She did, and I saw that she had two purple stripes on her skin. "Have you always had these?" I said. They looked like stretch marks and could've been--lots of kids got them during sudden growth spurts or weight gain.
"I'm not sure," she said. There was a pause. "I try not to look in the mirror too much."
My heart twisted. I knew that feeling. She grimaced again.
"Is the pain right here?" I asked, pointing to her left side. She nodded. "I'm going to press on your stomach, sweetheart. If you have to pass gas, go for it. You'll feel a lot better."
"I can't fart in front of you!" she said.
"Honey, people have vomited on me, pooped on me, peed on me, bled on me." I pushed gently with the palm of my hand. "Once, I was doing a rectal exam, and the second I took my finger out, the patient pretty much exploded with diarrhea."
She laughed...and passed gas. A lot of gas.
"Oh, man, I'm so sorry," she said, her sweet round face turning scarlet.
"But you feel better," I said.
"I do." She sounded amazed.
I palpated her abdomen again, but she seemed cured. "What did you have to eat today?"
"I didn't want to tell my dad," she admitted, "because he hates when Mom and I do this, but we ate Oreos and drank a lot of soda. We pig out and watch movies. It's... Well, it's fun. Kind of. I do try to eat right most of the time." She looked chagrined. "It's just that Mom and my little brother are skinny, so they don't think about that."
I ran my hand along her spine. It curved at the base of the neck. Dowager's hump, as it was unkindly called. "Are your periods regular, Audrey?"
"Not really. Every few months."
"How old are you again?"
"Fifteen."
I looked at her chart on the laptop. She was five-one and weighed 195 pounds. "How about backaches?" I asked. "Do you get those a lot?"
"Yeah. How did you know?"
"Another way-too-personal question--are you a little hairier than you'd expect?"
She covered her mouth with her hand. "Yes. It's so embarrassing."
She had Cushing's disease. I was almost sure of it.
"Okay, here's the deal," I said, sitting on the bed with her. "Your stomach pain was probably just gas from the Oreos and soda, which is a pretty horrible combination for your gut. But I think you might have something else going on. Something treatable that would explain some of the other things we've talked about. Is it okay to get your dad?"
She nodded, and I went to the waiting room, where Sullivan was pacing and Teeny was whispering into her phone.
"She's feeling much better," I said. Sully sagged with relief, then ran his hand through his hair. "Come on in, Sullivan." Teeny stood up.
"Stay here, Ma," he said, not looking at her.
"I'm coming in."
"Stay!" he barked. I liked him even more, knowing he took no shit from that harridan.
In Audrey's exam room, I gestured for Sullivan to sit down. Timmy came in, too. I made sure Sully could see me and spoke carefully so he'd catch every word.
"The pain seems to have been just gas, which can cause really bad abdominal cramps. That's resolved now, so she can go home tonight. But Audrey also has some markers for Cushing's disease, and I'd like her to get tested."
I explained what the disease was--a possible tumor on her pituitary gland, which then produced too much cortisol, resulting in just about everything Audrey had going on. The obesity in her stomach, her much thinner arms and legs, the extra hair, the full, round face, the curve in her spine.
Sullivan didn't look away from my face, the furrows between his eyes deepening. "What causes this?" he asked. "Did we do something wrong?"
"No, not at all," I said. "If she does have it, surgery will take care of the tumor."
"Surgery?" Sully asked.
"It's not bad, though it sounds kind of gross. They'll probably go in through your nose, Audrey. It's a very treatable problem."
Audrey was staring at me with a mixture of fear and relief. "So there's a reason I'm like this?" she said.
"Like what?" Sullivan asked.
She started to cry. "I'm fat and ugly and short, Dad. I'm tired all the time and have backaches like I'm an old lady! I have hair on my back! I hate myself!"
He wrapped his arms around her and pulled her close. "Hush," he said. "You're beautiful. You're the best thing in the world. And if you have this Cushing's thing, we'll get it taken care of. But don't you ever say you hate yourself. That's my best girl you're talking about. My favorite person in the whole world. I love you, and Mom loves you, and we think you're perfect."
She tightened her grip and had a good cry. Sully murmured to her, stroked her hair, and I turned away so they could have a little privacy. Timmy and I looked at each other and smiled damply.
Grabbing a box of tissues, I went back to Audrey's bedside and handed them to her. Took one for myself and one for Timmy, too.
"I think you should go to Boston for this," I said. "I know a couple of great doctors at Boston City who specialize in this. I'll call them tomorrow, okay? In the meantime, Audrey, just go home and enjoy the rest of the weekend."
She pulled back from her dad and gave me a dazzling smile. "Thank you so much, Nora," she said. "My stupid pediatrician never said anything about this. Just told me to eat more vegetables and stuff."
"Well, Cushing's disease is rare. I'm still not positive you have it, but we'll know pretty soon." I was sure, but doctors didn't get to say those things.
"I can't believe I can get fixed! This is probably the best day of my life." She got off the bed, grabbed her clothes and bounced into the bathroom to change.
"I'll be up front," Timmy said, leaving the room. We could hear Teeny's indignant squawking. Well. I could hear it. In this case, Sully might be lucky not to catch everything.
Sullivan stood up. "Thank you," he said gruffly.
"Just doing my job."
"You're good at it." He let out a shaky breath. "What would've happened if this hadn't been caught? Is it...you know. Fatal?"
I hesitated. "It can be."
"Jesus H. Christ."
"If you have any questions, and I'm sure you will, just ask me, okay? Don't be--"
My words were cut off by his hug. A hard, long hug.
Sullivan Fletcher was lean and strong, and his neck smelled like the sun. He held me tight for a long moment. "Thank you," he said again, quietly, and his voice caused a ripple down my side.
Then he let me go, and the bathroom door opened. I got another Fletcher hug, from Audrey this time. "I can't believe all this," she said.
"Well, let's get it confirmed," I said. We doctors, always covering our butts in the face of too much hope or too much darkness.
"I want to be you when I grow up," Audrey said, beaming at me. She slid her arm around her father's waist and tucked her head against his arm.
Sullivan glanced at me. He put his fingers to his chin and then moved them away and down, almost like he was blowing me a kiss, but not quite.
I knew that gesture. It was sign language for thank you.
Yeah. Not falling in love with Sullivan Fletcher was going to be quite a challenge.
18
When I was a junior and Lily was a sophomore, we both went to the prom.
I went with another girl--Emily Case, who, like me, was on the fringe of high school, another invisible girl with bluish-white skin and hair the color of dirty dishwater. We weren't friends; we were simply united in the knowledge that no one would ask us, we wanted to go, and there was safety in numbers, even if that number was two.
I honestly don't remember where I got the guts to go through with it. I remember that I simultaneously didn't want to go and couldn't not go. I had no delusions of a Carrie-like turn of events where, even if for a little while, the freaky girl got to be popular. So what if she was drenched with a bucket of pig's blood? Small price to pay.
No, I knew how it would be. Emily and I would barely exist at th
e prom unless someone took it upon herself (because it would be a girl) to mock us. But even at the age of seventeen, I knew that on prom night, the Cheetos would be too obsessed with themselves to notice people like Emily and me.
Without telling anyone, I took the ferry to Portland, went to the Goodwill store and bought the first dress that didn't pinch too much, an utterly unremarkable royal blue halter-top dress with sequins along the neckline. There was a tear along the zipper, but I could fix that.
On the Saturday of the prom, my sister announced that she'd be going to Darby's house to get ready.
"I'd like to see you all dressed up," Mom said.
"Then come to Darby's," Lily said. "If you have to." The disgust in her voice was so thick you could cut it with a dull knife.
"Are you goin' to Darby's, too?" Mom asked me.
Lily's head nearly spun off her shoulders. "You're going to prom?"
"Yes," I said, feigning calm. "Emily and I thought it would be fun." Things that were also on par with prom fun would be performing a limb amputation on oneself or eating a live rat. Still. Had to do it.
"Emily who?" Lily asked.
"Case."
"Who's that?"
I sighed. "She's someone in my class, Lily."
"Why do you even want to go?"
Excellent question. I started to answer, but Lily cut me off. "Just try not to talk to me." Even after all this time, her cruelty slashed like a razor.
"Lily, apologize," our mother said, her voice harsh.
"Sorry," she sang.
"Who's your date?" I asked. I knew, of course. Everyone knew.
"Luke Fletcher." She looked at me and smiled evilly, her pure blue eyes narrowing like a cat's.
That's why I was going, of course. To see them together. To see what it would be like to be as effortlessly beautiful and confident as my sixteen-year-old sister, to have the attention of the best-looking, most popular boy on the island. To torture myself with unrequited love for both of them.
I didn't go to Darby's, of course. I stayed home and tried to flatiron my hair, which was having none of it. I ended up putting it in a puritanical bun. Emily's father picked me up, Em sitting in front, me in the back of their minivan, which smelled like dog. There was a bag of pretzels on the floor, reminding me that I was hungry.
Back then, Scupper Island couldn't afford a big prom at a banquet facility or hotel, so it was held at the gym each year, the decorations comprised of tired crepe ribbons in yellow and black--our school colors--with clusters of black and yellow balloons tied to a weight for centerpieces.
Aware of our status as Invisibles, Emily and I clung to the edges of the gym and took a seat at the table farthest from the entrance. I tried to talk to her (maybe we'd become real friends!) and asked all the questions I could think of--What bands do you like? Have you seen any good movies? Do you like math? I was treated to monosyllabic answers and gave up. Emily chugged Hawaiian Punch and manically nibbled Chex Mix, one piece after another, like a starving mouse. I occasionally offered a comment, no matter how banal, just for the sake of making it look as if we were talking. Not that anyone was checking.
"Check out Mr. Severy's tie!" I said, laughing, though his tie was perfectly normal. Emily didn't respond.
Chances were, we both looked unstable. Neither of us cared.
The Cheetos hadn't arrived yet. Prom had already been going on for more than an hour, and they'd probably spent that time getting drunk or high. Until then, everyone (except the freaks like Em and me) had been having a pretty good time, dancing, talking, the girls a little nervous in their finery, the boys awkward and sweaty.
Then the doors opened, and in they came--Amy, Darby, Carmella, all so hatefully beautiful, so fake-tanned, their teeth bleached too white. I'd have sold my soul to look like any of them. They were like beautiful, exotic birds in their bright dresses and sparkling sequins. Sullivan, Brett, Lars and Luke trailed in after them, aware that prom was really for girls.
And then I saw Lily--oh, Lily, she was the most beautiful girl in the world. She was Snow White--pure and lovely and perfect, and I couldn't help the surge of pride and love that flooded through me at the sight of her.
My sister, though she belonged to the group, was not technically a Cheeto--her skin was ivory, her hair black and shiny, its natural color, cropped short and chic when all the other girls in our school, including me, kept theirs long. Her dress was a one-shouldered black gown, full skirt with some kind of silky, sheer fabric over the skirt, so it looked as if she were floating. I didn't know when or where she got the dress; she well may have stolen it, but no matter the case, it was ethereal, making my royal blue dress seem as cheap and common as it was.
For once, Lily's makeup wasn't overdone, making the Cheetos look like RuPaul on performance night. No, my sister was simply stunning. She was Audrey Hepburn. She was Anne Hathaway. She was Lily Stuart, the most beautiful girl in Maine. In the world.
And she was with Luke, who already looked sloppy, his tie askew, his gait crooked.
"That's your sister," Emily said flatly.
"Yes."
"You don't look anything alike."
I didn't dignify that with a response. The truth was, I couldn't take my eyes off Lily. Everything about her was flawless. She seemed both to absorb the light and reflect it, and I felt such a rush of tenderness for her, the same as when we were little and she'd fall asleep, and I'd just stare at her and stroke her hair until Mom told me to stop.
Then Lily bumped into a chair and burst into wild laughter, and the spell was broken.
My sister was high. That probably wasn't new, but it was the first time I'd seen it so blatantly. I stood up, the metal chair screeching behind me. Lily was lost in the crowd of Cheetos and their dates. Sullivan and Amy were dancing, I noted, their foreheads touching. He could do better, I'd always thought.
I made my way to the dance floor, alone, moving like a silent hippo through the crowd, who parted reluctantly for me, a few castigating looks from girls at my dress, my hair, which was coming out of its bun, my ordinary sandals. I didn't care. I wanted to get my sister home.
Her pupils were dilated, her voice shrill. "Shut up, Brett!" she said, giggling wildly. "I did not. Not yet, anyway."
This caused a roar of laughter and some jostling among the boys. Whatever Lily hadn't done yet was sexual. I wasn't stupid.
"That's not what Conrad says," someone said.
"So what? It's no big deal," said Darby, trying to steal the attention from Lily. "I already did it."
"So did I," said Carmella.
"Yeah, no kidding," Brett said. "Come on, Lil. Have some more." He offered her a flask.
"Lily," I said. "Hey."
Silence fell over the little group. "Hey, Nora," Luke said. After all, this was junior year, before he realized I might threaten his future.
"What are you doing here?" Lily asked. "Oh, right! You came with that girl! Are you a lesbian, Nora?"
Another roar of laughter. "Lily, come with me a second, okay?" I said. I took her arm and started dragging her to the bathroom. She struggled for a second, but, hey, I outweighed her by at least seventy pounds.
"Everything okay?" Luke asked, trailing after us, blinking too much. Stoned, I guessed.
In my instant fantasy, he'd be sober. I would tell him someone gave Lily drugs, and he would be furious. It would be Brett, and Luke would whirl around and punch Brett in the face and take Lily and me to Stony Point Lookout (I had no idea why). Lily would fall asleep in the back seat, and Luke and I would talk and talk, remembering good times at the Math Olympics and Robotics Club in seventh grade. He'd say something like "Nora, you're so funny."
And that would be enough. That would be the world to me.
But in reality, I knew better. "We're fine," I said.
I got Lily into the bathroom. "What did you take?" I asked, future doctor that I was.
"Don't worry about me," she said. "I'm great. Where the hell did you get that dress,
by the way?"
"Lily. Do you know what you took? What it looked like?"
"Nora. Do you know how you look in that dress? Like a fifty-year-old housewife crashing the prom, that's how."
Anger and hate and love wadded in a ball in my throat. "You are such a bitch, Lily," I hissed.
It was the first mean thing I'd said to her...ever. She looked at me for a second with those clear blue eyes, shocked.
Then she heaved forward into a stall and started puking.
Oh, God. And yet, good. She'd get it out of her system, whatever it was. Ecstasy or a roofie or painkillers.
I crouched next to her and put my hand on the back of her neck, the way Mom used to when we had a stomach virus.
"Nora," she said, glancing up at me. Her eyes were streaming, and I was undone.
"It's okay, baby," I said. "Get it all out."
She vomited again, and then again, and then there was nothing but dry heaves. I stroked her cropped hair until she stilled, her sleek little otter-like head resting on that skinny arm.
"Come home with me, honey," I whispered. "Let's go home and watch TV, okay?"
She turned her head and looked at me. "You don't understand, Nora," she said, closing her eyes, and her voice was so weary and old my eyes filled with tears. "You just don't get it."
"No, and I don't want to. Not if it means being with them. They're so hateful, Lily. They'll use you up."
"I don't have any other choices, do I?"
"You do. You can come home with me."
She almost laughed. Didn't open her eyes. "Yeah, right. If I'm not with them, then what am I? How do you think I'd survive if I wasn't popular?"
The same way I do, but we could be together again. "Let me take you home and take care of you. Please, Blueberry." My old name for her.
"I miss Daddy."
The words punched me in the heart. "I know," I whispered, petting her head again, savoring the sleek curve of her skull. "Come on, sweetie. Let's go."
Lily opened her eyes and looked at me for a second, and I saw how tired she was, how empty, and all I wanted was to save her.
But then the bathroom door squeaked, and in came Amy. "Um...are you two okay?" she asked.
For one second, I thought Lily might choose me. For one second, her eyes said something other than disgust.
Then she looked at Amy. "I had the pukes," she said brightly, struggling to stand up. "I feel better now. Do you have any gum?"
Now That You Mention It Page 22
