Doctor Fiske Pays a Call

Warren Fiske had been the doctor in Bellhaven for thirty-one years and had learned in the first four of them that he was not being paid for medicine, he was being paid for a verdict. People in that valley did not want to be cured, they wanted to be classified, and the cure could come later or not at all, and Fiske had gotten good at the classification and slack at the cure, and had long ago stopped being troubled by it, which troubled him sometimes.

So when Vera Pell called him on the Thursday and said he had a patient upstairs whether he liked it or not, Fiske came with his bag and a fairly settled view that the man in bandages was either a burn case or a crank, and that the difference between those two was mostly a matter of how long the visit took.

He got up the stairs, and he knocked, and the door opened four inches, and Fiske said his name and his business, and the man in bandages said, "No."

"You've got a burn," Fiske said.

"I don't have a burn."

"Vera Pell says there's acid in this room and that you've been to the sink in the hall four times in the night and that you ran the water cold for eleven minutes on Tuesday. That's a burn."

There was a silence behind the four inches of door.

Then the door opened and the man said, "One arm. You look at one arm and you write down nothing."

"I write down what I see."

"Then write down that you saw nothing."

Fiske told the story of the eleven minutes that followed exactly twice, once to the county attorney and once, at the end of it all, to a woman in a green coat who had come up from Oregon Health and Science with a recorder, and both tellings were the same telling, and the telling was this.

The room was hot and smelled like a paint shop. There was a chair by the stove and a towel on the chair and the man sat down and rolled his left sleeve back above the elbow and made a fist and put his forearm on the towel, and the forearm was wrapped in gauze the way the head was, and the man took the gauze off with a pair of cuticle scissors, cutting along the top, and under the gauze the arm was pink and wet and shining and it was exactly the arm of a man who had put his forearm in a hot bath and then in a cold one and then in something worse.

"Benzalkonium," the man said. "And something else. It's a rinse. It's not a burn, it's the rinse, and it hurts because the nerves came back first."

Which was, Fiske would say, a correct and unremarkable thing to say, and the only remarkable thing about it was that he said it before Fiske had asked.

Fiske looked at the arm. He took the wrist in his hand and lifted it to the light.

Fiske had held, in thirty-one years, somewhere in the neighborhood of nine thousand wrists, and his hands knew a wrist the way a farrier's hands know a hoof, and what his hands had in them was a wrist: a bony wrist, with the ulna's little knob, and a pulse, sixty-four, regular, and tendons that slid when the fingers moved, and a temperature of about ninety-eight, and a smell of gauze and kerosene.

And he was looking at his own two hands holding nothing.

That was the whole of it, and it was not a hallucination and it was not a trick of the light, because a trick of the light does not have a pulse in it. The room was bright, the lamp was on, the arm was there in the sense that his fingers could find it and the light was not. What the light found was a smear, a sort of oily wandering of the outline of the arm, like heat coming up off a road, and within that smear, and this was the part Fiske could not get the county attorney to write down, within that smear there were three places where something was visible, and all three of them were inside: a dark speck moving down the length of the vein, a pale curved line that was the bone's edge, and, in the middle of it all, a small dark knot the size and color of a prune, lying still.

Fiske said, "What is that."

"That's what I ate."

Fiske put the arm down. He got up. He walked to the window and looked out at Vine Street, which had a truck on it and two women on it and one dog on it and was doing everything a street has ever done to reassure a man.

"I'm going to write you a referral," he said. "Portland. There's a man at the university who —"

"No."

"— who does exactly this, he does work on refractive —"

"No," the man said again, and his voice did something Fiske had not heard it do, which was to lose the flatness. "No hospital. No university. I want you to understand the position. If you write a letter about me, I will read the letter. If you send a photograph of me, there will be no photograph. If you send a man up here, I will be somewhere else, and you will explain to him why you dragged him six hours for nothing, and you will be the doctor in this town who sees things."

Fiske stood at the window with his bag in his hand and his hat hanging off the bag, and did the arithmetic that a man does, which is not arithmetic about the patient, it is arithmetic about his own Tuesday.

"Which university," he said.

"Doesn't matter."

"There's a man at Alder."

"Which man."

"Nathan Sayre. He came out here for the year with the child, the one with the —" Fiske stopped. "You know him."

"I know him," the man said, and the flatness was back, all of it, closed like a door. "Sayre is a good doctor and a bad scientist and I will not be sending him anything either."

Fiske went to the Bitterroot at six and had a whiskey, which he did about four times a year, and Bernie Kaminski set it down and did not ask, and Fiske drank it and then said, "Bernie, do you believe in any of this."

"I believe Danny Wexler saw a watch in the air."

"Yes."

"And I believe Augie's dog wouldn't go near him."

"Yes."

"And I believe Ellery Gibbs came down out of that house white as a plate."

"Yes."

"So it doesn't matter what I believe," Bernie said. "It's here. Whatever it is, it's here, and it's got money, and it's upstairs at Vera's, and I know four men in this town who could be in that room tonight if it was up to me and it is not up to me."

Fiske finished the whiskey and went out and drove home past the mill, which was dark, and past the tall chainlink that the state had put around the waste ponds in 2011 and that everybody in the valley had a story about, and he thought, as he did most nights, about the difference between a verdict and a cure, and about how a man can be paid for thirty-one years to make a sound about a thing, and how the sound he was going to have to make about this one was the sound that ends a doctor in a small town.

What he did instead — and he was never able to explain it, not to the county attorney and not to the woman in the green coat, and not really to himself — was nothing. He went home. He did not write the letter or call Portland. He did not call Nathan Sayre, though he thought about it for two days, and he told himself he was thinking about it because Sayre was an old friend of the town and ought to be told, and he knew that was not it. He was thinking about it because he wanted very badly to be told by somebody with a letterhead that the world was the world.

And on the third night, when he had decided to call Sayre in the morning, he was woken at twenty past two by the sound of the county road, which was a sound he had been hearing for thirty-one years and which told him exactly what it was, which was a Bellhaven deputy driving somewhere in a hurry with his radio on.