by Janice Lynn
Finding his behavior odd, Liz followed him and Glenda to check on Mrs Guess. The older woman was sitting on her sofa, watching a soap opera. She seemed more interested in the program than in discussing the wound the director was concerned about.
Adam washed his hands, massaging the soap into his fingertips for longer than normal, once again making Liz question if he felt OK. But with a smile on his face, he dried his hands before putting on gloves and assessing the older lady, asking about the sore that had come up on her abdomen.
“I don’t know what caused it,” Mrs Guess said in her sweet grandmotherly voice, her gaze still on the television. “I woke up with a red spot one morning, and each day it’s worse than it was the day before.”
“Does the area drain?”
The woman waited until a man on television finished expounding an argument in court to a serious-looking jury. Once the scene cut to a commercial, she shifted her glasses-rimmed eyes to Adam. “Yellowish stuff is on the bandage when I take it off.”
“Can you show me the place while sitting, or do I need to help you lie down?”
“You can see.” Mrs Guess raised her shirt and lifted a pasty white skin roll. A gauze pad crumpled. She removed the pad and held the bandage out. “This is the drainage I was talking about. Just yellowish gunk.”
“I see.” But Adam’s gaze had already taken a quick glance at the dirty dressing and gone to the ulceration on the woman’s abdomen. An open nickel-sized lesion with a large area of surrounding redness oozed a sticky honey-colored exudate. Streaks of angry red shot out.
Liz had seen worse wounds, but Mrs Guess did have a serious problem. From the look of the ulcer and drainage, she’d need IV antibiotics and possibly isolation as discovering MRSA had caused the infection wouldn’t surprise her.
“Have you had a fever, Mrs Guess?”
“How am I supposed to know?” She seemed annoyed that Adam had asked her another question now that the program she’d been watching had come back on.
“I don’t have a thermometer, but I have felt a tad warm the past day or two. I thought it was from the heat.”
Adam took her hand, forcing her to keep her attention on him rather than the television. “You’ve got an infection. From the way the wound looks, I suspect a particular strand of Staph.” He confirmed Liz’s suspicions. After burning the gloves and washing his hands again, Adam returned to Mrs Guess’s side. “I’m going to call for a non-emergency ambulance to take you to the hospital.”
The woman looked alarmed. “The hospital? Surely a little sore isn’t that serious?”
“It can be. You need strong antibiotics through an IV. In the morning I’ll recheck you and may opt to surgically clean the wound. Similar to what I did last year to the place on your leg.” Placing his fingertips to his temple, Adam closed his eyes and rubbed the spot for such a brief moment that someone who didn’t know him so well might have missed the tell-tale action. Liz saw.
Did he have a headache? After he finished with Mrs Guess, she’d offer to drive the truck back to his place, run him a hot bath, maybe give him a neck rub. Goodness knew, he hadn’t been getting enough rest with the hours he was pulling at the hospital. But he’d said he needed to make up for the couple of days he’d taken off to be with her following Gramps’s death.
But when Adam turned to Liz, any traces of a problem had disappeared and he wore only a concerned professional expression. “I’ll drop you by your place and meet the ambulance at the hospital. That way I can do a direct admission and Mrs Guess won’t have to go through the emergency room.”
“I’ll go with you.” She’d be there when he finished. She wanted to ask him about his headache, to make sure he got some rest tonight. He’d been taking such good care of her. Tonight she’d make him prop his feet up and she’d pamper him.
Not meeting her eyes, he shook his head. “No, I’ll drop you at your place. I may be a while.”
Huh? Liz blinked at him, sure she failed to hide her surprise. “I’d rather go with you.”
“Liz,” he began, and she’d swear he winced. “I need to make rounds on my other patients. It would be better to drop you off since I don’t know how long I’ll be.”
She didn’t bother to point out that until Glenda had asked him to check Mrs Guess he’d planned to spend the entire day with her. But she did think it and wondered why he’d want to drop her at her place.
They’d always had to make use of every available second because of busy schedules and her limited free time. Maybe he thought time wasn’t so precious now that Gramps was gone and the confines of their relationship not so rigid.
Yet she’d barely seen him since the day of Gramps’s funeral.
“I don’t mind,” she assured him, sending a smile his way to let him know she wanted to spend whatever time they could together. Later, when they were in private, she’d reassure him that every moment they spent together was precious.
“But I do,” he stunned her by saying. He cast a quick glance at Glenda and Mrs Guess, then continued. “You’ve been clearing out your grandfather’s things all day. The last thing you need is to get stuck at the hospital for hours on end. I’m taking you home.”
Bewildered, Liz nodded her agreement, knowing there must be a good reason he didn’t want her with him.
* * *
“Adam? Is something wrong?” Liz asked the following night. Concern filled her voice and he could just picture her twirling a strand of hair around her finger while she asked.
Adam closed his eyes and gripped his cellular phone all the tighter.
From his caller ID he’d known the caller was Liz. So why had he answered? He should have just avoided the call altogether.
Avoiding Liz was what he’d done for the past twenty-four hours. Why stop now?
But he’d eventually have to talk to her, tell her that he was…was what? No longer a whole man? Not healthy? Not sure exactly what was going on with his body, but that he’d be seeing the neurologist for a spinal tap and the other tests in the morning?
On Monday the specialist had agreed with Larry. He believed Adam had MS.
Which was why he’d wanted to spend yesterday with Liz, but gripping that walker in his palms had messed with his head, had panicked him. All he’d been able to think was that if he had MS, the day might come when he wouldn’t be able to walk without a walker. Or worse. The day might come when he wouldn’t be able to walk at all.
Each time he’d looked at Liz, all he stood to lose had constricted his throat, made it difficult to breathe, made him afraid she’d see the anxiety in his eyes.
Then, while examining Mrs Guess, a searing pain had stabbed the right side of his head, making him wonder if he’d black out from the intensity.
Even in her distress over losing her grandfather, Liz was too smart to miss that something was wrong with him. She’d noticed yesterday. He couldn’t keep hiding his symptoms from her. Others perhaps, but not Liz. She knew him too well.
He should have told her the moment he’d started having the blurred vision, the pinpricks in his fingers, the tiredness. He should have told her the night her grandfather had died. Before then.
Instead, he’d pretended that everything was fine, not letting on that he was having symptoms of any kind.
He’d thought he was saving her pain by delaying, but the more time that went by the more he wondered if he wasn’t making things more difficult by keeping his symptoms, his fears to himself.
He should tell her now.
He opened his mouth, intent on telling her the truth. “I’m just busy.”
That wasn’t what he’d meant to say. Not even close.
“OK.” She didn’t sound convinced. He didn’t blame her. His unusual behavior confused her. Hell, he was pretty confused himself.
Silence buzzed over the line, acutely broadcasting that change was eminent whether he wanted it or not.
“I looked for you after I finished my shift. They told me you’d already left for t
he day. Are you coming over? I could order take-out.” Her voice held hopefulness.
“Not tonight,” he managed to say. What if he had another episode of pain? How would he explain it to her? “I had a long day and am tired.” True. He seemed to always be tired these days. “I’m flying to Alpharetta in the morning and want an early start.”
A lame excuse and they both knew it. An avid pilot of his own Cessna, a scheduled trip had never stopped him in the past. And why had he lied to her? He was going to Jackson, to see the specialist, to find out the truth behind his symptoms.
Which was why he’d lied to her.
He didn’t want her to worry, didn’t want her sympathy, didn’t want her to possibly be tied to another invalid. Liz deserved a life.
“If you’re sure, then…” She hesitated, making him want to tell her how much he needed her, just to have her wrap her arms around him and tell him everything would be OK, that she’d be there for him no matter what those damned tests showed.
The crux of it was Liz would be there for him in a heartbeat. If he let her. But he wanted better than that for her. Lots better.
Be strong, man. You’ve got to see this through, find out for sure what’s going on before involving Liz.
“Sorry, Liz, but I’ve got to go.” He hung up before she could say anything more.
But mostly before he could say anything more.
The next morning Adam sat in a Jackson Neurology Clinic exam room, staring at a framed Norman Rockwell print that hung on the wall opposite him.
Too bad real life wasn’t as idyllic as Norman Rockwell presented it.
When the neurologist walked into the room, Adam knew by the expression Dr Winters wore that the test results hadn’t been good.
By now he should be used to that expression. Hadn’t every bit of news he’d gotten thus far been bad?
The neurologist pulled up his stool, glanced down at the piece of paper containing words that would forever change Adam’s life, and then glanced up. “There’s no good way to put this and we pretty much already knew what the conclusions of the tests were going to be, so I’m going to be blunt. You have MS.”
Adam’s ears roared. His blood boiled. His skin crawled. He gritted his teeth. He clenched his tingling fingers. Still his body threatened to explode from the impact of those words.
He had MS.
“You’re sure?”
“Yes. The analysis of the cerebral spinal fluid shows protein, cells, and increased antibody production. Antibodies containing oglioclonal bands. Unfortunately, that in combination with the demyelization revealed on the MRI are conclusive even if the evoked potential testing hadn’t been positive.”
There was that damned expression again.
“But they were positive, too, weren’t they?” Because all his tests pointed in one direction. A direction he didn’t want to go, but had no choice but to take.
He had MS.
The specialist nodded. “I’m sorry.”
All night he’d lain in bed preparing himself for this, preparing to hear that his body was attacking itself. Yet he shook. Any moment he expected the earth to open, for lightning to strike, for a tornado to rip him from the ground. Because any of those things were possible and expected in this horrible nightmare.
This had to be a nightmare.
God, he hoped it was only a nightmare.
He couldn’t have a debilitating disease. Not him. Not when he had so much to live for. So much he wanted to do with and give to Liz.
MS.
He shuddered. His stomach churned. His heart sank.
Fate couldn’t be this cruel.
Could it?
He closed his eyes and forced himself together. Forced his emotions under control. Well, not control, but the closest he could manage. He doubted he’d ever feel in control of his body, his life, again.
Steeling himself for the worst, he met the specialist’s gaze. “What does this mean, exactly? What should I expect?”
Did he even want to know? With the way things had gone thus far, perhaps he shouldn’t ask. Perhaps ignorance was bliss. Before seeing Larry, he’d known something was wrong but hadn’t felt this heavy sense of impending doom.
“Since this is your first known exacerbation, it’s difficult to say. As you probably already know, symptoms vary from individual to individual just as the course of the disease varies. It’s possible this exacerbation could go away tomorrow and you won’t have another episode for decades.” Dr Winters shrugged. “Maybe never.”
“It’s also possible that this is only the tip of the iceberg, that what I’m experiencing is mild and will get much worse before going into remission—if I go into remission at all.”
“That’s true. There’s no way of knowing the course of your individual disease, or how progressive your case will be,” Dr Winters agreed. “Generally there are considered to be four classifications of MS, each a different level of progression of the disease.”
“There’s no way to know which type I have, is there? No test or study that can be done to determine which one?”
“With time we’ll know, but as far as a test I can run…” the doctor shook his head “…there’s not. The best we can hope for is that this will be your only exacerbation and that you’ve already experienced the worst of your symptoms.”
“But that’s not what you expect?”
Dr Winters frowned. “You know I can’t predict the future. Anything I said would only be a guess.”
“I could lose control of my body functions, go paralyzed, even die from this.”
“That type of progression is rare, Adam. The majority of MS cases fall into the category where the person only has a few exacerbations throughout his or her lifetime.” Dr Winters gave a stern look. “You can’t go into this thinking the worst. You have to fight, keep a positive outlook.”
But no matter how Adam tried to focus on the positive, on the fact that this might go away, the stark reality wouldn’t let up.
“I could end up in a wheelchair. Crippled.” He winced. “Bedridden.”
Just like Gramps.
The thought of Liz putting her life on hold to wait on him hand and foot while he lay in a hospital bed caused bile to rise up his throat.
“What about my job? My career? I’m a surgeon with MS.” He laughed with ill humor.
He felt like he’d made an admission much as an alcoholic would at an AA meeting. Hi, my name is Dr Adam Cline, and I’m a surgeon with MS. Only with alcoholism a person could fight. How did one fight one’s own haywire immune system?
“Am I medically clear to perform surgeries? To pilot my plane?”
“For now,” the neurologist said. “As long as you’re physically and mentally capable. However, you should check with your airport on any regulatory guidelines that would restrict you from flying. But if your symptoms worsen, I’d have no choice but to put you on medical leave.”
Adam liked his life. He had a great job, a hobby he loved, financial freedom, and Liz. Now all the best parts were slipping through his fingers like loose grains of sand. He wanted to grasp each bit, hold it all in place, but doing so was futile.
“Adam?” Dr Winters touched his forearm. “I’m concerned about you. You’re not suicidal?”
His life might be over in many ways, but he wasn’t a murderer and in his eyes suicide was a form of murder. He laughed with a bitterness he wasn’t sure had ever come from his lips before. “Suicidal? No, I’m not suicidal.”
Although he’d rather die than burden Liz with taking care of him for years on end.
“You know…” Dr Winters studied him “…there are lots of people who have MS who live fairly normal lives.”
Adam nodded. There were, but he had to face facts. His life would never be the same. He had MS and no way of knowing that the future wouldn’t leave him an encumbrance.
How could he do that to Liz? How could he put her in the position of having to take care of him that way? It would be like starti
ng all over with her grandfather. Each day Liz would have to care for him, wonder if he’d be able to do anything for himself, if he’d know who she was, as memory issues occasionally went along with MS.
She’d lose all possibility of having a normal life.
They had to end. Continuing their relationship was condemning Liz to a life sentence.
He wouldn’t be able to tell her why. She’d never let him walk away if she knew about his MS. Not his Liz. No, she’d insist on staying by his side, caring for him despite him trying to push her away so she wouldn’t carry this burden.
He didn’t expect her to understand. Not at first, but in the long run she’d discover he’d done the right thing to set her free.
What woman who’d already given up so much of her life to care for an invalid would want to take on that burden a second time?
Worse, what kind of man would he be if he knowingly let her?
CHAPTER FOUR
WHILE chatting on the phone with Kelly, Liz chopped a tomato. Her stomach protested at the thought of yet another salad, but she had to eat and these days her stomach protested at everything anyway. Tonight would be no exception regardless of what she ate so she’d at least eat healthily.
“I’ve barely seen Adam since my grandfather died. I miss him so much. We haven’t spent enough time together for me to figure it out, but I know something is going on with him. He says nothing’s wrong, but he’s just not been himself.”
“He has seemed a bit distracted at work lately,” Kelly agreed, pausing in thought before saying, “Maybe he doesn’t know what to say to comfort you and that makes him feel inadequate.”
“Maybe.” What Kelly said sort of made sense, but Liz wasn’t convinced. Adam wasn’t an inadequate kind of man. With reason. There wasn’t a thing inadequate about Dr Adam Cline. Except his communication skills for the past month. “But Adam was perfect during Gramps’s funeral and right afterwards. He held me and with his arms around me I knew everything would be all right. Just his being with me was enough.”