“I guess we’ll just have to work that out,” I concluded. “Maybe I’ll just go to mass every night,” I joked gently.
“Carlos,” she chided me, “Don’t make promises you cannot keep. How about another cookie? There is a PBS Christmas special we can watch together.”
Chapter 44
After my talk with Abuela, I felt a lot better prepared when I picked up Jillian at the airport. I was the very picture of cheerfulness as I lifted her off her feet with a welcoming hug and kiss and practically skipped to the car carrying her bags.
Jillian regaled me for quite a while with stories of her adventures in Vienna. She made fun of the hyper-competitive musicians. She waxed eloquent about the art and architecture of the city. She described the cuisine in intimate detail. It was quite a while before she addressed the 400 pound year abroad gorilla in the room.
“Carlos, I hope you don’t think I’m happy at the prospect of being away from you for so long next year,” she began.
I replied with a script that I had rehearsed in my head a million times, “Jillian, you have never questioned my professional aspirations and how my medical training could affect our relationship. God knows that the long hours of medical residency and fellowship aren’t always kind to couples. I am incredibly thrilled that you won the competition and will have this amazing chance to go to the next level in your profession. You’re the best thing that’s happened to me in a long time. How could I possibly think of throwing a wet blanket on your dream?”
That is when she asked me to pull over to the shoulder of the road.
She looked hard into my eyes and said, “Okay then Dr. Vega, but know this: I tried to let you go once before because we hardly knew each other and it seemed like we were heading separate ways. We stayed together and our relationship was strong enough to grow even with some time apart. Two different continents is a whole different story. I love you but I can’t ask you to wait a whole year for me. It just isn’t fair…” That’s when she sobbed for the first time since she had contemplated the thought of her grandfather in a nursing home without the comfort of his family and his music.
“Jillian,” I said quietly in her ear as I held her close, “Go to Vienna and find out where your dream takes you. I only know that I love you, too”.
Chapter 45
The Christmas holidays flew by and I spent every moment I could with Jillian—even Abuela didn’t give me a hard time about it. Right after the glow of our New Year’s Eve celebration, I found myself back at the airport dropping Jillian off for her flight back to Vienna because her fellowship was to begin right away. They had worked something out so that it could satisfy her remaining graduation requirements at the conservatory.
I don’t remember the details of that farewell very much—maybe because I was already trying to resign myself to an existence without Jillian. I think I was subconsciously trying to detach myself. I knew that we would write and videochat and that my feelings deep inside were unchanged, but if I dwelled on those emotions too much I knew I would be too much of a mess to function. So I created a little wall to protect myself.
That January was important professionally for me in two ways. First, I needed to focus my attention on my Emergency Medicine rotation. Second, by mid-month I was expected to submit my choices for the National Residency Matching Program.
The ER rotation was great in that in got me back in the groove medically. The teaching physicians were eager to answer my questions (even if I found their personalities a bit callous at times) and get me involved in every way possible. I helped with everything from airway management to cardiac arrests to severe burn injuries to automobile accident victims. One great thing about the ER was you had to stay organized. ER docs take care of three or four patients at once all with very complicated critical problems and keep everything straight. This was a very handy skill for later in my training. I even briefly toyed with the idea of becoming an ER physician because it not only has the kind of immediate and dramatic opportunity to make an impact on patient’s lives but also the chance to get paid full-time for working three 12 hour shifts per week which would leave more time to spend with a wife and family. The downside is that there is even less time than in surgery to create an interpersonal bond with people that you take care of because you usually get one encounter one time with the patient and that is it.
A particular encounter in the ED stood out for me above all the others. It was early on in the rotation and I was just getting my feet wet. One of the attending physicians was trying to give me an easy case to get started.
“Vega,” he said, “there’s a drunk in room 21 with a simple head laceration. Ask one of the Physician Assistants to go in with you and they’ll give you any help you need with the repair, okay?”
I had done simple skin closures as part of my surgical rotations, so this sounded like the perfect way to begin my orientation to emergency medicine. I talked to Sarah, one of the PA’s, and she and I entered the room to begin the encounter.
Inside we found a disheveled middle-aged man with a several day growth of beard smelling of alcohol and urine. I looked at Sarah who was already wrinkling her nose.
She whispered to me, “Hurry up and sew this guy up so we can get out of here.”
Do it from the beginning. Use the fundamentals. Don’t take anything for granted.
“Mr. Smolenski,” I began, “I’m student Dr. Vega and this is PA Trachtenberg. We’re here to help you with that nasty cut on your forehead. Can you tell us how you managed to get it?”
When he spoke, Mr. Smolenski didn’t sound intoxicated at all. “The funny thing is, I can’t remember all of it. I know I smell like alcohol right now, but the truth is that I’m not much of a drinker. In fact, it was kind of stupid for me to drink anything because I get migraines so I usually stay away from the stuff. But I lost my job as a software developer six months ago and I’ve been kind of depressed. Finally, two friends from my old job invited me out unexpectedly for my birthday so we had two beers. But I swear to you, that’s all it was. Next thing I know, we’re leaving the restaurant, they drop me off at my house and drive off, I start to walk up the steps to my town house and that’s the last thing I remember until I wake up with this cut on my head and a monster headache.”
“Tell me about other headaches you’ve had.”
“Well,” he continued, “I’ve had headaches for the last six months. They’ve steadily gotten worse. I often wake up in the middle of the night with one and throw up. After I’ve been up for a while, they get better and I can go back to sleep.”
“Did you have any other injuries in the fall?” I pressed on.
“When I got up, I realized I had bitten my tongue and—this is really weird and embarrassing—I think I peed myself. I’m also very achy all over, but maybe that’s just because I fell.”
“Mr. Smolenski, would you excuse us for a moment while we assemble the materials to close your wound?”
“No problem.”
We exited the exam room and I looked at Sarah. “Pretty interesting story, huh?”
She wasn’t entirely convinced, but didn’t object to me phoning the neurologist on call.
I presented the case with my impression, “Sir, I don’t think this man passed out in a drunken stupor, I think he had a seizure and with the prior history of worsening headache, I’m worried about a brain tumor. He’s in CT right now getting a scan of the brain and an MRI will come later but I think he will need an admission and we would like to consult you.”
The neurologist agreed. “Tell your supervising ED attending that I concur with everything you’ve said and I’ll be arriving shortly. The patient can be admitted to the hospitalist service. We’ll get an EEG in the morning. Nice work, son.”
And thank you again, Dr. Greco.
That’s when Sarah said to me, “Way to turn a 15 minute case into a two hour marathon, Vega. Now are you going to close the head wound or not?”
As for choosing a specialty
, I was probably the last student in my medical school class to pick a field of medicine and location for training after medical school. I literally sat at my computer at the deadline comparing the benefits and drawbacks of being a family doctor like Dr. Greco versus being a trauma surgeon. High-tech or low-tech? Definitive interventions or long-term gradual changes? Brief focused encounters or being assimilated into families with all their joys and tragedies? Emphasis on procedures with state-of-the-art equipment or emphasis on diagnosis and medications? Huge income or merely comfortable income? With one hour to spare before the deadline, I pushed the ‘send’ button which would transmit my ranked list of training programs.
I hoped I had made the right choice.
Chapter 46
At the close of the Emergency Medicine rotation, I traveled back to Midcentral for another poker game with the old gang. We were all on edge for the results of the Match, which would be released in two weeks, but no-one really wanted to talk about that. Instead, we focused on the preparations for Gomey’s wedding after graduation in June.
We were at Courtney’s apartment and, sensing our anxiety, she prescribed an all-natural vegetable based remedy for our nerves—Coors Light. The quality of the poker playing deteriorated quickly but the conversation was as entertaining as always.
“Invitations to the wedding are going out very soon,” Gomey began as he dealt the cards, “but all of you are, of course, invited--along with a date.”
“How many of your relatives are coming from Africa to attend the wedding?” Courtney wanted to know.
“My parents, 2 brothers and 3 sisters will all be coming. I have some aunts and uncles who already live in the U.S. and they will come, too. But, according to custom, Chloe and I will have another ceremony in my home country so the whole village can attend.”
“That is a really cool custom. What about you, Tyler,” I asked the confirmed bachelor, “Will you be bringing a date?”
“Well, there is a girl I’ve been seeing for the past four weeks…”
“Four whole weeks!” Courtney exclaimed “Isn’t that three weeks longer than your previous record?”
“Actually, she might be something special. She thinks my apartment decorations are cute.”
All of us broke up in laughter over that one.
“Decorations?” I blurted out. “You mean the old pizza cartons and take-out containers from the Chinese restaurant combined with posters of your favorite NASCAR heroes?”
“I don’t understand it either,” he agreed, “she saw all that stuff and still wanted to keep dating me.”
“You know the rules,” Gomey said, “let’s see the picture.”
Tyler took out his phone and passed it around to everyone, “I’ve only got two pictures” he explained sheepishly.
I don’t know what we were expecting, but this was one cute girl—kind of girl-next-door pretty with a really friendly smile.
Courtney summarized what we were all thinking. “Tyler, I didn’t know you had it in you.”
Tyler actually blushed, “She’s a nurse on 6 North Telemetry at Midcentral Hospital.”
Gomey smiled admiringly and said, “Save up for a Land Rover and an elephant or two.”
“How about you, Courtney?” I inquired, “Will you bring a date for the wedding?”
“Um, I don’t know, I hadn’t thought about it,” she replied evasively.
I don’t know if it was the beer or whether we were just becoming more comfortable around one another over the years but I was feeling pretty bold.
“C’mon Courtney, tell us what’s up with your love life. We know we’re not supposed to notice, but you are way too pretty to have been unattached for this long.”
“Do you really want to know?” she said, looking at each of us around the table.
Three heads slowly nodded up and down.
“Okay, but this is a secret, and what I’m about to show you stays in this room, understood?”
Three heads nodded much more quickly this time.
Courtney got up and left the room. When she returned, she was wearing only a one piece bathing suit. My first impression was that she had a very nice trim body. As she got closer, I saw the point she was trying to make.
Her beautiful body was absolutely covered with scars.
“Not a turn-on, is it guys? If you’re wondering what the point of this little show is, I fell out of a tree when I was a small child and broke way too many bones to count. The orthopedic surgeons put me back together, but I have these horrible scars to prove it. Everything works, but I’m not exactly eager to get to the point in a relationship where you have to undress. Everyone thinks I dress conservatively because I’m modest or because I’m too dedicated to medicine to look for a guy. The truth is, I would love to show off my body a little more—but who would want to look at this?” and she pointed to herself despondently.
Tyler, Gomey and I were quiet for a moment. Finally, I figured I should say something since she was responding to my question.
“Courtney, I’m so sorry. I didn’t know.”
“It’s okay, Vega. I just thought you guys ought to know the truth.”
After she changed back into jeans and a surprisingly sexy tank top, the game continued, but the humor and the conversation were a lot more subdued. Gomey even took less of our money than usual. Around 11 PM we called it an evening and helped her clean up. Gomey and Tyler walked out into the night leaving me and Courtney to say goodbye.
I was still shaken by her earlier revelation and I wasn’t sure what to say.
“Courtney, I just want to say that I think you are really beautiful, no matter what you are wearing.”
A smile slowly spread across her face and before I knew it she was hugging me. I looked down into her eyes and we kissed. Then we kissed again with a lot more intensity than one would expect between poker buddies. I took a crazy chance and traced one of the scars on the upper part of her chest with my index finger. She froze and took a step back.
“Carlos, please. You are a terrific guy and it would be so easy to go to bed with you right now. But I know that we are both a little drunk and you are missing Jillian big-time. I can’t be your consolation prize even if it would feel great for a little while. Please go home before we do something we’ll both regret, okay?”
She was right and I looked down at my feet as I blushed miserably. I felt completely embarrassed but somehow the next time I looked up we were both laughing hysterically.
“Courtney, you are so amazing. You deserve someone so much better than me. Please tell me that when that someone asks you out, you won’t be afraid to say yes.”
“Alright Vega, I think I can promise you that. Now get your ass home. Please?”
She pushed me out the door and I walked home.
Chapter 47
My next rotation was Plastic Surgery at Johns Hopkins Hospital in Baltimore. While I certainly didn’t mind learning about facelifts and tummy tucks, I was most interested in reconstructive surgery after trauma or cancer. I wanted to know just how much one could do to restore the human body after it had been marred by severe injury or the radical surgery sometimes required to remove a tumor. To me, such surgeons were the artists of the medical profession and I wanted to learn all I could from them.
I continued to hear from Jillian throughout the winter as much as videochats, texts and phone calls allowed. She was thrilled with all she was learning and seeing in Vienna. And I was thrilled for her. Still, it was hard to stay close in the way we were before, though we tried very hard.
And then I met someone.
I didn’t mean for it to happen. I certainly wasn’t looking for anyone else. I still felt completely committed to Jillian in every way.
At least I thought I did, until one day in early March when I got an unexpected call from Tyler.
“Hey Vega,” he greeted me, “How are things in boob job land?”
“C’mon Tyler,” I cautioned, “I’m here to see a lot more than co
smetic stuff. There are a lot of patients with awfully disfiguring deformities here that need treatment.”
“Yeah, right,” he scoffed back, “Nothing more disfiguring than an A cup when what you really want is a double D.”
“Thanks for the show of sensitivity, Dr. Video Game.”
“Touche, Vega,” he allowed, “anyway, I’m calling to ask a favor. My cousin Emily is coming to a teacher’s convention in Baltimore and she is new to the area. She’s kind of shy and doesn’t know anyone. Would you be willing to show her around a little bit? I know it’s asking a lot but you’re honestly the only one I know in the area.”
“I don’t know, Simmons, this sounds way too much like a blind date.”
“Relax, Vega,” he assured me. “Emily is not looking for a boyfriend and I know you’re still carrying a torch for Jillian. This is strictly a friendly couple of hours as a tour-guide thing.”
I thought about that for a minute. A little companionship wouldn’t hurt me either, come to think of it. And with the rules so clearly outlined as Tyler stated, what could go wrong?
“Okay Tyler, what’s her number?”
Chapter 48
I decided to meet Emily on a Saturday afternoon after she had completed a half day of sessions at her convention in the morning. I picked her up at the Renaissance Hotel downtown across from the Pavillions of the Inner Harbor and we decided to embark on a little driving tour. We started at the shops and restaurants of Fell’s Point then moved on to a late lunch in Little Italy at Sabatino’s. We then drove past the Science Center and the National Aquarium. We then took a little walk through the Federal Hill neighborhood before driving to Mount Vernon and took a quick stroll past some of the wonders of the Walters Art Museum. By then, it was dinner time and I asked if she was hungry.
“I’m a little hungry and a little tired,” she admitted, “Do you mind if we get something to eat?”
“Not at all,” I replied, “Is it okay if we go back by the Inner Harbor? The views out over the water are really something to see this time of the evening.”
She had no problem with that so off we went. We found a nice little restaurant looking out over the water taxi stop with enough passers-by that everything seemed somehow quite festive.