The first time they took something out of her was seventeen years ago, when she was twenty-six and she was travelling through Europe with a couple of friends. She was staying in Rome in a pensione near the train station, coming back from a visit to the Forum, feeling nauseous and dizzy, as if the spectacle of ruin in the midst of a busy city were making her ill: the masses of tourists picking their way through the stones, the sun beating down on a roofless arcade, the garish remains of triumphal arches, celebrating plunder. She’d been having trouble breathing. And then, after she mounted the flight of stairs up to the lounge of the pensione she was gripped with an agonizing pain in her abdomen, and she collapsed and passed out and woke up only later, when it was all over. She was in a hospital room unlike any she’d ever seen before: a large ward, where the beds were separated by gauze-covered portable room dividers about five feet high. The ceiling above was immense, its pale green paint chipped and peeling. There was no TV, but she could hear voices, shuffling, chairs being dragged, trays clattering, arguments, laughter, echoing; and the first thing she thought to herself was, I want to go home, I want go to my room and close the door. But there was a pain in her side and her lungs felt full, and she could barely reach the bell on the nightstand next to her without straining herself; a nurse came and went. A doctor showed up. One of the friends with whom she’d been travelling these past few weeks, Melinda, sat at her bedside, looking white and green. And now the doctor was hovering over her, trying to explain to her in halting English that she had been subjected to a surgical operation. Ache ache, he kept saying something like ache, almost in two syllables, and then something like Topeka. She’d been pregnant, only not really. Ache Topeka. Ectopic. The baby – no – the embryo was two months old; it had been growing in the walls of a Fallopian tube, outside of the womb, and it had been getting bigger and nearly killed her. But she was better now, chay veroh. They had removed it. She’d go home the next day or two.

So that was the first time. On the airplane coming home, her girlfriends with her, still a little woozy with the medications they’d given her, she’d started drinking, and started feeling happy, and then dropped off to sleep. At eleven o’clock in the morning they’d landed in New York for a two-hour layover before heading back to San Francisco and she had a headache, so she decided to start drinking again, and after the second bloody Mary she was feeling better and happy and after the third she was happy and angry. So she got on the pay phone and tried to call Sam collect, and when he wouldn’t accept the charges she hung up and called him collect again and this time before he could say no to the operator she yelled out Sam you bastard I don’t care what time it is in California you better talk to me I just had your baby and I killed it.

You’re nuts, Sam said, hanging up.

Helen held the telephone in her hand, numb. She shouldn’t have said that. She hadn’t meant it. Now he would never take her back. Now it was hopeless.

***

The second time they took something out of her came not much later when she had gone back home to her parents and the small house near the park in San Bruno on a narrow hilly street they’d inhabited for years, a white stucco tile-roof bungalow, long and narrow with eight rooms in a row, all of them kept immaculate, her mother putting in an hour or two of housekeeping every day even when she was also working at one of her temporary jobs as a bookkeeper, and all of the rooms, even when a TV or a radio was on, were improbably quiet, as if in keeping them free of dust and clutter her mother had also kept them free of sound. In front of the house a small yard was still planted as it had always been with rose bushes, hydrangeas, and dahlias, and the rose bushes were in bloom. Helen’s room was in the back, looking out to a patch of a backyard, which had been cemented over to minimize the need for upkeep. She’d been thinking about moving out. At my age already, she would say to herself. She often imagined her father saying that to her, although he never did. At your age already. She was twenty-six.

She had a job in the City, processing transactions for an investment banker, and she liked the City. She’d travelled through Europe now too, and Helen liked an active life, an urban, busy life. She liked her job. She liked walking up Market Street in the morning in a long top coat and a two-piece suit with a small slit up the side of her skirt and a pair of matching leather two-inch heels. She liked coming into the office under the mean fluorescent light amid the clattering of typewriters and the ringing of phones; she liked getting involved in the procedures she executed, moving the transactions she managed from stage to stage from her little cubicle by the hallway away from the windows and the views but still comfortable, isolated and secure, completing the sales and transfers of stocks and bonds and certificates of deposit and real estate holdings to the letter of the law. She liked being busy. And she liked the release that came from finishing for the day, having money in her pocket and going out – out, even her, with all of what seemed to be her fears, out with the other women from her office, going for drinks at one of the singles bars down the street – fern bars they were called then, long smoky rooms furnished with Victorian-like antiques and wood-paneled walls and lots of potted plants, the lights turned up, the rooms echoing with chatter and laughter, the men in their suits, drinking on their best behavior, pretending not to prowl.

But she couldn’t give up living at home, in the quiet bungalow. The thought of not having her old bedroom alarmed her. And anyway, Sam lived in a suburb nearby. And then she started feeling sick again, and gaining weight, and when she went to the doctor he told that she was five months pregnant. She may have aborted an ectopic embryo three months earlier, but its twin was still alive and well, seated in her womb, exactly where it ought to be; she was going to have a baby. And where was she to go?

So four months later she was in the hospital with her mother and father. The nurse had given her something and she felt woozy, and for a moment she imagined herself sitting up in the bed and taking her father’s hand and telling him I’m sorry, I’m sorry I did this to you. Then she was worrying about whether the baby’s bassinet should be set on the left side of her bed or the right and then she was out. When she woke up they told her that the c-section went fine and here was the baby they’d taken out of her Melissa baby Melissa a girl. This time they’d given her back what they’d taken out of her and in the happy haze of the drugs still in her and with the baby in a blanket her eyes wide open, quiet, the baby Melissa, Helen said to herself, I’m not sorry. Her father looked at her as if to say, how could you have done this, or maybe just to say, at your age, but Helen didn’t care. There’s four of us now, she said aloud. And her mother was beaming and her father had tears in his eyes and Helen felt good, too good.

***

The third time they took something out of her she was ready for it finally. Over fifteen years had gone by and she was in the hospital again and they were giving her drugs again and trying to talk to her and Helen was woozy again but this time she was able to talk back, or at least it seemed she was able to talk back. She could register her protest, speaking up to the ceiling, a high ceiling again, shiny with high-gloss blue paint and rigged with what seemed to be halogen lamps ringed in polished metal cups, the light like too much sun, forcing her to shut her eyes. But she would speak up; she had something to say.

Melissa had been a healthy and happy baby but needy too; and in those first years when Helen was at the door leaving for work Melissa would start crying and Helen would feel a spasm of tears at her breast. So Helen had cut back on her hours, taking work home with her whenever she could. Sometimes when Melissa was in a quiet mood Helen would take her into the bedroom with her and do her work with Melissa at her side. She would spread out her files on her bedroom floor, matching blank document forms to photocopied ledgers and memos, intents to buy, intents to sell, agreements to establish a partnership, agreements to dissolve a partnership, petitions to be filed with the courts, the commission, the broker, the lawyers, the auditors, the excluded partners, the included partners. Everything had to be matched and put into order; all the numbers had to agree. Everything had to be done by a certain day and a certain hour. Tomorrow. Soon. But Helen would play games. Where’s the number one? She’d call at to Melissa. Where ‘s the number one? Here’s the number one. Bop! Tapping Melissa on the tip of her nose. Where’s the number two? Where’s the number two? Bop bop!

Other parts of her life – the dressing up, the singles bars, the memory of Sam – didn’t seem to matter much anymore. Who had the time or the money or the energy for any of it anyway. At her age. She had started gaining weight. She found that she had to be careful when she bought clothes for herself, just as when she bought clothes for Melissa, and not get anything that fit her too well; she had to buy loose things that she could grow into, just in case. She was getting fat and there didn’t seem to be anything she could do about it; her obesity was as inevitable as life. But she was proving a good planner, a good anticipator. Not quite fat – zoftig really; but she knew how to do the practical thing, how to prepare for a distant future, and anyway she liked to shop. She had begun anticipating buying a house for herself and Melissa in the City, nearer to work, and putting away money for a down payment. The two of them together, into the future. Sam had finally been defeated in court and was coming up with child support payments – not paying them regularly, but paying something in any case, enough to allow Helen to be serious about saving up and owning her own home, even if, as she knew, something else was going on with her, something else she would have liked to stop, if she could figure out what it was and how to stop it.

But then Helen’s father took ill, a cancer that had started on his skin, which was removed and then came back, lingered, and worsened. So whatever else she might have planned for herself or wanted to find a way of planning for, Helen needed to stay home to help her mother take care of her father and help pay the bills. She wasn’t able to save any money anymore. She couldn’t even begin to think about moving out for some time. For five years she kept up the routine of going to work in the City by day, where she kept to her cubicle and processed forms, and then of coming home to San Bruno, where she mothered her child, mothered her mother, nursed her father, worried about her father, and in effect kept a family together which knew –even Melissa understanding that something was wrong, hearing them talk about grandpa in whispers, seeing grandpa come and go to the doctors, seeing grandpa in bed much of the time, unable to move, but leering at them from under his half-closed eyelids as if to reprove them for being ambulatory – that what kept them together was the knowledge that eventually they would break apart.

When Helen’s father finally died neither she nor her mother had much emotion left. Grieving was quick, and maybe grief wasn’t what they really experienced. It may have been relief, combined with the fear that they had done something wrong. Her mother decided to go away, to sell the house (which after all these years turned out to be worth a lot of money, real estate value in Northern California being what it was), to pay off the debts the family had accrued while Helen’s father had been sick and out of work, and move down to San Diego to live with her sister, another widow.

Helen saw to the transactions, made arrangements with the brokers, made arrangements with the probate court. Opened new accounts. Closed the old ones. Set her mother up as a tenant-in-common with her sister in a condo just outside of La Jolla. And then, alone, Helen bought her own house, a small wooden two bedroom bungalow in the Mission district near San Francisco General Hospital, on a not-quite-quiet treeless street with several rundown, sooty houses among the kept-up ones, and a lot of beat-up looking cars parked at the curbs. At almost hours, as if part of the architecture of the neighborhood, small groups of teenagers menacingly congregated on the corner by the liquor store; yet the house was the best she could afford, and it was close to an inexpensive, subsidized private school Melissa could attend and to Helen’s office downtown. And it wasn’t really unsafe, it just seemed that way. So Helen and Melissa settled in.

Helen had long since given up on the idea of being with a man. She never heard from Sam anymore except to receive a check now and then. Sam was a doctor in Marin County now, married. Every so often Helen would catch herself in a dream where she had a man with her in bed, the two of them naked under a thin sheet; and when she awoke she would wonder who the man could have been. She saw men at work and she was still capable of flirting, joking around. Men and women both seemed to like her. She knew that when people thought about her, the first thing they recalled was her sense of humor, her cheerfulness, her bright smile. The shopping queen, they called her. Maybe a man or two thought about her as sexual quarry but she doubted it. And even if they did, what could she possibly do about it, when did she have the time? She was a single mother with a continually increasing workload. Her Saturdays were workdays. On Saturdays while Melissa played with her toys or watched TV Helen sat at the kitchen table going through her files and documents, processing transactions. And she’d gone on gaining weight. She was a size 12, a size 14, a size 16, a size 18. She knew that a man wouldn’t want to touch the thing she’d become; that a man wouldn’t be able to bring himself to enter her.

At night, after picking up Melissa from after-hours care at her school, Helen would pop a couple of frozen dinners in the microwave, and open a bottle of Seven Up, maybe adding a salad of iceberg lettuce with ranch dressing and some Parisian sourdough bread with unsalted butter. She and Melissa would eat together, mainly in silence, Melissa usually feeding herself quickly, with little appetite. Then Melissa would hurry off to watch TV and Helen would open the evening newspaper, reading the news and the opinions and the “Style” sections, and eat more bread and butter, and maybe put another dinner in the microwave and eat that too. Sometimes she had some wine – she liked to drink – but not too often. Drinking would make her tired. And she was already tired. She was always tired. After eating some more she would join her daughter in the living room and watch sitcoms and melodramas on the TV, sitting on the couch with her daughter at her feet curled up on a pillow on the floor, stroking her daughter’s hair. She might get up and bring a bag of potato chips or some cookies into the room, and as the families on the sitcoms argued and laughed and insulted each other and laughed and then worked out their problems, or as the cops on the melodramas traded cynicisms and then worked out their problems, she’d go through her potato chips and cookies and feel a pleasing numbness inside of herself and nod off to sleep. Melissa often put herself to bed. Helen would wake up in the middle of the night, still in her clothes, sprawled on the couch, the lights still on, the things from dinner and her snacks at the TV still not put away, dirty dishes and glasses piled on the tables. But there was no time for anything. When she got back to her bedroom she would often find the bed piled high with dirty clothes, or stacked with newly laundered clothes not yet folded and put away, or with files from the office stacked where her pillow ought to have been, and the overcoat she’d worn to work that day draped over the clothes and the files, and the pairs of shoes she’d been fiddling around with in the morning, trying to decide which to wear, standing on a jumble at the end of the bed. And so she’d grab a blanket and go back to the couch and spend the rest of the night there. She was such a hard worker at the office, she knew; she was getting so much done, and she was putting up a good front. But here at home it was hard, too hard. She’d lie down on the couch and have a chocolate chip cookie or two and go to sleep again.

Before long she would give up going to sleep in her bedroom altogether. In any case, by staying on the couch she was sleeping closer to Melissa’s room. There was comfort in that. And so now the living room became a bedroom. The living room bedroom became a storage room as well. Stacks of clothes lay on the floor. Boxes piled up. An old box of toys became a dining table, so that now the living room bedroom was a dining room as well, but still it was an old box of toys, the toys no longer needed, relics of a simpler age. Dirty dishes sometimes got stacked up on the box. Why clear them just now? Soon there would be more dirty dishes, and when there were enough then she could drag herself up, stack the dishes, make her way into the kitchen and do something with them. Such a bother. She started buying paper plates and plastic spoons and forks and knives, which she could just throw in the trash. When she was ready she could throw them in the trash. Along with old newspapers and magazines. Along with the empty boxes of chocolate chip cookies and empty pints of vanilla ice cream.

It was when Melissa was 17 years-old that they had to take something out of her again. Melissa had grown into a tall thin athletic young woman, with beautiful thick brown hair. She was an excellent student, and won a full scholarship to an exclusive private school, where many of the students went on to college at places like Stanford and Vassar and Brown. She was going on dates. Still a virgin but thinking about not being a virgin, she would talk to Helen about the boys, and what they did. But she would also talk about her schoolwork, the books she was reading, her interest in writers – she liked Alice Walker – her interest in theater. She didn’t know what she wanted to be yet. She liked the idea of creating things. She’d be an architect, maybe, if her math was good enough; but that seemed unlikely. A historian of architecture perhaps. An art historian. She liked old things. She liked thinking about the past, about the rise and decline of things, the building up and the falling apart of civilizations.

Helen involved herself as much as she could in Melissa’s life but was careful not to overdo it, knowing that she had to give the girl her own space. And anyway, she had little free time. Her firm had moved down to Palo Alto, so now Helen was commuting an hour each way to work, and she was working as much as ever, although her income wasn’t increasing. The kind of work she did had been downgraded. Her job was considered “clerical” now, and she was making a “clerical” salary, even with all the extra hours she put in and the years of experience she had. She had acquired a knowledge of the finer points of what she did. The different kinds of deeds. The different kinds of filings. The deadlines. The deadlines above all. And it was tiring. It was all so tiring. Helen found herself falling asleep at her desk at the office. She found herself falling asleep while on the sofa when she got home. She was finding it hard to get up off her sofa in the morning and pull herself together. Her bedroom had become a kind of walk-in closet. Someday, she kept saying, she’d clean it out. Someday she’d hire someone to come and help her.

She was over a hundred-and-twenty pounds overweight. She was beginning to have difficulty walking, sitting, breathing. Her skin felt sore, as if insects were swarming over her and rubbing her red. Her doctor diagnosed her to be suffering from Type II diabetes, and he found lesions and tumors on her legs, lesions that might develop into tumors and tumors already developed that were related to diabetes and poor blood circulation and that would have to be removed.

So Helen was in the hospital again, although only for a day and a night most likely, the operation being routine, and the tumors non-cancerous, officially “benign.” She had called a friend to bring her in, Melinda from high school, one of the girls who was still around, who had been with her before, who had gone on being blonde and who had a husband and children and who liked to go shopping and who Helen liked to talk to on the phone in the mornings after coffee. Helen hadn’t called her mother to tell her what was happening. Helen hadn’t even told the whole truth to her daughter, saying that the operation was merely for a cyst, and largely cosmetic, telling Melissa not to bother coming to the hospital, she should stay home and do her homework. Melinda had promised to check up on her and that was enough. Helen could go through this alone. She would rather go through it alone. She called her office and told her supervisor that she was sick with the flu. And remembering what the medication was like during her other surgeries, she found herself looking forward to the experience, anticipating the forgetfulness and painlessness that would arrive with the drugs, the momentary euphoric certainty that regardless of what was happening or was about to happen, nothing mattered, and nothing would ever matter. Isn’t that what she had felt? It was like the quiet when she drifted away in front of the TV, stroking Melissa ‘s hair, after all her work was done for the day. It was like the lights going off even as the lights were still on, and she could feel her body filling up, filling up and growing, and her body getting tired, her body full, complete and rested, in need of nothing, having more than enough. It was the third time but this time it really didn’t matter, as long as no one knew about it, and anyway she had something to say this time; she had a speech to make.

They came and shaved her carefully and bathed her feet. They injected her with her anesthetics. It is only a mild anesthesia, a technician said, just enough to put you asleep and keep you from smarting. A doctor was there, two doctors, three. Or maybe they were only nurses. You couldn’t tell anymore as they were all wearing blue gowns and masks, the men, the women, and women were doctors and men were nurses. How many were there? You’ll wake up refreshed, one of them was saying. Or had he said that a long time ago? You probably won’t feel any pain, maybe a little soreness for a few days. We’re not cutting very deep. Your problem is almost literally superficial.

No it’s not, Helen said. But it doesn’t matter. (Yet was she saying this too? Who was listening? Where were the doctors now?) She was riding on the gurney. She was being wheeled into the operating room. The lights were up and the metal was in her eyes but she kept her eyes open. No, they were closed. But the doctors and technicians were around her. Feet were shuffling. Something clattered on a tray. Something was being put on Helen’s arm. But Helen was speaking. This is what you’ve got understand, she said. I’ve been saving up for it, for this, for this right now. Don’t be shy. Take as much as you want. Take whatever you need. Take as much as you can. I’ve got plenty left to spare.

What’s that? a nurse asked.

But that was the last thing Helen ever said.