by Barbara Ebel
“Mary, I bet we haven’t had a decent meal this week and I haven’t been to Downtown Italy in a long time.” He hesitated; surprised at something he had not done before. “Simply put, how about an evening together?” He sat tall and smiled. “Would you like to go to Downtown Italy next weekend?”
“Casey,” she said delicately, “is this invitation for a date or to pal with your best friend’s sister? Your answer will be the clue to what I should wear.”
“Absolutely as a date. Your being my best friend’s sister as well as being a good friend stays intact no matter what. Deal?”
“Deal.”
Chapter 11
Todd Summer’s physicians extensively consulted with each other. The origin of the unwanted mass came from his kidney, a renal cell carcinoma, but not all cerebral metastases warranted surgical treatment. Management depended on the clinical situation and outcome probabilities. The internist and oncologist would treat him long-term, and Danny would excise Todd’s solitary metastatic cancer lesion in his brain.
Danny leafed through Mr. Summer’s chart in the preop area, familiarizing himself again with the medical background of his patient’s diagnosis. Mr. Summer still had hematuria, or blood in his urine. That had been the initial symptom landing him in a doctor’s office, besides constant pain in his back, below his ribs.
As Danny hurried to OR 5, he wondered if there would be a perk to his case. He wouldn’t mind seeing Rachel’s eyes again or being the center of her attention. Maybe that would alleviate the drudgery of the operating room’s four walls, the drone of anesthesia machines, and the routine familiarity of drilling into someone’s head. It would keep his mind from wandering to the fresh pain of Melissa’s death. Something squeezed his heart when he thought of his oldest daughter.
The CRNA and his anesthesia attending staff had Danny’s patient intubated and the table turned forty-five degrees. Danny donned a mask and walked in, placing his beeper on the aluminum table under the wall phone. He turned to look at the scrub nurse. Hallelujah, there would be a bright side to his case.
Everyone gave Danny their condolences while Rachel counted instruments on her table. After a speedy start, Danny spied the tumor in Mr. Summer’s brain.
“Dr. Tilson, I’m so sorry about your daughter,” Rachel said. “I cannot imagine how you must be feeling.”
Danny glanced quickly, making eye contact. “Thank you,” he said.
“Is that the only one to remove?” she asked, pointing at the odd looking mass with a scalpel, then handing the scalpel to Danny.
“There’s only one, and in the course of treatment for his kidney cancer, this basically comes first.”
“Why?”
“Because they are going to treat him with interleukin-2. If this lesion stays here, the chemotherapy will cause cerebral edema. So we have to remove this metastasis before treatment.”
“Maybe sometime you can further explain that to me. It’s a mystery. The pathophysiology of brain edema.”
Danny slowed his hand. Her voice, her tone, was so soothing, she almost purred.
“So what’s his name?” he asked, changing the subject.
“Whose name?” she asked.
“That super dog you have.”
Under the mask, Rachel smiled.
“Oh, him. Dakota,” she said, bobbing her head with enthusiasm.
“Hmm. Solid name. Big dog?”
She chuckled. “Dr. Tilson, do you know the breed?’
“My wife and I haven’t owned dogs. We’ve concentrated on kids.” And now my daughter is gone, he thought.
“I can tell you all about dogs. Hopefully, you can educate me about brains.”
________
Annabel found her mother in Melissa’s bedroom, the door ajar. Sara sat on the bed, her thin legs uncrossed, her sandals firmly planted on the rug. Her face still looked puffy, her eyes narrow and drawn. Her movements had slowed as if arthritis and old age had taken root overnight.
“Mom, you okay?” Annabel asked.
Sara turned to her daughter, teary eyed. “No, Annabel. She’s supposed to be here right now. It isn’t fair.”
“I know, Mom.” Annabel sat at Melissa’s desk, arranging pens in a pencil caddy. “Can we leave Melissa’s room the same, until we have the heart to go through her things?”
“Yes. You’re right, we’ll do that.” Sara wiped her cheeks.
“Let’s not be late, Mom. It’s not like every day I let some man attempt to straighten my haphazard tooth.” Annabel got up and reached her skinny arm around her mother’s neck, lightly bumping her forehead, forcing Sara to grin.
“Okay, let’s leave things well enough alone. Until I come in here again tomorrow. And cry.”
“Mom, let’s visit Melissa’s grave again this weekend.”
They left the bedroom door open. Sara pulled a sporty jacket from the closet and Annabel slid on her sister’s hoody as they left.
“Have you decided yet?” Sara asked, when they got into the car.
“On what Mom?”
“Clear or color?”
“Hmm. What would Melissa do?”
“I can guess, but whatever you decide, tell your orthodontist before he starts putting wires in your mouth.”
________
After Danny’s surgeries were finished for the day, he rounded on several hospital patients, including Mr. Summers who slept groggily in his room. Danny scanned his head dressing for bleeding then lightly roused him. On morning rounds, he’d learned not to ask patients how they slept, otherwise, he’d hear, “I would’ve slept fine without someone waking me at 4 a.m. to see if I had a blood pressure or to ask me how I was sleeping.”
“Mr. Summers, you did fine,” Danny said. “I’ll be by to see you tomorrow.”
Danny left the hospital thinking about Greg, especially since it had been a few days since he had seen him. His father couldn’t understand why the family grieved or why there had been a funeral. Otherwise, the blow would have been heart wrenching.
He undid the top button of his blue shirt while walking along Wellington’s main hallway when he arrived at six. He passed residents with cruel Alzheimer’s, fading their previous vibrant minds into another sunset without time or place. Every time he entered a senior facility, he vowed to avoid them for Sara and himself. Even some of his Iraqi war vet patients were dependent on others, but most of them lived with family and not in a nursing or assisted living environment. It had to do with loss of independence and not how great the care was.
Danny felt confused, and he didn’t even have dementia. He missed his daughter; there would never be a day that he wouldn’t wonder what Melissa would be doing if she were alive.
Greg was rocking gleefully in his chair. He wore a plaid shirt with tan trousers that Sara had bought him, and his right hand cupped an applesauce container. He waved it toward Danny, plunked it on the nightstand, tapped at it with his index finger.
“Dad, let me open it for you and I’ll get you a spoon.”
Greg resumed pounding the container and grimaced as Danny noticed a pile up of other single unopened servings from the last few days. Greg hollered his frustration and before Danny could console him, he began to cry.
“Dad, I’m sorry. I wish I could be more helpful.”
Danny hurried down the hall to the nurses’ station to ask an evening nurse for a spoon. “Please,” he asked, “can you make a note for someone to help my Dad late in the day? One of the few things my Dad likes and eats anymore is applesauce. He needs it, he’s so skinny. Plus, the irritation of not being able to peel off the foil triggers his anger.”
“Dr. Tilson, I’ll pass that through to the other shifts.”
“Thank you.”
In his room, Greg ignored Danny while he slowly shoveled applesauce from two Mott’s cups into his mouth.
________
“I stopped by to see Dad. I asked them for extra assistance with his snacks,” Danny said to Sara at home, forging a stale effo
rt at enthusiasm. “Bet the sunset was pretty enough to have sat on the deck tonight.”
“It seems warmer than usual for April,” Sara said. “This evening I finally pounded the subdivision again. I ran two slow miles.”
“That’s a warm up for you.” Danny sat on a stool with a glass of wine. “Where are Annabel and Nancy?”
“They’re both upstairs. Annabel had clear braces put on today. Nancy finished homework. I suspect she’s on MySpace.”
The family’s automobile insurance policy lay before her as she wrote out a six-month check. “I simmered two large cans of beef vegetable soup. There’s some left in the pot.”
Danny ladled the chunky broth into a bowl and resumed his perch at the counter.
“I talked to Mary this afternoon,” Sara said. “I think your best friend’s eyes have sprung open. He’s noticed your little sister.”
Danny contemplated that. “Hmm. That will take some getting used to. But she’s not that little, she’s the same age as you.”
“I know. You dirty old men. There may not be much to get used to though, if it’s Casey’s conventional six-month relationship.”
“Best to stay out of this,” Danny commented. “Sisters are sisters and friends are friends. Don’t want to jeopardize that.”
But Sara’s attention had drifted. She gazed out the window where she would never see Melissa on the porch rocker again.
________
When Danny and Sara went to bed at nine-thirty, Sara brought a section of The Tennessean. She lay on her side, facing her husband, but never turned a page. Her eyes scanned the same sentence over and over again. Danny read his political terrorist novel without absorbing a paragraph.
“Sara?” He glanced at Sara holding moisture in the pockets of her eyes and a pillow to her chest after closing the newspaper. Sara put her hand lightly on Danny’s.
“She’d be hiking and fishing this summer. Her enthusiasm before leaving for college would’ve been infectious.”
“I know. I miss her too.”
Soon Sara’s lids closed so Danny slid her hand back on her pillow. The room folded into itself like a deep space vacuum. A hollow feeling settled in his chest and he dozed off to dreams which reflected his troubled mind. A vision unfolded of a small child in a front passenger seat. An adult stopped the car, took the boy’s hand, and deposited him at an intersection with a cemetery on each street corner. The car drove off as the little boy turned in each direction, scared, abandoned.
________
Mary chose a thin, dark brown headband to let her hair fall softly but to keep off the angle of her cheeks. She softened some coconut oil into her palms, and then ran it through her hair. Her pale green top plummeted in front but white cotton ran horizontally, as if she wore a white blouse underneath. She selected a linen camel skirt, perfect with low heels. For her, wearing higher, spikier heels accentuated her toeing in. For the grand finale, she chose her favorite orchid summer lipstick.
Casey arrived promptly at six-thirty. “Madam,” he said, “you look lovely.”
“Thank you, handsome prince,” she said, returning his smile and closing the front door.
Casey opened the passenger door of his new Jeep. “Nice car color,” she said, when he started the engine.
“Thanks, it’s called Serengeti sand.”
“I must admit, the last date I had drove me away in a rusty sedan with a broken door handle.”
“That’s more common in Tennessee than this new baby. You didn’t hold that against him, did you?”
“Not at all. I own a rusty pickup truck in Alaska. It’s heartbroken for me.” They glanced at each other and laughed.
Angelo seated them at an intimate round table at the front window. The only change Casey could detect because of the new owners was a missing room divider, knocked out to make room for several more tables.
“How is your PaPa?” Angelo asked Mary.
“A slow decline, Angelo. Maybe Gianni can fix one of his light pastas so tomorrow I can bring Dad a small container.”
“On Italy,” he said softly. He handed Mary and Casey a long menu. “Tonight’s special is very nice. Escalope of veal sautéed in marinara sauce. Fresh sautéed vegetables on the side.”
Mary nodded at Casey and Angelo. “Make that two,” Casey said. “And Mary, shall we order wine?”
“A Cabernet?”
Casey nodded.
Mary unfolded the napkin on the bread basket. “Casey, thank you in advance for the date. The timing is perfect. I needed to dump the smeared-paint-on-my-face look.” She spoke softly. “So, what made you choose to be a paramedic?”
“I knew I wouldn’t have lasted with a nine-to-five desk job. I love what I do, whether it’s CPR in a roadside ditch, starting an IV on a teenager pulled from a burning building, or evaluating someone’s airway in an overturned car. Lucky for me, I wasn’t born fifty years earlier.”
“Why’s that?”
“For two reasons, but now I’m really going to bore you.”
Mary shook an emphatic no. “That’s not possible.”
“The concept of emergency medical services began in the early 1960’s. Since then, it’s evolved into a successful public service field, including the ability to just dial 9-1-1. It all began due to two innovative anesthesiologists. Both doctors worked independently, but they both saw the need for airway management and CPR to reach victims outside the hospital. And there you have it, the training of paramedics began.”
“And what’s the second reason?”
“If I was born fifty years earlier, I wouldn’t be sitting here with you.”
“Casey Hamilton, if you aren’t the flirt.”
“A subtle flirt. Maybe if your dark blue eyes weren’t aglow like this candle, I wouldn’t have said that to you.”
Mary tried to keep her cheeks from flushing, but she couldn’t stop them.
“What about you? You aren’t in a nine-to-five job, either.”
“I was always outdoors, toting around sketch paper, so that was the remotest of possibilities. And Dad and Mom always taught Danny and I that we had to build on the unique gifts we had. It would serve others as well as us to the best advantage.”
“I think that’s why your parents were so successful. Their business was an offshoot of what they loved to do.”
“They weren’t afraid to work, either.”
Angelo placed two warm plates down and left them to taste their entrees.
“Excellente,” Casey said when he returned.
“Ottimo,” Angelo said.
When they rounded off their dinner with a cappuccino, Casey suggested a movie. They saw an action-adventure film at a nearby theatre. It was midnight when they drove into Mary’s driveway. Mary thought the moonlight did justice to Casey’s gregarious smile.
“Did the glass company restore the window?” he asked at the front door.
“Good as new. And your board held up well in the interim.”
“I apologize in the first place for smashing it.”
Mary touched his forearm. “No, thank you. You were trying to save Melissa’s life.”
Casey circled his arms around her and gave her a warm hug.
Chapter 12
Danny leaned against the wall as he dictated a note on his patient. Mr. Summer had been discharged from the hospital on Monday, donning a robust smile ever since, grateful for “a new lease on life,” even after Danny referred him back to the oncologist. Danny told the office staff to send all his neurosurgery records to the other involved doctors, and then closed the chart. He had to hurry to attend the monthly medical staff meeting.
“Socializing is a prerequisite to gathering patient referrals,” Bruce would often say. Danny had also been reminded by Bruce and the OR staff, including Rachel, that prior to the meeting that night there would be a gathering for the hospital CEO’s fifty-fifth birthday.
Danny left the physicians’ office building and drove the short distance to the back entrance
of the hospital, forgoing the doctors’ lot. He entered the first floor public cafeteria and went into a large private room where a spread of hors d’oeuvres, a flowered sheet cake, and bowls of red punch covered the center conference table.
Mr. Summer’s primary oncologist approached Danny. “Dr. Tilson, from your neurosurgical standpoint, how is Todd Summers?” he asked with a slight stutter. “Will I be seeing him soon?”
Danny shook Mike Carlson’s hand. “I saw him for his postop visit this afternoon. His head is clear and he’s ready for you. You should be receiving his surgical record.”
“Appreciate that.”
“I’m glad for the CEO’s birthday party,” Danny said, gazing at Mike’s plate. “I could use some of that food.”
“It should tide us over our boring meeting.”
Danny nodded and took a step toward the covered pans. He sampled a cracker with a creamy artichoke dip.
“You must try this,” a warm voice offered.
Danny turned sideways to Rachel’s outstretched hand with a speared Swedish meatball. The red and gold sleeveless blouse she wore matched her russet silk pants and the ends of her blouse were tautly tied in front. If there was a beauty pageant under way, she’d steal it.
“Really,” she said, “they must have an authentic Swedish cook in the kitchen.”
“I should. Before the rice wiggles its way to the floor.”
Rachel laughed at his comment as she guided her own meatball to his mouth with her right hand, her left palm shadowing it, ready to catch anything from falling. They both giggled at her risky method.
“Very tasty,” he said.
“Dr. Tilson, should I get you a piece of cake? I want to indulge since this is also my birthday month. I won’t be having marble cake with butter cream frosting like his.”
“You must be turning twenty-five,” Danny said.
“Really, you are a gentleman. I’m going to turn the same age as you … thirty-seven.”
“Really, you are a lady, but I’m a whopping forty-five.”