by David Horne
“Yup,” Lawrence said.
Graham sighed and rubbed the bridge of his nose. “Bad news, Doc.”
Lawrence winced, his heart beating fast in his chest. “What do you mean bad news?”
“Well, the Hunter family, they—”
Lawrence shook his head, leaning forward to speak quietly to Graham. “He needs antibiotics, it's not an option for him not to have them.”
Graham sat back in his chair, setting his gaze right on Lawrence’s face. “Explain to me what's going on.”
“He has something called sepsis,” Lawrence said. “It's an infection that has gone into his bloodstream, and we are handling it at the clinic, but we can only do so much. We have to send him home with a course of antibiotics to really finish fighting it all.”
“Okay,” Graham said. “Talk me through the worst-case scenario.”
“If the infection gets worse, he's going to go into something called septic shock. The survival rate for that is only fifty percent. The kid isn’t even eighteen years old and I'm not going to let him die from this.”
“And what’s the best-case scenario?”
Lawrence blinked. “The infection is handled with the IV antibiotics,” he said. “Everything goes back to normal and the kid goes back to having a normal life.”
Graham sighed. “Look, if it were up to me, and if we had more resources, then I wouldn't mind giving him the antibiotics. Unfortunately, like I said, there is a limited supply of antibiotics for a large group of people. That’s the reason there is a certain amount allotted to every family per calendar year, and according to the system, he has used his.”
Lawrence took a deep breath. “The system is going to let a kid die if you don’t give him antibiotics.”
“Maybe,” Graham said. “You did say it was worst case scenario.”
“Antibiotics are used to prevent worst case scenarios, Graham,” Lawrence replied.
“Lawrence,” Graham said, using his first name for the very first time and sending a jolt up his spine. “I’m not trying to be difficult. I would help if I could, but we only have so many resources available. You're going to have to learn that those are the only resources available to you, because this island is small, and we only get a certain amount of aid per year. I mean, all sorts of aid, whether it’s antibiotics, bottled water, your salary, my salary… We have to make sure that everyone gets the medicine that they need.”
“Right,” Lawrence replied. “We need to give him this medicine.”
“I’m afraid that he's already had his medicine this year.”
Lawrence opened his mouth to try and articulate why that was wrong, but he could tell that Graham already knew that it was wrong. He knew that he sounded like he was pleading when he spoke again, but he didn’t even care. He was there for a reason and he wanted to make sure that what needed to be done was done. “Well, he didn't need it as much as he needs it now. This is serious, I wouldn't be talking to you about this if it wasn't.”
Graham sighed. “I know, and I wish I could help. Unfortunately, I can’t decide to take away someone else’s antibiotic just to give them to him because I want to be fair to anyone. What if someone else has sepsis?”
Lawrence sighed. “Please,” he said. “Just make this happen.”
“I’m not a magician, Dr. Jones.”
“A child needs medicine,” Lawrence said. “A child.”
“I know,” Graham replied. “And if it were up to me, he would have it. But if someone else needs medicine and I have taken that away from them, what does that make me?”
“Graham—”
“Stop,” Graham said, pinching the bridge of his nose. “Do you think that I want to deny a kid his medicine? Of course I don’t want this. But if I give him the antibiotics and I don’t give other people the antibiotics, then what do you think is going to happen?”
“He will live,” Lawrence replied angrily, his eyes narrow, as he stared down at Graham.
Graham looked sick, his skin pale with a newly acquired yellow undertone. “Lawrence, I’m trying—”
“If you were trying, you would be giving this kid antibiotics,” Lawrence spat out, his eyes narrow.
“Lawrence—”
“Thanks for the help,” Lawrence said, scraping the seat on the floor as he moved back. He turned around and walked back to the clinic, his fists clenched at his sides. He was shaking by the time he got back to the clinic. Outside the door, he took a deep breath and tried to calm down. He didn’t want his patients to see how upset he was coming back, so he took a little while to feel more grounded outside the door. He needed to find a way to sort this out. He wasn’t sure how to yet, but he had to.
Chapter Four
After he had seen a bunch of different patients, all of whom were relatively fine, with some minor bruises, a few colds, and general malaise, Lawrence went back to see Jimmy again. He was in the bed in the back, the one nearest to the fans, and he had a thin white sheet on top of his body. He was breathing fine and while Lawrence knew that the antibiotics would take a little while to work, he was also pleased that they were able to monitor him.
Karen was standing near Michelle, who had arrived when Lawrence was talking to Graham. They were talking to each other quietly until Karen caught Lawrence’s gaze and he beckoned her over with a hand gesture.
“Yes, Dr. Jones?”
“How long can we keep him in the clinic for?”
Karen looked at Jimmy. “We can keep him in as long as we don’t need his bed.”
“Okay,” Lawrence replied. “We’re going to try to keep him in for as long as we can, okay? Keep giving him the medicine.”
Karen nodded, tucking her curly black her behind her ear. “Graham didn’t help?”
Lawrence shook his head. “He tried, but there’s only so much he can do.”
“Yeah,” she replied. “I’m sorry. He really does care, but he has to be fair.”
When Lawrence spoke again, his voice was a whisper. “What if I buy them?”
“If you buy them, you’re going to have to start buying antibiotics for everyone,” Karen said.
Lawrence rubbed the bridge of his nose. “I don’t care about that. I’m going to do what I need to do.”
“Dr. Jones, with all due respect, you can’t start buying medicine for everyone,” Karen replied, her voice as quiet as his. “These people have to see you as a doctor, not as someone who will give them charity. You can’t give them the impression that you’re going to buy their medication for them too. You’re already helping them by diagnosing them and treating them.”
“Well, I’m not helping them by treating if they aren’t getting antibiotics, Karen,” Lawrence replied, trying to temper the anger in his voice. He knew that she was only trying to help, but he couldn’t help but feel annoyed at what she was telling him. After all, his commitment was to his patients, and he didn’t care that much about how people saw him. On the other hand, if Karen was right, and if they were going to start seeing him as a philanthropist instead of a doctor, that would be a problem when he was trying to diagnose them.
“Dr. Jones, there’s only so much you can do.”
Lawrence bit the inside of his mouth. “That’s right,” he said. “If you people keep getting in my way, there’s only so much I can do.”
***
Lawrence was sitting on a chair in front of his window, which was cracked open, and a book in his hand, stewing. He was still angry. The AC unit whirred loudly in the living room near him. He still felt a little sick and the small standing lamp nearby wasn’t making him feel any better. The light was bright and harsh, and his eyes were having a hard time adjusting. It somehow felt brighter inside than it did outside, even with the bright Caribbean sun hitting off the cement downstairs. Lawrence had always lived somewhere relatively cold, but the main difference was that it was overcast where he lived and he was used to not having to wear sunglasses whenever he went outside. He was getting used to the heat, which could b
e quite pleasant, but the brightness—his delicate blue eyes could hardly handle it. It didn’t help that he couldn’t concentrate on his book, either, running the events of the day in his head over and over again until he was breathless with anger. The idea that a child, one downstairs, would die because they didn’t have enough antibiotics, he couldn’t even contemplate it.
It was getting dark outside and Lawrence wasn’t sure when the pharmacy opened or closed. He didn’t want to be seen and he was sure that the locals were going to notice him. He tried his best to remain unseen, but he was tall and he looked different from everyone else on the island. His best hope was that he would be confused for Graham. Lawrence didn’t even want to think of Graham right then, he was so angry with what he had told him earlier. He had tried to understand it, he really had, but he was struggling to believe that Jimmy Hunter would be left to die because of bureaucracy. Lawrence wasn’t naive, he knew that it happened, but he had never had to deal with it like this before. His dad’s practice was handled by his mother and as the administrative assistant, she was the one who dealt with all the insurance claims and the patients’ payment plans. It was a hard, stressful job, but his mother was great at it and Lawrence couldn’t help but miss her when he was there. He knew that she would find some sort of solution to his problem.
His mother, of course. He didn’t know why it hadn’t occurred to him to call her. He had already emailed her to let her know that he had arrived safe and sound, that he still hadn’t been bitten by any deadly mosquitos and that no one had stolen his wallet yet. So far, Lawrence had told her, he had managed to avoid pirates, but he couldn’t promise her that he would steer clear of them since they seemed quite cool and Lawrence had always wanted to be a pirate anyway. His mother had thought it was funny, but Lawrence could tell that she was still worried.
He opened his laptop, booted up his social media and checked that she was online. She was a couple of hours behind him, so he didn’t want to call her when she was busy, and his mother was an exceptionally busy person. He messaged her before he called her, trying to make sure that she was available, and then went to make himself a snack. He got back to his laptop, a plateful of crackers and cheese, a tall glass of orange juice and checked the message that his mother had sent. She had some time to talk before she went to a church meeting and Lawrence smiled at how quickly she had replied.
He called her immediately. She answered straight away, the camera pointed at her chin.
“Hey, Mom,” he said, trying his best to hold back a snicker. “Move the camera down.”
She laughed, moving the camera down. He smiled when he saw her face. Lawrence had often heard that he looked exactly like his mother, but he didn’t see it. He had his father’s build, slim and tall, but he’d inherited his mother’s wide blue eyes, her long black eyelashes, her marked cheekbones and her slightly turned up nose. On him, these features looked ridiculous, but his mother was a sophisticated woman, known in their city for her beauty. Unfortunately, Lawrence had been on the receiving end of many tales about how hard it was for people to court her and how lucky his father was.
“Hello, honey,” his mother said. “How is the Caribbean?”
“It’s… an adjustment,” Lawrence replied. “I mean, I didn’t expect it to be the same when I got here, y’know? But a lot of it is triage, and they don’t have as many resources as I thought they would. It makes medicine hard.”
She nodded. “You look upset.”
Lawrence licked his lips. “I am upset. There’s this fifteen-year-old kid with sepsis and we might not be able to give antibiotics.”
She winced. Lawrence’s mother wasn’t a doctor—her job was almost entirely administration related—but she was smart and she was surrounded by doctors, since her husband and both of her children practiced medicine, so she had picked up plenty of medical knowledge through the years. She knew how serious it was the moment that he said it.
“Oh, no. And there’s nothing that can be done?”
Lawrence took a deep breath, pinching the bridge of his nose. “I don't know. I was hoping you could help me out.”
She narrowed her eyes. “Okay, tell me what's going on.”
Lawrence sighed, took a deep breath, took a sip of his juice and then he did. He spent about twenty minutes telling her everything that had happened on his first day, including what Graham had said. By the time he was done, he felt like he was on the edge of tears again. His mother had been taking notes while he had been talking, something that he only noticed once he was almost done with his tale, and he was far too into the story that he was telling to really question her about it.
She tutted once Lawrence was all done. “I hate to say I told you so, but sweetheart, this is why I told you about Médecins Sans Frontières. The process would be a lot more structured, and you would have less to do with the clerical side of things.”
“I know, Mom, but they needed a doctor here,” Lawrence quietly replied. “And what kind of doctor would I be if I had turned them down? What kind of man?”
She sighed. “You’re right. Of course you are. You have to do what you can. Listen, let me make a couple of calls. My friend Lydia Wheeler manages some of the disaster relief funding for a few charities here, and she might be able to send some more money your way soon.”
Lawrence licked his lips. “I mean, I wouldn’t say no to more aid, but none of that helps Jimmy Hunter right now and he’s my immediate problem.”
“I can find a way to get in touch with Graham’s boss,” she replied after a little while. “What did you say his last name was?”
“I didn’t,” Lawrence replied. “And I don’t want to get him in trouble, Mom. I know that he’s just doing his job. But I do need to find a way to treat this boy.”
“Okay,” she said. “Well, the Jones practice still has some income to donate this year… I could move a couple of things, send it over to your pharmacy, make sure that you get the medicine tomorrow. You’ll need to write me an impassioned email about it, so that I can put it in our records. You think you can do that? And don’t just focus on Jimmy Hunter, but on everyone else, too. We’ll definitely be able to send at least a few grand, but you might want to ask Graham for help. He’ll be used to writing these kinds of letters.”
“I don’t want to ask Graham for anything,” Lawrence replied in a quiet voice.
“You’re the one who said he was only doing his job,” his mom said. “Anyway, sweetheart, get this done as soon as you can so I can help you.”
“Thank you, Mom,” Lawrence said, tears welling up in his eyes as he thought about Jimmy downstairs. “You’re the best.”
“I am, and don’t you forget it,” she replied. “Seriously, ask him for help.”
“Okay,” Lawrence said. “I will.”
Once he was done eating his snacks and thinking about what his mother had said, Lawrence made his way downstairs. The sun wasn’t out anymore and it was okay weather to take a walk. It was going to be humid out and he didn’t have to look professional, so he grabbed the closest black shirt that he could find, one that clung to his body, and knee length shorts. He wasn’t going to be out for too long, he just wanted to go outside, gather his thoughts, and then go back to Graham once he had calmed down a little. Talking to his mom had calmed him down slightly, but when he went downstairs and peered into the clinic—the second nurse was there, a slightly underweight man with a scruffy beard and an affable smile—he looked at Jimmy Hunter and his blood started to boil again.
He didn’t like the idea that he had to call his parents for help, but it wasn’t about him. It was about little Jimmy, who might have died without their assistance. He knew that he would have to eventually confront Graham. Not just confront him, ask him for help. Right then, though, the very idea of seeing him made him dizzy with anger. He knew that he shouldn’t—that he couldn’t—blame Graham for simply doing his job, but at the same time, the tangible results of his neglect were a person’s life. Not just a person,
but a child. Lawrence could hardly wrap his head around that. He was walking toward the pharmacy. He figured that he would be able to find the pharmacist around there and let them know about the upcoming donation. Plus, there was also the fact that he should be chummy with the pharmacist. The pharmacist was the person who could give patients samples and they were also someone that Lawrence knew that he would have to influence eventually.
The pharmacy was on the other side of town, but the town was small and the walk there couldn’t have been longer than ten minutes. It would have been even shorter, but people kept stopping him to greet him or to tell him how happy it was that he was there. Everyone was really nice and Lawrence felt like the popular kid, which was a little weird. He appreciated it, though. He had left his apartment feeling like he didn’t want to be seen, but this was a different kind of response than he had expected. Genuine appreciation from the community made Lawrence feel like he had made the right decision when he had decided to come to this island. He knew that it was a controversial decision when he had taken it, he knew that his father wouldn’t approve—but his mother had talked to his father about it and he had finally and begrudgingly approved.
In theory, Lawrence was an adult, a fully-independent one who didn’t need his father’s approval. But the truth was a lot more complicated than that. Lawrence wouldn’t have a job if it weren’t for his father, never mind an education full stop. Lawrence understood that he was privileged, but he never took it for granted. His parents made sure that he and his sister had grown up going to places where people who were less lucky than they were could go. Lawrence had always been passionate about volunteering. He wanted to make the world a better place and he knew that he could do that if he became a doctor. His father’s practice influenced him when he was choosing what kind of doctor to be, but he had always wanted to work exclusively in a burn unit. It wasn’t going to happen for him, not until he paid off all of his student loans, and he needed to get away from his father and his family. That was partly why he had chosen the Caribbean instead of somewhere close to Europe—because no matter how much he wanted to spend some time by himself, if he had chosen a country that was close to Europe, he would have been expected to vacation with them at the very least. The last thing on Lawrence’s mind was a vacation, though. He wanted to have a few days of fulfilling self-sacrifice, ones that he could look back to and think that they had made him a better doctor and, in general, a better human being.