After the Rain (5 page)

I moved to Jake’s bedside and leaned over. He wouldn’t make eye contact with me.

“Hi,” I whispered. He didn’t respond. He continued staring past me toward the ceiling. His eyes looked hollow. “Jake?” I said softly.

I watched his Adam’s apple bob as he swallowed his fear and spoke. “You all should have left me out there.”

“Oh Jake, I’m so sorry.” I fell forward onto his chest, overcome with guilt. He was paralyzed because of me.

I knew he could move his hands and arms but he didn’t even try to cradle me. He just let me slide off of him. I collapsed onto the floor in sobs.

Jake spent a month in the hospital and then a month in a recovery center. For each milestone he achieved—regaining full use of his hands and arms, using a wheelchair—I danced around and celebrated while he sat there and glared at me. One day, when we were with his physical therapist, I asked her if Jake could try to work up to using his legs again.

Jake snapped before the therapist could answer. “The doctors said it would be impossible. Are you deaf? Did you not fucking hear that?” Before the accident he never spoke a hurtful word to me.

“I’m sorry, babe,” I mumbled.

He didn’t respond. Instead he wheeled himself down the hall toward the exit.

At our cabin, Dale and Redman built a ramp and made other accommodations for the wheelchair. Life didn’t get any easier once Jake was home. He didn’t want me to bathe him or care for his needs in any way that would embarrass him. Instead, he would call Bea, and even then it was only to do the bare minimum. It made me feel useless and drove a big wedge between me and Jake. By winter his hair and beard had grown long and his eyes had become more expressionless and distant. The electrical current that animated his eyes had disappeared, and they dulled in color to a doleful, hazy blue. He spoke few words to me or anyone else. He would sit in his chair all day long in the front room and stare out the window. People on the ranch would walk past and wave to him but he would never wave back. There was a small TV in the corner that he kept on all day, usually on a news or sports channel. I think it was to drown out his own thoughts.

Besides Jake’s looks, his personality changed a lot in the months following his accident. He didn’t talk to me about how he felt. He wouldn’t kiss me; he would barely even look at me. Dale tried over and over to help him. He even encouraged Jake to begin studying so he could go back to school and become a veterinarian, or at least an assistant. Dale offered to let Jake work with him but Jake refused. He oftentimes got very agitated at anyone who made suggestions like that.

I stopped trying to convince Jake that he could have a normal life. He would sometimes call me stupid and then he would beat himself up afterward for treating me that way. The only thing I could do was try my best to make Jake comfortable. I continued working on the ranch so that we would have money. I ordered everything that a handicapped person could possibly need and had it all delivered right to our doorstep.

The doctors convinced me that Jake didn’t need pain medicine anymore but he would get so aggravated if I tried to lower his doses. He would tell me that I was lucky I didn’t know what it felt like to be crushed by a horse. He was wrong, though; the pain and guilt I felt was like a stampede of twenty wild horses trampling my heart every day.

On the coldest night that winter after the accident, Jake found a bottle of whiskey under the sink. I sat on our couch and watched him drink glass after glass in front of the fire. Before I went to bed, I went to him. I brushed a hand down his arm from behind and bent to kiss the side of his face.

He grabbed my hand, stopping me, and squeezed it so hard I had to hold my breath to prevent a scream from escaping my lips. Pulling me down toward his face, he seethed through gritted teeth: “Don’t. Touch. Me.”

He let go and I grabbed the bottle. “No more of this, Jake.”

He reached his long arm up, took a hold of my hair and neck from behind, and slammed my head down on the TV tray over his chair. I tried to pull away but he slammed me down over and over again. Scratching at his arms and trying desperately to get away, I could feel my hair being yanked out with every effort. I was crying and screaming and shocked by his strength. When I tasted blood in my mouth, I pleaded for mercy.

“Please, baby, stop,” I cried.

He held me down over his chair and whispered, “I’m taking you with me.” He smelled of whiskey and thick B.O. mixed with the muskiness of his greasy hair.

I fell to my knees as he gripped my neck tighter. “Please! Let go, you’re hurting me!”

“You want to come with me, don’t you?” he said, matter-of-factly.

Seconds later, I felt Redman forcing me out of Jake’s grasp. He didn’t say two words to Jake as he scooped me up and carried me out.

Walking toward the big house with me in his arms, Redman said, “You’ll be okay.” His voice was low and soothing.

He took me into the guest room and laid me on the bed. Bea came in with a bowl of warm water and a washcloth to clean my face. I reached up and felt my swollen cheeks and the blood mixed with tears.

Bea’s expression was stoic as she dabbed at the cuts over my eyes. “You don’t deserve this,” she said.

“Yes I do.” I believed it like it was the ultimate truth, just like I believed that the sun would rise in the morning and fall in the evening.

She started singing “Danny Boy” quietly while she continued cleaning my face. I fell asleep wondering when Jake would come back to me.
I
f
he would ever come back to me.

One eye was swollen shut in the morning. I shuffled back to our cabin with my head down and found Jake staring out the front window with his usual blank expression. He turned his chair and looked up at me, studying my face for an entire minute. It was the first time since his injury that I saw any sign of compassion or of the man I knew before. He was guilt-stricken by what he had done to me. He scowled and shook his head but didn’t say anything. He just turned and went back to looking out the window.

After cleaning the cabin, I put on a thick jacket, baseball cap, and sunglasses and headed for the door. “I’m going to get milk and bread and cheese for sandwiches. Is there anything else you want?”

He didn’t answer me, which wasn’t unusual. At the bottom of the ramp, I looked up to the window and saw that he was watching me.

I love you
, I mouthed to him.

I love you
, he mouthed back.

I let a smile touch my lips before turning toward my truck. When I reached for the handle, I heard the explosive, ringing sound of a gunshot. I whipped back toward our cabin and saw, through the window, Jake slumped over in his chair.

It was a cold January morning when my husband, Jake McCrea, put a pistol in his mouth and pulled the trigger, taking his own life just seconds after he had told me he loved me.

I couldn’t fix him. There were no healing powers in my hands.

He hadn’t physically taken me with him, as he had threatened to, but he took what was left of my heart, ending any semblance of life inside of me. At nineteen, I became cold and hard and looked forward to the end of my bleak existence.

CHAPTER 4

Binds Us

Nathanial

SPRING 2010

A
t twenty-nine I was the youngest attending physician at the UCLA medical center, which earned me the annoying nickname of Doogie. I had skipped a couple of years of the bullshit in high school that the rest of my classmates got stress-acne over. I could do calculus in my sleep so it was no surprise that my general surgery and cardiac residency also flew by at a faster than normal pace.

Every other doctor from my residency found a way to screw up and extend the already painfully long road to becoming an attending. Frankie blew his chances by fucking everybody in the program. Then there was Lucy Peters, who started dating a senior resident and then botched an appendectomy after he broke up with her. But the biggest loser of all the degenerates was Chan Li, who came to work hungover one day and left a thirteen-inch metal retractor inside the abdomen of the patient he had performed a textbook surgery on. Idiot.

My dad started to pull away from me as I climbed the ranks at the hospital. He was still the chief but I think he was trying to avoid rumors of nepotism that plagued me, especially after I began acing every surgery. I went to work and occasionally went back to the apartment I lived in with my cat, Gogo. My mom and dad expressed concern that I was making work my entire life. I thought: So what? How else can you be the best?

I met Lizzy Reid one Monday as I stood over her hospital bed and examined her chart. The fifteen-year-old was asleep when I walked in but began to awaken while I read through her medical history. She looked up at me through piercing green eyes and smiled. Her skin was tan and lush. It was hard to believe she had a faulty heart.

“Hi, Doc,” she said shyly, reaching her hand out to me.

“Elizabeth, I’m Doctor Meyers. It’s nice to meet you.” I shook her hand and went back to reading her chart.

“You can call me Lizzy.” I didn’t respond. “You seem kind of young for a surgeon.”

“I assure you I’m old enough.”

“Oh.” She shrugged and looked away. She mumbled something to herself.

“What’s that?” I asked.

She smiled coyly. “Oh, I was just thinking out loud. Just wondering something. I’m just super curious about stuff.”

“What do you want to know?”

Her lips flattened and her tone went harsh. “I wonder if they teach bedside manners in medical school anymore?”

I couldn’t help but laugh. I placed her chart into the slot at the front of her bed, slipped my pen into the pocket of my white lab coat, and crossed my arms over my chest.

Smiling I said, “Technically it’s ‘manner.’ ”

“Same difference,” she shot back.

“Maybe you’re right.” I put my stethoscope in my ears and warmed up the diaphragm on my arm, rubbing it back and forth. “Can I have a listen to your heart?”

“Thank you for asking, Doc. Your manners are getting better. And thanks for warming that up,” she said as she pulled the top of her gown down just enough for me to slip the chest piece in. I heard the atrial bigeminy right away but I expected it from her ECG results. Her heart sounded like a musical beat. Instead of
boom-boom . . . boom-boom . . . boom-boom
, it sounded like
boomboom-boom . . . boomboom-boom
. I moved the stethoscope and heard a deep heart murmur caused by an interatrial septal defect.

“Well?” she asked.

Her parents entered the room with concerned faces.

“Doctor Meyers,” the mother said. “We heard you’re the best around.” She reached out to shake my hand.

Lizzy spoke up and jutted her thumb toward me. “You mean this young guy is the best?”

“Elizabeth,” her mother scolded then turned back to me. “Sorry about that.” She shrugged. “Typical teenager. I’m Meg and this is Steve.”

I shook their hands, picked up the chart, and began writing down notes. Without looking up I said, “Elizabeth’s condition is very common. She has an irregular heartbeat but it shouldn’t have any long-term effect on her health. What we’ll need to address, and the reason she was feeling light-headed during exercise, has to do with a minor defect in her heart. We’ll use a catheter to correct it.”

“Will you have to open her up?” Steve asked.

“No. We’ll go in through her upper leg into the femoral artery, which leads to the heart. At first the pressure of the
heart will hold the device in place. Eventually new tissue will grow over the septum, which will correct the oxygen levels in her blood. I’m confident she’ll be able to go back to her usual activities in a month or two.”

“That’s it. She’ll be fine after that?”

“That’s the hope, Meg.” I grinned confidently but I could tell my attempt at charming Lizzie’s mom was ineffective.

“Okay smart guy, how many times have you done this?” Meg asked.

“Four times, and I’ve assisted and observed a similar procedure on a patient of the same age. It’s textbook, and there’s little risk of complication. But, keep in mind, that doesn’t mean there’s no risk.” I went to Lizzy’s bedside and observed her vitals. “We can schedule the procedure for this afternoon.”

“I trust you, Doc,” she said, “even though I still think you look too young.”

I finally smiled at her. “You’re going to be fine . . . better than before.”

Her eyes sparkled as she smiled back. I wondered briefly what she would look like in ten years. A vision flashed through my mind of her in a wedding dress and then another of her holding an infant. Struck by my uncharacteristically sentimental reaction, I shook my head in an attempt to eliminate the thought.

“What?” Lizzy said.

“Nothing.” I offered a short nod to Lizzy’s parents, left the room, and gave my instructions to arrange the surgery.

Later that day in the operating room, as my surgical team and I watched the X-ray screen and fed the line up from Lizzy’s leg, her pressure started to drop. A few moments passed as I calmly ordered the administration of medicines
and gave instructions to the other surgeons and nurses, but her blood pressure continued to plummet. The anesthesiologist looked at me intently, waiting for me to make a decision.

There is something to be said about knowledge and experience in the medical field. You can know every fact and read every case study, but when you have less than ten seconds to make a decision your experience is mainly what is tested. Your ability to be confident in your answers comes from knowing the positive outcomes in study and the negative outcomes from your own goddam mistakes.

“We have to open her up,” I said.

Every nurse and doctor went into motion the moment the words came out of my mouth. Within seconds trays were shoved in front of me with surgical instruments of every kind. The smell of iodine was heavy in the room, even through my mask. The sound of the saw piercing Lizzy’s sternum was like nails on a chalkboard. I had never had an emotional reaction to the gruesomeness of surgery until that moment. Everything about what I was doing seemed wrong. Cranking the spreaders to pull her bone and tissue apart took more effort than usual, and I had to cauterize several leaking ends from the breastbones. I gagged behind my mask at the smell of the vaporized blood and bone. Lizzy’s beautiful chest was peeled apart and spread open, revealing a nightmare about to unfold.

To my absolute shock and horror, her entire chest cavity was full of blood. Like in a dream, my hands and arms moved slower than my brain. “Suction!” I kept yelling, but I couldn’t find the source of the bleeding. Seconds felt like days. “Fuck! Suction, goddammit!”

“She’s crashing,” someone said calmly.

“I’m trying,” I said through gritted teeth. I was doing
everything right. I couldn’t understand what was happening and why it was happening so fast. I began running through long procedural lists in my head. Had I checked every possible source, I wondered? I continued barking orders at the team.

Twenty minutes later, a fellow surgeon told me it was over. I called the time of death with Lizzy’s heart still warm in my hands.

The first face I saw when I left the operating room was my father’s. He put his hands on his hips, which forced his overweight Hawaiian-print-clad belly to protrude from his lab coat. He pointed to the waiting room at the end of the hall and said, “Go tell the mother and then meet me in my office.”

Was he mad? I had just lost my first patient, a beautiful fifteen-year-old girl who’d had the rest of her life ahead of her.

I swallowed back anger. “You’re not going to apologize to me?”

“Apologize for what?”

“This is fucking tragic,” I said in a frantic voice.

“Keep your voice down,” he barked back at me, but it was too late. I had already gotten the attention of Lizzy’s mother, who was watching me through a wall of glass from the waiting room. My father leaned over and in a quiet and calm voice said, “It wasn’t a tragedy, it was a mistake—that
you
made. I read the chart. You misdiagnosed her.”

Shocked, I stared blankly at the wall behind him. I couldn’t blink my eyes. They were dried out and stuck open, and my heart was beating out of my chest. Thoughts began swirling frantically in my head. I was a terrible surgeon. I was a fuckup. I was a murderer.

“Why didn’t you stop me?” I whispered. I still couldn’t look him in the eye.

“Because you were so goddam anxious to get in that O.R., I didn’t have the time.”

I heard a cry from the waiting room. I watched as Meg, Lizzy’s mother, fell to the floor, sobbing. Somehow she knew; she could see we weren’t discussing good news.

I left my father, ran to her, and knelt by her side. “I’m sorry. I couldn’t . . . I tried.” Tears made their way to the front of my eyes and spilled over. I reached out and took her in my arms and rocked her back and forth for several moments while she screamed out, “No!” over and over in loud sobs.

When I felt Steve’s hands pulling me up, I looked into his tearstained eyes and said, “I’m so sorry.” My voice was trembling unprofessionally and laced with sadness and guilt.

He didn’t respond, he just pulled his shattered wife into his chest and walked out the door of the waiting room. I looked down to see my father still standing at the end of the hall, looking unemotional and stoic. I couldn’t face him.

I left the hospital and went to my apartment where I stayed for six days without speaking to a soul. My father rang the doorbell on a Sunday afternoon.

When I opened it, he gave me a pitying smile before walking past me into the living room. “It wasn’t entirely your fault, Nate.” I sunk down on the couch and watched him walk around, opening the blinds. “Son, you are the hardest-working person I know. Please don’t be discouraged. This is part of the deal. Every doctor makes mistakes and every doctor loses patients. We’re humans and we’re flawed. That girl needed a heart transplant, not percutaneous clo
sure. Who knows if she would have made it long enough to get one.”

“You mean, if I hadn’t killed her?”

He stood over me as I stared at my fidgeting hands. “I put you in for leave.”

“What? Why?” I said with no expression on my face.

“I made an executive call. You were getting a little cocky, Nate.”

“You’re punishing me for losing a patient?”

He sat down next to me. “Look around this place. This is where you live? You’re almost thirty years old and you haven’t purchased any décor for a house you’ve lived in for five years, not even a television?”

“I’m never here.”

“You’re always at the hospital.”

“Your point being?”

“It’s not healthy.”

“Okay, so now what? You want me to take time off and decorate my apartment?”

“I called your Uncle Dale.”

“Why?”

“You’re taking a month off. I’ve got your patients covered. Son, look at me. . . .”

It was hard to look him in the eye because I knew he was right. I needed to get away but didn’t know what I’d do without the hospital. “What about Uncle Dale?” My father’s brother, a veterinarian, lived on a ranch in Montana, one that I had visited as a kid. The owners, Redman and Bea, were friends of my grandparents. We visited the Walker Ranch during the summers when I was a kid, but now my uncle lived there.

“Dale could use some help and they have the space. It’s
beautiful there this time of year. You could fish. Remember how to do that?” He smiled.

“What, and help Dale deliver calves?”

“Something like that. You’re not above that, are you?” My father’s expression was one of disappointment. It was the first time I had seen that look in his eyes in a long while. The last time he seemed disappointed was when I was seventeen and I drove my mom’s car over her flowerbed in the front yard. That look made me feel small.

My jaw clenched. “No, Dad, I’m not. I’ll go.”

“That’s my boy.” He patted me on the back.

Even as reluctant as I was at the idea, two days later I was packed and ready to go. Frankie was going to live in my apartment and take care of my cat while I was gone. His brisk knock came promptly at six a.m.

“Hey, brother.” He gave me a sideways hug and dropped a large duffel bag in the entryway. He looked around and said, “Wow, you still haven’t decorated this place?”

“Haven’t had time.”

“You bring women back here?”

“Haven’t had time.”

“It’s not like it’s hard for you. You’re a doctor, and you look like . . .” He waved his hand around at me. “You look like that.”

“It hasn’t been on the top of my priority list.” My cat jumped onto the couch in front of us. “Anyway, that’s my girl.”

“Wrong kind of pussy, man. What’s her name again?”

“Gogo.”

He laughed. She went up to him, purring, and rubbed her back on his hip. He shooed her with his hand. “Go-go away.”

“You better be nice to her.”

“She’ll be fine. This situation is kind of pathetic; I don’t know why I agreed to stay here. This apartment and that cat are going to kill my sex life. You might as well get five cats now and just quit. Seriously, Nate, when was the last time you got laid?”

“I don’t know. Let’s go. Are you gonna take me to the airport or what?”

“Tell me.” He began moving toward me.

“A while,” I said, towering over Frankie’s five-foot-five frame.