The Mill River Recluse Page 24
Confused, she looked at him. “Why, yes, Michael, I’m fine. I’m a little tired, but other than that... why do you ask?”
He didn’t know exactly how to describe her appearance to her. “Mary, have you looked in the mirror today?”
“No, you know I don’t like mirrors. What’s wrong? Why are you acting this way?”
“I’ll show you,” he said, taking her hand. He led her to the washroom and flipped on the light. “Look at yourself, Mary. Do you see it?”
She stepped in front of the mirror, hesitating before looking into it. When she did, she saw immediately the contrast between her skin and the white wall behind her. She raised up a hand in front of her face and examined it.
“Michael, I, I don’t know what’s happening. I don’t feel any differently than I normally do.”
“Your coloring isn’t normal,” Father O’Brien said. “I think people turn yellow when there’s something wrong with the liver. You remember me telling you about old man McGee? He was yellowish for years before he died. They said it was liver disease, on account of his drinking.”
“You know I never touch alcohol, Michael.”
“Of course I know that.”
“Then why would anything be wrong with my liver?”
“I don’t know.” He lowered his voice, preparing for her reaction at what he was about to suggest. “I know you’ve never had much use for doctors, but I really think you should see one.” She shot him a fearful look, but he pressed on. “You wouldn’t have to go anywhere. Doc Richardson’s an old friend of mine. I’m sure he’d come by to see you if I called him.”
“No, oh, no,” Mary said, backing out of the washroom.
“It wouldn’t be so bad, Mary,” he said, following her. “And I think whatever is happening to you is serious.” They were back in the sitting room now, facing each other. Mary trembled.
“I can’t, Michael.”
“You can. And I think you must. A simple exam won’t take very long. I’ll stay with you the whole time. Please, Mary. I’m so worried about you. Do it for me, if for no other reason.”
Eventually, to Father O’Brien’s great relief, she agreed to a quick visit from Dr. Richardson. Two days later, he brought the doctor to the back door of the marble mansion, warning him again of Mary’s extreme reaction to strangers.
“Why don’t we leave our coats here, Fred,” Father O’Brien said as they stood in the kitchen. He took the doctor’s coat and draped it with his own over a chair. Dr. Richardson looked around the room with great interest.
“I’ve always wondered what it was like in this house,” the doctor said. His hair was graying but still thick, and the glasses he wore for his farsightedness augmented his expression of wonder. He rolled the sleeves of his white shirt to his elbows. “I don’t suppose, given what you’ve told me, that many people have seen it.”
“No,” Father O’Brien said.
Mary was waiting for them in the sitting room, clutching the ends of a shawl that she had wrapped around her shoulders. She didn’t even turn to greet them as they entered the room, although Father O’Brien felt sure she had heard them come in. She was quivering again, and wearing a black patch over her left eye. She hasn’t worn that patch in years, Father O’Brien thought.
He also noticed that her skin was slightly more yellow.
“Mary, this is Dr. Fred Richardson,” he said, coming around in front of her.
“It’s good to meet you, Mrs. McAllister,” the doctor said, looking carefully at her.
“Hello,” Mary whispered. She did not make eye contact. In fact, she kept her head down, as if she were cringing. Her quaking increased.
“Mrs. McAllister, there’s no need to be afraid of me. I’m here to help you,” Dr. Richardson said, taking a step toward her. She recoiled at his advance. Unsure how to proceed, the doctor looked over at Father O’Brien.
Father O’Brien had seen Mary in this agitated state many times. He hoped that she wouldn’t bolt upstairs and lock herself in her room. She had done just that three years earlier, when contractors had come to the marble house to reshingle the roof. It occurred to Father O’Brien that they should sit, so that they appeared less threatening. He lowered himself into an armchair and motioned for the doctor to do the same.
“Mary, I told the doctor you’ve not felt bad at all, just that we noticed your complexion looked a little different a few days ago,” Father O’Brien said.
Mary glanced at them and nodded.
“I also told him that you never drink anything alcoholic.” He looked at the doctor and raised his eyebrows in a silent prompt.
Dr. Richardson took the hint. “Mrs. McAllister, have you ever had any medical procedure that required you to receive a blood transfusion?”
“No,” she whispered, and drew the shawl tighter around herself.
“Have you had any unusual pain in your abdomen recently?”
“No.”
“Are there any particular foods that give you an upset stomach?”
“No.”
“Have you noticed any weight loss over the past few months?”
“A little.” She stole a glance at Father O’Brien before he could hide the new surprise and worry that clouded his face.
“Have you noticed any change in your appetite?”
She was quiet a moment before she answered. “I’m eating a little less, I suppose.”
Dr. Richardson paused before he spoke. “Mrs. McAllister,” he said gently, “I think it would be very helpful if I could examine you. It won’t take long, and you could stay on the sofa right where you are.”
Father O’Brien watched Mary. Her whole body jerked twice, and he knew she was fighting an instinctive urge to run away. Yet, she surprised him by staying put as the doctor slowly went over to her.
Dr. Richardson sat on the sofa beside her and drew a penlight and stethoscope from his medical bag. His movements were careful and deliberate. He kept his voice low and soothing. “First, I just need to look in your eye with this little light. It won’t hurt at all. Do you think you could look at me for just a second?”
Keeping her face turned downward, Mary slowly rolled her gaze up to his chin. She still wouldn’t look him in the eyes. The doctor shone the light into her one visible eye, highlighting the yellowing of the sclera. He made no effort to remove the patch to examine her other eye.
“That’s good,” he said, clicking off the penlight. “The next thing I’d like to do is listen to your heart and lungs.” He put on the stethoscope and slowly, slowly placed the end on her chest. “Try to take deep, steady breaths,” he said. Mary cringed, breathing rapidly.
“You’re doing great, Mrs. McAllister,” Dr. Richardson said, although she didn’t look as if she were doing well at all. The doctor moved off the sofa and knelt on the floor. “The last thing I need you to do is stretch out here so I can examine your abdomen. It will only take a minute, and then we’ll be done.”
Mary slowly acquiesced, drawing her legs up onto the sofa and lying down flat on her back. She turned her face away from him. Her hands were clenched into tight fists on each side of her.
“Good,” he said. “Now, all I’m going to do is feel to see if everything is okay.” He placed a hand on her abdomen and pressed down ever so slightly. She didn’t move. With both hands, the doctor palpated her abdomen, moving down each side. When his hands reached Mary’s right side, just below her ribcage, he hesitated, felt more carefully.
“Does this hurt at all?” the doctor asked.
“A little.” Her whispered reply was muffled by the fabric of the sofa-back.
“Okay, then, we’re all finished,” he said after another moment. He retreated to the armchair while Mary sat up and pulled the shawl back around her shoulders. She did not speak but kept her head bowed, waiting. Father O’Brien got up and sat next to her on the sofa.
“Mrs. McAllister,” Dr. Richardson began, “I can’t be sure exactly what is happening to you without some addi
tional tests, but there are several possibilities. What we know is that jaundice--the yellowing of the skin--is caused when the blood supply isn’t being cleansed properly. Usually, your liver filters all the blood in your body and removes waste products that build up. Then it dumps the waste products into the intestine through a little tube called the bile duct. People become jaundiced when either the liver isn’t working as well as it should, or when the bile duct is blocked, preventing the waste products from leaving the body. Both of those things cause the waste products to enter the bloodstream and make the skin appear yellow.” He paused, watching Mary’s face.
“Do you understand all that, Mary?” Father O’Brien asked. Mary nodded.
“We can’t say for sure what’s causing your jaundice,” Dr. Richardson continued. ‘Based on your history, I don’t think it’s because of hepatitis or some other liver condition. I’d say it’s more likely that you have something blocking the bile duct, maybe a gallstone. If it’s a gallstone causing the problem, we can take care of it, but like I said before, we can’t be sure that’s what it is without some other tests.”
“What other tests?” Father O’Brien asked.
“Well, I’d suggest a CT scan,” Dr. Richardson said. “It’s not invasive – it’s just having a big camera take a picture of your insides. We’d run a blood test, too. But the best thing, I think, would be to also have a procedure called an ERCP. I’m not going to try to pronounce what that stands for because I’ll just get tongue-tied. Basically, it involves putting a little camera down through your mouth and stomach to the bile duct to see exactly whether and why it’s blocked. But you’d be asleep for it, so you wouldn’t feel anything.”
Mary shivered as if she were submerged in ice water.
“Couldn’t the first test, the scan, do that?” Father O’Brien asked. The look of concern on the doctor’s face worried him. It was the look of a man who knew or suspected more than he was revealing.
“It might, but it varies from person to person,” Dr. Richardson said. “The CT scan is quick, and takes a good general picture of the inside of the body. But the good thing about the ERCP is that while the camera is down in there, if a gallstone is blocking the bile duct, it can be removed. Or, they can put a stent, a little tube, into the bile duct to keep it open. Everything could be scheduled at the clinic in Rutland. And it’s done on an outpatient basis, so you’d be home the same day.”
Mary had reached the breaking point. She shook her head and started to say something. Suddenly, with swiftness uncommon for her advanced age, she flew off the sofa and up the staircase to her bedroom.
“I think she needs some time to think about all this,” Father O’Brien said. “And she’ll need some time to calm down.”
“You sound like you’ve seen her do this before.”
“I have.”
“Well.” The doctor took a last look around the sitting room and reached for his medical bag. “Let me know what she decides, then, and I’ll be happy to give her referrals or help her however I can.”
“I’ll walk with you to your car,” Father O’Brien said as they retrieved their coats from the kitchen.
Once they were outside the marble home, Father O’Brien turned to the doctor. “Okay, Fred, let’s have it.”
“What do you mean?”
“I mean, what do you really think is going on with her? I’ve known you for years, and something serious is all over your face.”
Dr. Richardson sighed and shoved his hands into his coat pockets as they neared his car. “Look, I can’t make a definitive diagnosis on the basis of that limited examination.”
“But you’ve got an idea of what’s wrong.”
The doctor paused and sighed again. “She’s got an enlarged gall bladder. That in and of itself isn’t so uncommon. But the thing is, I think there’s something else there. A mass of some kind. I couldn’t tell what it was, and didn’t want to scare her any more than I already had, but....” His voice trailed off as they reached his car and leaned against it. “Some years ago, I had another patient who came in with jaundice like hers. Had about the same history – no drinking or anything that might cause liver disease. It wasn’t good. I think the oncologist who treated him is still in Rutland. I’ll look up his name and call you with it.”
“An oncologist?” Father O’Brien said.
Dr. Richardson nodded.
It was as if the doctor’s words hit Father O’Brien’s chest with the force of a charging elephant. He took a step backward, struggling to speak. “Do you really think she has cancer?”
“It may not be that at all. I’m just worried because of the mass, and also because gallstone blockages of the bile duct usually occur after a patient has had a history of trouble with gallstones. She doesn’t show any symptoms of gallstones. But she’s obviously a very sick lady. It’s critical that she have those tests done so we can determine why she’s in this condition. Do you think you can persuade her to do it?”
“I don’t know. Just getting her to agree to see you was nearly impossible."
The doctor shook his head. “I don’t think I’ve ever seen such a severe case of social anxiety disorder. Has she always been that way?”
“As long as I’ve known her. More than sixty years now.” Social anxiety disorder, Father O’Brien thought. A three-word description of a lifetime of suffering.
“She’s probably progressed to full-blown agoraphobia…which means she’s so afraid of panicking that she’ll avoid leaving familiar surroundings for fear of having an attack. And her eye...I wasn’t about to ask to see it. But that’s just a damned shame.” The doctor opened his car door and got behind the wheel. “Look, Michael, do your best to convince her to have the tests. She really needs to have them right away. I can prescribe some sedatives for her so it’s easier for her to leave her house.”
Father O’Brien nodded. “I’ll be in touch,” he said. He waited until the doctor had driven down the spiraling driveway before returning to the back door of the marble home.
He was eighty-five years old, in the waning portion of his life. He straightened up his skinny, arthritic frame and adjusted the white ring that showed through the front of his shirt collar. A slight, cold breeze ruffled the sparse hair on his head but did nothing to his jaw. It was clenched tight with determination.
Mary’s condition was no toothache, or flu virus, or any other minor health problem that she had endured by herself in the past. This time, she truly needed help, even if she didn’t think she did. He smoothed the wisps of hair back down on his head. It was almost amusing to him that at this time in his life, as an old man, he felt like David about to confront Goliath. He knew he would face the battle of his life in trying to convince Mary to leave her home to receive the medical care she needed. It was a battle he resolved to win.
Father O’Brien opened the back door of the marble mansion, took a deep breath, and closed it softly behind him.
~~~
The scenery outside the window of the truck was finally visible in the thin light of the winter sunrise.
Mary blinked and tried to focus on something. The houses and trees and everything else shifted from blurry to clear to blurry. She was unaccustomed to taking medication, except for an occasional aspirin. The effects of Valium were strange and disturbing.
The anxiety was still there and had been ever since Michael had helped her into the front seat of his old pickup. Now, though, it was blanketed by the sedative, compressed into a little ball that spun around and around inside her, confined and harmless. Even the constant chatter of Daisy Delaine in the backseat didn’t disturb her.
“I really like going to the doctor, Mrs. McAllister,” she said over the back of her seat. “Father O’Brien’s so nice to take me when I need to go. I usually have a checkup and get some new medicine. Are you going for a checkup and medicine?”
“I suppose,” Mary said. She felt odd when she spoke, as if her own thoughts were being expressed in someone else’s voice.
“I really like my doctor, too. His name’s Dr. Mann. It’s an easy name to remember, since he’s a man, not a woman. I’ve been seeing him for a long time. Let’s see,” Daisy said, counting softly to herself, “I think about twelve years now. Woo—wee! Time sure flies, doesn’t it, Father O’Brien?”
“It does, Daisy,” he said, glancing up at her in the rearview mirror. Then he looked down at Mary next to him. “Are you doing all right?” he asked.
“I’m fine,” she said. Waves of sleepiness were flowing over her, even as the sun climbed higher. She leaned her head against the window.
“We’re coming into Rutland now,” he said. “The clinic is only a mile or so from here.”
“Oh, goody!” Daisy said from the back seat. “I can’t wait to show Dr. Mann my new spells.” Mary heard the sound of notebook pages turning and smiled to herself.
Michael had told her years before of how Daisy had taken up residence in Mill River after the death of her elderly parents. The Devines were dairy farmers who had adopted Daisy as an infant despite the mild brain damage she’d suffered during birth. They’d taught her to be self-sufficient and outgoing, but they worried about what would happen to their daughter once they were gone. With Michael’s help, they had arranged to move Daisy from their farm outside Rutland to Mill River, where she could live safely on her own. He’d helped her find a place to live and tried to ease her transition into the community. The little round woman had always been naïve, almost child-like.
Mary had seen Daisy several times from a distance, usually walking up the main street in town carrying potions or groceries. Most people in town treated her politely, and enough of them bought her potions to provide a supplement to her government checks. Even so, through Michael, she knew that Daisy was still treated differently, and she probably didn’t understand why. Mary felt a certain kinship with the little round woman. They were quite alike--she and Daisy wanted so much to fit into the community. Even though Daisy sought out people in her attempts to gain acceptance while she herself avoided them, were they not both completely isolated from others in Mill River?