Shama and the Ghost
Chaya Bhuvaneswar
Dr. Shama Mysorekar MD was late for therapy. Since she was the patient here and not the therapist, the lateness could be explained and forgiven, and since the therapist was a good friend of hers, and a mother of two small children who was often late herself, Shama felt sanguine when she sat in the waiting room. Four old Vogues rested in a neat pile on the largest coffee table in the room, a table Shama touched in fond recognition. The Vogues were circa 1991, the year Shama had graduated from high school after being in the US for only five years by then. The table was newer. Shama had come along when her friend had proudly bought the piece on an antiquing trip a few months ago- the first time Shama had understood that "antiquing" could be a verb, the first time she'd realized that now, with only herself to support, she too could afford to buy beautiful things.
Shama the young psychiatrist - or sort of young, at least, at forty-five-- slid all four magazines into her lap before even taking off her coat and wondered, for the hundredth time, if she should risk seeing the man she still thought of as ruining her life, and what the hell she ought to be wearing when she saw him.
Once last year when her therapist was traveling to a conference in Denmark, she'd sent Shama a postcard. That had been before Shama had started therapy, and her friend had wanted to know if Shama thought it would be ok to ask a gorgeous single dad she had met in Copenhagen on a date. The postcard had a photograph of the Little Mermaid, a sculpture that made her look like a young girl, made you forget the cruelty and strangeness of the fairy tale, made you believe in fairy tales. When that postcard arrived, it had cheered Shama at a bleak time.
Around then Shama's grandfather, the person she had cherished most in her life, had just started a long stay in an acute rehab center out in Rochester, a half an hour from where Shama practiced in one of the run-down community clinics at Unity. The rehab center staff told Shama that he had been refusing to cooperate, turning his head away when the physical therapist came on her morning rounds to get him up and walking in the hall. He'd had to be intubated when he first went inpatient and that had been terrible to see, the panicked scratching of his fingers at the mask over the tube, his sheer exhaustion from breathing, his cyanotic lips and the way his hair grew matted and scraggly behind his head, tufting up like an thin, angry bird each time the nurses turned his body or bathed him. There was a smell that clung to Thatha, not urine because of his constant baths but sweat, sebum and age, an old man's smell of fear and fatigue. When Shama touched his stooped, rounded shoulders she wanted to cry for how clearly they signaled his decline.
Since leaving the hospital for the rehab, he'd had the growing delusion that his wife was dead. It had begun the first day at the rehab center, when the man in the bed next to his wept for his own wife who had passed. Throughout that long day, Thatha with Shama sitting beside him was watching as the man's family surrounded him with pictures of the matriarch, bringing flowers of mourning. These struck Thatha as painful reminders of the flowers in the wedding garlands he had exchanged with his wife long ago, he told Shama. Thatha seemed to absorb the man's grief and regret as if they were contagious, breathing them in with the flower scent.
It got to the point where Thatha had to be kept separate from his very-much-alive wife. Believing her to be an imposter, he heaped terms of abuse on her head. She was shaming her family by talking to him, a strange man. She was a whore, a bhutam - a ghost who had become an evil spirit, haunting him. The last time she attempted to bring him a glass of water he had turned his face away and said that if he couldn't have his wife, he didn't want anyone else. It hadn't registered with Thatha that the two of them spoke in Tamil while everyone else in the rehab center addressed him in English, or that Shama's grandmother wore one of the saris Thatha had bought her in Little India in New York City, on a special trip planned by Shama nearly five years ago, when her grandfather was still really alive. On crowded streets in Jackson Heights Thatha had been talking and laughing in the language he had spoken all his life with the people who loved him. After he'd turned away from her his wife had cried for days, then settled into a stoic passivity, letting Shama do the work.
This was what Shama did best - stability, rationality, convincing others not to be afraid of ghosts.
But every day, Shama herself was haunted, and not even by her grandfather's ghost, though he had died in the rehab alone, his wife following about a month after.
Shama had been shaken up earlier today by a sexual proposition from a young woman patient. The girl was nineteen and coping with two babies and a husband addicted to crystal meth and alcohol. "He says he only does the meth so he can keep drinking," she said. "He says he's going to stop when our boy gets into nursery school and is old enough to remember what we do for the rest of his life probably, in his heart and in his spirit and in every cell of his body. I can't stand him, he's such a jerk." She talked fast enough so that Shama had wondered, on her last visit, if the girl was doing an occasional hit of the amphetamines herself now and again. She'd get a tox screen on her next set of routine labs, maybe today, Shama had been thinking as she was listening, vowing to be extra attentive and put her feelers out for any signs of abuse in the relationship, any intimation of violence to anyone in the house, especially the kids. Her mind went through a mental inventory of every detail of the patient's suffering. The moment before the patient grabbed at her breast --when Shama was standing at the door waiting to close it behind the patient once she left-- Shama was floating, detached from her own needs and wants. Shama had been pure empathy. But then after the intended grope Shama had had to step way back and call in a nurse to witness the necessary ensuing discussion about boundaries and not touching in psychiatry and safe space versus self- harming, and as she was talking, the girl began tsking her tongue and rolling her eyes, shaking off the nurse's well-meaning hand on her arm and finally shouting, "Fine, already! Be a prude!" before storming out.
The reason Shama was shaken up wasn't anything the patient or Shama herself had done. Making appropriate responses, proper documentation, witnesses - these had all assuaged Shama's slight and understandable professional anxiety. Shama had been affected by the incident because it made her remember James. It was the kind of encounter James would have thoroughly enjoyed talking about.
James had been her supervisor during a medical school rotation in psychiatry that Shama had enrolled in to try to get into a prestigious residency. But instead of advancing her career, spending four weeks with him had nearly ended it. She felt lucky to get the residency she did, ranked 44th out of a 100, at a university at least and not at an anonymous community hospital. Like the community hospital clinics where Shama worked now.
"Not that I slept with him," Shama was always quick to say, making her friend - her therapist - smile the subtle, tolerant smile that any good shrink could summon up.
Shama hadn't seen or ever tried to contact James for an entire twenty years. But he'd come up again because she had gotten her first paper ever accepted to an academic journal. The paper was about Capgras delusions. Delusional beliefs - among schizophrenia patients, following a stroke, or in any number of conditions - that reality was not to be trusted, not false in substance but prey to imposters; that any human being could easily be replaced, that there were strong forces in the universe deceiving people all the time. She'd written the paper in the hospital waiting room, more forbidding and sterile than this one. She'd written about the nature of several of her patients' fears. She hadn't thought about submitting to journals at first. Writing the paper had only been something to do instead of crying while her grandfather's breathing slowed.
What Shama hadn't admitted in the article: since she had been a little girl in Chennai, cared for by her grandparents since her mother died of cancer and her father shortly thereafter committed suicide, Shama believed with all her heart in both demons and ghosts. She would never be convinced that Capgras patients were wholly deluded. They could be seers, not patients. Especially the ones who saw demons, she thought - they knew the demons were shadows of things, sinister possibilities, substitutes that were a reminder of how powers beyond us could change reality without warning. The seers knew no one was safe. They knew that ghosts didn't care about being believed in.
In Capgras scholarly circles, which Shama hadn't even realized existed, her paper had caused a minor sensation for what in several admiring e-mails people had called its "phenomenology". Just a few months ago Shama received a warm invitation from a famous professor at a famous medical school to come and speak. Once Shama had been a visiting medical student at that school and that was where she'd worked with James.
Now Shama looked up at the therapist's waiting area-clock. She realized her friend must have already taken the next patient, because Shama was late, and that if she was lucky, she would be fit in at the end, two hours from now. She settled in her chair for a rare nap, thinking of James Zimmerman and the moment she had first wanted to have sex with him.
No one could have read her thoughts, she was sure of it. The two of them were sitting at a reasonable distance apart in a tiny, locked room with two residents, all four of them working busily on notes and reading through charts, stopping every now and then to make mean, aggravated-sounding jokes about the most difficult and demanding patients. The two residents were friendly enough so she and James were often left alone. Shama's silence was an expected, perhaps even a required thing, and James ignored her, which was also expected. But the way he talked to patients was seductive to watch. For one thing, he had a physical presence, always immaculately groomed and making Shama wonder what it would have been like to be a real glamour girl, not just pretty but model beautiful, to match the way she suspected he thought about himself. Though minus the perfectly pressed and fitted clothes, his trimness, his carefully cut hair, he would be just average, she thought. Just one other anonymous white man. In patients' rooms though, James became a star. He crossed his arms and stood back just watching the patient, hardly seeming to do anything, then making a comment or two that seemed somehow to create momentum, remove the barriers between the patient and some reality that he or she had thought would be impossible to face. It was strange to watch someone that deliberately charming - flirtatious even, with young, pretty pharmacists or social workers in particular - treat patients with so much kindness, gentleness. It made Shama wonder how much of James’ kindness might be real.
"Are you married?" a young psychotic woman had demanded of him earlier that day. Her hair was askew and she had been wearing a dirty nightgown, but she posed with hand on hip. "I mean, it's a simple yes or no question. Are you married? If you were not married, for example, I could put in my application. I have the right to put in an application, don't I? I'm mailing it in," with utter seriousness, holding a piece of paper and pen as if she were about to fill one out and place it on top of the stack of applications she had already completed, to be the wife of a software tycoon, a Nobel-winning physicist who was no longer alive, and an MTV presenter. But James didn't laugh. He nodded his head with his arms crossed, asked the patient if she was still hearing the voices; stood listening as she asked over and over if he was married, until she exhausted herself and fell silent. The team waited. The patient looked at Shama and James, took a few steps and fell back into the bed, flailing her arms erratically. The nurse whispered, "She's faking a dystonic reaction, she did the same thing last night." The young woman grabbed at James in distress and he didn't flinch. "I'm right here," he said, in a tone of voice that Shama remembered for years, indelibly, as kind, endlessly kind but matter of fact and competent. It was a tone of voice she tried to use with terrified psychotic patients; it was still something he had given Shama to this day in her practice as a psychiatrist, no matter what.
One day toward the end of her first week, Shama had finished her work early and was thinking about James, trying to make sense of the fact that he could be one way with patients, and so different with Arthur, the male resident on their team, a guy who was a former ballet dancer who lived with two former models in a orgy-driven cottage on Sausalito. James was buddy-buddy with Arthur, whom Shama had never seen be kind to anyone. Arthur was a dissolute sort of person who looked for ways to be as disengaged from the patients and the work as possible, who focused on "getting the weekend started right" rather than taking the extra fifteen or twenty minutes it required to make sure nothing would go wrong over the weekend. But instead of taking Arthur aside and talking to him about his carelessness, James chuckled with him about his weekend parties. And forget about teaching Shama, the medical student, anything. James couldn't be bothered to take five minutes and explain why he chose one antidepressant over another, or what had happened to a patient after a major stroke. At first she thought it was because he didn't consider her intelligent enough to understand, and so she took to bringing in the articles she read, talking about their finer points.
James' response to Shama's articles was puzzling and entirely useless. He either gave an infinitesimal nod, suggesting he was bored with her minor observation, or stared hard at her face and mouth before interrupting, say, her presentation of a drug addicted patient, to ask, "Have any of you ever tried cocaine?" - only to tell her about how he dabbed a bit on the inside of his cheek at a party once, and how euphoric it had felt. At her shocked look he'd laughed and said: "If it was good enough for Freud…"
On this particular day, with three whole weeks to go of the rotation, she felt herself becoming increasingly frustrated with James, wanting him to pay the right kind of attention for once. He had been sitting and joking with Arthur for about twenty minutes before she found the courage to interrupt and ask politely when he would be teaching her about any patients. He didn't respond. She looked at Arthur's smirking face, remembering how she had stayed until ten o'clock the night before doing the interview for one of his admissions, doing his work, and found herself standing up to James, saying in a quietly determined way that maybe she would go over and "talk to the team on the other unit", because "they seemed to have more time to teach." It was a direct challenge to his authority from the med student, a lowly and most unlikely source. James the attending finally made full eye contact and nodded, smiling angrily, making her notice his dark and glittering beard. Arthur looked at her nervously. Her whole career in medicine could depend on what James wrote about her at the end of her month of visiting; her whole ability to train and get a job at a merely decent hospital, or a prestigious one, her future position in psychiatry, the city she lived in, the kind of apartment she could afford, the car she drove, perhaps even the man she married and where her children went to school - or so it seemed to Shama then. With a few scribbled lines James had utter discretion to undo everything she had been working so hard for since she stepped onto the plane in Chennai at the age of twelve and came to the US with her grandparents. There was nothing to stop James from writing what he liked. Even though everyone in the room was aware of this, no one said anything, returning to the joking as before, as if nothing had happened. After they left, Shama gathered up her papers, preparing to check on a few orders for one of the patients she was unofficially following. Alone in the room, she felt a strangely precarious satisfaction, as if she owned the room by doing right. "Screw what's his name," she thought, deciding to go to Grand Rounds after all, where she knew James would be at that moment, striding out of the unit as if she weren't afraid of anything.
There must have been something of this self-confident-seeming anxiety in Shama's walk when she appeared in the Grand Rounds lecture hall, in the way she stood against the door and smiled back when James turned to smile like a wolf at her. She was wearing a medium-length, deep-V, wrap dress, a Diane Van Furstenburg she'd gotten at deep discount that skimmed the tops of her knees, her feet in high-heeled clogs that emphasized the delicacy of her ankles, the smoothness of her bare, well-lotioned calves. She was carrying her keys and a handful of change in the same hand and got slightly flustered at making eye contact with him. Naturally the keys and the change dropped, rolling toward him, and as he bent to pick them up he looked at her legs and then her face.
"You can keep it," she found herself muttering, making him laugh as he pressed the coins into her hand, touching her palm with his blunt fingers and making her shake slightly again. People in the back of the room turned to frown at them as the speaker droned on, so Shama walked away with her heart racing. After work that day, at night alone, she hung up the dress and looked at it, looked at herself in the mirror critically for nearly fifteen minutes from every angle, paced the apartment feeling the color and heat in her cheeks, before calming down with ginger tea and scented candles and forcing herself to read another chapter of her psychiatry textbook for next day's rounds.
A few days later Shama and James were sitting in the work room, going through charts. She was pretending not to be aware that he was looking at her, trying to catch her eye as she bent over her notes and gave the appearance of being absorbed in them. She'd just gone over some articles in rounds, the updated treatment guidelines for manic depression, and he'd let her talk for nearly ten minutes, making it clear he wasn't going to punish her for talking back the few days before. She supposed she must have been feeling relaxed, as if they had an understanding now that she was a serious student, more worthy of his time than Arthur and his stupid stories about models in hot tubs. James had even taken the trouble to ask her if she'd ever seen Dr S, a famous neuroscientist at the university, lecture in person, and if she'd ever read his famous monograph. They had been talking all day about patients, some of them truly unnerving. She'd just come out of a room where a patient was describing in vivid detail his fantasies of taking a meat cleaver to his wife. He had in fact picked up a knife and a gun from a hunting shop and begun driving home a few days before, when the wife had gotten a panicked call from his outpatient psychiatrist and left for her mother's house, taking her two young children with her. The patient had been absorbed in his dream world of blood and gore, hardly aware of Shama listening and recording what he said, but she had found him overwhelming. In the room with the patient, Shama had kept calm, but seeing James alone, his eagerness, his interest evident at last, she couldn't resist blurting out, "I couldn't believe that patient's fantasies. They were really crazy, really crazy shit," as if she were back home with a good friend, unwinding over a glass of wine, relieving the stress. There hadn't been anyone else to say it to. When she went back to her apartment, she'd be alone. None of these thoughts relieved her shame when she replayed the conversation later in her mind; none of these facts made it safe to talk to him so casually.
James looked startled but pleased, nodding, then making a show of continuing with his own work, and being too busy and important to talk. "But find me later," he said, pausing near her at the door the workroom, bold enough to touch her bare arm. She looked up into his black eyes, fathomless, ruthless, understanding that simply by her uttering that phrase, "crazy shit," she had let him win again. She wasn't a doctor but an observer. A pretty girl on the sidelines of the serious work he was doing. A cheerleader, a lay person. A lay.
In the end, twenty years later, trying to decide if she was strong enough to go back to that med school where James was still teaching and practicing (she'd looked him up on the Internet the day the speaking invitation came to her e-mail; she'd realized going to speak on Capgras at that medical school meant seeing him again) - it was a set of queasy moments that Shama that she remembered vividly: the day she wore a new diaphanous skirt from The Limited, long sheer layers of silvery gray floating around her hips, flaunting her toned twenty-five-year-old perfectly beautiful, strong thighs underneath. She had been wearing it when she was walking down a corridor with James at the end: he stopped mid-sentence to stare at her. By then he was actively including her, making sure there was time in rounds to listen to her point of view, calling the ward during the day and asking only for her, sort of stalking her. Calling the ward once at night, even, to see "if there was anything she needed" as she continued to stay until nine or ten nearly all the time, doing more and more extra work for the residents. Coming a bit too close to her on the pretext of reading along with her notes; guiding her with his palm at the small of her back when she entered a room in front of him.
His eyes moved over her again when they were sitting at a conference table with a patient, a young, anxious woman Shama's age who was trying to starve herself to death and was afraid of trusting anyone. Shama was patient and firm with her, bolstered her confidence but set clear limits. After nearly a week the patient was smiling more and had begun to gain a few pounds with Shama's daily attention, something she had never before been able to do on her numerous hospitalizations. She had stopped going to the bathroom to vomit up her food. "You did a good job with her," James actually made a point of saying when they were alone after the conference. Shama beamed at him, unguarded, and he stepped closer. "We can talk more later if you want," he said softly, and there was that stare of his again, only by this time it had begun to look like plain neediness, his hand for no reason on Shama's shoulder.
By the end of her last week, she didn't know if she was infatuated with him or worried about him harassing her, only that thoughts of him weighed on her mind, made it nearly unbearable some mornings to be under the bright, sterile glare of the psychiatric ward. At times she would have to leave the ward for the waiting area, walk around and try to compose herself. She'd seen another patient with James, a woman in her late forties whose children had gone off to college, who was presenting with a severe depression. The team had attempted to get her husband involved in the treatment, but she resisted without giving a reason, finally admitting that she no longer trusted him because he was commanding her to watch him masturbate while he watched one sex video after another. The patient's husband talked again and again about how he wanted to "come all over her face", which the patient also perseverated about, finding the image distressing and bringing it up unbidden, even when her husband hadn't been visiting. When Shama tried to present this in euphemistic language on rounds, unwilling to describe the sex acts so explicitly, focusing instead on the possibility of the husband being abusive or coercive, James interrupted with a forceful exclamation. She didn't need to tell him the details; he had already spoken to the patient, read the note, knew everything.
"You never know what the real story is with them, with him making himself hard and jerking off to porn. She could completely enjoy it and just feel guilty about it later. She's probably just not being honest with herself. I mean, she made a point of telling you and telling the person she saw in the ED; she talks about it all the time, thinks about it."
Shama's face was so hot, she felt dizzy. "I have to go now but let's get back to this," he murmured, standing over her and rubbing his beard. "That's okay," she stammered. "I didn't have any more questions. I'll ask one of the residents what to do if something comes up." He stared at her lips for a few seconds more and at the way she touched her collarbone with her fingers nervously, avoiding his gaze. "If you're sure," he said, gathering up his things from the table next to them. "I thought you were interested. In psychiatry."
"Well, do you want to have lunch then?" she blurted out. He nodded, taking a few steps toward her. The room seemed to grow smaller. "To talk about psychiatry," she clarified,before he could speak. Just then the door to the work room opened and one of the senior case managers, a savvy woman in her fifties, addressed them.
"You're having too much fun in here, I can tell. Dr Zimmerman needs to do some work. Come with me, James, hard as it is to tear yourself away."
Shama didn't bring up the idea of lunch with him again, but a few days later, on the very last day of the rotation she worked up the courage to ask for his office number to call him. He gave it to her with a peculiar look, saying, "It's probably best to page me directly. That way I won't miss your call." But she persisted. Holding a chart up to her chest and calling him 'Dr Zimmerman' twice for emphasis, she asked if he would write a support letter for her. He nodded, kind, professional, and she wondered for a minute if she had simply imagined the whole thing. "You've done a great job this month," he said, continuing to be what a psychiatrist would call "appropriate". "You really have." Then he surprised her with a spontaneous apology. "I'm sorry I didn't spend more time in teaching you. I could see you really wanted to learn."
She was confused, even bereft. But it had been what she wanted: her work ethic deflecting the hostility and indifference he'd shown to her at the beginning, the sexual attraction adding an element of - what? Not simple playfulness but three-dimensionality to how he thought of her. He would be sure to remember everything important for the evaluation now. She wouldn't be just an anonymous visiting student, but someone he could describe vividly, someone he could say good things about. She tried to ignore the fear she felt, that he would retaliate in some way for being flirted with, that ultimately she'd lost his respect, as well as her own self respect, for talking to him casually, for letting him touch her, for asking him to lunch, for wearing that gray see-through skirt, for everything she'd thought about. Still standing there, she'd urged herself toward being rational. He'd given her no real reason to fear. Admitting that, she felt calm, she could smile back at him calmly, and she too was "appropriate", albeit still holding the chart up, still covering her chest.
But the in a weak moment, Shama had smashed it all to bits.
Now waiting for her therapist, Shama remembered the day of no return. It was the day after her last working day,a sort-of free day. She'd worked like a dog the night before, staying up to finish all the dictations and paperwork that residents normally did on their own, and had made an appointment to see the chairman of the department where she had been visiting. It was an informal interview, a declaration of interest. She was wearing a knee-length skirt and a bright red top. Nothing clingy or revealing but she looked good. She was fifteen minutes early to her appointment with the Chair and was asking for directions at the front desk when James appeared.
"Are you here for me?" he asked. She shook her head, and the secretary, oblivious, asked him if he would show her the way to the chairman's offices. They were walking down a side corridor when James took her arm, demanding to know why she was really here.
"I'm going to meet the famous Dr F," she repeated, with a mixture of worry and pride, too absorbed in the task of impressing the great man to question why he was asking that. They had stopped near the doorway of an empty room with the lights off.
"We've really missed you on the unit, you know," James said.
"Did you get the materials I left for you, in the envelope?" she half-demanded, stepping out of his light grip. She'd put an envelope with her curricula vitae, an article she'd been a co-author on as a third year medical student, and a blank evaluation form in his mailbox, along with a handwritten personal note that contradicted and undermined all of these items, a note full of longing and ambiguity saying that he "inspired her every day" and that he "rocked". Now she was regretting all of it.
James looked taken off guard. "No, but I'll scramble for them. I'll definitely look for them."
He sounded like a school-boy. Where was the arrogant man she'd seen at first? And what were those gray hairs doing in his beard, the white hairs at his temples, wrinkles in his tanned face?
They were standing at the end of the right corridor. A few more steps and they would be directly in front of the chairman's suite of offices, in full view of two secretaries and three research assistants. But this part of the hallway was empty. He moved closer to her and asked softly, "What exactly did you leave for me?"
"Well, just a note to thank you and say that you were great - I mean, a great attending," she said, more confused and confusing than ever, her eyes wide and alarmed as she heard the words come out. The voice and even the inflection were hers but the mouth was not. "Well, thank you much," he said awkwardly.
Shama was gasping for air, a mermaid that had leaped out of the sea into an unforgiving atmosphere. Phones rang; from a distance, someone laughed. "Well, I'll definitely find it," he promised, before she could reply, looking around as if to make sure no one else had seen them, walking away from Shama with top speed.
About an hour later, after an extremely encouraging interview with the chairman, Shama was back in the corridor that led to James' office. Boldly and senselessly, she sat in his waiting room for nearly half an hour in full view of anyone passing. The reason she gave herself for waiting for him was that she was going to explain what had happened. The truth was that she was desperate to see what he'd do next. It could be that she was supposed to fall in love with James. She was supposed to have his kindness all the time - not just in small parcels of the day, like his unfortunate patients. James would be someone who would comprehend the loss she had suffered from her parents' deaths, without her having to try to find the words for it.
At first he didn't come out of his office, and she hesitated to let him know she was waiting. She almost left, but then stopped at the front desk to check with his secretary to see if he had gone home for the day. The secretary urged Shama to go back and knock on his door. When she finally did, James came out immediately, resting his arms across his chest.
"Did you really meet with the chairman?" he asked. He had left his door open. There was a patient sitting in his room, an elderly woman who looked out at Shama's lovely face and then stared at the ground disconsolately, running her fingers through her faded hair.
She saw the patient, saw James' eagerness; she knew that anything she did or said at that moment would be wrong, just by virtue of her being there. Yet some devil still possessed Shama to say, "I want to find a program where I can have a really good time," emphasis on the "really" instead of the "good". As the words were coming out, she couldn't believe herself. She sounded about as professional as Marilyn Monroe being paid to sing "Happy Birthday" to John F Kennedy, even though all she thought to convey was that she was someone who wanted happiness. That she could fall in love with James.
James forgot himself and broke out into laughter. She stood there, paralyzed, as he gave her another of his scorching looks and reached out for the soft place between her shoulder and breast, rubbing it tenderly and ingeniously with his knuckles in a way that made it impossible not to contemplate what it would be like to have him rub and caress her all over. Standing in front of his office, he didn't kiss her, though he came close enough so that the woman sitting in the office across from his, an older professor who was well respected in her field, stared out her doorway at the two of them with vehement disapproval.
There Shama was, a ridiculous someone. A fish trying to walk with fins. "See you soon," he whispered, going back into his room, seemingly happy and satisfied at how she had just traded her dreams and sacrifice to be a doctor, a serious person in the world, for a vague promise to be with him.
She hadn't seen him again, hadn't returned a call he'd made before she left California. Perhaps he was angry that she'd never given him a chance, or that she'd placed him at risk by writing a letter, because after the rotation, once she was back at her home medical school, her evaluation had come in the mail: a cold one line that gave no hint of any of the work she'd done, any of the effort she'd put in; a lifeless summary that would move her absolutely nowhere in the world, that suggested she had little if any contact with James for the entire month despite having visited the hospital for that purpose, and little contact with patients, for that matter. "Shama was adequate," he'd said. No more. It wasn't even a minimal evaluation, and it was nothing like any of the evaluations Shama received all through med school for working long hours and studying hard. But those had come from a no-name medical school. Ranked 44th. Those wouldn't get her into any top notch residency. Everyone, including James, knew that.
"But the real question," said Shama's therapist twenty years later, "rather than why James might have been angry at you, is - why did you find yourself so drawn to him? Why did you feel that you were powerless?"
In most of her sessions revolving around the lecturer invitation from the med school where James was still practicing, Shama had come no closer to answering that question. She had seen James' shortcomings from the first; she'd even thought about the risks. It still puzzled and dismayed her that she hadn't been able to keep her distance and not blurt things out. Not her, not Shama - the girl who at eleven, before her father had died, never burdened him with her feelings. The woman who, at forty-five, was known for listening compassionately - for sitting silently in staff meetings, then speaking just a few, thoughtful, short words.
But today, waiting for her therapist for two whole hours and sleeping in the waiting room, Shama thought she finally might have guessed. Why James. When her mother was dying of ovarian cancer, belly swollen in a cruel parody of pregnancy, lungs overloaded in what the medical resident self-importantly called, "Meig's syndrome", writing down the name on a card and telling his colleagues that there "might even be a paper in it", Shama began to hate doctors.
When Shama's mother was diagnosed with cancer, Shama was only eleven, and until then she herself had been the neighborhood doctor, the older girl who was always called when some little one fell and scraped his knee or got something in her eyes. Shama was the one believed to be stoic enough to clean her mother's bedpans and soiled saris when Amma was too ashamed to let the servants in the room and see her in this state. Shama was the one who pressed her edematous feet and hands, massaging them with almond oil the way her mother had once massaged Shama in infancy.
Her father couldn't afford to have the doctor come to the house, and so they took her mother to the hospital when there was no way to avoid it. It was a decent enough place compared with the others, but now that Shama had seen the glistening hospital in California she recognized its filth. The resident doctors were indifferent at best, outright rude at other times. In her mother's final days in hospital in India, there had been no women doctors on that ward.
In time Shama developed a full-blown hatred of doctors, and so she determined that she would be a doctor, and that when she became one, she wouldn't put up with arrogant men. Moreover, she decided to be dead. The wish for death had started as a whisper when she was twelve and her father started taking to his bed, depressed. In his suicide note, which Shama's grandfather had hidden away from her in a locked drawer, her father himself said that he was happy to be joining her mother. After losing both of them, Shama felt such a pull to please them by dying too, to be the same as them in misfortune instead of being young and vigorous, a bright, healthy, pretty girl. A girl with a laugh that made others look at her and wonder how to prolong it; a girl that James had been attracted to without question. Every step forward that looked like living was really a step closer to death and undoing. Shama worked long hours in a boring, low-prestige, exhausting job for little pay, but had yet to be on a first name basis with anyone like Dr S or Dr F at the famous med school, who were still alive and emeritus now, still sought after as famous speakers. In twenty years since medical school she had only published one article, even though she had studied so hard and memorized hundreds. But now someone from James' own hospital had invited her, and she could make the famous men know her. She could accept the invitation to California; she could speak to them and captivate. She could even maybe get a plum job now, at a competitive place that might even encourage her. If not in California, somewhere else.
Was it too late? Not about only James, but to want things?
What she'd done was lay waste to her life, not merely squander it. What she'd done was all in the service of trying to be dead. Trudging through residency and then through her practice, dating only casually, not having children though she'd badly wanted them, making Thatha her pet child though he'd been well past eighty when he died.
Yet the impulse for life was still strong in her, guilty as it felt. As much as sleeping with James could have destroyed her career, the pull towards him was from that impulse to be alive, from the desire she could hardly admit to herself - to be taken up, laid down on a bed covered with rose petals, caressed and taught to forget death. But since the day she'd started residency, head down because she’d failed to get the showy win, not going to conferences or traveling, and then as they’d aged, refusing to leave her grandparents even for a weekend, Shama had never gone anywhere where she could meet someone to want as much as she’d once wanted James.
The door of the waiting area opened and a man in his late fifties came through. He looked unnervingly like James. He smiled when Shama caught his eye in wonderment. Then he sat down beside her, kissing her deeply and longingly, touching her shoulders, hair, her neck. She kissed him back, then took him in. He wore a white shirt that glimmered as he breathed, as perfect as when she'd seen him twenty years ago one morning right before their rounds, stepping out of a shining black convertible, immaculate in the dazzling sun.
"Didn't you always want to?" he asked her wistfully, caressing her hair one last time. Then he was gone.
"Thanks for waiting!" Shama's therapist said, holding open the door of her cheery and over-bright office. "We've got a big session ahead. Let's get started."
Shama the young psychiatrist - or sort of young, at least, at forty-five-- slid all four magazines into her lap before even taking off her coat and wondered, for the hundredth time, if she should risk seeing the man she still thought of as ruining her life, and what the hell she ought to be wearing when she saw him.
Once last year when her therapist was traveling to a conference in Denmark, she'd sent Shama a postcard. That had been before Shama had started therapy, and her friend had wanted to know if Shama thought it would be ok to ask a gorgeous single dad she had met in Copenhagen on a date. The postcard had a photograph of the Little Mermaid, a sculpture that made her look like a young girl, made you forget the cruelty and strangeness of the fairy tale, made you believe in fairy tales. When that postcard arrived, it had cheered Shama at a bleak time.
Around then Shama's grandfather, the person she had cherished most in her life, had just started a long stay in an acute rehab center out in Rochester, a half an hour from where Shama practiced in one of the run-down community clinics at Unity. The rehab center staff told Shama that he had been refusing to cooperate, turning his head away when the physical therapist came on her morning rounds to get him up and walking in the hall. He'd had to be intubated when he first went inpatient and that had been terrible to see, the panicked scratching of his fingers at the mask over the tube, his sheer exhaustion from breathing, his cyanotic lips and the way his hair grew matted and scraggly behind his head, tufting up like an thin, angry bird each time the nurses turned his body or bathed him. There was a smell that clung to Thatha, not urine because of his constant baths but sweat, sebum and age, an old man's smell of fear and fatigue. When Shama touched his stooped, rounded shoulders she wanted to cry for how clearly they signaled his decline.
Since leaving the hospital for the rehab, he'd had the growing delusion that his wife was dead. It had begun the first day at the rehab center, when the man in the bed next to his wept for his own wife who had passed. Throughout that long day, Thatha with Shama sitting beside him was watching as the man's family surrounded him with pictures of the matriarch, bringing flowers of mourning. These struck Thatha as painful reminders of the flowers in the wedding garlands he had exchanged with his wife long ago, he told Shama. Thatha seemed to absorb the man's grief and regret as if they were contagious, breathing them in with the flower scent.
It got to the point where Thatha had to be kept separate from his very-much-alive wife. Believing her to be an imposter, he heaped terms of abuse on her head. She was shaming her family by talking to him, a strange man. She was a whore, a bhutam - a ghost who had become an evil spirit, haunting him. The last time she attempted to bring him a glass of water he had turned his face away and said that if he couldn't have his wife, he didn't want anyone else. It hadn't registered with Thatha that the two of them spoke in Tamil while everyone else in the rehab center addressed him in English, or that Shama's grandmother wore one of the saris Thatha had bought her in Little India in New York City, on a special trip planned by Shama nearly five years ago, when her grandfather was still really alive. On crowded streets in Jackson Heights Thatha had been talking and laughing in the language he had spoken all his life with the people who loved him. After he'd turned away from her his wife had cried for days, then settled into a stoic passivity, letting Shama do the work.
This was what Shama did best - stability, rationality, convincing others not to be afraid of ghosts.
But every day, Shama herself was haunted, and not even by her grandfather's ghost, though he had died in the rehab alone, his wife following about a month after.
Shama had been shaken up earlier today by a sexual proposition from a young woman patient. The girl was nineteen and coping with two babies and a husband addicted to crystal meth and alcohol. "He says he only does the meth so he can keep drinking," she said. "He says he's going to stop when our boy gets into nursery school and is old enough to remember what we do for the rest of his life probably, in his heart and in his spirit and in every cell of his body. I can't stand him, he's such a jerk." She talked fast enough so that Shama had wondered, on her last visit, if the girl was doing an occasional hit of the amphetamines herself now and again. She'd get a tox screen on her next set of routine labs, maybe today, Shama had been thinking as she was listening, vowing to be extra attentive and put her feelers out for any signs of abuse in the relationship, any intimation of violence to anyone in the house, especially the kids. Her mind went through a mental inventory of every detail of the patient's suffering. The moment before the patient grabbed at her breast --when Shama was standing at the door waiting to close it behind the patient once she left-- Shama was floating, detached from her own needs and wants. Shama had been pure empathy. But then after the intended grope Shama had had to step way back and call in a nurse to witness the necessary ensuing discussion about boundaries and not touching in psychiatry and safe space versus self- harming, and as she was talking, the girl began tsking her tongue and rolling her eyes, shaking off the nurse's well-meaning hand on her arm and finally shouting, "Fine, already! Be a prude!" before storming out.
The reason Shama was shaken up wasn't anything the patient or Shama herself had done. Making appropriate responses, proper documentation, witnesses - these had all assuaged Shama's slight and understandable professional anxiety. Shama had been affected by the incident because it made her remember James. It was the kind of encounter James would have thoroughly enjoyed talking about.
James had been her supervisor during a medical school rotation in psychiatry that Shama had enrolled in to try to get into a prestigious residency. But instead of advancing her career, spending four weeks with him had nearly ended it. She felt lucky to get the residency she did, ranked 44th out of a 100, at a university at least and not at an anonymous community hospital. Like the community hospital clinics where Shama worked now.
"Not that I slept with him," Shama was always quick to say, making her friend - her therapist - smile the subtle, tolerant smile that any good shrink could summon up.
Shama hadn't seen or ever tried to contact James for an entire twenty years. But he'd come up again because she had gotten her first paper ever accepted to an academic journal. The paper was about Capgras delusions. Delusional beliefs - among schizophrenia patients, following a stroke, or in any number of conditions - that reality was not to be trusted, not false in substance but prey to imposters; that any human being could easily be replaced, that there were strong forces in the universe deceiving people all the time. She'd written the paper in the hospital waiting room, more forbidding and sterile than this one. She'd written about the nature of several of her patients' fears. She hadn't thought about submitting to journals at first. Writing the paper had only been something to do instead of crying while her grandfather's breathing slowed.
What Shama hadn't admitted in the article: since she had been a little girl in Chennai, cared for by her grandparents since her mother died of cancer and her father shortly thereafter committed suicide, Shama believed with all her heart in both demons and ghosts. She would never be convinced that Capgras patients were wholly deluded. They could be seers, not patients. Especially the ones who saw demons, she thought - they knew the demons were shadows of things, sinister possibilities, substitutes that were a reminder of how powers beyond us could change reality without warning. The seers knew no one was safe. They knew that ghosts didn't care about being believed in.
In Capgras scholarly circles, which Shama hadn't even realized existed, her paper had caused a minor sensation for what in several admiring e-mails people had called its "phenomenology". Just a few months ago Shama received a warm invitation from a famous professor at a famous medical school to come and speak. Once Shama had been a visiting medical student at that school and that was where she'd worked with James.
Now Shama looked up at the therapist's waiting area-clock. She realized her friend must have already taken the next patient, because Shama was late, and that if she was lucky, she would be fit in at the end, two hours from now. She settled in her chair for a rare nap, thinking of James Zimmerman and the moment she had first wanted to have sex with him.
No one could have read her thoughts, she was sure of it. The two of them were sitting at a reasonable distance apart in a tiny, locked room with two residents, all four of them working busily on notes and reading through charts, stopping every now and then to make mean, aggravated-sounding jokes about the most difficult and demanding patients. The two residents were friendly enough so she and James were often left alone. Shama's silence was an expected, perhaps even a required thing, and James ignored her, which was also expected. But the way he talked to patients was seductive to watch. For one thing, he had a physical presence, always immaculately groomed and making Shama wonder what it would have been like to be a real glamour girl, not just pretty but model beautiful, to match the way she suspected he thought about himself. Though minus the perfectly pressed and fitted clothes, his trimness, his carefully cut hair, he would be just average, she thought. Just one other anonymous white man. In patients' rooms though, James became a star. He crossed his arms and stood back just watching the patient, hardly seeming to do anything, then making a comment or two that seemed somehow to create momentum, remove the barriers between the patient and some reality that he or she had thought would be impossible to face. It was strange to watch someone that deliberately charming - flirtatious even, with young, pretty pharmacists or social workers in particular - treat patients with so much kindness, gentleness. It made Shama wonder how much of James’ kindness might be real.
"Are you married?" a young psychotic woman had demanded of him earlier that day. Her hair was askew and she had been wearing a dirty nightgown, but she posed with hand on hip. "I mean, it's a simple yes or no question. Are you married? If you were not married, for example, I could put in my application. I have the right to put in an application, don't I? I'm mailing it in," with utter seriousness, holding a piece of paper and pen as if she were about to fill one out and place it on top of the stack of applications she had already completed, to be the wife of a software tycoon, a Nobel-winning physicist who was no longer alive, and an MTV presenter. But James didn't laugh. He nodded his head with his arms crossed, asked the patient if she was still hearing the voices; stood listening as she asked over and over if he was married, until she exhausted herself and fell silent. The team waited. The patient looked at Shama and James, took a few steps and fell back into the bed, flailing her arms erratically. The nurse whispered, "She's faking a dystonic reaction, she did the same thing last night." The young woman grabbed at James in distress and he didn't flinch. "I'm right here," he said, in a tone of voice that Shama remembered for years, indelibly, as kind, endlessly kind but matter of fact and competent. It was a tone of voice she tried to use with terrified psychotic patients; it was still something he had given Shama to this day in her practice as a psychiatrist, no matter what.
One day toward the end of her first week, Shama had finished her work early and was thinking about James, trying to make sense of the fact that he could be one way with patients, and so different with Arthur, the male resident on their team, a guy who was a former ballet dancer who lived with two former models in a orgy-driven cottage on Sausalito. James was buddy-buddy with Arthur, whom Shama had never seen be kind to anyone. Arthur was a dissolute sort of person who looked for ways to be as disengaged from the patients and the work as possible, who focused on "getting the weekend started right" rather than taking the extra fifteen or twenty minutes it required to make sure nothing would go wrong over the weekend. But instead of taking Arthur aside and talking to him about his carelessness, James chuckled with him about his weekend parties. And forget about teaching Shama, the medical student, anything. James couldn't be bothered to take five minutes and explain why he chose one antidepressant over another, or what had happened to a patient after a major stroke. At first she thought it was because he didn't consider her intelligent enough to understand, and so she took to bringing in the articles she read, talking about their finer points.
James' response to Shama's articles was puzzling and entirely useless. He either gave an infinitesimal nod, suggesting he was bored with her minor observation, or stared hard at her face and mouth before interrupting, say, her presentation of a drug addicted patient, to ask, "Have any of you ever tried cocaine?" - only to tell her about how he dabbed a bit on the inside of his cheek at a party once, and how euphoric it had felt. At her shocked look he'd laughed and said: "If it was good enough for Freud…"
On this particular day, with three whole weeks to go of the rotation, she felt herself becoming increasingly frustrated with James, wanting him to pay the right kind of attention for once. He had been sitting and joking with Arthur for about twenty minutes before she found the courage to interrupt and ask politely when he would be teaching her about any patients. He didn't respond. She looked at Arthur's smirking face, remembering how she had stayed until ten o'clock the night before doing the interview for one of his admissions, doing his work, and found herself standing up to James, saying in a quietly determined way that maybe she would go over and "talk to the team on the other unit", because "they seemed to have more time to teach." It was a direct challenge to his authority from the med student, a lowly and most unlikely source. James the attending finally made full eye contact and nodded, smiling angrily, making her notice his dark and glittering beard. Arthur looked at her nervously. Her whole career in medicine could depend on what James wrote about her at the end of her month of visiting; her whole ability to train and get a job at a merely decent hospital, or a prestigious one, her future position in psychiatry, the city she lived in, the kind of apartment she could afford, the car she drove, perhaps even the man she married and where her children went to school - or so it seemed to Shama then. With a few scribbled lines James had utter discretion to undo everything she had been working so hard for since she stepped onto the plane in Chennai at the age of twelve and came to the US with her grandparents. There was nothing to stop James from writing what he liked. Even though everyone in the room was aware of this, no one said anything, returning to the joking as before, as if nothing had happened. After they left, Shama gathered up her papers, preparing to check on a few orders for one of the patients she was unofficially following. Alone in the room, she felt a strangely precarious satisfaction, as if she owned the room by doing right. "Screw what's his name," she thought, deciding to go to Grand Rounds after all, where she knew James would be at that moment, striding out of the unit as if she weren't afraid of anything.
There must have been something of this self-confident-seeming anxiety in Shama's walk when she appeared in the Grand Rounds lecture hall, in the way she stood against the door and smiled back when James turned to smile like a wolf at her. She was wearing a medium-length, deep-V, wrap dress, a Diane Van Furstenburg she'd gotten at deep discount that skimmed the tops of her knees, her feet in high-heeled clogs that emphasized the delicacy of her ankles, the smoothness of her bare, well-lotioned calves. She was carrying her keys and a handful of change in the same hand and got slightly flustered at making eye contact with him. Naturally the keys and the change dropped, rolling toward him, and as he bent to pick them up he looked at her legs and then her face.
"You can keep it," she found herself muttering, making him laugh as he pressed the coins into her hand, touching her palm with his blunt fingers and making her shake slightly again. People in the back of the room turned to frown at them as the speaker droned on, so Shama walked away with her heart racing. After work that day, at night alone, she hung up the dress and looked at it, looked at herself in the mirror critically for nearly fifteen minutes from every angle, paced the apartment feeling the color and heat in her cheeks, before calming down with ginger tea and scented candles and forcing herself to read another chapter of her psychiatry textbook for next day's rounds.
A few days later Shama and James were sitting in the work room, going through charts. She was pretending not to be aware that he was looking at her, trying to catch her eye as she bent over her notes and gave the appearance of being absorbed in them. She'd just gone over some articles in rounds, the updated treatment guidelines for manic depression, and he'd let her talk for nearly ten minutes, making it clear he wasn't going to punish her for talking back the few days before. She supposed she must have been feeling relaxed, as if they had an understanding now that she was a serious student, more worthy of his time than Arthur and his stupid stories about models in hot tubs. James had even taken the trouble to ask her if she'd ever seen Dr S, a famous neuroscientist at the university, lecture in person, and if she'd ever read his famous monograph. They had been talking all day about patients, some of them truly unnerving. She'd just come out of a room where a patient was describing in vivid detail his fantasies of taking a meat cleaver to his wife. He had in fact picked up a knife and a gun from a hunting shop and begun driving home a few days before, when the wife had gotten a panicked call from his outpatient psychiatrist and left for her mother's house, taking her two young children with her. The patient had been absorbed in his dream world of blood and gore, hardly aware of Shama listening and recording what he said, but she had found him overwhelming. In the room with the patient, Shama had kept calm, but seeing James alone, his eagerness, his interest evident at last, she couldn't resist blurting out, "I couldn't believe that patient's fantasies. They were really crazy, really crazy shit," as if she were back home with a good friend, unwinding over a glass of wine, relieving the stress. There hadn't been anyone else to say it to. When she went back to her apartment, she'd be alone. None of these thoughts relieved her shame when she replayed the conversation later in her mind; none of these facts made it safe to talk to him so casually.
James looked startled but pleased, nodding, then making a show of continuing with his own work, and being too busy and important to talk. "But find me later," he said, pausing near her at the door the workroom, bold enough to touch her bare arm. She looked up into his black eyes, fathomless, ruthless, understanding that simply by her uttering that phrase, "crazy shit," she had let him win again. She wasn't a doctor but an observer. A pretty girl on the sidelines of the serious work he was doing. A cheerleader, a lay person. A lay.
In the end, twenty years later, trying to decide if she was strong enough to go back to that med school where James was still teaching and practicing (she'd looked him up on the Internet the day the speaking invitation came to her e-mail; she'd realized going to speak on Capgras at that medical school meant seeing him again) - it was a set of queasy moments that Shama that she remembered vividly: the day she wore a new diaphanous skirt from The Limited, long sheer layers of silvery gray floating around her hips, flaunting her toned twenty-five-year-old perfectly beautiful, strong thighs underneath. She had been wearing it when she was walking down a corridor with James at the end: he stopped mid-sentence to stare at her. By then he was actively including her, making sure there was time in rounds to listen to her point of view, calling the ward during the day and asking only for her, sort of stalking her. Calling the ward once at night, even, to see "if there was anything she needed" as she continued to stay until nine or ten nearly all the time, doing more and more extra work for the residents. Coming a bit too close to her on the pretext of reading along with her notes; guiding her with his palm at the small of her back when she entered a room in front of him.
His eyes moved over her again when they were sitting at a conference table with a patient, a young, anxious woman Shama's age who was trying to starve herself to death and was afraid of trusting anyone. Shama was patient and firm with her, bolstered her confidence but set clear limits. After nearly a week the patient was smiling more and had begun to gain a few pounds with Shama's daily attention, something she had never before been able to do on her numerous hospitalizations. She had stopped going to the bathroom to vomit up her food. "You did a good job with her," James actually made a point of saying when they were alone after the conference. Shama beamed at him, unguarded, and he stepped closer. "We can talk more later if you want," he said softly, and there was that stare of his again, only by this time it had begun to look like plain neediness, his hand for no reason on Shama's shoulder.
By the end of her last week, she didn't know if she was infatuated with him or worried about him harassing her, only that thoughts of him weighed on her mind, made it nearly unbearable some mornings to be under the bright, sterile glare of the psychiatric ward. At times she would have to leave the ward for the waiting area, walk around and try to compose herself. She'd seen another patient with James, a woman in her late forties whose children had gone off to college, who was presenting with a severe depression. The team had attempted to get her husband involved in the treatment, but she resisted without giving a reason, finally admitting that she no longer trusted him because he was commanding her to watch him masturbate while he watched one sex video after another. The patient's husband talked again and again about how he wanted to "come all over her face", which the patient also perseverated about, finding the image distressing and bringing it up unbidden, even when her husband hadn't been visiting. When Shama tried to present this in euphemistic language on rounds, unwilling to describe the sex acts so explicitly, focusing instead on the possibility of the husband being abusive or coercive, James interrupted with a forceful exclamation. She didn't need to tell him the details; he had already spoken to the patient, read the note, knew everything.
"You never know what the real story is with them, with him making himself hard and jerking off to porn. She could completely enjoy it and just feel guilty about it later. She's probably just not being honest with herself. I mean, she made a point of telling you and telling the person she saw in the ED; she talks about it all the time, thinks about it."
Shama's face was so hot, she felt dizzy. "I have to go now but let's get back to this," he murmured, standing over her and rubbing his beard. "That's okay," she stammered. "I didn't have any more questions. I'll ask one of the residents what to do if something comes up." He stared at her lips for a few seconds more and at the way she touched her collarbone with her fingers nervously, avoiding his gaze. "If you're sure," he said, gathering up his things from the table next to them. "I thought you were interested. In psychiatry."
"Well, do you want to have lunch then?" she blurted out. He nodded, taking a few steps toward her. The room seemed to grow smaller. "To talk about psychiatry," she clarified,before he could speak. Just then the door to the work room opened and one of the senior case managers, a savvy woman in her fifties, addressed them.
"You're having too much fun in here, I can tell. Dr Zimmerman needs to do some work. Come with me, James, hard as it is to tear yourself away."
Shama didn't bring up the idea of lunch with him again, but a few days later, on the very last day of the rotation she worked up the courage to ask for his office number to call him. He gave it to her with a peculiar look, saying, "It's probably best to page me directly. That way I won't miss your call." But she persisted. Holding a chart up to her chest and calling him 'Dr Zimmerman' twice for emphasis, she asked if he would write a support letter for her. He nodded, kind, professional, and she wondered for a minute if she had simply imagined the whole thing. "You've done a great job this month," he said, continuing to be what a psychiatrist would call "appropriate". "You really have." Then he surprised her with a spontaneous apology. "I'm sorry I didn't spend more time in teaching you. I could see you really wanted to learn."
She was confused, even bereft. But it had been what she wanted: her work ethic deflecting the hostility and indifference he'd shown to her at the beginning, the sexual attraction adding an element of - what? Not simple playfulness but three-dimensionality to how he thought of her. He would be sure to remember everything important for the evaluation now. She wouldn't be just an anonymous visiting student, but someone he could describe vividly, someone he could say good things about. She tried to ignore the fear she felt, that he would retaliate in some way for being flirted with, that ultimately she'd lost his respect, as well as her own self respect, for talking to him casually, for letting him touch her, for asking him to lunch, for wearing that gray see-through skirt, for everything she'd thought about. Still standing there, she'd urged herself toward being rational. He'd given her no real reason to fear. Admitting that, she felt calm, she could smile back at him calmly, and she too was "appropriate", albeit still holding the chart up, still covering her chest.
But the in a weak moment, Shama had smashed it all to bits.
Now waiting for her therapist, Shama remembered the day of no return. It was the day after her last working day,a sort-of free day. She'd worked like a dog the night before, staying up to finish all the dictations and paperwork that residents normally did on their own, and had made an appointment to see the chairman of the department where she had been visiting. It was an informal interview, a declaration of interest. She was wearing a knee-length skirt and a bright red top. Nothing clingy or revealing but she looked good. She was fifteen minutes early to her appointment with the Chair and was asking for directions at the front desk when James appeared.
"Are you here for me?" he asked. She shook her head, and the secretary, oblivious, asked him if he would show her the way to the chairman's offices. They were walking down a side corridor when James took her arm, demanding to know why she was really here.
"I'm going to meet the famous Dr F," she repeated, with a mixture of worry and pride, too absorbed in the task of impressing the great man to question why he was asking that. They had stopped near the doorway of an empty room with the lights off.
"We've really missed you on the unit, you know," James said.
"Did you get the materials I left for you, in the envelope?" she half-demanded, stepping out of his light grip. She'd put an envelope with her curricula vitae, an article she'd been a co-author on as a third year medical student, and a blank evaluation form in his mailbox, along with a handwritten personal note that contradicted and undermined all of these items, a note full of longing and ambiguity saying that he "inspired her every day" and that he "rocked". Now she was regretting all of it.
James looked taken off guard. "No, but I'll scramble for them. I'll definitely look for them."
He sounded like a school-boy. Where was the arrogant man she'd seen at first? And what were those gray hairs doing in his beard, the white hairs at his temples, wrinkles in his tanned face?
They were standing at the end of the right corridor. A few more steps and they would be directly in front of the chairman's suite of offices, in full view of two secretaries and three research assistants. But this part of the hallway was empty. He moved closer to her and asked softly, "What exactly did you leave for me?"
"Well, just a note to thank you and say that you were great - I mean, a great attending," she said, more confused and confusing than ever, her eyes wide and alarmed as she heard the words come out. The voice and even the inflection were hers but the mouth was not. "Well, thank you much," he said awkwardly.
Shama was gasping for air, a mermaid that had leaped out of the sea into an unforgiving atmosphere. Phones rang; from a distance, someone laughed. "Well, I'll definitely find it," he promised, before she could reply, looking around as if to make sure no one else had seen them, walking away from Shama with top speed.
About an hour later, after an extremely encouraging interview with the chairman, Shama was back in the corridor that led to James' office. Boldly and senselessly, she sat in his waiting room for nearly half an hour in full view of anyone passing. The reason she gave herself for waiting for him was that she was going to explain what had happened. The truth was that she was desperate to see what he'd do next. It could be that she was supposed to fall in love with James. She was supposed to have his kindness all the time - not just in small parcels of the day, like his unfortunate patients. James would be someone who would comprehend the loss she had suffered from her parents' deaths, without her having to try to find the words for it.
At first he didn't come out of his office, and she hesitated to let him know she was waiting. She almost left, but then stopped at the front desk to check with his secretary to see if he had gone home for the day. The secretary urged Shama to go back and knock on his door. When she finally did, James came out immediately, resting his arms across his chest.
"Did you really meet with the chairman?" he asked. He had left his door open. There was a patient sitting in his room, an elderly woman who looked out at Shama's lovely face and then stared at the ground disconsolately, running her fingers through her faded hair.
She saw the patient, saw James' eagerness; she knew that anything she did or said at that moment would be wrong, just by virtue of her being there. Yet some devil still possessed Shama to say, "I want to find a program where I can have a really good time," emphasis on the "really" instead of the "good". As the words were coming out, she couldn't believe herself. She sounded about as professional as Marilyn Monroe being paid to sing "Happy Birthday" to John F Kennedy, even though all she thought to convey was that she was someone who wanted happiness. That she could fall in love with James.
James forgot himself and broke out into laughter. She stood there, paralyzed, as he gave her another of his scorching looks and reached out for the soft place between her shoulder and breast, rubbing it tenderly and ingeniously with his knuckles in a way that made it impossible not to contemplate what it would be like to have him rub and caress her all over. Standing in front of his office, he didn't kiss her, though he came close enough so that the woman sitting in the office across from his, an older professor who was well respected in her field, stared out her doorway at the two of them with vehement disapproval.
There Shama was, a ridiculous someone. A fish trying to walk with fins. "See you soon," he whispered, going back into his room, seemingly happy and satisfied at how she had just traded her dreams and sacrifice to be a doctor, a serious person in the world, for a vague promise to be with him.
She hadn't seen him again, hadn't returned a call he'd made before she left California. Perhaps he was angry that she'd never given him a chance, or that she'd placed him at risk by writing a letter, because after the rotation, once she was back at her home medical school, her evaluation had come in the mail: a cold one line that gave no hint of any of the work she'd done, any of the effort she'd put in; a lifeless summary that would move her absolutely nowhere in the world, that suggested she had little if any contact with James for the entire month despite having visited the hospital for that purpose, and little contact with patients, for that matter. "Shama was adequate," he'd said. No more. It wasn't even a minimal evaluation, and it was nothing like any of the evaluations Shama received all through med school for working long hours and studying hard. But those had come from a no-name medical school. Ranked 44th. Those wouldn't get her into any top notch residency. Everyone, including James, knew that.
"But the real question," said Shama's therapist twenty years later, "rather than why James might have been angry at you, is - why did you find yourself so drawn to him? Why did you feel that you were powerless?"
In most of her sessions revolving around the lecturer invitation from the med school where James was still practicing, Shama had come no closer to answering that question. She had seen James' shortcomings from the first; she'd even thought about the risks. It still puzzled and dismayed her that she hadn't been able to keep her distance and not blurt things out. Not her, not Shama - the girl who at eleven, before her father had died, never burdened him with her feelings. The woman who, at forty-five, was known for listening compassionately - for sitting silently in staff meetings, then speaking just a few, thoughtful, short words.
But today, waiting for her therapist for two whole hours and sleeping in the waiting room, Shama thought she finally might have guessed. Why James. When her mother was dying of ovarian cancer, belly swollen in a cruel parody of pregnancy, lungs overloaded in what the medical resident self-importantly called, "Meig's syndrome", writing down the name on a card and telling his colleagues that there "might even be a paper in it", Shama began to hate doctors.
When Shama's mother was diagnosed with cancer, Shama was only eleven, and until then she herself had been the neighborhood doctor, the older girl who was always called when some little one fell and scraped his knee or got something in her eyes. Shama was the one believed to be stoic enough to clean her mother's bedpans and soiled saris when Amma was too ashamed to let the servants in the room and see her in this state. Shama was the one who pressed her edematous feet and hands, massaging them with almond oil the way her mother had once massaged Shama in infancy.
Her father couldn't afford to have the doctor come to the house, and so they took her mother to the hospital when there was no way to avoid it. It was a decent enough place compared with the others, but now that Shama had seen the glistening hospital in California she recognized its filth. The resident doctors were indifferent at best, outright rude at other times. In her mother's final days in hospital in India, there had been no women doctors on that ward.
In time Shama developed a full-blown hatred of doctors, and so she determined that she would be a doctor, and that when she became one, she wouldn't put up with arrogant men. Moreover, she decided to be dead. The wish for death had started as a whisper when she was twelve and her father started taking to his bed, depressed. In his suicide note, which Shama's grandfather had hidden away from her in a locked drawer, her father himself said that he was happy to be joining her mother. After losing both of them, Shama felt such a pull to please them by dying too, to be the same as them in misfortune instead of being young and vigorous, a bright, healthy, pretty girl. A girl with a laugh that made others look at her and wonder how to prolong it; a girl that James had been attracted to without question. Every step forward that looked like living was really a step closer to death and undoing. Shama worked long hours in a boring, low-prestige, exhausting job for little pay, but had yet to be on a first name basis with anyone like Dr S or Dr F at the famous med school, who were still alive and emeritus now, still sought after as famous speakers. In twenty years since medical school she had only published one article, even though she had studied so hard and memorized hundreds. But now someone from James' own hospital had invited her, and she could make the famous men know her. She could accept the invitation to California; she could speak to them and captivate. She could even maybe get a plum job now, at a competitive place that might even encourage her. If not in California, somewhere else.
Was it too late? Not about only James, but to want things?
What she'd done was lay waste to her life, not merely squander it. What she'd done was all in the service of trying to be dead. Trudging through residency and then through her practice, dating only casually, not having children though she'd badly wanted them, making Thatha her pet child though he'd been well past eighty when he died.
Yet the impulse for life was still strong in her, guilty as it felt. As much as sleeping with James could have destroyed her career, the pull towards him was from that impulse to be alive, from the desire she could hardly admit to herself - to be taken up, laid down on a bed covered with rose petals, caressed and taught to forget death. But since the day she'd started residency, head down because she’d failed to get the showy win, not going to conferences or traveling, and then as they’d aged, refusing to leave her grandparents even for a weekend, Shama had never gone anywhere where she could meet someone to want as much as she’d once wanted James.
The door of the waiting area opened and a man in his late fifties came through. He looked unnervingly like James. He smiled when Shama caught his eye in wonderment. Then he sat down beside her, kissing her deeply and longingly, touching her shoulders, hair, her neck. She kissed him back, then took him in. He wore a white shirt that glimmered as he breathed, as perfect as when she'd seen him twenty years ago one morning right before their rounds, stepping out of a shining black convertible, immaculate in the dazzling sun.
"Didn't you always want to?" he asked her wistfully, caressing her hair one last time. Then he was gone.
"Thanks for waiting!" Shama's therapist said, holding open the door of her cheery and over-bright office. "We've got a big session ahead. Let's get started."
