Not a Sound

by Heather Gudenkauf

  I click on P. McNaughton’s image and it takes me to his page. I scrutinize the photo carefully. I can’t tell for sure if he and the man I saw dropping the flowers at the river are one and the same. I scroll through his photos in hopes of finding a picture that fully reveals his face. P. McNaughton is at the very least an amateur photographer. I skim past pictures of sunsets and clouds and I pause when I come to a series of photos that look suspiciously like they could have been taken in the area of Five Mines near my home. Interesting.

  Finally, I come across a photo of the man and it’s clear that it is the person I saw earlier today. Same slight build, same receding hairline, same intense gaze. I return to the top of his page and see that he lists Mathias as his hometown. No profession is listed.

  So what have I learned? Not much. Maybe Jake was right, that he’s just a friend of Gwen’s who marked his condolences with a bouquet of flowers. Or maybe there’s more to it.

  I read through P.’s comments one more time and, again, nothing really jumps out at me except that there are so many of them and he obviously really cared about Gwen. I’m just about to call it a night when another comment from McNaughton appears on Gwen’s page. I’ll miss her terribly—a light has gone from the world. My fingers itch to respond but someone does it for me. A woman named Chris, who I know as a skilled care nurse at Mathias Regional, replies to him, Amen.

  I hesitate and type, How do you know Gwen? I watch the screen, waiting for his response but none comes. He’s gone.

  Strange. I click on the woman’s profile and send her a friend request and a message asking her what the deal is with P. McNaughton. I consider sending McNaughton a friend request too, but think better of it. He acted so suspiciously at the river and I don’t want him to know my name in case he had something to do with Gwen’s murder.

  I decide that I can at least be somewhat productive while I wait around for Chris to reply to my message so I spend the rest of the evening researching more about Five Mines Regional Cancer Center and Dr. Huntley just so I’m clear as to what I am to expect in working there. He has nearly a five-star rating on MedicalReportCard.com. Dozens of patients rave about his bedside manner and the time and dedication he gives to those under his care. One woman describes how Dr. Huntley is always available at any hour of the day and how he patiently answers all of her questions.

  There are only a few negative reviews. One from a woman with the user name of LWinthrop who says that Dr. Huntley became belligerent whenever she questioned him about the treatment protocol he prescribed for her husband. He asked me if I graduated from medical school and when I said I didn’t he responded, “Then let me do my job.”

  The other reviewers skewered her. How dare you criticize Dr. Huntley! He’s the most dedicated doctor I know. I’ve been to two other doctors and Dr. Huntley is the only one who listens to me. And on and on.

  By the time I read through all the reviews and check out a few other sites I’m convinced that Dr. Huntley is a highly qualified, well-loved physician. Compared to the reviews of many of the other doctors, Dr. Huntley is top-notch.

  I get ready for bed with a sense of possibility and excitement that I haven’t felt in a very long time. This is the beginning, I think to myself. My first step back into nursing.

  Guiltily, my thoughts shift once again to Gwen. I check my Facebook page for a message from Chris and to see if P. McNaughton posted any more comments on Gwen’s page but find nothing. It doesn’t seem right. Just as a new life is starting for me, just as I’m getting a second chance, Gwen’s life has been brutally ended.

  10

  The morning of my first day at the center can’t have started any worse. I oversleep. Last night I couldn’t get the man I saw by the river out of my head and I kept checking my Facebook page to see if P. McNaughton had left any more comments but found none and Chris didn’t send me a message. When I finally fell asleep it was around 1:00 a.m.

  I haven’t needed to wake up at a certain time in more than a year and I manage to fail miserably when it comes to my brand-new, no-fail, flashing-light, bed-vibrating alarm clock expressly made for the hard of hearing. Stitch nudges me awake at seven twenty-five and I need to arrive at the center by eight. In lieu of showering, I get dressed, comb my hair, feed Stitch and make it out the door by seven forty. That leaves me twenty minutes for the twenty-five-minute drive to Mathias.

  Breathlessly, I step through the center’s front door at 7:58. So much for arriving early to make a good impression. There is a plump, freckle-faced woman seated behind a tall counter speaking on the phone. When she sees me she smiles and holds up a finger to let me know she will just be a moment longer. Already the waiting room is filling up. A couple sits shoulder to shoulder, holding hands. An elderly man connected to an oxygen tank works a crossword puzzle while his wife shuffles through a thick stack of what looks like insurance forms. A young woman, her smooth head covered with a bright pink head scarf, is sitting in a far corner of the room, flicking through a magazine with unseeing eyes. Though her face is expressionless, her bouncing leg gives away her agitation. A toddler plays happily at her feet.

  I sit on the opposite side of the room and wait for the receptionist to finish with her phone call. A minute or two later, a nurse in yellow scrubs opens a door and summons the young woman who rises from her seat, bends down and picks up the small child and follows the nurse from the room on unsteady feet. It wasn’t so long ago that I was the nurse in the scrubs. I was the one who gently guided patients to an examination room. I wonder what is coming next for the woman. Is she nearing the end of her treatment? Is she getting good news or bad? Part of being a nurse is sitting with the patients when they receive the best news of their lives. Or the worst.

  The receptionist steps out from behind her barrier and greets us with a toothy smile. “You must be Amelia and this must be Stitch. I’m Lori.”

  This brief introduction is all I really catch. I shake her hand and futilely try to follow what she is saying. Lori’s mouth is moving too fast and she’s not used to communicating with a deaf person. I was offered a sign language interpreter to help with today’s training, but I declined. Now I’m wishing I hadn’t. I’ve been so independent my whole life and even more so since David and I separated. It’s hard for me to accept help, even harder to ask for it.

  Combined with Lori’s rapid description and last night’s online research, I learn that Dr. Huntley is the medical director for this location and three other satellite clinics dotted across the county. Oncologists from eleven counties from the tristate area utilize the state-of-the art technology provided by the center.

  I also learn that the clinic has another oncologist, a Dr. Sabet, four nurses, a nurse practitioner, Barb (the office manager) and an additional receptionist. Inpatient care is done at Queen of Peace and all other treatments and procedures are done on-site at the clinic.

  Lori leads me down a long hallway to a door that’s marked Infusion Center. Inside is a surprisingly cheerful room filled with individual infusion areas separated by curtains. Each area holds an infusion chair that looks much like a comfortable recliner, a television and an additional chair for a companion. All the infusion chairs face a wall of windows providing a stunning view of Mathias and the river. Lori also points out a door labeled Radiation Therapies, though we don’t go inside.

  We return to the front of the office, and Lori pauses in front of a closed unmarked door. She opens it and flips on a light to reveal a large, windowless room filled with a maze of battered gray metal file cabinets. Taking up most of a wall is an empty, but brand-new open shelving unit that nearly reaches the ceiling. Against another wall is a top-of-the-line scanner and a long, narrow desk that holds a computer and a telephone.

  “We’re working on digitizing all our files. It’s not glamorous work, but you’ll be scanning and transferring all patient information into the computer. Don’t wor
ry about the files in this cabinet.” She points to a six-drawer cabinet in the corner of the room. “Those are our inactive files. We’re in the process of shredding them.” The room is dim and depressing. I knew the job consisted of clerical work but I’d hoped that I’d have more interaction with the nurses and even with patients.

  “Don’t worry,” Lori says, reading the expression on my face. “We won’t keep you locked in here all by yourself if you don’t want to. If you get lonely you can bring your computer out to the reception area and you can move back and forth between the two rooms to do your work.”

  “Thank you,” I say with relief. If I had to be stuck by myself in that grim, dark room all day long I may just start drinking again.

  “What do you think?” Lori asks. “You ready to get started?”

  “I am,” I say, and I spend the next three hours tediously transferring names, birth dates, family histories, immunizations and other information from the paper files into the computerized system. I’m a little unprepared for the disarray I find the files in. Many are out of alphabetical order and several times I find a doctor’s note or lab result in the wrong patient’s file. I set these wayward documents aside until I can refile them in the correct spots.

  The work may be monotonous but Lori checks in on me every so often to see if I need anything, and after an hour of work Lori urges me from the file room for a break. I’ve been around so many people who can’t be bothered to engage in conversation with me. So I appreciate Lori’s efforts.

  We sit behind the main desk and she shows me a picture of her sixteen-year-old daughter and asks me if I have any kids.

  “A stepdaughter,” I say, pulling out my own phone and showing her a picture of Nora. “She’s seven, almost eight.”

  “Cute. What’s your husband do?” she asks innocently.

  “He’s a doctor,” I say. “David Winn. He’s an ob-gyn with Queen of Peace.”

  “I know of him,” she says. “He’s my sister’s doc. She says he’s a nice guy.”

  “He is,” I agree. I don’t mention that we’re separated. If the clinic is like all the other health care facilities I’ve worked for, it won’t be long until everyone knows my business.

  An older gentleman with black hair salted with gray and wearing a white lab coat approaches the main desk. Lori stands and I set my phone aside and also get to my feet.

  “This is Dr. Sabet, Dr. Huntley’s partner,” Lori says, introducing us.

  “It’s nice to meet you,” I say.

  “And this is Amelia Winn,” Lori continues. “She’s working on scanning all the patient records into the new system.”

  “Welcome, and it’s my pleasure,” Dr. Sabet says, and we shake hands. I have to really concentrate on the movement of his lips. I wonder if Dr. Sabet speaks with an accent, something that always throws me off when I’m trying to speech read. “Have you seen Dr. Huntley?” he asks, looking harried.

  “He’s with a patient right now,” Lori explains. “Exam room three.”

  “Please tell him I’d like to speak with him when he gets a moment,” Dr. Sabet says. He pauses, scanning the crowded waiting room. Another patient comes through the entrance and Dr. Sabet shakes his head and picks up a file from Lori’s desk, then retreats down the hallway. I wonder if the clinic is always this busy.

  * * *

  The young woman and child that I saw in the waiting room when I first arrived come out of the examination room. If she looked scared and bewildered before, she is even more so now. I want so badly to go to her and tell her that everything will be okay. But I know that there is nothing okay about having cancer. There are no guarantees. I give her an encouraging smile but she looks right through me. I wonder who is at home waiting for her.

  I watch the woman leave and Lori, noticing my worry, lays a hand on my arm and I read her lips. “Breast cancer. Stage four. She’s only twenty-five. But Dr. Huntley is her doctor. He’s the best.”

  I return to my files and out of curiosity, I search for the file for LWinthrop’s husband, the woman who left such harsh comments about Dr. Huntley and the center on the website I found last night. I type the last name Winthrop into the center’s patient database and come up with John R. Winthrop and a listing of basic information: address, phone number, age of thirty-nine, wife’s name, Linda, but nothing else.

  I decide to take a look in the paper files. I go to the file drawer labeled W and riffle through the folders but I can’t find it. I think a moment. This could be an example of the inactive files to be shredded that Lori told me not to worry about. I go to the corner and pull open the bottom drawer in the hopes that it will be filed under W. No such luck. It looks like the inactive files were just tossed in here randomly and one drawer is half-filled with what looks like patient and insurance company billing statements. It takes me about fifteen minutes but I find what I’m looking for. John R. Winthrop. It’s a thick one and it takes two hands to pull it free.

  I open the file and pick through the pages until I think I find reference to what appears to be his last visit to the clinic, when he was given an infusion of Rituximab. It’s dated eight months ago, not long before Linda Winthrop left the review. I return to the beginning of the file. John Winthrop was diagnosed with a condition called idiopathic thrombocytopenic purpura or ITP. Not cancer, but a bleeding disorder where the immune system destroys its own platelets, making it difficult for blood to clot. ITP falls under the umbrella of illnesses that Dr. Huntley would treat as an oncologist/hematologist. The file gives me no sense as to why Linda Winthrop would be disillusioned with her husband’s treatment. But in my experience this isn’t all that uncommon. Choosing a doctor is very personal, not unlike choosing a mate, and finding the perfect physician can take a few tries. I return the file to its spot and get back to work.

  I scan and upload three more files, each taking about thirty minutes to complete and when I look at my watch again it’s after noon. Time to go. I tidy up my work area, round up Stitch who wandered off to visit the staff lounge.

  When Stitch and I step out into the cool air I’m at once exhausted and exhilarated. My first day of work in two years. I want to talk to someone, to tell someone about Lori and that maybe someday I’ll actually be working as a nurse again. My brother will still be at work, my dad out on the golf course. I will call them this evening. I think of Jake. I pull my phone from my pocket and find a text already waiting for me. It’s not from Jake but from David.

  How was your first day?

  I’m not sure how to respond. Almost every conversation that I’ve had with David, in person or by text, has been loaded. I can’t tell if he’s genuinely interested or just wants to know if I screwed things up.

  I decide to presume positive intentions and reply, Great! I have my own desk.

  Impressive, David replies with what I’m sure is sarcasm and then adds, Are you going to Gwen’s funeral tomorrow?

  I have mixed feelings about attending the services. Tomorrow is only my second day of work and I’m hesitant to ask for time off already. But Gwen and I were once friends and I was the one who found her. I feel like I need to be there but don’t know if I can bring myself to attend.

  I’m not sure, I text back, and it surprises me when he quickly responds I’ll be there. I know that David and Gwen were acquainted, that she occasionally worked on the maternity floor and surely helped David deliver a few babies, but did he know her well enough to attend her funeral?

  Another text comes through and I look at it for a few beats waiting for the punch line. Come over for dinner on Friday. Nora and I will cook.

  Well, this is an interesting turn of events. Is my estranged husband really inviting me back into his house? He’s just trying to be supportive, I tell myself. After all, the sooner I get my act together, the sooner he can cut me loose with a clear conscience. Not that I’ve been a burden
on him, financially speaking. Once I moved out, I refused to take any money from him, surviving on my meager savings and cashing in my 401(k) plan twenty-five years too early.

  Sounds good, I finally type. What can I bring?

  Dessert and Stitch. Come around six.

  I smile. See you Friday.

  11

  When I arrive at the Lutheran church where Gwen’s funeral is being held I park beneath the shade of several towering pine trees. I’ve brought Stitch with me and the morning air is cool enough that I can leave him in the Jeep with the windows cracked and a brand-new bone and he’ll be just fine.

  I find a spot to sit in the rear of the church and watch as the mourners file in. Many I know by name, even more by sight. There are nurses and doctors, aides and custodial workers from the hospitals. I recognize the CEO of Mathias Regional Hospital and several of the board members from Queen of Peace. I can’t help but notice the curious looks that I get. Most of these people haven’t seen me out in public in nearly two years.

  The hush of church has always left me conflicted. When I was young and would attend Mass with my parents and brother, it was as if the moment we stepped inside church the outside world would slip away. So different from our gregarious life at home filled with laughter and fun. I didn’t like it. During the long spans of silence I would covertly make noise as I sat next to my mother, drumming on the wooden bench with my fingers, rustling the pages of the missalette, swinging my legs so that the tips of my shiny black patent leather shoes tapped the seat in front of us. My mother would try to still me with a hand on the knee or a stern look. It would work for a while but then I would click my tongue against the roof of my mouth or press my lips together and hum until the fusty old woman in front of us would turn around and glare at me and my father would have to take me outside. What I wouldn’t give to hear even the slightest of murmurs, the scuff of feet across the tiled floor, the sonorous timbre of the priest’s voice.