birthday cake
Photograph by Chase Middleton for The New Yorker

Dr. Cole eased his car from his garage, then stopped, out of habit, to watch in his rearview mirror the garage door slide gently down and the light above it extinguish itself. This had once given him an absurd, vain satisfaction; now it was his only goodbye. The car was expensive and comfortable, as was the house that went with it: large, sedate, islanded in lawns and leafage, like the others in the discreet crescent.

As he drove off, the purr of the engine and the crackle of gravel were the only sounds, except for—though inside his car he couldn’t hear it—the great anthem of birds. It was a little after six on an April morning, but at eight it would still be astonishingly quiet. Except for the birds. They had become extraordinarily loud, as if by some conscious effort. But that was an illusion. It was the contrast with the silence. Less than an hour ago, he’d been lying in bed, listening to them and marvelling. A solitary man in a big house, surrounded, hymned by birds.

And the roads, even the main ones, would be empty. They would be just as empty at eight. The phrase “ghost town” sometimes came to Dr. Cole as he made this journey. Ghost world. He would reach the hospital within fifteen minutes. Normally—when had “normally” ceased to apply?—it might take forty-five.

As he turned out of the driveway, a fox slipped nonchalantly through the beam of his headlights. One morning, he had counted six foxes. The birds and the foxes. They had reclaimed the world.

This journey was his time not just for counting foxes but for thought. Or, rather, his corridor for memories, which came thick and fast, unbidden. Ghosts. He had proved what was commonly said: that, when we are old, it is our earliest recollections that return to us most pressingly, while the later stuff recedes.

The later stuff could be soberly condensed: two marriages, one divorce, no children in either marriage, and the second much longer and more meaningful than the first. His second wife had been the love of his life—he could say that without hesitation. But she’d been dead now for most of two years. The loss of his life. She’d died only a year after he retired. For a while, they’d lain together in the bed in which he’d just been lying alone, listening, as dawn broke, to the birds. She’d said to him once, softly, “We can do this now.” As if lying there together were the simplest but greatest gift retirement could bring. It was.

Despite or because of the empty roads, he’d begun to leave earlier than he needed to, so that he could deliberately dawdle, even take detours, to permit the gush of memory to run its course. It was memory, not thought. His mind simply filled and throbbed, a function of driving. He vaguely rejoiced in the peaceful roads that allowed it to happen. That word, too, came to him. “Peace.” In a little while, he would enter a scene of war.

He had come forward. How could he not? He was seventy-two and retired, but how could he not? He was a specialist in respiratory disease. He had retired shortly after his mother had died. She was ninety-two. Decades ago, after his parents’ divorce, it was his mother who’d wanted him to be a doctor. It was his mother who’d almost exclusively claimed him, and he hadn’t resisted. He had become not just a doctor but, as it turned out, a top man in his field. So he’d fulfilled his mother’s dream, and more.

A top man in medicine, but he hadn’t been able to save her. Or his wife. Within two years they were both gone. The women of his life.

He’d come forward. It was hardly a choice. He’d come forward like a called-up reservist. They’d been “honored” to have him back. But what did that mean amid such havoc? A queue of casualties. A queue of deaths. One of which, he clearly understood, might be his own. All of them understood it. It might be any one of them.

What they didn’t know, as he strove to be a figure of cool authority, was that he actually liked being there. It “took the mind off,” as they say. It gave him something to do.

Except now it took the mind off in a different way. It didn’t happen on the journeys home. He did his extendable, unquantifiable “shift.” He found something to eat. He drove home, numb. He slept. Thank goodness, he could sleep. It was only here, on these dawn rides, that his life returned to him, from its wondrous distances. Otherwise, it had departed; it had seemed already over. And now he understood—accepted—that soon it might be truly over.

As he held the wheel, he was a child again. If it were a matter of calculation, he could say with exactness that he was ten. But he didn’t have to calculate. He was ten.

He was ten, and he was lying in bed on a sunny June morning because he was ill. He saw his mother’s face as she leaned toward him. She was sitting on the end of his bed, now and then stroking his covered foot or knee, and, though he was ill, her face didn’t look in the least bit troubled. It looked full of gladness and even quite merry.

She would have been—what?—a woman in her early thirties. And Dr. Henderson’s face—Dr. Henderson!—though it was the face of a doctor and therefore provisionally grave, also looked quite merry. This always happened when he visited. Doctors “visited” in those days. He would loom in the doorway, holding his doctor’s bag, a forbidding figure, more often than not still in his black winter coat and bringing with him a residue of chilly air. But very quickly he would melt and become friendly, even jolly. And how old would he have been? In his late thirties. A “young doctor.”

Now he would be dead, of course.

But on this morning Dr. Henderson wore a pale-gray lightweight summer suit. He sat down at the bedside on the chair that was always provided for him. It wasn’t part of the bedroom furniture. His mother would fetch it. The chair for Dr. Henderson! He could see it now. It had striped upholstery, red on cream, and he later learned that the stripes were called Regency stripes. Its usual place was in his parents’ room, where it seemed not to be used for sitting on, since when he looked it was nearly always draped with items of his parents’ clothing. So now Dr. Henderson sat where his parents’ clothes had mingled.

But even before he sat, even as he crossed the room, he said, “Well, Jimmy, you’re a lucky man. You could have been poorly on your tenth birthday. Many happy returns, if I’m not too late. Your mother tells me you had a wonderful birthday party. Let’s take a look at you.”

The doctor sat on the chair. His mother sat on the bed. This was how it always was. There was no question of it being the other way round. His mother stroked his foot or knee and sometimes leaned toward him. And Dr. Henderson bent over him in his professional way.

Each time, lying there, he’d have the thought, but keep it to himself, that they were like a little family. They were like the little group of three that normally lived in this house. And suppose his father, who was now busy at work, were to be suddenly replaced by Dr. Henderson. Would it be so terrible? Dr. Henderson had a way—though at ten he didn’t yet have the word for it—of being fatherly. Was Dr. Henderson even more fatherly than his own father?

His mother’s face was so bright and glad, and there seemed this morning to flutter round them all a particular kind of glee.

He knew what it was. He felt it himself, even though he was unwell. It seemed that he had now completed the list of illnesses that, though they were illnesses, it was highly desirable he should have. It was like a duty, a duty that had taken, in his case, ten years. His whole life! Each illness was challenging, one or two were nasty, but at the same time a strange source of pride and pleasure. Now he’d done them all. He was to be congratulated, and not just for his recent birthday.

And as he lay there, ill, the object of his mother’s and Dr. Henderson’s attention, he felt a strange surge of happiness. Even the word “happy” seemed to hover over him, like Dr. Henderson’s not yet conferred diagnosis, like something that might hover over him all his life.

“Well, Jimmy, I’d say, by the look of you, your mother was quite right. She’ll be doing my job next. Mind you, as illnesses go, it’s not one of the hardest to spot.”

Dr. Henderson gave his mother a quick glance that might have been called cheeky. It was a nice glance. His mother often used the word “cheeky” (usually about her son)—“Don’t be cheeky.” And now it would have been particularly appropriate.

Dr. Henderson said, “Scarlet fever. I’d say so, too.”

Then his mother said, with a sly kind of smile, “Unless he’s just blushing.”

Dr. Henderson couldn’t have known what special meaning this had. If his mother had been given to winking, she might at this point have winked.

Dr. Henderson gave a half snort, half laugh. “So what have you got to blush about, young man? Open wide.”

And how clever of him. To have asked such a question, then taken away the means of answering it. The question floated off into the air as Dr. Henderson inspected his tongue and tonsils.

“Scarlet fever, no doubt about it. Let’s have a look at your rash.”

As he drove now between rows of tomblike houses, he remembered his little pajama top, striped like the chair, but in softer colors. And he remembered his rash, the creepy feeling of it, and how, long after it had gone away and he was otherwise well, his skin was still strange and rough. And he remembered the whole list—of which this, in his case, was the last—of those childhood illnesses, with their names that were themselves faintly childish and fairy-tale-like, as if invented for infant use. Measles, mumps, chicken pox, whooping cough . . . All of them to be undergone, then left behind, usually forever, like little piles of children’s clothes that were no longer needed, like miniature versions of the clothes on the chair in his parents’ bedroom.

Children everywhere went through it. The illnesses had once been perilous and in some cases still were, and could even potentially kill. When he was smaller, there had still been the real frightener, polio. Though that had been simply dealt with, one morning, by a jab in his arm. Frightening enough. But he hadn’t cried. And his mother, then, too, had looked particularly glad, though it was a different kind of gladness. There was even a slight wetness in her eye. It was all over. Polio dealt with. And you didn’t even have to lie in bed for two days. A jab in the arm. It meant you could never get it, because you’d had it already, in a manner of speaking. His mother had tried to explain. It was called vaccination.

Another fox. In the dim light, you couldn’t see their faces or even their reddish fur, but he always had the impression that they were wearing a sneer.

His bedroom curtains had been half closed—a ritual of sickness. His mouth was silenced again by the insertion of a thermometer. Dr. Henderson, armed by his mother’s prior diagnosis, produced medicines from his bag and gave his mother some words of instruction. Two of the pills were to be taken immediately. He wrote a supplementary prescription. Then he removed the thermometer, looked at it, wiped it carefully, and put it back into a little liquid-filled tube.

“It’s a mild case, Jimmy. You hardly have a temperature. I’ve seen much worse. You’ll live. You’ll be right as rain in a few days if you do as your mother says. And no school for at least a week.”

You’ll live!

“As for blushing, young man, I can’t cure that. You’ll have to take care of that by yourself.”

He tightened his lips, both serious and not, then, snapping his bag shut, he got up from his chair and looked at his watch. “Your mother’s promised me a cup of tea.”

Dr. Henderson was always offered a cup of tea.

His mother got up, too, and they stood together at his bedside, as if he were their child. Dr. Henderson said, “And no playing with your friends, either. But you’ve already done that. A wonderful birthday party. You’re lucky you didn’t miss it. I’m sorry I missed it myself.”

Then they went downstairs, leaving him with the sudden thought that Dr. Henderson might never enter his bedroom again. If this was the last illness. And then with the thought, not so stabbing, yet puzzling: Why should Dr. Henderson be sorry to have missed his party? Had he been invited?

And then with the sudden returning image, as he lay in bed, of that party, every detail of it. A memory merely a week old. But now, sixty and more years later, it came back to him just as piercingly fresh.

That party! Even the hypothetical presence at it of Dr. Henderson. Though why, indeed, should he have been there? Why should he have been standing there, a special guest, among the gaggle of mums? The mums were the only grownups at the party. There were no men. It was a teatime party. All the men were absent at work. All the fathers. All the doctors, too.

“Just call now and then, to let us know you exist.”

But it was true. It was a wonderful party. It reënveloped him now. The best of his birthday parties, because, after all, he was ten, a big boy, two numbers to his name. And the best party because—but this, he now knew, was hindsight, neither a thing nor a word he had then—in less than a year’s time his parents would start the process of not living together. The world would disintegrate.

It wasn’t his mother and Dr. Henderson, as he might have supposed, even vaguely wished. His mother sometimes went to see Dr. Henderson by herself. But this was only to “see her doctor,” in his surgery. “Women’s stuff,” his father had once bafflingly said about these visits. Then shrugged, as if he didn’t care.

Putting two and two together, he’d wondered if this “stuff” might have to do with the little brother or sister he’d once been promised. But surely that was all finished with long ago, long before he was ten. His mother had settled for just one. So had he—settled on being the one. It was his mother and him. Then he’d dared to suppose that the visits might not be about anything medical at all.

But it had been his father. It had been the other way round. When his father went to work, he didn’t, sometimes, just go to work.

Though none of this had clouded his tenth-birthday party, no more than had the illness he would have a week later.

Awonderful party on a gorgeous summer’s day in the garden that lay beneath his bedroom window. If he’d got up from his sickbed, he might have surveyed the scene of his party. But he didn’t need to—it was in his head.

As it was in his head now.

The lawn strewn with his guests, his school friends. Only an hour before, they’d all been at school and the lawn had been just a lawn, quietly basking in the June sun. But a transformation had occurred. The boys, including himself, had been thrust into clean shirts and the girls, more willingly, perhaps, into party frocks. Then they’d all regathered at his house and taken possession of the lawn.

On the narrow terrace between house and lawn stood a table bearing food and drink, and round it clustered the mums, in party frocks of their own. Under the table, hidden by a tablecloth hanging to the ground, had been, though not for long, everything needed for a succession of party games, and the presents to go with them. Everyone, he understood, was to have presents, but he would have the most and the best.

And so it had transpired. What was on the table was soon pillaged—the tablecloth would eventually need a serious wash—and what was underneath achieved its purpose. The lawn became strewn not just with children but with torn and crumpled wrapping paper and other debris from the games, not to mention many smeared and sticky paper plates and cups, some trodden on.

And all this joyous litter was a tribute to his mother’s toil. How she must have labored that day, preparing little fancy cakes—and one big one—as well as ice cream, jellies, bottles of lemonade, jugs of lemon and orange squash to be topped up with ice cubes from the new fridge. In the brief interval between his return from school and the start of it all, he had watched her set everything out with unpanicking efficiency, a calm smile on her face. How she must have worked—wrapping the presents as well!—and how unflappably and triumphantly she had assembled the results of her work.

In the unit, soon, he would inwardly invoke, to assert his necessary poise, his mother’s busy serenity before his tenth-birthday party.

At the last moment, she’d gone up quickly to her bedroom to put on her own party frock. She reappeared in a dress that was a mass of swirling red blooms on white, and in a delicate waft of perfume. Her day dress would have been left on the Regency chair.

Then the front doorbell began to ring.

He saw it all now, as he drove toward what was no party at all: the children in charge of the lawn, the women subserviently but floridly in charge of the table, dispensing the food and drink and stepping onto the grass, some in unsuitably high heels, only to deal with the games and the crucial issuing of presents.

The names of some of his friends, his party guests, came clearly back to him, though he had not thought of them for decades: Bobby Scott, Nigel Wilson, Helen Fletcher, Wendy Simms . . . There they were on the lawn. Where were they now?

A party for both children and mums, an invisible wavering line between the two. But there was a moment when the mothers all claimed him. They drew him away from his pride of place on the lawn and took him aside. They said things like “You mustn’t forget us, Jimmy.” Or “Let’s have some of you, too.”

It was Mrs. Simms who said that. “Let’s have some of you, too.” Whatever it meant. She said it after popping into her mouth, almost whole, one of the little cakes, and as she did so her eyes bulged and goggled in exactly the same way that her daughter’s did when she attempted the same. She flicked away bits of cake from her lips, then waggled her fingers in the air. Her party dress was also flowery—they were in a garden, after all—and had no sleeves and a deep collar. When she brushed her mouth, a sizable crumb fell into her neckline and disappeared. Did she know? Did she see that he saw? But she said, after the waggly thing, “Let’s have some of you, too, Jimmy.” And added, “Us girls, too.” So all the mums were now “girls.” It was confusing.

And then she said, which was even more confusing, “So come on, Jim, you’ve got to tell us.” Her eyes swivelled round the crowded lawn. “You can tell us. Which one do you like best? Which one is your favorite?” Then, as if to correct herself, she said, “Which party frock?” More and more confusion. Did she really mean, as he’d momentarily thought, “Which girl?,” or did she mean “Which frock?” Or was it one and the same? In order to give an answer, did he have to separate the girls from their frocks? Which was a thought. Did he have an answer anyway?

So he said nothing. He struggled, a magnet for confusion. Was Mrs. Simms really wanting him to choose her daughter, Wendy, both frock and girl? Then another mum—was it Mrs. Scott?—chimed in, “He’s blushing!” Worse and worse.

But his mother quickly and gently said, “Leave him alone. Let him be. It’s his party.” It wasn’t reproachful of the other women; it was just a little soft statement that at once rescued him. He felt again now, a seventy-two-year-old man at the wheel of a car, its protective touch winging to him like a bird.

And had he immediately stopped blushing? How could he know? And perhaps no one knew, not even Mrs. Simms, that he was blushing not at the choice put to him but at the thought of that crumb that had dropped down her dress. Where had it gone? And at the thought of all these grownup party dresses, rustling, pressing, and whispering round him, which had been put on in more complicated ways than the girls’ ones and, it was at least partly true to say, especially for him.

For a moment, he’d been claimed by the women, even made to feel he belonged to them. And been made to understand that they were also girls. And for a moment, too, after his mother’s magical intervention, he’d even seemed to see everything through their eyes. Not just the spectacle of the party, of the child-sprinkled lawn, which supposedly still guarded his secret choice, but everything. Everything all around. Not just the lawn but the rest of the garden and the adjoining gardens, all with their own lawns and trellises and cascades of roses and apple trees and clumps of hydrangea bushes. And the houses with their red-tiled roofs and glinting windows, many of them flung open as if to draw delighted breath on this scintillating afternoon.

He let his eyes sweep round, the way their eyes—he saw—now and then swept giddily round to take it all in. Everything.

The houses, he had once been told, were roughly the same age as him. They’d been new when his parents moved in. The homes of pioneers. Now they were settled and established and ten years old but still had an aura of newness. Just like him. Inside the houses were new fridges, new televisions.

Though not inside or even outside them on this radiant day were all the fathers, who—but had he thought this then?—were working like billy-o to pay for it all, to keep the whole sublime fabric intact.

Why should Dr. Henderson have been invited?

Here and there among the gardens were tall, massive trees, their leaves green-gold in the afternoon light, left over from when it had all been farmland, hedgerows and fields. A farmhouse and barns had once stood where his primary school was now. It was hard to believe.

He looked around and could even see how to the mums it must look like Heaven. Everything that they’d once wished and hoped for. It was Heaven. And they’d achieved it, as they’d achieved their children and watched them grow, as they’d achieved this party—if he didn’t see it then, he saw it now—a dazzling homage to it all.

He saw that it was happiness. What else? He gasped, holding the wheel, at the sweet breath of it all. A seventy-two-year-old man driving between Heaven and Hell.

He gasped and recognized that this was his chosen field. The breath of life. Breath.

And why do we blush? Why are some of us prone to this blazoning of embarrassment, that is itself a cause for further embarrassment? Can you blush from sheer happiness, its flagrant touch on your skin? He was acquainted with the workings of the human body, but he knew no more about blushing than, apparently, Dr. Henderson had known. It wasn’t his field. It was supposedly an affliction of the young and even innocent. Later, you got over it. “Blushing like a girl.” Or boy.

But he knew that he himself could still go pink-faced for no obvious reason. Perhaps he was blushing now, in his car, recalling the blushes of decades ago. Though did you blush—it was a paradox—if no one could see you? And soon he would be concealing himself not just in a face mask but in layers of protective clothing. All to spare his blushes?

Was it the crumb in Mrs. Simms’s bosom, or the vexing question she had put to him? Was it the prospect that lay behind the question, that had never so invitingly floated before his vision? That life itself might be a great choosing of girls. Girls! How delightful. What happiness.

But, if it was true, it was over now. The women of his life. And he himself might be near the end, for all the care he took with his protective gear.

Near the end and, so it seemed, near the beginning. Ten. It was what they said happened when you drowned. You saw your whole life pass before you. And it was what the patients did, in the unit, when they reached the end. Effectively, they drowned.

The hospital was now very close. He could see in the dip of the road its tall incinerator chimney and the spangle of lit-up windows in the not yet full April daylight. At any moment, he might be chased and overtaken by an ambulance, with a quick blast of its siren. One morning, he’d been overtaken by three.

In a few minutes, he would have to switch off his memory. Apply himself only to what was before him. He would have to turn off his life.

How would this pandemic pan out? No one knew. He could only do what he could, for several uncountable hours, in a place of great suffering. And risk.

Some of the staff were near to snapping, he could see. Psychiatry was not his field, either, but he could see. They had homes and families to deal with, not just in their memories. They did not have empty mansions with automatic garage doors.

A cheery colleague had said in one of their brief breaks that this was only a blip. The pandemic was a blip. It was just a great preliminary distraction from the real calamity, that the planet would be uninhabitable, for human beings, within a century. Unless miracles were performed.

He saw again the shimmering ancient trees, watching like sentinels over the gardens. He saw the lawn. His father had mowed it specially on the eve of his birthday. He saw the party frocks. He saw that wardrobe of illnesses so gallantly put on by little souls, then happily discarded. He saw Mrs. Simms. Her bare shoulders. He saw his mother. And he saw himself lying in bed just a week later, his mother leaning toward him and Dr. Henderson in his chair.

It was because of Dr. Henderson, he was sure of it, that his mother had wanted him to become a doctor. The two of them had left his bedroom and gone downstairs for their cups of tea. He could hear only the murmur of their voices. No words. Grownup conversation. Then Dr. Henderson had left.

But he heard again now his mother saying to Dr. Henderson in the striped chair, “Unless he’s just blushing,” though with that look that was meant for him, lying beneath the bedclothes. And so he knew, after Dr. Henderson had completed his diagnosis, that it must have been on his tenth birthday, at his wonderful birthday party, that he’d caught scarlet fever. ♦