The White Coat Diaries, page 17
“Damn! You’re good. That wasn’t as bad as I thought,” the man says. He wipes the corners of his eyes. One would never guess that the patient, sixty-five and tawny with barely a wrinkle, has stage-four renal cancer if it wasn’t for the fact that he’s lost his hair and, therefore, has no eyebrows. Stuart presses a square of gauze over the man’s wrist. His pager sounds, and he frowns in my direction. “It’s Francesca. Gotta run. Can you hold pressure?”
We’ve been trained that, after puncturing a patient’s artery, pressure should be held over the site for at least two minutes. “Sure. Thanks, Stuart,” I say, taking his place at the bedside. Stuart waves and is gone, and I can’t help but feel decidedly inadequate compared to him. He makes everything look so easy.
The patient interrupts my thoughts. “Let me ask you something, Doc.”
“Sure, okay. Ask away.” I smile down at him.
“This chemo I’m on”—he points to the IV bag dangling from the pole next to the bed—“you know anything about it?”
“I’ve read about it.”
“And you’ve read my chart?”
I nod.
“So, what are my chances of getting better?”
“Well, there’s a study in the New England Journal,” I say, proud to have some useful, current information. I might be developing some sort of phobia of needles, but I can still memorize facts just as well as Stuart can. “It just came out six months ago. It says that, for your type of kidney cancer, with the treatment you’re having, the average five-year survival is forty-five percent.”
“Forty-five?” the patient says. He takes a long breath. Then he says slowly, “You mean to tell me that I’m going through all this—the tubes, throwing up, peeing in a bag—for worse odds than flipping a coin?”
I hesitate. I hadn’t anticipated that sharing this information would upset him. “I can get you a copy of the article . . . ,” I say, my voice trailing off.
“Why didn’t anyone tell me? Why didn’t my doctor, Dr. Portnoy, tell me this?”
“I don’t . . . I’m not sure,” I say.
“Do you know when Dr. Portnoy told me I had cancer, he just said the word ‘cancer’ and left the room?” The man’s face reddens. “He had his student, the resident or whatever, explain the treatment to me. Can you believe that? That made me furious. I know the guy’s supposed to be the best, but he’s an ass when it comes to bedside manner.”
“I know he can come off a little uncaring,” I say, trying to course correct, “but he’s really a great doctor. You’re in excellent hands. And we can help you with the side effects of the chemo.”
The patient shakes his head and indicates his surroundings. “This isn’t what I want. This isn’t living. You’re barely human in here. And I think, according to your study, that I’ve been in this goddamn hospital for three weeks when I should have been at home enjoying what quality of life I have left.”
“I just . . . know what the study says,” I reply, shifting uncomfortably.
The patient says nothing for a moment. Then, he extends his hand. “What was your name again, Doc?”
“Kapadia.”
“Thank you, Dr. Kapadia. And I think I would like a copy of that article.”
* * *
* * *
My pager sounds later that morning, just after I’ve poured milk over my cereal. A resident at another table smiles at me sympathetically, shrugging her shoulders as if to say, Isn’t that always the way? I cram as many Frosted Flakes into my mouth as possible while dialing the callback number from the wall phone in the cafeteria.
“We have another patient who fell out of bed,” the nurse on the other end says.
I groan. “How many does that make since yesterday?”
Her voice weary, the nurse says with a sigh, “Six. Although this is a repeat offender.”
Rounding a corner on the Oncology floor five minutes later, I see Clark, standing before an audience of nubile student nurses, dip his pinky into a stool sample and taste it as if it were a bit of exotic caviar. I smirk as the girls erupt in shrieks of horror. Clark’s melted-chocolate-looks-like-stool routine never fails to cheer me up.
It’s 9:45 a.m., and my weekend call shift is almost over. Only fifteen more minutes.
I enter a room to find the Tallys with their arms crossed, glaring.
“Why are there so many electrical cords in here? She could have broken a bone!” Mr. Tally says. I’ve stopped expecting from him the formal greeting that accompanies most normal human interaction.
“Mrs. Tally, once again, you are not supposed to get out of bed,” I say. “The nurse reviewed the falls precautions with you, right?”
Mrs. Tally sighs in frustration, folding and unfolding the bedsheet on top of her. “Yes, she did, practically a hundred times. But how am I supposed to go to the bathroom?”
“You ring the call button and your nurse will take you,” I say.
“I don’t want to bother someone every time I need to use the hopper. I birthed four children; I pee all the time.” She offers her arm. “It’s just a scrape.”
“Your chemotherapy is affecting the nerves in your feet that control your balance. Relax your arm for me.” I flex and extend her elbow and press into the springy fat of her forearm. “Does this hurt? No? Good. Call your nurse next time. I promise they won’t mind.”
“Oh, okay, okay,” she says, her eyes on the television high on the far wall.
I hurriedly scribble in the chart Called to see patient status post fall out of bed with complaint of left upper limb trauma. Patient examined. No tenderness to palpation of the limb. Full range of motion. I sign my name and note the time, then head for the elevator. Just as the door is sliding shut, a hand appears to stop it. Mr. Tally steps inside and turns to face forward, his hands clasped over his abdomen.
“Cafeteria?” I say.
He nods. I push the “2” button and notice a text message from Ethan: Movie today?
I grin and struggle briefly to compose a clever reply before finally typing: Sure. Where? When?
Matinee? Ritz? They’re showing some old movie, he sends back. The elevator lurches. Mr. Tally has pushed the Emergency button and we are stopped between floors. I glance at him, my pulse quickening.
“No one in this place gives you a straight answer,” he says, his eyes on the floor. I reach into my pocket to arm myself with keys. I wish I still had that mini pepper spray key chain Ma gave me when I went to college.
“Doc, I need to know. Is my wife going to die?” Shoulders sagging, eyebrows overgrown, and a button-down shirt that barely closes over his rotund midsection, he is harmless, I realize.
“She’s in excellent hands,” I say brightly.
“But what she has, it’s very dangerous, right?”
“Oh, she has one of the most treatable forms of lung cancer, and Dr. Portnoy is the best oncologist in the country. She’s going to be fine.”
“What will she be like after all this? The side effects of the chemo, I’ve heard, can last forever. She’s losing her balance, and her personality. . . . She’s so depressed. Will she be the woman I married? I’m already losing her, bit by bit.”
“Well, it’s best to take this sort of thing one day at a time,” I say, reaching past him to push the Emergency button, starting the elevator moving again. “But I can order a Psychiatry consult for her. They can help her with the depression.” The doors slide open on the second floor, and he steps out.
“Okay, sure. That may help. Sorry I stopped the elevator. Thanks, Doc.”
I wonder momentarily if I should get out, too, offer to sit with him for coffee. I sense he himself could use someone to talk to. But I’m exhausted, and I remember what Ethan said about the importance of having boundaries. So instead I smile, nod, and press the button for the ground floor.
Sure! See you there! I text to Ethan as I cross the towering, sunny lobby lined on either side by leather armchairs and pass under a sprawling fresco of Hippocrates swearing his oath painted over the threshold.
* * *
* * *
“So, he just stopped the elevator? Without any explanation?”
We are the lone patrons at the Sunday 11:45 a.m. showing of Casablanca. On the screen, Rick and Ilsa drive through Paris in a montage of pre–World War II reverie.
“Yeah, but it wasn’t creepy or anything,” I say, yawning. “Not really.”
He reaches into the box of popcorn on my lap. “That guy’s a prick. Everything’s your fault, no matter what.” He scrunches his forehead and says in a gruff voice, “‘The TV’s not working and I’m constipated. And you call yourself a doctor!’”
I laugh so hard I snort. I am both startled and ashamed. Ethan grins.
“I can’t take you anywhere.” He puts his hand on my knee, and an effervescent rush of butterflies shoots through my body and out the tips of my fingers and toes, taking my fatigue with it. His warm breath on my bare shoulder draws me toward him. As his lips move toward mine, I am vaguely aware of the box of popcorn slipping from my grasp, spilling kernels all over the floor.
It’s curious that a culture that created the Kama Sutra is so buttoned up about sex. If you asked Ma if she would rather that one of her children engaged in premarital sex versus became a cocaine addict, she’d struggle to choose the lesser of the evils. Sex is so taboo a topic in my family, it was simply never spoken of, in any way, by anyone. If it came up on a television show, Ma immediately switched the channel. If I insisted on asking where babies came from and wasn’t satisfied that they came from God or were delivered via FedEx, she sent me to my room. Ma wasn’t only actively discouraging me from learning anything about sex, she was trying to fashion a reality in which it didn’t exist.
I was twelve before the mechanics of human reproduction suddenly became clear to me while watching an animated video in Health class titled Sexual Intercourse: It’s a Natural Thing to Do! A cartoon man inserted his penis into a cartoon woman’s vagina, and I was so horrified that I wrote a strongly worded letter of complaint to the principal that I never worked up the nerve to send.
In medical school, the Reproductive Physiology course—which I, admittedly, found fascinating—covered, among other topics, genital anatomy, the microbiology of sperm, venereal diseases, and the landmark 1957 study by the gynecologist William Masters and his research assistant, Virginia Johnson. Masters and Johnson were the first to identify and name the four phases of the human sexual response cycle—excitement, plateau, orgasm, and resolution—and the changes in heart rate and blood pressure that occur with each. Their research techniques were unorthodox and included randomly pairing volunteers into “assigned couples” and observing them having intercourse in a laboratory. They were scientific visionaries, trailblazers in a burgeoning field. They were also, in my opinion, abjectly perverted.
Personally, I can barely stand to look at the word “Sex!” printed on seemingly every magazine cover in the grocery checkout aisle (“How to have great sex! Also, recipes for cheesecake!”). My prudence is deeply rooted, my id squashed firmly under the thumb of thousands of years of Indian tradition and disapproving, tongue-clicking aunties.
But kissing. There’s something unexpectedly freeing about kissing. The thumbs and the aunties disappear, and I estimate I could make out with Ethan in this empty movie theater, Humphrey Bogart’s voice in the background, my heart pounding in my ears, our arms and legs and lips intertwined, for hours, days, maybe forever. At a paltry one hour and forty-two minutes, Casablanca is far too short. Suddenly, the credits are rolling and Ethan breaks our embrace and murmurs into my ear, “Want to come over to my place?”
We hold hands, walk fast, and say nothing. I tell myself to calm down. Humans, after all, have been engaging in sexual intercourse since, literally, the origin of our species. Entire civilizations have been launched solely because two people decided to comingle their genitalia. Which, when I look at it that way, underscores the fact that sex is both critical to the survival of mankind and, at the same time, no big deal. I should stop overthinking this. Confident and breezy. Fun and spontaneous. I’m that uninhibited girl in country songs who dances on the roof of the hunky singer’s pickup truck in the rain in cutoff shorts. Country songs love that girl. Everyone loves that girl. I mean, she’s obviously someone who doesn’t make decisions with personal safety in mind, and she might have a problem with impulse control but, regardless, they write songs about her. No one writes songs about people like me, virginal twenty-six-year-old risk-averse nerds with closets full of yoga pants.
What I’m feeling—heart skipping, breath fast, skin flushed—is, obviously, the result of a raucous jumble of emotionally triggered neurotransmitters and hormones bombarding my nerve endings. I don’t think I’ve ever felt anything this intensely before. And I don’t want it to end.
It’s fourteen floors up to Ethan’s apartment. I follow him into the elevator. He smiles and kisses my hair. I push the button for the fourteenth floor. The doors slide shut, we rise, and without looking back, I leave the old me behind.
CHAPTER ELEVEN
It’s ironic. I’ve spent the better part of the last decade studying the human body, dissecting it, poring over diagrams of it, memorizing the names of every crook, divot, and fleshy hanging nubbin of it, yet I’m still so uncomfortable being naked. I get dressed immediately.
“You’re not leaving?” Ethan asks from the other side of the bed.
I freeze. “Um . . . did you want me to leave?”
He laughs. “Of course not.” He glances at his watch. “I mean, I have to go in to work at five, but I thought I’d order us some Chinese and we could hang out.” He folds his arms under his head and looks at the ceiling. His clothes are in a pile on the nightstand. “You’re probably the coolest girl I’ve ever met, do you know that?”
I grin. Poor Jeremy Corkie from sixth grade is somewhere right now, probably eating a sandwich that doesn’t belong to him, with no idea that he once rejected this insanely cool girl. “You’re cool, too,” I say, then cringe inwardly at how awkward that sounds. I sit on the edge of the bed.
“This might sound weird,” Ethan says, lifting his head off the pillow, “but can I just ask: Have you had a lot of experience with . . . this sort of thing?”
I clear my throat. “Um, you know, ‘a lot’ is a relative term.” Good lord, how would he react if I told him he just took my virginity? I imagine him leaping out of bed and running, naked and horrified, from the room. “I’ve had some experience, you could say.” Was it that obvious? I’ve studied the anatomy and physiology enough to know how it should go, but what if I somehow got it all wrong?
Ethan raises his eyebrows and smiles. “So, are the rumors true?”
“Rumors?”
“You know, about you and Clark?”
I hesitate, sensing an opportunity to cast myself in a less naïve light. Having an on-again, off-again relationship with a fellow resident is just the type of thing a spontaneous, non–socially awkward woman would do. “Well, actually, that rumor might be true. But that’s all I’m going to say about it.” Leave a little mystery. That’s what they say, right?
Grinning, Ethan reaches over and slips my glasses off the bridge of my nose. Everything around me dissolves into blurry background, leaving only his smiling face in focus. “Dr. Shocks-a-lot, you are nothing like what I expected when I first met you.” He kisses my neck, and I surrender to a dizzy, delicious haze before I can wonder what exactly he means.
* * *
* * *
As afternoon turns to evening, we finish off the Chinese food, taking turns reaching our chopsticks into each other’s takeout containers.
“Someday we should watch the rest of that movie,” Ethan says.
“You’ve never seen Casablanca?” I crack open a fortune cookie.
He stands at the refrigerator, staring at the mostly bare shelves. “Not until today. I wish I’d known you were coming over. I would have straightened the place up. And bought groceries.”
I laugh and cross my legs, attempting nonchalance. “It’s fine, really. I love Chinese.”
He gazes at me over his shoulder for a long moment. “I really wish I wasn’t on call tonight.”
I shrug in a way that underscores my confident breeziness. “Duty calls, right?”
He smiles and places a can of soda on the counter before me. “See you at work tomorrow?” He slings a backpack over his shoulder, grabs his keys from the hall table, and waves sheepishly. “Stay as long as you want, okay?”
I grin and wave. As soon as the door shuts, I stifle a high-pitched squeal of delight. Do I feel different? I think I feel different. More worldly, maybe. Or just slightly less awkward. Whatever it is, it’s exhilarating. For all the talk in popular culture about losing one’s virginity, I don’t feel like I’ve lost anything. Aside from a brief moment of pelvic soreness, the experience was entirely enjoyable. First-class, as far as I’m concerned.
I feel as if I’ve crossed some invisible threshold of life experience, and I have no regrets or second thoughts about it whatsoever. To think, all those years the aunties were subtly brainwashing us, shaming us about the evils of sexuality, it was all an elaborate lie. Not unlike Santa Claus.
I jump up and call Meryl.
“Thank goodness you called!” she says.
“Yes, I— Wait, what? What’s wrong?”
“I don’t know what’s going on with Gabe.”
I open the soda and walk around the apartment.
“What do you mean?” I say. “I thought you were breaking up with him.”
