Susan sank down onto the couch with a sigh. The first day back at work was always hard, she knew that. She was tired … not that that was a particularly bad thing. If she was tired enough, she might actually sleep tonight.
Supper first, then sleep. She didn't really feel like cooking though. Maybe she'd send out for something. It's part of living alone. Easier to eat out, or send out for something, than to cook for yourself all the time. Less depressing, certainly. No, nothing could make this less depressing.
Maybe she'd call Carter and Sam, see if they wanted to split a pizza. She shouldn't, she really shouldn't. She'd promised herself that she wouldn't lean on them so hard. But she couldn't avoid facing the uncomfortable realization that there wasn't anyone else. She'd never had a lot of friends. And during the past year she had let most of the friendships she had fade away. She'd been so wrapped up in Luka that she had ignored almost everyone else. She hadn't bothered to stay in touch with anyone in her old apartment building. Her work-related friendships had faded into purely professional relationships. She hadn't exactly burned her bridges, but they'd mostly collapsed from simple neglect. Well, except for Abby. That bridge had been well and truly dynamited.
Susan reached for the phone then saw the numbers flashing on the answering machine. She had 9 messages. She might as well listen to them, one or two might be important. She hit the playback button.
Hi Susan, it's Elizabeth. Please let me know if there's anything I can do. BEEP.
Susan, it's Father McLaughlan. I read it in this morning's paper. I'm so sorry … remember that you can always call me if you want to talk, or if you need anything at all. You will both be in my prayers. BEEP
Hi Susan. It's Chuck. I just heard. Dr. Weaver asked me to come to the memorial service this afternoon, but I don't feel right about going. I hope you understand. I really am sorry. But if there's anything I can do ...BEEP
Susan, it's your father … BEEP
Susan, it's Kerry. Jerry told me … BEEP
Susan, it's Kerry again. Please … BEEP
Susan, it's Ke …BEEP
Hello, Susan. An accented voice. This is Gordana Horvat. I'm an old friend of Luka's. You may remember me … we met a few years ago. When Luka's father called to tell me, I was … it was quite a shock. Everyone here is still in shock, I think. I just spoke to Luka a few months ago. He sounded quite well then. I had hoped I would see you at the funeral. Please call me, Susan. I would like to … BEEP
Susan, it's John. Look … we've decided to go away for a few days. Sam and I both have the week off. We were going to just spend it at home with Alex, but we decided to go to St. Barts for the holiday. My family has a villa there. I'll have my cell phone if you need anything. But I think we just need to get away, be a family for a while. We're flying out early tomorrow morning; we'll be back on the 31st. BEEP.
Well, one dilemma solved. They would be busy packing, getting ready to go.
Susan hit the 'delete messages' button and waited for the digital voice to announce "all old messages deleted." There was nothing really important there, except for John's message. The rest … nothing that mattered. What exactly could anyone do? They couldn't bring Luka back. Nothing else mattered. A deep breath, then she picked up the phone and dialed. "I'd like to order a pizza to be delivered. Medium deep-dish pepperoni, bread sticks, large diet coke."
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"May I join you?"
Susan looked up in surprise from her magazine. Dr. Dubenko was standing across the table from her, holding a lunch tray.
"Sure…"
"If you'd rather be alone, or if you're busy …"
"No, please sit down." Susan closed her magazine and managed a smile.
Lucien set his tray down and sat across from her. "What are you reading?"
Susan showed him the cover. "People. I stole it from the waiting room." Anything, even 3 month old gossip magazines to fill the emptiness. She'd been eating lunch alone every day since she'd come back to work. John and Sam were still in St. Barts. No-one asked her to eat with them, and she felt unable to ask. They all walked on eggshells around her; they graced her with sad little smiles, they made empty small-talk. But they mostly just left her alone.
Lucien didn't reply, just began to eat his own lunch. And Susan almost sighed. She would be eating lunch alone yet again. She cast about for something to say. "So, you read psych journals?"
"What?"
"The other day you mentioned an article in a psych journal."
"Yes, I subscribe to several, actually. Psychology, psychiatry, family counseling."
"Isn't that rather far afield for a surgeon?"
"Not at all. I think it's important to be aware of the psychological needs of the patient. It's so easy for physicians, especially surgeons, to lose sight of the fact that our patients aren't just bodies … just diseases to be treated and injuries to be repaired." Lucien put down his fork, leaned a little bit across the table. This was obviously a subject he felt passionate about. "Every patient has emotions that are affected by their illness and that, in turn, affect their illness and their recovery. And it's important that we connect with those feelings, understand them. But how often do we, as doctors, take the time to really talk to our patients? How often do we really listen to them? How much time do we devote to talking to the families?"
"In the ER we don't usually have the luxury for that sort of thing."
"Treat 'em and street 'em?"
"That's the idea."
"But it shouldn't be. Time shouldn't be viewed as a luxury. It should be part of the package, part of what we offer our patients as physicians, as healers." He paused and took a drink from his glass. "So, how are you doing?"
The sudden change of subject caught Susan by surprise. And she was even more surprised by her own response. The sincerity in his voice, the honest concern in his eyes drew a different answer from her than the usual 'I'm fine. Really.' "I'm ok … as well as can be expected, I guess. It's hard. But it wasn't exactly unexpected. Luka had been sick for a long time. He was ready."
"But you weren't." It wasn't a question.
Susan could only shake her head.
"How did he die?" Lucien asked after a moment.
"AIDS."
"I knew that." A quick smile. "I'm not completely isolated from ER gossip. But what was the immediate cause of death?"
Susan wasn't sure what to say. Why was he even asking such a question? Concern? Medical interest? Morbid curiosity? What answer to give? He gave up on living? Dehydration? The death certificate said 'subdural bleed', but that was no more than a best guess. It hadn't really mattered.
Lucien was still looking at her expectantly; waiting for … expecting an answer. "Ummm… infection."
"You don't know what kind?"
"No. We would have had to come back to the hospital; blood draws and tests. Luka … didn't want that. There wasn't much anyone could do for him anymore. But he knew that if he did go back into the hospital they would insist on treating him … talk him into things he didn't want …" Susan trailed off, looked down at her plate. Lucien didn't need to be hearing all this. He'd never known Luka, he barely knew her. He certainly didn't need to hear Luka's entire life history – as short as it might be.
"He had an advance directive, didn't he?"
"Yeah. But as we like to say down in the ER 'do not resuscitate doesn't mean do not treat.'"
"I've always found it fascinating that doctors deal so badly with death. We see it every day, we should handle it well, be comfortable with it. But we're not. We go into medical school believing that it will be our job … our duty … our privilege, to save lives. And that becomes our focus. So when we can't save a life we take it as a personal failure … that we weren't good enough. We can't accept that death is a normal and natural part of life. When death wins, it means we have lost. Every extra day, every hour, every minute we can gain for a patient is seen as a personal victory for us. And an advance directive, a DNR order … that takes away some part of our power to save … to cheat the enemy out of another victory."
Again Susan could see the fire in his eyes as he warmed to his subject; his lunch forgotten, eavesdroppers at near-by tables ignored. "And then, if … when … a patient does die, we aren't allowed to feel it, are we? We're told to maintain our professional distance. So we can't feel angry about our failure. And we can't empathize … we can't even sympathize with the families. Instead, we all have our little scripts that we rattle off; 'Your child/husband/mother/whatever was brought in with severe injuries. Everything possible was done but we were unable to save him and he died. I'm sorry.' I've probably said that speech a thousand times or more. We all have. But we aren't allowed to actually feel it. They're just words, aren't they? We aren't allowed to sit down with a grieving relative, cry with her, feel some part of her pain, or our own. A really fascinating dichotomy, isn't it? On the one hand, we're expected to give our all to win this particular fight. But then, when we lose, we're expected to immediately put it all behind us, forget it, forget that patient, that life ... and go on. Treat the next patient; save the next life."
The shrill sound of a beeper interrupted the monologue. Susan automatically reached for her pocket, but Lucien said, "That's me." He checked his beeper. "The ER needs me." A smile. "Another life to save, I suppose." He rose. "It was a pleasure chatting with you, Susan. We'll have to do it again some time." He started for the door, then turned back. "Oh, and Merry Christmas."
"Merry Christmas," Susan said automatically in return, and watched him vanished into the hall. She shook her head and returned her attention to her lunch.
What a strange thing for him to say. What a strange man. No-one else expected her to have a Merry Christmas. She had offered to work today specifically to try and forget that it was Christmas. Forget that it was Christmas and she was alone.
How could he have forgotten that? How could a man who claimed to be so interested in, and aware of, people's feelings have been so blind to hers? To ask so many personal questions; to rattle on at such length, so impersonally, about loss and grief and death; not realizing that he was pouring salt into open wounds. Almost blaming her for her pain. If she wasn't a doctor, he seemed to be saying, she would know how to grieve.
Or had he been saying that at all? Maybe he had forgotten she was even there, forgotten her own situation. He was talking because the subject interested him, that was all. And Susan was amazed to realize that there was no fresh salt in her wounds, that she felt, in fact, better than she had in a long time. Lucien was the first person in days who had actually talked to her, to have treated her like a normal person rather than a grieving widow … or leper. And there was something oddly endearing about his cheerful bluntness, his ignorance of social graces.
Susan couldn't help smiling. What a very strange man.
