Gemini (15 page)

Felipe was the last to speak, and Charlotte heard the hint of accent that crept in whenever he was tired after a night on call; it lent a sadly romantic note to his discourse on Jane’s history and likely future. He explained that the latest complication was her kidneys, initially shocked by the low oxygen levels and low blood pressures she had suffered after her surgery and then, just as they were recovering, she had developed an infection and her blood pressure had dropped again. She would probably need dialysis in the next day or so.

Helen Seras asked, “Can you tell me, Dr. Otero, if she isn’t dialyzed, how long might she survive?”

“That is perhaps the only easy question you have asked. Her potassium level will rise about one point a day, and when it exceeds seven, her heart will fibrillate and she’ll die. Painlessly.”

At noon people began to leave the room for other patients and other meetings. Felipe waited for Charlotte and as they neared the door Christina Herrand intercepted them. “Dr. Otero, what do you think the chances are that Jane will survive this?”

“Survive? There are many ways to survive. Do you mean will she wake up? Go back to her life as she knew it before? Those chances are slim, Ms. Herrand.”

“Slim,” she repeated the word to herself like that might reveal more than Felipe had said. “Could you make a percentage guess?”

Felipe glanced at Charlotte and she knew what he was feeling—they had been here before with patients, had this same conversation with actual relatives, people who shared blood or name or love with someone so near death. They wanted numbers. Numbers were comforting, numbers were the Dow Jones average and mortgage rates and the statistics of lightning strikes. “Okay,” Felipe finally answered. “Eleven percent of slim.”

—

Christina asked Charlotte to introduce her to Jane. The nurse who’d been covering for Anne during the meeting reported that Orthopedics had scheduled Jane’s cast removal for the next day. She’d needed to suction Jane’s tracheostomy a few times but otherwise the patient was stable. Stable, Charlotte thought, seeing Christina react to her first view of Jane. Stable, meaning no deterioration. No improvement. The downhill tumble arrested but the monumental climb back up barely begun.

Christina walked to the bedside and turned to look at Charlotte, waiting for her. “Why does she have a tracheostomy?”

“We put in a trach anytime a patient needs long-term ventilation—when they’ll have to be on the breathing machine for more than a few weeks.” Charlotte whispered the words out of habit as much as for any valid concern that Jane might hear them. Early in her career she had seen a supposedly sedated patient open her eyes when an oncologist had described her tumor as “a death sentence.” And once, freakishly, a cardiac patient had gone into ventricular fibrillation and been coded for forty-five minutes with chest compressions and electric shocks—as close to dead as a live person can get. He’d survived, miraculously, and the next Christmas, Charlotte got a nice card from him that contained a miracle of its own—a postscript quoting an exact phrase she had used to convince the code team to keep going for just three more rounds, “my lucky number,” before they called it off.

Jane’s face was pale, flaccid, and swollen from the fight to balance her fluids and blood pressure. The stuffed toy raccoon Charlotte had bought for her had rolled facedown into the corner of the bed. With each delivered breath the coiled plastic tubing that tethered Jane to the ventilator moved like something alive. Charlotte leaned near and said, “Jane, someone is here to meet you. Her name is Christina Herrand.” Then she pulled a chair to the bedside for Christina, left the two of them, and started working on chart notes at the computer. After fifteen minutes or so she looked up. Christina was still there, sitting quietly with her head tilted slightly, her hand resting lightly on Jane’s casted arm. Charlotte couldn’t see her face from this angle and wondered if she might have dozed, she was so still. Finally Christina stood and gathered her purse and briefcase, brushed her fingers against Jane’s cheek, righted the toy raccoon, and then walked over to Charlotte. She whispered, “You won’t know how much she’ll remember about the accident until you can take her off the ventilator?”

“Her MRI showed the fat emboli injured a lot of her brain, as I explained in the meeting. On top of that her blood pressure and oxygen levels were low for a long time.” She paused, trying to assess whether Christina understood how critical that was. “We really can’t know how much permanent brain damage she has yet. It could take months.”

“Or years? Years spent . . . like this?”

She said it kindly, inoffensively, but the phrase piqued Charlotte, as if Christina Herrand were already predicting a contest. Charlotte wanted to give her the benefit of the doubt, though. This case
was
“an unusual dilemma,” to quote Christina. This Jane Doe had family, most likely. Somewhere. God forbid they pop out of the woods after Beacon and its legal teams and guardians, these strangers, made an irreversible decision.

Just then an aide came into the room and called out, “Good morning, good morning!” She walked to Jane’s bedside. “Hello, Ms. Doe, it is a beautiful sunny Tuesday and it’s time for your bath!” She turned on the faucet at the sink and with a clatter of plastic and metal she filled a pink bucket with warm water.

“That’s nice—they bathe her?” Christina asked.

“Oh, yes. She gets physical therapy too,” Charlotte said. “Christina, may I ask, have you had much intensive care experience?”

“Actually, this is only my second medical case, and the first was for financial guidance.”

“Do they give you any medical training? For your work?” Charlotte asked.

Christina seemed to weigh Charlotte’s intent. “CPGs work in many different areas, whenever someone needs help with legal decisions because they’re too overwhelmed or unstable.” She paused. “I have no specific medical training. No. But then neither do most family members.”

The aide placed the bucket on the chair Christina had left at the bedside and pulled the sheet back. Christina was visibly startled and took a step toward Jane. “What’s wrong with her hand?” Three of Jane’s fingers were blue black.

“It’s ischemia. When her blood pressure was low for so long, her limbs weren’t getting enough flow.” Charlotte eased the sheet off Jane’s lower body. All of her toes were a mottled purple and the lower portion of her right foot was obviously dead—black sunken skin edged with a serpentine line of bright pink. “It isn’t infected, so we’re leaving it alone for now. She’ll have to have it removed eventually. If she recovers.”

Christina brought a hand to her mouth. “My God.”

Yes, thought Charlotte. My God, indeed.

—

Charlotte, Eric, Pamela, and Will had decided to meet for dinner the next evening at a restaurant on the pier. Charlotte arrived late, as often happened, this time held up by a phone call about Jane from the orthopedics team just as she was leaving the hospital. She found them drinking cocktails at a table in the back that overlooked Elliott Bay, all of them bathed in summer sunlight reflected off the water. Pamela hugged her as if they hadn’t seen each other in months, though they rarely went a week without talking. Eric stood up to pull out Charlotte’s chair; after three years together he still treated her with manners her grandmother would have demanded.

Pamela poured Charlotte a glass of wine from the nearly empty bottle on the table and said, “Eric’s telling me about all the quirky genetics stuff he’s learned researching this new book. Apparently there’s a lot more incest going on than anybody’s admitting to—shows up when they do the organ matching. I want to know if they keep a transplant list for cats. Effie’s kidneys are going, and the vet says I should think about putting him down. It would kill the boys. And me. God, I’ve had him longer than I’ve had
you
,” she said, leaning into Will’s shoulder. Pamela had a passion for both cats and birds, though an unfortunate intersection of the two had left her currently birdless. Effie was an enormous tortoiseshell—a male, which Pamela swore was so rare he was worth what she paid. He’d nearly eaten Charlotte’s own cat alive when she’d boarded him over a weekend.

“Did Eric tell you his book’s almost finished?” Charlotte said.

“It is? We have to toast!”

“I still have a chapter to go. And I never toast until after the reviews come in,” Eric said.

Charlotte felt compelled to add that he never read his reviews, not even when she screened them first. “But he’s close enough to finishing, he’s looking at new laptops. He buys a new one for every book. Like they came with a preloaded manuscript.”

“What do you do with the old ones?” Will asked.

“I give them to my brothers.”

“Where did the youngest decide to go to school?”

“Seattle University. He’ll be at my place for a few weeks this summer. He wants me to help him get a dog.” Eric started telling them about his half brother’s scholarship, the new girlfriend, the plot for sneaking a dog into his dorm room. Eric’s voice lifted whenever he was on the subject of his two half brothers, but especially Jimmy, the younger one. He talked faster, easier, with an almost parental pride, understandable given that Eric was practically old enough to be his brothers’ father. Suddenly Charlotte became aware of Pamela’s probing, almost wistful gaze, begging the question of when Eric and Charlotte would finally move forward and have their own child. Her instinctive response was to change the subject. “Hey, I’ve got news from Beacon Hospital. My Jane Doe has finally given us a clue about her identity!”

Pamela leaned closer. “She’s identified? How did that not make the six o’clock news?”

“Well, no, she isn’t identified. But the orthopedics department took off her cast this afternoon and discovered a scar. Unique enough it might match with records somewhere, or at least be recognized by someone.”

“I bet she’s from the Olympic Peninsula after all—some little town out there and whoever knows her wants her to stay missing. Maybe it will turn into a murder mystery. Attempted murder, at least. Eric can write a book about it. What did they find?” Pamela asked.

Charlotte hadn’t seen the scar herself yet, but she’d already called Blake Simpson to give him the orthopedist’s description. “Some circular rings wrapping around her right upper arm. The deputy on her case knows about it; it might be in the news tomorrow.”

Pamela asked if it could be a tattoo or gang mark and maybe that was why she’d been run down, but before Charlotte could answer, Will asked, “How does that feel? For you, I mean. I have the sense you’ve been her family so far. It might be strange to have a husband or parent step in and make decisions.”

The question stopped her. How did it make her feel? Her job wasn’t to be Jane’s family—Keith Sonnenberg and Christina Herrand had made that clear. The legal system might be allowed to act as Jane’s family, but not her. Not the doctor. For Charlotte the agenda was clear—to use the best of modern medicine to keep Jane alive. To hope that at some point, some part of her mind would recover. It was vague, yes. She meant it to be vague. “At some point” required no time limit. “Some part of her mind” required no measurable parameters. But what if Jane’s family believed keeping her alive was futile? Cruel, even? Other doctors at Beacon had said as much. Christina Herrand likely agreed. “I don’t know. I guess it depends on how well they knew what Jane would have wanted. But how well does anyone know that about someone else? Even family? Does anyone really know what they’d want until the time comes?”

Pamela said, “Well, doctor to doctor, we both know nobody gets out alive.”

—

Eric was quieter than usual on the walk home. Charlotte wrapped her arm through his, pacing her step to his longer stride out of habit. “Too much medical talk?”

Eric shrugged. “I should be used to it by now. Sometimes too much.” He dropped it after that, but his body was less relaxed against her own. He had never discussed his brain tumor with Charlotte’s family. She wanted to tell him she understood—to risk burdening him with how much his own medical condition weighed on her too. They could talk about so much together, but never this. The facts, yes, but not the implications. Sometimes Charlotte saw Eric take a Tylenol and she wanted to rush him in for another MRI. It was always there in the background, in the scar on his head barely concealed by his thick black hair, in the extra years it had cost his education, his career, in the missing, broken gaps that nobody but him could mend. And, more and more lately, in the stalled decisions for her own future that seemed to be eroding the love between them. All stolen by a single fractured gene.

“I’ve never told Will or Pamela about your medical history. Being pediatricians, they would totally get it, but . . . What am I saying? I’m just saying I think it’s your decision, not mine.”

“No big deal.” But he headed for the bathroom as soon as they were back at his apartment. Charlotte heard the medicine cabinet open and close before he took a long shower. She was half-asleep by the time he got into bed, so cautious not to awaken her she knew she would hit either a stone wall or an argument if she tried to talk it out. In minutes he was snoring and she was wide awake. She walked her cold feet up his back until he muttered and let go of the day in a long sigh, rolled onto his side, and breathed quiet enough for Charlotte to let her mind go.

Why could she not love an uncomplicated man? Her mother had done it for forty-two years—found someone smart and sturdy and been plenty entertained by arguing about the pros and cons of lumpectomy over mastectomy, laparoscopic surgery versus open. Their shared careers, two children, and four weeks of vacation (usually to medical meetings in serendipitously tropical locations with suspiciously empty meeting rooms) had kept her parents happy enough. But we love who we love, and how do you fix that if you discover you need different futures? She couldn’t think about it without feeling the solid earth split black and gaping beneath her.