Rebecca Givens Rolland


by Rebecca Givens Rolland

It was an ordinary morning when Sarah first met the girl.

Sarah was standing in her third-floor office brushing her hair, only a little more briskly than she would have at home. A few quick short strokes, just enough to neaten, then she put the flat black brush in the particleboard closet above her files. Five minutes before her next patient arrived.

She drew in a breath. Another ten-hour day at Mercy Hospital, fifty-eight-minute sessions with two-minute breaks in between. The same routine as usual: she reminded herself to stay calm, make as little fuss as possible about her needs. Two glasses of water per day, no more than the allotted bathroom breaks. It was the patients she was supposed to worry about—her bodily functions were, at the most, only minor annoyances.

Most days, this reminder would have worked well enough. Her mind would quiet after a minute or two—she’d press herself with both hands away from her desk and stride down the hallway with confidence, like somebody’s mother, somebody who could handle anything. It was what her bosses at Mercy demanded, that extraordinary attention to detail. Craning your ear to a patient’s slight cough, the heave after the swallow, could tell you almost everything. The place was still the best in the country for adult disorders, even in the face of rumors it was going downhill. But today, hands on her standard-issue white coat, its twice-stitched hem hitting at her knees, the thought came into her head again, a thought she couldn’t silence, no matter how hard she drew the brush from root to end: no children for me.

She’d just turned forty years old, and Dr. Meta had said last week it wouldn’t be possible. Even if she’d met a man right now and got started post-haste, the doctor said, laying one hand on her arm, no way would any child find itself to her. A problem with her ovaries—early atrophy, she’d said, then continued talking, her high-pitched voice almost whiny as she bent down so close Sarah could smell the mint on her breath. Then, sticking her file in the drawer with the others, she gave a perfunctory lipsticked frown.

Knowing she would look it all up later, would read the diagnosis over a thousand times, Sarah tried to close her ears off and not hear anything. There would be time to reckon with the sadness, time to figure out if she had any other options, to beat herself up for anything wrong she might have done to get there, any possible role she might have played. There would be time to call up her mother and stare at the telephone, waiting for a long enough pause in the silence to slip in the news. Only a forty-minute drive away, in a suburb outside of Charlotte, and yet they weren’t exactly close—no matter how long Sarah stayed on, she knew she’d hang up without letting her know.

The worst part about them, her ovaries, was she couldn’t even feel them. Those little egg-shaped buggers lay somewhere deep inside her, plotting dysfunction, whispering exactly where they would put on the brakes and decide to halt the engine, and she’d never even know till the game was over.

Not feeling anything, what an awful concept, Sarah thought. As a third-year speech pathologist at Mercy, she had made her living out of words, helping patients speak again after stroke, traumatic brain injury, or in the face of disease—but what could she do when the seeds so deep inside her had ceased to function, when no argument would make them change their minds?

But she didn’t have time to consider that—her office door was opening, a shot of shadow widening on the floor, dark and impossible to ignore. The girl was coming. Her father, Henry, had said he would bring her, scheduled an extra twenty minutes for his appointment, insisting that she was a special case.

Sarah swiveled her head around, her arm grazing the supersized poster of the trachea on the right wall. Black lines snaked down the larynx, the esophagus, showing which way food was supposed to go down, and which you should be sure to avoid.

Henry was standing in the slice of shadow, holding the girl on his shoulder, face in. His body was stocky, blue polo shirt a little too narrow for his shoulders. He had an upright stance, like he’d been playing squash competitively for years. She’d known him for little over a month, and had only seen him alone a couple of times. From the size of the girl, she couldn’t be more than a year or so, with little red booties and old-style overalls that looked oddly fashionable for her age.

“How can I help you?” she said, pulling her coat tighter over her chest, smoothing her hair down for good measure one last time. Henry was looking her over carefully, patting the child’s shoulder as he fixed his gaze on her cheek, then her eyes. How long had he been watching? Smile and look happy, Dr. Rance from grad school had always said, giving a broad-toothed laugh himself, like he was trying to model good behavior. The patient shouldn’t have to deal with your problems on top of his.

But even as she tried to calm herself, she started to feel the familiar floating feeling that came to her when she was panicked. Her feet shuffled, unsteady, on the tiled white floor. Sit down, she told herself, swinging her chair out from the hinge of the desk. Just sit down and you’ll be all right.

“Would you like to have a seat?” she said, gesturing to the chair, then grabbing onto the steel-edged patient table. The words were like a strange croak in her mouth.

For a second, the two of them just stood there, not moving. Two arms’ worth of distance. Sarah let her gaze fall on the girl.

Sausage-chunky arms wrapped around Henry’s upper chest, the very image of a cherub from a Renaissance painting, sun-drenched blonde curls, and an impish, cross-eyed look to her as well. Legs that dimpled when she sat, knees bent a touch inward, as if she might be bowlegged when standing. It was almost impossible to see her eyebrows, they were so blonde and narrow, but when Sarah looked closely, there they were, slightly raised. Her smile was a crooked zigzag, and strangely knowing, like everything she’d ever seen was contained in her open mouth.

Catching Sarah’s smile, the girl gave a sweeping wave of her hand, fingers wiggling from knuckle to tip, the smile breaking out further on her face.

“Meet my daughter,” Henry said, holding the girl’s hand out, palm flat and straight. Sarah bent toward the girl, leaning far over the table so she could feel it hitting at her waist. A single, deferent gesture, bowing down.

Sarah felt an immediate surge of longing and thirst, then a rush of exhaustion. Was this what the border between having and not having a child felt like? Were those two conditions so far apart? If only she could hold onto those fingers a moment longer—there was something about them, the feeling of powder mixed with egg yolk, with an undertone of grittiness, of dirt, that made her want to grab onto them and not let go.

“She looks like you,” Sarah said, leaning back slightly, with a tense sort of shiver in the chair. Maybe getting a cold. Around here, you had to be careful. “So how can I help?” For a second, she heard an echo of her mother’s voice in her own.

“I haven’t been able to get an appointment at the city hospital since her six-month check-up—they said it’s going to take several months, that it isn’t an emergency. So I thought, since you’re treating my dad, you could give her a look. You’re the only one I know who’s qualified.”

Henry swept his sandy hair back with a single hand.

“You know, I’d love to help, but I don’t treat children. You know Mercy’s just set up for adults, and since grad school I haven’t worked with them—”

Henry turned his daughter around on his knee, so she faced out. That same wave of the fingers, this time with her outstretched left hand.

“What are her symptoms?” Sarah said, sighing. Out of politeness, she at least had to ask.

“Only one, to be honest—if you want to call it a symptom. She doesn’t talk, or doesn’t make any noise, I should say, and never has. From the moment of her birth, she has been silent, and nothing we can do has convinced her to produce sound. Maybe it’s psychological, the shock of birth, nobody knows. And we don’t know whether it’s something she’ll grow out of, or whether she’s going to live her life like that. It’s killing us all, to be honest.”

Leaning over the table, Sarah stared at the girl. Round heart-shaped mouth, lips thinner than her father’s, but the same basic shape. Slight double chin that jiggled when she bobbed her head. Brilliant blue eyes that focused right at her face, brightened a little, then shifted away.

“Has she been seen by the neurologists, or the pediatrician—have they checked if there’s anything physically wrong?” Sarah ticked off the possibilities, her fingers freezing to the touch.

“Yes, of course. We’ve been through the usual channels, when she was born, at least. Everything with her larynx checked out fine, her lips and tongue, her tonsils even—no clear problem there. She even had a brain scan as a baby, to see if there was anything wrong, and everything checked out fine—no unusual splotches or anything, just the regular gray matter. Once the doctors decided there wasn’t any clear reason—or nothing they could put a medical name to—they basically gave up. Told us to come back every once in a while to check on her progress, teach her sign language if we wanted. And we’ve been trying….but she’s still so young, it’s awful to think that’s all we’ll be able to do. . . .”

Henry gestured high up in the air, a mixture of deft movements that Sarah couldn’t follow. A hint of light rose into his eyes, blue streaked with brownish flecks. A glassy sheen. He looked defeated, Sarah thought, like he’d been searching for a secret, poking into every cranny, but always turning up empty.

That must be how I look, she thought to herself all of a sudden. A woman who’s always looked in every place she was told to, always colored right within the lines. And now, no children to throw bread on the counters, tip the chairs over. No children to keep me up at night.

Rolling his chair backwards, Henry clapped his feet on the floor. The vibration made Sarah startle, and she looked up, expecting the girl to shuffle in response. Nothing. Motionless on Henry’s shoulder, the girl had clearly fallen fast asleep.

“Look,” Henry said, sitting up straighter, with a steelier tone. “I get it, it’s not your specialty, you’ve got other patients—but I’m getting desperate. Her mother’s not around, and it’s just been me trying to help her all this while. Watching her grow up, seeing her try to talk—I can’t bear it, knowing she has things to say but won’t be able to say them. I can’t just give up like that.”

“I understand, but I don’t want to get your hopes up. I’m not a miracle worker—there’s no speech therapy I can think of that would work,” Sarah said, bending over to search through brochures from various companies—how to fix stuttering, what to do when you start noticing the signs of Parkinson’s.

“I’m asking you as a person, not just a therapist,” Henry said, narrowing his eyes, drawing his right hand over the desk. It almost touched hers—Sarah could feel the heat rising. He had a heavy, bearish weight to his palm. The knuckles hung with tiny hook-shaped scars. “You’re someone I trust, someone I already count on. Couldn’t you just try for me?”

Widening her eyes, the girl shifted her head around to stare. A questioning look, as if Sarah were someone from another species, not a woman at all. Her smile was crooked, almost exactly like Henry’s. How unfair, that she’d never get to have that for herself.

“I don’t know,” she said, her throat clenching.  “What if we realize there’s nothing we can do?”

“Sure,” he said, turning the girl toward him, patting her cheek with the flat of his hand. “I get it. Wouldn’t want to disappoint anyone. But this is my daughter we’re talking about. We worked so hard to have her, and every day that goes by, it’s like I’m losing her. Like I’ll never understand her.”

Henry’s voice was strained as he leaned over the girl, smoothing her loose wisps of hair with his hand. His face had a look of pleading, his eyes turned down, as if he’d wait forever if he had to, fly to whatever country, just to catch the sound of his daughter’s voice.

They all sat in silence. Sarah watched them. The position of their bodies—Henry’s back reclined against the chair, the girl’s shoulders and back horizontal, resting in his arms—reminded her of an image she once saw of the Pietà, mother grasping her son, heavy folds of drapery over them both, the whole of the earth’s sadness contained in her face.

She felt a sudden tension welling up in her body, coiled anger that wouldn’t release. How much suffering could they take? Her body failing her, her skills failing this girl, whom all the doctors had given up trying to save?

At this rate, she’d grow old without children. The girl would grow up without speech. Her father would walk around imagining her voice, the sound a glittering ring around his neck, wondering what she might have spoken of, how she might have sounded when she laughed.

She couldn’t just stand by and watch it happen, Sarah said to herself, clenching her fists underneath the desk. That was how she’d built up her career, taking what she’d called the conservative approach, telling her patients to eat only the thickest purees until she was certain they could swallow all right. This time, she felt sickened by the prospect. She’d had enough of waiting, of hoping. So what if it all came to nothing? The least she could do was try.

“All right,” she said, leaning her head back. Resting on the cool of the black-tiled wall. “I’ll ask around and see if I can find some answers. That’s all I can promise, okay?”

“Thank god,” Henry said, exhaling hard. The muscles in his cheeks unclenched. “You can’t imagine what great news this is. You won’t regret it.”

“No problem,” Sarah said, folding her arms tight. “Like I said, no promises, but I’ll try.”

Leading them out, the girl lying loosely in her father’s arms, Sarah shivered. She pulled her coat tighter, clutching her files to her chest. She felt colder than she’d remembered feeling in years.

Back in her office, she strained up to catch the flash of the digital wall clock. Two minutes until her next patient. Time to pull herself together. Drawing in a rustling, achy breath, she shut her eyes. When she opened them, she was standing in front of her taped-on office mirror, big enough to barely frame her face. Her cheeks blotchy, caked with flecks of mascara. Eyes clogged with faint leaky tears.

No matter, she told herself, blotting them out with a tissue. Keep moving. Give it a try.

All her life, she’d imagined the faces of her children, their milky blue eyes, their hair slightly longer and more tightly curled than her own. All her life, she thought she’d have enough time. Now that was over. Now she did what she could. She couldn’t stand to lose another child.


Sarah was lying on a hospital bed in a white-walled room high up in a foreign city, with doves and cooing birds racing across the sky. It felt as though the whole city had been scraped of sound, or the room at least had been turned completely soundless. Long strips of masking tape edged each of the windows, tracing their outlines from window to floor. Her green hospital robe, tied at the back, smelled of linen, of summer, of heavy rain.

Two strange men were standing beside her—Sarah knew they were doctors, but they wore plaid shirts and khakis rather than medical clothes. They were both taller than her, one slightly pudgier than the other, and had bushy mustaches. Chain-linked gold watches on their wrists.

Clutching her stomach, Sarah felt something shift inside it, some awful ache, a screw driving into the flesh above her belly button—slowly, impossibly slowly, being turned. Grabbing the hand of the thinner man, she begged him to cut her stomach open, pleaded with him to take the ache out. And he kept refusing, leaning over her with a knitted expression, said she was going to have to keep it inside…


Twisting her head, the way she did when she stretched in the morning, Sarah felt herself come to her senses. That dream again, its images so vivid it was hard to imagine the men as only figments, impossible to see the pain as unreal.

Bolus, she said out loud, the word echoing with a single gong in her throat. That word made her lips pop out with the initial plosive, then the labial in the middle forcing her tongue base up, then the fricative snake-like s at the end. Meaning: clump of liquid or pile of food.

Up until now, that dream had only caught her in the middle of the night, three or four in the morning, when she woke alone in her second-floor walk-up, lying in the double bed that she once shared with Andrew. Alone, she said to herself—even a ghost would catch more noise, attract more spirits. At least the dream had never bothered her during the day, not until now.

Sarah blinked her eyes twice, smoothed her hair down. Get back, she told herself, start your mind over. Remind yourself what you’re here for.

In the third-floor imaging room, Sarah hunched near the filing cabinet, next to two of the floor’s senior doctors and her seventy-five-year-old patient, Mrs. Bar.

Mrs. Bar shuffled in her chair but didn’t turn. The room reeked of latex and applesauce purees. Sarah wrinkled her nose, breathing out. In the three years she’d been here, she still hadn’t gotten used to the smell.

Last month, Mrs. Bar had a stroke, and in the past couple of weeks, she’d been losing alarming amounts of weight. Just didn’t feel like eating, she said. The doctors were conducting a study of her swallow to see if it was safe for her to eat. Sarah put her hand on the woman’s shoulder. She could feel the bones right underneath, the musculature trembling. Mrs. Bar sighed, shifting in her chair. “All right, everybody,” she said, in an achy voice. Shrugging her left shoulder, she shook off Sarah’s hand. “I’ve had enough with you hemming and hawing. Let’s just go.”

All at once, looking at the back of Mrs. Bar’s head—white waves of unkempt curls—Sarah thought of the girl again. Her silent smile, like the smirk of the Mona Lisa. That single-minded look on Henry’s face. Could that have been just this morning? Ever since her own diagnosis, she hadn’t been sleeping. The promise she’d made to Henry made everything worse.

Sarah drew a cupful of liquid from the upper drawer, laced with barium. In the imaging study, they had to use barium sulfate—opaque to X-rays, she remembered her professors saying—so it will show up as a black line on the screen. An eerie feeling, watching that dark line on the screen as it slipped over the top of the tongue, slid to the back of the throat, and down. It made her feel just how fragile the body was, how easily visible everything that went wrong. Did her ovaries look like that, frozen and twisted, or shrunken like raisins, locked into their useless rooms? Why hadn’t they at least allowed her to see them, given her a little while to mourn?

“You’ve prepared it?” Dr. Gans said, leaning over her. Beard frizzy, full. Voice steely and directive, warning almost. Don’t make a mistake.

“Yes, it’s all ready, the liquid bolus,” she said, handing him the thimble-sized cup of radioactive liquid, crossing over Mrs. Bar’s chest. Squeezing her eyes shut, with a cough so light it could almost be a giggle, Mrs. Bar took the cup and swallowed its contents down.

Sarah glanced over at the screen to catch it. Nothing—goddammit, too slow this time.

Pursing her lips, too fast for Sarah to stop her, Mrs. Bar spat the contents out. A shapeless glop of liquid on the floor, laced with a drop of spittle. Sarah couldn’t draw her eyes away.

“The wipes?” Dr. Zeller said from the front of the room. The kind of man her mother would have called dashing, would have said, Why can’t you find somebody just like him?

Turning to the packet on the table, Sarah bent down to collect the mess.

“No more spitting. You’re going to have to hold it in your mouth for the test to work,” Dr. Zeller called out, bending over his files, not a wrinkle in his knee-length white coat.  Maybe he ordered his wife and kids around too.

Mrs. Bar looked panicked, putting her hands to her neck, fiddling with the straps of the plastic covering.

Sarah shuddered. The place did feel claustrophobic. “I know it’s bitter,” Sarah said, feeling guilty to sound so harsh, “but you have to give it a try. We have to know whether it’s safe for you to swallow or not. Whether the gag reflex was compromised. Otherwise, you could get really sick, and we wouldn’t know why.”

Sarah felt oddly worried about the woman. She pointed with great emphasis to her chest, seeing how she was hard of hearing.

“Okay, for you, dearie, I’ll give it a shot. You seem like such a nice girl,” Mrs. Bar said, shifting her shoulders back, opening chapped lips, her mouth a narrow O.

Bending down to get the next bolus ready, Sarah stole a look back at Mrs. Bar. So silent in her green oversized gown, so hopeless-looking, deep crow’s-feet at the corners of her eyes.

That woman looked just like her mother, she realized with a start, or what her mother might have looked like in a decade or so. Same tightly rolled curls, the blondish color laced with a Saran-wrap transparence, a few streaks of red. Same slanted eyebrows that turned downward in disgust, or fear.

For a second, standing next to Mrs. Bar’s chair, Sarah caught the woman’s gaze. The momentary look back started her—sweeping blue eyes, pinprick irises with large pupils that held a deep tightness, as if attempting to will her away. In those eyes, she saw for a second her mother’s look, then her mother’s whole presence waiting, as if the transparent film of one face had lifted, revealing the face of another, more fragile, beneath.

That look was the same one her mother had given Sarah for years, whenever Sarah had disappointed her. She couldn’t disappoint her now, not this time, not so harshly. No grandchildren to show at the family reunion, no one to teach how to slide down the river’s rocks, that river winding around the family land, sand-flecked stones perfect for lying on, then dropping down. How could she possibly break the news?

Of course, it wasn’t like she had no other options, what with technology these days, and adoption—right now, though, she struggled to rinse those thoughts from her mind.

But what about Henry? she thought, looking back up at the imaging screen. Blank again, with intermittent moments of blinding light. Two seconds of brightness, then back to dark. She had to find a way to help the girl. Was there research about cases like hers? Would Dr. Zeller know of anything? She couldn’t wait forever—she’d have to face Henry tomorrow. After Mrs. Bar left, she’d have to ask.

It was so quiet, Sarah wondered if the study was working. She glanced back at Ms. Bar. Her eyes were shut tight.

Then, all at once, Mrs. Bar must have felt it—Sarah could see the liquid shooting down her throat on the imaging screen.

“No, no,” Mrs. Bar screamed in a high-pitched, sing-songy voice. A sugary, pleading tone. “Stop it, stop it, all of you—take me home!”

Thrusting her body forward, she shot completely out of her chair, sliding down past the safety catch at the chair’s end into a crumpled heap on the floor.

Such a small woman, no more than five feet tall. Sarah had never really examined her before. Locked in the fetal position, the woman heaved with the effort of her speech, a whistling yell, then an inhuman, deep-throated howl.

The room went back to dreamlike—Sarah couldn’t stop it—her own body rising up with a swoop from her seat, hovering in the space between the imaging machines, in the freezing darkness.

She had to bend down and pick up Mrs. Bar. It was her job, to help whoever needed it, to exhaust herself with the effort of it. But no part of her body moved.

A ringing in her ears, getting louder and louder, like the train outside the window of her childhood house. Dr. Zeller spitting at her to get Mrs. Bar seated, his eyes widening, the same hand gesture you’d use to manage a dog—and yet she couldn’t help it, couldn’t stop her feet from levitating in their clogs, her knees from knocking in, one panty-hosed leg rubbing up against the next, chest and shoulders winging backwards. She felt each individual vertebra arcing through the base of her tailbone, a shot of energy searing along her spine.

“I’ve gotta go,” she said. “Feeling sick. Sorry—oh god—don’t know what’s wrong.”

“Where do you think you’re going? Are you crazy?” Dr. Zeller rushed toward her with his heap of files.

Bent halfway over, she stumbled out of the office, stepping over the curled body of Mrs. Bar. Only a few more steps to her office. Keep running. Food, please stay down.

Thank god for the patient bathrooms. Dragging the door open, Sarah rushed into the last open stall. Kneeled next to the toilet, heaving. Nothing. No lunch or breakfast. Her knees ached on the lumpy edges between the tiles.

How could she have let everybody down? She shifted backwards, yanking her hair tightly into a bun. Mrs. Bar, who needed her, and the girl too.

The image of that girl—those glittering eyes, that open, trusting look, the little dip at the center of her mouth—hung in Sarah’s mind. She smiled, thinking of the girl’s face, the ease of her sleeping body. Something about her could make her forget the green-lipped toilet bowl, the lump of Mrs. Bar’s spit.

Something about the girl made her feel full of warmth, relaxed even. She imagined a hint of perfect sunlight over her face, peach-fuzz cheeks soaking up the heat. What was it about her? Maybe her soundlessness, maybe the intensity of her stare, taking in everything and letting nothing out. Or maybe the way Henry held her, both hands grasping her torso, fingers linked.

She’d simply promised to look into her case. She never said she could fix anything.

“Not your child,” Sarah said out loud, against the hum of the air conditioning. “Can’t forget that.” Her voice sounded odd, the voice of a person rising up out of a dream. Dragging herself up, she steadied herself on the stall’s steel railing. Too much, she thought, all this pressure, at a time when she already didn’t feel well.

Just say you’ve got a meeting with a specialist scheduled. Let them know you’re doing your best.

The idea felt simple suddenly, a real solution. Why hadn’t she thought of that before?

Pulling a tissue from the floral box on the sink, she scrubbed with vigor. The marks of her mascara rubbed off halfway. Both cheeks blotchy, spotted, burning red.

Terrible, she thought, that word bolus, the lack of children, everything that could rise up and come down. It felt gross, almost rancid, in her mouth.

Listing her tasks on her fingers, Sarah tried to stand taller. She’d have to put one foot in front of the next. Tomorrow she’d check in with Mrs. Bar. Apologize to the doctors for running out. Talk to Henry about the girl, stall a little. Tell her mother about her barrenness.

There’s always hope, she thought, rinsing her face one last time, drying with a single paper towel square. Let her know you’re managing, and you’ll be fine. A little cry, and you’ll both come to terms with the news.

The paper’s grimy bits, the acid cling of sanitizing soap, made her feel at ease, even safe somehow. The automatic dryer grated off and on, on and off, as she passed under it, with a mechanical rub of her hands.

Rolland author photoRebecca Givens Rolland won the 2011 Dana Award in Short Fiction, and her poems have appeared or are forthcoming in Witness, Kenyon Review, Cincinnati Review, Gettysburg Review, Georgia Review, Many Mountains Moving, Versal, American Letters & Commentary, and Meridian. Her first book, The Wreck of Birds, won the 2011 May Sarton New Hampshire First Book Prize and was published by Bauhan Publishing. She is a speech-language pathologist and doctoral student at Harvard.

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