I’m looking at my hands on my lap, fidgety, restless, as he sings, but I can feel his eyes on me. I can almost feel his pulse racing next to mine, the familiar rhythm beckoning, as if we were alone right now, and not being recorded for a million witnesses. When I finally lift my eyes to look up at him, though, he’s looking right at the camera, and not at me at all.
The whole room claps, and the host gushes some more, rattling off information about Be The Match, and asking me something else, but it’s all a blur. All I can think about is the fact that whatever was there—if it was there at all—is gone now. At least for him.
And then José is wheeling Link away, just like that, and it’s all over.
“You okay, Guddi?” Vish says. “That was great, right?”
Lizzie comes up then, rubs my shoulders. “Great, but rough.” She throws an arm around me, and the other around Vish. “So come on, guys. I think it’s time for some Pizza Hut.”
In the Jeep, driving, he finally brings it up. “That was weird, wasn’t it?”
I’m sitting in the passenger seat, with Lizzie in the back, and it feels so familiar and comfortable, like an old sweater that still fits.
“Every single minute of it,” I say, and it’s like I can finally breathe again.
But Lizzie’s suddenly livid. “Yeah, who the hell is Risa?”
I don’t want to cry, so I don’t say a word. But they won’t let it go.
“It’s like you barely knew each other at all,” Lizzie says.
“When that song was totally about you,” Vish adds, his voice low. “Like, for real.”
The tears will come if I don’t do something now. So I pivot. “Did you talk to your parents yet?”
He nearly smashes the brakes at the red light. But he can’t avoid the conversation forever.
“I’m not ready.”
“I won’t say anything. Until you’re ready. But you do know that this makes me the bad guy?” I ask. I’m always the bad guy these days.
“Villains are the most interesting characters,” Lizzie says with a grin.
“Especially when their motivations are true,” Vish adds, taking my hand. “And yours definitely are.”
But that doesn’t make this one bit easier.
CHAPTER 45
For two days now, I’ve been going through the motions. The Nightline segment featuring me and Link is supposed to air tonight, and everyone at the hospital has been talking about it incessantly. But I don’t even know if I’ll be able to bring myself to watch. But José’s planned a screening in the lounge for anyone who wants to show up. I kind of don’t want to, but probably should. Even though Link and I haven’t talked since then. I wouldn’t know what to say. So I just won’t say anything at all. But he hasn’t texted me, either. I wonder if he has my new number. Unlikely.
I’m updating files in the intern lounge when the alarm goes off. It goes off all the time—we’re in a hospital, of course, so there are always patients coding. But this time, it’s one of the machines me and Howard are logging. Alina’s machine.
“Code blue! Code blue!” We all rush forward at once, waves crashing on a shore. Alina’s pressure has dropped severely by the time we make it to the hospital bed. She’s already in some unreachable place, and unwilling to be called back.
I get to her first and amp up the oxygen line, carefully placing a mask over her mouth, her thin lips gone blue, the limp coolness already settling into her limbs.
Dead weight.
I try to push the thought out of my head, but there it is. She feels like one of the countless cadavers I’ve sliced open on my journey to this very room.
“Pulse dropping, BP base-lining, we’ve got to get moving!” Howard’s shouting. “Now.”
Diagnosis: Acute cardiac arrest.
Prognosis: We’re going to lose her this time.
There’s nothing in my endless years of education that could really have prepared me for this moment. Not all the lectures, or the many months spent poring over twenty-pound tomes and patient files. Not the summers at genius camp or by my mother’s side in her office, delivering babies and stitching up new moms. Not the MD degree—with highest honors—or the many surgeries on soulless bodies I had to do to get it. Not all the months I’ve spent by Arora’s side here, observing and taking notes and assisting. The history books might mark me as the youngest doctor ever to practice medicine in the United States, a teenager, Dr. Girl Genius.
But in this moment, that means nothing.
Because it all comes down to this: A narrow hospital bed, a monitor flatlining, a little girl whose bright spirit is slowly seeping away, right here, right now, and there’s nothing I can do to fix it. Nothing. And I didn’t even get to say goodbye.
I stare at the small body lying there, skin pallid and cool, the fading heartbeat’s every movement marked by machines and recorded as evidence of our failure to save a life. Her life. The monitor’s beep burns into my brain, flat and dull, like my dad’s car when I forget the seat belt, a warning, a threat.
“Start the IV thread,” Arora’s voice says, and he sounds murky and faraway, like we’re all floating underwater in a dream, and any minute we’ll surface and laugh, and this will be over. “Up the dosage to the highest level, we’re losing rhythm fast. Go.” His voice rises, and all the nerves in the room are firing, splitting, burning.
I hear the words. I know what they mean. But my body doesn’t move. Sweat beads down my neck and dampens the back of my scrubs. My papery mask is soaked through with sweat or tears or maybe both. “She’s flatlining! Start compressions now.”
José dabs my forehead with a pristine white towel, preventing the salty sheen from blinding me. “Focus, Saira, focus,” he says, bringing me back to earth and this moment, the one that’s slipping away much too quickly. The one that’s not like anything I really expected, despite everything they’ve told me. He runs from one end of the body to the other, rubbing feet, checking IVs, shouting instructions to the galley nurses. “Come on, niña. We’ve got to move.”
But my hands are shaking, useless by my sides, and the tremors are catching like the slow build of a Southern California earthquake, starting on the edges and working its way to the center. “Saira, you’ve got this.” José’s voice is a low rumble in my stomach, a warning that this is about to all slip away if I don’t do something now.
All right, slow down, breathe. Please.
José tries to hand me the paddles, but I reject them, trusting my hands instead. I lean over the body and pump over her chest—one, two, three. Nothing. I stop for the same count—one, two, three—and then do the compressions again. Still nothing.
“The defibrillator, Saira. We don’t have time,” Cho shouts. “We have to!”
All eyes are on the monitor, and the rhythm is falling, flattening. My hands are not enough to save her, but she made me promise to let her go. If it came to this. Which she knew it would.
“Nothing’s happening,” José says, his voice roaring with stress. “Defib, now!”
I nod, and he rushes off, rolling the machine over.
“All right, set up, hurry,” Howard says. “You know where, right, Saira? Let’s go.”
Cho’s already setting up the pads on the girl’s chest, moving forward, with or without me. Even now, he has to win.
“She doesn’t want it,” I say, and can’t believe the words have escaped my mouth. “She told me so.”
Howard stops cold for a second, and she looks like she might smack me, she’s so livid. “It doesn’t matter what she said—her chart says all means necessary, not DNR,” Howard says. “And she’s not an adult. She doesn’t get to make that decision. And we need to do this.”
“She’s a human being!” I say, and realize too late that I’m shouting, my words bouncing around in my head. “Of course she does.”
But Howard’s plowing ahead, too, prepping for the charge. The machine’s even more frantic now, beeping wildly, and the rest of the team storms in to s
ee what’s wrong.
“Code blue, code blue!” The words echo through the room over the dull, flat extended tone of the monitor, the steady rhythm flatlining into a long, low moan. “We’ve gotta do this now,” Howard says. She’s staring at me.
“You guys keep fighting it out,” Cho seethes, his voice acid. “We’ll just stand here and watch her die.”
Howard checks the IV streams, aligning numbers, her eyes steady. “Her chart clearly states all means necessary.” She looks down at the pages and up at me, the creases in her forehead aging her fast, making me feel like the child I am. Cho reads over her shoulder, nodding. “We’re doing this, Saira. With or without you.”
“We’re gonna lose her,” José says, carefully applying gel to the nodules, where the paddles will go. “I’m going in.”
“No,” I say, finally stepping forward. “It … She’s my responsibility.”
Slowly, carefully, I place the electrodes in careful alignment across the girl’s chest, one just to the right of her heart, one to the left slightly below it, as I’ve practiced so many times. Her skin is cool to the touch already, her eyes flutter, once, twice, the pupils dilating, then rolling all the way up, as if she was looking for another view, a better place than here.
But despite the endless conversations we’ve had about dying and dignity, and knowing when to let go, I plow ahead, feeling the weight of a million prayers on my shoulders as I ramble off directions to José—monitor the rhythm, check her fluids—and prepare the paddles for what I hope will be a miracle. Even though, as a scientist, I’ve been taught not believe in those.
“Two hundred. Ready? One, two, three,” I shout, and the defibrillator fires up and she shakes on the bed. “Clear. Charge two fifty. Charge! Clear.”
Arora counts this time, and we go again. “She’s not reacting. Is the EPI in? Charge three hundred. CHARGE!” Arora’s face is lined with worry, his eyes red from endless hours on night call and countless shots of caffeine. I wonder if mine looks as worn. His exhaustion flattens his voice as he looks down at his watch and says the words I’ve been dreading. “I think we’ve done all we can. José, mark it down. Time of death, eleven forty-three p.m., Friday, September twenty-first.”
It can’t be. Just a month before she’d be thirteen. A teenager. Like me. “She’s got a strong heart, and so do you,” I keep reminding myself. But as the lines flatten and fade, tears spill down my cheeks fast and furious, and I’m wondering what I’ve gotten myself into.
Maybe I’m not cut out for this. Why did I ever think I was?
Cho removes his mask, staring down at the body in disbelief.
Howard’s already scrubbing up and preparing herself for the worst—telling the family—but I can’t let this be over. Not yet.
“We’re going again,” I tell José, even though he’s already starting to shut down the electrocardiogram machine and detach the IVs. “One more time. Now!” My voice rises in a way I didn’t know it could, and I’m already prepping the defibrillator by the time he gets back to the gurney. “I need another dose of lidocaine, and fast. Three hundred! Charge again,” I shout. “Charge again.”
I’m not giving up. Not this time. I will fix this. I won’t let her die.
But it’s not up to me.
CHAPTER 46
I can’t stop crying. I can’t stop shaking. I feel José’s arms wrapping around, me, and Howard’s chin on my head, and even Cho patting my back, whispering that it’s okay, it’s all right, we did the best we could. “She’s in a better place now,” he keeps saying, and I stop cold for a second.
“We don’t know that,” I say, and the truth of it hits me so hard, like the dirt they threw on top of Harper’s tiny, kid-sized coffin that day all those years ago at the funeral, that day that has haunted my sleep ever since. “We don’t know anything at all.”
But Cho takes my hand then, and looks straight into my eyes. I wait for the zinger, but it never comes. Instead, he says, “Saira, I promise you two things. She knows how hard you tried. She knows. And wherever she is, she’s not in pain anymore.”
The wave of shudders start again then, and the sobs follow, blurring my vision, and taking the others down with me. Then Arora is standing there, looking like the only grown-up in the room, and reminding us that, as hard as this is, it’s about to get a whole lot harder.
“I have to go talk to the family,” he says, and there’s a crack in his voice, even though he’s learned how to mask it. “You guys should get yourselves together. I think they’ll probably want to see you, too, given how close you all became to Alina. Especially you, Saira.”
I nod. But I can’t let him go alone.
“I need to come with you,” I say.
“I don’t think that’s such a good idea,” Arora says, but he’s looking at me like he already knows it’s a waste to argue.
“I have to do it,” I tell him.
He nods. “Clean yourself up. I’ll be waiting outside.”
* * *
Mr. Plotkin and Bubbe are in the family room waiting, and for a minute I think back to the last time I was here—just after Pinky’s surgery, and how we all celebrated that moment. How that little girl got to live. This time, we’ve come to break hearts, to offer a grief that has no salve. They sit on the sofa in the far corner, CNN droning on the TV just above their heads, Bubbe’s frail hand sitting just on top of Mr. Plotkin’s, a small comfort during this endless moment.
As soon as they hear our footsteps they rise, impatient for news, and I can tell from Mr. Plotkin’s lined, worn, exhausted face that he knows the worst is coming. He’s known it for weeks and months and years now, and I remember that small relief from when I experienced it myself with Harper. The lifting of pain and the horror of loss, encapsulated in the same unforgettable, unforgiving moment, the one that will stay with you forever after.
He hugs me, the gesture more of a command than a comfort, and his hand is on my face when the words spill out. “She’s gone,” I say, and I’m sobbing again, and Mr. Plotkin’s tears are soaking my hair. And it’s okay, because I know he knows I understand. And I know he knows I’ll miss her forever, too, and carry her with me for always.
* * *
The tears are still streaming when we leave, Bubbe, and Mr. Plotkin and mama Tina and the children all gathered, all needing the comfort of being alone with Alina one last time. I almost can’t bear to part from them, knowing that the thing that connected us for so long has been ripped away now. But I have to go, to let them have this moment.
Arora’s arm is around my shoulder, my tears soaking his lab coat, as we walk back toward the oncology office.
“I feel like a failure,” I tell him through tears, and he smiles sympathetically at me. “And I can’t stop crying.”
“Honestly, I’d be worried if you weren’t crying. And trust me, Dr. Sehgal. This will be the first of many failures you’ll have as a doctor. A wise woman—I think it may have been your mother, no?—once said to me, back when I was a lowly resident doing my pediatrics rotation, that where there is life, there must always be death. They’re a pair. Better to learn that quickly.” He looks at me for a moment, all Yoda in his wisdom. “Although I think you know that already.”
“They don’t call me a genius for nothing, Dr. Arora,” I say, and manage to crack a smile.
That’s when José comes racing down the hallway, like his scrubs are on fire or something.
“They found it! They found it!” he’s shouting to everyone in sight—then he grabs me, twirls me, and does a little salsa, right then and there.
“What are you saying?” I ask, the tears starting fresh. “What are you saying?”
Arora jumps in, impatient. “Link?”
José grins. “They found a match.”
Arora looks truly stunned, and I’m sure he’s pondering that thing he just said about life and death.
“Well then, Dr. Sehgal. Would you like to deliver the news?”
I almost say no. How
can I? It’s too much.
But José’s nodding and pushing me along down the hallway, and then there we are, standing in Link’s doorway, with Link’s mom and Dr. Radcliffe looking at us expectantly.
But I walk right past them all and to Link, who sits up, weary, tired but curious, in his bed.
“Hey,” he says, that smirk on his lips again. But when he sees my tearstained face, it fades fast.
And then I grin. “They found one,” I tell him, sitting by his side. “A match. They found one.”
And for a minute, he just looks at me, floored, his eyes shimmering, but steady on me. Then he leans forward and kisses me, in front of his parents, José, and even Arora. And it’s okay. Because at I know, in that moment, that I will take every last kiss I can get.
* * *
STATEN ISLAND SUMMIT—SEPTEMBER 24
PLOTKIN, ALINA K.
Passed on September 21, in Princeton, New Jersey. She was 12 years old, and succumbed to complications related to leukemia. She was survived by her bubbe, Marina Plotkin, 83, father Alfred Plotkin, 48, mother Tina Plotkin, 44, and twin sisters, Anna and Amelia Plotkin, 8. The family resides in Staten Island, New York, and funeral services will take place at the Rosewood Cemetery on Saturday at 4 p.m. In lieu of flowers, the family has requested that donations be made to the National Pediatric Cancer Foundation.
CHAPTER 47
It’s been a week since we got the news. And after that kiss, Arora decided that perhaps it would be wise for Link and I not to see each other at the hospital, in any sort of “official” capacity. Especially since he’s immunocompromised. Which sucks. But makes sense. In any case, he didn’t tell Davis, and he didn’t report it to Mom. So I still have my job. And my head. Two good things to have.
Link’s procedure is Monday and I am banished—how very Romeo and Juliet—from the hospital until Tuesday, just to be safe. Which is well and good, because today I have a major hurdle of my own to overcome. My driver’s test.
Symptoms of a Heartbreak Page 28