The Fourth Hand

boys’ institutions when he’d attended them is insufficient explanation for the single-sex attitude that accompanied his presence as strongly as his bad choice in aftershave.

No one from his Deerfield days, or from his four years at Amherst, remembered him. He’d played varsity lacrosse, in both prep school and college—he was actually a starter—but not even his coaches remembered him. It is exceedingly rare to remain that anonymous on athletic teams; yet Nick Zajac had spent his youth and young manhood in an uncannily unmemorable but successful pursuit of excellence, with no friends and not one sexual experience. In medical school, another med student, with whom the future Dr. Zajac shared a female cadaver, would forever remember him for his outraged shock at the sight of the body. “That she was long dead wasn’t the problem,” the lab partner would recall. “What got to Nick was that the cadaver was a woman, clearly his first.”

Another first would be Zajac’s wife. He was one of those overgrateful men who married the first woman who had sex with him. Both he and his wife would regret it.

The female cadaver had something to do with Dr. Zajac’s decision to specialize in hands. According to the former lab partner, the cadaver’s hands were the only parts of her that Zajac could stand to examine.

Clearly we need to know more about Dr. Zajac. His thinness was compulsive; he couldn’t be thin enough. A marathoner, a bird-watcher, a seed-eater—a habit he had acquired from his observation of finches—the doctor was preternaturally drawn to birds and to people who were famous. He became a hand surgeon to the stars.

Mostly they were sports stars, injured athletes, such as the Boston Red Sox pitcher with a torn anterior radio-ulnar ligament on his throwing hand. The pitcher was later traded to the Toronto Blue Jays for two infielders who never panned out and a designated hitter whose principal talent was hitting his wife. Zajac operated on the designated hitter, too. In attempting to lock herself in the car, the slugger’s wife had shut the car door on his hand—the most extensive damage occurring to the second proximal phalanx and the third metacarpal.

A surprising number of sports-star injuries happened away from the field or the court or the ice—like that goalie for the Boston Bruins, since retired, who slashed his superficial transverse ligament, left hand, by gripping a wineglass too tightly against his wedding ring. And there was that frequently penalized linebacker for the New England Patriots who severed a digital artery and some digital nerves by trying to open an oyster with a Swiss Army knife. They were risk-taking jocks—an accident-prone bunch—but they were famous. For a time, Dr. Zajac worshiped them; their signed photographs, radiating physical superiority, looked down from his office walls.

Yet even the on-the-job injuries to sports stars were often unnecessary, including a center for the Boston Celtics who attempted a backward slam dunk after the time on the shot clock had expired. He simply lost control of the ball and made a mess of his palmar fascia against the rim.

Never mind—Dr. Zajac loved them all. And not only the athletes. Rock singers seemed prone to hotel-room injuries of two kinds. Foremost was what Zajac categorized as “room-service outrage”; this led to stab wounds, scalding coffee and tea injuries, and a host of unplanned confrontations with inanimate objects. A close second to these were the innumerable mishaps in wet bathrooms, to which not only rock stars but also movie stars were inclined. Movie stars had accidents in restaurants, too, mostly upon leaving them. From a hand surgeon’s point of view, striking a photographer was preferable to striking a photographer’s camera. For the hand’s sake, any expression of hostility toward something made of metal, glass, wood, stone, or plastic was a mistake. Yet, among the famous, violence toward things was the leading source of the injuries the doctor saw.

When Dr. Zajac reviewed the docile visages of his renowned patients, it was with the realization that their success and seeming contentment were only public masks. All this may have preoccupied Zajac, but the doctor’s colleagues at Schatzman, Gingeleskie, Mengerink & Associates were preoccupied with him. While they never called Dr. Zajac a star-fucker to his face, they knew what he was and felt superior to him—if only in this regard. As a surgeon, he was the best of them, and they knew this, too; it bothered them.

If, at Schatzman, Gingeleskie, Mengerink & Associates, they refrained from comment on Zajac’s fame- fucking, they did permit themselves to admonish their superstar colleague for his thinness. It was commonly believed that Zajac’s marriage had failed because he’d grown thinner than his wife, yet no one at Schatzman, Gingeleskie, Mengerink & Associates had been able to persuade Dr. Zajac to feed himself to save his marriage; they were not likely to have any success at convincing him to fatten himself up now that he was divorced. It was principally his love of birds that drove Zajac’s neighbors nuts. For reasons that were incomprehensible even to the area’s ornithologists, Dr. Zajac was convinced that the abundance of dogshit in Greater Boston had a deleterious effect on the city’s bird life.

There was a picture of Zajac that all his colleagues savored, although only one of them had seen the actual image. On a Sunday morning in his snow-covered yard on Brattle Street, the renowned hand surgeon—in knee-high boots, his red flannel bathrobe, and a preposterous New England Patriots ski hat, a brown paper bag in one hand, a child-size lacrosse stick in the other—was searching his yard for dog turds. Although Dr. Zajac didn’t own a dog, he had several inconsiderate neighbors, and Brattle Street was one of the most popular dog-walking routes in Cambridge.

The lacrosse stick had been intended for Zajac’s only child, an unathletic son who visited him every third weekend. The troubled boy, disturbed by his parents’

divorce, was an underweight six-year-old, an obdurate noneater—quite possibly at the urging of his mother, whose uncomplicated mission was to drive Zajac crazy. The ex-wife, whose name was Hildred, spoke dismissively on this subject. “Why should the kid eat? His father doesn’t. He sees his father starving himself, so he starves himself, too!” Therefore, in the divorce settlement, Zajac was permitted to see his son only once every three weeks, and for no longer than a weekend at a time. And Massachusetts has what they call no-fault divorce! (What Wallingford called his favorite oxymoron.)

In fact, Dr. Zajac agonized over his beloved child’s eating disorder and sought both medical and practical solutions to his son’s condition. (Hildred would barely acknowledge that her starved-looking son had a problem.) The boy’s name was Rudy; and on the weekends when he visited his father, he was often treated to the spectacle of Dr. Zajac force-feeding himself copious amounts of food, which Zajac would later vomit up in private, disciplined silence. But with or without his father’s example, Rudy hardly ate at all.

One pediatric gastroenterologist called for exploratory surgery to rule out any possible diseases of the colon. Another prescribed a syrup, an indigestible sugar that worked as a diuretic. A third suggested Rudy would outgrow the problem; it was the only gastroenterological advice that both Dr. Zajac and his ex-wife could accept.

Meanwhile, Zajac’s former live-in housekeeper had quit—she could not bear to see the quantity of food that was thrown away every third Monday. Because Irma, the new live-in housekeeper, took offense at the word “housekeeper,” Zajac had been careful to call her his “assistant,” although the young woman’s principal responsibilities were cleaning the house and doing the laundry. Maybe it was her obligatory daily retrieval of the dog turds from the yard that broke her spirit—the ignominy of the brown paper bag, her clumsiness with the child’s lacrosse stick, the menial nature of the task.

Irma was a homely, sturdily built girl in her late twenties, and she’d not anticipated that working for a “medical doctor,” as Irma called Zajac, would include such demeaning labor as combating the shitting habits of the Brattle Street dogs.

It further hurt her feelings that Dr. Zajac thought she was a new immigrant for whom English was a second language. English was Irma’s first and only language, but the confusion came from what little Zajac could understand from overhearing her unhappy voice on the telephone.

Irma had her own phone in her bedroom off the kitchen, and she was often talking at length to her mother or to one of her sisters late at night when Zajac was raiding the refrigerator. (The scalpel-thin surgeon limited his snacks to raw carrots, which he kept in a bowl of melting ice in the fridge.)

To Zajac, it seemed that Irma was speaking a foreign language. Doubtless some interference to his hearing was caused by his constant chomping on raw carrots and the maddening trill of the caged songbirds throughout the house, but the primary reason for Zajac’s mistaken assumption was that Irma was always hysterically crying when she spoke to her mother or sisters. She was recounting to them how humiliating it was to be consistently undervalued by Dr. Zajac. Irma could cook, but the doctor rarely ate regular meals. She could sew, but Zajac assigned the repair of his office and hospital clothing to his dry-cleaning service; what chiefly remained of his other laundry were the besweated clothes he ran in. Zajac ran in the morning (sometimes in the dark) before breakfast, and he ran again (often in the dark) at the end of the day.

He was one of those thin men in their advancing forties who run along the banks of the Charles, as if they are