Of Flesh and Blood (39 page)

“You took my advice, after all.” He pointed to the bright pink wig she wore over her natural hair. “That’s wild.”

“I’m just trying this one out.” She shrugged as she chomped noisily on a wad of bubble gum. “Agnes said I could see how I liked it.”

“Well, I love it,” Tyler said as he approached her bed. “Very punk. Makes a real statement.”

With a giggle, she ran her hand over the wig’s short-cropped hair. “I figure everyone’s going to know it’s a fake, so I might as well go over the top with it.”

The gum’s fruity scent hit Tyler as he reached her bed. “Go for it,” he said.

Paige pulled off the wig. Numerous strands of her hair stuck to the liner. She straightened her thinning hair with great care, clearly attempting to avoid any more hair loss. But the effort was futile, as clumps came out with each pass. “I’m not totally sold, Dr. McGrath,” she said. “Agnes has an okay wig in a brown that’s kind of like my natural color. I might go with that one . . .”

“Why not both?”

“Yeah. I guess.”

Tyler sat down on the edge of her bed. He glanced at her exposed skin, pleased not to see any blotches or rashes apart from the few small pimples
across her cheeks and forehead. “Day two of the new treatment and no sign of another allergic reaction,” he said.

“Could I still break out later?”

Tyler knew a delayed reaction was still a remote possibility, but he didn’t want to spook her. He was about to dismiss the concern when he thought of the Staffords and the repercussions of his decision to withhold information. “You can develop an allergy to any medicine at any time.”

Her face paled.

“
But
, Paige, you have already had four doses,” he soothed. “If you were going to have a serious reaction, it probably would have happened by now. You’re tolerating it well.”

“I hope so.” She swallowed and some of the color returned to her cheeks. “I never want go through that angio . . .”

“Angioedema.” Tyler helped her with the pronunciation. “Me, neither.”

“They said you saved my life.”

He shook his head. “I’m the one who ordered the medicine that caused your reaction in the first place.”

She shrugged again. “And the new stuff is just as good as the drugs I was supposed to get?”

Tyler hesitated. A week before he would have answered with a simple “yes,” but Nate’s outcome had affected his approach. “About ninety-eight or ninety-nine percent as good.”

“I guess that’s pretty close.”

Tyler told Paige about her latest lab results, specifically the drop in her circulating white blood cells that was expected after starting chemotherapy. He explained how she would have to be watched even more closely for fever or other signs of infection and kept isolated from the outside world, since her depleted immune system would have trouble fighting off previously harmless microorganisms. Paige raised several concerns of her own—including the question that most teens asked first: “Can my friends still visit?”—but overall she seemed far calmer, showing little, if any, of the fatalistic angst that she used to ooze.

Upbeat, Tyler left Paige to her wig-fitting. He made it only a few steps down the hallway when a hand grabbed him by the elbow. He looked over to find Maya Berry standing beside him. She brought a finger to her lips. “Will you meet me in the courtyard in five minutes?” she whispered.

Her pained expression stopped him from questioning her secretive approach. “Okay.”

Ten minutes later, he walked out the sliding glass door of the cafeteria and into the courtyard beyond. Maya was already outside, pacing back and forth in the shade of two large maple trees when Tyler reached her. Without a word, she began to walk toward the pathway that led to the administrative building, and he followed her. She stopped near the entrance of the building and had a glance around, ensuring no one was within earshot. “Dr. McGrath, I read that newspaper story about Nate and you.”

Her cloak-and-dagger behavior suddenly made sense. “I see.”

“Is any of it true?”

He looked her in the eyes. “Most of it.”

“Honestly?”

“Maya, I won’t make that mistake again.”

“Do you mean about the consent?” She paused. “Or never using Vintazomab again?”

“The consent. I won’t ever downplay the risk again.”

Maya’s eyes filled with insight. “What happened to that boy . . . that’s why you’re reluctant to give Keisha the medicine, isn’t it?”

Tyler nodded. “I’m a little gun-shy, yeah.”

Her voice cracked. “There are no other drugs that can fight Keisha’s cancer, are there?”

“I don’t think so, Maya.”

She sniffed a few times, but when she spoke her voice was strong. “I hid the newspaper from my husband.”

“Why?”

She sighed. “Jonah doesn’t think we need to take drastic steps for Keisha. He is still convinced the Lord will intervene.”

At a loss for words, Tyler just nodded.

“He won’t, at least not how Jonah thinks He will. I don’t know how I know, but I know it in my bones.” She gaped at him. “I don’t care what Craig Stafford or that reporter said. I trust you with my baby’s life. If God is going to help us, it will be through
you
, Dr. McGrath.”

“Maya, my department head has banned any further use of the drug until—”

She waved a hand to stop him. “We both know Keisha needs that
medicine. You just have to give it to her.
Please
. Just give my baby another chance. That’s all I ask.”

They stared at each other for a long moment. “Okay,” he said softly. “I’ll order everything up this afternoon. We should be able to start Keisha on the Vintazomab tomorrow.”

Tears suddenly welled in her eyes and flowed down her cheeks. “Oh, thank you, Dr. McGrath. Thank you.”

“I have to tell Jonah everything. You understand?”

She nodded. “He doesn’t have to know about Nate, does he?”

“I won’t lie to him, Maya.”

Her round face creased with purpose. “I would never ask you to. I want Jonah to know about the risks and all. I just don’t think he needs to hear what happened to that poor boy. Besides, isn’t there some kind of doctor-patient confidentiality that would stop you from talking about it?”

“But it’s in the newspaper. And I think it’s a story ‘with legs’ as the expression goes.”

She wiped away the last of her tears. “Let me worry about that, Dr. McGrath.”

Tyler left Maya on the pathway and headed back to the children’s hospital. Despite Keisha’s temporary improvement on steroids, the medicine had only been stalling the inevitable. Her mother was right. Vintazomab was Keisha’s last real hope. But the dread rose with each step nearer at the thought of infusing the same experimental medication into Keisha’s spine that had pushed Nate over the edge.

Tyler cut off the pathway and onto the lawn. Focused on his thoughts, he walked past a tree without even noticing the person sitting at its base until she called out to him. “Well hello, Tyler.”

He stopped and looked down to see Nikki. In her mauve scrubs, she sat on a small blanket with her back to the tree trunk. She held a bagel in her hand.

“Not a bad spot for lunch,” he said.

“There are worse.” She sheltered her eyes from the sun and grinned. “Want to pull up a tree?”

“Okay,” he said. “I’m just going to grab a sandwich. You need anything?”

She dabbed at her lip with a finger. “I’d look a lot less trailer-trashy with a napkin.”

“Done.”

A few minutes later, he wandered back out with a chicken breast sandwich, a bottle of water, and several extra napkins. He sat down across from her and unwrapped his sandwich.

“So?” she said, stretching out the word. “How are you?”

“Better.”

“Me, too.”

With her brown hair falling loosely around her shoulders and her cheeks flushed with a healthy golden glow, Nikki did look better. And more attractive than ever. But as he raised his eyes to hers, he saw that the pupils of her brown eyes were tightly constricted. He had noticed the same small pupils the last time they were together, sitting in Paige’s room after her life-threatening reaction. Tyler wondered if her eyes were simply reacting to the bright sunlight, but the doctor in him did not accept the explanation. Her pupils were the size of pinholes. He had seen the same response many times in his patients, but only the ones on narcotic painkillers.

The state of her pupils, combined with the dreamy quality of her features, reminded him of her confession about her hydromorphone addiction.
Is she using again?

“What’s the matter, Tyler?” She dabbed at her cheeks. “Am I still wearing cream cheese?”

“It’s just . . .” He cleared his throat. “You don’t usually let your hair down at work.”

“Are you being funny, Doctor?”

“Apparently not,” he said, eager to change the subject. “I am going to start Keisha on Vintazomab tomorrow.”

Nikki smiled broadly. “About time,” she said.

“It is, isn’t it?”

She squinted at him and her front teeth dug into her lower lip. “You nervous?”

He nodded. “Once bitten . . . and all that.”

“It’s going to be okay, Tyler,” she said softly. “You’ll see.”

“Will you be around to help me?”

Her hand swam through the air in a florid gesture. “I’m your humble servant. Always.”

“Nikki, are you all right?”

“We’ve been through this. About five minutes ago. Remember? We established we were both better.” She giggled. “You want me to read the transcript back to you?”

“It’s just that . . .”

“Out with it.”

“You’re acting a little . . . different.”

She dismissed the idea with a small wave. “It’s all this fresh air and sunlight. Does wonders for me. Sometimes it makes me a little silly, too.”

He did not intend to pursue it, so he almost surprised himself when he said, “And your pupils . . .”

Her smile drained away, and she shifted uneasily. “What about them?”

“They’re so constricted.”

“So? I forgot my sunglasses,” she snapped, and quickly looked away. “I’m not sure you’ve noticed, but it’s damn bright out here.”

“Of course—”

She hastily gathered up the remains of her lunch, stuffed it back into her nylon bag, and jumped to her feet. “I’m already over my break. I better run.” She turned to go.

He stood up and caught her arm. “Nikki, listen, if you want to talk, anytime, I’m—”

She pulled her wrist free of his hand. Without looking at him, she said, “Remember the last time we talked?
At O’Doole’s?
That didn’t work out so good for either one of us.”

“That was my fault,” he said. “I meant that if you had anything you wanted to get off your chest—”

“I don’t need your sympathy, Tyler.” She glanced at him briefly, her eyes bloodshot and her expression pained, and then looked away. “And I certainly don’t need any more of your mixed fucking signals.”

“Nikki . . .”

But she lurched away from him and broke into a jog toward the children’s hospital. He stood and watched her go. Her sudden defensiveness only hardened his suspicion.

Squinting to read his watch in the sunlight he realized he was already late for his afternoon in the outpatient clinic, and his appointment slate was crowded.

Dodging between examining rooms, he ran a minimum of two patients
behind all afternoon. His load was compounded by the phone calls he had to make between appointments to organize Keisha’s Vintazomab infusion for the following day.

It was after eight
P.M
. when he pulled into his driveway. Kramer met him outside the front door, meowing to be let in.

“Jill?” he called out as he stepped inside.

“I’m in the kitchen,” she replied weakly.

He walked into the kitchen to find her sitting at the counter with the newspaper spread out in front of her. She cradled a mug of tea in her hands. He was surprised to see that she was dressed in the same pink dressing gown she was wearing when he had left for work in the morning. She wasn’t wearing any makeup. Her face looked pale and drawn, but her lips cracked into a slight smile. “Hi,” she said.

Tyler headed over to her chair. He bent to kiss her, but she moved her mouth away and his lips brushed against her cheek. Uncharacteristically, she shot out her arms and pulled him into a tight hug.

“Tyler, I’m so sorry,” she said as she released him.

He detected the faint odor of vomit underneath her toothpaste. “Sorry? For what?”

With a worried frown, Jill turned the pages of the newspaper over to reveal the article featuring him.

He nodded. “It’s okay. I’m dealing with it.”

“Really?”

“Yes.” He pointed at her dressing gown. “Did you leave work early?”

“I never went.” She ruffled the lapels on her robe.

In their ten years together, he had never known her to miss a single day of work. “Jill, what’s wrong?”

She shook her head. “My stomach is a little upset. It’s just stress.”

His concern rose. “You sure that’s all it is?”

“Yeah. I’m better now.” She waved her hand. “I even ate a banana and a few crackers.”

“Is that why you didn’t go to work?”

“I couldn’t, Tyler.” Her eyes dropped to the countertop. “All those people in my lab, all the phone calls and the e-mails, my colleagues . . . I just couldn’t face any of them today.” She pushed back her hair. “I just don’t know what to say to any of them.”

Tyler had rarely before seen his wife look so vulnerable. The sight moved him. He reached out and tenderly ran a hand over her cheek. “Jill, they’ll understand.”

“No,” she said hoarsely.

“How do you know?”

She swallowed loudly. “Because if this kind of research fraud happened to anyone else, I wouldn’t understand . . . or excuse them . . . for it.”

He wanted to say something reassuring but everything he thought of struck him as trite and empty. Instead, he wrapped his arms around her and pulled her head against his chest.

“Thank you,” she said.

“For what?”

“Understanding.”

“If only I were one of your colleagues.”

She chuckled into his chest and then pulled her head far enough back to look up to him. “Tyler, I need to show you something.”