Of Flesh and Blood (6 page)

“The pulse has improved, Dr. McGrath,” the nurse said in a relieved tone.

Evan squeezed the last of the pus out of the belly and pulled his hand out of the wound. Satisfied, he began to suture the peritoneum closed with a continuous thread. He sewed all the layers that he had cut through back together until he reached the skin, which he chose to leave open to lessen the chance of a wound infection.

Evan put the needle back down on the table and dipped his blood-caked fingers into one of the pots, clouding the water inside. “Sister, will you please bandage the wound?”

“Certainly, Doctor,” the nurse said.

Marshall squinted hard at the surgeon. “Will my girl be all right now?”

“Olivia is still very ill, Mr. Alfredson.” Evan lifted the steel bowl containing the necrotic appendix. He held it out to show the pale giant, exhibiting it for a shade longer than he knew was necessary. “Now that
this
is no longer festering inside her, I hope she will make a full recovery.” He looked down at his fingernails, which were still encrusted with Olivia’s blood and pus. He thought of those jade eyes. “But that is out of our hands now,” he said quietly.

Tyler McGrath didn’t leave his office at the Alfredson’s outpatient clinic until after seven
P.M
., and only then to rush back to the SFU to treat a patient, Paige Newcomb, who had broken out in a severe allergic reaction to her first dose of chemotherapy. The allergy was easy enough to treat, but the fourteen-year-old—already devastated at the prospect of losing her hair from chemotherapy—was inconsolable at the sight of her swollen lips and neck and the diffuse blotchy rash covering her body.

Tall and gangly with a scattering of pimples over her cheeks and forehead, Paige teetered in the awkward stage between child and adult. But with huge eyes and sculpted cheekbones, she was destined to grow up beautiful.
Only if she survives the cancer
, Tyler thought grimly.

As the antiallergic medication ran into Paige’s intravenous line, Tyler sat on the edge of the bed trying to calm her. Desperately self-conscious, the girl recoiled from his initial attempt to squeeze her puffy hand, so he avoided any further contact. But he stayed where he was, hoping his proximity might reassure her.

Paige had pulled a handheld mirror out of her nightstand when the rash had first broken out, and she had clung to it ever since despite Tyler’s encouragement to put it away. She consulted the mirror again in disgust. “Dr. McGrath, my friends can’t see me like this,” she sputtered. “They just can’t.”

“They won’t, Paige.” He nodded at her engorged face and discolored arms. “In thirty minutes this will all be a distant memory.”

“Promise?” she asked desperately.

“Promise.”

She snuck one more horrified glimpse of herself in the mirror and then
lowered it to her chest. “Doesn’t matter,” she groaned. She ran her hand through her lustrous brown hair. “This is all going to fall out soon.”

Tyler nodded sympathetically. “You wouldn’t believe how quickly it grows back, Paige.”

“In a year or something,” she muttered.

He forced a smile. “I remember when I got these horrible braces in eighth grade. I don’t think I smiled for a year and a half. Now, I can barely remember them.”

“At least you could hide your braces.” She looked up at him hopelessly, tears welling again. “Everyone is going to see me bald.”

They had already had this conversation multiple times, but Tyler didn’t mind running through it again. He hoped to see just a glimmer of acceptance in the girl’s desperate eyes. “Remember Agnes? The lady who came to see you about the wigs.”

Paige nodded.

“Agnes makes them out of real hair. I’ve seen lots of patients wearing them. And if I hadn’t known different I would’ve been fooled every single time.”

“Honest?”

Tyler brought his hand to his chest. “I swear. And if you want to mix it up and go blond and short, or red and curly . . .” He winked. “Hell, if you want a blue Mohawk, Agnes can do that, too.”

Paige giggled, but the reassurance was short-lived. Her face crumpled again. “Everyone’s still gonna know.” She plucked at her eyebrows. “You can’t make a wig for these.”

Tyler spent another fifteen minutes trying to calm Paige. He didn’t begrudge a moment of the time, but he left with the niggling sense that the teenager wasn’t much, if any, more at ease than before his arrival.

As he drove away from the hospital, Tyler tried to focus on anything aside from work, but it didn’t help. His thoughts kept drifting back to his patients, especially Nate Stafford and the almost insurmountable odds the boy was facing. By the time Tyler pulled into his driveway, he decided that his thirty-fifth birthday had fallen on a particularly lousy day.

Jill and he had lived in the house for over a year but it still didn’t feel like home to him. They had bought the recently renovated two-story house soon
after relocating to Oakdale. The once-sleepy town, sixty miles outside of Seattle, had grown in step with the Alfredson, which was its primary employer and sole industry. They had not bought the house because of its country charm or elaborate wine cellar—though those were definite plusses—but because of its proximity to the hospital, a five- to ten-minute drive. On drier days, Jill or Tyler could cycle or even run to work, but neither of them ever seemed to find the time.

Though Tyler had grown up in Oakdale, he had not wanted to return to the town or the Alfredson. He doubted he would ever be able to escape the shadow of his family name or establish his own professional reputation there. But Jill had argued that the move was critically important to her career and so, against his better judgment, he relented. While it may have been the right career decision, it had proved the wrong step for their marriage. Their emotional divide had only deepened. At times, it seemed as though they were living independent lives under the same roof. He wanted things to change, but his guilt over recent events made it even harder to reach out to his wife.

Tyler stepped into his house just after nine o’clock. Closing the front door behind him, he called out, “Hello? Jill?”

His only birthday greeting came from their fat old calico cat, Kramer (named after Jill’s favorite sitcom character), who rubbed against his leg and meowed for his dinner. Tyler reached down, halfheartedly scratched the cat behind his ears, and then filled a bowl with a mix of wet and dry food, which the cat attacked as soon as it hit the ground. He would have replaced Kramer—or at least augmented him—with a dog or two, but both Jill and he were gone for too much of the day to leave a dog alone at home. Only cats were self-sufficient enough to survive such extended periods of neglect. Tyler wondered how they would cope if Jill ever did become pregnant but, fertility issues aside, that wasn’t much of a possibility lately.

Tyler wandered upstairs, undressed, and stepped into the shower. Standing under the hot spray, he tried to scrub away the remnants of his day. He heard the bathroom door whoosh open. “Happy birthday,” Jill Laidlaw called out from somewhere behind a cloud of steam.

Tyler switched off the nozzle and pushed open the shower door. His wife’s form emerged out of the mist as she leaned forward and pecked him on the cheek. “This bathroom has a fan, you know,” Jill said as she swirled
a finger through the mist. “But I guess people of your advanced age start to forget those kinds of things.”

Tyler held up four fingers and wiggled them. “A few months and you’ll be looking at the wrong side of thirty-four, too.”

At one time, Jill would have shed her clothes and hopped into the shower with him, but he knew that the passionless kiss on the cheek would be as much affection as he would see. Even if they weren’t mired in their rut, she was swamped with a major research grant reapplication and their personal, romantic, and sex life always ground to a halt in its wake. Suppressing a sigh, Tyler reached for a towel, dried off, and wrapped it around his waist before stepping out of the shower.

Jill studied him with those keen blue eyes that had so captivated him. Stylish as ever in funky black low-cut pants and a pale work blouse that still managed to accentuate her slight curves, Jill leaned back against the vanity’s countertop. Her blond hair was clipped behind her ears and she wore just a trace of mascara and lipstick to look polished. A distant smile parted those full lips.

Tyler was very familiar with the almost standoffish pose. Though he had picked up on his wife’s remoteness—“the wall around your heart,” as he had called it during one bitter fight—from their first meeting, it had grown more pronounced recently. Sometimes her inaccessibility left him cold, while other times he admired it as a sign of her inner strength or just found it desperately sexy. At the moment he felt nothing, but he didn’t read anything into that. His numbness was a natural response to an overwrought day.

“Ty, I planned on taking you out for a birthday drink,” she said.

Recognizing the beginnings of an excuse, he reached beside her for the brush on the countertop. “But?” he said.

“I have to get my grant renewal proposal finished. It’s due in a couple days. And it’s a monster.”

“No problem.” He halfheartedly ran the brush a couple of times through his thick brown hair. “Don’t feel much like celebrating, anyway.”

Jill misread petulance into his comment. “Ty, this is no ordinary grant. My whole lab is riding on this funding. And I still haven’t enrolled enough patients in my study to publish the results.”

“You will.”

“You can’t know that!”

“You always have before, Jill.”

She shook her head. “Times are bad now. Government funding for medical research has been steadily drying up since the federal deficit ballooned. The competition for grant money is fierce.” She grimaced. “One of my old professors just had his grant renewal rejected. The guy is nationally renowned. It should have been a slam dunk. Would have never happened a few years back.” She sighed. “I couldn’t be reapplying at a worse time.”

“It’ll work out, hon,” Tyler said. “Besides, I don’t feel like going out tonight. I’ve had a crappy day. All I want to do is to open a bottle of wine and wallow in self-pity.” He summoned a smile. “I thought that might appeal to you.”

“Normally it would be irresistible, but tonight . . .” Jill glanced at her reflection in the mirror and tucked a wayward strand of hair behind her ear. “What was so bad about your day?”

“Remember the boy with acute myeloid leukemia I told you about?”

She ran a finger along the side of her hair. “The baseball star who failed his bone marrow transplant?”

“Yeah. Nate.”

Jill turned from the mirror to face him. “Is it hopeless?”

“We’re going to try one of the new targeted therapies, but even if it were to work, his immune system is so shot . . .”

Her eyes lit with momentary tenderness. “I’m sorry, Ty.”

“He’s such a cool kid. And his parents . . .” Tyler shook his head. “I have another posttransplant treatment failure, too. Almost the same story. Keisha’s only eight.” He had a mental image of the girl that almost made him wince. “She has this wacky smile with the two front teeth missing . . . melts your heart, you know?”

Jill leaned forward and wrapped him in a brief hug. She pulled back and held him by both shoulders. “It’s your job. Think of all the ones you do save. These treatment failures . . .” She shrugged. “They’re simply unavoidable.”

Though he knew she was right, he resented her matter-of-fact tone. “It all evens out in the wash, doesn’t it?”

She let go of his shoulders. “You know what I mean.”

He nodded contritely. “I’m just venting on you. Venting and wallowing. It’s all part of that same irresistible package.” He sighed. “Sure you don’t want to stick around to join me?”

She studied his face. “Are you going to be okay to night, Ty?”

He noticed her steal a furtive peek at her watch. “Yeah, yeah. Go,” he said.

Jill started for the door. “I’ll try to get back at a reasonable time. Save a glass for me. I’d like to toast the old geezer.”

“I’ll leave my teeth in till you get home.” But he knew, as well as she did, that by the time she got back he would be asleep.

After Jill left, Tyler forced their relationship out of his thoughts. He knew better than to judge their marriage in his current headspace.

The ringing phone drew his attention. He would have ignored it, but as soon as he saw his sister’s number on the call display he grabbed for it. “Hey, Erin.”

“Happy birthday, Pip!” Erin said, using the childhood nickname—shortened from “pip-squeak”—that she coined for him when he was still a preschooler.

He warmed at the sound of her voice. Four years younger than Erin, Tyler always looked up to his older sister; though he didn’t see as much of her as he would have liked, even now that they worked at the same hospital. When they were together, few people recognized them as siblings. Tyler had inherited their mother’s blue-gray eyes and lighter angular features, whereas Erin had acquired their father’s darker coloring and narrower bonier face. Temperament-wise, the pattern was reversed. Tyler shared William’s intensity, while Erin had inherited their mother’s easygoing unflappable nature. Erin had always seemed to sail through life, succeeding at anything she bothered to try and rising to the top of her field in cardiac surgery without ever showing much ambition.

“You haven’t called me Pip in a while,” Tyler pointed out.

“Didn’t want to chance one of those famous temper tantrums.”

He chuckled. “I could really throw them in my day, couldn’t I?”

“I can still picture you lying facedown on the floor in Harris’s grocery store, fists and feet flailing, while poor old Mr. Harris tried to negotiate with you like he was talking down someone with a bomb strapped to his chest.”

“What can I say? I really wanted those chocolate Pop-Tarts Mom wouldn’t buy.”

She uttered a small laugh. “My baby brother is thirty-five. You have no idea how old that makes me feel.”

“Join the club,” he said. “Erin, thanks for the book. I love it.”

She had left the gift—a coffee-table pictorial book on the history of flight—for him with his receptionist at the outpatient clinic.