The Devil Wears Scrubs (20 page)

“We can’t just
give
you patient records,” she says, folding her arms across her chest. “You need a release to be filled out.”

Triumphantly, I hold the signed release in the air.
Jean Rogers is pretty demented, but not so much that she can’t sign her name, thank God.

“Fine,” the woman grumbles and gives me a set of hasty and confusing directions to get me to medical records.

“Thank you,” I say.

I glance over at Ryan, who is still clutching
the cake, still with that deer-in-headlights expression. I know he isn’t about to tell me why he’s here, and I’m betting that by the time I emerge from medical records, he’s going to be long gone.

I’
m totally right about Ryan vanishing from the nursing home. I make a quick pass through the first floor on my way out and he’s nowhere to be found.

What the hell was he doing in a nursing home?
And what was up with that cake?

The most obvious answer is that his dad is a resident of the nursing home and he’s bringing him a cake for his birthday.
But that seems kind of unlikely, somehow. I mean, Ryan’s only maybe in his early thirties, tops. How old could his father possibly be? 60? 65? That’s way too young to be a resident in a nursing home.

Or m
aybe the cake wasn’t from Ryan, but was from a patient’s family member. Maybe Ryan’s big secret is that he volunteers in a nursing home on his days off. Despite his assholish exterior, he’s really a saint who reads to old people with failing vision. And he didn’t want to tell me because he doesn’t want to ruin his tough guy façade.

No, that doesn’t seem very likely.

Ryan re
ally does seem like an asshole. I can’t imagine him having the patience to volunteer with old people. Plus that would be such a cliché.

But then what on earth was he doing at that nursing home?
It’s driving me crazy! Especially the fact that he seemed so uncomfortable about it and clearly didn’t want me to know why he was there.

When I get back into the hospital, I immediately get accosted by a man who’s looking for the outpatient pharmacy.
I keep insisting I don’t know where it is and he keeps insisting I must know, until I finally just point in the opposite direction of where I’m going. I swear, being a doctor is starting to make me dislike human beings.

Unfortunately, Mrs. Rogers’s nursing home records are not terribly enlightening.
I flip through the pages, searching for any mention of weird or mysterious smells. Nobody has made a note of anything like that.

Right now, in the battle of me versus Mrs. Rogers’s body odor, the BO is definitely winning.
  Has anyone ever published a case report about an atypical case of horrible, mutant BO?

As I head upstairs to report to Alyssa that I have failed to learn absolutely anything new, I practically smack into Ryan at the elevators.
His head is clearly somewhere else because he appears to be just as shocked as I am.

“Oh,” he says.
“Jane.”

“Hi,” I say.

Neither of us makes a motion to press a button for the elevator.
“So,” he mumbles, scratching his short blond hair. “That was… a coincidence, I guess. Huh.”

“Yeah,” I say.

He’s avoiding eye contact. I’ve never seen him do that before. Sexy Surgeon is the master of eye contact.

“My dad works there,” he says.
“It’s his birthday, so, you know, I brought him some cake.”

“I thought you said your dad was a lawyer.”

Ryan is quiet for a moment. Finally, he says, “Yeah, he’s a lawyer for the nursing home.”

“The nursing home has its own lawyer?”

“Sure, why not?”

Well, it
is
a pretty crappy nursing home—they could probably use a lawyer. Although it seems doubtful that place could afford an on-site attorney.  They can’t even afford air conditioning.

“Okay,” I say.
“Um, in that case, happy birthday to your dad.”

“Thanks,” Ryan says.
“I’ll tell him you said so.”

I don’t know if Ryan planned to take the elevator, but it’s clear he doesn’t want to be in a confined space with me right now
so he takes off for the stairs. I have no idea what Ryan Reilly is hiding, but I’m willing to bet anything that he wasn’t at that nursing home to celebrate the birthday of his dad, the nursing home lawyer.

“
Ooh,” Nina says. “Maybe he’s doing some undercover work there. Maybe he has a whole secret identity!”

Nina and I are taking advantage of our first day off in God knows how long to try to sort out the mystery of what Ryan was doing at that nursing home.
It felt so luxurious to wake up without an alarm, and to not have to drag myself to the hospital. I almost don’t know what to do with myself.

We ended up
in my room because Nina apparently owns the most allergenic cat that ever lived. Everything in her apartment was coated in a thin layer of cat hairs. I never had cat allergies before, but after five minutes in Nina’s room, my eyes were watering and my nose was itching. I told her I was going to asphyxiate if I stayed there another minute. She was a little offended, but agreed to relocate.

“I don’t think Ryan has a secret identity,” I say.
“I don’t think he has
time
to have a secret identity. He practically lives in the hospital.”

“Maybe he’s getting drugs from the nursing home,”
Nina suggests. “Ooh, maybe he uses the cake to smuggle drugs!”

I roll my eyes.
“You think Ryan is a drug addict?”

“Maybe he just sells them,” she says.
“You have to admit, there’s quite a market at County.”

She’s right about that last part.
But I can’t imagine Ryan selling drugs. He’s worked too hard to get where he is to screw it up like that. Anyway, it’s not like he lives large. His only attire is scrubs, and as far as I can tell, he seems to subsist solely on beef jerky and pizza.

“Well,” Nina says.
“What do
you
think it is?”

I’ve put a lot of thought into this.
And there’s only one really reasonable explanation that occurs to me.

“I think the cake really was for his dad,” I say.
“I think maybe his dad has some menial job at the nursing home, like a janitor or something, and… he’s ashamed.”

It makes a lot of sense.
Ryan acts like he’s such hot shit, and he wouldn’t want anyone to know if his dad had a job that was any less important than his own.

“Maybe,” Nina says thoughtfully.
“That or he’s smuggling drugs.”

I stick out my tongue at her, and she th
rows a pillow in my direction, giggling. “We should have a pillow fight,” she says.

“A what?”
I must have heard wrong.

“
A pillow fight!” Nina whacks me in the shoulder with a pillow and I shield myself. “Come on, it will be fun.”

“I’m sorry, but no,” I say.
“I think that we are at the age where the only place it would be appropriate to have a pillow fight would be in pornography.”

Nina flops down against my bed, pouting.
“Well, what are we supposed to do then? Come on, this is our golden weekend. I don’t want to waste it.”

In most hospitals, a golden weekend refers to the one weekend of the month where you get both days off.
In other words, a golden weekend is just a normal weekend to most people. However, the way the call schedule is set up at our hospital, having both days off is impossible. So the golden weekend just means you get
one
of the two weekend days off. This is actually a rare enough event that it’s worth celebrating. But just for the record, our golden weekend isn’t even as good as a normal weekend to most people.

“It’s not really a golden weekend,” I point out.
“It’s more like… a silver weekend.”

“It’s a day that I’m not in the hospital,” Nina says.
“Which makes it pretty damn special.”

Our conversation is interrupted by banging on my door.
I struggle to my feet and go to answer it. Naturally, it’s my roommate, Julia. Her hair is still in that uber-tight ponytail and she does not look happy.

“You have an unauthorized visitor,” Julia says, glaring across my room at Nina.

“It’s just Nina,” I say.

“I didn’t give my approval,” Julia says.
“Plus you have to give me 24 hours’ notice.”

“Are you shitting me?” Nina says.

Nina and Julia are glowering at each other. I feel compelled to at least attempt to make some sort of peace between the two of them.

“Come on, Julia,” I say.
“It’s our day off. Why don’t you come join us?”

Nina seems horrified, but for a moment, Julia actually looks like she’s considering it.
But then she stiffens and shakes her head.

“I’m busy studying,” she says.
She looks me up and down critically. “You should be studying too. I overheard Alyssa complaining to another resident that you never do any reading and have no idea what you’re doing.”

Why
am I not surprised?

“We’re going out
now anyway,” Nina says, jutting her chin out in Julia’s direction. “I just came by to have a look at how disgusting your bathroom was.”

Okay,
yes, I did tell Nina about the Bathroom Manifesto. And Julia looks pretty wounded at the mention of her bathroom being any less than spotless. But I have to say, she kind of had this coming. I actually feel a twinge of satisfaction as we brush past her on our way out the door.

I’m locking the door to the suite when I hear Nina gasp slightly.
I look up and there he is: Sexy Surgeon. Wearing real clothes: jeans and a T-shirt. His hair is sticking up slightly and he looks pretty tired, but of course, still sexy. “Ryan,” I murmur.

Ryan glances at Nina, then back at me.
“Jane, can we talk?”

Nina’s eyes widen—she gets the hint immediately.
“I’ve got to go give Val her shot now, actually,” she says. “Um, I’ll see you later, Jane.”

Nina scurries down the hallway, and Ryan watches her go.
He frowns. “Who’s Val?”

“Her cat.”
I add, “He has diabetes.”

“Right,” Ryan murmurs.
He couldn’t care less. He jerks his head in the direction of my door. “Can we go inside?”

I hesitate.
Julia said not to, but I’m hoping she’s gotten the crazy out of her system for the day. Anyway, I saw Ryan yelling at her in the hallway the other day for an inappropriate consult, so I suspect she’s a little bit afraid of him right now. I don’t think she’ll bother us.

“Sure,” I say.

Inside my room, we both settle down on my bed. But it’s clear that there isn’t going to be any sexy time right now. Ryan sits about three feet away from me, and he does not appear to be in an amorous mood. His usually ramrod-straight spine is slumped over and he’s staring down at his hands. I don’t say anything. I’m afraid that if I say the wrong thing, he might change his mind about telling me.

“My father isn’t a nursing home lawyer,” he finally says.

Yeah, no kidding.

“I’m sorry I lied to you,” he adds.

“It’s okay,” I say.
I want to reach over and take his hand, but he’s just a little too far away. “Whatever he does for a living, there’s no shame in that.”

Ryan lifts his head.
His brow is furrowed. “What do you mean?”

“I mean,” I say, “there’s no shame in cleaning toilets or… or, you know, whatever it is your father does.”

He shakes his head. “Jane, my father isn’t a janitor at the nursing home.” He averts his eyes again. “He’s a resident.”

“Oh,” I say.

That’s odd.
I did think of that, of course, but immediately rejected the idea, because Ryan’s father is probably only…

“He’s 64,” Ryan says, completing my thought.

“Oh,” I say again.
Apparently, that’s the only thing I’m capable of saying anymore.

“Jane,” he says.
“You can’t tell anyone about this, okay? You swear, right?”

“Of course,” I say.

He inspects my face for a minute and I try to look as truthful as possible.

Finally, he says, “He has Huntington’s Disease.”

In medical school, you end up learning a few facts about practically every disease there is. Like there’s this disease where your urine smells like maple syrup. For real. I’ve never seen anyone with that disease and surely never will, but I could name at least three facts about patients with maple syrup urine disease.

Huntington’s Disease
is relatively rare and not something I’ve ever seen before. But I learned about it and could recite three facts about it. First, it’s a severe neurodegenerative disease where you get something called chorea, meaning large, involuntary movements of the extremities. Second, the patients usually get a cognitive decline that evolves into dementia starting at around age 40, which I guess is why Ryan’s father is in a nursing home.  And third…

“Ryan,” I say, “isn’t Huntington’s disease…?”

He nods. “Autosomal dominant.”

The mutation that causes
Huntington’s Disease occurs on a single gene. Every person has two copies of every gene, one from each parent. If a disease is “autosomal recessive,” that means you need two copies of the gene in order to be affected. If the disease is “autosomal dominant,” however, that means you need only one abnormal copy.

In
practical terms, what that means is that if your parent has an autosomal dominant disease, you have a 50% chance of getting it yourself.

Oh my God.

“Do…” My voice comes out squeaky. I clear my throat. “Do you have the gene?”

Ryan shakes his head.
“I don’t know.”

I cock my head at him.
“I thought you could be tested for it?”

“Yeah, you can,” he confirms.
“But I’m not interested. I don’t want to know.”

“Seriously?”
I stare at him. “But… isn’t it driving you crazy not to know? I mean, what if you don’t have it?”

“Jane,” he sighs.
“Listen, I’ve thought about it. A lot. But here’s the thing. My sister got tested and she was negative. She’s happy now, has a job, a husband, and two kids. A great life.” He looks back down at his hands. “My brother got tested and was positive. He’s now an alcoholic, and he lives in his car. That’s if his car hasn’t been impounded.”

I see what he’s saying, I suppose.
But to me, it seems worth the risk. How could you go through life without knowing?

“I’ve got a 50% shot of having it,” he says.
“I can live with that. I can still go through my life, enjoy my job, and do everything I want to do more or less with that 50% chance. If it were 100%... I’m not sure if I could. I can’t take that risk—50% is the most I can deal with.”

“But it’s irresponsible,” I blurt out.
“I mean, what about when you get married and have kids?”

He smiles crookedly at me.
“Well, I’m not going to do those things, so it’s not a problem.”

“Are you serious?”

He nods. “I
can’t
. I can’t take the chance of passing it on to another person, so… I’m not going to start a family. No kids. You’re right—it would be irresponsible. Even if I didn’t pass it on, my father started having symptoms in his early forties. That’s too young to lose your father. I should know.”

I can’t believe what I’m hearing.

“If you knew you didn’t have the gene,” I say, “would you get married and have kids then?”

“Yeah,” he says, his voice heavy. “I would. But…” He looks up at me with those deep blue eyes. “I love being a surgeon, Jane. I love my job, I really do. And that’s enough for me.”

“I don’t know,” I say.
“I think you should get tested. Imagine how great it would be if you turned out to be negative. Right?”

Ryan frowns.
“Seriously, don’t try to talk me into it. I’ve been dealing with this decision for twenty years. I promise you, you’re not going to change my mind.” He slides over a foot on the bed, close enough that he can put his hand on mine. “If you really want to help me, then just promise me you won’t tell anyone else.”

“Of course I won’t.”
I raise my eyebrows. “Nobody else knows?”

He shakes his head.
“I don’t want people to look at me funny. And I definitely don’t want pity.”

No, he just wants to be the asshole surgeon.
But I get it. He doesn’t want to be treated any differently. He wants to earn respect, just like everyone else.

Ryan envelops my fingers in his.
“I’m glad I told you, Jane. I’ve been keeping this to myself for so long… it feels really good to finally tell someone. Get it off my chest, you know?”

He starts kissing me, pushing me down onto the bed, his hands lacing into my hair, which is loose for a change.
I can’t help but think about the fact that Ryan doesn’t have the luxury of falling in love. No matter how much he cares about a woman, he can never be with her for more than a short term relationship. He’ll never have a family. He’ll never have some little kid looking up to him and calling him Daddy, even though I can see in his eyes that he wants that. He has to give up so damn much.