Chapter 17: The Care Team
The tension was thick in the car. Felicity looked over at her husband to find him once again studying his sister in the rearview mirror as he drove. Felicity turned her head to look over her shoulder and found Thea staring vacantly out the car window, every bit as quiet as she had been for the past two weeks.
Several days had passed since Oliver had discovered Thea wallowing in her apartment, mired in deep depression. Oliver had managed to get Thea in for a same-day appointment for a new antidepressant prescription and the next day Thea had attended an emergency therapy session with Claudette. In spite of plenty of urging from Oliver, Thea had yet to connect with an online HIV/AIDs support group.
Oliver had insisted on staying over at Thea's apartment the first night after he had found her, but Thea had willfully asserted her independence by the next day. Once both Dr. Henson and Claudette had verified that Thea was denying any intention of harming herself, Oliver had reluctantly returned to the Loft.
Felicity could feel the distance between her and Oliver, and Thea. Felicity had always had a pretty easy connection with her younger sister-in-law, but now Thea seemed so detached from everything and everyone. Her mind seemed a million miles away, and no amount of coaxing or promising to listen without judgement induced Thea to share.
In spite of Thea's obvious disengagement, Felicity gently called out, "How are you doing, Thea?"
The silence stretched on longer than was comfortable. Finally, Thea said tightly, "Fine."
"Come on, Thea," Oliver chided, eyes attempting to meet Thea's in the mirror. "It's an infusion and a follow-up appointment. You must have done a hundred of these."
Some of the dull look in Thea's eyes faded and they became a little sharper. She said, "Not accompanied by prison guards."
The churlish answer seemed to agitate Oliver, who quickly defended, "You wouldn't need 'guards' if you just -"
Felicity silenced him with a firm hand on his arm. Oliver swallowed down the rest of his comment. Felicity turned in her seat saying, "We're just here for support, Thea. No one is forcing you."
Felicity was startled when Thea focused her stormy gaze directly at Felicity. Thea asked in a casual voice which belied the calculating look on her face, "So I can get out of this car and go home?"
"No!" Oliver said firmly.
Thea continued to look at Felicity. "'No one is forcing me'; exhibit one." Felicity winced at the point Thea had proven – okay, so maybe with Oliver involved, Thea didn't have a choice. "The defense rests," Thea said sarcastically as she turned to look back out the window. This time, as silence descended again on the car, Felicity didn't try to break it.
Getting Thea into the clinic took plenty of time and patience. Felicity had never seen someone so exaggeratedly unbuckle their seatbelt and open the car door. Thea's steps were so slow that Felicity felt silly matching her pace across the parking lot.
Despite the intentional delays, it wasn't long before Thea was seated in the familiar vinyl recliner with Oliver and Felicity taking up residence in two chairs next to her. Oliver had pulled out his phone and was engrossed – or at least, pretending to be engrossed – in something from his news feed. Felicity watched, fascinated, as the nurse busied herself with a small tray covered in tubes, needles, and vials.
Out of the corner of Felicity's eye, some movement caught her notice. Turning to see what had pulled her attention, Felicity became aware of a change in Thea; while Thea had been quiet and almost surly before – now Thea looked anxious. Her skin had paled and her eyes looked wide and vulnerable.
The nurse began to wipe an alcohol doused piece of gauze on the end of a wand against Thea's chest and Felicity watched as Thea's breath quickened. Her entire body was tense and her eyes watched the process with fear.
The nurse poised the Huber needle over the port site and said, "Preparing to access."
Thea threw her hands forward, as if to push the nurse back. She desperately cried out, "Stop! Please," and then leaned forward, sucking in air like she was drowning. After a few more painfully deep breaths, Thea gasped vulnerably, "Wait!" and Felicity thought she could hear tears in Thea's voice.
The nurse took a step back and asked sympathetically, "Is everything okay? What's going on?"
"I don't want to do this," Thea pleaded, her voice thick with distress.
Oliver's phone was forgotten in the excitement, clutched in his hand. Oliver said gently, "Thea, you've done this before. You'll be fine."
The words seemed to have the opposite of their intended effect, as Thea's hands began to tremble and clutched onto the armrests. She ducked her head, hiding her eyes.
Not unkindly, the nurse directed, "Sir, ma'am, could I have you step away for a moment? I'd like to talk with my patient."
Oliver opened his mouth like he intended to object. Felicity quickly looped her arm in his and tugged him up to accompany her towards the front desk.
Once they were far enough away, Oliver said in a low voice, "I don't know why Thea is acting like this!" Felicity watched past Oliver as the nurse settled onto a stool next to Thea and seemed to be speaking with her quietly. Oliver continued, his voice agitated, "It's not like this is her first infusion! That medication," he indicated with a wave towards Thea and her IV, "is the only thing standing between Thea and a quick death."
Felicity watched as the nurse again positioned the Huber needle, and this time Thea stayed in place, face turned away, as the needle was inserted into her chest.
Felicity turned back to focus on her husband. "Oliver," Felicity said, feeling the worry pouring off of him, "I know how you are feeling. You just want Thea to be as healthy as she can be. I do too. But telling her what she has to do clearly isn't helping." Oliver grimaced. Felicity noted, "She's stubborn, like someone else I know." She shot her husband a wry smile. The smile fell away as Felicity added, "If we push, she's just going to push back or push away."
The nurse approached them and Oliver turned to stand beside Felicity. Giving them a small smile the nurse said, "You can return to sit with Thea. Just be gentle – she's having a hard day."
Oliver asked with a deeply furrowed brow, "Did she tell you why?"
The nurse said with a kindly expression, "I'm sure if she wants you to know, she will tell you."
As Oliver and Felicity approached Thea, Felicity noted the liquid from the IV bag filling the tube that connected into Thea's chest. It brought back strong memories of the hospital, watching bag after bag of antibiotics and fluids drain into Thea's body. Felicity was really beginning to hate that port. It felt like such a physical reminder that Thea was very much not okay.
Oliver stood over Thea and asked in concern, "Hey – are you okay?"
Felicity was unprepared for Thea's voice to shake as she responded, "Please, not now."
Oliver quickly raised his hands to acquiesce, saying soothingly, "Alright."
The thirty-minute infusion felt interminable. Oliver had told her before Felicity had left the Loft with him that morning that Thea liked to bring books and puzzles to keep herself entertained: that wasn't the case today. It seemed like Thea was far too anxious to do anything more than to try to ignore the needle attached to her port. Thea bounced her leg so quickly it blurred while clenching and unclenching her fists. When Thea began to dig her fingernails into the skin of her arm, Felicity gently extricated Thea's hand and held it loosely in her own. That extra connection served to make Felicity aware that Thea's entire body was trembling with excess energy.
Oliver did his best to pretend not to notice his sister's jitteriness and returned to staring at his phone. Felicity kept up some light, inane chatter. She talked about her mom's taste in restaurants (going to Olive Garden instead of, for example – actual Italian), Curtis spilling coffee while trying to open the door to the clean room (his absentmindedness was going to cause a city-wide blackout someday, Felicity was sure of it), and a stupid story about the time Felicity thought the "turf-drive" to raise funds for her high school's new stadium grass was asking locals to bring actual chunks of their lawn (thank goodness she had only said it out loud to her mother – if she said it at school, she would never have lived it down). Felicity wasn't sure that Thea had actually heard a word of it, but every time there was silence, Felicity felt the shaking and Thea's breathing speed back up.
To Felicity's surprise, Thea didn't seem particularly relieved once her port was deaccessed and she was free of the IV fetters. Her nervous energy continued as she sat on the exam table waiting for Dr. Henson with Oliver and Felicity sitting nearby. Thea crinkled the paper lining the table, poking it with her fingers and repeatedly kicking her foot into the hollow drawer below her.
When Dr. Henson entered, he exchanged pleasantries with all three of them. Then with eyes only on Thea, he said warmly, "I understand from Vicki that you had a tough morning with your infusion." Thea immediately looked down at her hands using one hand to mess with the fingernail on her other hand. "Can you tell me a little about what's going on?" Thea shook her head silently.
Dr. Henson glanced over at Oliver and Felicity and asked, "Would you like your brother and sister-in-law to step out so we can talk?" Thea glanced up, considering the question, then shrugged and shook her head.
Dr. Henson sat in silence, waiting to see if Thea would talk. When she didn't, he said, "Let's talk about how you've been feeling after your ibalizumab infusions."
"It's the same," Thea said shortly, eyes back on her hands.
"Diarrhea, stomach cramps." Thea nodded. "Any nausea? Trouble breathing?" Thea shook her head no. "Fatigue?"
"Sometimes."
"Headache?" A head nod.
"And the diarrhea still lasts up to twenty-four hours after your infusions." Thea nodded, looking miserable. "And on a pain scale of one to ten, one being no pain and ten being the most you've ever felt, how is the stomach cramping?" Felicity felt like that was a stupid question – Thea had life experience being stabbed through the chest. Her pain scale had to be a little different than the average person.
Thea murmured, "a six. Sometimes higher."
Dr. Henson nodded. "It would be pretty understandable to want to avoid something you knew would bring you pain," he said empathetically.
Thea sniffled and Felicity could now tell Thea was fighting back tears. After a moment of silence, Thea said softly, "It's not just how sick it makes me." She hesitated, like she was trying to figure out how to explain. "It's just – I'm sitting there, trapped, knowing that it's going to make me sick and, that was fine when I thought it was making me better. Like, you know – I could handle it because I was fighting back, or something. But – if I'm just dying anyway … the idea that I'm going to get super sick every other week until -" Thea stopped abruptly from saying it aloud. "I just," Thea said, "I can't. I can't keep doing this. I don't want to keep doing this."
Dr. Henson studied her with sad eyes. He nodded and said, "That sounds really hard. You have been incredibly brave to keep pushing through for a long time." Thea sniffled in response. "I'm sorry it has been so difficult. And I'm sorry we don't have an easy answer to keep you healthy." Thea swiped her hand under her eyes, wiping away tears.
"Thea, I wish I could tell you I have a better alternative to your infusions. I just don't. We have to be really strategic about how we use any other inhibitors. If we stop ibalizumab to try something else, we risk the medication not being an effective option in the future. I would only consider recommending stopping your infusions if you were telling me you absolutely would not return for another treatment. Do you think you're at that point?"
Thea didn't answer. She just held Dr. Henson's gaze with damp, weary eyes.
"Thea," Dr. Henson said, "I don't want you to feel like we are at the end of the road. Your immune system is badly compromised, yes. But you are young, and strong, and there is still plenty that can be done to keep you as healthy as possible and doing the things you want to do." The statement startled Felicity. She immediately understood the unspoken caveat in every encouragement Dr. Henson gave; there was no promise of health. There was only a promise to do the best they could and hope that that would be good enough for Thea to feel like she could be a normal twenty-something. Felicity felt a sickening hopelessness at the thought.
Dr. Henson hesitated like he was not looking forward to what he had to say next. "I am recommending that we transfer your care from our clinic to Dr. Matthew Ruiz. He is an infectious disease specialist who runs a specialty AIDs clinic out of Starling General." Felicity looked over to catch Thea's reaction and saw Thea freeze, eyes wide. Dr. Henson continued, "The AIDs clinic includes specialists who would help manage your care: a dedicated pharmacist, dietitian, social worker, physical therapist, and neurologist. They would work together to ensure you are receiving the best holistic care designed to manage your symptoms."
Thea croaked out, "I – I don't understand. You wouldn't be my doctor anymore?"
Dr. Henson agreed. "I could still be your primary care doctor, but that's correct - I would no longer see you to manage your HIV/AIDs treatment. You would also set up future infusions through Starling."
"And what happens if I say no?" Thea asked desperately.
Felicity caught Oliver drawing himself up to speak and laid a hand on his arm, squeezing to get him to stay silent.
Dr. Henson said kindly, "We need to consider how you can receive the best possible care. I personally believe that working with Dr. Ruiz's team is how you can do that. Treating HIV/AIDs is what this team does, and they are very good at it. But you are right – ultimately the choice of where you receive care is up to you."
Oliver took a breath in to respond and Felicity dug her fingers in a little harder, warning him to stop. This was Thea's decision, and as much as she or Oliver might agree that a transfer in care sounded like the best plan, they couldn't make it for her. Looking at the horror in Thea's eyes at even considering the possibility, Felicity knew that the decision wouldn't be as easy for her.
"What are you thinking, Thea?" Dr. Henson asked.
"I don't want to go," Thea said firmly. "You have been my doctor forever. I trust you to do what's best for me. I don't know this guy."
"I understand," Dr. Henson said understandingly. With gentle firmness, he added, "but I care about you and want to see you do well. That's why I think transferring your care is the right call."
"Can I think about it?" Thea asked softly.
"Of course."
As soon as Oliver pulled the car onto the street, he said, "I think we should talk about transferring to Dr. Ruiz." Felicity could have slapped her palm over her eyes at Oliver's immediate, careless pressing on something that was clearly far more emotional for Thea. Felicity managed to withhold any outward sign of her frustration outside of a sharp look before turning to check on Thea.
Thea had returned to looking out the window in the back seat. Felicity thought in the window's reflection, it looked like a tear had slid down Thea's face. Thea stayed silent.
"Thea?" Oliver pressed. Oliver sighed in frustration and said, voice weary, "Come on, Thea."
Felicity was startled to hear Thea's low voice say, "I don't want to talk about it."
Oliver was unprepared to give up. He said, "I think that Dr. Henson is right, Thea: you could have a whole care team specializing in your disease. And I think that the sooner you start working with them, the better -"
"I said I don't want to talk about it!" Thea said sharply.
The tension was heightened in the car and Felicity could feel the impending fight. Invariably Oliver or Thea would say something that they couldn't take back. As if the situation weren't painful enough – pushing each other away wasn't going to help anyone.
"You know what," Felicity said quickly, inserting herself between the siblings' fight. "You can drop Thea and I off at Recovery Park."
Oliver looked at Felicity in confusion. "What's that?"
Felicity turned a shade darker in embarrassment, then said, "Sorry, I mean Grover Park. The one near my office at Palmer Tech." She glanced back at Thea, trying to bring her into the conversation. "Thea and I call it 'Recovery Park', because that's where we used to walk – wheel - after I was shot by Damien Darhk."
Oliver opened his mouth to argue and Felicity rested a gentle hand on his arm. Oliver looked over and seemed to read Felicity's pleading expression to trust her. Oliver let out a small sigh, clearly unhappy with the turn of events but turned his car in the direction of Palmer Tech. He dropped them off without further comment.
The day was overcast and cool and the park was completely empty. There wasn't a lot to the space in the heart of the city. Grover Park covered about four blocks with trees that predated the city that had risen around them. Paved paths wove in and out of the trees and grassy patches were dotted with benches and streetlamps. On nice days, the park was usually filled with people taking their lunch breaks from surrounding office buildings, but the threat of a cold Fall rain seemed to be keeping people at their desks.
As they stepped out onto the path, Felicity noticed Thea was steadily falling behind her. Felicity stepped back and took Thea's arm in hers. Gently Felicity said, "Come on Thee – just walk with me."
They walked in silence. Felicity thought she could feel Thea's heart pound through the contact of their intertwined arms.
The quiet gave time for Felicity to think. She was at such a loss of what her role was in all of this. She didn't know how to support Oliver or to support Thea. She was so far out of her depth. They were all hurting, Felicity included, and she didn't have the words or the actions or the … anything to make it better.
Felicity's thoughts halted as she heard a sniffle coming from the woman next to her.
Felicity asked delicately, "What are you thinking about?"
In a low, emotional voice, Thea began to explain, "I don't want to leave Dr. Henson. I don't want new nurses, or a new infusion team." Felicity nodded in understanding, not surprised that Thea was frightened by the idea of changing care and leaving people she trusted. "God," Thea said abruptly, "I don't want to be sicker and need a dietitian or a … a neurologist! I don't want any of it!"
Felicity murmured that she understood. "It's not fair," Felicity said.
Thea laughed humorlessly and said, "It's not even like I chose this! I didn't choose to sleep with those guys. I didn't choose to get sick!" Felicity agreed with an affirming hum. "Maybe if I hadn't stopped taking my meds when I was a kid, I wouldn't be this sick now," Thea added mournfully, turning her anger inward.
Felicity opened her mouth, ready to tell Thea that she couldn't bear guilt for her actions as a child, but Thea kept talking, scarcely breaking to breathe. "Maybe if I had just told someone sooner! If I had told my mom, or Raisa. The first time Mr. Phillips kissed me, or the first time he … raped me, or, or … the first time he took me to a hotel -"
Felicity fully stopped walking and pulled Thea to a stop with her. Felicity dropped Thea's arm, catching her hand in hers, and turned so that she was face to face, making sure Thea could see how serious she was. "Thea, this is not your fault," Felicity said, her eyes doing her best to catch Thea's. "You were a child and you cannot blame yourself."
Thea took a step back to escape from Felicity and demanded hysterically, "Then whose fault is it? Because I don't want any of this! I don't want to feel like this! I don't want to have to catch my breath because I took the stairs. I want to sleep through the night and not still feel tired when I wake up. I want to feel hungry again! I want to plan ahead for ten years from now and feel like I am still going to be here! God, I want to fall back in love and I want to have fucking sex again. I just – I'm not ready for this, I'm not ready for any of this!"
"You can be angry, Thea," Felicity said, voice low with emotion and feeling tears fill her eyes at her hurting friend. "Hell, I am. I'm so mad and hurt for you. It's not fair, none of this is!" Tears began to trickle down Thea's cheeks, which were bright red from her heartfelt rant. Felicity stepped forward to catch up one of Thea's hands in hers and squeezed it. "But we can't go back and change what has happened. I wish we could, Thea, but we can't. We can only do the best we can from now on."
Thea sniffed, allowing the tears to fall unchecked. "I don't want to leave Dr. Henson," Thea said, struggling to make her voice firm. "He's cared for me longer than anyone and I don't trust anybody else."
"Do you trust that Dr. Henson would only recommend what he thought was the best for you?" Felicity asked.
Thea refused to answer, instead letting out a quiet sob. Felicity gathered Thea into a hug, placing her hand at the back of Thea's head, cradling her softly.
Felicity spoke quietly as Thea cried. "Don't look too far ahead, Thea," she said. "We just need to look one step at a time."
A few days later, Thea surprised Oliver and Felicity by inviting herself over to the Loft for dinner. When Oliver opened the door to admit his sister, Felicity was surprised to see that Thea looked more put together than she had since she had been released from the hospital. Gone were the baggy outfits she had been lounging in and Thea was once again wearing an expertly crafted outfit – black, fitted pants with a flowing maroon top, framed by a buttery brown leather jacket.
Felicity thought that the main difference in Thea was her clothing, but as they ate together, Felicity kept getting the niggling feeling that something else was different. It came over Felicity at once as Thea chuckled at something Oliver had said. It was Thea's eyes. No longer was Thea hiding her face by looking down at the table or her hands. Thea's head was up and when she looked Felicity's way, the greenish-gray eyes seemed to alight on Felicity. Unbidden, a smile lit up Felicity's face.
When their meal was nearly finished, Thea announced, "So, I am transferring care to Dr. Ruiz. I'll be seen in the AIDs clinic next week."
Oliver's eyes widened in surprise, before the barest of smiles crossed his face, likely worried that any more reaction would set Thea backpedaling. "Really?" he asked incredulously. Thea continued to meet his eyes as she sipped water from her glass. Oliver looked a little wary as he asked, "Can I ask what changed?"
Thea cleared her throat and said, "I decided I want to be around for as long as I can." Oliver's eyes became immediately softer as Thea continued, "I want to see Sarah start Kindergarten and Laurel and Josh get married. And maybe, if you guys plan to, I want to be there to meet any nieces or nephews. Maybe be around long enough so that they can get to know me a little."
Felicity appreciated the sentiment, but it was readily apparent what Thea wasn't saying. Felicity asked, "And what do you want for yourself?"
Thea looked genuinely surprised at the question, like the thought hadn't occurred to her. Thea seemed to think and then said slowly, "I think I've done pretty well for myself. I had two parents who loved me; a brother who has always tried to protect me," she said shooting Oliver an appreciative look. "Friends who have become my family." She looked a little introspective as she continued, "I've fallen in love. Led a winning political campaign, started my own business, and brought criminals to justice. I've saved people's lives and have saved the world. If life had a BINGO card, I think I got bingo." Thea shrugged. "What more could I ask for?"
Felicity said, "It just seems like everything you want to stay around for is for other people. I think you need to find the thing that brings you joy and go after that."
Thea seemed to consider this. She gave a half-smile and said, "Maybe I'll get a dog."
Felicity snorted in response. Well, if Thea couldn't think of anything, maybe Felicity and STAR Labs could help Thea find her reason.