The Graceview Patient By Caitlin Starling - 4

They placed my IV without issue—a first. Along the back of my arm, which was something I’d read about for those labor and delivery stays, but hadn’t expected or even asked for. I peered at it as the nurse, Penelope, taped everything down.

“It should be more comfortable,” Penelope said, reading my mind. Probably just long years of experience, knowing what questions patients always asked. She was a little older than me, surface-nice but with an impenetrable wall behind it. “It’s also more fragile, so try not to bump it into things, but you’ll be able to bend your elbow.”

“Oh,” I said. “Thanks.” I didn’t see an IV pole anywhere, but maybe that would come later. I was halfway through my admission paperwork, a clipboard balanced on my knees.

“At some point,” she added, “we’ll be talking about a PICC. They last longer.”

And I was going to be here for a while. Still, the thought made me squirm. “That’s the kind that goes…” I gestured to my arm, up to my shoulder, around to my chest.

“Yes,” Penelope said.

That sort of detail hadn’t been covered in the onboarding documentation. “Are there other options?” I asked. I was so squeamish back then.

“I suppose a port-a-cath,” Penelope said after a moment’s thought. “We usually save that for outpatient, but we can talk about it later.”

“Okay. And the doctor…?”

“Will be by soon,” Penelope assured me.

He wasn’t.

My suitcase was unpacked. I was already in my gown. I sat on that bed for at least half an hour, wiggling my toes and scrolling on my phone, my arm feeling strange where the tape pulled at the fine hairs and where the plastic catheter snaked into my vein.

From inside my room, I could only hear some of the noise from the hallway. Overhead, announcements were muffled into unrecognizable murmurings. Dull thuds came at irregular intervals. Beneath it all, the faint beeping of a hundred different monitors and alerts.

All of it at a remove, like the roar of waves from a quarter mile away.

At least Penelope had written the Wi-Fi code on the board. I couldn’t focus on any of the books I had queued up. I was just about to start an old tool restoration video when there was a knock on the door.

I jolted, shoving my phone under my leg like I’d been caught looking at porn, hoping it was the doctor.

Penelope poked her head in. “Margaret, you have a visitor,” she said.

Visitor?

I stared at her blankly. For a half second of panic, I thought it might be my mother—but even if she’d been calling from the airport, a cross-country flight would be somewhere over the Midwest. My dad certainly wasn’t coming. Nobody else knew I was here, but she wouldn’t call a tech coming to draw my blood a visitor, surely?

With the door open, I could hear more from the hall. “Priority page,” a disembodied voice recited. “Code gray. Adult. East tower. Sixth floor. Med surg. Room six-two-three.”

“Sure,” I said, finally.

She smiled and opened the door the rest of the way, then ducked back out into the hall. My phone was warm beneath my thigh, actively charging.

A man appeared in the doorway, wearing an easy smile and a well-tailored suit. He was maybe mid-forties, enough older than me that he had visible smile lines and silver in his hair. He was tall, broad-shouldered. Handsome. No white coat, no stethoscope. Not the doctor, then.

“Hi, Margaret,” he said. His voice was rich and resonant. “I’m Adam Marsh. I’m the representative of the team behind SWAIL.”

“So … the pharmaceutical company?” That made more sense. They do know how to pick them for the hard-line sales jobs.

He covered his heart with his hand. “You’ve got me,” he admitted. “But don’t hold it against me, please. I actually started off as a researcher. May I come in?”

I glanced at Penelope.

“Dr. Santos is dealing with an emergency,” she apologized. “He’ll be at least an hour, I’m afraid.”

(I would get used to this quickly; the doctors never arrive when they say they will, but they do come eventually.)

“Okay,” I said, and they both took it as aimed at them. Penelope left, and Adam came into the room. The door closed. The outside world receded again.

“Hospital life,” he said, when we were alone. “But I can answer a few of your questions, at least. Come join me?” He motioned to the little table tucked by the window, two chairs next to it.

I levered myself out of the hospital bed, checking the belt of my robe, keenly aware of how not dressed I was now that I’d switched to hospital clothing. “Is this a courtesy call?” I asked, wary, as I sat down.

No , I imagined him saying, unfortunately I’m here to say there’s been a mistake. We’re not paying you after all. You’ll need to leave tonight, and you’ll just need to figure out a place to stay.

“Actually, an overdue introduction,” he said, sitting down across from me. “I try to touch base with all our patients to give you more of an orientation before things get started. The hospitals we’re working with are great, but their approach to customer service is a little different from ours. Understandably, of course—they’re here to give care. But I’m here to make you happy.”

I turned away from him, toward the window. It was late afternoon but the light was still good, good enough that I didn’t have to see the ghost of my reflection in the glass. I knew what I looked like. Psoriatic patches, red and scaling across my temples and cheeks, get an immediate, Oh my god, are you okay? What’s wrong with your face? The only makeup I was wearing, if you could call it that, was ChapStick. And I’d buzzed my hair that morning. Less to take care of while I was here, and my hair had turned thin and brittle years ago. No great loss.

Looking at the mountains was much nicer than thinking about all of that.

“They’re doing a pretty good job,” I said. “It’s a nice room.”

“We paid for certain improvements,” he said.

“For, what, the twenty of us you could find with Fayette-Gehret?”

“A few more than that. And we do have trials in the works for other, related conditions.” He set something on the table, and despite myself, I glanced over at it. Two small ceramic pots. “Yogurt,” he said. “Full fat, real fruit, European. I thought you might like a treat.”

A treat I’d actually be able to eat, maybe even enjoy. I softened by degrees.

“Thank you,” I said, and accepted the spoon he offered. It was made of some kind of plastic. Not cheap plastic, but smooth and easy on my mouth as I took a few bites.

I was not going to cry. I refused to cry. There was real mango in the bottom of my cup, pureed but smooth and tart and sweet, unmistakable, that fibrous edge proving it wasn’t syrup. It was just yogurt, but I’d had so little contact with other people lately, and so few kindnesses.

“I don’t know if I can do this,” I blurted, thinking about the PICC, about my mother’s fears of MRSA, about—all of it.

“You can,” he promised me, and there was a soft fervor in his voice. Confidence. I looked up, into the full brunt of his steady caring. “But,” he added, “you don’t have to. I hope you’ll stay, but you can leave. Hell, you can still leave next week. Next month. Past a certain point, it’s easier if you keep going, but we can stop whenever.”

“That’s not what I meant,” I said, though the open door was a relief. “I just mean…”

I waved my spoon in the air.

“It’s a lot,” I said, finally. “The change. The upheaval. I almost wish you hadn’t made things nicer .”

Adam hadn’t touched his yogurt beyond uncapping it, and he sat back now, folding his hands over his belly. They were nice hands. He wasn’t wearing a wedding ring.

How pathetic is it, that I can remember that detail? No wedding ring . As if …

As if that mattered.

“Well,” he said, after a moment, “I have two answers to that. One, the one I bet you’re not going to like, is that you deserve it. Every patient does. Two, which might be more palatable given the sense I’m starting to get of you, is that soon you’re probably going to be uncomfortable enough from the treatment regimen to not really give a fuck.”

I laughed. I couldn’t help it.

He grinned. I’m not sure if he could.

He threaded a needle I’d thought was impossible: gotten past all my armor, all my cynicism, all my fear, dodged it all like it was nothing, and said exactly what I needed to hear. Nobody else had managed that before. Some of it might have just been the good looks and the poise, tinting everything he did, but I think there was real skill there.

The question I’m still wrestling with is if he meant any of it.

“Is it really going to be that bad?” I asked after I’d had a bit to pull myself back together. He was finally digging into his yogurt. Strawberry, from the scent and the flash of arterial red on his spoon.

“At times,” he said. “Chemotherapy is the closest equivalent to what they’ll be doing to you, right? And chemotherapy is, at its heart, poisoning the patient and the cancer in such a way that the cancer dies first. Extreme, but effective.” He stirred the yogurt; it bloomed pink. “We tried other options. Standard immunosuppressants, autologous stem cell transplants … none of those are pleasant, either, of course, but they’re a little less radical. But none worked the way we wanted. We’re not just killing off your immune system, we’re retraining how your cells respond to certain signals and laying the groundwork for the new immune system all at the same time.” He held up the ceramic pot. “Like scoring wet clay so that a new piece can be joined.

“To a certain extent, the suffering is necessary.”

( Necessary , he’d said. Not unavoidable . I think about that often.)

“We’re going to keep you as comfortable as we can,” he reassured me, because neither of us was laughing now. “But yes. It’s going to be that bad.”

I finished my yogurt. It was wonderful, and I wanted to enjoy it while I still could. So I guess his speech was effective.

He watched me for a long time as I ate, the both of us silent. And then he stood.

“Why don’t you come with me?” he said, and he held out his hand. “There’s somebody I want you to meet.”