Necessary Medicine

by M. K. York

  Tricia flicked through the slides with practiced ease, outlining the need for good pain control, downsides of traditional NSAID treatment, and then going through the early clinical outcomes of the drug she’d been involved in developing.

  After the talk, she said, “Questions?”

  “Yeah,” said a cardiology resident he dimly remembered. “You’ve proposed a mechanism for—” and he was off on something Neil couldn’t follow.

  He watched Tricia instead. Everything about her body language said she was comfortable up there on the stage. She was smiling tolerantly, leaning loosely against the podium. As soon as the resident finished asking the fairly convoluted question, she said, “Okay, so if I’m understanding you, your concern is about—” and there she went again, naming biomarkers he’d never heard of. “And I can tell you that our data on that are suggestive, but not conclusive, that we’re looking at decreased activity.”

  She was like that with everyone—attendings got in on the act, firing off increasingly pointed and specific questions, and she fielded them all, unruffled. She was wearing a delicate bracelet that looked like it was set with diamonds, and high heels, but she wasn’t shifting in them or looking uncomfortable.

  She was beautiful, put together and brilliant. And funny—a couple of times she snapped out comebacks to comments from attendings that had even their targets laughing. It was hard to imagine what could have gone wrong.

  After the meeting, he got up, ready to escape. But he only made it as far as the table with the free bagels (the cream cheese was all gone) before Dr. Liefers waylaid him.

  “Neil!” He clapped Neil briskly on the shoulder. “Just who I was looking for. I was thinking about your comment at the last meeting about needing to update our website. What do you say to writing the new content?”

  “Oh, I don’t know.” Neil started to sweat. “It’s not really my area, and I’m not in Cardiology.”

  “That’s why you’d do a good job. None of us see the department clearly, we’re all hip-deep in it. You could write up something clean and tidy.”

  “Well, I could try—”

  “Jim!” came a bright, ringing voice from his left, and he had to keep from flinching.

  “Tricia!” Dr. Liefers immediately grabbed her in a bear hug. “It’s been too long! What are you doing in our neighborhood?”

  She grinned, pounding on Dr. Liefers’s back as they separated. “Pharm conference we’re presenting at, the school asked if I’d like to come do a talk here, too. Of course I said yes.”

  “Presenting? You’re keynoting, aren’t you?”

  She threw back her head and laughed. “I wish that were the case!”

  “I’m being rude. This here is Neil, one of the Cardio—sorry, Surgery residents. He’s helping us with the diversity initiative.”

  “Oh, that’s the one Eli’s heading up, isn’t it? Hi, I’m Tricia, I’m Eli’s ex-wife.” She put out her hand, and Neil shook it.

  “Yes, he mentioned you were going to be giving this talk. It sounded interesting.”

  “I hope it was interesting!” She laughed again, merrily.

  “Oh, very. The postsurgical implications are—”

  “I know, I know. We need better analgesics so badly!”

  “Absolutely.” Neil nodded.

  “Are you going to ACS this year?” she asked Neil as Dr. Sisk accosted one of the other cardiologists to ask about a medication regimen. “It’s in DC. I don’t have an abstract in there but I might go anyway, network a little.”

  “Oh, I don’t think so. I might go to ASC, though. It’s in San Diego.”

  “Not too far away, good choice. I’ll be skipping that one. I try to stay on the East Coast when I can.”

  “But we have the sunshine,” he said. She laughed again. She had a big, hearty, open laugh. She sounded nice.

  “It’s a lot closer to home. And you know, I’m not trying to avoid Eli—we’re going to have lunch today—but it helps that we divvied up the US for our territorial ranges.”

  “I see.” Neil’s pager went off, and it was the first time he’d been grateful for it in months, glancing down. “I’m sorry, I have to—”

  “Oh, trust me, I know,” she said. “Well, look me up if you’re ever out east, I’ll introduce you around the program.”

  “Thank you, I really appreciate that.” He escaped.

  He tried not to think about it, but he couldn’t help it. His brain undressed her, unhelpfully, dissecting the curves under her suit, suggesting that with the obvious restrained style and the gentle work she’d probably had done on her face, she was still beautiful naked. For a woman who was probably in her forties, her face was remarkably smooth. It could be good genetics, but was more likely careful Botox. Fillers here and there. And a woman who took care of herself like that still cared about her body, must go to the gym to maintain the firm calves he’d seen. There was a kind of friendly, boisterous sensuality to her. He could see the appeal.

  She seemed genuine and pleasant and brilliant. He’d hoped—he didn’t know what. That he’d see her and think, Well, he’s better off. But was he?

  Maybe Eli should be dating instead of spending his free nights on the work group. But he couldn’t bring himself to regret that Eli was talking to him, for those ten, fifteen minutes every other Tuesday, as he slowly put more pieces into the puzzle of who Eli was under the white coat and stethoscope.

  * * *

  He emailed Dr. Wendling to ask if they could get coffee. It wasn’t on their usual schedule, but Dr. Wendling got back to him the next day. Sure, this afternoon works.

  So he made time—left his first-year resident temporarily in charge—and went up to find Dr. Wendling.

  “Hey there,” said Dr. Wendling when Neil stuck his head in.

  “Hi. You want to go downstairs for coffee?”

  “Depends. Do you?” Dr. Wendling hit one last key and turned away from the keyboard to raise his eyebrows at Neil, fixing him with a penetrating stare.

  Neil dropped into a chair next to the desk. “I don’t know. I’m just feeling—I know everybody’s busy, but I miss having a personal life.”

  “You want to talk about it?” Dr. Wendling’s voice was gentle.

  “I haven’t been on a date in six months. I don’t even remember what’s in my refrigerator, it’s been so long since I looked in it. I don’t feel like I exist outside of the hospital.”

  “That’s a pretty common problem in medicine.”

  “I know. But it’s—it can’t be healthy.”

  “It’s not. We’re pretty bad at being healthy, as a profession.”

  “How do you deal with it?”

  Dr. Wendling leaned back in his chair. “I try to spend time with friends. Block out an hour a week for dinner with somebody who’s not another radiologist. I cheat, you know, I do dinner with people I end up talking shop with. But it helps. I call my family regularly. I’m close with my niece—she sends me pictures of her kids and tells me what they’re up to.” He waved at a picture above his desk, a young woman standing next to three children.

  “I know this is a personal question, but—how do you figure out how to be happy?”

  Dr. Wendling laughed shortly. “I wish I knew. I do the best I can. I’d say I’m reasonably satisfied, but I don’t know about happy.”

  “Shit.” Neil rubbed at his forehead. “I just don’t even know what I’m doing.”

  “Look, don’t beat yourself up too much for not having your shit together right now. You’re what, late twenties?”

  “Thirty. About to turn thirty-one.”

  “I know it feels like a lot of pressure, but thirty is young, still. You’ve got time to meet somebody and settle down. Even time to do that on top of residency.”

  “And then ho
w do you—how do you make sure it lasts?”

  “Definitely the wrong person to ask about that,” said Dr. Wendling. “I’ve been married twice. Haven’t been married since I was twenty-nine.”

  “Do you have any suggestions, though?”

  “Well, don’t fuck around. That was marriage number two.”

  Neil nodded slowly.

  Dr. Wendling sighed. “I mean it. You’re young. Just...try and do right by whoever you’re with, and make sure they’re committed, and you’re committed, too. Don’t brush things off, don’t let things slide, talk it all out. That’s what I hear, anyway.”

  “Thanks.”

  “Is this about—” Dr. Wendling cut himself off, shaking his head. “Never mind. None of my business. Just take care of yourself. You have to get through the rough times before you can sort out your schedule and try to relax a little.”

  “I’m worried it’s always going to be rough times,” Neil admitted.

  Dr. Wendling shrugged. “It’s up to you. Pick your job carefully. Pick somewhere you can have some say in it.”

  “Yeah.”

  “Sounds hard, I know, but you’re walking out of here with good credentials unless you really screw it up. Leverage that. Do it at the beginning.”

  “Thank you.”

  “Almost thirty-one? When’s your birthday?”

  “October 23.”

  “Good to know.”

  “No parties. Please.”

  “Oh, wouldn’t dream of it,” said Dr. Wendling, smirking. “Certainly wouldn’t.”

  Later, assisting on a Roux-en-Y—really, just holding a retractor—he had time to think about it. Leverage that. Don’t start out on a road you don’t want to stay on.

  * * *

  Dr. Wendling was a dirty rotten liar; on Neil’s birthday, he showed up as Neil emerged from the showers after a nasty polypectomy that had ended up requiring the removal of some bowel.

  “Not a party,” he said cheerfully.

  “Not sure I believe you,” muttered Neil, tugging on a fresh scrub top.

  “Not a party! Just dragging you along to an ordinary dinner. It’s me and Eli and Cathy from Rheumatology, and your friends Mark and Kristi.”

  “Sounds a little like a party.” Neil tried to keep from letting the sudden warm anticipation in his gut show.

  “But with my boring old friends to go with your hip young ones. We’ll kill any party atmosphere. Come on.”

  “I’m wearing scrubs.”

  “Funny thing about that, Mark knows where your spare key is.” Dr. Wendling heaved a paper bag at him. “Dress up and meet me out front in five.”

  “This is invading my privacy,” Neil shouted after Dr. Wendling as the door swung shut.

  But he was dressed and out in five, ducking into Dr. Wendling’s car.

  “All right, Dr. Wendling. Where are we headed?”

  “Call me Pete, for Christ’s sake. It’s been two years.”

  “Fine. Where’s dinner?”

  “You’ll see,” said Dr.—Pete, and grinned toothily.

  It turned out to be a sushi restaurant, which was fine. Neil glanced around as they walked in; the decor was all blue and gold, beautiful and soothing, with a huge modern chandelier dominating the dining room, and low dark wood walls separating the larger tables. Everybody was there but Cathy. They started grinning and waving when they spotted him, and he met Eli’s eyes for a long minute, smiling unwillingly back.

  One of the remaining chairs was next to Eli. He took it. It had been a long day.

  “Heard you had a bad case today,” said Mark.

  “Yeah, necrosis we didn’t see coming. It got ugly.”

  “Colorectal stuff always does.” Kristi was staring in unabashed envy at another table’s plates.

  “We could probably talk about something else over dinner,” said Neil.

  “Well, if you’re going to talk about bowels, at least we’re all doctors here,” Pete pointed out.

  Just then, Cathy got there, smiling and breathing hard as she dumped her purse next to the last open chair. “Sorry I’m late. Hey, Neil, I hear it’s your birthday. The big three-oh?”

  “Three-one, actually.”

  “Huh, close enough. I’m surprised nobody made a fuss last year!”

  “We didn’t know, or we would have.” Mark shot Neil a dirty glance.

  “It wasn’t a big deal,” protested Neil.

  “It could have been, though.” Mark picked up his pencil, starting to tick the boxes on the order sheet. “You only turn thirty once.”

  “And when are you doing that?”

  “Not until June. You’ll have forgotten by then.”

  “Not a chance,” said Neil. “I promise you, there will be strippers dressed as police officers.”

  “Whoa, whoa, save it for my stag night!”

  Neil snorted. He hadn’t looked at Eli since he’d sat down, but he could feel Eli’s presence at his right like the warmth of a fireplace.

  “Did you get that abstract in for the ACR in time, Cathy?” asked Eli.

  She nodded and was starting to answer when the waiter came. They had to listen to the recitation of the specials, and then were permitted to order, handing over their little lists.

  Cathy ended up mostly telling Pete about her abstract, while Mark and Kristi were talking about the Plastics rotation she had coming up.

  Eli turned his full attention on Neil. “So, Tricia says you’re thinking you’ll go to ASC this year?”

  “Oh. Yeah, I’m working on something—I’ve pulled enough data on esophageal defects in our system that I think I can put together a case series.”

  “That’s interesting,” said Eli. “Tell me about it.”

  So he did, over the wine that had gotten there before they did—Eli poured it for him, murmuring say when, and Neil felt his cheeks start to go hot. Neil told him about the abstract he was planning, and Eli told him about going to ASC “a couple years back,” culminating in a funny story about mistaking a man in a white coat on the subway for a doctor and trying to start a conversation about the keynote speaker, only to find that he was actually a pharmacist just trying to get back from a lunch break.

  “The look on his face!” Eli was laughing. “I felt like an idiot!”

  Neil was laughing too, out of breath. He glanced up and saw Mark looking at him, and the expression on Mark’s face stopped him in his tracks. Mark’s eyebrows were just barely lifted, and his mouth was quirking ruefully at the corners. It said oh no. It said you’re fucked.

  He played it off with a cough—badly, he thought—and took a sip of water.

  The food arrived, and he was able to dig into the sushi rolls. Conversation came to a dead halt as everyone started to eat. Next to him, Eli made a little noise that was almost pornographic when he bit into the salmon roe.

  As people were finishing up, starting to chat again, slower, Pete’s eyes darted up over Neil’s shoulder and he grinned.

  “Oh no,” said Neil. “Tell me you didn’t—”

  A waitress appeared with a slice of chocolate torte. “I hear it’s your birthday.” She bent over to put it in front of him, neatly trading it for an empty plate.

  “That’s, uh, that’s correct.”

  “We don’t sing here, but happy birthday on the house.”

  “Thank you. Very much.”

  She left, and he rolled his eyes at Pete. “I don’t know that I need the carbs. I haven’t been to the gym in a week.”

  “Birthday calories don’t count.” Cathy grinned. “If you don’t want it, though—”

  “No, no, I do!” He made a show of pulling the plate back toward him. Eli laughed next to him, low and rich, as the first bite of the torte spread over
his tongue.

  As they started to leave, gathering coats and purses, Mark said, “Okay, how’s everybody getting home? Pete, you’re driving, but you’re heading east. I’m dropping Kristi off, and we’re out a ways from you, Neil.”

  “I’m heading east too,” Cathy volunteered. “But I could take somebody?”

  “I’m more south,” said Neil. “I could get a cab.”

  “Nonsense, I’ll give you a lift,” said Eli. “I think you’re on my way.”

  “Okay, great.”

  They bundled out the door as a group and split up, Neil getting quick hugs from Mark and Kristi and a solid backslap from Pete. “You’re almost halfway through your residency, you know,” said Pete. “It may feel like you’re never going to get there, but you will.”

  “Thanks.” Neil smiled back at Pete.

  Eli touched Neil’s elbow, and Neil felt himself turning around before it was even a conscious decision. “Good night, Pete,” said Eli. “Cathy. Good seeing you.”

  “You too,” said Cathy. Pete waved.

  “I’m parked over here.” Eli motioned down the block with his head. His hands were tucked into his pockets.

  They walked in silence for a moment before Eli asked, “So how was the case today?”

  “Well.” Neil started to tell Eli about the bleeding—it had been hell to staunch it, even after they’d gotten the bowel cleaned out—as they headed down the street. Eli stopped next to a car, pulling out a set of keys, unlocking Neil’s door first. The car itself was an older model, nice but not ostentatious. Exactly what Neil would have expected if he’d had to have an opinion.

  “Sorry about the mess,” said Eli as they climbed in.

  Neil laughed. “Oh, please.”

  “Well, it’s the kind of thing people say.”

  “Right. I can’t let you see my car, then.”

  Eli buckled himself in and started the car. Neil couldn’t stop watching his hands—long fingers, graceful in the shadows of the streetlamps.

  “So how’s your practice going?” Neil asked. “Any new transplant cases coming up?”

  “Actually, one of my patients is just about at the top of the list. I wouldn’t be surprised if we had a heart for him within a couple of weeks. I can’t say for sure, but I’m hoping.” Eli huffed out a sigh, leaning forward to peer at the street as he pulled out. “He doesn’t have much time left, otherwise.”