She looked back at Nana, who still ate her lunch, seemingly in no hurry to respond, and leaned back. She’d had about enough of this shit.
She opened her mouth to say so, but instead, Nana said, with no inflection in her voice, “It’s spread. The next step is—what did he call it?—multimodal treatment, a mix of chemotherapy and radiation. He hopes it will slow the disease, though for how long he wouldn’t say.”
Shayla sat up straight and launched into her questions, lamenting again that her stubborn grandmother hadn’t allowed her to come to the appointment. But she’d find the doctor later and get the information. That might be a slight breach of doctor-patient confidentiality, but oaths didn’t seem to mean much to her these days, and if she’d break it for Ian, there was no limit to what she’d do for Nana.
“When do you start? Did he say whether you’ll need round-the-clock care, at least initially? I’ll need to check into this treatment, make sure it is the best course for you and that the doctors here can perform it. It never hurts to have a second opinion.”
“Shayla,” Nana said quietly, her voice full of the weariness of age and illness, “I’m not doing it.”
“What?” she said, brows lifting. “You’ve heard of some other treatment?”
“No, but I’m not doing it. Any of it. I’ll live the rest of my life the best I can, but no more hoops for me. Sometimes you gotta let go. I’m letting go,” she said with a finality that couldn’t be questioned.
Shayla sat for a long moment, mouth gaping like a fish’s as she looked first at Ethel and then Ian, searching for support.
“It’s her choice, Shay,” Ian said, leaning over to wrap his arm around Nana in a show of support. It was her undoing.
“Fuck you, you scumbag. You’re just happy you’ll get your little inheritance sooner. You are a fucking useless scoundrel.”
Nana looked stunned, but Shayla couldn’t stop now.
“And, Nana, you’re quitting on us. You don’t care enough to even fight. You always told us to try, never give up. I guess that was a lie too.”
She stood and stormed out of the cafeteria, unable to look back, wiping the angry tears that clouded her vision as she went.
••••
Thankfully, the after-lunch emergency-room crowd was steady, and once she took a few minutes to compose herself, Shayla was able to immerse herself in her work. There were no serious injuries—two broken arms, a sinus infection, a couple of patients with chest pains, but the distraction was sufficient, allowing her to put Ian and Nana and everything else out of her mind and do what she did best. The afternoon flew, and when her shift ended, she was tired but not ready to go home, and she was way too wound up to call a friend, knowing she’d make terrible company, so she just went home and stewed, too grumpy to even eat.
Shayla eventually went to bed hungry and annoyed, and woke up the same. It was Wednesday, her cherished day off, and she was too distracted to enjoy it. Between the disastrous lunch with Nana, and the fleeting thoughts of Demon that sneaked in whenever she wasn’t thinking about Nana, she was a mess. She moved from her bed to her couch and then onto the balcony three times before she gave in. The guy, well, he was an unwanted distraction, but her mind couldn’t let go of what Nana had said yesterday, and she knew there’d be no rest until she cleared it up.
That thought in mind, she called Dr. Humphries, Nana’s pulmonologist.
“Dr. Humphries, hello, it’s Dr. Rodgers.”
“Shayla, hello. Are you in today?”
“No, but I did have a question. Do you have a few minutes?”
“Sure, what’s up?”
His voice was warm, comforting, and she was reminded again of why he was one of the most respected and well-liked physicians at the hospital.
“You’re treating my grandmother, Ethel Rodgers.”
“Umm…Dr. Rodgers,” he said, the hesitation in his voice and his use of her title warning her that he was uncomfortable with the direction of this conversation, “you know I can’t discuss my patients, not that I’m confirming that Mrs. Rodgers is indeed a patient.”
“I know, I know. I wouldn’t ask you to violate confidentiality”—that was exactly what she was doing and he knew it as well as she did—“but I had some general questions about the condition.”
“Okay, I can answer some
general
questions.”
“So, what’s the prognosis for someone with her—I mean someone at stage IV of the disease?”
“You know mesothelioma is a progressive disease, Shayla. The prognosis is poor.”
His tone was warm but still firm, reminiscent of the one she used when delivering devastating news, attempting to straddle the line so that the gravity of the illness was clear but without killing every glimmer of hope. She hated it.
“There’s no course of treatment?”
“Oh yes, there are several, including a multimodal protocol that attacks with both radiation and chemotherapy,” he said, mirroring the language that Nana had used.
“And surgery’s not an option?” Shayla said, already knowing the answer.
“No. I’m afraid not. Surgery can be successful if we catch mesothelioma early, but once it metastasizes, surgery is no longer an option. And in infirm or elderly patients”—
like your grandmother
went unsaid, though Shayla got the message loud and clear—“it’s an especially poor option. The surgery is risky and hard on even the healthiest of patients. And there’s a chance we won’t get all of the tumor anyway. The risk is too great and the likelihood of success too little, I’m afraid.”
Shayla weighed his words, the reality of them inescapable, but she was not yet willing to give in.
“So what’s the benefit of the multimodal approach?”
Shayla felt silly asking, but somehow, having someone else walk her through this was comforting.
“It’s purely palliative care. There’s no cure, but the treatment can prolong lives, and as we learn more about what works and what doesn’t, more and more people are having full, longer lives, longer than they would have otherwise.”
“But?” she asked, picking up on the hesitation in his voice.
“But, frankly, it’s a crapshoot. At that stage of the disease, there’s no real way to predict how a specific patient will respond, and it’s a hard, painful road.”
She knew this already, but hearing him say it hit with the force of a body slam.
“But there’s still a path.” She clung to the thread of hope that ran through her chest.
“Yes. For some patients there is,” Ned said with a sigh.
“Okay. Thank you, Dr. Humphries. Maybe we can grab lunch next week?”
“Sure, Shayla. And good luck.”
He hung up, and Shayla sat in the silence of her living room, mind churning over the conversation. Dr. Humphries had been honest, almost grim, but there was a chance. They still had options. She clung to those. She did a quick Internet search and printed off treatment information for Nana to read, formulating a plan as she went. Reenergized and as optimistic as possible under the circumstances, she quickly dressed and hopped into her car to drive to Nana’s.
The trip was uneventful, but Shayla found the drive comforting, and her spirits were buoyed as she parked and walked up the stoop and let herself in. She hadn’t called in advance, wanting to see Nana face-to-face when they spoke.
“Nana, you up?” she called as she walked through the formal dining room and into the den that was the hub of the house.
“Shayla? I’m in here, darling,” Nana said, her voice light with the affection. Shayla felt no trace of their earlier disagreement, which was not a surprise since Nana rarely held a grudge.
Nana’s voice filled her with warmth, and she was reminded of all the good times they’d had, the years she and Ian had spent here after school, on summer breaks, and for Sunday dinners. The feeling was only intensified when she walked in and saw Nana settled in her recliner, dry toast and cup of instant coffee on the tea table beside her. It could have been 1987, 1997, 2007, or any year in between. The picture would have been the same. Her nana, her rock, the one who’d been there no matter what, providing the love and support when her parents had been unable, from birth all the way through medical school and her residency, when she’d been so tired she hadn’t had the energy do anything but work, study, and sleep. She couldn’t count the number of times she’d come home, almost comatose with exhaustion, to find clean laundry or a decent meal waiting for her. Nana had slowed down over the years, but that love and support had never wavered.
Her gaze snagged on the oxygen tank, a relatively new and thoroughly unwelcome addition, and she saw the thin plastic tube leading to Nana’s nose, almost transparent against her brown skin in the low light of the den. But now that she’d seen it, acknowledged it was there, it was a sight she was unable to unsee, a physical manifestation of the fragility that she’d tried to ignore but that would no longer be denied.
Her grip loosened, and she was faintly aware of the papers she held slipping through her fingers and falling to the floor. And then her vision was blurred, clouded by tears that she didn’t try to control.
“You can’t. I won’t let you,” Shayla said around the tears.
Nana smiled the smile she had used all through Shayla’s life. “You can’t stop it, dear. Neither can I.”
“But you can’t just quit, give up! You always told me not to quit, not ever to quit!” she practically screeched.
“I also told you to pick your battles. I’ve picked mine, and I’m at peace with it.”
“I’m not,” she said as she walked across the room and settled at Nana’s feet as she had so many times in the past.
Nana patted her head. “You will be.”
Shayla again heard the finality in her voice and couldn’t bear to look up.
“What can I do?”
“Just be with me while you can. And take care of your brother like you always have.”
“I will, Nana. I promise.”
Thwack
.
The violent sound of fist hitting flesh rang loud, loud enough to be heard over the roar of the crowd, and the bright red spray of blood that flew from the combatant’s mouth only made the roars louder.
It turned Shayla’s stomach.
Everything in her screamed at her to jump in, stop this madness, but she did nothing. She’d done a lot of that recently, and it was taking its toll. This was the fourth—no fifth—of these she’d come to, and so far, stitches and some general patchwork had been the extent of her medical care.
Still, she hated it. And she knew she was on borrowed time. Something terrible was going to happen here; someone could die, and she would, at least in some way, be responsible.
Unable to watch the fight that continued, she scanned the crowd and was again struck by the range of people in attendance. All races, all genders, seemingly every class, gamblers, curiosity seekers, pretty much any person she could imagine, all together to enjoy the show. In a way it was pretty spectacular. Other than her emergency room, Shayla couldn’t think of another place where such a dynamic mix of people would congregate willingly. Too bad it was in service of something so ugly.
Ugh.
That was another thing she hated about this. It made her morose, forced her philosophical side to consider the human condition and whatnot. So not her speed. She was a healer; she fixed things. Give her a broken bone, she’d set it, cardiac arrest, she’d do CPR, but leave her to figure out what motivated these individuals, let alone her role in it all, and she was stumped. And she didn’t like the feeling.
Her gaze snagged on Ian, who was across the room holding court. Then she looked to one of the men standing next to him. It was the guy Lottie had introduced her to—Craig? No Greg—Williams. Odd that he would be here, but then maybe Lottie had mentioned what Shayla had said. But then again, he seemed perfectly relaxed, at ease with everything that was happening around him. Maybe his reason for being here was something else altogether. At this point, nothing would surprise her. She sighed, unable to devote energy to that mystery but equally unable to pretend that Greg’s presence here didn’t raise flags.
Then she glanced back at Ian. He too seemed relaxed, more at ease. Maybe whatever…whatever had been hanging over his head—she still couldn’t bring herself to ask for details, willing to acknowledge that she didn’t have the mental space to dedicate more attention to worrying about Ian than she already did—had been resolved, and she could take a step back. She needed to take a step back.
As she stood, a tingle slid across her scalp, and she was suddenly aware that she was being watched. An instant later, she caught a whiff of that clean, woodsy scent, his scent, clear and unmistakable even in the mass of bodies and smells that packed the space, and then she felt him beside her.
Her lips curled up into a smile before she could stop them, and she realized she didn’t want to stop. He was the only sliver of goodness to come out of this mess, and she’d replayed their meeting at the Diner, as ugly as it had ended, in her head a million times, again and again feeling herself pulled into those teasing green eyes, let herself relive the lightness he made her feel, however briefly. Even worse, she’d relived that kiss a thousand times, the feel of his lips against hers, the way their bodies had touched, so vivid a sensation it was almost real. Each time it made her burn for him, making her wish with all her heart that they hadn’t been interrupted. That was one thing that she knew with crystal clarity: she wanted this man, knew that, despite her resolve to stay away, despite who he was and what she suspected he was involved in, she would have him if presented a chance. There was no use pretending otherwise.