THE ONE ARM

Normally he got a leg in too, but this time it was just the one arm, and the doors closed on it. With great pressure, they clamped shoulder tissue against bone. As he pried at them, a train operator two cars down leaned out and shouted something hostile.

In the train car, he saw the one arm illuminated, wormlike, observed by standees glancing up from their phones. It was early morning. His wife, who had been following behind, came up to him with a sigh and knocked on the bleary glass. The doors shuddered, loosened their grip, then clamped with renewed force. He gasped. The pain was excruciating.

His wife worried at his sleeve with a small well-manicured hand. She tugged on the rough plastic edge of the door, then his collar.

Oh, don't pull me there, please.

The doors repeated their clattering but didn’t let go. Inside the train, a man became quite animated, shouting and gesturing the way you would shoo a rat. A hefty woman shook her head.

Then the train made that little anticipatory sound it makes, that anticipatorywhiny little charged whinehum preparatory to movementhum preparatory to movement.

Oh my God! he yelled.

Just pull it out! his wife cried, yanking at him. But this only intensified the pain and pressure on the one arm.

I can’t move! he cried.

The conductor leaned out and made the same shooing motion the man inside the train had made.

—

When the doors finally came open, he was weeping. He gripped his shoulder, rubbing it vigorously. His eyes burned. He heard gasps, his own, echoing grotesquely as the train diminished and disappeared.

Behind him, his wife paced up and down the yellow safety strip.

Oh, God, we are so fucked now!

It was true, he knew it. They were late for the first appointment with a marriage counselor.

—

One week later, they went to the doctor together. It was, of course, about the one arm.

The doctor blinked several times. The patient was nude before him but for a pair of tight underwear. The doctor did not respond to the question posed by both the patient and the patient’s wife, then again by the patient, and again by the wife.

You have very serious contusions.

Yes, I know that.

The edema is quite extreme, surprisingly so if you really did take ibuprofen daily.

I'm aware of the swelling too.

He took them all, the wife said. I made sure.

The doctor held two fingers toward her, as if to keep her at bay via some magic force. He continued to gaze steadily at the arm.

You're sure you took those?

Yes, for a week, I've taken them. Religiously.

The doctor breathed out; currents of vegetal odor infused the air of the small room. Then he shook his head and said nothing.

—

It was easy to assume that the arm would improve, given some more time. But another week passed, and the arm still did not improve. In fact, it was worse.

Compartment syndrome, came the diagnosis.

The doctor wiped pasty flecks of saliva from the corner of his mouth. He gazed steadily at the patient and the wife.

Do you folks eat meat?

Yes.

No.

The doctor smiled, and his lips moved excitedly before his explanation came, as if anticipating something savory.

If you've ever gone to the butcher and gotten a nice roast or a shoulder, you might have noticed the flesh is encased in a stretchy casing—well, that's called fascia. And we all have it—it's all over us. Normally it's a very flexible protein mesh that expands and contracts as needed, supporting the muscle as it does its work. However, in compartment syndrome, the fascia becomes damaged and inflexible. It can't accommodate swelling muscles. This creates a stupendous pressure inside. A truly stupendous—inhuman—pressure.

A pressure.

It's like a pressure cooker. In some cases, the fascia can even necrotize. In any case, it creates ideal conditions for a very serious infection to develop or worsen.

The patient looked at himself in the mirror, which was on the office door. The arm had lost all definition. It was tubelike and blue, like the butcher’s ink on a rump roast.

Sounds fun, he remarked.

The injury had already made his sarcasm worse.

It is not fun, the doctor stated. It is quite a serious condition. Best case, months of rehabilitation.

And worst case?

Well, the doctor said. He was licking his lips.

—

When they went back in for the next scheduled visit, the fingertips at the end of the arm, which no longer seemed like a part of him, had turned black.

The doctor sat on a swivel stool and leaned forward with his palms planted against the cushion, between his groin muscles, like a gymnast performing on the uneven bars.

I want you to know I'm making this call under great pressure. Great personal strain. It's not an easy decision.

He allowed the silence to deepen.

In fact, I didn't sleep at all last night. My wife is very angry with me. It doesn't matter. I think my child is going to fail his math class. This is all de rigueur. My vocation requires a high tolerance to stress generated by other people. I see a lot of pain, on a daily basis, but this is the worst thing I've had to face in a long time.

They all leaned forward together, a huddling gesture.

So what do we need to do? they asked the doctor.

The doctor flicked a finger along one nostril, absently rolled something with his thumb.

I'm afraid we need to perform a surgery.

What?

What kind of surgery?

What kind of surgery?

What do you mean, surgery?

I don't see why surgery would be necessary.

Nothing else was said for some time. The doctor, shaking his head ever so slightly, gazed off into some other realm. Each person let the silence deepen in a very personal way.

—

On a sunny Monday morning, just after 10:00 a.m., they went to surgery. Small lollipops with colorful wrappers were involved somehow. Or maybe that was later. Pink and yellow forms to fill out. In the waiting room, his wife sobbed in uncontrollable bouts. Her tears fell on the pages of golf magazines depicting vast sun-drenched green expanses under tropical skies. The waiting room was both bland and tasteful, like daytime television. Children with bumped heads, bleeding knees, allergies, and sunburns sat listlessly looking at said daytime television. He had a vodka hangover. The night before he had tried to kill himself with a bottle of it, which isn't enough to do the job. The vodka hangover alternated between a pleasant state of continued inebriation and a hard-edged hell of unforgiving perception. His wife commented on the smell emanating from him. He remembered pig dissections he did in middle school. You shouldn't have done that, she said. They told you to stay hydrated and only drink water twenty-four hours before. They told you to avoid alcohol, not binge on it. They told you.

But she placed a reassuring hand on his shoulder, gave a gentle squeeze.

It will go okay, she said.

A short while later the arm was prepared. It was isolated, clamped and tented, slathered with iodine wash, immobilized. The saw entered just inches below where the deltoid connects to the humerus, cut clean through the bone, and released all of the dangerous pressure that had been accumulating in the myofascial webs containing the damaged, swollen muscles.

He lay supine in his own tent of clothlinenlinens and plastic portholes, fully awake. The saw was like a distant lawnmower heard above the breeze of a summer day in his childhood. He felt a light tugging, pleasant like the grasp of an infant.

—

There were many things that normally involved at least two arms that were suddenly impossible with half that number.

Rightly, he complained all the time. His wife listened, tolerated, then cautioned against it. He could see her patience fading day by day.

I don't feel unbalanced, he said. I don't feel off kilter. But sometimes, when I get out of bed, I just keel over.

It takes time to adjust, his wife said. It's what all the support groups say.

In my dreams I still have two arms. I don't understand why this happened.

It just happened, she said.

It's not fair. It's not fair that it's me. That I'm stuck with the one arm.

You still have the one arm. What do you mean you're stuck with it?

You know what I mean. I'm stuck without the other.

But you still have the one. Yet you said you're stuck with it.

You know what I mean. Why are you acting like you don't?

You have one arm. That's exactly the way you should see it. Just that you have one and no fewer.

I'm stuck with just one.

Could you maybe for once focus on something else, maybe something that's a solvable problem? Day in and day out I listen to your complaints, and they're all about the one arm.

He wagged his one remaining index finger at her:

Actually, more about the lack of the other arm.

You need help, she said.

So do you.

—

They got help. Separately, they each found a therapist.

Hers was named Rogert, with the T on the end silent.

The therapist he saw had a cherubic but simpering face, wore summer sweaters and slacks, and had a hearing aid in one ear.

We have some paperwork, the therapist said.

And he filled out a form.

Oh, this is incorrect, the therapist said, looking it over. You're on your wife's insurance?

Yes.

Okay, you're going to have to write your wife's name in as the patient.

What? Why?

This is just the way this particular insurance works. You'll have to redo this.

But it's her insurance, and I'm the patient, not her.

I can hear just fine, the therapist said. You don't have to lean forward. All you need to do is articulate properly. There's a lot of street noise. That will be a co-pay of fifteen dollars, please.

The therapist looked at each bill in his hands as if counting them, although there were only two. He counted them that way again, then a third time.

—

It's just what it is, she said. We have to live our lives without constantly lamenting this.

Honey, I'm a typist, he said. My whole career is at stake here.

Honey, I just can't take the daily litany of complaints.

Honey— ...

 His employer, at least, had pitied him so far. He'd been there for years and could still hit his deadlines single-handedly. All the clients now regarded him with a mixture of pity and awe. Their eyes got moist with disappointment and sympathy. They shrugged for him. What can you do? they said. If you get the job done, who can complain?

But he wasn't given any new assignments. The days stretched on, week after week, and the work started to dwindle.

That's it, he told his wife one night. I quit. Today. I just walked into his office and quit.

I saw this coming, his wife said.

But it's like I told you, there was no new work coming my way.

Saw it coming a mile away.

That boss, he was just keeping me around so he could feel okay about things. He was just avoiding guilt. He was exacting pity upon me every day!

Peeling an apple, his wife said, I knew this situation would get even more fucked.

—

After that, he had unemployment to complain about too.

—

My therapist says you're not committed to this, she told him one night. My therapist says you should look at a new arm. HShe says I should encourage that.

A fake one?

A prosthetic, yes.

We can't afford it.

I can afford it. And my insurance will cover part of it.

We talked about this. It's just not my style.

Oh so it's not the cost that you have a problem with.

No, I guess it's not. I'm just not a fake arm kind of guy.

Shit, you're not? What are you, a one arm kind of guy?

That's a mean thing to say.

I’m sorry, she said. Look, a new arm is on me. And you don't have to wear it if you don't like it. Just try it for me.

He examined her desperation. She would do anything to stop his bitching. Was that love? He thought maybe it was, and that was worthwhile.

—

The arm they settled on was made of green plastic. It had a stretchy mock-flesh sock you could unroll over it—The Naturale, the model was called. It was unclear how to pronounce the name, with an Italian or French flair, but it was one or the other. The sales guy kept calling it “The Naturally.” It was cocked at a slight but pragmatic angle. The fingers were in an apparently relaxed state, bent at the knuckles but frozen that way. The arm had straps on it like a musical instrument would, except you could actually buckle it on. Each morning, before putting on a shirt, he carefully and methodically buckled it with a degree of satisfaction about equal to the comfort of putting on socks.

Oh my gosh, it looks good! she exclaimed, after he'd gotten dressed. It's like you used to look!

Sort of, he said, frowning at his reflection. Not like it does anything except hang there.

I think no one will even know.

This is such a tragedy, he said.

With an irritated look, she straightened out wrinkles in his sleeve.

My whole life is a tragedy. If this hadn't happened— ...

The fabric doesn't quite hang right, she said.

It's sticking to the mock skin, he said. And all our years together, it's come down to this.

Maybe a polyester shirt would work better?

•

For a few weeks, he was happy. It felt like a step forward. A step, he thought . . .  ... with an arm. His sarcasm, whenever possible, gleefully attacked his happiness.

The deceptiveness of the new arm was obvious. The hand was a giveaway, glove on or off. If not for that hand, it might have passed as a slightly paralytic limb, a stiff arm. But that hand exposed its fraud.

He was a fraud, a partial person, a one arm. He would never get a new job. No one would ever hire him again. Not for typing, even as a one-handed skill. It cast just enough doubt in people's minds, the one arm did. Now no one would ever have the guts to take a chance on him.

He keeled into another vodka-flooded depression.

—

His therapist tapped a pen against his pad with a tight-lipped smile. He rarely made any notation on the pad but seemed to tap it with vigor at times.

Two years ago, you said?

No. No, I didn't say that. It was just earlier this year.

Oh, my, that is recent.

Yes, it is recent, as I said in the last session.

The therapist mused: It must have been a terrible feeling, no? To have that kind of operation. What did you feel? I mean emotionally, of course, to have a part of you just removed like that. Must have been an awful feeling. To just have part of you taken off and thrown away.

There was a tug—

Oh I know about the tug. The tug-, tug. It's a commonly reported sensation. But for land's sakes, the knowledge that this piece of you was being taken, just thrown out like so much trimming.

I hadn't thought about that, yes.

It was medical waste at that point, really, wasn't it? This part of you that you'd lived with your whole life. It's a kind of death, really. A death in itself, of a loved member. So very tough to deal with. I'm sorry. I'm truly sorry about it.

The therapist stopped tapping the pen then and simply looked down at it. They both looked at it for a while, that pen.

—

After a month had passed, his wife started talking about getting him an even better arm, a more realistic one, a more durable one with more features.

The best arm on the market, the salesman said, holding it up.

Is there really any need to hard-sell prosthetics?

Oh you'd be surprised! said the salesman. The value proposition is newer, better technology—every year they're coming out with ever-so-slightly more natural-looking arms, and plenty of them are articulated, not frozen moldings, plenty have a more flesh-like covering, more detail, more craftsmanship, more thought put into their design than,  ... uh, the one you have.

The only thing more expensive, the salesman said, is the standard limb-scan-with-custom-build option, where they literally copy the design of your remaining arm, model it in the computer, and deliver it made to order right from the factory in Indonesia.

The new arm fit like a wonder. He could position it in a way that made his typing look more natural, poised above the keys as if suspended, briefly, on a whimsical thought. He felt a surge of optimism. The new medications could be thanked, surely, but this new arm was clearly a hanger for his hopes. And that meant he could now contain certain negative thoughts. Now, instead of exposing his own feelings, he just listened to his wife’s. And what the esteemed Rogert had to say about them.

One evening, for the first time in a long time, things took an intimate turn.

Take your shirt off, she whispered.

They were tangled together in the bed, writhing, whispering at each other.

No.

I don't mind, she said.

He tried kissing her. It had been a while, he realized, since they'd even so much as attempted that. Her lips moved around beneath his, her breath warm under his nose. Her head seemed enormous.

Take it off, she said.

I'd prefer not to, he said.

Really, for me, just do it.

So he took the shirt off. Then he was naked except for the fake arm hanging off him, so she helped unbuckle that, and it fell to the floor with a thump. And she was naked too, and her body moved to bear his weight, and both her hands clamped his shoulders as he moved against her.

But then her face changed. A cringe?

Her hand slipped down to encircle his penis, squeezed it briefly as if to test something, and then fell away completely.

What is it? he asked.

She looked away from him.

What? he asked.

She shook her head.

He sighed.

She shook her head at the sighing.

He shook his head at the head-shaking.

—

A month passed.

—

His therapist said:

What she's rejecting is your need to be whole, but your need to be whole is false.

And Rogert said:

He needs to meet you half way. And right now he's not budging beyond half of half way.

—

Another month.

—

One morning he looked down at the disconnection place, at the lumpy little mound of flesh there, and he noticed a nubbin. Yes—a nubbin. It was the size of a pencil eraser, soft and nippleish. In its center was another small nubbin, very small this one was, and from his angle it was hard to examine.

He stood up and went to the mirror to look closer. He pointed his ghost arm at its own lack of reflection and craned his neck.

There were five even tinier nubbins on the nubbin in the center of the nubbin.

—

In ten days, he could see exactly what was happening. The original nubbin had gotten longer, and the formations in its middle had extended too. It was very clear now that what he gazed upon was a very tiny, brand new arm, complete with a hand, with four little fingers and a thumb.

And so, because of these nubbins, he could no longer wear the fake arm. But he didn’t tell her that was why. And she didn’t protest or ask for any explanation.

—

You're letting yourself go, she said.

Just wait.

I only want you to care about your appearance a little bit. I know the job search has been hard, but you have to stay optimistic.

I am, he said. And he smiled. Just wait.

—

Her ambidexterity had become a powerful force in the household. The meat sat in the fridge. If there was to be a marinade, he wasn't quick enough. If there was chopping of things to be done, she instructed him to work on the vegetables first. Soon meat had disappeared from most meals. But that would change now. That night, he brought home a chicken breast and put it in the microwave. He microwaved it for four minutes and then asked her to cube it for him and mix it into whatever else they were eating.

You can't ruin this with chicken, she said.

I need my protein, he muttered.

It was white like mozzarella but chewy and mostly flavorless.

He decided he would eat it every night.

—

I can't help my situation, he said.

Exactly, she affirmed. I know. That's what I have a problem with.

Fuck it then.

Yeah, okay, she said cheerily. Fuck it.

I just won't even bother.

Fine, she said. Don't.

——

In another week, his dangling T-shirt sleeve would no longer conceal what was happening.

I have something to announce, he said.

She gave him a look, an invented one that was both pitiful and scornful.

I wish you would at least shave, she said.

I'm growing a new arm.

A what?

You heard me. Take a look.

She frowned at it. She wouldn't admit it was an arm. You need to get that checked out, she said.

Why? It's growing fast.

Exactly. It could be dangerous.

But—it's growing really fast!

Two days later, she said, So would you please schedule with the doctor this week?

I want to wait.

She didn't think he should wait. It went to and fro in that manner. There were a lot of words exchanged at high volume, on various evenings. He consumed vodka. He almost took a bus to Portland, Maine. But in the end, she let him wait.

—

In another week, it had its own new elbow. Its tiny hand wiggled loosely, and he found if he concentrated, he could form a tiny fist with it.

She didn't seem to be paying it much mind. She came home from work on edge and only wanted to know about how the job search was going.

It's going, he said, although he'd given it up. Hey—check this out.

He raised up the new arm and made a tiny fist for her.

She looked harried and disturbed by his behavior. I want you to get that looked at, she said.

It's coming along really nicely, he said. I've been exercising it.

With his big arm, he piled chicken cubes on his baked potato.

You need to get it checked, she said.

Checked is right.

They might want to do a biopsy, so I would schedule it right away.

I predict, he said, flexing the tiny elbow with the fist still clenched, that in thirty days it will be full size.

She threw a potato at him in sudden anger. To his surprise, he almost caught it in the new arm's tiny hand. Had the hand only been a bit bigger, he could have grabbed the potato, but instead he felt his new tiny fingers grasp at its rough skin in futility. It went hurtling past his shoulder and fell on the kitchen floor.

—

It's a new arm, he told the doctor.

Yes we'll get to that in a minute, said the doctor. How long ago did you say that you noticed this?

Did I say what?

That you noticed this? This new growth.

He knew exactly how many days, but he thought it best to be imprecise in this scenario. Uh, let's see, about three weeks ago. Yeah, something like that.

Weeks ago, said the doctor. Three weeks ago you noticed something, or you noticed this exact protuberance?

I, well, it's an arm, not a protuberance, but yes, I noticed something, not this exact thing. It's changed quite a bit.

Changed, said the doctor.

It’s amazing, right? I mean, I feel like a new man, this whole—this whole sordid affair has wreaked havoc on my—on our—placid life, and here it is, a miracle. Things are going to go back to normal, I should say.

I should say, said the doctor.

No, I should say.

I should say.

Okay. You say. I don't care. I'm so happy about this, I don't care what you say. My wife wanted me to come down here, I'm doing that, and afterward, she'll shut up about it.

The doctor was staring at the new arm. He uttered one word, distinctly:

Brachialblastoma.

What?

Nothing, the doctor said with a sardonic smile. Uh, I'd like to do a biopsy.

At the end of where the one arm had been, the tiny fist clenched.

Are you okay with that?

Fear struck him now for the first time in this visit. Fear usually struck him at any doctor's visit, but this time it was very intense. He didn't feel that saying no to a biopsy was an option. In particular because it was the very thing his wife believed he needed.

What's involved? he asked.

Just a pinprick. Maybe a small bead of blood.

Um—

Now . . . ... You said you are no longer able to wear the prosthetic.

I don't wear it.

Yes. Are you able to?

I just don't. I don't want to crush the new arm.

So you haven't tried?

I don't want to.

Well, we have an option at this juncture to clip the whole mass and send it as the biopsy sample, if you want to. It would perhaps be more comfortable to think of wearing your prosthetic after that procedure.

The doctor appeared to be serious.

We'd just nip it, the doctor said. While it’s not an indicated treatment, it would allow us to send it to the lab as a complete sample.

There is no way I will allow that, he said to the doctor.

The doctor shrugged, as if acknowledging that a bad choice had been made by a particular person in this room—not him, but some inconsequential other entity—and because of that, it was beyond his responsibility to influence the course of events. Okay, he said. Whatever you wish to do. But you want to proceed with the standard biopsy procedure?

I guess so.

All right. Then we'll get you in for a local and a CNB across the basal area of this mass. Up to two weeks to get results back. Sound good?

The fear now surrounded him like wet clothing, pulled him down by the shoulders into a lake of hopelessness.

But I don't have to get it clipped?

The doctor shrugged like nothing in the world was of real importance, like everything was relative in a way that rendered it all essentially meaningless.

You don't have to, no. Of course you don't have to.

Just then a bunned woman peeked into the room, looked shocked at what she saw, and closed the door again.

—

His wife wanted it clipped.

I think you should go back, she said. I think you should call him. Tell him you changed your mind.

That wouldn't be true, he said.

You never even wear it any more. We spent so much on that thing, and you don't wear it. And the beard. You just don't care how you look anymore. I just can't stand this. This existence. With you complaining, not caring, letting go.

I'm not letting go! he protested. I'm hanging on!

Honestly, a one-armed, bearded, unemployed man is not what I bargained for.

I didn't realize there was bargaining, he said. That's how it works? We had a bargain?

Honestly, she said, again. I have been patient. I have been kind. I have been helpful. I've tried to steer you the right way. But you're being stubborn. And you're delusional. And you're just completely letting yourself go. And all it says to me is you don't care. You don't care about you or about me.

I care about this new arm, he said. I don't want to shave the beard until the new arm is completely grown in.

Oh give me a break! she shouted. All you ever have is excuses anymore!

He stood his ground.

It's not an excuse, IT'S A NEW FUCKING ARM!

But she had already stormed off.

—

He measured it every day. In ten days since the biopsy, it had grown five more centimeters. The base of it was widening. The creases and dimples of the stump seemed to be flattening out slowly as the new arm increased in girth. The little hand could tug imperceptibly at the fibers on the back of his wife's bathrobe. And with its increasing length and fine motor development, he could grasp a hair of his beard between the tiny finger and thumb, pull it till he felt something like a pinprick on his skin, or pick up singular crumbs from the table after he ate his toast.

He mostly kept it out of view, but at dinner one night he deliberately showed off its new dimensions to his wife. She stopped chewing her asparagus, covered her mouth, and gagged into a napkin.

It's okay, he said.

She waved him away from the table, and he didn't move. Then she stood up and ran into the bathroom.

Sorry I didn't give you enough warning!

—

He could pick up dead flies and throw them against the windowpane.

—

He could lean sideways over his typewriter and peck out his full name.

—

He could tear sheets off a spiral-bound like nobody's business.

—

He'd begun to clip tiny new fingernails emerging on the hand.

—

He could flip the light switch above the bathroom sink. On. And off.

—

He could grasp and hold a plastic shopping bag that held one, two—but not three—limes.

—

He could reach his penis and arouse it by rubbing the tip.

—

The results still hadn't come in.

—

He shaved his beard off.

—

He did a job interview, but it didn't go well.

—

His wife told him: My therapist says we've lost our balance. HShe thinks we were on the edge of a precipice and that now we're falling and can't control our descent. HShe says we're reaching for whatever we can find, and we're never going to get purchase.

Get purchase? he asked.

Yes, grab something on the way down, reverse the course of things.

That's ridiculous.

It's true. Listen, you're obsessing about this growth you have, and meanwhile you're not spending any time trying to find something that's not rotten.

I can grab things with it, he said, becoming belligerent.

Honey, it's a dangerous complication resulting from your surgery!

There's no turning back now, he told his wife. I have to grow it all the way.

She shook her head and kept shaking it, like she couldn't stop.

No, seriously, he said. I have to follow through on this.

Just shut up, she said. Shut up about it.

Honey, he said. He believed, as the therapist had recommended, that it was worth an effort. He raised the new arm toward her face, and he could just reach her cheek. With the back of his miniature knuckles, he brushed forward along her tender jawline.

Her scream and her hitting hand came simultaneously, knocking him backward. He fell into the bookcase, which creaked and wobbled precipitously. It didn’t tip over, but a few books fell out on either side of his head and then a floppy magazine went sliding down his chest.

She was still screaming.

He held up both hands, large and small, and begged her. Waved them both at her. Honey! he cried. She screamed and backed up to the far wall, knocking a picture frame off-kilter.

Please, please, he begged. Stop it--—stop the screaming!

But she didn't stop screaming. She ran into the bedroom and shut the door behind her.

—

The results, for some reason, were still not in.

One day he came home to find she'd packed up three suitcases and placed them by the door. She was sitting at the kitchen table with her arms crossed.

I'm going to live with my sister, she said. You're never going to change.

Actually, I am changing. I'm doing it now. I'm becoming more powerful by the day.

You're selfish and weak and you always have been. And I am too.

Fine. Then it will be better this way.

He watched her leave, drank the two bottles of wine she'd left behind, and observed the arm in the mirror to see if he could detect its growth.

Yes. He could. In the silence left behind by her leaving, he could even hear it.

—

The results came on a Monday. The doctor himself called.

We would like you to come in, he said.

Why? What is it? I've been wanting to update you—

It's just going to be best if you come on down.

Oh, I don't even want to know.

We need to do another test. I can explain everything when you get here.

—

He drove there in the automatic. On the way, he held the wheel with one knee while he tried out the new arm on it. Slowly, he released the pressure from his knee, feeling the wheel start to shudder. He struggled to steady it with all the strength he could channel into the new arm. And sure enough, he was able to keep the wheel just like that. For two, three stoplights and counting.

At the next intersection, the light was changing. He gunned it, then thought better and braked hard. The wheel went all wobbly on him, and he had to grab it with his other hand as the car screeched to a halt in the pedestrian crosswalk.

He pumped his tiny fist in jubilation.

—

The doctor had two female nurses with him. One held a large book that she wrote in constantly. The other was holding a clipboard with a sheaf of papersn eruption of papers. She shuffled back and forth through the pages as the doctor spoke. The doctor's voice was different now. In a slightly breathless litany, he recounted what he knew of the accident that had led to the compartment syndrome, the various examinations afterward, and the difficult decision he’d made about amputating the limb. He had some theories about what it took to be a doctor, but he elided them, allowed how much more it took to be a patient. To come as a supplicant, but with an almost godlike ownership of the universe of microorganisms that is one's body. To submit this body to another's perusal, supposition, speculation, decision, and incision. To abdicate some territory in favor of another's expertise. To make proxy. He said that—make proxy. He said it three times at least. The third time or so, he sounded choked up. There was a degree of power that barely allowed any doctor to rise above a mere servant's role.

It was benign, he pronounced. All this by way of saying that. Benign. Oh. My. And in this knowledge came wrapped a mystery, which gave way to the kind of career-making accounting that every noble practitioner since Hippocrates wished for as a once-in-a-lifetime opportunity.

The findings were of note.

The doctor closed his eyes momentarily. The nurses averted their eyes to the carpet: the flesh-toned, aggressively bunched, springy, institutional surface on which they all stood.

How so?

There was a silence. The tray on the counter reminded him of a collection plate.

The tissue sample.

Just tell me. What about it?

Differentiated.

I don't understand that response. Is that bad?›

It's good.

How so?

The doctor very slowly shook his head. We can't explain it.

In a good way, you can't, or in a bad way?

In a bad way. I mean good way. This has become a case of note. Uh, and I, must ask,. . . I must ask if you'd like to cooperate in our study. In my study. Nothing harmful, just a few tests. Some additional visits.

The nurses now looked directly at him in unison. One was long-necked and storkish, the other one South Asiatic and sandpiperish.

Of course you'll be compensated.

Compensated?

Yes, of course. This is funded research now.

How much will I be compensated?

He smiled. From deep within his chest, there was a suppressed and tolerant chuckle. He intoned: Nina can share the details of that with you when you and I are finished here.

But is it going to be okay? he asked. I mean, is everything going to be okay?

The doctor began to nod. The two female nurses nodded—both less pronounced—more feminine, delicate, considerate—but nodding all the same—in time with the doctor's deeper, beneficently wise nods.

It's fine, one of the nurses, Nina, whispered.

You're going to be okay, the doctor said.

Okay, the other nurse, Janet, whispered.

But he would never be okay. It might even get to full size. It might do that, yes. But he didn't believe, not anymore, that it would ever be like the one before. That could not be. And the nurses kept nodding. And the doctor kept nodding.

A knock at the door broke the silence. The knob turned and it swung inward. His wife stood there, framed by the white- trimmed opening. She was holding a thick, flesh colored binder against her chest. She was still his wife, yes. She had come back. And she, too, was nodding.

They all just kept nodding . . ., and and nodding. , and ...