Thomas McGuane - Driving on the Rim

When I left the Res and came here to begin my actual practice, I was still an odd combination of competence and imbecility. There had been enough things from early on in my life to teach me that being an imbecile is a tremendously effective way of getting along in America; if it had been more satisfying, I would have stuck to it. Wanting to cure people of illness robbed me of all that happy conformity. Sometimes I worried that my ambivalence about a career in medicine was best understood as a wish to be stupid again. I might have done better to stay longer on the reservation, where hard times and hard lives had begun to anneal my foolishness and make a man of me.

Wilmot’s latest wife, Jane, was a gruesome woman with big red hands and an overbite. She had a very strong personality, terrifying really, and held opinions on everything, far right politics of the bomb-them-all-and-let-God-sort-them-out school. Once more, Wilmot was my regular patient. He seemed to have forgotten all about tormenting us from his post on our board. “I used to be a leg man,” he confessed to me. “The ankle, the knee, the thigh, all infinitely important. Those days are gone. Now I’m into hereditary landowners. I’ve had a good life. I’m a great guy, but I’m careful. I have never had relations with any woman who was not required to sign a release. I call it the ‘Wilmot Proviso.’ Only you can tell me how much runway I have left. I do hope to defy the actuarial tables, old friend.”

“You have as good a chance as anyone.”

“I noted a dwarf in the waiting room. Is that your patient?”

“Yes, she is.”

“I had a word with her. She said she was a staunch Republican. We take them all sizes. Have you ever had a dwarf?”

“No.”

Wilmot had either mellowed or was slipping into dementia. And why, when he chaired our board of directors, did he so frivolously torment us? I thought he was cruel. There was still a challenge to his bouncing gait and the air of the world at his feet, perplexing and grotesque. I was fascinated that he was so successful financially. That was always a mystery; the relationship of people to money was a much more closely held secret than their love lives, far more covert. We all love stories of the shabby recluse who raided a corporation, lived in a cellar, and hid his fortune in Switzerland. As for my patients, they would rather have to admit they ate ten pounds of mothballs than let me glimpse their bank accounts.

Wilmot would fire me, from time to time, but then he rehired me, and he often had some little ailment he wanted me to look into. He also had some larger problems, most especially a failed kidney requiring dialysis: of such things he never complained. I realized, based on my experience, that Wilmot was one who would face the largest, even terminal illness with equanimity without failing to complain about smaller issues — his hemorrhoids, eczema, dry eyes — because those were signs of ongoing life.

Before the Adrienne affair, I’d bought a rental house on his advice and later sold it, averaging nearly twenty-five percent profit a year for five years. And Wilmot found the renter, a skilled handyman who paid on time and improved the property. In business, he was most helpful; it was what really interested him and briefly suspended his many neuroses. At such times, he even looked normal, the tension gone from his face, his mouth less ready with an unpleasant remark. The other directors on our board had never dealt with a tyrant before and just gave in to him. Wilmot was a high-end idiot savant with Neanderthal social views and the air of continuing crisis. I don’t think he had friends, not real friends, but he did have social connections that were wonderfully enabling whenever he wanted to get something done. Where were those social connections? All over the world. They came with his birth certificate. I think he kept in touch with me in the hope that my peculiarities would see me fail. It all went back to Adrienne. Even when he was laughing at my conciliatory jokes I could see the hatred in his eyes.

Guy McCracken was another of my regular patients, but one of whom I knew remarkably little considering that I had seen him, advised him, and treated him from the beginning of my career. He had previously been cared for by Al Christiensen, a general practitioner who retired to Hawaii. Guy was an unmarried man in his forties, remarkably private, of a cultivated demeanor and very fit. There was never anything wrong with McCracken, but he was punctilious about his annual physical and following up on any health concern, usually dermatological, as he worked outside and had unusual exposure to the sun. Guy was a handyman, in great demand because he could do absolutely anything — plumbing, electrical, carpentry, automotive — and he made a very comfortable living at it. In town he had the standing of a specialist in the several crafts he practiced, and his advice was sought by homeowners. His home was a Craftsman cottage he had restored to perfection, and it was considered an exemplar of its type on the annual home tour. Guy never struck me as being happy; his reserve seemed more a bulwark than anything else. It may have only been that the local habits of forced jollity were not his style.

Right after the Fourth of July, Guy came to see me, still in his work clothes — well-washed jeans, a clean flannel shirt neatly repaired here and there, and work boots. His tanned face was almost unlined, though the flecks of gray in his short, neat brown hair correctly asserted his age. He nodded formally and showed me an infected thumb. It must have been painful, as the swelling had emerged around the base of the nail in an angry red mound. “We’ll give you a shot of antibiotic and may have you back for another.” Guy nodded without expression.

I had my nurse, Chelsea, come in to give the shot. Chelsea is no longer with me because, as entertaining as she often was, Chelsea was a consummate airhead who misfiled records, abandoned patients in examining rooms, incorrectly recorded weights and blood pressure, and so on. She was sweet, comical, and madly insecure, and ended up the affluent wife of a real estate developer, a big fat lout who thought she was a scream. They’ve had several babies, round little tubs that Chelsea brought in for the staff to admire. Extravagantly adorned, she herded them around for the other nurses, though after she left, they said terrible things about her.

Chelsea blew the injection, the needle skimming through a pinch of Guy’s skin and into the palm of Chelsea’s hand. I gave Guy another shot while Chelsea moped in the corner, and this should have been the end of it. Unfortunately, the event triggered the AIDS protocol series of questions and answers, shrouded in political correctness and colored, I’m embarrassed to admit, by my own suspicions. Guy disliked these questions as I read them from a sheet, and his glances at Chelsea encouraged her to leave the room. Finally, I put the paper down and said, “Well, what these questions are meant to determine…”

“Whether I’m gay? Of course I’m gay. What else is there to do in this town?”

I didn’t have a good answer for that. I flicked the sheet of paper onto my desk with affected weariness and said, “If that doesn’t do it, follow up with these.” And I wrote a script for antibiotics, bearing down on my prescription pad with warranted concentration. Guy smiled at my efforts, stood up, took the prescription from my hand as I sat at the desk, gave my shoulder a friendly shake, and, with a small chuckle, left my office.

I lived in an annoying house. I’d bought it in the spirit of nostalgia and the hope that its looks would confer some of the old-time virtues, especially the one we all long for, the one we call “simplicity,” which — it doesn’t matter — may never have existed. The doctors, the fellows nearly retired when I first started, gave me a sense of the old-time simplicity, and it wasn’t that pretty at all. Some of that simplicity spat out corpses like a Gorgon. As to the house, there was nothing simple about it; the wiring, the plumbing, the heating all required expensive attention. Sensible people had moved away some time ago, into homes that were more easily used, and many of the places around me had been divided into apartments. Across the street from my house, a second-floor apartment housed a battling couple whom I’d never seen, but I heard their often hair-raising shouts.