Читать книгу Endings - Barbara Bergin - Страница 12

The evening had been strange for Leslie and she felt guilty. She had actually enjoyed herself, enjoyed the company, even the food. This was the problem with commitments, long term work, as opposed to the usual short term obligation. Doc and Brenda cared about her relationship with their patients. On shorter term jobs, it wasn’t so important. She could do very little harm in a short period of time in terms of getting along with patients. If she just did her job medically, everyone was happy. This was going to be a longer commitment and her temporary employers wanted to make sure she could take care of things on a larger scale. They wanted to get to know her. Chalk that one down to experience. No more jobs longer than a week.

Leslie made sure she carried the torch. It was necessary. She felt it deep inside. It wasn’t work for her to do it. It just happened. Three years had passed and she wasn’t ready to let go. Rather than try to sleep tonight, she tried to remember. She tried to remember their faces. Chris, tall, thin, marathon runner. That part was easy. His face was almost a blank now. She couldn’t remember the shape of the scar on his chin that he got from a bicycle accident when he was six. She memorized the verbal description of his features but couldn’t see them anymore. When had that happened? The same with the twins. Both fair. Blonde, curly hair. Couldn’t appreciate the curls on Vic because they kept his hair short. In a few years he would probably have started letting it grow because that was the style for teenage boys. Vivian had curls and she had started to hate them, just like her mom did. They had lazy soft eyes, like Chris. Full lips like hers. But she couldn’t picture their eyes or their lips anymore. They were obviously brother and sister. The same age. Totally different personalities. Leslie smiled, thinking about them. It was so hard to imagine that she would never ever see them again, except in her mind’s eye, and that was slowly fading. She thought about the photos in the storage room back home. Why had she kept them if it wasn’t to look at them again someday? She got undressed and went to bed.

The six o’clock wake up call was unnecessary. Leslie was already up. She lifted the receiver and hung it up. She showered, got dressed and drove to the hospital. She ran into Doc in the hall on the way to the cafeteria, where they had agreed to meet.

“Morning Doc,” he said to her. Was this to be her title as well?

“Morning. Hey, thanks again for dinner last night. Really enjoyed it.”

“Well good. Same here. I think we’re all going to get along just fine. You ready for some coffee?”

“You bet. Can’t get started without it.” They got in line and Doc put his hand out for her to go first.

She got coffee and some bacon and eggs. Doc got a couple of breakfast tacos. “Best tacos in town and at a hospital cafeteria no less.”

“I know…make a bull dog hug a hound.”

“Doc, you’re all right.”

They sat down at a table away from everyone else. They talked about the practice, the hours, how he liked to do things. He gave her the lowdown on personalities in the operating room and his office. He poured salsa on his tacos and talked in between bites, leaning over his tray as if the taco might try to escape. He licked his fingers when he was done, then got up to go get a refill on the coffee.

“Can I get you some more coffee?”

“Sure.” She handed him her cup. Doc returned carrying a fistful of creamers in addition to her coffee.

“So, what d’ya think? Can you handle it?”

“I think so. It’s been a while since I did the whole practice deal, but it sounds like I’m going to have a lot of help.”

“You’ll do great.” Doc wiped his mouth with a paper napkin while pushing his chair back from the table. “What do you say we go and round? I’ve got about nine or ten folks in the house. Shouldn’t take too long.” They got up and set their dishes on the kitchen conveyor belt, then walked down the hall to the elevators. Doc pushed the fourth floor button.

“Most ortho patients are on four. Occasionally they go to the fifth floor when they have medical problems or need telemetry.”

On the fourth floor, they stepped out, discarded their coffee cups and went to the nurses’ station. “These gals can make or break you. They really know their stuff when it comes to orthopedic problem solving. None of that calling you at three in the morning, asking for a sleeping pill for a patient who can’t sleep. It’s a general hospital, but this floor is run like it’s a specialty hospital. Everyone’s happy, knows their job.”

“Sounds too good to be true, Doc.”

“Here we go.” As he walked into the station, several nurses greeted him. “Morning, Doc.” “Good morning Doc Hawley.” Smiles and greetings all the way around. From both sides. Doc happy to see everyone. They were happy to see him.

Doc asked, “Mary Ellen around?”

Then from the room in back of the station, “I’m here, just hold your horses. You’d think I had nothing better to do than…” and it trailed off when she saw Leslie in her starched white jacket. “Ooo, sorry, didn’t know we had company!” Then she handed Doc Hawley the cup of coffee she had in her hand. “Black with a skosh of honey.”

“Mary Ellen, Doc Cohen. Mary Ellen is the head nurse up here on the fourth floor. And the best there is. Runs a tight ship and knows everything there is to know about your patients, the OR, ER, whatever. You need anything, and I mean anything, you can ask her.”

“Doc’s just blowin’ up my skirts to impress you, Doctor Cohen. We’re sure glad to have you here to help Doc out. Come on. Let me introduce you to the staff.” She took Leslie around the station introducing her to all the nurses, assistants and the ward secretary. Each stood and shook her hand as if she were a visiting dignitary.

“Y’all want to go round now? Doctor Cohen, how about a cup of coffee? It’s fresh.”

Even after the two earlier cups, Leslie accepted the offer. Mary Ellen turned around and went to the break room for the coffee. “What do you take in your coffee, Doctor Cohen?”

Leslie volunteered to fix her own because it was always impossible to specifically define a ton of creamer, and then on top of that a pink, a blue, and a pinch of the real stuff. People were always surprised, and it always embarrassed her. Mary Ellen, giving no indication that she was surprised, said she’d remember that recipe the next time.

Right, Leslie thought to herself, and pigs will fly.

She often simplified the position of physicians in her world in terms of a personal experience she had while she was a pre-med student in college. She had been employed during the summer between her freshman and sophomore year as a ward secretary on the surgical floor of the local hospital. She was required to wear a blue and white pin-striped, drop-waisted dress, of an unfashionable mid-knee length. It had a little rounded collar. She wore Keds and bobby socks, which were equally unfashionable at the time. She was introduced to the head nurse who was totally competent, totally in-charge and striking in her tiny starched white, belted dress, with her white cap and school pin in place. Her silky white stockings with lace-up white oxford shoes completed the picture perfect nurse. Leslie couldn’t even remember her name now, but in her mind, this woman epitomized what would always be her idea of what a head nurse should be. She ran the department. Saw to the care of all the patients. Knew all the patients. Knew what each doctor on the floor wanted for their patients and in their coffee. She gave Leslie her job description, the must-do list, the next-must-do list and the don’t-do list.

But the thing that Leslie remembered most clearly was her instruction on what to do when the doctors arrived on the floor. “You must get up and offer the doctors your seat because they have important work to do.”

Eventually an attending surgeon and his entourage of students and residents came on to the floor. This nurse immediately got up to let the surgeon sit down. She then brought him a cup of coffee and asked if he was prepared to go around and see patients. When he replied to the affirmative, she went over to a rack of metal backed charts which she and Leslie had previously prepared with updated hand written lab slips, extra progress report sheets and doctor’s order sheets. She wheeled the rack around the hall with the group of physicians and reported on every single patient on the floor.

During her training, Leslie often thought of the day when she would be assisted in this fashion, on some unknown hospital floor, by some unknown head nurse like this one.

When pigs fly.

Thirteen years later, on her first day when she rounded at her first hospital, there was no one to greet her. Forget about that cup of coffee. She tried to identify a nurse. Any nurse. By then nurses no longer wore uniforms. They wore various forms of scrubs and sometimes on Fridays they wore jeans. This made it hard to tell who was a nurse, a therapist, a doctor or a visitor. She went around on her own, to see all two of her patients and then sat down to write in the progress notes. There were none in the chart and so she went to the area in front of the nurse’s station to ask where they might be. She was pointed in the direction of some shelves by someone she later found out was the I.T. guy, up working on the computers. She grabbed a couple of progress notes, stamped them herself and returned to her seat where she was promptly approached by a large woman wearing Hawaiian printed scrubs, who said indignantly, “Excuse me. You’re sitting in my seat. I was charting there and went to check a patient’s vitals.” This happened to be the nurse taking care of her two patients.

Leslie, Mary Ellen and Doc then, set off to round on all of his patients. It took an hour and a half. Mary Ellen had the lab results on every patient filed in the charts. In Leslie’s experience up until now, most lab values had to be tracked down, either on the computer, a file box at the nurse’s station or stuck somewhere in the chart. Mary Ellen knew about any ongoing problems, both medical and social. In Leslie’s current experience, she usually had to rely on patients and their families to tell her if dad had a problem today. Only the nurse taking care of the patient had any knowledge of the situation and if they were down the hall or on break, there was no other way to get current information. It could be read in the chart if it was charted. Nurses were overwhelmed and Leslie understood why. They needed help and help was too expensive for the hospitals to afford. The nurses were not to blame. It was a complex problem for everyone involved.

Of course, she never forgot the nurse who asked her to give up her seat, thereby ruining and at the same time cementing her concept of what it would be like to be a contemporary doctor.

Mary Ellen and Doc interacted with patients as if they were neighbors, Doc taking a seat on the window ledge, sometimes helping himself to candy sitting on the rolling bedside table.

“Take more, Doc!” The patients eagerly encouraged him.

“Oh, no, I’m watching my figger.”

Patients were as interested in Doc as he was in them. He introduced her to everyone. “Doc Cohen, my replacement.” Patients then calling her “Doc” too. There was something about Doc’s easy going, good ol’ boy affability that struck a little envy in Leslie. Some guys just have it, and there’s just no point in trying to fake it.

They saw four patients who had just had total knee and hip replacements. There were two elderly ladies with broken hips, one waiting to have surgery today. There was a guy who had a herniated disc removed from between his fifth lumbar and his first sacral vertebrae. They said hello to a patient who had her rotator cuff repaired yesterday and had to stay overnight because she didn’t have any help at home. Her daughter was arriving from Chicago today to take care of her. There was a guy with a broken tibia and an Abilene Christian College coed with a broken ankle which Doc had fixed. Leslie was surprised to see the two trauma cases because she figured Doc wouldn’t be seeing emergencies this close to his leave.

“The fellow with the broken leg is the son-in-law of one of my best friends and Christy is one of the medical floor nurse’s daughters.” He looked at her kind of stupidly and shrugged his shoulders. “When the agency said you could come and you could stay for a while, I figured, what the hell.” Leslie figured the same. Mary Ellen just looked at her, smiled and shrugged too, like, “What’re ya gonna do?”

Rounds were done and for once Leslie didn’t feel like ripping her hair out. Maybe she had died and gone to heaven. Would Chris and the kids come walking around the corner? Mary Ellen would suddenly have angel wings and Doc would be wearing a robe, hold his hand out to her and say, “Even though you stopped believing, you were a good girl and we’re inviting you in anyway.” Then pigs would start flying all around her.

“You wanna give me a hand with a couple of cases after you get your credential forms signed? Let’s see what a lady doctor can do!” Mary Ellen looked at him with stern eyes and tight lips, like a mother getting ready to scold him. Leslie was totally unoffended because there was no malice in his voice. He was innocent of prejudice when it came to her, she felt certain of it. He was just a good ol’ boy and he could have been talking about cattle or surgery, either one. She knew the sound of malice when it came to women in a man’s world and she wasn’t hearing it now.

They headed to the administrative wing of the hospital and met up with Terryl. He introduced her around the office and she was once again struck with the fact that it seemed she was treated more like a permanent fixture rather than the transient locum tenens.

She remembered her arrival at the county hospital in New Paltz. Just having finished her residency and joining the local group of orthopedic surgeons, she was treated nicely by everyone at the hospital. They were desperate for a warm body and she filled at least that job description. The three senior partners were totally beat up, having taken every third night call for the past ten years. No new blood for ten years! They put her to work instantly taking every other night call and the major holidays. The senior partner went into semi-retirement. At Christmas all three took off for a skiing vacation, leaving her alone to run the ship. Of course she didn’t think twice about it. That was standard in the industry. It was pretty rare to just walk into a group and get handed an equal call sharing arrangement.

The people at Taylor County Regional Hospital were treating her very nicely and she began to feel good about it. After completing the vast amount of paperwork that would allow her legally to start cutting in Abilene, Texas, she and Doc took off for the operating room. He directed her to the women’s dressing room where she got dressed with the female nurses and scrub techs. Male doctors always had their own dressing rooms. Only the newest and largest hospitals had designated female physician dressing rooms. It was only an observation because she didn’t really mind getting dressed with the staff. That way she got to know people. Girl chat while getting ready to work. It could be fun most of the time. She could also get the lowdown on some of the surgeons that way.

She slipped on a pair of grey green scrubs, booties, poofy blue paper hat, and was ready to go. She met Doc out in the sterile corridor and he again introduced her around. She thought she might be the only female surgeon they had ever had around there, never mind being an orthopedic surgeon. There were probably some female Ob-Gyns, but they mostly hung out in labor and delivery. Very rarely did they operate in the main OR. Again, everyone clearly having great respect and affection for Doc Hawley, from which she in turn benefited.

Eula Parsons was ready for surgery. She had an empty stomach, a signed permit for a right hip hemiarthroplasty, and a bag of IV antibiotics hanging. She was prepared for her operation. They stopped by the holding area to talk with her a little, then headed down the hall to the sinks outside the operating rooms where Doc did most of his cases. They scrubbed their hands with a sweet smelling pink soap, held their hands up in the air and went into the operating room. Lots of friendly talking with the patient while everyone was getting ready. The anesthesiologist began to administer the Fentanyl through a syringe in one hand while he rubbed the patient’s eyebrow softly with his thumb. Very nice. The patient went off to sleep quietly, easily.

Then everyone got very busy with intubation, gowning and prepping. She heard a little benign ribbing between Doc Hawley and the scrub tech. Introductions were made again. How would she memorize everyone’s name? At each previous job she didn’t have time and it really wasn’t expected. These people were important in the day-to-day operations but had become nameless and faceless within days of leaving the town.

The charge nurse in the operating room was a guy. He seemed friendly enough and was knowledgeable and efficient. He tied up the back of their gowns and helped them bring their belts around to tie in front. He then took another look at the permit, reminded and confirmed the right hip with Dr. Hawley. The patient had a big red “YES’ written on her right hip exactly where the incision would be. Eula was then gently turned onto her left side with her right side up. Positioning devices were utilized to hold her in place. Her right hip was prepped with gooey Betadine liquid and covered with about a dozen sterile drapes.

Doc stepped up to the table followed by Leslie on the opposite side. He made a curved incision across the side of Eula’s hip and cut straight through to the fat underneath. The bleeders were cauterized. Some were squirting blood and it was harder to stop them. He cut quickly through the large flat tendon that goes all the way from the pelvis to just below the knee and exposed the big bone on the side of the upper end of the thigh. He took some leg measurements now so he could make sure the legs were the same length at the end of the case. He then divided the muscles that rotate the hip outward from their attachment to bone. Blood and joint fluid oozed out from the hip joint and had to be sucked out so he could see. Leslie worked quickly to this end. She took just as much pride in being a good assistant as being the primary surgeon.

A giant screw was stuck down into the broken head of the hip, twisted home and the broken head was pulled out of the acetabulum, holding on for dear life until it gave up with a loud sucking sound. It was a brutal maneuver, without a doubt, but there was something satisfying about pulling out that dead, broken head of the hip bone. It had failed its owner and now was useless, because in the process of breaking it had also lost its blood supply and so could not be counted on to heal. Better to remove and replace it than to try to repair it in a patient this age. They made some extra cuts in the bone and then replaced the dead broken head with a brand new shiny metal hip replacement. It was measured to fit the cup, and the leg length was checked. Leslie then took the leg, pulled firmly and rotated it to the point where it went easily home with a soft sucking sound. Eula would be able to get out of bed the next day, and then start walking when she regained her energy. Her overall feeble condition and not the hip would be the limiting factor.

Leslie thought of her own grandmother, who had died of a blood clot which went to her lungs after a long period of bed rest following a hip fracture. Leslie had been in grade school and only vaguely remembered the circumstances. An orthopedic surgeon had fixed the hip but the fixation methods then were not thought stable enough to allow early mobilization. She was placed at bed rest for an extended period of time and it didn’t take long before she had bed sores and contractures of her already weakened extremities. When she was finally deemed ready to rehabilitate she got up out of bed, became short of breath and died of the pulmonary embolism that had broken off from the clots which had been growing up the deep veins of her legs for weeks. At that time the majority of people who sustained hip fractures were dead within a year of their fracture, victims of those blood clots and other medical complications. Those statistics had improved remarkably in the past quarter of a century. Still, blood clots were a dark potential.

Doc and Leslie started to close the wound. They got into a rhythm, both of them experienced with this operation. The critical part was done and now the closing of each specific layer. The two got their timing down and the closing became sort of an assembly line of throwing stitches, tying knots and cutting them. Doc threw the suture with the needle driver and Leslie pulled the suture from the needle then quickly tied a single hand knot. Bam, bam, bam. Doc looked up over his mask and gave her a nod. They sailed through all the layers of muscles, fat and skin like they had done this together a thousand times. Doc grabbed all the sutures upwards in his big fist and Leslie cut them very carefully, turning the scissors “just so” in order to keep from cutting the knots.

When she was a resident or medical student and cut a knot, she’d get her ass chewed out in front of everyone. And everyone loved to see it happen. Nothing like seeing a student doctor get humiliated. That might also be an opportunity for an attending surgeon to ask some questions to which she might not know the answer, like naming all the stages in the blood clotting pathway, or something. And everyone loves to see that happen too.

Leslie was confident she would never cut a knot, but she did. Doc looked up at her again, this time with a raised eyebrow. She went over the stages of blood clotting in her mind, thinking, once a student, always a student, and Doc said, “Shit, I knew it. You’re a no-suture-cuttin’ fool, is what you are.” Everyone laughed, Leslie included and Doc said, “Now, I’m gonna have to ask you all the branches of the sacral plexus!”

“But I can recite the blood coagulation pathway.”

“Well, that just won’t do.” Again, chuckles in the OR. “Seriously, Doc, that went great.” He put his fist across the table over the patient’s hip, to receive her fist in the manner of the “hood.” They winked at each other and Leslie was smiling under her mask. It really had gone well…for them and the patient.

They helped the nurse apply dressings, then turned the patient on her back. Doc wrote orders while Leslie looked over his shoulder to check them out. They discussed their opinions on deep vein thrombosis prophylaxis and both were basically in agreement on the protocol for that.

In the surgery waiting room they found Eula’s family. Doc introduced Leslie. He told them the operation went great. Talked about the expectations for the next few days, rehab, and the things the family could do to help her progress. Leslie realized she would be taking over the care of their mom and seeing her in the office too. It was strange thinking that Doc would be in Lubbock having his surgery in a few days. She wondered how he was feeling about it. They all shook hands. Doc and Leslie headed off to the doctor’s lounge for lunch.

Leslie drove Doc to the office where they were greeted by Brenda who introduced her to the staff. “So Hal, did you take Doctor Cohen to the floor to see patients?”

“Course I did and they all loved her. They can’t wait to get rid of me.”

“Hal, don’t be silly.” Then to Leslie in a coquettish tone of voice, “Did Doc introduce you to Mary Ellen?”

“Yes, he did.”

“What do you think, girl to girl? Do I have competition up there?” She had a little mischief in her eyes.

“Brenda, leave Doctor Cohen alone. That’s not a professional question, and you’ve always been jealous of that old battleaxe.”

“Battleaxe, my ass. Hal used to date Mary Ellen, but she didn’t know anything about office management. Basically he needed an office manager more than a nurse. I was cheaper too.”

“I think I’ll just go check out the clinic layout here…” and Leslie pointed down the hall.

“Brenda, see what you’ve gone and done, gotten Doc Cohen’s nose outta joint.”

“Don’t be silly, she knows I’m just teasing. Did they treat you good over there, sweetie?”

“It was really nice, for a first day and all. Everybody’s very helpful. From what I can tell, things are run very well. Best I’ve seen in a long time.”

“Doc and I operated on old J.T. Cullen’s mother-in-law. Remember, she used to be a school teacher. I had her once. Didn’t like her at all. She sent me to the principal’s office more than once. I thought about making her leg short.”

“Well…you did.” Leslie said it really seriously. Brenda and Doc both looked at her, eyes wide, and she smiled.

“I can see you’re going to have to be on your toes with this one, Hal.”

“Tell me something I don’t know.”

“You’d better come with me. I’ll show you around the office. Then we’ve got over twenty patients this afternoon. You going to stay?”

“Of course.”

“Good. You’ll see how Doc does things with the paperwork and stuff. I don’t know what you’re used to, but my staff and I do all the coding so you don’t have to worry about that. If there’s diagnosis codes you use that we don’t know, we’ll just ask you, that’s all.”

That was pretty sweet as far as Leslie was concerned. Coding was a pain in the ass and had absolutely nothing to do with patient care. It was just something used to try to help doctors get paid, but half the time it didn’t help and some of the time it had the opposite effect. Plus, she was always paranoid that if her codes didn’t match up perfectly, some guys in black coats would come marching through her front doors accusing her of fraud. Ridiculous. Let doctors practice medicine and nurses take care of patients. It’s what they do.

They saw the twenty patients together and it was one of the strangest experiences she had ever had in a clinic. Again patients were treated almost like family, and some of them were. People talking in the hall, comparing notes. The staff showing patients off to other patients. A nice incision, a good range of motion. Doc, bustling in and out of rooms telling patients what they needed to do. There wasn’t a whole lot of privacy, but no one seemed to care. If there were delicate situations, then those patients were put in a room and the door closed. People were chatting with each other in the waiting room and didn’t seem to mind if they had to wait. No one complained anyway.

Today patients were more concerned about Doc. He had a pile of gifts people had brought with them. There were flowers, plants, homemade jelly, a teddy bear, chocolates of every sort, and a number of gag gifts. The whoopee cushion was her favorite. Doc went into a couple of kid’s rooms and intentionally sat on it. Then that prompted the kids to start making their own variety of fart noises. Some were adept at doing it with their armpits.

What is it about gas and kids? She remembered having some great whoopee cushion fun with Victor and Vivian. They blew it up and squished it over and over until the thing wore out and Leslie’s cheeks were sore from laughing so hard with them. Everyone who came over that week got directed to the seat with the hidden pink balloon. Each time it went off, they all got off, laughing like they had never heard it before.

Later on, after clinic was over, they went into Doc’s office where he put the whoopee cushion under one of his consultation chair cushions. Then he called Brenda in and asked her to sit down, because they needed to go over some things. There was ever so slight a change in his voice so she knew he was up to something.

“Now what?” She looked at them suspiciously as she sat down, and out came the bleeeep, riiiip, braaaaap. She jumped up.

“Oh, you. You are just acting like a little kid. I should have known. Look at the two of you.”

Her voice was full of indignation. And the two of them just laughing, a knee slapping, gut laugh. It was an irresistible situation, infectious, and pretty soon Brenda was laughing too. And just like that, Leslie felt the tears welling up in her eyes unexpectedly, as she thought of Vic, Vivi and their whoopee cushion. Did she throw it away? To her astonishment, Doc and Brenda saw it too and stopped laughing, kind of fizzled out. She was embarrassed, but Brenda stood up and came over to her.

“This reminded you of something, didn’t it sweetheart? Let’s quick think of something else. Hal, go get us some Diet Cokes, will you?” And he was already up, moving as fast as he could to get out of that room.

“I am so sorry,” Leslie said. “I can’t believe that happened. You probably think I’m some kind of baby, crying all the time or something. I don’t know what came over me.”

“It’s okay, Leslie. Don’t even think about it here. We understand, and we’re like your family while you’re here. You’ve brightened up Hal’s day, in some way. I can see it in his eyes. Maybe, in our way, we can return the favor.” Brenda put her hand on top of Leslie’s and patted it. “I just knew you two were up to no good when I came into the room.” She stood up. The moment gone. All better. Leslie smiled at her.

Doc yelled from down the hall, “Two Diet Cokes, coming up!”

Leslie felt exhausted when she left Doc’s office. They made plans to meet again the next day. She gave him her cell phone number, just in case something came in during the night and he needed help. Of course she knew he didn’t need help, but she felt ready to get to work, day or night. Work had the ability to exhaust her mentally and physically. It made it easier to get to sleep at night and easier to get through each day. Some of the doctors doing locum tenens work wanted low key, easy jobs, but as far as she was concerned, the busier the better. Most jobs were set up to be like babysitting. The surgeon would shut down his practice, farm out the follow-ups to other guys in town or to their family physicians. She would be there only for emergencies. There would be nothing else to do. She could sight see, but a lot of times there was nothing to see. It was excruciating. She would try to read, watch TV, exercise, but always her mind went back to her family.

Already she could tell this job was going to be different. On the one hand the inevitable questions into her background would come. It was simply the way nice people behaved. It would be difficult to keep from telling the truth. On the other hand, Doc seemed to be making no attempt to lighten her load, and was apparently ready to turn everything over to her. This would make the month or so she was there fly by.

It was a cool evening with a soft breeze and a clean smell in the air. A little dust devil stirred in the front of the hotel under the portico. The wind defined west Texas. There was very little to stop its progress. Dust devils were always at play in areas that diverted its course. It was as if the wind was trying to get even for standing in its way. Doors would stay open indefinitely if one didn’t turn to make sure they were shut. There were annoying little triangles of dust in the corners of windowsills where the wind constantly tried to penetrate. Grasses and small trees were permanently bent to its will. The little dust devil swirled and swirled unimpeded until she stepped into the view of the automatic eye opening the sliding doors to the hotel. The miniature tornado played out, dropping its contents on the ground at her feet.

“Ah, Doctor Cohen. Good evening! You had a long day. Would you like some coffee? I have some fresh in the dining area over there?”

“You know, I think I will have a cup. Do you have decaf?”

“Of course, of course, if that pleases you. I have just to make it, but it will take no time at all. Please wait, I will fix it. It will take no time. Please come. Sit here.” He pointed to a chair near the coffee maker.

“Well, thanks, but I do hate to put you to this trouble. No one else will drink this coffee, I’m sure.”

“Do not even worry. It is no problem, I assure you.” The decaffeinated coffee was already brewing. Soon the smell wafted over to her. She loved the smell of coffee even more than the taste. She was looking forward to the brew. They had little half-and-halfs sitting out. They would be room temperature instead of cold, which is the best because it doesn’t cool off the coffee. She fixed it the usual way. Raghu gave no indication that her manner of fixing the coffee was at all out of the ordinary. She thanked him profusely for his trouble and he again reassured her that it was no trouble at all.

“Wake up call for six again, Doctor.”

“Yes, please Raghu. Goodnight.” She went up to her room. It was later than she thought and she was very tired. Looking forward to a good night sleep. She took a warm bath and got into bed.

She had not forgotten about them during the day, and they were there with her thoughts now. Some vision, some day in that past life. Tonight it was a birthday. Birthdays were special for twins simply because there were two of them. Things were always special because there were two of them. They looked so much alike, acted so differently, but were connected beyond the usual sibling bonds. Their cake was half pink and half blue. They stood on their respective sides and each blew out four candles. Vic was laughing and sort of spat on his side of the cake while blowing. They cut pieces from the pink side.

Sometime in the middle of the party Leslie went to sleep and appeared to dream. Her eyes darted back and forth under closed lids. She occasionally gritted her teeth and the corners of her mouth wiggled into a half smile. She was in the middle of REM sleep when her cell phone rang.

The phone was across the room. She really hadn’t expected any callers so had forgotten to put it at her bedside. She flew out of bed, cleared her throat so she could sound awake and poked at the CALL button.

“Hey, Doc, Hal Hawley here. You awake?” She looked across the room at the clock and could see it was almost two in the morning. It would be admitting sleeplessness to say yes.