The Immune Box Set [Books 1-5]

by Kazzie, David

  Adam started each day with a quick look at his body of work, at the chubby babies, the skinny ones, preemies, late arrivals, the Down Syndrome babies, the healthy babies, black babies, white babies, Asian babies, Latino babies. The oldest, the very first picture on the bulletin board, was in high school now; the newest photo was of a little boy born about three weeks ago. Two of the babies on the wall had since died, one of leukemia at the age of nine, the other in a car accident before her first birthday. Neither mother was his patient anymore; Adam didn’t know if it was appropriate to keep those photos up, but he couldn’t bear to take them down, and so there they remained. He thought about Patient A again, who’d said at her last appointment that she couldn’t wait to send in her picture for the board.

  At 7:45, he changed into a spare pair of khakis and button-down oxford he kept at the office and eyed the worn couch in the corner, a holdover from the old apartment he’d lived in during med school. He’d been up for twenty-four hours, but Adam had never needed much sleep, a useful skill for a doctor. It would be more for the brief escape from this new reality of his. He rubbed his eyes, ran his hands against his closely shorn hair, decided against the nap. He sat back down and read the letter again. For the hundredth time? The thousandth? He didn’t know.

  A knock on his open office door interrupted him, and he felt a burst of heat run up his back, as if someone had caught him looking at Internet porn. He briefly debated stuffing the letter in his desk, but then it would look like he was trying to cover what he was doing, and then it would look like he was admitting he was guilty of the terrible thing the letter was accusing him of, that he had, in fact, failed to adequately monitor Patient A, which, of course, was a euphemism for killing Patient A and her unborn baby, who had been doing just fine, thank you very much, until Dr. Adam Fisher had gotten his incompetent hands on them.

  During a professional ethics class he’d taken his last year in medical school, one of those weekly classes he frequently skipped, Adam had been required to observe a hearing before the Board of Medicine. It was a Scared Straight sort of thing, designed to remind these fledgling doctors that they should avoid the Board offices, unless they’d made the right kind of friends and gotten themselves appointed to the Board itself. Adam couldn’t even remember what the respondent, an oncologist (or was it a cardiologist?), had been charged with. He’d gotten there late, a little hungover, and could barely manage to stay awake during the interminable hearing. He remembered very clearly thinking that would never happen to him, feeling a certain detached pity for this poor sap before the Board, four doctors and one chiropractor (a chiropractor – for God’s sake, medicine’s equivalent of a snake oil salesman!) second-guessing his life’s work.

  He looked up and saw Joe McCann standing in the doorway. He was a large man, and despite having rounded the turn toward his seventieth birthday, he was still blessed with a shock of thick red hair topping his huge dome. This was his medical practice, now in its fourth decade of serving the Richmond area. He didn’t work a full schedule anymore, but he still had his finger on the pulse of what his six physicians were up to.

  “Morning,” Adam said. He didn’t try to put on airs or pretend like nothing was wrong, because Joe would have sniffed it out in a heartbeat. Worse, he would have felt like his intelligence was being insulted, and there was nothing the man hated more.

  “How you doing, son?” McCann asked.

  So he knew. Of course he knew. Did Adam really think he wouldn’t know? McCann had friends everywhere in the medical community, including, but not limited to the Virginia Board of Medicine. Besides, there was nothing secret about the Board’s Notice for Adam L. Fisher, M.D., to appear on September 9, some five weeks hence. It was public record, out there for all eternity, so even if Adam was fully exonerated, that Notice would be out there for all to see, a little whisper in the ear of a prospective patient who’d decided to check Adam out, telling her the terrible story of Patient A.

  Adam was a little relieved McCann knew. It was out of the way, and Adam was spared the humiliation of having to knock on McCann’s door like a kid who’d smashed his neighbor’s window with an errant baseball.

  Adam took a deep breath and let it out slowly.

  “I’ve been better,” Adam said.

  “I know, son,” McCann said. He addressed each of his three male doctors as son. “We’ll get through this. It’s a bullshit charge, but you can’t let it eat you up like this.”

  “I’ll be OK,” Adam said. “The work will keep my mind off it. We’re loaded up with Amanda on maternity leave.”

  McCann closed the door and dropped his big frame down on Adam’s couch. He leaned forward, propping his elbows on his knees.

  “Here’s the thing,” McCann said. “I’ve been thinking about this a lot. I want you to take a little time off so you can deal with this thing. Get your head straight. I have every confidence the Board will clear you, but you’re no good to me while you replay every moment of that night every minute of the day.”

  Adam looked at his boss, his mouth agape.

  “Are you firing me?” Adam asked, his voice small. The office felt hot all of a sudden.

  “No,” McCann said. “Absolutely not. I’ll pay your salary until the hearing, and then they’ll reprimand you or cut you loose or whatever it is they’re going to do, and we can all move on with our lives. Look, I’ve read the chart. I talked to the nurses on duty. You did every goddamn thing I would’ve done. Sometimes patients die.”

  Adam couldn’t hold McCann’s gaze; he fiddled with the blotter, his fingers peeling up the corner of the August calendar.

  “I don’t know. I just don’t know.”

  “I’ve been watching you the last few months,” McCann said. “You second-guess yourself. You order unnecessary tests. You scare patients. You’re like Chicken Little all of a sudden. You’re a good doctor, a goddamn good doctor, but this is no good for you, no good for the patients. Adam. Sometimes they just die.”

  Adam wanted to argue, shout, beg, plead, bargain, do something, anything to keep working. He dreaded the idea of five empty weeks ahead of him, nothing left to fill the time but his thoughts. But he remained silent. Once Joseph McCann had made up his mind about something, he didn’t change it.

  “What am I supposed to do for five weeks?”

  McCann smiled.

  “Whatever you want. Go to Vegas. Go visit your daughter.”

  The mention of Rachel made his stomach tighten. She was a rising sophomore at CalTech and lived with her mom Nina and stepfather Jerry near San Diego; Adam saw her once or twice a year. He couldn’t bear to tell her about this. Their relationship had finally reached a point where they spoke regularly, where he didn’t feel like an interloper in her life. This though, he was afraid how she would see him in her eyes. She would see herself in Patient A. She would see her mom, her closest friends, because that’s how she thought, how her mind worked. And she would think less of him. This just served to depress him further. Just tack on Shitty Doctor alongside his talent as Absent Father!

  McCann pointed at the letter on Adam’s desk. Before continuing, he grimaced and struggled to clear his throat. He coughed twice.

  “Are you OK?” Adam asked.

  “Yeah,” McCann said. “Woke up feeling a little off. Might be coming down with something.” He felt around under his neck. “Glands are a bit swollen.”

  “I can stay and work today,” Adam offered. “You wanna go home?”

  “Fisher, if I went home every time I felt a little under the weather, I wouldn’t be much of a doctor, now would I?” McCann asked.

  “You’re not gonna let me slide on this little vacation, are you?”

  McCann winked at him.

  “Good one.” He rapped twice on the doorjamb before disappearing down the hall, calling back as he ducked into his own office.

  “Work on getting that thing out of your life.”

  #

  He drove home slowly, sticking to the
city streets, thick with rush-hour traffic headed toward downtown Richmond for another workday under the broiling August sun. This time of year, the traffic was made up of two groups of people - those who’d already been on vacation and were already missing it, and those who’d yet to escape on their summer getaway. Adam turned south on Robinson, rolled by Buddy’s Bar & Grill, one of his old med school hangouts, when life had been so much easier. His whole career ahead of him.

  Traffic slowed at Robinson and West Grace Street, and Adam coasted to a halt. The oscillating lights of emergency vehicles in the intersection flickered silently in the morning steam. Two paramedics worked to load a stretcher into the ambulance bay, and a police officer directed traffic down a side street. In the middle of the intersection, the mangled remains of a motorcycle and the spider-webbed windshield of a Ford Taurus, parked at a crazy angle.

  Adam rolled down his window as he approached the officer. He was stoutly built, his beefy arms straining against the short-sleeve police uniform.

  “I’m a doctor,” Adam said to the man. “Need any help?”

  “Naw, thanks,” the officer said. “Car versus motorcycle. Dumbass wasn’t wearing a helmet. DOA.”

  Adam sighed. Callous as his words might have been, the officer was correct that the biker had been a dumbass.

  “Sorry to hear it,” Adam said.

  “Thanks anyway, doc.”

  Another block south, he turned right onto Floyd Avenue and found a spot just in front of his two-story brownstone. The premier parking spot was, to Adam, a pretty shitty attempt at evening the cosmic scales. Yeah, yeah, so your career is on the line and you just drove by a fatal car crash, but how about that primo parking spot, big A! Still, if that was all that the universe was prepared to offer him today, then he would take it. Maybe, just maybe, this good parking spot was the bloop single triggering a long streak of good fortune.

  He checked the mail and made his way up the front walk, past his small yard, roasted to a burnt orange, the product of another hot, dry, merciless summer in central Virginia. Maybe the planet was warming, and maybe they were all roasting themselves one barrel of oil at a time. Or maybe it was because the world was such an angry place these days, and a hot, angry planet was just what mankind deserved.

  He’d bought the place just after finishing medical school, when he learned he’d been matched with the Virginia Commonwealth University Hospital in downtown Richmond for his OB/GYN residency. After a childhood spent in Culpeper County, a rural stretch of horse farms and not much else in central Virginia, he’d grown to love city living, in no small part because his father Jack, an accomplished computer scientist and giant prick, hated it so much. His house was in a historical neighborhood of brownstones and Victorian-style mansions called the Fan, so named because of how its half dozen or so main streets fanned out from a centerpoint near the VCU campus.

  He liked its feel, of sitting on his porch and drinking a cold Sam Adams when he wasn’t on call, smoking the occasional cigarette (even though he was a doctor and, of course, he knew better). In the evenings, he liked walking around the corner to Pints & Pies and eating pizza while listening to the local music scene. Sometimes, he’d make the acquaintance of a young lady, and that would last a few weeks or a few months, long enough to make him realize she wasn’t The One either. He liked his strange hippie neighbors, the poet on his left, the alternative fuels guy on his right.

  As he let himself in, he took note of how quiet it was. He wasn’t here often on weekday mornings, and so he wasn’t especially tuned in to the neighborhood’s weekday rhythms. The whole neighborhood was ghost-like, a shadow of its normal self. He didn’t see any joggers or stay-at-home moms pushing their strollers like he expected. It unnerved him a little. Quiet mornings in the beach cottage, those were different, when the lines on the calendar dissolved. The silence spurred him on, urging him to pack quickly.

  He threw clothes and toiletries into an overnight bag. A stack of unread novels stood precariously on his nightstand, books he’d collected during his trips to the various local bookstores, and he imagined himself sitting at the water’s edge lost in a long book, his feet buried in the wet, shifting sand. There was something about a long novel that Adam had always found alluring, the way he could disappear into the story and not look up until the tops of his thighs had burned to a crisp. A couple of paperbacks found their way into his bag as well. After packing, he hopped online and suspended his mail service, his newspaper, set up his bills to auto-pay.

  Adam leaned back in his chair and scratched his chin, sandpapery with a couple of days of stubble. He thought about calling Rachel, who would be getting ready to head back to campus. He took out his phone and dialed her number, his heart throbbing. As it rang unrequitedly, he wondered, like he always did when he called and no one answered, if she was sitting there in Sunnydale, holding the phone in her hand as his name flashed on the caller ID, deciding whether she should answer the phone.

  He was greeted by the phone’s prerecorded message, which always made him smile; he once asked her why she didn’t leave her own outgoing message on her phone, and she’d said she didn’t have time to waste on bullshit like that. Bullshit, she’d said. That was Rachel.

  “Hey, Rach,” he began, “it’s Dad.”

  He paused, trying to think of something funny to say, but as the seconds ticked by, he became aware of the silence, of the hiss of the open phone line, and how the silence would sound on her end.

  “Sorry about that,” he said. “Dropped an apple.” His cheeks flushed with embarrassment. “Anyway, I’m headed out down to the beach house for a little vacation. I know you’re probably busy getting ready for school, but I’d love to hear from you. Give me a call when you get a chance. Bye.”

  He nearly told her he loved her but decided against it. He hung up.

  He started to get out of his chair, but then he sat back down and pulled up the website of an online florist. Daffodils had always been her favorite, and as sensible as she was, she’d always had a soft spot for flowers. He found an arrangement he thought she would like, cursed at the outrageous price - really, seventy-nine bucks for eight flowers and a cheap glass vase? He raced through the order, pausing at the screen asking for a personalized message.

  Rach,

  I know you’ll do great this year.

  Love,

  Dad

  He left it at that.

  #

  Adam left Richmond a little after noon. It was about a five-hour trip, taking him south-southeast through tobacco country for about 175 miles before doglegging east toward Wilmington on Interstate 40. It rained lightly, off and on for most of the first half of the drive. Adam passed the time by imagining where each driver was headed.

  He stopped once, just east of the I-95/I-40 junction, for fuel and a gas station hot dog, a guilty pleasure he admitted to no one. He ate in the shade of the pump island as the nozzle delivered its payload into his gas tank. The concrete shimmered in the heat, cooking the scraggly weeds poking up through the zig-zaggy cracks here and there across the tarmac. A tired-looking banner strung across the building’s façade announced the sale of a $50,000 SuperLotto ticket, and Adam wondered about the type of person who would be swayed to buy a lottery ticket by the display of such an advertisement. The crumpled-up remains of his lunch flew into the wastebasket, he imagined himself burying a three-pointer to bring the Wizards their first NBA title since the 1970s, and he got back on the road.

  It was murderously humid, the sky a hard blue, the kind of day that would fire up big thunderheads by dinnertime, scaring the beachgoers off the sand and into their cottages and condos, the ones with any sense anyway. Even on full blast, the air conditioning strained to keep the car cool, and he grew impatient, the little boy in him wondering when the hell they were going to get there already. Traffic was relatively light as he made his way southeast. The southern North Carolina beaches were still a relatively well-kept secret, and the easy access always made for a relaxing
start to a vacation.

  A little after five, he turned east off Route 17 and rolled past the vegetable stands and crumbling postwar ranch houses toward the coast. A few minutes later, the white causeway leading to the skinny island of Holden Beach arced up in Adam’s windshield. To the west, the sky had darkened, a line of purplish clouds with mayhem on the brain. They looked like a giant bruise on the sky, a harbinger of atmospheric violence to come.

  He stopped for groceries and supplies at the big store just before the causeway. Might as well get it out of the way, he thought. He bought steaks, chicken, ribs, sausage; he scoured the less-than-impressive produce aisle because after all that meat, he’d need something to keep the plumbing clear, he stocked up on chips and cookies and beer. As he made his way up and down the aisles, grabbing batteries and pancake mix and bacon, magical, delicious bacon, and whatever else his heart desired, his body loosened, his mind decelerated.

  His Explorer stocked with groceries, Adam climbed the causeway slowly, taking in the Atlantic Ocean ahead, gray and choppy on this summer afternoon. Humid air wafted through the open windows, the salty brine tickling his nose. He could hear the waves, the sound of the ocean, of this monolithic thing, forever there, and he could feel his blood pressure drop. Once he was on the island, he picked his way past the quaint post office, past the sign announcing TURTLE PATROL THURSDAY NIGHT 7 PM! before turning west along Ocean Boulevard.