by Milly Taiden
I shrugged. “I’m not in this for titles. But I did like my job.”
This did not sway Duffrey at all, and I could see why people thought he was a hard-ass. “Fill out the application so I can get your irate benefactor off my back. If you decide not to do the program, let me know, and we’ll go the other route. Either way, I need you back in your room like nothing has happened by midafternoon.”
Now it was time for my power play. I had him over a barrel. It was plain as day. “I want a budget for supplies,” I said. “And a new table with an adjustable height for the different age groups.”
He waved his hand at me. “Those are easy. Just don’t go anywhere. We’ll be drawing up a contract that will keep you here until the program stipulations are met.”
Wow. I was going to be stuck here. “How long?”
“Probably a year at least, possibly for the duration of your master’s program.”
“If I leave?”
“You forfeit the money for your program and have to pay it back.” He frowned. “It’s not often you get a free ride for a graduate degree. I’d take it.”
“All right.”
“Let my secretary know your budget needs. Find this table you want and bring her the ordering information.”
“And chairs,” I said hastily. “I need both adult and child chairs.”
“Just tell her.” He walked back to his desk, probably disgusted that I was bringing in petty details. His job was just to make sure the hospital didn’t lose the money for this program.
And to appease some powerful person.
I wanted to know who it was.
***
Chapter Eighteen: Dr. Darion
I had a break in the day around lunch and decided to check on Cynthia. I wanted to make sure her temperature was normal and there were no ill effects of her little expedition yesterday. Her first clinical trial chemotherapy was scheduled for tomorrow. I had hoped her ANC would recover between rounds, but since the clofarabine infusion would destroy her immune system again, it wasn’t relevant at the moment. We had to divide and conquer the various complications she was experiencing. At least for now, we were keeping the cancer at bay.
I checked my phone as I crossed through the outdoor courtyard. Tina had not responded to my text. Perhaps I had been too emotional, too emphatic. I regretted the message. I should have been simpler, plainer. Can we meet for coffee tomorrow? Or Let me know how the meeting went.
But I had been overwrought, affected by her physical proximity. Away from her, I could remain detached, see the situation from the outside.
Maybe.
I still felt an ache, a need for her that I couldn’t quite subdue.
Damn nuisance.
I should stay far far away from the spritely art therapist.
But I already knew I wouldn’t. I’d gotten my hands on her. There was no direction to go except closer.
The chemotherapy hall was quiet on a Friday afternoon. Few patients were scheduled during this time slot, although a smattering of family members dotted the waiting-room chairs. It always surprised me how many didn’t sit directly with their loved ones on the drip. It shamed me that I couldn’t sit with Cynthia, not anymore.
At our first hospital, where they knew she was my sister, we would play games. Her favorite was called “Brother Pix.” She would start a drawing, then pass it to me, and I would add to it, then return it to her. We’d do this until the page was too full to add anything else to the picture. We had dozens of these now, amassed during the hours we waited on her bag to empty.
But here, after I’d purged her records of my name, I was her doctor. Whenever I felt a twinge of regret that I’d chosen this course, I remembered the mistakes they had made at Children’s. Not catching the tumor cells in her kidney until it was too late to save it, misdiagnosing a strep infection that almost killed her. I knew this was what I had to do. I didn’t trust anyone else with her care.
In the late evenings, when I was forced to go home to my empty apartment, I studied her charts, placed her stats in spreadsheets, looking for patterns like a fortune-teller might divine the future from tea leaves. If there was a way to save her from this aggressive form of her disease, I would find it.
Here at the hospital, I kept personal interaction with staff to a minimum. I wanted to do my job with competence, to garner respect and not camaraderie, the sort that might get me found out.
The wireless on my iPad usually dropped in certain spots of the courtyard, so I waited until I was back inside to pull up Cynthia’s current chart. Her temperature an hour ago was normal. I relaxed a little. She would be able to see Tina, if we got that chance.
If Tina messaged me. It had been two hours since our encounter in Surgical Suite B. Her meeting had to be over.
Before I could make it to Cynthia’s room, my hospital phone buzzed with a code. Harriet.
I rushed to her room. The team had already assembled. Abrams was acting as code doctor.
Harriet’s husband stood by the window, frozen with fear.
I glanced at the monitor. Ventricular fibrillation. A nurse was sliding a CPR board beneath her while another affixed the pads to her chest.
The respiratory therapist leaned over, pumping air in. “She’s fully intubated.”
Abrams glanced back and saw me. “You want to handle the code?”
“Yes. Prepare for first shock,” I told the cardiac assistant. To the nurse, “Prep one milligram epinephrine.”
I turned to the nurse holding an iPad. “She might be septic. When was the last bloodwork?”
The nurse glanced down. “This morning. Bacteria present. Antibiotics started three hours ago.”
“Call someone in infectious disease — maybe Dr. Carter — to get on top of this.”
The nurse nodded, clicking her stylus on the pad.
“Clear,” a man said, and the first electrical pulse went through.
We all stared at the monitor. The pattern settled back to a regular heartbeat.
“Three hundred milligrams of amiodarone, then get her to imaging,” I said. “I want to see if there is fluid on her heart.”
“We can bring in a portable chest X-ray,” the nurse said.
“Perfect.”
I kept watch another minute. Harriet’s rhythm held. The room visibly relaxed.
“Continuous amiodarone infusion at one milligram a minute,” I said. “Get that image, then move her to ICU.”
While having a patient code was always an emergency, this particular situation was not unusual during heavy rounds of chemo. I didn’t want to cause more damage by overtreating her.
I turned back to the nurse with the iPad and took it from her. They had to be treating the wrong bacteria, or not aggressively enough. We had to get the infection down, or she would have more organ failure.
The code team began to withdraw.
“Is she okay?” her husband asked.
I stepped over to him and placed a hand on his shoulder. He was shaking. “She’s stable. This was just a little bump. She has an infection. Her body isn’t able to fight it. We started treating it this morning, but it was more aggressive than we expected. We’re going to go check her organs now and administer stronger medications to fight the bacteria.”
He nodded, although I’m not sure how much he was hearing. Families who witness a code go into a type of shock themselves. I’d repeat all of this to him again later.
“Will she be okay?”
“We’ll get that fluid off her, and that will help her heart.” I wasn’t answering the question, really. Second onset of cancer as an adult after pediatric leukemia was not an easy thing to treat. Harriet had a lot of damage to her body already.
Life was always a risk. Everything about it.
“When will she be back?”
“They will move her to ICU for close monitoring.” I glanced up at the waiting aide and squinted at her badge. “Sheila here will show you where the waiting room is for that.”
I squeezed his shoulder. “Hang tight. She’s a tough woman.”
Sheila helped him gather their bags, and I headed out to the hall. I’d go check on Harriet again after imaging. With the amiodarone helping her heart, she would be all right for a while, long enough to treat her.
The code had used up most of my break, but I had about five minutes to eat a sandwich with Cynthia. I turned down the hall toward her room. Angela was by the door, taping another image onto the collage.
“Almost out of room here,” she said.
“She’s prolific, that’s for sure.”
The new picture was the one she had drawn with Tina, Mom onstage singing. I could almost hear her voice, clear and pure, belting out one love-gone-wrong ballad or another. My father hadn’t seen how much she cared for him. He wasn’t wired to recognize it. But I had. I had always known. When he’d accused her of sleeping with other men after her pregnancy became obvious, it had cut her deeply.
I followed Angela inside. Cynthia was sitting on the bed cross-legged. “Dary!” she cried.
“You look good,” I said. She was surrounded with a deck of cards all spread out. “What are you doing?”
“I’m learning a card trick!”
Angela rummaged through a soft-sided cooler. “Her little friend Andrew,” she said.
“Pick a card!” Cynthia said.
I selected one from the center.
“Not that one!” she said.
I laughed. “Which one, then?”
“Mmmm. This one,” she said, pointing to one near the end.
I picked it up.
“Is it the eight of spades?” she asked.
It wasn’t. I showed her the card.
“Well, rats.” She began stacking the deck back together.
“Just a little more practice.”
Angela produced a sandwich and a bottle of water and handed them to me. “Here you go, Dr. Darion,” she said.
“How is she today?” I asked as I unwrapped it.
“I was going to suggest some IV fluids, actually, if you want to take a look. She’s not getting much output.”
Cynthia had tuned us out, her habit lately if we started talking about her illness. She hummed a little tune as she shuffled the cards by pulling a few out and stuffing them back in the stack.
“I’ll check her chart,” I said, trying not to feel any concern, pushing down emotion so I could retain the same cool detachment in assessing Cynthia as I had done in the room with Harriet.
But her one functioning kidney had to be watched carefully. If the cancer cells liked renal tissue, they could attack the other. I would order a PET scan, just to be sure.
“Dary, will you draw me a picture?”
“Of course. What would you like today? A blue unicorn? A pink bear?”
She giggled as she tugged a drawing pad out from under her pillow. I found it amusing that she slept with it. Mom had pulled my sketchbooks out from under my blankets many nights.
“I want you to draw Miss Tina.” She held out the pad and a pencil.
I rewrapped the sandwich and set it down. “But you have so many very good pictures of her.”
“But you do it better. Make her a princess!”
My heart hammered a bit as I accepted the sketch pad. “Does she have a castle?”
“Yes! St. Anthony’s Castle.”
I laughed. “A hospital castle?”
“This is where she will rule!”
“Crown or cone hat?”
“Crown!”
I laid out the lines of the overall image. The flowing gown, the indentation of her waist, the bend of her elbow. “Pigtails?” I asked.
“Of course!” Cyn bounced a little on the bed as I drew in Tina’s head and flared out a few arching lines for her hair.
“Ribbons?”
“Big ones!”
I smiled. Tina was not a big-bow kind of girl, so it was fun to sketch in giant ones on either side of her head.
Now that the rough shape was in place, I began filling in features. The detail of the gown. Her eyes and nose and mouth.
I paused, shifting her expression to one I knew, looking up at me with vulnerability. As I formed the dress to her curves, I could feel them again, warm skin under my fingertips.
Behind her I added just a foggy suggestion of a castle with a big red cross on it. Her hands were empty, so I added a paintbrush in one and a palette in the other.
Beneath it, I wrote, “The brush is mightier than the sword.”
“What does that mean?” Cynthia asked.
“That art is more powerful than fighting,” I said.
“Ooooh,” she breathed. “I think so.”
Angela peered over my shoulder. “I didn’t know you could draw.” She picked up the sandwich and passed it to me again, taking the sketch pad.
Right. I had to eat, too. “I did it as a kid.”
“You should have kept going,” she said, studying the image. “You knocked this out in no time flat. You could be one of those sketch artists in amusement parks.”
I smiled as I chewed. She should tell that to my father. Switch a life’s ambition of changing medical history for drawing caricatures at Disneyland. Sounded good to me.
Cynthia reached for the pad. “Can I color it in?”
“Absolutely,” I said. “Make her face green.”
“Noooo!” Cynthia howled. “She’s not an ogre!”
“But Fiona is a green princess!”
“Noooo! Tina is a human princess!”
“Did I hear my name?”
We all looked up. I’m not sure whose heart jumped more when we saw Tina’s blond head pop around the edge of the door, Cynthia’s or mine.
***
Chapter Nineteen: Tina
That little girl sure was happy to see me.
Cynthia cried, “It’s Tina! It’s Tina!” over and over as I walked over to the sink to disinfect my hands.
By the time I turned around, Cynthia had come off the bed and crashed into my leg. “Where did you go?”
I kneeled down. “I had to go buy more art paper!” I bonked her pert little nose. “Somebody I know was using it all up!”
“Come look what Dary did!” she said. Then her eyes got big. “Dr. Darion.” Suddenly she hesitated. “Never mind.”
I hadn’t missed Darion sitting on the edge of Cynthia’s bed, eating a sandwich. This was not standard practice anywhere. Clearly he was a family friend. This would explain his closeness to her.
The aunt sat in the corner, watching us. I waved at her.
“What did Dr. Darion do?” I asked.
“Nothing,” Cynthia said. She sat back on her bed.
That was odd. I turned back to her quizzically. What was going on?
Darion spoke up. “I was just checking on her. She thought it was funny her doctor was eating lunch.” He shoved his sandwich in the pocket of his lab coat.
“You don’t have to stop,” I said. “And whatever your relationship is with the family, it’s no big thing to me.” He was covering up something, and this upset me. He can get all up in my shirt in a surgical suite, but he can’t tell me he has a personal relationship with a patient? He could have said it on the first day, when he asked me to watch out for her!
Except he didn’t trust me.
Or maybe it was something more.
I could see panic in Cynthia’s eyes. Were they asking her to lie about it? This little girl? Indignation burned in me. The doctor was going to get a piece of my mind about this later.
But I had come here for a reason. “Cynthia, classes will be back on this afternoon, but just a little off schedule since I missed this morning. Are you going to come?”
“Yes!” she said, her face brightening again.
I passed a half-sheet of paper to her. “Make sure your nurse knows when to bring you. This is the schedule for today and tomorr
ow.”
Cynthia pressed the paper to her chest like it was a treasure. “Okay.”
I noticed Angela holding an oversized sketch pad. “Have you been drawing?” I asked Cynthia.
Her eyes got big again. She held up a deck of cards instead. “I’ve been practicing card tricks.”
Weird. Another redirect. I glanced over at Darion, who was studying his iPad as though he needed to memorize something. What was going on here?
“Can I see the picture you made?” I asked.
Nobody answered.
Now the whole room was tense. I decided to back off.
“It’s okay,” I said. I’d take this up with Darion later. Ask him straight out who this little girl was to him. His niece? The daughter of a colleague?
I hadn’t responded to his text. The message had hit me in the gut.
Let me shelter you.
So emotional. So unlike him. Or maybe it was like him, and I was the only one who saw it. I didn’t know what to make of it. Instead, I had sat in my room, rearranging the schedule to make sure I saw all the patients today so that whoever had paid for the program would know I was back.
But was it Darion? Could he be the benefactor? Or his family?
I glanced down at his shoes again, expensive and perfectly polished. He had money. Came from money.
Hell, maybe I wouldn’t confront him after all. Maybe I should just shut the hell up. He could be my meal ticket. An anonymous one.
What a mess.
“I’ll see you in class,” I told Cynthia.
“You might not see her tomorrow,” Darion said, his voice back in professional mode. “She has a three-hour chemotherapy drip.”
I glanced back at Cynthia. She seemed so full of energy today. That would go away after the treatment. “I’ll come by your room later.” I glanced at Darion. “If that’s okay.”
Everyone looked at him to see what he would say. “I think that will be fine,” he said. “She will be tired but probably not sick for a few days.”
“I don’t usually start throwing up until the next day,” Cynthia said matter-of-factly.
I couldn’t even imagine being where she was. “Then I’ll come by. See you in class later.”
