Against Medical Advice

Six in the morning wasn't zero dark thirty any more. Not by a long shot. May 3rd and the sun was sliding in through the bay windows of the hospital cafeteria, bright and golden with a new day. It rained in Seattle, but not near as much as in Forks. Today looked like it might even get hot.

"Bring her home, Charlie. There's nothing for her here. If she was gonna get better from their medicine she would have already."

Billy took a long drag off his coffee. His eyes never left Charlie's.

"All they can do for her now is cut holes in her and put her in an institution. Is that what you and Renee want for her?"

No.

Renee had dug in her heels after the apnea test. Dug in hard. Wouldn't say yes to the surgery.

Their conversations came back full force.

You need to be reasonable here.

Reasonable? You're telling me to give up on our daughter!

It's giving her a chance.

A chance at what? Being a vegetable?

The doc says if she gets better they can take out the tubes and sew her back up again.

Who's going to marry her with scars like that?

Oh for Christ's sake, Renee.

And so it had gone, back and forth, around and around. Until she'd played her trump without a shred of remorse. She was the parent with custody. Her word was the law on their daughter. Unless he wanted to go to court about it. Here, east of Jesus in Seattle. With their daughter wasting away in a hospital bed.

Meanwhile everyone and their uncle was pushing at him. Dr. Sabswari wasn't holding the hospital and insurance suits off of him any more. Bella had been put in the step-down unit and still the hospital was pushing to free up her bed. Insurance was threatening to stop coverage if they didn't get her to long-term care. The doctor herself was pushing hard for the surgeries, insisting that they were the best way to prepare Bella for the long haul.

And now Billy was telling him to give up and just bring her home to die. Got Jacob to drive him all the way to Seattle to do it. On a learner's permit. How he'd gotten wind of the decisions they were up against now, Charlie didn't know. He hadn't made any phone calls.

"You're not hearing me, Charlie. Kevin's got the lodge all cleaned out. Joshua's rounded up the group. Everything's ready. Just waiting on you and Bella."

"She can't breathe without the tube down her throat. And they got feeding going into her around the clock."

"Take all that stuff out. She don't need it."

"It's not that simple." Charlie was too tired to try to explain everything that the doctors had told him over the past weeks. He was so sick of hospital cafeteria food.

Billy took a small, carved stone out of his pocket and put it on the table. It looked to be obsidian, shaped vaguely like some kind of animal. "Look, Charlie, leave the tubes in her if you have to. Won't make any difference to us. Just bring her home. What have you got to lose? What has she got to lose?"

Charlie wondered if he hadn't lost everything already. A month, now, Bella'd been in that bed. In six more weeks her classmates would be getting ready to finish junior year, ready to be seniors. Bella was getting left behind. Vague pictures hazed in and out of focus in his mind: of her class growing up and having kids, and Bella staying unchanged in a hospital bed somewhere, breathing through a hole in her throat, getting fed through a tube in her stomach, turned every couple hours – if people did their jobs – sleeping through years, years turning into decades. Until she ran up against it – the end game that was in store for her no matter how well she was cared for. Pneumonia, UTI, bedsores, tube site infection. Dead in her twenties, maybe. Or thirties on the outside. But never having lived past sixteen and a half.

Charlie's forehead fell into his hands. He did that too much lately. He realized that he was cold. His fingertips felt actually icy. The sunny morning wasn't touching him at all. "What are you going to do?" he asked.

"Bay wants to see her. Talking about soul retrieval."

"Sue's mother?"

"Yeah."

"I don't know, Billy." It was the best he could do and still be polite. The woman dressed like a man. Her hair, more salt than pepper now, was shorter than Charlie's. But she'd had five kids, counting Sue. Charlie wasn't exactly clear what her standing was in the tribe. He did recollect she had a temper you didn't want to cross. The elders had had to bust her out of Eastern State in Spokane back when Charlie'd been in basic, but she'd kept her nose clean enough after that.

"Admitting you don't know is the first step, Charlie. Bring her home."

"Bella's in no shape to be moved without medical support."

A shadow came between him and the window, and sat down beside him.

"Hi, Auntie Renee."

"Hi, Jacob."

Charlie's head stayed in his hands. "How's she doing?" he mumbled.

"Same. I'm going to get something to eat. Jacob, you want something?"

"Nah, Auntie, I'm good."

It was Renee. Renee had called Billy. God damn. When did she get tight with him? Woman had barely said three words to Billy the whole time she and Charlie had been married. Complained when he'd taken Bella with him to the rez.

"What the hell's going on, Renee?' he accused, when she came back with a plate of French toast and a tall coffee. Light and sweet. How she always took it.

"She can't stay here."

"I know that."

"I'm not sending her to any of those institutions."

"We don't have the equipment to care for her at home, Renee." Much less at La Push. Charlie wondered if Renee had any idea of what Billy had actually come here for.

Billy drained his cup and rolled forward a quarter turn in his chair, breaking in on Charlie's thoughts. "Jacob and I are gonna check out Pike Place."

"You got my number," he added pointedly.

And then Jacob wheeled him away, leaving the little black stone effigy on the table.

The drive back to Forks was through rain. Full dark by the time they passed Port Angeles. Retracing his steps. It felt to Charlie like he'd been doing that a lot. There was no one in the seat beside him this time. He had to look in the rear view mirror to see a sliver of Bella's face. Renee had her cradled against her in the back seat, seat belt over them both. The endotracheal tube was still sticking out of Bella's mouth – not attached to anything now, just whistling hoarsely as she took breath after breath. The feeding tube hung out of her nose, too, clamped off and safety-pinned to her shirt. Charlie got his eyes back on the road. Jacob and Billy were following him in Sam's Rabbit. One-eyed, the damn thing was. It was up to Charlie to keep all of them on the road.

The windshield wipers squeegeed back and forth across the glass, half a beat faster than Bella's breathing. Charlie tried to just drive and not think too much.

He'd caved. He knew it. Caved. Failed.

There'd been too many people hammering at him from all directions. And then the paperwork they'd had to sign, to get Bella out of there. Renee might be the custodial parent, but he'd had to sign every page, too. Nobody wanted this to come back and bite them in the ass when what they considered the inevitable happened. Maybe before Bella even made it back to Forks. Let alone La Push. The look on the doctor's face as he'd handed everything back to her pretty much said it all. And still she'd stopped him before he went into the room to collect his daughter from the bed. She'd taken his hand and squeezed it.

"Salaam, Mr. Swan. That is my wish, for your daughter and all your family." And she'd squeezed his hand again. She'd turned away quickly after that, and he'd been just as glad. He was hanging on by a very thin thread as it was.

The miles rolled by under the cruiser's tires – wet, slick, and dark. He half expected to see a dead deer on the roadside again. But no. That omen had already been delivered. The image and memory slammed into him. The crushed body. The rain drumming loud on his hat, and icy wet down the collar of his jacket. Bella sitting quietly in the front seat as he wrestled the tarp out of the trunk and around the carcass. The blood.

Bella.

He was going to lose it. He could feel it coming. Like a rain squall drumming over the mountains.

Breathe.

It's what the chaplain, of all people, had told him to do.

In through your nose, out through your mouth.

When the heat and the light – and one too many bombed out tank and charred corpse – had had him half-way between puking and passing out.

Breathe.

Don't stop.

Don't stop.

The ring tone of his cell phone crashed through everything.

"Jesus Christ!"

"I got it, Charlie, I got it."

Renee reached forward with Bella full in her arms, to take the phone from him.

"This is Renee."

Faintly, Charlie could hear Billy's voice.

" … just … straight through … Push … Sue's … warm meal … waitin' … got … Bella … be alright."

It was out of his hands. It had never been in his hands to begin with. His girl. His daughter. Watched her grow up in tiny excerpts – like through a keyhole, once in a blue moon. Stopped cold now, at sixteen.

Charlie drove on through the night.

All the way to the end of the land.

It was almost one in the morning when they got to La Push. Sue and Harry were out in front of their house to meet them. Sam was there, and Jacob's sisters, too. Charlie smelled salt, and seaweed, and dog, and stew, as soon as he opened the car door. Sue threw a blanket over him. "You're cold, Charlie; you need to step inside."

No, he needed to get Bella settled first.

He stepped around to open the door for Renee. The air was damp and fresh, but rain free. Renee had the seatbelt off already and was sliding over toward the door. Bella lay there in Renee's arms, where she had the whole trip – six-hours counting the ferry – limp as ever.

There was something wrong about her, something missing.

The tubes.

Her face was clear of all the tubes.

"RENEE! What did you – ?"

Charlie lunged at his wife and daughter. Sam and Jacob held him back. He saw, with horror, the breathing tube and the feeding tube both lying on the filthy floor of the back seat of the cruiser. They wouldn't even be able to put them back in.

Rage and fear choked in his throat as he tried to launch himself at his feckless wife again, but the two boys had him fast, and all he could do was squirm in their double arm lock.

"Relax, Charlie, she's fine. She's breathing better without the tubes than she ever did with them."

The last half hour of the ride had been quiet, the rain dying back to a soft mist; he'd been able to turn the wipers off at last. Now the meaning of that quiet crushed him. The whistle of the breathing tube had been silent, too.

"Check her! Check her!"

"She's fine. The nurse showed me exactly how to take them out."

No. The nurse had shown Renee exactly how to keep the pilot tube – the thin little side tube that inflated the breathing tube's cuff – sealed. And how to re-inflate the cuff if it looked like it had lost pressure and the tube was slipping. She'd made Renee memorize the centimeter mark on the feeding tube right where it came from Bella's nose, and promise not to try to put anything down it if it moved from that mark. To get someone medical to look at it as soon as possible if it did. Renee had been irresponsible before, but this … Charlie saw black.

"Check her. Oh, God."

Sue's voice came to him as he struggled to see again. "She's breathing easy, Charlie. She's okay."

No. She wasn't okay. They didn't understand. Bella wasn't just sleeping. The inside of her mouth and throat were flaccid. Without muscular tone, the tongue falls backward in the throat and closes off the windpipe. She would suffocate on her own tongue. And without a sound, because she had no sensation, no gag, no cough.

"We have to watch her! We have to watch her every single minute!" He was sobbing. There was nothing he could do. They'd gone past his last limit.

"We will, Charlie, don't worry. She's safe here." Harry took over from Sam and Jacob. "Let's get you all inside. Sue's got her ragout on the stove and Bay's been waitin' on Bella all day."

Billy talked as they fed him and Renee, and propped Bella up in the old bed in the kids' room.

" … white doctors … can't see … spirit sickness … " Charlie didn't really hear or care. Back at the car he'd been livid with Renee. Never in his life had he ever raised his hand to a woman, never even dreamed of it, let alone to Renee. But back there, he would have throttled her if he hadn't been held down like he was. Now he just felt numb.

"Done is done," Billy had said. "No use cryin' over spilled milk." Harsh words, but they had done their job. Calmed him down enough to eat, which seemed like everybody's main concern right now.

Sue's mother stayed in the kids' room with Bella while they all ate. It was good stew – savory, hot, rich, with lots of bread to sop up the gravy. Food like he hadn't eaten in a long time. As the girls, Leah, Rachel and Rebecca, were clearing off the table, Bay came out and sat beside her daughter. Everyone quieted down, even Renee; and the older woman started to sign.

Sue spoke for her mother.

"I have seen her color. It is red. She has gone abroad on the water road, searching for the boy."

They were going to try to cure his daughter with voodoo.

"The lodge is ready. The gifts have been gathered. The drum and the singers are here. We will call her back."

Charlie looked at Renee. She wasn't fazed by this at all. She wanted that badly to believe. To imagine Bella awake and returned to them. She sat there listening as if it all made sense to her.

"Let her rest now," Sue repeated. "We begin at first light."

Thank you for reading.