New York Doc, Thailand Proposal

by Dianne Drake

  She listened to Mongkut’s heart and the beat was off. Too slow, too labored, with some kind of arrhythmia she couldn’t identify just from listening.

  “The next thing that can happen is a cardiac arrhythmia, where the heart isn’t beating correctly, and usually not pumping hard enough to distribute oxygen to all the places it needs to go.”

  She felt his carotid artery again and the pulse there was decidedly slower than it had been only moments earlier. But Mongkut was alert, still showing no outward signs of pain. Yet. Which was often the case when the body was shocked so drastically that the normal reactions weren’t felt.

  “Finally, we get to renal failure, meaning your kidneys shut down and the waste products start spreading through your body. Sometimes that takes a while, but if you’ve had a kidney injury, it can happen pretty fast.”

  She was glad he couldn’t understand what she was saying because there was nothing good here. No help, no hospital, no treatment.

  “Right now, you’re not experiencing symptoms because, as your muscles are breaking down from a lack of oxygen, toxins are building up, getting ready to rush into your bloodstream. But the cart on top of you is acting like a dam, holding those toxins back. Keeping you alive.”

  Even though Mongkut couldn’t understand her, she didn’t have the heart to tell him what might happen once the cart came off.

  “So, let’s hope someone comes along pretty soon to help us.” Optimistic words meant for her, not for Mongkut. “Because I’m sure you have a family at home waiting for you.”

  In her mind she saw a young wife, maybe a couple of young children, perhaps a baby. Sad images. Images she didn’t want to have. Images that brought tears to her eyes that she tried hard to sniff back for fear he would see them then begin to sense what was really going on. She didn’t want him to know. Not yet. Because if there was life, there was still hope. There had to be hope.

  “And I’m not going to leave you, Mongkut,” she said, automatically reaching over for the other carotid pulse, knowing the results before her fingers even touched his skin. “So, tell me about yourself,” she said, even though that was impossible. But the sound of her voice was comforting to her, so she prayed it would be comforting to him as well. Especially as she struggled to sound upbeat. “Are you from around here?”

  He must have guessed that to be a question, because he responded. His voice was weak, but he didn’t sound scared, and she was grateful for that. As far as she knew, he was still feeling no pain, which, to almost everybody in his situation, meant nothing was wrong. “I’m originally from California, but my parents moved us to New York when I was young, and I loved our house...”

  She looked up the road, hoping to see someone, but no one was coming. So she continued to hold his hand, feel for his pulse and talk—talk about anything. Because the words didn’t matter. But being there with him—he needed to know he wasn’t alone. Maybe that would ease his fear a little. Because it was beginning to show on his face.

  So she talked, describing her house, the journeys she’d taken with her parents, the ups and downs of medical school and, after what seemed like an eternity, she finally heard a sputtering engine, one she recognized as Arlo’s scooter. “Sounds like help is on the way,” she said, stretching to look over the cart as Arlo came to a stop on the other side.

  “Layla?” he cried, running over to her. “Are you hurt?”

  She shook her head, fighting for control. “But Mongkut here is.”

  Arlo jumped down into the shallow ditch next to Layla, then smiled at the young man, who returned the smile. “What do we have?”

  Layla swallowed hard before she said the awful words. “Crush injury.”

  “Are you sure?” Arlo asked, immediately grabbing Layla’s stethoscope to listen to Mongkut’s chest.

  “I’ve been here fifteen or twenty minutes, and he’s shifting down rapidly. Is there anything we can—?”

  Arlo pulled the stethoscope off and handed it back to her. “Nothing,” he said. “Not a damn thing.”

  She nodded, too afraid to speak for fear Mongkut would hear the discouragement in her voice. “So, what happens next?”

  “He has a young wife and a baby daughter. His parents also live nearby as well. I think I need to bring them here. He needs them, and they should be with him when he...” He turned his head away. “Can you stay here with him, or do you want me to do that?”

  “You know where his family is. You go.”

  “Are you sure?” Arlo asked, still looking away.

  “I think you’d better hurry,” she said. “I don’t know how long he’s been down, but I think it’s been a while.”

  Arlo nodded then turned back to look at her, his eyes brimming with tears. “I’ll be back as fast as I can.” He pulled her close then hugged her. Then whispered, “I’m so sorry you have to do this.”

  His touch made her feel better. His kindness, his empathy... “Me, too,” she said, wiping back tears. “It’s the part about being a doctor I hate. The part I try to pretend doesn’t exist until I can’t pretend any longer.”

  With the back of his hand he also wiped away the tears streaming down her face, then kissed her lightly on the forehead. “I wish I could stay here with you, to take care of you and help you through it. You shouldn’t have to do this alone.”

  “Neither should he.” She looked down at Mongkut, whose eyes were shut now. “And there’s really nothing left to do, is there?” She swallowed hard, as the man’s breathing started to go agonal—a sort of gasping that happened just prior to death. “Get his family here, Arlo. Please...”

  He nodded, then squeezed her hand, stood up and ran instead of getting on his scooter, which, at its top speed, was painfully slow, leaving Layla alone there, still holding Mongkut’s hand. “He’s gone to get your family. It shouldn’t be long.” And it wouldn’t be. But she desperately hoped it would be long enough for his family to get here, to help him go on.

  Mongkut smiled, then nodded as if he understood, and Layla wondered if somehow he did. “Anyway, let me tell you about the time in medical school when I—” She looked down at Mongkut, who was listening, but she noticed his eyelids starting to flutter. “You can’t go to sleep,” she said. “Your family’s on the way, and you need to stay with me until they get here.” She gave his hand a squeeze, but this time he didn’t squeeze back. And his eyes finally fluttered shut. “I’m so sorry I couldn’t fix it,” she said, then stared off down the road, waiting for Arlo to come back. Not letting go of Mongkut’s hand, even though he was gone.

  * * *

  An hour later Arlo found Layla sitting in the dark, on the supply-closet floor. Not crying. Barely moving. “What can I do to help you through this?” he asked, sitting down next to her and pulling her into his arms.

  “Sitting here like this is good. When I don’t see anything around me, I can shut off my mind. Sometimes I have to do that—just shut down.”

  “What about feeling someone around you? Can you shut yourself off then?”

  “I don’t know,” she said, honestly. She leaned her head into his shoulder. “I don’t let myself get this involved, so I really don’t know.”

  “You did everything you could,” he said, sliding his arm around her. “His injury was too severe to fix.”

  “I knew that. But still...” She swatted at tears streaming down her face. “Sometimes there’s just so much futility.”

  “Back when I was a resident, sometimes when I’d walk away from something I couldn’t fix, I’d stand outside in the hall to collect myself before I turned myself loose on the world. Usually, I wanted to punch the wall. I still do, sometimes. Mentally, not physically—hands of a surgeon and all that. So I know what you’re going through, Layla.”

  “You never told me that.”

  “Because I always wanted you to see me as better than I really was.”
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  “I never saw anything but good in you, Arlo. Even though we had problems, I always thought you were an amazing man and an amazing surgeon.”

  “Thank you,” he said, his voice almost a whisper. “That means a lot to me.”

  Layla sighed. “What we just did out there—I want to reframe it. I don’t want to see it in my mind, but the darkness isn’t pushing it away. And I’m not good at forgetting.”

  “Because you always think there’s a way to make things different. Like with Mongkut. His destiny was sealed before you got there, but you helped him. He wasn’t alone at the end. You were there, holding his hand. It’s a good thing, Layla. Nothing that needs reframing. And I’m so proud of the way you took care of him even when you knew...”

  “I’m glad you’re here now. You always took good care of me in the bad moments. I liked that. Got spoiled by that.”

  “I didn’t know.”

  “Because I didn’t tell you. What was the point? What was the point in telling you a lot of things? You weren’t going to stay. You weren’t going to be a real part of my life. I always hoped holding back would keep me from getting hurt in the end.”

  “Did it?”

  “No. I liked us—together. Loved us together. Loved you, Arlo. I loved you.”

  “But you loved your independence more.”

  “I needed that independence to survive. Did I love it more? I don’t know. Maybe at the time I did because I was struggling so hard to find out who I was. And there was you—the rock-solid man who’d found himself long before we’d met. I wanted to be what you were, Arlo. But I wasn’t at a place in my life yet where I could make that happen. All I knew from life was that if it didn’t turn out the way I thought it should, it would break my heart. So I really didn’t embrace the opportunities I had.”

  She started to relax against him. “Living large, as they call it. That’s what’s always frightened me most. I didn’t know how to do it because everything I had was handed to me. I’d never had to work hard for anything, and I didn’t know how. Which made me hide behind a wall of independence that would have crumbled in a slight breeze had it ever really been tested. It was a façade, Arlo. And I was a fake.”

  “So even now you hold yourself back. Shut yourself in the dark and pretend the scary things don’t exist.”

  “Sometimes it works.”

  “And now?” He tilted her face toward his. “Is it working now, Layla?”

  Rather than responding, she reached over and ran her hand through his curly hair. Then she kissed him. Thoughtfully, deeply. Urgently. Once, twice, until every pore in his body was filled with longing, and every nerve-ending in his mouth tingled. Harder, deeper, with a need he’d never felt in her before. “Should we stop?” he whispered, pulling back from her, but only slightly. He hoped she would say no, hoped that she would insist on continuing. But this was Layla, and she was not predictable. Not in anything they’d ever had between them.

  “Do you want to?” she asked.

  He had no will to tell her no, but answered her with his lips pressed to her cheek, causing her to shiver so hard he could feel her body tremble. “I can. Right now...” He brushed the hollow of her temple. “Or now.” Next, he brushed kisses to the line of her cheekbone then continued down to her throat, her shoulder, finally nuzzling his way into the top of her breast. “Tell me, Layla. Because I won’t stop if you don’t.”

  Again, she said nothing, but she did knot her fists against his chest, then slowly, very slowly splayed them open and pulled him hard against her. Arlo groaned softly, a low growl in his throat almost, then circled his arms, pulling her on top of him. As he slid down to the floor from his sitting position, she slid with him, on top. And they rolled over to let him take the top position, still tangled together, still kissing. Then she reached up, ran her fingers through his hair once again, something she’d always done, something he’d always loved, and she finally spoke. “No, don’t stop.”

  * * *

  “You’re a damn good doctor, Layla. A damned good surgeon. People with your skills don’t come along that often, so why give up everything you’ve worked so hard to accomplish only to become what my grandfather is—a great administrator who’s been away from patient care so long he’d be a detriment if he stepped back in. Is that what you really want for yourself? To keep yourself hidden away from your true talent?”

  It was evening now, and they were sitting on the front step of the hospital, eating bowls of sticky rice and fruit. What had happened in the closet—they hadn’t spoken of it. It had been a brief moment in time, a little bit of history repeating itself, and Layla was afraid to think past that, afraid because she wanted more, but she didn’t trust herself enough to believe that she could ever be enough for Arlo. She wanted to be, but her only real confidence was in her ambition and not in what she truly wanted.

  Maybe because the one thing she’d always wanted—her parents’ respect—had always been refused her. They were excited now that she was finally advancing. Showing more interest in her now than ever before. And in a life where she’d futilely tried to earn their respect, she was afraid to walk away from the sure path. “What if administration is my true talent?”

  “What if patient care is?”

  “Here, in the jungle, like what you do?”

  “Anywhere you want, Layla. You just don’t trust yourself enough.” Arlo took her bowl and set it down, then took her hand and pulled her up off the step. “I want to show you something.”

  Rather than heading through the village, they turned away from it and walked, hand in hand, down a moonlit dirt path until they came to a pool of water. In the glow, she could see it was surrounded by massive boulders. And she could hear night sounds: birds and monkeys. Maybe even Chauncy, looking for his lady love. It was a beautiful place, filled with such peace she didn’t even think about the snakes or the other things she feared. With Arlo, she was safe.

  “See that rock?” he said, pointing to a large round boulder sitting just at the water’s edge. “Let me help you up there.”

  “Why?” she asked, as he pulled her in that direction.

  He didn’t answer, though. Instead, he bent to give her a foothold, and there she was, sitting atop a boulder and trusting Arlo enough to simply experience the moment without her usual doubt or fear.

  “Now stand up,” he urged, reaching up to hold her hand as she did so. “And shout, ‘I am strong.’”

  She hesitated for a moment, not because she didn’t want to do as he instructed but because this was a perfect place, a perfect moment and she didn’t want that to change.

  “Do it, Layla,” he urged. “I am strong.”

  Smiling, she nodded. Then drew in her breath and shouted, “I am strong.” And her voice echoed back to her. Strong...strong...strong...strong. For an instant the monkey chatter stopped, and the birds went silent, and all she could hear were her words. “I am strong,” she whispered. Then she shouted again. “I am strong.” Strong...strong...strong. And closed her eyes to take in only her voice. Her voice. Nobody else’s.

  “You always have been,” Arlo said. “You just never knew that.”

  She smiled down at him but didn’t speak as there were no words to say to the man who’d just given her the world.

  CHAPTER SEVEN

  “KANYA BANLENGCHIT HAS asked us to take the evening meal with her and her family tonight. She has three small children, so they eat early—if you’re interested.”

  They’d spent the day working, going in different directions, passing each other on the road occasionally, but only long enough to wave or say hello. It was good. He liked the hard work, and watching Layla throw herself into things like he’d never seen her do before made him happy. She was actually smiling each time they met up. Smiling, enjoying her work, anxious to get on to the next patient.

  It didn’t surprise him that they worked so
well together. They shared the same ethic, the same skill. But they’d always been beaten by their different destinations. Not so now. Even though they weren’t together, they also weren’t apart.

  Layla, who was stretched out on her cot with Chauncy, raised herself up to look at him. “Tell her I appreciate the offer, but I’m really exhausted. I don’t know when I have ever worked so hard.”

  “Did you enjoy it?”

  She laughed. “If I admit that I did, are you going to tease me about all the times I told you I would hate it?”

  His eyes crinkled into a smile. “Probably.”

  “Have you no pity for the doctor with blisters on her feet?”

  “Aloe vera is a good cure for that and, as it happens, several of the ladies here grow it in their gardens.”

  Layla’s response was to moan. “And if I tell you my leg muscles ache, you’ll tell me to eat more magnesium-rich foods, then run out and pick me some bananas.”

  “Thailand does have about a hundred different varieties.”

  She sat her tea cup aside and dropped back onto her pillows. Chauncy got up from his spot at the end of the cot to investigate what was left in the cup. “Raincheck?”

  “Food’s been cooking all day. People will be offended.”

  “So how long before I have to go?”

  “Right now,” he said, with the most innocent of all smiles she’d ever seen on him crossing his face.

  “And when were you supposed to have told me?”

  “This morning.”

  She sat back up, then climbed off the cot. This reminded her of some of their dates. He’d make the reservations then forget to tell her until the last minute. Or he’d accept a party invitation then tell her about it thirty minutes after they were supposed to arrive. Typical Arlo. Actually, she’d gotten used to this and found it almost endearing. Almost. “I’ll be ready in twenty. After my shower.”