by Julie Cross
And I don’t usually do this taking-care-of-people routine. Diagnosing, prescribing, operating, labs, blood work, and tests—I’ve done all that. But the rest I hand over to nurses, family members, or the patients themselves. I don’t even think about these parts of patient care. If I thought about these things for every patient I treated, my head would probably explode from overload.
I roll on my back and stare at the ceiling, watching it turn blurry from tears. All my effort becomes devoted to keeping my breaths even and normal. Let him fall asleep again and then you can go in your own room and cry or whatever.
That plan works for about two minutes, and then Marshall is shaking my shoulder gently. “I know you’re crying, so let’s cut out the denial part of the routine. How about you just tell me what’s wrong?”
I lift the bottom of my shirt and wipe my face with it. I can’t look at him, even in the dark. My eyes stay focused on the ceiling. “I get it now. I get why you didn’t want me to know anything about your medical history. It’s like that for me, too, except it’s something else. I’ve been carting it around for almost a week, and it’s just so … I’m afraid that if I tell people, they won’t be able to see me anymore, and everything I do will potentially be a symptom.”
“If you tell me you’re dying and this new take on college is a part of some bizarre bucket list, I swear to God I’ll kick your ass,” Marshall says.
I shake my head, my throat even more constricted now. “It’s not like that. I have all these feelings like heaviness—I have for a few years now. Like I can’t maintain control of my thoughts. I can’t force myself to feel what I know I’m supposed to feel. Death doesn’t scare me. And by that, I mean other people’s deaths. And then I’m sitting alone, cursing myself out for all the horrible thoughts. Most of the time I think I’m right, that I’m not doing anything wrong—everybody else is wrong. And then I have this crushing realization that maybe I’m so screwed up in the head, my system of right and wrong are not even on the map.”
“That’s your secret?” Marshall asks.
I still can’t look at him, especially knowing that I’m going to tell him the rest. He deserves to know. It would help even the score. “That’s only part of it. I’ll tell you the rest, but I don’t want to talk about it. So can I tell you and then we can go back to sleep?”
“Okay.” There’s an odd tone to his voice, something hinting that he might be afraid of what I’m going to say. He’s no longer touching my hand and I sense a few more inches of space between us.
“I’ve only done what I did with your records one other time. Last weekend.” I draw in a deep breath, forcing away the images of pages and pages of text from the other medical file I illegally searched. “You know how I’m adopted?”
“You searched for your birth mother?” he guesses.
“Not exactly.” I cover my face with my hands. “After last week … when we … after we—”
“Yelled at each other and then started making out?” Marshall suggests.
“Yeah that.” I breathe again—in and out. “I had to know what the stupid psychologist wrote about me. Whatever she said kept me out of every residency program. I thought I could figure out how to pass next time on my own, but then other things were screwed up and …”
“You had to know,” he fills in for me, giving me a second to compose myself.
“I read a little bit and then I tried to shut down my brain, to not memorize or think about the rest. I closed it so fast but my stupid fucking photographic memory sucked it all up. Every word. Every page. My birth mother had three different Ph.D.’s—history, anthropology, and forensics. All before she was twenty-five. So my IQ isn’t a fluke. It’s obvious where it came from. She wasn’t married and didn’t have me until she was forty-two. There was no father, at least not outside of the technical sense. She used a sperm donor and in-vitro. She’d been treated for depression on and off since age twenty-one.” I can feel Marshall inhale and hold on to that air. I hate that I’m causing him even an ounce of stress. But it’s a little too late to turn back now. “She killed herself. Postpartum depression, supposedly.” I leave out the details described so vividly in the medical records and stop talking right then. The ones I tried not to read. The ones I can’t erase. I wipe my nose on the sleeve of my T-shirt and turn on my side.
Marshall doesn’t speak at first, but he breaks his promise after about two minutes. “The depression, it’s hereditary, right? That’s what you’re afraid of?”
“Mental illness is hereditary, Marshall. There’s dozens of ways that I could go crazy—there’s bipolar disorder, clinical depression, borderline personality disorder, which would make sense given my tendency to—”
Marshall’s fingers touch my lips, cutting me off. “First rule of crazy people is that they never think they’re crazy. You’re extremely self-aware for someone who thinks she should be headed to the asylum.”
“But I’m exempt from the rule. I know too much.” There’s a great deal of panic in my voice now. I dial it back and add, “I’m sorry. This is not what I wanted to do tonight. I’m not one of those people who likes to make everything about me. You’re sick. Let’s make that the priority.”
He returns to sinking into his pillow, but he reaches under the covers and finds my hand. “I don’t know any great medical theories that you haven’t already learned, but I know you didn’t risk your medical license to dig through my records because you don’t care. Maybe you just aren’t letting yourself see it for what it is.”
The weight of telling him my worst fear lifts off me and I’m suddenly exhausted, and for the first time in I don’t know how long, I fall into a deep sleep without a long round of solving mental equations or calculating the probability of natural disasters alphabetically by continent. I’m Izzy, falling asleep because I’m tired and a little bit upset and a little bit relieved.
But then I do form a random theory in my sleep. I’m soon wondering if I’m relieved because what I’ve told Marshall might make him run for the hills as soon as he’s healthy and then I don’t have to figure out how to do this whole friendship or whatever it is we’re doing. I don’t have to face it if he pushes me away first. And then I don’t know which I’m more afraid of—that happening, or that not happening.
Chapter 17
“Marsh?” I sit up after feeling the empty space beside me and take in the light peeking through the curtains, then I notice Marshall seated at the end of the bed, dressed in track pants and a hoodie, wiggling his feet into those bright orange flip-flops. “Where are you going?”
“For a walk,” he says, like this is perfectly normal for someone who is sick enough to be hospitalized. “I need fresh air.”
“It’s forty degrees outside.” I shake my head. “Seriously, what are you doing?”
He shrugs and heads for the door. “I’m getting stir-crazy, that’s all.”
I spring to my feet. “I’ll go with you.”
“No,” he says, using a tone that makes me stop right where I am. “I’d rather go alone, but thanks.”
I stare at the door after he exits, wondering what he could possibly be up to. Then I remember last night’s conversation. Is he going somewhere private to make a phone call and report my craziness to some university authority or to my parents? I spin around in a circle and quickly spot his cell phone lying on top of the dresser. Okay, so it’s not that … but maybe he’s bringing a therapist to me?
Through the curtain, I spot him outside the building, hands in his pockets, shoulders hunched up like he’s freezing cold. Of course he’s freezing—it’s forty degrees and he’s got a fever.
Since I’m not brave enough to risk chewing any more fingernails, I keep myself busy by grabbing breakfast from my mini-fridge stash, brushing my teeth, and changing into yoga pants and a tank top. I hear Marshall coming up the elevator about thirty minutes after leaving. He doesn’t make eye contact with me, so I sit back on his bed watching him move around the room, trying t
o guess what conspired outdoors over the last half hour.
An odor along with the outline of a tiny bottle in his pants pocket catches my attention. Visine. “You went outside to smoke weed?” I blurt out, my mouth hanging open. His silence is all the answer I need. Then he proceeds to dump his supplies back into the top drawer. I continue watching him, mulling over this new discovery before asking, “Does it help?”
Marshall finally looks at me. “Yeah, I think so.”
I retrieve my laptop from under the bed, and after closing down Marshall’s medical file, squeezing my eyes shut as I’m hitting the exit button so that I don’t read another word of it, I return to my research from last night.
“That’s it? You’re not going to say anything?” He sits beside me, pulling his legs under the covers.
“What do you want me to say?”
I wait while he searches around for the remote, then clicks the TV on. “I don’t know. I figured you’d have a medical lecture for me or some kind of comment about my lungs turning black.”
“You told me no more medical jargon,” I remind him.
“So you’re thinking these things, but not saying them because of our previous agreement?” he asks.
I shut my laptop again and turn to face him. “Off the record?” He nods. “The side effects of marijuana are less detrimental than the side effects of long-term steroid use. So, if it keeps you from needing prednisone—though Dr. Me would have forced prednisone on you already—then it’s worth it. But if not, then there’s no medical benefit, which leaves only the side effects.”
“So I can smoke in here next time?” he asks tentatively. “Because it’s fucking cold out there.”
I laugh. “We’ll crack a window.”
“I only use it when I’m sick,” he adds. “It’s not a regular thing for me.”
“Okay.” I grab two more bottles of Gatorade from the fridge and hand them over, and luckily he takes them and begins drinking more without argument.
“Holy shit!” Marshall says, flipping through channels. “It’s our lucky day. Almost Famous is on The Movie Channel in fifteen minutes.”
“Right. The most important movie in existence. You do realize you’ve set the bar very high, right?” I tuck my laptop away and focus on this happy, though probably high, Marshall and his choice of activity for us today. Maybe if I let him call the shots for the remainder of the four-day weekend, I won’t get myself into any more trouble.
@IsabelJenkinsMD: Your mother is wrong. Chocolate and fried foods do not cause acne. Hormones, genetics, stress … maybe. But not junk food.
By Friday afternoon, Marshall is giving new meaning to the term stir-crazy. But I am a doctor. I can tell he’s not recovered, just much less dehydrated than on Wednesday afternoon. I’ve lost count of the number of movies we’ve watched between yesterday morning and today. Okay, I haven’t lost count—it’s eight—but the average person would have lost count by now.
I didn’t mind Almost Famous, kind of enjoyed it actually, but many of the others recommended by Marshall’s sisters made me want to throw up.
“I can’t believe what the Disney Channel is doing to children. Have they decided kids shouldn’t be subjected to intelligent thought processing? Or a story that doesn’t follow an identical structure to every other story?” I complain to Marshall after the final scene in Teen Beach Movie.
Marshall jolts awake, having dozed off twenty minutes ago. “Huh?”
“And why are the adults never more intelligent than the preadolescents? Seriously, it’s like a genetic nightmare.”
He rubs his face with both hands. “You’re overthinking this. It’s obviously for the sake of making the plot work. If the adults were on to the kids’ secret plans, then there wouldn’t be any story at all.”
I toss an empty plastic water bottle at the TV. “That’s lazy writing. It’s like me picking twenty diseases and making every patient be diagnosed with one of those twenty diseases because I’m too lazy to learn any more than that.”
“Sorry you’re stuck here with me,” Marshall says. “You could have been watching heart transplants instead. I feel bad that you missed it.”
I hadn’t talked to my dad since Wednesday, right before he went into surgery, but I talked to his scrub nurse this morning and got the scoop on everything I’d missed. “He lost the patient.”
“Fuck,” Marshall says under his breath. “I’m sorry, I mean … you know, sorry for your dad, I guess.”
I shrug. “It was a long shot and the patient had recently taken a turn for the worse. He was twenty-four hours from dying before the surgery.”
“It was a kid, right?” Marshall asks, and I nod. “Jesus Christ. That sucks.”
“Heart transplants are probably the riskiest of any major organ transplant surgery, but the success rate is still really high. It was well worth the risk.”
He stretches out on the bed, arms behind his head, T-shirt riding up just enough for me to catch a glimpse of the trail of hair that leads from the waistband of his sweat pants up to his belly button. “So how does it work, the whole business of yanking out a heart and then putting someone else’s in? What happens while the new one’s being installed?”
I can’t help laughing at the use of the word installed like it’s a new version of Microsoft Word. “Is this a trick question or do you really want me to answer? There will be medical-speak.”
“I’m lifting the treaty for this question only,” he agrees.
“It’s the most amazing surgery. Seriously.” Wanting to take advantage of my free pass, I sit on my feet beside him and shove his T-shirt up until it’s tucked under his armpits. Marshall lifts an eyebrow but doesn’t say anything. I place my left index finger directly between his nipples. “The first step after the patient is under anesthesia is to break the sternum using a saw.” I trace my finger down the center of his chest, mimicking the proper amount of pressure. Beneath my fingertip, I feel Marshall’s heart speed up, his breathing becoming more rapid. I falter for a second, grappling for the next step. “The broken sternum and rib cage are then pulled apart using a retractor.” I place both hands on his chest and slide them outward toward his sides as if spreading his rib cage.
“Now the heart is visible. Next you have to seal off all the blood vessels around the heart and then cut through the pericardium. The pericardium is a sac around the heart that protects it.” I glance up at his face, noticing the intense way his eyes are locked on me. My cheeks flame and my stomach gets that fluttery feeling. I shift my focus back to his chest. “The heart is placed into a dish. Usually it’s discolored and diseased. Sometimes it’s twice the size of what it should be. Surgeons never really know how bad a heart will look until they get in there and see it with their own eyes.” My fingers are now tracing the outline of where his heart should be. “Is this boring you? Too much jargon?”
“Uh-uh,” Marshall says with such certainty, my face grows even warmer.
There’s a smoothness to his skin that my fingers can’t seem to get enough of. There’s no way to mimic the “installation” phase, but I still make up movements to have an excuse to keep my hands on him. “Next, you have to trim the vessels of the donor heart to fit inside the chest cavity. Then you attach the donor heart’s blood vessels to the patient’s blood vessels. The patient is removed from the heart-lung machine, and the patient’s own blood begins to circulate through the new heart.” I glance up to make sure I haven’t lost his attention. “At that point, there’s a moment in the OR when the entire room goes completely still. No one speaks, no one breathes. And we wait for that new heart to jolt to life. It’s literally seconds, but it can feel like an eternity.”
“What goes through your mind when you’re doing something like that?” Marshall asks, his voice barely above a whisper. “What do you think about for those seconds?”
I begin to retrace with my hands the procedure I’ve already demonstrated on his chest. “The first transplant I scrubbed in on was wit
h a surgeon at a different hospital from where I did my internship, and she said she thinks about the patient walking, talking, running—she imagines that person’s future,” I explain. “My dad thinks about the steps he’s just made and goes through them over and over in his head so that he’s ready to react if any potential problem arises. He always preaches that every doctor makes mistakes, but it’s how you recover from those errors that truly determines your ability.”
“What about you? What do you think about?”
“I count.” My heart rate increases. My pulse is pounding hard into my fingertips, and I’m sure he can feel it. “I count the seconds that elapse, and I focus on each number representing an infinite amount of smaller numbers and those numbers representing an infinite amount of even smaller fragmented seconds. And when I do that, time slows down and I don’t have to rush.”
Marshall closes his eyes and sighs when my fingers trace over his collarbone. “My anatomy grade would benefit hugely from this type of hands-on studying.”
Now it’s my turn to lift an eyebrow, but I decide not to analyze. I’ve already committed to letting Marshall dictate the activities. At least until Monday morning, when the dorm comes back to life. I lie flat on my back beside him and give his hand a tug. “All right. Locate the deltoid muscle.”
He rolls on his side, props himself up on his elbow and meets my gaze. No, I’m not kidding. He hesitates a moment then barely brushes a finger over the correct shoulder muscle.
“Good. Triceps.” I close my eyes and sink into the feeling of Marshall’s hand sliding from my shoulder to the back of my arm. “Correct. Now, femur.”
The skin-to-skin contact is interrupted by my annoying pants sitting in the way of his finger and my thigh.
“Something a bit more challenging,” Marshall suggests.
I pull in a breath, trying to keep calm. “How about the sternocleidomastoid?”
