by Hannah Paige
“Pam, what was your second goal, again?” Dr. Chase asked, clearly trying to suppress a smile.
Pam’s voice came out shaky, a little more timid than she was hoping it might, “To not worry.” She understood his point and stopped herself short, “Oh, I see.”
“Those are your goals, not mine. You don’t get to rewrite them, because you don’t need to. You wrote them down for a reason, and in this case, your first instinct is usually the correct one. Read me what you wrote, please.”
Pam bobbed her head in agreement and swallowed, trying to wet her throat, “Right, right, okay. My third…my third.” She closed her eyes for a second, focusing on her breath—in, out, in, out—then opened her eyes once more, “My third goal, though it’s not the last one I’m going to make, is to take care of myself.”
She felt herself relax as a caring look of pure pride melted over Dr. Chase’s face, “Yes. Yes, you got it, Pam.”
“I got it?”
“Yes, you did. You found the door, didn’t you? I don’t know where or when or how, but you did. You found a third option besides ending your life or accepting a solitary one in a hospital.”
He waited patiently for her, until she finally found the confidence to nod, “I think I did.”
“I know you did, Pam. You still have a long way to go, but you’ve made sensational progress this past week. I’m very proud of you. You should know that.”
“Thank you, Dr. Chase. I’ve—I’ve tried,” she couldn’t remember the last time she’d said that, let alone the last time that she’d actually felt the self-pride that came with hard work. She hadn’t had the energy or the drive to work one bit in such a long time.
“It feels good, doesn’t it? To want to work hard, for no other reason besides improving yourself.”
Pam nodded.
“I’m happy for you, Pam. Don’t take this the wrong way, but I hope this is our last visit together.”
She sighed and pressed her lips together. She wanted to smile, but still hadn’t reached the point where her desire was enough to contract the appropriate muscles in response.
“I do too, Dr. Chase. I do too,” she stood up from her seat and grasped the door handle in her hand.
She heard the doctor call from behind her in the room, “Goodbye, Pam, take care.”
To anyone else, it was just a goodbye, just a conversation ender, maybe even a good omen that would get passed along to an old friend as farewells were exchanged. But Dr. Chase and Pam knew better.
They were the strong ones.
Chapter One
June 1, 2011
Ian
At precisely 7:02 am, Baloo was barking at the front door. Ian was just pouring himself a cup of coffee and was looking forward to squeezing in breakfast before he had to head to work.
“Not now, Baloo, in a few minutes,” he scolded, gulping down some coffee. He opened the fridge to pull out the carton of eggs—he couldn’t remember the last time he’d made an omelet and his taste buds were feeling neglected this morning—but was interrupted by more scratching at the front door.
Ian sighed, returning the eggs to the top shelf of the fridge, “You have to go out?” he asked, turning to the dog fidgeting beside the door.
The terrier hopped up on his hind legs, yipping in response.
“Alright, get your leash. Go on!” he commanded, and Baloo scampered into Ian’s bedroom. Momentarily, he trotted back into the kitchen, dragging his leash behind him. Ian kept it on the floor beside his bed for easy access for the miniature dog.
“Good boy,” he praised, leaning down to rub the dog’s head, and linked him up.
Ian shut the door behind him—it still didn’t have a lock—and let Baloo lead the way downstairs. The familiar sounds of coffee brewing and Chuck, the reliable early-riser employee, shouting out orders seemed to take up space in the narrow hallway down to the main floor,
“I have a large caramel macchiato and an onion bagel for Harve!” Chuck hollered as Ian and Baloo entered the coffee shop, “Hey, Ian!”
“Morning, Chuck, beautiful day today,” he greeted, giving him a smile while pushing the door open with his back. Ian had befriended him a few years back when Baloo tried to make the great escape. No Steve McQueen, Ian found Baloo at the end of the street, belly presented and tongue dripping down on the sidewalk while his chosen chest-scratcher for the morning did his duty. Luckily, the stranger Baloo had stumbled across was an NYU student named Chuck. The college kid had quickly become Ian’s go-to dog-walker during the day while Ian was at the hospital.
Ian held the door open for a businessman in a crisp suit who didn’t say a word but brushed past Ian fast enough to knock Baloo sideways on his teetering feet.
Ian shook his head. “Some people,” he said to Baloo, who snorted in agreement, and they continued down the street for a few blocks until they reached the park. It was a beautiful day; Ian hadn’t just said that to maintain his optimistic reputation. The sun was out, warming Manhattan to a balmy sixty-five. And at this time of the morning, that was pretty good for the beginning of June. Kids were out of school and a couple of boys were tossing a football back and forth on the park’s field. A few minutes later, after Baloo had done his business and they’d had sufficient time to walk around, enjoying the morning, it was time for Ian to head back home to get ready for work.
A new group of caffeine-addicts had rotated into the coffee shop by the time Ian pushed the entrance door open. He jogged upstairs, closing the door behind Baloo, who trotted right over to the water dish in the kitchen. It was 7:30 by that time, which meant Ian didn’t have time to make his own breakfast. He dressed in nice pants and a collared shirt, leaving the top couple buttons undone so he could breathe. Ian was far enough into his career that he didn’t have to bother with a tie or dress shoes, but he did try to dress acceptably. He didn’t bother trying to tame his hair; it had grown out to the point where the natural curls spiraled all over his head. It gave him a younger look. Even though he was almost forty, his hair could have matched that of a ten-year-old boy’s. And he liked it that way.
He filled up Baloo’s food and water dishes and grabbed his briefcase, heading out the door once again. He enjoyed his morning walks to work. It gave him a chance to see all of the people, the sights, the smells that made up this city. He passed the homeless boy on his block, selling newspapers from a paint bucket. Ian always gave him a dollar but never took a newspaper. He passed the hotdog cart two streets over from his apartment where, during lunch time, the woman who ran it made the best everything dogs Ian had ever had. He swore she made her own mustard and his compliments made her blush and laugh at him. He could hear the subway barreling under his feet and when he passed over the grate at the intersection before the hospital, hot air sometimes drifted up in spurts.
His fluctuating schedule made it difficult, but occasionally he was lucky enough to pass the same people on consecutive days. Like the umbrella-woman. She always wore a business suit and had an umbrella looped over one wrist, no matter how nice the weather was. Ian passed her every morning, when he went in early enough, but she never recognized him. She stared at the ground, maybe counting the cracks she had to step over so as not to catch her heel on any uneven sidewalk. She never looked up to notice that where the most cracks congregated at her feet, the healthiest trees bloomed over her head. Blossoming trees, pruned by the city, were like museum artifacts kept behind glass that nobody saw but everyone respected. They were small in numbers in the urban culture and the umbrella-woman never saw them.
A few blocks later and he ran into the dog walkers who always remembered Ian. They were two young girls who had kicked off their dog-walking business at the start of May. Once Ian said hello to them enough times, they started hanging out around the hospital in the mornings, making that part of their daily loop. Ian never forgot to tuck an extra couple of dog treats in his pockets for whomever the girls had that day.
Ian joined a couple of other physicians in the ho
spital elevator and pressed the number three button—Oncology. A kid—probably around twenty-three, based on Ian’s guess—in wrinkled blue scrubs swayed next to him and when Ian ventured a glance at the boy, he swore his eyes were almost closed. He bumped up against the boy’s shoulder on purpose,
“Rough night?” he asked and the boy—obviously an overworked intern; Ian didn’t miss those days one bit—jerked awake, clutching the pile of folders in his arms.
“What? Is it morning? I’ve been here since noon yesterday. I was supposed to come in just for a few hours, it was my day off, but no. Dr. Chon needed me to stick around because Mike called in sick. If you ask me, Dr. Chon just didn’t want to do the work,” he shook his head and Ian swore he saw the rings around his eyes spread out even further like evening paint.
“Ridiculous. I can’t wait until we rotate, that guy is—” he stopped as he looked up at Ian. His jaw dropped and all of the color drained from the boy’s face as he recognized the physician to whom he’d been complaining, “Dr. Chase. I am so sorry, I didn’t mean—I am so sorry, I’m just tired and I wasn’t thinking. I’m—”
Ian laughed as the elevator doors opened on his floor, “It’s okay, I won’t tell Dr. Chon. Don’t worry about it.”
He stepped out of the elevator and shot a glance back at the intern who was still pale and stricken. Ian shook his head, chuckling as he went down the hall.
“Hey, Judith, beautiful morning out,” he greeted the nurse who had been there since Ian had resembled the poor intern far too closely for his taste. He stopped at her station, taking inventory of the files for his first visits of the morning.
She propped her chin up on her fist, “Ian, I don’t know what you’re taking every morning, but damnit, why don’t you share with the class? You’re so damn cheerful all the time, doesn’t it get tiring?”
He shook his head, taking his files with him, “Nope, never. Have a great day, Judith.” He headed back to the lounge room where the other department heads gathered to change. They had upgraded from a locker room that the interns and residents used. Ian guessed that once men and women had devoted half of their lives and every minute that could have gone towards constructing a social life to helping people, the hospital thought a suitable consolation was a couple of couches and nicer cabinets to keep their clothes in.
Ian reached for his coat in one of the cabinets lining one wall. Dr. Chon, or Lee, as Ian referred to him, was on one of the blue couches, flipping through some medical notes.
“Morning, I passed one of your interns on the way in here. You trying to kill him?” Ian asked, setting his briefcase down beside his cabinet.
Lee scoffed, “It was Brian, wasn’t it? That wimp. I asked him to go do some work in the clinic for a couple hours.”
“How many hours? The kid was barely standing.” Ian slung one arm through the white coat, then added his stethoscope around his neck.
Lee shut the journal with an emphatic ‘thunk’ and stood up, “How should I know? I was busy.”
“You know the point of interns is to teach them, not send them to do the work you don’t want to do.”
“No, that’s exactly what they are here for and you know it. You remember, you were an intern more recently than I was, you young whippersnapper.” He joked and smacked Ian’s cheek, “Come on, we got work to do.”
Lee closed the lounge room door behind them and led the way down the hall back to the elevator.
“What are you doing on this floor, anyway?” Ian asked, looking at his first patient’s file: a man, age sixty-five with lung cancer.
“I had to move a kid up here this morning.”
Ian cringed. Lee was his best friend, but nobody wanted to see the head of Pediatrics on the Oncology floor. “How old?”
Lee sighed, grabbing a file off of Judith’s desk, “Eleven.” Before Ian could ask anything regarding the poor kid, Lee’s pager went off, “I gotta go. Catch you at lunch maybe.”
“Doubtful!” Ian laughed as Lee jogged into the closing elevator.
Ian breezed through his morning rounds, skipped lunch to read up on some new trials on patients suffering from lung cancer, and at about three in the afternoon he was pleased to see that he had a follow-up with one of his favorite patients.
He opened the door to exam room two and smiled at the nurse as she exited, after having taken the patient’s vitals. Ian looked at the man hunched over on the exam table, and felt as if he was seeing a family member that had parted from his life for too long.
“Mr. Adkins, how are you this afternoon?” Ian asked.
The man smacked his dentures together, “Not bad, not bad. But I wish this weather would cool off, too hot for my taste. Though, my daughter,” He sighed and rubbed his palms along his khaki pants that cuffed early, showing off a strip of plaid socks, “she loves this kind of weather.”
Ian gave the man a melancholy smile, taking a seat on the stool in front of the table.
When Ian first met Mr. Adkins almost exactly ten years ago, the old-timer had been suffering from grade two brain cancer. The cancer spread quickly and soon it was considered grade three. While the tumor was removed and he had been cancer-free for about seven years now, the disease had taken a toll on his brain and left him with occasional dementia. He often went on about how his daughter ‘does this’ or his daughter did something ‘just yesterday’ that made him laugh, when Ian knew better than anyone that his daughter had died ten years ago.
“Yes, I’m sure she does, Mr. Adkins. So, any dizziness, fatigue, headaches?” he asked.
He frowned, scratching the furry, grey goatee growing on his chin, “No thanks, I’d rather not have any of those.” He slapped his knees, cackling to himself; Ian shook his head at the amusing old man, “Ooh-doggy, I crack myself up. Ah. Oh yeah, nope. I’ve been good since my last check-up, Doc.”
Ian nodded, pulling out his flashlight. He steadied the back of Mr. Adkins’ head with his free hand and shone the light in his eyes. His pupils dilated accordingly, and Ian clicked the light off, returning it to his pocket, “Good, good, Mr. Adkins. How about nausea, you been feeling alright?”
“Well, I do on occasion get a spell of indigestion, but other than that, I’m feeling pretty good.” He patted his rounded belly, “Hey, I even thought about training for that half-marathon coming up. ’Course my knees will need a stern talking-to so that they don’t give out on me halfway through the race.” He expelled a low, gravelly chuckle, “But, uh, I think I feel good enough to do that and maybe even win!” He shot up a triumphant fist and Ian couldn’t help but smile encouragingly at the old man.
“I’ll bet you could too, Mr. Adkins. You’re looking pretty good, I’m giving you a clean bill of health. Just remember to take it easy on the training, Rocky. You could feel dizzy or weak, so keep taking care of yourself. If you feel any of those symptoms that we’ve talked about, come right in and I’ll see you personally,” Ian said, patting his hand on the man’s soft shoulder.
“I ’ppreciate that, Doc. I’ll let you know if I get a case of the vapors,” he said, standing back up to shake Ian’s hand, “That all you got for me, today?”
Ian wished. Unfortunately, cancer survivors didn’t have it that easy, “Well, not quite, Mr. Adkins. I’m going to send you down to radiology, you’ve got a scan this afternoon. As long as that comes up clean, you should be good to go.”
The man’s forehead crinkled like tissue-paper being balled up in a nervous kid’s hands, “A scan? I thought I was feeling good, I thought—”
Ian stopped him before he could work himself up, “Oh, no, no, Mr. Adkins, it’s just a precaution. We want to run some tests every so often, just to make sure the tumors aren’t returning. They do that more often than you think.”
“Well…can’t you do it for me? Last time I went down, there was just a kid working the thing. I swear she’d just lost her last baby tooth.”
Ian smiled—one of the radiology interns, no doubt, “Mr. Adkins, you’ll be fine
without me. I’m afraid I’ve got other patients to see this afternoon. They’ll take care of you down there, you have my word. Alright?”
He frowned, furrowing his caterpillar-sized eyebrows, “Alright,” he grumbled, letting Ian usher him out of the exam room.
“Okay, Mr. Adkins, I’ll see you in a few months,” he said as he watched the old man hobble out, leaning heavily on his cane, into the lobby.
“Hey, Judy, how are ya’? Lookin’ good, you been drinkin’ that prune juice I keep hearing about?”
Ian smiled as he heard Mr. Adkins call to Judith outside of the exam hallway. He had known her for the past ten years, seen her before and after visits, radiation, surgeries. He probably remembered more about the seasoned nurse than he did his own beautiful, young daughter.
The rest of his afternoon went off without a hitch, and Ian was out of the hospital by seven—pretty early, in his experience. Lee, having been a department head longer than Ian and thus having more seniority to leave earlier, had been off since six and was waiting for Ian down the street at Tino’s, a favorite meeting place for the hospital staff after hours.
Lee flagged Ian over to a table with a basket of fries in the middle and two beers, dripping with condensation, on either side.
“Hey, Ian!” the bartender and owner waved at Ian from behind the bar. The five-foot tall Chicana was actually named Tina but when she opened the bar nine years ago, she’d wanted to sound more Italian so she changed the ‘a’ at the end of her name to an ‘o’. Nobody knew why though. Ian thought maybe it was so that people would take her more seriously, but then again, nobody ever treated Tina with anything less than the utmost respect. Her brother worked as a part-time manager, part-time bouncer at the bar. Ian always believed that he was more destined for WWE fighting, making a terrific incentive to consider all of Tina’s marketing decisions foolproof.
“Hey, Tina! Shouldn’t you be at home, off your feet?” he asked.
She stepped around the counter, revealing her nine-months-pregnant, swollen middle.