28. Ahead Of Ourselves
AHEAD OF OURSELVES
“Hi,” Luca said, moving into the exam room with his next patient. A sixteen-year-old with abdominal pains. “I’m Dr. Luca Brewer, but you can call me Dr. Luca if you prefer.”
The younger kids did, the older ones not always.
“Hi,” Taylor said.
“I’m Cora, Taylor’s aunt. She’s been complaining about her stomach not feeling right for weeks.”
“First, are you Taylor’s guardian? I don’t see a release in the file.”
“I am,” Cora said. “It’s a long story, but I’ve got the paperwork right here.”
Cora pulled out some documents, he looked them over and handed them back.
“Okay, we’ll get that updated. Make sure you give a copy to the front desk when you check out. What exactly isn’t right, Taylor?” he asked.
“I don’t know,” Taylor said. “I can’t explain it.”
“Try to,” he said gently. “I’ll work around it the best I can or ask more questions.”
“She’s eating a lot of Tums,” Cora said. “She’s clearing her throat and I know that feeling. Like acid reflux. I’ve got it.”
“Do you notice it more at the same time of the day or different times? After meals?”
Taylor shrugged. “I don’t really pay attention, but it’s worse at the end of the day and at night.”
He noted that in the computer. “Anything else?”
“I get these pains in my stomach at times. Like a muscle cramp, but not really. Almost like my skin is pulling but inside of me.”
“Show me where,” he said. “Lie back on the table.”
Taylor climbed on the table and pointed where she felt the pain.
He lifted her shirt some. “Can you unbutton your jeans and just open them a little? I’m only going to press around and you can tell me if it hurts.”
He moved his hands around, pressed down, then stilled. She wasn’t flinching or saying there was pain, but he was feeling something he didn’t want to be feeling.
“Nothing,” she said. “But that is the area when I do feel something.”
“Where?”
He moved his hands back. “Right there.” He nodded and moved his hands away. “Anything else?”
“Sometimes in that area I feel these like bubbles. Like gas.”
“Got it.” This was tricky. “Would you mind stepping out, Cora? I’ll call the nurse in, but I’d like to talk to Taylor first, if that is okay?”
Cora looked at Taylor and got her nod. “Okay. Is it serious? I feel that I should stay, but I’m trying to give her some freedom to make decisions too.”
“It’s just a conversation.”
“It’s okay, Aunt Cora,” Taylor said. “It’s kind of embarrassing.”
Cora laughed and moved out. He saw Kate in the hall and waved her in. “Hey, I need you in here.” The door was open until Kate made her way.
“Do you need me to get a gown?” Kate asked.
“Not yet.” He didn’t really think he had to do a pelvic exam. He could get his answer another way. “Taylor, is there any chance that you might be pregnant?”
“What?” Taylor asked, her eyes wide enough, you’d think he’d just asked if she were an alien.
He changed courses. “Are you sexually active?”
“Yeah. But not often. I mean, it’s only been a few times and we use condoms. Mostly.”
He held back the groan. “When was your last period?”
She shrugged, looking a little panicked now. “I don’t know. Not that long ago. I never really kept track and it’s never been regular or anything. But I’m positive I got it a few weeks ago.”
Maybe he was wrong and if he was, then they had a serious issue on their hands because something was growing in Taylor’s abdomen.
“Was it normal? Lighter, heavier?”
“I don’t really pay attention to those things, or remember. Maybe lighter.”
“Well, we’ve got two options here. Because you are sexually active, I have to rule out pregnancy. I can do a pelvic exam, or you can take a urine test. That’s much easier and will verify it faster.”
“Urine,” Taylor said immediately. “Are you going to tell my aunt?”
“First, there isn’t anything to tell her. Not until we get the results. But you are a minor in her care. One step at a time. Kate is going to take you to the bathroom and there are cups in there.” He made eye contact with Kate. “Tell them it’s urgent.”
“Got it,” Kate said, then led Taylor out.
Cora returned while he was typing into his computer.
“Is she pregnant?” Cora asked.
He looked up, but couldn’t answer. He wasn’t surprised Cora put that together. “She’s taking a urine test right now to rule out a UTI, among other things.”
Cora was shaking her head. “I should have known. Her mother kicked her out. She couldn’t handle her with all the other kids in the house.
I didn’t want her on the streets or to end up in the system and thought bringing her to the island would be easier.
A change of environment and not so many tempting things right at her fingertips. ”
He was just letting Cora talk. “Let’s not get ahead of ourselves.”
Taylor returned, Kate held up the sample and walked down to get it tested.
“Are you having sex?” Cora asked Taylor. “Could you be pregnant? I need to know what is going on.”
He didn’t want to get in the middle of a family conversation. These were landmines he tried to tiptoe around.
“I’m sixteen,” Taylor said. “I’ve got a boyfriend.”
“Who is it?”
“He’s in Boston,” Taylor said.
“When do you see him?” Cora asked, running her fingers through her hair.
“He comes over on the ferry now and again. I’ve gone to see him.”
“When I’m working?” Cora asked. “Or are you lying to me about where you’re going or where you’re staying?”
“Maybe this isn’t the time for that discussion,” Luca said. “We’ll see what the results are and go from there.”
But ten minutes later, the positive pregnancy test came in.
There were tears in the office. Taylor’s and Cora’s.
Both were scared, but he assured them the best he could and called over to the OB office in the building to get her seen right away.
Her age, not knowing how far along she was, but he was guessing four or five months at this point. Add in the fact she wasn’t taking care of herself.
He shouldn’t feel the frustration of it, but he was.
He shouldn’t get a flashback of the baby he always wanted and might have had with his wife.
“That’s a rough one,” Gabriela said to him later that night.
She’d finished her shift, had dinner at her parents’ and was back at her condo.
He had an hour left on his shift and rather than go to the ER to check in on things, was finishing up his orders for the night for his patients on this floor.
But he couldn’t focus on that.
He needed someone to talk to. Someone who could understand what he was thinking. Going through.
The pain in his chest for the child he’d wanted so badly and the life he could give it, knowing that others were getting what he couldn’t.
“I can’t stop thinking about it. She’s a child and she’s about to have one.”
“We see it enough.”
“I know. I rarely feel sorry for myself,” he admitted. And hated that it’d crossed his mind multiple times today. Or worse yet that his thoughts of Zoe came with frustration rather than kindness.
Like he was resentful now and shouldn’t be.
“You can.”
“Thanks.”
“For what?” she asked.
“For being someone I know I can talk to. Who understands without me having to say much at all.”
“I’m always here for you.”
He knew that, but maybe he needed to hear it also.
“There are moments,” he said quietly, staring at the computer in front of him without really seeing it, “when I hate myself for the thoughts that come. For things I need to move past but get sucked back into.”
“I think it’s normal for your mind to go there,” she said gently.
“It feels like it’s unfair,” he went on. “Like the universe got it wrong. I wanted a child. I was ready. I had love to give. Stability. And instead…” He exhaled slowly. “Instead, it’s happening to someone who doesn’t even know how to take care of herself yet.”
There it was. The truth he rarely let surface, let alone voiced out loud.
But in the past, there was no one he could say it to.
His parents? Who would jump right on with him and talk badly about Zoe for not letting him be part of their decisions?
Zoe’s parents who would defend their daughter?
He had to eat that pain alone and had for years.
That maybe he was still pissed that Zoe wouldn’t budge.
That she wouldn’t just open her mind to other possibilities to make them a family.
“That doesn’t make you a bad person,” she said.
“It feels like it should,” he said. “I know better. I tell myself parenthood isn’t morality.
That readiness isn’t something you earn by wanting it badly enough.
Or that is what I told myself for years when we were trying and it wasn’t working.
But some nights—” His voice caught. “Some nights, it just hurts.”
Even when he thought he was done with this. That he’d put it behind him.
“I think,” she said after a second, “that you’re still grieving.
Not death. Just something else that maybe it’s hard for you to understand because grief isn’t logical.
It doesn’t care how fair you are or how kind.
Or what you want more than the next person.
Even how much better you can handle a situation. ”
The underlying words were there.
It was meant for the fact that Zoe made their decisions when it came to having a family and he let it go.
That maybe he was more disappointed in himself for not fighting harder for what he wanted.
For letting his voice be heard also.
He swallowed. “I look at Taylor and all I see are risks. Statistics. Fear. And then I picture the life I would have given a child, and it makes me angry. At no one. At everyone. Like you said, not really logical. I’m having a moment is all.”
“That anger is love with nowhere to go,” she said.
Her voice was tender. Caring. Like she was right there with him looking into his eyes.
He felt that and needed it more than he could express.
“But it doesn’t mean it will always be that way.
Cut yourself some slack, Luca. You’ve been through a lot and just because you’re doing good now, doesn’t mean triggers don’t exist. You know that. ”
He closed his eyes.
He let out a breath he hadn’t realized he was holding. “You make it sound so simple.”
“It’s not,” she said. “But it’s human.”
The silence settled between them was steady, but not heavy. It wasn’t humor, more serious, like she knew exactly how to dial it in.
“Thank you for letting me say it out loud,” he said. “Most people would try to fix it. Of course I wouldn’t have told most people.”
“I’m not here to fix you,” she said softly. “That’s not what a couple does. Tonight, I’m here to listen. If we were in person, maybe I’d let you steal my fries without slapping your hand, but I’d still be listening.”
He laughed.
She was joking but not really trying to change the subject, just injected a tiny tidbit.
Not trying to redirect it from the seriousness or to make him feel his thoughts had no validation.
It was more about what they had together.
What they brought out of each other.
That maybe she knew he might have reached his limit and it was time for a small laugh.
“Is it too much to say I wish you were here and not there?”
“Nope,” she said. “It’s not. Because maybe I wish I were there instead of here also.”
“I know we said we wouldn’t put pressure on the other while we were in our rotations.”
“I can be there tomorrow night if you want,” she said. “Or better yet, my place is closer to the hospital. You tell me.”
“I’ll come to you,” he said easily.
Because that was how he was going to let it be between them.