“Mary Sarah,” I said, affecting a scandalized air. “That is a very young college person.”
“I know, right? Love the view.”
A server materialized. “Hi, Dr. Porcher, Dr. Colley, Dr. Anson. Can I get you ladies a beverage?”
“Oooh, yes. It’s hot as balls out here. I’ll have a sweet tea. Thanks, babe.”
“Nonsweet tea,” said Emma.
“Just ice water.” I hated putting extras on Emma’s tab, on top of the guest fee for the pool.
The morning sputtered along. After Mary Sarah had downed what seemed like five thousand sweet teas, each of which was the equivalent of drinking a pound of sugar laced with caffeine, she finally needed to use the bathroom. Evidently she had the metabolism of a newborn and a bladder the size of Canada. Emma and I watched as she somehow bounced away in her four-inch cork mules and then turned to each other.
“Quick,” I hissed. “Fill me in. Did he get the job?”
Chapter Five
DRINK UP, HONEY
Emma, Present Day
I looked Zadie in the eye as I answered, “He did.”
“Does he know you’re in the group?”
“I don’t honestly know,” I said. This was true. “I assume he would’ve checked out our website at some point, and even though my last name has changed, he’d recognize my photo and bio. So surely he knows?” I shifted around in my chair. “He interviewed while I was out.”
“So . . . so . . . where is he now? Do you know anything about him?” A band of worry lines crinkled Zadie’s forehead.
“I got his CV. He’s board certified in liver and gallbladder surgery, and he’s been out west somewhere. Denver, I think. Sounds like he still does a lot of research; he had a lot of publications. He listed his interests as golfing, snowboarding, and running, but there was no mention of anything personal. I asked our manager why he’s leaving, and she said—”
“Dr. Anson! Hiiii!”
Oh no. Not good. The mother of one of Zadie’s patients stood in front of us. I knew her too, from the club. The kid appeared likable enough—for a kid—but I’d mentally diagnosed the mother as a hypochondriac veering toward full-on Munchausen by proxy, a psychiatric disorder in which people induce illness in their children because they enjoy the attention. Plus, I detest close talkers.
“Hi, Tillie,” said Zadie, with baffling warmth.
“Hi,” I said, striving for a pleasant but uninviting tone. “Zadie and I were just—”
Oblivious, Hypochondriac Mom interrupted me again. “What good luck to run into you, Dr. Anson! I was about to call,” she said, plopping uninvited onto my chair, forcing me to shift over so that one buttock was dangling midair. I stared at her back. Was I invisible? “I hate to bother you”—clearly a lie—“but I’ve been noticing some potential issues with Newton’s pulse ox, and—”
She prattled on. I sighed. This failed to gain attention, so I raised my eyebrows and cleared my throat, which neither woman noticed. Finally I broke in. “Oh,” I said to Hypochondriac, gesturing across the pool to a clump of people standing near the bar. “Isn’t that Dr. Porcher over there? Is she your pediatrician?”
Hypochondriac cut off midword and leapt up. The difficult moms tended to love Mary Sarah, whose effusive personality made everyone feel validated. “Great!” she shouted over her shoulder as she galloped off. “Thanks!”
“Two birds with one stone,” I said, relieved. “I’ll buy Mary Sarah a drink later.”
“I think you’ll have to buy her a whole pitcher.” Zadie giggled, watching a little herd of men in golf shirts who’d been chatting with Mary Sarah disperse in all directions as soon as Hypochondriac descended on them.
We could faintly hear Mary Sarah’s voice carry across the pool: “Well, heyyy there, sugar! What’s wrong?”
“I don’t understand,” I said. “How do you tolerate those people?”
“Em, please,” Zadie said. “Why is he leaving Denver? When does this become official?”
Unease percolated in my chest. Two million people live in the Charlotte metro area, but I would never be able to avoid Nick, even if he weren’t joining my particular group. And actually, Zadie wouldn’t either. There were lots of hospital functions and medical society events where doctors of various specialties ran into one another. Not to mention the social scene: if you had a house in one of the neighborhoods near the hospital, and your kids went to one of the schools nearby, and you or your spouse volunteered in the same philanthropic circles as everyone else (did Nick have a wife?), and you joined one of the main country clubs in town, then you were a de facto member of a group that knew everything about you. Could I dare hope that he’d be a confirmed bachelor who didn’t mind commuting in from Lake Norman?
“Hey.” Zadie snapped her fingers in front of my eyes. “Why is he coming here?”
“Nobody really said why he was leaving his current practice,” I answered quickly. “Jack Inman”—this was one of my partners, the medical chair of the executive committee that managed my practice—“spoke with some of his current partners and didn’t pick up on any glaring red flags. ‘Technically gifted, innovative, strong presence in the American College of Surgeons’—that kind of thing. I asked him if anybody mentioned what he was like and Jack asked if I was looking to step out on Wyatt. You know what a pervert Jack is. Anyway, it’s a done deal. They got him credentialed already. I found out today he’s already here.”
A rare moment of silence gripped Zadie.
“Well,” she said, finally recovering, “I guess we will deal with this. But nothing gets said to Drew, okay?”
“He doesn’t know?” I said with some surprise.
Despite her discomfort, her irrepressible good humor returned. She flashed me a mock-guilty grin. “I know this sounds weird,” she said, “but we never really dissected our pasts with each other. Childhood, and families, and college angst—all that, yes. But the one time I tried to pry information out of him about old girlfriends, he got so embarrassed I had to terminate the conversation out of mercy.” She stopped, apparently transfixed by a mental image of her blushing, grimacing husband. I pictured him too. Drew Anson was one of those guys who will always appear boyish; even when he’s gray-haired and creaky, he’ll probably look like he’s fourteen.
“Zadie?” My turn to wave a hand in front of her face after a minute went by without the conversation resuming. She was staring at the horizon with the intent but sightless expression of a wax figure, her mouth hanging slightly ajar.
She blinked and said, “Oh, yeah.”
Before I could steer us in a different direction, she relaunched the conversation right where we were. “And Drew doesn’t want to hear a word about my, uh, romantic past with other guys, either. We never really had the ‘how many people have you slept with’ conversation. I tried one time, but he actually put his hands over his ears. Drew isn’t the kind of guy who wants to delve into my every inner thought. He’s, uh, fine with a little mystery here and there.”
“Oh, that’s like Wyatt too. Silent and mysterious,” I said.
“It is?”
“I’m joking!” I always had to explain to people when I was joking, unfortunately. Even Zadie sometimes. “Of course not. He put me through a two-hour interrogation about my sexual past on our first date.”
“What? He did? And it took you two hours to talk about it?” Zadie shrieked. I knew what she meant. One mysterious and wonderful thing about Wyatt: he never failed to behave exactly the opposite of what one might find appropriate, yet somehow he always got away with it. “How did you never tell me this before?”
“Well, you know Wy. At first I was shocked, but he was so straightforward, like this was normal, and also he conveyed such interest in me that after a few minutes of it, I actually felt charmed. He wasn’t a bit judgmental, not that I was confessing any bizarre fetishes or
anything—I was always shy with guys—but he asked me everything.”
Zadie mulled this over. “Did you tell him about . . . our third year of med school?”
“Yes. I did.”
“All of it?”
“Yes, everything.” Almost true. Wyatt knew more than Zadie did about what had happened that year. “On our first date.”
It still astonished me, three years after marrying Wyatt, that he’d conjured up such a sense of ease in our relationship that I was capable of confiding in him. I was a fiercely private person. Before I met Wyatt, Zadie was my only close friend, and I loved her with a devotion born of shared history. Ours was a friendship forged when we were young, the kind that endures no matter what because losing it would be like losing an aspect of your own personality: your sense of humor or your ability to empathize. You wouldn’t be the same person without your friend as your external hard drive. I know, because for quite a while I thought I would lose her.
But even so, there were things I’d never been able to articulate to Zadie. We didn’t talk about certain topics, much the same way we didn’t mention Nick: even now, more than a decade later, it was too threatening. I fixed my gaze on the far side of the pool and began silently counting chairs, trying to erase the memories crowding into my consciousness.
Zadie was clearly about to query further when I noticed some sort of commotion over by the bar. Two men were standing there, one hugging the other from behind, which was odd; the man in front began waving his hands around frantically. The hugger was shouting, but I couldn’t quite make out the words. Behind the bar, a couple of servers were also gesticulating wildly, and there was an accumulating crowd of people. Were they fighting?
I craned my neck. As I did, Zadie jumped up, and in one fluid motion she was on her feet and running hard, yelling over her shoulder for me to follow her. As I rose, I saw the man who was getting hugged slump forward. Two women, one of them Mary Sarah, rushed forward and eased him to the ground.
Zadie was on her knees. The man on the ground was unconscious, his face a florid blue. I elbowed my way through the throng of horrified people and joined them.
Instantly, I assessed the situation: he was choking. I looked up at the bartender. “Get me a sharp knife, right away, and some napkins and straws. Also a couple forks.” I looked back at Zadie. “Do you remember how to cric somebody? I need you to hold pressure if there’s a lot of bleeding. Okay?”
“Okay,” Zadie said, her eyes wide, but then she flashed me a resolute look. I was accustomed to cutting holes in people’s tracheas—in this case, in the cricothyroid membrane of the trachea—but it wasn’t a procedure that occurred in a cardiology office. It had been at least a dozen years since Zadie had seen this done, but in med school she’d been a competent assistant surgeon. I’d been surprised and then—almost—jealous when the class rankings for our surgery rotation had come out: I’d been ranked first, of course—no one was going to get a higher score than I was in my favorite subject—but when I realized Zadie was ranked second, I’d had to control an unattractive feeling of dismay.
I looked down at the unconscious man and realized I knew him. It was Buzzy Cooper, the owner of a local commercial real estate firm and the father of Sumner, who Zadie had informed me was Delaney’s bitee. This needed to go well; imagine Caroline Cooper’s wrath if Zadie was involved in both the repeated biting of her daughter and the grotesque mauling of her husband as he choked to death.
Buzzy was bluer by the second and twitching slightly, his face a dusky parody of itself. I nodded briskly when the bar server arrived with a tray of the items I’d requested, along with a bottle of gin and an entirely superfluous thermometer. Zadie upended the alcohol over Buzzy’s outstretched neck and swiped it dry as I used the knife to cut a small bundle of the straws in half. I then palpated the thyroid and cricoid cartilage rings, which wasn’t easy, given the blubber that ringed Buzzy’s corpulent form, and made an unhesitating incision between them, cutting through the skin. Blood oozed out from some peripheral vessel, obscuring my view. Using the blunt end of the forks, I positioned them as makeshift retractors to hold the edges of the incision open, handing them to Zadie, while I used my finger to dissect down through the subcutaneous tissue. Meanwhile, there was no sign of any respiratory effort at all from Buzzy; were we too late? No, he was bleeding, and his heart was still pumping. We still had time. After making a horizontal incision through the cricothyroid membrane, I thrust my finger into the incision, widening it and holding it open. With my other hand, I positioned a few of the cut straws into the opening between the tracheal cartilage and blew gently into them.
There was an agonizing moment of nothing. Then I blew again, then waited . . . and waited . . . and then, with a lurch, Buzzy’s chest rose a little and sank. There was an odd whistling sound from the straws as air moved through them. The color in Buzzy’s hypoxic face improved slightly.
Now I became aware of the people around us; dozens of spectators were clustered in a vibrating hive, watching the impromptu surgery with wide eyes and still faces. A cry went up from the crowd when they realized Buzzy was alive.
Two EMTs appeared, toting a backboard. One was a smallish Asian man, the other a borderline obese white female, both of them moving swiftly. The crowd parted for them, and they knelt beside Buzzy, taking in the scene.
“Dr. Colley?” said the female, hitching at her pants. “I didn’t recognize you!”
“Hey, Jen. I dress better at work,” I said as casually as I could, despite having stabbed a man in the throat in front of half the club. While wearing a bikini, no less. “This here”—I motioned at the makeshift tube—“is not stable. Can you give me the smallest ET tube you’ve got, and something to use as a guide wire? And a suture, if you’ve got any. Meanwhile, let’s get some blow-by oxygen going toward these . . . straws.”
“Will do, Dr. C,” said the man, turning and sprinting toward something behind them, while the chubby woman started fiddling with an oxygen mask.
Hurriedly, I managed to get a legitimate endotracheal tube in place, although it was not the correct size and was meant to be inserted through the mouth, so it looked completely wrong. I tried not to let this bother me; it did look better than a handful of straws. I threw a quick suture to stabilize the tube so we wouldn’t lose the precarious airway on the way to the hospital.
The sun was beating down on us from directly overhead, and the pavement was scorching hot. A frozen margarita appeared, as if by magic, in my hand as I boarded the ambulance; I looked at it stupidly. “Drink up, honey,” said Mary Sarah. “I think you need that.”
Chapter Six
VERBAL EVISCERATION
Late Summer, 1999: Louisville, Kentucky
Zadie
An hour or so after Silver died, the TICU doors swung open and the rest of the team charged in for rounds. Dr. Hollister, the attending, looked remote and scary; Dr. Kalena looked remote and cool; Clancy wore a supercilious smirk; Ethan, the other med student on my team, looked tired; and Dr. X, who seemed restored to his usual hard-charging character, looked smoking hot, at least in my opinion. He noticed me and grinned, all traces of his earlier grimness gone. “Sadie. You ready to give us the lowdown on our unit players?”
“I think so,” I replied, grabbing my list, now inexplicably covered in a dense array of hieroglyphics. Could this be my own handwriting?
“Excellent. Fire away.”
I took a deep breath and looked around. Silver’s mother had arrived, ashen and out of breath, ten minutes after the last beat of his heart. A curtain pulled around his bed shielded them from view, but the sound of her weeping and the softer murmur of the hospital chaplain filtered out, blending with the babble from the people assembled for morning rounds. Bystanders had morphed from a few nurses into a crowd of about thirty people—surgeons, the other trauma teams, respiratory techs, physical therapists, social workers—who now all t
urned like a wheeling flock of birds, focused on me.
The chair of the Department of Surgery, Dr. Spencer Markham, cleared his throat. Trying to ignore everyone’s stares, and the terrifying lidless gaze of Dr. Markham in particular, I stood in front of Bed 1. I glanced at the patient; he was perfectly still except for the forced rise and fall of his chest. My audience rustled.
“This is hospital day twenty for Mirror Trauma,” I reported. “He’s the nineteen-year-old unbelted driver of a high-speed MVA, resulting in splenic laceration, open left femur fracture, closed shear injury of the brain, and multiple skin lacerations and abrasions. He is day twenty status post exploratory laparotomy for splenectomy, day twenty for left femur rodding by the orthopedic service, and is being followed by neurosurgery for his head injury. Vital signs—”
“Stop there, please, and tell us what procedure of this patient’s care you have forgotten.”
I froze. Dr. Markham was legendary for the verbal evisceration he performed on anyone who did not straight-up know their shit. He fixed me in an unblinking reptilian stare. Phantom ice water surged up around my scalp as the weight of dozens of other eyeballs bored into me too. What procedure is he talking about? I named all the procedures! Didn’t I?
“Let’s try this another way. Please recount the injuries again.”
Dr. Markham did nothing to disguise his disdain of yet another flailing student. Most of the audience kept their faces unrevealing, but I could discern an expression here and there: empathy mingled with fear (Ethan), pity (Emma), and undiluted schadenfreude (Clancy).
“Um. There was the splenic laceration, the femur fracture, and the closed head injury.”
“And?”
There was a long-entrenched belief among the surgery residents: you never admitted that you didn’t know. Even with Dr. Markham. Any answer, even a moronic one, was better than confirming that you were clueless. This position had filtered down to the medical students, resulting in many a ridiculous answer during various conferences and grand rounds. But try as I could, I could think of no other injury, and I couldn’t just make one up. I’d singlehandedly brought trauma rounds to a screeching halt.
The Queen of Hearts Page 5