Patricia Penn
Fiona looked around carefully before slipping into the waiting room of the palliative care unit. Visiting hours were over and the room was abandoned; yesterday’s newspaper lay discarded on a chair. For a moment she felt more like a character from a Jane Austen novel than a doctor on a busy shift. Her heart was beating loudly against her chest. She was fairly certain that a simple phone call should leave neither an accomplished physician nor a romantic heroine that anxious.
Even if it was a call she wasn’t supposed to make.
It had been five months as of yesterday. Miriam’s number was still saved in position one on her speed dial. Fiona told herself that she just hadn’t gotten around to replacing it with somebody or something she might need to reach quickly, like her boss or Admission. She’d been working doubles ever since Thanksgiving, no time to play around with her phone. That was all.
Home, the display said as the phone made the connection, mocking her by stating as fact another piece of ancient history. Miriam’s home wasn’t her home anymore; intellectually she knew that. Yet her heart beat faster with every ring, and when the recording kicked in she exhaled with the violence of an addict getting a fix. The voice sounded painfully familiar, low and a little bit hoarse, sending a shudder of remembered intimacy down her spine.
“Hi, you’ve reached Miriam. I’m either not available right now, or I’m too lazy to pick up the phone. But don’t worry, you can leave me a message. Happy Hanukkah and Merry Christmas!”
Fiona didn’t leave a message. She closed her eyes, breathing in and out and allowing herself, for a second, to imagine that it was still five months ago. That she would open her mouth to say she’d be working late again because that patient had crashed, and that she was sorry, but she promised to bring Chinese, and “I love you, hon, talk to you later.”
Instead, expectant silence settled in after the beep. Disconnecting the call, Fiona plopped onto one of the nondescript chairs. The back of her head hit the wall with a heavy, frustrated thud.
You’re pathetic, she informed herself, but she’d known that already. She just couldn’t bring herself to care.
* * *
An hour later she should have been on the way home, but with the looming prospect of her empty, half-furnished apartment, she never quite made it to the staff locker room. It was December twenty-third, and she had promised Dr. Kapstein from Oncology to take care of his patients through the Christmas holidays so that he could spend it at home with his wife and three children. So she dropped onto the couch of the doctors’ lounge and immersed herself in the case files the old oncologist had practically thrown at her on the way out. Rounds wouldn’t be necessary, he’d said. The resident would be at the ready to disrupt his skiing vacation at any point if she had any questions. He was so grateful for Fiona’s offer, he’d assured her on his way to the elevator, leaving her with a stale sense that he’d forget her face and her favor by tomorrow.
The door opened. Bald, gangly Dr. Brian Eddleston sauntered in, as if he had any business crashing her floor instead of getting actual work done in the radiology labs where he belonged.
“No, I won’t have time to go to the staff Christmas party tomorrow,” she said rather unkindly, not bothering to look up. From the corner of her eye she saw Brian take one of the chairs and turn it around, straddling it to sit in front of her. He rubbed his head unabashedly.
“Not even with an astonishingly handsome and successful doctor such as myself?”
“I’m gay.”
“That’s not a problem for me.”
“You’re gay.”
“Sexuality moves on a continuum,” he said sagely, then shrugged and added in a normal voice, “Or so I keep reading in Cosmo.”
She rolled her eyes, suppressing a chuckle. “Yeah, you’re so gay.” Looking up from the chart after all, she found herself facing her supposedly forty-year-old friend’s self-satisfied smirk.
“In other news,” she said, determined to change the topic and pointing at her charts, “did you know that Oncology is treating an eighteen-year-old for multiple myeloma? She’s waiting for a bone marrow transplant now. It’s wild: chemo, autologous transplant, none of that’s an option anymore. And it’s going to be a one-allele mismatch—unrelated registry donor—so she’s running straight towards the light there. The whole hospital should be talking about this. I mean, she’s eighteen. I bet Kapstein took her on just so he can publish about her.”
“The hospital is too busy placing bets on whether or not that cute new nurse from the E.R. will turn out to be a lesbian when you woo her at the Christmas party.”
“I’ll be on-shift at the Christmas party.”
“See, that’s why they invented those little devices called pagers. Some might say they’re old-fashioned, but they’re really reliable in that they—”
“I’ll look a little bit bad if Kapstein’s crowning glory of a paper dies while I’m drinking fruit punch. He’ll be at that party, you know.”
Now it was Brian’s turn to roll his eyes, and Fiona resisted the urge to tighten her shoulders defensively. It was as if her whole body wanted to curl up and present a wall. She’d been feeling like that rather a lot recently.
“I just…have a lot of work to do, okay?” She turned the page on her chart despite not absorbing anything it said since her friend had walked in.
“You’ve had a lot of work to do for five months,” Brian pointed out softly.
His face had turned serious; she didn’t even need to look at it to know. The change in tone hit her like a lightning bolt, the way a raised voice never could have. She immediately hated everything about it.
“Brian…” She put the chart on the pile in her lap, knowing that she sounded pained.
“Fiona,” Brian said, in that firm voice of his that convinced patients to do a procedure, even though it would suck. “Listen to yourself. This isn’t healthy anymore.”
She shot him a furtive look. “Come on. It’s just a stupid hospital function. Nobody ever really wants to go to those.”
But Brian was shaking his head. “I’m not talking about the party. Forget the party for a moment. All this?” He made a gesture that encompassed much more than the charts in her lap. “It isn’t good for you. You’ve barely moved into your apartment—”
“Yes, because I work all the time, all right?”
“Because you hide yourself away at work like you don’t even want a private life anymore! Used to be that you and I would go out for drinks. You used to have friends. Now you’re practically living at the hospital, and you pull all that crap where you do favors for people like you actually care about promotions, and the only people you ever talk to are old dying folks!”
Taken aback, Fiona leaned away from him, making sure he saw the way she raised her eyebrows to show how little he’d impressed her with that last one. She was a geriatrician who worked at palliative care, the unit for pain management. Most of her patients were in the last stage of their lives, yes. Many would never leave the hospital alive, but somebody had to take care of their special needs now that treatments had failed, and make things more bearable for them, and help them retain some dignity. Brian had never found anything wrong with that before. “Oh? Says the glorified brain photographer?”
Brian sighed as if she’d never made the quip, although she personally thought it had been a pretty good one. “I’m saying I’m worried about you.” He hesitated. “It’s been long enough, Fiona. Yeah, you didn’t want a divorce, but there you have it anyway, and you’ve got to move on. Miriam—”
“Leave Miriam out of this,” she snapped, her tone changing to something that sounded ugly even to her own ears. She couldn’t help it, though. In truth, this whole conversation had been about Miriam from the start. Everything always was about Miriam these days.
No, Fiona didn’t hang out with her friends anymore, because they had been their friends, and God knew which of them had known about the affair: the way Miriam had been cheating on her with some Parisian stewardess of all people, who probably had endless legs and a go-to plastic surgeon.
She still couldn’t bear to think about it.
“Miriam was a bitch,” Brian declared.
“Miriam was my wife.”
“Yeah,” Brian said. “And now she’s not.”
Frowning, he stood up, brushing imaginary dirt off his lab coat and placing the chair back in a corner. He would be working through Christmas as well, Fiona suddenly remembered in an angered, jealous way. It wouldn’t be because he had no better place to go. His husband worshipped the ground he walked on, and was probably preparing the Christmas turkey already. Brian only had to work because he’d drawn the shortest straw in Radiology.
That thought left a bitter taste in her mouth. The sudden surge of anger ebbed off as fast as it had come when she noticed how petty she sounded even in her own head. Fiona slumped back, feeling tired and faintly miserable, like when she stabilized a patient after he or she had crashed and all was well, except not, because they would be dying anyway.
She really didn’t want to go home. She didn’t.
“I’m not hiding out,” she muttered without looking Brian in the eye.
“Sure,” he said. “That’s why you’re going to the Christmas party with me. I put a fifty down on you and that nurse.”
Fiona groaned.
* * *
“We’re called Fragged. Garage punk gone death metal. Band’s touring through Ohio right now, but Doc Kapstein says if I’m lucky, I could catch up with them in New York in spring and play at least a song or two.”
It was a lot of words to say at once for a hoarse eighteen-year-old who was undergoing chemo and high doses of radiation; they were systematically bringing down her immune system in preparation for a bone marrow transplant. Exhausted to the core, June Sekelsky was bald and a translucent kind of pale. Sunk into the pillows of her bed, tiny to begin with, she might as well have been a child. But there were tattoos of dragons snaking all over her arms, remains of clipped black nail polish still glued to her fingernails, and she seemed admirably determined to retain her sense of self.
Even more interesting to Fiona was the petite woman sitting at her bedside. Jessie McGee—June’s fiancée, introducing herself with a politeness that spoke of a lifetime of strict nannies—stood in stark contrast to June: her careful prep school enunciation to June’s Boston working class drawl, her health and radiant beauty to her fiancée’s exhaustion. Jessie was African American, while June was white, though so discolored that the circles under her eyes looked like bruises. Fiona admitted without shame that Kapstein’s medical marvel had become two hundred percent more notable to her the moment she had turned out to be a lesbian.
Jessie took June’s hand in her own gloved one, throwing her a sickeningly loving look, the rest of her face obscured by her facial mask. “My dad discovered them when they were playing at T.T. The Bear’s,” she said to Fiona. “He’s a music producer. It’s how we met.”
June gave Fiona a weak smirk. “Don’t forget to tell her that he’s paying all my hospital bills, just ‘cause I’ll marry his daughter. He’s awesome like that.”
“That’s what family does,” her fiancée said in a soft and insistent voice, as if she had reminded June of that many times.
June grimaced, acquiescing unhappily.
The duty nurse finished checking the IVs. With a nod, she left Fiona to mark down June’s status on the chart. As a palliative doctor, Fiona worked with a lot of cancer patients, and she’d be just fine in Oncology as long as nobody expected her to heroically do an emergency transplant. Having rounded on almost all of Kapstein’s other patients before attending to June, she was already well on her way to settling into a routine. There wasn’t a lot that could be done for the girl during transplant prep, apart from careful monitoring. She had kidney damage, but it was mild, and they could probably gently hydrate her through; if not, a nephrologist would be at the ready to start her on dialysis. The isolation room she was in minimized the risk of bacterial infections, as did the administration of broad-spectrum antibiotics, and the most worrisome new symptom she had reported this morning was a sore throat. Her hemoglobin was down but her platelet count remained stable, so all in all, things could be worse.
Apart from the partial match transplant she would be receiving next week, anyway. After that little deal with the devil, Fiona would likely be meeting June again while she died in the palliative care unit.
“It’s good that you have somebody to stay with you.” Fiona checked off the last couple of boxes. “This can’t be how you imagined spending Christmas.”
“Better than dying,” June muttered, and Jessie looked like she was trying to be scandalized, except that she agreed.
“Me and the band are gonna all go bald for real the moment I get out of here,” June informed Fiona, touching her head. “I think it looks rad.”
“You’re so full of shit,” Jessie said fondly.
June shrugged. “Cancer sells, I bet,” she said, and coughed.
Beneath her mask, Fiona forced a smile.
She might very well be seeing June in palliative care again, yes. But she shouldn’t. The girl was young and obviously strong-willed, sick with a disease meant for Fiona’s regular patients—sixty-five plus. A part of her felt like she should run from the room before the misery simmering beneath the brittle optimistic surface could make her choke. But at the same time—maybe because those two girls made for such an unbearably sweet couple—they infused her with an unfamiliar, unexpected, almost desperate sense that she should help. Eighteen-year-olds weren’t supposed to die of MM. None of this was supposed to happen.
It was December twenty-fourth. It wasn’t supposed to be a time of death, either. Fiona thought of med school, of when she’d still believed that medicine would be about improving people’s lives.
That had been a very long time ago, though.
* * *
As Fiona had feared, the Christmas party wasn’t the best idea Brian had ever had.
She forced a blank face. Standing with both hands wrapped around a glass of bad, non-alcoholic fruit punch, she had edged into a corner of the garishly decorated cafeteria, escaping from surgical fellows competing over who’d managed the most exciting flip on their snowboard during the last vacation, and bleary-eyed residents comparing the relative merits of ER night shifts during Christmas with those at Halloween. “When you’ve been puked on by Count Dracula, you’ve seen it all,” she’d heard one of them say, and the other had smirked into his drink: “Only if he puked up blood.”
Christmas meant working with an even shorter staff than usual, doing more shifts in a row than was technically allowed. Meanwhile, suicide attempts went up, as did turkey-induced salmonellosis, and the emergency room supplying the rest of the hospital with more and more work put a strain on everybody. Doctors and nurses alike dropped into bed like dead weight when it was finally over and slept until it was time to rinse and repeat all that at New Year’s—with less salmonella, but more burn injuries.
All in all, physicians were about the last people on Earth who should be tortured with a Christmas party. Or so Fiona kept telling herself, despite the laughter all around. The lights and tinsel on the walls looked as fake as only professional interior designers could achieve, complete with a huge Christmas tree and a recording of trembling children’s voices blaring “We Wish You a Merry Christmas” through the speakers on what was starting to feel like infinite repeat.
Through the crowd of chatting receptionists and security staff, Brian was making his way to her, a curvy blonde in nursing scrubs trailing in his wake.
Great.
It should have been her pager that saved her. It wasn’t. Instead, her phone buzzed in the breast pocket of her lab coat, and Fiona pulled it out a second later. Waving it at Brian apologetically before discarding the punch and getting the hell out, she ignored the outraged face her friend made at her—another thing she rightfully didn’t care about.
What she did care about was the caller ID, when she had a belated look at the display once the doors closed behind her, cutting off the noise in the dim hallway.
It was as if everything froze, after catapulting her back into the past.
Her hands shook when she raised the phone to her ear.
“Miriam,” she breathed.
You shouldn’t have kept calling her. You knew you shouldn’t have kept calling her. You knew she’d call you back eventually, and then what?
A part of her couldn’t help clinging to the wild hope that Miriam would tell her all those things she’d imagined hearing when she was alone, lying on her bed with those sheets that didn’t fit, because they were made for a double bed. Miriam had decreed that Fiona should have those, because she’d chosen them. But it had been Miriam’s house and Miriam’s bed, so Fiona had ended up with sheets she couldn’t use.
Miriam’s and Fiona’s were categories that hadn’t even existed in her head before the night she’d learned the truth.
Miriam’s real voice sounded a lot more agitated than the cheerful recording from the day before, real emotion in place of multi-purpose holiday greetings.
“Hello Fiona,” she said. It was a firm voice, learned in law school and well-practiced in court. “Listen, I don’t know what you’re playing at, but you have to stop calling me like this. It creeps me out.”
Miriam would have looked at herself in the mirror before she called, straightening her shoulders and muttering those words to herself to check her tone.
Funny how that worked. Fiona knew that she would have done that, but it didn’t take anything away from the effect. Miriam might as well have been talking to a stranger.
Closing her eyes, she took a deep breath to calm herself and not go into fucking cardiac arrest. She struggled for words.
“I’m sorry. God, Miriam, I’m sorry. I just…I’ve been trying to reach you. I didn’t want to disrupt your holiday. Uh, it’s just, there were some of your books in one of my boxes and I wanted to know if you would like me to—”
“Oh, cut the bullshit.”
Fiona’s mouth snapped shut. Miriam sounded weary and angry, like she was out of patience and tired of her ex. Fiona wondered if she was working through the holidays too, because she did that, especially when Fiona wasn’t there to watch out for her. But Miriam’s mind clearly wasn’t on that. She continued with more determination.
“I don’t know what this is about. But it’s making me uncomfortable, all right? I know you’re not trying to reach me at all! You call when you know I’ll be at the gym, or at Kim’s. You don’t leave messages. You just call.”
“Ah, I must have lost track of time. My schedules have been—”
“It’s over, Fiona,” Miriam said, an edge to her voice.
Fiona flinched. She couldn’t help it. It hurt.
There was another pause.
Miriam sighed, as if she had been there to see.
“Listen, I’m sorry,” she said, her tone implying that she was anything but. “I’m sorry I broke it off so abruptly, okay? I wasn’t being fair to you when I did it that way. I realize that now. I thought that a clean break would be best for both of us.”
Well-measured cadence. Sometimes, Fiona ended up telling patients lies exactly like this one. She didn’t tell a dying man that his daughter hadn’t cared enough to visit, or that the reason they couldn’t reach his wife was because she had moved away to live in Spain.
“But it’s been months,” Miriam continued, “and you agreed to sign the divorce papers and all, and you keep calling my voicemail like some kind of stalker…”
“You left me!” Fiona exclaimed. The words spilled out, a wave of dry nausea accompanying them. She took a furtive look around, but the hallway was still empty. Still she lowered her voice to a hiss, retreating further into a corner. “What do you expect? You left me for some stewardess! Next thing, you say you never loved me anyway! Do you have any idea what that felt like? How do you expect me to just…to just…” Anger mixed with a helpless void, a lack of any available reactions. “How do you get over that? Explain that to me, please.”
It was like she was trapped, like her life had knotted itself into this snare, tightening around her the more she moved, and she didn’t even know why.
A moment of silence passed. Miriam seemed too far away, though her voice was too close, directly in Fiona’s ear.
“That’s not my problem anymore, all right? It’s yours. Stop calling me. Goodbye.”
There was a click when she hung up. Fiona resisted the urge to throw the phone against the wall, the way a character in that modern Jane Austen novel would who didn’t have to care about propriety and what it would cost to replace a phone.
Sometimes Fiona thought this could only have been worse if Miriam had left her for a man.
None of it was ever real. That was the worst part, how Miriam had never loved her to begin with, despite stepping up to an altar with her. Relationships ended, even marriages, that was the way it went; Fiona knew that intellectually. But she’d never loved anyone else so much. This had been how she had wanted to spend the rest of her life, and for Miriam, it simply…hadn’t been like that. She’d met another woman who worked better for her. A helpless part of Fiona kept insisting that Miriam should have warned her of that possibility up front, of how her marriage could be ripped away like a Band-Aid, disposable, applied only as long as required.
Laughter and “Jingle Bells” could be heard far away, muted by the walls of the cafeteria, and Fiona was sick of it, sick to her bones. She turned on her heel. She had two units full of patients to keep going until they perished.
* * *
June Sekelsky was the only patient on the Oncology floor who was awake. Remote control in hand, the young woman was following a Christmas special on TV with that mix of exhaustion and boredom exclusive to long-term patients. Jessie was nowhere to be seen, and it seemed like the stubborn glow that had fueled June’s demeanor during Fiona’s previous visits had left the room with her fiancée.
When Fiona entered, the young woman smirked without joy, not even bothering to raise her head from the pillow; yet it was surprisingly easy to picture her with defiant black eyeliner and a multi-colored Mohawk on a stage in a punk rock band, trashing somebody else’s guitar and screaming “Fuck!” into a microphone.
“Anything interesting on?” Fiona asked, sitting down on the visitor chair. She would check June’s chest sounds in a moment, to make sure that sore throat didn’t grow into anything more worrisome.
June squinted at the screen, as if Fiona’s appearance outside of rounds was quite ordinary, and she got courtesy visits by doctors all the time. Maybe she did; maybe her band was more famous than Fiona had thought, and there were fans amongst the staff.
“Dude called John visiting the family of dude called Sherlock. I’m not sure if they’re gay or what; it’s British. I think Sherlock poisoned his parents?”
“Okay. Please tell me you have actually heard of Sherlock Holmes before. Unless television has gone through some drastic changes recently, I’d say he’s straight.”
June snorted. “It’s British,” she repeated, as if that explained everything.
A moment of companionable silence passed as Fiona made an attempt to follow the story alongside June. Restlessness had befallen her, a need to move around and act, while at the same time, nothing that she could have done came to mind. She was trapped in the hospital, after all, and would be until Christmas was over.
“Your fiancée went home?”
“Christmas thing with the family.” June’s smirk grew. Although she’d started running a fever again and her mouth had to feel sore along with her throat, her voice remained strong. “Woulda dragged them all here if Nurse Leena’d let them in and all.”
“Seems like a great girl.”
“Oh yeah.” June made a weak, wavy gesture, eyes still on the television. “They’re all fab. Paying my bills and all, I mean, how great is that, right? Jessie thinks it’s weird that I keep bringing that up, but it’s, like, it’s a lot of money, you know? Her dad’s a real bigwig, though.” She paused and closed her eyes to breathe before she continued, betraying how much the conversation exhausted her. “When we signed the contract with him, we totally thought we’d made it big. And then we kinda did, too.”
Fiona looked at her hands for a moment, wrapped in rubber. Picking at the wristband of the glove, she thought of Miriam.
“I’m gay, too.”
“Yeah. Figured,” was all June had to say to that.
Fiona chuckled at her dismissive tone. Textbook generation gap; it made her feel old.
“Don’t you have a place to be on Christmas or nothing?” June asked.
“Not how it works in a hospital. We can’t close shop and go home.”
“Coulda fooled me the way Doc Kapstein got the fuck out of here yesterday to eat turkey and shit.”
Fiona laughed despite herself. “You’re an orphan, I gather? There might have been a better bone marrow match in your family otherwise.”
June averted her gaze. “Might as well be,” she muttered, studying the remote control.
Fiona frowned.
Sometimes, her clinic patients over at the hospice prattled on about bone aches and shortness of breath for what seemed like hours until quite suddenly, they brought up the actual alarming issue, like the blood in their urine, hidden in some subordinate clause.
“June,” she said firmly. “If you’ve got blood relatives out there—”
“Well I don’t,” June said, eyes still fixed on the remote.
Fiona tried picturing old, ever-distracted Kapstein questioning a stubborn young woman further after she gave him this answer but couldn’t. So she may not have known which doctors June had seen before she came here, but she could bet that nobody at St. Anne’s had pressed the issue.
“This is vital information, June,” she said. “Listen to me. You’re only going to receive a partial match transplant. Do you have any idea how huge the risk is with a MUD that your body will reject it? It’s called donor-versus-host disease. I know they’ve told you about that. If there’s any chance—any chance at all—that there could be a relative of yours out there, he or she could get tested and the odds that they’d match better are incredibly short—”
“You’re not gonna find anybody from my family who’ll donate anything for me!” If June had been on a heart monitor, it would probably have blipped in rapid elevation, sending nurses running her way. She tried sitting up, paling, the words followed by a coughing fit.
Muttering a swearword under her breath, Fiona reached out to steady her. But June had already caught herself, swatting her away weakly.
“I ran away from home back when. I haven’t seen them in years; I have a new family now. The old one don’t want anything to do with me!”
“Oh dammit, June…” Fiona hovered for a moment longer and then slumped back in her chair, eyeing the kid with a mix of shock and pity. After waiting to make sure that June had calmed down and that she had her full attention, she spoke firmly. “Tell me what happened.”
June threw her an unkind look that showed how little she appreciated that question.
“I got out of there, all right?” she said defiantly after a moment. “I made it on my own. It wasn’t hard. School is stupid anyway,” she muttered to herself, taking an unsteady breath.
“I was playing at this club with some guys. Dude picks me up, says he needs someone to play guitar in a band. Next thing, we’ve got a contract with McGee, and I’m meeting Jessie and all.”
Wow, Fiona thought. Your regular lesbian Oliver Twist. Except that June had cancer, and she wasn’t speaking to her family that apparently existed. Fiona was fairly certain that nobody in Oliver Twist acted that stupidly, or readers would have rightfully complained.
She focused on the important part. “Why did you run away from home? Was it because you’re gay?”
“Sure didn’t help,” June said cynically, still looking away.
The television was forgotten; in the corner of Fiona’s eye, men were shooting at each other.
“I…” June closed her mouth, paused. Then she opened it again, angrily. “Shit happened, all right? They hate me. They want nothing to do with me. They said.”
“And that was how long ago?”
“Three years.”
“Geez, June. They’ve probably been too busy being scared to death for you to waste a thought on whatever it is you think you did so wrong.”
But June was shaking her head already. “They threw me out. They said I’m a monster. So I ran. I don’t need them anymore. I’d rather try the bad match than ever talk to them again.”
Fiona couldn’t believe this. “Even if it gets you killed?” This wasn’t the time to sugarcoat the ramifications of that decision. She could have recited any number of ways that receiving the wrong transplant could do terrible, terminal damage.
June pressed her lips together. “Yeah.”
“If they’re really that awful,” Fiona said, carefully handpicking each word, but getting more determined to get through to the girl. She felt more motivated to get to the bottom of this than she’d felt about anything in weeks, filled with a new, unexpected kind energy. “If they’re really that bad, then what’s wrong with using them for your health? You don’t owe them anything. Call them up, tell them what they want to hear, laugh in their faces afterwards.” She took a calming breath. “Do you have any siblings? You could ask them.” A sibling was likely to match best anyway, a nine or even ten-out-of-ten match.
But June’s face hardened even more—an angry, bald, sickly statue of pride. “Not anymore,” she said, barely audible.
Everything that Fiona had just learned was such a waste. She couldn’t believe it had taken a substitute from geriatrics to hit on this. June had been sick longer than she’d been a legal adult. This shouldn’t be happening.
“They hate me,” June said for the third time, like an incantation.
Why do people always throw the good things away? Fiona didn’t understand. It was almost like they didn’t need them. Like they didn’t care that there were all these other, hollow people who’d never had the privilege of letting a chance like this one slip away. June was gay like her, and maybe that was a shallow reason to feel any kinship when there wasn’t much else they had in common, but she couldn’t possibly want to risk her life out of some teenage upset. She had cancer. It was a great and exciting case for everybody at St. Anne’s except June.
Fiona wasn’t sure if her thought process made any sense at all, or if it made all sense in the world. She wouldn’t put up with it, in either case. She was tired of her life, tired of false Christmas cheer, when people could be doing actual good things instead. She was tired of managing pain but not improving patients’ health, when this one here was young and strong and proud, and maybe didn’t have to go down. June had a fiancée who loved her and a surprise career in music that sounded like it had been made for a movie. What was there to decide?
June was too young to know anything anyway, barely old enough to make the decision herself. When Fiona was her age, she hadn’t even known she was gay, and her parents hadn’t cared enough to give her either love or hate.
Much like Miriam, come to think of it.
If you don’t like a thing, do something about it, she told herself and stood up.
* * *
Securing the phone number proved shockingly easy. The duty nurse accessed the complete patient file on the computer at the Admission desk, then turned the screen so Fiona could see without so much as pausing the game she was playing on her cell phone. The Oncology floor was always quiet, but now it seemed particularly so; the staff party had to be reaching its fabulous fruit punch peak about now.
June’s complete history was located all the way down at the bottom, and there it said Father: Joseph Sekelsky and Mother: Edith Sekelsky. There were birth dates and job descriptions and an address. The last June had known, Mr. Sekelsky had been a factory worker.
Siblings: Tyler Sekelsky, deceased, it said, and a date from three years ago. Tyler had been two years younger than his sister.
Fiona didn’t dwell on it.
Seeking refuge in an empty exam room, she had no problem finding the landline attached to the address, a poor neighborhood in East Boston.
“Yes,” a harsh male voice answered when she called.
“Is this Joseph Sekelsky? My name is Dr. Porter. I’m calling from St. Anne’s Hospital in Andover.”
“Huh. What do you want?”
This was how people reacted to a call from a hospital when their circle of loved ones was both small and currently gathered in the living room in full.
Fiona took a deep breath. “I need you to come to the hospital, sir. I’m treating your daughter June. It’s not looking good.”
* * *
The sky outside the windows was pitch black by the time Mr. Sekelsky made it to St. Anne’s. This late on Christmas Eve, the I-93 would be empty; a drive from East Boston shouldn’t take over an hour.
Fiona identified Sekelsky immediately when he stepped into the mostly abandoned hospital lobby. His face was crunched into a frown and he was as short as his daughter, sharing her strong jaw, though where cancer treatments had left her skinny and haggard, he was badly hiding a beer belly underneath his ill-fitting, worn coat. He hadn’t aged well, his skin an unhealthy shade of nicotine-yellow, and he looked like he had brought very little patience along.
“Mr. Sekelsky,” Fiona said, stepping up and offering her hand. “I’m Dr. Porter. We spoke on the phone.”
Mr. Sekelsky eyed her hand without taking it. “Where is she? She dead yet?”
Fiona attempted a smile, then waved him down the corridor towards Radiology. The receptionist was already glancing at them with too much interest. Radiology was close by. Nobody would be there but Brian, and he would either be asleep on the cot in the lab, or busy with an emergency patient.
Her smile transformed into a grimace when they had made it down the corridor. She turned towards June’s father again.
“Thank you for coming here,” she said. “I’m currently June’s attending physician. She’s being treated in our Oncology unit for multiple myeloma, which is a cancer that attacks her stem cells and her bone marrow. She’s stable right now, but that’s probably going to change. We’re preparing her for a bone marrow transplant. It’s the only way to prolong her life.”
Mr. Sekelsky frowned. A number of emotions crossed his face, too many for Fiona to count, before it settled into something dark and defensive. Yes, she might have given him the impression that June had been brought in as a medical emergency, so that his immediate presence was required, but how else could she have made sure to get him into the hospital before Kapstein returned and took the case away from her?
A beat passed before Sekelsky asked, “Is this about money? She’s eighteen by now. She doesn’t need my insurance. Kid can get Obamacare now all she wants.”
“I understand that the bills are taken care of, actually.” Fiona collected herself, adopting her most serious and professional voice. “Mr. Sekelsky, your daughter is very sick. She needs that transplant to survive. However, the partial match found for her in the national donor registry has extremely shaky odds; it’s probably not going to work. A donation by a family member will raise her chances of recovery considerably, if you or your wife are a match.”
“She sent you after us to get a transplant from us?” Sekelsky exclaimed, and Fiona wondered if he was a little bit drunk, if this was a story of abuse by an alcoholic parent. I got out of there, June had said. But he didn’t smell of alcohol.
“A bone marrow transplant, yes,” she said evenly, despite her uneasy sense that something was off. “You can spare the bone marrow; it’ll regenerate completely. We would only take about five percent, from your or your wife’s hipbone. It’s a very safe procedure. And no, she didn’t send me. She didn’t want me to contact you, in fact. But as her doctor, I have to do what’s best for her health.”
“Best for all of us if she dies!” Sekelsky growled, taking an angry step towards her that made Fiona retreat in surprise, although he was just moving in agitation. Sekelsky wasn’t the type who’d dare hit a doctor; there was something intrinsically helpless in the man, a trait found typically in people who’d been poor all their lives. His kids, maybe he’d been hitting them, though suddenly Fiona wasn’t sure about anything.
“Demon spawn is what she is! That kid made me and my wife’s life hell, all those years! All that money that we spent to feed her!”
“Please, Mr. Sekelsky, hear me out,” Fiona tried again. His voice was ringing loudly through the empty Radiology corridors. Her skin was crawling now, the situation so out of her control.
Sekelsky’s Boston accent grew more and more pronounced the angrier he became. “You know what she did? Did she tell you what she did? Whore around before she was even twelve, that’s what! Ran around with druggies and juvie court regulars. Dragged her little brother around with her to parties, the poor kid, when she was supposed to be watching him ‘cause me and my wife had to work. She was doing drugs when she was supposed to be keeping an eye on him! Did she tell you any of that, huh? How them doctors called me up at work to tell me Tyler’s dead because her and her friends were driving around high as kites? My little boy! Jesus Christ, he was only thirteen years old!”
Fiona wasn’t a person who ran out of words easily, but today was proving a never-ending line of stutters, with nothing making sense. Yet again she’d been blindsided, unable to think of an appropriate reaction. “Mr. Sekelsky…”
“She did it!” Sekelsky sputtered, his eyes full of pain and his voice high and thin. “I don’t care that she wasn’t the one driving the car. She got her druggie friends to take Tyler on all their little joyrides. Let them drive her little brother around, stoned out of their minds on weed. Might as well have been her that smashed that car into that tree!”
Oh God. Fiona wanted to hide her face underneath her palm and whimper. This was…she didn’t have a word for what this was. Not what she had planned, anyway.
“Running away was the only good decision that kid ever made!” Sekelsky seemed to be trembling; another person might have spat at Fiona’s feet. “Now she’s afraid of dying, huh? Well, she should’ve thought of that before she threw away her brother’s life. Maybe it’s God’s will, wanting her to face up to what she did. If there’s any justice in the world, that’s what this is. That kid ain’t my flesh and blood anymore!”
He turned, looking frantically around to orient himself and almost walking down the wrong corridor, but then he found the exit sign and stumbled away, the ruins of his life almost visibly trailing in his wake.
Well, that could have gone better, Fiona thought, although that was a massive understatement. She wanted to clutch her neck with both hands and hide from the world.
Seeing Brian down the hall, a stone’s throw away, didn’t help. Of course Brian would have heard—it was that kind of day.
Her friend was standing in the door to MRI 1, lab coat rumpled, cheek reddened where it had rested against a hard surface in his sleep. But he was looking wide awake at Sekelsky’s retreating back, then turning to stare at Fiona with almost comically wide eyes.
They looked comical, anyway, to someone as close to hysterics as Fiona. Probably not so much to people who didn’t feel like their life was suddenly breaking into little pieces in even more ways than before.
“The fuck, Fiona,” Brian breathed, his usual wittiness falling off and making way for an expression that said that he didn’t know how to process this, but it scared him. That was startling, too—Brian looking scared. “Tell me that wasn’t what it sounded like, and you didn’t actually go behind a patient’s back to talk to her father! What in the world was that all about?”
“Just trying to make something right,” she muttered, waving it off to show it didn’t matter. She slumped against the wall.
Brian swore.
“Are you out of your mind?” he said in a lower voice, a concession to the fact that sound carried in these halls. Two big steps and he reached her, looking like he wanted to grab her, then reconsidered and rubbed his head instead. “That’s a doctor-patient confidentiality breach, big time. Do you have any idea what the Dean will do if the patient complains about that? Remember last year, that whole mess with Jennings? People lose their license for that kind of crap.”
But Fiona was so tired of doing nothing. She… God, she had no idea what she’d been thinking. It had seemed like such a good idea until Sekelsky showed up with a whole story that hadn’t been what she’d expected, and the complex tragedy had poured down on her. She couldn’t even make out who the bad guys and the good guys were in this one, too much information at once to immediately process. All she knew was that she’d had this great idea, until it hadn’t been great anymore.
“Don’t tell me you wouldn’t do anything you could to save a patient’s life,” she ground out, although she couldn’t look Brian in the eye. It shouldn’t be a platitude; it should be a good reason, but it didn’t sound like one the way she said it. “A couple of months and she’s probably dead.”
“You should hope that she’ll be dead,” Brian snapped. “Dead people can’t sue.” Staring at her for another moment, he shook his head. “What’s wrong with you? This isn’t a House episode. This is real life.”
There was nothing she could say to that, and when she made a helpless gesture, he shot her a grimace.
“The fuck,” he repeated. “You want to fall apart, you do it on your own time, where it won’t destroy your career.” Rubbing his neck for another moment, he seemed to reach a decision. “Go make sure your patient hasn’t heard about this. And get her to understand if she did. I’ll try and find out if that man complained to anybody on the way out. Didn’t sound like a guy with a lawyer. You better hope this’ll blow over,” he muttered, already walking away.
Fiona resisted the urge to sink to the ground and curl up into a ball in the middle of the empty RAD corridor.
The magnitude of what she’d tried to do hit her, making her realize how much it had backfired. Why in the world had she ever tried to do anything like this? She didn’t have a right to meddle in a patient’s life. Nobody did. It wasn’t her job, and it had been an arrogant thing to ever think differently.
It had been so much easier to try and fix June’s life instead of her own, though. It had been easier than facing the fact that she couldn’t handle her own problems.
She could admit that now.
* * *
At the Admission desk on the Oncology floor, Jessie McGee was waiting for Fiona, holding a phone in her hand. She wasn’t wearing the hat and mask for the isolation room, and she looked astonishingly beautiful, with long waves of black hair and delicate features—if it weren’t for that helpless look on her face distracting from the sight.
“He called me,” she said without preamble. “He said we better stay away from his family forever, or else.” Her face said he’d also spiced it up with some insults, probably aimed at her and June’s sexual orientation, or how they were a mixed couple.
It took a moment for Fiona’s brain to catch up. At first all she heard was that she was busted; it sent a cold shudder running down her spine fueled by a heavy dose of shame. Then she parsed the most important part: Mr. Sekelsky had Jessie’s number saved on his cell.
He knew her.
“You’ve tried talking to him, too,” she stated.
Jessie shrugged. “Yeah.” She looked tired, a girl of eighteen or nineteen preparing to go off to a very good college, and madly in love with a dying girl. “June can’t know,” she whispered as if it were confession at the church.
I’d do anything too, her tone said.
Jessie pressed her lips together.
“It’s not that bad,” she continued, as if trying to convince herself as much as Fiona. She looked up, determined. “It’s not that bad. June thinks she’s going to make it. She’s staying positive about it, and so should we. She’ll get better with the unrelated donor transplant. She doesn’t need her old family. She has us for family now.”
How could so many wonderful and so many terrible things all happen to the same person?
Fiona wondered if she’d be willing to pay the price of a terminal disease if in return, she’d get an otherwise happy life, married to a Miriam in love with her. She wondered if she’d exchange Miriam for health, her marriage for a bone marrow match.
It would have been an easy question to answer before Christmas had come around, but it wasn’t anymore now.
* * *
People stubbornly maintained the idea that all doctors should be infallible. Obviously, every med student learned the opposite the moment they saw their first real patient. Nevertheless, they too tried to keep up the illusion, partly because they clung to the hope that it would become reality one day and partly because it made their patients more compliant, their jobs easier to do. People sue human beings; they don’t sue angels of mercy.
Fiona had always felt safe as a doctor. She’d felt competent, knowing she was already good at what she did or else she could read up on things and practice and improve. She might not be perfect, but she always knew what she was doing.
Now she felt lost and like everything was floating. The scare after her confrontation with Brian and Jessie had left her shaky. At the same time, she knew that state would pass, and everything would settle down in a better way than before, although she didn’t yet know how. It was the strangest feeling.
June was lying curled up in her bed. For once she seemed too tired to keep up the proud façade, and she just looked faded and sick, the way every other patient in the cancer unit did.
“You know what creeps me out about the transplant shit?” she said without raising her head, sounding hoarse.
“What’s that?” Fiona had taken a seat on the visitor chair again.
“That they kill off all my old bone marrow before they transplant the new stuff. With the radiation, right? Doesn’t matter if a part of it is still healthy and stuff. They kill that dead, too.”
“Medicine sometimes just works like that. Your own immune system is damaged, so it needs to be replaced by the donor’s. But the old marrow has to be gone for that to work. You need to make space.”
June shrugged, a small twitch of her shoulder. “Just seems weird that you’ve gotta destroy something healthy to grow something new, is all.”
Fiona sighed, looking at the bald girl in the patient gown that the cancer had tried so hard to make anonymous. But it couldn’t eliminate her attitude, any more than it could damage her tattoos.
It was late afternoon on Christmas Day. The sun was going down outside; soon the night shift would start trickling in. Kapstein had called, wishing her a Merry Christmas and assuring her that she didn’t need to come in on her free day to round patients with him; handing them off to the night-shift resident would suffice. It was a strangely thoughtful gesture for the Chief Oncologist, who was known to never trust residents on principle and who she’d thought couldn’t remember her face.
Fiona would return to St. Anne’s to do doubles through New Year’s, three long free days in between, and when she did, June would already have been relocated to the ICU after receiving her transplant. If Kapstein needed another substitute in that time, an intensivist would be the better choice.
She watched June for a while, resisting an urge to stroke her head; the gesture would undoubtedly have been met with dismay. June wasn’t a child.
“Do you believe you deserve the long odds of the transplant because of what happened with your brother?” Fiona asked in a soft voice. She’d told June that she’d talked to Jessie about what had happened. Now that the first shock had passed, she had a hard time feeling guilty about the fact that she had tried to help, even if it had been for the wrong reasons.
Stress and treatments having worn her down, June’s eyes started filling with tears. Angrily she brushed them away. “I’m eighteen. I can do what I want. I don’t need them for anything now.”
Then she muttered abruptly, “They left us alone all the fucking time.”
“Your brother must have loved you a lot, trailing after you like that.”
The tears were running down June’s face now, silently melting onto the pillowcase.
“I didn’t want him to go on a ride with those guys,” she whispered. “But I couldn’t leave him alone in the house.”
Fiona remained quiet for a moment, hesitating. If she had learned one thing in these two days, it was that she shouldn’t assume she knew enough to judge.
But now, she was clear on one thing: June was eighteen and allowed to make her own calls. She’d decided to go build her own life on her own terms, no matter the odds. No, it wasn’t perfect, and the transplant probably wouldn’t turn out well. But it was still her choice, not Fiona’s. Fiona had different choices to make.
Suddenly it was impossible for Fiona to blink away the exhaustion of too many shifts in a row.
“You’ll be all right,” she told June quietly. It wasn’t a promise, but a statement of fact. It had nothing to do with whether the transplant would take.
* * *
When Fiona made her way out of the hospital, the halls of St. Anne’s seemed eerily empty, as they had throughout the Christmas shifts. She wondered if they ever really had been quiet, or if the strain of the last five months had made her see things that weren’t really there.
An icy breeze and a heavy wave of snow hit her full in the face in the parking lot, which was entirely covered in ice. The snow poured onto her head as if a bucket had been dumped on her from the sky, and she surprised herself with a chuckle when she looked up, snowflakes tumbling into her eyes. She had always liked the way snow made her feel: free and slightly adrift.
Her car door was frozen to the frame, and it took two hefty jerks to get it open. When she slipped inside and turned the key, the radio came alive with a stutter, promptly spitting out another Christmas carol. It was “Jingle Bells” again.
Fiona wondered what she would do with herself in these upcoming days. Her empty apartment still felt daunting, the rooms too sterile and the walls too white. It didn’t have any personality yet. Somehow, she’d always expected that would happen by itself. She’d open the door one day, and it would finally feel like home.
Now she thought maybe she should spend her free days painting the walls in a color she actually liked. Maybe she could invite one of the neighbors’ kids to build a snowman in the yard, complete with a carrot for a nose; one of her neighbors was bound to have a kid.
One way to pass the time, she supposed.
Carefully navigating her car across the ice, Fiona turned onto the main road, rows upon rows of decorated houses left and right, lush Christmas lights and plastic Santa figurines on roofs. They might have looked silly, but a part of her still appreciated the trouble that people had gone to, the effort that they’d made to decorate the street for random passersby just because they could.
She thought about destroying things and making space for something new.