“Have you done many of these before?” he asks critically. “Because I wouldn’t mind getting an opinion from someone in Toronto. They have a specialized children’s hospital there. Sick Kids, should she go there?”
As though I’m not aware that Toronto has a specialized children’s hospital. Toronto is a great place to be if you have a rare or challenging problem, but there’s no diagnostic dilemma here; Claire’s ultrasound shows she has appendicitis. A medical student could make the diagnosis, and I could have done the operation as a second-year resident. If she were in Toronto, the operation probably would be done by a resident, but no one would tell Troy that.
On most days of the week, there’d be a resident involved here too, but they’re all away at teaching this afternoon. I’m not sorry they’re gone; there’s no way I’d let a resident operate on Melissa’s daughter.
I look up and realize that Troy’s still waiting for an answer. “Why don’t we step into the hallway, Mr. Thompson?” Despite my efforts to include Claire, I don’t think this is an argument she needs to hear. “Kevin, can you keep an eye on Liam, please?” It’s poor form to ask a medical student to babysit, but hopefully it will keep him from scaring Claire again.
Troy, Melissa, and I move into the hall. “I’m a board-certified general surgeon with a fellowship in trauma,” I tell him. “I’ve done over a hundred appendectomies, and I’m very capable of doing this procedure.”
“You don’t think you should call Toronto?” Troy asks.
I bite back the urge to say that if I thought I should callToronto, I would have already done it. “I don’t have a question for the doctors in Toronto,” I explain. “This is a surgery that I’m qualified to perform.”
“But if I want to take her there?” he persists.
“I wouldn’t recommend it,” I tell him. “The longer we wait, the greater the chance that Claire’s appendix will rupture. If you insist on taking her to Toronto, you’ll need to sign her out against medical advice and drive her there yourselves. And if there’s a joint custody arrangement, both parents would have to agree to that.” I pause. “And if your daughter suffers consequences from your decision to leave against medical advice, the case could be referred to Child Protective Services.”
I’m not sure Child Protective Services would care, but the threat seems to make Troy think.
“Troy, you’re being ridiculous,” says Melissa. “I’m sure Dr. Carlton is highly qualified. He’s got at least ten letters after his name, and he’s a professor at Somerset Medical School.”
“Assistant professor,” I correct, wondering how Melissa knows this. She must have looked me up.
Troy doesn’t look overly impressed, and I guess it’s not surprising. Somerset’s the smallest medical school in Canada, and although Somerset Hospital is well-regarded locally, it doesn’t have much of a reputation outside the region.
But that doesn’t mean we can’t handle a straightforward appendectomy.
“It would be dangerous to drive Claire all the way back to Toronto with appendicitis,” Melissa continues, trying to press the advantage.
“I guess you can do it here,” Troy says grudgingly. As though he’s doing me a favor.
“Excellent.” I go over the risks of the surgery again for Troy before I excuse myself.
Before I leave, I glance at Melissa again. She’s holding it together, and most people wouldn’t know she’s anxious. But there was a time when I was closer to this girl than anyone else on the planet, and even though ten years have passed, I know her tells. There’s a furrow between her brows, and she’s biting her left lower lip.
And something in me responds to that pleat in her forehead, and I have to fight the urge to take her in my arms and tell her Claire’s going to be fine. It’s a physical response, not a rational one. A reflex.
Because Melissa’s not mine anymore. She hasn’t been mine for ten years, and there’s nothing between us now but regrets.
I collect Kevin, and we leave the ER together.
“How did you know the mom had had her appendix out?” Kevin asks again. I can tell this is really bothering him; he thinks there’s some sign that he missed.
“Like I said, it was a lucky guess.” But my traitorous brain replays a memory from fourteen years ago. I was in Melissa’s hospital room when her surgeon, Dr. Mackenzie, came to give her discharge instructions. Her parents had gone to the cafeteria to get lunch, so it was just the three of us in the room.
“My secretary will call you with a follow-up appointment,” Dr. Mackenzie told her. “I’ll see you in two weeks. No strenuous activity or sexual intercourse until that time.”
His eyes flickered to me, just for an instant, and his meaning was clear.Don’t push her for sex.I resented it a little, but I couldn’t really blame him; I was an eighteen-year-old guy, and she was Melissa. Dr. Mackenzie would probably have been surprised to learn that although Melissa and I had been together for over two years, we hadn’t gone allthe way until two months before. She’d wanted to wait, and she’d been worth waiting for.
We didn’t do anything more than hold hands until her follow-up visit two weeks later. Her mother had wanted to take her to the appointment, but Melissa had insisted on going with me. I watched as Mackenzie examined her belly and pronounced her fully healed.
“And physical activity?” Melissa asked. “Can I go back to running? And, um . . . other things?”
“Yes,” Mackenzie said. “Technically, there are no restrictions. But take it easy for the next week or two. Just do what you’re comfortable with.”
Melissa was unusually quiet as we walked out to the car.
“So, that’s good news,” I said as we drove out of the parking lot. “Do you want to go somewhere for lunch before we head back to school?”
