Requiem for Doctor Edward Browne

Requiem

for

Dr. Edward Browne

by

Richard Dean Smith

iUniverse, Inc.

New York Bloomington

Requiem for Doctor Edward Browne

Copyright © 2009, Richard Dean Smith

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher except in the case of brief quotations embodied in critical articles and reviews.

This is a work of fiction. All of the characters, names, incidents, organizations, and dialogue in this novel are either the products of the author’s imagination or are used fictitiously.

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ISBN: 978-1-4401-3771-6 (sc)

ISBN: 978-1-4401-3772-3 (eBook)

Printed in the United States of America

iUniverse rev. date:5/28/2009

Contents

Book I

Dr. Browne and Dr. Benson

The Green Dragon

Angela Foster

Antonia

Joanna Browne and Friend

Angela Foster Returns

F.Q. Hazzig, MD

Dr. Obadiah Clack, Washington, DC

Edward and Forbes

Antonia

Eld Krone

entrata: Ms. Shelby Hazzig

Young Dr. McHazzig

Sir Thomas Browne

On the Mend

Pearl Warner

F.Q. Hazzig, Provider

Micro-Power Lunch

Leave It!

Living On Gratitude

Letter From a Friend

Prodigal Protégés

Apocalyptic

Book II

Professor Ananais P. Blathersnivel, Humbug

Joanna and Phemie

Moving

Joanna and Mr. Armitrage

Sublime

Antonia’s Query

Orvieto Café

Beguiled

At Home

A New Exhibit, Joanna’s First

Health Care Consulting Gypsy

The Claret Inn

In toga virilis

Edward and Joanna

C.G. Ramona

Dr. Hastow

Stuart Davis

Rudy Frasco

Ruskin

Dr. Joey and the Desipient Fribbles

The Hustle

Lothario

Contract

To Prove

Warren Shoat

A Little Sense

A Vast Landscape

Paradigm

Garden Walk

Drs. Browne and Kennes

Retrograde From Hell

Tom Gerade

Necessary Devil

Book III

Climate of the Times

Messiah

Pyramid

Dr. Hazzig Meets Antonia

Submission

Habeas Lien, Esquire

Winds of Change

Half the Story

Choice, No Choice

Thirty-three Cents

The Gospel Hazzig

A Troubling Visit

A Quality Issue

Mr. Hagopian

A Beginning

Professor Hiram Henchcock

Tulips

Waste, Fraud, Abuse

Motherless Child

Exchange Walk

Prom Night

The Merest Chance

Stuart Davis Exhibit

Hal Marshall

Dr. Hazzig’s Question Box

Hazzig DPA-Aeternitas: Staff Meeting

The Daily Schedule

The Regionalists

Backing the Revolution

The Organization

Due Occasion

Empire

Antonia and Joanna

Phemie’s Place

Bandwagon

Book IV

Eye of a Needle

Mr. Wheadles’s Two-pronged Attack

Summer Vacation

Pearl

Urgent Meeting

Beginning of the End

OddLot

An Old English Painter

Misgivings

Sweet, Kindly, Ole Dr. Hazzig

Drs. Hastow and Dittlebrow

Rat’s Ass Ratone

At Orvieto’s

Wall Street

Oversight

Opening Week

Excitement: Anger

An Offer

Opening of Ruskin-Turner Exhibit

Ruskin and Turner

Desolation

Phemie’s Art

Longing

Behind the Wave

Sweat and Vexation

Senate Hearing Room

Call to Order

A Temperate Dispute

Fear and Suspicion

in absentia

OddLot’s News: Reprise

Conquest

Antonia and Fredric

Drs. Hazzig and Dittlebrow

A Big Player

Four Center

Eld Krone: Reprise

Book V

Mr. Wheadle Talks the Walk

Also by Richard Dean Smith:

Melville’s Complaint: Doctors and Medicine in the Art of Herman Melville.

Melville’s Science: "Devilish Tantalization of the Gods!"

CRS: Computer-Related Syndrome: The Prevention and Treatment of Computer-Related Injuries. with Steven Garske.

Managed Care: Anatomy of a Mass Medical Movement.

The Rise and Fall of Managed Care: A Comprehensive History of a Mass Medical Movement.

Rise and Fall of Managed Care: History of the Mass Medical Movement.

Trust: A Shock to the System. A Practical Guide.

The Circus of Medicine (Satire).

Trust in a Medical Setting.

Captain Noon! Captain Noon! or Procrastination Considered as One of the Fine Arts.

From what we have said it will be seen that the poet’s function is to describe, not the thing that has happened, but a kind of thing that might happen, i.e. what is possible as being probable or necessary.

Poetics. Aristotle

Book I

The Promise

Dr. Browne and Dr. Benson

Dr. Edward Browne shared an office with another physician, Dr. Meyer Benson, who had been in practice fifteen-or-so years longer than Browne and recruited Browne from a prominent medical residency program in the Mid-West. Their relationship was cordial with few disagreements about how to run their office, such as schedules, personnel, and other greater and lesser matters of everyday operation of a medical office. Browne wondered if their current fairly secure relationship could last with so much adverse publicity towards medicine and warnings of challenges to physicians.

Browne stood somewhat taller than Benson, who was somewhat stooped with age, and rather than trim like Browne, he was slightly endomorphic with a small paunch. Benson had a full head of white hair with a wave that remained from his youth. An aquiline nose showed effects of the sun while fishing, hiking and swimming. Benson had been a hard-driving, competitive physician who mellowed over the years becoming less intense and more personable. He always dressed like a professional man: a dress shirt, bow tie, cuff links, and manicured fingernails. Benson pursued pleasures of opera, theater, food and wine while Browne was satisfied with essentials; his wants did not become needs. I’m down-market, Browne said. Practical and down to earth, Browne was not as out-going or social as Benson but developed a loyal following in his medical practice as had Benson. Nor did Browne seek notoriety in his daily professional activities; his medical practice was its own reward.

One of these days, I’m going to give it up, Edward. I’ve had enough of practice. I’ve been blessed to have a gratifying career here in East Valley. We’ve had a wonderful association over these years, and I want you to know how much I appreciate our partnership. I’ve saved a good sum, and with my retirement plan, I’m able to leave practice comfortably. I will miss being in the office, but I intend to stay active in hospital affairs. All this business of managed care, or whatever it’s called, will be interesting to see how it develops. An insurance crisis of some kind comes along every so often. I’ve seen quite a few in my time.

I’m quite a ways from retirement myself, Meyer. I suppose we should look at these health insurance proposals as a challenge. We will surely confront them before I get to the end of my days in medicine.

Things seem to work out no matter the criticism and complaining, Benson said. In the meantime, it’s turmoil, chaos and crisis-time. One wonders if there is any common sense or judgment left in human affairs, in Washington or executive suites of insurance companies. I’ll start looking for someone to take over for me. I promise I’ll find a compatible replacement. I wanted to let you know.

Dr. Browne stood erect at six feet tall. His straight back made him appear taller than he actually was, though at times after a long day, round of a scholar’s hump appeared. His hair had thinned on top and grayed along the sides allowing long intervals between haircuts, which appealed to his Scot’s nature. A ruddy tint on his face showed effects of the sun but more often the pallor of a sage who preferred gentle light of libraries to sunlit golf links or tennis courts. He had a straight Celtic nose, thin slightly gray eyebrows and creases aside his cobalt-tinted eyes. He usually wore a white or blue, or striped button-down shirt, a college club-tie, gray or brown trousers, and plain black or brown shoes that he occasionally polished.

If Browne had an enduring interest, passion, or diversion in addition to his occasional outings at pool, it was the writings of Sir Thomas Browne, a seventeenth-century English physician. Like Sir Thomas, Dr. Edward searched through the surface of things. He did not succumb to excited enthusiasms of his day but took a longer view of events. The claims of revolutionary times in the practice of medicine were not new and could not have a lasting influence. Browne was neither fooled by threats from managed care proponents, nor liable to emotional appeals and intimidation from hospital administrators, healthcare planners, economists and consultants since many a strange fire has burned on the altars of medicine.

Newspapers and lay magazines were laden with articles calling for radical changes in medicine, especially by promoting cutthroat, marketplace competition in the form of managed care. Browne kept himself briefed as well as possible, although he could see no justification in the over-all idea of managed care. He was not persuaded that its claims were being presented in an honest, forthright way. Further, Greifter-Kemple, a managed care clinic or HMO, was located in East Valley across town. He wasn’t particularly worried but kept a wary eye on matters related to managed care’s growing sanction.

Criticism of doctors and medicine saturated the media, especially threats to the ability of doctors to survive without managed care. Yet, Browne knew criticism of doctors was not new. Wasn’t Chaucer’s Doctour of Physik excessive in his self-approval and accused of being in league with apothecaries to fleece the public? Wasn’t Flaubert’s Dr. Bovary a problem physician? What about Rosamund and Tertius Lydgate, a young doctor and his wife in Eliot’s Middlemarch? Wasn’t Dr. Lydgate out of step with doctors in the town? Wasn’t Trollope’s Dr. Thorne a poor man living on edge of insolvency?

Still waters run deep, Joanna said of her affection for her husband when they courted during his residency-training days. His mellow blue eyes she called deep pools. A ready smile, a flash of warmth made up for his social deficiencies though at times she was concerned he was not more talkative and outgoing. He could not fake interest or manufacture conversation, Sir Thomas Browne says:

Such Silence may be Eloquence, and speak thy worth

above the power of Words.

Dr. Browne conducted his practice with an austere simplicity. Pearl Warner, an old time patient, asked, Why don’t you have papers and journals piled on your desk like other doctors? His desk was nearly empty with only a few patient instructional handouts neatly arranged. Medical journals were read and discarded the day they arrived.

What I need in my daily practice, Browne said, I must hold in my mind.

Each morning, Browne entered by the back door, stepped down a short corridor, turned right to his office, removed his jacket and hung it in the closet, donned his white coat with pockets for his pen, penlight, and stethoscope, checked for messages from the previous day, straightened his desk of its few papers, and glanced at his day’s schedule. Squinting into the early morning sunlight, he proceeded quickly across a brick pathway to the Doctor’s Lounge where he occasionally visited. He greeted hospital employees like old friends.

Hello, Dora, he said to the housekeeper.

Mornin to ya, Doctah Browne.

Dr. Browne discussed matters related to patients in the same concise manner and spare use of language he conducted all of his communications. Browne made his rounds, and as succinctly left with no wasted motion, no gossip and no off-color jokes. The short distance back to his office was a quiet respite from bustle of the hospital and confinement of the office. Sometimes he hurried along a garden route, a path of pea gravel shaded by ginkgo trees and lined with oleanders bordering the parking lot; its black tarmac beat summer heat to his face and absorbed sparse light of winter.

Many physicians disdained their offices preferring the stimulation of the hospital’s bustle, yet Browne handled each with equal interest, although he tended to fret about hospital patients because a trying, demanding diagnostic problem required time to resolve often wore on his patients and their families. Occasionally, when their behavior went beyond what he considered reasonable, he would take control. Pressed for premature judgments, he would reply, Time will tell. I am not a prophet.

Dr. Browne may have felt a sense of relief and accomplishment upon achieving a diagnostic solution, but relief was sometimes short-lived since the results were not always favorable. When the problem was cancer or another dread disease, Browne suffered along with patient and family. Yet, his experience told him he must maintain a professional, objective and fiduciary role. He could not let his own anxieties and fears enter into decisions on what was to be recommended. No matter how bad the situation, we can proceed reasonably once we have enough information. Not knowing is the worst. Anything can be faced once we know.

Dr. Browne stayed in association with Dr. Benson because they were compatible partners, and their office was convenient to East Valley Medical Center. Browne never got the Jewish holidays straight, so each year his partner patiently explained whether it was time for New Year’s wishes or atonement of sins. A few years into their association a third doctor joined them only to discover he disliked medical practice or dealing with patients; he departed after a few months. When last heard of, the doctor had taken a paper handling, functionary position with little stress, safe from rigors of medical practice. The experience soured Browne on expanding into a practice larger than himself and his one associate. Little occurred to disturb Browne’s sense of the future or his satisfaction that his patients appreciated his attention to their medical needs, yet a nagging-uncertainty was ever present.

* * *

Following a lengthy search, a young physician accepted Dr. Benson’s offer, and Benson retired. Dr. Forbes Quigger Hazzig attended Johns Hopkins Medical School and completed his residency training in internal medicine in Boston. After college and before medical school, he worked in his father’s businesses. He described his father as an entrepreneur, but he gave no specifics, except that his father was successful in high-risk, high-return ventures.

In fact, Dr. Hazzig seemed to be black sheep of the family by going into a profession, especially internal medicine. His grades in medical school qualified for scholastic honors; his letters of recommendation were flattering and enthusiastic. He expressed interest in new healthcare programs and insurance industry management of medicine that were beginning to spread nationwide, that is, managed care which some experts predicted would replace all medical insurance. A few physicians became excited and enthusiastic about the new plans; most doctors, like Dr. Browne, were wary and cautious. Browne especially felt his attention and personal style of care was free from its intrusion. When managed care plans were offered to doctors in East Valley, he turned them down in order to maintain his sense of independence and self-respect, that he was still in charge of his own fate.

Nevertheless, managed care like Greifter-Kemple grew steadily over forty years to the extent it had enrolled over one-third of East Valley’s population. It seemed not to matter as long as doctors in town were busy and the private practice of medicine was healthy. Every bed at East Valley Medical Center was occupied and sometimes experienced a waiting list for admission. The hospital was well respected in East Valley because of its professional staff and solid management. Little attention was directed towards the potential threat of managed care, or Greifter-Kemple for that matter.

The Green Dragon

At East Valley Medical Center, Dr. Browne was sometimes thought to be a little odd, a standard deviation or two off the norm—the doctor played pool, billiards. Dr. Browne’s participation in the game of pool instead of fashionable games of golf and tennis caused some of his fellow physicians to think him eccentric, a little off center. Yet, when doctors were confronted by a difficult diagnostic or management problem, it was Dr. Browne who was called to consult, straighten things out, and take care of it.

At Green Dragon Billiards, the doctor’s talk of the art of pool, its metaphysical aspects, pool’s inertia, gravity and internal harmonics of spheres made the nuts-and-bolts pool players think Dr. Browne had gone around the twist. Bends, one of Green Dragon’s regulars, surmised Browne was a half a bubble out of plumb. Otherwise, he seemed ordinary enough and not a bad player, but no one would put money on him. To those who doubted he could live equitably in both worlds, Browne contended it is not the game of pool but the players who came from all walks of life, every nook and cranny, every size, shape, color and creed, every job description and social strata. Though some dwellers in Green Dragon Billiards were on the dark side of society, others were successful and responsible business and professional men and women, like OddLot a financial genius, GigaFlop a computer wizard, and Bends an underwater construction expert and retired drunk.

Dr. Browne occasionally played in tournaments or competed in what players call significant competition, that is, competing in tournaments or playing for money. Men playing a child’s game, its competitive and psychological stakes intensified. Whisper of chalk brushed on cue-tips; the colorful luminescence of aramith-phenolic resin orbs once made from ivory; ordered-chaos of the rack; snap of the break; click and disorder of a rainbow of colored balls; and a muffled drop into woven pockets were, to players, it was music of the spheres.

Presence of an introspective doctor in Green Dragon Billiards was a little dangerous. Ray Hamanaka, an engineer and professional at karate, judo, and other martial arts as well as a regular player at the Green Dragon, taught Browne some defensive skills just in case. Browne said, My experiences at Green Dragon when my opponents try to distract or intimidate me sometimes help me contend with difficult patients, families or visitors. Sometimes they were out for blood, but Browne discovered people behaved in the same manner under trying circumstances at the hospital as they behaved elsewhere.

On a sunny afternoon away from his office, Dr. Browne said to Norm, houseman at the Green Dragon, "I must go back to my office to see the granddaughter of a long-time patient of mine. She hasn’t gotten very far with doctors at Greifter-Kemple. Norm, not given to talk, looked lazily from the green tables to Dr. Browne, said, Some surprise." The glass to of counter-top where they stood reflected a blurred myriad of table lights.

Norm watched a delivery truck from a market down the street rumble past, and squinted at a flash of sunlight off its windshield while keeping track of things in the neighborhood. It was his unofficial duty as a citizen of Green Dragon Billiards to be on the lookout.

"Medical planners and experts are trying to convince us into becoming another Greifter-Kemple as if we need another Greifter-Kemple in this town. Lots of bad talk about doctors and threats to doctors’ confidence and self-respect. Most doctors have never faced a hustler, a shark, or subjected to this kind of intimidation. Doctors think if we do good works somebody or God Almighty will look after us. Makes it easy for opportunists, like it’s the answer to a hustler’s prayers or a con-man’s dreams come true," Browne said.

Some of these hotshots who play in here every day, think they can walk over people, thinkin they’re so smart and everyone else so stupid. Lookin for a cheap hustle, Norm said, one foot resting on a brass rail, chin in hand, and elbows leaning on the glass counter top. Usually, they’re the ones that get hustled. Mostly they’re losers. Losers recognize each other. Get in each other’s faces and jaw at each other. I let them go on a while, till they’ve had enough and get tired of each other, and it blows over.

Norm shifted his gaze to players standing in a cone of light at Table 14 where a money game was in progress, their long shadows drawn across the hardwood floor. Each player taking his turn bending to level his cue over the green table, reaching with one hand and stroking a shot with the other.

One going on over there, nodding his head toward table 14. Think they’re hot stuff, playin for money," Norm said.

Norm stirred himself, collected from players coming from playing on Table 8.

Neither one can rub two quarters together. Posturing and bad-talkin their opponents, Norm said.

Norm picked two cubes of blue chalk from a drawer and put them on a tray with sixteen brightly polished, multi-colored, striped and solid pool balls. He passed the tray to a young couple that plays once a week.

"Greifter-Kemple, Norm said, twisting his face into a sour contortion, Losers all. He resumed his stance, with one foot on the brass rail, looked about the room, and after a hesitation added, Tombstone insurance."

Angela Foster

"I’m twenty-six years old, Dr. Browne, I’ve lost everything. My grandmother Mrs. Geri Miles sent me here to see you. I don’t think there is anything you or anyone can do for me." Unblinking, wide-eyed, Angela Foster looked intently at Dr. Browne.

"I’ve been going to doctors at Greifter-Kemple Clinic for a long time. They tell me it’s all in my head. They send me home with a different tranquilizer or antidepressant each time I go. I seldom see the same doctor twice. Usually, it’s a nurse practitioner."

Although it was a cool, breezy late autumn day, Angela wore summer shorts and a light blouse, while women who worked in the office were wrapped in sweaters and people on the street went about in woolen coats and jackets. She leaned against the sidearm of her chair as she confided in Dr. Browne.

I’ve lost my husband. I’ve lost my daughter. I’ve lost my job. I think I’ve lost my mind. Only Granny seems to care. Angela hung her head as she spoke.

When were you last well? Dr. Browne asked, opening her folder to make a note.

I don’t remember exactly. After my daughter was born three years ago. I lost a lot of weight and never got it back.

Angela was keyed up, restless, stimulated, and talking under pressure. She folded her arms to still her tremulous hands.

"I’ve not been able to sleep or concentrate. A doctor sent me to a psychiatrist at Greifter-Kemple who gave me lithium, which made me worse. Since they only allow three visits to a psychiatrist, the psychiatrist told me I should see a doctor outside of Greifter-Kemple. It’s managed care, an HMO. Sometimes at Greifter-Kemple the doctors tell its own patients to see someone outside its system. A nurse at medical clinic told me the same thing, but Dale’s firm pays for Greifter-Kemple and it’s supposed to take care of everything."

What happened between you and your husband? Browne asked. He rested his forearm on his pitted, walnut desktop, and reached for his desk pen.

We couldn’t get along. Actually, I couldn’t get along with him. He is perfectly cool, okay, decent, but everything about him annoyed me. I yelled at him and accused him of all sorts of things I knew weren’t true. We’re separated. Dale has our daughter. I used to work, also, but not anymore.

Angela related these events with little show of emotion except dejection. Her face became flushed. She used one tissue after another to wipe moisture from her brow and chin. Her skin was as thin as a rose petal.

What about your work? Browne asked.

I used to work as a secretary. I couldn’t concentrate. I couldn’t sit still. My manager counseled me and gave me every chance. Everything bugged me. I began to make mistakes I wouldn’t ordinarily make. I was impatient and rude to people at the office until everyone began to avoid me. My closest friends gave up on me. That’s not like me, Dr. Browne. I used to get along with just about everybody, Angela said. She lifted her head and stared at the ceiling.

I used to weigh one hundred-twenty pounds. I would eat and eat and I still lost weight. I’m down to ninety-two pounds now. I don’t get hungry anymore.

Did you tell the doctors about your difficulty? Browne asked.

Yes, everything. Angela said.

"What did doctors at Greifter-Kemple tell you? Did they do any tests? What was the doctor’s name?" Browne asked.

I don’t remember any doctor’s name. They’re faceless, anonymous. After a blood count and a chemistry panel were done, one of the doctors gave me a prescription for a beta-blocker. She said it was all I needed, Angela said.

Did the medicine help in any way? Browne asked.

I was a little less fidgety maybe, but that was all. I still had trouble with the stairs.

The stairs? Browne asked.

The stairs are my nemesis, Angela said emphatically. I’m so weak, I can hardly climb a step.

When do you see the doctor again? Browne looked up from writing his note.

The doctor said I would be all right. I didn’t need to make a return appointment. Angela wiped moisture from her chin with swipe of her palm.

No return appointment? Browne said.

No. The last doctor said everything was fine. I asked if I needed any other tests. The doctor said my coverage only allowed so much. I know that’s not true, but it’s a way to get patients out of their clinic. Angela shifted restlessly in her chair, she crossed and uncrossed her ankles. She showed no evidence of being annoyed or disappointed about her visits to Greifter-Kemple doctors.

"When did you last see a Greifter-Kemple doctor?" Browne asked.

Probably six months ago, I quit going. What’s the use? I’ve heard it has some good doctors, but getting to see one takes forever. Once you’ve been to its clinic a number of times like I have, you get a reputation as being a difficult over-utilizer who is untreatable. You get labeled as someone who is abusing its system. I try to take care of myself. Granny gives me money for food and rent. Lately, I’ve gotten so weak I can hardly get up from a chair. Angela hesitated to catch her breath. Climbing the stairs to my apartment takes longer and longer. When I get to the top, I plop on a bench for a while till I catch my breath. I try to stay upstairs all day so I don’t have to drag myself up those god-awful stairs again. So, all I have to do is watch television, but it drives me nuts. To be alone all day everyday for someone like me is torture. Angela shrugged her shoulders as she related her story and rubbed her palms together as if resigned to her fate.

Have you had any other illnesses or operations? Browne asked. He turned his page of notes over silently, and, with his palm, smoothed it on the desktop.

No. Nothing. I just can’t get it together. I’m not stupid, Dr. Browne. I graduated from Hillsdale University with honors. I had a lot of friends. None of them call me anymore. It’s like I don’t exist. That’s about it, Angela said. "I was able to help support our little family. Greifter-Kemple doctors say I’m fine, okay, just nervous—and a pain in the neck." Angela’s voice weakened as she continued speaking, and she grew short of breath again.

Angela needed help from Dr. Browne to get up onto the examining-table step. He took her by the arm and guided her, one foot after the other, assisting Angela up onto the high step at end of the table. She mopped her brow with a towel. Her forehead felt as hot as a Tuscan oven.

Dr. Browne took her blood pressure—200/30. Pulse—140. Her skin was fine, smooth and luminous. He listened over her throat with his stethoscope and heard a soft, whispering sound with each heartbeat. Her hands felt warm, the heels of her palms were flushed and sensitive to touch, and her fingers shook with a fine, rapid tremor. When he placed his hand over the left side of her chest, he could feel the rapid pounding of her heart. Angela’s knee reflexes were quick and brisk. In spite of a wasted appearance, her straight, brown hair was glossy and lustrous.

Looking at Dr. Browne’s hand pressing against her chest, Angela said, I used to have a good figure and nice boobs. Look at me! A stick. A twig. A mop. My hair is impossible, it won’t hold a wave, a curl or anything.

When Angela returned after dressing, she was out of breath and sat restlessly on the edge of her chair for several minutes before she could resume talking.

I hate to waste Granny’s money. It was her idea for me to come here to see you. I don’t think doctors can do anything for me. There is no use having hope for the hopeless. I can manage the way I am now if I have to. I don’t want anybody’s charity, and I don’t want sympathy from anybody, either. Somehow, I’ll pay Granny back someday. Someday, far off probably. If I can.

What would you like to do that you can’t do now? Browne asked.

I would like to be well enough to take care of my daughter again. I can hardly get to the other side of town to see her. And Dale has too much on his mind with his firm and trying to make partner. Angela said, eyes full and glistening.

How about your parents? Do you see them very often? Browne asked.

"No, I don’t. They’re in cahoots with the doctors at Greifter-Kemple. Once they told my parents I was just nervous, they wrote me off, too. Everyone else in our family is productive and successful. PhDs, doctors, lawyers, engineers, you know? They are on honor rolls and achieve academic honors. Their kids are top performers, too. I had no business being born into a family like that. No room for failures in that clan, believe me. It didn’t bother me until now. Troubles, Dr. Browne, just troubles. Troubles and loneliness. I seldom hear from anyone in my family, and that’s a lot of people, let me tell you."

Be sure you have these tests, Angela. Amy will give you an appointment. I’ll keep it simple to save your Granny’s money.

Why don’t you give me a beta-blocker and be done with it? Like at Greifter-Kemple Clinic? Angela used both arms to try to push herself up from her chair.

A beta-blocker may control some of your symptoms, but it won’t control the underlying problem. Dr. Browne rose, bent down to help Angela stand up and assisted her to the front desk.

Angela turned and headed straight to the office doorway without waiting, but Amy brought her back.

Go to the laboratory with her, Amy, and make sure she has the tests.

Antonia

Joanna and Edward were blessed with and surprised by the arrival of a daughter after five years of marriage. Signs announcing a child was on the way came gently. Progress through stages in the womb, and delivery into earthly existence were equally calm and relatively effortless. Joanna named her daughter Antonia, ‘praiseworthy’ in Latin. Edward and Joanna made a compatible, agreeable couple who had settled into a pleasant, comfortable and staid life together. Antonia was greeted with joy, as well as apprehension with this upheaval of their happy status quo.

Once on the scene in the Browne fold, Antonia declared she was not going to be an amicable or easy child. From the beginning she was obstinate, as children were called by Browne’s parents if they were being stubborn. She certainly has a mind of her own. Antonia learned to talk early, talk often and talk long. Little peace was laid on the Browne family by this busy sprite, a pixie from the whirlwind. Antonia talked-back to her parents and playmates, her teachers and complete strangers. Despite a seeming forwardness, her parents adored Antonia and a host of her friends clustered around the Browne home; life with Antonia was never tedious or dull. As though materializing from a vapor, Antonia sported a ruddy complexion of health; her hair, lots of it, gently swayed over ears and shown with at crimson luster.

By time Antonia went to Kindergarten, she was called a holy terror. Her flouncy red hair bobbed and whipped atop her spindly frame, showing the tips of her ears as she strode briskly and heavily on her heels into school. Joanna combed and smoothed Antonia’s hair and straightened her skirt in the back. Her teachers were fascinated and frustrated by remarkable Antonia, a bright, quick know-it-all. But argue and challenge anyone in authority, even in pre-school! Miss Fenwick, her first grade teacher, made a project of civilizing Antonia. She lost. Antonia was able to work her will without causing anger or resentment. She could on occasion be equally disarming and loveable in a beguiling way, unsettling anyone who might be offended by her manner. Surely, she couldn’t be so manipulative at such a tender age. Joanna spent hours consulting her teachers, friends, councilors and her pediatrician.

When Antonia was in the Christmas Pageant at St. Paul’s Church, she was the red-haired Virgin but objected to having no speaking part. When the event came to pass, she tugged at at the neck of her white gown, took center stage, and provided an impromptu monologue on the nativity, explaining the importance and responsibility of the religious meaning of Virgin Mary: The Virgin Mary belonged only to God! raising her tiny fist to the heavens. Joanna and Edward cringed in the front row while the audience applauded.

Joanna was alarmed by Antonia’s precociousness which prompted serious discussions with Edward, What are we to do about Antonia, Edward? We must get her to cooperate before she gets into more advanced grades.

Edward said, In every other way, she seems to be perfectly normal. Uninhibited, true enough, but she has many friends and her teachers say she is a good student in spite of all of her outbursts and disruptions. Many know her, for sure, but even more have heard her or heard about her.

When Edward’s mother had protested to his father about behavior of their children, his father would say, It’s a phase. Although his mother was rankled by his father’s reply, time and again his prophesy proved correct, and so it was with Antonia. After a period of extreme parental distress, when she became defiant and opposed to everyone and everything, she suddenly changed, not to a quiet, passive child by any means, but to a hard worker who challenged herself to excel without outside influence.

Edward was right when he said without conviction, It’s a phase. Pre-adolescent Antonia was their pride and joy. Antonia occasionally went to Green Dragon Billiards with her father and learned the game of pool. She developed a solid cue-stroke as well as an understanding of the game, but eventually she lost interest. Later, Antonia teased Edward about playing a game of pool for money, hustling the unfortunate out of their paychecks, and hanging out in a pool hall. Edward didn’t object and invited her to join him. Antonia usually declined.

Antonia occasionally led an entourage of her peers to Green Dragon Billiards to show off her skill at pool. They were astonished she could pocket balls and make bank-shots. She was not very consistent but to a novice she was impressive, indeed. The crowd of girls, all talking at once, upset the tranquil poolroom but they were so enthusiastic, the regular players stopped their games and helped coach the noisy throng. Norm, the houseman, made special arrangements for Antonia and her friends. He watched out for them and joked with Antonia about her new career as a pool player.

I’m so good Papa won’t play me anymore. I’d win too much of his money. He wouldn’t like it, you know. I’d have to throw him a few shots, right? Antonia said, standing at the counter, one foot crossed over the other, her cue leaning against her hip, elbow on the countertop in total confidence with Norm.

Now, you are talking like you belong here, Antonia, Norm said. We have a lot more women these days. They are not terribly serious players who come in at noon and have lunch. We call it the Chattering Hour. I’d say they are not like the carpenters and pipe fitters out for the kill."

I’d just like to run the table once. Once again, I mean, Antonia said.

That takes practice and dedication to perfection. Every little part of the game is vital. Then you can compete with the best of them, Norm said, his grave, expressionless face cracked into a smile.

I’ll see if I can beat Papa at 9-ball. That’ll be a test. Antonio turned around, her back against the counter with both elbows leaning in the edge of the countertop.

When you can get any of your father’s money at the pool table, Antonia, you can come here any time and get a game.

Joanna Browne and Friend

Mrs. Joanna Browne was an art historian who worked as a volunteer at East Valley Art Museum four hours a day, three to five days a week depending on the schedule of events. She assisted Mr. Armitrage, the museum’s curator, arranging exhibits, contacting artists, scheduling displays, promotion, and occasionally presenting lectures on art history. Joanna managed both home and museum without disruption as long as artists didn’t take up too much of her time or cause too much concern.

The hallway light became progressively dim as Joanna entered from the museum’s stark Gothic main entrance, turned right down the marble corridor of East Wing, and continued past the permanent American Art exhibit the right, to finally reach her office at the rear of the museum. Her office was tiny. In was sparsely furnished with a desk and side chair with books and folders stacked neatly everywhere. An old, badly worn imitation Oriental rug, saved from a flea market, and two framed prints, one Dürer’s Owl, the other Raphael’s Madonna of the Nativity, floated like spirits from a temple of ancients alongside the doorway: the room’s only artifacts suggesting its exacting place in a museum of art. A single Pewabic Pottery vase held a dozen blue flax blossoms that were replenished by the gardener according to the season. A multi-paned window with a dark oak sash opened onto the Museum Café patio. Morning sunlight reflected off the few bare patches of her desk that was transformed by shadows by midday. A soothing murmur of conversation from museum goers and patrons of the café made a pleasant, relaxing background to the sometimes frenzied activity in her little space. Aroma of pesto or peppers or curry drifted through her office before lunchtime.

The museum was constantly in need of funding; raising financial support was a full time occupation for curator Malcolm Armitrage. He left most actual museum-matters to his reliable assistants and Joanna who was his only college-educated staff member with a master’s degree in art history. A movement was afoot to change the museum’s holdings and exhibits from a dominance of eighteenth and nineteenth-century artists to more modern and contemporary artists, especially featuring regional artists who were not particularly adept but vocal and demanded change, which meant more exhibits and more opportunities for sales.

Joanna’s one confidant from the artist community of East Valley was Euphemia Harper, who went by the name Phemie. Phemie was unrestrained, undisciplined and unpredictable, the opposite of Joanna. The two women were drawn to each other by mutual interests and equal intelligence but on different paths. Phemie came to the museum to lay out her problems, challenges and conquests to Joanna.

Phemie was from the School of Earth and liberal to an extreme, but not a political activist. Just liberal, free from convention. Phemie was tall. She wore shoes or sandals with many straps and buckles, long skirts, layers of filmy blouses, flowing drapes and gauzy scarves wound around her neck and shoulders. No two pieces of clothing were of the same material, pattern or color. All studiously uncoordinated, or matched, or combined sprezzatura of studied carelessness, yet fit the individual when she took the time and effort to get the myriad of colors, swirls and folds gathered together. Lots of jewelry, chunks, she called them, dangled and sparkled from her ears, and around her neck and wrists. Sometimes it ‘worked.’ Her long, untamed, black hair flowed across her shoulders and down her back. Under it all was a swaying, easy voluptuous sonsie woman of experience. Phemie moved a little awkwardly with a nonchalant unconcern. Many lovers and many ex-lovers, she was ever optimistic and seldom discouraged or depressed.

Why were you named Euphemia? Joanna once asked.

Euphemia was a saint, actually a martyr during the persecution of Diocletian. Her blood was supposed to produce miracles. So, I always use a little color of blood in my works, Phemie said. Great blotches of color. Actually, it’s a notion, a thought or intuition. A feeling.

I see what you mean, Phemie. Early modernists tried to imitate the photograph but couldn’t match its exactness. A certain undisciplined, blurring of detail gave art a new outlook, so that color became more important.

I couldn’t possibly take time to get details exact, not like etchers.

In college, we studied English painter J.M.W. Turner whose use of color and light anticipated French Impressionists, Phemie said.

Never heard of him, Joanna.

I would like to have a Turner exhibition here someday. John Ruskin, an art critic I’ve studied a great deal, championed him. It would be a huge project to undertake, but it could be wonderful. If you haven’t seen Turner’s work, you are in for a great surprise and an incredible experience.

Tell me more about Turner, Joanna.

Originally, Turner’s works were representational, almost photographic in detail. Later, his use of color and his innate sense of drawing, well, actually Phemie you must experience them first hand. It wouldn’t be fair or possible for me to describe them in words. Ruskin was a master of word-descriptions of works of art, especially Turner’s pictures. Just wait. You will see for yourself.

Phemie held a large particleboard measuring about 4 by 6 feet, with its bottom resting on top of her foot. Okay, Joanna. How about this picture?

Joanna stretched her arms, exhaled a deep breath, and tilted back in her chair to study Phemie’s picture.

You certainly have a way with color, large splotches, slanting dashes and zigzags. Even in modern art, color and motion should have a plan, a history or an outline. The eye must travel from point to point.

Phemie respected Joanna’s opinion; no one critiqued her pictures as expertly or as severely. She made Phemie think about what she was doing and what her art meant or expressed besides attracting buyers. Joanna’s mother was an artist but the development of her ability was limited by demands of a family, since she was married to a busy and successful attorney in Ohio. Joanna majored in art at Ohio University and obtained a masters degree in art history from the University of Kansas.

What sort of poem or building would fit with the picture you’re showing me?

Phemie was stumped for a moment. A scattering of disconnected words.

And what sort of building?

Phemie let her picture rest against a bookcase along the wall in Joanna’s office. She stood away from it, walked around it, then stepped back again. She stood squarely in front of her picture with her hands on her hips shifting her weight over one foot while the other pointed to the side. Phemie tucked her crinkled chin into her scarf. The corners of her mouth were drawn down and her forehead furrowed as she conceded:

I don’t know.

That’s what I think, too. It doesn’t fit anything. Strong colors alone don’t give any feeling except monotony. By grouping color into a tension between bright and subdued, or warm and cold, a picture takes on new meaning.

Phemie sat down heavily in an oak straight-backed chair, then leaned forward resting her elbows on her knees, chin in hands.

Culture is directed towards harmonious perfection of both becoming and not having something, an inward condition of mind and spirit, not outward circumstance, Joanna said. Now, look at your picture again. It may show the surface of our culture but not anything else.

Phemie frowned causing deep creases across her usually smooth, confident brow.

Art is ruthless, Phemie. It doesn’t care if you are blind, crippled, insane, or intelligent and faithful. It is art itself. Once a work of art is parted from its artist, it’s as if the artist no longer exists except in his or her remaining works of art, Joanna said.

Phemie was disheartened, but she saw that her pictures lacked something vital. Just what might improve her work was a puzzle.

"Culture is freedom from fanaticism by its attitude towards a picture of machinery, even while art insists it is machinery. The Industrial Revolution dramatically changed Europe’s culture and not entirely for the better. The machine lead to unbridled competition and beginnings of a marketplace society. The machine was a threat to culture as well as a threat to individuals unless tamed and controlled. It didn’t happen. In one form or another, the machine is as great a threat today as in the nineteenth century."

Phemie stood up suddenly with a freshened expression on her face, a sense of newness. She gathered her many layered, studied chaotic, wafting scarves and drapes about her shoulders, and turned her particleboard picture towards herself.

One last thing and I won’t bother you again, Joanna said. Culture is one’s best self.

Phemie brusquely hoisted her pressed-wood panel with gobs of gaudy paint splashed and swirled here and there, balanced it on top of her head, cautiously passed through narrow doors, tramped down long shadowed passageways, exited through the front entrance of East Valley Museum of Art, and packed her picture into her paint-worn Plymouth.

* * *

At breakfast the next day, Joanna placed a plate of scrambled eggs and whole wheat toast on the kitchen table. Antonia and Edward served themselves. Antonia poured herself a glass of orange juice while Edward brought the coffee pot to the table and filled Joanna’s and his own cup with steaming French/Italian roasted coffee.

I’ve told you about Phemie Harper haven’t I? asked Joanna.

You may have mentioned her, Edward said.

You wouldn’t forget if you had seen her.

What do you mean?

For one thing, men might say she is built like a brick pergola in shimmering silk, Joanna said.

Phemie’s humungous, stupendous, out of this galaxy, Antonia said.

She’s an artist? Edward asked.

Phemie brings pictures that are wildly colorful but disorganized. Whatever is left over from a construction job, she uses in her paintings, Joanna said.

Perhaps she is random and aimless herself, or she sees society as being random and aimless, and, for that matter, uninteresting, Antonia said.

She’s not far from pop-art with her bold stripes, poster-bright colors and visual jokes produced by self-promoting individuals and their marketing skills rather than something to call culture, Joanna said.

Phemie may be saying a truth about our society. People are not exactly in pursuit of perfection, but in pursuit of money, Edward said.

It’s more like art of the sixties which was influenced by enormous profits in television, like a visual form of a happening of the sixties. Antonia, you’re not eating your eggs. Are you all right? Joanna asked.

I’m fine. I’ll get around to my eggs. I’m listening, Antonia said.

Phemie, the way you describe her, is just that, Edward said. A visual happening.

Culture tries to draw a raw person nearer to a sense of what is beautiful, graceful and becoming, Joanna said.

Do you mean discipline and suffering? That’s retro, Mom. Sufferin’ is out. Pleasure and self-indulgence are in, Antonia said.

Phemie, your raw person, has a ways to go, Edward said.

Phemie is worldly, true enough, but she has other qualities that are worthwhile, Joanna said.

I’ll have to meet Phemie one of these days, Edward said.

It won’t be long, Joanna said, We have an interesting show coming up. She’ll certainly attend.

Antonia finished her breakfast and cleared the table.

I’d better get to school, Antonia said

Angela Foster Returns

"I have your test results, Angela. The results are what I suspected. They show—"

I’m a complete nut, Angela interrupted Dr. Browne. "like they say at Greifter-Kemple, and—"

No, Angela. The tests show you are suffering from hyperthyroidism, an over active secretion of thyroid hormone which controls the rate of metabolism. When in excess, patients lose weight in spite of eating plenty of food, become irritable or nervous, develop a tremor, and have trouble concentrating. I think it explains why you have had so much difficulty at work and with your husband. Sometimes, hyperthyroidism can be difficult to diagnose, but you seem to have a full-blown example. If it isn’t treated soon, complications such as heart failure and severe debility may occur. Dr. Browne scooted his desk chair forward.

It’s a little late to do something about it don’t you think Dr. Browne? Angela hung her head. She folded hands together and held them tightly together in her lap. Her face was flushed. She couldn’t sit still. Why not just let it go? Maybe it will go away like it came.

No, I don’t think so. We can’t undo everything, but if you are under treatment, you should feel better soon and regain the weight you’ve lost. The cognitive component of hyperthyroidism improves fairly quickly, so you can concentrate and eventually get back to work, Dr. Browne looked directly at Angela.

After all the time I’ve been away, not much chance.

After you start treatment, I’m sure your concentration will improve and you will feel a lot better in many ways.

"I don’t want Granny to know about this. I don’t want her to know anything, nothing at all. I won’t