Flu Shot

David Watts

She stands in my examining room unable to sit, pacing, then stopping tensely, as if paralyzed by the urge to pace. Three times she has made this appointment, three times a no-show. My secretary raised her eyebrow when she came in. But I have nothing to say.

Now her eyes touch and glide, touch and glide over me like the scan of an electron microscope, programmed for the penetrating search.

I fetch the vaccine, rend the silver packet for its sterile pledget, swab the red nipple of the rubber disc at the top, then plunge and withdraw just the right 0.5 cc., amount. I have anticipated this visit.

I ask if she’s ready. She says yes. And now the killed virus I inject into the dense fibrils of her shoulder will evoke from the rangy lymphocytes their molecules of protection. She winces, turns to go, then turns back.

Why did he have to die? And as she says this, her body gives a little seizure-like lurch. Couldn’t you have prevented it?

I was gathering the detritus I had left behind: the silver crimps of packet walls torn open, the needle guard, the soiled pledget with its spot of blood in the center, the dangerous needle I would place in the red plastic carton marked hazardous. I remembered his last office exam: 62 years old, healthy. A few small problems with his cholesterol medications that we focused on. As a part of his general check-up I might have ordered a screening sigmoidoscopy. I did not. In my ear I could hear the admonitions of hospital lawyers cautioning me not to say too much. Don’t commit yourself, they might say. And I felt—what was it?—something like the shame of being caught doing something wrong. But in the cavity of that humiliation, finally exposed, I felt no desire to waffle or dodge. She deserved better than that.

Yes, I said. The cancer might have been prevented. And then there was just me and her and the truth in the room.

Strange, she said. All those years with you and with the doctor before you, nobody ever recommended a sigmoidoscopy. If that had been done the year before, would you have caught the cancer in time?

The detritus was removed. The needle was in its safe place. I had no urge to fidget in the face of her question.

It’s possible, I said, if it were still a polyp. Or if it hadn’t spread too far. And I realized that though this was true, it was a manner of deflection. I was drawn to return to the unadorned answer. It’s possible, I said. It’s possible it could have been prevented.

She was silent.

I was silent.

She waited. I have no one. No children, no family. He was all I had.

I nodded.

She reached for her overcoat.

You’ll probably have to do something about this or let it go, I said. All this hurt will come to no good.

I would never do anything, she said. I like you. I think you are a good doctor. I want—I think I want—to continue to come and see you, but it will be hard.

I’m sorry, I said. And I want you to know that I believe you should do what you need to do even if it means…

No, no. Well, maybe. I don’t know.

She left. And returned for her flu shot the following year, and the year after, never mentioning her husband, and then, eventually, for her own screening sigmoidoscopy, well in advance of its time, a request I filled like an obedient pharmacist filling the unusual prescription, knowing it was too early, but conscious of the fear she was facing, conscious of the forgiveness she brought, coming to me for the help I might give, the test that might have saved her husband.