Gemini: A Novel

by Cassella, Carol

  Suddenly, after so many dragging days and hours, it all moved too quickly. This should be the drawn-out part of it, Charlotte thought. Stamping every moment with the full weight of the lives in balance.

  Jake barely glanced at her. She felt a rush of blood to her feet, a moment of panic—had she and Eric spent enough time considering it from Jake’s side? Eric tensed when Jake was led to the front of the room. He wrapped her arm in his and gripped her hand so hard the bones were pressed uncomfortably against the wooden bench. The judge paused between cases, read the papers handed to him by Jake’s lawyer, nodding once or twice, exchanging words. They spoke too low to be heard. Charlotte tried to read the judge’s face across the floor. Then, at last, the judge called Jake Remington Flores’s name. And then he called Robert Eric Bryson.

  The judge looked at Jake. “Young man? You understand what we are here for?” Jake nodded. “You have to speak up, son. For the record.”

  “Yes, sir. I do.” He wore khaki pants so new the creases across the thighs and calves were still crisp. Someone had combed his hair straight across his forehead with a neat part; illogically tidy for a kid. If he were mine, thought Charlotte, I would muss it up.

  The judge continued. “If the court found reason to place you in Mr. Bryson’s custody”—he lifted the papers in his hand to indicate Eric—“would you be willing to go?”

  Jake looked at Eric with the same solemn expression Charlotte had noted at the trailer in Queets and at Louise’s foster home in Port Angeles. It reflected his worldview, Charlotte decided. Appraising, considering—revealing nothing until he was ready. She was sitting so still the bench beneath her seemed to drift in space, gravity a matter of perspective. Finally, after a long moment of apparent consideration, Jake nodded again, and then said, “Yes.”

  The judge sorted through the papers on his bench and unfolded a single sheet, smoothing it flat. He read the test result aloud and then, for the first time, he smiled. And when Charlotte saw Jake’s face, when she saw his own smile, she knew it would be all right. They would be all right.

  “I must be willing to give up what I am in order to become what I will be.”

  —ALBERT EINSTEIN

  Acknowledgments

  While the events and characters in this novel are fictional and drawn from my imagination, all the medical detail and genetics I’ve incorporated are scientifically factual.

  No acknowledgments is complete without a huge shout of thanks to you, readers! It is the dynamic confluence of readers, knowledgeable booksellers, and libraries that keeps novels a living part of our culture.

  For all that the author’s name is the one on the cover, no novel gets published without the work of many minds, and I am indebted to the entire Simon & Schuster team. My editors Marysue Rucci and Jonathan Karp have been true partners on Gemini. How often you saw the forest when I was lost in the trees. Jonathan Evans and Emily Graff, your meticulous attention to detail was my life raft through those final drafts. Thanks also to my agents, David Forrer and Kimberly Witherspoon at Inkwell Management. You know when to hold my hand and when to push me harder.

  It took three years and months of research to wrestle this book to a final draft. I depended on the expertise of many people without whose generous gifts this fiction would have none of the solid weight of facts. Thanks to Dr. Anna Beck for her general medical expertise and wisdom in hospice care and oncology; Dr. Karen Hanten for her wealth of pediatric advice and experience; Dr. Lorrie Langdale for details on intensive care and trauma; and Drs. Michael Souter and Lynne Taylor for those first illuminating conversations. For their unending patience explaining details of genetics and neuroscience, I thank Drs. Kurt Benirschke, Manuel Ferreira, Clement Furlong, Stan Gartler, Sidney Gospe, Lee Nelson, and Virginia Sybert. Additional medical details were contributed by Drs. Terry Clark, Farrokh Farrokhi, David Feldman, Bernard Fikkers, Terri Graham, Anna Harvey, Bill Healey, Chris Kuhr, Dana Lynge, Tom Malpass, Mette Peters, Peggy Sargeant, Sam Sharar, and Brad Watters.

  All the Googling in the world could not replace the legal details provided by Deputy Gary Simpson; also Lieutenant Mark Hanten, Sergeant Roy Frank, Criminal Identification Specialist Kaycee Leaonard, and Crime Analyst Sandy Curry. Mr. Keith Thomson, King County guardian ad litem, put up with infinite questions with the best humor, as did Heath Fox, GAL Paula Martin, Debra Madsen, LuAnne Perry, and Briana Rogers of DNA Identifiers.

  Paul Svornich, thank you for your intimate familiarity with commercial fishing. Other facts included in Gemini are thanks to Barbara Blackie, Elena Giorgi, Gloria Sayler, Joan Hanten, Carole Ober, Jennifer Olanie, Shawn Otorowski, Nancy Johnson, and Rhona Jack.

  Many dear friends read early drafts of this work and their forbearance, faith, and forgiveness led to a far better book. Thanks to Erica Bauermeister, Randy Sue Coburn, Claire Dederer, Anne Gendreau, Sherry Larsen-Holmes, Martha McLaughlin, Zan Merriman, Suzanne Selfors, Jennie Shortridge, Gail Tsukiyama, and, for her brilliant painter’s eye, Martha Burkert. And to the most fabulous writing group on the planet and their commitment to supporting literacy, thank you Seattle7Writers!

  This book was born, revised, and completed at Hedgebrook Writer’s Retreat on Whidbey Island. I am forever indebted, and so grateful to be one voice in your phenomenal community of radical hospitality.

  My research included conversations with intensive care physicians, oncologists, hospice caretakers, cancer-stricken friends, biblical scholars, spiritualists, and books ranging from neuroscience to Proof of Heaven to The Tibetan Book of Living and Dying. In all of them, perhaps not surprisingly, I found more similarities than differences. A special note of remembrance is offered to my friends whose lives came prematurely to their physical end during the course of writing this novel. Anna Harvey, you are remembered, and some of your words are in these pages. As you once said, “Death is the ultimate act of our humanity, because it is the last thing we do as humans.” Kay Monahan, Annette Moser-Wellman, Marta Wagner, Chris Bernards, Susan Thompson, and Lucie Rose Gendreau, we miss you.

  And last, first, and ahead of all else, thanks to my family: Kathie and Ray Wiley, Ellen Bywaters, and Marilyn Wiley. My children, Sara, Will, Julia, and Elise—in you I witness miracles every day of my life. Steve Cassella: twenty-two years and counting, plus all the love that’s at the heart of this book.

  Charity Suggestion

  for Book Clubs

  Rose Grant

  If your book club is interested in contributing to a charity related to some themes in this book, consider donating to the Rose Grant. Established in memory of Lucie Rose Gendreau, the Rose Grant funds classes, lessons, or tuition for teens who need an extra show of community support during a time of personal struggle. Helping teens succeed in an area of their own positive passion can stop a downward spiral and carry them through difficult years to thrive as wiser adults. For more information email: rosegrant@bainbridgeyouthservices.org.

  Simon & Schuster

  Reading Group Guide

  Gemini

  Carol Cassella

  When an unidentified Jane Doe, the victim of a hit-and-run, arrives in Dr. Charlotte Reese’s intensive care unit, she brings with her mysteries—both medical and personal. As Charlotte cares for Jane, she becomes increasingly caught up in the questions of her patient’s identity and what led to her accident. Why has no one stepped forward to claim Jane? What will happen if she doesn’t wake up? When Charlotte’s search for answers reveals links between Charlotte and her patient, the repercussions will forever change her life and her understanding of what love can make possible.

  Questions for Discussion

  1. Why does Charlotte feel such a strong sense of responsibility for Jane Doe? How does she balance her protective feelings for Jane with her practical understanding of Jane’s prognosis?

  2. From the moment she first sees Bo, Raney is acutely aware of the differences in their circumstances. How does her sensitivity
about her background affect their relationship over the years? In what ways do they have more in common than she thinks? Why is their childhood attachment so enduring?

  3. Charlotte sees her job as giving nature “as much time as possible”. In practice, what does that mean? How does it influence her feelings about Jane’s care and the appointment of a guardian ad litem?

  4. How does the small town of Quentin, with its natural beauty and financial struggles, shape Raney’s life? In what ways does she identify as a small town girl, and in what ways does she resent that role?

  5. Charlotte and Eric’s relationship is haunted by her desire to have a child, and his reluctance to do so. Why is the subject so difficult for them to discuss? Why does Charlotte feel they have stalled?

  6. What reasons does Raney give for marrying Cleet? Would she have made the same decision if she were not pregnant? How is her understanding of love and loyalty shaped by her marriage to him?

  7. How does Eric’s awareness of his neurofibromatosis, and the brushes with death it caused, influence his life? What choices does he make as a result? What boundaries does he lie down? Are his boundaries intended for his own protection or for others’?

  8. As a child, Raney makes do with scavenged house paint for her art. How does that same make-do attitude manifest in her adult life?

  9. What is the significance of Raney burning her paintings when her grandfather’s farm is sold? Why is this a turning point in her life as much as her grandfather’s?

  10. Does Charlotte go too far by seeking David out and by trying to uncover Jake’s paternity? Does her involvement with Raney compromise her objectivity?

  11. When she was a child, Raney’s grandfather taught her to light a campfire “with one match and her own wits”. Does Raney take his lesson about self-sufficiency to heart? At what points does she fail to follow his advice?

  12. What prompts Raney to marry David? Why does she ignore her growing misgivings and stay with him? Do you think David was responsible for the hit-and-run?

  13. Why do you think the author chose Gemini, the zodiac sign represented by twins, as the title of the novel? How does she develop the theme established by the title? What characters or events are “twinned”?

  14. Gemini contains several mysteries: Jane Doe’s identity, whether the hit-and-run was accidental or intentional, Jake’s parentage, and others. Was there a particular revelation that you found most surprising or satisfying? What devices did the author use to maintain suspense?

  15. Discuss the role of genetics in the novel. How does Eric’s “fatal flaw” link the characters? Eric wrote in his editorial that knowledge of your genetic code could be more damaging than helpful; is that true for Jake? Would you rather know if your genetics carried a “fatal flaw” or not?

  16. Gemini raises challenging questions about our fear of death and our willingness to confront or discuss it. Did you react differently to Jane Doe’s situation than you did to that of Raney’s grandfather? How would you answer the question that Eric poses to Charlotte: “Should quantity of life always trump quality?” Did reading Gemini stir you to look more closely at your own feelings about death?

  A Conversation with Carol Cassella

  What was the genesis of Gemini? Did you begin with an idea about a character or plot point? Or something else?

  After writing two novels told from a doctor’s point of view, I knew it was time to give the patient a chance to speak, so that was the first step in creating Raney. Then I needed to decide what the mystery would hinge upon and I turned to the world of genetics, which is rich with possible storylines.

  As a mother of twins, and as a doctor, I’ve long been interested in how much of our lives is dictated by the genes we land here with—a blueprint over which we have no control. But my identical twins (who share the same DNA and upbringing, but have very different personalities), have also confirmed that who we are and how we respond to events in our lives is far more complex than either nature or nurture can explain.

  Once I had those starting points decided, my characters began to emerge and the novel grew into a story that encompassed those elements, but also much more. Truly the most fun part of writing a novel is watching it take on a life of its own as it grows and changes over time.

  In your first novel your main character was an anesthesiologist, your own specialty; in Gemini your main character is an intensive care physician. How did you approach writing from the perspective of this specialty? How are the demands of this job different from anesthesiology?

  Intensive care medicine and anesthesiology overlap quite a lot—they both focus on acute care situations rather than long term problems, and to do them well you need to love physiology—the mechanics of how the heart, lungs, kidneys, and liver keep us alive. They are both fast-paced patient care settings where things can change very, very quickly, so they tend to attract similar personalities. In fact, many intensivists begin with a residency in anesthesiology before doing a fellowship in intensive care medicine. So Charlotte’s work was more familiar to me than, say, a pediatrician’s or an oncologist’s. On the other hand, it has been years since I worked with patients who were as sick as Raney, and I depended on several ICU experts to get the details I needed. The biggest difference between the two specialties is that in the ICU the patients arrive very, very sick, and the intensivist has to try to turn that ship around. In the operating room, most of the patients arrive reasonably healthy—or at least stable—and our job is to keep them that way.

  The title of the novel is the zodiac sign for twins. Why did you choose to highlight that theme?

  The title Gemini was suggested to me by an editor, so I can’t take full credit. It doesn’t fully make sense to the reader until the end of the book, when all the pieces of the mystery come together, but once you see the novel as a whole, the title seems perfect! The Gemini myth of Leda the swan and her twins Castor and Pollux—one mortal and one immortal—plays perfectly into Jake’s life, both biologically and metaphorically. But there are other “twin” stories at work in the novel, too: Raney and Charlotte, for all their differences, share similar personalities. They are both gritty, skeptical of the status quo, independent yet loyal to those they love. I imagine they would have been friends if they had been born into more similar circumstances. And in the course of the novel they are both faced with wrenching decisions about how far to go when caring for a terribly ill person they care about. I even saw Eric’s life in twin terms—the boy he was before his diagnosis usurped his belief that he could ever live a normal life, and the man he became afterward.

  The settings of the novel help define your characters and contribute to the novel’s conflicts. Was it important to you to have parts of the novel set in the Olympic Peninsula? Did you base Quentin on a specific place?

  If you have visited the Pacific Northwest you know that our natural beauty is unparalleled. (Yes, I am prejudiced!) One day of sunshine here is well worth the ten days of rain that pay for it. It is such a joy to describe our landscape that I can never resist setting parts of my novel within it. But it also reflects much about Gemini’s characters and their conflicts—particularly Raney’s. The Olympic Peninsula, home to Olympic National Park and the rainforest, is completely unspoiled in areas, but many of the towns and the reservations are struggling with poverty and unemployment. In ways, it is only four hours but ten light years from Seattle. This has a huge affect on Raney’s life, of course. What would she have been able to do if she had been born into a more privileged family? How would that have changed the decisions she made?

  On a more thematic level, contrasting the natural world of Raney’s woods and coast against the highly technical setting of an urban hospital’s ICU made a good backdrop for a novel that raises questions about natural death versus using every possible intervention at the end of life.

  The novel deals head-on with moral and ethical questions about death and l
ife, and when and how it should be extended by medical means. What prompted you to confront these questions? Do you find your own answers to these questions changing with new experiences from your work or life?

  I don’t think you can be a doctor in this day and age and not struggle with these questions. We have all seen miracles result from new medical discoveries and interventions—people who are given another chance to hold new grandbabies or hug their spouse. But we have also stood at the bedside of patients tethered to a ventilator, going through a long and drawn out death that none of us would want and which causes the patient’s family extraordinary grief. Too often we, the doctors, are to blame, because we weren’t strong enough to advise them honestly. And as medicine has become more complex, we need more and more specialists involved with critical patients, each focused on their own organ system rather than the complete picture. Sometimes families hear conflicting messages but no one physician is taking the time to listen closely, answer questions, and help them come to difficult decisions. It isn’t that doctors don’t care, it’s often that a rushed and fractionated healthcare system inadvertently neglects that hand-holding component. I often worry that we have raced forward in inventing medical marvels, but our ethical framework and guidance hasn’t had time to catch up.