“You most certainly do not have to text Isabelle. What you have to do is get your sister off my leg. Now.”
“I’m sorry, but this is urgent.”
“It is not urgent. What is urgent is responding to your mother before she flies off the handle,” I yelled.
The whimpering coming from my ankle suddenly stopped. I looked down. Delaney was staring at me, mouth wide open. “Mom,” she said, awestruck. “You can fly?”
There was a pause, and then Rowan and I both started to laugh. I turned off my induction cooktop and leaned over to pick up Delaney, who smiled faintly, unsure of what she’d done to break the tension but pleased that she had gained undivided attention.
“Lainie,” I said. I stroked her corn silk curls and breathed in her baby fragrance, guiltily availing myself of the comfort of her perfect, unbroken body. “I can’t fly. I meant that I was getting mad. I’m going to finish this cooking and Sissy will read to you for a few minutes, and then we can cuddle on the couch.”
“Mom!” Rowan fumed. “I do not have time to read baby books! Why can’t the boys do it? In my opinion—”
“Your opinion is immaterial,” I interrupted. “Only my opinion matters here.”
“Well, that’s offensive.”
“Rowan, do it.”
Rowan grumbled, but she moved over to the comfortable couch in the sitting area off the kitchen and grabbed a book—our much-loved copy of Bink and Gollie—off the bookshelf. Delaney followed her and climbed up into Rowan’s lap, settling with her head resting sleepily on her big sister’s shoulder. Rowan tucked an arm around her and began to read.
The evening slogged along. No call from Emma, no call from Betsy. These sun-filled late-summer days tended to go forever, making it especially hard to convince the children that it was bedtime. They fought the good fight, complaining loudly of thirst, hunger, feeling unloved and lonely, hearing strange noises, and my personal favorite, suffering from “itchy teeth.” In response, I had begun barking, “Stall! Stall! Stall!” every time a small head poked out of its room, which made me sound like a plane going down. It was effective, though: it so annoyed the children that eventually they surrendered. I was a noodle by this point: droopy limbs, half-mast eyes, and garbled thoughts swirling around in my tired head. But the quiet peace of the house was way too precious to waste on sleep. I poured myself a glass of wine and ran a bath. I put in a few drops of rosemary-infused massage oil, which turned the water into warm liquid silk while giving the bathroom a seductive clean smell. I caught a glimpse of myself in the mirror. My hair, which has a tendency to go haywire by the end of the day, sprang out from my head in uncontrolled coils so that I resembled a demented lion. I gathered it up into a hasty topknot.
After sinking into the water, I closed my eyes and exhaled into a luxurious cloud of rosemary steam. Total bliss. On the ledge, my phone began to buzz like an angry wasp, but it was an out-of-state number so I ignored it.
I felt my body unwind, muscles unclenching and relaxing into my curves, as I submerged myself up to my ears. My body was not exactly perfect, especially given that I was in my late thirties and had had three pregnancies, one of them twins. I’d even considered a breast augmentation, which my friends referred to as a “refill.” That a refill was aesthetically desirable was incontestable: after the pregnancies and a total of four-plus years of breastfeeding, my breasts looked like they belonged on a four-hundred-year-old Yoda. But in the end I decided my babe status was still intact, despite having all those babies. And Drew wasn’t complaining either, not that he’d had much contact with me lately.
The thought of Drew and his absentee status from our home life was a touchy one. When we’d first met—on one random evening at Selwyn Pub—I had been in the beginning of my residency in Charlotte. My nonmedical girlfriends gape when they first learn the breakdown of my education: four years of college, four years of medical school, three years of pediatrics residency, and—because that clearly wasn’t enough—another three years of fellowship in pediatric cardiology, with a year of research worked in. Every now and then during that first year of peds residency, I’d escape the hospital, desperate to interact with humans who didn’t wear blue pajamas and white coats all the time.
Charlotte was chock-full of men like Drew, since the local economy was fueled by the financial industry. Uptown crawled with them: handsome, jet-lagged guys in button-downs. But Drew stood out in the horde of i-bankers and private equity guys.
I’d been sitting at the bar the night I met him, trying to simultaneously project aloof unavailability to the guy to my left (an opinionated tool) and cautious interest to the guy to my right (cute, good hair), when a beer came sliding down the length of the bar and planted itself in my cupped hand. I stared at it in delight and turned with the entire rest of the bar to see where it had come from. A guy at the end of the bar lifted his hand in a wave and mouthed, Hi.
I waved back. The guy smiled—he had a nice face, open and affable—and motioned to the stool next to him with a hopeful look. I hopped up, ignoring the crude leer from Mr. Tool, and joined Drew at the end of the bar.
The first thing he said: “I can’t believe I did that.”
He looked so shocked at his success I had to laugh. “It’ll make a good story to tell our kids,” I said cheerfully, and then clamped my hands over my mouth in horror. Oh God, no. Unrecoverable.
But he didn’t run out screaming: he laughed. And we talked until the bar closed. Everything happened in a whirlwind after that: our marriage, the kids, the blistering insanity of trying to parent very young children while one of us was working hundred-hour weeks, mostly at the hospital, and the other was working hundred-hour weeks, mostly on last-minute flights to Abu Dhabi or Hong Kong. Somehow we survived it.
Thinking of how we met reminded me I’d barely seen Drew this week. Maybe this weekend, we could—
The bathroom door flew open. Delaney staggered in, blinking against the sudden light. “Oh, hi, Mom!” she chirped.
“Lainie,” I began, resigned, standing and reaching for a towel to wrap around my wet hair. “Why, why, WHY are you up?”
“I missted you, beloved dear!”
“Well, you need to get back in your bed. Right now. It’s very late.”
Alarm crossed Delaney’s features, replaced quickly by cunning. “So, darling,” she began, clearly casting around for a conversational topic to distract me. Her huge owlish eyes lit on my wrapped head. “Is that . . . is that the same towel you wore in your wedding?”
It was an effort to keep my stern look in place. “Mommy wore a veil in the wedding, darling girl. No stalling. You are going back to bed.”
An epic battle ensued, which I won by virtue of superior strength and the fact that Drew had doctored up the children’s doors so that the locking mechanism was now on the outside. Padding back down the hall, I felt naked. I was more or less naked, but I realized the sensation of something missing was coming from my absent iPhone, which had gained the status of an extracorporeal appendage since I was never without it. Suppose Emma was texting me right now! Everyone agreed that these smartphones had rewired all the neural circuitry in the brain, setting up a feedback loop where you required more and more and more screen time, or else you suffered from a depletion of neurotransmitters and became all twitchy. This was problematic enough at my age, but just imagine what it was doing to the plastic little minds of preschoolers. Well, best not to think about that, or I’d be guilt-stricken at my failure to parent like my own parents. Of course, they had not even had cable TV to contend with, let alone fiendish mobile computers.
Ah! I spied the phone still resting on the bathtub ledge. Just as I reached for it, the bathroom door opened again. I whirled around, flailing for a towel, mentally cursing the children and their insistence on hopping out of bed seven thousand times a night, and nearly screamed as I collided with someone much larger.
“Oh my God, Drew,” I breathed. “How about a warning knock? I almost peed on the floor!”
Drew, who had been enthusiastically reaching toward me, pulled back. “That’s not a good visual,” he mumbled.
“What are you doing home so early?” I smiled. “It’s not even midnight.”
“Ha-ha,” he said, pushing his glasses up and rubbing the bridge of his nose. Drew had deeply etched symmetrical laugh lines bordering a strong chin, thick dark hair, and agreeable green eyes, which crinkled into half-moons when he smiled. In college, he had been vaguely embarrassed by his myopic vision, but someone had gotten him a pair of those dark-rimmed rectangular nerd glasses that really suited him; they brought to mind an intellectual but still sexy male model, perhaps reading the New York Times while smoldering postcoitally amid rumpled silk sheets in some trendy loft.
“I would have been home hours ago”—he grimaced—“but I got McGuired on the way out.” Reginald McGuire was one of the upper-echelon partners at Elwood Capital, and his propensity to corner colleagues and underlings and talk until their ears bled was much feared around Drew’s division. Reginald adored meetings and would produce elaborate multipage agendas with various subheadings about the most trivial issues, which absolutely tortured the shit out of everyone else. Resistance was useless though, because any attempt to tone him down resulted in him taking such miserable offense that the fallout was worse than just gritting your teeth and enduring the original McGuiring.
“I’m sorry, darling,” I said, coming over and rubbing his neck. “Was it very terrible?”
“It was,” Drew said happily. He loved a good rub. “He’s all over me about the securitization of the French thing, which, frankly, looks a little sketch.” Sometimes Drew lapsed into gangsta speak, which I found hilarious, given that he had been born in some lily-white suburb of DC. I reflected that I lived in a world where suburban moms were trying to sound like bankers, bankers were trying to sound like rappers, and the privileged offspring of the moms and the bankers were trying to look like gangsta-rapper football players.
“Anyway, I said how about we run this by Edgar? And Edgar said—Oh, that’s good, Zadie. I’m forgetting all about Edgar, actually. I can’t believe I even brought this up while I’m getting a massage from my hot, naked wife.”
I smiled. “But you aren’t naked.”
“I can fix that. Prepare to get lucky.”
Really, men were very impressive in the biological-urge department. If I got as little sleep as Drew did at this age, sex would disappear right off the radar screen. But he managed to rally, taking advantage of the rare night where he was home and I was awake and the kids were asleep all at the same time.
Afterward, Drew immediately lapsed into a postcoital semicomatose state that we referred to as being whammified. Since he was whammified—drooling, fetal-positioned, unable to respond—there was no point in babbling to him about Delaney’s biting, or Rowan’s girl drama, or the fact that Finn had appeared at school today without shoes. And there was certainly no point in waking him up to tell him the awful news about Eleanor Packard. I patted his face—in whammified mode it had relaxed into an expression of unfiltered peace—and with tremendous effort he grasped my hand and kissed it.
Now thoroughly awake, I wandered back into the bathroom. The iPhone still waited, lurking innocently in its little pink case. I pushed the home screen button and saw the call from the unknown number.
I punched the button to listen to the message and immediately dropped the phone onto the marble floor, shattering what remained of the already-cracked screen into a spiderweb of shards. But even so, I could still hear the inflection in that voice: the piercing intelligence, the razor-edged note of humor. I knew who it was as soon as he said my name.
Zadie, it’s Nick. Any chance you would have lunch with me tomorrow? I really need to see you.
Chapter Thirteen
A LATE SIGN OF DOOM
Emma, Present Day
Our unnatural quiet from the ER carried over to the OR. The worst trauma cases are often desperate affairs, but rarely were they this solemn and silent. Just before the case started, Eleanor’s blood pressure finally dropped—a late sign of doom in children; they tended to maintain their pressure until just before the end—and we all held our breaths as she was positioned on the table. I had a great scrub nurse, with experience in both trauma surgery and pediatric surgery, and she handed the correct instruments to me and Sanjay even before we could ask for them.
Despite the urgency, a sense of calm engulfed me. The only sounds I could hear were the whoosh-hush of the ventilator and the nasally breathing of the medical student peering over my shoulder. The subdued sounds, along with the sea green color of the tiled walls, combined to create an underwater, otherworldly ambience, and I felt my breath slowing as my focus narrowed. Ever since I was a resident, I’ve had a ritual in the seconds before a case starts: I close my eyes and visualize the anatomy I’m about to see.
I opened my eyes. In front of me, Eleanor Packard’s vulnerable little form gleamed in the brilliance of the OR lights: a shining fish caught in a shaft of sunlight. She was swathed in blue OR towels, framing a yellowish sheet of sticky film clinging to her abdomen.
Sanjay, his hand steady, made a deft incision down the length of Eleanor’s tummy, curving around her little outie belly button. I followed with the cautery. Without needing to confer, we manipulated our instruments with balletic intricacy, elevating and snipping through the lining of her abdomen. Even though I expected it, I exhaled behind my mask as a torrent of blood gushed out at us. The anesthesiologist, peering over the sterile blue curtain dividing Eleanor’s face from her body, took one look at the red lake we’d uncovered and called to the circulator for another unit of blood to hang. Sanjay and I rapidly packed OR sponges into the little girl’s abdominal cavity, trying to stem the hemorrhage long enough to get her stabilized.
It worked. With the blood loss slowed and the anesthesiologist transfusing her, Eleanor’s vital signs began to rebound. Still, we didn’t know where the bleeding was coming from. I suspected the spleen, but it could also have been the liver. Or both.
Or maybe it was something else. I felt the first little flurries of panic trying to worm their way into my consciousness as I removed some of the packing; the lake of blood immediately repooled. I shut off my mind, silently chanting to myself. No bad thoughts, no bad thoughts, no bad thoughts. The panic receded. “It’s the spleen,” I said.
Sanjay and I worked quickly but carefully, first identifying and then clamping the blood supply to Eleanor’s macerated spleen. This improved matters, but the hemorrhaging didn’t fully stop. An hour went by, and then another one, as we painstakingly identified the little bleeders scattered around Eleanor’s belly. Thank goodness for the anesthesiologist, who was fighting as hard as we were to keep her alive.
“Send word to the Packards that we’re closing,” I said finally. “I think we got them all.”
For the first time, the atmosphere in the room relaxed. “Bless you, Dr. Colley,” said the circulator, clasping her hands prayerfully toward the heavens. “That was a hard one.” Behind his curtain, Bart Fisk, the anesthesiologist, started whistling as he clicked at his computer.
The medical student behind me shifted his weight from foot to foot, probably sick to death of just standing there. “Can I help close?” he asked.
“Absolutely not,” I said. “We are going to make this scar so pretty they’ll think plastics did it. But you can have the next drunk that comes in.”
Only Sanjay seemed unaffected by the good cheer suffusing the OR. He studied the little body in front of him. “Maybe we should leave her open,” he said.
I frowned, considering this. What Sanjay suggested—not closing the surgical incision, in favor of leaving the packing in place and the huge gaping wound covered only by skin or surgical dressings—had some consider
able disadvantages. The risk of infection was higher, and we’d have to keep the child fully sedated, among other things. And it felt barbaric: the image of a tiny girl with her belly split open is not one anyone wants to contemplate, especially the child’s parents. But it offered the advantage of easy access if we’d missed anything, and we could even leave the packing in place temporarily to try to get the bleeding to stop on its own if it started again. It was a drastic effort, but it also offered protection after a catastrophic injury.
I made my decision. “We’re not going to do that,” I said. “We got this. And I don’t want to put this family through any more.”
Sanjay studied the area where we’d ligated—tied off—the biggest blood vessels. I knew what he was thinking.
“We didn’t hit the pancreas,” I said. “I’m sure.”
“Okay,” said Sanjay. I could not read his expression.
“Have a little faith in us,” I said, starting to close the first layer. “Her abdominal pressures will be fine.”
“Of course,” said Sanjay.
“You finish up,” I said. Sanjay’s closures were meticulous and beautiful, maybe even better than mine. I turned to the med student, reconsidering. “Come up here,” I offered. “You can cut sutures for Dr. Patil. You might as well get something out of standing there sterile all this time.”
“Thank you!” yelped the student.
“Don’t do anything stupid,” I told him. “Cut them exactly the length Dr. Patil tells you.”
“Yes, ma’am,” said the student, eyeing his hands warily. I made a mental note to look up his name as soon as I left the OR; for some reason, I kept forgetting it.
“Great job, everyone. Thank you,” I said to the room as I broke scrub. “Now I’m going to find the Packards to tell them their little one should be fine.”
The Queen of Hearts Page 10
