by Dean Mayes
“It’s all right,” she replied.
Turning to a trolley beside him, Arlo found a box of adhesive ECG pads.
“You’re seeing Fedele today, I take it?” he inquired, inspecting each of the cables in turn.
Casey nodded. “This afternoon at three. Just gathering the usual data for him to pore over.”
“Oh that’ll be fun,” he commented with a knowing smile. “I take it you’ve been running to and fro here.”
“Oh, sure. It’s been a real party,” Casey retorted dryly. “It seems like this entire bloody hospital is filled with people who are in desperate need of a personality transplant.”
Arlo chuckled pleasantly. “This place tends to breed eccentric personalities, I’ll grant you. But, you appreciate the importance of all the tests.”
Casey clicked her tongue. “As you say…”
“He does like his data,” Arlo finished for her. He raised an eyebrow and both of them laughed. Casey noticed that his mischievous smile had broadened.
“You wouldn’t be taking the mickey out of him, would you?” she remarked. “You’re skating on thin ice there.”
“Never,” Arlo retorted jokingly. “He’s my mentor and inspiration. I couldn’t possibly.”
Casey giggled at his mocking tone, appreciating that it helped to put her at ease.
“You’re doing well?” he asked, changing the topic.
“I am,” Casey said. “I could do without all of this attention. It’s no fun feeling like Fedele’s personal voodoo doll. But, I’ll survive. I guess.”
Casey was surprised when Arlo’s eyes glinted with sympathy.
“I can appreciate how disruptive it must be. It won’t always be like this though.”
“Here’s hoping.”
Arlo took the last of the cables, the one attached to her shoulder, and examined the alligator clip attached to the adhesive pad.
“Looks like we’ve got a faulty clip,” he said, swivelling on his stool and retrieving a replacement from the wall cupboard. “Luckily, it’s easy to fix.”
He swapped out the removable clip from the cable, then replaced the dot before reattaching the cable. Glancing at the ECG display, he hissed triumphantly as the missing wave form finally appeared on screen.
“Ahhh,” he mused. “Okay, I’m going to ask you to take a deep—”
Before he could finish his sentence, Casey filled her lungs with air and held it. Arlo grinned and keyed a series of buttons on the ECG machine. Casey watched the screen, waiting for a small ‘complete’ icon to appear. She didn’t have to wait long. A printout began to emerge from a desktop unit nearby.
“All done,” Arlo said. “You can get—”
Casey didn’t wait for him to finish. She sat up and began peeling the sticky pads from her chest as quickly as she could.
Arlo retrieved the printouts and placed them into a clear plastic folder. By the time he turned back to Casey, she was fully dressed.
“I’ve emailed these over to Fedele,” he said. “But hang on to these just in case.”
“Thank you.” Casey took the folder.
“It was good to see you, Casey,” he said warmly. “Give my best to the boss, won’t you.”
She nodded. “It was good to see you too, Arlo.”
Arlo’s eyes narrowed slightly, but he maintained his smile. “How many times have I told you? It’s Francis.”
“Right,” Casey blushed. “Francis.”
Flipping him a jaunty salute, Casey turned and left the examination room.
___
The consulting suite was a world away from the cold and clinical confines of the hospital. Though it was a modern and minimalist environment, there was a surprising sense of warmth. Casey sat on an L-shaped, cream leather sofa centred in the expansive suite, looking out through a floor-to-ceiling window that took in a view of Melbourne’s leafy eastern suburbs and the skyscrapers of the city itself. Though there were a couple of art pieces on the pale, wood-panelled walls on either side of her, the scenery beyond the glass was artwork in itself.
Her hospital experience had faded, becoming just another one of her bad memories.
They weren’t even bad memories really. Just a trio of awkward experiences she would relegate to the periphery for another month until, inevitably, she would have to drag herself back to do it all over again.
For now, she let go of the tension that had gathered in her and relaxed. She could do so because of the environs she found herself in now.
This was the office of her chief surgeon, Simeera Fedele, one of the most celebrated heart transplant specialists in Melbourne, if not the entire country. His reputation as a leader in the field of transplant surgery was renowned worldwide and his expertise was routinely sought from around the globe.
Of all the clinicians she had consulted with or who had some hand in her care, Fedele had been with her since the beginning, not only as her chief clinician but also as a type of mentor and confidant.
The charismatic surgeon was especially known for forging close professional relationships with his patients. He did not see them as just another case file. Each of them were important and valuable individuals and Casey had to admit that she held a grudging respect for him.
It was hard for her to see him as just another intrusive member of the medical profession wanting to pick her apart and examine every corner of her body. Fedele’s interest in her seemed purely centred on her total well-being: mental as well as physical and, unlike everyone else, it did not focus solely on the heart she carried.
Not to mention that his taste in interior design was impeccable.
Twisting in her seat, Casey regarded the shelving behind the desk, noting a considerable collection of books: medical texts mainly, along with a smattering of other academic titles. There were also a number of photographs featuring Simeera Fedele posing with other esteemed scientists and medical colleagues, some of whom Casey was familiar with through her own experience. There were a couple of pictures featuring prominent community figures, in particular refugee and human rights advocates.
Fedele was a noted humanitarian who had worked for a number of causes. There were high-level state and federal politicians in the photos, including the Federal Minister for Immigration and even the Australian Prime Minister.
Simeera Fedele was also known as a shrewd political operator, particularly when it came to lobbying on behalf of his medical and humanitarian causes. Casey also noted a couple of medals housed in custom frames. Community medals she assumed, although one of them appeared to feature the Rising Sun motif that was synonymous with Australia’s armed forces.
Soft music was piped into the room from expensive speakers embedded in the ceiling. A mid-century modern desk sat facing the sofa. Crisp white and lacking any decorative flourishes, the piece appeared to have been hand-crafted. Casey guessed it would have cost a fortune.
Fedele’s receptionist had seen Casey through into his office and had ensured that she was comfortable. A cup of herbal tea had been brought to her and sat on a glass-topped table just in front of her. Aromatic wisps of steam curled up into the air from the liquid. She leaned forward and lifted the cup, cradling it in her hands.
On the table was a single photo frame housing a somewhat incongruous image for this kind of ultramodern office. The black and white photograph depicted two soldiers, adorned in heavy field gear, embracing one another in the desert with wide smiles across their dusty visages. Casey had seen the photograph before and it had intrigued her. Leaning forward, she reached out and drew the frame closer to her, squinting as she inspected the name patches on each soldier’s breast pocket. The soldier on the left was J. Sonmez. The solider on the right: S. Fedele.
Her Simeera Fedele.
A decorated soldier as well, she mused absently, shifting the photograph back to its original position.
Leaning back in the sofa, Casey twisted and looked out at the panorama before her. She inhaled calmly, filling her lungs. The last v
estiges of tension came out with that expulsion of air and she smiled inwardly. She sipped from the cup, appreciating the expensive herbal tea.
Behind Casey, the door to the office clicked and opened and she stood at the sound to see a tall figure enter. He smiled upon seeing Casey.
Simeera Fedele stood nearly six feet three inches tall, with flawless olive skin and a dark, ruggedly handsome face, the most prominent feature of which was piercing blue eyes. His head was shaved completely bald which only added to his intensity. He wore an expensive shirt over his muscular frame. The sleeves were rolled up and the neck was open. A pair of slim charcoal trousers finished the ensemble. He was holding a thick bundle of mail in one hand. He appeared relaxed, as though nothing ever bothered him.
He held up the bundle of mail fleetingly, revealing an elaborate logo on the envelope that was facing towards Casey: a crimson bird’s wing, edged with gold, that swept around in a circle to form an e. It caught her eye and she lingered on it for a moment.
“It’ll take me until the middle of next year to wade through all of this,” he said as he set the bundle down on the edge of his desk. “My mail seems destined to consume more of my time than my patients.”
He approached Casey and offered his large hand to her, which she took. His grip was firm, confident, and she returned it in kind. Fedele smiled again. When he spoke, his voice was smooth and accented; hints of his Parsi background melded with his British upbringing.
“How are you, Casey?” he greeted warmly. “You look well.”
Casey nodded as Fedele gestured towards the sofa. “I am, thank you,” she replied simply, if a little nervously.
Fedele strode to his desk and gathered up a thick folder from the surface. He put it under his arm while he rolled his desk chair around to position it opposite Casey.
He sat down and opened the folder, lifting the first sheet of paper from inside.
“I’ve had a chance to review all of your test results and I am pleased to say that the picture looks very good.”
Fedele lifted a finger to his mouth and touched the end of it to his tongue then turned over another sheet.
“MRI showed normal heart size, good ventricular function and pulmonary flow. Your ECG shows a remarkable sinus rhythm and an almost perfect set of complexes—comparable to that of an athlete, in fact.”
Casey nodded, then hesitated as Fedele’s expression seemed to harden, so subtly that she almost missed it. She knew what was coming, even before he opened his mouth to speak.
“Your mother…called me this past week,” he began cautiously, wringing his hands together as he leaned forward.
Casey’s hackles bristled and she dug her fingers into the leather arm of the sofa. Fucking hell, she fumed silently.
“She is concerned that you’re continuing to use.”
“I’m not,” Casey snapped; the lie sounded hollow, even to her.
Fedele’s piercing eyes drilled into her; the emotion projecting from them was a mixture of concern and disappointment.
“Your blood work tells a different story.”
His words hung in the air. Casey shifted uncomfortably, her anger and embarrassment fluctuating wildly. Her gaze faltered and she looked down at her lap.
“Levels of tetrahydrocannabinol detected in sufficient quantities to indicate recent usage of cannabis,” Fedele read from the report in front of him. His voice was flat and cold enough that it chilled Casey. More than any other time today, she felt exposed, naked, laid bare.
He set the report down and reclined in his chair, steepling his fingers in front of his mouth thoughtfully.
“I don’t understand, Casey,” Fedele said, lowering his hands, palms out on either side. “You are recovering from a significant scare to your new heart, a diffuse histological response indicating an acute rejection of the organ. That was barely six months ago. Now, you’ve remained compliant with your medication regimen. You’ve achieved effective immunosuppression that has prevented any sign of a recurrence. It is clear that you’re exercising and committing yourself to a balanced diet. Yet, you continue to use cannabis in sufficient quantities that they are detectable in your drug screen.”
Fedele leaned forward, resting his elbows on his knees. Casey retreated further into the sofa, unable to meet his eyes.
“Casey,” he began. “You’re an intelligent young woman. I know you’re aware of the highly dangerous effects using marijuana can have on the heart, especially a transplanted heart.”
“Cannabis interferes with the function of immunosuppression therapy and greatly increases the risk of fungal infection from spores carried within the marijuana,” Casey’s voice was monotone as she recalled information that she had committed to memory.
Fedele’s eyes widened in question and he held his hands out, palms open.
“So, what is it? Why is it? Ever since I’ve known you, you have never appeared this troubled.”
Casey began fidgeting. Fedele sensed the defensiveness in her posture; the subtle hints that there was something, some piece of information she was holding close. Information that she was unable, or unwilling, to reveal.
“What?” he repeated once more, hoping that she would respond. Casey gulped, looked down at her hands.
The door to the office quietly snicked open and Fedele’s receptionist stepped into the room.
Fedele looked away from Casey and up at her. “What is it, Stephanie?”
“I’m sorry, but I have Elyria Medical Services on line two. They say it’s urgent but I can stall them if you like.”
Fedele’s lips tightened as he considered the information. He nodded quickly. “Tell them to wait.”
Stephanie nodded and retreated from the room.
Finally, Fedele relaxed back in his chair and closed the folder in front of him.
“Okay,” he said softly. “Look. I am going to tweak your tacrolimus prescription and your steroid, just as a temporary measure to get you across this hump. But…”
Fedele’s voice dropped away as he thought about his next sentence. “You have to stop using, Casey. It is imperative. If you begin to show signs of rejection again, I am certain that we will not be able to arrest the damage the next time.” He paused once more, allowing the import of his words to reach her. “And if we can’t stop the damage to your heart and you find yourself back on transplant list, your drug use will be looked upon very poorly. In fact, I cannot guarantee that you will even qualify.”
Casey dropped her head once more. She nodded, giving him the clear impression that she had at least heard his words.
Fedele reassembled the folder and stood. He returned it to his desk then stopped and turned at the door to his office.
He saw that Casey hadn’t moved from the sofa. He waited quietly until she was ready.
Finally, Casey stood, brushed her dress and slung her handbag over her shoulder. Making her way over to the door, she stopped before Fedele and looked up at him.
She hesitated, as though she was about to speak. Fedele’s eyes narrowed in expectation, then hope, but at the final moment Casey faltered and she retreated from the office.
“I’d like to see you again in a week,” Fedele called after her. “I’ll send you the appointment time.”
Casey glanced back and nodded as she hurried from view.
Fedele closed the door and turned back towards his desk where he touched his hand to Casey’s medical file.
He shook his head slowly as he moved his fingers from the folder to the bundle of mail. He touched the embossed crimson logo, the winged e. Underneath it were the words Elyria Medical Services.
He scowled.
From his perspective, Casey Schillinge was his most successful recipient. Her initial recovery had set new benchmarks and she had been a dedicated, willing participant in her own journey.
This recent turn of events, however, underpinned a troubling change in the young woman. Something that was totally out of character for her.
And he was
damned if he knew what it was.
CHAPTER 4.
Removing her leather flats, Casey looked out across the beach towards the cool waters of Port Phillip Bay then stepped down onto the sand. The warm granules shifted between her toes and she glanced up at the late afternoon sun that shone down on Mentone beach.
A long pier in front of her was occupied by a smattering of elderly fishermen, casting their lines out into the languid ocean. None of them were really concentrating much on their angling as much as they were on their raucous conversation. There was a wide variety of people on the beach who strolled either leisurely or with purpose: hand-holding couples, dog walkers, joggers. The sunny afternoon had brought out a few families as well and Casey observed a few of them either playing cricket on the sand or gathered on picnic rugs enjoying an early take-away dinner. The aroma of KFC chicken wafted in her direction and her stomach responded with an envious growl.
Of all the outdoor places, this was one of the few that didn’t cause Casey the kind of panic that her agoraphobia had gifted her. It was quite the opposite. Here, she felt a rare peace, a sense of safety and comfort that was unlike anything she felt anywhere else.
She stepped across the powdery sand, approaching the flat sea that lapped gently at the beach. Stopping just before the water’s edge, she found a relatively dry, compact area of beachfront and sat down.
Shielding her eyes, Casey looked across the bay again, then lowered her head to the tops of her knees, holding her legs in place with her arms. She exhaled noisily between her clenched teeth.
Thank God that’s done.
Her hand dropped to her side and she pushed it into the pocket of her shorts. She felt the sharp edge of a piece of cardboard there.
Scowling, Casey pinched the edge of the card and extracted it, lifting it up before her. Blocking the sun from her eyes, she read the familiar print on the card.
Geddie Kirkwood - Clinical Psychologist.
She flipped the appointment card into the palm of her hand and crushed it angrily. She then flung it as far away from her as she could. It landed several feet away on the sand just before the water’s edge.