One of the nurses—it was the same big scrawl—punctuated her notes with exclamation points: patient late for injection! Patient does not understand reason for the shot! Patient swollen at injection site! She had not signed her initials on the chart. We were supposed to initial and date our notes.
How I’m supposed to work? Who going to watch my kids? My mama ain’t able.
That’s no excuse, Mrs. Seager was saying.
There were other notes that were not so clear: confused but comfortable, robust constitution with signs of fatigue, poor comprehension, poor candidate for oral contraceptives, unfit.
Unfit? Our patients were mostly young, poor, uneducated. But that just underscored the importance of our work. They needed us.
After the procedure, you can take pills that will help with the pain. Please. Just sign this form and I can get the process started.
My hand hovered over the drawer. What exactly did she mean by unfit?
Is it forever? I mean, if I get this done can I change it later?
Yes, of course you can. They can do a reversal procedure. It’s easy. Just sign here.
I wasn’t finding any evidence of a government conspiracy, at least not in the files. Maybe Mrs. Seager was just doing her job. Besides, Depo-Provera was being administered all over the country, not just here. This wasn’t the same as Tuskegee.
There, there. Don’t cry. You’ve made the right decision.
I pushed the file back into its proper place and closed the drawer. It creaked as I turned the key.
Sign right here. Mmm-hmm. Yes, I will come to pick you up and take you to the hospital myself. Don’t worry.
Abruptly, I heard the exam room door open.
I wasn’t going to make it out in time. Think fast, Civil. I could sit in the chair and pretend I was waiting for her. I put the key back where I’d found it, then cracked open the office door and peeked out. She was holding on to the exam room doorknob, her back to me. I slipped out of her office. Two steps left and it was as if I’d been walking down the hall. She turned to look at me, her eyes suspicious for a fleeting moment.
“Civil, I need you to run this sample over to the lab since you don’t seem to have anything else to do. Can you do that for me, please?”
“Yes, ma’am.”
I hoped the files I’d touched weren’t sticking out. I’d moved so quickly, I couldn’t remember if I’d replaced them perfectly.
I turned around. “Mrs. Seager?”
“Yes?”
“I— One of my patients, one of the girls I visited at their home. You see, I wanted to ask you about her.”
“Yes?”
I spoke quickly before I lost my nerve. “She’s just eleven years old, Mrs. Seager. And I discovered that she hasn’t even had her first cycle yet. I didn’t learn this until after I’d given her the shot. Surely the nurse before me made a mistake. I didn’t see a note in the file.”
She didn’t say anything, and I waited. I realized I hadn’t asked her a question, so I said, “I’ve marked her chart. I won’t give it to her again.”
“Keep a close eye on her, Civil. Do not let that girl slip through the cracks. She will start her cycle soon enough, and you need to be right there to protect her.”
“Yes, ma’am,” I squeaked.
She got close to me and spoke softly, as if concerned her patient would overhear. “Civil, you understand we have to work together to help these people. We are working for the common good. They need us. We are like . . . God’s guiding hand.” She inhaled sharply, then exhaled through her nose.
“Yes, ma’am.”
Once I was in my car, I let out a long breath. Mrs. Seager assumed that India and Erica were sexually active or would be soon. Had I assumed that, too? I realized that I had. I started to cry, but then I quickly wiped my tears. I did not have time for tears. I had to act quickly if I was going to figure this all out.
Ty had given me a piece of paper. I took it out of my purse and unfolded it. Rhesus monkeys. Beagles. Different species, yes, but uterine cancer had shown up in both. I read the words again. I’d read them over and over the night before. Upjohn Pharmaceuticals. Dr. Harold Upjohn. The drug had first been marketed in 1960 in the United States for threatened and habitual miscarriage. And for endometriosis, a painful pelvic disorder. Upjohn was the head doctor at this pharmaceutical company. The monkeys and dogs were different species, he’d argued, so it didn’t mean the same thing would happen in humans.
But they couldn’t know for sure. Mrs. Seager might not even be in on it. It was entirely possible the federal government was using our patients as if they were the subjects of a live clinical trial, the same thing they’d done to those men at Tuskegee. If the drugs were dangerous, it could be years before we knew if they’d caused cancer. By then it would be too late to connect their illness to Depo. They’d be too old or maybe even dead. Could we trust the government? Hell, I worked for the government. Who was I fooling? I wanted to talk to my daddy, but I was afraid he would tell me to quit the clinic before I could investigate further. I could talk to Alicia. She’d heard it the same as I had. I needed to know if we were injecting poison into our patients.
Poverty motivated a lot of the city’s crime. Despair. Racism. Lack of opportunity. We weren’t just helping these families. We were doing community work. Better to step in before things got worse. By giving the patients birth control, we were saving them from more dire choices. Mrs. Seager was right to be concerned.
I thought of India and Erica, their freshly washed hair and new clothes. I thought of how much they’d enjoyed listening to my records and how they’d marveled at the needle on the vinyl and the sound it made spinning in the groove.
FOURTEEN
I was listening to Booker T. and the M.G.’s’ “Behave Yourself” when Mama came into my room. I still had six more weeks before Erica was due for another shot, but each day that a woman anywhere was being injected with that drug made my head hurt. I didn’t know what to do.
Mama bounced her head, and I remembered how she used to dance. Not this kind of melancholy small movement she was doing now, but arm-swinging, hip-shaking dances. Back when I was younger, Mama danced all the time. I remember waking up at night hearing her feet moving on the floor in the den and Daddy slapping the armrest as he whistled.
I noticed a piece of white paper dangling from her hand. It had been creased into a trifold, as if it were taken from an envelope.
“Some years back, your daddy and I went to see Booker T. and the M.G.’s perform at the Coliseum in Memphis. We stayed at your aunt Ros’s house, but none of us slept. We partied and stayed up all night. The drummer’s name was Al Jackson Jr. He hung out with us that night after the concert. Ros knew them all.”
“Lord, Mama. You never told me that. Where was I?”
“You were away at vacation Bible school.”
“So y’all partied while I was getting saved.” I laughed.
I wanted my parents to dance again, to smoke reefer and curse and act like young people. Surely they had earned the carelessness of success. I wanted them to enjoy it.
Mama looked past me at the painting on my wall, a monochromatic green study of a woman walking into a fire. It was one of the few representational works I could remember Mama ever painting. I’d always been drawn to it, and when I’d found it in the back of her storage closet she had let me have it with a shrug. Now she was looking at it as if she were reassessing it, her small mouth puckered in concentration. I stared at her in admiration. I’d always viewed Mama’s beauty as so ethereal that it was the kind you didn’t pass on to children. Her face was chiseled, the skin stretched thin over sharp bones. She was wispy, ghostlike.