Necessary Medicine

by M. K. York

  Neil watched the streets slide by through the windshield. He couldn’t bring himself to look out the passenger window; he liked having Eli in the corner of his eye. “What’s his function like?”

  “Ejection fraction is nine percent.”

  “Jesus.”

  “I know. And he declined to it pretty rapidly. I have patients with ejection fractions like that who are functioning, but they decompensated slowly. He just went down the tubes.”

  Neil nodded. The air was cool on his skin, giving him goose bumps.

  “I should get your address for the navigator,” Eli said. Neil gave it to him, and he nodded. “I was right. You’re practically on the way for me.”

  “That’s convenient.” Neil smiled at him. Eli glanced over to smile back.

  “So are you doing a Transplant rotation this year?”

  “I am, yeah. It’s coming up in the spring.”

  “Well, that will be nice! I’ll probably see you on some cases. I’m sure you’ll be working with Chaudry, he’s solid.”

  “That’s what I hear.” Neil had, in fact, heard that Chaudry was a stick in the mud, but solid seemed like a reasonable alternative.

  “Got plans for Thanksgiving?”

  “I think I’m on call,” said Neil, “but I’ll head home for the day after.”

  “Oh? Where’s home?”

  “Portland. Whole family’s up there.”

  “That’s nice. Were you raised there?”

  “I was. Big Italian family, you know the drill.”

  Eli laughed. “I don’t, actually. I grew up in Jersey, only child.”

  “Wow, really? What’s that like?”

  “Boring. I always wished I had siblings.”

  “I thought they were the worst pain in the ass when I was kid. But they grew up all right. My little sister has a kid, I get all the fun parts and then I just hand him back when he gets noisy or leaky.”

  That got a bigger laugh from Eli. “Yeah, honestly, I love kids, but they’re—they’re a lot of work, aren’t they? And they are noisy and leaky.”

  “They really are. Their parents know! They’ll spend an hour telling you all about it and then ask why you don’t have kids.”

  “Are you thinking about them?” Eli shook his head. “Sorry. Too personal.”

  “No, it’s okay,” said Neil. “I—it’s not that I haven’t thought about them, but I don’t know if that’s really what I want out of life. And besides, I’d have to settle down first, and then we’d—well, we’d probably adopt, and that’s such a hassle too.”

  “Oh, are you interested in adoption?” Eli sounded genuinely curious, which meant—oh, God. The grapevine must have incomplete penetration. He really hadn’t known.

  Neil coughed delicately. “Well. I’m—I’m gay. So.”

  “Oh,” said Eli.

  There was a long moment’s silence in the car. Thank God, they were almost to Neil’s street.

  “You know,” started Eli, and Neil braced himself—he wasn’t even sure for what, maybe the words your lifestyle, or you didn’t think—and Eli said, “I hear there’s an Internal Medicine resident—”

  Neil laughed explosively. “Thanks, yeah, I heard that too. We’re, uh, no.”

  “I see.” The car eased to a stop. “Well, if the navigation is correct—”

  “Yeah, this is me. Thanks for the ride.”

  “No problem.” Eli took a breath, like he was about to say something, and then said, “Happy birthday!” with a certain forced bright cheer.

  “Thanks. Good night.” Neil shut the door. He heard the car idling as he went up to the front door; only when he got it open did the car start to slide away, the noise blurring into the night as the door shut behind him.

  Chapter Six

  The next day, Mark found him at the dictation booth behind the nurses’ station.

  “Hey, buddy,” said Mark, sticking his head around. “How’s it feel being old?”

  “You’ll know soon enough,” said Neil, muting the mic. “Thanks for coming last night. I had a good time.”

  “Yeah, I saw.” Mark’s mouth turned up at the corners in that rueful half smile from the night before. “Buddy. It’s like that?”

  “It’s not—no. It’s not like that.”

  “He’s got an ex-wife.” Mark was leaning in, speaking softly, so they wouldn’t be overheard.

  “Yeah, I don’t think he even knew I was gay until last night. We were just talking about families on the way home and he asked if I wanted kids.” Neil shook his head. “He wanted to set me up with that guy in Internal Medicine. Mike.”

  “Mike’s pretty cute, I don’t know why you’re against it.”

  “Have you seen him eat? He just chews with his mouth open!”

  “He could be a nice guy.”

  “I once saw him reading Guns and Gardens. I didn’t know you could even get a subscription to that in this state.”

  “Anyway.” Mark’s face went serious and sad. “You all right?”

  “Yeah, I’m fine. I’m fine.”

  “You want to go out and get shit-faced this weekend?”

  Neil hesitated. “It sounds good, but I swore I’d actually clean the place. And I’ve only got Saturday off.”

  “You’re turning down the opportunity to record me spilling beer all over myself so you can clean your apartment? You are a sad shell of a man.”

  “I might as well be what I feel like.”

  Mark nudged his shoulder. “Fine, but you change your mind, you say the word, all right? Friday night we can find somewhere to get so drunk we forget that we’re laboring for less than minimum wage.”

  “Fuck you.” Neil shook his head sadly.

  “Look, I’m sorry,” said Mark. “For what it’s worth.”

  “Thanks.”

  “I’ll let you get back to work. I’ve got an ex lap, Ronning is going to let me do part of it.”

  “Okay. Good luck.”

  “Thanks!”

  Mark straightened up from his slouch, saluted briefly and was gone.

  Neil sighed, resting his forehead against the cubicle wall for a second, before turning the mic back on. “Patient received one unit crystalloid...”

  * * *

  The next work-group meeting was fine. Eli did his usual—listening to the proposals, cutting through the endless rambling that Erickson and Lambert could generate, putting together bite-size plans.

  Afterward, Neil hesitated. Should he start getting the trash? Would they still have their routine?

  “If you’ve got a minute,” said Eli, carefully, “I could use your help with the whiteboard again.”

  Relief flooded him. “Sure. Let me just get these napkins.”

  They were in the elevator when Eli said, “I hope—I hope I didn’t make you uncomfortable the other night. I just—hadn’t heard.”

  “No, that’s fine.” Neil stared at the numbers ticking upward with the floor and fervently willed them to go faster. “I’m surprised the hospital intelligence community failed, is all.”

  Eli huffed out a small laugh. “Me too.”

  “So, what are the big conventions for Cardio this year? Going to any of them?”

  “Actually, I’m thinking about the ACC in March—American College of Cardiologists. I go to a fair number of the surgical conferences to keep up with transplant surgeons, but I try to go to at least a couple of the Cardio conferences every year.”

  “That’s cool.” The doors slid open and they started grappling the whiteboard out. They had it down to a science by now, Eli slipping his hands under the bar at the bottom as he lifted it over the hump, Neil scooting it forward until he could lift the second pair of wheels up and over. Neil couldn’t
imagine why Eli hadn’t started checking one out from Facilities.

  “How about your abstract? Is that coming along?”

  “So far so good. I’m about ready to submit, Pete’s reading it over for me.”

  “That’s great. He’s a good editor, actually. He’ll make it shine.”

  “Good, I need all the help I can get.” They slid the whiteboard into Eli’s office. He didn’t reach for the light switch; there was still light from the hall falling in, a long slice of it across the floor.

  “Oh, I doubt that.” Eli smiled again, not quite the smile he used for patients and public meetings, a little more complicated. Personal.

  “Thanks.” Neil ducked his head. “Well, I’ll see you at the next meeting.”

  “Neil,” said Eli.

  Neil turned back around, raising his eyebrows, but Eli didn’t say anything; he was just looking down at the folder in his hands, which he was turning over and over restlessly.

  “I think you’re very brave,” he said, finally. “And I want you to know that—I support you.”

  “Thank you.” Neil felt overwhelmed suddenly, almost ready to choke up. When Eli didn’t say anything else, he escaped back out into the hall.

  He risked a glance back when he was at the elevators, waiting to go back downstairs. The light in Eli’s office was still off, but the door was open. He must have been in there.

  He had a moment’s image in his head of Eli sitting heavily at the chair at his desk, thinking about—what?

  He put it out of his mind, shook it off. He had to get back. He was on call, he had a patient to check in on. On cue, his pager went off as he stepped into the elevator. The sound was shrill in the quiet hallway, echoing off the elevator walls.

  Chapter Seven

  In January, after another tango with the ABSITE, he found himself sitting in the cafeteria staring at his phone in dull shock.

  “Wow, who died?” Mark slid in across from him.

  He shook his head slowly. “Justin wants to visit.”

  “Justin, wh—oh. Oh.”

  “Yeah.”

  “I thought that, uh, ended...” Mark made an indecipherable hand gesture. “Poorly.”

  “It did. I don’t know why, but he says he’s going to be in town next week and he wants to get lunch.”

  “Wooing you back?”

  “Highly doubtful. When we broke up—Christ, that was, what, first year of med school? He said he’d never wasted so much of his time on anyone and he was never going to again.”

  “Ouch.”

  “Yeah.”

  Mark waved his sandwich. “So, lunch. Friendly, normal lunch, like friends have.”

  “Apparently.”

  “What’s he do now?”

  “Office manager for a biotech startup.”

  “Good money?”

  “Hell if I know.” Neil sighed. “He always sounds happy enough on Facebook.”

  “Man, how are you guys even friends there?”

  “Don’t ask me. He friended me.”

  “Yikes. Are you going to go?”

  Neil raked a hand through his hair. “I guess. Free food.”

  “And maybe he’s fat now!”

  Neil laughed, unwillingly. “I think I’d know.”

  “Hey, I’m looking on the bright side.” Mark reached across the table to put his hand on Neil’s arm. “You sure you want to see him?”

  “I’m not sure, but I’m sure enough. It’s been—Jesus. Six years?”

  “You’ve aged well.”

  “Shut up.”

  “All right.” Mark leaned back. Neil glanced up and saw Eli, standing with a tray in his hands at one side of the crowded dining room, looking uncertain. Neil smiled and waved. Eli smiled tentatively back, and Neil waved him over.

  “Don’t let me interrupt.” Eli sat down next to Mark. “I just had a break and it was a good time for lunch.”

  “Not interrupting anything,” said Mark. “This guy’s just seen a ghost.”

  Eli raised his eyebrows. “Oh, really?”

  “Figuratively.” Neil rolled his eyes. He didn’t want to talk about it in front of Eli.

  “His ex.” Mark, who had no such compunctions, had crammed a bite of sandwich into his mouth. He swallowed and added, “Who isn’t a surgeon, might I add.”

  “Oh?” asked Eli politely.

  Neil shrugged. “He’s coming to town. We’re just going to get lunch and catch up.”

  “I see.” Eli was stabbing his lettuce repeatedly with his fork, looking lost.

  “Any hot drama in Cardio?” Mark asked Eli.

  Eli shook his head. “Aside from whether we should increase teaching faculty salaries. I wanted to talk to you about that, actually,” he said, looking up from his plate at Neil.

  “Yeah? That’s Bob’s project, isn’t it?”

  “It is, but you had such good luck talking to the residents—”

  “You want me to talk to the faculty? Why?”

  “If you would, I want you to talk to some faculty candidates we have coming to interview.”

  Neil rocked back in his chair, the front feet coming up off the ground as he considered, rolling his lips in and pressing them together as he thought. “Hmm. Sure. I can do that. I don’t know how much I really have to offer them, though. I don’t know much about cardiology.”

  “If you could just talk to them about the diversity initiative—reassure them that it’s serious—and also, maybe, tell them how great our personalities are.” Eli gave him a little bright flash of a smile there.

  “Sure, of course. I can’t promise I won’t get paged.”

  “Understood, but I’ll run it by your attending. Thursday next week?”

  “Yeah, that’s perfect. I’m meeting Justin on Wednesday.”

  “Where are you guys going?” Mark mumbled around another bite of sandwich.

  “God, close your mouth when you chew. He said Antonio’s, I said that sounded fine.”

  “Italian food for his Italian ex? How cliché.”

  Eli coughed a little, pausing on another bite of salad. “Well, I’ll let Bob know you’re willing to meet with the candidates.”

  “Yeah, absolutely.”

  * * *

  Lunch with Justin had all the hallmarks of turning into a nightmare. He was late, for one thing. Neil got there on time—he’d had to give the second-year resident a pep talk before she would settle in and accept she could handle an emergency during the forty-five minutes he’d be gone, and his pager was clipped to his belt like a bird of ill omen—and then Justin was five minutes late. He was just starting to look for the exit when Justin came to the table, flushed and panting.

  “God, I’m sorry I’m late.” Justin pulled out the chair opposite Neil. “You must think I’m being an asshole.”

  Neil surprised himself by laughing. “Not at all.” He reached across the table to offer Justin a handshake. Justin looked taken aback, but he shook anyway. He hadn’t gained weight. Or lost hair. He looked—if anything, better, strong and polished, adult in a way he hadn’t before. There were fine lines at the corners of his eyes, just barely visible.

  “Did you order already?” asked Justin.

  “Not yet.”

  “Okay, great. How do you feel about the fish?”

  “I’m thinking the personal pizza. It’ll box up well and then I’ll have dinner taken care of.”

  Justin tipped his head to one side to consider him. “You’re planning on being at the hospital for dinner?”

  “Yeah. I mean, I’m working eighty-hour weeks.” It was a little more than that, but that was close enough.

  Justin sat back, whistling through his teeth. “Damn. I was going to ask if
you wanted to go out this weekend. Not to jump the gun.”

  “Wait—what?”

  “No, you know what, we haven’t even ordered food yet. Let’s catch up. How’s the hospital?”

  “It’s fine. It’s a good residency. How have you been?”

  “Good. Spending most of my time on work.”

  “Yeah.” Neil belatedly realized he was twisting the cloth napkin through his fingers under the table.

  Justin flirted a smile, looking up at him from under his eyelashes—still long, still cornsilk blond. “I’m guessing you know something about that.”

  “I do. Yeah.” The waiter came to take their orders then, rescuing him.

  Justin leaned back in his chair. “I can’t believe it’s been so long. I’m just glad you had the time for lunch, honestly. Eighty hours a week—what is that, twelve hours a day?”

  “More. We take call, so I spend the night in the hospital every couple of nights.”

  “God! Do they at least give you a bed?”

  “Yeah. They can’t break the Geneva Convention on us.”

  “Small favors, I guess.” Justin took a sip from his ice water.

  “How about you? How’s work going?”

  “Pretty good, as it happens.” Justin smiled, self-consciously, crookedly. “I mean, they’re talking about opening up an office in San Francisco, so I’ve been busy. We’re scouting locations for it.”

  “We?”

  “Well, just me. We’re talking a second branch, but we’re still not a big company.”

  “And you’re—huh. Are you going to be managing the office up there, or down here?”

  Justin shrugged. “We’re still deciding that.”

  “Getting tired of Seattle yet?”

  “Not really, but it wouldn’t be a bad move for me. I mean, it’s not like I have family up there.”

  “No.” Neil found himself thinking, so if you’re moving here—but cut that line of thought off before it could get too far.

  “How’s Angie doing?”