The Anatomy of Perception

by AJ Rose

  Sabrina apparently took my silence as fear of commitment. “You boys are all the same.”

  I scoffed. “Why, because I’ve concentrated on getting my career going first? Are you married?”

  “No,” she snorted. “But there’s no Mr. Right in my apartment either.”

  “If there were, would you be married already?”

  She bit her lip and tilted her head as if acquiescing. “Probably not. I’d want to be further into the program than this.”

  “See? I wasn’t sure I’d be staying in New York, and if I had to move, I didn’t know if… she would have moved with me.” The betrayal of Craig’s identity stung far more than I thought it would. But this was my first day on the job. Sabrina had already established herself as nice, but not necessarily the you-have-my-back, I’ll-have-yours type. I didn’t have her loyalty, and I wasn’t about to risk my position. My gut burned again, nausea roiling as it had when I’d first arrived, but my answer seemed to make Ballard back off.

  “You have a point. Most relationships don’t survive long distance. So, is she still in school or something? Is that why she might not have moved with you?”

  “No, animator, remember?”

  “So you don’t think she would have?”

  “Why don’t we scrutinize your life instead of mine?”

  “Because we’ve already established my lack of a relationship to scrutinize. I live alone. I have no pets. And I’m kind of a slob, so no roommate, Mom and Dad upstate, no siblings. See? You’re much more interesting.”

  I heaved a breath. “What do you think could be causing Mia to cough up blood?”

  “Seriously?” she asked. “That’s your way of changing the subject?”

  I shrugged. “It’s the only thing you seem more interested in than my personal life.”

  She grinned and dipped her chin in agreement. “Several things. Cancer, blood clot in her lungs, respiratory infection, tuberculosis. Take your pick. We don’t know enough yet.”

  We went back to waiting, though I did sit sideways on the couch, propping my leg up, bent at the knee, in order to keep her from getting too close while I texted Craig back.

  Me: If I thought I could get away with it, I’d sneak you into the hospital tonight so you wouldn’t have to sleep alone. I knew I would never go so far; the risk of getting caught was too great. But the reassurance still made me feel better in the face of my denying him just moments before.

  Craig: Maybe we can try that when you get the lay of the land. Wouldn’t want you to risk your position.

  I knew he’d understand. He always did.

  Several hours and tests later, Dr. Kingsley sighed and wheeled a stool over to Mia’s bedside, looking her in the eye with gentle authority. Sabrina and I hung back against the wall, observing as invisibly as we could. Carrie and Dr. Getty were off waiting for test results for their own patient.

  “Miss Nguyen, your blood test showed elevated creatinine levels, and there’s protein in your urine. We need to admit you and run more tests. Have you been experiencing any kind of excessive fatigue?”

  Mia shrugged and stared at the ceiling, a tear leaking from the corner of her right eye. Jake took her hand and squeezed. “I haven’t been at my best, but I figured it was just from starting a new job. You know, learning something new has been kind of overwhelming. I’m tired but still functioning.”

  “What about joint pain or any skin rashes you can’t seem to get cleared up?”

  “No,” Mia answered.

  “Mia,” Jake admonished. She blinked at him, confused. He turned to us. “She’s been complaining that her hands are dry, and no amount of lotion seems to clear up this painful skin she’s had around her fingernails. She also said a few days ago she might be experiencing the early signs of rheumatoid arthritis. It runs in her family. She told me typing sometimes hurts her fingers.”

  While Mia scowled at her boyfriend and protested that those things were just everyday discomforts, Kingsley beckoned us closer and took Mia’s available hand. Her nails looked fine, but the skin around them and above the cuticle was reddened and irritated.

  “How long have you suspected you might have arthritis?” Dr. Kingsley asked, donning a pair of gloves. “Do you mind if I take a skin scraping of this irritated area? It shouldn’t hurt.”

  Mia gave her permission, and as Dr. Kingsley ran the edge of a tongue depressor over and around her nail bed to dislodge a couple skin flakes into a petri dish, Mia answered the other question. “Since it runs in my family, I’ve always figured I was destined to take the arthritis train. In college, it got worse as I wrote more papers or worked on projects. I’m a graphic designer, and if I spent long hours on my computer for days or weeks at a time, I’d have these flare-ups where my knuckles would feel warm and they would hurt, just like my mother’s and grandmother’s hands. It comes and goes.”

  “So, for the last couple years, at least?” Dr. Kingsley clarified.

  “Yes,” Mia admitted, apparently resigned to being open from this point on, since her boyfriend would rat her out anyway.

  “Have you been tested for carpal tunnel?”

  Mia nodded. “Yeah, don’t have it. That’s why I assumed arthritis. That and the heat in my knuckles.”

  Dr. Kingsley capped the petri dish and handed it to Sabrina, who affixed the label that had printed with the patient ID number and directed the specific test needed. Kingsley stood and asked Mia to raise her arm above her head so she could do a more thorough exam. As she was pressing on the patient’s abdomen, Jake spoke up.

  “So, why does she have to be admitted?”

  “Because we can’t pinpoint the reason there’s blood in her airway. We’ve ruled out strep throat and the more innocuous respiratory issues, lung infection, and a few other things. There’s a chance we’ll have to do an endoscopy, which involves inserting a camera into her stomach. Have you been having any aches and pains anywhere else, Mia?”

  The kindness in Kingsley’s voice didn’t seem to lessen the blow to the couple, who were looking at each other in terror. Mia gripped her boyfriend’s hands hard. If she felt pain in her fingers at the moment, she was apparently able to ignore it.

  “Um, my lower back has been sore, but I just figured it was the new office chair. They’ve ordered me a new one but it hasn’t arrived yet.”

  “Have you had swelling in your feet or hands? An increase in frequency of urination or any blood in your urine?”

  “Sometimes my hands swell up. And I seem to go to the bathroom once overnight when I never did before.”

  “What does all this mean?” Jake asked, panic rising.

  While Dr. Kingsley indicated Mia should roll to her side so she could check her back, I stepped forward, leaving the resident to concentrate on her exam.

  “We just don’t know enough yet, but getting you admitted means if your condition worsens, we’re right here to intervene,” I reassured them as best I could despite having no real answers. I had no idea if I was doing it right, but I told her what I knew I would want to be told in her shoes. When we had gotten the first test results back, Sabrina had suggested we look up all potential causes, which had led me to suggest to Dr. Kingsley that we expand the blood testing. So, while we’d waited for labs, I’d spent a lot of time reading and eliminating possible outcomes.

  Mia winced as Dr. Kingsley’s fingers palpated above her right kidney. The doctor pulled down her gown and bid her to lie on her back once more.

  “Mia, I’m going to order an ultrasound of your kidneys and a CT scan of your chest and stomach. I’ll have Dr. Perry get your admission papers started, and once we get you into a room, we’ll get your situation under control.” Dr. Kingsley wrote something in Mia’s chart and then passed it to me. “Get her a room and do the CT. Call me after and we’ll do the ultrasound while we wait for the scan results.” Dr. Kingsley turned back to Mia and her boyfriend. “If you have any questions, give me a holler.” Then she left the room.

  “Wait
,” Jake said to our backs. Sabrina and I both turned. “What do you think she could have?”

  “We aren’t sure yet,” Sabrina answered before I could. “It depends on how the next tests go. If the ultrasound and CT come back reasonably clear, we’ll keep doing more specific tests until we find the source of the bleeding.”

  Sabrina and I exited the bay, and I couldn’t keep from grinning.

  “Awful cheerful for having just told a girl we don’t know her problem and have to keep poking her,” Sabrina quipped.

  “I can’t help it,” I said, leaning on the workstation counter in the middle of the ER to hand the chart off to the nurse. “It’s our first case and we get to admit her. Maybe that makes me a jerk, but I like the challenge. I’m thinking Pulmonary Renal Syndrome.”

  “Well, you’re still nicer than I am. I’m thinking if she didn’t say anything about her fingers for a couple years now, she probably didn’t mention her back pain to anyone either. If her kidneys are damaged, she could need a transplant. Which means surgery.”

  “You’re hoping she’s bad enough to need surgery?”

  “Well, not really. If she does, finding a donor kidney wouldn’t be a swift process, but still. Chances are good she’d come back to the hospital where she was diagnosed, so we might get to scrub in if everything works out.” The plain hope on Sabrina’s face made me laugh, albeit quietly.

  “You’re kind of twisted.”

  “Shhh, don’t tell anyone,” she whispered as the nurse returned with admission papers and Mia’s chart. When she walked past me with it and winked, my stomach bottomed out.

  She’s not flirting with me, is she? I’d been so focused on people not finding out I was gay it had never occurred to me I could end up with an even bigger problem—someone developing an interest in me. Or worse, a crush. It seemed I’d spent so much time worrying about the medicine, I’d forgotten that almost every job also came with politics. I sucked at politics.

  Two mornings later, when the sun was but a pink promise in the eastern sky, I unlocked the door at home and crept in, trying to be quiet so as not to wake Craig. It was a moot point anyway, because when I pulled off my clothes and folded them before slipping between the sheets as inconspicuously as I could, Craig rolled over sleepily, peered at me through one barely open eyelid, and smiled.

  “Well hello, stranger,” he mumbled, coming into my arms and resting his head on my shoulder, his face pushed into my neck. “You smell clean.”

  “I showered at work. Didn’t want to smell like a doctor’s office when I came home.”

  “Mmmm, how was the first shift?”

  “Craig, we can talk later. Go back to sleep.”

  He squeezed my torso and hiked his leg over my thigh, his soft cock pressed against my hip. “I will, I promise. But I have hours to sleep, so we can talk for a few minutes.”

  “Hours?”

  He smiled and pressed his lips to the pulse in my neck. “I took the morning off. C’mon, this is a big deal, your first shift as a doctor. I want to know how it went.”

  “Well, I have a lot of respect for my resident, Dr. Kingsley. She’s going to be tough but fair, I think. One of my med school classmates is in my intern group. She was the valedictorian.”

  He smiled, still listening but with his eyes closed. “Carla, right?”

  “Carrie.”

  “Yes. Go on. How many in your group?”

  “Four.”

  “You like them?”

  “Yeah, I think so. The other guy is a little too serious for my blood—no sense of humor. But Sabrina, the other girl, is pretty cool.”

  “Good,” he murmured. “I’m glad you like everybody. First step in having a tolerable job. How’d the medical stuff go?”

  “I was the one to diagnose our very first patient. Dr. Kingsley let me do a needle biopsy yesterday when we found out the kidneys were damaged.”

  “Ouch. Painful?”

  “We used a local anesthetic, so not really, but there was enough damage the patient needed to go on the transplant list. Both kidneys are pretty bad. Patient let it go too long before coming in, which sucks because she’s really young.”

  “What’s she have?”

  “Lupus.”

  “That does suck. But look at you, making the diagnosis. Could she have died?”

  “Unlikely. Her symptoms would have worsened to the point where she’d have gotten treatment before it was that dire, but it wouldn’t have been pleasant.”

  “Sabrina. That’s an uncommon name. Tell me about her.”

  I hesitated. By the end of day two, it was clear she’d been flirting with me, and the more I ignored her advances, the bolder she became. I didn’t want Craig to have a reason to mistrust me while I was at work, considering he’d heard all the stories about musical pillows while I was in med school. He’d often said he couldn’t wait until I graduated to get myself away from the horndogs who counted collecting sex partners as “research.”

  “She’s kinda fierce, actually, but really nice. I think you’d like her. In fact, you might like to paint her. She’s very pretty.”

  Craig peeled an eye open to look at me. “You noticed a girl is pretty?”

  “In a totally platonic way, yes. I observe people, and you’ve sort of trained me to notice them in a different way than I used to. So yeah, she’s stunning, and I think she’d make a great subject for you.”

  He closed his eye again as if it were no big deal, but I felt a change in his embrace. He was no longer as relaxed as he was before I’d opened my stupid mouth.

  “You’ll have to take a picture of her for me next time you’re at work. Let me see if I’d be interested.”

  “In just painting her,” I teased, trying to lighten him up.

  “I’ve never slept with a subject.”

  I snorted. “That’s a blatant lie.”

  “I haven’t!” he protested. The corners of his mouth turned up, and he hid it by nuzzling my neck, his hands wandering as though they were mischievously contradicting him.

  “You’re sleeping with one right now. Well, sorta sleeping. Trying to go back to sleep in the arms of one.” I trailed my fingertips up his spine, making him squirm. His dick became a more insistent presence at my hip.

  “Or trying to break my streak of not sleeping with my subjects.”

  “Pretty sure I’ve fucked your gorgeous ass before,” I mumbled, nibbling his earlobe. “And I’m pretty sure I want to do it again. Over and over.”

  Now I was getting downright poked, and poking at the sheet myself.

  “Pretty sure? You don’t sound very enthusiastic,” he taunted, leveraging himself over me so he was on top, our budding erections trapped between us and coming to full mast on contact. “Maybe you’d rather Sabrina be the one on top of you.”

  “Pretty sure she has the wrong parts.”

  “Does she know that?”

  Instead of answering, I mashed my mouth onto his, ignoring his morning breath, which had never been that bothersome to me. I didn’t want to admit to him Sabrina had flirted shamelessly. I didn’t want to tell him that yeah, I’d been uncomfortable, but also flattered. I could barely admit to myself how nice it had felt for someone to find me smart and hot. Not that Craig didn’t. But he didn’t understand the books and diagrams and biology. My career would always be a bit of a barrier between us, because he just couldn’t follow half of what I said. I supposed we were like any couple where one held a more technical job than the other. And one shift did not make me an expert on how hard this job would be, but HIPAA laws would prevent me from giving Craig all the details if I needed someone to talk to. Sabrina would pose fewer such challenges.

  I didn’t want to fuck her, but I didn’t want to shun her entirely, either. She was funny and smart, and for some reason she found me interesting. So few ever had, and I’d been brought up to believe I wasn’t just uninteresting, but also downright useless, to put it mildly. Sabrina’s interest made me preen, however internall
y. So was it cheating to flirt? I didn’t think so. It was harmless. Because, duh, I liked dick.

  As I clearly demonstrated at present, while Craig slid our flesh together and I let my hands explore his gorgeous, lithe body. I should have been too tired for this, having only snagged a few hours’ sleep here and there in one of the on-call rooms, but he set me on fire, and while he was this close, I was helpless to keep my hands to myself. There was no reason to when no one but Craig would ever make me feel this good. Sabrina who?

  Present Day

  I didn’t even try to pretend our Thursday night plans weren’t a date. Thinking of the evening as such was the one thing I’d glommed on to after Craig insisted our destination stay a surprise. If I hadn’t wanted to be with him so much, in any capacity, I’d have called and canceled. As it was, I’d nearly canceled three times anyway. Allowing myself to hope, to believe in the promise of this outing, was what prompted me to shower and dress nicely in black slacks, a lavender button-down shirt, and a slate gray tie that Holly said brought out my eyes. It was the goal, the reward to which I’d clung just to keep one foot in front of the other on the quick train hop to the loft building. A date with Craig. This was worth it. He was worth it.

  Craig was waiting in the lobby, fidgeting in what, for him, was nearly formal dress: pressed jeans without holes, a hunter-green button-down, boots instead of tennis shoes, and a black sport coat. He kept pulling at the sleeves, and his shirt collar was caught in the set of the jacket.

  “You’re a mess,” I greeted fondly, twirling a finger so he’d turn around. He obeyed. As I fixed the way his clothes lay, my fingers brushed his neck, which was warm and a little clammy. I marveled at how just seeing him was enough to soothe me, though I couldn’t help but wonder what had him so nervous.

  “I’m always a mess before these things,” he deadpanned, shooting his cuffs again.