She shifts her weight on Dr Wainscott's couch and hunkers like a child settling in for a story. Transfixed in his armchair, Dr Wainscott mentally scrabbles for an answer that could satisfy her. Unfortunately, he can't think of one.
*
Bernadette Fry walked into his office for the first time about a year ago, her hair uncombed and her gaudy dress too tight. Dr Wainscott gestured at a seat and she dropped into it, fat shimmying. According to her file, she had no chronic illnesses, prior surgeries or major health concerns - apart from this one. Her mammogram pictures were clipped to the light box on the wall.
Dr Wainscott removed his glasses. "If I may call you Bernadette," he said, and indicated the pictures with a roll of his wrist. "Now Bernadette, this image is of your left breast and this one is of your right. These spongy areas suggest normal breast tissue. And this little spot here, on the left." He tapped the arm of his glasses against a starfish shape. "Do you see?"
"Yeah."
"That spot isn't what I would consider to be normal breast tissue."
"So I have cancer."
She said it as a statement rather than a question, which surprised him. He leaned back in his chair and said, "Yes, Bernadette. I believe the lump you found is what's known as invasive ductal carcinoma."
"But you're not sure?"
He put his glasses on his nose. "I've been the cancer surgeon in this town for close to thirty years. I would think, Bernadette, that after all the cases I've treated, I can recognise breast cancer from a mammogram, don't you?"
Bernadette Fry didn't respond. Her grey eyes took him in and waited.
Dr Wainscott opened his diary and checked his schedule. He picked up the handset on his desk phone, flipped the intercom and asked his secretary whether Friday morning at the hospital was clear. She put him on hold while she called the hospital, then got back to him and said yes, theatre two would be available on Friday at eleven o'clock and should she book it for him? He said yes, hung up and made a note in his diary, wrote a few lines in the medical file, then regarded Bernadette Fry. The arrangements had taken him some five or six minutes - more than enough time for most patients to be pulling handfuls of tissues from the dispenser on his desk - but she was humming and looking at a wall-mounted poster on skin cancer awareness.
"I can perform your operation on Friday morning," he said, and she stopped humming and turned to him. He said, "I'll do a lumpectomy. Most of your breast will remain but you'll need radiotherapy. That's a kind of x-ray that kills off any remaining cancer cells but don't worry about that now, we can talk about further treatments after you've recovered from surgery."
Bernadette Fry stood up in a single motion, quick for her size, and the raft of disturbed air carried a scent of sweat and sunscreen lotion. Dr Wainscott took off his glasses.
"Don't you have any questions?" he said.
She stopped at the door. "Okay, what time do you want me at the hospital?"
Friday at eleven o'clock sharp, nurses delivered Bernadette Fry prone on a gurney into operating theatre number two. The anaesthetist knocked her out. Dr Wainscott removed her tumour, along with a thick rim of healthy tissue just to be sure, and dropped the grey and red mess into a kidney dish for the nurse to take to the pathologist. Next, he opened Bernadette Fry's armpit on the same side and scooped out two lymph nodes, stained blue from the pre-op injection, and tossed them into another kidney dish. Then he paused to reflect. With just a few swipes of his scalpel, he had saved the life of Bernadette Fry.
*
Dr Wainscott drove home in a contemplative mood. The traffic at half-five was light, as always - with a population of just forty-eight thousand, peak hour lasted no more than ten minutes. His Edwardian-style bungalow sat on the only hill in town. He eased his Mercedes into the single garage, parked, took the interior door straight into the kitchen. At the bar, he fixed a whisky and soda. Then he changed into shorts and a singlet, sat on the balcony and worked on his drink and then another as he watched, as he did every night, the lights from the street lamps and houses below switch on and pin-prick the dark.
Like any other Victorian town, this place had its Main Street, turn-of-the-century clock tower and rash of truck stops but it had one distinguishing feature: a tourist attraction named "The Big Broccoli", which Dr Wainscott could see from his balcony. Back in the 1970s, one of the mayors had authorised its construction in honour of the town's major export - broccoli, naturally. The concrete and steel fabrication was a twenty-foot sprig of its vegetable namesake and housed a gift shop that stocked items such as broccoli magnets, t-shirts and stubby holders. Behind the gift shop in a separate building was the Big Broccoli Bistro, dubbed "the Triple B" by locals. The Triple B had always been a low-rent pub for drunks and gamblers, but in the past year or so, new management had transformed it into one of the district's most popular restaurants. And new management - according to the anaesthetist who had gossipped to Dr Wainscott over the various unconscious bodies in theatre that day - was none other than Bernadette Fry.
Dr Wainscott finished his second drink and thought about making a third. On the horizon, clouds were bunching in a dark scrum, threatening havoc, but he knew that the much-needed summer rain would head east as usual and waste itself in the ocean. He went inside.
*
"She refused chemotherapy."
"Come again?" Dr Wainscott said.
"She wants to keep her fertility. To be a mum some day, I guess."
"But she's over forty. And what man would have her?" Dr Wainscott went to the urn to make a coffee he didn't want. Behind him at the clinic's staffroom table sat his long-time associate, medical oncologist Dr Emily Ta. Since she was close to fifty and didn't have any children herself, Dr Wainscott hurried on and said, "Doesn't she realise the cancer could return? Hasn't she seen the graph? You showed her the graph, didn't you? Granted her lymph nodes were clear, I accept that, but does she understand that cancer cells can travel through blood as well as lymph? Did you tell her?"
"Of course."
He stirred his coffee, dropped the teaspoon into the sink and said, "Well, isn't that rich. Isn't that just a show and a half." He stuffed his hands into the pockets of his white clinician's coat. "Did she seem upset?"
Emily shrugged. Dr Wainscott abandoned his coffee on the draining board and left the room.
*
Apart from Emily Ta, Dr Wainscott's only other associate at the clinic was radiation oncologist Jason McDougall. Dr Wainscott had arranged to have their regular Tuesday meeting at the Triple B rather than the clinic staffroom and Jason was late. Dr Wainscott bought a whisky and soda and tucked himself into a booth that had a line of sight to both the bar and the front door.
The remodelled Triple B was a kind of sports bar but it didn't feature the memorabilia of famous Australian athletes; instead, it showcased players from clubs around the town and surrounding districts. Photographs, local newspaper clippings and significant items of small-time glory filled every wall. Next to Dr Wainscott's booth, for example, hanging in a mahogany frame complete with an engraved silver plate, was the jumper worn by the sixteen-year old captain of the town's A-side football team during their Grand Final win last season. At first, people had come to the refurbished Triple B to bask in the public homage to their sons, daughters and friends but they had returned for the menu. According to the anaesthetist, you needed to book a table for Saturday night at least one week in advance, regardless of who you were.
Dr Wainscott took a gulp of his drink and surveyed the bar. And there she was like the shock of cold water, emerging from a rear doorway, Bernadette Fry in a loud print smock, breasts jouncing against her belly, frizzy hair wrestled into a topknot. Dr Wainscott hunched down in the booth. He couldn't hear her but he could see her well enough. She chatted to her bar staff, laughed, then shouldered through the rear door and disappeared.
"I can't believe it, sir, you're drinking."
Dr Wainscott turned. Dr Jason McDougall, standing a metre or so from the booth, must have entered from an unseen side entrance. Dr Wainscott scowled. Jason had the pinned pupils and jittering intensity that suggested drug addiction, and a personality that made Dr Wainscott miss the previous radiation oncologist, a diabetic smoker who had retired to Queensland last year with his fourth or fifth wife.
Dr Wainscott swallowed whisky and soda. "Give me the radiation summary for Bernadette Fry."
"Yes sir," Jason said, and took a seat at the booth. "Twenty-five treatments for the whole breast and five boosters to the tumour bed, which amounts to thirty treatments altogether over six weeks with weekends off, assuming the machine doesn't break down."
"Did she have concerns? You haven't listed any in her file."
"None."
"None whatsoever? All right, fine. And I see you've written her down for Wednesday morning checkups. I'll be sitting in."
Dr Wainscott raised his glass in an unusual display of camaraderie and Jason blushed and grinned in return.
*
The oncology wing of the local hospital featured the only external-beam radiotherapy machine for hundreds of kilometres. Nicknamed the Blue Whale by its technicians, the monster filled a cavernous room, was finished in a baby blue powder-coat and could swivel on mighty pivots both horizontally and vertically above its fixed stretcher. The Blue Whale had cost over two million dollars and it was a beauty.
But three weeks into her radiotherapy treatment, Bernadette Fry complained of gastritis. The next week, she added heartburn and reflux to her list of grievances. The week after, she grumbled about abdominal bloating and what she delicately described as "changes in bowel habits". Dr Wainscott blamed these symptoms on stress and Jason agreed. At her sixth and final checkup, Bernadette Fry said, "I rang a Melbourne expert in radiation side effects and she reckons it's the radiation."
Jason looked at Dr Wainscott. Dr Wainscott ignored him and said, "What you're talking about, Bernadette, is called 'mucositis'. It only happens if the alimentary tract is in the direct path of the radiation. In your case, the alimentary tract is clear."
Bernadette Fry didn't argue. She took off her shirt and bra and kept quiet during the brief medical examination. The radiation damage was mild - peeling skin, a blackened crescent of blistered flesh in the armpit and beneath the breast, charring of the nipple - and Dr Wainscott dismissed her. In her medical file, he wrote, "Patient is delusional and in need of psychological help. Will advise the nurse accordingly." Then he slid the manilla folder across the desk so that Jason could sign the entry.
But according to the breast care nurse, Bernadette Fry refused the offer of free psychological counselling. Soon after that, the town hospital's Patient Advocate called Dr Wainscott and Jason into a meeting.
Bernadette Fry had complained that her cancer care was uncompassionate and negligent. In her written statement, which the Patient Advocate allowed Dr Wainscott to read, Bernadette Fry noted that the doctors had not investigated her gastrointestinal symptoms - an oversight that the Patient Advocate could write into Dr Wainscott's record despite three decades of consistent and exemplary life-saving.
Dr Wainscott placed Bernadette Fry's statement on the Patient Advocate's desk and composed himself. He could hear Jason breathing rapidly in the chair next to him. "We examined her," Dr Wainscott said. "And her symptoms were imaginary."
The Patient Advocate shelved Bernadette Fry's complaint.
*
Dr Wainscott paced his balcony with a drink in one hand and cordless phone in the other. He said, "Harvey, if we do nothing, it's her blood on our hands."
"You're telling me she's suicidal?"
Dr Wainscott downed a slug of whisky. It was strong without the soda and he shuddered.
"Are you still there?" Harvey said.
"Yes, yes, I'm here. Listen, Harvey, you're the chief clinical psychiatrist around here, don't tell me you don't have the shove to get a favour or two."
The following week, just after the lunchtime rush on a Thursday, two police officers turned up at the Triple B and took Bernadette Fry to the psychiatric unit of the local hospital. She asked to be booked as a voluntary patient. Within an hour of her admission, a staff doctor gave her the mandatory physical examination. Two hours after that, she was brought before Dr Harvey Bennet and two of his colleagues and put through a detailed psychiatric assessment. Based on their joint findings, Dr Harvey Bennet and his colleagues immediately released Bernadette Fry. The police officers who had taken her from the Triple B were the same ones who drove her back and both of them stayed for nachos and beer on the house.
*
About six weeks later, Dr Wainscott was at his office performing a follow-up review with a patient when his secretary buzzed the intercom; the Public Advocate was on the line. Dr Wainscott apologised to his patient for the interruption and took the call.
"Bernadette Fry didn't like her visit with Harvey," the Public Advocate said. "She's got the Health Services Commissioner on side."
"All right, thanks for letting me know," Dr Wainscott said, and felt the sweat pop to his face.
He called an emergency meeting after lunch. Jason came to the clinic staffroom with a bag of muffins and ate steadily during the wait for Emily. She arrived at last, clutching her handbag and a rolled-up magazine, but remained in the doorway.
"Did that Fry woman complain again?" she said.
"I don't know," Dr Wainscott said, "but I suppose it would be prudent if we made a plan."
"For what?" Jason said.
Dr Wainscott stood up, clattering his chair. "This is serious, this is a Victorian government thing, the Health Services Commissioner has the power to shut us down."
"Us?" Emily said, and slapped the rolled magazine against her thigh. On her way out the door, she said, "If it's that Fry woman again, it's got nothing to do with Jason or me."
Dr Wainscott returned to his office and called his union rep, who wasn't any help. So at the end of his working day at the clinic, Dr Wainscott drove his Mercedes at the glowing green dome of the Triple B. In the car park, he killed the engine and sat for a while. Against the fence, a breeze idled at fallen maple leaves, stirring them into a lazy circle; it was the start of winter and still no rain.
Inside, he sipped at a double whisky for nearly twelve minutes before the door behind the bar opened to reveal Bernadette Fry, resplendent in a purple velvet dress. She crooked a finger and he followed her around the bar and through the doorway. The whiff of cleaning products brought an operating theatre to mind. The staffroom was crammed with fridge and sink, formica table, two vinyl chairs and the bulk of her voluminous body.
"Take a seat," Bernadette Fry said. "Coffee?"
He shook his head. While she boiled the kettle and fixed herself a drink, Dr Wainscott looked at the curios of meaningless sporting achievement that decorated the walls. Almost at eye level was a black-and-white photograph of a fat person, comically spherical in a wetsuit, brandishing flippers and a mask and standing on the deck of a boat. Then he realised that it was a shot of her, the hood of the wetsuit concealing the wiry hair to fool him, but before he could lean in for a better look, Bernadette Fry sat at the table. She had to angle her chair into the middle of the room because her thighs wouldn't fit between the table legs and he thought momentarily of how it might feel to press his feverish face against those soft, velvety knees. He waited for her to speak but she appraised him with distant eyes and said nothing.
Finally, he said, "Bernadette, my dear, have you thought about what you want?"
She smiled with one side of her mouth. "Yeah, a scan of my whole body."
"But I was told you weren't interested in chemo."
"Not for that, to see if I have cancer anywhere else."
The tension went out of his shoulders. He actually smiled and meant it. "All right, Bernadette, it's a deal. CT or MRI?"
"Which is better?"
"It's much of a muchness, really."
"Then either one and I don't want to pay for it."
Within a fortnight, Bernadette Fry had her CT scan at no charge. Just over one week later, the deputy Health Services Commissioner of Victoria called Dr Wainscott at his office to tell him he was required to attend a hearing in Melbourne and that he may bring his lawyer if he wished. Dr Wainscott thanked the deputy Health Services Commissioner, hung up the phone with great care and paused, reeling.
So it had come to this, somehow, for a surgeon who couldn't walk down Main Street on a Sunday morning without at least one ex-patient, brimming with unshed tears, stopping him to shake hands or kiss his cheek. Shocked, Dr Wainscott felt wetness on his own lashes. This single glitch, somehow, might mean more than the miracle of one thousand lives that still ticked on earth solely because of him.
He had no choice but to call her. Bernadette Fry wished him good luck and hung up. Dr Wainscott returned the handset and leaned over until his forehead rested on the cool desktop. He closed his eyes and focused on the pulse fluttering at his throat. After a time, his secretary knocked on his office door and delivered the mail. One of the envelopes held Bernadette Fry's CT scan results and the significance of this coincidence forced Dr Wainscott to pray for the first time since childhood.
Then he opened the envelope and read the report. Bernadette Fry had her answer. The telephone was near his right hand. And at his left hand, underneath the desk, sat the paper shredder.
*
Dr Wainscott recalls this moment of indecision. He tries to smile then says, "I'd very much like to talk about it with you."
"Okay," Bernadette Fry says. "So tell me why you did it."
The daylight has drained from Dr Wainscott's lounge room but he can't move from his armchair to switch on the lamp because he is trussed with duct tape. Bernadette Fry, sitting in his couch with the coffee table between them, is reduced to a silhouette. The balcony is behind her and the town, with its points of warm yellow light streaming from the hundreds of homes below, is beyond his view.
At last, Dr Wainscott says, "We both took things too far. You nearly cost me my licence. The Health Services Commissioner went through me like a dose of salts, my dear, and the legal fees were horrendous."
She says, "You told me the scan was clear."
"Did I? Then it must have been."
Bernadette shakes her head. "This morning, I tracked down a copy of that report from the hospital. The report they posted to you. The one you called me about."
"I don't remember."
"You don't remember my liver tumour?"
Bernadette raises one of her hands, the hand that's holding the spear gun, and Dr Wainscott's chest seems to shrivel in on itself as if anticipating the terrible blow. He shouts, "It was six months ago and I don't remember, I swear. Please don't, Bernadette, please. For god's sake."
Despite the dark, Dr Wainscott can see Bernadette Fry lower the spear gun. Her hand, resting on her thigh, angles the weapon harmlessly at the floor. Dr Wainscott can breathe.
Then she says, "Listen to me very carefully. Tell me the truth right now and I won't shoot. Hurry up or the deal is off."
Dr Wainscott, sweating through his clothes, stares into the wild halo of her hair and says the first thing that comes out of his mouth.
