Chapter 22
Weight
~RéMI~
“You are running a slight fever, Miss O’Shea.”
The doctor is a small woman in her early forties with a quiet voice and the steady reading-glasses-perched-low look of a professional who has, in the course of her career, watched approximately ten thousand Omegas try to talk their way off her exam table.
She holds the digital thermometer up to the recessed light above the bed and reads the number off it for her own private confirmation. She sets it down.
I turn my head and look at Iris.
Iris, on the paper-sheeted exam table in my hoodie and her practice leggings, pulls the top half of the hoodie up over her nose and bottoms her eyes at me from the visible inch of face that remains, in the small undisguised pre-emptive crouch of a child who has been read the diagnosis and is preparing to be scolded.
Pinky.
“Doc.” Iris’s voice is muffled inside the hood. “Respectfully. Do not say another word in front of him before I have time to talk him down. He is going to scold me. He has the face.”
I do not have a face.
I am not going to scold her.
Maybe I have a face.
The doctor smiles. It is the small unsurprised smile of a woman who has seen this exact small Omega across this exact exam table fourteen hundred times in the course of her career. She turns her shoulders to me. “Can I have a word with you in the hallway. Briefly.”
“Yes.”
“I am not here,” Iris announces from inside the hood, pulling the covers on the exam table up to her sternum. “You cannot see me. I have achieved invisibility. This exam table is empty.”
The corner of my mouth does the millimeter thing it does when she is being herself.
I give her a look. She is, by my reading, dead on her feet, but she is also, for at least the next eight minutes of in-room time, going to do the small pre-emptive theater of a woman trying to keep the temperature in the room from getting too serious. I leave her to it.
The hallway outside the exam room smells of institutional pine cleaner, the chemical-citrus floor wash they all use, and the warm baked-paper scent of a sterilizer that has been running since dawn. The doctor pulls the door three-quarters closed behind us and turns to face me.
I expect her to break off and walk me to the nurses’ station. She does not. She stays where she is.
I arch an eyebrow.
“If this is the funding conversation,” I tell her, “I can cover anything. Bloodwork, the new prescription, the weekly follow-ups, anything that needs ordering. You can put it on a card I will leave with reception.”
She shakes her head, mild. “Oh. No, Mr. Bellerose. Thank you. That is not what this conversation is.”
“Then.”
“The fact that you brought her here at all,” the doctor says, “already tells me everything I needed to know about whether her pack is in support of treatment. I am not auditing your intentions. I want to talk with you first because I am about to give Miss O’Shea a piece of information she is going to be too proud to fully receive in real time, and I would like one adult in the pack to have heard it cold sober before she walks out the door. ”
Oh.
Yes. Yes, please.
“Go ahead.”
The doctor exhales. She pulls a small chart out from under her arm. She does not look at it. She has, I suspect, looked at it enough.
“Miss O’Shea has been on continuous suppressant blockers,” she says, “from puberty. Which I am putting at age sixteen. Based on the dosing history that her former GP’s office faxed us this afternoon.”
“Mm.”
“It is a common timeline. Frequently, the parents put the daughter on them. Sometimes out of protection, because they do not know how the daughter will react when her Omega scent comes online and they are scared of triggering an early Heat. Sometimes out of the convenience of avoiding the conversation. Sometimes because the daughter is, by family standing, in a household that does not really want her to be an Omega in the first place, and the blocker becomes the easiest way to perform the small daily denial.”
My stomach does the small flip it does when a stranger has, very neutrally, just held up a mirror to a piece of Iris’s biography I had already assembled in pieces and not yet had the courage to look at as a whole.
“Okay.” Level. “Keep going.”
“Regardless of the reason,” she continues, “remaining on blockers for the better part of a decade is detrimental to the body. The medical literature is unambiguous, and the medical profession is, in my honest opinion, not loud enough about it. Long-term suppression alters the endocrine baseline. It elevates cancer risk in the tissue groups it suppresses. It thins bone density. It frequently produces sleep architecture disruption. It makes Heats, when they do break through, more violent. None of which is, I should clarify, her fault. This is the system she was handed.”
“Mm.”
Keep your face still. Keep your voice level. You can think about the rest of it later.
“The complication,” the doctor says, “is that her body has, at this point, adapted to the blocker the way a body adapts to any long-running medication. Which means we cannot, professionally, take her off it cold turkey. If we did, she would go through a withdrawal cascade similar in clinical presentation to the withdrawal cascade of a substance dependency. Chills. Panic attacks. Disorientation. Vomiting in the first seventy-two hours. Possibly worse, depending on her chemistry. We will not be doing that.”
“Good.”
“What we are going to do is taper her off the current formulation while titrating in a softer replacement, designed to do the same job at a meaningfully lower physical cost. The taper is going to take three to four weeks. During the taper window, she is going to feel some of the adverse effects, in compressed form, as her endocrine system rebalances. The fevers are likely to continue and probably to intensify. The insomnia is going to get worse before it gets better. There may be hot flashes. There may be some emotional volatility, the kind that surprises her.”
“How much worse.”
“Manageable. She will be functional. She is not going to be hospitalized. She is going to be uncomfortable for two to four weeks, and then, on the other side of it, she is going to feel better than she has felt in eight years. The current fever, for the record, is, in my reading, mostly attributable to a different problem. She has been suddenly placed in extremely close quarters with three Alphas and her body is, very simply, overheating in the small constant low-grade way Omegas overheat in that situation. The fever is functionally a thermoregulatory drift, not a Heat onset. We can treat it with aggressive hydration and a serious nap schedule.”
Three Alphas. A nap schedule. A nest. A nest she does not, structurally, know what is.
“Okay.” I take a moment. I file. I open the next folder. “On the medication itself. The new one. There is no overdose risk if she, for example, accidentally double-doses.”
The doctor’s eyes register the question with the specific small reading of a professional clocking that the question came from a slightly different direction than expected. She does not press.
“Dosages are calibrated to the individual Omega,” she says, evenly.
“I personally triple-check every prescription that leaves this office. The therapeutic window is wide. An accidental double would not, in the medication class we are using, produce a fatal outcome. It would produce a bad night and a phone call to me at three in the morning, and I have, as I told her in the room, made my personal line available for exactly that scenario. Twenty-four-seven.”
“Thank you.”
She tilts her head. The very small read of a woman who would, in fact, like to know why I asked.
I look at the door of the exam room. The corner of my mouth flattens.
“Our pack leader,” I say, quiet, “lost his best friend to a drug overdose, four winters ago. Connor. The man was the fourth of our four. If I keep our captain informed about Miss O’Shea’s prescription history in the way that I am going to need to keep him informed about it, he is going to react.
Possibly disproportionately. I want to be in a position to tell him the math is safe. ”
The doctor’s eyes soften.
“Mr. Bellerose. The math is safe. And I am happy to set you up with weekly in-person check-ins for Miss O’Shea, with copies of the notes routed to you and any other member of the pack she designates. I am here to make this season easier for her and the people who love her. Not harder.”
“Thank you.”
“Of course.”
She turns to push back into the exam room, to walk Iris through the next four weeks at the level of detail Iris is, in fact, going to actually need.
My phone buzzes in my pocket.
Matteo. Of course.
“Santori.”
“Why in the actual hell,” Matteo demands, “are you not answering my texts. I have sent you, by my count, four. Four. The fifth was going to be a photo of my own face.”
“I am at the campus clinic. With Iris.”
Silence.
It is, by Matteo standards, an unusually long silence.
I can hear, on the other end of the line, the very small ambient noise of a room he is currently in.
Voices. The faint thump of a music speaker.
Then a shuffle. The unmistakable creak of a heavy door opening, the swift drop of the background noise as he passes through it, the soft thump of the door closing behind him.
“Okay.” Matteo, now in a smaller quieter room. “So do I need to fly there, or what.”
I roll my eyes. The roll is, on my face, professional. The fight against my own mouth doing the millimeter thing is, internally, undignified.
“You do not need to fly here, Santori.”
“Describe the situation. Right now. Use small words.”