Ginny sat crying in the pinching plastic chair when Otto woke from the treatment. Tears had become part of the daily protocol that the rushing blue nurses, green aides and white doctors accepted as another medical device’s sobbing descant under the beep-beep chorus. Otto felt surprisingly well. The hollowing ache which slicked him with fear and transmuted the little he could eat into acidic effluent had gone—for the moment—he amended. Three false remissions over the past year, those tantalizing flirts hugged close until bid a bitter adieu in light of the latest test. This was likely nothing more than heartbreak number four. The most recent imaging still displayed a shadow, on his liver or colon or maybe the big toe. Otto tuned out all the explanatories on what exactly was wrong inside him. There was Ginny for dealing with the doctors and the entire physicality of existence, in sickness and in health.
Her eyes were red-rimmed storm clouds closing in to water the tube rooted in his left hand. “You’re doing so much better,” she said quietly, wiping his damp cheeks with a cloth. “Doc says blood count is way up.”
Up to what, he refused to ask, eyeing a nurse eyeing a machine. Fifty grand a week to grow a few white cells; I’m supposed to kiss somebody for that. But Otto smiled to think he might get better, and how the terrible secret the treatment placed on him was worth keeping. Certainly if he was improving they would move him back into the other room again, The Chamber of False Hope, Otto called it. It was larger, or seemed so, with less equipment menacing the bed, especially without that one: the gray-framed screen mounted just right of his head and segregated from the other monitors. Otto would not ask what the screen was for or its pulsing, ever-present sine wave.
Each failed treatment returned him to this dying room, where the sine wave quivered in anticipation. At his weakest it made up the entire visible world, watching like some oscillated carrion eater, as if it knew there was no escape other than the last-chance, government-paid experiment which might save his life and in saving him destroy everything.
* * *
Otto woke next in the larger room to cake and people he almost recognized spilling into the hall. Ginny played host in a golden dress bought for someone’s wedding back in the before-time. The theme apparently was to exhibit the restored patient for as many staff as possible. He managed a swallow of gravelly chocolate crumbs while Ginny led a young woman to his bed. She was lovely in green scrubs, tempting Otto to joke that his wife would try anything to cure him, including pimping. He took a soft hand while searching Aphrodite’s cornflower eyes for some reflection of the ass-kicking mutha-fuck he’d been, and so what, he thought, when they returned a shriveled gnome. He did feel something like his old self.
“You know Tonya. She kept the equipment going and … what do you call it … calibrated! See, I even remembered.”
“Thanks so much,” Otto muttered, pegging Tonya’s age at twenty-three. Her oval features were crowded out of the air-space too quickly by craggy gray.
“And here’s our hero, Doc Tomlinson, who got you in the H.A.R.P. program.”
“Bastard won’t let me die in peace.”
They were old friends, or at least the months of doc to dying patient in and out invited some pretense. Tomlinson gave a little gurgle which approached polite laughter. “You nearly screwed up our average but I think this new drug finally got you.”
“Can’t you be grateful even once?” Ginny whispered, tapping a warning on Otto’s chest. She moved from his side toward Tomlinson. “This will have to be from both of us,” she said in a voice already breaking, jumping at the good doctor with arms wide, resting her head on his shoulder. “You’re the best,” she sobbed.
Otto enjoyed the hell out of Tomlinson looking uncomfortable until the enormity of keeping H.A.R.P. secret pressed him flat. He turned in bed as far from the party as the tube allowed. “Where’s my tablet?” he demanded. “I need to get my mail.”
Get your ass out of that socialist bed you pussy and come back to the light of free enterprise. Seriously, we’re all happy as hell for you. Counting on you to be ready for the conference—Fred
Heard you’re in the Medicaid wing—ha ha. Can’t wait ‘till you’re sticking it to those lazy whiners again. Time to take this country back—Robert
Sure wish you had informed me of hospital choice BEFORE, but I think we might still pull it off. Glad you’re feeling better. We need to get our heads together about election ASAP—Lexie
* * *
Mt. Hope’s lounge looked disgraceful even for a neglected public hospital. The door had been removed—or fallen off—and a cramped rectangle of stained green carpet and chipped furniture lay exposed to inspection and all the noise of staff and patients passing by in the hall. Couldn’t they maintain some privacy for people chewing over life and death choices? Probably the government made those decisions for everyone now. Anything could happen in a year. Otto waved his son onward to the far wall. Tommy spun him around and began fumbling with the wheelchair brake. “We’re on carpet for Christ sake,” Otto said, dismissing him to a chair. Ginny settled several chairs removed, her face flaming into the final stage of a reddening begun when Otto proposed “A little family meeting.” Like seeing a friend after a long absence, that sullen heat creeping up her neck, heralding Otto’s return to ascendancy more than the doctor’s positive remarks or even the day by day strengthening of his legs. Time for the resurrected to consider what came next and certainly Ginny suspected the formerly pliable dying man of reverting to form.
Tommy’s attention clung to a triptych of cheery sunrises (no sunsets here) dangling from peeling ochre. Otto preferred him like that and further preferred despising his son for never pushing back. Especially with Ginny gushing on about him stepping in and doing “such a wonderful job” running the family construction firm—which Otto, without anyone’s help, magicked out of thin air and an ancient back-hoe in 1985. McCutchen Construction had lifted him to a lower echelon of the moneyed class, plus the attention of some truly wealthy patrons, like Lexie and her friends. They let him enlarge their vacation homes, and year by year, over drinks and at discreet little parties at their clubs, re-created him as the public embodiment of an agenda. Their favorite self-made man had proved more contemptuous of government programs and “slackers” than they dared hope.
“So … Tomlinson says I might be around a little longer,” Otto began, watching his audience. “Which leaves us with a situation to manage, don’t you think?”
A flash of Ginny’s eyes was not agreement. He knew well enough, but she would wait for an opening.
“First, Tomlinson hasn’t said when I can go home. That’s tricky with the election for county supervisor less than two months off. I’ll have to work from here. Next, it’s vital we keep H.A.R.P. to ourselves as long as possible. Lexie and a few people are coming by next week, and they won’t understand. I need your help on this.”
“We’re to say nothing about a treatment that saved your life,” Ginny stated flatly, as though rehearsing it for future use. “The only reason you’re around to worry about anything, let alone an election, is H.A.R.P.”
“I know that. The new drug is working—there’s no reason to keep it quiet. Just don’t volunteer any details. Give me time to get past Lexie and a few of the donors.”
“Where were your friends when the doctors gave you days to live, and we were making funeral arrangements? Nobody came.”
Otto laughed. “The dying are such a useless demographic. And let’s face it, this is enemy territory. Lexie joked about bringing a bodyguard.”
“Everyone’s been nice.” Coming from Tommy it amounted to rebellion. Otto said nothing until the son risked a glance at the father.
“That’s great. Get a job here. Better yet … instead of running my company, maybe you’d like to hump concrete forms in hundred-degree heat with the other dummies.”
“I didn’t mean it that way.”
“What?” He rounded on his wife. “I don’t have time for stupidity. The stakes are too high.”
“They are,” Ginny said, “but we’re not talking about the same thing.” She put an arm over her head and stretched side to side in the chair. “Tom and I had a little family meeting of our own after Doc Tomlinson gave us the news. We’re so very grateful to have our Otto back, you know, but we agreed on a few changes we’d like now that you’re feeling better.”
“Dad … listen … a little consideration, that’s all. Just a ‘hey, you’re doing a good job,’ or something, every once in a while.”
“I want more than that,” Ginny said.
Otto rose on rubber-band legs, trembling as he escaped the wheelchair. His family jumped to help but he pushed their hands away, to stand alone for the first time in months. Burning, atrophied muscle stretched, bringing Otto all the way back, making him once again taller than most men. His enemies feared him. He owed his success to no one but himself.
“Let’s get something straight …”
One sentence of preamble, one sweet step free of the wheel chair—his foot caught the carpet. Otto toppled face-first across the aisle onto a chair. The shock of it took his breath; he sucked air in a great wheezing protest, draped over the chair arm, an out of fashion suit ready for donation and a fat deduction. Ginny screaming down the hall please, please somebody help—Otto was shaking with anger, and where the hell was his goddamn useless son?
The sine wave pulsed to the beat of his throbbing head. It was a tease, skipping across the screen and offstage, only to reappear for another encore. I know a secret I KNOW YOUR SECRET I know a secret I KNOW YOUR SECRET. Why had Tomlinson put him back here? He felt all right. He’d fallen, that was all. Not sick any more, only sore, and angry. What day was it … there was a meeting to prepare for.
If Lexie discovered H.A.R.P. was paid for by a federal program—Otto’s hand flailed against the IV. It wouldn’t matter to her that the insurance denied coverage for experimental treatment. Or the tally so far, which stood at just over a million for the new drug. Tomlinson thought he might need out-patient care for a year. Otto was well off by most standards, yet such a cash burn could not be sustained. Without H.A.R.P. he’d already be selling retirement assets—not that Lexie’s rich friends would find that compelling. Nor was there any traction in explaining how McCutcheon Construction lay balanced like spun sugar atop a layered confection of capital and financing. Even Otto wasn’t sure which assets backed which loans. Extracting large sums might bring it all down. In her recommendation of Otto for membership in the Saginaw Club for Growth, Lexie had praised him as a true twenty-first-century hero of libertarian principle. He lay in bed imagining her indictment written in Mt Hope’s cracked plaster and broken floor tiles: He wasn’t rich enough, after all, to play.
* * *
Tommy was setting up the room when Lexie appeared in the doorway, dangling a briefcase. She took in the lounge as though appraising it, the decor and the two men, before making her way past the collection of chipped tables pushed out of the way against a wall. Her eyes settled on the wheelchair. Otto sat up straight and tried to project health, even as he recalled she seldom looked directly at anyone, and never shook hands.
“What a place. Patients lying on carts in the hall like harpooned walruses. Is everyone in this country fat?” In her voice, the almost theatrically patrician inflection Otto connected with serious wealth requiring offshore protection from any government presumptuous enough to tax it. Otto felt some small responsibility to defend the hospital, except there was nothing to gain from that vector. “Looks like it around here,” he agreed, sucking in his stomach, wanting to smile at Lexie’s elegant figure in just-folks dress, her faded jeans and sweater costuming for blending in with the ninety-nine-and-three-quarters percent. Otto had to picture someone on her staff picking her clothes because few details of Lexie Simmons’ personal life were available, even to Google, beyond a marriage to someone she never referred to, and an adult daughter, also never mentioned.
“You look well, Otto,” she allowed, turning to consider the circle Tommy had formed of the five best chairs. Pulling one out of the round, she sat. Otto wheeled into the gap, gesturing for Tommy to re-orient the circle’s remaining chairs toward her.
“I came early.” She hefted the briefcase onto a leg. “I thought we should chat about whether you’re up to this election. You’ve been ill a long time. It changes priorities, sometimes.” Her eyes drove past him to the triple sunrises.
In a vague domestic past, Otto and Ginny had taken a day trip down the coast to a weathered restaurant canted over a tidal flat. The sea receded steadily between the lobsters and the dessert until a silvery fish was exposed beneath the window. Whether it was sick, or terribly unlucky, Otto had never forgotten the shimmering skin dulled with mud, the disastrous flopping mere feet from the water that would have saved it. Or the crab, dark as wet autumn leaves, scrabbling out of the rocks—at that point Ginny proposed a glass of brandy at another table—but Otto couldn’t not watch the crab, attacking sideways, rushing in to pinch off the squirming flesh, receding to masticate, rushing in again, never facing its victim yet never relenting until the air was aflap with too many darting gulls for the gory claws to fend off.
“My priorities haven’t changed. I’m ready to jump back in.” Otto surged ahead in the wheelchair, a race car cheating the starter’s gun.
“I’m relieved to hear it, Lexie said, looking pointedly at the wheelchair. “That’s not permanent?”
He got on his feet and took a few steps. His legs no longer trembled. “Two more days of therapy, and I’m rid of it.”
A scream shot through the hallway, trailing off like death’s Doppler effect. Lexie had a shake of the head for the gurney rushing past the doorway trailing three colors of staff. “And this wonderful facility?”
“I’m in remission, Lexie. They haven’t said I can go home but it’s any day. I’ll need some outpatient treatment. That’s all. I’m cured.” Otto circumnavigated her before returning to the wheelchair.
“Can we talk?” She nodded toward Tommy, waiting near the far wall, his body holding a tense uncertainty that carried Otto back twenty years to a day at the Boston zoo. He’d pretended the python had slid free of its cage. Watch out, he cried to his six-year-old son, pointing into the damp stone shadows where a monster hunted the formerly safe places of the world.
“Tommy’s no problem.”
Lexie had a frown for the carpet. “You’re more fortunate with your offspring … do you think they ever have this cleaned?”
“Tell me what’s wrong, Lexie. There’s something, or you wouldn’t be here before the others.”
He thought, now we come to it. If she suspects about H.A.R.P. this is my chance pinched dead, in a hospital lounge with dirty carpet, if I let her.
“A few of the donors—“
“It’s about this place, isn’t it? That’s what they’re choking on?”
“Otto, our friends taste betrayal. You were the man after that talk at the club on ending public funding for hospitals, including this one. Now we’re not sure.”
He rolled closer. “You mean, you’re not sure?”
“I want to be on your side. This would be the right time to re-earn my trust. Start by explaining how you ended up in this monument to entitlement. You know I’m on the board at Oceanside Hospital. My family donated half the buildings. You built the Simmons Eye Center for me. You could have gone to the best private hospital in the state, built for people like us.”
Otto had rehearsed—of course he had—every day since the first H.A.R.P. drug was pushed through his tube, green as antifreeze or plant food. Would it fertilize his hair back? It did, though there was little enough to celebrate as stubble re-colonized his denuded head, lengthened to the medium salt and pepper of middle age, dragged him by millimeter increments to this moment. He’d been brilliant in extremis, shivering under three blankets, framing his argument, a treatise on the exigencies of last-chance medicine that only Mt Hope offered. Too sick to go anywhere else, the theme went, and yes, he summed up, a public hospital was unfortunate, but who of you would choose death over it? Only the detail of who was footing the bill had been left out.
“I was dead. Ever been dead?” Otto asked. Have you ever been anything other than immensely wealthy, he imagined adding. Have you ever not had the luxury of ignoring whatever you felt like ignoring.
“I suppose you mean you weren’t making the best decisions at the time. I get it Otto, really, I do. As you say, you were dying. Two months ago, I was telling everyone you probably wouldn’t make it. It’s a miracle to see you looking healthy.”
Otto nearly jumped at her hand on his arm, even as she continued to watch Tommy. He felt its coldness pushing through the sweater, the hospital gown, beyond the skin, into the blood.
“Everyone at the club is so happy for you and your family. I was hoping to see Ginny and tell her.”
“She’s around here somewhere,” Otto said, involuntarily glancing at the hand, browned under exotic suns to a patina suggesting antique furniture. “I appreciate you coming here for me. You don’t know how I’ve missed giving those talks at the club. It’s barely sunk in that I might actually get another chance.”
“And I want you to have that chance,” she said. This country needs you. On the way over I was thinking back over the first time I knew you were special. It was late on a Sunday, out on Cape Cod. You had a crew finishing my conservatory. I asked how you got them to work so late every day, even on weekends. Do you remember?”
“I see you do. McCutchen Construction isn’t a welfare state, you said. Oh, after that I had to know everything about Otto McCutchen.”
Otto laughed for what felt like the first time in months. “You wanted to know how often they were off sick.”
“I did! I’d forgotten that, but yes, I remember now. You said, don’t give them health insurance, and they won’t get sick. I told everyone at the club. That was our beginning.”
“I never dreamed it would lead to politics. It’s all because of you.”
Her eyes came to him then. Otto was shocked at the tears, as though a god had been chained to a lower plane of existence.
“We waited for you,” she said. “You’re our stealth bomber, Otto. We’re going to blow up Saginaw County government and never rebuild it. Privatize both public hospitals and close them when they run deficits—which they will. Why should you and I pay for the county’s losers?”
Yes, but, Otto nearly complained. They do some good work here. What about the people who can’t afford to go anywhere else?
“I want to work on the schools,” he chose instead. “Why should smart kids be held back by idiots?”
Lexie smiled in appreciation. “The world needs janitors too, right? What’s wrong with a permanent service class that doesn’t require public education. We have majorities on four of the five school boards to help you. The teacher’s union is on the run.”
“I can’t wait to gut those whiners for good. This county will run dry on unions about two minutes after I take office. We’ll have the only completely non-union county in the state.”
“And then cut taxes.”
“I won’t cut them. I will end every fucking local tax.”
“We have friends in state government to help you.”
“After that we’ll get serious.”
“The useless indigent wasting our resources.”
“Nothing but their backs to offer. We’ll find a use for them, believe me. Everyone else will go along when we eliminate their property taxes.”
“A golden age,” Lexie sighed, unsnapping the briefcase, pulling out some documents. She looked past Otto, the distance between them restored. “You’re telling me it had to be Mt. Hope because the illness was so advanced no other hospital would take you. And there isn’t anything else I should know before I tell our friends? They won’t be embarrassed?”
“I did what I had to. Mt. Hope takes the sickest people. I qualified. End of story.”
“That’s good enough for me.” She set the papers on his lap and indicated an X. “Sign here. It says I’ve raised our concerns, and you state there’s nothing to them.”
Otto signed. “So everyone’s happy now?”
Lexie was silent. Otto followed her eyes to Ginny standing in the doorway. “There you are,” he said.
“I was just saying how much we’ve missed you guys,” Lexie called out smoothly.
Otto waved his wife over. “We’re finished. Come sit.”
Ginny settled in a chair facing Lexie. “Why don’t you join us,” she invited Tommy. Otto stiffened, started to say no, Tommy wasn’t needed, but his wife’s features had set in an unfamiliar pattern. Tommy took the chair next to his mother.
Lexie smiled past them. “We’re all here now.”
“We are!” Ginny answered too brightly, pulling silence down over them. Otto saw in his wife’s profile a stranger’s mouth describing a half smile, half rictus, against Lexie’s predatory side glance. Tommy got reacquainted with his friends on the wall.
“Everyone’s so happy for your family,” Lexie said, not exactly to Ginny.
Ginny leaned toward her. “Believe me,” she stage-whispered, “You don’t want Otto.”
“Ginny …” Otto warned.
Lexie bent to meet her, wearing not quite a smile. “We don’t want him?” she asked in a tone that was not quite playful.
Their heads remained in the same plane, as if a photo had been staged with actors playing friends sharing a moment. Shoot the damn picture, and let’s get out of this, Otto prayed. Whatever this is.
Ginny chuckled. “My husband cries when they give him the drug, did you know? For the poor boy he was, and his mama dying alone, poor and sick last year, while he was off building that little get-away place of yours in East Hampton. She embarrassed him, but now he cries he’s going to help her. It’s a bit late.”
Lexie recoiled. Her gaze split the difference between husband and wife. “Otto, I assumed your family was on board with this.”
“They are,” he said, watching his wife. “What’s this about?”
“Oh, I’m on board,” Ginny said, and tapped their son on the shoulder. “How ‘bout you, Tom?”
She smiled at Otto. “It’s just Tom and I are concerned you’re not as tough as your friends need you to be in the battle ahead.” She turned to Lexie. “He’ll be on the drug another year. The crying seems to be a side effect when he’s under stress. He doesn’t know he’s doing it. Imagine him in public, blubbering on about poor mama living and dying on Medicaid.”
“Dad, we don’t want to see you embarrassed.”
Otto would remember afterwards the snapping of Lexie’s briefcase as it pinched shut, how her eyes swept past him to the doorway and returned when Ginny got up to wipe his cheeks with a sleeve that came away stained. Otto wiped tears from his eyes and studied his fingers. “This is a temporary thing,” he proposed.
Lexie produced a long sigh while fishing around in a pocket, pulling up a phone. “Fred. We don’t need the meeting at Mt Hope after all. Tell the others.” Then she was sliding away sideways between the chairs. “You never mentioned you had family on Medicaid, Otto.” Otto didn’t see her go. The hollowing ache had come back worse than ever, doubling him up until he felt he might fall out of the chair. “No,” he moaned, and then he too was rolling toward the doorway after her. He thought he was doing it himself, chasing her down to plead another chance. Yes, yes, it might still be put right if he could explain. The election was six weeks off, plenty of time for Tomlinson to do something. Otto wiped his eyes. It was Tommy pushing him down the hall to the nurse station. “We’re just going to find the doctor for you, Dad. Don’t worry about anything.”
The world beeped when Otto woke. He listened to the chorus with eyes shut for fear of what watched, except after a while it felt too pitiful lying there like that. He counted down from ten before turning eyes right—and the screen was dead! Something gnawed him which no drug could ever tame, yet he was alive. It had died. It was gone, but still one element was missing. Where was Ginny in all this joyful noise? There was no sobbing accompaniment to his victory. Turning by degrees, gasping from the effort, Otto found his wife in the pinching plastic chair, with the sine wave dancing across her eyes. It began pulsing when she smiled, swelling larger, stealing more of him each time until at last he was pressed flat with dread. “I hope you’re happy,” he rasped.
“We did as you asked. Lexie never heard anything from us about who’s paying for H.A.R.P.”
“Yeah thanks, that was so good of you.”
The sine wave grew enormous when Ginny closed in over him. It sucked at him like a black hole until Otto had nothing left, was ready to go with it. “I’m done,” he muttered as it came nearer, swelling beyond his vision, becoming a thing of infinite, irresistible beauty. Yes, Otto cried. Yes, now, he invited it. But it disappeared again when Ginny kissed him, leaving him to search those red-rimmed eyes with the expectation that his life had been transmuted into … what?
“You’ve had a bit of a setback,” Ginny said. “It’s just a dosage issue, doc says. Happens all the time at the beginning stage of remission. The images came back crystal clear.” Ginny took his hands. “He’s letting you go home Monday.”
Otto gasped. “Why? I mean … what … am I going to do?”
“Well, that’s the question, isn’t it?” She was quiet then, stroking his arm. Otto felt himself accelerating toward ten thousand empty tomorrows stretched beyond a gray horizon. How could he go back to his company after this?
“I thought we might try becoming citizens of the world,” she said finally.
“What in hell does that mean?”
“Oh, you know, look beyond our own anthill, our own dung-heap.”
Otto shook his head. “Still not with you.”
She patted him. “I know. Don’t you worry about it. We’ll start easy. Maybe a few words of thanks to the agency paying for H.A.R.P. I’ll find out where to send it. I’m thinking we should write an open letter of gratitude to the American people, for paying the taxes that fund that agency.” Ginny smiled. “And while we’re at it, let’s include Social Security and Medicare. We’ll be eligible in a few years.”
“You know I won’t do that,” he whispered, turning away when her face set again in the pattern he had never seen before that day.
“Your choice, Otto. There’s a price to pay, of course.” She reached over him, he heard a click. “This monitor keeps cutting out. Tonya says there’s no budget for repair because their funding was cut again.”
Otto wouldn’t look at the screen, but it didn’t matter because the sine wave was back in her eyes as well. “Oh God, whatever,” he cried. “Write the damn letters and I’ll sign. I’ll sign anything. Just give me back my life.”
His wife kissed him again. Her eyes were clear. “You’re all grown up now, Otto, and the world is waiting outside the door. Tommy’s doing a great job running the business on his own. I was thinking … have you ever considered running for office? I think you should give it a shot.”