Millard Salter's Last Day Read online

  “A date with destiny,” replied Millard.

  “Destiny. Sexy name.” Laguna slapped his shoulder. “I hope you get lucky.”

  4

  Two glossy stickers graced Millard’s office door. One, a gift from Hal Storch, read: “If Moses had been a committee, the Israelites would still be wandering in the desert.” The other—from a former patient who designed irreverent bumper stickers—warned: “Life is unfair. Get over it.” This latter message never drifted far from Millard’s thoughts as he rounded in the hospital. Life was unfair—in countless ways, major and minuscule. One could dwell infinitely upon the grander injustices, the children born without limbs, the adolescents raped in refugee camps, the journalists roasted alive inside oil drums in Eritrea. But at least these victims had the solace of acknowledgment, even if only self-acknowledgment, that they’d been given a colossally raw deal. Yet so much suffering arose from the small wrongs, the petty inequities, as painful as splinters: the less attractive sister sitting home alone on prom night; that doting aunt and uncle who would have made such great parents; a beagle crushed by a taxi; a parakeet lost through an open window; his mother’s black nanny, Dora, who should have been a college professor. Psychiatry was the art of helping people to cope with this unfairness—with the latent, unvoiced recognition that if only one had been born with different attributes, raised under different circumstances, loved more . . . Early in his career, Millard had toyed with the idea of writing a book, Letters to a Young Psychiatrist, modeled after Rilke’s Letters to a Young Poet, which was to have expounded upon the nuanced cruelties of existence. Instead, he had deceived Carol and seduced Isabelle, doing his own part on behalf of injustice.

  And in spite of everything, reflected Millard, I’ve gotten a far better deal than most.

  Among those worse off than Millard were the three patients remaining under his care. (Over the course of the preceding month, he had pared down his list of cases, using the service director’s prerogative to delegate; his coworkers hardly seemed to have noticed.) Regrettably, none of these three unfortunates could be foisted upon a junior colleague without drawing unwanted attention and causing unnecessary affront. One was the daughter of a retired ICU nurse—a longtime friend of Isabelle’s—who’d lost a leg and a pregnancy in a traffic accident. Millard had also been corralled into looking after the psychiatric needs of a well-heeled St. Dymphna’s donor, Lucius Jeffers, who’d developed precocious dementia in his fifties. They’d set aside a VIP suite for Jeffers, paid for out-of-pocket, where the one-time hedge fund executive alternatively ranted about the future of the Polish zloty and pinched the rumps of the phlebotomists. And Millard had also acquired the duty—part professional, part social—of visiting Rabbi Steinmetz, the recently minted St. Dymphna’s chaplain, sequestered in an isolation unit after a bone marrow transplant. As he traversed the glass-enclosed atrium for his final meeting with the first of these victims, pausing briefly at a cork announcement board to read one of the myriad flyers warning passersby against the escaped lynx, Millard sensed an ominous presence—like a scythe-bearing demon—sidle up behind him. The shadow belonged to the all-too-corporeal form of Denny Dennmeyer, St. Dymphna’s deputy finance director.

  The glorified accountant, who might generously have been described as rotund, had earned the disparaging moniker of “Quantity Control Officer” for his officious insistence on relentless auditing. He’d been riding Millard’s ass for months about a delinquent report regarding the consult service’s staffing needs; no matter what he wrote, Millard sensed, the data would be used to lay off providers and to increase caseloads—so he had submitted nothing at all.

  “Dr. Salter,” declared Dennmeyer, “I’ve been looking everywhere for you.”

  The administrator sported a seersucker suit and a bolo tie. He bellowed as though testing the acoustics inside a cathedral, nearly pinning Millard to the corkboard with his gut. His breath smelled mephitically of cinnamon.

  Millard sucked in his own abdomen. “And now you’ve found me.”

  “None too soon, Dr. Salter. Don’t you check your email . . . ?”

  Dennmeyer had the habit of adding “Dr. Salter” to every phrase—probably something he’d learned in corporate training, or from a self-improvement manual. The tic made the fellow sound like an English butler gone haywire. “I’m too old for email,” lied Millard, who had actually grown rather adept at computing in his seventies. And was quite proud of it. “You might have tried to reach me the old-fashioned way . . . .”

  “In all fairness, Dr. Salter, I’ve been leaving messages on your voicemail for nearly a month,” persisted Dennmeyer. “And I sent you a written memo.”

  “Voicemail? Who has time for voicemail?” said Millard. “Go low-tech, next time. Two paper cups and a string. Works like magic.”

  “Dr. Salter?”

  “Or smoke signals,” continued Millard—biting his inner lip to suppress a grin. “The Native Americans have been using them for thousands of years . . . .”

  For a man with only half a day to live, Millard was surprised by his own good spirits. How free he felt, for the first time in ages, maybe ever, to voice his mind. Yet he did not have much time to waste on Dennmeyer, not even to mock him, if he intended to keep his noon lunch date with Lysander. Blood swelled into the accountant’s neck, his cheeks, his simian forehead. The vein along his temple pulsed, limned with a fine bead of sweat. He appeared to sense that Millard was enjoying a joke at his expense.

  “See here, my man,” objected Dennmeyer, now visibly flustered. “I really do need that report. Every other division head in your department has submitted an annual assessment—some more thorough than others, I’ll admit—but, at least, they’ve submitted something.” He rubbed his brow with his fingertips, regaining a modicum of composure. “This is important, Dr. Salter. How can we plan for the future unless we understand the present?”

  The best laid plans of mice and men, reflected Millard, and whatever species Dennmeyer belonged to, also . . . “I’ll make you a deal,” he replied. “If I’m alive tomorrow, I’ll have that report on your desk by five o’clock.”

  His pledge caught Dennmeyer by surprise. “That would be very helpful, Dr. Salter.”

  “Oh, I don’t know how helpful it will be,” said Millard. “But you have my word.” He glanced at his watch for effect. “Now if you’ll please excuse me, I have sick people to heal and dead people to raise and all that . . . .”

  5

  The victim of the motorcycle accident, Dolores, had been dispatched to radiology for a scan of her femur, so Millard crossed the seventh-floor walkway to the VIP unit. Along the way, he exchanged waves and hellos with half a dozen colleagues, including Saul Duransky and Art Rosenstein, the latter rolling his left foot in a traction boot; the charge nurse from the pulmonary care center, who’d been a nursing student during Millard’s own internship, gave him a hug; one of the housekeepers from the Luxdorfer Pavilion, where he’d once had an office, greeted him by name. What a good feeling it was to be known someplace, to have been part of something in this way. Not that he considered himself irreplaceable—he wasn’t foolish enough to believe that. Everybody was expendable. Presidents, kings. When the pope died, they found a new pope. Fools and narcissists forgot that at their peril, as, over the years, had several of Millard’s bosses. So no, he wasn’t irreplaceable, but he was well-liked, and he was grateful for it. Reflecting on his encounter with Dennmeyer, Millard found himself grinning, almost giddy.

  In nearly five decades at St. Dymphna’s, Millard had encountered his fair share of celebrity patients: politicians, performers, a retired five-star general. As a fourth-year resident, he’d sat up late one evening with a dying Tallulah Bankhead; during his first months on the faculty, he’d prescribed a sleeping aid for Charles Lindbergh after the aviator’s appendectomy. Back then, the VIP unit had been located across Madison Avenue, on the top floor of the Hapsworth Annex, affording critically ill power brokers a 270-degree view of Manh
attan. The titans of entertainment and industry had since been ousted from this perch by hospital executives, who’d appropriated the penthouse for office space, but the new VIP digs, overlooking Central Park, proved none too shabby. In the spacious entryway, furnished with damask wingback chairs and a baby grand piano, a glass-encased waterfall tangoed under kaleidoscopic lights. At four o’clock every afternoon, white-gloved orderlies served high tea in the visitors’ lounge. The most striking contrast between 7-West, as the unit was known, and the rest of the hospital, was its stunning silence. Yet the floor also harbored a secret, known only to senior clinicians: When compared with the treatment provided elsewhere in the hospital, the medical care itself was substandard. No amount of complimentary scented bathing gel or gourmet Equatoguinean chocolate compensated for the benefits of having medical students and junior residents and nursing trainees bustling through one’s room, always on the lookout for an errant tube or a wrongly hung bag of electrolytes. Lives had been saved, many times over, by the fresh-eyed neophyte asking, in complete innocence, “Why are we giving that medicine to this patient?”

  Millard encountered Lucius Jeffers as he had left him. The currency guru relaxed on the sofa, lanky limbs splayed like branches, watching the stock ticker scroll across his plasma TV. Mrs. Jeffers lay on her stomach atop the patient’s bed, reading an airport novel, her stockinged feet a pair of scissor blades. She was a pleasant, soft-spoken woman in her forties. Not unattractive, but certainly not a former fashion model. They had a daughter at Vassar, Millard vaguely recalled—or possibly Bryn Mawr. Name the Seven Sister schools, he mused: now that was a good challenge for the medical students. At one time, he’d been a frequent visitor to several of these diminished institutions, including Barnard, when he’d dated a botany major, and Wellesley, Carol’s alma mater, where he’d grown intimately familiar with the shadowy pull-off behind a nearby country club. Back in the days when you could get an Ivy League education at a women’s college. Long time ago.

  Over the years, Millard had discovered that the wives of the terminally ill—which Jeffers likely was, despite the absence of a formal diagnosis—fit into one of two factions. In a first group clustered the loyal victims: women who never left their husbands’ bedsides, transforming overnight from homemakers or schoolteachers or retired librarians into devoted nursing assistants whose lives revolved around applesauce feedings and sponge baths. He could picture Isabelle as one of these votaries, stoic with forced cheer, singing him lullabies in his dementia. Carol also fit this mold—although one could more easily imagine her bullying house officers than reading bedtime stories. So did Mrs. Jeffers. At the opposite extreme were the fair-weather mates, often younger women on their second or third marriage, who dropped their moribund husbands off at the hospital like so much soiled bed linen and vanished into the ether. As one wife had said to Millard, when he finally reached her by phone, “I love my husband, Doctor, but I didn’t sign up for this.” Millard wondered whether, had circumstances proven different, Delilah would have camped out in his hospital room or fled into the night. He honestly didn’t know.

  “Look who’s here,” said Mrs. Jeffers. “It’s Dr. Salter. The psychiatrist.”

  Jeffers looked up. He had a towel draped over one knee, as though at a sauna.

  “Good morning, Lucius,” Millard said. “Do you remember me?”

  “Of course, he does,” interjected Mrs. Jeffers. “Don’t you, honey?”

  Millard threw her a silencing look. He pulled up a chair alongside her husband.

  “Do you remember who I am?” Millard asked again.

  Jeffers nodded. “Sure. You’re the fellow from that place.” He grinned, tapping his thigh methodically. “I’m so glad you’re here.”

  “What kind of building is this, Lucius?”

  Millard’s question educed a benighted shrug. “This . . . this is a . . . you know,” said Jeffers. “Anyway, I’m glad you’re here. I was just saying we should strike a stake in the Brazilian real. Latin America is where it’s at. Not China. Not India. Have you been following the Paraguayan guarani and the Uruguayan . . . and the Uruguayan you know . . . ?”

  Millard waited for a break in Jeffers’s rambling.

  “I have to ask you a few basic questions,” he said. “I want you to tell me where we are. Is this a bank? A library? Or a hospital?”

  Jeffers frowned, irked. Millard glanced at Mrs. Jeffers, his eyes warning her not to assist.

  An uncomfortable pause followed, punctuated by the low murmur of the financial news rumbling from the television console. Then Jeffers pounded his fist on the cushions without warning and snapped, “A bank, dammit. Do you think I’m stupid?”

  Confabulation was one of the symptoms of the financier’s dementia. A costly battery of tests—MRIs, LPs, EEGs, PET and SPECT scans—had revealed no explanation for his sudden decline; next on the agenda would be a brain biopsy. Not that the results particularly mattered: Anything they discovered at this stage in the dismal game was probably irreversible.

  “Nobody thinks you’re stupid, Lucius,” soothed Millard. “I have to ask everyone these questions. It’s a formality.”

  Millard thanked Jeffers for his time; he was about to promise to visit again the following morning, but he checked himself—no need to deceive gratuitously. What he really wished to do was to return to the afflicted man’s room after lunch, while Mrs. Jeffers was running an errand, and to serve him a lethal injection of potassium chloride. In his fantasy, Millard imagined wandering from ward to ward all afternoon, euthanizing the tortured, senile casks of flesh who lacked the power to terminate their own indignities. He doubted the authorities would catch him before he offed himself—not if he operated with stealth, choosing only the most severe cases. By the time the coroner unraveled the etiology of this daylong epidemic—the “Millard Salter Massacre”—he’d be playing shuffleboard and canasta on a cloud with his so-called victims, or toasting crisply in Hades. Needless to say, Millard knew that he would do no such thing, that after five decades saving lives—at least, to the degree a headshrinker could claim to save lives—he did not have inside him whatever je ne sais quoi was required to kill strangers, not even with impunity, not even if justice and morality linked arm in arm at his side. Helping Delilah die with a mite of self-respect was a deed that strained at the far reaches of his moral tether.

  Mrs. Jeffers escorted him to the door. “Not his best day,” she said, almost apologetic.

  “He seems comfortable,” replied Millard. “That’s important.”

  They stood face-to-face in the dim vestibule. The man you love is dying, thought Millard, and the woman I love is dying, yet we’re each trapped in our separate hells.

  “Any news?” she asked.

  “Not yet,” said Millard. “We’ll hope the biopsy shows something.”

  He offered her a few additional words of solace and ducked into the corridor, grateful to have escaped without confessing his own secret.

  A young girl, unchaperoned, had commandeered the piano. The child was decked out in a white taffeta dress, overlain with tulle, as though truant from a first communion; an indigo bow in her butterscotch ponytail offset the pallor of her long, bare arms. What a pleasure, reflected Millard, to see someone—even a child—dressed up to make a sick call for a change. How recently, it seemed, that one had been expected to don a necktie, or at least a sweater and slacks, when traveling by airplane or dining out; now middle-aged men wore dungarees to the opera. He watched the child perform with admiration. Her fingers danced across the keys, filling the forecourt with a perfectly respectable, if uninspired, rendition of Liszt’s second Hungarian Rhapsody. At the height of the friska—that moment where Liszt leads his listeners into the eye of the hurricane, as the key shifts from F-sharp minor to the cadenza—the music halted abruptly. The girl had caught sight of her parents regarding her from the far end of the plaza.

  Millard nodded at the couple. With his rumpled white coat and his stethoscope draped over
his shoulders, he looked avuncular, grandfatherly—not threatening. And what a crazy world he’d be leaving, where, without these accoutrements, a seventy-five-year-old widower, pausing to admire a child’s piano performance, might be mistaken for a pervert.

  The girl’s mother clapped softly, urging the girl to continue, but the child refused and dashed across the atrium for a hug. For many, the great miracle of life was parenting—childbirth, the transformation of a helpless infant into an autonomous adult—but for Millard, who’d found fatherhood meaningful, but not particularly magical, the great marvel occurred earlier, in the pairing off of unsuspecting young men and women. Or, these days, men with men and women with women, which was just as improbable and miraculous. Parenting, after all, had a logical, almost inexorable drive: conception, pregnancy, labor, nursing—and then cowboys and princesses, bar mitzvahs and communions and sweet sixteens, college visits to Cambridge and New Haven. But romance! One could be casual acquaintances for twenty years, as he’d been with Isabelle, and then a single, brief conversation in an elevator—about Leontyne Price, of all people—could lead you down a path of loaning cassette tapes and making love in vacant call rooms. Or one could be casual acquaintances for twenty years, and chat about Leontyne Price, and never experience some embryonic spark that sent one down the road to fusion. Why Isabelle? Why Carol before her? And why Delilah now? Why these women and not that leggy, fern-obsessed coed from Barnard whom he’d dated before Carol, or Art Rosenstein’s widowed sister-in-law, who’d been nominated for a Tony Award in the ’70s? Or doe-eyed, coquettish Lettie Moshewitz, who’d taken a mortar to his heart at age twelve? Yes, that mutuality was the true miracle. Millard watched as the young girl buried her head in her mother’s skirt; her father stood by, momentarily superfluous, exchanging a troubled glance with his wife. From the sorrow on the man’s face—he couldn’t have been more than thirty himself—Millard sensed that the sick call had not gone well, that soon the junior musician would be wearing black crêpe.