SWIM LESSONS | Joanne Wilkinson

I grew up unable to swim. I lived near the coast, so it was unusual that I couldn’t; my friends swam and lifeguarded and went water-skiing and sailing on their days off, while I sat silent and awkward on the sand. Neither of my parents could swim, and probably didn’t understand the importance of introducing me early to the water. But the real reason I couldn’t swim was because of what happened to me the summer before fifth grade.

I was attending a day camp on the grounds of a lush prep school in the next town. Its pool was housed in a brick building that looked like a library: deep and narrow with high walls around it, windows high up in the walls showing a slice of blue sky, and a slim sort of catwalk on the left side where you could leave your towel, and carefully hoist yourself onto the ladder to descend the eight or so feet to the water. 

Even standing on that catwalk near the towel hooks gave me vertigo; the edge of it was an unprotected cliff edge that led to nothingness, a long straight drop to the surface of the water. I was afraid to venture away from the wall and attempt the maneuver where you swung yourself over the abyss to hook your bare feet onto the rungs of the slippery ladder. I held tight to the hook instead of hanging my towel on it and hoped the swim teacher, a brisk petite woman who never smiled, would not notice me back there. This, it turned out, was a bad plan.

“You there! What’s your name?” she barked at me after she had seen the rest of the lemmings down the ladder. I told her. She nodded briskly. Her name was Mrs. Martha Nesmith.

“Come on then,” she said, clapping her hands. She had the kind of frown that adults have when a kid’s emotions are getting in the way of their plans.

“Um. I can’t,” I pleaded, my finger wrapped around the hook.

“Okay.” She conceded quickly, and I felt relief. Then she said, “Just come sit on the edge and watch, for today.”

It took me several minutes to work up the courage to inch myself to the edge, sit down, and finally let my legs dangle from the knees. The tile was cold on the backs of my legs. I was too far up to feel the splashes of cold water from the kids in the pool. Mrs. Nesmith watched me dispassionately, arms crossed, not helping me. From time to time she called down the ladder to the others in the swim class, that she would be just another minute and they should practice blowing bubbles. I took some solace from the fact that she was staying up here with me, making sure I was safely situated on the ledge before she abandoned me for the ladder. I would have to stay calm up here alone, I told myself, and practiced taking a steadying breath, the way I did during thunderstorms or scary movies. I was so focused on my breathing that I missed the moment when Mrs. Nesmith, with brutal efficiency, placed her foot against the small of my back, and pushed.

My fall was immediate and terrifying. I plunged into the cold water, all of my orifices were immediately filled with bleachy chlorine. I remember that I fell hard enough to go all the way to the bottom of the pool, where I bumped my tailbone hard on the concrete, the noxious liquid making my throat and the inside of my nose burn. My vision turned red, as though my eyes were bleeding. I don’t know how I emerged from the water; I don’t remember if my father had to come fetch me from camp, if there was a doctor’s visit. All are possible, because what I do remember is that I was permanently removed from the swim session, reading in the director’s office while my camp-mates went away and then came back smelling of chlorine each afternoon. It goes without saying that I did not learn to swim.

***

Forty years later, I am the senior attending on call over a holiday weekend at the hospital downtown; in midafternoon, I get two admissions at once. One is a middle-aged man with pancreatitis who can’t seem to stop drinking and gets admitted every six weeks or so. The other is an elderly woman with right heart failure being admitted for a cardiac catheterization. Her name is Martha Nesmith. 

I hang up the phone from the emergency room, my jaw clenched. Is it possible this patient is the same woman who pushed me into the pool? Or just someone with the same name? I never saw Mrs. Nesmith after that day; I don’t know what her usual job was. She might have been a teacher at that school, a full-time swim teacher, or someone’s mom. She has become bigger and more menacing in my memory, although my logical mind knows she was just a scrappy little woman who believed in the doctrine of ‘sink or swim.’ I don’t think of Mrs. Nesmith as evil, just clueless, which isn’t the same as saying I forgive her.

I find myself dawdling in the attending lounge, empty at this hour except for a tired post-call internist who is dictating in a soundproof booth. I do a thing that feels inappropriate, somehow: I go to the internet to search for someone named Martha Nesmith. Martha Nesmith teacher, I try. Martha Nesmith swimming. M Nesmith + swimming + camp. I tell myself that I’m not searching for information about a known patient of mine; I’m searching for a person who was a former teacher, the way you might Google an old boyfriend on a boring Sunday night. I’m just curious about where she wound up. Already, in my head, I’m separating her from the patient I’m about to go see. The internet has zero information about Mrs. Nesmith; I wonder for a moment if my frightened memory was real. But no: my memories of that day are so vivid that her name seems seared into my mind.

I decide that I can’t delay any longer, and go to the ED to see the patient. She is unfamiliar, stooped and white-haired. I introduce myself as I usually do, and say that I will be helping to look after her during her hospital stay. “Great,” she says, upbeat, without any trace that she recognizes anything about me. “You want me to sit up so you can listen to my lungs?”

An agreeable patient. Under normal circumstances, I would like her. She’s sanguine about the cardiac cath, and doesn’t complain about the hospital food or the long ED stay. “Of course, it’s the holiday weekend,” she says with a shrug. “I know the nurses are busy.” 

I realize that my neck is stiff from looking down at her. I am tall, and she is lying on a hospital gurney at the level of my thigh, and is tiny besides. At age ten, paralyzed with fear, I felt dwarfed by the confident swim teacher standing over me at the pool, her fists balled at each hip. Now I am big, strong, well-educated, powerful, and she is an old woman helpless in a bed. I would never say this out loud to a patient - to anyone - but the voice in my head is clear as a bell: This time I’m the one in charge.

***

I am sure it sounds petty of me to refer to what happened at the pool that day as trauma. To dwell for so long on the actions of what most people would call a brisk, no-nonsense coach doing her job. To not have decided to laugh about the story when I tell it, years later. 

After all, we laugh about the things we experienced during our medical training. The objects thrown in the OR. The beat-downs in morning report, question after question as though it were a court deposition instead of an effort to collaborate and help a patient get well. The day that one of my attendings turned to a colleague, and said, gesturing at me, “Get me a new one. This one’s malfunctioning.” We tell each other these things were funny, that they helped us learn and become physicians, that it was ‘hazing,’ and we are proud that we survived it.

Did I survive my swim teacher’s hazing? Eventually, I found a sport I liked and became an athlete. I remember the first time I pushed through a rowing practice when I got tired and wanted to stop. I felt a shadow of the panic I’d had at the pool - panic that my body would not be able to do what everyone else’s could, that I would fail as a result. I could feel my coach watching me as our eight slogged along in the chilly fall air - watching all of us - without judgment. I wonder what she can do, his expression said. I gripped the oar and went on. When we finished the piece, steam rising from our arms and legs in the twilight, I knew this: what I could or couldn’t do was up to no one but me. 

Years later, I went to a pool in the next town and signed up for swim lessons. My teacher, a high school kid, was helpful and kind. Within a month, I was swimming with a masters team, churning through kickboard drills among my teammates while the chlorine-scented water swirled around us. Within a year, I completed a two-mile open water swim in the ocean. Who knew that learning to swim would be so easy? I felt cheated that I had let one bad teacher keep me from this pleasure of conquering the water.

I teach medical students and residents. I never engage in hazing; I don’t think people learn well that way. If I find myself starting to grill a resident during rounds, I stop and say, kindly, “Sorry. You don’t have to guess what I’m thinking. Let’s talk this through together and come up with a plan.” What I am doing is stopping the cycle of toxicity. I received it, absorbed it, and then made a choice not to pass it on. 

It’s not hard for me to look back on some of my teachers from med school and think They didn’t know how to be better, but I do. That feels compassionate. But when I look back on that swim lesson when I was little, the only thing that comes to mind is: It should have been different. It should have been better. It should have been safe.

***

Mrs. Nesmith is going to be stuck in the hospital for the entire holiday weekend, waiting for her cardiac cath; it’s enough of an emergency that she can’t go home until it’s done, but not enough of an emergency to call the team in on a weekend and pay them overtime. Each day, as I approach her room, I think about ways to broach the topic. Did you ever teach at this prep school? Did you ever work at the camp there? Do you like sports? Hey, did you ever teach swimming? I want to find out obliquely, without telling her that I went to the camp. But each day, when I update her, she laughs merrily and says she feels fine, and at least the food here is good, and I lose my way in the conversation and forget to bring it up. I don’t ask her. 

On the morning of her cardiac cath, I stop outside her room for an extra moment; this might be my last opportunity to bring it up, since there is a good chance that she will be discharged home afterwards. In order to steel myself to ask the question, to approach the confrontation, I take two deep breaths, the way you do when you’re preparing to swim underwater.

***

 In the middle of the first open-water swim I ever did, my goggles started leaking. This happened to me so often that I had not one but two backup pairs on the kayak that was following me. I stopped, pulled the goggles off, and swam over to reach up and swap them out. My kayaker gave me a thumbs-up and said, “Looking good.”

 I laughed and said, “Slow,” which was true. I was in the last third of the field of swimmers making their way across the bay, but I felt okay to go the distance.

 “But for your first time? Awesome.” I backed off the kayak, treading water while I fitted the goggles to my face and used the flat of my palm to push each side onto my eye, feeling the reassuring suction. I was in the middle of the bay on a Saturday morning, in the shipping channel. It was undoubtedly hundreds of feet deep and yet I was still suspended on the surface. I had a slight moment of panic when I imagined falling all the way to the bottom, like I had at camp, and then I tightened the goggle strap and swam away.

***

 The transport team comes for Mrs. Nesmith while I am listening to her lungs. In that compressed moment when they are moving her from bed to gurney and organizing her IVs, I realize that in leaving it for the very end, I’ve already made my decision. 

 I give her hand a gentle squeeze before they wheel her away. “Good luck,” I say, leaving her room to start my walk down the long hospital corridor. There is a wall of windows on one side; the sun makes a dazzling reflection on the lacquered floor and creates the illusion of a waterway, a river, and for a moment, it seems that instead of walking away from Mrs. Nesmith, I am swimming.

Joanne Wilkinson is an academic family physician working in New England. Wilkinson, who is an MFA student in her spare time, writes fiction about women physicians under the pen name Kate Campo.

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