Chapter Twenty-One
“Hello! What brings you to the ER today?” Lark asked one Mr.Darren Holmes, age forty-eight. He was a red-faced man with a beer belly, a Red Sox Nation T-shirt and a Boston cap on his head.
“My head aches,” he said, giving her a cursory scan. “Are you old enough to be a doctor?”
“I’m twelve, but I’m very advanced for my age,” she said with a smile. “Just kidding. I’m thirty-three. Tell me about your headache. When did it start?”
“Four days ago.”
“Has it been constant, or does it come and go?”
“Pretty constant,” he said with a slight shrug.
“Did you take anything for the pain? Tylenol, Motrin, aspirin, weed, narcotics?”
“Nope. I had a couple beers the first night, but it didn’t help.”
She quashed a smile. “I see. Do you get headaches often?”
“Not really.”
“Any visual changes?” she asked.
“No.” He scratched an ear.
“I’m gonna shine this light in your eyes, so just look at my finger and follow it, okay?” Lark clicked on the light and had him track her finger. Pupils equal, round, reactive to light. “Can you tell me, where is the pain specifically?”
“My head,” he said, as if that cleared things up.
“Front, back, left side, right side…” she coaxed.
“Kind of right here,” he said, pointing to the top of his head, slightly to the left.
“Let’s have a look. Would you take off your cap, please?”
“Sure.” He did, and a huge flap of scalp flopped over from the top of his head almost to the tip of his ear.
“Yikes!” she yelped. “Okay! Wow! You have…a very large laceration there.” It was inches of scalp. Inches, just hanging there.
“Yeah. I hit myself with a crowbar. I figured the hat would help it heal.” He reached up to touch the wound.
“Don’t touch!” she commanded.
His hand went back to his side. “It didn’t work, huh?”
“No, it did not. You said this happened four days ago?”
“Yeah. Friday.”
“Did you lose consciousness?” she asked.
“Like, faint?”
“Black out, fall to the ground, see stars, anything like that.”
“No. But, man, that thing bled like a motherfucker.”
“I bet.” Dr.Unger would love this. “I’m just gonna have you lie back, okay, and get my supervisor in to take a look.” She adjusted his bed so he was more prone. “No, nope, don’t put that hat back on.” The inside of it was crusted with blood. Mr.Red Sox Nation was not the brightest star in the sky, was he? Then again, he might have suffered a brain injury.
She went into the hall. “Dr.Unger? I think you might want to see this.”
“Oh, goody. I’m tired of heatstroke and UTIs. What’ve you got?” said Howard.
“Patient presented with vague headache, left upper anterior.”
That was all she said, not wanting to ruin the surprise. She opened the door, and Howard said, “Hello, young man, I understand you have a—well, tie me down and spank me with a fish! That is a lot of scalp, sir! How did this happen?”
Red Sox Nation had been busting up some concrete, raised the crowbar a little high and dropped it.
“He thought the baseball cap would jump-start the healing,” Lark said.
Howard looked at her, his eyes dancing. These were the calls that made work fun. Cocktail party stories. Lark had started to dictate them into a phone (no names, of course).
“And what would you recommend, Dr.Smith?” he asked.
“Well, I’d get an x-ray to rule out a fracture. No LOC on the scene, the patient reports. If the x-ray is clear, I’d irrigate and suture it closed, since it’s fairly deep. Prophylactic antibiotics, since it’s been four days.”
“Sounds good to me,” Dr.Unger said. “Mr.Holmes. Mind if we bring in a couple other people for this exciting teachable moment?”
“Sure!” said the patient. “Can I see my cut?”
“You bet,” Howard said. “We’ll grab a mirror.”
Lark was the belle of the ER for the rest of the shift. “You’re buying beers tonight,” Luis said, because yes, they were all going out, once they finished documenting and updating the incoming shift.
They were a merry bunch as they went into the London Brewing Company, which was next door to the Naked Oyster. That one was a bit too pricey for a bunch of residents, so beer it was. After this, Lark was driving to meet Lorenzo in Chatham, as he’d ordered when she’d requested an audience. She suspected her rapport with the staff at the Naked Oyster irritated him.
“How’s Satan?” Luis asked, reading her mind.
“Oh. Well…I’m not sure it’s going to last.” She felt herself blushing, still sorry for lying to these nice people.
“Time of death, happy hour,” Danny said, grinning.
“I can’t believe you’ve lasted this long, to be honest,” Lalita said.
“You Americans,” Mara said. “Let your parents find someone for you. Your Western fairy-tale Tinder bullshit is not working.” She held up her left hand, which sported a very sparkly diamond. “Aashish and I fell in love about three minutes after we met.”
“Show-off,” Miriam said, bumping her shoulder against Mara’s. “Can your parents find someone for me? Look at poor Lark here. Don’t make me walk that path, dating a wretched man in a desperate attempt to find someone.”
Lark felt a pang of loyalty for Lorenzo. “That’s not completely accurate. Dr.Sa—Lorenzo’s not as bad as he seems.”
“What a stirring and passionate defense,” Luis said.
“Okay,” she said, laughing. “It’s weird, I get that. But you know how it is, guys. A patient comes in with, I don’t know, gas, and we all sigh and think, ‘Is this really an emergency?’ But then you find out that they lost their mom and haven’t cried yet, and they’re just looking for someone to talk to, and that gas is really heartache.”
“Are you drunk already?” Danny asked.
“So Lorenzo Santini is to love as a gassy patient is to the ER,” Lalita said. “That tracks.”
“Well, he is a genius,” Howard said. “I once saw him save a patient who—listen up, this is a great story. A guy came in. He’d been working outside, tripped, fell, and stabbed himself in the chest with the screwdriver he was holding.”
“Phillips or flathead?” Danny asked.
“Excellent question. Phillips. I bet the flathead would’ve killed him. Anyway, he gets in his car, steers with one hand while pressing a roll of toilet paper against his chest with the other.”
“He drove?” Lalita asked.
“Yep. He lived in Yarmouth, figured he’d bleed out if he waited for the ambulance.”
“He wasn’t wrong,” Mara said.
“Exactly. So he drives himself here. Triage nurse can’t believe what she’s seeing—this yellow-handled screwdriver sticking out of his chest, a guy completely soaked in his own blood, trying to stanch the wound with Charmin. She pages Surgery, super stat, the patient collapses in front of her, we all run out, get him on a gurney and into the ER. He’s soggy with blood, I’m afraid to take out the screwdriver because he’ll bleed out for sure. He already is, right? I’m thinking there’s just too much damage to save him. We intubate, but by now we’re standing in a veritable lake of blood.”
Lark was transfixed. They all were, leaning forward, beers forgotten.
Howard continued, well aware of his storytelling prowess. “Blood pressure is almost nonexistent, pulse is fluttering, and I think, ‘Sorry, pal, you’ve lost at least half your blood because this is what happens when you stab yourself in the heart.’?” He leaned back and took a sip of beer. “Enter Santini. Says one word. ‘Scalpel.’ We give the man a scalpel, and he does an anterior thoracotomy right then and there. Spreads the ribs, reaches in and grabs the patient’s beating heart. He’s holding the guy’s heart in his hand, and somehow puts pressure on it enough to slow the bleeding. And that’s how they wheeled him into surgery—Santini elbow deep inside the guy’s chest. Nine-hour operation, ten units of blood. And by the grace of the thumb-sucking, brown-eyed baby Jesus and Lorenzo Santini, the guy made a full recovery.”
“Wicked pissah,” Danny said.
“Wow,” Lalita said.
“So he’s an asshole, sure, but he gets to be an asshole,” Howard said. “Another round, my ducklings?”
“I’m actually meeting the legend himself,” Lark said, “so I have to go.”
“Good luck. Tell him we admire and fear him,” Mara said. “And if his people skills improved, he’d be the head of a worldwide cult in two days, tops.”
Lark paid for the round of drinks, waved to her friends and walked to her car, wishing she could stay a little longer. This was something she hadn’t had in Oncology. In her year of residency there, she’d never felt…celebratory. If a patient responded well to treatment, obviously that was fantastic. They had the bell to ring for the last session of chemo.
But there always lurked the fear that the cancer would come back. There was no high fiving, no muffled laughter. Yesterday, Howard had done a needle aspiration on a tonsillar abscess and had been so pleased with the amount of pus he’d gotten, he’d trotted up and down the ER, showing everyone his prize before discarding the tube. They’d reset a dislocated hip last week, and when the patient had come out of sedation, she’d said, “Oh, my God, I feel incredible!” and kissed Danny on the lips.
Obviously, there were the tragedies, too. But most times, they weren’t right there in front of her, day after day. Send them up or send them out, that was the motto. By and large, she finished each shift knowing she’d helped someone feel better, whether it was through medication or knowledge or, in a lot of cases, just by being kind. The golden retriever effect.
The sun was setting as she pulled into the Chatham house driveway next to Lorenzo’s “look at me” Maserati. The sky was a gentle lavender and pink here on the ocean side, and the air was soft. It sure was a beautiful home. She rang the bell.
“You didn’t change.” Lorenzo stood in front of her, looking at her scrubs.
“Hi,” she said. “Great observation.”
“Unsanitary.” He stepped aside to let her in.
“Nice to see you, too, Satan. Thank you for letting me and my germs desecrate your perfect house. Did you make us dinner?”
“No. I ate already.”
“Well, make me a sandwich, if you have bread in the house, that is. I’m starving.”
His blue eyes narrowed slightly. “I don’t remember you as being so…brazen,” he said.
“It’s your influence,” she said, sitting at the kitchen table. “You’re very direct and don’t care if anyone likes you. I’m learning from you.”
“I’m honored. Will a grilled cheese suffice? I don’t eat cold cuts.”
“A grilled cheese would be lovely. With mustard and tomato, please.”
As he assembled her sandwich and stood at the stove, watching it cook, Lark had to admit he was right. She was a little different these days. Once, being the nicest, most helpful, kindest person anyone had ever met had been Lark’s life mission. Maybe it was because this particular good deed—being Dr.Satan’s date this summer—hadn’t had the desired effect on Noni. Maybe it was the ER, where patients didn’t always like you—you didn’t give them the drugs they wanted, or you contradicted what Google had told them. They thought you were too young to be diagnosing them and wanted a “real” doctor, or this was their fourth time here for the same problem, and that was your fault somehow.
Her skin was thickening. It beat the pulsating, open-wound feeling she’d had these past seven years.
“Here,” he said, setting the plate down in front of her.
He’d cut the sandwich in half, and she took a bite. Oh, that was good. She bet the cheddar was top-drawer stuff, and the bread was sourdough.
He got her a glass of water, one for himself, and sat down across from her.
“Thank you,” she said. “This is fantastic.”
“So why did we need to meet, Lark? I’m very busy.”
“Right, right,” she said, taking another bite. “Um…this is a little awkward, but I’ll just say it. I have a crush on your brother.”
His head jerked back a little. “Dante?”
“Do you have another brother?” Another bite of sandwich. She could eat four of these, she was sure.
“But Dante? Seriously?”
She swallowed. “Yes, Lorenzo. He’s handsome and funny and good-hearted.”
“But he’s a firefighter.”
“Exactly. People love firefighters. Straight women especially love firefighters.”
He looked pissy. “I assumed that after talking to one, you’d change your mind.”
“Wrong again.”
Lorenzo pushed back his chair and folded his arms. “How did this crush develop?” he asked.
“Does it matter?” she asked, her mouth full. Sadly, that was the last bite. She’d ask for another, but she already knew the answer.
“Yes.”
“Well, we actually met a long time ago. I didn’t recognize him right away, but he…he did me a favor a few years ago in the course of his work.”
Lorenzo didn’t ask for more details, and she didn’t offer any.
“He also drove me back from Sofia’s engagement party when my car got towed. I texted you about that, by the way. My brother had to drive me into Boston so I could get it back from car jail. It would’ve been nice if you’d helped me.”
“Why would I spend half a day at a tow lot when I’m a world-class surgeon with a very full schedule? Why, Dr.Smith?”
“For one, it only took half an hour, and two, I was towed because I came into town to be your date. Anyway, back to your handsome, lovely, helpful brother…he’s very…nice.”
Lorenzo cocked his head to one side, not looking at her. “Has he made a play for you?”
Her cheeks grew hot. She’d made the first play, hadn’t she? After he’d spent the afternoon being generally wonderful, holding her and letting her cry all over him. But that hadn’t been much of a kiss.
At the picnic, though…different story.
“He kissed you, then?” Lorenzo asked.
Oh, heabsolutely kissed me, Satan. Her mouth made a few squeaky noises before forming words. “Well, I…yeah. It was not…unwelcome.” She tapped her finger against the side of the glass.
“I see.” He drank some water, expression neutral. “Let me give you a little information that might put that in context. My brother was dating a woman a little while back. A model named Brie, like the cheese.”
“I know. He told me.”
“Anyway, the minute I met her—”
“He’s told me this story, by the way.”
Lorenzo gave her an irritated look. “Please curb the interruptions and work on your listening skills, Dr.Smith. I doubt he’s told you all of it. As I was saying, the minute I met this Brie person, I could tell Dante was in trouble. He didn’t see her for her true self. She was…ambitious.”
“Oh no, an ambitious woman, how dreadful, did the world stop spinning?” She brazenly scratched her nose with her middle finger.
“Ambitious in that she wanted to marry him.”
“I think we humans call that love.”
“Oh, she didn’t love him. It was obvious.”
She was curious against her will. Not her business, and yet impossible not to want to hear more. “How so?”
“Well, at first, she hung herself all over him, and Dante, the poor idiot, gobbled it up. But it was for show. It made us all very uncomfortable, especially my grandmother, who doesn’t approve of public displays of affection.”
“So I’ve learned. At Joy’s picnic, she told me I’d spoil my niece by kissing her.”
“Anyway,” he said pointedly. “I took Dante aside, explained my concerns—”
“What did you say?” Lark asked. She was kind of enjoying interrupting him, since it so clearly irked him.
“I said exactly what I thought. I didn’t like her and thought she was fake and shallow. He told me to get over it, because he was planning to propose.” Lorenzo huffed. “She was very attractive, I’ll give him that. A swimsuit model.”
The little flash of jealousy surprised Lark. When was the last time she’d done a sit-up, after all? Tenth grade? “Go on.”
“I knew she’d do wrong by him. She was greedy, and a woman like that would not have been satisfied as a firefighter’s wife.”
“God, you are so arrogant.”
“Dr.Smith, give me some credit. She looked at this house with dollar signs in her eyes. I think she assumed there was family money, since my parents’ home is also quite nice. Because I bought it for them.”
“Yes, you’ve told me at least seven times. So what happened?”
Lorenzo shifted slightly, and his gaze went to just over her head. He didn’t answer the question.
“What happened, Lorenzo?”
“The second time we met, she made it very clear to me she would trade up. Ditch my brother, take up with me.”
Lark sat back in her seat. “Oh.” Dante had said she’d left him for someone else. He hadn’t said that person was his brother.
“Yes,” Lorenzo said. “So I told him about it, and he broke up with her, but he blames me for the situation.”
“How long ago was that?”
“Two years. Which was a shame, because…” He stood up and brought her plate to the sink, then leaned against the counter, the kitchen island between them.
“Because why?” she asked when he didn’t pick up the thought.
He shrugged. “We’d been getting a little closer. I took him to a Red Sox game. Box seats, right over the dugout. He invited me to his housewarming party. Little things, but I thought that since we’re adults now, even though it took him much longer to get there, obviously—”
“You have such a way of insulting people, Lorenzo,” she interrupted. There was that brazen thing again. “Even when you try to say something nice, it comes out as damning. You should work on that. Just say the nice thing, then shut your mouth.”
He held out his hands, palms up. “You asked for this story.”
“And what is the point of it? To show your superiority to your brother because his girlfriend was a money-grubbing social climber?”
“Yes. No, I mean. My point, is, he probably kissed you to get back at me.”
She rolled her eyes. “You just did it again.”
“What?”
“You implied that Dante would kiss me only to get back at you. I’m not hideous, Lorenzo. A lot of people think I’m very nice, in fact, and fairly attractive.” Not Lorenzo, though. Her looks didn’t affect him one bit. It was a little refreshing.
“You are attractive,” he said. “That’s the reason I first approached you. You being very nice is more of a weakness, wanting people to like you—”
“Okay, fuck off. There. That needed to be said. Listen. I don’t want to pretend to be your girlfriend anymore, Lorenzo. Okay? I’m tired of it.”
“Can’t you just wait till my grandmother dies?”
“I have a feeling she’s going to live forever.”
“She’s not. She stopped eating. Just thickened liquids for the past few days. She needs oxygen now.” For the first time this evening, Lorenzo looked…human. A little sad. Her dopey heart softened.
“I’m sorry to hear that.”
“It’s not unexpected.”
“I’m still sorry.” She sat back in her chair. “How do you think you’ll be after she dies?”
He didn’t answer right away. Then he looked at her, and his eyes might have been a little shiny. “I don’t know. Fine, I’m sure. But she took care of me all those years. She was the only one who didn’t look at me like…like a zoo animal. I know I’m smarter than everyone else”—no ego there, no sir—“but she also treated me like a kid. And she’s the only one who noticed that I was…”
“That you were what, Lorenzo?” she asked.
He looked away. “Lonely.”
“Lonely,” she echoed.
“You can tell I don’t exactly fit in with my family. I have colleagues, not friends. I don’t know that I’ve ever really had a friend. I’ve talked more with you than with just about anyone this year.” He folded his arms across his chest. “So of course I’ll miss her. She’s the only one who treats me like a regular person. An exceptional person, but a person just the same.”
She had to smother a smile. “I think your family loves you more than you see, Lorenzo. You’re very guarded around them. Maybe if you weren’t so…clenched and trying to show off all the time, it would be easier.”
He gave a nod. “Well. The situation with Brie didn’t help. Anyway. Are we done here?”
“What about our arrangement? Can we end it?”
“Why? So you can date my brother? I just told you he’s only interested in you to get back at me.”
She sighed. Loudly and pointedly.
Lorenzo looked at the floor. “Can’t you just stick it out till Sofia’s wedding? It’s three weeks away. I’d rather not have to deal with anything else right now.”
He looked…tired. Well, he would be tired. He did have a full schedule, and he was a world-renowned surgeon. He might not be the easiest person, but he did a lot of good, she had to give him that. “I’ll think about it, how’s that? Great talk. Seriously. You’re doing well in becoming a human.” She couldn’t help a weird rush of fondness and tousled his hair as she walked past.
“Dr.Smith?”
She turned. “Yes?”
“I appreciate that you…that you’re trying. And also that you wouldn’t do this for money. It speaks well of you.”
She smiled. “Good job, Dr.Santini. And thank you for noticing.”
With that, she left.