NOT TODAY, NOT TONIGHT | Donald Kollisch

There were little signals when we got up. Like the way my wife smoothed the sheets when we made the bed, or the smile she gave me in the bathroom when I watched her dry off and then kissed her neck before I stepped into the steaming shower myself. Maybe she didn’t even know she was sending them, and I didn’t want to tell her, in case it might change the magic. Maybe the signs weren’t really there and it was all me, projecting my expectations and I was the one smiling. In any case I thought the signals were there and then they disappeared in the energy of the morning rituals and chores. I chose a yellow tie with owls, thinking about the patients who I would see today and wondering if they will care if I do this small special thing for them, choosing a tie with them in mind.

I gave medicine to the cat, thinking that she’s old and may not be there for the evening dose, who knows, so I gave her some extra food. When I ran my hand down her back the caress was for her, not for me. The usual morning rituals. Think breakfast, think lunch, think dinner, what do I need to shop for, what’s low, what food can we have in the house now with the boys gone, either healthy like brown rice or forbidden like chocolate milk. It was a dance as we each got things done, not always smoothly, sometimes asking advice and “What do you have today?” or touching a shoulder, bumping a hip as we moved between appliances and doors. “Hospital Board meeting this evening,” I said. I didn’t let myself think about tonight, only today, and then we were gone, apart, carrying on as if we were each alone, as if a seed hasn’t been planted, germinating, sending down small roots that tickled me below the level I can feel.

Each patient surfaced from the blur of the day, unique and special. I remembered them for a moment but then there was another one and the feature of the previous visit would fade. The special word, the story of the skin sealing over the glass splinter, the patient describing something usual in an unusual way, like the old lady saying, “I feel squirrelly,” the odd little exostosis hiding in an old man’s ear canal, the rotten teeth in the mouth of a beautiful woman who tells me she hates her life. All of the stories and words and fears and bodies, the hassles with the specialists and the labs, the letters and the forms to file. Each one was special, unique and alike, the string of beads that measures my day.

I wasn’t sure about this next patient in the early afternoon. I knew her last name, but not the first, so I guessed I knew the family. Sixteen years old, probably another kid I hadn’t met yet. I thought I knew them all. The dad did shift work at the tool plant, the mom — what a mom — it was always hard to picture that house with her doing the mothering. The house must be a chaotic railroad station, with kids and friends on every couch, card games and beer and plenty of other stuff, all in and out, with the mom in the middle when she could get home from painting nails, directing the switches and tracks, letting each one know what they can do and can’t and with who.

I had delivered the baby of the daughter who I thought was the oldest, but then I learned she was number two. The first girl had gone away before graduating and I later learned that she died out in the west someplace on a motorcycle trying to ride with a tough guy who spun out on gravel and ice at the top of a pass and went ass over teakettle a thousand feet. They had told me the story during the delivery, just as the baby’s head was crowning. Then the mom laughed because I was so upset and she wasn’t. I almost forgot to clean out the baby’s mouth. She said, “This is what happens to my kids who don’t do what I tell them to,” and I didn’t know which daughter she meant.

So I figured I was going to meet yet another member of the family and I couldn’t tell from the name — it was one of those that can go both ways - if it was a boy or a girl. She turned out to be a third girl and she looked normal enough, and acted OK. She wasn’t full of beans and in my face like her mother but also she wasn’t withdrawn and pulling back like the usual girls her age who use their mothers for protection. This one had some energy of her own and her eyes grabbed onto mine really tight. The mom said “This girl needs some medicine,” she said. “This girl here doesn’t do what I say either.” Mom said “This girl is going towards the boys but not there yet and that’s why I brought her in.” Dana, that was her name, looked down and didn’t say anything. And Mom said “I’m not going to take care of another little baby there in that house, so you have to give her the pills.” She even named the brand and the dose. And although I thought this was a hell of a scene and full of memorable gestures and words, I was also thinking that the kid herself has got to want this, not the mom. But when I asked, Dana said “Sure” and I figured sure you bet I don’t want to see any more of these babies being born, either.

So we did the talk about living life as a kid and “Don’t grow up too fast and is there someone special?” And she said “Yes, and well maybe they had done it a month ago,” and stared at her mother. At hearing this, her mom laughed and said, “Well I should have guessed that. Aren’t I smart to bring her in?” I think mom seemed especially keyed up about it because I thought it weird that she and I were hearing about it together for the first time. I must have shown it on my face even though I don’t think I usually show when I’m affected by stuff like that. I don’t think the girl saw it on my face, but her mother sure did.

So we went ahead and did the usual questions about dates and protection, and then the exam because you have to do that if you’re giving the pills. So the mom said to the girl “It’s OK he does this to me, too and this is what happens when you grow up.” I figured what with the mom and all of the action in their house and everything that this was going to be not a big deal for Dana. So I let mom stay because she knows how I do an exam and it usually isn’t a big deal. I’ve examined Mom down there at least twice a year because the husband’s not home much and she tells me that there are other guys, always some different other guy she’d be telling me about. So I’d check her out and do some cultures and tell her, “You’re OK this time, but maybe you shouldn’t keep on doing this.” But it’s her life and I figured her daughter sees those other guys there at the and would know the score. The mom would have told her about it for sure and anyhow there’s got to be lots of stories in the house, and no surprise.

After the talking and time for the exam I knew that the nurse was working on the routine urine test and had a full waiting room, so I said to the mom, “No need for the nurse to help, you’re here. You know the ropes and can help and I don’t want to have to wait for the nurse.” The mom said, “Sure that’s what a mom is here for, is to help the kids and so sure.” And so we got her ready with a gown and a sheet and did the first part of the exam with the heart and the chest. There was lots of modesty but that’s good, that’s right for her age and I was glad but also a little surprised because Mom wasn’t modest at all, not at all. She used to just strip down and jump on the table.

But then, when I said to Dana “Now is the time to do this part down here,” I began to wonder if it was modesty or what because she wouldn’t spread her knees. And her mom said “You do it, you open your knees. This is the first time for this and it might hurt a bit but not a lot and then it’ll be done and you’ll have had your first one and now’s the right time you agreed.” Well, I wasn’t sure all of these words sounded right. It was another type of tickle, a bad tickle, but the mom was right there and talking to her own daughter. And she was correct that now really was the right time, we shouldn’t put if off because of the guy a month ago. But the girl kept her knees and her legs all tightly together and I had to put one hand between her knees to show her where to relax her muscles to let her legs go, and she actually hurt my hand it was so tight. Her mother saw this and said, “Relax come on now, I’ve had this lots. It isn’t going to be bad, relax now.”

So the first part with the metal speculum was hard enough because her knees kept on going closed and I had to sit down to get the right angle to look inside. When I was down there looking, the cervix looked OK but maybe a bit kind of dusky, but normal enough. Then I took a culture because I didn’t want to be fooled like I have been sometimes with other girls when they say no, I never did that and I couldn’t get an infection, but later you find out different. So now I always take a sample. I was putting the cap back on the sample tube and taking out the speculum when I stood up and looked up and Dana’s got her eyes closed tight and some tears. And now her legs are limp and her mom is standing there looking grim and pleased like she had won another argument. I wasn’t sure then what I should do, should I stop and say enough, but I thought I really should finish, and do it right. Like I said I don’t like to make mistakes. I knew I should feel her uterus, see if it was bigger than usual.

So I got ready with some lubricant on my fingers and said, “OK now, for the next part when I feel inside,” and touched her and her knees slammed shut again, with my hand right down there, and she’s saying, “No, no, don’t.” So I looked at her mom. I don’t know what the right thing is to do. But mom steps back and pulls on one leg and says “Come on do this you’ve got to, this is what you said you came here for.” And she’s looking really determined like this has got to happen and I wasn’t sure but I went ahead and did it because it seemed like I had to. I went ahead and checked inside with two fingers, and she moved around like it was wrong and said, “No, no,” but I was right there and so went ahead and checked. She was crying now and moving and trying to push my fingers out. And the mom said “You asked for it and now it’s happening and there isn’t anything you can do about it.” And mom’s sweating and looking like she’s in a frenzy. So I could barely tell that the uterus was maybe larger than I would’ve thought. But I wasn’t sure and I didn’t have much time because I was fighting her now, and losing. So the whole scene is really bad and now I don’t know if it makes any sense that I’m doing this, or even what is really going on. And then I think it is all over so I step back and try to look calm and take off my gloves and tell her “You can sit up it’s all over and OK, and I need to step out to talk with the nurse about the samples.” But as I turn to go, she’s sort of whimpering and the mom is flushed and excited and I got out of that room quick and just had to sit down on a hall chair.

The nurse came around soon and I told her about some of it but … but I didn’t tell her about the girl fighting me because it didn’t seem quite right for her to know. I told her that the Mom was in there cleaning the girl up. “The mom was, you know, the way she always is, too much, you know. Over the top.” And then I asked the nurse to run the urine again, this time not just for sugar but also for pregnancy. I sat with my eyes closed until the nurse came back said “Positive” with a shake of her head. And then I had to go back in to tell Dana and Mom.

I couldn’t get the girl to meet my eyes, she was just sitting there, dressed in the corner with her legs crossed and twisted in their black glistening pants. Her jaw was working and Mom was on the other side of the room. It was bad. Her mom had calmed down some but was still breathing hard, and eyes shining, looking back and forth at me and the girl like she had just done something important. Like she was right as always, and won again and always would. I told them about the positive pregnancy test and asked, “So what do you want to do about this now?” I thought I was ready for anything.

So I was really surprised when the girl just got up and walked past me fast on stiff legs and maybe still crying. When she passed me, she looked up with this look of rage that I really didn’t expect because what had I really done? Her mom followed quickly out and said, “I’ll call tomorrow and find out the infection results and talk but now I need to be with my little girl.” Just like that they were gone. I was left standing there with everything to say but my mouth sort of open and no one there to hear any of it.

And then the nurse came with another chart. I had someone else to see as if the day was going to go on like always and normal. I moved through the rest of the afternoon in a blur. I was glad that no one had anything really complicated or hard because I think I was using only a small part of my brain and those patients sure weren’t getting me smart. Then at the end of the day I was so frazzled I didn’t even write my notes, so I knew the next day would be impossibly long. But I couldn’t do them right now. I couldn’t focus just sitting there with a chart and Dictaphone in front of me but also in my mind the girl’s face and those knees and the yelling mouth of her mom. These things stayed with me through the hospital board meeting that I couldn’t skip and the bad hospital dinner I couldn’t eat. Enough was too much and I had to get out to get home to get along with my life because this day was wound too tight.

Then here’s the thing that happened. I had forgotten the signs of the morning but my wife reminded me with the way she got the dishes done quickly and the mail sorted. She told me about her day with her clients and I listened and didn’t hear but she near-smiled and caught my eyes twice, three times, soft and easy. She wasn’t going to let me stay downstairs alone this evening, she was taking me up with her. I remembered then the signs and the quickening. I wanted to tell her about what happened but I couldn’t because I didn’t really know what had happened. And I felt guilty, like I was complicit. Our bedroom was dark except for the light from the bathroom as we lay together and I tried hard to see her face and her bright eyes, but then when she opened her knees and drew me in towards her, into her, I saw the wrong face, the wrong faces in the room. I began to say out loud, “No, no I can’t do it I won’t do it, I have to do it, I won’t do it again.” And then I was on the floor in a ball and looking inside with that same fury, not able to say anything at all.

Donald Kollisch is a Family Physician and teacher who started his career as a country doctor in Northern New Hampshire. Although he has worked in academia for the last 30 years - in New York City, North Carolina, and New Hampshire - his writing heart is still back in his rural roots. The people he met and cared for back then now populate his short stories.

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