Chapter 38
Five days later, Annie sits on an examining table in the ambulatory-care wing of the hospital.
The frigid air finds the skin between the ties of her hospital gown. Her bare legs are covered in goosebumps. She tries to
rub them away.
Evan would have wanted to come. He would have sat patiently in the waiting room for as long as it took. Afterward, he would
have pressed for details and plans, with those attentive eyes.
During med school, right after Ruth died and Annie entered that year-long-barely-eating-barely-showering-zombie-robot-phase,
she tried all the antidepressant medications. First, the Cipralex that didn’t numb much at all, except it made her face feel
like it was incapable of moving. She was nauseated all day, even when she broke the 10 mg tablet in half.
“Try a different kind, maybe?” Evan had said, in the bathroom, while Annie bit off a quarter of a tablet with her front teeth
and wondered if a medication could fix the fact that she’d lost everything. If a medication could make her a new life.
Next was the Zoloft; she couldn’t stay awake, even when she took it at night.
The fatigue was incapacitating, the fatigue spilled out everywhere and it was impossible to study and her always-anxious-feeling rode underneath it, still surfacing.
Her anxiety became a swampy mix of tired-anxious heart palpitations and wanting to prop her eyelids open at 8:00 p.m. Effexor and its electric brain zaps every time she tried to lower the dose or stop it.
Pristiq was the same, and Abilify gave her godawful headaches that made her wonder about subarachnoid hemorrhages and if her brain was really truly being squeezed into the bones of her skull.
Trintellix made her feel like she was behind a plate of Plexiglas.
“Maybe it’s undiagnosed ADHD,” Dr. Tessa said, as Annie tried to explain that everything was both faraway, unreachable, but
also too close, too loud, and at times exquisitely beautiful, all at once. She told Tessa she wanted to get better, and about
the violin trio at the Vancouver Public Library.
Tessa gave her a six-page ADHD checklist to complete.
“The Plexiglas feeling is better than nothing,” Annie concluded.
Whatever was wrong with her back then, meds couldn’t fix it. It needed time and baby steps. She tapered down to half-of-a-half
of a standard dose of Trintellix through med school, as it let her work night shifts in the ER without being a puddle. And
things had become so much easier. In her last year of residency, she was taking a microscopic dose of Trintellix—-Tessa said it was
doing nothing—-and many days she forgot to take it at all.
Annie has logistical things figured out, like weekly grocery lists, batch cooking. Tax filings and how to get an oil change.
She’s discovered other small satisfactions: the heaviness of a down comforter on her feet, the bittersweet taste of espresso,
the hummingbird feeder on their balcony. The birds visit most mornings, with their iridescent throats and the way they sometimes
hover beside Annie’s ears and tickle the insides of them, a Walker-ish vibration that starts in her scalp and cascades itself
down her neck and arms, rushing off her fingertips.
And they have each other. He knows everything about her and vice versa. Annie and Evan have built something new, a life that
resembles the lives of people around them here in the city. The way lives are supposed to look.
Ruth would have approved.
“Maybe we should have a baby,” Evan had said casually, two months ago. He was lounged out on the couch, watching a reality
TV show about a middle-aged guy who lived on the edge of Vancouver Island, off-grid with his dog, and built cabins for people
in the middle of nowhere. Even though she hates TV, Annie couldn’t help sitting next to him to watch.
“We could get a sailboat,” Annie replied, shocking herself. A sailboat? It came from nowhere; she had not allowed herself
to think about sailing for years.
Evan paused the show. “Or that.”
She went off all the meds.
Not because she had to. Even if she were pregnant, they were likely safe to take. But she didn’t want to get pregnant yet
and it wasn’t the idea of having a baby that made her want to stop taking them. It was the views of the Pacific Ocean on the
screen, the sunburn on the man’s cheeks. It was the waves hugging the shore and the trees too large to wrap your arms around,
the sand covering his dog’s paws.
It was that TV show.
Annie doesn’t need Evan in the waiting room today, worrying about her, the way he does, especially if nothing is fixable.
Especially since she can’t reveal the thing about Walker’s sound, which would possibly verify what Isaac has been warning
Evan about all along. She didn’t mention to Evan that she had booked in with Tessa. She left him at home repairing their leaky
faucet.
“I’m shift one today. I’ll be home around four.” She said it quickly as she zipped up her fleece.
“I’ll do dinner.” He kissed her gently in the doorway, his palm lingering on her cheek. “Try to claw your way out of there
on time.”
Annie is not working shift one.
Tessa whirls into the room, carrying a take-out coffee in one hand, a pile of folders in the other. She’s tall with a long neck and reminds Annie of a graceful giraffe. Her sleek brown hair is tucked behind her ears. “God. Sorry, Annie. I’m so behind.”
“No, thank you for squeezing me in.”
Tessa sits down on a swivel desk chair and clicks rapidly on the mouse in front of the computer. “This thing never starts
up fast enough . . . There we go.” The hard drive comes to life. A sign-in box flashes onscreen.
Annie shifts on the table.
“So, you’re tired,” Tessa says, typing. “When did it start?”
It’s been months. When was the last time she felt vital? She can’t really remember. She’s been zoned out and repeating the
days this week, lugging herself around like a sandbag. Maybe she is pale, too, like Evan said? It isn’t only this Walker preoccupation.
Something else is off.
“I’m sure it’s nothing,” Annie says.
“Any other symptoms?”
A laundry list. She cannot sleep, again. In loud places, her ears ring with that splitting not-really-tinnitus but whatever
it is her ears do. She’s isolating in her apartment and doesn’t leave except for work. And also, she might be certifiably
insane—-listening for a sound no one else can hear, made by a man who is most likely dead.
Annie says: “No.”
“Well. Let’s take a look.” Tessa stands. She’s wearing an army-green tunic and scuffed brown leather boots. Her knee-high
socks are patterned in mathematical equations. She wraps the blood pressure cuff around Annie’s arm. “Are you light-headed?”
she asks.
“Sometimes, lately.”
Tessa removes the cuff and places her stethoscope against Annie’s chest and listens. “Take some deep breaths.”
The air is parched. The insides of Annie’s nostrils sting.
Tessa cocks her head, moving the stethoscope around the circumference of Annie’s ribcage. “Lie back. I’m going to throw the ECG on.”
The paper rips underneath her as Annie shuffles down the table onto her back. The vinyl is tacky against her skin. To avoid
her feet hanging off the end, she bends her knees and tucks the gown around her thighs.
Tessa wheels in the ECG machine and attaches stickers and leads to Annie’s skin. A series of waves and spikes fills the green-and-white
screen, until it stops and prints off a page of tracings. Tessa studies it. Her mascara is smudged under her left eye.
“You can get dressed,” she says.
Tessa pulls a curtain around the examining table, then washes her hands at the corner sink. The room fills with the mild scent
of soap. Annie peels the stickers off her skin and leaves them in a pile, the adhesive now on her fingertips. She fastens
her bra and pulls her sweater over her head. Her leggings get stuck on her toes. She inches them up while Tessa types.
“I got your bloodwork results,” she says.
Annie tries to pull the curtain aside, but it catches on the metal rail. “Are they normal?”
Tessa stares at a table of numbers. “You’re anemic and iron-deficient. I can’t believe you’re still walking, let alone working
your crazy shift schedule.”
“My schedule’s not that crazy.” Annie yanks on the curtain until it gives.
Tessa pauses. “And you’re bradycardic.”
Annie blinks and she’s back in the warehouse, in the berth of Polaris. I can hear your heartbeat, Walker says.
“My heart rate’s always been lower than average.”
“It’s in the thirties, though.”
Annie sits back down. It’s never been that low, has it? And why is her iron low? “None of this has been an issue before.”
Tessa types into a pop-up box. “I think we should set you up with an iron infusion, to start. Get a Holter monitor done. I want you looked at by cardiology.”
“What about oral iron? I could start tablets.”
“I can book you this afternoon for an IV. Faster.”
Annie hesitates, a shiver rolling up her skin. Outside, a garbage truck backs up. Footsteps and voices fade in and out from
the hallway.
Tessa’s eyebrows arch as her cursor hovers over a booking slot. “It’s not a trick question.”
“But why is it low?”
“Are you eating?”
She goes whole shifts without eating. She can’t stomach the hospital cafeteria, all sugar and cellophane, wilted celery and
small plastic pots of hummus, soggy egg-salad sandwiches. She never buys any of it. Is that why she’s not eating? A flicker
in her brain, but it flits away. “I eat okay.”
“I get it. You don’t have time to pee in there, let alone eat,” Tessa says. She has clicked out of Annie’s chart and into
her message inbox, scrolling through hundreds of red lines: alerts, reminders, due dates. Her breath is shallow. Her eyes
skim across the screen.
“I could eat better, maybe.”
“Well.” Tessa clicks back into Annie’s results. “Maybe it’s your periods. Are they heavy?” She takes a sip of her coffee.
The lid is imprinted: compostable. Drips have escaped, staining the sides of the paper cup.
“Not really,” Annie says.
A faded birth control poster detailing probabilities based on contraception methods is pinned to the far wall with brown thumbtacks.
A hundred stick figure women line up, all coloured in grey, except one is pink.
“Let’s book the infusion anyway,” Tessa says.
Annie can’t stop the forward momentum. And why would she? This is normal, this is reasonable. This is how low iron is treated. Maybe she’ll feel better.
“Three p.m. today.” Tessa tosses her unfinished coffee in the garbage.
The room feels crowded and small. Annie feels small. She sticks her hands under her thighs.
By 3:48 p.m., a catheter flows into the hollow of Annie’s elbow.
She tries to get comfortable on the plastic chair in the hematology unit. It smells curiously of turpentine. The walls are
whitewashed.
A janitor walks past with a bucket of water the colour of mud. A yellow sharps container is screwed to the wall beside her;
the biohazard warning across the front is peeling off.
The nurse writes on a clipboard. “You good?” she asks, as Annie’s heartbeat creeps across the monitor. “Your heart rate’s
low.”
Annie nods. “I’m fine. That’s normal for me.”
It is not normal.
“Alright, Dr. MacLeod,” the nurse says. “We’ll keep a close eye on you.”
Annie watches the drip, hoping it helps. Hoping she’ll feel more human again, and Evan can stop worrying, and they’ll be fine.
If she focuses, she can hear the liquid iron falling from the bag into the plastic reservoir above the tubing. Each drop reverberates.
“You’ll get some energy back soon enough,” the nurse says and slides the clipboard into a slot on the wall.
Her footsteps disappear down the hallway.
Annie looks out the window at high-rises, electricity lines, low-hanging clouds. In the distance, through an opening between
buildings, she can see the ocean.