“Of course. That goes without saying.”
Dr. Howell looked at Yoss again. “It seems to have perked you up considerably, Yoss. So whatever Imogen is doing, she needs to keep doing it, I’d say.”
Yoss’s eyes flashed in my direction. “She’s helping a lot,” he said quietly.
“Good. Good. Everyone here at the hospital is committed to getting you healthy.” Dr. Howell opened the chart again and slid his glasses up over his nose. “I finally received the results from your biopsy and the other blood panels we ran. So let’s go over them and then we can talk about options.” Dr. Howell sat down in a chair opposite me.
“Options are good to have,” Yoss said lightly, glancing at me again, his lips turning up slightly at the private joke. I couldn’t smile back. I was focused on Dr. Howell as he flipped through the pages in Yoss’s chart.
“Nurse Rogers says you’ve healed nicely from the biopsy. Are you feeling any residual soreness?” he asked and Yoss shook his head.
“Not really. The first couple of days were a little rough. But it’s fine now,” Yoss answered.
“That’s excellent. Because as we’ve talked about before, with your condition, the risk of infection is high. You were given a heavy antibiotic after the surgery as a precaution.”
Flip, flip, flip through the chart. I was on edge. Yoss, who finally seemed to pick up on Dr. Howell’s placating vibe, folded his hands together in his lap and clenched them tightly.
“High risk for infection. Got it.” Yoss’s mouth pressed into a thin line.
“I want to have you moved out of the ICU tomorrow morning. There’s no need for you to stay in intensive care and a bed has opened up on the second floor.”
“Oh, that’s good,” I interjected.
“Yes, given everything, you’re doing very well, Yoss,” Dr. Howell went on.
“Given everything? That sounds pretty fucking ominous. Can we cut the crap and get to the main act here? What did the biopsy say?” he snapped impatiently.
Dr. Howell wasn’t fazed by Yoss’s attitude. The older doctor read over the results and then cleared his throat. When he looked at Yoss again, his eyes were kind and compassionate, his expression concerned and serious.
“Your biopsy confirmed that you have end stage liver disease. Your liver function is very low and you are at significant risk for acute liver failure,” Dr. Howell said succinctly. Carefully. Gently. His words falling between us like shrapnel.
This was my cue to say something supportive, just as I would have done for any of my other patients. But this was Yoss. And I felt the reality of his situation hit me square in the chest.
Yoss began to pick at his stitches. “Okay. You had mentioned liver failure before. I think I got that part.”
“I’m going to be frank with you, Yoss, your condition is very serious. Hepatitis B is a tricky disease because of how long it can take to show symptoms. The longer it goes untreated, the more likely you are to suffer from liver damage. That however, isn’t insurmountable. A strong course of antibiotics as well as treatment with medication and we can significantly slow down the progress of the disease and the impact on the liver. However—” Dr. Howell stopped for a moment and gave Yoss and long and penetrating look. “Your situation, Yoss is a bit more complicated.”
“Isn’t it always?” he muttered. He was biting on his lower lip, his knuckles white as he clenched the sheet in his fist.
“To put it simply, your best chance is to have a liver transplant and the results from your biopsy show that you are a prime candidate. The good news, Yoss, is that there is no indication of vascular invasion. That means that the areas around the liver don’t appear to be affected. Yet. That increases the likelihood of a successful transplant, ” Dr. Howell concluded.
I finally found my voice. “That’s great.” I turned to Yoss and gave him a smile. “See, some good news.” He didn’t return my enthusiasm, so I spoke again to Dr. Howell. “Okay, well didn’t you say that he’d be high on the list? That he’d be given priority if the health impact was significant enough?”
“His MELD score is high, which means the wait time is significantly less. However, I want you to be aware, Yoss, that even with high priority, you could be waiting for several weeks, even months, before a transplant is made available.”
Yoss’s face had gone grim. His green eyes dull.
“Let’s be straight here, Dr. Howell, what you’re saying is that I could quite possibly die before I get a new liver?” Yoss was angry. Really angry. And I could understand why.
How else were you supposed to feel about the idea that you could die? Even though Yoss had been reckless in his choices, the realization that death was a possibility would knock anyone down.
“Your condition is potentially fatal, yes, but so is walking across the street during rush hour,” Dr. Howell pointed out and Yoss snorted.
“I don’t think you can compare playing Frogger across the road with my liver giving out, but nice try,” he remarked dryly.
Dr. Howell closed the chart in his lap, his face set in severe sternness. “Yoss, you are a very sick man. I will always give you the facts as I have them. But you have many options. There are treatments available that cannot only slow down the disease’s progression until a transplant becomes available, but can also make you feel better. To give you back your quality of life. But mental outlook impacts every part of this process. I spoke with Imogen about getting you some counseling. The medication you are taking can cause an increase in depression and suicidal thoughts. It’s incredibly important that you talk to someone. They can help you process what you’ve been through. Help you with coping skills.”
“Dr. Howell’s right, Yoss. Speaking to someone, even informally, could help you tremendously. I know a number of wonderful therapists who could come to talk to you—”
“So how long do I have to stay here then?” Yoss interrupted, not acknowledging that I had spoken at all. “I can’t hole up in the hospital for months while I wait for a possible transplant that may never come. I don’t have insurance. And I sure as shit know that the hospital won’t keep me here indefinitely if they’re not getting paid.”
“As I said earlier, you will be moved out of the ICU later today. I am recommending that you remain in hospital, for at least a few more days. Your injuries sustained from your attack have healed nicely. And if you remain vigilant about taking your anti-viral medication, you can go about your life. However, you would have to come back for frequent follow-ups to monitor your symptoms and your viral counts. This would mean routine blood work and tests. While you are physically stronger, given your situation, I have serious concerns about your health once you leave. I’m assuming you and Imogen have talked about where you will go once you are discharged?” Dr. Howell looked at me and I nodded.
“Yes, Dr. Howell, we’ve talked about the Salvation Army downtown. Tracey Higgins says they have available beds. But Yoss and I are still discussing it.”
Yoss gritted his teeth and I anticipated an outburst at the mention of the shelter. I was relieved when there wasn’t one.
“I would strongly encourage you to find suitable accommodation. Somewhere safe, clean, and warm. I don’t feel comfortable signing off on your discharge until we know you can properly look after yourself.”
“I’m not a child, Doc. I’ve been properly looking after myself since I was twelve,” Yoss spat out.
I reached over and put my hand on his arm, not caring that Dr. Howell was in the room. “He only means that with your diagnosis, you have to be somewhere clean. Somewhere that lowers the risk of a possible infection. We don’t want anything to happen to you, Yoss,” I said softly.
Yoss met my eyes. He wasn’t just angry.
He was terrified.
“But again, I want you to stay in hospital for another two to three days at the very least. You still need some rest and until you secure housing, I think it’s best to keep you here. Okay?” Dr. Howell said, his eyes flitting fr
om Yoss to me and then back again.
Yoss nodded, his gaze drifting to the window. The sun was dipping below the horizon and it was mostly dark. His chest was rising and falling rapidly, his face drawn.
“All right, we will talk more about this tomorrow. It’s almost dinnertime; make sure you’re eating as much as you’re able to. Especially now that the nausea is subsiding.” Dr. Howell stood up. “Imogen, a word.”
I let go of Yoss’s arm and just as I was about to move away, he grabbed my hand and held it tightly.
I squeezed his fingers.
He squeezed back.
“I’ll be back in a minute,” I assured him.
“Can I watch the rest of the movie?” Yoss asked, his voice small.
“Sure.” I pulled the table back around and clicked the mouse.
“Thanks,” Yoss murmured. “I have to see if they ever find the lady. It’ll bother me all night otherwise.”
“You’ve seen this movie before. You know what happens,” I chuckled.
“I just like to make sure some things don’t change,” he said with a strained smile as his eyes drifted back to the screen.
I joined Dr. Howell out in the hallway where he was updating Jill Rogers, the head nurse on duty, about Yoss’s medications.
When he was finished, Dr. Howell turned to me. “I’m very concerned about Mr. Frazier.”
“I know his condition is very serious—”
“It’s not just his illness, it’s his situation. Have you been able to secure him a place at the Salvation Army?” Dr. Howell asked.
“He doesn’t want to go to the shelter. He’s had some bad experiences there and he is adamant he doesn’t want to go back,” I explained.
“Then it’s important that another place is found for him. He has a rough road ahead of him. It’s an uphill battle for those that don’t have all of the other risk factors that Yoss faces. This has to be a priority, Imogen.” Dr. Howell peered at me closely.
I swallowed thickly and only nodded. “How likely is he to get a transplant?” I asked.
“The waiting list is almost a year long. Given the gravity of his health, it will give him a higher priority, but like I told him, he could still be waiting for weeks. Or months. And I’m not sure Yossarian has months to wait.”
A punch to the gut.
The wind was knocked out of me.
I couldn’t breathe.
My knees threatened to buckle underneath me.
“Are you saying that he could…”
I couldn’t finish the sentence.
I couldn’t say it.
I wouldn’t.
“Imogen, Yoss’s liver is failing. He has already lost the function of almost 80% of his liver cells. His situation is precarious at best.”
“I understand,” I choked out. Lies.
I didn’t understand anything.
Least of all how I could find Yoss only to lose him again.
It was my greatest fear.
It paralyzed me.
“We can’t keep him in the hospital. We simply don’t have the funds for that, even with the government grants. You know that. And the truth is, he doesn’t need to stay in the hospital. He can function somewhat normally. He should carry on with his life. But it’s our job to ensure that life doesn’t include him living on the streets. Or carrying on with the lifestyle that got him to this point in the first place. Have you spoken to him about any of this? Perhaps there’s a support group for that sort of thing.”
That sort of thing.
What a polite way to refer to Yoss being a hustler.
“We haven’t spoken about it. Not yet anyway. I’ll do some research to see what support and services are available that deal with homeless issues. I had planned to talk to Lee Cutler, he’s a therapist with the grieving center and has met with some of my clients in the past,” I suggested.
Dr. Howell clicked his pen a few times. “That sounds good. Thank you, Imogen. I appreciate your dedication to Yoss’s situation.”
“It’s my job, Dr. Howell,” I replied.
Dr. Howell patted my arm, but didn’t say anything else.
I held it together until the doctor walked away. I turned towards Yoss’s room, my hand on the doorknob.
Yoss was dying.
It was the plain and simple truth.
I tried not to get angry with him for doing this to himself, but it was difficult.
I remembered all those nights I’d lie awake at The Pit, wondering where he was. Imagining what he was doing.
My mind went back to another night. A night when I had seen entirely too much.
It had been the end for us. The day when it all changed.
The alleyway was dark and I could just make out the shadowed figures hidden away from the street. I took a tentative step forward, hoping Manny was lying.
That when Yoss had promised me, he meant it.
I had to learn to trust him.
I started to turn away, disgusted with myself for doubting him.
Then I saw him. I’d recognize the dark black waves of hair anywhere. Even in the shadows, I knew him.
He was on his knees.
And then I saw the man with his sick, sick smile. His hand on the back of Yoss’s head. Holding him in place…
The bile rose in the back of my throat.
Tears burned my eyes and I wiped them away furiously.
I had to get it together.
Falling apart wasn’t an option.
I walked back into his room, prepared for the cold, icy man I had become somewhat used to. I anticipated the brick wall I was about to walk into.
But it wasn’t there.
Yoss looked up as I walked in and patted the bed beside him.
“They’ve finally figured out where the lady is being kept. It’s getting to the good part,” he said. He sounded edgy. Tired.
I should talk to him about so many things. It was my job. It’s what I was paid to do.
“Yoss,” I began, but he cut me off with a shake of his head.
“Come watch the rest of the movie with me. At least until the sun goes down,” he said, a note of pleading in his tone.
“It’s already dark,” I pointed out. The day was long gone.
“We can pretend it’s still sunset, can’t we?” he asked.
Sunset.
It had meant so much to the kids we used to be.
The soft light at the end of the day had been the only time we could feel hope.
Yoss would look at me and smile as the sun became shadow and I would feel a stirring in my broken heart. Because no matter how bad things had become, at least we had survived another day.
After the world had thrown us away, we could hold onto that. To each other. And feel something close to happy.
So I would imagine it was sunset. For Yoss. For me.
I slowly walked to his bed.
He patted the space beside him again.
I didn’t overthink it. I carefully sat down beside him. I was rigid at first, not sure what I was supposed to do.
I felt his hands on my shoulders, pulling me back. Into him.
Anyone could walk in and see us. I should use my head. Not my heart.
But this was Yoss.
And I was Imi.
So I gently molded into his side, my head resting on his shoulder as we pressed together on the small hospital bed.
“Patti really is the smartest one in this whole movie,” Yoss said and I felt his voice rumble beneath my ear.
“Kelso’s not so bad,” I added, letting my palm rest on his stomach. I felt the muscles clench and then relax underneath my touch.
Yoss laid his check against the top of my head, his hand on my back. “Well, it took him long enough to figure out where Mrs. Miller was. He seems pretty inept to me.”
“He found her in the end. That’s all that matters really,” I murmured, my eyes feeling heavy. It would be so easy to fall asleep.
Just.
Lik
e.
This.
“I would do it all differently if I could.” Yoss let out a long pent up breath. “I wouldn’t be stupid enough to think that what I thought was the right thing actually was the right thing.”
“You were young, Yoss. You did the best you could,” I excused. Maybe I shouldn’t. Perhaps he should be held to task for the choices he had made. But I couldn’t do that to him. Because what would be the point? I couldn’t stomach the thought of making him feel any worse.
“I don’t think that’s true, Imi.” I felt him rest his head against the top of my head. “At least with you, I got something right.”
I wasn’t sure exactly what he was referring to. Was he talking about being with me?
Or leaving me?
But they were questions for another day.
I remained quiet and we finished watching the movie. Pressed against each other. Trying to ignore the real world that waited for us.
Like the kids we used to be.
Embracing a second chance that had been stolen from us years ago.
Fifteen Years Ago
Yoss carefully slipped out from underneath the blankets. I knew he was hoping not to wake me. But I had already been awake since daybreak.
Mable, the lady who screamed as though she were being attacked every single morning, had been at it for hours. I had learned to block it out most of the time, but not today.
Someone had started a fire somewhere and the large, open room of The Pit had filled with a thick, acrid smoke. I was terrified everything would go up in a blaze. But it was starting to get cold at night. So cold that the thin blankets Yoss and I slept under were no longer enough to stay warm.
“Where are you going?” I asked, my voice scratchy with lack of sleep. I already missed the feel of him against me. I felt an indescribable panic at the thought of him leaving me alone again.
He did it often. I should be used to it. But I wasn’t. I didn’t think I’d ever be.
He squatted down beside me and smoothed my hair back from my forehead, leaning in to kiss my lips. Softly. So softly.
One Day Soon Page 18