He turned to check on the men, peering through a cracked window at the top of the stairwell, and told me, “Red does tranq”—a powerful tranquillizer called xylazine mixed with fentanyl. “If he doesn’t get clean soon, he’ll die. I’ll come down here one day and nobody will have any idea where he is, and he’ll be buried in a potter’s field.” He shook his head, then shook it again, as if to snap out of the thought. It was ten to seven. Red was just one of many patients he needed to see. “Let’s get breakfast!” Gulbransen called, heading inside.
The hamlet of Oyster Bay, on the North Shore of Long Island, is pleasant, verging on twee. There’s a beachside park with a snack bar, and a town common where you can buy Italian ices from a stand that’s been open for a hundred and twenty-eight years. Billy Joel owns a vintage-motorcycle shop. Teddy Roosevelt’s “summer White House,” Sagamore Hill, is a short drive from the high school. On Tuesday nights in the summer, old guys parade their classic cars. Some parents in Gulbransen’s practice sail at the Seawanhaka Corinthian Yacht Club; a few are celebrities or hedge-fund billionaires. But most are middle class, and about a third of the charts in his office’s filing cabinets are blue, indicating Medicaid. The town is a jumbled American place.
Gulbransen’s office has a relaxed, even buoyant, vibe and a homelike floor plan. A doorway from the porch faces the reception desk; a hallway leads past well and sick waiting areas. A Pinewood Derby racecar hangs upside down from the ceiling of the well area. In the sick area, photo collages display hundreds of smiling patients, from infants to young adults. Gulbransen’s practice handles around twenty thousand visits a year, but his team is small and the quarters are close. Working in the exam rooms in the back, Gulbransen is able to call out and greet arriving families by name.
Not long ago, my wife and I brought in our daughter, Alice, who’d been out of sorts for a couple of weeks. Gulbransen, who has a slightly impish demeanor, burst in: “Hi, Mom! Hi, Dad!” He chucked Alice under the chin, grinning even as she wailed. (She’d learned to anticipate a shot.) “Crying is good,” he reassured us. “Visits are always combative at eighteen months.” He gently laid Alice on the exam bench, teased open her mouth, and showed us four molars coming in at once. “She’s perfect,” he declared. “You guys are doing great.” In general, he likes to boost parents’ confidence in their own instincts. Five years earlier, after examining our newborn son, Peter, he’d told us, “You got this.” Waggling his eyebrows, he’d asked, “What’s the biggest determinant of pediatric health?” When we hesitated, he said, “Zip Code!”
“O.K., does anybody have any conflict-resolution strategies that aren’t spraying liquid from your anal glands?”
Cartoon by Ellie Black
Gulbransen grew up ten minutes away, in another waterfront town, Glen Cove. A natural with kids, he taught phys ed and science before becoming a doctor. He bought the practice from two other pediatricians in 1999 and set about building it up with a new father’s anxious zeal. The accident happened on an October night. Around nine-thirty, Gulbransen and Leslie returned to their condo after dinner with friends. The babysitter had already put Cameron and his older brother, Scott, to bed. But Cameron called out, and Gulbransen went upstairs to check on him. The boy was sitting up, smiling and holding his blue blanket. Out on the landing, he threw himself into his father’s arms. “I remember that hug,” Gulbransen told me. “There was something intense about it.”
He carried Cameron downstairs to hang out until a new bedtime could be contrived, and watched as he ran toward the babysitter and Leslie. Then Gulbransen went outside, closing the front door and a screen door behind him, to move the family car from the street to the driveway.
Cameron had seemed to be with the other adults, and had never before left the house on his own. Gulbransen is organized and meticulous—he doesn’t drink and is so energized he avoids even coffee—and he checked his mirrors before backing in. But, as he reversed, he felt a bump near the front wheel. He leaped out to find Cameron on the ground, in the headlights, clutching his blue blanket and bleeding from his head. As a doctor, he knew instantly that Cameron was dead. Still, he performed CPR, tasting his son’s blood in his mouth.
“There are actually scales that psychiatrists use to quantify life stress,” he said. He recalled one from medical school: “ ‘Have you lost a job? Are you divorced? Have you lost a child?’ They don’t even talk about ‘Have you killed your own child?’ That’s not even on the list.” He told me this on the second floor of his office, in a sitting room he’d redecorated about ten years ago, after the practice had reached a stable level of success. Surrounded by photography books, four American Girl dolls regarded us from an alcove. In the community, the accident has given Gulbransen a special role; families who suffer traumatic losses sometimes seek him out. He gives the dolls to their children.
Leslie is Jewish, so Cameron’s funeral was held three days after his death. Anguished and ashamed, Gulbransen saw a therapist who advised him to take a few weeks off. Instead, he went to work the next day. Flowers were heaped on the steps to the office. A postman, passing by, asked what they were for.
“I have no idea,” Gulbransen said, hurrying inside.
He told the surprised staff that he was ready to see patients. A mother waiting in the exam room had heard what had happened—everyone had—and stared at him in silence. “Then I said, ‘Let’s go,’ ” he recalled. “And everybody just knew, Don’t talk about it. And I just started working hard.”
Therapeutic workaholism is part of Gulbransen’s altruism. Ever since the accident, he said, he’d struggled with the feeling that he didn’t deserve to be alive when Cameron was dead. “You’re constantly, constantly asking yourself, ‘Are you good enough?’ ” he told me. “That’s why a lot of people turn to drugs or alcohol after these accidents, or get divorced.” (He and Leslie are happily married; their daughter, Julia, was born the year after Cameron died.) “I’m lucky to have this office, where I can keep reaffirming that I’m good enough for kids,” he went on. “It becomes a dopamine drip.” He almost never takes weekends off, and his vacations are rare, indulged in to please his family. The dopamine wanes. If Gulbransen doesn’t do something of value once or twice a day, he starts to ruminate. “Feeling needed, feeling useful, feeling important—they’ve helped me hide the demons,” he said. He told me how, on a recent day, he’d correctly diagnosed four kids with pneumonia: “Drip.” Mothers marvel at how he makes house calls on Sundays. If you text him late at night, he replies.
In the Bronx, we descended to the street, and Gulbransen, mindful of the clock, set a fast pace. Red and K.B. staggered behind and reminisced. Red had been born addicted to opiates; he’d built a life, which went off the rails after his girlfriend overdosed. Not long ago, he’d run into her mother. “She still sees something in me,” he said, in a thoughtful tone. “I don’t see it. But I’d like to be the person she sees.”
“You got this, buddy,” Gulbransen said. “You’ll get out of this.”
At a bodega, the men ordered breakfast. Gulbransen helped Red pick out some basics—a T-shirt, some packets of Pedialyte—and paid. We headed for a park where they could eat. Near the empty, sunlit basketball courts, a big flat-screen TV sat incongruously on a bench, its power cord coiled around it like a tail.
