Dario
TWO
I’m in hell.
Fifteen minutes. That was all it was supposed to be. I needed the lidocaine, the irrigation syringes, and the suture kit that Hale promised to pull for me six days ago and apparently stopped thinking about the moment I left the building.
We’ll have to have a talk before I go.
The supply closet at the Archer Street free clinic is organized by someone with a strong opinion about categories and no discernible logic within them. I spent eight minutes finding what I came for, which is longer than it should have taken.
I had the box. I was done. I was walking out.
But then I heard that whimpering breath. That shallow, careful respiration, the kind a child uses when swallowing has become an event rather than a reflex. A strained breath that hurts when it passes over very damaged soft tissue.
I’ve spent enough time in enough acute-care environments that certain sounds have bypassed my conscious processing and gone directly to the part of my brain that catalogs clinical information. I heard it, and I knew, before I looked, roughly what I was going to find.
The girl is maybe five or six. Fever flush is clearly visible even in the shitty hallway light.
The stillness of a child conserving energy because fever costs more than healthy people realize.
Her head, resting in the woman’s lap. The woman’s hand, moving in slow circles on her back, even and automatic, the motion of someone who has been doing it long enough that it’s gone past conscious to something else.
She hasn’t looked up yet. She’s looking at her daughter with an expression I’ve seen enough times in enough different contexts to know what it means. Someone holding themselves together by sheer will, who has been doing it so long that the will has begun to show at the edges.
I don’t typically stop for it. And yet, here I am. Stopped.
When the woman looks up, my feet have nowhere else to go.
Honey-blonde hair coming loose from whatever was holding it, brown eyes with gold in the undertone that the fluorescent light does not flatter.
That’s okay, though. Her eyes don’t need flattering light to be stunning.
She has the face of someone who’s beautiful without enhancing it.
She’d look odd with colorful makeup. Whatever she’s doing now, natural or natural-like, it works for her.
Fuck, she’s so young. Mid-twenties, maximum. The little girl could be her daughter or her sister. I can’t tell.
She asks if I’m the new doctor. I lie.
I tell myself to do a quick intake, write a script for the kid, hand it over, done. “What’s her name?”
“Opal. Opal Swan,” the woman says. Her voice is smooth and a little deep for someone her age.
I spread my lips over my teeth and move my cheeks along with them, letting the imitation smile meet my eyes. If I don’t concentrate on smiling, it comes off cold.
Threatening, I’ve been told more than once.
The little girl winces as she tries to return the expression.
“No need to smile or talk, Opal. I’m going to take a look at your throat now, okay?”
She nods.
I flash my penlight and find the telltale yellowish-white exudate and fiery redness of terrible strep. “You can close up. That looks pretty rough, Opal.”
She nods once, then clings to the woman who says, “We keep doing antibiotics, but strep keeps coming back. Had her tonsils removed, and it’s still here. I don’t know what to do next.”
“Opal, can I palpate your lymph nodes?”
The girl frowns in confusion.
“Can I feel along your jawline to check for swelling?”
She extends her neck out to me in silent permission, so I check her. Swollen all to hell. I continue the exam and find her temperature is 103.6 tympanic. The right ear is borderline.
“Any response to the antibiotics? Any whatsoever?”
The woman nods. “It usually seems like she’s recovering, and for a few weeks, she’ll be herself again. But then it comes back faster each time. I don’t know what I’m doing wrong.”
Mom. Definitely the mom. That kind of guilt almost only ever creeps onto moms.
I try for a sympathetic smile, but it’s like wearing the wrong size shirt, so I give up. “I’m sure you’re not doing anything wrong. What’s your name?”
“I’m Lena. Her mom.”
“Good to meet you, Lena. I’m Dr. Spinelli.
You can call me Dario—I’m not formal.” I shrug.
“Most cases of chronic strep are due to proximity to a carrier. Could be a classmate or a neighbor. Anyone she commonly has contact with. But it can also be as simple as an antibiotic-resistant strain or an infection that has set up shop somewhere other than the throat or tonsils. If it’s in the sinuses, for instance, she can seem healed for a little while, then get reinfected with a couple of sneezes. ”
“Oh.” She looks confused now. “So, I’m not doing something wrong?”
No, you’re perfect. “You’re not—”
“So, I can’t fix it, can I?”
Shit. I can hear the depression spiral in her voice. “It’s not like that, Lena. It can also be chronic stress, poor nutrition, or incompletion of the antibiotic course… There are tons of things you can do. You’re not helpless here.”
She takes a breath, and her top stretches across her full breasts. It’s impossible not to notice—she’s built by curves that distract. “That’s good to know. But I don’t know what else I can do. Trying prescription after prescription gets very expensive.”
Hence why she’s in the free clinic. Azithromycin script. The macrolide is the right call given the recurrence. “Be right back.”
The supply closet houses plenty of samples.
It’s amazing anyone can find a damn thing in this alphabetical-order-optional drawer, but I manage after a minute or four.
I put together enough for a five-day course and return to the pair.
“Enough to start tonight, skip the pharmacy delay, get a therapeutic level established. She must take all of them—”
“She will, I promise.”
“In the meantime, get to the pharmacy with this.” I pass her the script. “Hopefully, they’ll get that to you in time so there’s no lag between the samples and their bottle.”
Those warm brown eyes shine up at me, and I have the strangest sense that I’m happily sinking into the floor. “Thank you, doctor. Thank you so much.”
Something scrapes in my chest. Her gratitude, I think. Not sure I like this feeling.
Then she follows it up with, “None of the other doctors here listen like you do. Did the clinic change ownership before they hired you or something?”
“Not to my knowledge.” Need a cover story.
“My practice is private. I come here on a volunteer basis, a few times a month.” Mostly true.
“I want you to have a direct line to me.” I write my number on the back of the prescription.
“Call me if things go sideways. Day or night. Not the clinic. If they’re jerking you around, there’s no point in calling them when I can help. ”
But she hesitates at that. “A private practice is out of my budget, but thank you for the offer.”
That won’t do. “Free of charge. As I said, I volunteer here. So, the patients I see from here get my volunteer rate.”
I can’t figure out why she stopped breathing. But before I can ask, she throws her arms around me. “Oh my god, seriously?”
Every sense in my brain lights up. She smells incredible.
Like a meadow full of early spring flowers.
The press of her against me is its own hell—I must maintain decorum, but here she is, all warm and soft and mind-blowing.
I want to run my fingers through her hair, then pull it back tight until she gives in to whatever I want—
Stop. Not here. Not now.
I go completely still. My instincts are not normal.
They never have been. According to the doctors my parents took me to when I was a kid, I have a personality disorder some might describe as sociopathy.
But I was too young at the time to be properly diagnosed, and I haven’t bothered to go back.
A certain level of detachment has always been a boon to my lines of work, so why try to change that?
Still, sometimes it would be nice if I didn’t have to consider every move just to seem normal. It gets exhausting to pretend all the time.
Two pats on the back, then I gently pull away. “Yes, seriously.”
She starts to ramble while my brain takes notes on the exchange. I’m not a man who is touched much. Not for free, anyway.
In my medical life, contact is purposeful and bounded.
I’m examining, suturing, maintaining an airway, keeping a situation from becoming worse.
In the other part of my professional life, contact is also purposeful, but the people who touch me in that context do so for reasons I don’t mistake for warmth.
What Lena did fell into neither category, and I have no real framework for it immediately available, so I stand there and wait for what is the common amount of time for such interactions I have observed.
It’s nothing more than that, yet I can’t stop feeling her warmth against me, even though there are at least three feet between us now.
Odd.
I give her prescription instructions and watch her gather the girl and the sample pack and leave.
Lena’s round ass sways crookedly as she carries her daughter from the clinic—cocked to one side to support the half-asleep Opal—and I find I want to watch her ass sway until I go blind from focusing too hard.
This has been the strangest interaction I’ve had in months, and I’m unsure what to do next.
So, I stand in the empty bay for a moment in the aftermath, still noting the contact.
But she’s gone now, and there’s Hale to handle.
He’s finishing up in bay six with a patient who has clearly been waiting longer than necessary for what turns out to be a straightforward presentation. I wait until the patient is discharged, and then I step into the bay and pull the curtain.
“I’m going to say this once.” I keep my voice low.
“There was a five-year-old with chronic recurrent strep and a fever of 103.6 sitting on your floor for over an hour tonight. You’ve had her chart several times.
The treatment you prescribed on both occasions was inadequate for the presentation. I’ve corrected it.”
The middle-aged fucker squints at me. “Where do you get off—”
“If this clinic’s standard of care stays where it is, I’ll have a conversation with the coordinator. If I come back and find something like that waiting on the floor again, I’ll have a different kind of conversation. One you’ll find less comfortable than this one.”
Hale’s mouth opens.
“Think carefully, Hale. You know who funds this place.”
His mouth closes.
I collect my things and leave.
I sit in my car for a moment before starting the engine. Chilled leather in all directions. The city is wet from earlier rain. It’s a cold rain. The kind people avoid when they can. The streetlights scatter on the asphalt, making everything look like itself and its reflection at the same time.
Lena’s answers to my questions were the self-minimization of someone who has spent enough time in rooms where her problems are received as inconveniences.
Meek, mild, inoffensive, not out of her natural personality, but because she’s been forced to fit into that mold.
A woman who has learned to make herself smaller so that when she asks for something, the ask seems proportionate.
There’s a fire in that woman that she can’t unleash, because she’s learned it’s dangerous to do so.
I try, in a genuine and specific way, to remember the last time I did something because it’s simply the right thing to do. Not because it serves a purpose. Just because a kid is sick and her mother is running on empty, and it’s the correct human thing to do.
I go back a long way in my history to remember my last good deed.
Nothing comes up.