The Devil You Know

by Freida McFadden

  “Hi, Dr. Kirschstein,” I say.

  “Dr. McGill,” he says. “I’d like to share a word with you.”

  “Sure.”

  “We’re having a guest speaker next week at Grand Rounds,” Dr. Kirschstein tells me. “So she’ll require extra assistance on your part.”

  “Of course,” I say. In my head, I’m wondering how I can shaft this grand rounds responsibility onto someone else in the near future. “Who’s the speaker?”

  Dr. Kirschstein beams at me. “She’s an expert on hospice care. And with our aging veteran population, I think this is an incredibly important point of interest.”

  “Yeah, that’s true.” Hospice is an incredibly underutilized service, in my opinion. Many elderly people spend more on healthcare in their last six months of life than in the entire rest of their life. And for what? To die in a hospital? I want to die at home. Surrounded by people who love me. Possibly while eating an ice cream sundae. “Who is the speaker?”

  “Her name is Dr. Alyssa Morgan.” Dr. Kirschstein raises his eyebangs at the look of absolute horror on my face. “Oh, do you know her?”

  _____

  Dr. Alyssa Morgan.

  I could write a novel about that woman.

  Alyssa was my senior resident during the first month of my intern year of residency. That meant she was in charge of training and supervising me during the very first month that I was a physician. Instead, she nearly made me quit. Over and over.

  Okay, to be fair, I wasn’t the most knowledgeable intern on the face of the planet. But no matter how much I studied, there was no way I could automatically know that ordering an echocardiogram at County Hospital inexplicably required two forms instead of one. There was no way I could round on ten patients in sixty seconds. There was no way I could have every lab ever ordered on a patient over their lifetime at my fingertips while presenting a patient.

  But that was just the tip of the iceberg of what Alyssa expected of me. Her favorite phrase was, “How could you not know that by now?” She used it on my second day.

  By the end of my month with Alyssa, I hated her with every fiber of my being. I hated my life, and the only thing that kept me going was the sexy surgery resident who used to make visits to my dorm room. Then I moved on to a new rotation and had a new senior resident named Lily who was… lovely. Inexplicably lovely. If I didn’t know a lab value when I was presenting a patient to Lily, she would say, “Don’t worry! We’ll look it up together.” Then we’d skip off to the computer together. Lily covered a patient of mine once so that I could have an extra day off. She even bought me lunch on two separate occasions!

  It was something of a vindication to discover that there were plenty of other interns who didn’t like Alyssa, but nobody hated her quite as vehemently as I did. But that’s okay—every intern seemed to have an Alyssa of their own. My best friend during residency Nina had it out with her senior resident right in the middle of the ICU when the resident repeatedly undermined her and badmouthed her to their attending physician.

  When I became a senior resident, I remembered the way Alyssa was and tried to be the opposite, even when my interns turned out to be grossly incompetent. No matter how much they baffled me with their stupidity, whenever they did anything right, I would reward them with an enthusiastic, “Good job!” The truth was, I didn’t have it in me to treat an intern the way Alyssa did. It’s probably the same reason my daughter didn’t get potty-trained until she was nearly four years old.

  After Alyssa finished her residency, she impossibly did a fellowship in hospice and palliative medicine. Of all the fields I imagined Alyssa doing, hospice would have been my last choice. It seems like by definition, hospice medicine calls for a physician who is remarkably kind and caring—everything Alyssa was not. Unless it was one of those things where after dealing with Alyssa, you’re just kind of glad to die. That was probably it.

  I’ve run into Alyssa a handful of times since then. You’d think after all this time, my memories of her would have faded—and they have. I don’t stay up at night thinking about all the things I wish I had said to her. But on the rare occasions that I run into her, I sort of want to punch her in the face. And by “sort of,” I mean “desperately.”

  So when Dr. Kirschstein tells me that I have to show her how to use our AV equipment or just even be within arm’s length of her, I want to throw up. I’m not even joking. I feel this instant, dizzying nausea that takes me a few seconds to recover from.

  “Alyssa and I were in residency together,” I explain to him.

  “Is that so?” Dr. Kirschstein smiles in amusement. “You are certainly quite well-connected, Dr. McGill! It seems like you know everyone. Next you’ll be telling me that you know Benedict Cumberbatch.”

  Benedict Cumberbatch? That’s such an odd choice of someone a well-connected person might know. Why didn’t he say, “Next you’ll be telling me that you know the President”? Or even, “Next you’ll be telling me that you know Kevin Bacon.” Why Benedict Cumberbatch?

  “Well,” Dr. Kirschstein says, “I expect you’ll make Dr. Morgan feel at home here at the VA. She’s a quite well-respected physician.”

  Is she? Damn. I was hoping she’d been discredited and disgraced.

  After Dr. Kirschstein leaves, my fingers start itching to send Ryan a text message. He’s the only one around who truly knows how much I hated Alyssa. Ben has heard the stories, but he wasn’t there when it happened, so he doesn’t really know. Of course, Ryan could match Alyssa shot for shot with being cruel to his residents. But Ryan was actually trying to make his interns cry—Alyssa just did it because it was her personality. Now that I think of it, I’m not sure which was worse.

  Before I can stop myself, I retrieve my phone from my purse and shoot a text message to Ryan: Alyssa Morgan is giving grand rounds at the VA next week!

  I must have caught him between surgeries, because he responds after only a few seconds: The devil returns.

  I smile. That’s the great thing about Ryan. Even though he barely had any interaction with Alyssa during residency, he still remembers her on my behalf. I write back: Maybe she’s nice now.

  Maybe. Just don’t strangle her to death. You’ll be the first suspect.

  Chapter 32

  Tonight Ben and I have special plans. We’re going to a peanut butter tasting. Don’t laugh.

  This is part of our marriage counselor’s directive that we spend more nights out as a couple. Ben is obscenely excited about the whole thing. He discovered it about two weeks ago, and it’s practically all he can talk about. He’s been texting me about it all day. They’re promising several dozen varieties of peanut butter and unlimited milk to go with them.

  It’s an event for adults. I swear.

  We have a babysitter booked. Ben has agreed to pick Leah up at preschool so that I can make one final stop after my clinic ends and still get home in plenty of time to taste twenty-seven different varieties of peanut butter. After I conclude the note on my final patient, my phone buzzes with a text message. It’s Ben.

  Do you think they’ll have samples we can take home?

  I smile at the phone. I imagine the two of us leaving the tasting with a dozen little containers of peanut butter samples. I don’t think he was this excited when we got married. And he wasn’t exactly casual about us getting married. He was shaking so much during the ceremony that he dropped the ring while trying to get it on my finger. Twice. One of his buddies posted a video of it to Facebook under the title, “Ben’s epic wedding fail.”

  Don’t you have enough peanut butter? I write back.

  Ben replies: No such thing.

  I glance at my watch. I have just enough time to pay a quick visit to Mr. Katz’s hospital room before I have to take off.

  Mr. Katz has been transferred to the Medicine service, as his medical needs have now superseded his neurological needs. On top of the pneumonia, he developed a blood clot in his leg that traveled up to his lungs, so they’ve put him on
a heparin (a blood thinner) drip. Mr. Katz seems to be one of those patients who is destined to have every complication there is.

  I take the stairs to the Medicine floor, deciding I don’t want to deal with another encounter with George. Even with all the sick patients on the Medicine service, the floor is quiet right now. The way my shoes create loud echoes when they touch the ground makes it feel more like it’s midnight rather than barely five o’clock.

  When I reach Mr. Katz’s door, I see a young man in scrubs leaving the room. I read the ID tag clipped to his shirt pocket: “Deepak Singh, MD.” And underneath, “Vascular Surgery.”

  When the surgeon sees me approaching the room, he smiles apologetically, “Mr. Katz is asleep.”

  “Oh,” I murmur.

  Dr. Singh raises his bushy black eyebrows, verging on a unibrow. But at least he doesn’t have eyebangs. “Are you… his daughter?”

  “Me?” I look at him in surprise, then I realize that I’ve pulled off my own ID badge and am now wearing my jacket. I’m surprised I didn’t get stopped sooner. “Actually, I’m Dr. McGill. He was… is… my patient. Outpatient. In primary care.”

  “Oh!” Dr. Singh nods. “Sorry, you just looked… I mean, you seemed so concerned… not that you wouldn’t be as his doctor, but…”

  I raise my hand. “No, it’s okay. Don’t worry about it.” I look over the young surgeon. He doesn’t remind me much of Ryan or most of the surgeons I’ve met—he’s too nice. “Are you Dr. Reilly’s resident?”

  For his sake, I hope not.

  Dr. Singh smiles. “Yikes, do I look that young to you? No, I’m an attending surgeon. Finished my fellowship and everything.”

  I frown at him. “Yes, but…” Where the hell is Ryan then? Too good to see the patient he screwed up on? “I thought Mr. Katz was Dr. Reilly’s patient?”

  He hesitates, and I get this awful, sick feeling in the pit of my stomach. For a moment, I’m sure I’m going to lean forward and vomit all over this nice, young surgeon. But I keep it in at the last second.

  “Dr. Reilly isn’t seeing any patients anymore,” Dr. Singh says quietly. “For… medical reasons.”

  I stare at him. “But he still works here?”

  He nods. “Yes. But he’s not involved in patient care.”

  I glance down at my watch. Ben is going to go crazy if I’m late, but there are some things more important than peanut butter. I can’t leave here while still wondering what happened with Ryan.

  I mutter a quick goodbye to Dr. Singh, then sprint down the hallway. I take the stairs two at a time to get to Ryan’s office. Although whatever time I saved by racing up the stairs is lost when I spend a good sixty seconds doubled over in the stairwell, gasping for breath. I probably should get in shape again one of these days.

  I nearly miss him. When I get out of the stairwell, I see Ryan locking the door to his office and race the rest of the way as fast as I can.

  He’s not wearing scrubs. He’s in fact wearing a nice pair of gray dress pants with a pressed white dress shirt and a blue tie that makes his eyes look that much bluer when he turns to face me. Ryan in scrubs is handsome—Ryan dressed up is almost painfully handsome. I feel like I should shield my eyes.

  “Jane.” He scrunches up his forehead. “Are you okay? You look like you just ran a marathon.”

  I didn’t run a marathon, but I did go up three whole flights of stairs. “Are you not seeing patients anymore?” I manage.

  He doesn’t answer me right away. He glances around to make sure we’re alone in the hallway, which we obviously are, since it’s OMG five o’clock. Finally, he says, “Who told you?”

  “Dr. Singh.”

  Ryan sighs and his shoulders sag. “Yeah. That’s pretty much the situation.”

  “What happened?”

  He sinks against the wall, shaking his head. “I was doing a surgery last week and… I don’t know what the hell happened because it’s never happened before. My hand just would not stop jerking. I had to scrub out and get Singh to finish the surgery for me.” He shuts his eyes. “About five minutes later, the department chair called me into his office. I had to tell him everything.”

  My phone buzzes inside my purse. It’s almost certainly Ben. “I’m sorry,” I murmur.

  “So that’s it,” he mutters. “No more operating for me. Ever again. I get to do paperwork for the rest of my goddamn life.”

  “You could still see post-op patients, couldn’t you?” I ask.

  “Yeah, big thrill.” He rolls his eyes. “I could, but they don’t want me to. No patient care. They don’t trust me. They think the Huntington’s might affect my judgement too.”

  “Well, there are usually cognitive deficits associated with Huntington’s,” I point out. “Don’t most people with it get demented?”

  Ryan stares at me. “Really, Jane?”

  “Sorry,” I mumble. Although it’s true.

  My phone buzzes again inside my bag. Ben’s going to kill me if I don’t get home soon. He’s not that understanding when it comes to peanut butter.

  “Is that Pip trying to reach you?” Ryan asks me.

  “It’s okay,” I say.

  “No.” He shakes his head. “You should go. You’ve obviously got somewhere to be.”

  “It can wait.”

  Ryan rolls his eyes. “What—are you worried about me? Well, don’t worry. I’m fine.”

  My phone buzzes again. “Are you sure?”

  He raises his eyebrows at me. “Don’t I look fine?”

  Actually, he does look fine. More than fine, if I’m being honest.

  “The truth is…” He glances down at his watch and winks at me. “I’ve got to get out of here too. I’ve got a date.”

  I manage a smile. “Hooking up?”

  “She wishes.”

  I laugh at that because he’s probably right. It always seemed sick the way girls used to fall over themselves for Ryan. And whatever else he’s lost, he definitely still has the quality that drew women to him so reliably.

  The truth is, he’s taking this a whole lot better than I thought he would.

  Chapter 33

  My Alyssa-related responsibilities on the day of her Grand Rounds the next week not only involve helping her set up her presentation, but I also have to pick her up at the Long Island Railroad, because she is coming in from Manhattan and doesn’t have a car. I am Dr. Jane McGill—maid for examining rooms, laundress of hospital gowns, and now chauffeur for Grand Rounds presenters.

  Dr. Kirschstein forwards me Alyssa’s itinerary for the morning (only Alyssa would have an itinerary for a morning trip to Long Island) and advises me to show up “well before” the arrival time of Alyssa’s train. That doesn’t quite go to plan when Leah face-plants during the long, long journey from the garage door to the car, and I have to take her back into the house to wash and cover her wounds with Frozen Band-Aids. I end up driving like a madwoman to make it to the LIRR on time.

  I beat out Alyssa’s train by mere seconds. I watch it pull into the station as I get that horrible feeling in my stomach that accompanies every interaction I have with this woman. I shift from foot to foot, clenching and unclenching my fists. I silently recite my mantra:

  She has no power over you anymore. There’s no reason to be afraid of her.

  Except it doesn’t work. Even if I live to a hundred, I will always be afraid of Alyssa Morgan.

  My hands ball into permanent fists as I see Alyssa emerge from the train. Alyssa was several years older than me when she was my senior resident, and I estimate that by now, she’s at least in her mid-forties. But she doesn’t look a day older than she had been during that month when she made my life a living hell. Alyssa isn’t beautiful but she’s got a timeless appearance, with her high cheekbones and strong jaw. She always kept her hair swept up during residency, but now her straight brown locks fall just below shoulder-length, barely sweeping the edge of her gray suit-jacket.

  Although I’ve seen Alyssa a handful of
times since residency, this is the first time we’ve had to do more than smile and nod. I’m actually going to have to speak to her. And presumably, be pleasant. This is going to be a challenge.

  Alyssa glides across the train platform. She regards me briefly, then strides right past me like I’m a homeless person she’s trying not to make eye contact with. She looks around the platform, maybe checking for someone holding up a big sign that says “DR. MORGAN,” or perhaps a stretch limousine waiting for her.

  I clear my throat, but Alyssa doesn’t turn. Finally, I call out, “Alyssa!”

  She turns and regards me with more curiosity. I’m genuinely baffled. She knows that someone is here to pick her up—why is she having so much trouble figuring this one out?

  “I’m here to take you to the VA,” I tell her.

  Alyssa’s face falls. “Oh.”

  I don’t know what to say. Should I apologize?

  No, I shouldn’t! I schlepped all the way over to the LIRR to pick her up. And I’m not even late, in spite of a major tripping incident this morning.

  Alyssa finally holds out her hand to me. “I’m Dr. Morgan.”

  I stare at her hand. I’m not entirely sure what to do. Should I pretend we’re just meeting each other for the first time, even though we worked together for two years? Finally, I say, “I know. It’s Jane. You remember me, right? Jane McGill.”

  Alyssa’s eyes widen. “Oh! Jane… I didn’t realize. You look…”

  I’m very glad she doesn’t finish that sentence. I genuinely don’t want to know how it ends.

  I lead Alyssa to where I parked my car, and she looks nothing short of horrified by the sight of my Toyota Camry. I’m a VA internist—did she think I was going to be driving a Mercedes? Okay, the car does have a few scratches on it, including one really long scratch that runs across both the front and back doors on the right side. Also, there’s that big dent in the front fender. And the smaller dent in the back fender. But that’s just body damage—it’s fine on the inside and that’s what counts.