Thursday Afternoons Page 6

  Erin. Right, she’s the mom of a toddler, so this case won’t be easy for her. She’s already pale and her voice trembles when she asks Amy questions. Amy places a steady hand on her forearm. “This kid needs our help, okay? We need to be at our best today, because we’re all he’s got right now. Focus on what we can do, not on what we can’t do.”

  His name is Jeffrey. He’s unconscious, and Dr. Connors is in the process of placing a tube down the boy’s throat, which will be connected to a ventilator. Amy takes a turn listening to the patient’s lungs—breath sounds on both sides, which is good. But his blood pressure is low and his pulse fast and thready. He looks so small. And so pale. Like he’s waiting to die. Connors gives her the slightest shake of his head. He doesn’t think the boy will make it, and Amy can’t disagree. But they’re not giving up.

  “Have you alerted University?” she asks Connors. University Hospital - London Health Sciences Center has the expertise and the equipment to give the boy a fighting chance. Connors nods, says the medevac helicopter team has been placed on standby, but they won’t make the trip here and transfer Jeffrey until he’s stable.

  Abby carefully examines the child’s head. There’s a small entry wound on one side, a much larger exit wound on the opposite side. Each hole oozes a darky, gooey substance that is blood and brain matter and bone. Shit. She pinches the skin on the boy’s chest to see if he reacts. Nothing. Next, she lifts each eyelid, shines her pen light in each eye. There’s no reaction. Double shit.

  “CT is ready for him.” It’s Amy’s friend Kate, who has answered the all-hands-on-deck code and come to help.

  Amy, Connors, Erin, Kate, and another nurse rush the bed to diagnostics, where the CT scanner resides, then step out to let the technicians do their job. Jeffrey looks so vulnerable, so tiny, Amy thinks as she watches through a window. If she had to operate, she could, but it’s a neuro case and a pediatric one at that. Her ego is healthy enough, but she’s a realist, and she understands that the kid’s best chance of survival does not lie with her. She’ll do everything she can to help stabilize him, and if he doesn’t make it, she knows she’ll still find a way to blame herself. She’s not one of those surgeons who can file away every unsuccessful case, who can move on simply by propelling herself onto the next case and the next and the next. She’ll mull over every tiny detail for days, examining what she might have done differently, what she could have and should have done differently. It’s always been her way.

  For now, though, there’s a kid fighting for his life. As his scan images start popping up on the computer monitor, she can see bullet and bone fragments traversing the brain from side to side. Not good, but not the absolute worst she’s ever seen, though she’s only ever seen adults with gunshot wounds to the head, not kids. She explains to Erin, Erin who’s clearly struggling to keep her composure, what they’re looking at.

  Kate tugs on Amy’s sleeve. “The helicopter’s grounded now because of the storm coming in.”

  “What storm?” Amy says absently. She’s so focused on the patient that she’s momentarily forgotten what day it is, let alone the weather.

  “A bad storm’s minutes away. Coming in off the lake.”

  Connors says the neurosurgeon from London is on the phone and wants to speak with her. He’s already seen the scans, thanks to a secure network between hospitals across the province, where doctors can tap into patients’ test results in a matter of seconds, no matter which hospital they’re in.

  “You’re going to have to do it, Dr. Spencer,” the neurosurgeon says flatly. “This isn’t going to wait a few hours. I’ll be on speaker and I can walk you through it.”

  Amy swallows against her dry throat, against the momentary rise of panic in her chest. The boy’s vitals are worsening—his oxygen saturation level is dropping and so is his blood pressure. The London doc is right. Jeffrey won’t survive a land transfer and can’t wait for the helicopter to be cleared. “All right,” she says into the phone and motions to Erin that she’ll be scrubbing in. Erin looks like she wants to flee, but she doesn’t. Extra points to the young resident for hanging in there.

  Twenty minutes later, scrubbed and prepped, it’s Go Time for Amy, Connors, Erin, Kate, an anesthesiologist, and an OR technician. The London surgeon remains on speakerphone, telling them that the situation is extremely grim, that generally speaking gunshot wounds that cross the midline of the brain are almost always lethal. But he adds that it’s a small caliber bullet, and since the boy is so young, his chances of survival are better than most. Treatment has to be aggressive, he cautions. Amy isn’t afraid of being aggressive.

  For the next two hours, she carefully removes portions of the boy’s skull on both the left and right sides, then meticulously removes the tiny burned and pulverized bits of irreversibly damaged brain tissue. She irrigates the bullet’s path with saline solution, thinks how surreal it is as she watches the liquid pour out the exit wound.

  “Doing okay?” she says to Erin, who’s even paler than she was a half hour ago.

  Erin nods. “What happens next, Dr. Spencer?”

  The boy’s brain is extremely swollen and angry looking, given the trauma it’s sustained and continues to sustain from Amy’s instruments. It looks like rising bread that’s expanded beyond its bony confines. “We won’t get the pieces of skull back on for some time. Not until the swelling is gone.”

  Kate whispers close to her, “Good job, Doc. He’s a tough kid.”

  Amy passes her friend a look that says “I hope it’s enough.” Hope is always the final tool in her tool kit, after she’s exhausted everything else.

  An hour later, Amy sags against a stairwell wall, the cinder block rough against her thin cotton scrubs. She wipes her sweaty forehead, cheeks, with the back of her hand. It’s up to the boy now, or some divine being, if he’s to survive. She tells herself this but doesn’t entirely believe it. There’s always something else that could have, should have been done. Had they dithered too long deciding whether to transfer him or keep him here? Had she excised too much brain tissue? Not enough? Nicked something she shouldn’t have? Taken too long in the OR, where his exposed brain might have picked up an infection? And if Jeffrey does survive, how much function will he regain?

  In an instant, she’s back into that rabbit hole of guilt and uncertainty and self-flagellation that she learned so well—too well—from her years with Lisa. She can still remember how, blind with exhaustion from the endless hours of studying, she’d help Lisa study, because Lisa would have probably—no, definitely—bombed out of med school much sooner without the crutch of Amy there to help her. There were times she’d beg Lisa to get off the couch and see a counselor when depression and inertia kept her there for days. Hiding Lisa’s liquor bottles, flushing her pot down the toilet and whatever else she was using to self-medicate. Taking notes for her when she couldn’t drag herself to class. But nothing worked for very long, and so Amy would aim higher, vow to do more—sacrificing sleep, sacrificing friendships, shutting everything out but Lisa and her own school work. But nothing seemed to halt Lisa’s spiraling or Amy’s quiet desperation. Mental illness doesn’t fight fair—it’s a hell of an opponent and one Amy wishes she’d never had to go up against. She vividly remembers the day she decided she could no longer be with Lisa. She literally woke up one morning and couldn’t move, could barely breathe, just lay there curled up like a bean as she saw herself becoming a carbon copy of Lisa. Saw her dreams of becoming a doctor going quickly down the toilet. It scared her so badly that when she could finally get up, she called Lisa’s parents and asked them to come get her. And they did, all the way from the west coast. It was the last time she ever saw Lisa.

  Until then, Amy had never quit anything. Her problem, she knows all too well, is that she doesn’t know when it’s time to stop trying. When it’s time to pull the plug.

  * * *

  Ellis sits down at her desk for the first time all day and pulls up a house rental website. She was told in a m
eeting this morning that as her project becomes more intense over the next few months, more of her time will have to be spent in a small town on Lake Erie, almost an hour’s drive away. And while she could simply keep residing at her rental apartment in Windsor, the idea of a nearly two-hour round-trip commute each day, on top of long work hours and on-site meetings, is less than ideal. Moving certainly won’t be as convenient for making her Thursday afternoons at the hotel with Abby. Hell, that should be the last thing on her mind, but it isn’t. Spending a couple of hours in bed with Abby once a week has become her week’s highlight, the thing that keeps her sane or at least her stress levels manageable. It’s been the one thing she looks forward to. No matter what she has to do, she will keep those appointments with Amy. Or as many of them as she humanly can.

  Her cell phone chirps. She decides to ignore it until she glances at the screen to see who’s calling. It’s Marjorie Hutton, Mia’s grandmother. Shit, now what? she wonders with only a modicum of patience. Then she remembers they still haven’t resolved the issue of who Mia will be staying with this summer.

  “Hello, Marjorie,” she says into the phone. “How are you? Is something wrong?”

  “Something’s wrong, all right.” Marjorie’s voice is pitched with exasperation, a breath away from tears.

  “Oh no, is Mia okay?” What the hell has that kid done now?

  “No, Ellis, she is not okay. We’re at the police station. She’s been arrested.”

  Aw fuck. Immediately, she thinks it must be the pot Mia’s been caught with. “What happened?”

  “Shoplifting. A leather bracelet or something and some other stuff. Plus…she had a joint in her pocket, Ellis. A joint, for God’s sake. Marijuana!”

  “Is she being charged?”

  “I…yes, but the police seem to think that because of her age, there’s some sort of diversionary program so she won’t end up with a record. Ellis…” She can hear Marjorie suck in a deep, ragged breath before whispering frantically into the phone. “We need your help. Please. We don’t know what else to do. You’ve got to help us.”

  “I understand, Marjorie.” Goddammit. Of course Mia has done something to draw attention to herself, to cry out for help. The kid is a mess and probably in much more need than Ellis and certainly the Huttons can give her. Ellis’s first urge is to run away. Again. Use her career as an excuse. Like always. To say she’s sorry but she can’t help.

  Before she can utter a refusal, she pauses to wonder what Nancy would do in this situation. Nancy, who doted on Mia, who protected her and sheltered her and loved her. They both had, in the three years Ellis was part of their lives. She remembers how Mia would reach for her hand before crossing a street. How Mia wanted Ellis, and not her mother, to teach her how to ride a bike. It’d nearly cut her in two the day she explained to Mia that she had to leave, that her mother and she couldn’t be together anymore. Six-year-old Mia had cried and cried and then refused to speak to Ellis ever again.

  Ellis knows she’s being a coward and that she’s scared. But Mia doesn’t have her mother anymore, and her grandparents are most definitely in over their heads. If she doesn’t at least try, Mia will surely end up on the trash heap of lost causes—she’s well on her way to it now. “What do you need me to do?”

  “Will you come with us before the judge next week?”

  “Yes. Absolutely.” She’ll figure out a way to clear her schedule.

  “And…”

  “Yes?”

  “Ellis, we really need you to take her for the summer.” Marjorie’s voice hitches. “We…it’s too much for us.”

  Well, Ellis thinks, at least’s it out in the open now, the fact that Mia’s grandparents are abandoning her, too, for the summer at least, and that Ellis is the girl’s only recourse. She wants to protest, to say she didn’t sign up for this, but instead she sighs in resignation. She may have walked out on Nancy—and Mia—all those years ago, but she won’t walk away this time. Walking away is getting damned exhausting. “All right, Marjorie. All right. Text me when you know more.”

  Chapter Seven

  “I’m so very sorry, ma’am, but there’s a plumbing issue on the ninth floor and we’ve had to evacuate everyone.”

  Oh please no, no, no, Amy thinks. Not on a Thursday afternoon. She needs this today, needs this pleasurable escape more than she’s needed it at any time in the last three weeks. “Um, I’ll take another room on a different floor please,” she tells the desk clerk, who frowns immediately and shakes his head.

  “I’m afraid we don’t have any other free rooms right now. There’s a big convention in town. But you’re welcome to wait. It shouldn’t be more than an hour. Ninety minutes at the most.”

  What if Ellen can’t hang around and wait that long? And if she does, what are they going to do while they’re waiting? Knit? Play Scrabble? Have a long, personal heart-to-heart? Absolutely not. “Thanks,” she says to the desk clerk. “I’ll let you know what I decide.” It’s unreasonable, this sudden melancholy over events beyond her control, but it pulls her down like an invisible weight.

  She wanders over to the waiting area in the lobby, where she can watch for Ellen. Maybe it’s a sign that this whole thing—the weekly trysts—is a bad idea. No, wait. She’s a science geek who doesn’t believe in signs and all that voodoo. The plumbing issue is a small complication, that’s all. And even if Ellen doesn’t want to wait around in the lobby until the room is ready, maybe they can get a quick drink or go for a walk—without conversation straying too far into the personal. There must be something amusing or entertaining or interesting they could talk about, because strangely enough, Amy finds herself wanting to spend more time with Ellen, and not just in bed. Wow, that’s new. Seeing Ellen outside of a bedroom? Her palms turn clammy at the prospect, but there’s something exciting about it too.

  Before she can obsess over it any further, Ellen walks into the lobby, her thick, wavy hair flowing past her shoulders. Her posture is perfectly straight, her stride purposeful. Amy’s gaze drifts down to her long and shapely legs, and she is instantly reminded of how they feel wrapped around her. Ellen, as usual, is dressed impeccably. Tan Capri pants and a silky, short-sleeved blouse capped at the shoulders that perfectly matches the dark mint of her eyes. She’s wearing onyx earrings and a slim, white gold watch that says she’s a woman who likes nice things, but isn’t a showoff.

  Amy drinks her lover in, basks in the vision that is Ellen. Just looking at her makes her feel good. She knows she shouldn’t, but she lets herself momentarily indulge in the fantasy that Ellen is her actual girlfriend. She draws in a long, slow, deep breath and is shocked by the unexpected jumble of emotions. For a single moment, she wants to be in that place again with a woman where there are no pretensions. No pretending. That place where she can be herself, where she can let everything out—fear, joy, frustration, her dreams, her disappointments—without fear of censure or condemnation or even disinterest. That place where she can be accepted, loved, protected, understood, known. If there ever is a next time, it’ll have to be with someone who’s an equal, who’s every bit as strong as Amy, who’s happy to take her share of the load. Months of counseling after ending it with Lisa had taught her that much, except she’s never been brave enough to actually look for such a woman. Do they exist?

  Ellen sees her, smiles, and strides over. “Hi! Everything okay?”

  Amy explains the situation, and Ellen’s look of disappointment heartens her, because she can’t bear Ellen turning around and walking out like it’s no big deal. She suggests a drink in the hotel bar, and Ellen goes for it, making Amy smile for the first time in hours.

  Heads turn in their direction as they take a seat in a corner booth. They’re looking at Ellen, Amy knows, although she supposes her own height of almost six feet is partly the reason. In her scrubs or with a stethoscope around her neck, she’s used to people looking at her. Looking to her. It’s in a hospital that she’s most comfortable, most confident, most assured of her
authority and her abilities. Out in the civilian world, she’s never been accustomed to being the center of attention and prefers the refuge of anonymity. She’s glad Ellen is next to her. Ellen, whom the spotlight seems to so effortlessly find and to whom anonymity is probably foreign.

  The server asks them what they’d like to drink. Amy orders a glass of Chablis, while Ellen says she’s feeling a little adventurous and orders a cosmopolitan.

  The way she says “adventurous” and the way her eyes sparkle like sunshine dancing on a mountain river make Amy’s heart skip a beat. There are freckles, very faint ones, sprinkled across her nose in a random pattern. They’re cute. They’re adventurous. So is the faint scar near her eyebrow. In combination, they make Amy want to get to know this woman, really get to know her. How did she acquire that scar? And did she always have freckles? She doesn’t even know Ellen’s actual name. And she wants to know, but she won’t risk jeopardizing what they have. Honesty is too risky for them. Honesty might lead Amy out onto that limb that so terrifies the crap out of her.

  “So,” Ellen says. “How was your week?”