Fire & Water Read online

  I tried to resist watching Mary K inject herself from the small vial she pulled from a thermos in her pack. I waited for a wince of pain as the needle entered her soft flesh. Her expression unchanged, she took a deeper drag off of her cigarette as she pressed the plunger. She exhaled a smoke stream and reattached her overall bib. “Say, Murphy, I’d appreciate it if this could be between us,” she said, jutting her jaw toward the thermos. “It’s not really the impression I want to give to the profs around here. People get weird about it. Maybe we could establish some, I don’t know, roommate code of silence or something. I’m not much of a blabber, so your secrets are safe with me.”

  I shrugged, wishing I had a secret for Mary K to keep. “Sure. I understand. We all get a fresh start here, right?”

  “True enough.”

  * * *

  Mary K came back into our kitchen after snuffing her cigarette on the porch rail. The breakfast table that had for so long been cluttered with textbooks and medical journals was now clean but for The New York Times sports pages, a dish of jellied toast, and an ashtray full of cigarette butts.

  “You look like hell. Not like you to be out so late on a school night, Murphy.”

  “Thanks. You’re gorgeous, too,” I said. I twisted my unruly swarm of hair into a knot. I perused the limited but orderly contents of our fridge. In the door compartment, insulin bottles, and in a clear jar of isopropyl alcohol floated several hypodermic needles.

  One semester in the dorms trying to manage her sugar levels on the carbohydrate-laden cafeteria food was enough for Mary K. We found off-campus housing by the second semester. Over that first Christmas break, we retrieved Ben Casey from her sister’s third-floor walk-up in New York and drove him to California in my Bug.

  “Your folks called about a hundred times.”

  I focused on my fridge search.

  From under the kitchen table, the now elderly Ben Casey huffed as he rose from beneath Mary K’s feet to greet me. I rubbed his slack old jowls. “How are those hips today, huh, buddy?” He let out a little whimper. “Did you inject him yet? He looks pretty stiff this morning.”

  “We’re both rigged up,” Mary K said. “He got me up early with the wet-tongue alarm. Had a pretty rugged night.” Ben’s cold nose found the gap between my pajama waistband and my undershirt. The sound of a sweet soprano voice rang from the shower down the hall, singing “Crocodile Rock.”

  “Who’s this morning’s diva?” I asked.

  “That would be the aptly named Melody, a lovely ingénue I met at The Lex. A sociology undergrad who wants to change the world. She certainly changed mine last night.” Mary K took a long swig from her Mets coffee mug and twitched her eyebrows.

  “Don’t think you’ve ever sported a Melody. Am I right?”

  “Nope. A personal first. Did have a Harmony once back in high school, though. Sort of seems like I’m balanced out now.”

  “Anything serious?”

  Mary K cut a glance at me.

  “Not for you. For her?”

  “Melody’s a LUG, out for a good time.”

  “LUG?”

  “Jesus, Murphy. How many lesbian bars have I taken you to? LUG. Lesbian Until Graduation. She’ll have her flings.” Mary K pointed to herself. “Moi. Then she’ll get an engagement ring for graduation, marry an accountant, get a split-level house in the burbs, and have two-point-five kids. End of story.”

  Finding a yogurt, I slid into the chair across from Mary K. “Thanks for the Reader’s Digest version of the LUG life cycle.”

  Mary K’s sun-freckled face broke into a sly grin. She licked her finger and turned the page. “And where were you until the wee hours?”

  I shrugged and kept my eyes focused on the inside of my yogurt carton.

  “I thought you decided to move on from Nigel Abbot for the fiftieth time.”

  Nigel and I had spent the whole evening talking about the hospital. I’d mentioned nothing about Tully’s drunken announcement, instead welcoming the distraction. At the end of the evening, I’d decided I wasn’t up to spending the night, so Nigel had driven me home. “Nigel’s easy. Uncomplicated,” I said.

  “Boring. And if your face tells the story, he’s also a bum lay. What was all that about not wanting to lead him on? Give the wrong impression?”

  “Nigel is not a bum lay. Not that it’s any of your business. Nigel helps me, you know, get some release now and then.”

  “God, Murphy. You make sex about as erotic as lancing a boil. Don’t get me wrong. Nothing wrong with having a fuck buddy. But you come home looking shit-faced with remorse every time. You could use some genuine passion, you know? Some wow. Some pow. Some oh-my-God, even.”

  “Look, Kowalski, you’ve got a real grown-up woman, a brilliant, skilled physician, completely enamored of you, though I’m not sure quite why.”

  “Who, Barbie?”

  “That would be Dr. Andra Littleton.”

  “Ha! You think some Texas beauty queen is the real deal?”

  “When you’re actually in love with the woman who’s in your bed, or when there aren’t four different misty-eyed coeds in a given season, I’ll listen to your advice on relationships,” I said, grabbing a bite of one of her pieces of toast. “Just please tell me I’m not going to have to field calls from a broken-hearted Melody.”

  Mary K was momentarily distracted by Ben, who plopped his giant head in her lap.

  “You’re lucky that Ben is such a poor judge of character,” I said.

  A smirk crossed Mary K’s face. “Romance notwithstanding, I have a sterling character. Don’t I, Dr. Casey?” Ben lifted his massive salt-and-peppered form from the floor, stood by Mary K’s chair, and licked her face. His head was bigger than Mary K’s, and right at her eye level when she sat. “You know, you could ratchet the judgment quotient down a few notches. Since you’re still all creamy from a guy you only tolerate for purposes of relief-fucking, I don’t know that you’ve got lots of room here for moral superiority.” She mashed her cigarette in the ashtray. “Let’s face it. Despite our brilliant medical minds, both of us are completely fuck-tarded. You settle for the likes of the Nigel Abbot, the tofu of sexual passion, instead of having true love. I don’t fall in love at all, even when the sex is mind-blowing.” Mary K clicked her tongue. “And Miss Melody Truman was certainly mind-blowing. What she lacks in depth and complexity, she makes up for in enthusiasm and joint flexibility—”

  “Spare me the details.” I looked again at the plate of Mary K’s half-eaten toast, glimmering with berry jelly. “What’s with the breakfast of champions?”

  “Little shaky. No big deal. Sugar levels dipped a bit. But good old Mr. Smuckers here is helping me out.”

  Upon closer examination, I could see her hands tremble as she held the paper. Her complexion was gray, and dark circles hung like shadows under her eyes. “How low?” I asked.

  “Not to worry. It’s cool.”

  Despite her rigorous dietary discipline, her recalcitrant pancreas still kept her sugar levels unpredictable.

  “Wipe the worry off your puss, Murphy,” she said. “This is just one more little turd float in my personal shit parade. It’ll pass.”

  I reached for her hand. Feigning disgust, she jerked her hand back and wiped it on her shirt. “Hey, I know where those hands have been. And recently, too.”

  * * *

  Near-blistering water poured over my head. I stood still in the steamy shower, trying to wash off the weariness of the night before. Tully’s words raked through my brain and the look on my dad’s face almost melted me. “Liars!” I said out loud.

  I stood until the water began to grow cold. “All right,” I shouted in surrender to whatever god reigned over water temperature. “I’m getting out, already!” I’d just turned the water off when I heard a crash and Ben Casey’s chesty bark. With a towel flung around me, I ran toward the barking.

  Mary K lay ashen on her bedroom floor, a toppled lamp on the rug beside her. I lifted her limp
arm, trying to find a pulse. “Mary K!” I shouted. “I’m here. Wake up!” I couldn’t find a pulse. Ben Casey let out a low, mournful moan. Low. She said her sugar was low. I grabbed the phone before I ran to the fridge. “Stay with her, Ben. I’ll be right back.” The stately dog lowered his massive head and licked Mary K’s face. I returned with orange juice and lifted Mary K’s head. Her lips were parted, her jaw slack. The juice I poured dribbled from the corner of her mouth. “Come on, Mary K. DRINK!” As she sipped, I fired our address to the 911 operator.

  The ambulance arrived in five minutes, but it seemed like hours had passed.

  “She’s diabetic. Type 1,” I instructed. Soon Mary K’s body was on a gurney and they were wheeling her out the front door and into the ambulance.

  I grabbed Mary K’s emergency card from the desk drawer. “She wants to go to Oakland.”

  The EMT shook his head. “No way. UC’s around the corner.”

  I thought of the promise I’d made so long ago. Going to the ER would be like taking out a billboard, announcing her condition to the whole hospital.

  “SF General then,” I barked.

  The other EMT opened Mary K’s eyelid and shined his pin light beam into her eye. “No time,” he said.

  “Look,” the first EMT said, “we’re working to get her stable, but she could go into diabetic coma. That could kill her. The faster we get her into the hospital, the better her chances.”

  I looked down at my friend, so small and still. “Okay, but I’m going with you.”

  “You can’t go in the ambulance, Miss.”

  “I’m a doctor. I’m going with you.”

  The two boy-faced EMTs glanced at each other. One reached out and touched my forearm. “Why don’t you get dressed and meet us at the hospital.” I looked down to see the towel still wrapped around me.

  As the ambulance pulled away, its siren screaming as it went, Ben Casey nudged my hip with his great snout and let out a soft whine.

  * * *

  From the nurse’s station in ICU, I could see into Mary K’s room. She lay there looking like Goldilocks in Papa Bear’s bed, her face toward the window.

  I felt a hand on my shoulder. Andra’s eyes were moist, green pools. “How’s she doing?”

  I sniffed. “Stable. Better than this morning, but it was dicey for a few hours.”

  “That’s good.”

  “Managed to avoid slipping into a coma. Barely.” I’d calculated and recalculated the seconds I’d delayed the ambulance, trying to protect Mary K’s secret. It all seemed so foolish now. “So I suppose the news is all over the hospital.”

  “Like a fire in a hayloft.”

  “She’ll hate that.”

  Andra gave me a reassuring pat on the forearm. “Let me know if she needs anything.”

  “You’re not going to see her?”

  Andra shook her head. “I’m the last person she wants to see right now.”

  “I’m afraid that line forms right behind me.”

  After Andra left, I eased my way into Mary K’s room. “Hi.”

  The head of her bed was raised and an untouched tray of food sat on the table in front of her.

  “Looks like they’re treating you all right.”

  “Yeah, well. It’s a class joint. Any kind of gray vegetable you want.” She turned her face back toward the viewless window.

  I resisted evaluating the readings of the monitors and instead sat in the visitor’s chair.

  “Ben okay?” she asked, her voice flat.

  “Yeah, Mrs. Koblenz is watching him. Ben’s the one that let me know you’d passed out. Probably saved your life.”

  Mary K gave a small nod. “For about the thousandth time.” She coughed and cleared her throat.

  “Thirsty?”

  “I’ve got enough fucking nurses. Go home. Take care of my dog.”

  I fought back tears. “I tried to get them to take you to Oakland, but there wasn’t time.”

  “I’d have fucking died on the Bay Bridge. That would have been a shit-for-brains medical decision.”

  I sat not knowing whether she was grateful to me or furious. “So now you can go to a doctor on this side of the bay. That’ll make things more convenient.”

  Mary K turned to me, piercing me with an icy stare. “Look, Murphy. I’m not quite ready for your silver lining theories. You got your wallop last night. I got mine today. Life’s just a series of nasty crap you’ve got to deal with and a few pleasant distractions to make you forget and that’s as good as it gets. Once I’m out of this bed I’ll go through the necessary arrangements to decline my residency here and take the one I was offered in forensic pathology with the coroner’s office.”

  My head was full of buzzing bees. “Wait a minute. You applied for a residency with the coroner?”

  “Needed a backup plan. Besides, you know how excited I get around a corpse.”

  Her words were a sock in my stomach. “Autopsies? You want to do autopsies and tissue scans? With those hands and that mind?”

  With a sudden burst Mary K slammed her fist against her table. “Fuck!” She held out her quivering hand, palm down. IV tubes dangled like tendrils. “Would you want me to do a liver transplant on your dad on a bad sugar day, Murphy? Would you? I’ve been kidding myself. Jesus, you act like I have all the choices you do. I fucking don’t, okay?”

  Mary K had spent years creating the illusion that nothing at all was wrong with her, so much so that I’d almost come to believe it. I knew what becoming a surgeon meant to me; it had been the focus of all of my energy for so many years. The thought of losing it was too painful to fathom. It was a dream that we had shared for so long. I wanted it almost as much for her as I did for myself.

  “Wipe the pity puss, Murphy. Or I swear to God I’ll slug it off you.”

  I swallowed and tried to erase whatever on my face was betraying my thoughts.

  The ICU nurse came into the room at a run. “Everything okay in here?”

  “Fine,” Mary K barked back at her. Cora was a seasoned nurse we’d both met during rotations. She had the tact and good sense not to fawn over Mary K. She checked Mary K’s IV lines. “Look, you need to stay calm. You’re stable and we’re about to transfer you out to the floor. But you still need rest.”

  “I’m not going to the floor. When I go out of here, I go home.”

  Cora put her hands on her hips. “We’ll just have to talk to your doctor about that.”

  “I’m my doctor. What do you think of that?”

  Cora looked back at me with a smirk. Leaving the room, she said, “Five minutes.”

  “Do not talk, Murphy. Just do not talk to me.”

  “But, I’m so sor—”

  Mary K shot a glare at me that scalded my skin. She drew ragged breath. “So, did you call your dad?”

  I tried to mimic the heat of her searing look. She didn’t flinch. “Best defense is a good offense, right?”

  “I know it’s shitty finding things out the way you did, but what the fuck do you expect? They should tell an eight-year-old her mom croaked herself?”

  My mouth suddenly tasted sour. “They lied.”

  “Everybody lies, Murphy. Either by saying shit or by not saying shit. People lie. That’s why I prefer dogs.”

  “Whose side are you on?”

  “I’m Switzerland. Look at me. About the only thing I know is that life’s short. Quit acting like a baby. Talk to your folks. They’re going crazy.”

  Just then a young hospital volunteer, probably a high school student doing her community service project, brought in a bouquet of Get Well Soon balloons. With a broad smile and a voice right out of a Disney cartoon, she said, “The tag says they’re from the entire intern group.”

  Mary K’s lips pressed together and her eyes narrowed. “Get that shit out of here.”

  The young volunteer blinked in confusion. “But they’re for you, and balloons are okay in ICU. No flowers because of allergies, but—”

  �
��Get—Them—Out.”

  Balloons bobbing behind her, the volunteer made a hasty exit. Just as I was about to tell her what an ass she was, I spied tears spilling down Mary K’s cheeks. She quickly wiped them away with the shoulder of her hospital gown.

  It was the first time I’d ever seen her cry. I wanted to hold her, tell her it would all be okay. We’d talk about things—think through all of her options. Make a new plan.

  “Out,” she whispered, before she resumed staring toward the window.

  I began to object, but I knew I had to leave her alone for a while. In the mood she was in, I could see her jumping out of the bed and slapping me senseless.

  Unlikely Pairings

  I first saw his name on a chart in the spring of 1988: Jacob Bloom. Healthy, thirty-six, and in the ER because a shard of flagstone had hit him in the face and the lens of his glasses had shattered into his eye.

  My patient lay flat on an exam table, a bloodstained towel and icepack over his right eye, his other eye closed. A small radio rested on his chest; the wires went to his ears, and his paint-dappled Topsiders swayed with a rhythm I could hear only as a pulsing buzz. His left hand fingered the neck of an air guitar.

  I cleared my throat. He looked up at me, his one-eyed gaze lingering somewhere near my lips. He tugged at the cords of his headphones. His mouth widened into a soft grin.

  “So, Mr. Bloom, I see you’ve injured your eye,” I said, lowering the bloody towel.

  “Wow, Doc, you’re really good.”

  “As a matter of fact, I am,” I said, examining the deep gouge under his thick, dark brow. I dismissed his mild flirtation and maintained my focus, trying to ignore his beguiling smile. His eye was filled with blood, and the socket was bruised, not broken. I applied anesthetic drops and removed a sliver of glass lodged in the corner of his eyelid, then stitched his brow. The glass had nicked his eyeball just millimeters from his cornea.

  “See, I’m an artist,” he explained with a note of silliness. “And I was a little short on red paint. Inspiration was with me, and well—”

  Flirtation felt uncomfortable, like a stiff new pair of jeans. “Human blood, particularly your own, seems a poor paint substitute, Mr. Bloom, if only because of its limited quantity and the obvious outcome of over-use.”