Go By Boat
By Dr. Chuck Radis
Go by Boat will be released April 15, 2021.
If you would like to pre-order Go By Boat there are many options.
Print: A Bookstore: Go By Boat: Stories of a Maine Island Doctor – 9781608937554 (rowman.com)
Rowman&Littlefield: Go By Boat: Stories of a Maine Island Doctor – 9781608937554 (rowman.com)
Amazon Books: https://www.amazon.com/Go-Boat-Stories-Island-Doctor/dp/1608937550/ref=sr_1_1?dchild=1&keywords=9781608937554&linkCode=qs&qid=1600189690&s=books&sr=1-1
Brooklinebooksmith National Book Network: http://nbnbooks.com/book/9781608937554-go-by-boat
Indie Bound: https://www.indiebound.org/book/9781608937554
Google Books: https://www.google.com/books/edition/_/G6MZygEACAAJ?hl=
“Not every doctor works for every patient.” Ron Anderson MD
“Lance it.” Bud Perry reached up with the tip of his index finger and felt the swollen edge of the infection beneath his left eye. “Take a blade. Slice it open.”
“It’s not ready. The infection hasn’t come to a head. There’s nothing to drain,” I answered.
“Lance it. You know it needs to be lanced.”
I sucked in my cheeks. “It’s. Not. Ready. You have a fever. This is a serious infection. We need to get it under control with intravenous antibiotics in the hospital.”
“Forget about the hospital. Give me some pills and I’ll come back tomorrow. I probably nicked the edge of it trimming my beard.”
I raised an eyebrow. The unkempt tobacco-stained beard billowed out from Mr. Perry’s chest and flowed across his face like a virgin forest. Through the partially open door, I caught the eye of Kathryn, seated at the front desk. Petite, with olive skin and dark wavy hair, Kathryn comprises 100% of the support staff for the Peaks Island Health Center. She schedules and rooms our patients, records their blood pressure, draws their blood, calls in prescriptions, and has seen Bud Perry bully his way through three previous doctors at the Health Center.
Several months into my island practice I am mortally close to being the fourth.
“Don’t you think it’s time you switched to an electric razor?” I suggested, buying time. “This is serious. Infections like this can attach to your artificial heart valve.” No reaction. “At least let me draw some blood.”
Mr. Perry grunted and offered up an arm as I applied a tourniquet. While a second red top tube filled, my gaze shifted to an ear sticking out beneath his captain’s cap. Leaning inward for a closer look, I examined the top of the ear. The lesion was definitely cancerous; either a squamous cell or basal cell carcinoma.
“I’ve had that gizmo, whatever it is, on my ear for years. Never mind about that, just give me something for this damn infection on my cheek.
“Mr. Perry,” I took a deep breath. “You’re already blind in one eye, let’s make sure we do everything we can to protect the other eye. We can have you in town in no time, start IV antibiotics and have you home…”
Abruptly, Bud Perry leaned on the handle of his make-shift cane, a cut off coal shovel, and pushing himself to his feet, started for the door. “Fine, maybe Tommy Elkhorn has some pills left over from his prostate infection.”
Kathryn knocked on the door. “Can you take a phone call? Cliff Island. They need a house-call.”
“In a second! Hold on. Hold on Mr. Perry,” I exhaled in defeat. From the cabinet I counted out sixteen cephalexin and sealed them in an envelope. I am making a deal. It is the best I can get, for now. For all I know, Tommy Elkhorn’s pills were prescribed to de-worm his cat. “Take two pills, four times a day with food. Alcohol is not food. The rest of your prescription should be down on the 3:45 afternoon ferry. I want to see you tomorrow, bright and early. If the blood cultures grow out bacteria, I’m admitting you.”
I took out my pocket calendar from my shirt pocket and wrote: “Call Bud Perry 766-3439 if alive tomorrow and skips appt.”
Emptying the envelope in his palm, Bud looked at the pills skeptically. Suddenly, he was in no particular hurry to leave. He held a pill up to the light and squinted through his sighted eye like an indecisive Cyclops. “You’re not giving me sulfa are you?”
“No Mr. Perry, I’m not giving you sulfa.” I involuntarily ground my teeth. Hold on. The man needs help. Try to understand where he’s coming from. I placed my hand on his shoulder. “I’ve checked your chart and you took this same antibiotic last year and…”
“You know I’m allergic to sulfa,” he interrupted, “laid me out good as dead. But I’ll take these pills, what do I know anyway? They’re probably better than Tommy’s pills.” Then he jabbed the end of the coal shovel towards my mid-section. “Doc, you need to put some weight on those bones. I’m serious. You look like crap. And nobody calls me Mr. Perry. It’s Bud.”
I looked helplessly to Kathryn, who could only wave limply as she tried to smother her laughter. Bud hobbled out to the front desk to pay his bill. I followed behind, scribbling a note, and reached for the phone behind the partition separating me from the check-out counter by all of six feet.
“Hello, this is Dr. Radis.”
“Doctor, this is Gerald Tingley on Cliff Island. Mother’s been having some trouble, wondered if you might come down the Bay and look her over.”
“Trouble?” I asked uneasily before committing myself more fully.
“Breathing trouble,” then after a long pause, “Can’t seem to catch her breath.”
I closed my eyes, focusing, running my fingers through a shock of thinning light brown hair. Self-consciously, I felt the edge of my belt buckle and realized I was on the last notch. My pants draped loosely off my hips. I glanced at the mirror above the sink. I pulled down a lower eye lid, inspecting the conjunctiva for signs of anemia. Maybe I need some vitamins.
“Her breathing problem, did it start today?”
“Been this way since last week, but got worse last night. The oxygen don’t seem to be holding her. She’s asking if you can make the trip, come out to Cliff Island, check her out, maybe switch out her pills.”
Resting a foot on the edge of the metal three drawer desk and leaned back on my chair, listening, sorting out what to say next. Beyond the check-out counter was the waiting room. A toddler stacked blocks at the feet of a young mother on the dull orange, thread-bare carpet as several nuns, seated directly across, looked on. One nun was humming as she knitted. The other, a good 80 pounds over ideal body weight, grimaced as she shifted a swollen leg on a cushion; that would be Sister Mia.
To the right, adjacent to the waiting room I could see a narrow alcove with a refrigerator and sink. To enter, one passed through swinging half-doors, saloon-fashion. On the counter was an ancient microscope with brass fittings manufactured by the Bausch and Lomb Optical Company. Next to it was a package of microscope slides and cover slips, a bottle of immersion oil with a dropper, and a rack of smaller bottles required to perform a Gram Stain—a series of stains enabling me to visualize bacteria—either gram positive or gram negative—when I focused the microscope on the highest magnification. Adjacent to the microscope was a centrifuge, a critical piece of equipment. After drawing blood and centrifuging the tubes, they would be refrigerated until I transported them to the hospital laboratory.
In the cabinets above the microscope were sterile containers for urine cultures, dip-sticks to assess for blood or protein in the urine, throat and wound culture swabs, and a spare glucometer. A syringe pre-filled with .3 cc of 1:1000 epinephrine was taped to the inside of the cabinet door. If a patient suffered a severe anaphylactic reaction, injecting the epinephrine promptly might be the difference between life and death while the Fire-boat chugged out to Peaks. I liked the surety of the pre-filled syringe; the last thing you want to do when a patient abruptly gasps for breath is to track down where the epinephrine and syringe are located. Medications? Samples of antibiotics, blood pressure meds, and pain relievers were stored in a shelf adjacent to the hallway. Some patients had family members who could pick up prescriptions in town after work, but if not, it might be two or three days before a prescription arrived on the island from a pharmacy in Portland, an unacceptable wait.
Around the corner from the laboratory were two exam rooms. One was a bit larger than the other, our ‘procedure room,’ where I kept supplies for wound care, suturing, and performed gynecologic exams. The other was cozier with framed photos of animals and island scenes on the walls. This was our pediatric room. All told, the Peaks Island Health Center measured, perhaps 35 by 25 feet, making up the bottom story of a cottage donated to the island by a family who lost a child to suicide.
In recent years, insulation has been blown in to the walls, the double-hung windows replaced on the ground floor, and a wooden ramp installed to improve access, but from the outside, if one was walking up Sterling Street, you’d never guess the cream-colored cottage was the home of the Islands Health Center.
Kathryn reached around the divider and flashed me a note: PORTLAND POLICE BOAT CAN BE AT PEAKS ISLAND DOCK: 40 MINUTES. I mouthed the words NO HOUSE CALL and shook my head emphatically; an elderly woman short of breath six miles off the coast needs an emergency room, not a house call.
“Gerald be fine.”
“Hold on there doc. Mother, you’ve got yourself tangled up but good. No wonder you’re having such a time, tube’s crimped under the chair. Lean forward; let me snake this round your neck. There. Now try to slow down your breathing. Doc, oxygen is on four.”
“Gerald, listen to me carefully. I’m in the middle of clinic hours here on Peaks. Even if I did come out to Cliff Island later today, I can’t properly evaluate your mother, much less treat her without a chest x-ray and blood work. We can arrange a transfer uptown in less than an hour and a half. I can meet her at the hospital later this evening…”
“Doc, I’ve moved to the kitchen, got to keep my voice down. We’re having quite a time, I’d say quite a time, and the straight up is she’s not coming into town. Said so when she got off the ferry last week.”
“Mr. Tingley, help me out here. Why is your mother on oxygen? What’s wrong with her lungs?” I asked.
“Lung. Only got one lung. Lung cancer. Surgery was in Philadelphia last month where she lives when she’s not summering on Cliff. The doctors say she’s cured, but they had to take a lung. We thought she’d never get off the respirator. Pneumonia settled in, heart failure, the works.”
I slouched down further in my swivel chair. “Gerald. Your mother absolutely has to be transferred to an emergency room. Now, which hospital do I tell the rescue boat she’ll be coming to?”
“Doc, she says she’d rather die here at home than go back to the hospital.” He cleared his throat. “It’s not a pretty sight; hard all the way round, if you take my meaning. My brother and me been up all night with her. Things are running kind of thin.”
The sound of a woman’s voice cut Gerald off and the phone rattled to the floor. Then, silence. “Doctor,” Mrs. Tingley was on the line, her breathing coming in shallow, raspy gasps. “Dr. Radis, Thank. You. For. Coming.”
I heard myself telling her I was on my way as soon as the Police Boat arrived. Hanging up the phone, I grumbled to Kathryn there was no room in my bag for an emergency room. I should have stood firm: No House Call.
“You should see Sister Mia before you leave,” Kathryn said. “She has an infection behind her heel. Sister Marie Henry is fine; she’s here for support. I’ve already taken a throat swab on the little boy. It’s positive for strep; we have liquid penicillin samples to get him started. I can call Rosemont Pharmacy for the remainder if you write out and sign the prescription. I’ll call your wife, Sandi. She may need to hold your dinner. Do you have the spare oxygen tank and an extra IV set-up? If something comes up, I’ll reach you on your beeper.”
Thirty minutes later I straddled my three-speed Schwinn, the emergency box dangling off one handle-bar and my green satchel off the other, strapped the spare oxygen tank onto the bike rack and set off for the dock.
“Good morning Dr. Radis!” An adolescent boy jogged past as I turned onto Island Avenue. “We have the day off from school!” he shouted, briefly running backwards. I tried to place him; Carrot-mop hair, long legs, short torso. Had I seen him at the Health Center? I watched him disappear around the corner; compact stride, quick leg turn-over. As a former college runner, I knew a budding talent when I saw one. Ricky…. Ricky Hogan, now I remembered. He mowed our lawn twice this summer. Sandi said he could use the money. Nice kid; he played with our two year-old Kate after finishing the lawn. Single mom. Dad, what had I heard? Absent. I tested my brakes Down Front and rattled down the ancient cobblestones of Welch Street to the Peaks Island wharf.
The twenty eight foot Connolly glided into the dock at mid-tide. Exposed mussel flats shhhhhd as the wake of the boat sent a freshet of water further up the beach. With his wrap-around aviator glasses, Officer Bob Eldridge gave the heady impression that at any moment he might be called away for a crucial drug bust. In reality, he has the cushiest assignment on the force. Pushing off, he maneuvered the boat past several late season moorings before throttling up the diesel and slicing through uneven chop into mid-channel. “Where we off to?”
“Cliff Island. Tingley’s.”
“The Tingley boys lobster.” He seemed to be searching an internal database of island names and associations. A fog bank loomed ahead in the channel between Peaks and Long Island. Officer Bob removed his sunglasses and flipped on the radar screen and casually adjusted the settings. “Old lady Tingley, I thought she died.”
Not yet, I thought.
Under way, I opened my emergency tackle box, quietly reviewing my medications from A-Albuteral inhaler—an asthmatic medication, to Z-Zaroxylon—a potent diuretic that can quickly remove excess fluid. My Sears Bass Master tackle box included several drugs I’ve never used outside the hospital setting. These are my ‘what if’ drugs. As in, what if I am an hour from the hospital and a patient’s asthma is life-threatening? IV methylprednisone and subcutaneous epinephrine are the answer. What if an islander becomes psychotic? Haldol. Heart attack? Subcutaneous heparin, aspirin, morphine. Or falls into a diabetic coma? Insulin and IV fluids. From a side pocket I pulled out my portable glucometer and checked the batteries. Everything seemed to be in working order.
House calls are a throwback to the time when medicine was more art than science, more intuition than definitive diagnosis, and not all of my house calls have been resounding successes. On my first house call last summer I forgot to pack a thermometer, its significance heightened by my inability to simply stop rummaging through my black bag. I should have felt the patient’s forehead and declared it felt a little warm instead of acting like a total imposter. Over time though, I am developing a routine, a comfort zone.
No, this house-call is out of my comfort zone. Way out.
The fog met us, blanketing the boat in a cool, white mist. Officer Bob cut our speed by half and adjusted the gain on the radar. He unbuttoned his collar, his face reflected in the green glow of the radar screen. A wave slapped the bow, and then another, the heavy-set police boat rocking ever so slightly. Flipping the radar off and on, Officer Bob rechecked the chart, and tapped the compass with his index finger. We slowed further. It felt wrong. He gave the horn three long blasts, a warning to nearby boats, and took off his cap before re-adjusting it a little lower over his eyes.
The wind shifted and the outline of Pumpkin Knob, an outcropping off the north end of Peaks Island, materialized as if touched by a magician’s wand. Moments later we were in full sunlight, bouncing over shore driven chop towards Cliff Island five miles distant, the fog bank receding behind us like a great gray wall. Outside the shelter of the inner islands, the wind gusted a good fifteen to twenty knots but the sky was a brilliant blue with an early September chill in the air. We scattered a raft of eiders, the chunkier black and white males (skunk ducks in the local parlance), beating their wings frantically to clear a line of white caps.
Coming into Cliff in the lee of the wind, we maneuvered past the dilapidated main pier to the inside of a rectangular float where dinghies were tied like horses at a hitching post. I clambered out on the bow of the police boat with a paddle, pushed aside a dingy, and jumped onto the float. I realized this was exactly what Cliff Island hoped for last winter: a house-call.
No one said it would be easy.
Above us, on the main pier, a slender, gaunt, bearded man in a faded blue windbreaker silently watched our progress. As I come off the float, we shook hands. “She’s not great, but that extra fluid pill you told me to give mother seemed to do the trick Doc, that, and turning up the oxygen a dight. Gerald Tingley.” He extended a calloused hand and shouted over my shoulder to officer Eldridge, “Hey Bobbi, want to come out to the house?” Bob waved him off and opened up the newspaper.
I was tight as a bow string, reviewing ‘my what ifs.’ Shoot, I realized, I forgot the blood draw kit. What if I need to draw blood? Maybe I have a spare kit wrapped in with my reflex hammer and tuning fork. No, it doesn’t matter. No need to draw blood; she’s coming to town. Period.
We climbed into Gerald’s ancient Dodge pick-up, the corroded bed covered by two sheets of plywood. Rust had claimed the wheel wells and worked its way back towards the tailgate. A massive piece of oak driftwood served as a bumper. The engine caught and sputtered, stalled. I fumbled instinctively for my seat belt before realizing the truck lacked not only this rudimentary feature but also had no directional signal, emergency brake, radio, inspection sticker, or windshield wipers.
Curious about the heater, I asked Gerald if it ran. “Like a pip.” He flipped the blower on and my baseball cap flipped off. “Just the basics,” he grinned. “Most of the trucks and cars on Cliff couldn’t get stickered in town, so they wound up here instead of a junk pile. Elephant’s graveyard.”
Traveling down a narrow dirt road, away from the bay, deeper into red spruce and low bush blueberry, I closed my eyes and tried to relax and enjoy the scenery. Out of the wind, late morning sunshine warmed the cab as we drove by fading patches of chicory and rose-hips and tangled clumps of Queen Anne’s lace. Above us a canopy of sugar maple interwoven with stands of spruce and white pine glided by. The muffled sound of surf on a cobble-stone beach reached us over the drone of the muffler less Dodge. Gerald pulled over and cut the engine.
“Grab your stuff Doc.”
Okay, I thought, this is it. Placing my Littman stethoscope around my neck like a talisman, I patted my cow-lick down and gave myself a pep talk: Here we go. Be sharp. But from the roadside there was no house, only unbroken forest.
“The house is down this way, out on the point,” Gerald pointed to a narrow dirt path leading into the woods.
I dutifully followed, lugging my supplies into the cool darkness. The path wound around bare outcroppings of ledge and stands of stunted red spruce, their low lying branches draping over the trail. “How in the world did your mother get to the house?” I asked
“Walked,” Gerald replied.
“Isn’t there another entrance, a road-way, some type of short cut?”
“Trail don’t usually bother her, reminds her of a fairy tale. I usually clean the trail out once or twice a year.” He paused. “To be truthful I didn’t think she’d be back this fall.”
I heard the surf long before we emerged from the forest. Stopping at the edge of an overgrown meadow, we watched shoulder high rollers explode onto exposed bedrock, sending geyser-like plumes of spray skyward. On the point, a weather beaten, brown-shingled cottage faced the open ocean. A shallow porch with a sagging roof-line extended from the water side. Across the reach, perhaps three fourths of a mile distant, was Jewel Island, beyond it, the Gulf of Maine.
Reaching the porch I gripped my black doctor bag tightly, and opened the screen door. Inside, Mrs. Tingley, all ninety pounds of her, looked even worse than I expected. Slumped in a wooden rocker, her blue eyes focused on an indefinite point beyond the breakers, her breathing came in irregular, shallow bird-like gasps. Another son, stockier and shorter by a head than Gerald, fidgeted with her oxygen tube and managed to shake his head hopelessly.
I laid my hand on Mrs. Tingley’s shoulder and told her without much conviction she was going to be okay. On the sofa behind her, I opened the tackle box, the three trays on each side unfolding like a flowering rose, exposing my therapeutic options. The two brothers stood off to one side, waiting.
I listened briefly to the right lung, or rather the former site of the right lung. Silence. Inching my stethoscope around to the left lung, I auscultated a racing, chaotic heart rhythm amid a background of high pitched wheezes and crackles. I placed my stethoscope on the chest again and palpated her pulse at the wrist. The rhythm was definitely an irregular irregularity. The diagnosis: atrial fibrillation with congestive heart failure, or in a more descriptive bygone era: dropsy.
Glancing down at my watch I counted the heart rate over 15 seconds and then multiplied this by four: one hundred sixty per minute. I wrote this down in my pocket calendar and continued my exam. Her finger tips were a dusky blue, her lower legs massively swollen. When I pressed with my index finger into the soft tissues around the ankles, it left a persistent indentation.
Her heart rhythm—atrial fibrillation, was responsible for her rapid decline. As the heart races, fluid backs up and spills out into the lungs and soft tissues. Less oxygen leads to further pump failure, and inevitably a slow motion, drowning death. It’s a hard way to go; no wonder the brothers wanted me to come; it’s tough watching a loved one drown.
I reached for a vial of digitalis and as I drew it up, realized we may have passed foxglove, the original plant source, on our walk through the field. Digitalis strengthens the pumping motion of the heart and will slow the irregular, racing rhythm of atrial fibrillation, but I’ve never before given it outside the hospital setting. Give the proper dose and the heart responds, infuse too much, and it acts as a toxin. In medical parlance, digitalis has a “narrow therapeutic window.” I broke open a vial and slowly injected 1/4th milligram, wrote down the dosage and time, and waited.
“Mrs. Tingley,” I squatted down in front of her rocking chair. “Mrs Tingley?” She looked up vacantly, as if seeing me for the first time. “I’m afraid I need to insist you come into town. The police boat is waiting.”
She clasped my hand lightly. “Thank. You. For. Coming.”
I took that as a yes. We’ll make the transfer, but first, Mrs. Tingley needs to be stabilized. If she decompensates on the trail…well, I pushed that thought aside. Focus. Concentrate on the present. During the next hour and a half I drew up and injected several additional doses of digitalis along with furosemide, a potent diuretic.
Gerald moved a bedside commode next to the rocker and the boys lifted her onto it when their mother felt an overwhelming urge to urinate. Three times she relieved herself only to nod off, slumping forward, when she returned to the rocker. By mid- afternoon, her heart and respiratory rate were halved, the coarse, rattling congestion of her lungs replaced by a Buddha-like serenity.
Pulling a strand of matted hair behind her ear she looked at me, as if for the first time. “Thought you were going to lose me, didn’t you?”
“Your lungs, I mean lung, is clearer now,” I answered. “Yes, you were close. You can’t stay here tonight.”
“It’s an awful feeling, not getting enough air,” she replied. “I felt like I was in the water. Warm milk was all around me and I couldn’t see.” She cleared her throat. “Alright, I’m back in the life boat,” she said firmly. “Gerald, get my cane.” She rose abruptly and took a step towards the screen door.
“Mother! Hold on! Wait!” Gerald grabbed the oxygen tank. Mrs. Tingley’s doughy legs suddenly crumpled and she allowed herself to collapse back into the rocking chair, rivulets of sweat soaking her night gown.
It was Gerald who suggested we transport his mother in the rocking chair. There was no other way. The brothers hoisted the chair onto their broad shoulders while I assumed the lead carrying the portable oxygen tank. Through the open field we marched in royal procession while I struggled to maintain the proper distance: Too far ahead and the oxygen tube pulled at her nose like a ring on a bull’s nose, too close and the trailing cord threatened to trip up our entourage. I mulled over the treatment she’d received and decided nothing more could be done to stabilize her for the transfer to town.
At the edge of the meadow, Mrs. Tingley looked back, straining, for one last glimpse of the cottage before we entered the woods, then, THWACK! A low lying branch sprung back against her face. The brothers wobbled uncertainly as a shower of spruce needles rained down. Panicking, I compounded the problem by stretching the oxygen line and Mrs. Tingley’s head lurched forward. The two men attempted to right the load.
“Lower!” Mrs. Tingley gasped. “Lower!” Duck walking, their knees nearly bumping their chests, the men pushed on. “My nose! Watch my nose!” Too late, the tube whipped off her nose onto an adjacent spruce branch, oxygen hissing from the free end.
The men backed out from beneath the rocker, somehow changing their grip to the outside rail and lowered their mother gently to the trail. In the thirty seconds it took for me to retrieve the oxygen tube and place it back on her nose, her fingers turned a pallid blue-black. This time I taped the tube to her cheek and pinned a loop to her wool sweater. Better to pull off a swath of cloth than lose the oxygen again.
Gerald smoked a cigarette and wiped the back of his bloodstained hand against his trousers. We sat on a moss-covered log reviewing our options.
“No way we can drag the chair on the trail.” Gerald said. “She’d bout come undone.”
“It’s not too far,” I said finally. We all knew that was a lie. Gerald looked at his cigarette and snubbed it out on a tree root. We soon found that if I walked backwards, facing Mrs. Tingley, I could control the tension on the oxygen tube. To free up my hands, I placed the emergency kit on her lap and dangled my doctor’s bag off an arm of the rocker.
Mrs. Tingley, for her part, assumed the role of scout, guiding me against the vagaries of the trail. The men were blind. Bent like beasts of burden, they could see no further ahead than their boot tops. There was no grumbling; if there is a gene for willful stubbornness she had passed it on to the boys.
“To the left,” she rasped. I scuffed an elbow against a wind scoured boulder. “Lower!” Mrs. Tingley flailed at the under-story. Somehow, the men stooped even lower. “Lift your feet!” I tripped and caught myself by flinging an arm around a sapling. On the rebound, Gerald caught the sapling square in the face, grunted an obscenity, and held on.
Reaching the road, the brothers lowered the rocker while I re-examined Mrs. Tingley. Her heart rate held steady at a reasonable 90 beats per minute. The digoxin had done its job. Breath sounds in her remaining lung were moist with crackles in the lower portion but clearer in the upper portions. A superficial scrape across her forehead was the only evidence of her harrowing journey through the woods.
Gerald lit another cigarette and leaned against the truck. He handed the cigarette to his brother who took two nervous puffs, coughed, and licked his fingers before snuffing out the cigarette between his thumb and forefinger.
Three Monarch butterflies fluttered erratically about, drawing nourishment from late season goldenrod and milkweed before launching improbably across the sound towards Mexico, two thousand miles to the southwest. Their movement caught Mrs. Tingley’s eye and she silently followed their graceful dance until they disappeared across the meadow. Only then did the two brothers load their mother onto the truck bed. Tight against the cab, she faced the rear bumper, straight backed, emotionless. The boys clambered up and stood on each side of the rocker. Gerald brushed a pine twig out of her hair and reached up with his shirt-tail to wipe a smudge off her cheek. He knocked on the window. I started the truck.
Like phantoms, island neighbors drifted to the roadside. I drove as if I were leading a funeral procession for the living, no faster than a slow amble, stopping once for an elderly woman who motioned me over, and clasping Mrs. Tingley’s hand, left a faded blue aster in her palm. By the time we reached the dock, there were eighteen in the entourage.
Officer Bob folded his newspaper as he saw us backing down the wharf. He steadied the front of the rocker as we transferred Mrs. Tingley aboard the Connolly and placed her on the diesel cowling, a flat, elevated platform at mid-ship outside the cabin. The boys reluctantly cast off. Underway, a fine mist played over the water. Mrs. Tingley faced astern, a solitary figurehead, the crowd on the dock growing smaller and smaller until we rounded the point.