Necessary Medicine

by M. K. York

  * * *

  When he showed up at the next work-group meeting, it felt like nothing had changed, except that the warm flush of anticipation he’d felt before had been replaced by something that had him clenching his teeth and then trying to remember to relax his jaw.

  Thank God, the first person he ran into was Dr. Erickson, who wouldn’t have talked about anything too personal even under torture.

  “Nice weather today,” observed Dr. Erickson.

  “Yeah.” Neil felt a rush of relief as he realized that he was probably going to be able to make it to a seat before Eli could head him off and try to talk. He followed Dr. Erickson to the table. Unfortunately, Dr. Erickson still had it in his head that Neil would sit in his old place, so he had no choice but to settle in near the head of the table again.

  He could pinpoint the exact moment when Eli realized he was there; Eli turned around from a conversation with Dr. Chaudry, who was the only transplant surgeon in the work group, and his eyes rested on Neil. There was a moment when Eli’s eyes widened, and Neil realized with a sinking sense of chagrin that he’d been watching Eli, and Eli must have seen that. Well, too late now.

  But Eli’s face changed immediately, and it was like watching a spring thaw.

  Neil exhaled shakily before turning back to Dr. Erickson. “So, has your daughter’s wedding happened yet?”

  “No, not until June. She wanted a summer wedding. Apparently that means she can do it all outdoors without a rain plan, so she’s still going crazy. You should never take more than two months to plan a wedding. Gets out of hand.”

  Neil smiled, and it felt almost real.

  Eli called the meeting to order shortly and didn’t comment on Neil’s presence at all, which suited Neil just fine.

  Afterward, Neil was ready to go the second they were dismissed, bolting out the door almost before Eli had called the meeting done. He almost felt bad about leaving Eli with the trash and the whiteboard alone. Almost.

  He got an email from Eli the next day. Hi, If you’re ready to help out, we haven’t finished the project you were working on—the website content for the page on the diversity initiative. Are you still up for that? Sincerely, Eli

  He sighed, staring at it, and ended up leaving the computer before he could think of a reply. It was such a small project, but every small project ended up taking months. Everything moved so slowly in the work group. They had to come up with ideas, and research them, and research how to implement them, and get group approval on a plan, and then finally, finally execute the plan. He wasn’t at all surprised they hadn’t managed to get the webpage put together.

  It would give applicants something to see when they were researching the school—tangible evidence that the initiative existed, at least.

  He didn’t make it back to his email for a couple of hours. This time he wrote, Sure, and sent it before he could change his mind.

  Great! Thank you! was the reply he got, almost immediately. He tried not to let it unsettle him too much.

  Like somebody kicked a puppy, he thought.

  * * *

  That night, he lay on the bed in the call room, eyes shut but not sleeping. He couldn’t.

  His brain was drifting into a space between awake and asleep, and in it, he had a moment where he replayed the moment when Eli had seen him at the meeting. His face going open and warm and—and fond, he thought. Relieved too. Like his being there was a benediction. Like Eli had been afraid Neil was mad at him.

  And hadn’t he been? Irrationally, sure. But if they hadn’t been interrupted just then, maybe he and Justin—maybe they could have—

  He owed Justin a call. He was pretty sure about that.

  Not at three in the morning, though. He wasn’t that big an asshole.

  * * *

  The next night, he didn’t make it home until almost midnight. Still not a good time.

  Finally, his next Saturday off, he managed to call.

  “Hello?” Justin sounded wary.

  “Hi. It’s Neil.”

  There was a moment’s silence.

  Neil cleared his throat awkwardly. “I just—I owe you an apology. I shouldn’t have—”

  Justin was talking, too, in a rush. “I’m sorry. I know I wasn’t—”

  They both stopped at the same time, and then laughed together.

  “It’s—” Neil hesitated. “Work is so important to me. It’s not something I can really get away from.”

  “Yeah, I kind of got that impression.”

  “I am so sorry for yelling at you. I was so excited and then I realized—I saw it probably wasn’t going to work.”

  “It’s okay. You gave me fair warning. More than fair.”

  He could hear Justin let out a little quiet breath after that.

  “I’m just—look, if you’re still single when you finish residency, and I’m still single, let’s, uh, let’s get married, okay?”

  Neil burst out laughing. “I’ll take it under advisement.”

  “Okay.” There was laughter in Justin’s voice.

  It was too easy, really. Justin had every right to be pissed at him. But it had been like this between them before—easy. Smooth. Even when it came time to be angry.

  * * *

  The next day at the hospital he caught himself humming as he held the cautery for the attending.

  “Something on your mind?” grunted Dr. Landry, spreading the fascia.

  “Got a proposal of marriage yesterday.” He nipped off another bleeder.

  “Oh, really.” Dr. Landry was one of his favorites so far—he hadn’t expected to enjoy surgical oncology so much, but Dr. Landry had a dry, clipped sense of humor and was only a little tyrannical and irrational, unlike most attendings, who were incredibly tyrannical and irrational.

  “Yeah, but it’s conditional.”

  “Do tell.”

  “It’s predicated on me surviving residency.”

  “Oh, well, good luck with that, then.” Dr. Landry peered down over his glasses at the tumor, nestled into the kidney. “Hmm. We’re going to need to do this delicately.”

  * * *

  He had coffee with Pete again the next week.

  “Good to see you.” Pete drank half of his coffee in one long gulp.

  “Are you talking to me or the coffee? Long day?” Neil gestured at Pete’s coffee cup with his own.

  “ER is chock-full of people with internal bleeding today. I’m just escaping by siccing my resident on them.”

  “My condolences.”

  “Yeah. How about you?”

  “It’s good, actually. We had a case this morning, but I should have a little time this afternoon to write up the notes.”

  “That’s great! How’s the work group going? Did you make it to the last one?”

  “Yeah, I did. It’s good, I’m working on the webpage for the initiative. At least, one to go as a subpage under the general Cardiology division website.”

  “That sounds boring.”

  “It is, but somebody’s got to do it.”

  “Maybe that’s why Eli missed you—you do the boring shit. He hates that. Did I ever tell you about the time he sassed his Chief at McGill?”

  “No.” Neil blinked. “I’m pretty sure I’d remember that.”

  “Well, it was getting on time for his yearly evaluation. He did his fellowship there, you know. They have a program on cardiac transplantation under Cardiology, and then he went on to work there for a while. Think he taught too. Anyway, the Chief comes barging into his office wanting to know why he hasn’t finished some—I don’t even remember what the project was, but it was like a pre-pre-meeting agenda. And Eli looks him dead in the eye and says, ‘Sir, if you are so fond of telling people how to arrange their schedules, perh
aps you should take over the agenda. I’d be happy to recuse myself.’ The Chief was mad enough to spit. Eli called me and told me about it that night, and I told him he was fucking nuts, baiting the Chief like that. He said, ‘It’s about principles. The principle of me not having to do busywork for that windbag.’”

  “What did the Chief do?”

  “He left and pretended the whole conversation never happened. It never came up again, I don’t think.”

  “I have to imagine it came up when he applied here.”

  “Nah, we recruited him pretty aggressively when we found out he was going on the market. A good transplant cardiologist is a terrible thing to waste.”

  “Mmm,” said Neil in agreement.

  “Heard you got proposed to.”

  “Landry has a big mouth.”

  “Hey, you want something to stay secret, don’t talk about it in the OR. Nurses have ears.”

  “Yeah, I called Justin. We had a good talk.”

  “Your ex?”

  “Yeah.”

  “You going to snap him up?”

  “Not quite that simple. He said if we were still both single after I finish residency.”

  “Oh, I see.” Pete leaned back in his chair. “Not committing to you while you’re still bugnuts.”

  “Yeah, it’s about like that.”

  “Just as well, if you ask me. Residency—either you start it with somebody, or you should just stay single the whole time. It’s cruel enough to impose this kind of schedule on one person, let alone two.”

  “Yeah,” said Neil.

  “My second wife hated residency. Just hated it. We were married when it started, and I was single by the time it finished. So.” Pete was staring off into the distance, over Neil’s head. “Keep that in mind. It’s hard to make things work when you’re never there.”

  Neil nodded.

  * * *

  That night was another work-group meeting; he finished the webpage text ahead of it and emailed it to Eli for review.

  Looks great, he got back.

  So he wasn’t surprised when Eli asked him to talk about it at the meeting. He did, briefly, and got the go-ahead from the group on posting it.

  “Do you need the contact info for the guy who does the website?” asked Eli.

  “No, I think I have it.”

  Afterward, he hesitated—maybe he should—

  “Neil,” said Eli, “do you—if you’re not in a hurry, could you help me with this?”

  He turned back to Eli, starting to feel something like relief in his bones.

  “Sure.”

  They were quiet as they gathered the trash, Eli looking down at the table while he gave it a wipe. Neil hadn’t been able to stop staring at him during the meeting; it was lucky that Eli’d been doing most of the talking. He was so damn handsome, sharp cheekbones, fox-like features under that shining silver hair.

  Without asking, when Eli finished with the cups, Neil moved to one side of the whiteboard.

  “Thanks.” Eli smiled, still hesitant.

  “How have you been?” asked Neil, determined to act like this was all normal.

  Eli let out a breath as they turned into the hall, pausing to flip off the light switch behind them. “Busy. I had that patient I was telling you about—he ended up getting a heart, and he’s had a rocky course postsurgically. So Dr. Chaudry and I have been working on managing him.”

  “Rejecting the transplant?”

  “Looks like it, but then, every time I get ready to suggest hospice, he starts doing better. So I’m trying to focus on the short term instead of worrying too much about his long-term survival right now.”

  “Baby steps.”

  “Yes. Exactly.”

  They were quiet in the elevator, but as they got the whiteboard to Eli’s office, Eli said, quietly, “I hope I didn’t say or do anything that made you think you weren’t welcome in the meetings.”

  “No. No. I just—it was a rough time.”

  Eli’s tongue darted out to the corner of his mouth. “Yes. I hope you’re not mad at Pete for this, but he let me know you were going through a—difficult personal time.”

  Neil laughed humorlessly, running a hand through his hair. “Yeah. That’s one way to describe it.”

  “I’m sorry. For what it’s worth.”

  “Thank you,” said Neil. Eli gave him a little nod and turned to flip on his office light, so Neil left.

  * * *

  “Movie night, asshole,” said Mark.

  Neil groaned and stood aside, letting Mark and Kristi into his apartment. “Jesus Christ. I didn’t mean it when I said you could come over.”

  “Too late.” Kristi produced several packets of microwave popcorn. “We’re here. Like an infection creeping into your bloodstream.”

  “Real nice.”

  “Hey,” called Mark, “I brought Citizen Kane and Robocop because I couldn’t decide. What are we watching?”

  “You know I have Netflix, right? We’re not stuck with your crappy DVDs?”

  “Oh, look at the big man! Netflix! Okay, fine.” Mark dug out the remotes and started fiddling with them to get the TV set up.

  The microwave in the kitchen started whining as Kristi got to work on the popcorn.

  “So the way I see it,” said Mark, “we’re all on tomorrow. It is currently 8:00 p.m. We have time to select and watch one, count ’em, one movie, and then we go the hell home and sleep. Sound like a plan?”

  “Yeah, as long as nobody falls asleep on my couch again,” Neil called into the kitchen.

  “That happened one time,” Kristi yelled back.

  “You refused to leave!”

  “I was exhausted! I would have been a hazard on the road!”

  “Anyway,” he said, turning back to Mark, “that sounds like a plan.”

  “Talked to Justin lately?”

  “Oh, for Christ’s sake. No. I haven’t. I’ve been busy.”

  “Sure you have. Not just being chickenshit?”

  “No! We’re not even—we were pretty clear about this not happening until I’m done with residency. I’m sure he’ll have met someone else by then.”

  “Or you will.” Mark waggled his eyebrows.

  “Unless you’re hitting on me, knock it off. Actually, even if you are. You’re not my type.”

  “Wounded,” said Mark. “I’m—oh, look, they have Funny Face!”

  “Now I’m extra not sure you’re straight.”

  “If I weren’t, I solemnly swear I would marry you myself and save Justin the trouble.”

  Kristi came back into the room with three bags of popcorn. “Did I miss something? Are you guys going to make out?”

  “No and no.”

  “Neil’s no fun and I’m heterosexual,” said Mark. “And we’re watching Audrey Hepburn.”

  “Okay.” She settled down comfortably on the floor with a throw pillow she stole off the couch.

  “So what’s your next rotation?” asked Mark as the music came up.

  “Uh, I’m over at County again.”

  “Oh, fun.”

  “Yeah. But it’s okay. I can survive there for a while. How about you?”

  “I’m still at Kingsland.”

  “Ugh, I feel like you get all the rotations there.”

  “Yeah, but it just means there’s plenty of time for the attendings to learn my name and face. That’s dangerous. It’s better when they have no idea who I am.”

  Neil tipped his head, considering that. “You’re not wrong, I guess.”

  “Yeah. You’re just jealous because you’d rather be—ow!”

  “Don’t go down that road. I can and will pinch you again.”

  �
��I thought you took an oath not to harm anybody!”

  “That’s in a professional capacity. On a personal level, I am fine with pinching you black and blue.”

  “So what you’re saying is I shouldn’t talk about your mega crush?”

  “I’m saying I will hurt you if you do. Like this.”

  “Ow!”

  Kristi was laughing silently, waving her hand at them. “Shut up, the movie’s starting!”

  At least that time she managed not to fall asleep on his couch, although Neil did feel a little bit dubious about sending her back into the world as tired as she was.

  Chapter Ten

  His Transplant rotation finally came due. It was only a month, which was something, but it was an entire goddamn month, and Chaudry turned out to have earned his reputation for stony-faced, humorless pimping. “So, Carmona,” he said—it was never entirely clear to Neil whether he did it on purpose, because no one ever called him by his first name, or whether he just preferred it that way—”tell me the difference between tacrolimus and cyclosporine.”

  “Well, uh, cyclosporine is a calcineurin inhibitor, and—”

  “So is tacrolimus. What step of the pathway?”

  Shit. He could see the pathway in his mind, but he couldn’t label the thing that distinguished it from tacrolimus. He knew he’d learned it for Step 1, but that was five years ago. “I don’t know, sir.”

  “Look it up. Tell me after lunch.”

  “Yes, sir.”

  The nice thing about Chaudry, at any rate, was that his pimping was straightforward. There were no trick questions. He never berated the residents for not knowing. It was just like that: Look it up and tell me. Neil got the feeling Chaudry pimped because he felt like it was important, rather than out of a desire to make himself look smart, which some of the other attendings certainly could not have said.

  Their first cardiac case came with a side of consult: Eli, to be specific. “Carmona.” Chaudry was scribbling on the whiteboard in the patient’s room. “Talk to Newcombe. Ask him whether she was evaluated for pacemaker.”

  “Oh, I was,” said the patient.

  “Then get the details on it.”