THE SEASON OF COLD
David came to her place one afternoon when she was away and snowshoed over the cleared path through the woods three times, packing down the deep snow so the two of them could travel the trail on cross-country skis. The trail was too short, too quickly covered by a skier; they agreed they would have to finish it in time to have better skiing the following winter.
The woods became a very different place in the cold season. They saw tracks that told of animals that in the summer would have passed through the woods unnoticed, spoor of deer, mink, coon, wild turkey, bobcat. One set of rabbit tracks ended in a broken place off the trail. When David stirred the snow with a ski pole he uncovered frozen blood and bits of white rabbit fur, where an owl had fed.
Snow was a serious reality of everyday life in the hills. At David’s suggestion, R.J. bought a pair of snowshoes and practiced using them until she could make reasonable progress. She kept the snowshoes in the car, “just in case.” In fact, she didn’t have to use them that winter. But early in January there was a storm that even the town’s old-timers called a serious blizzard. After a day and a night of steady, heavy snowfall, her telephone intruded just as she was sitting down to breakfast.
It was Bonnie Roche. “Dr. Cole, I have a terrible pain in my side, and I’m so nauseated I had to quit in the middle of milking.”
“Do you have a fever?”
“My temperature’s a little over a hundred. But my side. It hurts like hell.”
“Which side?”
“On the right.”
“Low or high?”
“High … Oh, I don’t know. In the middle, I guess.”
“Have you ever had your appendix removed?”
“No. Oh, God, Dr. Cole, I can’t go to the hospital, that’s out of the question! We couldn’t afford it.”
“Let’s not assume anything. I’ll come out to your place right away.”
“You can only get as far as the highway. Our private road isn’t plowed.”
“Sit tight,” R.J. said grimly. “I’ll get there.”
Their private road was a mile and a half long. R.J. called the town ambulance squad, which had a rescue unit that used snowmobiles. They met her at the entrance to the Roches’ road with two of the machines, and soon she was seated behind Jan Smith and hugging him, her forehead tucked into his back as they skimmed over the snow-buried dirt track.
When they arrived, it was clear at once that Bonnie’s problem was appendicitis. A snowmobile wouldn’t ordinarily have been R.J.’s transportation of choice for a patient with a hot appendix, but under the circumstances it had to serve.
“I can’t go to the hospital, Paulie,” Bonnie told her husband. “I can’t. Dammit, you know that.”
“Never you mind about that. You leave that to me,” Paul Roche said. He was tall and rawboned, in his twenties and still looking too young to drink alcohol legally. Every time R.J. had come to their farm, he had been working, and she hadn’t ever seen him, out here or in town, when his worried boy’s face wasn’t creased with an old man’s frown.
Despite Bonnie’s protestations she was helped onto Dennis Stanley’s machine, which moved off as slowly as Dennis could manage. Bonnie rode hunched over, guarding the appendix. At the plowed public road the ambulance and the crew were waiting, and they whisked her away, the siren splitting the silence of the town.
“About the money, Dr. Cole. There’s no insurance,” Paul said.
“Did you clear thirty-six thousand last year from the farm?”
“Clear?” He smiled bitterly. “You’re joking, right?”
“Then you won’t be charged by the hospital, under the rules of the Hill-Burton Act. I’ll see that the hospital sends you the papers to sign.”
“You mean it?”
“Yes. Only … I’m afraid the Hill-Burton Act doesn’t cover doctor bills. Don’t worry about my bill,” she forced herself to say. “But doubtless you’ll still have to pay a surgeon, an anesthesiologist, a radiologist, and a pathologist.”
It hurt her to see the worry flood back into his eyes.
That evening she told David about the Roches’ predicament. “Hill-Burton was meant to protect indigent and uninsured people from disaster, but it doesn’t work because it pays only the hospital bill. The Roches are riding a fragile economic ship. The expenses that aren’t covered may be heavy enough to sink them.”
“The hospital raises its charges to the insurance companies to cover what they can’t collect from patients like Bonnie,” David said slowly. “And the insurance companies raise their rates they charge for their insurance to cover their increased cost. So everybody who buys health insurance ends up paying Bonnie’s hospital bill.”
R.J. nodded. “It’s a lousy, inadequate system. There are thirty-seven million people in the United States without any form of medical insurance. Every other leading industrial nation in the world—Germany, Italy, France, Japan, England, Canada, and all the others—supplies health care to all its citizens, at a fraction of what the world’s richest country spends for inadequate health care. It’s our national shame.”
David sighed. “I don’t think Paul will make it as a farmer even if they survive this problem. The soil in the hills is thin and rocky. We have some potato fields and a few orchards, and some farmers used to grow tobacco. But the crop that grows best up here is grass. That’s why we had a lot of dairy farms once upon a time. But the government doesn’t support milk prices anymore, and the only milk producers who can make money are the big-business outfits, enormous farms with giant herds, in states like Wisconsin and Iowa.”
It was the subject of his novel. “Small farms around here have popped like balloons. With fewer farms, the agricultural support system has disappeared. There are only one or two veterinarians left to treat the herds, and agricultural equipment dealers have gone out of business, so if a farmer like Paul needs a part for a tractor or a baler, he has to drive clear into New York State or Vermont to find it. The small farmer is doomed. The only ones left are those with personal wealth or a few like Bonnie and Paul. Hopeless romantics.”
She remembered how her father had characterized her desire to practice rural medicine. “The last cowboys, searching for the vanished prairie?”
David grinned. “Something like that.”
“Nothing wrong with romantics.” She determined to do everything in her power to help Bonnie and Paul stay on their farm.
Sarah was off on an overnight field trip to New Haven with the school drama club, seeing a revival of Death of a Salesman, and almost shyly, David asked if he could spend the night.
It was a new wrinkle in their relationship; he wasn’t unwelcome, but suddenly he was in her living space in a more serious way, something that took getting accustomed to. They made love, and then he was there in her room, sprawled over more than half of her bed, sleeping as soundly as if he had spent the last thousand nights there.
At eleven o’clock, sleepless, she slipped from the bed and went into the living room and turned on the television for the evening news, keeping the volume low. In a moment she was listening to a United States senator castigating Hillary Clinton as a “dreamy do-gooder” for vowing to gain passage of a universal health care bill. The senator was a millionaire whose every medical problem was taken care of, free of charge, at the Bethesda Naval Hospital. R.J. sat alone before the flickering screen and cursed him in furious whispers until she began to laugh at her own foolishness. Then she clicked him off and returned to bed.
Outside, the wind screamed and moaned, and it was as cold as the senator’s heart. It was good to snuggle up to David’s warmth, one spoon fitting into another, and presently she slept as soundly as he.