What James Dinn Knew

When I tell my third patient of the day that he has three months left to live, I want to kick myself in the groin. I am a liar. James Dinn will probably be dead before the end of the month. But he doesn’t know that, so he goes ahead and asks all the classic questions.

“Is there a cure at all?”

We’re talking about stage three lung cancer, sir. In my mind’s eye, I see the blooming, blackish-grey tumour on the CT scan.

“There is a new treatment being developed in Los Angeles,” I finally say. “Some doctors are quite optimistic about it. Worth a try.” His face lights up. I squirm inwardly.

“Talk to Doctor Zacks. He’s in touch with their team.”

The dying James Dinn shakes my hand, and we part ways.

When I decided that I wanted to become a doctor, I never believed I’d get this far. I was a very serious medical student, but equally aware that I was one among many.  I didn’t consider myself special in any particular way. It’s true that I was young and twenty and fairly ambitious, but aren’t we all?

I went through medical school because I wanted to be a doctor anyway. I felt – and knew – that healing has always been my calling. My father used to joke that I should be a nurse, because I’m such a pathetic, feminine, nurturing type. “No boyish qualities at all,” he’d pat me gently on the back. I set him straight at age fourteen when I responded with a punch at his jaw. Secretly, though, everyone knew he was mostly right. My place belonged beside the patient, before and after the operation, patting wounds clean with my soft healing hands. But I dreamed to become a doctor. So I did, and very successfully too. Today I am one of the senior surgeons in the hospital, and I’ve cut many famous bodies open in my lifetime. I guess people like the gentle touch.

I am very, very good at what I do.

Evening comes after a gruelling day. Outside the air is cold and comfortingly icy, which makes me happy. I’m going to enjoy my long drive home, with my car windows wide open, the wind kissing my face, so I’ll feel alive. Medical practice can do that to you. When I’m in that zone, it’s like I’m sunk in a deep tunnel of misfortune. Hot, sticky, sick bodies. The cold is always a better idea.

My Lexus is waiting for me. I’m in, on the road, and immediately James Dinn, little Ray, Salina Smithson, and the old redhead, Patricia, are out of my mind. All of them failing patients. They never used to bother me, all these faceless, ruined bodies, but then something changed. Maybe it was Mother’s death. Or perhaps turning fifty gave me an age-old sentimentality? Regardless, for the last few years, out-and-out strangers have been filling my headspace, hounding my dreams, and crawling in and out of my consciousness throughout the day.

The moon is very white tonight. I don’t want music. I’m surprised to find that I’m content with an open window and the steady rhythm of my car’s wheels brushing against asphalt. Predictable, smooth noise. Not like the pop music Sandra plays, or anything like the cough that’s been plaguing me since morning.

James Dinn calls me the next afternoon.

“Doctor Radburn, are you available to take the call?”

When I ask my secretary who the caller is, she tells me it’s yesterday’s patient. I’m on my lunch break, but take the phone. James wants to know if Doctor Zacks is trustworthy, and if I have any contacts at the hospital in Los Angeles. He sounds desperate, but hopeful. I jot down his email address and promise to be in touch. But suddenly, I can’t get the image of a very, very long black coffin out of my mind.

James Dinn is a very tall man.

When I get home that night, it’s after an extra long drive, again with no music. But I’m not relaxed at all, because my cough’s been getting troublesome. I can’t ignore it any longer, and neither will my wife.

“You should really take a day off,” she tells me sternly. Then I raise my eyebrows, and she laughs.

It’s strange between us, when it comes to health affairs. I’m the expert, so who is she to tell me how to look after myself? The absurdity of it lies within the reality that I’m only still at my job because of her. Sandra likes the prestige and the style of it, and I don’t think she minds the money either. I was ready to retire three years ago. Work wears me out those days. I think I’m getting old.

“Your cough is scaring me.”

She sits down on the sofa, next to me, and our legs are touching. The steadiness of her body calms me, and I feel secure and oddly happy. Sandra is looking at me intently and she knows I can feel it. So I turn to look at her, into the concerned dark brown eyes. Something melts inside me, inside my heart, very near where my cough hurts most.

“You think so?” Why do I sound like I don’t know the first thing about medicine?

Sandra nods slowly.

“OK. I’ll check myself out tomorrow.”

Three days later, after I reply to James Dinn’s email in great length and detail, Doctor Robert Zacks is ready at my side. He was actually the one who suggested the scan, not me. At first I was almost touched by his concern, but now that he’s being so insistent, I’m beginning to have grave suspicions of the Sandra effect. She can do that to men, sometimes.

“Ready when you are.”

We walk in silence down the long corridor. For the first time in my life, I become acutely aware of a strong chemical smell that’s overwhelming me, and I want to choke. Bromine? I’m not sure. Our shoes are rapping smartly along the smooth, cold floor. It’s a perfect, synchronised deranged rhythm. Shoes on a floor. I never noticed that either.

A neon green light shines brashly above us now, cheap and synthetic in the white daylight. It’s time to have my scan. Inside, the room is very, very spacious. There are too many air conditioners on. I will not shiver.

“You’ll take off your coat off now?”

I’m taken by surprise. Coat? Then I remember that I’m wearing my white doctor’s coat. But of course, I’m not a doctor now. I’m the patient.

Obediently, I take it off. Underneath I am dressed in a simple navy woollen jumper, and corduroy black trousers. Sandra would cringe. I always convince her that no one ever sees me in these. Ah, well.

“Into the next room, please, sir.”

In the next room, which is slightly smaller, I’m greeted a little too brightly by familiar nurses. One of them, a tall blonde named Sara, comes over to me.

“We’ll need you to take these off.”

My jumper, my vest, my trousers. They all come off. A broad white wheelie bed is brought to me.

“Lie down, please.” Sara is still very friendly. I give her an embarrassed smile, and she blushes. Then I remember that I’m the senior here.

Once I am lain down, things happen quickly. The bed moves along another smooth floor, and into a very small room indeed. The familiar white and blue PET-CT Scanner looms ahead of me like a faceless opening into unknown territory. I never realised how much it resembles an arch. A gateway. I’m right underneath it now, right inside it. I can hear my own breath, loud and living. I’m engulfed by its momentum, surprised, almost. Then the door clicks softly closed. I’m alone.

Is this what it feels like, just you and your body and the machine? There are a thousand lights around me, and the noise is deafening. I’m flat on my back, and I cannot look right or left, only straight up overhead. The blue and white archway above me is as clean and expressionless as ever, and suddenly I want to know all its sinister secrets. How many death sentences has this room delivered? How many frightened people have lain on this bed before me, looking up at the same cold archway, thinking and waiting? All of a sudden, I can see little Jay, the small thin body, and two black eyes staring up in terror. Salina Smithson, stoic and brave, but surely quavering inside. The old redhead, Patricia. And James Dinn. He lay here too?

Finally, the lights go off, and the beeping stops. Roberts Zacks is waiting for me outside. He motions me toward the computer room. That’s where all the paperwork comes through. We call it paperwork; out there they call it results. But this is not an exam, is it?

“Shall I email it to you?” He is very benevolent today.

“No thanks. I’ll go in myself.”

I get a phone call from Mrs Dinn the next morning.

“Doctor Radburn?” The voice is muffled and unfamiliar.

“Yes, it’s me. Is everything OK?” I’ve developed a formal though friendly relationship with James’ wife.

“Doctor Radburn... James died this morning.”

“I’m so sorry.” I feel hollow inside. That’s a new feeling, I realise immediately. I’m not used to the sensation.

“The funeral is at three o’clock. Do you think you can make it?”

Of course I can. I knew James Dinn for three weeks, after all. She gives me directions and a location, and we hang up.

I spend the rest of the day in a haze of emotional destitution. The more time passes, the more strange and empty I feel inside. Is it guilt? I should have been open with James and the family. I knew he was dying, I knew I’d be attending his funeral so soon. This isn’t a surprise. And after all, his last two weeks were wonderful. He was planning a holiday with his wife next month. The last holiday, he was calling it. James was so happy about that, and so was his family. I think I’m glad he died like this. His wife thinks he went early, and so tragically. But she is so grateful that he shared those last two blissful weeks with her the way he did.

At two-thirty, I get into my car and drive off. The graveyard is small and remarkably beautiful. There are lilies growing around the stone archway. I pause underneath it and look up. Old stone, grey and strong. I walk through it.

There is a small crowd standing around a black coffin. It is even longer than I imagined. Around it stand three very tall men, and a gorgeous young woman, also tall, and very poised. Mrs Dinn is weeping softly in front of them, her three children. They are not crying.

Someone steps forward and begins to speak. I hear none of it, no words at all. I can’t take my eyes off that black wooden box. I can see James inside it, still brave, still hopeful. There is no tumour, I believe. He is happy now, happy and free and as hopeful as the larks singing above me. I hear them even more clearly now, because everyone is quiet; the speech, I realise, is over quickly. They all stand in silence for a long time, so dignified and tall and brave, and still admirably positive; even Mrs Dinn isn’t sniffing anymore. Of course, it is another stunningly cold day, yet nobody shivers in their black suits. More birds are singing now. I can’t control my ugly coughs anymore. Out they come, hoarse and loud and rasping.

I turn away from the small procession, wave one last goodbye to the body I know is still inside the coffin, about to be buried. I’m going home. I have other patients to attend to, but there isn’t much time left. After all, I know what I’ve been feeling instinctively for a very long time. Sandra will know nothing of it, I promise myself. The fact that there are only two weeks left will remain secret till the very end.

Hope, I realise, is what keeps us human. But it also gives us an unexpected joy. And as I take one last look at that still, quiet coffin, I feel a twinge of jealousy for the dead James Dinn and his everlasting hope.

Because after all, I am a dying man myself. Right now, it is only a matter of time.