Free Black & White by Dani Shapiro Page B

patients. His brown eyes are clear and limpid, radiating good healthy habits. He probably cleanses himself with green tea and takes Mexican mud compresses preventatively.
    He gives Ruth’s chart a quick read.
    “I see you’ve been to Dr. Abelow,” he says. “Ah, and Dr. Krellenstein.” He reads farther. “And Dr. Chang.”
    Ruth watches him carefully. Clara remembers this look. Her mother’s eyes—large, unblinking, as dark and impenetrable as a telephoto lens—taking everything in, processing it with her quick, visual intelligence.
    “I brought my X-rays,” Ruth says.
    “Let’s have a look,” says Zamitsky.
    He pulls the X-rays from their manila sleeves and attaches them with clips to an illuminated board. Six films in all—two of each lung, and two of another part of the body—liver? Spleen? Clara isn’t sure.
    Zamitksy stops in front of each image and examines it closely, as if it were hanging on the wall of a gallery. Clara can’t possibly tell, looking at the X-rays, where the malignancies are located. That shadow on the far left? The white swirly material in the center? They look like the night sky, seen through a telescope. Bits of cosmic matter. The images are nothing more than abstract harmless shapes, if one hasn’t been taught how to read them.
    “Ah,” Zamitsky says, tapping the last of the six films with the eraser end of his pencil. “And has Dr. Chang discussed these with you, Mrs. Dunne?”
    “No,” says Ruth. “Dr. Chang’s office just received them from radiology yesterday, and I asked for them to be messengered directly to me.”
    “Why is that?” Zamitsky raises an eyebrow.
    “I don’t feel comfortable with Dr. Chang,” says Ruth. “His receptionist was rude to me, and I…”
    She falters. And in the space left where her words trail off, Clara knows that the reason Ruth has left Dr. Chang—as she has left the doctors before him—is that he’s not telling her any news she wants to hear.
    Zamitsky continues to tap the X-ray on the far right with his pencil.
    “Here’s our problem, Ms. Dunne.” He waves the pencil around a wide area on the film, which looks grainy to Clara, full of hundreds of tiny specks. An aberration. An image left too long in the developer, breaking apart.
    “What are we looking at?” Ruth asks.
    “Your brain,” says Zamitsky.
    Ruth sits up straighter in her wheelchair.
    “Can you see all these pinpoints in this area here?”
    Ruth stares at the X-ray, uncomprehending.
    “I don’t see—”
    Zamitsky points with his pencil. “They’re hard to see, if you’re not used to it; they’re very small, like grains of sand.”
    She still looks a bit puzzled, her head cocked to one side. Clara sees her try to swallow.
    “What are they?” Ruth asks.
    Zamitsky turns off the light, plunging the films into darkness. They are now blank. The images disappear. As if Ruth can’t be hurt by what she can no longer see. Zamitksy sits on the step leading to the examination table, so he is eye level with Ruth.
    “They’re tumors,” he begins. “Very, very small tumors.”
    “Small is good,” Ruth says. “Right? I mean, small is better than big?”
    Zamitsky sighs. “I wish I could tell you that it matters, in this case. But what we’re seeing here is that your primary cancer in the lung has metastasized to your brain. This is what usually happens, when—”
    “Usually!” Ruth coughs from the effort. “I’m not interested in usually, Dr. Zamitsky. What can you do for me?”
    “I’m sorry,” he says. How many times a day does he have to do this? How often is he in the position of telling a patient there is no hope—that the illness has progressed beyond the miracle cures of green tea colonics and Mexican mud? And how does he relieve himself of that burden at the end of each day? He must be a marathon runner. Or maybe he smokes a lot of high-grade medical pot. He must have some way of escaping.
    “But what about that woman you treated?” Ruth