Necessary Medicine Read online

  Neil wasn’t going to ask Dr. Li, she wasn’t her brother’s keeper, but—finally, he cracked.

  “Did I say something?” he demanded the next time he saw her.

  She sighed, lifting her face back above the file she’d ducked into when she saw him coming. “Oh, God. Look, I...Ming liked you but he is insanely picky, okay?”

  “So—where did I fall down?”

  “He wants to settle down and start a family. Like, yesterday. And you...”

  “Oh.” He’d said it over dessert, cutting his cheesecake with his fork, laughing: I don’t know that I can see myself as a father, really. Surgery is my baby these days. It keeps me up nights. He hadn’t been looking up, so he hadn’t seen how Ming reacted to that.

  “It’s not you! It’s him!”

  “No, it’s okay. It makes sense. Thanks for telling me.” He glanced at her sharply. “If I did something awful or tacky you’d tell me, right?”

  “I would! I would.” She frowned at him. “Since when am I known for not hurting people’s feelings?”

  “Okay,” he said, mollified.

  * * *

  “How’s the self-confidence going?” Dr. Wendling and Neil were actually sitting outside for once, the first flush of March’s wave of greenery starting to come back over the bushes around the patio.

  Neil shrugged, rolling the tension out of his shoulders. “I’m not sure. I mean, there’s still a lot of people ahead of me in line, you know? I’m not really getting a crack at the interesting cases. The senior residents and the fellows get them.”

  Dr. Wendling smiled fondly off into space, poking at his iced coffee with the straw. “Hah, I remember those days. You know, I’ve known Eli—Dr. Newcombe—since his residency, if you can believe it, and when he had his first chance to put in a stent by himself, I thought he was going to crack his face smiling.”

  “Really,” said Neil, who was trying very hard not to crush his paper cup of coffee in his hands.

  “Oh, yeah. It’s totally normal to feel like you’re being held back. But that’s part of residency—just learning when it’s time to ask to do more, who you can ask.”

  “Any hints? Do you know the surgeons pretty well?”

  “I do, I suppose. Don’t ask Wei, he’s kind of a dick—don’t tell him I said that. And Liddell’s a total asshole. Don’t tell him I said that, either. But most of the others are fine. And I think it’s worth talking to the residents in the subspecialties too, just in case something really interesting comes through that you could take a look at.”

  “Thank you. I appreciate it.”

  * * *

  He made it out for lunch with Mark later that spring, which they both counted as a victory. Having a social life had turned out not so much difficult as fucking impossible.

  “How’s it going?” he asked Mark while they were waiting on their food.

  “Ugh.” Mark drummed his fingers on the table. “I started seeing this girl. Not from the hospital. Met her at the grocery store, you know? But I had to cancel every date we had for three straight weeks, and she just told me yesterday she thinks I’m not ‘in a good place’ to be dating.”

  Neil twisted one corner of his mouth down in sympathy. “I don’t know that she’s wrong.”

  “She’s not wrong. I’m just...I’m really single, and I hate being single.”

  “Me too.”

  “I feel like it would have to be somebody at the hospital to understand, you know? But there’s nobody at the hospital I’m interested in, and then I think, they’re going to have crazy schedules too. God knows if we’d ever even see each other.”

  “I think that’s when you put a sock on the call room door.”

  “Hardy har.”

  * * *

  Orthopedic Surgery was a bloody rotation. Once the patients were under, the tools came out: huge, intimidating even to Neil. His third—and fourth-year rotations hadn’t prepared him for the bloodbath that was a hip replacement, suction going constantly, the whine of the drill and the faint smell of charring bone. He was taller and stronger than some of the senior residents who might have had a better claim than him to assist, so he found himself helping out with positioning bones, leaning on them with his whole body weight until there was an almighty give under his hands.

  It wasn’t bad, all told, but he had to change his scrubs constantly. Every surgery seemed to have complications. Every day he’d be out hours later than he meant to. The orthopods were mostly burly, genial men, but they liked to talk about sports and fly-fishing and motorcycles. They had an aggressively masculine way of talking to each other, like fifty-year-old frat boys.

  “It’s not a good fit,” he said to Dr. Wendling over a cup of coffee, absentmindedly flicking a chip of bone off his scrub pants. He’d only changed his shirt.

  “Can’t say I’m surprised. Ortho’s where the money’s at, but it’s so full of the good old boys’ network you can’t swing a dead cat without hitting somebody who’ll tell you about how much better he is at polo than you.”

  Neil wrinkled his nose. “That was...unnecessarily vivid.”

  “Hah!” Dr. Wendling drank most of what was left of his coffee in one gulp. “Vivid sticks better than anything professional you can say. That’s just good teaching. Good mentoring.”

  “Yeah, I’m sure mentored is what I’m feeling.”

  “That or the caffeine.”

  “No, I’m definitely not feeling the caffeine anymore. I can’t feel my face, either.”

  “How much longer do you have on Ortho?”

  “Only until Friday. Then I’m on to minimally invasive.”

  “That’ll be a nice change of perspective. You’ll enjoy that after all the gore.”

  “Christ, I hope so.” He sighed.

  “Have you given any thought to going to a conference this year? There’s a couple you could look at.”

  “Yeah, but I’d need to get an abstract put together, and I’m honestly just staying afloat right now.”

  “Let me know if you want me to read a draft over for you sometime. I wouldn’t mind getting my name attached to a paper again. I’m shockingly lax in my publishing. I’ll be perishing any day now.”

  “I can’t imagine them kicking you out. For one thing, I think you’ve been in that office so long you have squatter’s rights.”

  “Maybe I do, or maybe I have the goods on the department chair.” Dr. Wendling leaned back. “Speaking of chairs, did you hear about the new initiative?”

  “I don’t think so.”

  “I’m surprised more people aren’t talking about it. It’s a diversity initiative.”

  “Really? That’s great!”

  “Yeah, well, you think that, and I think that, but rumor has it that a couple of the department chairs and admins are being real assholes about it.”

  “What? Why?”

  “Well, some of them are racist, and others are just power hungry and they don’t want any fingers in the pie but theirs. It’s turning into a goddamn turf war.”

  Neil shook his head slowly. “Okay. Huh. I hadn’t heard about it at all.”

  “Surgery’s got to be an example department, you’ve already got one of the highest rates of physician diversity in the entire hospital system. Hell, your chair probably isn’t even worried about it.”

  “That’s—cool? I guess? But wow. We’re still pretty white.”

  “You know it. And word from on high is that it’s not just a racial diversity initiative, although that’s going to get a lot of the press. They’re looking at recruiting more people from impoverished backgrounds, more women.” He gave Neil a sharp look. “More nonheterosexuals.”

  “Oh.”

  “Yeah. So remember, if they bring in somebody cute, keep it in your pants. Dating
in your own department can only end badly.”

  “I’ll, uh,” said Neil faintly, “keep that in mind.”

  Chapter Four

  It was July before he knew it, and he was suddenly a second-year resident, with the noticeable bump up in expectations that that implied. Also, there was a new crop of residents. None of them were both cute and interested.

  He was rotated off to an outside Gen Surg program immediately, and it took all his time just to keep up with it. There were more beds, more patients, and fewer physicians and residents than at the academic center. It wasn’t like the VA, either, where the patients were mostly middle-aged men wheezing from their emphysema. Patients kept coming.

  It wasn’t bad, actually. He liked it. He got into the habit of sitting down with the families before the surgeries in the pre-op rooms, shaking the hands of the patients lying in their beds, and introducing himself: Hi, I’m Dr. Carmona, I’ll be assisting the surgeon on your case...

  They liked him too.

  He managed to keep up with weight lifting. He was proud of that. It was easy to start to let go of things like this, physical fitness falling by the wayside as the hours and cases piled up, but he had a set he kept in what was probably supposed to be his breakfast nook for when he wasn’t going to make it to the gym. There was something meditative, contemplative, about the moments when his muscles were straining as he lifted the weights.

  It was like residency, he thought once, trying to keep breathing as he pushed up into the incredible pressure of it. He was sore and tired and he hadn’t slept in two nights, and here he was. Here he was.

  Lots of the residents never really managed to make friends, but Neil had made an effort, right from the beginning—maybe too much effort, maybe he’d seemed desperate, needy, but Mark had just kind of shrugged and fit into the place in his life Bobby had occupied.

  Mark wasn’t Bobby, of course. For one thing, he didn’t have a mom who would cluck her tongue over whether Neil was eating enough, and he didn’t like karaoke, which was some kind of crime in and of itself. Neil said, “I am going to change your mind, asshole,” and Mark laughed and waved that off.

  But the addition of Kristi to their little troupe—it took all three of them by surprise, he figured, because at first it looked like she and Mark might date, but then they didn’t. And once they’d passed that stage, they turned into friends. They watched movies together sometimes on nights off, or borrowed earbuds for nights in the call room, battery chargers for their phones.

  It was nice. It was good.

  He thought sometimes about what it would be like to have a significant other. He’d had that, once upon a time. Before all this. It would be nice to have somebody again. A boyfriend, maybe with the kind of job where he’d be waiting when Neil got home, roll over in the bed they shared and look up at him with sleepy eyes, smiling: Honey, I’m home, Neil would say, and his boyfriend would laugh and drag him down.

  Instead, his bed stayed obstinately in whatever state of dishevelment he left it in the mornings.

  * * *

  There was a department-wide mandatory meeting that May, which Neil would really, really have preferred to skip completely. But it was on the diversity initiative, which was finally starting to go from vague backroom mumbles to reality.

  He found a spot—there were too many people to cram into any of the conference rooms, so they were in the auditorium they usually used for the M&Ms. Dr. Pearn was up at the podium, beaming over all of them.

  Somebody bumped the back of his chair. He heard them whisper, “Sorry,” and he turned around to say that it was okay. But halfway through it he felt his brain stutter to a halt, because it was Dr. Newcombe, smiling ruefully at him.

  “No worries,” he got out, and turned back around, heart suddenly racing. Claudia appeared out of nowhere to sit next to him. Her fellowship was almost up, and she’d be off doing CT surgery as an attending in a matter of weeks.

  She nudged him with her elbow and smiled, and he smiled back.

  He felt hyperaware, the whole time, of Dr. Newcombe behind him; he kept starting to reach up to fidget with his hair and stopping himself. At least he wasn’t falling asleep. God, his coat was filthy, though.

  The weight of his stethoscope around his neck started bothering him. He’d gotten so used to it he never noticed it, but here he was, noticing it. Another thing not to fidget with.

  Thank God, Dr. Pearn finally started talking.

  “Thank you for coming, everyone,” he said. “I know this is time out of your day, so we’ll try to keep it brief. In short, our department has been asked to spearhead the hospital’s efforts to recruit more diverse talent. Surgery has been singled out because we already have some of the best diversity numbers at the hospital, but we can do better; we’re still looking at far below population representation in our doctors, despite how many of our medical assistants are from Asia or Africa.” He flicked through a series of slides as he talked, graphs illustrating racial disparity in number of medical graduates and medical graduates recruited to the hospital. “And I don’t think I need to explain to you why it’s easier to find diversity in lower-paid jobs. So, in order to help the hospital develop a plan, we’ll be working with other departments, starting with Cardiology and Nephrology, which have both expressed a strong desire to help us and to improve themselves. There will be two working groups, one with Cardio and one with Nephrology, and those two groups will meet regularly with each other and with me, as well as with the hospital COO.”

  “Nice,” Claudia murmured to him.

  “We’ve got the leaders of those groups with us—from Cardio, we have Dr. Newcombe—would you give us a wave?” Neil twisted around again, looking back at Dr. Newcombe with a sort of warm shock settling over him. “And from Nephrology, Dr. Blatch.” A squat man in thick glasses with a friendly face waved from the other side of the room. “These gentlemen are both volunteering, so please be kind to them. If you’d like to join their work groups, we would be ecstatic, please let them know.”

  Dr. Pearn went on to talk about “other facets of diversity that also deserve representation—we’re talking gender, gender identity, sexual orientation, socioeconomic background. The more people we have from different backgrounds, the better we’ll be able to serve our patients, who are themselves from wildly different places in life and even in the world.”

  Neil slouched a little farther down in his chair. He probably shouldn’t. He was busy. He was about to start his third year of residency. He was a thirty-year-old man for God’s sake. He didn’t need to start—

  After the meeting, when the lights went all the way back up, ignoring Claudia hovering next to him, waiting for him, he stood up and turned around. “Dr. Newcombe,” he said.

  “Oh, call me Eli, please.”

  Neil smiled, trying not to squint. “If you’re looking for volunteers for the work group, I’d be happy to join up and help out.”

  “That’s great!” Eli reached out and clapped him on the shoulder. “Send me your email, I’ll add you to the list.”

  “Great,” he said faintly, “thanks,” as Eli pulled his hand back and got distracted by another surgeon coming up to talk to him—one of the fourth-years, he thought.

  “That’s cool!” said Claudia as they started to shuffle out of the row of seats. “You’re going to be part of the work group? I think you’ll do a good job!”

  “Thank you,” said Neil.

  When he was at a computer station later that day and had finished working on the note he’d been dictating, he took a deep breath, used the online directory to find Dr. Newcombe’s email address and sent him an email: Hi, we talked earlier about the work group. Go ahead and add me to the list!

  He mostly managed not to obsess over whether that was going to come off smarmy.

  He got a reply a few hours later: T
hanks!

  * * *

  He mentioned it to Dr. Wendling the next time they met up.

  “That’s good,” said Dr. Wendling. “I mean, it’s going to be a goddamn clusterfuck, but I think it might actually accomplish a little of what it’s setting out to do, you know?”

  “I—sure.”

  “I told Eli when he took this on, you’re going to regret this even if it goes perfectly, because it’s going to be a huge time suck and you’re already busy. You know what he said?”

  Neil shook his head.

  “He said, ‘Well, I guess I’ll give up my Wednesday golf.’ That son of a bitch never golfed a day in his life.” Dr. Wendling smiled fondly. “He’s full of shit. But you’ll get to see that firsthand.”

  Neil took a sip of coffee so he wouldn’t have to say anything.

  “Besides, Pearn’s throwing his weight around,” Dr. Wendling added contemplatively. “With Pearn leading and Bruckner on board, this might actually go somewhere.”

  “You sound so perky about it.” Neil swirled his coffee cup.

  “I’ve seen a lot of work groups and task forces and initiatives come and go. You get cynical. Hardened. And we’re pretty cynical to start with. We’re not that far from Die Hard.”

  “I would pay money to see you climb through a vent.”

  Dr. Wendling burst into laughter. “You and everyone else!”

  * * *

  That was the summer that Proposition 8 was repealed.

  Bobby called him. “Hey, man,” he said, “now you have no excuse not to get married and give your mom some grandbabies!”

  “Oh, shut up,” said Neil, laughing. He felt like he’d been smiling all afternoon, even through a nasty abscess draining.

  “No, but really, how big a deal is this? This is a big deal! You should celebrate. By getting married.”

  “And are you getting married?”

  There was a beat, and then Bobby said, “Actually, yeah. Karen and I talked about it last month. We’re—I’m going to propose to her as soon as we pick out a ring she likes, and I was wondering if you’d be my best man.”