Reeducation

By Emily Gray Tedrowe

MERRILL PUT TWO gloved fingers inside Gretchen K.

“It helps if you close your eyes,” she said. Or so she had read. Merrill French, M.D./Ph.D. from University of Illinois, fellow of the American College of Obstetrics and Gynecology, 20-plus years in private practice, was — she hated to admit — winging it.

Gretchen K. snorted, moving around a little in the stirrups. “Where have I heard that before?”

Merrill smiled, acknowledging the joke. It’s true that Gretchen K. — a long-time patient, a mother of three kids, the youngest autistic — was one of her favorite trial participants. But there was too much at stake. Already she’d had two other women drop out, and if she couldn’t find replacements in the next week, the data would be suspect.

“You want to isolate those muscles,” she said. “Let’s do another set of 10, slowly.”

Gretchen K. looked like she had another retort at the ready, but instead, she shut her eyes. Utter silence fell between them in the small examining room. Merrill stared into the distance, in the grip of a fierce concentration, and waited for the first squeeze.

When eventually Merrill had won the research grant after four previous attempts, each rejection provoking a subsequent downsizing of her project, it was less than a third of what she’d specified she would need. But that was almost OK, because what she’d asked for was about twice what she thought she would actually need — for equipment, participant compensation, not to mention her own time. It was all one big game of chicken, she had thought, staring at the piece of paper informing her of the award. The funders knew she would go forward with or without their support — she had practically subtitled her grant proposal “A Labor of Love” — so they withheld as much as possible. Then, after she killed herself gathering the paper’s bare minimum of data, the general attitude could be, “Congratulations! See, you didn’t need us after all.”

Or was that Brigitta’s voice again? One of the most persistent repercussions of splitting up with her partner of 18 years was that Merrill now often heard the other woman in her own head, that unmistakable bone-dry Nordic accent, tinged always with wit and weariness and what did you expect? It had been one of the reasons for Merrill leaving, that way Brigitta had of forever absorbing any disappointment (of her own, of Merrill’s), with barely anything more than a shrug. Even their own breakup, which came as a monumental shock to everyone in their circle, caused Brigitta no signs of agony or despair — none that she chose to show, that is. Merrill, on the other hand, showed up at work with swollen eyes for at least a month.

Why did it happen? The usual reasons, all the more humiliating for their banality: growing apart, wanting different things, incessant arguments. But it was Brigitta’s even keel that stung the most. Callousness, Merrill had called it, this deliberate refusal of her lover to commiserate, to open herself to sadness, to at least act surprised at the myriad ways the world could hurt you. Pragmatism, was Brigitta’s own term. In any case, instead of eliminating this infuriating worldview, it seemed that Merrill had now merely absorbed it as her own.

But you loved this project, she argued with her absent lover. Going against the male medical hierarchy, wellness over surgery, reparation for all the episiotomies we inflict . . .

It’s not my fault the trial’s going badly. You should have known there would be problems.

That’s just it! “Badly”. . . who said so? Why do you have to put the worst spin on things, as if you were always expecting them to fail...

And she’s off. Re-enacting the gist of every quarrel they ever had, in the now-silent car, in the now-silent house.

It was true that Merrill’s partners at the clinic, both men, were less than excited about her grant when she announced that she had won it at their monthly meeting.

“I didn’t know you were into this,” Steve Plattner said, tossing onto his desk the proposal she had bound and color-coded.

“Which part?”

“All of it. Research,” he added, as an afterthought. “Are you up for a tenure line? I thought your fellowship at Rush was –”

“No,” Merrill said. “Not necessarily. This is about practicing, about post-birth care. And our own shortcomings. You know we’re behind the curve on this — it’s been standard practice in Europe for some time to –”

“That’s what Kegels are for,” her other partner, Bryce Dent, said. He twirled one of their ubiquitous pharma-giveaways, this one a pen that said, “Celebrex: Is it Right for YOU?” “And why is it called perineal reeducation? That sounds so ... academic.”

“So Chairman Mao,” Steve jumped in. He and Bryce shared a quick laugh, cultural superiority affirmed.

Merrill had no patience for it, this bluff heartiness. “Reeducation is just the current term. You’ve seen the studies. With several sessions of the electro-stim, it’s been shown that women presenting significant post-birth vaginal –”

“Physical therapy,” Bryce said. He clicked the Celebrex pen four times fast. “It’s PT, it’s not medicine. I’m just saying.”

“Pretty time-consuming,” Steve said, his tone a bit kinder. “You sure?”

Merrill nodded, too exhausted to say more.

Bryce shrugged. “It’s your billing hours,” he said, pointing the Celebrex pen at her. “Not mine.”

Sam Cohen was chair of the math department at DePaul; he had lived in Merrill’s condo association for four years, which, in the world of Geneva Terrace, meant that he was a newcomer. Their Lincoln Park courtyard building was a modest grouping of two-story townhouses built in the 1970’s with a brown, brick plainness that sat on the border between unattractive and ugly. Most of the residents were the original owners and kept to themselves, breaking companionable silences only when small crises arose (a spate of garage break-ins, the black-out last summer). Merrill recognized Sam, of course, but it hadn’t been until a few weeks ago, the morning he helped her right three garbage cans in the alley, that she took notice of his wit and affability, his quick grin and the strength in his arms.

Sam Cohen was divorced. Merrill knew his teenage son went to Lincoln and lived with his mother. She knew Sam was a Cubs fan — he wore the same faded blue cap over longish brown hair nearly every time they’d run into each other.

And that was the sum total, thought Merrill, vigorously pounding on a veal chop. No verifiable information about his character, habits, religion (Jewish, likely), parenting style, past relationships, political affiliation (Democrat, surely), food preferences, book favorites or finances. Of course, she could just ask; he was standing in her living room, flipping through a rack of CDs.

“What’s the difference between folk music and mountain music? I forget.”

“What?” Merrill wiped a floury hand against her pant leg. When she was nervous, she tended to cook elaborate, too-fussy meals, and this one — veal Milanese, couscous in beef broth, turned carrots in ginger glaze — proved especially telling. But it was their third date, and she was showing off. Actually, that first date — a joint stroll to a neighborhood art fair and coffee afterward — could have been called something else, a loophole in place to save face for both of them. But when Sam had taken her to La Fette last week — and paid — and then slowly took her hand in both of his as they said goodnight, his intentions became clear. To her surprise, Merrill had responded with a flirty why not attitude that she hardly recognized. Hence, this ridiculous gourmet meal, which she now regretted.

“I mean, is there a difference? Maybe one’s a subset of the other.”

Merrill glanced at the disk he was holding — Bill Monroe. “I don’t know,” she said. “Brigitta bought that.” She turned back to the sauté pan, where a lump of butter melted into olive oil, two shades of murky gold. She waited to hear what response might come, but there was nothing. What kind of man wanted to date a newly single 50-year-old woman who had lived as a lesbian her entire life? Merrill scraped at the smoky oil with the back of a wooden spoon. What kind of lesbian, she heard Brigitta ask sourly, chooses a man after so many years? This man — any man?

She risked a glance behind her. Sam Cohen, now on the couch, took a drink of wine and picked up a magazine — Journal of Obstetrics, Winter/Spring issue. At his elbow, a small tabletop full of framed photographs: Nina at her high school graduation, an arm around each mother; five-year-old Nina bundled into a snowsuit, her smooth Asian features crinkled into a smile; Merrill in sunglasses, holding up a live lobster, Brigitta’s hand on her shoulder. Merrill took a deep breath.

“Give me a hand in here?” she called, and as he ambled over, she looked around desperately for a job to assign.

“What do you think of peonies?”

Merrill stared, in astonishment. At first, she’d heard “penises.”

“Garden committee has a little leftover in the budget. We were thinking a new border, out by the middle entrance.”

“Can you reach that platter, the one up in the –”

Sam turned automatically to the right cabinet, easy within the close confines of the kitchen. His home was on the east side of the courtyard, and hers on the west; inside, they had the exact but opposite layout. Merrill used tongs to turn each piece of veal as it browned and spattered.

“Or yet another row of rose bushes. That’s the majority view, but ....”

“Not yours?”

“Well, you see, Dr. French, I’ve got vision. I see the bigger picture. Maybe you’re not aware of this, but I am deputy chairman of the landscaping committee.” Sam’s smile was warm and direct.

“Vision, huh?” She put the veal on the platter he held.

“You have no idea. And listen, we should probably be discreet about this, but –” Sam looked around and dropped his voice. “You’ve got an in. I’m just saying.”

“Peonies lining my front walk and nobody else’s?”

Sam set the platter to the side. “That’s the idea.” He picked up a dish towel and began to daub at the streaks of flour on the front of her shirt, and the tiny dots of grease. He held her steady with a hand on her arm; neither spoke. He continued brushing lightly, on one shoulder, across her stomach, a spot on her throat.

The pan sizzled and popped. Sam was, or was not, aware of what he was doing. Merrill stood still. She tried to read her own response, but there was blood pulsing in her ears and a sudden heat flush in other areas, ones for which Merrill knew every Latinate term.

Claudia R. was 24, Mexican, quiet and watchful. Merrill had been caught off-guard when she agreed to participate: Claudia was known to flinch at the first sight of the speculum. Also, there was the gold cross she wore on a thin chain that slipped into the pudgy folds of her neck. And there was the matter of her husband, whom Merrill had met only once in the hospital lounge (she never saw him in the rooms where Claudia delivered and held their newborn children): dour, older, not given to questions or concerns about his wife’s health. Taking these things together, when Claudia R. signed the form with a firm flourish, Merrill had to hide her own surprise.

You see? She told herself, warmly thanking Claudia R. It just goes to show.

By the end of their second session, though, it was clear why Claudia R. had signed on. There was no pressure from within, no result at all from Claudia R.’s clear struggle — her face was red — to tighten her inner pelvic walls.

“OK, that’s enough,” Merrill said, smiling to conceal her dismay. She herself had delivered Claudia’s last child — a nine-pound boy — and her notes on the procedure indicated nothing more than an unusually long labor (especially for a woman having her fourth baby) and the stitching of two small tears and one one-inch cut. Nothing to suggest or explain the amount of damage done to this woman’s perineum — an extent of weakening Merrill had seen in none of her other participants.

Claudia R. struggled to sit up, and Merrill gave her a hand.

“Have you had any incontinence?” she asked, to a blank stare. “Any ... urine leaking? When you sneeze, maybe?”

“Right now do I?”

“No, I mean — is that a problem for you?” Merrill’s mind was racing. She’d seen Claudia R. twice since her last son was born, both routine visits. Everything had checked out, and Merrill knew the woman hadn’t brought up any problems either time, but ... had she even asked?

“Yes,” Claudia R. said, unsure if this was a right or wrong answer.

“You have? How often? Every ... month? Once a month?”

At this, Claudia R.’s face twisted into a bitter smile. “Once a day,” she said, pointing to the pile of clothes stacked neatly on a chair next to the examining table. Merrill saw then: a pair of blue nylon bikini underpants, and the bulky white pad jammed inside them.

“Is normal. Yes? The urine. Normal after baby.”

Merrill turned away, to the open notebook on the counter, angry at herself. She searched for the right words, hesitant as always to describe a patient as abnormal.

“It doesn’t have to be,” she said finally, as Claudia R. began to get dressed.

“Here’s Com Ed, and the car payment. Mortgage is mine, and where’s the — oh, here.” A paper cup of chicken noodle soup balanced between her knees, Merrill sorted through the packet of mail. Once in a while a pigeon would wander close enough to the half sandwich set next to her on the bench, and she’d swing a foot in its general direction. After a while, Brigitta picked up the sandwich and held it for Merrill on her own lap.

“And look at this, from the Joffrey. Didn’t we already tell them we weren’t renewing those seats? This looks like they’re billing us anyway.”

Brigitta took a sip of coffee and shrugged. A puff of warm summer wind blew against her face, lifting her hair, revealing a much-younger woman with a carefree lightness in the unprotected pale skin of her throat and ears and forehead. But soon the wind died away, and Brigitta’s severe pageboy fell down again like gray shutters, closing her off.

“My sister sent these. I guess they went to Six Flags.” Merrill handed over a stack of photos of their twin nephews, now 12, driving bumper cars and riding a roller coaster. While Brigitta studied them, she watched a tiny old man navigate his walker through the unmoving flocks of pigeons. Chicago’s Washington Square Park was a block long and criss-crossed with diagonal paved pathways, each leading to a center fountain. It sat just west of Michigan Avenue’s traffic, a respite from the high-priced shops of the Gold Coast, and was bordered on the north by the Newberry Library, where Brigitta worked at the reference desk.

“I talked to Nina last night,” Brigitta said, handing back the photos. She held up one to keep with a questioning expression, and Merrill nodded.

“You did? What time? I left her a message, earlier in the day.”

“She wanted to know if she could borrow my car next weekend. Their group is going to the dunes.”

Merrill started to take another bite of her sandwich and then stopped. “I didn’t know that.”

“Anyway, I told her yes, but she knows she has to speak to you about it.”

Too many questions swirled in Merrill’s head for her to respond immediately, laid over with a thick uneasiness at this news of their daughter’s plans. She hated to imagine Nina and her college friends — who had a summer share and a variety of babysitting and waitress jobs up in Charlevoix — driving around at night on those winding highways by the beach, drunk or who knows what. Well, at least that answered why Nina hadn’t called her last night. Since she was little, Nina had known exactly who to go to for what request or favor, which mother would be more apt to say yes. But Merrill couldn’t help feeling a little hurt anyway. And she knew it was stupid, but she couldn’t help keeping track of the phone calls themselves, their frequency — did Nina call Brigitta more often? Did she suppose, despite both of their repeated assertions, that Merrill had done this to Brigitta? That just because Brigitta was the one to move out of their home — that had been her choice! Merrill argued, in her head, yet again — that Brigitta was the one who suffered more, who needed more phone calls?

Maybe these lunches weren’t all they were cracked up to be. They were striving to remain friends, or friendly, at least, and not just for Nina’s sake. But Merrill came away more often than not with fresh pain renewing the old hurt.

“You will be at group next month? Or maybe not.”

“Why wouldn’t I be at group?” Merrill said, letting loose a shot of annoyance. She noticed there had been no questions about her study.

Brigitta shrugged, and began to pack up their soup cups and sandwich wrappings. “How’s 1830?” she asked. Their address. But before she said anything, Brigitta added, looking carefully toward the fountain, “and how’s 1804?” Sam Cohen’s address. In the spirit of honesty — which she now regretted — Merrill had said only that they had spent some time together.

So both women watched the fountain in silence, its endless rounds of colorless water splashing down a series of mildewed stone levels into the foamy pool at the bottom.

Most of the trial participants seemed only vaguely interested in the genesis of the project, or in its expected goals and outcomes. Perhaps they were simply polite in the face of Merrill’s overwhelming enthusiasm for this new way of treating women who had borne children, humoring their long-time doctor, who handed out another packet of photocopied information at each monthly appointment and spoke too highly about the way things were done in France or too darkly about the U.S. medical-industrial complex. Most women came for their sessions, thanked her and left. It couldn’t be that they were just interested in the money, a small amount by almost any standard. Merrill wondered if they weren’t taken aback by all of it, by the premise that there was something wrong with their bodies (something they hadn’t noticed or been bothered by before), something that only experimental treatment could “fix” — or by distrust in the study’s methods, which seemed too homespun, too slow to show results or too embarrassing. (The massage technique, for example — but it had been demonstrated to improve elasticity in nearly every study.)

Or maybe they were put off by Merrill’s own demeanor. She was impassioned about this, and she let it show. That was different for her patients, she could tell. They had come to expect their OB/GYN to be hyper-competent and pleasant — but a bit cool. Distant. They weren’t used to anything more than calm and steady ... and why should they be? Merrill had perfected that approach, through years of working for and with male M.D.s like Bryce Dent. Every woman doctor she knew had a version of this ice-queen exterior, a professional survival tactic honed by sheer necessity. If Gretchen K. noticed the change in Merrill, though, she didn’t seem to mind. Nor did Claudia R. Both brought questions, anecdotes, new ideas to each session, which regularly ran overtime. But the other participants were merely going along, or so it seemed.

As for Merrill, this new fervor for work was a rush. She had nightly dreams about the project and spent more time than she cared to admit in fantasies where her groundbreaking study changed the face of obstetrics care for women in America. She hadn’t felt this energized since her days as a resident and she relished it. The only nagging fear was the cause for her zeal. She told herself it was the work itself, but a deeper worry said that she was simply compensating for Brigitta’s absence — pushing herself, over-investing, substituting research and data and treatment for the great missing piece in her life.

Or was it possible that ...?

No.

None of it could be related to Sam Cohen. Nor to the way she now rushed straight to the answering machine as soon as she came inside, still holding her purse and coat — once, leaving the keys in the lock. Or how she woke up smiling, refreshed after only a few hours of sleep, and left plates of food unfinished, able now to subsist on little more than PowerBars and frozen yogurt. Or how so many things about herself that Merrill had thought were fixed were now fluid, and the flip side of how terrifying that felt was how exhilarating it was, too.

“It starts out with this older couple cross-country skiing. Julie Christie plays the wife — know her? I didn’t, but my God is she beautiful.” Gretchen K. kept her eyes on the ceiling as Merrill moved the electro-wand inside her, a millimeter at a time. “Anyway, she gets Alzheimer’s and has to go into a home. And they’re just wrecked. But it comes out that he –” She drew a sharp breath in, and Merrill paused.

“You OK?”

Gretchen searched the light fixture for a long moment. “Where was I? Oh. Yeah, so he’s a dog, this guy, despite his wounded eyes and brave noble act — he was sleeping with all sorts of his students back in the ‘70s. You can tell he didn’t know she knew the extent of it, but she does — it’s her short-term memory that’s going. Did you see this?”

“I don’t get out to the movies that much.”

Gretchen shifted, as if her body was slowly becoming resigned to the wand and its motions. Merrill had a crick in her shoulder and an itch on her forehead, but both hands were occupied, so she tried to ignore them. She was exhausted, physically burnt in a way she didn’t remember being for years. Because she was still keeping to her normal patient schedules — routine pregnancy checks, annual exams, urgent care — trial participants had to be fit into every free minute, and now her days ran late and long. Plus, all the babies in the practice seemed to want to be delivered at 3 a.m., on her one weekly on-call night.

Sam Cohen had taken her to dinner at Marge’s, a neighborhood place. Another night, he brought over pizza, and they watched a rerun of “The Daily Show.” They had plans to bring a picnic to the Grant Park Symphony next week.

“Then, in the nursing home, the wife becomes infatuated with another man. She just holds his hand and wheels him around, and the whole time, her husband has to sit there and watch this happen.”

“Sounds cheerful.”

“It’s payback!” Gretchen exclaimed, inadvertently dislodging the wand. “Oh — whoops.” They rearranged themselves. “It’s either karma or maybe it’s supposed to be some kind of metaphor for marriage, the regular everyday kind. How we screw each other over, again and again, in the same old ways. Because that’s just how it works.”

A new bitterness in her patient’s voice made Merrill look up.

“Well,” Gretchen K. said, “hetero marriage, I should say. Sorry.” She smiled up at her doctor. “Don’t mean to lump you in with us assholes.”

“I should go.”

They were on her couch, fully dressed, kissing. Sam Cohen held Merrill’s glasses in one hand, and with his other, he stroked her body — the back of her neck, and then down her ass and the side of her thigh. After each slow circuit, Merrill opened her legs a little more, pressing against him. Then again, she also had a hand locked firmly against his hipbone, a friendly reminder of the limits, a barrier.

At this range, Sam Cohen’s face was blurry, indistinct. But the feel of his wider mouth on hers and the grainy texture of his skin — those were singular. As they went on with what they were doing (fooling around, Nina’s phrase), a little binary switch flipped inside Merrill: on/off, on/off, on/off. Same/different. Usual/special. Familiar/unknown.

“I should go,” Sam Cohen said again. She could feel him smiling. Nobody moved.

The group meeting this month was at Rhona Hendricks’ new apartment on Cleveland Street. Rhona had moved to this smaller space, a one-bedroom on the ground floor, once her kids were out of college; her partner, Dara, traveled so often for work, and Rhona hadn’t liked being alone in their large, empty house in Oak Park. “Noises at night,” she said. “What can I say? I’m an old scaredy cat.”

Just inside the front door, Merrill shifted her casserole dish and gave Rhona a one-armed hug.

“Am I late?” Behind Rhona, she could see that Myra and Kathy had already arrived and were sitting rather quietly around the coffee table. Even Brigitta was there.

Rhona took Merrill’s arm and gently tugged her back toward the door. A sweet, faintly sinister fragrance drifted from the other woman’s shining hair. “I should have called you,” she said, in a low voice. “This is messed up. But some people thought we had to air our –”

“What’s wrong?”

But Rhona pulled away, sniffing. “Did I forget to –? Shit. The cheese puffs!” And she went racing back through the apartment, leaving Merrill standing alone in the tiny foyer with the front door still ajar.

“Hi, there,” Kathy said, and looked down at her hands. Merrill entered slowly, the bowl of artichoke dip warm and heavy in her arms. Why was everyone just sitting there? Usually a clamor of laughter, music and wine opening mishaps greeted her at these monthly meetings.

They had never found a name other than “group” for their group — any other term seemed too formal or no fun. What had started in the early 1980s either as a late-stage consciousness-raising project or a semi-political strategy session for lesbians in the city had evolved into, well: group. They were middle-aged now, these women. Together, they had been through career changes and health crises and teenagers’ crises and failing, aging parents. They leaned on each other. When there was discrimination (once, an after-school program denied a child’s registration because of his mother’s “lifestyle”), their group got outraged and then they mobilized. They listened to each other’s stories of playground slights and other insults that were overheard or imagined. They celebrated milestones and anniversaries; they aired grievances; one night, memorably, they bravely inspected newly purchased vibrators, strap-ons, bondage gear. Being lesbian, being middle-aged were often the subjects. But they were also women and mothers (most of them) and successful in their fields. Over the years their own individual stories had blended into a wider picture of life in a big city.

Or at least that’s what Merrill had thought. “What’s going on?” she said.

“I think you probably know,” Myra instantly replied. Of course, Myra. Always the shit-starter.

“I still think there’s a way we can handle this,” Kathy said, beginning to cry.

“Don’t get emotional, Kath.”

Still holding the dip, Merrill sat on the edge of the coffee table. “I take it there’s an issue with me being here.” She tried to keep her own voice calm.

“Is it true?” Rhona leaned against the doorway that led down the hall to her kitchen. “You’re dating a man?”

Merrill shot a look at Brigitta, who returned her gaze openly. “Dating is a weird word. I don’t know what I’d call it, but yes, there is someone that I’ve –”

“Were you going to tell us?” Kathy said, in a tiny voice.

“Well, it’s not that easy,” Merrill said. She gestured to Brigitta. “Other people’s feelings are involved and –”

“Don’t do me any favors,” Brigitta muttered.

Myra brushed imaginary crumbs off her pants. “We didn’t want to be put in this position, Merrill. Personally, I was betting you would step up and do the right thing.”

“What are you talking about?” Merrill said, looking from face to face with a growing sense that she’d stumbled into an intervention of some kind. She still expected to find someone’s smile breaking through. “It’s been OK with me and Brigitta — right? I mean, it’s been fine here with both of us coming. But not together. You know what I mean.” Flustered, she hugged the dish of artichoke dip.

“Of course that was fine,” Rhona said. “But –”

“But not everyone is comfortable with you jumping tracks here,” Myra said. “On a whim, apparently. What are you, experimenting? I mean, didn’t we all go through that phase about 40 years ago?”

“Most of us have been with men before! Kathy used to be married to one, for God’s sake.”

“Well, I haven’t,” Myra said. “And this is supposed to be a safe space.”

Merrill was speechless. Not safe? Brigitta — to her credit — had dropped her gaze to the floor. Soon, everyone was talking at once, backtracking, rationalizing: time to process this — how does it affect me — feel like I don’t know you right now .... Merrill could only sit there, stunned.

“It’s probably best,” Rhona said, in a soothing voice, “if you just ... you know. Until you sort out where you are in that relationship and what your future –”

“You want me to go?” Merrill said. No one answered. “You want me to go. OK.” She carefully set the casserole dish down on the table next to her and stood up. “So much for tolerance, I guess. So much for solidarity.” For friendship, is what she thought.

“But it is just experimenting, isn’t it, Merrill?” Kathy cried. “With this man? You’re just ... trying it out. For a little while.”

“Well, I don’t know if I can –”

“Do you really care about this person?” Rhona asked. She sounded genuinely curious.

Still standing, Merrill tried to form an answer. It was impossible, of course, with Brigitta right there in front of her. She hadn’t even slept with Sam Cohen! Yet. And how could she summarize the confusing mix of feelings that he touched off within her? She flashed on the standard protocol for diagnosing illness: To the patient, say nothing (even while symptoms piled up), until the tests came back.

So she left. It was a short trip to the foyer, and no one stopped her.

At the door, she paused, mind whirling. “It’s not as if I’m moving to the suburbs,” she said, trying a short laugh. Kathy was crying again, silently. Rhona had a hand on Brigitta’s shoulder, and Myra was staring, her eyebrows raised.

“Well, thanks,” Merrill said. “Thanks a lot.” And to cover the sudden shakiness in her voice, she rushed back to the table and snatched up the artichoke dip.

Two days later, she sat motionless in her office, with a cup of untouched coffee on the desk next to a pile of mail. It was 7:30 a.m., the reception desk was dark, and most of the lights in the hallways weren’t on yet. On top of the stack, a new issue of American Gynecology and an orange Post-it note with Bryce Dent’s handwriting: “You’ve probably already seen this, but ....”

No, Merrill hadn’t already seen it.

A cover story on a research team in Boston, whose trials in perineum realignment — using Merrill’s same methodology and treatment plan — had produced “significant positive results” and were “causing scientists and doctors in the area to take a second look at this previously little-known form of gynecological therapy.” Merrill could only read half of the article, especially after scanning the numbers in the trial: four times as many participants as she had, a statistical control group, funding for follow-up data ....

She crumpled Bryce Dent’s Post-it, pressing the sharp edges of the paper deep into the flesh of her palm. Whatever she completed could only be seen now as confirming — or not — someone else’s work. Why had she imagined she could compete with actual medical researchers, with their grants and labs and status, those doctors who had no patients or practice, nothing but time for their studies and data? And every name mentioned in the article had been male.

Claudia R. waited in examining room one, but Merrill could barely muster a smile to greet her. She moved quickly into the routine cardio checks, ran down a list of questions and stepped back outside to let Claudia change into the paper gown. In the hall, Merrill tried to recoup her thoughts: It didn’t mean her study wasn’t valuable, and there were local journals she could submit to. Maybe she could redirect the focus of her topic; maybe she could speed things up and put together an abstract by the fall. Or what she might do is spin her own data as particularly relevant to practicing OB/GYN — to doctors, not just researchers. After all, wasn’t that why she had started all of this in the first place?

As they went through a third round of electro-stim with the wand, Merrill noticed, even through her fog, a buoyancy in Claudia R. The small, round woman was positively beaming.

“Dr. French,” she said. “Everything’s better now. You see?”

No, Merrill didn’t see. She had no idea what Claudia R. was talking about.

Claudia gestured with her chin, down to the area between her legs. “You can tell?” she asked, shyly. “Is much better.”

Reflexively, Merrill glanced at the open chart to her left. For a split second, she recognized the bump — the way the plotted points led a wavering line of low, incredibly low measurements and then popped upward, just slightly, in the past month. Her hands were occupied, but she wanted to rub her eyes. Could there be any connection between the dots on paper, and Claudia R.’s claim of improvement?

Just then, the door to the exam room opened. Claudia made a sharp moan, scrambling to cover her exposed body with the paper sheet. Sitting between her patient’s bare legs, Merrill gaped up at the intruder — one of the new P.A.s, horrified.

“I’m sorry,” the young woman gasped. “You didn’t have the flag up”– the plastic indicator above the door. “And I thought –”

“Get out of here!” Merrill shouted. Dislodged, the electro-stim wand buzzed loudly. As the door quickly shut, she bit both lips, deeply shocked at the tone of her voice. Claudia R. held still on the table, whispering something in Spanish.

Merrill sat in bed and listened to her front door gently close. She listened to the receding footsteps, waited another 90 seconds and then picked up the phone.

“Hello again,” Sam Cohen said. He was slightly out of breath. She pictured him taking off his baseball cap, dropping the keys on the counter.

“Look, I never promised this would be easy for me. The physical part of it. It’s easy in one way — and not. Also, I’m sorry for before.”

“Apology accepted.”

“I didn’t mean it. And I know you’re not –”

“Merrill, it’s 1 in the morning. We don’t need to go through all this. Not right now.”

“I mean, maybe it’s a matter of just getting it over with, that first time. And once that’s done, I wouldn’t be so — you know — tense.”

“Close your eyes and think of England?” She heard the ticking of the gas as Sam turned on his stove and then water filling a kettle.

Merrill pulled the sheet away from her body. There was her belly, wide and pale, her breasts, large and soft, her thighs, her ankles, her bony feet. What did he make of it all? With Brigitta, sex was always so natural, so comfortable, even as everything else in their relationship went sour. Was it normal for this — sex with Sam, potential sex with Sam — to be so jumbled with thrills and discomfort? So charged? A razor’s edge, it seemed, separated excitement from disgust.

“Maybe it’s being here, in this bed,” she mused. “We could try over at your place.”

“Great. You know the way,” Sam said.

“Most of the time I’m turned on,” Merrill blurted, unable to stop. “But sometimes I’m repulsed. Not by you, just by your .... By it.”

“Ooh-kay. That’s –”

“But only when it’s flaccid,” Merrill said quickly. She clapped her hand over her own mouth. There was silence on the other end.

“I’m going to hang up now,” Sam Cohen said, a steely thread in his voice. “Let’s talk tomorrow. Preferably not about this, but –” She heard him sigh. “If we have to, we have to. Good night?”

Merrill looked around her room, but all the objects — dresser, rumpled bed, pile of books — were mute. They had nothing to offer her. He was a good man, she thought, but still a man, and he wouldn’t wait around forever. “Good night,” she whispered and listened to the answering click.

Gretchen K. was fully dressed — jeans, flat shoes, and a long, loose sweater. It was just September, but an early cool front had blown into Chicago. Merrill’s first thought as she entered the exam room was that she wished she had thought to bring a sweater. Then she stopped short, confused.

“Did you need more time?” She pointed to the folded paper gown on the exam table.

Gretchen swung her foot, a shoe dangling from her bare toes. She had a funny smile. “Of all people, I thought you’d be able to tell.”

Merrill waited. Then it hit her: “You’re pregnant.”

“Yup.” Gretchen slapped both feet back on the ground. “Six weeks, give or take a week. I took the test this morning. I haven’t even told Robert yet,” she said and let out a whoop. “Is that bad?”

“So you –”

“We weren’t even trying, not really trying, anyway. After everything with Eddie”– her autistic son — “this was the last thing on my mind. And, of course, I’m a million years old, so there’s that. But I have to say, I’m actually excited. I mean, I’ve had this crazy grin on my face all morning.” Gretchen K. pointed two fingers to her mouth and made a grotesque, exaggerated smile.

“Well, I .... Congratulations,” Merrill said. She realized she was holding Gretchen K.’s trial chart too tightly and she couldn’t stop glancing at the unused paper gown.

“I’ll stop by the front desk to make an appointment. I just wanted to come by in person. Dr. French? You OK there?”

“You have to drop out,” Merrill said flatly.

Gretchen K. just stared at her. “You mean — oh! Right. From your experiment. Well, yeah. I guess so. But that’s cool, because I’m going to be a wreck after this baby’s born anyway. Physically, mentally, everything. Those first months with a newborn are like a living nightmare.” She put a hand on her lower belly and smiled slowly.

Merrill thought that she had never seen her patient look so soft and at ease. Gretchen K. was beautiful, she thought. All the woman’s hard edges — though they were often the things Merrill liked best about her — had faded into a calmness. Merrill listened to Gretchen go on and on about due dates and screen tests and hand-me-down onesies, and at some point she put the chart on the counter, face down. Gretchen K. didn’t notice.

People crammed Washington Square Park on one of the last warm days of fall: senior citizens out for a midday walk, children chased by nannies, college students on cell phones. Everyone seemed out for lunch at this one spot, and Merrill found herself squeezed uncomfortably close to Brigitta on a bench they had been hard-pressed to find. It was the first time they had seen each other since the confrontation at group; Merrill had been too hurt to respond to Brigitta’s emails after that evening, although by now enough time had passed to allow her to pick up the phone, at 9 this morning, to suggest lunch.

“I’m sorry about the study,” Brigitta said.

Merrill carefully pulled a slice of tomato out of her sandwich and dropped it in a paper bag. “Me, too.”

“You won’t finish? Is there no other way?”

“I might be able to do something with the data, but it won’t be a journal article. Maybe a note, to confirm other people’s trials.” Merrill tried to peer at Brigitta without actually turning her head, but there was no sign of that infuriating shrug. “What I might do,” she went on, “is use the findings to lobby for more funding at the office, for some of the treatment to continue. I doubt we could get more than one electro-wand, but there’s a chance. A couple of the patients are definitely interested.” She thought of Claudia R., who was presenting significant improvement in all perineal measurements and who had recently asked — for the first time ever — about different birth control options. “The real problem would be Bryce and Steve. Although Steve might be coming around. In 10 or so years.”

“Neanderthals,” Brigitta spat. “They have no idea how lucky they are to have you leading the way.”

Merrill filled with warmth at the sound of her partner’s indignation. Her once-partner.

They watched a cluster of pigeons scatter and reform around the crusts and wrappers of someone’s fast food lunch.

“Did Kathy call you?” Brigitta asked, carefully staring ahead, blowing on her coffee.

“Yes, she left a message. That was nice, I guess. And Rhona stopped by, last week. We’re going to get a drink one night when she’s free.”

For a few minutes, they ate their lunch while the crowds swirled past.

“Forgive me, Merrill.”

“Of course.”

Sam Cohen was on top of her, and Merrill had her eyes shut. It was easier that way, or so she’d heard. No one had said so, but there hung in the room a sense of now-or-never.

He kissed her mouth and throat, and she ran both palms down his back. Sam pushed himself down to her breasts and he licked them for a while; he put his lips all over her belly and her legs and back up again. On the darkened inside of her eyelids, reddish blobs swept by like clouds. Descriptions for what she was experiencing formed and, before she could put catch them, dispersed. Heat built. Sam Cohen’s body was wiry, not as hairy as she would have guessed, and when his full weight was on her — well, it came as a shock how much she loved that. But still: advance, barrier, retreat.

Many years ago, during the fourth delivery she attended, things went very wrong, very fast. The baby was posterior and stuck tight halfway down the canal: Monitors spiked, fetal heart rate dropped, maternal heart rate surged. The nurses, old hands, who up to now had offered plenty of pointed “Sure, Doctor” comments to their brand-new resident, all went silent. Merrill remembers paging frantically through a prodigious amount of information stored in her brain, knowing there was no time to get a consult. Windows of opportunity — prepping for a C-section, ordering forceps — slammed shut before she could act. Just as the mother was about to code, Merrill reached deep in and took hold of the baby’s face. Blindly, she felt for the jaw and once she found it, locked her fingers underneath. Several harrowing seconds later, the baby was out.

The techniques and training fell away, everything she had memorized, until she was left with the most basic of physical instincts: grab and pull. Really, a teenager could have done it. Merrill was dismayed and embarrassed for a long time, until eventually she began to incorporate that experience into her story of herself as a doctor and even found herself using it when she taught new residents on rotation.

And that baby, the one she had yanked out, was now 19 — a burly kid who played the clarinet in his college marching band. His mother still sent a Christmas card every single year, long after the family moved to Rhode Island. Although Merrill saved few of the photos her many patients mailed her, she kept these in her office, each one, tucked inside her old reference texts — Moore and Hacker’s “Essentials of Obstetrics,” Bates’s “Guide to Physical Examination.”

In her bedroom now, Merrill put her hands on Sam Cohen’s shoulders and pulled him to her. It wasn’t hard to feel her way into the right position. His breath caught, but she kept arranging until they were lined up and on the brink: nose to nose, her thighs around his.

Then Merrill opened her eyes. Everything stood still. She raised her hips.