"You are one hell of a case study," said his doctor, and the voice pulled Augie back to the waking present: the hum of the air conditioning, hot light being sliced by narrow blinds, the waxy paper of the exam table crinkling under him, the smell of alcohol masking but not effacing the intimate aromas of sundry sorts of human goo. "Rest awhile if you like. I'll come back for you later."
Nina Silver was waiting in the consultation room. She sat on the edge of a green leather chair and stifled an urge to straighten the frames of the gold-sealed diplomas and purple-bordered certificates: paraphernalia of reassurance, fetishes of hope, pompous promises that things would probably turn out O.K., and if they didn't, well, at least everything humanly possible had been done. A silver pen stood next to a tortoiseshell box that held prescription slips. Behind the doctor's imposing chair was a pen-and-ink caricature of a fat woman bending over to receive a shot in the behind: No Norman Rockwell prints for Manny Rucker.
He bustled in, hands buried wrist-deep in his labcoat pockets, and started talking before he'd even reached his desk. "Nina," he said, "your husband is an extremely stubborn man. He really should be dead about five different ways."
She swallowed and slid backward in her seat. Her spine went soft and it took tremendous concentration, a gymnast's concentration, to hold herself erect. The doctor bounded around his desk, tossed a manila folder onto his green blotter, then dropped so heavily into his swiveling, rolling chair that the entire office seemed to quake around him. "I'm not saying this to frighten you," he resumed. "I'm saying it because I'm impressed as hell. I'm amazed.
"Listen. We don't yet know everything that went on with him—we won't know that till the lab work is done, and even then a lot of it will be surmising, reconstructing. But here's the minimum we're up against."
Rucker bore down on the arms of his throne until the springs creaked and the casters chattered against their Plexiglas platform. He exhaled noisily, then leaned forward, opened the folder, and spread his thick and hairy elbows on either side of it.
"Last time Augie was in here, he weighed a hundred seventy-four pounds, and he wasn't fat. He now weighs one sixteen. That kind of weight loss, the dehydration, the metabolic craziness, is very debilitating. His kidneys shut down for a while—the function seems to be returning, but we can't tell how badly they've been compromised. His stomach has shrunk up smaller than a fist, which means it's going to be a long, slow process getting the weight back on him. His spleen is enlarged, who knows why. That's another obstacle to recovery."
The doctor paused for breath, and Nina felt herself starting to cry. She struggled not to, because doctors' offices make everyone feel like children being spoken to sternly but well-meaningly by a grownup, and, absurdly, pathetically, it seems important to be brave and well behaved. Still, she thought she could feel her own stomach shrinking up like a puddle in the sun, her own spleen swelling like a sodden sponge, her kidneys growing parched and brittle, tubes and passageways caving in like long-abandoned tunnels.
Manny Rucker noticed that her face was collapsing and decided not to acknowledge it. She was not the patient and there was nothing to be gained by coddling.
"He's had a concussion," the doctor resumed. "That's rather a vague concept, concussion is. It basically means he's been clunked on the head and something went kerblooey. We don't yet know if he's fully recovered his memory or where the gaps might be. We don't know if the loss might recur. Probably he's now at somewhat higher risk of Parkinson's and of stroke."
Manny Rucker flipped shut the manila folder, and Nina Silver allowed herself to exhale. She thought she'd heard all she had to listen to. She was wrong.
"There's one other thing," the doctor told her. "He's had a heart attack."
Nina's eyes went out of focus and settled vaguely on the buttocks of the fat woman awaiting her injection. "Heart attack?"
"There's a pronounced irregularity in the EKG that wasn't there before," said Rucker. "It's clear evidence. Too much time has passed to gauge the severity from the blood enzymes. But there's no doubt that something happened."
The room was falling away from Nina Silver, the angles between walls and floor and ceiling becoming jarring, oblique, and insane. Her other reunion s with Augie, the ones in dreams, had never been so complicated, so fraught. "He told me his chest ached, his arms, when he crawled into the dinghy."
Rucker nodded. "Very possibly he was having the attack while he was in the water. Truly amazing he didn't drown."
There was a long silence. In the examination room, Augie Silver, all alone, was rousing himself from a catnap; his bony fingers clutched the edges of the table and he gamely strained to sit himself up without assistance. His wife was trying equally hard to ask a simple question. She opened her mouth three times before the words squeezed past her clenched throat.