THE LAST COWGIRL
They met for dinner at Pinerola’s, a restaurant in the North End. When she had first gone there with Charlie Harris she had to walk down a narrow alley between tenement buildings, then up a tall flight of stairs into what was essentially a kitchen with three small tables. Carla Pinerola was the cook, assisted by her elderly mother, who shouted and grumbled at her a lot. Carla was middleaged, sexy, a character. She had had a husband who beat her; sometimes when R.J. and Charlie came into the restaurant there was a bruise on Carla’s arm or she had a black eye. Now the old mother was dead, and Carla was never visible; she had bought one of the tenement buildings and gutted the first and second floors, turning them into a large and comfortable eating place. Now there was always a long line of patrons waiting for tables, businesspeople, college kids. R.J. still liked it; the food was almost as good as in the old days, and she had learned never to go there without a reservation.
She sat and watched her father hurrying toward her, slightly late. His hair had become almost completely gray. Seeing him reminded her that she was getting older, too.
They ordered antipasto, veal marsala, and the house wine, and talked of the Red Sox and what was happening to theater in Boston and the fact that the arthritis in his hands was becoming quite painful.
Sipping her wine, she told him she was preparing to go into private practice in Woodfield.
“Why private practice?” He was clearly astonished, clearly troubled. “And why in such a place?”
“It’s time for me to get away from Boston. Not as a doctor, as a person.”
Professor Cole nodded. “I accept that. But why not go to another medical center? Or work for … I don’t know, a medical-legal institute?”
She had received a letter from Roger Carleton at Hopkins saying that at present no money was budgeted for a position that would suit her, but he could arrange to have her working in Baltimore in six months. She had received a fax from Irving Simpson saying they would like to put her to work at Penn, and would she come to Philadelphia to talk about money?
“I don’t want to do those things. I want to become a real doctor.”
“For God’s sake, R.J.! What are you now?”
“I want to be a private practitioner in a small town.” She smiled. “I think I’m a throwback to your grandfather.”
Professor Cole struggled for control, studying his poor child who had chosen to swim against the current all her life. “There’s a reason why seventy-two percent of American doctors are specialists, R.J. Specialists make big money, two or three times more than primary care physicians, and they get to sleep through the night. If you become a country doctor, you’ll make a harder, tougher living. You know what I would do if I were your age, in your position, no dependents? I’d go back for all the training I could force myself to accept. I’d become a superspecialist.”
R.J. groaned. “No more externships, my Poppy, and certainly no more residencies. I want to look beyond the technology, beyond all those machines, and see the human beings. I’m going to become a rural physician. I’m prepared to earn less. I want the life.”
“The life?” He shook his head. “R.J., you’re like that last cowboy fella they keep writing books and songs about, who saddles up his bronc and goes riding through endless traffic jams and housing tracts, searching for the vanished prairie.”
She smiled and took his hand. “The prairie may be gone, Pop, but the hills are right out there on the other side of the state, full of people who need a doctor. Family practice is the purest kind of medicine. I’m going to give it to myself as a gift.”
They took a long time over the meal, talking. She listened carefully, aware that her father knew a great deal about medicine.
“A few years from now, you won’t be able to recognize the American health care system. It’s going to change drastically,” he said. “The presidential race is waxing hotter and hotter, and Bill Clinton has been promising the American people that everybody is going to have health insurance if he is elected.”
“Do you think he can deliver?”
“I really think he’s going to try. He seems to be the first politician to give a damn that there are poor people without care, to confess he’s ashamed of what we have now. Universal medical insurance would make things better for you primary care physicians, while lowering the incomes of specialists. We’ll have to wait and see what happens.”
They discussed the financial requirements of what she proposed to do. The house on Brattle Street wouldn’t bring much money after all the debts were paid; real estate prices were very depressed. She had made careful assessments of the money she needed to set up and equip a private practice and get through the first year, and she was almost fifty-three thousand dollars short. “I’ve talked with several banks, and I can borrow the money. I have enough equity to cover the loan, but they insist on a cosigner.” It was a humiliation; she doubted they would make the same stipulation to Tom Kendricks.
“You’re absolutely certain this is what you want?”
“Absolutely certain.”
“Then I’ll sign the note, if you’ll permit me.”
“Thank you, Pop.”
“In a way it drives me crazy to think of what you’re doing. But at the same time, I have to tell you how much I envy you.”
R.J. raised his hand to her lips. Over cappuccino they reviewed her lists. He said he thought she had been too conservative and that the figure she was borrowing should be ten thousand dollars higher. She was terrified of the financial depths and argued forcefully, but in the end she saw that he was right, and she agreed to dive even deeper into debt.
“You’re a pistol, my daughter.”
“You’re a pistol too, my old man.”
“Are you going to be all right, living up there in the hills all by yourself?”
“You know me, Dad. I don’t need anybody. Except you,” she said, and leaned forward and kissed him on the cheek.