclear exactly why this has occurred, but it has. Most, but not all, of the doctors and nurses are caught up in it.

The shift—from cool callousness to overt mockery—occurs when the intern doing the rectal examination refers to it as the "hospital handshake." There are chortles all around. Initially our patient is clad only in pants, his shirt cut away to allow for monitoring leads and IVs. Someone comments on his fat stomach bobbing this way and that as his chest is compressed during CPR. I wonder who said that, but I can’t look up or even address the speaker since I’m busy confirming airway tube placement and function with Alexis. Besides, the hubbub in the room and the critical nature of the situation preclude discussion. I store the comment away for later reflection. Many other remarks are made as the man's pants are scissored away and his genitals revealed. A nurse grunts that finding his penis to insert a urinary catheter will be a real challenge given his fat belly, his small "package," and the movements of his flaccid body being buffeted about during the efforts to revive him.

It has become obvious that this man will not survive, no matter what we do for him. One of the senior residents dryly observes that our patient will shortly be "taking a dirt nap." Some take this as a signal to begin playing with his mangled arms and legs in an effort to clinically diagnose his orthopedic injuries. Each limb is twisted in a different grotesque way, angled sharply into unnatural positions from the force of the impact of his car hitting the pole.

Off to my left I see a burly resident attempting to straighten the patient's left thigh where a bone protrudes from its lateral border. He's not trying to be helpful; it's a contest for him. "Can I do it?" his face seems to say. He looks around the room to see if any of his mates appreciate his wrestling match with the leg. No one really notices, but he continues to push and pull, jerking the body back and forth until I command him to stop. One of the emergency nurses begins waving the man's abnormally limp right wrist about aimlessly, stating, "This is all screwed up, too." She seems irked when I ask her to please cease what she's doing. But she stops and busies herself with charting. I can see I'm not making friends. All the while, various voices are commenting about how this man is "kicking the bucket," "buying the farm," "going toward the light," and so forth. For me, it's a grim tableau, and I feel powerless to reconfigure it since almost everyone is playing along, and I'm outnumbered twenty-five to one. If outsiders were watching, they'd think they'd stumbled into a house of horrors.

Finally it's over. The patient is "pronounced," as we say in medical shorthand. He came in dead and stayed that way. The gallows humor ends because there's no longer a subject any more; he has passed away, literally and figuratively. Cleanup begins, and I have a chance to draw a full breath and think about what just happened.
I look down at my patient's face. It is in repose, eyes closed. Tubes stick out of his nose and mouth. A smear of dried blood lies across his forehead; his head rests in a puddle, which frames it like a corona. Were it not for his ashen gray color, I could imagine him sleeping, perhaps about to awaken from a nightmare. I notice that the dead man is younger than I, much younger, and I'm not that old. His hands are those of a laborer, the skin rough and cracked, the palms thick with calluses. His neck and torso are thick too. Muscles and fat bulge beneath his skin. Were he walking past me on the street, intact, there's nothing about him that would draw my attention. He's ordinary looking, just a man.

As the trauma room clears, I ask Alexis to find his family and notify them of our patient's sudden death. She nods her assent and begins to search about for some form of identification. I watch as she pulls the dead man's wallet from the right rear pocket of his bloody, shredded jeans. It falls open in her gloved hands, to a picture of two little girls, his girls, their picture shown so often his billfold has developed a memory, marking the most-dear place in his life. Instantly tears well in Alexis's eyes. From the foot of the patient's bed she murmurs, "He had a life; oh my God."

The janitor's mop swishes back and forth softly on the yellow linoleum floor awash in blood.

The man's wife and brother, who had been outside in the waiting room, fell to the ground screaming when told he was dead. They beat their chests and clutched at the hem of Alexis's coat. I noticed that Alexis's normally bright white doctor's jacket was sullied with faint spots of blood. Other wet patches marred its purity as well. She had dabbed at the discolorations with hydrogen peroxide but some stains are almost impossible to remove.

Our patient was thirty-seven, married, a workingman on his day off, helping friends move furniture. His name was Juan. His accelerator had apparently gotten stuck, and he'd crashed into a pole at high speed. The picture in his wallet was of his two children, ages three and five. According to his wife, he was scheduled to donate one of his kidneys to his sister with renal failure who was on hemodialysis.

I found myself wishing that all the members of the trauma team could have observed the Trauma Room #1 epilogue. "Blunt trauma full arrest" were no longer words I could use to describe Juan's life, not even the tiniest part of it, the portion I had witnessed. They were small, cruel, and demeaning, as odious as some on the team had been during our patient's final moments.

I saw something of my resident-self again today, in me and in others. My initial encapsulation of Juan as "blunt trauma full arrest" stirred echoes. It sounded like a slightly milder version of, "It’s only the flu," my long-ago catchphrase used to dissociate myself from pain and loss.

I was thankful that I'd learned the particulars of Juan's life only after it was ended. I needed the detachment to focus and perform properly during my attempts to save his life. Alexis needed it too as she tried to master the moves inherent in a complex resuscitation. But we both desired to know something of our patient as a person. Talking with his family, studying his face, and crying over his children's photograph enshrined in his wallet were part of that.

I often compare my professional detachment to the aperture of a camera. It adjusts to changing conditions. If a large influx of light is required, it expands accordingly. If less light is needed, it contracts.

I didn't want images of Juan's two little girls dancing in my head while I focused on saving his life; that's far too distracting and emotionally too close to home. I can't cry and bleed for every patient, especially while they're in extremis. Their pain isn't mine, nor is the sorrow their family members experience. I can't be too near, or I'd dissolve at every bedside in the ED. However, when the critical moment passes, and the patient either stabilizes and improves or worsens and dies, I have to open up and let a portion of their life touch mine. We're all in this together; that's my feeling. That human-to-human connection has to be a part of what I offer in medicine. I'm cheating myself and my patients if I do less than that.


Gary Weinstein, Co-conspirators

She'd said yes. She actually said yes, Nathan Heinz murmured to himself, still holding the phone, her voice still faint in his ear. The feel of fortune washed over him.

I'm sixty-one for God's sake. Look at me, he thought, smiling, stunned. Time slowed, expanding to touch all things. He glanced at his hands. The cacti in the eastern window glistened with pink flowers and framed a view of the Poughkeepsie high-rises beyond, graced with spring bloom, dogwood and magnolia.

"Very much," Lily Woodrow had just told him. "Yes, I'd very much like to see you for lunch again."

The May breeze pushed through four broad, southern windows. Nathan's yard glistened in the late morning sun and cloudless blue. Lily's words and a swirl of memories moved inside him. The happiness he felt was wholly unfamiliar and unsettling. Be careful, he told himself. Contentment has its shadows.

He revisited their small conversation. Yes I would . . . very much. His heart quavered. The garden by the front walk was bordered with hyacinth and daffodils, some with a triple crown of exquisite beauty that seemed to wave back at him. It's all right. How many springs had he and his former wife Allana rejoiced and argued over the perennials? The complicated dance of marriage, like a flame fighting the wind.

He looked throughout his home. Thirty-one years here and now his life was changing out from under him. He was leaving. The last one of his family out. Lily's affirmation, now, atop the prospect of moving left Nathan lightheaded. He felt unmoored. The great bulk of his life lived inside these walls was offered up now for recollection; he and Allana raising their three children, their countless comings and goings, the growing up and the tears, the loving and fighting, the nights asleep safe and dreaming, awakening, their meals and friends and loved ones all known to this house—the numberless moments that compose a family's life all passed.

And the last three years so laden with sorrow. How it had rent Nathan and Allana when Mark, their middle child, had lost his life with three others in a senseless bus accident, caroming over a Pacific coast road edge in California.

Lost his life. . . . was killed. . . . The words never leave. Death robs one of certainty, of even knowing with what words to think or speak.

For certain, however, in ten days the movers would arrive to haul everything out, and he'd be the last one out.

Allana had months ago settled in her own apartment and was apparently happier than she’d been in many years.

"I can bear to look in the mirror again," she'd told him. A month from now he would be sweltering in the Texas sun, living just blocks from his daughter Lorraine in Austin where she had invited him to live. Tracy their youngest was somewhere unknown in the Algerian countryside on an extended escapade from which she rarely wrote. His family was grown and dispersed, each settled solitarily in the world. The remnant of parenting within him checked for their whereabouts and their well-being and marveled that his children were grownups. And he thought of Mark.

He whispered a soft greeting to Mark's portrait on the mantle, a tiny ritual he promised himself to uphold, and heard his own voice with faint strangeness. He needed ground, something in the present, something anchoring, something future oriented. Friday he would see Lily again.

Their first lunch had lasted almost three hours. Without one glance at the clock the afternoon had just flown. They'd both felt the amazement of it and laughed. To think, they worked in adjacent offices for more than eight years and had seen one another many times: passing in the lobby, in the vestibule, by the fountain, or packed together on an elevator. But in the last three years or so Nathan had only hung his head, his eyes to the ground, unseeing, in the endless gloom of losing Mark. Three years of days in which Nathan had felt little reason for living except that he found himself still alive for his daughters. Slight greetings and elevator doors held for Lily, but Nathan unseeing. Allana moving out and Tracy in North Africa and his loneliness compounding and no one mattering.

Those last three years yielding, imperceptibly, to the moment on their way out one evening last month, when he'd felt alive enough again to greet Lily, to say hello and accept her invitation to Saturday lunch.

Lunch had gone well, and he thought she'd even looked at him with some affection. I'm in my sixties, for God's sake, he chided himself. Look at me, wondering and worrying like a damned teenager.

Her story consumed that afternoon as he'd listened and forgot about time. He'd wanted to tell her about Mark and about Tracy and Lorraine and so many things. He'd even brought a photo of Mark and the sweet letter from Lorraine inviting him to Austin. But these precious items were still in his pocket when he returned home.

Lily had told Nathan of her daughter Bonnie's unfathomable distance, how Bonnie had cut herself off from the family for reasons Lily could simply not grasp. Bonnie, her beloved, had severed ties without warning, without explaining.

"I'd like you not to call me," she'd told Lily four years ago this past November, just before Thanksgiving. "Doug and I won't be coming for Thanksgiving. We won't be seeing you. For a while, Mom. A long time, really, I don't know. . . . " And then trailing off.

Lily, had been lost for words, anguished, "What are you saying, Bonnie? Why? What? Honey!" A blur of floundering talk is all Lily remembers any more, she told Nathan. What remained, what stung so terribly was that from that point and ever since, she had neither spoken with her daughter, nor ever met her grandchildren, who, born soon afterwards, were now two and three and a half years old.

Lily told all this without tears, though Nathan was certain she'd cry at any time. "I cried myself out years ago," she said. "You would not believe how much someone can cry." But he did believe and told her. "It certainly meant the end for my husband and me. We lasted less than a year once Bonnie cut herself off. The heartache, the baffled, tormented blaming and wrangling we went through."

They shared remarkably like circumstances: losing a child and the catastrophe of divorcing. In moments, he was sure, he'd find the chance to tell her his story, but it never occurred. In a way, she was speaking for them both without knowing it, and so he remained quiet.

"It was as if Bonnie wished us dead or to think of her as dead. To this day I find it senseless. I have no better understanding of it now, Nathan, than I did at the beginning. But as a mother I would not accept it. I couldn’t, you know? I could be sick with grief for only so long.

"Eventually my anger surfaced. Until then I was only behaving the way Bonnie had wanted me to. I'd felt empty and paralyzed. I finally realized I'd be God damned, you know? I began to do things I never thought possible."

For months, beginning last summer Lily said, she would just drive by her daughter's house on weekends, on evenings. Just to see. Just to be near. She would park outside the cul de sac, sit, and watch. Obscured by trees, the summer dusk allowed light. "Bonnie and Doug had no idea what car I was even driving by that time. My anonymity worked. I watched through the tinted windshield for hours. I raked my life for clues to Bonnie's walling off of herself. All through August and into the early autumn I watched, you know: Bonnie waving to neighbors, chatting on the cordless, bringing in groceries. Scooters and balls and the little girls on the smooth driveway, the dollies and balls on the lawn. All the things that fill the days of young parents."

"It was entirely strange. I felt as if I was looking into my past, watching myself mothering Bonnie as a toddler, or even watching myself as a toddler. I turned my life over for clues. It is one of the hardest things I've ever done, and yet I couldn't not do it."

Soon thereafter Lily brought binoculars and could suddenly make out her granddaughters' faces, their fine toddler hair and glistening eyes. Some of the younger one's earliest steps. It was as though, disembodied, Lily stood among them, a ghostly, undetectable presence. Mouths and faces moving to unheard words.

"My grandchildren," I would whisper to myself. "Bonnie, sweetie, I still love you. It's me, your mom. I'm right here," I would say, tears on my cheeks and blurring the eyepieces.

In late autumn they retreated indoors. For months Lily was vexed. Phone calls long ago were useless, their number changed and unlisted. She paced, awaiting an idea, an avenue to action.

"When it finally came to me, it took my breath. I remember sitting down, dumbstruck at my inventiveness," she told Nathan across their empty plates and half sipped mugs of coffee gone cold.

"I had tailed them many times. It was like a bad TV show, Nathan!" she laughed. "Or like Hitchcock—remember in Vertigo, you know, the spooky way he follows that woman for days, and she has no idea. The whole damned thing feels dreamlike. Even talking about it with you. . . . Jesus, I've been stalking my own daughter!"

She looked away for a moment of passing disbelief, then swiftly returned, eyes upon him.

"I knew where the girls went for day care. I'd watched them get dropped off. One morning I went in after Douglas had left. I asked whether the Center accepted volunteers. I was told yes, and to apply, so I did. They told me they would be pleased to have a woman my age. I fibbed and said I was semi-retired and needed a new involvement. It was too easy. A week later I was working there."

"I flexed my hours at work," she pulled in breath and puffed her cheeks to breathe out. "For just over a month now I've been there, two mornings a week. They placed me in a room just one door down from the girls."

She rested and allowed the air to move around them. She looked at Nathan over her hands now woven together prayer-like and held to her lips.

The diner had emptied out. Cars hissed on the street out front. Three o'clock April sunlight filled the front windows. He would know a lot more about this Lily Woodrow and himself in another minute. She radiated a sense of knowing this as well. Are you ready for me, Nathan?

"Last week I talked with the older girl. We were alone in the children's bathroom. Her name is Clara. I helped her dress and with her hair. I was touching her and looking so intently at every little aspect of her." Lily was speaking carefully now, with details, wanting to get it right.

"The angle of the sunlight pouring through the bathroom window, the radiant sparkle in Clara's hair, the fragrance of her clothes, the shape of her fingers reminding me of myself. Touching her for the first time, ever, in my life."

"And then yesterday I sat with them both during lunch and recess—Shawne and Clara—helping them with their food. Afterwards I held their hands and we talked."

"No one knows, Nathan. No one has any idea who I am. I'm just this friendly older woman who helps out. I'm no one. I have this feeling when I'm with them, that at any moment someone will discover me, swoop in and wrestle me away. But I also know that's not true. I sit with them, and I tremble, and I see myself in their little faces."

Tears welled, finally, though she was looking nearly though Nathan.

"I think about taking them," she said suddenly, resolute again.

"Just gently taking them. Holding their little hands and walking them out to my car and going. It's crazy. I could never. It's . . . " she searched for a word, her hands waving and vibrating in mid air " . . . just nuts! To even think like that, but I do. It occurs to me. When I'm sitting right there with them, I think, 'I could just take you home with me, you sweet, little lovey babies. You belong to me. Do you know who I am? Wouldn’t you like to know your mommy’s mommy?' I want to say to them, 'I want to know you. . . . Will you come with me?'"

There are moments you do not spoil with words. Nathan sat very still.

"That was this morning, Nathan, just before I came here."

Cars outside. Half-sipped mugs. A radio way back in the kitchen.

"What do you think I should do, Nathan? Really. I wonder what you think."

His mind fairly raced. Lily leaned back comfortably, sadly, finished, and held her cold mug in both hands to her chin as a reflex as if to hide her mouth. Careful what you ask for, he thought, and it amused him for a passing instant, buying time.

She looked at him and looked infinitely far away in turns as she awaited his thoughts. It was a kind of non-question question she had put into the air. Again, Hitchcock, he thought. Strangers on a train. They could conspire.
He could be her hero. Really win her heart, this woman for whom his heart and feelings stirred. He would drive the getaway car. No plates. They would speed off to his cabin in the Adirondack foothills. A clean operation without trace. He saw it all in an instant.

That had been last week. And now she wanted to have lunch with him again. To tell him more. To find out what he'd decided, if he’d decided.

He tried picturing it. The two little girls. Himself, the stranger at the wheel. Lily triumphant. The newspapers, the trial, the television, the buzz.

Big, big trouble. Yes, very much.

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