Chapter Thirteen
MY FIRST MONDAY AT Cruz Occupational Health, Alma hands me a coffee and tells me not to drink it.
“I made it, but it’s from his beans and that terrible machine,” she says. “I’m warning you out of professional courtesy.”
“Dawson said it tastes like a tire fire.”
“Dawson is being generous. It tastes like a tire fire that somebody tried to put out with more tire.”
I drink it anyway. It’s terrible, just like the last time I tried it.
I drink the whole cup because Alma made it, the mug has the Cruz clinic logo on it, and this is my desk now, by my exam room, in a clinic where my prescriptive authority agreement is filed, approved, and signed by a physician who has never once used my career as leverage for anything other than patient care.
The first week is orientation. Dawson walks me through the workers’-comp documentation flow, the employer notification protocols, and the return-to-duty clearance process.
The clinical work is different from primary care.
The patients come in with injuries, not chronic conditions.
The visits are shorter, the paperwork is heavier, and the insurance structure is workers’-comp rather than commercial, which means the billing codes are different and the prior auth process has its own vocabulary.
I learn it by doing it carefully and asking questions when the doing isn’t enough.
By the second week, the schedule starts filling.
Not because I solicited anyone from Ridgeline.
The case managers at two of the larger employers in the area already know my name from referral paperwork, and when they find out I’m at Cruz, they start routing their primary care clearances through me instead of through the rotating pool of providers they’d been using.
Three referring physicians send patients directly.
One of them, an orthopedic surgeon at Methodist whose post-surgical patients I’ve been managing for eight years, calls Dawson and tells him he made a good hire.
Dawson tells me this while we’re charting in the break room, which is a closet with a microwave, a table for two, and Alma’s coffee maker.
“Dr. Reinhardt called,” he says. “He says you know more about his post-op protocols than his own PAs.”
“I’ve been reading his op notes for eight years. At some point, you absorb the protocols by osmosis.”
“He also said he tried to send you a fruit basket. I saw it. Alma ate all the pears.”
“Alma ate my pears?”
“Alma eats everyone’s pears. It’s a known workplace hazard. I should have disclosed it during the interview.”
I laugh, and the sound is easy, not practiced or controlled. Just a laugh in a break room with bad coffee, stolen pears, and a colleague who doesn’t make me perform composure before I’m allowed to be useful.
Alma appears in the doorway with a stack of intake forms.
“Those go in the east cabinet,” Dawson says without looking up.
“I know where they go. I’ve been filing them for nine years.” She sets them down and looks at me. “He’s less grumpy since you started. I want that on the record.”
She walks out. Dawson doesn’t respond, but the tips of his ears go slightly pink, and I file that away without commenting on it because some things are better left to accumulate on their own.
MOLLY GRADUATES ON a Saturday in late May.
The ceremony is at Johnson High’s football stadium, folding chairs on the turf, families packed into the bleachers under a sky that’s ninety-two degrees and unapologetic about it.
I sit with Caleb, who drove from Austin that morning in a car that needs an oil change.
We watch Molly walk across the stage in her cap and gown and accept her diploma with the grace of a girl who has survived the worst year of her life and graduated anyway.
Caleb whoops. I take a video on my phone that I’ll watch eleven times tonight. Grey is somewhere in the bleachers, separate, and I don’t look for him because today is Molly’s day, and she doesn’t need her parents performing polite proximity.
After the ceremony, Molly finds me in the crowd and hugs me so hard that my sunglasses fall off.
“I did it,” she says.
“You did it.”
“Trinity in August.”
“Trinity in August.”
She pulls back and looks at me with the clear, steady expression she’s been wearing since the night she told me I looked tired.
She’s not a child anymore, and the distance between seventeen and eighteen is wider than most people think.
Somewhere in the gap she started seeing things as they are and stopped needing them prettied up.
“You look good, Mom,” she says. “Like, actually good. Not just holding-it-together good.”
“I’m actually good.”
“I can tell.”
DAWSON ASKS ME TO DINNER on a Tuesday.
We’re charting after hours, with the clinic closed, and Alma has gone home.
The overhead lights are off in the lobby, the exam rooms are dark, and the only sound is the hum of the server rack in the supply closet and the scratch of Dawson’s pen on a return-to-duty form.
He still fills out forms by hand because he doesn’t trust the autofill on the electronic system, and I’ve stopped teasing him about it because the handwritten forms are actually more legible than the digital ones, since he’s a rare doctor with good penmanship, but telling him that would give him too much satisfaction.
“There’s a place on South Presa that does Oaxacan food,” he says, without looking up from the form. “Small, not fancy. I’ve been going there on Fridays for about a year.”
“On Fridays.”
“On Fridays.”
He looks up. His pen is still in his hand. He’s wearing the same expression he wore when he offered me the job, direct and unhurried with no pitch or angle. A person saying what he means.
“I’m asking if you’d like to come with me,” he says. “This Friday. Not as a colleague.”
I think about it for exactly as long as it deserves, which is the time it takes me to recognize that the warmth I’ve been calling professional respect has been something else for weeks. I’ve known it, and it doesn’t scare me.
“I’d like that,” I say.
“Good.” He goes back to the form. “Alma will want to know. She’s been asking me when I was going to stop being an idiot about it.”
“Alma’s been asking?”
“Alma asks about everything. It’s part of the workplace hazard disclosure I mentioned.”
I go back to my charting. We work in the clinic with the lights off in the lobby, the server humming, and the scratch of his pen filling the space.
The silence between us is comfortable, warm, and full of something that isn’t urgent, because neither of us is in a hurry and neither of us needs this to be anything other than what it is.
Friday works just fine.