by Lara Swann
Hannah isn’t looking at either of us anymore, and she shifts uncomfortably at my words. Maybe I’m coming on a little too strong, but I can’t help it. As much as I’m trying my best to maintain a professional distance, this one is hitting me hard, and I can’t say how relieved I am that Hannah did admit it to me. Sure, I picked up on the slight nervousness and a few light medical signs - dental erosion, mild nausea and occasional headaches, as well as a few slightly abnormal test results - but none of it was conclusive enough for a diagnosis, despite the feeling I couldn’t shake. If she hadn’t told me, there’s very little I could have done, other than continue monitoring the situation more closely.
It took a lot more effort to convince her to tell her Mom too, but she’s an intelligent young girl - when I laid out the information and statistics about what she might end up doing to her body if she didn’t - she reluctantly agreed.
At least she wants to get better. It wasn’t quite so simple with Lori, not for a long time.
“I’d like to refer Hannah for cognitive-behavioral therapy.” I continue, deliberately pushing that out of my mind. It’s not fair to either of them to let my own issues distract me right now. “I’ve got a friend who is a brilliant psychotherapist and I know she has a couple of spare slots right now, so if you’re willing I’ll get in touch with her…?”
I look over in Hannah’s direction. I want this to be from her as much as from Debra - and thankfully, her Mom seems to take the hint.
“What do you think, sweetie?” She says quietly, placing one hand over her daughters’ knotted fingers. “Would you be up for that?”
Hannah shrugs slightly, still not looking up.
“Okay.” She mumbles. “I’ll…I’ll try it.”
“That’s good.” I say gently. “It’s been found to be the most effective method of treatment and it’s my best recommendation, but I’m going to prescribe you a course of fluoxetine tablets too. They work very well together and I’d like to see how you get on with them, but if you have any issues or you’re struggling with either the tablets or the therapy, please do contact me. I’ll be available to talk about this - whenever and however many times you need me to - okay?”
Hannah just nods, but Debra sends me a grateful glance.
“Thank you—” She starts, and I nod before the emotion in her voice risks overcoming her.
“Do you have any questions? Either of you?” I ask.
Debra looks uncertainly between her daughter and me. “I…I don’t think so.”
“Okay, that’s not surprising at this stage.” I say. “It’s going to take you both some time to adjust, and it’s going to be difficult for a while - but whatever happens, don’t forget everything from here on out is all a form of progress now. And when it’s hard, try to remember that however it might feel, you’re both trying your best.”
I pause, uncomfortably aware that I’m getting too personal and that my urge to give them every piece of advice and insight I can is probably only making things worse. I turn to the drawers beside me, sifting through papers to distract myself and cover the momentary lapse, and by the time I find the right pamphlets I almost feel cool and professional again.
“I’m going to give you some information to read in your own time.” I say, sorting the different papers together and placing them on the desk between us. Then I grab a pen and start writing the names of a few websites and additional resources over the top of them. “And these are a few more resources that you might find helpful if you wanted to look at them. They should help if you do have any questions - and you can always call me if you need to.”
I scan the list I’ve written out before nodding and finally handing the papers over, a weird tightness in my gut as I do.
Debra takes them with a nod, both her and Hannah still looking a little dazed, and I give them a moment before starting to wrap up the appointment. I walk with them to the door of my clinic and as they’re leaving, Debra turns back with such a look of gratitude that it’s almost difficult to see.
“Thank you.” She says, her voice slightly hoarse with emotion. “I’m not sure anyone else would have known—just—thank you.”
She steps out to join her daughter before I can say anything, wrapping one arm around her shoulder. From the way Hannah shifts uncomfortably, I’m not sure that’s quite what she wants right now, but I feel Debra’s need for physical contact almost as if it were my own. I sigh as I watch them walk away, hoping they find a way to work through this together, my mind drifting.
“Dr. Rivers.” Macy’s voice interrupts my thoughts, and I look up to see our secretary walking down the hallway, on her way to or from the latest errand. “Your next patient is waiting for you.”
I don’t miss the carefully neutral tone there, or the slight curiosity in her gaze. This appointment was only meant to be a routine physical and I know I’ve run way over that.
“I know.” I say, wincing internally as I estimate just how long he’s been waiting.
“Would you like me to send him through?”
“Yes. Please.”
She nods, turning back to the reception area and I return to my clinic with a sigh, letting the door close behind me as I wait for my next patient. I’m going to be running behind schedule all day now, but that doesn’t matter. Debra and Hannah needed my time - and cases like those are exactly why I became a doctor in the first place.
The rest of the day passes without incident - a mixture of common flu-like symptoms, diabetes and one nasty rash - but Hannah’s appointment stays with me. I can’t get it out of my mind and by the end of the day there’s a leaden weight in my gut and my chest is tight with tension.
There’s only one thing that’s going to help with that and I don’t even wait until I’ve left my office to navigate onto the video chat icon and call home. My face pops up immediately, way too large as always, and leaves me squinting at the weird lighting.
Do I really look that washed out right now, or is it just some combination of the not-amazing connection and clinical office lighting?
Mom answers before I can work it out and instead I’m left squinting at her as she smiles at me, her image tilting precariously as she holds the phone up in front of her.
“Jessica! I wasn’t expecting to hear from you tonight.”
“I know.” I say, trying to put on my best smile. “But I thought I’d call and see how you’re all doing anyway. I’ve been missing you all lately.”
That’s true, if not entirely the reason for the call. I missed my usual monthly visit to cover Nathan’s out-of-hours Saturday clinic a few weekends ago at the last minute, and it feels like it’s been too long since I headed back up to Springfield.
“We miss you too.” She smiles fondly at me, but it doesn’t quite ease the twisting in my gut. Not yet. “Listen, I’m just prepping dinner - are you okay to talk to your sister first?”
Despite myself, I feel a wave of relief at the suggestion. That’s exactly what I need right now.
“Yeah, of course. Sorry to interrupt—”
“No, don’t be. You know I love hearing from you.” She says easily, then turns away from the camera. “Lorelei! Jess is on the phone!”
“…on a Tuesday? What?”
I catch Lori’s voice in the background, getting louder as it gets closer, and smile softly to myself.
Am I really that predictable?
Mom hands the phone over and then my sister’s face is in front of me, the camera jerking wildly as she walks back to the couch and throws herself down on it.
“Hey, sis. What are you doing calling on a Tuesday?”
“Nothing much. Didn’t have anything on tonight and I just wanted to see your face.” I grin at her, and she makes a face at me.
“Well, you’ve pulled me away from watching Twilight, so you better make it worth my while. Got any fun patient stories?”
“Mmhm. Considering you’ve watched that a dozen times already and it’s not all that good anyway, it sounds li
ke I’m saving you from dire boredom. You should be thanking me.”
Lori makes another face and I end up obliging with a couple of anonymous stories from last week just to watch the way her eyes shine when she laughs. She might be twenty-four - a full adult in her own right for years now - but the eight year age gap between us means that to me, she’ll forever be my kid sister. I’m not going to forget all those years I spent watching her while Mom and Dad were working, running after my trouble-making, adorable little sister. I think I’ll always be looking for ways to make the cute spattering of freckles across her cheeks scrunch up with laughter, the way I used to back then.
We chat about amusing, inconsequential things and as we do, I slowly start to feel better. She’s looking good - I can still see the prominent bones of her cheeks and her face looks a little gaunt - but it’s nowhere near as bad as it used to be, and she’s got so much more life and energy in her.
Still on track. Thank god.
“Heyy—stop looking at me that way.” Lori groans at me.
“What way?” I say, not quite hiding my smile.
“All assessing and analytical, like you’re trying to work out what’s going on with me. I get enough of that already, Jess, you knoww that. Quit being a doctor and just be my sister, huh?”
“You know that’s easier said than done, right? I am a doctor - and being your sister only means I care more.”
“So try harder? If I can tell, you’re doing it wrong.”
I laugh, I can’t help it. My little sister and I have gone forwards and backwards about everything so many times now that we know each other inside out - and mostly, all the things we find infuriating about one another have become as much a part of our relationship as anything else. Familiar and comfortable enough that instead of annoying the hell out of each other, we call each other on our bullshit and joke about it instead.
Sure, we’ve had more than our share of blazing arguments along the way - and I wouldn’t be surprised if they happened again - but we’re in a good place now.
“Alright, I’ll stop doing the analytical doctor thing.” I agree, smiling inadvertently. “Maybe I’ll try just asking you instead. So how are you doing, Lori, really?”
“Fine.” She rolls her eyes at me. “I’m totally fine.”
“Mmhm?” I say, prodding at her casual dismissal. She’s only doing that to make a point now.
“Yep, absolutely fine—really, ask Mom if you want to.”
“I will.” I say, my smile creeping higher. We both know I was always going to do that anyway. “But I’d still like to hear it from you.”
“Ughh…alright, alright.” She makes a show of groaning, flipping over onto her stomach on the couch. “I’m all good, sis—promise. No starving myself, or power-walking everywhere to sneak in more exercise, or refusing therapy, or anything. I’m following all the prescribed meal plans and everything—you’d be proud of me, Jess. Really.”
“I am proud of you.” I say immediately, the warmth of it rising up in my chest as relief washes over me. “So proud. You know that, right? I couldn’t be any more damn impressed right now, Lori.”
It’s okay. Everything is really still okay.
The last of the tension from my day finally eases up and I start breathing a little easier. I knew this would be the only way I was going to start feeling better.
Lori shrugs, shifting awkwardly and I know the attention is making her uncomfortable - and not in a good way - but it’s hard to restrain myself in these moments, where it’s so clear how far she’s come and everything she’s achieved.
“Yeah. Sure.” She says, tucking her hair back behind her ear. In that moment, a hint of vulnerability escapes her usual flippant manner and my heart swells in my chest. I want to reach out and gather her into a hug, even as I know she’d shrug it off with that long-suffering expression she pulls off so well. “Well I’m trying, anyway. Don’t expect too much.”
It comes out as a mumble and I nod.
“That’s all that matters - and I’ll shut up about it now. Promise.” I give her an almost apologetic smile. “No more weird analytical looks, either.”
“Yeah, sure. Like you’re ever going to stop with that.” She says, sighing dramatically, but there’s a hint of a smile playing around her mouth too. “So when are you going to get your butt back here?”
“Lorelei! Don’t talk to your sister that way.”
Indistinct shapes move behind Lori on the couch, and she swivels her head around at Mom’s voice.
“I’m not twelve, Mom.” She says, groaning loudly. “I can say ‘butt’.”
“Nope. While you live under my roof, you’ll…”
“Follow your rules—yeah, yeah, I know.” Lori finishes for her, rolling her eyes as she turns back to me. “Better question - when can I move in with you, Jess?”
I laugh. “What if I don’t let you say ‘butt’ either?”
“Ugh, c’moooon…” Lori starts, before looking back over her shoulder.
“…talk to Jessica before dinner…”
“Hang on, Mom wants to talk to you.” Lori says, turning back toward me as she talks. “Thanks for the laughs, Jess. Come visit soon, okay?”
“Will do—” I start, but Lori is already passing Mom’s phone back over to her.
There’s more jerky screen movement, with just a hint of Mom’s slightly wrinkled, jovial face, and I hear the television resume in the background before Mom walks into another room and sits down at the table. She holds the phone up in front of her in a way that can’t be comfortable, but does give me a suddenly clear image of her beaming back at me.
“Jessica! Sorry about that—it’s all in the oven now. It’s lovely to hear from you. Is everything okay?”
“Yes, yes, everything is fine. I just wanted to catch up—sorry I called just before dinner.”
“Oh, it’s never any problem. But you’re sure?” She repeats, frowning slightly. “You’re not calling about anything in particular?”
“No, I just had a bit of spare time and thought I’d put it to good use.” I say, smiling as I ignore the small twinge of guilt at the lie. There’s no reason to explain about my day and get Mom worked up with my own unsubstantiated worries about Lori.
“Well, if you’re sure…” She says, looking me over carefully. I’m pretty sure it’s close to the look I was giving Lori earlier, and one corner of my mouth tugs up as that occurs to me.
“I’m sure.” I say, in my best reassuring tone. “How are you, Mom?”
She finally shrugs, smiling back at me and launching into a description of the yoga class her friend has just started.
“I’m not sure it’s really for me, if I’m honest, my body doesn’t seem made for bending - and holding all those semi-indecent positions when you’re about ready to either collapse or fart—”
I burst out laughing, and she shoots me a flushed, indignant kind of look. I’m not sure whether it’s trying to picture my short, rather robustly built Mom trying to bend herself into awkward positions, or that she just said ‘fart’, but I can’t help myself.
“It’s not funny! I want to support her, but, well…” She starts, valiantly attempting to remain serious, before the laughter slips out of her too. “Okay, maybe it’s a little funny. But I can’t tell her that.”
“I’m sure she’ll understand.” I say, trying to be sympathetic. “Maybe go to the first few sessions and see what you think? If you don’t want to continue after that, I’m sure she’ll appreciate that you tried it.”
“I really want to like it, you know. It’s the first activity I’ve taken up since…oh, I can’t remember when.” She says, and even though I know she isn’t thinking of it that way, I’m suddenly struck by how much Dad and her have given up over the last ten years, too. “And it’s meant to be very good for you.”
“Yes, Mom. I know.” I say, amusement creeping back into my voice at her instructional tone. I love my Mom, I really do.
“Of course you d
o. You’re a doctor and all.” She says, and I try not to wince at the note of pride in her voice. I really hope she doesn’t bring that up among other people as often as she does with me, but somehow, I doubt it.
“That’s not really why…”
“And how is all the doctoring going?” She continues, almost in the same breath. “Are you still working too hard and almost single-handedly running that practice?”
“That’s not how it is.” I laugh. “And you know it.”
“Well, it’s how it sounds.” She retorts. “You’re there all hours of the day, you never have time for yourself with all the extra admin you help out with, and the seemingly endless stream of patients you see—”
“That’s just what being a doctor is, Mom - especially a primary care doctor at a small practice—”
“Even so, I think you deserve a promotion for all the work you do. You’re always covering for that boss of yours.”
“He’s got a three-year-old daughter.” I point out. “I think he’s entitled to an emergency every so often - and he covers for me too. We’re a team - and there aren’t any more promotions to get, anyway. Small practices like this have a pretty flat structure.”
Not unless I’m aiming for a partnership here, or want to try to strike out on my own - and there’s no way I can start saving for the investment something like that would take. Not right now, anyway. But I’m only thirty-two. I’ve got time.
She makes a ‘hmm’ noise, and I shake my head as she continues. I can almost guess what she’s going to say.
“I still think you should be entitled to a few days off every now and then.” She says. “I mean, how are you ever going to meet someone if you’re stuck in the clinic all the time?”
“Mom. I don’t need to meet anyone—I’m not really thinking about any of that right now.”
“I know, Jessica, that’s what you always say. But don’t you think you’re going to have to start thinking about it at some point? I mean, I don’t want to worry you, but…you don’t want to leave it too late.”
