Always Watching

  If I’d said something, she might still be alive.

  Finally, I looked up Daniel’s number, took a deep breath, and made the call. As I dialed, I realized my hand was shaking.

  His voice was husky from sleep but also tinged with fear. He must’ve seen the hospital name on his call display.

  “Hello, Daniel, this is Dr. Lavoie.… I…” I was at a loss for words, my head aching and close to tears myself. How was I ever going to tell him that his wife had died? I had assured him she was safe—assured him.

  “Dr. Lavoie?” Daniel sounded more alarmed. “Is everything okay?”

  “I’m calling to talk about your wife.” I had to say this as gently and as swiftly as possible. “There was an incident on the ward tonight, and Heather was found unresponsive. We tried to revive her, but it was too late. We don’t know the exact cause of death, but it appears to be self-inflicted. I want you to know that we tried everything we could to save her.”

  There was a sharp intake of breath on the other end, like he was strangling for air.

  “I don’t understand. What happened?” His mind was grasping, spin wheeling. The weight of my words hadn’t hit home yet.

  “We’ll know more when the coroner finishes his investigation.” I took a breath and steadied myself. I didn’t like that I couldn’t give him details, but the potential for a lawsuit was too high. The hospital would appoint someone to handle all future communications.

  “How did she die?” His voice was horrified, shocked.

  My mind filled with visceral images of Heather, writhing in agony on the floor, clawing at her throat. Her esophagus burning.

  “I’m sorry. I don’t have that information right now.”

  “I just don’t understand. I saw her this morning. She was better than she’d been in days—she kept telling me how much she loved me.”

  His tone was heartbroken confusion. The mind tries to reason, to find a justification: One plus one equals two. I did the same after Paul’s diagnosis. He just had to eat right, get chemo, and think positive. He would beat cancer. But life doesn’t work like that. Good men die before their time, and patients, despite getting our best care, still find a way to destroy themselves.

  “Yes, she did seem to be doing better.” I didn’t have the heart to tell him that it’s when suicidal patients start feeling better that they sometimes complete the process—they now had the energy to follow through. Even though she’d told me that she wasn’t thinking of hurting herself, she’d likely had a plan for a while and was just waiting for an opportunity. She’d been so convincing, and seemed so genuine, but I regretted believing her. I thought about how desperate she must have been to choose such a painful way to die.

  I flashed to an image of her face the last time I saw her, the wistful smile. You’re a good doctor. Was she trying to make sure I didn’t blame myself for what she was about to do? I also thought about Kevin, how she had thanked him that day. Even her loving words to Daniel could now be interpreted as a good-bye.

  Daniel’s voice turned hard and accusing. “You said she was safe—you promised that nothing would happen to her.”

  Anger and blame were the next steps. I had expected it, but I still felt the blow, ached with my own guilt and regrets.

  “I realize this has been an incredible shock, and you’re upset—”

  “Upset? My wife just died—when you were supposed to be watching her.”

  I chose my words carefully, struggling with my need to comfort him and my need to protect the hospital. “I’m truly sorry for your loss. Someone will be in touch with you soon. They’ll help you with the next part of the process.”

  I was glad I didn’t have to go through it step by step with him, didn’t want to brush past her death and move on to the particulars: picking up her personal belongings, her remains. My eyes stung when I thought of everything he was going to have to face in the coming days. “You shouldn’t be alone right now. Is there someone you’d like me to call for you?”

  This time there was no anger in his voice. He just sounded hollow and defeated as he said, “Heather was all I had.” Then he hung up.

  CHAPTER THIRTEEN

  The next few days were a blur, but I needed to be on the ward, with the support of the team, all of us still reeling from the tragedy. We had a couple of group counseling sessions, most of the nurses breaking down at one point. A few times I came close as well. The young woman whose room was next to Heather’s was having a particularly bad time. Jodi suffered from anorexia and was extremely underweight, below ninety pounds. She had to have meal support, where a nurse sat and ate lunch with her. Heather had befriended Jodi and also sat with her at meals. Now Jodi was refusing to eat again.

  The staff who saw the scene in the utility room were also struggling. One nurse mentioned having nightmares about all the blood from when Heather had cut her wrists, and I flashed to an image of Heather’s writing on the wall: He’s watching. The moment I first saw the words was still burned in my own mind—the streaks of red, the violent shock to the eyes. I’d been so upset by Heather’s death I hadn’t had a chance to think about the meaning of them. Now a quick snapshot of a memory came rolling out of the dark: Aaron at one of the late-night teaching sessions, the smell of a campfire, his voice raised in a fervent warning: The Light sees everything we do. He’s always watching over us. What had he been talking about? I calmed my mind, tuned out the voices around me, concentrated on that moment. Then, with a stab of fear, a sharper memory came into focus.

  I’m hiding under a cabin watching a ceremony that’s just for adults, a cat clutched in my arms. Joseph’s face is angry in the glow of the fire as he kicks a man on the ground, his voice punctuating each blow. “Aaron warned you. The Light’s always watching—he knows what you did.” The man moans and curls into a fetal position as Aaron pulls Joseph away. Members mill about, some faces concerned, others excited—sharks smelling blood in the water.

  I yanked myself out of the memory, shaking off the cold fear that had crawled up the back of my neck. That was then, this is now. You’re not a child anymore, you’re safe. I turned my mind back on the current problem. Why had Heather written those words? I couldn’t remember her saying anything like that in our sessions. So why had she taken the time to leave them as a final message? Was it related to the commune? Maybe guilt over having violated some of their rules or teachings? Or had Heather been trying to tell us something else? For a brief moment I considered if anyone from the commune could’ve gotten into the ward. No, the security was too tight. It was most likely my original thought: She couldn’t fight her guilt about the miscarriage any longer, and she probably viewed her parents’ death as her fault somehow. If Aaron still taught his members that the Light was watching, her grief-stricken mind might have felt she was being judged.

  I tuned back in to the meeting. They were talking about procedures, what we could’ve done better. I thought about the unlocked door, and regret spread through me again. I wasn’t the only one replaying events.

  Michelle said, “I keep seeing her face—her body just lying there. I can’t sleep. Every time I close my eyes I see … that.” She made a motion with her hand over her face, our minds filling in the blanks: the chemical burns around Heather’s mouth from when she vomited, lips pulled back in a grimace, her skin mottled, and the ends of rags still visible in her throat. We were all quiet for a minute, and I had to close my eyes, blinking hard. When I opened them, Kevin was watching me, his face full of sympathy.

  * * *

  I went home for lunch, and when I came back, I was just getting out of my car in the staff parking lot when Daniel suddenly materialized by the hood. Heather’s bag was over his arm, a box in his arms, and their wedding photo, which she’d kept by her bed, clutched in his hand. Had he been waiting for me?

  “Daniel. Are you okay?”

  His eyes were red-rimmed, his hair a mess, and his face unshaven. It was clear he hadn’t slept in days. When he met my eyes, I almost s
tumbled backward from the grief burning in his gaze.

  “No, I’m not okay, Dr. Lavoie. But you don’t really care about that, do you? Your job is done, so what do you care about my life now.”

  There was something in his voice that scared me, a ready-to-snap, dangerous edge. Adrenaline rushed through my body, making my stomach pull up hard under my ribs. I gripped the key fob in my hand, finger over the panic button.

  “Of course I care, Daniel. I know this must be a very painful—”

  He took a step closer. “You don’t know anything. Not about me, or my wife. She was just another patient to you, but she was everything to me.” His voice cracked, and he stopped, then shook his head and pulled his chest up high. “You people let her die. I’m going to sue every damn person in this hospital.”

  I was pinned between my car and the one beside me, blocked from behind by a cement wall. I hoped a security guard would notice, or someone parking their car, but when I looked around, the lot was empty.

  I kept my voice low and soothing. “Would you like to go inside and talk about this?”

  “What’s left to talk about?” His face was angry, his breathing rapid. “She’s dead, and nothing’s going to bring her back.”

  I wanted to help him, wanted to explain about depression and chronically suicidal people, about the damaging effect a center like River of Life could have on someone already struggling with a mood disorder, but I was thrown by the situation and the despair in his face, by my own feelings of remorse and sorrow. According to the hospital lawyer, I shouldn’t even be having this conversation.

  Daniel was smart enough to realize that and said, “It’ll be lies anyway. You’re not going to tell me what really happened—no one at this hospital will.”

  “Daniel, I truly am sorry, but—”

  “I don’t want to hear any more apologies. I trusted you.” The words hit hard, and fear followed when he took another step forward. “I thought she was getting better.” His voice had started to rise. I was scared, but I was also hoping he’d attract attention. “What happened? I don’t understand what happened.” His hands on the box were shaking now, tears leaking from the corners of his eyes.

  A strong male voice rang out, “Hey, you all right?”

  Then Kevin was walking briskly toward us. I sagged with relief against the side of my car. Daniel backed up, slowly, wiping at his eyes. When Kevin reached Daniel’s side, he said, “Can I help you?”

  “I’m done with all of you.”

  “Then I think you’d better go home now.”

  Daniel turned and took a step toward me. I held my breath, and Kevin’s body also tensed. But Daniel just held out a photo.

  “I want you to have this.” He thrust it toward me again. I took the photo. He nodded once, then turned and walked toward the main parking lot.

  Kevin and I were quiet for a moment, watching him, then Kevin looked at me. “You okay?”

  I nodded. “I’m fine.”

  He met my eyes and raised his eyebrow. He knew perfectly well I was upset. I gave a sheepish smile.

  He said, “Do you have time for a coffee?”

  I hesitated. I’d wanted to get started on some paperwork. But I was shook up. It might be nice to talk to someone who understood what I was going through.

  “Sure, that would be great.”

  * * *

  We sat in the cafeteria for a while, and I shared my guilt over Heather’s death, how I was struggling with it, wishing I’d done more. The wedding photo of Heather that Daniel had given me rested on the table between us as we talked. My gaze dropped down to it often, my mind still trying to make sense of her death, as though her face, captured forever in a smile from a happier time, might hold all the answers. Kevin shared that he’d also lost a patient before.

  He said, “I started wondering if I had what it takes.”

  I nodded. “I have to admit that’s how I’m feeling right now. I’m second-guessing myself with every patient.”

  “Completely natural. It took me a while to get my confidence back. I traveled for a while, trying to reconnect with myself. Then I starting thinking about all the people I had helped, and all the ones I could still help. It’s impossible, I think, to save everyone, but if we help even one person in our lifetime, then we succeeded.”

  “That’s a good way to look at it. But I still feel like I missed something. I should’ve placed her on a one to one, but we’d just had the meeting about funding.…” One to one is when a nurse is assigned to monitor a patient constantly. We usually reserve that for high-risk cases because of budget restraints. And in Heather’s case, she hadn’t indicated she was having suicidal thoughts again.

  “If you’d requested it, it would’ve been shot down.” He was right, but I still wished I’d tried. “You did the right thing by putting her back in the seclusion room. Even if she’d been up in PIC, it still might’ve happened. You know as well as I do that if someone wants to complete, they’ll find a way.”

  “True. But even one day can make such a difference.”

  “And then something could’ve tipped her back the other way.” He held my gaze. “You did your best.”

  I stared down at my coffee, fiddled with the cup, avoiding the photo, and Heather’s blue eyes, which now seemed accusing and angry, her mouth saying all the things I was thinking. You should’ve saved me. You missed the signs.

  Kevin leaned over the table. “Hey, you didn’t do anything wrong, okay?”

  I searched his expression for any insincerity, found none.

  He repeated, “You’re not responsible for her death.”

  I gave him a smile. “Thanks. I really appreciate the support. This has hit me even harder than I realized at first.”

  “We should—” He stopped as his pager went off and glanced down, made a disappointed face. “Duty calls.” He looked directly at me. “If you want to talk again, let me know.”

  “I will.”

  * * *

  After he’d left, I sat there for a minute, looking at my reflection in the window, wondering what Kevin had been about to say. I tucked Heather’s wedding photo into my pocket, then picked up our cups, Kevin’s still warm from his hand.

  CHAPTER FOURTEEN

  Heather’s obituary was in the paper the next day, along with an announcement for her funeral, to be followed by a burial at the memorial gardens. The same place Paul was buried. A heavy pressure settled on my chest as I remembered the sound of each shovelful of dirt falling on his casket while I stood numb by his grave. Then I thought about Daniel and how hard it was going to be for him. I wanted to go to Heather’s funeral to pay my respects but wasn’t sure it was a good idea even though it’s appropriate for a doctor to attend a patient’s service. I didn’t want to add to Daniel’s distress. In the end, I decided to visit Paul’s grave the same day—I hadn’t been for a while—and if I could, watch Heather’s burial from a distance.

  * * *

  The afternoon of the funeral was sunny but cold enough to make the skin on my cheeks tighten and my hands ache. I wore my black trench coat, a gray-and-cream scarf Paul loved, and big sunglasses. I set some tiger lilies on Paul’s headstone and saw that someone had planted a small flowering shrub at the base of the stone. I knelt and spotted a tiny plastic dog nestled in the roots—white, like our beloved husky, Chinook, who’d passed away a year before Paul. My eyes welled up. Lisa must have left it for her father.

  Then, in the distance, I saw a small procession moving toward Heather’s grave, which wasn’t far from Paul’s. There weren’t a lot of people, but I wasn’t surprised. Heather had mentioned that her parents didn’t have much family, and Daniel had told me she’d pushed her friends away.

  When the ceremony was over, people said a few words to Daniel before drifting off. Daniel stood by the grave for a while, his head bowed, then turned and walked down the path toward the parking lot. I made my way down to Heather’s plot with my bouquet. I placed the white roses on her grave, remembe
ring her sweet smile and sad blue eyes when she’d look sideways at me through the veil of her hair.

  I’m sorry I wasn’t able to help you.

  Behind me, a man’s voice said, “What are you doing here?”

  I spun around. It was Daniel.

  “I just wanted to pay my respects. Sorry if I’ve intruded.” I brushed away tears and turned to go.

  “Wait,” Daniel said.

  I turned back, my body tense.

  His eyes met mine, and this time there was no anger in them, just a tired sadness.

  “I owe you an apology.”

  My shoulders relaxed, and I loosened the grip on my shoulder bag. “You don’t owe me—”

  “No, I do. The things I said to you in the parking lot.” He shook his head. “That wasn’t fair. It’s just seeing all her stuff in that box, our wedding photo…” He stared down at the flowers on the grave, swallowed a few times. “She tried to kill herself when she was living with me—and even before that. I’m not going to sue the hospital. It’s my fault anyway. I should’ve brought her back to the center sooner.”

  “I don’t know if that would have helped, Daniel. They seemed to upset her.”

  “She was doing great there—it’s when we left that she fell apart.”

  “That may be so, but it seemed like Heather felt they were harassing her to come back. And they didn’t appear to respect her boundaries or wishes.”

  “They weren’t harassing us—they just wanted to make sure we were okay.”