Jake shakes his head. “The ME couldn’t say for sure. Something smooth but strong enough that it didn’t snap.”
I gather up the photos and hand them back to Jake. I feel ill. He was right, I didn’t need to see these. “Where do you go from here?” I ask.
Jake looks defeated. “We keep investigating. Keep asking questions.” We settle back into the couch cushions and stare at the television, both of us lost in our own thoughts.
After a few minutes I say, “Gwen sent me an email a few weeks ago. I think she...” I begin and look over at Jake. His eyes are closed, his mouth is slightly agape, his chest rising and falling evenly. He’s fast asleep. Good to know I have that effect on people. I arrange the blanket around him and press the mute button on the television so it doesn’t wake him.
Nothing about this past week makes sense and I have so many more questions and my one source of information is fast asleep.
I turn off the light and except for the glow from the television we are covered in darkness. I flip through the channels, finally deciding on one of the countless housewife shows. It’s a good way to practice speech reading curse words. Next to me, Jake is still sleeping soundly. His thigh pressing against mine is warm and comforting. He looks younger while asleep, unguarded, vulnerable. All my life Jake was the tough one. He came from a home that I knew was filled with harsh words and violence. Came over to our house with more than his fair share of suspicious bruises. But Jake didn’t end up taking the same path as his father. Jake was tough, but kind.
Hours later, I awake with a start. It takes a moment for me to realize where I am. On the television the housewives have been replaced with an infomercial and I’m stretched out on the couch with Jake’s arms wrapped around me. I hold completely still, hardly daring to breathe. I don’t remember falling asleep and I sure as hell don’t remember shifting positions so that Jake’s chest ended up pressed against my back. Stitch is lying on the floor next to us and raises his head so that we are eye level. He’s looking at me as if I’ve lost my mind, which could very well be the truth. I do a quick mental check and as far as I can tell I still have all my clothes on.
Jake’s warm breath sweeps across my neck, sending a jolt of electricity down my spine. Be careful, I tell myself. I know better than this. We’re old friends, and we’re both lonely. Every fiber of my being screams at me to get up, to put distance between the two of us, to stop whatever this is in its tracks. But I don’t want to move. With Jake’s solid form snug against mine I feel whole, safe and completely out of my element.
This is not supposed to happen. Jake is the one who told me that the Tooth Fairy was make-believe, that no boy in his right mind would ever want to kiss me. But when I was fifteen Jake was also the one who beat the crap out of the guy who got me drunk at a party, then told everyone I slept with him. He was also the one who drove all the way out to my house on Five Mines to pick me up for our sign language class once a week.
I reach for the remote, careful not to jostle Jake awake and turn off the television. We are plunged into darkness and for the first time in a long time, I’m not afraid of the dark. I match my breath with the rise and fall of Jake’s chest, and with the weight of his arm around me, a ballast, I drift off to sleep.
16
I awake to the smell of coffee brewing and sun streaming through the window. Momentarily disoriented, I then remember Jake’s breath on my neck, the feel of his hand resting on my hip. I’m alone on the couch and I wonder if Jake woke up this morning mortified to find us tangled together. I close my eyes again, giving myself a few more minutes to think about how I’m going to handle this. I could pretend it never happened. Two exhausted friends who accidentally fell asleep on the couch. It didn’t mean a thing.
I open my eyes to see Jake standing over me, dressed in fresh clothes, hair still damp from his shower, a cup of coffee in his hand. “Good morning,” he says.
“Morning,” I say, sitting up and taking the mug from him and I wait for him to say something about last night. I try not to show my disappointment when he doesn’t.
“David has been trying to get ahold of you,” he signs. He’s wearing his cop face. Unreadable. “He sent a text.” Jake hands me my phone.
“Probably just something about Nora,” I say because I can’t think of anything else to say.
“Actually, it’s about dinner Friday night,” Jake says.
“Jeez, it’s seven,” I say. “I have to get ready for work.”
“There are towels in the bathroom if you want to shower,” Jake signs. “I went ahead and let Stitch out and fed him.”
This is new territory for the two of us and I don’t know how to act. I want to escape, get out of here but I don’t have time to run back to my house and still get to work without being late.
Self-conscious of my messy hair and morning breath, I follow Jake through his bedroom and he opens the door to the master bath where he pulls a set of clean towels from a cupboard and sets them on the sink.
“And by the way, McNaughton is all kinds of weird but he didn’t kill Gwen. He was at the emergency room with his eighty-five-year-old father during the time we think she was killed. He also said that next time he catches you on his property he’s calling the police. Best if you stay clear of him.”
“Did he say anything about who he thinks might have killed her?” I ask, thinking of our interrupted conversation the day before.
“No, just gave his alibi and let us know that you’re a menace to society. I’ve got to get to the station. The roads are pretty bad out there. Be careful driving,” Jake signs. “I have to get to work. Just lock up when you leave.” Then he’s gone and I’m left alone. This wasn’t how I wanted this morning to go at all.
I shut Jake’s bedroom door and strip the clothes from my body, fold them neatly and lay them atop a bureau. I wonder if anyone at work will notice I’m wearing the same outfit as yesterday and then decide I really couldn’t care less.
The peaceful, sage-green room was obviously decorated by Sadie. A duvet in a white, soft blue and green floral pattern covers the bed along with a mound of matching pillows. The furniture is painted white and a dusty wreath of dried flowers hangs above the bed. Knowing that I shouldn’t, I go to the closet and peek inside. My stomach drops. Sadie’s clothes hang neatly from their hangers next to Jake’s. It’s been four years and still she’s here. Always here. I slam the door shut, causing Stitch to flinch.
It’s good that things didn’t go any further with Jake last night, I tell myself. Nothing good can come from falling in love with someone who is still in love with his dead wife. Besides, I’m still married to David, but more and more I wonder if that’s even what I want. I look at the text that David sent this morning, the one that Jake read. See you tomorrow night. Don’t forget dessert.
Of course this text would be confusing to Jake. It’s confusing to me. As far as Jake knows, my marriage to David is all but over. Countless times I’ve ranted to Jake about David’s unwillingness to give me a second chance, his refusal to let me spend time alone with Nora. But now it seems David is softening, willing to let me back into his life. Into Nora’s. See you tomorrow at six, hesitating only momentarily before hitting Send. I take a quick shower, dress in yesterday’s clothes and run my fingers through my wet hair. I make sure that the house is locked up tight and spend fifteen minutes warming up the Jeep and scraping layers of ice from the windshield.
Jake’s right, the roads are an icy mess. The only good thing is that everyone else in their right minds had the sense to stay home until the salt trucks have a chance to treat the streets. A trip that should only take five minutes from Jake’s house takes fifteen but I manage to get us there in one piece.
When Stitch and I walk into the center it is nearly deserted. The waiting room lights are on but the rest of the clinic is dim. No nurses or doctors have arrived
and Barb, the ever-present office manager, is nowhere to be found. Lori is behind the counter nodding patiently to a scarecrow-thin woman wearing a heavy pair of snow boots and who is nearly lost in the folds of an oversize down parka that falls below her knees. She has a stocking cap pulled down low over her ears and she has the round moon face of someone on heavy doses of prednisone. Angrily, she slaps the thick pocket folder she is holding down onto the counter and flips it open with trembling hands. Lori waits for the woman to shuffle through the papers to find what she is searching for but gives me a beleaguered roll of her eyes as if to communicate that it’s much too early in the day for this.
The woman’s eyes barely register our presence as Stitch and I pass by. Though I don’t know exactly why she is upset, from her stack of papers it’s probably an insurance issue. Being sick is obscenely expensive and when you are ill and can’t work, every penny must be counted and saved. I can relate. Even though David and I had good insurance, the medical bills following my accident were staggering.
I go back to the file room and retrieve a stack of files from the cabinet, my thoughts turning back to Jake. He has been a lot of things to me over the years: my first crush, obnoxious big brother, best friend. Waking up together, with his arms around me, felt good. But confusing.
I open the first folder, eager to stop obsessing over the night before when Stitch leaves the room. I call to him but he doesn’t return. I’m not too worried about him getting into mischief, but not everyone is a fan of dogs and some of the patients may be allergic or with their suppressed immune systems susceptible to illnesses spread by pets. I head back to the reception area to find Lori kneeling over the still form of the woman she had been talking to minutes earlier.
I order Stitch to stay and rush over to them. The woman is barely conscious and Lori moves aside so I can get a better look. Blood oozes from a head wound. I look to Lori for more information. “She just went down,” she says, distress etched across her face.
“Has anyone else gotten here yet? Dr. Huntley or one of the nurses?” I ask. Lori shakes her head.
“Bad roads,” she explains.
“Call 9-1-1.” I get up and run to one of the examining rooms and grab as many supplies as I can hold, then dash back to the woman. My heart is pounding, but not because I’m scared. My nurse’s instincts kick in and my adrenaline is in overdrive.
I quickly pull on a pair of rubber gloves. “Do we have a cervical collar?” I call out. I’m guessing she fainted and struck her head on the counter as she fell to the ground. She may have a neck or spine injury. She’s bleeding heavily from a gash along her hairline. Head wounds bleed a lot, but I don’t know if this is her biggest issue at the moment. I gently press two fingers into the soft groove at the side of her windpipe to check her pulse. It’s faint but it’s there.
I stanch the bleeding from her head with gauze and then I unzip her parka. I dig through the pile of supplies I grabbed and find a pair of scissors. I need to get her coat off her by moving her as little as possible. With difficulty I cut through the fabric in order to free her arms. I gently lift her T-shirt and see an eggplant-colored bruise spreading across her abdomen. Maybe a ruptured spleen. I’m guessing due to her chemo treatments she has thrombocytopenia—a low platelet count. Any injury, no matter how minor can be devastating to a cancer patient.
“She’s bleeding internally,” I say. “Where’s the ambulance?” I ask, locking my eyes on Lori’s lips.
“Ten minutes out.” She holds up ten fingers so she’s sure I understand. “The roads are a sheet of ice.”
I nod my comprehension. I hope we have ten minutes. If I’m right and the woman doesn’t get into surgery soon, she will die. I strip off my bloody gloves and toss them aside. Together, Lori and I carefully place the cervical collar on the woman, hoping to stabilize her neck and prevent any further injury.
“Let’s get some fluids in her and treat her for possible shock until the EMTs get here,” I tell Lori. “Go get an IV starter kit, a blanket and a few pillows.” I pull on a fresh pair of gloves and check her pulse again. It’s still thready.
Lori returns and hands me the IV starter kit and I tell her to tuck the blanket around the woman to keep her warm and to prop her legs up with the pillows in hopes of increasing blood flow to her brain.
I haven’t inserted an IV in two years. I know I should wait until the paramedics or one of the scheduled doctors or nurses arrives, but I know I can do this. It’s as natural to me as breathing.
“Hold this,” I say to Lori and hand her the IV bag of fluid. I uncoil the tubing, puncture the bag with the tubing spike and pinch the drip chamber between my fingers. Once I open the roller valve and release the line the fluid will run down the length of tubing without bubbles. Bubbles in an IV line can be disastrous. I slip on the gloves and search for a prominent vein on the woman’s arm and can’t find one. I grab another sterile package, this one holding a narrow hose-shaped rubber tourniquet. I tie it tightly around her arm and a vein swells with the pressure. Her eyelids flutter and open. A good sign. I swipe her skin with a disinfectant wipe that Lori hands me.
I insert the needle and catheter in one smooth move and once I’m sure I’ve accessed the vein I remove the needle, leaving the catheter in place. I cover the catheter with Tegaderm, and I remove the protective cover from the end of the IV tubing and insert it into the catheter hub, screw and lock it into place.
I push myself to my feet and survey the bag of fluid that Lori awkwardly holds, making sure that the saline has started to flow into the woman’s veins. It looks like it’s going to work. There’s nothing more I can do. We have to wait for the paramedics to arrive. I untie the makeshift tourniquet from her arm and already a tubular bruise is forming, momentarily reminding me of Gwen’s autopsy photos and the garish marking around her neck.
Thankfully, the emergency workers push through the doors and I step aside. The EMTs will need all the information that can be given about the woman and I know that the time it will take for me to understand their questions will only put her in more jeopardy. Lori hands the paramedics the woman’s purse and fills them in on what happened while I lower myself into one of the waiting room chairs and watch as they efficiently transfer the woman to a stretcher and roll her from the building.
The waiting room looks like a tornado has struck. Blood stains the carpet and discarded latex gloves, gauze, antiseptic wipes litter the floor. I feel a new pair of eyes on me and find that Dr. Huntley has arrived at the clinic. He looks pissed and I realize that I could be in trouble. I was not hired to act as a nurse here and I’m not even sure what I did was legal. I could open Dr. Huntley and his clinic to a lawsuit. I’m an office worker. I was hired for data entry and filing and in an emergency to answer a phone call or two. But it felt so good to be tending to a patient, to be making those split-second decisions. I don’t question a single move I made.
Stitch must sense the gravity of the situation because, miraculously, he is still in the same spot where I ordered him to stay.
“Ke mne,” I say, and he comes to my side. I massage the spot behind his ears that I know he likes and breathe into his ear, “Hodney pes, Stitch, hodney pes.” Good dog, Stitch, good dog.
Dr. Huntley comes over to where I sit. I only catch every third word or so but I get the message.
I nod, the pit in my stomach expanding. Dr. Huntley goes out the clinic doors and off to the hospital to check on the woman. When he returns I’m to meet with him.
I spend the next hour helping Lori clean up the detritus of the morning’s emergency. I gather up bloody gloves, the tattered remains of the woman’s parka and the pillows used to prop up her feet.
“Do you think we should call someone?” I ask. The thought of the woman at the hospital all by herself seems so wrong.
“I’ll double-check her emergency info,” Lori says as she picks up a wad of bloo
dy gauze, “but I think she lives alone.”
That could be me, I think. If something happened to me who would they call? David, I guess. But he doesn’t really count, seeing as we’re probably not going to be married for much longer. I think of Stitch and what would happen to him if I was hurt. Who would take care of him? It makes me wonder if the woman has a pet at home.
I gather up all the papers that fell to the floor when she collapsed. I’ve already decided that I’m going to stop by the hospital to see how she’s doing and give her back the folder of paperwork she brought in with her.
I futilely sponge at the bloodstain left behind on the carpet. “I think we’re going to have to get a steam cleaner for this,” I say.
“Just leave it,” Lori tells me. “Let Maintenance finish cleaning it up.”
I drop my rag into the bucket of sudsy water and pull off my gloves. “I’m not looking forward to meeting with Dr. Huntley. I think I may have made a big mistake.”
“Why?” Lori’s eyebrows rise in surprise. “You saved her. He should give you a raise.”
I give a small laugh. “Yeah, but that wasn’t our deal. I’m only supposed to be doing clerical work, no patient care. I blew it and I’ve only been here a few days.”
Lori gives me a sympathetic smile as she takes the bucket from me, and I go back to the file room with the woman’s jumbled mess of papers. I clear space on my desk so that I can sort through her paperwork and put it back in some kind of order.
I learn that the woman’s name is Rachel Nava and she was diagnosed two years ago with multiple myeloma, cancer of the blood cells in plasma. Multiple myeloma is incurable and often deadly. To date, Rachel had three bone marrow biopsies and was prescribed monthly intravenous immunoglobin injections and a complex chemo regimen that seem to repeat itself every three weeks. Very aggressive treatment.
I organize the paperwork the best I can by date. Just as I suspected, the cost of Rachel’s treatment is startling. Most appears to be covered by insurance but not all. After doing the arithmetic in my head, it looks like Rachel owes the center well over fifty thousand dollars in medical bills. I place the file in my purse and decide that I’ll return it to Rachel at the hospital in the next day or so.