Winter 1996, Volume 13.1
Indian Health Service
Aden Ross (Ph.D., U of Utah), a playwright, fiction writer, and poet, teaches graduate courses in playwriting. Her musical comedy Showdown! and Dreamkeepers, a commissioned libretto for the Utah Centennial opera, both premiered in 1995.
Mabel Grant is a Ute woman in her seventies or eighties. Dr. Newman is a white doctor in his early thirties who works for the Indian Health Service. The time is the present. The place is an examination room in the Indian Health Service clinic on the Ute reservation. Mabel Grant sits on a low stool with wheels. Wearing old polyester pants and a blouse which is two sizes too small, she is hunched over and holding her stomach. Carrying a clipboard, Dr. Newman enters; he is wearing a starched pinstriped shirt, suspenders, expensive slacks and loafers with tassels. He also wears expensive tortoise-shell glasses, which he habitually adjusts on his nose. Newman appraises Mabel for a moment, then leans casually against the edge of the examining table.
Newman: Mrs. Grant? (No response.) Mabel?
(Her look stops him. He starts to remove his glasses, then pushes them back on his nose. She remains hunched over, but watches him.)
Newman: I'm Doctor Newman.
(Since Mabel does not respond, he assumes that she cannot hear or understand.)
Newman: (Raising his voice.) The doctor who told your daughter to bring you in.
Mabel: My granddaughter. Betsy.
Newman: Oh. Yes. Well—
Mabel: My daughter, Carrie, died when Betsy was just a baby.
Newman: Why did you wait so long to come into the clinic? The Indian Health Service—
Mabel: Carrie died in a snowstorm. One of them late spring blizzards that blow down the mountain faster'n you can take cover. Just when you think spring's settled in.
Newman: I've looked over your x-rays and blood tests—
Mabel: When it quit snowin', Larry Duncan and me found my daughter—
Newman: Mrs. Grant—
Mabel: In a snowdrift. We saw her hair blowin' in the wind. That's all we could see: her hair blowin' out of that snowdrift. Long and black.
Newman: I'm sorry: I really don't have time….
Mabel: Then go on. The waiting room's full. Ella Chapoose's out there with her sick baby.
Newman: I need to see you before I "go on." Okay? (Consulting her chart.) You've been in a lot of pain, haven't you? (Pause at her silence.) Haven't you?
Mabel: Pain is our friend.
Newman: Not if you're a doctor: it's the enemy.
Mabel: Pain tells you what's out of balance in your life.
Newman: (Smiling slightly.) I wish it were that simple.
Mabel: If you've done your spiritual duties, your body takes care of itself.
Newman: Your illness isn't spiritual, I'm sorry to say.
Mabel: You don't know me.
Newman: I don't need to know you. I know medicine.
Mabel: How can you heal somebody if you don't know 'em?
Newman: Mabel, there isn't any easy way to tell you this, but… you have cancer. Cancer of the bone. (Pause.) Rather advanced. (Pause.) In fact, the cancer has spread to eighty percent of your body. (Hurriedly.) By that, I don't mean that eighty percent of your bone mass is affected; rather, eighty percent of your body has some indications of the pathology. (Pause.) That's why you hurt. All over. (Pause.) Do you understand what I'm saying?
(Newman takes off his glasses and rubs his eyes.)
Mabel: Your eyes hurt.
Newman: (Putting his glasses back on.) Perhaps we should call your daughter back in. Maybe she could—
Newman: (Beginning to lose patience.) Okay: granddaughter.
Mabel: I sent her back to the car. This isn't a good place.
Newman: It's hard to have a good place full of sick people.
(Mabel nods slowly in agreement.)
Newman: I must impress upon you the seriousness of your condition. (Pause.) Do you live alone?
Mabel: I've got Mama and Carrie and Uncle Clifford—
Newman: But they're… dead, right?
(Mabel shrugs a characteristic gesture at someone's ignorance.)
Newman: I mean living people. Living with you. You're going to need help. (Pause.) You may not be… ambulatory very long. Fortunately, we have all kinds of services like… like Hospice. They do everything: give baths, change beds. They can even give you injections. Assuming you want to stay home until—
Mabel: Coyote wanted to fly, so the Duck Nation helped him by sticking feathers all over him. Then Coyote could fly. But he kept squawking all the time, not just when he landed on a lake. So they pulled his feathers out.
(Pause. Newman takes off his glasses and rubs his eyes.)
Newman: Mrs. Grant, why do you think I'm here? On the reservation?
Mabel: You lost your instructions.
Newman: (With a short laugh.) Some days it feels that way. (Pause.) I didn't join the Indian Health Service just to reduce my loans for medical school. I felt compelled to treat native populations because
Mabel: We didn't lose our instructions.
Newman: Because modern medicine can really help you people. (Pause.) But in order for me to help you, you'll have to help me a little. Okay?
(Pause. Mabel assesses him.)
Mabel: (Slowly straightening up in her chair.) I'll try.
Newman: (Surprised.) Good. (Putting his glasses back on.)
Mabel: You have headaches so bad, you see colors.
Mabel: They're so bad, you make me see colors: red and bright yellow. Like ribbons. (Gesturing with her fingers.) Blowin' in your hair.
Newman: How do you know? How do you "see" headaches?
Mabel: (Feeling a little jolt, bracing her head with her hand.) Ogh! And flashes. Like lightning. (Shaking her head to clear it, looking more closely at Newman, now sensing the totality of his pain.) Oh, child. I'm too weak to help you.
Newman: To help me?
Mabel: (Reaching toward his head, but reluctant to touch the color and his pain. Then, suddenly, uncontrollably.) Oh! Can't breathe! (Clutching at the neck of her blouse.)
Newman: (Immediately alarmed.) What? You can't breathe?
Mabel: (Fighting for breath.) It's so… dark.
(Newman tosses his clipboard onto the table and prepares to administer CPR.)
Newman: Mabel! Mabel!
Mabel: (As Newman touches her, she sees.) Your… father. It's your father.
Newman: F-father? (Backing away from her as if from a fire.) What about my father?
Mabel: (Closing her eyes and rocking back and forth.) So dark. He can't breathe. (She stops rocking. Pause.) He's crying.
Newman: (Thickly.) My father's dead.
Mabel: Stumbling around… and crying.
Newman: What are you? Some kind of medicine woman?
Mabel: (Opening her eyes.) Why couldn't he breathe?
Newman: He's dead. I told you.
Mabel: (Trying to find the answer in Newman's face.) Such darkness. Was he blind?
Newman: He died… in a coal mine. Okay? Now are you happy?
Mabel: Why would that make me happy?
Newman: He was in a… an explosion. In Pennsylvania. Buried so deep, they didn't even try to dig him out.
Mabel: (Feeling his pain.) Oh, son.
Newman: How'd you know about my father?
Mabel: I don't know how my father died. Or where he's buried. All my life, I've tried to see it. Maybe that's why I have the cancer.
Newman: (Hard.) There's no connection. Believe me.
Mabel: Our elders teach us how to die.
Newman: All my dad taught me was to leave home. And never look back.
Mabel: He told you to do that?
Newman: Well, no. He… didn't want me in the mines. (Small, bitter laugh.) Dad… always thought he'd die of "black lung," he called it. Emphysema. (Pause.) He never could breathe. Coughed all the time. Had to sleep… sitting up.
Mabel: You never went back?
Newman: Once I came West for med school, I didn't have time.
(Mabel shrugs as before.)
Newman: In three generations of miners, at last a doctor. He would have been proud of me.
(Newman takes off his glasses and rubs his eyes.)
Mabel: Are you proud of him?
(Newman stops rubbing his eyes and looks at Mabel. Pause.)
Mabel: Does your head hurt all the time?
Newman: This isn't about my headaches. (Putting his glasses back on, picking up his clipboard and looking over material he already knows.) Mrs. Grant, because you've waited so long—
Mabel: No children.
Newman: I know: your daughter died—
Mabel: You. Don't have children.
Newman: (Warily.) Who told you that?
Mabel: (With sudden insight and accompanying gravity and compassion.) Oh. Your babies, too.
Newman: (Grim, level.) What babies. (More demanding.) What babies?
Mabel: No children.
Newman: (With growing defensiveness.) Lots of people don't have children.
Mabel: (Again holding her stomach and rocking back and forth.) Can your wife… still have babies?
Newman: What do you want from me? What're you trying to do?
Mabel: (Feeling his pain.) You hurt so much. What happened to them?
Newman: What difference does it make?! (Sarcastically.) Do our children teach us how to die, too?
Mabel: We're all connected.
Newman: Well, nobody died. Okay? Elizabeth just had a… a miscarriage.
Mabel: (Still rocking.) Oh. Oh.
Newman: Two. Miscarriages.
Mabel: (Near tears.) Oh, for a woman to lose a child.
Newman: They weren't "children." Just… miscarriages. There's a difference. (Pause.) The first was… an ectopic pregnancy. (Pause.) The second was… Liz had severe eclampsia. (Pause, remembering.) Blurred vision and… headaches and… seizures… before we had to…
Newman: (Pushed to his limits.) Yes, stillborn. Ectopic pregnancy and severe eclampsia and yes, stillborn. Okay? OKAY? CAN WE TALK ABOUT CANCER NOW?
Mabel: For a woman to lose her children…
Newman: They were my children, too. (Pause, then suddenly pulling out his prescription pad and furiously writing.) We do what we can do. Sometimes it's only pain management. We do. What we can do. Do you understand? (Pause, continuing to write.) I can help your pain, Mrs. Grant. It's too late to do anything else. (Pause, nearly weeping.) Do you understand? (Tearing off several prescriptions.) I'm starting you on fifteen milligrams of morphine twice a day. In between, take the Percocet every four hours. (Thrusting the papers into her hands.) You'll need it. All of it. I want to see you in two weeks. (Pause.) Do you understand?
Mabel: (Playing idly with the prescriptions, with a growing smile.) When I was young, my husband, Luke, used to drive the tribe's cattle herds. In those days, we could run cattle all over the high Uintas. (Pause.) We lived in a canvas house—not a teepee, more like a tent. Even had a wood stove. Luke would get a deer when we needed one. I'd work that deer skin like Mama taught me—scraping the hair off and soakin' it and soakin' it to make it soft. Then I'd loop it around a pole and wring. Wring it till my hands ached. It'd be soft as baby skin. (With a little laugh, holding up her arthritic hands.) That's how I got these. (Pause.) When my baby came, Luke was gone on the fall round-up. The aspens were so yellow, and some red. Flutterin' in the wind. (Pause.) I had my baby up there, all alone. The way Mama had hers, and Gramma had hers. Well, not alone: with the deer and the aspens. (Long pause.) When my girl Carrie froze to death… I thought I would die. (Pause.) But you don't die. You go on. You learn to bless all your relations. Living and dead. And they bless you back.
(Near tears, Newman takes off his glasses and covers his face with his hands.)
Mabel: Carrie was beautiful. Even dead. When we found her, she was smiling.
(Newman drops his hands to look at her, and Mabel looks back with a huge smile.)
Mabel: (Raising her hands.) With her hands raised. (Pause.) Praising the snow.
(Hold, with Newman and Mabel looking at each other. Lights slowly out.)