Four of a Kind by Valerie Frankel Page B

the room. Taking a few deep breaths, Carla tried to find equilibrium, a calm center, the flatland of professional distance. Carla had to get there. And stay there. She had to be perfect, above reproach. Or she’d be hearing from the hospital administrators again.
    At the hallway sink between exam rooms, Carla washed her hands several times, and slathered them with antibiotic gel. She pulled the chart off the door of exam room two, and entered.
    Another black mother and child. She could count on one hand how many times she’d seen a black walk-in patient with her father. She saw a fair number of white and Hispanic dads. Where were the black fathers?
    Her own father, Luther Smith, left when she was three. He was gone, out the door, but just around the corner, in the apartment of another woman whom he quickly impregnated and then abandoned, a cycle he repeated three more times before fleeing Brooklyn for Florida, where he lived now with yet another family. Carla’s mother, Gloria, replaced Luther with Jesus Christ.
    The upside: Carla was an only child, which was rare in her neighborhood. Gloria divided her time and energy between church and Carla, sheltering her daughter, setting high standards for her academic success.
    The downside: Carla was chronically lonely. She was at the top of her class, but she hadn’t had a boyfriend until college. Despite spendingSundays in church, Carla never found spiritual comfort there. Carla believed in God and aspired to live by his laws, but she didn’t believe he bothered himself with the desires of individual people, or the entire human race. We are ants on a hill, she often thought. God had the universe to worry about.
    During med school, Carla was taught day after day about the frailty of the human body, and the tissue-thin protection we had against disease. Doctors repeatedly warned, “The more we know, the less we know we can do.” For all the advances of science, healers were still in the Stone Age. To cure cancer, you had to cut out the tumor. To cure a lice infestation, you had to pick nits, one by one.
    The girl in exam room two sat on the table. She looked about sixteen, but a glance at her chart put her age at thirteen. The girl looked terrified. Carla assumed the problem was gynecological.
    “What can I help you with today”—she glanced at the chart—“Selina?”
    The mother said, “Show her.”
    Reluctantly, Selina removed her shirt. On her shoulders and chest, the girl was covered with fleshy lumps, wartlike, several dozen of them of various sizes, the larger ones like pencil erasers.
    The mother asked, “Is it cancer?”
    “When did you notice the bumps?” asked Carla, taking a closer look.
    “A few months ago,” the girl whispered. “Can I put my shirt back on?”
    The mother added, “I didn’t know anything about them until last night.”
    Okay, Mom
, thought Carla.
No one’s accusing you
. “Do they itch?” asked Carla.
    “A little,” admitted the girl.
    Carla gave the girl a brief exam, confirming her immediate diagnosis. “You can put your shirt on.” To the mother, she said, “Selina has
molescum contagiosum
. Wartlike legions caused by a virus. Shemight’ve caught it anywhere, at school, from a friend who had no obvious symptoms. It’s common and
not
life-threatening. There’s no way she could have prevented it.”
    “Why are there so many?” asked the mother.
    Carla nodded, good question. “Selina spread the bumps across her chest and shoulders by scratching them, and then touching an uninfected spot.” To the girl, she asked gently, “Do you have the lesions anywhere else?”
    The horrified look said it all. The girl probably had lesions on her thighs and vulva.
    The mother asked, “Is it curable?”
    Carla pursed her lips. None of the treatment options were pleasant. Surgical removal, or chemically burning off the lesions. And even if every lesion were removed, more would crop up.
    “It’s not systemic,” Carla answered, “so