“I know, and your Mom was so nice.” Abby stifled a sob. “And you, thanks for the nightgown. It’s my old one, remember?”
“Yes, sure.” Megan tried to smile again, straightening up. “I still wear it, it got softer.”
“I know, right?” Abby managed a smile, too. “You look so awesome, you’re so skinny. Can’t call you Mega anymore, huh?”
“No.” Megan smiled at the old nickname.
“You have braces now? I thought you didn’t need them.”
“I know. My teeth shifted, doesn’t that suck?” Megan touched her mouth, self-conscious. “Two more years, and this is so lame but I have to go, I have practice.”
“It’s okay, I know. I hated those early morning practices.” Abby rubbed her forehead, and she seemed a little pale, even in the dim light. “God, I feel lousy. My head is killing me.”
Sam appeared at the doorway, in his bathrobe. “Hey, ladies,” he said, smiling, but it vanished when he sized up the scene. “I thought I would make banana pancakes, if anybody wants some. Abby, want to try my specialty?”
“Pancakes, yuck. I feel so sick.” Abby leaned over, and before anybody knew what was happening, she was vomiting on the bed. Megan recoiled, and Sam blanched.
“Here, honey.” Jill snatched up a wastebasket and rushed over, but Abby heaved again, spewing vomit on the bedclothes.
“Ugh, no, sorry, guys.”
“Come on, sweetie, let’s get you into the bathroom.” Jill set the wastebasket down, took Abby’s arm, hustled her out of bed, and got her to the bathroom just as she heaved all over her nightgown, the used towels, and the tile floor. Jill got her to the toilet, where she dropped to her knees, and Jill held her hair back.
“Mom, I’m gonna be late!” Megan called out from the bedroom. “Sorry, Abby, I have to go!”
“Hold on, honey!” Jill called back, torn. She wanted to say good-bye to Megan, to make sure she was okay, but she couldn’t leave Abby. She felt ripped in half, with both girls grieving and needy, but she couldn’t be in both places at once. “Just hang on one sec! I want to see you before you go!”
“I’m late, Mom, and Courtney’s mom is waiting! I can’t wait! Bye, I love you!”
“Oh, no.” Abby began to retch into the toilet, and Jill couldn’t leave her, holding her hair.
“I love you, too! Take it easy this morning! Call if you want to come home!”
“She will!” Sam called back, and Jill felt a wrench in her chest, knowing it meant Megan had left.
Abby coughed, spitting. “Please, close the door. This is so embarrassing.”
“Don’t worry, wipe your mouth.” Jill handed her some toilet paper, then closed the bathroom door. “Be still. Let your stomach relax.”
“Thanks,” Abby said, thickly. She wiped her mouth. “I’m so sorry.”
“Make sure you’re finished. Take your time.” Jill rubbed her back. “There’s still some things you haven’t thrown up on.”
Abby smiled and let the paper drop in the toilet. “I’m done.”
“Good. Let me help you up.” Jill steadied Abby, flushed the toilet, and put down the lid, with a clunk. “Sit here until your head clears.”
“Thanks.” Abby sat down and put her head in her hands. “Sorry, I ruined our nightgown. Can you help me take it off? It reeks.”
“Reach for the moon.” Jill lifted the nightgown off and dropped it on the floor with the soiled towels. She took Megan’s bathrobe from the hook and handed it to Abby. “Here, stay warm.”
“I’m not a drunk girl, I swear. If I were, I wouldn’t be this sick.”
“I know, honey.” Jill eyed Abby, straightening up on the seat. “Okay, wash up and I’ll be right back.”
“Okay.”
Jill left the bathroom and went into the bedroom, where Sam was balling up the comforter on the bed. “How was she? Was she crying when she left?”
“She’ll be fine. I gave her a big hug. I say we throw out this comforter and buy a new one.”
“No, don’t. She loves it, and I’m not sure they make it anymore. It’ll have to go to the Laundromat. I’ll take it when I get back.”
“I’ll do it, and by the way, Sandy emailed me to say that she’d squeeze Abby in next week, anytime.”
“Jill!” Abby called from the bathroom. “Help!”
“That’s great, thanks,” Jill said, already hurrying back to the bathroom.
Chapter Seven
“How are you doing, little guy?” Jill smiled at little Rahul Choudhury, an adorable one-year-old she was about to examine. She’d spent the morning treating a leaky procession of sniffles, fevers, and sinus infections, all the while worrying about Abby and Megan. They say a mother is only as happy as her happiest child, and it applied to stepmothers and ex-stepmothers, too.
“He’s such a good baby,” said his mother, Padma, steadying Rahul as he sat on the examining table, wobbly in his thick diaper. She was a pretty woman with a ready smile, dressed in a blue cotton sweater, khakis, and clogs. Jill would have normally worn a similar outfit, but she was dressed for the memorial service, in a dark jersey suit. Like most pediatricians, she never wore a lab coat, because children tended to associate them with needles.
“Rahul, hello, what a good boy you are.” Jill wiggled her stethoscope, and Rahul’s round, dark eyes focused on it so intently that they crossed slightly, under a sloping fringe of eyelashes that any woman would kill for. She kept it wiggling, initiating a tug of war with the baby, and felt satisfied when he reached out, made a swipe for the black rubber tubing, and caught it in his tight little fist. “Good for you! You’re strong, Rahul. You work out?”
Padma smiled. “I hate when he’s sick. I don’t have time for him to be sick.”
“I know just what you mean.” Jill was thinking of Megan, with no time to cry. She tickled Rahul, and he giggled, drooling. “It’s so easy to make a baby laugh. I should do standup, for infants.”
Padma chuckled. “All my sons are fans of yours. Roy loves it when you ask him if he brought his heart today.”
“Aww, good.” Jill didn’t add that joking around was part of her exam. The first thing she did with a patient was to engage him, to see if he was sick or not. One of her pediatrics professors had called it the gestalt, or the big picture, and her gestalt about Rahul wasn’t good. “Now, how long did you say he’d been sick?”
“Since Thursday. It’s another ear infection. He tugged at his ear most of last night, and I know, I was up, on the phone with my mother, in Mumbai. She’s not feeling well.”
“Oh no, I hope she feels better. You have your hands full.” Jill had read the notes from the nurse, who had taken Rahul’s vitals. Nothing was remarkable except a fever, at 101 degrees. Anything between 97.5 and 100.3 was normal. “When did Rahul get the fever?”
“This morning, it’s new. I wanted to get him on amoxicillin before it gets worse, because I have the week from hell coming up. Two field trips, one for Roy and the other for Devi.”
“Yikes. Got Xanax?”
Padma laughed, and Jill realized she’d made the joke because she must have been thinking of William. It was odd that he was taking prescription drugs, but she tried to put it out of her mind. She offered Rahul a finger in trade for her stethoscope and listened to his lungs, hearing transmitted upper-airway sounds. She checked his ears, and there was purulent fluid, or pus behind the drum.
“How’s Dave?” Jill asked. Padma’s husband Dave was in the Army Reserves, serving in Afghanistan.
“Fine, and he says hi and thanks for those books you sent. They all shared them. Thanks so much.”
“Please, it’s the least I can do.” Jill looked in Rahul’s nose, mouth, and throat, and they showed redness, irritation, and post-nasal drip, all consistent with a viral URI, or upper respiratory tract infection. “I give you so much credit, doing all that you do, on your own.”
“Sometimes it gets to me, but most of the time, I do okay.”
“I’m sur
e, but you can always vent to me, you know that. Email or call, I mean it.”
“Thanks.” Padma smiled, but Jill knew she wouldn’t take her up on the offer.
“Tell me, how are the boys?” Jill palpated the lymph nodes in Rahul’s neck, both the anterior and the posterior chain, and the anterior were slightly enlarged, also consistent with a URI and ear infection.
“Doing well in school, and they’re brown belts, both of them.”
“Wow, that’s great!”
“But they miss their father, so much.”
“I’m sure, poor things.” Jill found herself thinking of Abby and Victoria, and how much they would miss William. She’d have to get Abby to the therapist to deal with her grief, instead of talking about murder. “I bet it’s been hard on them.”
“It has been, but we email and Skype, so that helps.”
“That’s good.” Jill lay Rahul down gently and palpated his belly, liver, and spleen, all of which were also slightly enlarged, again, consistent with his little body trying to fight the infection. But for some reason, he was losing the battle, too often. It was Rahul’s fifth ear infection this year and he’d also had a pneumonia, which worried her.
“How old is Megan, now?” Padma cupped the back of Rahul’s head with her hand. “In middle school?”
“Yes, if you feed them, they grow. Right, handsome?” Jill spoke to Rahul, and he broke into a smile, with wet lips, which showed he wasn’t dehydrated. To double-check, she pinched him gently on the arm, and his skin didn’t tent. “What a tough guy! No crying, huh?”
“He’s the third. They learn.”
Jill smiled, stroking Rahul’s soft cheek, noting his color. His Indian ancestry gave his skin a glow, but she’d trained at D.C. Children’s, where she’d seen kids of all races, and she thought he was febrile, feverish. “He look flushed to you, Dr. Mom?”
“He always does when he gets an ear infection. So, do you have a wedding dress yet?”
“I’m thinking a lab coat. It’s white, right?”
Padma laughed. “Come on, tell me everything. It’s fun to talk girly stuff. I love being a boy mom, but I wish for something with ruffles at times.”
“Well, I do have a suit, a nice one.” Jill palpated the axillary lymph nodes under Rahul’s armpits, which were also swollen. “Megan’s addicted to Say Yes to the Dress, so I’m failing her as a mother.”
“I know that feeling. It comes with the territory.”
“Ha!” Jill peeked inside Rahul’s diaper, which was clean and dry. “They’ll grow up and realize how lucky they were, but by then, we’ll be dead.”
Padma laughed.
Jill’s last stop was to examine Rahul’s skin, and she noticed a tiny patch on his right arm, which reminded her of something about his older brother, also a patient. “Roy has hay fever. Do you or Dave?”
“Yes, I do. Why?”
“Look at this.” Jill showed her the patch. “This is eczema.”
“Really?” Padma peered at it, frowning. “I thought it was a rash, or maybe poison ivy. He was playing in the grass yesterday while I weeded.”
“It’s not uncommon in babies, and it’s nothing to worry about. But we call asthma, allergies, and eczema, the allergic triad. It runs in families, and several of them can be in the same child.”
“They do, I know, in my family.”
“Let me see the rest of you, Rahul.” Jill examined the skin on his chest, legs, neck, and back, with its tiny scapula, like the nubs of angel wings. There were no other eczema patches. “How’s he eating?”
“Not great, but not terrible.”
“Drinking?”
“Okay.”
“Sleeping? You said he tugs at his ear?”
“Yes, off and on, at night.”
“Poor little guy.” Jill looked up and met Padma’s eye. “I think you’re right, it’s another ear infection, but he gets a lot of ear infections for a baby who’s not in day care. On the other hand, he has older brothers, so I bet he gets all the colds they bring home from school.” Padma’s eyebrows sloped down unhappily. “Do you think he should get tubes? My brother does, and they helped my nephew.”
“No, I wouldn’t do that for Rahul. We used to do that more often, because of language impairment, but he isn’t showing any delays. You can dress him, now.” Jill went to the computer on the desk, typed her password into Epic, opened Rahul’s file, and typed in her notes. Pembey Family Practice had EMR, or electronic medical records, but Jill always waited until after the exam to record her findings. She liked to look the mom in the eye and stand in front of a child, not a keyboard.
“So no tubes?” Padma asked.
“Not yet. Let me check one last thing in his file.” Jill navigated to Rahul’s weight chart, with its line climbing up a hill, until six months ago. He’d started life in the thirtieth percentile, but now was down to the fifth, which meant he fell off his curve. That wasn’t good, either.
“So, amoxicillin?”
“Yes, since it’s been over a month since the last time he’d used it, and Tylenol, too.” Jill closed out the file, leaving the screen waiting for the password of the next doctor. She’d coded it as a URI for insurance purposes, but she wasn’t 100 percent sure why it kept happening. The saying in medicine was, if you hear hoofbeats, don’t go hunting for zebra, but Jill knew better. Zebras existed, and pediatrics was full of them. She stood up. “Let’s see him again on Wednesday. I know you’re busy, but I want to keep an eye on him.”
“Okay.”
“Also, before you leave, I’d like to take some blood.” Jill didn’t elaborate because she wasn’t about to alarm Padma. There was a chance that Rahul had an autoimmune problem, leukemia, or lymphoma, but they were only remote possibilities. “The lab’s just down the hall. It won’t take long.”
“Blood?” Padma’s dark eyes flared. “For an ear infection?”
“Yes, I want to know why he keeps getting them, and a blood test will give me a complete picture of what’s going on in his system and see what type of infection his body is fighting.” Jill didn’t add that the blood test would tell her how many and what type of white blood cells Rahul’s body was producing, whether lymphocytes, neutrophils, or monocytes, and that would eliminate the more serious diagnoses. “You only have to take him down the hall, and I promise Selena will make it easy.”
“Okay, if you think it’s really necessary.” Padma pressed a strand of dark hair into her short ponytail.
“I do, and I’ll call you when I get the results, probably on Tuesday. Please let me know if anything changes.” Jill printed out a script for amoxicillin, signed it, and handed it to Padma. “Here we go.”
“Thanks.” Padma picked up Rahul’s little jeans, and Jill placed a reassuring hand on her shoulder.
“I mean it, don’t hesitate to call me.”
“Will do. Thanks again.” Padma smiled, and Jill gave her a hug.
“Love to the boys and Dave. Rahul, bye-bye.” Jill caressed the baby on the cheek and left the examining room, checking her watch on the fly. Pembey Family Practice had office hours until one o’clock on Saturdays, and it was 1:15, so she wasn’t as behind as usual. She needed to spend time with the patients, but it put her in constant conflict with their office manager, Sheryl Ewing. Jill hoped to leave today without seeing Sheryl because she didn’t need the lecture, with the memorial service ahead of her.
She bustled to her office, thinking of William, and anger flickered in her chest, an ember that didn’t need fanning. She felt hypocritical going to his memorial service when, in her darker moments, she had actually wished him dead. And if she were really honest, she wouldn’t be surprised if it turned out that someone had murdered him.
Because in her very darkest moments, she would have done it herself.
Chapter Eight
Jill drove down Route 202, heading east toward Philly, with a somber Megan in the passenger seat, her face turned to the window. Even her phone was quiet, and Jill
wondered if she had silenced it or turned it off. Rain pounded against the windshield, and they passed a strip mall that used to have a huge Circuit City, which was now vacant. The only sound was the rhythmic beating of the wipers and the low rumble of the road.
“You look nice, honey,” Jill said, looking over. Megan looked grown up in a simple black dress she wore for choir concerts, with low-heeled black shoes. Her hair was still wet from the shower and gathered in a black velvet scrunchy.
“Thanks.” Megan turned to her, with a brief smile, but the strain showed on her face. “Is this service gonna be weird?”
“A little, but we’ll get through it.”
“Will it have an open casket like Grandma’s?”
“No.” Jill felt a pang, thinking of her mother’s wake, in the funeral home. “This isn’t a Mass, it’s a memorial service, in a church. An historic church.”
“William didn’t go to church.”
“Sometimes they hold services in church, even if the person didn’t go there.”
“Is there something after it, like with Grandma? Do we all go to a restaurant?”
Jill realized that Abby hadn’t mentioned a reception. “I don’t know.”
“Who else will be there, besides Abby and Victoria?”
“I don’t know. I guess William’s friends and maybe someone from work.”
“Where did he work?”
“I don’t know that, either.”
Megan shook her head. “We don’t know anything about him anymore, and he used to be my Dad.”
Jill felt stricken. She knew the feeling, albeit from the other side. If it was impossible to be an ex-parent, it was impossible to have one.
“It’s like he just forgot we were in the same family. Like he never even knew us, and we didn’t matter to him at all.”
“He didn’t forget you, honey.” Jill’s fingers tightened on the wheel. They’d talked about this many times, but it was all coming back now, with William’s death.