What Followed

For years you heard from your mother and your aunts and your bubbe that you had good hair and good teeth and that the rest would follow. Then, in eleventh grade, something amazing did follow: You grew five inches and passed six feet by a quarter inch. You were now the tallest man in the family, including the two uncles by marriage. You felt like the Bar Mitzvah boy all over again. Sure, no money this time, but your height felt priceless.

Now that you towered over your family, you began to slouch. Look, they said, look at how he loves the books, already such a go-getter for the medical school. They weren’t wrong. You got solid A’s or, at worst, the occasional B+ in the subjects the other kids avoided or barely passed: Chemistry; Physics; Anatomy. It’s med school or bust for our Jimmy! Uncle Raymond said all through your senior year.

Aside from growing tall and the early gift of the good hair and the good teeth, the rest did not follow. You were skinny, not lean; you wore thick lenses, not light wireframes; you sprouted sparse whiskers that didn’t cover your small chin. Your height was not enough to transform you into Jim or James. Jimmy would be okay for two years of community college while your folks saved for medical school. Later, though, it didn’t feel as okay when Jimmy wound up on your college transcript and even on your diploma. But all that would change once you entered medical school.

Sometimes one of the aunts tried to change the subject. “Are you seeing anyone special?”

“Don’t bother him,” your mother rushed in. It was like an interception on football Sunday. “Albert Einstein or Mount Sinai will be courting him soon enough!”

But that didn’t follow. You would have no relationship to Albert Einstein or Mount Sinai nor Ezra Cornell nor Samuel Hahnemann nor any medical school in the Northeast, for that matter. What followed was a single acceptance, to a school with a name that was just a string of letters: UCSF, clear across the country in California.

Your parents dusted themselves off. After all, it was medical school or bust! and this UCSF was an excellent medical school, you assured them, even if it was on the opposite coast, three thousand miles from New York. Your mother put on her bravest face. She squeezed your cheeks together, forcing your lips into an unpleasant fish-like pout, and said, “I’ll miss seeing this punim every day!” Your bubbe was less sentimental. “He’ll come to us in December, then before you know it, it will be summer again,” and with a back-sweep of her hand, she indicated that the rest would follow in quite the same manner.

Two amazing things did follow. One of the uncles by marriage had a niece who lived in San Francisco and needed a new roommate. You could rent the second bedroom starting in mid-summer. Then, the day you left for San Francisco, your Uncle Raymond surprised you with a soft, folded envelope that he pressed into your hand. “Get yourself a good used car,” he said. Inside, there was a thousand dollars in 50s and 20s.  “You pull up to school on a bicycle, the girls don’t look. You pull up in a good used car, now that could make an impression!” he said.

You found a 1975 Honda for $900 but the car was a stick and you had learned on an automatic. Andrea, the cousin by marriage, said she’d teach you how to shift and she did, once, at the far end of the A&P parking lot. Then you were on your own. You mapped the trip to the medical school but no matter what route you took, there was at least one steep hill with a STOP sign at the top. Gas, brake, and clutch pedals conspired against you. Cars honked behind you, and you had to wave them around. You sweated from places that had never sweated before, but after a while, you stalled less often. Solid driving skills would certainly follow.

But they didn’t follow, though it wasn’t your fault. School began and there was no time to practice driving. You drove the same two-mile route to and from school every day, the one that was a little longer but had fewer hills. As a first-year, you had to park on the top level of the student garage a quarter mile from your classrooms. If any girl saw you, you were not making a good impression. By the time you left school, it was dark. You were in no hurry to return to the apartment where you ate frugally and studied at the kitchen table past midnight.

The courses were hard, the books dense and inhospitable. Organic Chemistry would not reveal its secrets to you, no matter how long you stared at your notes. This had never happened to you. You thought to have your vision checked; perhaps you needed a new pair of glasses, but if you did, you wouldn’t be able to afford them.

You called home the day you received your white coat and took your Hippocratic oath to cause no harm. It was a disappointment to see Jimmy monogrammed on the coat in deep blue thread, but you left that detail out when the phone was passed from your mother to father to aunt to Bubbe. You also did not mention your first exam results, the ones you would have been only too happy to receive a B+ on. When your mother asked how you were eating, you told her that the cafeteria at school was passable, but that it had to be grab-and-go, of course; this was medical school. You didn’t tell her how much you looked forward to Tuesday nights at a place called Hana’s, where you and your Physiology classmates went for three-dollar sashimi and fifty-cent beers. She didn’t know from sashimi, and you didn’t think she’d want to know.

You tried to set the record straight. Your professors called you Jimmy and you told them that it was James, but you discovered that this wasn’t the kind of participation they were looking for, and they continued using Jimmy.

You didn’t sleep well. You were up so late that you got hungry again and you sat at the kitchen table and stared at the cereal box while you chewed. You used to read all the nutritional information on the box, but now the U.S. Daily Recommended Allowance figures irritated you. You suspected them of lying. You suspected you were nowhere near getting the nutrition you needed for medical school. 

You joined the study group for Physiology. The TA explained that routine was very important to success in medical school. “Make a detailed schedule of every waking minute and stick to it,” she said. “And don’t forget to include self-care.” You hadn’t included self-care. Your good hair already needed a cut, but you didn’t see how you’d find the time to make this happen. “You need good food and ample sleep,” the TA said. “The rest will follow.”

But the rest did not follow. You slept less, if that was even possible, and you were hungry all the time. You stopped brushing your good hair in the morning and sometimes you didn’t brush your good teeth at the end of the day. Your poor exam results continued. The TA called you out for not laundering your white coat, and you spent a meal’s worth on a one-hour dry cleaner. You asked the man behind the counter if he could change the embroidered Jimmy to James but he either didn’t understand or pretended not to. You thought about walking the two miles to school to save on gas, but you didn’t have the time. You even thought about leaving school but, of course, it was medical school or bust! and you had never thought about a plan B. You told yourself that you had been lucky once or twice before. Another stroke of luck would turn things around.

But that didn’t happen. One Tuesday night at Hana’s, you watched as the woman who always left with one of the men in the group went home alone instead of inviting you. You went to the library. “Goodnight, Jimmy!’ one of your peers called out and you returned a weak smile. The window to become James, even with your peers, had closed weeks before.

What followed the next day was that you received the first F of your life. “Come to study group,” the TA said when she placed the test in front of you, her eyebrows raised. You had never missed a session. Your neighbor stood, his test paper with the large B in one hand and gave you the kind of tight smile that said Sorry, man.

You studied until you finished reading all the pages you had written into your schedule. Never mind that you already couldn’t recall anything from the last ten. You started the car and left the student parking lot, noting the fog. You had never seen fog like San Francisco’s. At first you had found it mesmerizing, the way it rolled in like a giant welcoming carpet, but the magic of it had faded and it had become an inconvenience, something that slowed you down and strained your tired eyes. Halfway home, on the one piece of straight roadway between the hills, you shifted and accelerated to make up for lost time. You heard nothing before you felt the front wheels and then the back wheels rise as they ran over something in the road.

You thought it was an animal and you felt bad. You liked animals. You drove more slowly in the fog and reasoned that whatever it was, it was probably already dead when you came by, or else you would have heard the car hit it, you would have heard a Thump!

You drove home and had pounding palpitations after climbing the short staircase to the apartment. You were sure you wouldn’t sleep at all. You kept thinking, What if I did kill something? You heard your roommate open her bedroom door and go into the kitchen. She was looking at her food in the fridge. You told her about what had happened. “That happened to me, once,” she said, and her carefree tone made your happier than anything had in a long time. “It was probably nothing,” she said, standing up. “When that happened to me, I made a U-turn and drove back. Turns out it was only a wet cardboard box in the road.”

Back in your bedroom, you put your white coat on a hanger and tried to think rationally about the F. You tried to think how it would get better, how something good had to follow something so bad. One more sleepless night and you would fail another test and there would be nothing left except Bust! You grabbed your keys and went back to the road.

There were winding wisps of fog but nothing as bad as earlier. You reached the stretch of straight roadway. You looked in the rearview mirror and saw no one behind you. You drove down the stretch at 5 mph. You looked at the roadway and even the shoulder. There was nothing. Nothing in the road, nothing on the shoulder, nothing to indicate that something had been in the road and that you had hit it.

You put on your brights. You made a U-turn and drove down the other side of the road, thinking, What if the thing that I hit was flung off the road? but then you remembered that the wheels had passed over it. You did the U-turn five times, having decided that five was the magic number for you to feel sure.

You thought you would feel sure, but you didn’t. Something bad had happened on that road and you knew it but you couldn’t prove it. The red F on your exam paper came back to mind; you had never felt this much at a loss.

There was nothing left to do but drive back to the apartment. To the heavy books on the small kitchen table. To the white coat with the embroidered Jimmy staring at you. You should have taken a small scissor and pulled out the M-Y and made the name Jim, at least. That much you could have thought of. But now it was too late.

At the last minute, you decided to drive down the straight piece of road a sixth time, that, actually, six was the magic number. You kept your foot on the gas and shifted from first to second to third gear. Then you depressed the clutch again and shifted into fourth. You had never used fourth gear. Ahead of you, you saw a figure in the road. It was the size of a dog as far as you could tell but with the growing fog and with your tired eyes, you weren’t sure. It turned its head toward you, toward the coming car, that you knew, because its eyes became golden orbs in the dark. You kept your foot on the gas. When you hit the creature, you heard Thump! When you looked in the rearview mirror, you saw the body lying in the road. You looked a second time and a third and it was still lying there.

What followed next was that you drove to the apartment, opened the fridge, and ate your roommate’s food. You ate more than you had eaten in days. You showered and after, you took out your comb and made a fresh part in your good hair. You brushed your good teeth once and then a second time, with a new curl of toothpaste for good measure. You climbed into bed well before midnight. You slept deeply for the first time since you had left home. For the first time since you had left home, you had quieted an uncertainty. From this, success would surely follow.