Next of Kith

Jacob M. Appel

[av_hr class=’custom’ height=’50’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-fat’ custom_width=’100%’ custom_border_color=’#372a55′ custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’no’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’ admin_preview_bg=”]

Through thirty-six years as a general surgeon at New York Episcopal Hospital—during which she extracted over two thousand gallbladders, fifteen hundred appendixes, scores of thyroid glands, three miles of small bowel, and eighty-four foreign bodies, including a tie clip left behind by a colleague—Dr. Emma Inkstable had grown increasingly skeptical of human weakness. Let the headshrinkers spew their claptrap about clinical depression and generalized anxiety and post-traumatic stress; in a handful of extreme cases, they might have a point. So might the social workers with their tragic tales of stolen childhoods. Yet as far as Inkstable was concerned, all that most able-bodied people required to keep themselves on track was a strong work ethic—and, failing that, an equally strong kick in the pants. If she—the homely daughter of an unmarried switchboard operator—could hold her own against the good old boys in the OR, she didn’t see how anyone else had a right to complain.

“I make no apologies for how I see the world,” she told Sarah Steinhoff, the spirited high school junior who’d come to write her profile as part of a special college prep summer course. “I do realize I’m not going to win any popularity contests for what I’m saying. But if I sound callous, even heartless, it’s because anybody who’s lived as long as I have and doesn’t sound a tad heartless must have her head in the sand.”

“How old are you, Dr. Inkstable?”

The girl appeared oblivious to her own impertinence. She was a pretty creature, pert and busty, with a mane of auburn curls. Inkstable was glad they’d sent her. When she’d volunteered for the program, which paired aspiring female journalists from broken homes with recently retired professionals, all graduates of Hunter College, she’d feared getting stuck with some mousy, spiritless child who hid from her own shadow. Instead, they’d given her Mike Wallace in a low-cut blouse.

“I’m old enough, young lady,” replied Inkstable, “to remember a time when it was considered indecorous to ask a woman her age.”

“And how old is that?” inquired the girl.

Inkstable grinned, in spite of herself. “Next question.”

This was their third interview. On the first—the morning after the surgeon’s final day at the hospital—she’d given Sarah a realtor’s tour of the apartment. During the second, she’d shown photographs from her two-year stint at the National Institutes of Health. This evening, they sat in Inkstable’s kitchen, the air-conditioner groaning under the July heat, adversaries united in mutual-if-grudging respect.

“So however old you are,” said Sarah, brandishing her microphone like a stiletto, “you’ve obviously lived through a lot of changes during your career. What I want to ask you about next is the AIDS crisis. Specifically, what did you do to confront it?”

“I’m really not sure what you mean.”

“It was the 1980s. All of these men were dying,” pressed the girl. “How did you change your life to help them? For example, you could have opened up a clinic….”

Although Inkstable recognized the question as absurd—no more reasonable than asking what she’d done to end the Cold War—the girl’s sincerity unsettled her. She’d always thought of herself as living a life that mattered. She’d spent her days plunging blades into human flesh. She’d forestalled death. If she’d taken a pass on marriage and children—well, marriage and children weren’t the whole ball of wax. But over the last several weeks, as the sixty-eight year-old surgeon contemplated her future (and, if she took good care of herself, that future might extend another three decades), she’d experienced a subtle yet disquieting sense that she should have accomplished more. It was a new feeling for her. Not of failure, exactly, but of detachment. Now, Sarah’s cross-examination exacerbated that unease.

Fortunately, before any need arose to deflect the girl’s questions, the telephone sounded in the foyer. She reached it on the second ring. “Dr. Inkstable speaking.”

“I’m sorry to disturb you,” replied the caller in a tone genuinely apologetic. “My name’s Dr. Sucram. I’m one of the medical doctors taking care of Harry Hager.”

Inkstable didn’t recognize the name, but that was not unusual. She fielded countless phone calls about former patients she didn’t remember—though rarely at home on a Tuesday night. What seemed strangest was that the patient apparently had suffered a hemorrhagic stroke. Hardly a matter for a general surgeon.

“I think there’s some misunderstanding,” interrupted Inkstable. “Are you sure you want Dr. Inkstable from general surgery?”

“Oh, you’re a doctor,” said the caller, obviously surprised. “Sorry, Mrs. Inkstable—I mean Dr. Inkstable. I didn’t know. You have to understand that Mr. Hager isn’t lucid at the moment. But he had a note in his wallet with your name and phone number, so the attending asked me to call you.”

A glimmer of insight kindled in Inkstable’s mind. Maybe Harry Hager was mustached “Mr. Hager” from apartment 2B. Of course! She’d seen the name on his mailbox thousands of times over the years. But while she’d always been friendly with her neighbor—he’d worked at a library, she believed—their conversations had been largely confined to small talk in the elevator and laundry room. Hager had always impressed her as being an extremely private man, as someone nourishing a rich inner life. How strange that he’d have her name and number on his person.

“Which hospital are you calling from?” she asked.

Inkstable jotted down the floor and room number. Under the circumstances, the least she could do was to pay a visit.

When she glanced up from her pad, she found the young journalist spying on her from the kitchen doorway. “Do you want to make a sick call?” Inkstable asked. She didn’t have the energy to reproach the girl for eavesdropping.


Forty-five minutes later, they rode the elevator to the neurological ICU at Manhattan County Hospital. They’d caught the public bus—since her retirement, Inkstable was trying to take fewer cabs—and the surgeon enjoyed thinking that other passengers might mistake the girl for her daughter. As she’d informed Sarah en route, the care delivered at “County” was “slightly better than at a veterinary clinic.” Her companion had dutifully scribbled the remark in her notebook.

On the seventh floor, the air smelled pungently of disinfectant. Fluorescent tubes cast a hideous pink glow over the tiles. At the entrance to the neurological ward, a double-sided yellow sign warned that the floor was wet.

“Does it feel strange?” asked the girl—following Inkstable past the nursing station. “To be in the hospital now that you’re retired?”

“Not really,” lied Inkstable. “In the OR, maybe I’d feel different.”

They arrived at the curtained alcove where Harry Hager lay attached to a ventilator and a wall of monitors. You didn’t need a medical degree, reflected Inkstable, to realize that things looked dire. Her neighbor had always been on the lean side—wiry, with delicate features—but in his hospital gown, he appeared downright scrawny. The secret truth was that she’d once thought him handsome, albeit in passing. He was only three years older than she, she learned from his wristband, although she’d always suspected that a solid decade stood between them. For the first time, it struck her that taking a high school student to see a dying stranger might require parental permission.

She clasped Hager’s discolored hand; on instinct, she felt for his pulse.

“What are his chances?” asked Sarah, cool as ice.

“We all have the same chances in the long run,” quipped Inkstable—a remark honed on years of junior surgeons.

“And in the short run?”

“That,” replied Inkstable cautiously, “is a question for a neurologist.”

The neurologist arrived several minutes later, Dr. Sucram herself, a second year neurology resident. Behind her, looking rather like an injured lamb, stood the intern, Dr. Borrelli. “Are you Dr. Inkstable?” Sucram asked, offering up a hand with five burgundy fingernails. “I believe we spoke on the phone.”

“Indeed,” said Dr. Inkstable. “I take it things are as grim as they look.”

Her comment seemed to fluster the resident. “I can’t tell you how glad we are that you’re here,” she finally said. “We have to make a decision about surgery. His best bet is to put in a coil and drain some of that fluid—but, as I’m sure you know, he might come out of the OR pretty damaged. So the alternative is to let nature take its course…”

A long silence ensued, punctuated only by the rhythmic bleats of the cardiac monitor and the angrier tones of the IV pump as the saline solution ran low. Suddenly, Inkstable realized that they wanted her to decide.

“I’m not a relative,” she explained quickly. “I’m just a neighbor….”

“Do you know how to get in touch with his family?”

The short answer was no. She didn’t even know if he had family.

“In that case,” said Dr. Sucram, “as a neighbor who knows him better than we do, you’re allowed to act as his surrogate. If you’re willing, that is….”

“And if I’m not willing?” asked Inkstable.

Dr. Sucram toyed nervously with her engagement ring. “It would be really helpful if you could make a decision,” she said. “You did know him, after all….”

“What you mean,” replied Inkstable, unwilling to brook nonsense, “is that you don’t want to call the attending at home to tell him you can’t find a relative.”

That caught the junior physician off guard. Sucram shifted her weight from her right leg to her left, and for a moment Inkstable feared the young woman might flee in panic. It was July, after all, probably the resident’s very first night as the ranking house officer on call. Inkstable immediately regretted her harsh words—and especially uttering them in front of the high school journalist.

If she’d been in her neighbor’s shoes herself, Inkstable knew, she’d never have wanted the surgery. Better to end up dead than half-head—locked away in some nursing facility weaving baskets and re-learning how to count. But just because those were her own wishes didn’t mean they were Harry Hager’s. What if a relative showed up and said he’d have wanted every heroic measure?

“Okay, I’ll decide. For now. Until you can locate his family,” she said. “You’d better put in that coil and drain what you can.”


Inkstable left her cell number with the resident—“in case of inopportune developments”—and returned to her apartment. The next morning, at the start of visiting hours, she was back at Hager’s bedside. Sarah Steinhoff had secured permission from her summer program to accompany her. “It will be good exposure for her,” the girl’s aunt told Inkstable on the phone. “Maybe it will convince her to go into medicine like her grandfather.” While the surgeon suspected that the opposite might prove true—that a day beside the stroke victim could permanently kill any thoughts of a medical career—she didn’t have an axe to grind either way.   She wasn’t even sure why she’d come to the hospital herself, seeing as she had no formal connection to Hager. The poor man remained unconscious, his head now wrapped in gauze.

Sarah continued the interview during their visit: What was the worst mistake she’d ever made in the operating room? How did she feel about caps on malpractice lawsuits? What had she done to advance the cause of women in surgery? To this last question, she wanted to answer: “I existed.” Instead, she humored the girl with twaddle about all of the junior colleagues she’d mentored. Meanwhile, Harry’s ribcage rose and fell with his breath, his eyes swollen beneath closed lids, the cloak of impending death draped over his emaciated body.

Dr. Pastarnack, the neurology attending, made an appearance in the early afternoon. He was a pudgy, egg-bald gnome of a man; his lavender bowtie matched the handkerchief in his breast pocket. “So you’re the next of kith, I hear.”

“Excuse me?”

“When we can’t find a patient’s next of kin,” explained Pastarnack, beaming, “I like to say that at least we’ve found the next of kith.”

I’m not even that, thought Inkstable—but it wasn’t worth explaining.

“Mr. Hager,” called the neurologist. He rubbed the patient’s sternum, yanked open an eyelid, pressed his reflex hammer against the man’s nail beds. “Earth to Harry. Earth to Harry.” Inkstable’s neighbor remained unresponsive. Pastarnack turned to her and said, “I just looked at the imaging. That bleed did quite a number on his noggin, but we probably won’t know too much for a few days yet.” Then Pastarnack scanned the vitals clipboard at the foot of the bed and waved goodbye with a high-pitched “toodle-oo” that might either have been earnest or ironic.

“Sarah, dear,” said Inkstable, as soon as he’d departed. “Do me a favor. If you ever become a physician and, for some inexplicable reason, you’re tempted to refer to a stroke victim’s brain as his ‘noggin,’ or to call a surrogate ‘the next of kith,’ kindly resign your medical license at once.”

That led to a long discussion on the decline of formality in doctor-patient relationships, and in society more generally. “When I flew to my first medical conference,” recalled Inkstable, “I dressed up for the plane flight. I even wore jewelry. Nowadays, people travel first-class in dungarees and t-shirts.  They go to the theater in dungarees and t-shirts. I’ll never get used to that.” To Inkstable’s amusement, her ‘biographer’ embraced the other side of the argument. They were still debating the subject with gusto, two hours later, when Harry Hager blinked himself awake.


At eight o’clock the next day, Inkstable found Zyke, her Latvian doorman, and described what had happened to Hager. Unfortunately, the box beside her neighbor’s name on the building’s “emergency contact” list stood blank. (Inkstable was jarred to realize that her own emergency contact, a childhood friend, had been dead for five years.) After several lengthy conversations with the building agent, which also involved input from the management company’s attorneys, Zyke used a spare key to let her into Hager’s apartment.

2B was the mirror image of her own 2G. Its contents were largely as she might have anticipated: a living room lined floor-to-ceiling with hardcover books, a bedroom as sterile as a hotel suite. The only surprise was a peculiar musical instrument—Inkstable believed it to be an English horn—resting on the nightstand. She couldn’t recall her neighbor ever playing; she’d certainly have heard him practicing from across the courtyard. No television, no photographs. More significant for Inkstable’s purposes was the absence of an address book that might contain contact information regarding Hager’s family. As close as she came was a post-it note stuck to the refrigerator which read ‘Cousins in Israel,’ followed by an international number, but she phoned multiple times and reached only a machine. Eventually, she left the hospital’s info after the beep. Without even the cousins’ names to go on, what more could she do? Under Zyke’s watchful gaze, she also packed an overnight bag with her neighbor’s clothes.

Over the ensuing days, Hager displayed flickers of recovery. He managed to sit up in bed and even to swallow the Jell-O that Inkstable fed him, although he remained delirious throughout, and kept mistaking the surgeon for his grandmother. He had a vague notion that he was in a hospital—but couldn’t remember its name, despite daily reminders from Drs. Sucram and Borrelli. To Inkstable’s surprise, the budding journalist continued to join her at Hager’s bedside. “I want to see you in action,” explained the girl. “In New Yorker profiles, the reporters follow people around.” That drew an authentic laugh from the surgeon—her first laugh, she realized, since retirement.

The only unpleasant aspect of Inkstable’s duties—and that was how she thought of them—was the fifteen minutes each afternoon when Dr. Pastarnack stopped by to check on his patient’s progress. “So the next of kith is still with us,” he declared, as though the witticism were falling on virgin ears. “And how’s Harry’s ‘noggin’ doing?” He’d close each visit by pressing the stroke victim for some absurd task: Are you up for translating some Sanskrit today, Harry? Or Ready for some differential equations this morning? Or If you name the Roman Emperors in order, Mr. Hager, I might just let you go home…. Inkstable’s neighbor responded with a benighted smile. Occasionally, he added a “thank you,” if he concluded that gratitude was in order. As soon as Pastarnack left, Inkstable threatened the air that she’d report him to the state licensing authorities.

A lesser inconvenience of her newfound duties was that they required the surgeon to postpone several ventures she’d set up to launch her retirement. She’d previously committed to teaching scientific literacy in a GED program and to recording mental health journals for distribution to vision-impaired psychotherapists. Both of these endeavors, she postponed until September. She also put off a long-planned trip to Seattle, where her college roommate had settled, pleading “an illness in the family.”

Would she have gone to these lengths for a different neighbor? Possibly not. The truth was that during her long hours at Hager’s bedside, and especially during the bus trips to and from the hospital, Dr. Inkstable replayed her encounters with the man—numerous, seemingly trivial interactions—and she concluded that the poor fellow had been (as her own dear mother might have said) sweet on her. One time—she’d nearly forgotten—she’d run into him in the lobby, returning from her fiftieth birthday party, her canvas bag brimming over with presents; he’d congratulated her—and then knocked on her door several minutes later with a present of his own: A biography of the pioneering surgeon William Stewart Halsted. She’d never actually read the book, although she’d told him, on their next encounter, that she’d enjoyed it very much. On another occasion, only a few years ago, he’d received a crate of oranges from Haifa, and he’d invited her to claim as many as she wanted. Again, she never followed up. At the time, it hadn’t even crossed her mind that his conduct was more than neighborly—she was an old maid, after all, and not pretty—but now that they’d found her name in his wallet, she saw how oblivious she’d been. Not that she had any real regrets. She was simply disappointed in her own blindness.

“You used to have a crush on him, didn’t you?” asked the girl.

That was five days after Hager regained consciousness; they were chatting in the visitors’ lounge, waiting for him to return from an MRI. The only other occupants were a pair of obese sisters glued to a telenovela.

“Don’t be foolish.”

“I knew it. You’re blushing,” gloated Sarah. “I have very good intuition about these sorts of things.”

“Well, in this case, your intuition is dead wrong,” said Inkstable. “I don’t believe I exchanged more than one hundred words with Harry Hager in my entire adult life.”

“Maybe so. But that doesn’t mean you didn’t have the hots for him.”

Inkstable glanced across the room, afraid the sisters might overhear her. “Enough of this nonsense already,” she warned. “It doesn’t matter anyway.”

“It could,” replied the girl. “What if he gets better? I know the odds are low, but if Mr. Hager made a full recovery, would you go out with him?”

“If grandmother had testicles,” said Inkstable, “she’d be grandfather.”


“Nothing. Just an expression I shouldn’t have used.   But the point is the same: Harry’s not going to recover, and I’m far too old to be dating anyway.”

“But that’s not true. My aunt’s mother-in-law got remarried at eighty—”

Inkstable held up her hand. “She’s her. I’m me,” she said. “New topic.”

And yet, from that moment forward, the remote possibility that Harry Hager might make a full recovery, and that she might ‘go out’ with him, was never far removed from her thoughts.


Hager’s condition improved at a glacial pace. He had good moments, when he seemed to recognize Inkstable, and one breakthrough, when he remembered her name was Emma, but ten minutes later, he was calling her Granny Louise and asking her for help with his schoolwork. Yet cognitive reconstitution after a stroke, Inkstable recognized, often took many months. Even years. She’d read somewhere about a firefighter in Iowa or Idaho who’d awoken from a post-hemorrhage coma after three decades. Compared to that hapless fellow, Harry seemed in strong shape. By the end of his second week in the hospital, he’d been transferred to a general neurology unit and she’d somehow managed to get him into his own clothes.

“Thank you kindly,” he said, admiring his new look in her pocket mirror. “I’m not sure who you are, but I do appreciate your assistance.”

Even in his impaired state, one sensed her neighbor to be a gentle soul—in many ways, the spitting opposite of Inkstable. Since his stroke, he’d sprouted a fine white beard to match his mustache. Much of the bruising around his nose and chin had resolved. Once he’d traded in his hospital gown for a collared shirt, he managed to throw the cloak of death off his frame. Now she could not deny the truth: Harry Hager was indeed a strikingly handsome man.

“And who is this young lady?” he asked, smiling at the girl.

“I’m Sarah,” she said.

“Are you my daughter?” asked Hager.

Sarah smiled. “I’m not. I’m just a friend.”

“Are you her daughter?” he asked again, glancing at the surgeon.

“I’m nobody’s daughter,” said Sarah. “I’m a friend of Dr. Inkstable.”

The girl’s answer upset Inkstable—unreasonably so. She found herself wishing that Sarah had lied. Why not claim she was her daughter? In fact, why not say she was her daughter and Hager’s daughter? It was fantastical nonsense, she understood, but wasn’t everyone entitled to a small dose of fantastical nonsense?

“I’m glad you’re here anyway,” said Hager. “If I did have a daughter, I’m sure I’d want her to be like you.”

Later that day, when Sarah left for a dental checkup, Inkstable found herself alone with Hager for the first time since he’d regained consciousness. She held a straw to his lips, helping him drink a boxed juice. His right arm remained entirely paralyzed and he still had difficulty manipulating the fingers in his left hand. “It looks like it’s just the two of us this afternoon,” she said.

“I’m grateful for the company.”

“Do you remember who I am?” she asked.

He stared at her blankly. “I’m sorry. I’m afraid I don’t.”

“It’s Emma. Emma Inkstable. From across the courtyard,” she said. “You carried my name around in your wallet.”

“I’m sure I did,” he agreed. “If you say so.”

“Try to remember, Harry. Please. You gave me a biography of William Steward Halsted for my fiftieth birthday…and one time, you received a crate of oranges from your cousins in Haifa and you invited me to share them.”

“That’s right. My cousins,” he said.

“So you do remember?”

“I don’t know,” he replied. “I think I might have cousins in Israel.   But if I’m mistaken, please don’t be angry at me.”

“Nobody’s going to be angry at you, Harry.” She felt her frustration mounting, the urge to shake him like a broken vending machine until coins fell out. “I’m just trying to jog your memory.” She took a deep breath and added, “You had a crush on me once. We were going to go out together…like a couple.”

“Were we?”

“Yes, we were,” she answered decisively. “But we’ll have plenty of time to talk about that later.   Once you’ve regained your strength.”

They were interrupted an instant later by the shift nurse, performing her afternoon temperature check. Her presence reminded Inkstable of how different it felt to be a visitor: On surgery rounds, she’d have asked the nurse to return once she’d left. When they were alone again, Inkstable asked, “Do you play the English horn?”

“I don’t know,” answered Hager. “Do I?”

Inkstable regretted not having brought the instrument with her. She’d seen videos of amnesiacs playing Chopin and Tchaikovsky on the piano. Mightn’t Hager pipe out a sonata or two on the English horn? She even considered asking Zyke for the spare key to Hager’s apartment again—but realistically, she knew, they’d have little patience for brass performances on the neurology ward. Besides, when she’d mentioned the instrument the next morning, he had absolutely no memory of their conversation.


She knew what was coming, even before the nitwit Pastarnack asked to speak with her alone in the corridor. He’d traded in his bowtie for what looked like an honest-to-god ascot and he sported a peculiar silk scarf around his neck. “I hate to be the one to tell you this,” he explained, “but I spent all morning on the phone with the insurance company. Alas, your kith has to depart.”

“All morning,” echoed Inkstable. “Really.”

“You’ll have to talk to the social worker about your options. Quite frankly, I don’t see him getting much out of sub-acute rehab. It’s either home with services or a skilled nursing facility—but I’ll leave that for you to sort out.”

“How thoughtful of you.”

“In any case,” said the neurologist, “Harry’s fortunate to have you. Strong family—or non-family, as the case may be—support is the most important factor in a patient’s long term prognosis.”

This was too much for Inkstable. “Do you really believe that, Dr. Pastarnack? More important than the extent of tissue damage? So a patient with a massive mid-cerebral bleed and a loyal wife is better off than a loner with a tiny infarct? In my day, they taught that social support was valuable—but rarely determinant.”

The look of sheer bewilderment on the neurologist’s face brought Inkstable a surge of pleasure, the same joy she’d always felt making fast-paced decisions in the OR. Unwilling to sacrifice even an ounce of her satisfaction, she turned on her heels and abandoned Pastarnack before he had a chance to respond. But, nitwit that he was, he’d been correct in one regard: Harry was lucky to have her.

She consulted with the social worker early the following morning, Sarah Steinhoff joining them in what was almost a ‘family’ meeting. It turned out that Hager had been a patient at “County” once before, for a hernia repair, and so they had all of his records—including details on his supplemental insurance. He’d been a planner. Thanks to multiple, overlapping policies, he’d have a strong claim for 24-hour nursing care. (Inkstable couldn’t help wondering about her own insurance arrangements, which she doubted were nearly so generous.)   By the end of the day, they’d arranged for Hager to return to his own apartment. “It makes the most sense,” she assured the social worker. “This way I can visit him every day—even more often, if necessary. And maybe the familiar settings will jog his memory.”

“I do hope so,” agreed the social worker. She filled out a series of computerized forms while they spoke. At one question, she asked, “And you are his…?”

“Girlfriend,” Inkstable declared.

Sarah threw her a puzzled look—to which she responded with a stern glare.

Once they’d left the social worker’s office, she said, “It’s easier this way. What does it matter if they write ‘girlfriend’ on some pointless form anyway?”

“You don’t need to sound so defensive,” answered the girl, smirking. “If you want to be Harry’s girlfriend, who am I to disagree?”

“Impertinent little fiend,” said Inkstable. “That’s what you are, young lady.” But that didn’t stop her from taking the girl out for pizza.


The Israeli cousins, Bonnie and Albert, arrived while they were eating. When Inkstable returned to the neurology ward, she found the wife in a heated discussion with the social worker.   The pair were standing at the foot of Harry’s bed. Albert, who looked to be in his seventies—considerably older than his wife—sat by the window, reading The Wall Street Journal.   “Am I interrupting?” inquired the surgeon.

“Not at all,” replied the social worker. “I was just explaining the arrangements we’ve made to Mrs. Nalaskowski….” She lowered her voice—although it was unclear who could possibly overhear. “There seems to be some disagreement….”

“Bonnie. Harry’s cousin,” said the newcomer, extending a hand. She spoke with a faint accent. “His uncle was my father. And you are?”

“Emma Inkstable,” answered the surgeon. She was tempted to add, ‘his girlfriend,’ but she didn’t dare. “I live in his building.”

“You’re the neighbor who phoned us, aren’t you? I’m sorry it took so long to get here. We spend our winters in Maine. They’re supposed to forward our calls, but….” She shrugged. “You know how it is….”

“I should excuse myself,” interjected the social worker.

“Please don’t,” objected Bonnie. “I’d like to get this all sorted out quickly.”

Inkstable detected menace in the cousin’s tone. Behind her, Sarah Steinhoff was dutifully scribbling notes in her journal. “What’s to sort out?” asked the surgeon.

“We’re planning on taking Harry back to Israel with us,” said the cousin. “This week. We’ve arranged for a place in the same nursing home with my parents….”

“But I’ve already set up round-the-clock care,” insisted Inkstable. “I realize you have the best of intentions, but I’m confident Harry would have wanted to stay here.”

The woman stood arms akimbo, her eyes fierce under heavy liner. “Who are you to tell me what Harry would want?” She looked to the social worker for support. “My understanding was that family has the final say….”

“I’m afraid she’s right, Dr. Inkstable. They are cousins.”

“And what am I?” demanded the surgeon.

Yet she already knew the answer. Nothing. To Harry Hager, legally speaking, she was no more than a hunk of stone. If she’d had a scalpel at that instant, she had little doubt she’d have carved open the Israeli cousin’s chest.

“I appreciate your efforts,” said the woman—in a voice more hostile than conciliatory. “But family is family. Surely, you understand….”


Inkstable remained inside her own apartment for the next several days, knowing that movers were likely at work across the corridor. Those floor-to-ceiling bookshelves would need to be emptied from her neighbor’s apartment; everything—even that strange brass instrument—would have to go, all of the poor man’s earthly goods sold on E-bay or donated to charity or discarded. To distract herself, the surgeon rifled through her own closet until she uncovered Robustelli’s biography of Halsted, which had gathered years of dust atop a box of bird-watching guides. It was a fascinating read and a well-earned diversion. By the end of the week, she’d managed to recognize her relationship with Harry Hager for what it had been: a pipe dream. For all she knew, he’d had her name in his wallet because he wanted to complain about noise from across the courtyard or to solicit her vote for the co-op board. Who could ever know? And if she wanted to ‘go out’ with someone—which seemed rather silly, at her age—she could do a lot better than a cognitively-impaired stroke survivor. On Friday afternoon, she checked with Zyke, and was relieved to learn that Harry’s cousins had cleared out his apartment. Even the name “H. Hager” had been stripped from his mailbox in the vestibule, leaving behind only a pale band of discolored metal.

Inkstable was feeling ready to re-launch her retirement—to put this unfortunate interruption behind her—when the doorbell rang, shortly before noon on Saturday. She answered the door in her bathrobe, expecting a delivery. Instead, the young journalist stood at the threshold. The girl sported a backwards baseball cap and a spaghetti-strap top that exposed far too much midriff. In spite of that, Inkstable was delighted to see her. To the girl’s surprise, Inkstable offered her a hug.

“To what do I owe this honor?” asked the surgeon.

“I finished my biography,” replied Sarah—holding out a report binder. “I thought you’d want to read it before I turn it in.”

She’d almost forgotten about the writing project. She flipped through the crisp, white pages. The girl had obviously put in a great deal of effort.

“I thought maybe you’d read it while I’m here,” said Sarah. “It’s not that long.”

“I guess I can,” agreed Inkstable. “Why don’t you come into the kitchen and I’ll get you a nice glass of milk. And would you like some fruit? I have fresh cantaloupe.”

Only when the girl was finally settled at the table with a slice of melon and a bowl of white grapes did the surgeon open the manuscript. The title page read:






She turned the page and entered the world of her own childhood: the years spent in the railroad apartment above the cobbler shop, where the air always stank of rotting leather; her mother’s death from esophageal cancer; the scholarships that gave her enough of a financial foundation to work her way through Harvard and Yale Med. She was about to compliment the young journalist on her cogent, colorful prose style, when on page seventeen, she found herself meeting Harry Hager in the elevator. It was Christmas Eve, and she’d had a smidgen too much eggnog at the departmental holiday party. When her heel broke—she didn’t even wear heels!—and she twisted her ankle, the librarian helped her back to her apartment. By the following week, they were an item.

She skimmed through the pages that followed. She saw the words “wedding,” “anniversary,” “children.” Each blow hit her in the chest like artillery and her entire body started to tremble.

“What have you done?” the surgeon demanded. “What have you done?”

A look of alarm swallowed the girl’s features. “I didn’t mean to get you upset, Dr. Inkstable. Honestly, I didn’t,” she said. “I was just trying to be creative….and it has a happy ending. I thought you’d like it this way.”

And then the girl was sobbing, and Inkstable was sobbing, and somewhere, far away, a stranger was blowing the first joyful notes on her newly-acquired English horn.

Art by Kerri Augenstein

[av_hr class=’custom’ height=’50’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-fat’ custom_width=’100%’ custom_border_color=’#372a55′ custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’no’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’ admin_preview_bg=”]

[av_one_half first]


Jacob M. Appel is the author of many novels and short story collections including THE MAN WHO WOULDN’T STAND UP, EINSTEIN’S BEACH HOUSE, and MILLARD SALTER’S LAST DAY.  His short fiction has appeared in many literary journals including AgniColorado ReviewGettysburg Review, and more. His prose has won many awards including the Boston Review Short Fiction Competition and the William Faulkner-William Wisdom Award. His stories have also been shortlisted for the O. Henry Award and the Best American Short Stories. He has taught most recently at Brown University, at the Gotham Writers’ Workshop in New York City, and at Yeshiva College, where he was the writer-in-residence. His essays have appeared in The New York TimesChicago TribuneDetroit Free PressOrlando SentinelThe Providence Journal, and many regional papers.

[av_hr class=’custom’ height=’50’ shadow=’no-shadow’ position=’center’ custom_border=’av-border-fat’ custom_width=’100%’ custom_border_color=’#372a55′ custom_margin_top=’30px’ custom_margin_bottom=’30px’ icon_select=’no’ custom_icon_color=” icon=’ue808′ font=’entypo-fontello’ admin_preview_bg=”]Sports brands | Air Jordan

Categorized as Fiction

By Miciah Bay Gault

Miciah Bay Gault is the editor of Hunger Mountain at Vermont College of Fine Arts. She's also a writer, and her fiction and essays have appeared in Tin House, The Sun Magazine, The Southern Review, and other fine journals. She lives in Montpelier, Vermont with her husband and children.