Necessary Medicine

by M. K. York

  Neil had to blink, suddenly, to keep the tears out of his eyes. “Oh my God, Bobby, I’m so happy for you. Of course I will. Just—you’re going to have to give me a lot of lead time on this so I can get the day off.”

  “Yeah. You better, man. It wouldn’t be half as classy without you there quoting something deep.”

  “Just for that I’m going to sing the SpongeBob SquarePants theme song.”

  “You better not, asshole!”

  * * *

  The first email went out a couple of weeks later, just long enough that Neil had managed to wedge the knowledge that he had signed up for the work group to the bottom of his mind, submerging it under his other day-to-day responsibilities.

  He was on a break, checking his phone outside in a stray patch of sunlight, when it came in.

  Hi, everyone! Thank you for joining the Cardiology diversity work group! We’re planning our first meeting. Please use the linked poll to indicate your availability.

  Sincerely, Elias

  Under that, of course, was his signature block, full of qualifications. FACC, FAHA. It was the exact same thing all the doctors did. It was somehow still cute.

  Neil had to pull up two different calendars to check against the poll, but by the time he went back in, he’d filled it out. It was going to happen in the first week of his third year. He caught himself smiling.

  That first meeting ended up being at 6:00 p.m., in a conference room that had clearly been designed and built sometime between 1979 and the fall of the USSR. The fluorescent lights made everyone look ghostly, and the carpet was a study in pastel geometric shapes, but Dr. Newcombe had had the good sense to bring a disposable carafe of coffee and put a little stack of paper cups next to it. When Neil walked in, everyone already there was clustered around it, chatting animatedly.

  He walked up and slid a paper cup off the stack as he waited his turn; there was a light touch on his elbow, and he turned toward it.

  “Glad you could make it.” Eli smiled warmly.

  Neil smiled back at him. “Wouldn’t miss it.”

  “I think we’ve got really great people on board.”

  “You would say that.” Dr. Erickson turned away from the carafe. Neil stepped up to take his turn, listening to the amiable hubbub.

  “I mean it, though! I wasn’t sure we’d get any volunteers, but this is a very exciting group!”

  “How’d you get roped into this?” Dr. Erickson asked Neil as he turned back to them, cup now full of still-hot coffee.

  “It sounded like a good idea?” offered Neil.

  Eli laughed. “I think he would have gone for the Nephrology group, but I was closer.”

  “Can’t trust a nephrologist.” Dr. Erickson shook his head. “They think kidneys matter.”

  “Obviously wrong,” said Eli, straight-faced.

  “Well, obviously!” Dr. Erickson blew on his coffee.

  “I’m going to check in with folks and then we’ll get started,” Eli said to them both, and wandered over to talk to the cluster of doctors who’d formed at the far end of the long conference table.

  “Guess I’d better find a seat,” said Neil. Dr. Erickson, whose hands were starting to get knotty with arthritis and who wasn’t up for standing for too long, assented with a grunt. Neil found a spot near the head of the table and didn’t bother telling himself he wasn’t hoping Eli would sit there.

  “So how’s your daughter?” he asked Dr. Erickson, who’d followed and sat next to him.

  “Oh, she’s good. Getting married, you know, so she’s going a little nuts with all the planning. I keep telling her she won’t remember in the long run whether she got pink flowers or white, but she just says I don’t understand because I have no poetry in my soul.”

  “Do you?”

  “Hah! Just the right amount. The human body is enough poetry for anyone.”

  Eli sat down then—he did pick the head of the table—as the rest of the doctors settled in.

  “Hi, everybody.” He smiled broadly at the table. “I suppose you’re wondering why I’ve called you all here today.”

  A groan rippled around the table. Dr. Lambert said, “Elias, we are never wondering that, you can stop saying it at every meeting.”

  “Thank you too, Jerry. All right. So, we’ve got surgeons here and we’ve got cardiologists. Lots of bright minds. Between us, we should be able to figure out a way to liven up the department, don’t you think?”

  “I sure as hell hope so,” said Dr. Sisk.

  “That’s one vote of confidence from Bob. So, I thought we could get started with something pretty basic: setting priorities.”

  “We’re not brainstorming, are we?” asked Dr. Liefers. “I hate brainstorming.”

  “No, Jim, we’re not brainstorming. I don’t trust your brains to storm sufficiently.”

  “Good.”

  “I thought we’d start by using the metrics guidelines Surg developed. They’ve got concrete actionables—Pearn started in on them before this initiative even really got going, which is why Surg is ahead of Cardio on this.”

  “Like what?” asked Dr. Chaudry. That set off an hour of debate, which got heated at times, about which goals to prioritize and how to achieve them. In the end, the work group took a vote on which projects to start with. Recruiting more residents and teaching faculty rose to the top as things that could be tackled now with some visible results.

  “Great,” said Eli. “We should talk to residents about what the recruiting strengths were for them and then we can try and build on that for encouraging minority residents. Does anyone want to volunteer for that?”

  “I’m not doing it,” said Dr. Liefers. “They don’t trust old farts like me.”

  “You’ve got a point, Jim. Neil? You’re a resident, they might be more likely to open up to you.”

  “Sure.”

  “Great. So let’s meet back in—what, two weeks? Does that work for people?”

  “Send out another poll.” Dr. Chaudry frowned. “God knows what my schedule looks like.”

  “Okay, I’ll do that. Neil, Bob, send me what you find out.”

  Neil nodded.

  The doctors got up, shuffling chairs back, still talking—some going over patients they were seeing, some talking about the initiative, some about the weather. Eli shook the carafe. “If anyone wants a cup for the road, you’d better get it now.” That produced another little rush of traffic for the remaining coffee.

  Neil stayed behind, gathering forgotten cups and napkins, giving the table a brief wipe-down. When he was dropping things into the trash, Eli said, “Thank you for helping out with that.”

  “Oh, no problem.” He tried to sound light and nonchalant, instead of like he was strangling.

  Eli—it seemed like Eli was always smiling, or just on the edge of breaking into a smile, warm and expansive.

  “Actually, can you give me a hand with getting this whiteboard back up to my office?”

  “Sure. You brought your own whiteboard all the way down here?”

  “No, I’m running away with it.” Eli chuckled at his own joke. “No, but really, I only thought of it this afternoon, and I knew Facilities would give me a hard time about checking one out on short notice.”

  “That’s fair.” Neil took one end of the board—it had wheels, at least, thank God, so it rolled smoothly out into the hall and down to the elevators. “Watch the—okay.”

  “This is a funny question,” said Eli, squeezed into the other corner of the elevator, “but I think I’ve seen you before. I mean, before your residency here.”

  “You have, actually. You gave a guest lecture at my med school.”

  “Oh! Oh, that explains it. Was I any good?”

  Neil smiled. “Highlight of the class.”r />
  “I imagine you’d feel obliged to say that no matter what.”

  “Obliged? Ask Dr. Wendling whether I feel obliged to be polite to him.”

  “Oh, Pete’s got it coming! He’s got a mouth like a sailor. Have you ever heard him get going at a basketball game?”

  “Can’t say that I have, no.”

  “He can’t expect people to take him too seriously when he’s busy coming up with profanity.”

  “It does seem like a hobby of his.”

  The elevator doors dinged open, and they wrestled the whiteboard out over the little hump of the tracks and then down to the third door on the opposite side of the hall.

  “Well, this is me,” said Eli. “Thanks again for helping out. And volunteering—well, I guess I volunteered you.”

  “My pleasure. I’ll see you at the next meeting.”

  “Good night!”

  “Good night.” Neil started back down the hall, hands jammed into the pockets of his white coat, smiling in spite of himself.

  Chapter Five

  But it wasn’t the next meeting when he saw Eli again; it was the next M&M conference. He’d almost forgotten until he walked in and Eli was sitting against the back wall. If he could have thought of anything to talk about, he would have gone to sit by him, but instead he headed for his usual spot.

  Eli glanced up at him—and smiled, and waved. He smiled and waved back.

  He sat down heavily. Claudia was gone, off to her real adult job, but Kristi and a friend of hers were there.

  “Hey!” Kristi tapped his arm. “How are you doing? How’d that case go?”

  “Oh, fine. It took longer than we were expecting, but once we got the adhesions dealt with, the rest was pretty smooth.”

  He had two days off after that, in a row, with nothing scheduled. He woke up to the slice of golden light along the ceiling and thought, I’m going surfing.

  Out on the waves, with the crashing surf in his ears and the thick reek of salt air in his nose, he knelt down on the board and found himself laughing out loud.

  He stayed out until it started getting dark, until he could just barely make out the phosphorescent edge of the waves breaking. He got home exhausted, crusted in salt and sand. He peeled out of his trunks and climbed into the shower; he leaned up against the wall, long-ignored muscles screaming in protest.

  He texted Bobby after he crawled into bed, so tired his eyes kept dropping shut even though he was trying to watch television. How r you?

  fml Bobby said.

  that bad huh

  not so bad but i don’t remember sleep

  I feel you. I went surfing today. Neil rubbed at his eyes with the back of one knuckle. it’s been like a year

  ouch

  yeah I’m going to feel it tomorrow

  wedding planning is a bitch and a half

  well at least you know my toast will rock

  got a page

  ok ltr

  He fell asleep without remembering to turn the TV off. It was quiet, but he still woke up around three—everything dark out, just the screen flickering. He stared at the ceiling for a while.

  He felt peaceful, calm. His muscles would ache as the day wore on. Monday would be miserable. But he had time, right then, to stare at the ceiling, and to wonder what exactly he thought he was doing.

  Just doing some good. That was all. The work group was a good thing, the initiative was a good thing. If he was mostly doing it to be closer to Eli, if he was doing it so he could watch Eli for hours without it seeming strange, well, what did it matter? It was his own business.

  If Eli had an ex-wife—he was guessing, but the missing ring, the way he’d talked about her, seemed to suggest it—that was fine. You could have a crush on someone. It didn’t need to mean anything. Besides, Eli was a good doctor. Neil could probably learn something about cardiology by hanging around him, or even something about leadership. Useful things. It wasn’t just that his eyes were the same pure, electric blue as the sky over the water, or that when he smiled they lit up, or how kind he was with everyone from patients to the medical assistants. How he’d said, Always consider the encounter you’re about to have from the patient’s perspective: Will they be frightened? Excited? And don’t be afraid to ask them how they feel, either; you aren’t psychic, they won’t expect you to be. But they do expect to be treated with respect, and they should.

  It wasn’t just getting to call him Eli when almost everyone called him Elias. It was nothing, he knew. But still. Eli, he thought, his tongue shaping the name in his mouth in silence. Eli. Eli.

  * * *

  He managed to get some face time with a handful of Cardio residents.

  “I don’t know what I like best,” said one of them, thoughtfully, knocking back her coffee. “We get a fair amount of autonomy. Respect. I’ve never had an attending lay into me in front of anybody, even a med student.”

  Another one had a different perspective. “This is anonymous, right? Really anonymous? Okay. Our faculty are fucking hot. You can’t put that in the recruitment materials, but. You know. Introduce the candidates around. I think I met, like, two of the attendings before I started here, and one of them was Bob Sisk. Not exactly truth in advertising.”

  “What if I put it as, uh, ‘personalities of attendings’?”

  “Well, that’s not the truth, but it’s close enough, I guess.”

  * * *

  He emailed Eli. One thing that’s come up repeatedly is the positive culture in Cardiology, which I think is good—that’s definitely something to advertise and build on.

  He pretended he wasn’t waiting anxiously for a reply, but he did get one, almost immediately: Dear Neil, Thanks! That’s great! Be ready to present on it for the meeting. Sincerely, Eli

  At the next work-group meeting, they had the same conference room, the same coffee, and most of the same people. Neil nervously presented on his task, and the cardiologists mumbled and nodded approvingly at each other.

  “Damn right we’re good company,” said Dr. Sisk.

  “Praise in public, punish in private.” Dr. Liefers had been military before he went into medicine. “You save their dignity, they never forget the favor.”

  “And whose dignity doesn’t need saving once in a while?” Eli smiled out at them. “Great job, Neil, thank you. Bob, do you want to tell us what you found out about teaching faculty?”

  Dr. Sisk nodded gravely. “Pardon me if I don’t stand up. The only big complaint people have is the money. It’s just not competitive with what other institutions offer. They come here anyway because of our reputation, but we can do better, and if we want to attract people who are getting juicier offers elsewhere, we need to cough up the bucks.”

  “That’s a really good point. I don’t know where we can come up with more money, but if it’s critical to recruitment and retention, we can make a stronger argument with the school.”

  “And it is critical.” Dr. Sisk leaned forward, bracing his elbows on the table. “You look at these kids, they’re starting out with a hell of a lot more debt than we ever had, even accounting for inflation. If we want to get them and keep them, we need to be able to offer them more than the places that promise bonuses for underserved areas and that kind of shit.”

  “Do you know which institutions are doing that?”

  “Cascades up north. Couple in the area. I could put together a list.”

  “If you could do that, it would really help me take the case to the administration. I think it’s important to be able to match at least the reasonable offers they’re getting from other schools.”

  “Damn right.” Dr. Sisk subsided back into his chair.

  * * *

  The work-group meetings continued. Neil would clean up after each one. Eli would pause
and they’d talk for a minute, and if Eli needed help with anything, Neil would help.

  Once, in September, they were talking about their plans for the week. Eli said, offhand, “Trish—that’s my ex-wife—she’s coming by the hospital to give a talk later this week. You might want to see it, it’s on a drug trial for a new NSAID that’s tentatively showing fewer cardiovascular complications than the other COX-2 inhibitors.”

  “That sounds interesting,” said Neil. “Isn’t that awkward for you, though?”

  Eli smiled, shaking his head, but the smile didn’t reach his eyes; he looked sad. “We split on good terms. And she’s a fine researcher. Better than me, probably. I’ve got a grant I’m writing right now that’s driving me crazy.”

  “Well, it’s good that you still get along.”

  “Yes.” Eli didn’t seem to notice he’d been erasing the same spot on his whiteboard for a good forty seconds.

  “Do you need a hand with that?” Neil nodded at the whiteboard.

  “Hmm? Oh, yes. If you’ve got time.”

  Neil smiled at him. “Sure.”

  He changed the subject to the weather—a couple of cool days in the midst of a streak of unbearable heat.

  * * *

  He did end up going to Tricia Newcombe’s talk. It wasn’t just for the talk. But the talk did look interesting, did look good.

  She had blond hair going silver, and a wide, friendly smile that reminded him of Eli’s. She’d kept a trim figure and her suit was Chanel. Thick, dark frames on her glasses made her face look smaller, but she pulled it off.

  The talk was in the auditorium, and there was a wide smattering of people in the audience—doctors there for the free food, students attending to impress, residents to get some time off. The Pharmacy students were recognizable by how they looked haunted but put together.

  “All right, everyone!” she called as the crowd settled down. “Let’s get this started. I’m Dr. Tricia Newcombe, working with a group of academic physicians and pharmacy researchers. Full disclosure, we are funded by a pharmaceutical startup, so we have a definite financial interest in convincing you to try our drug.” There was a little ripple of laughter through the room.