Chapter 6
THAD
November
The highlight reels I scrounged up of Cash played silently from the tablet I propped on the outdoor dining table on the balcony overlooking the rocky shore line below my house. All his medical records and imaging sat cued on my laptop, waiting for me to riffle through them. Again.
Instead of focusing on either device, I watched the waves roll in. The Pacific—the sounds, the smell, the rhythmic cadence—calmed my raging thoughts. That calmness allowed me to sift through the information I’d spent the day pouring through.
The same information I’d spent yesterday and the day before looking at as well. I spent three days trying to find something. Anything. Because there had to be something.
Something I missed.
Something one of the other doctors missed.
Only I couldn’t find anything.
Turning back to the tablet, I tapped replay and turned up the volume.
The compilation video of Cash Money’s—the nickname tickled me—saves was edited to flow along with the song “Holding Out for a Hero.” The kid was an absolute menace in the net.
Big, bold, brazen. Along with a whole fucking slew of adjectives that didn’t begin with B.
He stopped pucks like he had a mind meld with them.
Or like he could read the skater’s mind.
Lightning struck, and I sighed before picking up my devices, shutting the glass wall panels, and climbing the stairs to my office.
I needed a bigger screen to dissect the images anyway.
The small screens weren’t cutting it. As I made my way up, the written reports played over and over through my head.
Benjamin, Caspian
Professional hockey goaltender for the Headland Cove Breakers. Breakers’ medical team reports the player has no prior major injuries.
Catastrophic right knee injury following an on-ice collision during an AHL hockey game.
In the office, I pulled up the hit. I’d watched it half a dozen times already.
It looked brutal. And having played…I knew it was.
I’d been taken down close to the net a few times myself.
If you played, you got your shit fucked up.
It was part of the game. The question was never if. It was always when.
After another replay, I turned off the hit. I ignored the written reports. Instead, I pulled up Cash’s radiological images and cast them to the touchscreen on the wall. I’d already read the report. Twice. I didn’t need someone else telling me what they saw.
I needed to see what they missed. If they missed anything. Even though I knew they hadn’t. The surgeon who did the repair did a spectacular job. I was proud of him. I could say that. I trained the doctor.
The MRI filled the screen, and I leaned forward, one hand covering my mouth as the other scrolled through the images slice by slice. The damage was significant. The original injury had healed well after surgery. It was all the issues during rehab that worried me.
A beautiful surgical repair didn’t mean a fully rehabbed injury. Sometimes what looked perfect in the operating room and on the imaging didn’t equate to the same outcome in physical therapy.
And this was the issue Cash Benjamin faced—a beautiful repair and a shitty rehabilitation response. Every time he advanced, every progression, resulted in the same thing: swelling. The inflammation was so bad they’d taken him back down, let him rest, then tried again.
I searched and found nothing to indicate Cash self-sabotaged his recovery.
As much as I didn’t want to consider it, the man I’d met at the charity event had been sarcastic, a bit combative, and determined to ignore his pain and limitations so much that he turned working a charity event into an endurance event for masochists.
But there was nothing. Not one damn thing in the file suggested he’d shown any disregard for his rehabilitation. Just the opposite.
Cash had done everything by the book.
No missed appointments.
No ignored restrictions.
He listened to the treatment team.
He attacked physical therapy and each progression with the same determination I witnessed from his highlight videos.
His range of motion returned, and so did the strength in his leg. The graft held. Remained completely stable.
The notes, at least the ones at the beginning, were boring as hell. Nothing to indicate he wouldn’t make it back to the ice. But then it changed.
Persistent swelling. Pain with loaded flexion. He’d hit a plateau that he couldn’t overcome. Unable to progress as anticipated.
Looking at the imagery, I saw what I’d seen every time I looked at the scans.
Nothing catastrophic. Just one torn structure, and one failed repair.
Then flipping through the images, I found it. One small but very obvious problem no one seemed to have addressed.
“Alright. There we go, Cash. I can do something with that.”
Not Cash. A patient.
A patient I’d met before I knew he would be my patient, but a patient nonetheless.
Which meant the fact that I’d spent entirely too much time looking at his mouth Saturday night had precisely fuck-all to do with the knee displayed across my high-definition touchscreen monitor.
Instead of making the call myself, even though I wanted to, I opened the office messaging app and sent the information to the schedulers, asking them to bring Cash in to go over next steps.
“So, Doc, what’s the verdict?”
A deep inhale expanded my ribcage as I contemplated how to answer him. I hated this part of the job. Loathed it. There was never a good way to tell someone the life they’d built everything around was gone. No combination of words made it hurt less.
“Thad… Dr. Vale, I mean…”
“There is a surgery,” I said.
Hope lit up his face like Christmas and Independence Day had just had a baby.
Two babies.
Twins.
One named I’m happy as hell, and another named I’m scared as fuck.
He leaned forward, his elbows braced on his knees.
The right one was wrapped in the brace I told him to put on as soon as he got home from the Halloween event.
He promised he would, and sure enough, it had been strapped around his leg when I’d stopped by Halo House to get the records he had on a thumb drive. “The cartilage surgery, right?”
I nodded. “Yes.”
“Awesome. So when can we do it?”
“Cash…”
His expression fell. Hope died in his eyes as they turned glassy. “No.” He shook his head. “Don’t say it. Please, Doc. Please don’t say it.”
“Cash, I recommend you have the surgery, but only if you hear me when I say this: I will be doing this surgery to preserve your knee, reduce your pain, and improve your function and mobility.” I stressed the goals I considered realistic.
“What I would not be doing is operating with the express purpose of returning you to the ice. Goal-tending as a professional wouldn’t be the expected outcome. ”
He stared at me. “Expected.”
Of course that’s what he heard. I hadn’t really counted on him hearing anything else, even if I had stressed several other outcomes.
“Cash—”
“You said expected.”
“Yes.” I stroked my beard with a sigh. “I did.”
“That’s not the same as impossible or never or not at all or any other way of saying there’s no fucking chance.”
“No. Expected isn’t the same as all that.”
Hope came roaring back to his eyes, lighting them up like a carnival in the dark of night.
This beautiful, eager boy’s face filled me with happiness and fear.
I wanted what he wanted. I wanted to give him the word.
Stupid, considering we’d just met, but sometimes you just knew.
Like I’d known Chelly and I weren’t a great fit, even though I tried to force our relationship to work.
“I could play again,” he said. His voice was soft and wistful, his face still wreathed in a bright smile.
I shook my head and warned, “That’s not what I said, Cash.”
“Doc, you just said it wasn’t impossible.”
“No. I said it wouldn’t be the expected outcome. I can’t tell you it’s impossible. There’s a difference,” I explained.
“What’s the difference? Explain it to me.”
I leaned forward and mimicked his posture by bracing my forearms against my thighs.
“The path from this surgery is a clear, straight shot to the back of the net—if the back of the net is you coming out of surgery with a significantly better knee. The percentage of that outcome is high enough that I’m recommending the surgery. ”
“Okay, but what about hockey?”
With a deep breath, I scratched the back of my head. Trying to come up with an explanation that wouldn’t get his hopes up. “There is a path.”
His whole demeanor changed. If I thought he was happy before…I’d been sorely mistaken. A grin stretched his face wide, and he sat up.
“Cash, you have to listen to the rest. You have to hear me, okay?”
“There’s a path. That’s what you said.”
“Yes. But that path is nearly nonexistent and so freaking narrow.”
“But there is one.”
“Yes,” I said hesitantly. “Given your age and the reports from the doctors and therapists about your compliance with treatment, I believe there is a sliver of a chance.”
“Then why the fuck are we still sitting here talking about this? Let’s schedule this shit, Doc.”
“Because surgery is only the first step—”
“Doc, you’ve seen the records. I know this. You know I know this.”
“Yes. Because surgery is only the first step. It has to go well. You have to heal. The knee has to tolerate rehabilitation, which, according to your records, it didn’t previously.
Then, if by some miraculous chance it does tolerate rehab this time, you have to regain your strength and range of motion.
Then it has to tolerate skating. Then goalie-specific movement.
Deep flexion. Rotation. Repeated butterflies and lateral recovery.
Practice-level workload. And after all of that, it has to tolerate doing it again the next day. And the next. And the next.”
“Thad. I understand. I can do all that.”
“But, kid, you don’t know that. You can’t know that.”
“And neither can you, Doc.”
A deep, heaving breath echoed between us as we stared at each other. “No, I don’t.”