It's no fun if it's too easy. So I dropped a few hints in the next few sessions.
When the rest of them started talking about slashing and showing off their arms, criss-crossed with more stripes than a Bengal tiger, I made sure Dr. Laura saw my forearms. Scar-free. Muscular. Never seen the wrong end of a razor or even a ballpoint pen. I flexed them for her under the fluorescent light. I caught her frown and her glance at Dr. Ven, the dude who's heading up the therapy, but he was oblivious.
I winked at her. She frowned some more.
When they asked us about "abandonment issues," I listened to the rest of them. My dad left, my mom hated me, my friends think I suck, boo-hoo. Then we were supposed to write down all this shit and rip it up. "Take away its power," urged Dr. Ven. "Tear it up! Rend it! You are in control today!"
I left a blank sheet of paper intact.
I lingered in the hall after hours and heard her talking about me. "...not like the others...uncertain diagnosis..."
I smiled. You know it, darling.
Dr. Ven sighed. His lower voice was harder to make out, but I thought I heard, "...would probably benefit from individual therapy."
Bull's-eye. One-on-one with Dr. Laura, coming right up.
***
"So that's it," said Ryan.
I zipped my bag closed. I'd grabbed a change of clothes and tossed in a banana and a thermos of water, but now I was ready to rock. "Pretty much."
"You have to go back and deliver a baby now."
"Yeah."
"And then you have to work in the morning?"
"Yes. Outpatient psychiatry."
"What if your patient's still in labour?"
I'd stay with the woman until she delivered and then I'd go back to work, but the fastest way to sum it up was, "I cancel everything."
"Like us," he said, under his breath, but I heard it. And, as usual, I wondered if we were ever going to make it. Back down to zero in another sixty seconds.
I stood and faced him. "I'm sorry."
He gave me a crooked smile that reminded me why I loved him. "But babies are like death and taxes, right? They don't wait for anyone."
"Right." I surveyed him for another millisecond. Was he really okay with this?
"This is crazy. You get paid, like, half of what I do. You're always running around. On top of that, you want to solve a hit-and-run from eight years ago. And you still love it."
I paused, my keys jangling in the air. "Yeah, actually." As far as I was concerned, there was no other reason to go into medicine.
He reached for his shoes.
"Ah, Ryan. I could be there all right and the rest of tomorrow and even the next night."
"I'm coming with you. I'll walk back from the hospital. You're driving this time, right?"
I nodded. "You sure?"
He kissed the top of my head. "Someone's gotta look out for you."
***
Mrs. Valdez, my patient so recently assigned by Dr. Callendar, was waiting in the tiny triage room on the obstetrics floor. She sat in one of the padded chairs, her black hair loosely braided, her eyes glazed with fatigue. Her husband stood at her side, holding her shoulder.
"Took them long enough to find you," said the triage nurse, handing me the chart.
A volcano of anger erupted in my breast. How was that my fault? It took me a good five seconds to come up with a mild response. "Sometimes locating needs a little help." I took the chart. "Hello." I nodded at the couple while I refreshed my memory with the file notes. This was Mrs. Valdez's third pregnancy. Her contractions were eight to ten minutes apart. The nurse thought her cervix was closed and posterior. No blood or leaking fluids.
In other words, she wasn't in active labour. Yet.
"Doctor, we are very worried," said Mr. Valdez.
"I understand that. Hi, I'm Dr. Sze. I was supposed to meet you in my clinic, but looks like the baby wants to meet me now." I smiled at both of them, concentrating on Mrs. Valdez. She nodded at me and closed her eyes, leaning back in her chair and spreading her legs under her loose green skirt while I said, "I have a few questions. I know your regular doctor is Dr. Mackenzie. Is that right?"
She nodded. Her eyes tightened.
"Are you having a contraction now?"
She nodded again. Her husband squeezed her hand and said, "Can you help us, doctor?"
"I'll do my best." I glanced at my watch to monitor the time of contractions myself. "But first I want to know what happened to your other pregnancies. You had two miscarriages, one at six and one at twelve weeks?"
Mrs. Valdez said something in Spanish. Her husband translated and said, "Babies gone. All gone."
"So it's good this baby has made it this far. Let me examine you." Things weren't fancy at St. Joe's. The triage room consisted of one curtained examination bed, crammed right beside the nurse's desk, across from two padded chairs.
Although I'm no obstetrician, it took a lot longer for me to get her gowned, draw the curtain around her, and find the speculum in the second drawer and lube it up, than it did to check her and to agree that her cervix was nowhere near ready.
I explained that active labour meant contractions lasting at least sixty seconds, of strong intensity, every five minutes or less. The whole time, I was wishing I hadn't sent Ryan home.
It wasn't quite 1:30 a.m. when I slipped into the apartment, trying not to rattle my keys too much.
My heart in high gear and my brain was in about Mach-3, imagining what sinful situation Ryan had set up.
One fall, he planted tulip bulbs in a giant "H" on my lawn so that in the spring, I'd see my initial in bloom. He'd meant to do a giant HS&RW with a heart around it, but he ran out of bulbs. I was so overcome, I ended up doing him up against a tree, even though it was still pretty freaking chilly out.
Obviously, Ryan didn't have time for any great prep tonight. But he might be lurking in my bedroom, ready and waiting. Or he could have made me dinner with himself as the dessert.
I crept into my bedroom. He'd left the door open. The closed blinds filtered the street lamps into translucent moons.
The bed was empty.
I detoured into my living room/study, following his breathing. Here the shades were open. It was easy to find him crashed on the futon with his eyes closed, legs akimbo. As I stared at him, he rolled on his back and gave a slight snore.
Man.
No sex tonight for Dr. Sze.
I draped a fleece blanket over him, the one with a lion and a giraffe printed on it. Ryan muttered a bit.
I dropped a kiss on his lips.
He stirred and lifted his head.
I couldn't resist. I slipped my tongue against his lips.
He groaned.
My heart beat faster.
He slid back into sleep, and this time, I let him.
***
In the morning, my clock radio fired up and Smash Mouth sang "Daydream Believer," prodding me out of a dream that I was in an elevator. Before I'd fully processed that, I heard the door open and felt the mattress indent on the other side of the bed. Ryan sat beside me, balancing something in his arms.
I blinked and rubbed my eyes. He smiled, which only increased his gorgeousness to my grunginess factor. His hair was wet and combed back from a shower. He smelled like soap. He seemed to be holding my round cookie sheet draped in a red-and-white striped tea towel. Huh?
He whipped off the towel to display a big white bowl of Cheerios, a glass of milk, and one other item I couldn't decipher.
I had to laugh. "What is that?"
He handed it to me. "Your sunflower looked like it belonged in the kitchen, so I made you another one."
It was a piece of newspaper he'd folded into a tulip. My heart turned over. "Oh, Ryan."
"Hey, I gotta make it up to you for crashing last night. I wish you'd woken me up."
I wasn't sure how to answer. Part of me wanted to yell, Hey, why don't we make up for it right here, right now? Who needs Cheerios? The other part of me hesitated.
He saw that and patted my leg through the blanket. "I'll leave you to it. I've got to meet some guys for breakfast. Are you going to be okay?"
I nodded.
"I'll call you." He kissed my cheek. Ever the gentleman, he closed the door behind him.
So instead of wake-up sex, I ended up bolting down my cereal and calling the police.
I got a relaxed young constable, Donald Stewart, who told me that harassing phone calls are illegal under the Criminal Code. The first step is to figure out who's calling and the second is to prove they're harassing calls.
"How often do you get them? How many times a day?"
I tried to think. "Well, it's only been two days. If I include the hang-ups, up to five a day. I get weird pages too, but I don't know if that's a problem with the hospital operator or someone harassing me."
His silence told me he wasn't that impressed. Good thing neither of us had mentioned the 'detective doctor' thing. "What makes you think it's harassment?"
"I got this picture in the mailbox." I described it to him.
He said he could bring it to the station and they'd have a look, but no promises about the fingerprints. "It's not like in the movies. Now, for the phone calls. Press *57 right away, before anyone else calls. That's 'Call Trace.' You'll get a message saying if the call was successfully traced and you get charged five dollars per call up to ten dollars a month. The information gets sent to the police. But we have to get a warrant to access the information. It's not like the good old days when we could just talk to Bell Canada and get the lowdown."
"Oh."
"It's not that big a deal to get a warrant. All you need is a few hours' typing and a JP on your side. But we need it to figure out what residence it's coming from. That's the best-case scenario. A cell phone server is a little trickier, but still possible."
"What about a phone booth?"
"Then you're pretty much Euchred. Oh, can you hang on a minute?" A male voice crackled in the background and Donald Stewart answered him before coming back to me. "Could I call you back?"
"Of course." I gave my name and phone numbers, but I already had my suspicions. If I were making phone calls like that, I'd use a phone booth. I wouldn't have a pattern. I wouldn't leave a trace.
"We encourage you to press charges. But I've only done that once in nine years. Most of the time, once we figure out where it's coming from, the person drops the charges. It's usually someone you know."
Great. I'd tell Ryan about it when he called, but he was going back to Ottawa in the next two days.
This was up to me. I activated Call Display online. I also decided to keep a phone log and make *57 my friend. When I had a chance, I'd bring the tombstone pic to the police. Now that I squinted at it, I could make out some of the original words on tombstone:
William.
Beloved husband and father.
1869-1911
Whoever made this picture wasn't even good at Photoshop. That comforted me a little.
I arrived uncharacteristically early for work so that I could visit Reena in the ICU. I hadn't rotated through the Unit yet, so I felt a little shy when I passed the small, dimly lit waiting room and pressed the button for the automatic doors.
I felt even more out of place when I saw the row of patients along one wall. What was I doing here? I wasn't on ICU. I wasn't responsible for the psych consult. And I'd decided to wear a miniskirt today, so even with the white coat, I looked like I'd taken a wrong turn.
A nurse looked up and frowned at me. Fortunately, Stan Biedelman hailed me from a large, square table by the window where he was reading charts and drinking coffee. "Dr. Sze! Are you bringing us more business?"
"Not if I can help it," I said, sliding beside him. "How's she doing?"
"You'll never guess what she has."
I pointed at an open chart, hoping it was Reena's. "Can I have a clue?"
"No, and you can't call a friend, either," he said in a bad "Who wants to be a millionaire?" impersonation. "Try this on for size. She was unconscious. Her vitals were a little abnormal, temp of thirty-eight point-o, heart rate one-hundred to one-ten, otherwise normal. Her first drug screen came back negative."
The ICU doctor arrived and nodded at Stan. I stood up to go, but Stan said, "This is Hope Sze. She's the psych resident who was looking after bed 4."
The doc held out his hand. "Hi, I'm Dr. Wharton." He had a British accent.
"Hi."
"I was just asking her to guess the diagnosis," Stan said.
Dr. Wharton folded his hands and regarded us with some interest. "Don't let me stop you." The unit coordinator handed him a form, but he was still watching me.
Just what I needed, an impromptu audience. "Uh..." Fever. Unconscious. I mumbled to myself, "Dry as a bone, hot as a hare, blind as a bat..."
Dr. Wharton smiled. "The anticholinergic syndrome. But her pupils weren't dilated and her skin was sweaty, not dry. I'll give you another clue. Her tone was increased."
The problem is, you study syndromes, but patients present with symptoms, and you have to figure out what it is, under pressure, without sleep, without a textbook, and patients don't tend to follow the guidelines anyway.
"It's something you might consider with a psychiatric patient," Dr. Wharton added.
There are only a few reactions they emphasize with psych patients, so that narrowed it down. My brain clicked. Fever. Sweating. Rigid muscles. "Neuroleptic Malignant Syndrome."
"Right on," said Stan. "We figure she got some Haldol or something. She was allergic to it, you know."
Dr. Wharton nodded at me and took the paper from the unit nurse, ignoring us.
"That's right," I said slowly. I vaguely remembered that from her chart. "But how would she end up taking Haldol? We didn't prescribe it."
Stan shrugged. "Who knows?"
"Especially if she had a serious reaction in the past," I said to myself. None of it added up. Haloperidol was a relatively unusual allergy, not easily forgotten. And what about her Medic Alert bracelet? A nurse wasn't likely to ignore that and jab Reena with a syringe. Haldol is an antipsychotic, but Reena wasn't hallucinating. Sure, she'd been agitated, and we use it to calm down dangerously agitated patients. But Reena wasn't psychotic and she probably hadn't fled from our ER to another.
Stan said, "If you go through her chart, the first time she got Haldol, she got a bit spacey, temp of thirty-seven point nine, that was it. Nothing like this." He waved his hand at her bed. From here, all I could see was the nurse, curved over a metallic cooling blanket.
"So is she going to be all right? How was her night?"
Stan said, "We haven't rounded on her yet, but I think she was stable. At least, she doesn't look like she's on dialysis."
I had to click through that. With NMS, the muscles seize up and start to break down. If the kidneys can't handle the protein load, you need dialysis. But twenty-nine year-old kidneys should be okay. I took a deep breath. I still felt responsible.
Stan said, "You know what the differential is?"
I shook my head. I'd blown my load with NMS.
"Serotonin syndrome. She's like a walking teaching case. We should bring the med students here."
I checked my watch. I was running out of time before my clinic. "Can I swing by her bed?"
Stan smirked. "Go crazy." He caught himself, glancing at Dr. Wharton. "I mean, good idea."
Reena looked even paler than the night before. Someone had smeared Vaseline on her closed eyelids, protecting her eyes from drying out, but rendering her even more unfamiliar. She was still on the respirator. Her breath condensed inside the translucent tube. The nurse clicked her pen closed and glanced at me questioningly. I explained, "I'm from psych."
"Thought so. She can't talk to you yet."
"I know."
I heard a bang from the doorway. The nurse and I both turned. Reena's sister, Wendy, had dropped a big box of Tim Horton's doughnuts just inside the automatic doors. She wailed, "I'm sorry, I'm sorry."
Another plump, middle-aged nurse hurried over to help her. The box was still closed, but Wendy had stopped and folded her arms around herself like she was in pain.
The nurse managed to pick up the box and put her arm around Wendy, almost simultaneously. "Are you okay, hon? Who are you here to see?"
"Reena Schuster."
The nurse led her over while I debated staying at the bedside. I chewed the inside of my cheek while the nice nurse said, "Isn't she lucky to have a friend get up first thing in the morning to visit."
Wendy wiped her face with the back of her hand, muffling her word, but I caught it. "Sister."
"Oh, I'm sorry." The nurse paused at the central desk to hand her a tissue.
"It's okay. Everyone says that. We're f—f—foster..." She burst into tears.
I twitched. It felt wrong, me being here. "I'll come back later," I muttered to Reena's nurse, and fled.
The psychiatry department was located on the third floor of St. Joseph's hospital. No other specialty or patients came here, to what Stan called "the land of vomit carpet" (short orange shag carpet flecked with green). Between that, dirty cream walls and narrow hallways, and residual cigarette stink from "the smoking room," it was enough to make you run right back out again.
If you could. The ward was locked, meaning you had to press a buzzer and identify yourself before they let you in or out. So the suicidal and psychotic patients were kept in, for their own safety, but still.
I remembered my med school psych rotation in London, Ontario. I was assigned to the psychosis ward. Just the name made me laugh uneasily.
However, when they let me in, the nurse's station was filled with light from large windows. It seemed calm and bright and, as one, the nurses turned to smile at me and bid me welcome. Nothing like One Flew Over the Cuckoo's Nest. It was actually much more organized than the internal medicine wards I'd just left. One thing I couldn't get used to, though, was that the psych patients kept wandering up and asking for things. Can I have a smoke break? Can I have my pills? Can Shirley have her pills? Is it lunch time yet? Can I have another cigarette? Did my brother come?
Here in Montreal, it wasn't just the ugly décor that bothered me. It was the silence. The section where you get off the elevators and have to either turn left, towards the locked wards, or right, toward the outpatient hallway, the silence had a peculiar, heavy, muffled quality, as if the carpet had absorbed all sounds and signs of life.
If I were crazy, I'd go even crazier here.
I turned to the outpatient side. None of the staff or patients had arrived for the day. The metal cage at the appointment desk was closed, reminding me of a canteen after hours. Even with the stop at the ICU, I was still eager-beaver early for my first outpatient clinic with Dr. Ludovich. I strode down the hallway. All the interview rooms were empty, even though the signs on some of the doors were turned to "occupied." I paused to drink at the water fountain, then walked back to the stairs, still uneasy. I'd rather leave and come back than hang around here.
In the hallway, outside the office, I paused to study the plaques arranged at eye-height. They were your usual variety, gold etched on black, mounted on a wood plank. One was for the St. Joseph's Residents' Award in Psychiatry. I was always on the lookout for awards, in case cash played a part, but I nearly choked when I saw the name for 2002.
Dr. Laura Lee.
My breath hissed out between my teeth. Maybe it was a coincidence, but it felt like a well-placed reminder from Mrs. Lee.
To calm myself, I scanned the other names, but the only other one I recognized was Omar. He was the second-year resident on my team, along with Stan, and had won the award last year.
I checked my watch. Five minutes until show time. Not enough time to go anywhere, but an eternity if I had to hang around this hall of creepiness.
The stair door banged open at the other end of the hallway. I jumped.
A young man with chestnut hair stood there. His face pointed away from me. His hair was haloed in the light from the windows at the end of the hall. His arms bent casually at his side.
My entire body seized up. Alex.
The last guy I slept with, and the last person in the world I needed to see.
The guy turned toward me. "Hey. Can you tell me where the cafeteria is?"
His voice was too high, his hair too curly, and his nose was too big. Just a random teenager. Not Alex. My heart still raged in my chest. I pressed a fist against it and said, "You're on the wrong floor. Go down one more."
"Thanks." He waved a hand at me and disappeared back down the stairs, the door banging shut behind him.
Alex was officially on a leave of absence. No one knew when, or if, he was coming back. I did hear he was going through counseling somewhere, but he obviously wouldn't choose to do it at St. Joe's.
I forced myself to take deep breaths.
I couldn't get used to the fact that you could fall for someone, make love with him, and, weeks later, have no idea where he was or what he was doing. Even if it was supposed to be Good for Both of You.
Right.
I'd lost touch with Ryan, but it wasn't the same. The Ottawa Chinese grapevine, i.e. my grandmother, kept me in the loop the whole time.
Alex could be incarcerated or incinerated, and I'd have no idea.
By the time I'd calmed myself down, it was one p.m. Time to amble toward Dr. Ludovich's office and pick up my first case.
Dr. Ludovich was a fifty-something blonde in a proper burgundy suit. She didn't waste much time on niceties. She said, "Welcome." Her accent sounded Eastern European or Russian. "Your first patient is a young man, Daniel Culpin. Here is his chart. He should be in the waiting room. You may pick either of the two interview rooms down this side of the hallway. Make sure you turn the sign to 'occupied' so that no one interrupts you. You should take a maximum of 45 minutes with each patient, so that we have time to review the case. You may go now."
Talk about getting to the point. Well, at least she didn't call me the 'detective doctor.' Also, organized doctors tend to start and end on time, instead of yammering away about hypertension for an extra hour while you try not to peek at your watch.
The "waiting room" was a bench near the elevators. St. Joseph's was not big on patient confidentiality. Just as I stood up to go there, my pager went off.
I didn't recognize the seven-digit number after the 514 area code. It looked like someone's phone number. It certainly wasn't St. Joe's. But what if they paged me to the pregnant patient's house or something?
"Excuse me," I said to Dr. Ludovich. "I'm just going to answer this now so I don't interrupt my session."
Her lips compressed. "Very well. You may use my phone, line one."
I punched the number in.
A woman moaned at me.