A finger gracelessly hit what sounded to Oliver like the return key.
“Your wife has leukemia?” Miss Culpepper’s voice was disinterested. She pounded the key a few more times. “We have here her needing a bone marrow transplant? Bone marrow transplant’s a major procedure.”
“That’s months away. You can appreciate — we aren’t close to that point.”
“Transplant costs more than what your whole policy covers.”
Taking a moment, giving his best, most apologetic, most adult, taking-you-in-my-confidence look, he explained to Miss Culpepper about the small policy they’d basically gotten for Alice’s pregnancy, how they should be able to transfer to another policy without hitting any rigmarole about preexisting conditions. He’d checked into all this, he said. He wasn’t looking for pity: “But while I’m figuring out our best next step, if we’re months away from even approaching our cap, I guess what I’m asking is: Why can’t we just keep using the policy we have?”
Her eyes had glazed. “I can respect your situation, Mr. Culverts. I hope you can respect ours.”
Oliver squirmed in place, decided to not correct her about his last name.
“Hospital procedure,” she continued. “Once you reach a certain level on your insurance coverage, we flag your status.”
“We’re not even—”
Yet again he caught himself. Behind him, though, damage had been done: the baby carriage stirring, minor tremors followed by calm, silence. A near miss. Oliver’s panic about the child awakening receded. He jutted in his chair now, whispering across the desk with the fervor of a person whose spouse’s life depended on him being understood: “We still have one. Hundred and. Fifty. THOUSAND dollars. Alice was in the hospital for thirty-four days in New Hampshire and we didn’t spend that much.”
“I’m sure you can appreciate, billing rates are a little different here in the Upper East Side.”
“Look, you really want to get into this, you want to get into specifics? Okay, say Unified has their way, just say we lose the appeal—”
“Mr. Culverts—”
“More of that billing’s going to be classified out-of-network. It’ll be a hit for me, a massive hit, fine, but it actually comes OFF our policy total of spent insurance money. We’ll end up being MORE under the cap.”
“I’d appreciate it if you please didn’t raise your voice at me, Mr. Culverts.”
“I’m WHISPERING.”
“I’m not raising my voice at you, am I, Mr. Culverts? I’m not losing my temper at you.”
“I’m not losing my temper at YOU, either, Miss Culpepper. If I’m upset, which I’m not, but if I am, my upset is not because I have anything against you, I don’t. It’s you as the de facto representative of a bureaucratic nightmare that’s creating all this BULLSHIT—”
“So you’re screaming now?”
“—instead of doing what it should be doing, which is to make sure my wife stays alive.”
“This hospital’s run by a private management company, okay? This management company, they has they own policies, okay? End of the day, I don’t make policy. My job, I make sure the hospital gets paid for the services it provide, okay? That ain’t me, that’s policy. If you need, we got all kinds of financial aid and payment options to our patients. I’ll give you the form.”
“Miss— Where…How do I…” Oliver reset himself. “I have a little software business. That’s what I do, Miss Culpepper. It’s not big, I’m the only full-timer. But when I hand in the tax forms for any financial aid papers, it looks like we’re loaded, like that lump is the business’s regular yearly income. Really, it’s all the money to get through development and onto the market.”
She did not seem to follow, but stayed silent until she was sure he’d finished. “Until you rectify this situation,” Miss Culpepper said, “your wife’s appointments have to be approved once at a time. There’s a hold. On Mrs. Culverts’s account. Hospital won’t make appointments after first of May for her. So that’s three months you have. You still under the cap come May we can revisit the situation. If I were you, though, I’d have this problem solved by then.”
This is the only way we know to make you better
IT TOOK ANOTHER hour before they let him back inside, where electric light, bright and pitiless, beat down on the sight. His wife was curled on her side, protecting herself in a sad imitation of a cocoon. Her bright blue wig, now askew, looked ridiculous, and worse. Her eyes were shut, but she wasn’t asleep, just recovering, breathing softly, a thin white sheet over her torso.
An unopened can of cranberry juice sat next to a plastic cup near her head. A spot of blood marred the plastic exam table paper, which was creased and crumpled and had been ripped along the top edge. Oliver softly kissed her raised cheek. She was fragrant with heat and sweat, her skin chalky on his lips. Oliver kissed one shut eyelid. Then the other one, half-pressed against the starched sheet. Alice lifted her hand to his cheek. Fluttering eyes were unfocused, her smile sleepy. She looked beyond his shoulder, to the carriage, checking.
“Dr. Howard Eisenstatt, MD, is upset at me.” Alice sounded airy, girlish, a little drugged. “I wouldn’t let him tell me any results until you came back.”
A brain trust of physicians were right outside the room, gathered over the equipment tray, checking the same paperwork and looking at the same clipboard; Oliver hadn’t noticed them, but now they began entering. Eisenstatt stepped forward, his forehead and cheeks still tinged with the flush of exertion, his expression uncertain. How was Alice doing? he asked. Indicating concern as to whether it was okay to talk, he glanced toward the carriage.
“Thanks for asking,” Alice said. “It might be a good idea to use our indoor voices.”
Eisenstatt helped himself to a cup of water, looked toward the nurse, who was prepared with a Magic Marker and then a dry-erase board the size of a lunch tray. “I know it’s been a long day,” he said.
The doctor uncorked his marker and started writing, first on the left, then the right side of the marker board, slanted, quick, and a little sloppy, forest-green capital letters appearing parallel to one another:
Eisenstatt accentuated the T with a squeaky, tight checkmark. “We need to get you to the transplant,” he said. Circling the I, he continued. “You’ve been through induction. That was big, and you came through with flying colors.”
“Doctor?” Alice’s head was lying on its side, resting atop her hands. “This is going to explain my aspirate results?”
“The board allows us to understand your results as they relate to the bigger—”
More knocking. An orderly entered with a carton of milk procured from a lunch tray. Alice thanked Miguel, then looked over to Dantelle, and mouthed Thank you. Oliver had already started toward the sink, where he began washing out the plastic nipple. Watching, the doctor seemed impressed, but also taken aback.
“I’m with you,” Oliver said, still pouring milk into the plastic baby bottle liner.
Only when the nipple top had been screwed back onto the bottle did the doctor allow his lips to form that tight smile, by now recognizable as a sign of growing irritation. “We want to make sure the cancer stays in remission,” Eisenstatt said. “The way to do that is to stay on top of things, be proactive — everyone with me? Standard plan of attack. Two months after induction, we bring you into the hospital, give you another dose of chemo. This time it’s a high-impact dose of cytarabine. We call this consolidation.”