“This can be your night to mend fences,” said Wyatt. Optimism shone from behind his smudgy reading glasses.
“I— How did you know something happened with Zadie?”
Wyatt raised his eyebrows. “I’m smarter than I look,” he said. “Do you even need to ask?”
“But—”
“Muffin, you have to fix it.” He waved his hands in front of him for emphasis. “You don’t have to tell me how it went down—I can guess—but you can’t let it go. You need your friend.”
“I don’t think she’s coming,” I said, feeling a familiar weight level me. “I can’t control how she feels at this point.” If there’s anything I’ve learned, it’s this: the past is never really gone. It’s one long chain linking the present and also the future, and sometimes it doubles back on itself, exposing the things you thought were buried. “I told her the truth, and I haven’t heard from her once.”
Wyatt trotted around to the passenger side of the car and let himself in. “I can’t be late, Wy,” I said, beginning to fret about the time even though I’d allotted myself thirty minutes for a five-block drive. “Let’s talk about it when I get home.”
“This will only take a second,” he said, leaning across the seat. “Look at me.”
I complied, taking in the warmth of him: his round cheeks and round brown eyes, the exuberant gleam of his grin. He smiled at me until I smiled back.
“There,” he said. “I wanted to see your face look happy.”
The smile felt good; I hadn’t remembered it could feel so good. Wyatt reached for me, tracing my cheekbones in his hands, gracing my nose with a kiss. “Your past is set, but your future is wide open,” he said. “Go get ’em, pumpkin.”
—
I pulled up to the Packards’ driveway, and after briefly considering parking on the street, I turned in. The driveway, intricately patterned with some kind of reddish pavers, led to a roundabout parking area where a Tesla slouched at an arrogant angle. I tried to suppress my disappointment. Some irrepressible part of me had clung to the hope that I’d see Zadie’s car waiting as I arrived.
To my surprise, Boyd Packard answered the door himself, wearing a blue golf shirt tucked into dark brown pants. “Dr. Colley,” he said. “Come in.” As best I could tell, there was no overt malice in his expression, but neither was there anything particularly encouraging. I followed him through a foyer dominated by a massive curving staircase and a chandelier the size of a cow, and then down a long hall constructed of wainscoting inlaid with antiqued mirrors. We arrived at a wood-paneled room at the back of the house, the ceiling soaring to the second story, brass-accented ladders on rails reaching to the upper shelves. A library.
“Fetch you a drink?” offered Boyd. He gestured in the direction of a bar: crystal glasses, decanters on trays, every imaginable liquor. The idea of a drink was abhorrent. I shook my head.
“Suit yourself,” said Boyd, refreshing the glass in his hand with an amber liquid from one of the decanters. “Betsy?”
I started a little; I had not seen Betsy, her legs crossed at the ankles, perched with balletic grace on the edge of a sofa. She rose and extended a hand to me. “Thank you for coming.”
I started to accept her hand but stopped, as for the first time, I saw the rest of the room. It was enormous, wrapping around a corner of the house, with a second seating area tucked into a bay of windows facing the rapidly darkening yard. I caught my breath as the person sitting near the windows rose and turned toward me. A clamorous hummingbird let loose in my chest. It wasn’t Zadie.
It was Nick.
—
I looked at him, uncomprehending, and then realized Betsy Packard’s hand hung in midair, waiting for me to shake it. I swerved my head back to her, three beats too late, and grasped her hand. “Thank you for having me,” I managed.
I drifted along behind Boyd and Betsy, stunned. What did it mean that Nick was here? I could not envision a scenario where this made sense.
We sat: Betsy and Boyd facing Nick, me alone in a straight-backed wing chair. I’d plotted my speech in a meticulous outline, but now I could remember none of it. We sat in awkward silence, no one sure how to proceed.
Boyd finally spoke. “Good of you to come, Nick.” He looked at me, and the bewilderment on my face must have spurred him to throw me a bone. He gestured to Nick. “We’re friends from the club.”
Nick cleared his throat. When he spoke, his voice was smooth. “Given that I’m a hepatobiliary surgeon, Boyd thought it might make sense to have me help interpret things.”
“Oh,” I said.
So that was it. He was going to hang me.
Nick leaned forward. “Let me start,” he said. “Boyd passed on the medical records so I could assess them. And I know”—he leveled his gaze on Betsy—“some of this is going to be very difficult to hear, and you may want to take a break from time to time.”
She gave him a tiny nod.
“Okay.” He paused. “As you’ve heard, your daughter likely died from a combination of two things: first, a condition known as abdominal compartment syndrome, which is an increased amount of pressure within the abdominal cavity. In her case, this was a result of the initial crush injury requiring a massive blood transfusion. She also had an unrecognized injury to one of the ducts in the pancreas, which leaked enzymes into her belly.”
No one looked at me. It was so quiet I could hear my own pulse.
Nick went on, his voice steady and reassuring, despite what he was saying. “The injury to the pancreas probably occurred during surgery, when the duct was inadvertently clamped. If she’d lived longer, it would have ultimately made her septic.”
Boyd spoke up. “Would Eleanor have lived if this duct hadn’t been cut? And if she’d not had the abdominal pressure problem?”
Now Nick looked at me.
“Yes,” I said.
The poison of the word settled over the room.
Boyd picked up the ball again. “Could she have been saved if this had been recognized earlier?”
I closed my eyes. “Yes,” I said again. “It’s very possible. Or if I had not closed her incision.”
Boyd directed his cold fury back to Nick. “Give me one reason,” he said, “that I shouldn’t sue her.”
Nick nodded, recognizing the question, but kept silent. We all watched him: the alert intelligence embedded in his handsome face, the answer to Boyd’s question whirring behind his blue eyes. He stood up.
“Boyd,” he said quietly. “I don’t believe you should sue her.”
I felt my breath freeze in my lungs.
Nick began to pace. “It’s hard to explain,” he said, “but this would have been a very difficult thing to recognize. Pancreatic anatomy is notoriously difficult, and in these circumstances, with a tremendous amount of bleeding from the spleen, it would have been nearly impossible to discern. It’s an error any of us could have made under the circumstances. Hell, it has happened to me before. I’ve done exactly the same thing. Some things are unavoidable.
“And, let me also add, when Emma says she believes your child would have lived otherwise, she’s not telling you why she would have lived.” He looked directly at me, and I had the impression he was searching my face for something, or trying to tell me something. He sat back down, his elbows on his knees, leaning toward the Packards. “It’s miraculous that Emma kept her alive at all,” he said softly. “That initial surgery was heroic, considering the injuries, and very few people could have pulled it off.” Tears began running down Betsy Packard’s face, but Nick kept going. “She’s an immensely talented, immensely thoughtful surgeon. This—this tragedy—is in every way a disaster, but I believe it was unavoidable. I’ve looked over all the records, and I cannot see anything I would have done differently. Closing Eleanor’s abdomen after the surgery was a judgment call, and it could have gone either way
. There were some miscues in recognizing what was happening after the surgery, but I don’t believe Emma bears any of the direct responsibility for that. Sometimes things go badly in medicine, and even the most competent people have losses. It makes our jobs unbearable at times.”
He was still speaking, but I no longer heard him. On the wall behind Boyd, a large painting hung under the warm glow of an art lamp: a black-haired, violet-eyed child. Unlike most expensive oil portraits, Eleanor was not seated, or even standing still: the artist had chosen to paint her in motion, charging toward the viewer, her mouth open, her hair streaming behind her. Had they known she would not live to see the end of the year, perhaps her family would have requested her to be painted in a more solemn manner, but as it was, the artist had portrayed her with an expression she must have often worn in life: impish, determined, and joyful, clearly caught in the instant before a burbling, delighted laugh erupted from her.
I cannot imagine my own expression as I looked at the painting, but something of it must have caught Betsy Packard’s attention because suddenly her arms were around me. A memory crossed my mind: comforting Zadie many years ago after she told me about screwing up an intubation. We’d clung to each other, my face wet with her tears, and this was what Betsy did for me now. I buried my face in her shoulder, reeling with a thousand wild emotions, still not having spoken a single word in my defense.
“This is over.” Betsy kept my hand in one of hers and walked to her husband, picking up his hand too. She brought my hand and Boyd’s hand together. “It’s over. Not once have you blamed me, honey. You’ve protected me by blaming her, but you don’t have to do that anymore. It’s over, Boyd. Please. Let something good come out of this.”
Boyd Packard nodded. He looked at me, and something in the mirrored pain on our faces connected, passing a wordless communication between us. He nodded again, releasing me. As he began to cry, his shoulders hitching like a little girl’s, Nick and I looked at each other, and then, silently, we headed for the door.
—
We stood outside, in the cooling night air, in front of Nick’s car. I had no idea how to interpret the evening’s turn of events, so I settled on painful honesty. “I don’t know what to say.”
“How about ‘thank you’?” Nick offered. He flipped his car keys into the air and caught them with a deft hand.
“It’s inadequate for what you just did for me. But yes: thank you.” I paused, then thought of something. “The duct of Wirsung. You cut it in a patient too?”
Nick grinned, lightness restored to his manner. “Nope,” he said. “You stand alone there, Dr. Colley. I’d never do something so asinine.”
I wanted to protest: it’s bad, but it’s hardly an unheard-of complication. I thought of the whole chain of missed chances surrounding the Packard girl’s death, and a larger question loomed. “But then why would you say—”
“I know what it’s like to lose a patient, Emma.” He met my eyes, serious again. “I haven’t inadvertently cut that particular duct, but I’ve made equally unfortunate errors. Bad shit happens sometimes, despite our best efforts; what’s the point in punishing you when you did what you thought was right? This wasn’t negligence; this was a case of everything going wrong that could go wrong.” He paused. “But I think you know me well enough to realize I didn’t help you because I was overcome by some infection of altruism, especially for someone who hates my guts.” He glanced down. “Zadie asked me to do it.”
His voice: so wounded and unguarded. He still loved her. Embarrassed, I closed my eyes, but my brain still burned with the afterimage of his face, so different from the way I usually saw it.
“I’m sorry, Nick.”
A blink, and his face recovered its usual self-assurance. “Don’t worry about it.”
“I owe you. I owe both of you.” I had no right to ask, but I couldn’t stop myself. “Do you think she’ll forgive us?”
It was a tricky question, because I exposed how needy I was by asking it, but also because I had no way of knowing if Zadie had told Nick the full extent of my behavior. But it was a reasonable gamble. She must have protected me this one last time.
He considered this. “I think she’s forgiven me,” he said. “Especially now. But that’s mainly because she doesn’t care much about me anymore. For what it’s worth, I did ask her to come here with me tonight.”
I waited, dread descending on me again.
“She said no.”
“That’s understandable,” I croaked.
He regarded me intently, searching my face for something. Finally, he reached into his pocket and flipped something in my direction: a letter.
“From Zadie,” he said. He watched as I unfolded it: a single line of print on stationery from the Ritz. With a start, I remembered this was the weekend Drew had planned a downtown minibreak for her, with a night at the Ritz, followed by the Panthers game. I folded the note and put it in my bag.
“Okay,” said Nick. His voice—full of studied nonchalance—was at odds with the disquiet in his eyes. “That wraps up a decade of weirdness, then. Are we good?”
“Yes,” I said, meaning it.
He turned toward his car and then abruptly turned back. “I know why I fucked things up with Zadie. But I’ve never understood why you did it. She genuinely loved you.”
“I know.”
“And your boyfriend. I always wondered: did you know that he knew?”
I thought of the week Graham had discovered my betrayal.
“No,” I lied. “I had no idea.”
Chapter Forty-one
THE COSMIC CALENDAR
Emma, Present Day
I don’t believe in fate. When people say, “Everything happens for a reason,” they are correct: technically, things happen because some series of events happened in precisely the order necessary to produce that occurrence. But that, of course, is not what the saying means. People want to believe that everything happens for some greater good. But if a child dies, it’s not because she’s needed in heaven, or because there was some cosmic plan for her to die so another child could be born. It’s because her mother was distracted when backing up the car, and her surgeon made a series of judgment calls that turned out to be wrong.
I thought about Eleanor constantly, and even now, walking away from Nick, I knew I’d never be free of that. I’d felt it before in my profession, the guilt that comes from the tie of your actions to someone’s death. A sense of inescapable doom hovered over me and around me and in me, so pervasive I could see how it could become a self-fulfilling prophecy: a person might do anything to make it stop.
Like Graham did. If I hadn’t understood at the time how some miseries were too much to be borne, I did now. I’d never act on these urges—I hoped—because Henry and Wyatt were my buffer against self-harm.
But Graham had not had anyone else to protect him.
—
When I was little, I had a lengthy fascination with metaphysics. While the other girls longed for Cabbage Patch dolls and Jordache jeans, I became obsessed with cosmology after an accidental viewing of the Cosmos series on PBS—one of three channels we got—one night when my mother had fallen asleep with the TV on. Right away I liked watching Carl Sagan, whose brilliance was evident even to an eight-year-old girl. It was a revelation to me that there were empirical studies of the physical world, that there were people—scientists—who had such novel and keen ways of thinking it was almost as if they were another race compared to the people I knew. Each new discovery about the universe and its origins led to another, more startling direction of wonder.
Take the conceptualization of time. Essentially what you had to do was imagine the entire history of the universe—more than thirteen billion years—squashed into one action-packed calendar year. You started with the Big Bang on January first. A whole lot of things, like the shaping of the universe, took plac
e in that first magical second. Spring was consumed with the formation of the Milky Way; appropriately, the Sun was born sometime in late summer. The formation of our solar system didn’t occur until September 9, and the Earth sprang up around September 14.
In December, things really started smoking. The first interesting multicelled organisms, like worms, flopped into the picture in midmonth. The great geologic periods on Earth began: Cambrian period, Permian period, Jurassic period. Then, in the waning days of December, primates appeared. They developed bigger frontal lobes and got smarter as, around them, the giant mammals flourished: dim-witted giant sloths, which could reach twenty feet in length; armadillos the size of Volkswagen Beetles; hippopotamus-sized rats; terrifying, voracious short-faced bears, more than twice as tall as a human.
But it was the last day of the Cosmic Calendar that really grabbed my attention. December 31 started out kind of slow, just more primates lurching out of trees and ambling around the savannas. Their brains grew, and their pelvises shrank. (The significance of this last fact would not fully dawn on me until I experienced Henry’s birth some three decades later.) The sun set and night fell, and still the earth spun about on its axis, innocent of humanity. Finally, finally, sometime around ten thirty p.m. on the last day of the last month, premodern humans joined the party.
At first they spent quite a long time doing things the hard way. Stone tools: eleven p.m. Domestication of fire: eleven forty-six p.m. Anatomically modern humans rolled in with eight minutes to go, but they kicked around until twenty-eight seconds before midnight before figuring out how to grow food. Once they acquired agriculture, however, the ball began rolling fast: all of recorded history, Sagan said, occupied the last ten seconds of December 31. The kingdom of Israel, the first Olympics: seven seconds until midnight. The life of Christ: five seconds. The fall of Rome: three seconds to go. The American Revolution, the first two World Wars, the Apollo moon landing—in geologic time, they all occur at one second before midnight.
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