13. Patient Compliance Poor
Chapter thirteen
Patient Compliance: Poor
NELLIE
Day four, and I catch Owen Peterson standing at my kitchen counter on a leg that has more hardware in it than my toolbox.
No crutches. No boot brace. One hand on the counter like that counts as medical compliance.
"Sit down."
"I was getting water."
"You were bearing weight." I point at the chair. "Sit, or I swear I will chart you as noncompliant and let Dr. Osei read it out loud at your follow-up."
He sits. Slow. Making a whole production of it, like the chair offended him.
"You know what my favorite kind of patient is?" I fill the glass myself and set it in front of him. "Unconscious."
"You're a ray of light, Greer."
"And you're a flight risk with a rod in your tibia."
I take the crutches. Both of them. I carry them to my bedroom and lean them against my closet where he can see them through the doorway and cannot reach them without crawling.
He watches me do it. "That's a war crime."
"Write your congressman."
The whiteboard on my kitchen wall has grown since he moved in. It started as MEDS / DO NOT LET HIM NEGOTIATE. Now there's a column for PT exercises, a column for what he's allowed to lift, which is nothing, and a tally in the corner labeled TIMES HE CHEATED.
I add a fourth mark.
"That one doesn't count."
"Tell it to the board."
***
The pain meds are their own show.
He fights taking them, every dose, like swallowing a pill is admitting something. Then twenty minutes later the man who communicates in grunts and radio codes turns into somebody I've never met.
Tuesday night he watches me dry dishes for a full minute before he says it.
"Your hair."
"What about it?"
"It's like angry sunshine."
I stop with a plate in my hand. "Excuse me?"
"Sunshine that's mad about it." He nods, real serious, eyes at half-mast. "That's the whole thing. That's you."
I set the plate down. I walk to the whiteboard. I uncap the marker.
"Nellie."
I write it big, top corner, where he'll see it from the couch every day for the rest of his sentence: ANGRY SUNSHINE.
"Nellie, no."
"Owen, yes."
"I'm on drugs. There's rules about this. Testimony under the influence—"
"Sustained. It stays."
He drops his head back against the couch and groans at my ceiling, and I stand there grinning at a whiteboard like a lunatic, and neither of us says the true thing, which is that this is the most fun I've had in any town, ever, and I have lived in a lot of towns.
***
Thursday, the home health aide cancels again. Which means the sponge bath falls to me.
It's a clinical task. I have done it hundreds of times. Stroke patients, hip replacements, a man in Tulsa who sang Conway Twitty through the whole thing. Warm water, washcloth, efficiency. Nothing to it.
I fill the basin and my hands are steady and I decide that means something.
Then I walk into my bedroom and there is a problem, and the problem is that Owen Peterson has already taken his shirt off.
He's sitting on the edge of my bed in athletic shorts, bad leg propped, waiting on me. I have seen this man's chart. I have seen his X-rays. I have not seen this.
Firefighter is a job title. It is also, it turns out, a body type.
Shoulders built for hauling grown men down ladders.
Arms roped with the kind of muscle you earn, not buy, one vein running down the forearm I stitched in another life.
All of it tapering to where those shorts sit low on his hips, and I complete my assessment in under two seconds, because I am a professional.
"You're staring, Greer."
"I'm assessing."
"Assess anything good?"
"Swelling's down." I set the basin on the nightstand. "In the leg."
His mouth does the almost-smile. I have a sudden, detailed thought about that mouth and where I'd let it go, and I file it under symptoms I am not charting.
"I could've managed in the shower," he says.
"You can't stand on that leg for eight minutes, and I am not scraping two hundred pounds of stubborn off my bathroom tile. Bedside bath. Sit still and behave."
"Which one? Can't do both."
"Owen."
He lifts his arms. Surrender. It does criminal things to his stomach and he knows it.
I start with his back, because his back is the safe side. This is my first clinical error of the evening.
Broad. Scarred along one shoulder blade, an old burn gone shiny. The washcloth moves and the muscle shifts under it, alive, and my brain, unsupervised, puts my mouth on that scar. Follows the water down. Two seconds of that. Then I fire the thought and go back to work.
He's gone still. Not the relaxed kind. The kind where a man is counting things in his head to stay civilized.
Good. Count faster than me.
Water runs the channel of his spine and disappears under his waistband, and I watch it go the whole way down, which is not a nursing requirement.
I wring the cloth. My knuckles graze the back of his neck and his breath catches, one rough notch, and heat drops straight through me and lands low. Noted, I think. Bilateral response.
"You're quiet," he says.
"I'm working."
"You're never quiet when you're working. You're quiet when you're thinking."
"Lean back, Peterson."
He leans back on his hands, easy, taking up my whole bed like he owns it, and front is worse.
Collarbone. The chain against his sternum, and I work around it without touching it, and he watches me not touch it. His eyes stay on my face while my hands are on his chest, and there is nowhere professional left to look.
His heart slams under my palm. Elevated, I note. Mine's worse.
I drag the cloth down his chest, over his ribs, and somewhere along the way it stops being the cloth. It's my hand, flat against his stomach, water running between my fingers, and the muscle jumps hard under my palm and his fists close in my quilt.
"Cold?" I ask.
"No." Gravel. "Not cold."
I should take my hand back. I move it lower instead, one inch, tracking the water into the low line of those shorts.
Those shorts are doing a poor job of keeping his opinion on this bath to themselves, and I look.
I look, and when I drag my eyes back up, he's caught me, and he doesn't say a word.
His jaw is tight enough to crack. His knuckles have gone white in the quilt.
"Nellie." Low. A warning or a request, and I don't think he knows which.
"Almost done." My voice comes out wrong. Too bright. Nurse-voice with a fracture line in it.
I kneel for the calf, which puts me on the floor between his knees, which I did not think through, which is my second clinical error of the evening.
The cloth moves up from his ankle. Calf. The inside of his knee. His breathing has gone slow and deliberate, a man doing box breaths, losing. Heat comes off his skin like he's still standing next to a fire. My thighs press together and it helps nothing.
I make the error of looking up.
He's already looking down. And the look on his face isn't want. Want is too small a word for it. It's the look of a man deciding whether to be good.
"Nellie."
His hand closes around my wrist, careful, thumb settling over my pulse, which is sprinting, which he can feel, which means the jig is up.
He draws me up by that wrist, slow, giving me the whole climb to stop him, and I don't stop him, and I land with one hand braced on his thigh, higher than balance strictly needed, and his breath goes ragged.
His other hand comes up. Knuckles graze my jaw. Trace down my throat, over my racing pulse, and my eyes close before I vote on it.
"Tell me to knock it off," he says, rough, against my temple. His mouth an inch from my skin. Not touching. Burning anyway.
I can't. I turn my head instead, and now his mouth is a breath from mine, close enough that we're trading air, close enough I can feel the shape of my own name when he says it again. His thumb presses the corner of my jaw. One more inch. One.
"Your bandage needs changing," I say, against his lips, almost onto them.
It does not need changing.
I'm up and off the floor with the basin in my hands before either of us can do the thing we're both dying to do, and I walk to my kitchen and grip the counter with both hands like the floor's tilting.
I run cold water over my wrists. It doesn't help.
There's a shirtless man twenty feet away with water drying on his chest and my name still in his mouth, and cold water was never going to help.
From the bedroom, wrecked and quiet: "Coward."
"Heard that."
"Meant you to."
***
He's been dodging the question for four days.
Who's Claire. I asked it the first night, with his hand crushing mine and the nightmare still wet on him, and he said, "Somebody I knew," and rolled toward the wall. I didn't push. You don't dig at a wound with the patient awake.
Tonight he brings it to me.
We're on the couch, his leg propped on the ottoman, some baseball game on mute. He picks up the remote and turns the TV all the way off, and the room goes different.
"Claire was my wife."
I don't move. I don't make a sound. Airway clear, I think, stupidly. Let the patient talk.
"We were married four years. She taught second grade. Hit my parked engine with her Corolla the day we met and argued it was the engine's fault." A breath that wants to be a laugh. "She kept a laminated list on the fridge. Things Owen Was Wrong About. Updated it weekly."
"I'd have liked her."
"You'd have been co-authors."
The chain is in his fist now. He doesn't seem to know he's holding it.
"Two years ago there was a fire. Apartment building on the north side." He stops. Starts again. "My company was toned out across the city that night. Warehouse job. We're pulling lines and the next call drops and the address comes over the radio."
He looks at the dark TV.
"It was mine. My building. My address, out loud, on every radio in the district."
"Owen."
"Everybody on the rig went quiet. Nobody would look at me. We ran it with lights and I did the math the whole way, response times, travel time, and the math didn't work, I knew it didn't work, and I got there and the third floor was gone. Fully involved. My floor."
His voice doesn't break. That's the worst part. It goes flat, report-flat, a man reading an incident number.
"I tried to make entry. My own crew pulled me off the stairs.
Took three of them. I broke Ruiz's nose doing it.
" He opens his hand and looks at the ring in his palm.
"I woke up in an ambulance and there was a chaplain sitting where the paramedic's supposed to sit, and I knew before he said one word, because they don't send chaplains for smoke inhalation. "
I take his other hand. That's all. I don't say I'm sorry. I don't say she's in a better place. I don't say any of the things people said to him in a receiving line while he stood there dying in a suit.
I hold his hand and I stay quiet and let him have the silence.
He looks down at our hands. Then at me. And something in his face comes loose, like he'd braced for the platitude and I never fired it.
"Two years I've been a live grenade," he says. "Write-ups. Fights. The department didn't send me home to rest, Nellie. They sent me home so they didn't have to fire me."
"And instead, you fell off my roof."
The laugh gets out of him before he can stop it. Rough, surprised, real.
"Instead, I fell off your roof."
We sit with the TV dark and his hand in both of mine, and I do not say the thing climbing my throat, which is that a man who ran into a burning building for her is sitting on my couch, and I have never in my life been the kind of woman anybody ran toward.
The nightmare comes at 2 a.m.
I'm awake before I know why. Then I hear it through the wall. Not screaming. Worse. His voice low and wrecked, saying numbers, an address, saying move, move, let me through, that's my—
I'm out of the chair-bed and across the hall before I decide to be.
He's tangled in the sheet, sweat-soaked, one fist twisted in the fabric like a strap he's hauling on. I take his hand the way I did the first night, both of mine around it, and I say his name once, low.
"Owen. You're in Willowbend. You're in my house. Everybody's out."
He surfaces hard, a man breaking water. Eyes wild, then finding me, then knowing me. His grip on my hand could crack walnuts.
"You're okay," I say. "I've got you."
His breathing comes down slow. The room settles. My hand is going numb and I don't take it back.
I shift my weight to stand, to go back to the chair, and his fingers tighten.
"Stay."
Barely a word. Eyes already closing. Asleep, or close enough that he'll never know he said it. Or awake enough that he'll pretend.
I look at the chair across the room. Ugly, floral, my back already aching from three nights in it.
I look at the bed. At the space beside him. At his hand around mine like I'm the thing keeping him above water.
Every rule I own is standing in that doorway with its arms crossed. Thirteen weeks. Never renew. Leave first, it's tidier. My mama's voice and eleven schools and one box I never unpack, all of it lined up, waiting for me to do the smart thing.
I stay.