20. Ethan
20
ETHAN
I slogged into work feeling a bit discouraged. Lily left after lunch and apparently had shut her phone off. She hadn't returned my calls either, though I didn't blame her. When Dad had the slip and fall and ended up in the hospital, I didn't pay attention to my phone either. Family was more important when things like this happened, and Lily and I, though we were hopefully on a track to be family someday, weren't quite there.
The phone rang off the hook back in the office, nurses rattling off stats of different patients. I was mostly overseeing the team of doctors who were diagnosing patients. Our diagnostic team was one of the very few in the country that were even warranted. With so very few rare conditions, average general practice or attending physicians could handle the bulk of the patient loads in their respective hospitals.
Most of our work came via consultation calls from other hospitals around the country. My team carried around five or six "second opinion" cases every week, and we had partnerships with several major health networks to facilitate serving more sick patients around the country. I really enjoyed the work, though sometimes it was boring and I missed St. Anne's and the surgery department.
After topping off a cup of coffee in the doctor's lounge, I made a pitstop in the men's room and headed to my office. The long day of work was almost over, and I looked forward to the meal stewing in the crock pot on the kitchen counter. I also looked forward to catching up with Lily and seeing how her father was. I hoped that everything was okay and that we could pick up where we left off.
She had stared at the papers with such disbelief I thought she was awestruck over it. I thought it was a romantic gesture to offer them to her, and the tears she shed upon seeing them were happy tears. It was why I kissed her, why we had sex like that. The self-doubt creeping in as I returned to my office, however, had me second-guessing myself. What if she was really going to tell me she wasn't interested and I took advantage of her vulnerability? She had mentioned she wanted to discuss something with me, and I never gave her the chance.
Organizing my files so they were in place for tomorrow's workday, I dialed Lily's number again but it went to voicemail again. I had the thought to swing by her parents' place, but I didn't want to be too forward. If her dad really was ill, a visit from a stranger from Lily's past might not be a welcome thing. I would have to wait until things settled down and she was ready to talk to me.
In the meantime, I had to do my job, and I had to take care of my own aging parents who needed me more than I needed them. I stood, taking my car keys and phone, and headed to the door, but before I got into the hallway, my phone rang. I turned and looked at the desk and rolled my eyes. Technically, I had thirty more minutes left in my shift and after that, all the call-ins would go to Dr. Adams who was on call, but something in my gut told me to answer it.
So I slunk back over to my desk and sat down. Picking up, I answered. "Dr. Matthews, how can I help you?"
"Dr. Matthews, I'm glad I caught you. This is Dr. Butler from pediatrics." The name sounded familiar, but I didn't interact with many doctors in the pediatric wing unless they had a child with a rare condition they needed a consultation for.
"Yes, Dr. Butler. What can I do for you?" I sighed and settled in. It could be a long night if there was trouble with a child, which made my heart ache. Treating adults was difficult at times, but children were so challenging emotionally. I wanted children of my own someday, and watching other people's kids suffer was heart-wrenching.
"Well, we have a young patient, a four-year-old boy with a bad case of diaphragmatic hernia. It's congenital and he's been through one surgery already, which means scar tissue." He paused, and I was already thinking through the steps to diagnosis in my head. If they knew what it was, why did they need me? "The situation is complicated by high blood pressure and difficulty breathing. The child is small for his age, underweight and of smaller stature due to poor digestion and heart complications. We need surgery immediately."
Again, I felt baffled, considering I wasn't in the surgical department, though my degree and expertise were in thoracic surgery.
"Dr. Butler, I can give you the name of a very good surgeon, though he is not typically a pediatric surgeon. He's on call this evening. His name is Dr. George Adams and?—"
"With all due respect, Dr. Matthews, you are the best. I don't want just any surgeon working on this child. We need a specialist, a thoracic surgeon with a delicate hand. This boy is frightened of doctors and in very shaky health right now." Dr. Butler sounded certain that this boy needed me, and I knew when one of my peers was so compelled to burden me with their expectations, I needed to listen.
"Alright, let me just stop down for a consultation and see how it goes. If the child is as bad as you say, you can prep an OR and we'll be in surgery in under thirty minutes." I hadn’t done a surgery in months, and that was a minor vascular repair for a post-heart-attack patient.
"Perfect, I'll send notice to the OR now." Dr. Butler hung up, and within thirty seconds, I had a text on my cell phone giving me the patient's age, room number, and name.
Noah Carter, age four, pediatrics room 422.
I stared at the information for a second and decided to feel grateful that I could help a little boy feel better instead of being grumpy that it would delay my call to Lily. Mom had food in the crock pot and Dad wasn't going to take visitors tonight anyway, so I sent a message to my neighbor, Mrs. Hensley, to let her know I needed her to pop in and check on Mom because I’d be working late. Then I went to pediatrics to find my patient.
As I walked, I ruminated over the child's name. Noah Carter—it made me smile. I thought of Lily and the coincidence that her last name was Carter also, and then I thought of what we might name our child if we had one. Noah was a nice name. It meant peace and rest from a curse. In Biblical times, Noah was a man of great wisdom and leadership abilities. It was something Lily would probably pick too, her parents being devout Christians.
I waltzed into the pediatrics department with a half-smile on my face and a skip in my step. Just thinking things like that made my heart come alive. Lily and I could have a family. We could be in love and be married. Mom and Dad could finally have grandchildren, and my irrational fears of growing old alone and not having anyone to care for me would go away.
"Dr. Matthews?" I heard, and I turned toward the nurses’ station to see an older middle-aged doctor with a patient file in hand looking up at me.
"Dr. Butler?" I asked, and he nodded in acknowledgement, so I walked in his direction.
"I have the patient's file here." He handed it to me, and I folded it open and started looking through the notes. Things were as they seemed, diagnosed with congenital diaphragmatic hernia in utero and surgery already before he was a year old.
"Are the parents aware that the boy needs another surgery?" I asked and folded the file shut. I would need an MRI to confirm how bad this was if it hadn’t already been ordered.
"She is," he said firmly.
"She is? No Dad?"
"None listed," Dr. Butler grunted and continued. “I can show you to the room and introduce you. I have the CT and MRI results up in the radiology review room too. When we are done briefing the family, we'll go there so you can prepare your plan for surgery."
He led and I followed. We chatted about the boy's medical past previous to this, and I agreed that with his blood pressure a little unstable, waiting a week or two for new medications to control it was a good idea, given the hernia didn't seem too dangerous. Now we were at the point it had to be done, and I was glad they called me. This would be a touchy surgery.
When he opened the door and pulled back the curtain, however, I was shocked. No—shocked didn't begin to touch what I was. Horrified? Dumbstruck? Sick to my stomach?
Lily sat in a chair next to the bedside of the little boy who was so pale he looked like a ghost. I walked in and stood at the foot of his bed and studied his perfect face. Dimpled chin like hers, thin, petite lips, a mop of brown chestnut curls all identical to his mother, who held his hand, kissing it as he slept.
"Dr. Matthews, this is Lilian Carter, M.D. She's a pediatrician here at Mountain View, and this is her little boy, Noah." Dr. Butler gestured, but I was so speechless I couldn’t even fumble out a greeting.
Lily's Mother stood in the corner of the room too, watching, mouth covered by a hand. I didn't see her father, but my vision was blurred, affected by the physical symptoms of shock. Four-year-old son? She was gone for almost five years. That's four years to be alive and almost one year of pregnancy… Could this be…?
"Dr. Matthews?" Dr. Butler said, and I blinked hard and snapped out of it.
"Uh, yes. Dr. Carter." I nodded at her and then opened the file, trying to focus on anything but the million questions in my head. "Tell me what happened to escalate the hernia." I wanted to handle this professionally, but my heart was hammering against my ribcage. Lily had a son she never told me about?
"Well, he was napping and I left home to stop by a friend's house…" Her voice trailed off for a second, and my gaze met hers. I saw the sparkle of tears in her eyes and knew I was that friend whose house she visited. "He woke up and Mom was watching him. He never told her he was awake. He jumped on the bed, and Mom found him and scolded him, but the damage was done."
She looked terrified, and I felt terrified for her. I also felt selfish for having the feelings I was having in the wake of such a huge situation for her. I loved her. I had to focus.
"And what did you experience since that point?"
Lily began to explain every symptom Noah had exhibited since and how they went to St. Anne's. I questioned in my head why she went there, but there was no reason. Nothing made sense. They were a smaller, less-well-equipped hospital. She had to have been hiding something, or someone, from me. That was why she didn't want him to come here. She didn't want me to see him.
Getting through the consultation challenged me to my core, but I made it. I felt like my face tone probably matched the sick boy in bed, who might be my son. I was upset and anxious, probably pale. I asked all the questions I could think I might need to know answers to and then excused myself with a promise to meet Dr. Butler in the radiology review room.
I had to get out of the room and breathe. I needed to put distance between me and Lily. The way I was feeling was not conducive to a safe surgery. My emotions were too heightened, too overwhelming to do this alone. I stepped into the hallway and paged Dr. Adams who I knew very well could also perform this, though he might want advice. We'd have to do it as a team, because if my gut was right, it wasn't even legal for me to operate on that little boy.
Dr. Adams responded with an affirmative and gave me a five-minute window to try to relax. I stepped around the corner and ran a hand through my hair and took a deep breath. The boy looked like her, not me. There was no evidence that he was mine. It was very possible that after I hurt her, she ran off and had rebound sex and wound up pregnant. We were usually very careful, though we did have a few times we thought we might have been irresponsible. But she would have told me, right?
I pressed my eyes closed and leaned my head against the wall. She would have told me. I kept repeating the words in my head over and over, trying to convince myself that the woman I loved would never have lied to me about something so important.
"Ethan, can we talk?"
I opened my eyes to see Lily standing there wringing her hands. She looked terrified, but with what was going on with her little boy, she had plenty of reason to be. I wanted to wrap my arms around her and comfort her, help ease the uncertainty and pain she was having. But I saw hesitancy too, as if she was afraid of me for some reason. As Noah's surgeon, I had to talk to her. I just didn’t know if I wanted to talk about the topic she had in mind.
"Of course," I told her, standing straighter. I pushed off the wall and straightened my tie—the tie she tore off me only a few hours ago.
"Ethan, I've been meaning to tell you since I got back. We had so many times I wanted to say something, and I just got panicked and I couldn’t say it. You were so amazing and loving, and I didn't want you to be upset with me." Her lip quivered and she blinked out a few tears.
"Why would I be upset? So you had a child and didn’t tell me. We are just getting to know each other again, Lily." I resisted the urge to take her hand because all of those words were my own self-reassurance. I was trying to convince myself this wasn't happening because the more she spoke, the more I knew what she was going to say.
"I'm not sure you understand fully." She audibly whimpered and continued. "Ethan, Noah isn't just my little boy."
"Please, Lily…" I willed her not to say it, not to put that in my mind before the most important surgery of my life.
"I have to, Ethan. You have to know. I need you to know and I need you to understand. I never meant to hurt you." She started sobbing, and I couldn’t take it. My heart broke, and I reached for her, but the elevator doors behind me opened and I knew it was Dr. Adams.
"He's my son?" I asked in a whisper, and she covered her mouth and sobbed harder, and I knew.
"Hey, now, don't you worry." Dr. Adams walked up with confidence and slapped me on the back of the shoulder. "Matthews and I are on the case, Momma. Your little guy is going to be A-okay and we'll get him all patched up." The man had no clue what was going on between us or how hard this would be for me. But I had to do it.
"We have to go get ready, Dr. Carter." My tone was calm and even, but she winced as if I were chastising her. I didn't have time to discuss it further. The OR was booked and we had to review the imaging results before we cut into my little boy's body to hopefully repair it.
"Go on back and be with him while we prepare. We'll come get him when it's time." Dr. Adam's cool bedside manner made Lily scowl, and she retreated and then he turned to me. "Moms, huh? All the emotion." He turned toward the elevators and said, "You coming?"
I stared after her for a moment with no breath in my lungs.
I had a little boy, and now it was my job to save his life.
After that, I could fall apart.