“I think you mean good morning, Dr. Medina.”
Chapter 10
Work as a Distraction
To my surprise, things were better after our near-miss. Hector remained respectful of me and all our interactions were nothing but professional, but his good mood was back. He stopped ignoring me, and it felt almost how it had when he’d first joined Heartland Metro.
Now that Dr. Keach had planted that seed of doubt, however, I was once again the main target for his jabbing. I hadn’t pieced together why Dr. Keach had backed off, but my bliss had only lasted while Hector ignored me. Now that I featured back on Hector’s radar, Dr. Keach gravitated back to pestering me, taking any opportunity to put me down in the presence of Dr. Medina.
He found me at the nurses’ station going over my next patient’s chart. “I see all is well in paradise again,” he said.
My eyes narrowed. “Excuse me?” I didn’t look up from the screen.
“You and Dr. Medina. You’re back in his good graces, I see.”
“You should be careful what you insinuate, Dr. Keach. Your daddy’s name can only protect you from so much. You sure you want to antagonize someone like Dr. Medina?” I raised an eyebrow.
That’s right, Dr. Keach, I thought. The mom and baby wing may be named after your father, but even your last name plastered on the hospital’s wall is laughable.
There was simply no way he would have gotten matched to this hospital without some serious money being involved. His father was a physician here before his retirement and was a regular—and generous—donor to the hospital. But Dr. Keach was not worth more than the research funding Hector could bring in.
Dr. Keach’s lips thinned and his nostrils flared. No one had ever called him out on his bullshit. I’d been tempted many times before, and I wasn’t exactly sure why I’d finally done it after all this time. Probably because before, his attention only affected me, but now he was also soiling the name of a mentor I valued. I refused to acknowledge any other feelings for Hector—even to myself.
“You really are clueless, aren’t you?” asked Dr. Keach.
“Please, enlighten me,” I taunted.
“Dr. Medina will be selecting the recipient of the fellowship in two years. The chief wanted fresh eyes on the graduating residents next year.”
I shifted in my seat. Of course Dr. Keach would have this information. The Chief of Oncology kissed his ass constantly. It came as no surprise that he would give him the advantage. It also stung a little that Hector hadn't offered me the same upper hand by telling me his role in selecting the winner.
Hector wasn’t witness to any part of this exchange. Dr. Keach was tactical in his attacks on me, and I knew that taking it to HR would only result in his word against mine. It chafed knowing that at this moment, his word would be worth a heck of a lot more than mine.
I didn’t see Hector until the next day when I had to work out his schedule with his assistant. We managed to free up the latter half of the day so we could go over the statistical report we had been neglecting.
Hector hadn’t changed much in his office in the few months since he’d joined Heartland Metro. From what I could tell, the only change was the appearance of a solitary picture frame on his desk. Once I sat down, I turned the photograph over to see what could be the only thing in his life important enough to look at every day. The simple black frame contained a black and white photograph of Hector and an older, shorter woman standing next to him. “Who is this?” I asked.
“That is Marisela Medina.” He smiled, and I put the frame back to its original spot on his desk.
“Your mom?”
He nodded. “Ready?”
We were going over the numbers together. We made a promise to open the email at the same time—he hadn’t gotten that far before we’d fought about it. He read one line, and I read the next.
An excitement very close—though also very different—to what I had felt at his house two nights ago crept up. My heart began racing.
“Are you seeing this?” Hector asked.
I couldn’t look up from my screen. My mouth dried up, rendering words inaccessible. I only nodded.
“What did I tell you?”
I looked up at him then, the question clear on my face. “Is this real?”
“Carolina, you are amazing. It’s going in the right direction.”
I nodded, too stunned to speak.
The results were what I was expecting—eventually.
Hector read out loud, letting the words wrap me in an embrace. “Thirteen percent difference in remission between the control and experimental groups at six months. Carolina, the experimental group treatment is thirteen percent more effective than the standard of care. I can’t wait to see data from year three and year four. I bet you it could go up as much as fifty percent when it’s all done . . . Carolina? Are you okay?”
I bolted out of my seat and ran out of his office. Luckily, the bathroom wasn’t too far down the hallway from his office. I made it just in time to vomit. I rinsed my mouth, and when I exited the ladies’ room, Hector was leaning against the wall across from the door, his brows knitted together.
“Are you okay?” he asked.
I nodded and walked back to his office. I sat and tried to listen to whatever he was saying, but I couldn’t. My eyes prickled with tears. He said he thought this could be up to fifty percent better than the standard of care. That, plus all the advancements in medicine since I’d lost her, meant she could have beaten it if she had been diagnosed today instead of so many years ago. I tried to do the math in my head. Yes. I was confident she would have lived.
“Carolina.” Hector stared at me.
Taking a deep breath, I met his gaze. “Sorry,” I said. “I think I’m in shock.”
“It’s okay. Take a minute.”
After a long silence during which I tried to compose myself, he finally spoke.
“Who was it?”
“Who was what?”
“The loss that drove you to this mad battle against cancer.”
I pressed my lips together in thought, not sure I was ready for him to know so much. I didn’t like talking about it in general, not even to Dad, with whom I shared everything.
“You don’t have to tell me if you don’t want to, but I very much want to know, Carolina.”
His eyes were so soft, so full of empathy, I couldn’t help myself.
“My mother.”
He nodded but didn’t ask any more questions.
“I’m sorry.” His glasses came off as he searched for whatever he was going to say next. “Please don’t get offended by what I’m about to say. It’s hard to put my feelings into words.”
“Okay . . .”
“I envy you. Not because you lost your mother, obviously that’s not what I’m trying to say. I only mean many people who lose someone do nothing about it. You decided to go into the toughest profession and fight for a spot in a competitive residency so that you could save another little girl’s mom.”
“No offense taken,” I said. “I think I understand what you are trying to say.”
“I also envy that you have a reason, a strong one, for doing this.”
“What? You don’t?”
“No. Not really.”
“So then, why did you decide to be a doctor and get into oncology?”
“See, this is where I find it tricky to explain myself. When I was younger, I was very concerned about my legacy. About what contributions I would make to the world before I died. I guess I still am, in a way.”
“I think that’s a great reason.”
“There is nuance there if you look carefully. It sounds noble to aspire to do good in the world, but no one ever admits the selfishness of the sentiment. All of us dreamers and would-be philosophers have the same thing in common: our bloated egos. You’d think we’d want to do good in the world for the world’s sake, but it’s more selfish than that. We do it for the personal satisfaction.” He grinned, p
leased with his explanation. “See? Selfish.”
“I don’t think it’s selfish at all.”
“You don’t?”
“No. Had you been my mother’s doctor and been successful in saving her life, do you think I’d have given a rat’s ass about what led you to that success? Dr. Medina, you’ve done so much good in this field. I expect you will continue to do good in the latter half of your career. The patients you save—and their families—don’t care why you do it, so long as you fucking do it.”
He chuckled. “God, Carolina. Sometimes I think you know me better than I know myself.” He paused. “Could you be any more perfect?”
I adjusted in my seat. I refused to turn this moment into something uncomfortable. This was my first significant trial, and all signs were pointing to success. I’d also had a beautiful moment with my mentor. We couldn’t turn this into something else and mar my memory of this day.
“Well, I’m getting hungry. Would you like to get a bite?”
“Dr. Ramirez,” he scolded me, looking at me from above the line of his glasses, now back on his face. “We have a lot of work to do.”
It was true. Now, we needed to adjust the treatment protocol and submit it to the internal review board (IRB). In phase two of the trial, all patients would receive the experimental treatment, but not before the IRB approved the protocol change. The process would take a few weeks, so the trial would be placed on hold until then. Suddenly, I had a few more days off.
“We don’t have to go anywhere,” I said. “I can have my RA order us some food and bring it back.”
“You have a research assistant? How come I haven’t met her?”
“She works at the information desk mostly, so she’s not around much. Doesn’t need to be. She schedules appointments, interviews prospective trial subjects, handles data entry—that kind of thing. She was only working the front desk part-time, and when my grant got funded, I offered her a part-time position as an RA. Now, she is employed full time by the hospital and eligible for health insurance benefits.”
“That was nice of you.”
“I’m lucky to have her. Amanda is pretty amazing. She’s more than just an assistant. She’s a great visual artist. I’ll introduce you sometime. Do you like sushi? I’ll have her bring it right over.”
“Sure. Sushi sounds great.”
I needed to go to my locker and grab a credit card to give to Mandy, but before I left, I turned to him once more. “Oh, and Dr. Medina?”
“Yes?”
“I’m far from perfect. I have my own demons and insecurities, just like anyone else.”
Chapter 11
The Broken Girl
Valentina’s test results from last week were back, and I called her in for a follow-up appointment.
She waited patiently in exam room five. My face fell when I saw her. She looked better physically. Her hair was growing back into a sort of a pixie cut, and some of her weight was back, though her muscles weren’t yet. But what threw me off was her pale complexion, her tightened lips, and, most of all, her perfectly-shaped eyebrows, almost fully grown in to their previous length, pulled-in, a crinkle forming between them.
“What’s wrong?” I asked her. “Are you not feeling well?”
“You tell me,” she said.
“Nothing’s wrong, Vale. But you look as though you’ve seen a ghost.”
Her expression not changing, her gaze fell to the floor.
“I read on the forums,” she said, “that if it’s good news, I get it over the phone. If it’s bad, they call me back in for a follow-up.”
“Oh, Vale, honey—”
“It’s back, isn’t it?” Her breath hitched as she formed the question.
“No!” I hastened to answer. “Valentina, I wanted to give you the good news in person. That’s all. Please stop reading about treatment or procedures online. It’s not the first time it’s gotten you in trouble.” I arched an eyebrow at her.
“Good news?” She looked up, hope misting her eyes.
“Yes, Valentina. Good news.” I grabbed her by the shoulders and squeezed them gently. “Six months remission. It’s a great milestone.”
“Really?” A tear spilled over and ran down all the way to her neck. Something inside me moved. Despite the hell and pain I put her through during her treatment, this was the first time I’d seen her cry.
“Really,” I said. “I thought we should celebrate. I’m actually not working right now. Let’s go across the street to the bar. Champagne. My treat.”
When Sofia asked what we were celebrating, I looked at Valentina. It was her choice who she wanted to tell—if she wanted to tell anyone at all. Many of my patients who didn’t want family around for the treatment didn’t tell them unless the treatment failed. I was in awe of Valentina. Not a soul helped her or took care of her, not that I knew of. She had zero support system, but she made it through. It was incredible.
“Six months in remission,” Valentina said fiercely. I imagined this was what she looked like after a fight.
“Wow. Congrats!” Sofia said.
“Thanks,” Valentina said.
“On the house.” Sofia placed two glasses of her best champagne in front of us. “All cancer ass-whipping is rewarded at La Oficina.” Then, she turned to attend to her other customers.
Valentina and I looked at each other, and we started giggling as we grabbed the glasses. I was about to raise my glass to make a toast when Dr. Dennis approached the table.
“Dr. Dennis,” I said.
“Please, Dr. Ramirez, call me Rory outside of work.”
“Okay, then, please call me Carolina.” I smiled at him.
“What are we celebrating?” he asked.
I turned to Valentina who was trying to tame her pixie hair back into place. She is self-conscious all of a sudden, I thought.
“You want to tell him?” I asked her.
“I, um—” the fierceness with which she’d told Sofia was absent from her voice. “Remission. Six months.”
“That’s great!” he blurted a little too enthusiastically for my taste.
Dr. Dennis had never been part of her care team. He was present at one of her rounds, from what I remembered, and I asked him for help maybe one other time. I didn’t think going over a consent form with her counted as being a part of her care team, but he was teetering on crossing a line. I was sure of it. He was still a doctor, and she was still a patient in the same department.
I couldn’t say shit, though. I was in a grey-area myself. Drinking with one’s patients wasn’t precisely in the hospital’s manual, but I couldn’t imagine it being okay with the oncology department leadership.
I rarely broke rules. I was too practical. But fuck it. Valentina had no one. She’d hinted at being estranged from her family, and the fact that no one ever visited or accompanied her to any follow-ups made me think she was alone. This was an important milestone to celebrate, and if she had no one, well, damn it, I was going to celebrate with her. To hell with the rules.
“Rory,” I said. “Why don’t you join us?”
He turned to Valentina, ensuring it was okay with her too. I smiled approvingly at him. Valentina nodded, and he sat across from us.
“Sofia,” I called out. “One more, please?” She tipped her chin, and soon after, a third glass of champagne joined the table.
I raised my glass, and they followed suit. “To kicking the shit out of cancer,” I said.
“To kicking the shit out of cancer,” they both sing-songed after me, and we all took a sip.
Rory had started asking Valentina about a fight she had won prior to getting sick when I heard the buzz of my phone coming from my purse.
“Excuse me,” I said, and pulled out the phone.
There was one text waiting to be opened.
Sara: Can you please come to the emergency room?
Something wasn’t right. I wasn’t on call, and this wasn’t an official hospital page. There was no reason Sara wo
uld be unofficially paging me to the ER. This wasn’t for a patient.
I had every intention of standing up and running, but the stone in my stomach pulled my center of gravity down.
Valentina must have noticed because she nudged me. “Is everything okay?”
“I don’t know,” I said, with my eyes still glued to the text. “I, uh, have to go.”
“Sure,” Valentina said.
Rory nodded at me, and I felt perfectly comfortable leaving them together.
Her nose was busted—a bandage covered it from cheek to cheek. I reached for the computer to look at her chart, but the ER doctor rolled the medical computer cart away from my grasp.
“It’s okay,” Sara said. “She can see my chart.”
He nodded and rolled the small cart back toward me.
Sara grinned at me with her eyes closed.
“She’s had quite a bit of pain meds,” he said. “Someone will come shortly to take her up to X-ray.”
“Thank you,” I said.
Sara was drifting in and out. When her eyes opened, she would look up at me and grin. I schooled my face. I was too angry, and there was no point in arguing with someone that far gone into their morphine. She would likely not remember this anyway.
I scrolled through the chart to avoid looking at her and landed on the physician’s intake note.
Patient presents to the emergency room with blunt force trauma to the nose, left arm, and ribs. Paramedic administered morphine on-site due to patient complaining of severe forearm pain. X-rays of right forearm and ribs have been ordered. Social work consult recommended after patient is admitted. Awaiting patient transfer to x-ray.
I rolled the computer cart away from me and sat in the only chair in the small exam room. Sara woke up when the x-ray technician walked in, ready to transport her. I followed them to x-ray and waited outside while they completed her scans. This was where Hector and Chief Stuart found me.
Remission Page 9