Lionel Shriver - So Much for That

“Oh, it wasn’t really for a better salary that I took the job with IBM,” Carol explained. “When Randy took over Knack – you know what a corner-cutter he is, what a bottom-liner – he switched to a cheaper health plan. With all our expenses with Flicka, the therapies and surgeries and bouts in the hospital, we couldn’t depend on Jackson’s coverage anymore.

“See,” she went on, “this World Wellness Group outfit is the health insurance company from hell. They levy co-pays on everything, including the meds, and we have to fill dozens of prescriptions every month. With their whopping deductible, you’re out five grand before you’re reimbursed a dime. Their idea of a ‘reasonable and customary’ fee is what a doctor’s visit cost in 1959, and then they stick you with the shortfall. They’re way too restrictive about going out of network, and Flicka requires very specialized care. Then there’s co-insurance on top of the co-pays: twenty percent of the total bill, and that’s in network . And here’s the killer: there’s no cap on out-of-pocket expenses. Add to that that their lifetime payment cap – you know, how much they’ll fork out in total, ever – is also pretty low, only two or three million, when someone like Flicka could easily exceed numbers like that before she’s twenty … Well, we had to find other coverage.”

“Gosh, I had no idea.”

“But you should know, Shep,” said Carol. “It’s your insurance, too.”

Shepherd Armstrong Knacker

Merrill Lynch Account Number 934-23F917

December 01, 2004 – December 31, 2004

Net Portfolio Value: $731,778.56

While they drove to Phelps Memorial in Sleepy Hollow, Shep kept one hand on the wheel, the other in his wife’s. Their clasp was relaxed; her palm was dry. They both stared straight ahead.

“It wasn’t necessary,” he said, “for you to go through the diagnostics on your own.”

“You were off in your own little world,” she said. “So I went off in mine.”

“You must have felt lonely.”

“Yes,” she said. “But I had been feeling that way for some time.”

By the next exit, she added, “You’re a planner, Shepherd. You always look before you leap. Really, you leap before you leap. In your head, you took that plane to Tanzania months ago.”

He was relieved that she was talking to him at all. He was willing to be castigated, glad for it.

To his horror, Glynis had already been subjected to abdominal X rays, a CAT scan, and an MRI. Memories fell into place. On two mornings in December she had declined not only breakfast but even coffee, which for Glynis was unheard of. He couldn’t recall the excuse, but it mustn’t have been persuasive, because the refusal of coffee in particular had injured him; she had spurned one of the sacred rituals of their day. On two evenings, she had kept rising for another drink of water, and yet another. So she’d not been quenching a powerful thirst, but rinsing contrast medium from her veins. Likewise one odd, floating memory finally lodged into an orderly narrative: of walking into the bathroom before she had a chance to flush, and noticing that the bowl was red. It had been awfully early in her cycle, but she was fifty, perhaps getting irregular; aware that she was touchy about the approach of menopause, he hadn’t passed comment. Now he realized: that was not her period. He also realized that she had started to wear a nightgown to bed not, as she had claimed, because she was cold; it was to hide the laparoscopy scar on her belly, which he had now seen. Though only an inch long, it alarmed him: a first violation, and not the last. The nightgown had injured him, too. They had slept for twenty-six years skin to skin.

Since that signal Friday evening a week ago, she had shared only bits and pieces about the tests. So her mention that weekend of one small technicality had stood out. Before the MRI, for which all jewelry must be removed, they had to do an extra X ray before sliding his wife into the tube. “Because they learned I was a metalsmith,” she’d said. “The imaging is magnetic. Metal screws it up. You can’t have any fragments or filings stuck to your body.”

He should have recognized why she had told him this: because she was proud. He shouldn’t have asked her, “So did they find any?” An effective but infuriating gambit increasing in frequency, she hadn’t responded to his question at all, which in this case meant no. They found no fragments or filings. She had worked so little in her studio for months that she could have taken the MRI just like anyone else. Even at such a juncture, he’d had to rub it in.

Your own little world . Her subterfuge would never have succeeded without his corresponding neglect. If he had noticed that despite the recent fullness around her stomach she’d grown thinner, he had made little of the observation, which was as good as not having noticed. He thought, I’d no idea that our marriage was in such disrepair, and then he remembered that until last Friday evening he was planning to leave her.

“That night,” he said. “You didn’t have to let me go on like that, about Pemba. You could have stopped me.”

“I was interested.”

“It wasn’t nice.”

“I haven’t been feeling,” she said, “ nice .”

“How do you feel?” Shep was ashamed. In the last week he’d been solicitous, perhaps annoyingly so. Yet in the months beforehand he could not remember the last time he had asked her how she felt.

She took a moment. “Frightened. For some reason it was easier when you didn’t know.”

“That’s because you can give yourself permission, now, to be frightened.” He pressed her hand, just. “I will take care of you.” It was a big promise, one he would fail. But he would fail valiantly, and that was the promise he made to himself.

Dr Edward Knox extended a hand to Shep, his clasp firm and generous. The oncologist gave off the astringent tang of antiseptic, as if he were one of those rare physicians who really did wash his hands. It was a smell Shep associated with anxiety. “Mr Knacker, I’m so pleased that you could finally arrange to join us.”

In this phrasing Shep detected reproof, and his wife’s outrageous misrepresentations. In other circumstances, he would have taken her to task for them. Since now he would not, he sensed that taking her to task for anything was now pretty much a thing of the past.

The familiar air with which Glynis took a chair indicated that she had been in this office before. These two had a history together, and though Shep was “finally” here he felt excluded. He got the peculiar impression that for Glynis this office was a seat of power.

As the doctor assumed his swivel chair, Shep adjudged that the oncologist may have been in his latter thirties, although he’d grown ever less certain about ages. While he could still tell the difference between sixty and sixty-five, lately his juniors all entered an undifferentiated category of Younger Than Me, which was odd, since he had been that age before, knew what it felt like and how it appeared in the mirror. But from the perspective of a greater age it always turned out that you hadn’t, at the time, understood being thirty-seven at all, what it was, what it looked like. Unfortunately for current circumstances, younger people always seemed callow to Shep now, their confidence, which Dr Knox radiated in pulses, hollow and unjustified – that is, enviably self-deceiving. Still Shep wanted to believe in this man, and rather hoped that with friends he went by “Edward” and not by the flip, less reliable-sounding “Ed.” Fit and trim, Knox probably chose fruit for dessert in the cafeteria and made time for the treadmill in the hospital gym; he practiced what he preached. Personally Shep always had a soft spot for medical practitioners who carried twenty surplus pounds and sneaked cigarettes in the staff parking lot. The hypocrisy was reassuring. From doctors, Shep had always sought less authority than forgiveness.