Still Life in Shadow (16)

Still Life In Shadow

or: The Order of the Universe, In a Smile

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She presented herself as a simple woman, and it had been said of her -- for as long as anyone on the island could remember -- that she had been unassuming, almost plain -- even when she was young. Before she left for Zurich.

But that was so long ago.

She had always been considered brilliant, even before the first day she first walked to the island school. She was different, and though not everyone understood her peculiar gift, that doesn't really account for what happened in our time together.

Maria Louisa D'Alessandro was her name. She was Portuguese, but after finishing medical studies in Switzerland she had unaccountably returned to her family's home near Horta, on the island of Faial in the Azores, and she had been practicing medicine there for almost thirty years -- when I stumbled along and became a part of her story.

She was a surgeon at the only hospital on the island, and she ran an inter-island clinic for off-islanders as well, and she had come to be regarded as something of a saint by almost every inhabitant of the island chain. She was an oddity within the medical profession, too. She had trained in cardiovascular surgery but had simply picked up and left that high-pressure world -- the bustle of Zurich, the certain promise of a celebrated career -- and returned to this last outpost of the Portuguese empire, to this end of the line. Who can say, really, why. Did she return to get as far away from that fast-paced world as she could?

Again, no one knew her reasons, not really. Those who spend their lives worrying about such things often said a man was involved, but her return wasn't really an open mystery anymore. The who and the why of it had, over the years, simply faded away. Gone too were the days, just after her return, when the young physician was looked on with lingering suspicion; she was brilliant, and she belonged to them -- and so what if she returned? The men who once tried to win her heart stopped trying, left to make homes with other women, or they had gone to the sea, fishing perhaps -- and on to their final rests.

Yes, that early part of her life was now little more than a memory; mysteries of uncertain unions, too, were now all of that untested past. Maria Louisa D'Alessandro watched all these mysteries play out in remotest seclusion, ignored the gossip as she watched the gossipers come and go, and she did so with kindness in her heart for everyone, for she possessed, in word and deed, a kind soul.

A Saint, if you really must know the truth of it.

Maria lived in her family's house, a small whitewashed stone cottage on the south side of the island, in a little village outside of Horta known as Pasteleiro. Her house, like many others on the island, sat just back from a cliff that looked out over the Atlantic Ocean, yet it was in her south-facing garden - a world apart full of gardenia and azalea blossoms most of the year - that Maria found what real peace there was to be had in this life. When not seeing patients in her clinic, or at the hospital in it's one operating room, Maria would inevitably be found on her knees, in her garden, slowly, perhaps even lovingly -- working on the petals of her God's creation.

Almost without exception, Maria would each day make dinner for herself at home. When the weather was stormy she certainly find her inside by the house's old, stone fireplace. Max would be there with her -- right by her side. Max, her soulfully faithful and very old Bernese Mountain Dog, a massive black mound of fur -- with copper and white accents on his face and belly. They had, on their many stormy evenings together, looked out over mad, storm-tossed seas and wondered what furies danced in the heavens to create such majestic anarchy. Max would sit closely by her side on those nights, warm her feet and watch her with all the love and affection of any loving husband, and he was happy in this world, happy with his life, and happy with Maria -- in the one and only way dogs know and understand our world.

In the normal, sun-drenched evenings of her island home, Maria would sit in her garden as the sun set and have a light salad, and perhaps some cheese with her wine, and invariably, no matter what the weather, she would sit in the afterglow of another day and read the works of Donne and Goethe and Yeats. She often read aloud to Max, and he would sit by the wall of her garden with the last of the day's sun on his neck, and he looked at her with what surely must have been curiosity on his face, because he alone -- of the all souls in this world -- truly listened to her.

Some might read these words and think about such an existence, find the routines of her life mundane, perhaps even boring. Yet there are few people who know the meaning of peace, or the myriad ways the souls of men can be ripped asunder, not in the way Maria Louisa D'Alessandro understood these things. Maria was an expert at recognizing a soul's dis-ease, you see, because hers had been dead for such a very long time.

At least she told me that was the truth of the matter, long after events relayed in this little tale passed into memory.

I assumed over time that she thought of her place in life, when she bothered to think of herself at all, as a vast emptiness, devoid of human love. She relied on Max the way the blind rely on their dogs; he helped her avoid the worst consequences of her own peculiar sightlessness. But was Max was old when I met him, already concerned more about the next life than he knew, and Maria Louisa D'Alessandro had yet to grasp what his failing eyesight really meant.

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I first heard David Latham's voice over the radio, and he sounded very stressed-out, very...I don't know...maybe weak is the right word?

But I'm getting ahead of myself.

So, let me take you back, back to a blustery May day a few months before we met, to an afternoon a few years ago, when I was en-route from the United States to the Mediterranean -- via Bermuda and the Azores -- and on an old friend's new sailboat. I had done some sailing before but this was my first long ocean passage, yet I had been -- and let's keep this simple -- hesitant to make the trip. But Harry Stinson, my oldest and most loyal friend, had begged and pleaded with me to make the trip with him, and in the end he simply hammered away at my resolve long enough -- until I gave up and said something noxious and brave like: 'Okay, let's do it!' Enthusiasm? I wouldn't go that far...

Harry was bringing along his wife and twenty four year old daughter, and he said they wanted someone with a strong back for the Atlantic crossing, which they rightly considered the hardest part of their journey to Italy. My wife, bless her black little heart, simply refused to join us, as she refused to do anything not her own choosing -- and that might crack a fingernail. Yes, my wife and I were at odds with one another, two fighters in the ring sitting warily in their respective corners, tending to our cuts bruises while friends huddled in front of us, urging us back into the ring for one more round. The fact she had turned into a bi-polar shrew had nothing to do with any of this, in fact, if anything, she had with age corrupted within the cask. She was vinegar now, bitter, sour, and only good on salads.

We, the Stinson's and myself, departed Mystic, Connecticut and sprinted for Bermuda, arriving a leisurely five days later. I will always remember the first 48 hours of this first leg with uncertain fondness in my heart, the number of hours we spent on our knees -- hurling the contents of our stomachs into the sea. When I think of those first few days at sea I could write volumes on the subtle forms human misery can take, yet when I think about the nausea that hit that first night at sea, and the avalanche that followed, words fail me. Despair comes to mind, but inadequately fails to convey the totality, the Gesamtkunstwerk that is ocean sailing at night, in a gale.

Suffice to say, as Bermuda appeared behind wind-driven veils of rain and her rocky reefs hove into view, I swore I'd jump ship and never set foot on another sailboat again -- for as long as I lived.

That is, until I found out what a same-day purchase, one-way ticket back to Boston would cost.

I am at heart a frugal sort -- my wife would say downright cheap -- but what does she know? In the end, that's why I -- allegedly -- remained onboard and agreed to finish the trip -- at least as far as Gibraltar. The other reason I refuse to talk about publicly, but if it must be known, it was because I really enjoyed myself the last four days of that trip in so many ways I can't even begin to relate them all to you. I had never known such peace, or had such fun. Let's just say that Harry's daughter had a lot to do with my decision to remain on board.

Could we just leave it at that?

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We left Bermuda in the middle of May and began the 2100 mile slog across the Atlantic to the Azores. Ten days out and as the sun was rising, we saw a sailboat a few miles ahead of ours; not a few minutes later the young man on this boat hailed us on his VHF radio.

"Hello, sailing vessel near three-eight-zero-three North by three-eight-five-eight West, this is the Sailing Vessel Bolero, over. Sailing vessel near three-eight-zero-three North by three-eight-five-eight West, this is the Bolero, over."

"Bolero, this is the Circe. What can we do for you?" Harry said.

"Uh, Circe, I think I'm sick, and I could sure use a hand over here."

That's when Harry sent his wife below to wake me, for you see, I too am a physician. That's also when Harry's wife found me seriously ensconced in their daughter. It was an ugly scene for a couple of minutes, but the exigencies of the moment prevailed.

"Circe, Circe, this is Bolero. You still with me?"

"Ten four, Bolero, stand by one, we have a doctor on board."

"Oh thank God!" came the young man's reply. "I'm going to drop sail; can you head towards my location?"

"Roger, Bolero, we'll be with you in a half hour or so."

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Jennifer Stinson, Harry's daughter, was banished to the forepeak while Harry and Trina ripped me apart back in the cockpit. I had violated a very basic trust, Trina yelled, and Harry looked at me with barely concealed contempt in his eyes. I'd earned that look and knew it; still, Jennifer was one in a million. After almost three weeks together I knew I was in love with her. I was willing to forgo everything I had to be with her, forever. I wanted to run away with her, journey to the far ends of the earth with her hand in mine, forever and ever.

I had, in short, completely lost my mind.

I'd been around to see her -- what she was two days old. We'd all gone to Disney World -- when she was in second grade. I'd helped her with her chemistry homework in high school, and when she chose a major in college I was right there, helping her make the choice.

Oh, it was philosophy, by the way. And let's not talk about irony for a while yet, please.

So, I'd known her for almost twenty five years, but now she was anything but a little baby, and I was no longer prudently married. I was married to the untamed shrew, my life a charade. Miserable didn't begin to paint the picture, and the thought of returning home filled me with dread.

So, no. I have no excuse. What I did was wrong, very wrong, yet I'd never been as happy as I was those few days at sea before our own little dangerous liaison was, well, uncovered.

With these facts firmly in mind, it was with no small amount of regret that, as we drew close to the Bolero, I realized my time on the Circe was coming to an end. An unhappy, unplanned for end. When we pulled alongside Bolero, I could see an emaciated young man almost wallowing in pain the cockpit, and I could see that he was indeed very, very ill.

Despite the fact Harry's a lawyer, and a good one too, he still has a few bits of compassion left in his heart, and he immediately took over responsibility for the lad in Bolero. "Pete, get your medical bag up here, then jump across; we'll stand by while you figure out what we need to do."

A few minutes later and I was on Bolero's deck; I thank God to this day that the water was calm enough to make the jump without incident. In rough seas we might never have made the transfer, and the closer we got to the Azores the more sharks we'd been seeing. In any event, Bolero was tiny in comparison to the Circe, and the little boat was rolling heavily with her sails down, so I hoisted the staysail and she steadied up a bit, and began tracking again to the east.

I remember looking at David Latham that first time. He was a sturdy looking fellow: sun-bleached hair, very tall, muscular and lean, and in his late twenties, but he was sweaty and obviously in a great deal of pain.

"What seems to be the problem," I asked as I started in on his vitals.

"What kind of doctor are you," he asked me. "Not a shrink, anything like that?"

"No, I'm an anesthesiologist. A gas-passer, I guess you'd say."

"Oh? You fart for a living?" he joked. Always a good sign.

"So, what's wrong, David?"

"My nuts hurt."

"I suppose you've tried jacking off?"

"No, it's not that. One of 'em hurts real bad, and it's as hard as a rock."

"That been going on long?"

"Been a lot of pain down there for a couple of weeks; some shooting pains down there for a, well, several months."

Step back with me here, will you? Imagine this conversation in your mind. Imagine a doctor's office, clean walls, antiseptic smell, a nurse waiting in the hall to draw blood or set up an ultrasound. Everything seems nice and orderly in your mind when you think about the conversation David and I were having. Only problem was we were in the middle of the Atlantic Ocean, and I was standing in the cockpit of his 34 foot sailboat. I had no nurse with me, no tests to offer, and to make matters even more inconclusive, I wasn't a urologist. What he was describing to me sounded just like testicular cancer, and if he'd been symptomatic for months -- time was of the essence. Fact of the matter is, even then I remember thinking it could very well be too late for the kid.

I hated to do it, but asked if I could feel the offending nut. Often times a testis can get wrapped in it's cord and swell up, causing immense pain; this usually results in loss of the testis but typically isn't a fatal event. Some penetrating hernia can flair up and cause pain in the region, but typically these cases don't present as an enlarged testis. In order to confirm my suspicions, I really needed to, well, get a handle on things.

Anyway, David dropped his drawers and I felt the offending nut. One was normal, soft and pliable, and it's cord was soft, too. The other was larger than a golf ball and at least as hard. I could feel the cord - stiff and barely flexible as far up as I could feel -- and I knew right then this kid was in deep shit. I took his temperature while I continued my history: he hadn't been able to hold food down for two days and was febrile, so I took him below and made him comfortable, then got on the radio when I got back up in the cockpit.

"Harry?"

"What is it, you son of a bitch?"

"This kid's sick, Harry. I mean real sick. Cancer is my guess, and we need to get him to a hospital as soon as we can."

The change in Harry's voice was immediate, and I loved him again, he was my friend again. "OK, Pete," he said gently. "What can we do to help on this end?"

"I'm going to need to start an IV and get some pain meds in him, so I'm going to need an extra set of hands over here for the ship, and to help out getting him secured. You might want to see if we can get a hold of someone in the Azores, alert them to the situation."

"OK, buddy. I'll send Trina over as soon as she gets the stuff together."

I know I haven't mentioned that Trina and I dated a long time ago. She'd been a nurse when I was an intern at Mass General, before she worked to put Harry through law school at Tufts. She knew the drill, anyway. Now it was just a matter of her not killing me when I wasn't looking...

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By mid-afternoon Harry had talked with Radio Azores on his single-side-band radio, and while we were out of helicopter range they advised that we call them the next day and relay David's condition. If he was deteriorating, they would come pick him up; if not, they would have medical attention standing by for our arrival at Horta.

Trina and I got an IV working on David, and I slipped him a small dose of morphine when it was apparent to both of us that lesser medications weren't doing the job. As the sun went down I could tell that the kid would have to be airlifted out of here as soon as possible; he was slipping into a deep fever and doubtless had some kind of septicemia working in the area of his groin or thighs, which were now hot and growing rigid. We ran a bolus of antibiotics and crossed our fingers.

Circe sailed alongside during the night, and at first light Harry called Azores Radio and apprised them of the situation. An hour and fifty minutes later we heard a helicopter approaching, and we made ready to transfer Latham to the aircraft.

When the chopper settled in overhead, I was surprised to see a man in orange coveralls descending on the rescue hoist. He discharged static electricity from the rotors while he dropped, than helped us put Latham in the gurney they lowered. The man, who spoke in thickly accented English, then told me he would sail the boat into Horta, and that I was to accompany Latham on the helicopter back to the island.

Conveying this to Harry by radio, we said our goodbyes to one another out there in the middle of nowhere, and he advised they would see me in Horta - most likely the day after tomorrow. I was then hooked up in the hoist and raised into the hovering helicopter. I sat by Latham while he writhed in pain during the ninety minute flight back to Horta.

He kept looking up at me during those tense minutes, thanking me with his eyes. I held his hands from time to time -- when his eyes were open -- then I saw the islands slip into view. It would be more than fair to say I was entranced by these islands timeless, volcanic beauty as we got closer, which might also explain some of what happened over the next few months.

The helicopter slipped over the northeast corner of the island and began it's descent into Horta, and we touched down at a Coast Guard pad near the hospital. We loaded Latham into a waiting ambulance and drove the few short blocks to the Hospital da Horta.

A tall, dark eyed woman was standing there, waiting for us when we turned onto the hospital grounds, and that was my first memory of Maria Louisa D'Alessandro. A tall woman, dressed in a white lab coat over a long black dress; her huge black eyes standing in wild contrast to her alabaster skin, her expression almost unreadable at first. She stood in the quiet shadow of the hospital building, looking at us as we arrived that morning. I, of course, mistook her quiet, contemplative manner as a look of contempt.

I was so wrong about so many things that summer, but I never saw her coming.

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She spoke English, of course, and better than I did. She moved to Latham's side as we pulled his gurney from the ambulance, and she quickly checked his vitals out there on the driveway while I filled her in on my observations?

"You are the physician?" she asked me as I spoke.

"Yes, doctor, I'm an anesthesiologist, at Brigham and Women's in Boston, and I teach at Harvard."