CLUB MEDicine: A Novel

by Jack Kinsley

  She gave him a stiff middle finger before she unlocked the driver side door. "You know, before I met you, I wouldn't even drive after a single glass of wine."

  This was true. Before Marilyn had met Travis, she only drank on special occasions. He was the devil on her shoulder, pulling her away from her macromolecules, and he felt a perverse sense of excitement in exposing her to the darker side of life. He was there when she smoked her first joint, chopped her first rail of cocaine; he was definitely there for the all-night sex sessions that followed. Their courtship was short and speedy, as was his corruption of her.

  Inside the car, she told him, "You're a dick."

  They were the last words she ever spoke to him. They left the parking lot, drove southbound on PCH, and then made a left up Latigo Canyon Road. It was a winding low-lit street with a soft shoulder. At a sharp curve, she drifted onto the loose dirt and overcompensated a tail slide that sent them straight into the massive trunk of a mature oak. The driver's side took the brunt of the impact, while Travis was shot out the passenger window. Miraculously, he suffered relatively minor injuries — a torn ligament in his right knee, a dislocated shoulder, and some deep scrapes.

  Marilyn was pinned inside the car behind the steering wheel, unconscious and bleeding profusely from a large gash on her forehead. The police arrived. Ambulance. They had to use the Jaws of Life to get her out; two burly firefighters kept Travis from the vehicle while they worked.

  Marilyn's list of internal injuries was long and ghastly. And irreparable. The doctor told Travis she had three broken fingers on her left hand, two on her right, a broken shoulder, and five broken ribs. That was where the real trouble began: three ribs had punctured and collapsed her left lung, while the other two had cut into major blood vessels — all contributing to massive internal bleeding, and bruising to various organs. She also had a fatal rupture to her aorta, caused by a compressed stomach, and a ruptured spleen. There was no chance of survival, the doctor assured Travis. The machines would only keep her alive for a short period longer.

  In the hospital, Travis wept over her broken body, begging for a miracle. For forgiveness. He even foolheartedly tried to strike a deal with the devil to take him instead, but there weren't any answers. Just the beeping of the machines.

  And then, he ran.

  He fled the hospital with thoughts of suicide. He wasn't man enough to watch her die in front of him. He had put her there, and couldn't witness the last breath he had taken from her. Back at their home, he drank himself into an oblivious rage, trashed everything around him, and cursed God and himself.

  An hour later, Marilyn died alone.

  Aside from Travis, Marilyn's family was almost nonexistent; both parents victims of cancer (a family history that had driven her scholarly ambitions), and one older brother who spent most of his time in the woods hunting and one day didn't return. She had an elderly step-aunt suffering from dementia in Massachusetts, and a few distant cousins, but they were never close and probably hadn't spoken to each other for over a decade.

  No, it was Travis who should have been there to hold her hand when she left the world. But instead he let her die in the hands of strangers. That was eight years ago, and he had never forgiven himself; the memory had never faded. He realized now that the burden of guilt had been weighing on him that much more this past year, living away from his family. Now, his little Bella was heading to the very same emergency room.

  — — —

  Inside the hospital, there weren't any signs of Bella and Ana. Travis shouted through the hole in the glass at the receptionist, but she was busy and gave him a one-minute finger to wait, so he blew past the swinging doors without permission into the second waiting rooms. Scores of people hurried past, in every direction. He didn't see a familiar face until he jogged down a hall and saw Ana seated with her head in her hands.

  "Ana!"

  Without hesitation, she stood. She ran to him and wrapped her arms tightly around him. Her body was flushed with heat and he felt his shoulder quickly dampen.

  He led her back to the blue bench she had been sitting on and they sat together.

  "It's my fault," she told him. "I can't believe I allowed this to happen."

  "What do you mean?"

  "Maybe an allergic reaction. I don't know." She spoke to herself and then looked into his face. "She was drinking my wine."

  "I don't understand. Why? Why would she be drinking wine for Christ's sake? She's five years old!" He mentally whipped himself for being so careless, but how could he have ever imagined this could happen?

  "Oh, Travis, please don't hate me for this."

  "No, never. Now tell me." He rubbed the side of her arm, touching her in the way he had comforted her for so many years.

  "You know little girls. When they start playing mommy, wanting to be like mommy — wearing our shoes and jewelry. It's all fun and games. And sometimes I would have a glass of wine around her and of course she wanted to smell it and taste it — and I only let her once. But then she kept asking to try it again, so I poured her a glass of grape juice and she would hold that while parading around the house in one of my dresses. We would take silly pictures and she would act like me and tell me it was my bedtime... 'Get to bed now or Mommy won't read you a story.' It was all innocent. But then I caught her drinking it while I wasn't looking. I saw her in the reflection of the microwave while I was cooking. Twice! She actually liked it! I mean, why? What kind of kid likes the taste of wine? I don't understand it." She suddenly leaned forward, as if suffering from a massive stomach cramp.

  Travis brought her in closer under his arm. He'd never heard of a child that young liking alcohol, but he could blame it on his own alcoholic genes. There was a lineage in his family of big drinkers.

  "She kept asking and I kept telling her no, but sometimes I was weak and I would let her have just a little sip — just a taste. I know it's terrible, but we were like two silly girls, and it was a stupid, stupid game that I should have never played with her!" She wiped at her swollen eyes. The scar on her neck was inflamed and its edges burned. "After a while, I had to hide it from her; somewhere high, out of reach. And I never thought she would get out of bed and go downstairs while I took a bath. She's afraid to go downstairs alone."

  "I'm sure she'll be okay," he said, but he wasn't confident. "How much wine do you think she drank?"

  "I don't know. It was hard to tell what was left on the floor... Maybe a quarter? Maybe half? I should have locked her in her room. My God, Travis, I'm a terrible mother."

  A quarter? A Half? He tried to calculate. If there were two hundred milligrams, then maybe she had taken fifty or one hundred milligrams? But he was almost certain a soluble didn't work that way. It was highly unlikely it would be a proportional split.

  "At least you got her here quickly." He tried in vain to comfort both of them, and Ana pulled in close to him on the bench as they waited for the doctor.

  It seemed all their anger and resentment toward each other had evaporated, their concern for their child unifying them for the moment. He knew then that he still deeply cared for her. How could he have done this to his family? How could he have ever imagined killing the mother of his child?

  "I know this isn't the appropriate time," he whispered to her, "but I want to tell you how sorry I am again about that night."

  She looked up at him, reading his genuine sincerity, and then rested her head back on his shoulder. Her arm wrapped around the front of his waist, she slowly rubbed his side with her thumb. It was something she would do as a sign of affection when they used to watch movies on the couch.

  The night of their last big fight, which had sent him packing within the hour, had begun when she found his little black box for the umpteenth time. There had been many arguments and empty promises made before then. She not only hated who he became while on the meds, but she was always finding the loose, candy-lookalike pills he dropped around the house.

  She slapped his face that night f
or the first time in their relationship, and the argument became physical. He didn't strike her, but threw her onto the bed, pinned her on her back, and ran his thumb firmly up the length of the scar on her neck. It lasted only seconds before he caught himself and let her go, but the irreversible act was the final break in their relationship. He had nothing to do with how she got the scar, but he knew its significance. It was an unforgivable act on his part.

  Ana had the opposite childhood of Marilyn. She ran with a tough crowd at an early age and had been arrested numerous times for shoplifting and drinking, and was eventually jailed for possession of heroin. Her mother, Nica, with her strict Catholic background, condemned her behavior and threw her out of the house. With little choice, Ana moved into an abandoned apartment complex with her boyfriend and continued her drug-fueled lifestyle, until she became pregnant. When she realized she was carrying, she stopped her substance abuse out of sheer willpower and earned herself a second chance to live with her mother. The turnaround came too late, though, and at the end of her first trimester her polluted womb forced a painful miscarriage.

  Distraught and severely depressed, she started using again, was thrown out of her mother's house once more, and ended up crashing at her drug dealer's pad — where he was going to get paid one way or another. One night, deep in a Romanian winter, he forced himself on her. When she kicked and screamed, he produced the serrated hunting knife that gave her the scar she wore today. He kept the blade firmly against her throat during the rape, the violence of the attack responsible for the scar's jagged and uneven quality. If he hadn't come when he had, the knife could have easily cut deeper and she would have most likely bled out.

  Once again, Ana ran back to her mother's and was given a third chance. This time, her mother didn't take her back because Ana had begged or sworn to never use again, but because she knew her daughter would live with the reminder of her transgressions for the rest of her life.

  "Everyone should live with a scar," Nica had told her daughter. "It will always stare back at you in the mirror and tell you who you were, and who you will never be again."

  From that day forward, Ana kept her promises. She had been sober for twelve years when she and Travis began their long-distance correspondence. In a lot of ways, it was their personal struggles in achieving sobriety, and her admiration for him in helping others, that became the catalyst in their early relationship and eventually cemented the marriage that followed.

  — — —

  It was nearing an hour that Travis and Ana had been waiting for Bella's diagnosis. They remained seated on the bench holding each other for most of that time, and there was a profound exchange of comfort and support shared in their silence. The fact that he still cared for her and yet had wanted her dead just that evening confused him terribly. There was no telling what the future held for the two of them.

  They watched the doctor exit Bella's room and walk over to them. He was a tall, thin man, and his long white coat dropped from his sharp shoulders as if it were still hung on a wire hanger. Clipboard in hand, he had the sympathetic eyes of a hound.

  They both stood to greet him.

  He checked their names on his board. "Mr. and Mrs. Martin?" They nodded. "I believe your daughter will wake from this and be just fine, but as a precaution we would like to keep her under observation for twenty-four hours."

  Though his words lit the end of their tunnels, skepticism remained in his tone, as if things could still turn south. Travis wondered if tests would be able to identify the Seroquel in Bella's system.

  "Was it the wine? A possible allergic reaction?" Ana asked. Travis could see she felt like a horrible mother, and also detected an inkling of judgment behind the doc's sagging, tired eyes.

  "It could be, but it's doubtful. She would have had to consume much more than what you described. We ran some initial tests, but nothing conclusive yet. We're running a few more that could shed further light, but the fact is we may not be able to pinpoint the true culprit."

  The culprit is standing right in front of both of you, Travis thought, and then he remembered Dr. Rubenstein. Why hadn't he called Dr. Rubenstein? The seventy-two-year-old doctor had been a family practitioner for half his life, and was a patient at Crystal Heights just last year. The ornery doctor went into semi-retirement, had gotten bored within months, and then got really happy with his own prescription pad. Although he pretended not to like Travis (or anyone else for that matter), Travis knew Rubenstein would answer his call and be secretly pleased to hear from him.

  "Can we see her?" Ana asked the doctor.

  "I'd say in about ten minutes you can go in. Let the nurses finish up in there." The doctor looked over his shoulder and spotted a nurse waving him over to join her in another room. He told them he'd be back as soon as he had the additional reports, and left.

  Travis pulled his phone from his pocket and pretended he'd just received a text message. He then told Ana about Betsy being admitted back at Crystal Heights and her terminal diagnosis, and said he needed to make a call in regards to her care. Ana soured a bit, but she had spent time with Betsy and held her in high regard, and waved for him to go.

  "But don't be long, Travis...please," she told him.

  He assured her he wouldn't be, and dialed Dr. Rubenstein while he headed for the exit of the hospital. It was getting late, but Travis was almost certain the tough old goat would be awake; he'd never slept more than five hours when he was at the rehab.

  The doctor answered on the third ring and barked into the phone, "This better be damn important. You know what time it is, son?"

  Travis apologized and went straight into what he needed to ask. Dr. Rubenstein was a just-the-facts kind of guy and Travis gave him exactly that — not all the exact facts, but close enough: a female, four years old (given Bella's size, he thought it safe to subtract a year), who could have accidentally ingested two hundred milligrams of Seroquel. What was the worst-case scenario?

  "Goddamn parents today — everybody's got a prescription for something, and they just leave this crap lying around like it's aspirin. All depends on the health of the child. Any pre-existing conditions?"

  Travis mentioned she may have been a preemie. After he requested a couple additional facts, Dr. Rubenstein told Travis there wasn't much to worry about.

  "She'll sleep for a solid twenty-four hours, and she'll be out of it for a day or two after. But so far as permanent damage... It's not likely. They got lucky. Tell your asshole client, whoever it is, to lock up their damn drugs next time, would you?"

  It was like the weight of a grand piano lifted from Travis, and his heart could beat regularly again — aside from the meth that continued to scour and pump fiercely inside his veins.

  He hadn't asked Dr. Rubenstein whether a blood or urine test could pinpoint the Seroquel in Bella's system, afraid it would raise suspicion from the already-distrustful physician. It was enough to know Bella would be all right. He would deal with everything else later, if it came down to it.

  Ana was entering Bella's hospital room when Travis returned to the emergency room, and he was able to grab hold of the door before it closed and slip in behind her. He knew Bella would be all right, but the sight of her unconscious in the hospital bed destroyed any image he held of himself as a model father. Oxygen tubes trailed from her delicate, pale face and her body was so still and her eyes so lifeless that it seemed she would sleep for an eternity.

  Ana swept the hair back from her forehead and kissed her repeatedly. She whispered how much they both loved her. That she was going to be just fine. That she would be home soon. Travis stood on the opposite side of the bed, Bella's fragile hand in his, and offered the same assurances.

  Ana had carried in with her a children's book she had chosen from the large wicker basket out in the waiting room. It was out of season, Rudolph the Red-Nosed Reindeer, but it was a story Bella had never grown tired of hearing. Travis remembered reading it to her on Easter, when Bella'd had enough of rabbits for the day.


  Now, Travis and Ana pulled up a couple of chairs and Ana began reading while they waited for the additional reports from the doctor. Travis listened and was again reminded how disturbing children's books could be: Rudolph the freak of nature excluded from all the reindeer games, ostracized, until they finally found good use for him and strapped him to a massive sleigh carrying the weight of the world's toys and the burden of a fat Santa.

  Travis pointed this out to Ana, who had heard his perspective before.

  "Christ, can't you think of the brighter side of anything?" she asked him, exasperated.

  "Christ," he pointed out. "Now that's what Christmas is really about. Not this obese man in a red suit with clogged arteries." He knew he was being a pain in the ass, but wanted to see if he could still make her smile. Ana covered her face with the opened book, and he knew she was; he could see the remnants of her smirk when she finally lowered it.

  Then the doctor came in and it was all business again, although this time his look of disdain was unmistakable. There was a new report snapped to his clipboard. He quietly reviewed it a last time in their presence. Ana and Travis looked at each other, feeling the profound weight he'd just carried into the room. Ana seemed to be trying to form a question, but couldn't get anything out.

  The doctor flipped through a couple of earlier reports and then removed his large rimmed glasses and squinted his baggy eyes at the two of them.

  "Tell me, do you keep any prescription drugs that are easily accessible around the house?"

  They both shook their heads absently, and Travis eyed Ana in his peripheral vision.

  "Are there any kind of antipsychotic medications? Clozapine? Or Quetiapine...also commonly known as Seroquel?"

  Travis watched Ana as her mind seemed to chase itself, and then he could see something click inside her. Her eyes shot at him. He felt his head pop like a balloon.

  "No," she told the doctor unconvincingly.