by Dianne Drake
“Is it a boy?” Beatriz asked, totally oblivious to the subtext going on around her.
Returning her attention to her patient, softness came back to Shanna’s expression. “Yes, I believe it is. And he’s a big one. Looks ready for that soccer ball,” she answered. “See, to the left? That’s his head. And to the right, that’s his...” Grinning, she moved back into position. “Definitely a boy, Beatriz. No doubt about it. Did you want a boy?”
Beatriz smiled contentedly. “We have two daughters. A son will be nice this time.”
“So, boys’ names...” Shanna said, pushing harder on Beatriz’s upper abdomen as the baby finally started to co-operate and slide into place. “Esteban, Gerado, Miguel...” Sucking in a deep breath, she bit her bottom lip and pushed even harder. “Rafael, Raoul...” Another solid push, and this time when she sucked in her breath she held it and gave one last final prod to Beatriz’s belly. Then let out her breath, smiled and nodded.
“And Nehuen, which means strong, because your baby is strong enough to give me quite a fight, Beatriz.” She nodded Ben over to her side of the table then instructed him where to place his hands. “Dr. Stubborn, meet Baby Stubborn. You two should hit it off well. As for me, my back needs a break so, Ben, will you hold the baby in place for a few minutes so he doesn’t reposition himself?”
He laid his hands on Beatriz’s belly, let Shanna physically manipulate him to the exact spots she wanted braced, and the feel of her hands with oil on them, sliding over his hands, purposely splaying each of his fingers into position...it was all he could do to focus on the fetal monitor. “Your technique was...I guess the only thing anyone could really say was flawless. When I’ve seen these done they were always more invasive, stressful. Is this something you learned at Brooks?”
Twisting from side to side to relieve the tightness in her back, she shook her head. “No. We have an outstanding obstetrics department so once my patients are confirmed pregnant, I send them to the experts. Can’t say that I’ve ever actually done the procedure at Brooks. But trying to make the ECV less stressful is something that made sense to me the first time I ever saw one done. I was still a resident, working through my obstetrics rotation. My advisor asked me to assist him in the procedure, which I was glad to do.
‘But he was so...rough. Too rough, I thought. Didn’t establish rapport with his patient, didn’t use oil to make the rub more gentle. A lot of subtle deficiencies, I thought. Then when the baby didn’t cooperate he resorted to using more drugs than I care to remember. Drugs were his first line of response and I don’t necessarily believe in that if the ECV can be done without them. That’s the way I am about everything—the fewer drugs used, the better.
“Anyway, that first time, all I saw was how scared the mother was and how oblivious to her needs the doctor seemed to be. At least, from my perspective, which could have been a little off since it was my first time. The next time he was called out to do an ECV, I asked him if I could try it and I pretty much did just the opposite of everything he’d done and it seemed to work. Could have been a different kind of response from the patient, could have been my ideas were actually good. Don’t know. But I liked the result, and continued to use my way throughout the rest of my obstetrics rotation. Haven’t done the procedure since then, though.”
She twisted a little too hard to the right, winced, grabbed her lower back, then twisted back to the left to straighten out her kink. “Don’t get me wrong. My advisor was an excellent doctor and an even better instructor, but somewhere in the mix I think he lost his bedside manner. Watching him, with all his excellent medical skills and his sub-par people skills was when I decided that a doctor’s manner in healing is nearly as important as the actual healing.”
“Well, however you accomplished it, this baby has surrendered peacefully. He’s holding his place just fine.” And so was Beatriz, who’d dozed off at the end of a procedure that was often traumatic. Shanna was right, though. The manner was important. And when that manner came from Shanna, it resulted in the smile like the one on Beatriz’s face. Like the one he felt in his heart.
Now, even more than before, he wondered what had gone so wrong in her life, or her medical practice, that had caused Shanna to leave one of the most reputable medical institutions anywhere and come to the jungle. Especially one where she was part-owner. Before today, he’d thought it might have been impulse or wanderlust. Or that she was just someone traveling the world in search of herself. All those made sense to him and in so many ways he understood that. Of course, that was coming from the perspective of someone who’d searched for the same thing and walked away empty.
What didn’t make sense about Shanna, though, was Shanna herself. Everything she did was well thought-out, nothing came without a precise motivation. And there was nothing about her that was lost. Or, at least, appeared lost on the surface. Which meant there was something much deeper going on with her. Something that made him wonder what would have caused her to pack it in and end up here.
He really wanted to think that the call of the humanitarian cause might have lured her, but he knew better. She had a reason for being here. And it was something she wouldn’t, or couldn’t, divulge to him. So, damn it, what was it? What wasn’t she saying?
“Look, I think we’re good here,” he finally said. “Why don’t I go get one of the volunteers to sit with Beatriz for the next couple of hours, and if nothing changes, we can send her home?”
“I could use a break,” she admitted. “Go somewhere and try to exercise out the knots.”
“Your back aching that bad?”
She nodded. “It comes and goes. Usually just some kinks from an old injury.”
“Another one of those Shanna stories? You know, the foibles of youth?”
Nodding, she said, “Big foible.” She stepped aside as Consuela Alvarez made her way to the bed and turned to shoo Ben and Shanna on their way. “Big, big foible. My family had picked out some kind of surgery for me to pursue, but bad backs and operating tables don’t mix.”
“I don’t see you as a surgeon. Not that you don’t have the skill but you like the personal interactions.”
“Precisely. But for the Brooks family, family practice is too mundane. Good for someone else but not us.”
“Someone else, like me?”
“Obviously, I don’t look down my nose at family practice, because it’s what I chose. And I think you’re a natural for family practice, but I could see you as a surgeon,” she said.
He shook his head. “I thought about general surgery for a while. Couldn’t see myself tied down to an operating room all day, so I looked for something with some variety. Which, for me, turned out to be what I’m doing. It’s good, too, because I like being someplace where the expectations are different.”
“You mean expectations of you?”
“No, not of me. But of medicine in general. The people here want to keep it simple. Pure. Maybe fundamental. They’re happy to get penicillin, yet during my residency when I prescribed it for a patient I was told it was outdated, that there were better antibiotics, to at least prescribe one of the updated penicillins. Yet, plain, old-fashioned penicillin’s a perfectly good drug that works, and it’s a lot less costly than any other antibiotic on the market.
“Your ECV’s another example. You tried the simple thing first, and it worked. So I guess what’s maybe the most important thing to me is that I like the expectation that medicine can still be pure. Or fundamental. And that’s not my patients’ expectations. It’s mine.”
“Then you’re a country GP at heart, aren’t you?”
“And proud of it. The bigger medicine gets, the more impersonal it becomes. But when someone is sick and needs a doctor, they still want to feel like their doctor cares in something other than a corporate-detached kind of way. So long live the country GP, because that’s where the true personal medicine is still being practiced.”
“The country GP who has found himself happy in a jungle village. Th
ere’s something quixotic in that, Ben Robinson. I envy you your choice. And your dream.”
An expression crossed her face, one that was sad, full of melancholia, and that was when he knew, when he finally could see her conflict. Somehow Shanna was caught between two medical ideals, trying to figure out which one she wanted. That was probably a simplified version of it, but he’d bet his best stethoscope that was where it had all begun for her. “For me, it was a simple choice. I tried it on, it felt right. So I adapted it to fit me.”
She smiled. “Well, I think the good thing is that your kind of medicine still exists to give medicine as a whole that more rounded, compassionate edge.”
“Until it gets shoved so far back nobody can find it. It’s already happening in a lot of places. The United States... Express the sentiment of being a country GP to your colleagues and they look at you like you’re crazy. Make a house call? No one does it anymore. Go back to simpler prescriptions? Some pharmacies don’t even stock them.”
“But the country GP found his country, and his practice, didn’t he? And he’s practicing happily-ever-after. Isn’t that the way it should be?”
“I don’t know, Shanna. You tell me.”
That sad, melancholic look passed over her face again. “When I was a girl, still in middle school, I accompanied my father on a lecture tour throughout Europe. He’s the medical academic in the family. Anyway, most of the time he stuck to the large cities and universities, but in England he went to visit a former colleague who lived in some little village...I don’t remember the name. It was old, coastal, very quaint. Buildings two hundred years old that would have been condemned for old age where I came from but still had a vital purpose in that village.
“And the people...they fished for a living. Worked so hard, and seemed happy doing it. There was actually still a millinery shop, Ben. Someone making hats, of all things. I mean, who makes hats?” Wonderment shone in her eyes. “It was the first time I’d ever seen anything outside my own life and I was in awe. I couldn’t believe people lived like these people did.
“Anyway, my father’s colleague turned out to be someone with whom he’d associated when he was guest lecturer at Oxford. Professor Augustus Aloysius Copp. He referred to himself as a licentiate in medicine and surgery, and I thought that sounded more important than just about anything I’d ever heard. Turns out he was a very important man in the medical field.
“But here he was in a fishing village, this man with the most impressive academic record, and he was working as a GP after such an illustrious career. Picking up his medical bag, walking out the door of his two-hundred-year-old cottage and making house calls on a regular basis to people who lived in other two-hundred-year-old cottages.
“My father and I tagged along with him one day and I kept wondering why Dr. Copp was doing it. It was hard work, all that walking, and he wasn’t so young. All I knew was the medicine I saw in my own life every single day. It was very narrow, the way my life was. But, Ben, this was the first time I became aware that there was another way. Dr. Copp was happy, his patients respected him and he loved his patients. It was a simple system that worked and he said it was truly the way he’d always wanted to practice medicine.”
“But that kind of a system’s not for you.”
She shrugged. “Not for me. At least, not in the life I have back at Brooks Medical Center.”
“Yet here you are, picking up your medical bag and electric toothbrush and making house calls on a regular basis now. And you’re enjoying it, Shanna. It shows all over you. How can you explain that?”
“I don’t know. Maybe it’s something about knowing how the world needs both Dr. Copp and Dr. Robinson.”
“It also needs Dr. Brooks, wherever she decides she wants to be.”
“Whatever she decides she wants to be,” Shanna said, her voice bittersweet.
“You’ll figure it out, Shanna. When you want to. But in the meantime...” He stopped at one of the exam rooms, opened the door and gestured Shanna in.
“What’s this about?” she asked.
He held up his hands. “Good with aching back. Won’t cure anything, but will sure make the aches of the moment feel better.”
“Really? You’d do that for me?” Before he had a chance to answer, she scooted into the room and was already halfway up on the exam table. “Never let it be said I don’t take full advantage when something good is presented me. So, do you want my shirt off, Ben?”
He gulped. “Your shirt?”
“For the massage. Would it be easier without my shirt?”
Images of Shanna without her shirt flashed through his mind, exploded in his mind, sky-rocketed all around his mind, and it was all he could do to maintain his doctorly comportment. Bad idea, this massage. Especially when he didn’t stand a chance of keeping it professional. At least, not in his mind—damned traitor to his resolves.
“No, leave it on,” he said, wishing he didn’t have to say that. But better safe than sorry. “I can get at the places I need without it coming off.” Unfortunately.
“Lower back,” she said, settling down. “Above the coccyx, just to the...” She sucked in her breath, held it for a moment as his fingers went, almost instinctively, right to the spot. “Yes,” she murmured, hoping it didn’t sound like a purr. “Right there.”
“So, tell me the story of your back injury. Your big, big foible,” he said as his fingers applied the first level of pressure. “And the tattoo. What’s that about?”
“Tattoo’s about my first real act of rebellion. Actually, the second part of my first real act.”
“The foible?”
“Yes, the foible. After the whole window-chair incident, I decided I wanted horseback riding lessons. My parents refused. They didn’t have enough time to take me, said it was too dangerous, kept telling me I had better things to do with my time. Take your pick. There was a counterargument for every one of my arguments.” She laughed.
“I will say, it was the first time they ever put up much of a united front against me. Most of the time they deferred me to the other parent, who deferred me back, turning most decisions concerning me into a volley between two parents who didn’t know what to do with me and didn’t want to take the time to find out. In the end, I usually got what I wanted because they got sick of the back and forth.”
“Making you a very willful child.”
He applied a little extra pressure just offside her tattoo, causing her to gasp, suck in a sharp breath, then let it out judiciously. “You really know where to hurt a girl, don’t you?”
“On the back, or in the pride?”
“A little bit of both. But you’re right. I was willful. Saw my advantages and took them where I could. Except about the horseback riding. I had no idea what to do against a united front. So I ignored their refusal to allow me to do it and did it anyway. One of my girlfriends had a beautiful chestnut mare boarded at a local stable so I’d go with her after school when she’d go to groom or ride her horse.”
“And you rode her horse?”
“Not exactly. You know that part where you said I was willful...” She flinched again. “Are you doing that on purpose? Trying to hurt me?”
“You’re tensing up.”
Because his fingers on her felt so...good. Perfect. Like they were the fingers that should be massaging her back. “I’m tensing up because talking about my family makes me tense,” she lied.
“Actually, you were talking about your friend’s horse.”
“My horse,” she corrected. “There was a beautiful gray there for sale, so I bought her.”
“You had that kind of money when you were a kid? Because when I was that age I was doing good to scrape together twenty dollars.”
“No, I didn’t have that kind of money, but I knew the combination to my dad’s safe so I took a little bit at a time, hoping he wouldn’t notice it missing, or would think he’d miscounted last time he’d checked. Eventually, I had enough to buy a horse.”
“Where I come from, too. But that’s not what happened. I bought my horse, paid for riding lessons and to have her boarded with that money I was taking, and had a perfectly good secret going for over a year. Then I fell off. Got sloppy saddling my horse, didn’t get everything cinched properly and took a mighty hard fall on one of the trails. Fractured my back, not seriously but serious enough that I had to be airlifted to a hospital by helicopter.”
“Riding in a helicopter with a broken back usually isn’t conducive to being kept secret.”
“Especially when the helicopter sets down on my family’s own helipad, even though I’d specifically told the pilot to take me to another hospital. Anyway, they’d radioed ahead, and when they pulled my stretcher out of the chopper, there to greet me were my parents, my grandparents and a few other family members. Imagine a whole platoon of Brooks medical workers standing there with scowls and folded arms... The scowls came only after they’d determined I was okay, by the way. But still...”
“Secret’s out.”
“In a big way. And I had to give my horse back. Then deal with the consequences of going into my dad’s safe and taking the money, which turned into the kind of hospital duty no one ever aspires to.”
“Did it involve bedpans?”
She nodded. “And that was one of the more pleasant aspects of my punishment.”
He chuckled as he shifted the focus of his massage up a couple of inches. “Something tells me that didn’t end the rebellion.”
“Hardly. My physical therapist...beautiful man, my first adult crush, actually. Let me rephrase that—my first teenage crush on an adult. I fell in love with his tattoos probably more than I fell in love with him. They represented freedom and self-expression. Anyway, he had these big,
muscly arms...”
“Unlike mine.”
“You have nice arms, Ben. Small in proportion to Lance’s arms, but you work out.”
“How can you tell?”
