Three Wednesdays back, Dr. Diaz—Nick—asked me—this was at the clubhouse after a late round of eighteen; Phil and Derrick had already deserted us—he asked me, “Father, can you take my confession. Here, I mean, without your closet thing?” I asked if he was baptized in the Catholic church. “No,” he said, “Episcopalian.”

“Then I can’t take your confession,” I said. “But I can listen, and hey, since when do you call me Father?”

“Sorry, Ben,” he said. “I figured on official business—”

“This is really weighing on you,” I said. It was easy enough to see. He was usually the one to jog from hole to hole, to forgo a caddy even at the little local tournaments. In fact he always looked like he’d just gotten out of the pool, tan and fresh. But that night he looked like an insomniac, like a man working himself up to something crazy. I waved to the waiter and ordered each of us a beer.

“Well if this isn’t a legal confessional—if it’s not, you know, legally protected—then I need you to promise to tell no one about it—really, no one. I could lose my license just for talking about it.” Other doctors I know, they’ll rattle off stories about their patients all day: their halitosis, their gland issues, what they’ve lost up their butts, complete with the real names of the patients—I know some of the people in the stories, and some of the stories have been corroborated in, you know, confession. But Nick? I’d never heard him discuss a case at all, not even Patient X had a cold.

“I promise,” I said.

“Do you swear to God?”

“We don’t really do that.”

“Can you do, like, Scout’s honor?”

“Fine,” I said, holding up a few fingers.

Last week, he began, he got a referral from Abel Meyer over at Brigham and Women’s, an email of a brain scan, an old woman with a tumor, and a note that said, “Can you take this case? I can’t. I just can’t.” Nick’s the type to help out a friend so he said sure, just bus her over. He agreed to take over the consult and, if everyone was on board, the surgery. He called the woman and her husband the Schwartzes, making very clear that this was not their real name—he said it twice.

He gave the transfer a couple hours then headed up to the floor. When he got there he saw an old, old man sitting in a chair outside the room—strange, because why not sit inside? You know, given that the patient he was there with was inside. The guy was like a cartoon or a caricature of an old man: his nose was enlarged with age and projected off his face like a freaking flying buttress, his cheeks hung down to where his lips should have been, and his chin skin dangled in a little nub slightly lower than a chin should be. There was something a little comic about him. A friendly old man from Looney Toons. He looked about ninety. He had all his hair still somehow, but it was thin and gray.

Dr. Diaz introduced himself. “I assume you’re Mr. Schwartz?” (Not his real name—I get it, I said.) “Is your wife inside?” He had a voice like a bratwurst—you’d think like cotton candy, breathy, insubstantial, given how decrepit he looked, but it was the deep voice of a healthy young man. He said his wife was in the room but he wanted to wait outside, to meet the doctor first, to warn him that his wife might have an episode while he’s in there. She’s got Alzheimer’s and—Doctor Diaz interrupted to say he was a neurologist, and quite used to Alzheimer’s patients.

“Well—” said Mr. Schwartz, but Nick was already in the room. He did not mean to be delayed. He was probably thinking about his lunch already. In the bed he saw a woman who looked even older than Schwartz, who looked like every part of her except her head had been shrunk: little elfin arms and shoulders, a concave chest, collarbones you could chain your bike up to. The head tottered over it—the skull really, the soft parts had shrunk as well, the eye sockets gray and sad, her mouth small and drawn.

As soon as she saw him in the room her knuckles clenched around the sheet and her body recoiled as far backward into the bed as possible, like a vampire reacting to sunlight. She started cursing him, warding him off in Yiddish and not using an indoor voice. Her feet churned under the sheet as if she were frantically pedaling a bike. She stopped yelling to catch her breath, breathed deeply one, two, three times, then ripcoiled the highest, loudest shriek you’ve ever heard, like you don’t hear in real life, a shriek of ultimate horror.   

He stepped back out of the room. Every eye on the floor was on him: every nurse, CNA, housekeeper, visitors who had stepped out of patients’ rooms, patients in the rooms across the way who could see into his part of the hall. A bit of “I told you so” in the face of Mr. Schwartz, but it was more sad than amused.

Dr. Diaz took him down to the cafeteria for coffee. In a cushiony little booth, the man explained: she was at Buchenwald from late 1943 until it was liberated in 1945. Most of the Jews who were there for that long died from disease or starvation or brutality, but some of the women—“Well,” Nick said, “I’ll spare you the gory details, a grace Mr. Ca—I mean, Mr. Schwartz did not extend to me.” I told him I could take it. I said it’s incumbent on a man in my profession to bear witness to such, and so on, but I couldn’t get any more out of him. He said he didn’t want to have to say it all, to weigh down his choice further.

“What choice?” I asked.

“In a minute.”

Schwartz told him, “One morning when I come down for breakfast, she hits me in the face with the toaster and runs out the front door.” The old man parted a fold in the heavy bags under his left eye with his index and ring fingers, making a peace sign which framed a little white scar the length of his thumb-knuckle and the width of a pencil. It was pinkish-white against the olive tone of his skin, stuck there like a dead albino leech. He laughed a little. “I had to chase her down the street, and of course she was looking back at me and screaming, thinking she’s being run down by a Gestapo knight. But what could I do, let her run off into Washington Square thinking it’s wartime Germany?”

“There are homes, you know. Specific to Alzheimer’s,” Nick advised.

“Not reminiscent of the camps at all, huh, Doc? Maybe they don’t use barbed wire, but…. Anyways, tell me about this surgery.”

He gave Schwartz the rundown, the medical names of the procedures he would perform and the parts of the brain he would operate on, then the summary—“We open up her head and cut the tumor out.” If he was able to get it all, if it didn’t come back, Mrs. Schwartz had no other pressing concerns. There were the risks of course, a laundry list as with any surgery, let alone a brain surgery, most notably death, brain death, mental deficits, strokes, personality change—

“Any chance all this will, you know, help her?” he said, tapping a finger to his temple.

Dr. Diaz was appropriately cautious. He sighed, he waited, he looked at the table before looking back up at Schwartz with his eyebrows in a sensitive deployment: “Maybe it will,” he said, “maybe it won’t. Your wife has Alzheimer’s. But depending on how much compression this tumor is causing, it could be aggravating the dementia. Or it could get worse after the removal. What I think is most likely is no change. Maybe a miracle happens. But that’s like getting hit by a car and getting your memory back. Soap opera stuff.”

It was Schwartz’s turn to sigh and stare off into space. He took several sips of his coffee, setting it down between each one. He was punctuating the conversation—a period, a paragraph, a line break—to make it clear what he was going to say next was not a response to what the doctor had just said.

“I’ve thought about it, you know.”

Dr. Diaz did not need to ask what “it” was.

“Her first, then me.” Schwartz laughed a little, sadly. “Can’t do it the other way. Once I was gone she’d forget to do herself.” He punctuated the conversation again, a minute or so of silence. Then he got up, lifting his coffee with a claw-like hand, but turned to Dr. Diaz before shuffling off back toward the elevators and said, “Maybe you should think about it too.”

From a church standpoint, I told him, that wouldn’t fly.

“But what about the Episcopal Church?” he asked. “In most respects they’re more liberal.”

“I’m no expert,” I said, “but I think they call that murder too.”

“Not that I’m decided,” he said. “But what’s really right, here? I mean, people in the camps either died or were eventually freed. An impossible thing to get over but the torment ended. But Mrs. Ca—Mrs. Schwartz—she is back in the camp. She lives it all over again with no hope of reprieve. If God is merciful, how can he let it go on?”

“God is a lot of things,” I said. “He’s jealous; he says so himself. He’s angry, obviously. God is love, too, but that’s not nearly as important as the Protestants would have you believe. It’s not in the Bible, but I suspect He’s also bored. You can’t predict the mind of God, you can’t understand Him. I can take a stab at it, though. Perks of the collar. Perhaps Mrs. Ca-Schwartz is serving as some perfect message to somebody else: to her husband, to you, to a nurse, maybe even to me. In which case I’m sure He’ll balance the account, you know, heaven-wise. Perhaps her soul is seeking some clue lost in those war years which will bring her to the truth of Christ. Or it’s possible—don’t tell anyone I said this—that as a denier of Jesus the Messiah she’s forgone the protection of God. Not covered under warranty, so to speak.”

“I don’t know,” he said. He didn’t follow it up with anything, though I kept waiting. I thought he might fall asleep on the table. Instead he got up, conscientiously wiped the tabletop with his napkin, said “I don’t know” again, and walked off in the direction of the parking lot.

What was I supposed to tell him? If he wanted frou-frou empowerment—“free her from her prison” and whatnot—he’d have asked Derrick. That he asked me was proof enough he wanted a preview of the blowback.  

I remember my own father in his last years, convalescing, yellowing. He suffered, and I thought about it, about kinking a tube with a hairpin or unplugging the monitor whose alarms the nurses mostly ignored anyway. As much for my sake as his. An old Catholic through and through, he loved the suffering. Probably figured he was earning an eternity of foie gras and fellatio. It was him who’d stuck me with my faith. I’d been able to ditch most of the auxiliary aspects. Not convinced He’s listening or that He intervenes, but never able to shake the notion that He’s up there.

I wasn’t sure I believed in hell, but the chance of it was enough to deter me. I thought, What if I go through with it and saddle myself for the rest of my life with this fear of eternal damnation? What if I do the old Kevork’ and just know, just feel in my soul, that I’m going to burn?  So during those years, I just waited for a mercy miracle instead. Kept thinking, this will be when He reveals himself. My dad went from ER to ICU to the general floor to a convalescent home to hospice. It took three and a half years. I remember looking up at the clouds on the day after he passed and asking, Do You really think that counts?   

The next Wednesday I kept waiting to get him alone. Phil and Derrick were so slow on the course I considered uttering an official malediction, but refrained. Best not to draw the eye of Sauron, so to speak, when you yourself are in the splash zone. They did depart to the bathroom together, giving me a few minutes to ask Nick if he’d done it.

“Done what?”

“You know—it.

“Her surgery isn’t until Friday.”

He wound his backswing, then let the head of his club fall into the grass and scrutinized me.

“You didn’t tell anyone, did you?”

“Not yet.”

“What the fuck do you mean, not yet?”

“No—I just mean—no—nobody.”

“Are you going to?”

His golf game had been terrible all night. Derrick and Phil were enjoying the hell out of it, but knowing the cause, I didn’t feel like it counted—like if I lorded it over him he’d just look at me like a prick. Now his swing got really bad. He missed the ball once, then clipped it so far to the left it was gone to the woods forever. “Freebies,” I said. “We won’t mark those. Now what’s your plan?” He set another ball on the tee and launched a high, arching shot that dropped straight into the pond. By then the two lovebirds were speeding back across the green in their cart.

As we played through the sixteenth, Dr. Diaz asked Phil, “What’s the worst thing you can imagine happening to you?”


“No, seriously.”

“Or like, if I could only wear the clothes I wore in middle school, adjusted for size.”


“Velcro sandals. Gecko shorts.”


“All right, already. I guess—well—acid to the face, maybe? Like that lady on the subway. Imagine how bad it hurts, right? And then, your face gone. Just like, melted off, obliterated.”

“Alcoholism,” Derrick said, suddenly serious. “I know it sounds minor, on like a stubbed-toe-to-Holocaust scale, but imagine just hurting everyone you love over and over, worse and worse. Constant, unsatisfiable need. Incurable guilt.” He stopped walking and said, “My father was an alcoholic.” He was clearly expecting the rest of us to stop as well, but Nick and Phil failed to notice and I failed to care.

“Remember that kid that got mauled by a tiger at the zoo The tiger just reached through the bars and, you know: rawr.”

Derrick trotted to catch up. “It destroys families,” he insisted.

“Getting conned,” Phil said. “Losing your life savings and feeling like a dumb jerk.”

The doctor just looked at me quietly, watching me assess their responses.

“Any of these compare?” he asked me.

“Acid to the face…” I said, but the conviction just wasn’t there.

“Come on,” he said. “It’s not hard to see what the right decision is.”

Friday night I knocked on his door. I had to know. His car was in the driveway but he didn’t answer my knock. Same on Saturday and Sunday. He wasn’t at golf the next Wednesday. When he wasn’t at golf the Wednesday after that, and wasn’t answering his cell phone, I drove out to Chestnut Hill again to see him. More lights were on throughout the house this time, and I heard his footfalls on the hardwood approaching the front door. I put on my most winning smile and asked him, “So? Did you set fire to your immortal soul or what?” He waved me in, led me to the den and poured each of us a Calvados.

“They brought her into the hospital and she sat in the waiting room with Mr. Schwartz, checked in. She was mostly lucid. Mornings are a good time for her, even if she’s in an unfamiliar place. My secretary said she came up to the front desk three times just to compliment the ficus.”

Well, after about twenty minutes she asked Mr. Schwartz for a sandwich, said she felt like she hadn’t had any breakfast. Her husband patiently explained to her that she hadn’t had any breakfast and that he couldn’t get her any food because her stomach had to be empty for the surgery. This was when she started getting suspicious. The smile disappeared from her face and her eyes narrowed.

“Of course you wouldn’t,” she said. “Not a crumb of bread for the vermin, you’d say. Good enough for your dirty thoughts but not enough to feed.”  

“Abigail,” her husband said—not her real name, of course. He tried to put a calming hand on her wrist. She grabbed the IV pole and swung it at him with surprising strength, catching him off guard and knocking him out of the chair. Nick went to him on the floor and before he knew it Mrs. Schwartz was darting out of the room. The IV pole jerked as she exhausted the slack. Nick half expected the tape to hold, for his patient’s feet to fly out from beneath her like a cartoon dog at the end of its leash, but instead the needle head ripped right out of her arm and she tore off down the hall trailing blood. Nick ran to the doorway and asked the nurses to call security. Didn’t want to be the one to subdue her, he said, and with good reason: the security guard, a huge fat white guy with a cheap goatee (“Is there any other kind of security guard?” I asked), bear-hugged her before she reached the elevator but with her one free arm she banged so wildly on his face that, when Nick saw him later, the whole left side of it was purple. He’d seen the guy take down PCP musclefreaks with less damage, he said. They sent him down to the minor injury clinic and it turned out she’d fractured his orbital.

While the nurses were getting her into restraints—she wailed and wept horribly—most of the nurses were crying—Dr. Diaz helped Mr. Schwartz back into his chair and administered a quick physical exam. His neck was swollen and sore from where the pole had landed on him, but most of the damage was psychological. It’s mind-bending how far the corners of an old man’s mouth can droop when he’s fighting tears—like weights hung in a slab of old wax. Tears didn’t run but his eyes ran so full with lachrymal fluid it was like they were hiding behind a fishbowl. Nick said it broke his heart. He put his hand on the old man’s knee, looked into the fishbowl eyes, and said: “Your trials are almost over.” He got on the phone with the anesthesiologist and rushed him down to the hospital. Mrs. Schwartz was on the table forty-five minutes later.

“And?” I asked.

Her brainpan was open, Nick said. The mass looked like they’d expected from imaging, suggesting a surgery that wasn’t a walk in the park, but was routine enough. He’d knocked out two or three dozen, no problem. He knew exactly what it would take. Didn’t have to research it; no incriminating Google history. Just nick the internal carotid, two millimeters from the mass, and be a little too slow in correcting it. It happens often enough, and not just to drunks and burn-outs. At the M-and-M no one would ask questions.

He put the scalpel to the artery. The scrub nurse was yakking about his lunch. Apparently it was incumbent upon the doctor to try the chicken salad at the Mediterranean place down the street. Nick said to let him focus. “Everything okay, boss?” the nurse asked. Imagine your bread knife against the crust of a dinner roll, Nick said, your index finger pressing into the back of the blade. One quick vertical movement, one ounce of pressure, and the roll splits open. “That’s where I was, and I was waiting for a moment of moral clarity, to reaffirm the decision I’d already made, and all I could think was ‘chicken salad, chicken salad, chicken salad.’” Poised there, at the very brink of her life, he found himself thinking about whether or not he’d had this particular chicken salad. He thought he had, but if it was as good as Nestor was saying he thought he’d have remembered it better. Were they thinking of different restaurants? he wondered.

“I was blinking and seeing a chicken salad, then opening my eyes to see brain, tumor, artery. I imagined a steak knife cutting through a white strip of chicken breast and that was it: I couldn’t do it. Nor could I think more about it. I reverted to autopilot for the rest of the surgery, clamping, suturing, closing, all the while my conscious mind trying to get a message through, like someone who keeps knocking at your back door. It was trying to ask a question—my mind was—and each incursion was a couple words from a question. ‘Right thing.’ ‘Weren’t you.’ ‘Supposed to.’ With work to do, with focus required, I could keep these words separate. I held them at bay until the surgery was over, and I took a deep breath and her life was back in the hands of the anesthesiologist. Then I could no longer keep them atomized:

“‘The right thing. Weren’t you supposed to do it?’

“‘Weren’t you supposed to do the right thing?’”

By then, it was too late. Her life was back in the hands of God, or at least back in the hands of her husband, if he continued “thinking about” the thing he “thought about” and had asked Nick to “think about too.” Nick said he wasn’t looking forward to meeting Mr. Cavanaugh (you mean Schwartz, I interposed—“Schwartz, exactly,” he corrected) in the waiting room. He didn’t know what face the old man would show him: anger? Disappointment? Despair? He feared it would be that same face he’d seen before the surgery, the sad fishbowl.

Schwartz was pacing in the waiting area. It was the first time the doctor noticed his limp, the kind that makes an old man raise one hip much higher than the other for each step of the left leg, as if the right leg were significantly shorter. With his right hand he made a continuous sub-audible snapping motion. But the pacing, the snapping, they both stopped when he saw Nick walking toward him. His lips dropped open. Nick told him they were able to remove the mass without complications, and that he’d be able to join his wife in recovery within the hour.

“So she’s okay?” Schwartz asked. “Still with us?”

Nick confirmed. Schwartz locked him in a big hug that surprised Nick with its strength. He didn’t think he could have broken out of it if he’d wanted to. Schwartz whispered to him, “You’re a saint. You’re a saint.”  

Her dementia, Nick reminded him, would in all likelihood be the same. The odds of it being aggravated were higher than the odds of it improving. “But she’s still with us,” he said. “Still with us. Blessings on you. Blessings on your children.”

“It wasn’t the time to get into anything else,” Nick told me, “my lack of children, his ongoing struggles. What is it they say in business? If the client is happy, I’m happy.”

“Not in my business,” I said.

He popped in on them in recovery. Mrs. Schwartz’s system was slow to wash out the anesthesia and she was in a half-sleep. Just a crescent of white peeked out from under her eyelids. Mr. Schwartz was in the armchair next to her bed, clasping her hand with one of his and using the other to brush her temple. She was speaking to him, but so softly Nick couldn’t make out what she was saying until he pulled up a chair on the other side of the bed, and even then he could only understand half of her drowsy speech.

“Goldie,” Mr. Schwartz whispered. “Goldie, this is the doctor who saved you.”

“Wussis name?”

“David,” he said, winking at me. “David Epstein.” A gentle smile lightened her face.

“A good Jewish name,” she mumbled.

Good thing her eyes were closed, I told him. Nick looks as Mexican as Pancho Villa. That was that, he said. She went back to her reverie. Mr. Schwartz smiled at him a gracious and silent goodbye, as if he (Schwartz) were holding a sleeping baby in his arms. Off Nick walked, to find an empty break room to cry in for a few minutes. Don’t tell Phil and Derrick, he told me.

“No promises,” I said.

The flashbacks, I asked him, what happened? Did they come back?

“Of course they came back. I called him for a follow-up on Monday. He answered cheerfully with his full name. I could barely hear him over the shrieking in the background. You know those fireworks? Piccolo Pete’s? Sounded like he’d lit off a fleet of them.”

“Everything okay over there?” Nick asked.

“Oh yeah,” Schwartz said. “Just had to close her in the bathroom to take your call. She came at me with a knife this morning.”

“Still the same, then?”

“Yes, sir,” he said.

“I prayed about her getting better. I don’t know if that matters to you, different God and all. It was never in the realm of medicine, but I wanted it. I really did.”

“Same God. Different supporting cast. Listen, Doctor, if you think I could feel anything but gratitude—shit—”

The Piccolo Pete sound gained volume or proximity, Nick said. It was like the sound of a descending artillery shell. There was a crash like a cast iron skillet swung into a tile countertop. “Schwartz? Schwartz?” he called out, but the receiver was abandoned. A few more, milder crashes, something glass breaking, and then the shriek quieting back down like a teakettle taken off the heat.

When Schwartz got back on the line he was out of breath. “Whew,” he said. “It keeps you young.” But he didn’t sound very young, not at all like the sturdy voice that had surprised Nick a few weeks earlier.

“Back under control?”

“Yes, but I shouldn’t talk long. There’s no window in there.”

“I had a moment of weakness,” Nick said. “I had planned….” He faltered, unsure if he should say it. “I had planned differently.”  

“Listen, I have moments of weakness all the time. That’s not what you had.”

Nick didn’t say anything in return. The screaming was muffled again but still impossible to ignore.

“I wasn’t in the camps, you know,” Schwartz said. “But I’ve known a lot of survivors. They talk about the ones who didn’t make it: say you could see it in their eyes. They gave up, didn’t want to keep going. A few days later they’d be dead. That sort of a place, if you didn’t want to keep living you didn’t have to. God’s mercy, maybe, if not the Devil’s. Who can blame the ones who didn’t want to go on? But that was never my Goldie.’”

You’d almost think he liked it, I said to Nick, chasing her around like that. I hadn’t noticed when he’d finished his Calvados. He rubbed his palms together as if for warmth, though the fireplace had the den nice and toasty.

“You know how I got through med school?” he asked.

“Hard work, I’m sure. And maybe some ass-kissing.”


“Prayer, huh?”

“Prayer. I was always asking God for strength. Can’t compare it to the camps, of course, but it was hellish in its own way. I was the smart one in my undergrad. In med school, as the saying goes, everyone is the dumb one. Constantly I just wanted to drop out and pluck up a job in research, but I never did. Just one foot in front of the other, like a good soldier, and I made it through. I suppose I should have thanked God. I made it through, after all. But I never felt that God gave me strength. It felt like I just went on and did it anyway, without strength. Is that sacrilegious?”

“The answer of my vestments is you should always thank God. Whether he did something for you or not, thank God. Whether you need his strength or not, thank God. The Maker, The Ruler, et cetera. But really, who knows? Ever hear God say ‘you’re welcome’?”

“I haven’t,” he said. “But maybe tonight.”

He ushered me out, citing an early morning. Never asked me how I got through seminary. Vodka-cranberry, mostly. I hadn’t really meant to go. Didn’t get into art school. They say you can’t escape history but I could never find it, never had a current of it to push me along anywhere, so I drifted and that’s the shore I found. I had to sneak in the booze. I’d buy sixty-four ounce water bottles at the CVS and dump them in the gutter before pouring in a handle of Stoli. Late at night I’d drink alone in my little dormitory, reading a comic book instead of the Bible. I’d sit there thinking “God will strike me down, God will strike me down.” Another form of call-and-answer. Or apropos of all those nights, call-and-wait.

Sometimes I think God’s answers are like a dog whistle, too high for most of us to hear. Nick stood in his upstairs window, watching me walk down his drive. He cocked his head as if he was listening for it. Who could say what he’d hear? You can’t live your life around it, around waiting for God to do the right thing. Just got to keep moving forward. Winter snow was late this year, fine by me. No dirty clumps of it on the shoes, no slippery sidewalks, no shoveling. To a grown man snow’s all inconvenience. When I was a kid I thought it a miracle.

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