"Doctor, heal thyself," I hear the first-year intern mumble to his cohort and the murmur of the newly degreed physicians as they leave my room.
I've forgotten my case files, and my hair is windblown and drenched from the rainy walk across the street to the patient pre-op apartment tower. But as Saint Bernadette's leading psychiatrist and a woman nearing her thirtieth year in practice with the remnants of menopause clinging to my body, they don't dare say a word more. A sudden hot flash would burn through my eyes and char their careers with a pen stroke or leave them on E.R. duty for a month.
The old cogs don't turn so quickly these days. It's a wonder I remembered to check in on my patients at all. Sometimes I feel as if I'm slipping into a fog, losing sight of why I'm even here. As I pass through the foyer of the apartment building, I pass by my first patient, little Nancy, hopscotching on chalked-out squares that fit perfectly in the tile pattern of the black floor of the hallway. She's staying in apartment seven, and at that exact age, she's more precocious than a girl facing a liver transplant should be.
“It’s raining and pouring,” she sings as she jumps, “The old girl is snoring, she bumped her head, nearly dead and won't wake up in the morning.”
"You know, I think you're a bit off, Nancy," I say with a smile on my face though I'm wondering where in the world she got such a morbid line from. "It's the old man…."
"No, it's about right." She says, preoccupied as she eyes the seven and eight boxes in front of her and lands both feet perfectly in them.
“How are you feeling about tomorrow?” I ask, hoping my probe doesn’t unearth a sudden fit of anxiety in her mind.
“Meh,” She shrugs, “Mom’s nervous though, she’s got her box and she’s looking out the window again.”
"Yeah, kiddo, big day. But you're going to be great." I say as I jostle the deck of cards in my lab coat pocket. It's a gimmicked deck and a sleight-of-hand card trick kids love. When I teach them the technique, they love it even more. "In fact, when I get done visiting my other patients, I'm coming to your room; I have a present for you. A bit of magic--"
“Really?” Nancy’s eyes go wide. “Let me see!”
"Soon," I wag my finger and head down the hall. I pause at Nancy's apartment doorway. The door is propped open with an overnight bag. Her mother sits across the studio, sipping a glass of Cabernet and staring into the overcast sky through their window. A box of Franzia and an ashtray are her only company.
“She’ll be okay,” I call.
“She’s an imp.” Her mother sighs without turning to face me, “Harry wanted to bring her, of course.”
“Is that your husband?” I ask, but I already know the answer. Nancy’s file mentioned her parents were estranged. “My Dad was named Harry too.”
Her mother turns to look at me finally, "Is he a lecher too?"
"What?" I'm stunned, and I check my watch without reading the display, "I…uh, well I need to go but I hope we can talk for a minute when I get back."
“Sure,” she waves me away with a hand and pulls a cigarette to her lips.
I hurry to the end of the hall and my first official check-in. I should make a note that Nancy's parents are prime candidates for family counseling, but I know the look her mother gave me. Disappointment, bitterness, and resolve are etched into her face, and I wonder how much of it will spread into her little girl before she's free from the woman's yoke.
Rae is in apartment sixteen. I remember her in admittance. She wore headphones the whole time. When I told the teen her prognosis was good, that the tumor was benign but still needed to be removed, only a small purse of her lips indicated any emotion beneath her subdued, apathetic stare.
“Your folks here yet?” I ask when she opens the door to my knock.
"No." she sighs and straightens her Led Zeppelin t-shirt.
“How are you feeling today?” I try.
One-word answers. She's extra talkative today.
“So, uh, how’s school?” I ask because I don’t know what else to say. She’s as much a mystery to me as she probably is to herself.
“Can I help you?" She rolls her eyes at me, "Or something?”
”Rae, it’s okay to be a little scared,” I fold my arms instinctively, deliberately mirroring her body language. “I used to be over all the bullshit too. Even had the same surgery you’re getting, believe it or not.”
"Really?" She lowers her guard a little.
"Yeah, and I promise you're going to be alright." I put my hand out, and she doesn't shy away. "You'll make it through this just fine."
“I’m not scared like that,” she says, “I just, I don’t know, what if I didn’t want to be?”
I pause, suicidal ideation is a red flag in patients, but I'm not sure this counts. "Can I ask why, Rae?"
“I just…I don’t know. Sometimes I think it might be easier. I’m ready to be done with school, with everyone putting me under the microscope. Sometimes I just want to get out of my skin, start over.”
“It will get better,” I say softly as I hold her gaze. “This part of your life is just a chapter, and one day you’ll turn the page on everyone and everything that can’t keep up with you.”
"Yeah, thanks." Rae manages a smile.
“So Jimmy or Robert?” I ask and point at her shirt.
“Oh well,” She giggles, “Robert’s got a great voice and all, but Jimmy any day.”
“Good choice,” I wink at her. “See you tomorrow.”
Mrs. Thomas in thirty-five welcomes me in before I even have a chance to knock. She's in her prime, with brunette locks and perfect skin, long before the worry lines of life will permanently etch their brand on her face.
“Love your hair,” I say as she offers me a seat at the kitchenette table near the window, “I used to be able to keep the same look, now I’m lucky if I can keep it from falling out.”
“Dr. Jensen, are you kidding me? You look great!” She smiles as she sips tea from a flowered cup. “Bob says I need to go on a diet, but I stopped listening to men’s opinions after husband number two.”
"Should've stopped at husband one." I crack a smile, and we both laugh. "Is your hubby here?"
“We’re not together right now,” Mrs. Thomas nods and plays with a lock of her hair, “I wanted to go back to school, and he said he wouldn’t let me, not ‘til I wrote the kids out of the will. You believe that?”
"His own kids?" I shake my head, but she smiles and shakes hers too.
“No, Bob shoots blanks. Jen and Jeff are from a previous marriage.” She pulls a Virginia Slim from her purse and offers it to me.
"I quit, thank you," I say, wanting her to continue. She needs to release.
She nods, “Do you mind?”
“No, I still love the smell, actually.”
“He doesn’t give a shit about them,” she continues as she lights it and takes a long drag, “Starting to think he doesn’t think much of me either. I was a waitress for years you know? I kept my twins healthy, kept them happy, well I tried, at least. Never needed a man - until I did.”
“It’s lonely being a single parent,” I tell her.
“I’ve dragged them halfway across the country following my heart,” She shakes her head, “Now I’m all they’ve got. I just don’t want to be bitter, I figured maybe it was time to do something for me - maybe not need to depend on anyone, for once.”
“You know I put myself through med school when I was in my thirties,” I say and watch her reaction lighten, “and the number of nights I left my kids with T.V. dinners, or to fend for themselves…but I did it. I made it.”
She points at me and nods knowingly, “Bet that haunts you too?”
“Oh yeah,” I sigh and think on the faces of grown children I haven’t called in months. “Every day I wonder if it was worth the sacrifice.”
I find myself walking to apartment seventy-eight and knocking on the door. I can't remember her file for some reason, but I'm sure I'll recall her name when I see her face. I knock on the door again, but there's no answer. I try the knob, wondering if perhaps she fell asleep or went out. It's locked. I jot down a note in my planner to check in with her tomorrow before her surgery. The day nurse will probably have her chart.
I need to catch little Nancy before her mom puts her to sleep. I take the steps and find myself at her door once again. I knock, and her mom answers.
"Hi! Me again." I smile, but the woman's annoyed expression makes me feel about an inch high. "Is Nancy here?"
“Last I saw she was out in the hall,” the cigarette dangles from her mouth as she speaks. “What? You lose her?”
“I wasn’t with her, ma’am - I was seeing my other patients. Are you sure--”
“Irresponsible little cow.” Her mother quips, “Well, get off your ass and do something!”
My mouth drops, and she slams the door on me. I turn to the hallway, but it's empty. Even the girl's hopscotch markings have disappeared.
"Nancy?" I call, but only my echo responds. I head back down the hall. It's possible she went to an ice machine or perhaps is even pestering another guest. I stop at Rae's room and knock once more. The door swings open to an empty room. No bed, no table, no chairs. No Rae. I look back at the room number. Sixteen. It's right, and it's all wrong.
"Rae! Honey? Are you here?" I call but taking a few steps into the studio; I find only a note taped to the floor.
“I don’t need you. Don’t call me. I”ll find my own way." I read her cursive as naturally as if it was my own.
"Rae!" I call again and glance for the phone, but it, like the furniture it sat on, is gone. The room feels cold and empty, like a tomb. I rush through the door and back to room seven and Nancy's mother. I pound on the door and feel my face flush with rage.
"It's not my fault! Hello?" I pound on the door again, "It's not my fault! I'm trying to find her!" I kick the door, and it opens to another empty space. "What the hell is going on?" I scan the room. Like Rae's, it's empty, lifeless, and hollow.
“Doc?” Mrs. Thomas’s voice questions me from behind as she drags a suitcase behind her down the last of the steps. “Are you alright?”
“Mrs. Thomas - I, sorry, I’m looking for a patient…or two,” I try to explain calmly as I turn to her, “their rooms are empty, did you see a little girl and a teenager, they’re about seven and sixteen, um one is--”
“They’re gone honey,” She says and smiles, “Long gone.”
"No, they can't be. They have surgeries tomorrow," I can only sigh. Clearly, the idea of a major medical procedure is alien to these people. "Patients don't leave here. They're obligated to stay; they are responsible for showing up. I'm responsible for them."
“You have to forgive them, hon.” She offers and rests her hand on my shoulder. “It’s such a little grace to give, but you owe them that much.”
I glance at her bag again, “Wait, where are you going?”
“Told you Doc,” she says, “I gotta do this for me. I can make all this up once I’m done.”
“Mrs. Thomas, slow down,” I shake my head, “your procedure is not something you can just put off.”
“I hope the kids can understand, I can manage it all,” doubt crosses her face. “ I just need some time.”
I want to tell her she can't manage, that her kids will drift from her as mine did. They'll call less and look to new faces to share their lives with. I want to tell her that following her dream can lead her to a room of degrees that won't share a smile or take her hand. I want to tell her how hard it will be to juggle those teacups and how much she'll hate herself when she drops one. But it's a choice she has to make, and as she heads for the front door of the patient tower, I can see she's happy for the first time in her life.
I take the steps, two at a time, until I reach the seventh floor. I'm catching my breath, and I don't care if my mascara is running when I'm knocking for my last patient, Ms. Unknown.
This time the door opens of its own accord.
And I find myself facing a woman dozing in a hospital bed. The floor has changed. The building has changed. I'm in my hospital looking at myself. A nasal cannula runs across my face to a small air tank at my side. The monitor's rhythmic beep is slight but steady.
"You have to forgive them," Mrs. Thomas had said, "It's such a little grace to give."
I think of the girl, lavished with her father's love, and the lies her jealous mother told to cripple them both.
I think of a teen who ran away at sixteen to find something she couldn’t at home.
I think of the woman that gave everything for her kids until she finally decided to give something to herself, and I think of every failure that loomed with each step I took.
I think it's time I finally love these women and let them go.
A first-year intern walks through me like a breeze and reads my chart to two other physicians taking notes. “Nancy Rae Thomas-Jensen - age seventy-eight.” He probes my toe with a pencil, “She was actually a physician here some time ago, her children found her in her home, unresponsive.”
As he pinches my arm and takes my hand, I can't feel a thing. Only his words strike a nerve, "Her children found her…."
"She made her end-of-life plans clear, D.N.R.," He says as he gazes at me for a moment, a sadness in his eyes, "They want to be present. I think she will be missed."
The others turn and leave. The intern follows them for a moment before whispering, "Doctor, heal thyself."
So I'll wait by the bedside for my babies' faces one last time, and though they won't hear it, I'll tell them...