Audrey had replied to my text earlier—she was doing something with her mom, and she was so sorry not to be able to make it. I just about could hear the wistfulness in her words. She’d have had a great time with us, I thought, trying to squash my not-so-sweet thoughts about her mother and Teeny. But yeah, it might serve her to be around women who were a little nicer than those two.
“So I met someone,” Gloria announced as we sat down to eat. “A man who has a job, doesn’t live with his grandmother, is good-looking, age appropriate and wants children.”
“A unicorn?” I asked, and we all laughed.
“Where’d you meet?” Xiaowen asked.
“When I went back to Boston to see my family last time. He was wearing a green-and-gray rugby shirt—”
“No!” Xiaowen said.
“Dump him,” I said.
The rest of them looked confused. “What are you guys talking about?” Poe asked.
“He’s a Slytherin,” I explained. “Green and silver are the Slytherin colors.”
“You’re such a dork,” Poe said.
“That didn’t occur to me,” Gloria said, “since I’ve only read Harry Potter twice, like a normal person. Anyway, we were standing in line at Starbucks, the one by the ferries, you know? And the line was like, fifteen people long, so we got to talking, and he was really cute, and maybe I gave him my number.”
“Invite him out here,” I said. “So we can observe, advise and pass judgment.”
“No way,” Gloria said. “He doesn’t get to know where I live for at least a month. I didn’t even tell him my last name.”
“Why’s that, dear?” Donna asked.
“The last guy I dated ended up stalking me,” she said, waving her hand. “Nothing too bad, but you know, getting up to pee at 3:00 a.m. and seeing him standing on the sidewalk, looking up at my window? No, thank you.”
There was that cold, strong snake of fear sliding down my spine again. I cleared my throat. “What happened? I mean, how’d you get rid of him?”
“I called the police, my four brothers and my dad. You don’t want to mess around with that shit. Sorry for my language.”
“Totally justified,” Donna said. “Men are pigs. Well, many men are pigs. I’ve heard some aren’t.”
“So will you see Slytherin again?” Poe asked.
Just then, my cell phone buzzed. It was the clinic.
“Hey, Doc,” said Timmy, the nurse on duty (one of the men who wasn’t a pig). “Come on down! We’ve got a teenage girl with acute abdominal pain.”
“I’m on my way,” I said. “Ladies, I’m so sorry. I have to go to the clinic. Don’t wait for me. Mom, can you handle grilling the fish?”
“Your mother is an expert griller,” Donna said. “And I’ll help just in case.”
“Let us know when you’ll be back,” Gloria said, pouring herself more wine.
“We’ll try not to burn this place to the ground,” Xiaowen added. “No promises.”
I pulled out onto Spruce Brook Road, a little sorry to be leaving, a little excited to practice emergency medicine. The strep throat swabs on the Robinson twins yesterday didn’t really get the heart pumping (though the kids were super cute). And this would be right up my alley—abdominal pain. Given her age, appendicitis was possible. We’d have to ship her to Portland for that, and if I suspected an abscess or a rupture, I’d be going with her. Could also be pelvic inflammatory disease.
I got to the clinic in under ten minutes, went in and started washing my hands. Timmy came through the swinging doors from the exam area. “Sorry to call you in on a Saturday night,” he said.
“No worries,” I said. “What have we got?”
“The patient says she knows you. Audrey Fletcher? She’s here with her father and her grandmother, too.”
Audrey? Shit. I frowned and rinsed my hands, then pulled on my white doctor’s coat and went through the door.
Audrey was the only patient here, lying on the hospital bed in a little ball, changed into a johnny coat. Sullivan sat by her side, looking ten years older, rubbing her back. Teeny was fluttering about like an irritable moth. “When will the doctor get here?” she demanded just as I came in.
“I’m here,” I said, going to Audrey’s side. “Hey, kiddo. Not feeling so hot?”
“Pretty bad,” she whispered. Her knees were drawn up, and her eyes were wet. I patted her leg.
“Oh, wonderful. Isn’t there another doctor?” Teeny said.
“Mom, be quiet.” Sullivan looked at me, lines slashing his face with worry. “She started having a stomachache about an hour ago.”
I glanced at the computer screen where Tim had entered her vitals and chief complaint. Everything was normal except for a slightly elevated BP and pulse, which was normal for someone in pain.
“Do an X-ray or something,” Teeny said. “Maybe she needs to go to the mainland. I’d be more comfortable if she was in Portland.”
“Mom, please,” Sullivan said.
“Does Grandma need to be here?” Audrey whispered.
“Nope,” I said. “Teeny, would you mind waiting out front, please?”
“I’m staying.” She folded her arms.
“Go, Mom,” Sully said. “There’s no need for you to be here.”
She didn’t move. “Tim, would you escort Mrs. Fletcher to the waiting room?” I said, not looking away from Audrey. Her face was a little flushed.
There was a hiss behind me, Timmy’s low voice. Good.
“Is it her appendix?” Sullivan asked.
“Let’s find out. Okay if I feel your belly?” I asked Audrey, pulling on exam gloves.
“Sure.” She rolled onto her back, grimacing.
“Any vomiting or diarrhea?” She shook her head. “When did you first start feeling this?”
“Um...this afternoon. And then it got really bad after Mom dropped me off at Dad’s.”
“Did you eat anything unusual?” I pressed on McBurney’s point. No flinch, so it wasn’t her appendix.
“No. Not really.”
“Have you ever had pain like this before?” I asked.
She glanced at her father. “Um...maybe? Once or twice.”
“Any blood in your stool?”
“Stool?”
“Poop.”
“Oh.” She blushed. “No. I don’t think so.”
“Have you lost any weight recently?”
“I wish.” Her face got even more red.
She winced as I felt her left lower quadrant. “When was the last time you pooped?”
“Dad, can you go or something? This is so embarrassing.”
“Yeah, and I changed your diapers. I’m not leaving.”
I looked at him and smiled. “I don’t think it’s appendicitis, Sully. But maybe Audrey would be more comfortable talking without you here.”
“I definitely would be,” she said.
“I’ll stay.”
“I need to be Audrey’s doctor right now,” I told him. “She’s still a minor, so you can stay if you really want to, but you’re making her uncomfortable.”
“Indeed you are, Dad.” Snark. Always a good sign.
He frowned, twin lines appearing between his eyebrows. “Okay,” he grumbled. “I’ll be right outside, angel.” He kissed her forehead, sucker punching me in the heart.
“I’ll take good care of her,” I said.
He nodded and walked out, wiping his eyes with the heels of his hands, and for that, I fell in love with him a little bit.
“Nothing like an overprotective father,” I said.
“I don’t really like talking about my bodily functions with him here, that’s all.”
“Understandable. Okay, some of these questions are a little embarrassing, but I can’t treat you for the right thing if I
don’t have honest answers. Okay?”
She nodded.
“Last time you pooped?”
“This morning.”
“And it was normal?”
“Yes.”
“Good. Next question—are you sexually active?”
“No! God, no. I probably won’t be for another thirty years. Or I’ll die a virgin.”
I squeezed her hand. “How would you describe the pain?”
“It’s like there’s a knot in my stomach. Down lower, actually.”
I felt where she pointed. She was significantly overweight, so it was a little tough to get a read on her organs. “Turn on your side, honey.”
She did, and I saw that she had two purple stripes on her skin. “Have you always had these?” I said. They looked like stretch marks and could’ve been—lots of kids got them during sudden growth spurts or weight gain.
“I’m not sure,” she said. There was a pause. “I try not to look in the mirror too much.”
My heart twisted. I knew that feeling. She grimaced again.
“Is the pain right here?” I asked, pointing to her left side. She nodded. “I’m going to press on your stomach, sweetheart. If you have to pass gas, go for it. You’ll feel a lot better.”
“I can’t fart in front of you!” she said.
“Honey, people have vomited on me, pooped on me, peed on me, bled on me.” I pushed gently with the palm of my hand. “Once, I was doing a rectal exam, and the second I took my finger out, the patient pretty much exploded with diarrhea.”
She laughed...and passed gas. A lot of gas.
“Oh, man, I’m so sorry,” she said, her sweet round face turning scarlet.
“But you feel better,” I said.
“I do.” She sounded amazed.
I palpated her abdomen again, but she seemed cured. “What did you have to eat today?”
“I didn’t want to tell my dad,” she admitted, “because he hates when Mom and I do this, but we ate Oreos and drank a lot of soda. We pig out and watch movies. It’s... Well, it’s fun. Kind of. I do try to eat right most of the time.” She looked chagrined. “It’s just that Mom and my little brother are skinny, so they don’t think about that.”
I ran my hand along her spine. It curved at the base of the neck. Dowager’s hump, as it was unkindly called. “Are your periods regular, Audrey?”
“Not really. Every few months.”
“How old are you again?”
“Fifteen.”
I looked at her chart on the laptop. She was five-one and weighed 195 pounds. “How about backaches?” I asked. “Do you get those a lot?”
“Yeah. How did you know?”
“Another way-too-personal question—are you a little hairier than you’d expect?”
She covered her mouth with her hand. “Yes. It’s so embarrassing.”
She had Cushing’s disease. I was almost sure of it.
“Okay, here’s the deal,” I said, sitting on the bed with her. “Your stomach pain was probably just gas from the Oreos and soda, which is a pretty horrible combination for your gut. But I think you might have something else going on. Something treatable that would explain some of the other things we’ve talked about. Is it okay to get your dad?”
She nodded, and I went to the waiting room, where Sullivan was pacing and Teeny was whispering into her phone.
“She’s feeling much better,” I said. Sully sagged with relief, then ran his hand through his hair. “Come on in, Sullivan.” Teeny stood up.
“Stay here, Ma,” he said, not looking at her.
“I’m coming in.”
“Stay!” he barked. I liked him even more, knowing he took no shit from that harridan.
In Audrey’s exam room, I gestured for Sullivan to sit down. Timmy came in, too. I made sure Sully could see me and spoke carefully so he’d catch every word.
“The pain seems to have been just gas, which can cause really bad abdominal cramps. That’s resolved now, so she can go home tonight. But Audrey also has some markers for Cushing’s disease, and I’d like her to get tested.”
I explained what the disease was—a possible tumor on her pituitary gland, which then produced too much cortisol, resulting in just about everything Audrey had going on. The obesity in her stomach, her much thinner arms and legs, the extra hair, the full, round face, the curve in her spine.
Sullivan didn’t look away from my face, the furrows between his eyes deepening. “What causes this?” he asked. “Did we do something wrong?”
“No, not at all,” I said. “If she does have it, surgery will take care of the tumor.”
“Surgery?” Sully asked.
“It’s not bad, though it sounds kind of gross. They’ll probably go in through your nose, Audrey. It’s a very treatable problem.”
Audrey was staring at me with a mixture of fear and relief. “So there’s a reason I’m like this?” she said.
“Like what?” Sullivan asked.
She started to cry. “I’m fat and ugly and short, Dad. I’m tired all the time and have backaches like I’m an old lady! I have hair on my back! I hate myself!”
He wrapped his arms around her and pulled her close. “Hush,” he said. “You’re beautiful. You’re the best thing in the world. And if you have this Cushing’s thing, we’ll get it taken care of. But don’t you ever say you hate yourself. That’s my best girl you’re talking about. My favorite person in the whole world. I love you, and Mom loves you, and we think you’re perfect.”
She tightened her grip and had a good cry. Sully murmured to her, stroked her hair, and I turned away so they could have a little privacy. Timmy and I looked at each other and smiled damply.
Grabbing a box of tissues, I went back to Audrey’s bedside and handed them to her. Took one for myself and one for Timmy, too.
“I think you should go to Boston for this,” I said. “I know a couple of great doctors at Boston City who specialize in this. I’ll call them tomorrow, okay? In the meantime, Audrey, just go home and enjoy the rest of the weekend.”
She pulled back from her dad and gave me a dazzling smile. “Thank you so much, Nora,” she said. “My stupid pediatrician never said anything about this. Just told me to eat more vegetables and stuff.”
“Well, Cushing’s disease is rare. I’m still not positive you have it, but we’ll know pretty soon.” I was sure, but doctors didn’t get to say those things.
“I can’t believe I can get fixed! This is probably the best day of my life.” She got off the bed, grabbed her clothes and bounced into the bathroom to change.
“I’ll be up front,” Timmy said, leaving the room. We could hear Teeny’s indignant squawking. Well. I could hear it. In this case, Sully might be lucky not to catch everything.
Sullivan stood up. “Thank you,” he said gruffly.
“Just doing my job.”
“You’re good at it.” He let out a shaky breath. “What would’ve happened if this hadn’t been caught? Is it...you know. Fatal?”
I hesitated. “It can be.”
“Jesus H. Christ.”
“If you have any questions, and I’m sure you will, just ask me, okay? Don’t be—”
My words were cut off by his hug. A hard, long hug.
Sullivan Fletcher was lean and strong, and his neck smelled like the sun. He held me tight for a long moment. “Thank you,” he said again, quietly, and his voice caused a ripple down my side.
Then he let me go, and the bathroom door opened. I got another Fletcher hug, from Audrey this time. “I can’t believe all this,” she said.
“Well, let’s get it confirmed,” I said. We doctors, always covering our butts in the face of too much hope or too much darkness.
“I want to be you when I grow up,” Audrey said, beaming at me. She slid her arm around he
r father’s waist and tucked her head against his arm.
Sullivan glanced at me. He put his fingers to his chin and then moved them away and down, almost like he was blowing me a kiss, but not quite.
I knew that gesture. It was sign language for thank you.
Yeah. Not falling in love with Sullivan Fletcher was going to be quite a challenge.
18
When I was a junior and Lily was a sophomore, we both went to the prom.
I went with another girl—Emily Case, who, like me, was on the fringe of high school, another invisible girl with bluish-white skin and hair the color of dirty dishwater. We weren’t friends; we were simply united in the knowledge that no one would ask us, we wanted to go, and there was safety in numbers, even if that number was two.
I honestly don’t remember where I got the guts to go through with it. I remember that I simultaneously didn’t want to go and couldn’t not go. I had no delusions of a Carrie-like turn of events where, even if for a little while, the freaky girl got to be popular. So what if she was drenched with a bucket of pig’s blood? Small price to pay.
No, I knew how it would be. Emily and I would barely exist at the prom unless someone took it upon herself (because it would be a girl) to mock us. But even at the age of seventeen, I knew that on prom night, the Cheetos would be too obsessed with themselves to notice people like Emily and me.
Without telling anyone, I took the ferry to Portland, went to the Goodwill store and bought the first dress that didn’t pinch too much, an utterly unremarkable royal blue halter-top dress with sequins along the neckline. There was a tear along the zipper, but I could fix that.
On the Saturday of the prom, my sister announced that she’d be going to Darby’s house to get ready.
“I’d like to see you all dressed up,” Mom said.
“Then come to Darby’s,” Lily said. “If you have to.” The disgust in her voice was so thick you could cut it with a dull knife.
“Are you goin’ to Darby’s, too?” Mom asked me.
Lily’s head nearly spun off her shoulders. “You’re going to prom?”
“Yes,” I said, feigning calm. “Emily and I thought it would be fun.” Things that were also on par with prom fun would be performing a limb amputation on oneself or eating a live rat. Still. Had to do it.
Now That You Mention It: A Novel Page 23