The Blue Cotton Gown Read online

  “I do. But I also have a complete protocol from the Gender Dysphoria Association.” She hands over a thick document entitled “Standard of Care for Gender Identity Disorders, Sixth Version.” I glance at the cover. Committee authors include ten MDs, six PhDs, a physician’s assistant, and a doctor of public health. The index indicates that the manuscript has chapters on the initial labs, the exam schedule, the follow-up labs, and the graduated doses of testosterone injections.

  I hate to ask again, but I do. “And you’re sure you want to do this?”

  She doesn’t hesitate. “I am going to do this. Once I made the decision I felt a huge weight lift off me, a feeling of hope that I could be free of a mask I’ve always worn. I wasn’t meant to be a woman. I’m sure of it. It just took me nearly forty years to come to that conclusion.”

  “And you’ve talked to your partner?”

  “Jerry’s gone to some of my therapy sessions and is supportive.”

  “What about your family, do your parents understand? I know you’re a grown woman and they can’t stop you, but do they understand?”

  “My mom’s dead. She died a few years ago. My dad understands.”

  “And why again do you want us to help you? Couldn’t you go to Pittsburgh?”

  “I will if you say no, but it’s a three-hour drive and then another forty-five minutes across the city. I figured I would have to take a day off work for each visit, and at first I’m supposed to come once a month. I thought I would ask you because Jerry said you were open-minded … I just thought I would ask.” There are no tears. She’s not begging. It took a lot of courage for her to disclose her plan.

  I could say no and be done with it, as I imagine most providers in Torrington would, but I hedge instead. I need to think this over carefully. “You know, this is something I want to consult with Dr. Harman about. I’ll ask him to read over the protocols and see what he thinks. I’ll tell him you seem like a thoughtful and intelligent woman.”

  “Tell him I’m Jerry’s husband. He knows her. He did a laparoscopy on her a few years ago for an ovarian cyst. I met him at the hospital.” Jerry’s husband, I mentally echo.

  Standing, I reach for Kasmar’s hand and shake it. “It’s not that I have any judgment against this, you understand. I just have to sort it all out. Can I get back to you in a few weeks? I want to do some research and I want to talk to Dr. Harman.”

  “That’s fine.”

  I watch the patient walk down the long white hall as she leaves. Is it true what I said, that I don’t have any judgment against it?

  Kasmar is tall and thin, with narrow hips and a long stride. From the back she could be a man. Inside she already is.

  Searchlight

  I don’t write down the patients’ stories every night, the stories they tell in the exam room. Some nights I sleep. Not many. Some nights I write poetry in a worn spiral notebook. Some nights I go over the practice’s low bank account or lie on my back in the dark and worry about our three mostly grown boys. My mind works like a searchlight, moving back and forth through the shadows, looking for trouble.

  Tonight I wander the living room in my white robe like a ghost, worrying about Orion. This is my middle son’s first year in the master of fine arts program at the University of Cincinnati. His live-in girlfriend of seven years, Lucy, left him six months ago. He’s alone in a place where he knows hardly anyone, and he’s still mourning her loss.

  Zen, at the College of Santa Fe, asks for spending money too often but is doing okay. Tom’s been tight with the handouts, told him to get a part-time job, but that’s hard when he’s taking so many credits.

  I turn my beam on Mica. He’s settled in Atlanta with his fiancée, Emma, and he’s unemployed but never asks for help. I’m not sure what he lives on. He does some Internet consulting occasionally but hasn’t phoned or e-mailed for weeks.

  I hate telephoning my oldest son. When I get his answering machine, I’m afraid I’ll sound like a mother in a sitcom. “Hi, Mica,” the recording will say in a thin nasal whine. “It’s your mom calling, for the sixth time.” I can picture him deleting my messages and rolling his eyes. I take a deep breath. He would call if he needed me, wouldn’t he?

  There was a dark time for us when Mica was fourteen. Tom and I had left the farm to go back to school, and for two years our oldest went back and forth between the commune on the ridge and our home in Ohio. When we moved to Minnesota so I could go to the graduate program in midwifery, he refused to come. He wanted to stay in West Virginia with his biological father, Stacy. It made sense in a way. He’d grown up there. All his friends were in Spencer. Why would he want to be dragged around the country and attend school in a different place each year? But I missed him so.

  That’s when I started the long conversations on my knees with God. “Protect my boys. Shine your light on them.” For almost two years we had no contact with Mica. I would write a letter every week, but he never answered, and I never knew if he got them. There was no phone on what was left of the commune. It was as if the child I had breast-fed for twenty-four months, read countless stories to, taught how to tie his shoes, was dead. Then, almost as suddenly as he left us, he rose from the grave. We started seeing him on weekends when Tom began medical school at Ohio State in Columbus.

  Now whenever I don’t hear from Mica for a month, I fear he will disappear again forever. Like tonight. I pace the porch missing him and worrying about him …

  I’m making myself sick thinking like this! I gulp down the scotch and go back to the bedroom. As I pass the dresser, I feel in the dark for the small red prayer box and place my hand on the round wooden lid.

  TRISH

  “Do you have a minute?”

  I look up at the clock. It’s one thirty in the afternoon, and I’m just finishing charts in my office. If Tom and I don’t leave by three, we’ll miss the ferry to the island, but Trish is my friend, and even if she weren’t, I’d pull up the guest chair and close the door with my foot, as I do now. “What’s up?”

  Trish sits but doesn’t say anything. Then quietly, “Aran’s pregnant.” There are tears in her eyes. “She’s been sexually active since she was sixteen, but she’s always taken birth control pills. It’s exactly what happened to me. I was planning to go to college and took my pills every day. I got pregnant at seventeen too.” Trish wipes her lightly freckled face with the back of her hand. “I guess we’re just fertile.” A weak smile. “It’s Jimmy. He’s the father. The one she went to the prom with. You know how Dan feels. He thinks the kid’s bad news, into drugs. I think he’s okay, maybe a little lazy, maybe just immature.” Trish never says anything bad about anyone, so her characterizing Jimmy as lazy is saying a lot. My friend’s straight sandy hair is parted to the side; she’s a sweet-looking woman with a soft oval face. She stares over my head out the window, then continues.

  “Aran’s a little on the wild side but she’s an A student. She’s already been accepted at State with a full scholarship.” Trish pauses and runs her hands over her flowered scrub top, smoothing the wrinkles. I notice her name tag is crooked. “I make an effort to like Jimmy, I really do.”

  She clears her throat. “I’ve been trying to go easy on Aran. She feels so bad. She said she was never going to have kids, and now this. And she’s not just a little pregnant. She’s been hiding it. I bet she’s four months along. She was afraid to tell us, just wore baggy clothes, and I didn’t notice. Dan found out last night when one of her friends made a comment.” Trish laughs bitterly. “I think what hurts most is she didn’t tell us.”

  I study my friend as she gazes out the window at a sky filled with rolling gray clouds. She rocks back and forth as if cradling a baby. There isn’t a sound in the office.

  Aran’s probably already in her second trimester, past the point of miscarrying or considering a termination. She won’t be going to college next year. Maybe any year. She’ll lose her scholarship. Trish and Dan live month to month. They’ve been fixing up a three-bedroom ra
nch house on Perry Mountain. They have an eight-year-old, an eleven-year-old, a seventeen-year-old … and soon a new baby. There will be no money for the university.

  “Do you think they’ll get married?” I ask.

  “I’ve been thinking about that. I hope not. I don’t want her to rush into it just because of the baby. If it doesn’t work out she’ll have to get a divorce. Truthfully, we haven’t talked about it yet. We haven’t talked at all. After everything came out, Dan slammed the door and went into the garage. He didn’t come to bed until midnight, and Aran locked herself in her room. He left for work early and then Aran got on the school bus.”

  “Have you told anyone else yet?”

  “No. I couldn’t. I couldn’t without crying. I wanted to tell you first, so I waited until the office was closed and you’d be alone. I just feel so sad. Aran wanted so bad to go to college. She would have been the first in my family.”

  I take a long breath. “So will Aran come see me?”

  “She’s still on my insurance, but I don’t think it covers obstetrics.”

  “It doesn’t matter about insurance. You know it doesn’t. I’ll get her an appointment when I get back from Canada. Did I tell you we’re going to the island? If my schedule is full, I’ll see her at five on Tuesday.” We stand up, holding on to each other. Trish’s head comes just up to my shoulder.

  If I had known then the pain that was coming, maybe I would have done something different. But you never know, do you? You can’t see it coming. The seeds of love and despair were already planted, already sown, like an embryo growing, or maybe a cancer.

  Earth Dream

  Somewhere between Cleveland and Sandusky, along the tollway where it stretches flat against the heartland, I start to nod off. Tom expects this and finds an oldies rock-and-roll station coming out of Oberlin. I pat him on the leg. “Just gonna take a little nap …” He smiles, knowing how I am. I don’t sleep well in bed at night, but put me in a warm car in the passenger seat and I sleep like a baby. I wake when we get to the ferry dock, trying to hold on to the dream:

  An old woman wearing a long white dress sits at the side of a garden. In her basket are children, miniature children, toddlers to teens. My boys are there too, little blond boys, now really men. I sit down beside her.

  What have you learned? I ask the wise crone.

  Her voice is the sound of water flowing over stone.

  The sun rises. The sun sets. We do not need to hold it up.

  The river flows downhill. We can swim with it or against. Spring always comes.

  The river flows downhill and I am swimming against it.

  Summer

  CHAPTER 4

  Liberation

  A low rumble as the ferry plows through dark waves, and the smell of diesel exhaust. I love this two-hour ride across Lake Erie. Usually we come in the daylight when we can see the other islands: Kelleys, South Bass, and Middle Bass Island. Tonight we see only the lights of cottages on the black masses that jut up from the lower basin of the huge freshwater inland sea. There’s something beautiful and exotic about the darkness and the water. We could be off the coast of France, but we’re only five hours from Torrington.

  I take a deep breath and let it out slowly, let the weight of the past few months blow into the wind. Officially it’s not summer yet, but our first trip of the year to the Pelee is always summer for me. I’m looking forward to the long weekend at our cottage, which sits on the southern shore of Pelee Island, the southernmost tip of Canada.

  “You cold?” Tom asks, putting his arm around my waist and pulling me over. “I could go down to the car and get you a sweater.”

  “No, I’m fine.” I snuggle up to him. I always feel like we’re coming home when we go to the island. Something unwinds inside me.

  An hour later, at the front door of the big yellow farmhouse, we scratch around in the flower bed, searching for the key. There are no street lamps, no ambient lighting, just the wide stretch of lawn and the trees and the starlight. I always forget which rock the key’s under. Tom always remembers. Just inside the door he finds the switch and flicks on the overhead. Blinking into the white, I see the familiar photographs arranged on the shelves along the family room wall, years of vacations captured in mismatched frames. Images of our three boys fishing, boys eating at picnic tables, boys on the ferry boat, boys playing in the water, boys dunking their father. There’s even a few of my husband and me.

  Tom drags in our bag and a small red cooler. The beds are already made with the colorful quilts I collect. Canned food is stored in the pine cupboards. All we have to do is put the milk in the fridge and open a bottle of wine.

  I check out the house while Tom digs around in the drawer for the corkscrew. The kitchen is tidy. The big table that seats ten has the same vinyl lace tablecloth that I put on last fall. The housekeepers are doing a good job, and the weekly summer renters are being kind to the place. I pull the blinds up and continue my inspection. Even though it’s dark tonight, I want to see the sun and the lake in the morning.

  In the living room, the sofa and love seat are covered with matching green quilts. My photographs cover the walls, and Tom’s pottery is displayed on the built-in shelves. I open the sliding glass door to let in some air and open the windows in the big downstairs bedroom where my favorite blue patchwork is spread over the bed.

  “You ready?” Tom yells.

  “Coming.”

  As we climb up the steps to the deck on the break wall I almost trip. One board is loose, and Tom says he’ll fix it in the morning. He carries the wine. I can smell that our two acres of grass have been mown by our local handyman just today.

  In front of us is water, twenty miles of water, and far in the distance are the lights from small towns on the U.S. side. Tom grew up in northwest Ohio. He can point out Port Clinton, Marblehead, and Vermilion. With his parents and two brothers, he lived in the house in Fostoria on Colonial Drive until he was eighteen. The same house. The same bed. Even now, when we visit, nothing has changed. The silverware and waxed paper are in the exact same drawers.

  Tom’s father was a welder at the Union Carbide factory. His mother was a stay-at-home mom who volunteered for the Red Cross and led a Boy Scout troop. The family fished these waters, pulling up thousands of perch, walleye, and bass. I think sometimes that it’s Tom’s secure upbringing that gives him his optimism, the same way my background makes me wait for something to go wrong.

  We sit quietly on the deck, taking in the smell of fish and grass, no car noises, no voices, just crickets and water and wind. We watch the sky, watch the sliver of moon and the clouds as they open and close around it.

  I break the silence. “Had an interesting patient this morning.”

  Tom groans. “Can’t you ever stop thinking about work, Patsy? Give it up.”

  “No, really, this is interesting.”

  “Okay,” he says with a grunt, filling our wineglasses a second time and scooting his chair closer to the railing

  “She wants to become a man. She wants us to help her.”

  Tom chuckles. I see the flash of his teeth when he smiles into the dark. “What did you say?”

  “That I’d think about it and talk to you.”

  “I don’t do that kind of surgery. She’d be better off in Cleveland. I know someone who does it. Remember? When I was a resident there I assisted Dr. Ernest with making a vagina into a penis.”

  “My patient doesn’t want surgery. She just needs help with the testosterone injections and labs. It’s all organized through some center in Pittsburgh. She gave me a protocol that tells what labs to draw to be sure there aren’t any serious side effects and gives all the technical information about the injections.”

  “Why doesn’t she just go to Pittsburgh then? Why’d she come to us?”

  “Her significant other is our patient. You remember a woman named Jerry Slater? I think that was it … Kasmar says she met you at the hospital when you did Jerry’s surgery. She says she
’s Jerry’s husband. Does that ring a bell?”

  “Sure, I did a scope on Jerry for a cyst last year. She’s a nurse at the university hospital. That tall, thin woman’s her partner? I didn’t even know Jerry was gay.” Tom remembers everyone’s name. Phone numbers, even.

  “Come on! You can’t tell by looking. I could be gay,” I tease him.

  “Right,” Tom says and laughs, trying to pinch my nipple through my sweatshirt. He’s on target.

  “Okay, now, listen. What do you think? Should we do it?” I hold him back with one hand.

  “You’re serious? Why would we?”

  “Because she’s a nice person, and if we help her she won’t have to drive all the way to Pittsburgh each month.”

  “You like her? How old is she?” Tom rises to peer down into the churning water.

  “Yeah, I do. She seems intelligent and committed … about forty-seven, I think. I admire her. My only concern is metaphysical. Is it right? Is it messing too much with nature?”

  “People do a lot weirder things. Will she be hurting anyone?” He turns to me.

  I shake my head no.

  “Well then, it’s a free country. I think we should help her. Who else in Torrington will?” Tom slides his gaze back to the distant shore and lifts his wineglass up to the sky. Fireworks are going off in the distance at Cedar Point Amusement Park, as they do at ten every night in the summer. The waves crash below us under the deck.

  I lean against him and lift my glass too.

  ARAN

  On Tuesday morning, back home, sitting on the porch holding my morning coffee, I sight the first Baltimore oriole of the season, a blaze of fire on the top of the peach tree. An hour later, in the clinic, I scan my schedule for Trish’s daughter’s name and find it in an improvised slot at the end of the day.

  At five, I knock on the exam room door, a new chart for Aran under my arm. I see a petite young woman with the same sandy blond hair as her mother, but cut very short. She has an unblemished face and three silver studs in each ear. The boyfriend, a solemn, stocky eighteen-year-old with buzz-cut red hair and thick eyebrows, slouches low in the guest chair. As I step by, he moves his black army boots out of the way.