“I’m not asking you for treatment. Max wanted us to call you, not me. I let him do it because I think he needs the help. I can’t get him to a psychiatrist any other way, he won’t go.”
“You mean he’s the real reason I was called down?” Eric was coming up to speed. It was one of those situations where the identified patient wasn’t the real patient.
“Yes. He knows I’m dying, but he can’t really accept it and he’ll be all alone when I’m gone. Can’t you help him?” Mrs. Teichner grasped the sleeve of Eric’s shirt, newly urgent. “Please, help him.”
“Explain to me what makes you say he needs help.”
“He tells me that if I just eat, I’m going to get better or live longer or whatever, but I’m not. I’m going to die, and he can’t deal with it.” Mrs. Teichner didn’t blink, her gaze steady and knowing. “I don’t want a feeding tube. I’m ninety, I’ve lived a long time, and when my pain pills wear off, I hurt all over. I want nature to take its course, at home.”
“I understand.” Eric hoped that he would face his own demise with as much bravery. He decided it wasn’t necessary to conduct a mini-evaluation. Mrs. Teichner was remarkably sane, and since she was refusing treatment, he was on safe legal terrain if he addressed what was bothering her about her grandson. “Where are Max’s parents? What do they say?”
“My daughter is his mother, but I’m embarrassed to say, she’s worthless. She lives with me, but she’s never home. She drinks too much and she can’t keep a job. She used to work for the phone company but they fired her for absenteeism.”
“How about his father?”
“His father ran away when Max was only two. He drank, too.”
“That’s too bad.” Eric felt a bitter pang of resentment, one that would never go away. His father had been an alcoholic, a truck mechanic who’d been driving drunk when he swerved into a tree, killing himself and Eric’s mother. Eric had just left for freshman year at Amherst. But he pressed the memory away, to stay present. “Does Max have any brothers or sisters?”
“No, he’s an only child. He doesn’t even have any friends. At home, he never leaves his room except to take care of me or eat dinner and he plays those computer games all night. I’m all he has.” Mrs. Teichner blinked away tears. “What’s going to happen to him? He could hurt himself, after I’m gone.”
“Please, take this.” Eric pulled a Kleenex from a box on the bedside table and handed it to her. As a psychiatrist, he spent a lot of time handing people tissues, but it still tore his heart out when women cried, especially older ones. They reminded him of his mother, whom he still thought about, every day.
“I don’t know what to do, I’m worried sick about him.”
“Do you really think he’d harm himself?”
“Yes, I really do.” Mrs. Teichner dabbed her nose, which came to a curved point. Pinkish mottling on its sides told him her oxygenation was poor, which was to be expected. “He’s an odd duck but he’s a good kid, with a good heart.”
“Has he ever tried to hurt himself? Or said words to that effect?”
“No, he doesn’t talk about himself or his feelings. His father was the same way, that good-for-nothing.”
Eric let it go. “Has Max gone to a therapist or gotten counseling at school?”
“No, he’s embarrassed. He says he’ll get teased if people find out.” Mrs. Teichner sniffled, wiping her nose. “I’m beside myself. I pray on it all the time. It’s just so hard. I’ve asked around but nobody comes through. Please, help him.”
“Well, I do have a private practice,” Eric found himself saying, though he hardly needed a new client. “I could make time to see him if he wanted.”
“Really?” Mrs. Teichner’s hooded eyes rounded with hope. “Would you?”
“I would, if he wants to come.”
“Thank you so much!”
“You’re welcome.” Eric’s heart eased to see her relieved. “But you have to understand that psychotherapy is a serious undertaking, and you’ve probably heard that it helps only if the person really wants to do it. I’ll make the offer to Max, but it’s up to him.”
“He’ll go, I know. You’ve lifted such a load off.” Mrs. Teichner clapped her arthritic hands together, holding her Kleenex. “Really, there’s nothing on earth that matters to me as much as that boy. I can be at peace if I know he’s okay. You understand, if you have kids.”
“I do.” Eric thought of Hannah, but kept that to himself. His daughter was only seven years old, and he worried about what would happen to her if he wasn’t around. Since his separation from his wife, that worry had become more than academic.
“And, Doc, I can pay you, don’t worry about it. What does it cost to see you, fifty or sixty dollars an hour?”
“About that, yes,” Eric answered. His fee was $300 an hour, and for clients who couldn’t afford that, he had a sliding scale that was never less than $250—except for crying old ladies facing terminal diagnoses. Psychiatry was among the lowest-paying medical specialties because it required virtually no procedures, with the highest fees generated by procedure-heavy practices like orthopedics, with its hip replacements and Tommy John surgeries, or plastic surgery, with its face-lifts, nose jobs, and boob jobs. Every psychiatrist hated the irony that the best-paying specialty was cosmetic surgery, as if you could fix your psyche by changing your face.
“Then it’s a deal. Thank you so much!”
“Happy to help.” Eric rose, brushing down his khakis. “Before I leave, are you sure you don’t want to talk to me about yourself? I’ve treated patients coping with a diagnosis like yours, and it’s understandable if you want some help.”
“Nah. I’m a tough cookie. Except for the cancer, I’m fine.” Mrs. Teichner waved him off with an ironic smile.
“Virginia, it was a pleasure meeting you.” Eric slid his wallet from his pocket, extracted a card, and set it down on the bedside table. “If you change your mind, feel free to call me. Don’t hesitate. You are one tough cookie.”
“You bet your ass,” Mrs. Teichner shot back.
Eric smiled, trying not to wonder if he would see her alive again. He gave her a final wave and motioned to the medical students to leave. “Mrs. Teichner, ’bye now. I’ll send Dr. Fortunato in. Best of luck.”
Eric followed the medical students out of the room, then spotted Laurie at the nurses’ station and Max heading for the vending machines. Eric was about to go see him when he felt a touch on his elbow and turned to see it was the female medical student, Kristine Malin. “Yes, Kristine?”
“That was such a sweet thing to do, Dr. Parrish,” Kristine said, her hand on his arm. She had a gorgeous face, big blue eyes, long dark hair, and a dazzling smile, like a toothpaste model.
“Thanks,” Eric answered, surprised. He didn’t know why she was standing so close, much less touching him, but he didn’t have time to worry about it. He was thinking about Max, who was standing in the small glass-walled room that held the vending machines, off the waiting area. “Excuse me, I have to go.”
Chapter Three
“Max, hi.” Eric walked to Max, who stood in front of a vending machine, staring at it blankly, his numb expression ghosted in the glass. The room was otherwise empty, and beyond it was the children’s waiting area, its primary-colored walls and boxes of toys an incongruously cheery backdrop.
Max turned. “What do you think? Can you help her? Give her something to lift her mood?”
“I understand that you believe your grandmother is experiencing depression, but I don’t agree.”
“Why not?”
“I evaluated her, and in my opinion, she’s fine, given the circumstances. She’s a special person—”
“What about the feeding tube?” Max’s blue eyes weren’t challenging, but pleading. “Why would she refuse a feeding tube if she wasn’t depressed? That’s, like, suicide. Like saying you don’t care if you die.”
“It’s not an irrational choice, Max. Many patients in her cir
cumstances refuse feeding tubes.” Eric kept his tone gentle. “You know there are two kinds, one tube that goes through the nose or one that goes through the stomach. Either is a very intrusive thing and—”
“But she’ll die if she doesn’t eat. She’ll starve.” Max’s eyes flared, pained, and Eric’s heart went out to the boy, who was too young to deal with this on his own.
“I understand that, and so does she. Still, I gave her my card and told her to call me if she feels the need for treatment. She’s facing her diagnosis with an acceptance—”
“I can’t let her starve. She has to get a feeding tube. Can’t I make her?”
“Max, I know this is hard to hear, but that’s not your decision. It’s hers. She’ll make it with her doctors and the hospice workers.”
“But she’s choosing wrong.”
“You have to let her decide. It’s her life.” Eric could see that the boy was trying to hold it together, his face flushed with emotion.
“What if she changes her mind? Can she get a feeding tube in hospice, even at home?”
“Yes, she can, but that’s not my bailiwick.” Eric paused. “I know how much you care about her, I can see that. Once she enters hospice, she will get a first-rate social worker to help her. They’ll call me if she develops depression or any other emotional problems.”
“For real?” Max’s eyebrows slanted downward under his raggedy bangs.
“Yes, and they have ample experience.” Eric placed a hand on the boy’s shoulder. Oddly, he wondered what it would be like to have a son. He hadn’t thought that in ages, not since Hannah was born, but something about the physical connection sparked the thought. “Max, this is going to be a difficult time for you both. Your grandmother believes that you’ll benefit from therapy, and I’m offering to see you in my private practice, nights or weekends.” Eric slid his wallet from his back pocket, extracted a business card, and handed it to the boy. “Please, take this. Don’t hesitate to call me if you want to schedule an appointment.”
Max accepted the card and glanced at it, blinking. “Okay, thanks. I appreciate it.”
“I’m not going to try to convince you because it has to be up to you. But if you don’t call me, then please do avail yourself of the support groups that hospice will offer. One of the best things you can do for your grandmother is to take care of yourself.”
“Yes, that’s what she says.”
“I hope you listen to her.” Eric took his hand from the boy’s shoulder. “I wish you the best of luck.”
Max managed a shaky smile. “Thanks.”
“Take care.” Eric turned away, with difficulty. He couldn’t help feeling that he was turning his back on the kid, but that was the hardest part of his profession, knowing that he could help only those who came to him. He walked back to Laurie, who was waiting.
Laurie smiled sadly. “I knew you’d come through for him, the poor kid. I owe you one.”
“So you were in on this, too?”
“Yes. I could see that her problem was him, really. Thanks for the consult.”
“No worries.” Eric looked around for the medical students. “Where—”
“They went back upstairs. The girl got paged. What’s her name, Kristine? Dude, she has a lady boner for you.”
“No, she doesn’t.” Eric had missed how blunt Laurie could be. They hadn’t gone running for a few months, since he’d been going through the worst of his separation.
“When you were talking to Max, she was gushing about how nice you were. Besides, she bugs me. There’s always one of them.”
“One of what?”
“She’s the Girl Who Dresses Too Hot For Work. Every rotation has one, probably every job.”
Eric hadn’t even noticed what Kristine was wearing, but she was pretty. He wasn’t blind.
“Also did you see Sandy at the nurses’ station? She was so excited I called you down. They’re champing at the bit, now that you’re divorced.”
“I’m not divorced yet.”
“Oh please. You filed, right?”
“Yes, but nothing’s final.”
“So there’s a waiting period. Whatever.”
Eric didn’t understand why he was making such a pointless distinction. “Permit me my denial. I’m a professional.”
“Well, in the good-news department, there’s no waiting period for single doctors.”
Eric checked his watch. “Can I go now? I’m late.”
“Where’re you going?”
“Home,” Eric answered reflexively.
Laurie scoffed. “You mean your soon-to-be ex-wife’s house? Why?”
“I have to drop off a check.”
“Ever hear of the mail?” Laurie lifted an eyebrow. “You put your check in something called an envelope, and they bring it to her door.”
“I told her I’d do some yard work. Mow the lawn.”
“At night?”
“It doesn’t get dark until nine.” Eric could feel a lecture coming on. He’d observed that doctors in hospitals tended to become their specialty. He’d become more cerebral as a psychiatrist, but Laurie had morphed into an emergency doctor to the max. She went right for the wound, exposed it, and flushed it out, no matter how much it hurt.
“Can’t she mow her own damn lawn? Or pay somebody?”
“I like to mow the lawn, and if I go over, I get to see Hannah when it’s not my night.” Eric didn’t want to hear it, not right now. “Why do you care?”
“I don’t like seeing you get used. It’s not right.”
“She’s not using me.”
“Whatever, I never liked her, she’s a bitch.”
“Okay, let’s let it go.” Eric didn’t like to hear bad things about Caitlin. He still was sorting out why she’d wanted a divorce, though he suspected its roots went back years. They had met at Amherst, and she’d married him after graduation, but when he developed an anxiety disorder, he could feel his cool factor vanish and her disillusionment begin. She’d wanted him to be the take-charge, confident, alpha male he seemed to be, killing it in college, summa cum laude, headed for Penn Med. She had fallen in love with a cardboard cutout of a man, a résumé rather than a human being, and when he’d showed a chink in the armor, it sealed his fate with her. Even after he’d gotten over the anxiety and they’d had a child together, she never looked at him the same way again. And the child only made things worse.
“All right, I’ll lay off, I’m sorry.” Laurie sighed. “It must be hard on you not to see Hannah. You’re a great dad, and she was always closer to you than to Caitlin.”
“Thanks.” Eric never allowed himself to think such things, much less say them, but it was true. He was closer to Hannah than Caitlin had been. He and his daughter had so much in common. Too much, according to his wife. Er, ex-wife. Eric wanted to change the subject. “So what’s new with you?”
“Nothing.” Laurie shrugged her broad shoulders. “I’m here all the time. We lost two part-time docs and I’m taking extra shifts.”
“That’s tough.” Eric admired Laurie’s work ethic. She was an absolutely dedicated emergency physician. “And how about that guy you were seeing, the new one?”
“Which one?”
“The fix-up.”
“The fix-up who texted too much or the fix-up who texted too little?”
Eric smiled. Laurie’s dating tales were the stuff of ED legend. “I’m behind on your love life. I meant the ethics professor.”
“Need you ask? Ethics professor? That says it all.”
“What? I think that sounds good.”
“You would.” Laurie rolled her eyes.
“Another one bites the dust, eh?” Eric felt a twinge of sympathy for her. She was too attractive to be single: smart, funny, and fun to be with. “Well, you’ll meet someone. You’re awesome.”
“I’m so awesome.” Laurie grinned. “Men are threatened by me, what can I tell you?”
“They don’t last long enough to be threatened by you.?
??
“I’m threatening right off the bat. I don’t want to be less than, so some guy can feel more than. Capisce?”
Eric smiled. “How’s that working for you?”
“Don’t ask.” Laurie laughed. “Anyway, enough. I think we should start running again.”
Eric groaned. “I haven’t run since I moved out.”
“We’ll start slow. How about next week, after work? I can’t Monday, but can you Tuesday?” Laurie glanced over at the examining room, and Eric turned, too, to see Max talking with his grandmother.
“Poor kid.” Eric watched Max take his grandmother’s hand. “How much time does she have?”
“Can’t say for sure. It’s been three days since she’s eaten. Older people don’t need the calories, but she’s dehydrated. We’re giving her two bags of saline, but she’ll lose that in a day or two.”
Eric recognized the answer-that-wasn’t-an-answer. He did it, too, hedging his bets when he answered questions from anxious families, will she get better, will he try to kill himself again, will she keep cutting herself, will the Klonopin work, does he really have to be admitted? Eric repeated, “How long does she have?”
“Two weeks, tops.”
Eric eyed Max and his grandmother, with sympathy.
Chapter Four
Eric turned the corner onto his old street, leaving behind the rush-hour traffic, the hospital, his patients on the unit, even Max and his grandmother. He decreased his speed and heard the reassuring rumble of gravel beneath his BMW tires. He looked forward to seeing Hannah, and Caitlin had even invited him to have dinner at home, which he took as a good sign—of what, he didn’t know.
He cruised along the winding road, lined with tall pin oak and horse-chestnut trees. He cruised past the trees, noting which were gaining buds or shedding bark. He was his mother’s son, she’d been an avid gardener who loved nature, and he’d come to know the trees, as well as all the other flora-and-fauna along the street; the Daleys’ forsythia that was sadly short-lived, the fragrant lilac bushes clustered around the Menghetti driveway, and the privet hedges that the Palumbos let grow tall, so they thinned out like older people. It reminded him of Mrs. Teichner, and he felt it like a brick in his stomach.