Exactly As You Are (Love in Louisville #1)

Chapter 7

7

J oan was lying on an exam table with a sheet over her naked lower half. She wasn’t shy, but she would be glad when she didn’t have to do weekly physical therapy for her vagina. She took deep breaths.

“Remember to relax your pelvic floor muscles on the inhale,” her therapist, Jamie, said. Jamie was a fit-looking woman in her mid-thirties with curly red hair and a soothing voice. If Joan were to construct a pelvic floor therapist’s personality from scratch, Jamie would be a close fit: she was gentle, kind, and easy to talk to. She also gave clear instructions and accessible explanations for everything she did.

“So you said you’ve been using the smallest dilator at home?”

Joan, who was still practicing her deep breathing, responded on the exhale. “Yes.” She turned her head toward Jamie. “And, um, I also used a tampon this week. My first time, so that was good.” She was downplaying her success a bit. In truth, she’d been ecstatic about the development.

Jamie beamed. “That’s wonderful!” She sounded so proud, like Joan had told her she’d won a Nobel prize. “That means you’re making measurable progress.” She started getting some equipment out. “So I was thinking that for the rest of the session, we could try some biofeedback with you. That’s the machine that measures muscle activity.” She gestured toward a computer with a plastic box connected to it. “I don’t think you’re quite ready for the internal version of that, but I’ve got an external version that involves putting electrodes on your skin. We can still get some good information from it that way.” She got out her plastic pelvic model and pointed out where the electrodes would go. “Is that okay with you?”

“Sure.” So far, she’d been okay with all of their treatments, even when they were a little embarrassing, but she appreciated being asked all the same. She stared at a ceiling tile. The fluorescent lights felt like spotlights on her face. “I’ve been wanting to ask you if you think this process would be better if I had a partner. I wanted to work on it for myself, not for someone else, but it’s hard to know if sex will be pain free if I’m not attempting it.”

Jamie stopped and turned to her instead of putting on her pair of gloves.

“That’s always up to you,” she said gently. “I can’t really give you advice about having a partner or not. I will tell you that I’ve treated other women who aren’t married or dating at the time they see me, and they just want to be able to have comfortable pelvic exams or be ready if they do have a relationship. I treat some who are in long-term relationships or marriages and have developed vaginismus or pain with sex when they didn’t have pain before. It’s a whole spectrum.” She reached for her gloves and slid them on before turning back to Joan. “If you do get a partner, feel free to talk to me about it, and I can give you advice about how to proceed if and when you feel ready to attempt intercourse.” She smiled. “I think if you can use the larger dilators, that would still be very good progress, and we would know that your pain is decreasing. And if need be, you can always come back and see me if, down the road, you get a new partner or new relationship.”

Joan nodded. “I don’t have any candidates at the moment,” she said, feeling ridiculous. Her mind flitted to Chet, the last in a line of a few serious boyfriends who decided they couldn’t tolerate her muscle dysfunction. “I’m just glad to have other period options besides pads for the rest of my life.”

Jamie laughed. “Amen to that.”

Joan tapped her pen against her thigh as she read the doctor’s new orders. Her responsibilities that day at her inpatient rehab job included the care of seven patients, a manageable number on a normal day, but her current load tested her abilities. Her charges were the most complex and difficult on the unit.

The first patient she passed meds to, a new bilateral amputee, vomited them up. Which honestly wasn’t the worst thing to deal with, except for the spatter on her new shoes. She spent several minutes scrubbing them with disinfectant wipes. Her next interaction involved an elderly patient who’d fallen off a ladder and broken several bones, and he had screamed at her and called her a bitch. He’d been transferred from the brain injury unit now that he was allegedly “less confused.” Still, she’d been called worse. Things really took a turn when she checked the vitals of another elderly patient who “felt a little off,” and it turned out he was tachycardic with a blood pressure somewhere near hell, leading to a subsequent transfer to the hospital for a cardiac emergency. She wasn’t sure he was coming back, and her chest squeezed at the thought. Generally, there were fewer medical emergencies in her current setting than at the ICU, but it could happen anywhere.

The real thorn of the day, though, was Celeste. Celeste the charge nurse bully.

Overall, the nurses she’d worked with were wonderful, lovely people. Joan got along well with others, and her previous superiors had all been great teachers. She liked people–-maybe not as much as Lucas, the human equivalent of a Labradoodle—but still.

Celeste, though. She’d been a nurse for twenty years and she knew her stuff, but she made the workday miserable. She preyed on Joan’s insecurities, like she’d seen into Joan’s past and could tell she’d white-knuckled her way through some of her classes. She made Joan feel like a toddler learning how to feed herself for the first time. Celeste threw out lots of “you should know that already” and “what are they even teaching in nursing school” comments, and frankly, Joan was sick of it already after four weeks on the job, but her general avoidance of confrontation and her people-pleasing tendencies nearly suffocated her. What she wanted to do was punch something. Instead, she smiled until her cheeks hurt.

She’d yet to figure out exactly why Celeste behaved in such a way, but she was determined to stick it out. She wouldn’t let one person ruin this setting for her.

It was just after lunchtime, so Celeste should have been feeling better about life now that she’d had a burrito. Alas, it seemed it was not hunger that drove her to bitterness. She eyed Joan from the doorway like a malignant specter.

“Have you changed Mrs. Franklin’s wound dressing yet?”

Joan clenched her teeth. “She’s with therapy. I plan to do that as soon as she’s done.”

“That should have been done this morning. You don’t want it getting worse.”

“No, of course not. But her therapy schedule changed. Something about not having OT and PT back-to-back because it exhausts her, so they moved her PT up. I’ll do it as soon as she’s done, I promise.”

Joan hated the pleading, obsequious note in her voice, but other than Celeste, she loved this job and her new coworkers. She was still in her probationary period, and she didn’t want any trouble.

“Well,” Celeste said, leaning against the doorframe as though she had nothing better to do. “I can’t hold your hand all the time. If you can’t remember to do things on your own, this isn’t going to work.”

“I did remember.” Joan relaxed her hand where she had gripped her pen hard enough to leave an ink indent on her palm.

Celeste narrowed her eyes. “How long have you been out of school?”

“Six years.”

Celeste huffed. Joan wasn’t sure how to interpret that, but she was saved from further interrogation by Martin, a fellow nurse with whom Joan enjoyed light flirtation. He was doe-eyed and adorable, about her age, and prone to peppering their conversation with little quips throughout their workday. His thin frame topped Joan’s own height by only an inch or two, and he had the sort of closely cropped hair that made you want to run your hand over it. He shouldered his way past Celeste to talk to her.

“Mr. Richards is yelling about his rights again. He also said something about Johnny bringing the cows in. I didn’t ask who Johnny was. You want me to help you with him?”

Joan smiled. “That would be great, actually.”

As they hurried down the hallway, Martin leaned closer to her.

“She’s awful. We’ve complained before, but she was friends with our old manager, and they never did anything. I was starting to think she’d have to murder someone to get reprimanded. I’m hoping our new supervisor is better.”

“God, she’s horrid,” Joan said, exhaling a cathartic breath. She’d been wanting to talk about this with someone for weeks. “This is the whole nurses eating their young thing I heard about. I’ve never experienced it before now. Ugh.”

“She’ll let up. It’s always rough on the new hires. She thinks young nurses aren’t as dedicated as she was, like all they do is stay glued to their phones and all that, so before they show up, she’s already played judge and jury. She’s alluded to some awful experiences, though I never tried to get the whole story. Something about her old workplace. I don’t know. It feels like an excuse.” He smiled at her, and a few flutters skipped through her abdomen.

Every time Joan entertained a crush, no matter how small, her brain barreled ahead of her, imagining how a relationship could progress and all the ways things could go horribly wrong when she had the dreaded conversation with them about what she couldn’t do. Her shame paralyzed her. Which might have been just as well in this case, honestly, since dalliances with coworkers could end poorly.

Mr. Richards came charging out of his room without the walker he should have been using. He swayed on his feet. “Where’s John?” he demanded.

“Oh boy,” Martin murmured to her. He rushed forward to steady Mr. Richards. “I haven’t seen John. Why don’t we go have a seat and you can tell me about him?”

“Get your damn hands off me,” Mr. Richards said, but he walked back into the room with Martin anyway. “I’ve got to find John. We’ve got a cow loose.”

Martin murmured some soothing reassurances on the way to the bedside chair. They got him situated then reconvened in the hallway.

“I’m not sure he was ready to come down here,” Martin said. “We’re going to have to talk to the doctor. We can’t have him wandering out the front door or hurting himself.”

“Agreed. I’ll start the process.”

She smiled at him again, and he did seem to stare at her for a beat longer than necessary. Maybe she shouldn’t start something with a coworker, but if nothing else, workplace flirtations provided some fun and distraction from the rigors of the job.

The rest of the day progressed a little more smoothly. She managed to avoid Celeste cornering her again. At least she did until 6:45 p.m., when Celeste found her at her computer.

“Anthony in room 312 needs to be cleaned up. Call light’s on.”

Joan turned to face her. She closed her mouth, which had dropped open. Was this lady serious? She was due to leave in fifteen minutes, and Anthony in room 312 wasn’t even on her assignments for that day. She didn’t mind doing things like that, not with the CNAs stretched so thin all the time, but she still needed to finish charting and give the handoff report.

“Is that a problem?”

A hundred responses bubbled up, more than one of them involving some version of “fuck off,” but instead she looked down at her lap.

“No. It’s fine.” She stood up. Dammit. As soon as she had more experience, she’d grow a spine. Or perhaps she’d need more therapy for that.

On her way out that evening—later than usual, of course—she scrolled through her contacts in her phone, hovering over Lucas’s name.

Her heart thumped. She wanted to talk to him, to dissect her day and get his advice on Celeste as well as Martin. He was her go-to for that sort of thing. She decided to call Gwen instead. Besides being a nurse, Gwen had the sort of take-no-shit attitude that Joan had always admired, but never been able to emulate.

As she held the phone to her ear, a sense of wrongness threaded around her ribcage. She loved Lucas, and she couldn’t imagine her life without him. She just didn’t know how to navigate this new rut she was in, not when he wondered why she was in it.

She would talk to him eventually, she decided. As soon as the idea of it didn’t mortify her.