Charlatans

Once it had been confirmed that the organ was on the premises, the sixteen-year-old girl recipient was inducted under anesthesia, and by the time the gifted organ arrived in the OR, Noah was nearly ready for it. It was a happy time for everyone, including Noah, who had known the patient for several years as she had waited. What made it particularly exciting was that the organ was a particularly good match, with an outstanding prognosis for the patient.

The kidney operation had been the highlight of Noah’s day. It was one of those episodes that confirmed for him that he had made the right career choice and more than justified all his efforts. It had even nearly erased the bad feelings associated with the unfortunate death of Helen Gibson and the confrontation with Dr. Mason, although Noah had yet to communicate on any level with Ava after the disaster in OR 8.

Noah had tried between surgeries to casually run into Ava to be assured she was okay, a shrug or a nod to suggest she was coping, but he hadn’t seen her. After he’d finished his last scheduled case, he’d made a concerted search for her around the entire OR area. It wasn’t unusual for anesthesiologists to remain after hours, even though it wasn’t Ava’s habit. Noah finally went so far as to ask for her in the Anesthesia office, where he was told she had left for the day. It was at that point that Noah had resorted to digital means to contact her.

The first thing he had done was text her. While he waited for her response, he’d started afternoon work rounds with the residents on the surgical floor. When rounds were done and she hadn’t responded, he texted her again, indicating it was urgent that she respond. Meanwhile, he’d started seeing his own inpatients, including the patients he’d operated on earlier. Between the colectomy and the hemorrhoid, he’d tried to call her. Not only had she not answered, but after listening to her stock outgoing message, he’d been told that her voice-message box was full.

Feeling frustrated by the technology that promised immediate contact but wasn’t delivering, Noah tried Facebook messaging, then went back to seeing his post-op patients. It wasn’t the best time to visit, since most were eating dinner, but still they were glad to see him. More important, there were no complications such as fevers or complaints of pain, and they were even complimentary about the food. Noah wasn’t surprised. Hospitals today, even tertiary teaching hospitals like the BMH, knew they were in competition and made an effort with their food service. It was just as Noah was seeing his last patient that the kidney notification had come through.

With the surgical call team prepared to take over for the night, Noah left the hospital through the main entrance. It was a warm summer evening and the sidewalks were busy. He crossed the green space created when the Big Dig had put the main north-south traffic artery underground. From there he walked through a portion of downtown Boston to emerge at the northeastern tip of the Public Garden. It was Noah’s usual route when heading home. But he wasn’t heading home. He was heading to Ava’s house.

He entered Louisburg Square from the opposite direction than when he was coming from his apartment. Ava’s building looked dark and uninviting.

Noah climbed her stoop. He entered the foyer. There was an overhead light, but it wasn’t on. To find the doorbell he had to go by feel. He pressed it and listened. In the far distance, he could hear a phone ringing, which was the way Ava’s doorbell worked, since it was tied into the phone system. It rang six times. No one answered.

“Shit,” Noah said. “Where the hell are you?” Out of frustration he pounded on the door. The moment he stopped, a heavy silence returned.

After a long sigh, he went back through the outer door. Stepping into the street, he walked over to the fence that circled the greensward and then looked back up at Ava’s house. There had been no change. All the windows were dark, including the three dormers on the top sixth floor. Although he couldn’t see any of the windows in the L portion of the house nor the workout room, he felt confident she was either not home or hiding from the world. Knowing what he did about her, he doubted the latter. There was nothing about her that suggested she was the depressive type. Besides, what could he do even if she was keeping to herself? It was her house. He couldn’t break down the door and look for her.

For a moment Noah debated what to do, but ultimately he recognized he didn’t have much choice. He had to either go back to the hospital if he wanted any companionship whatsoever or go back to his apartment. Under the circumstances, both destinations seemed pathetic. If he went back to the hospital, as the super chief resident he would be hard put to explain why he was there, and people would most likely ask. He had no idea what he would say, and it might turn out to be embarrassing. As for his apartment, at least he wouldn’t have to explain himself, although the idea of being there was far from enticing for a multitude of reasons.

Finally, as the least bad idea, he decided on his apartment and began to head in its direction. As he walked he found himself back to wondering if Ava could be seriously depressed, but then dismissed it again. He was convinced she was a doer like himself. When the chips were down and things weren’t going your way, you didn’t cry and mope. You sucked it up and worked harder.

As he climbed the stark stairs in his building, he couldn’t help but compare the experience with going up the stairs in Ava’s home with its mahogany handrail, hand-turned balusters, and custom carpeting. Yet the thought surprised him. Had four days and three nights spoiled him?

When he got into his unit, the comparisons were even more dramatic. It was like night and day. He couldn’t quite believe the barrenness and impersonal nature of the place.

Trying to ignore the decor or the lack of it, he sat down at the miserable folding table and booted up his HP, still wondering when he’d hear from Ava and wishing he’d inquired about her schedule when he’d visited the Anesthesia office. Quite suddenly, the disturbing thought came to him that she might have some time off and be away on one of her frequent trips without telling him.

After quickly checking if he had gotten any emails or Facebook messages on his computer that might have mysteriously eluded his phone, Noah sent another email to her. He struggled with the phrasing so as not to sound as irritated as he felt. In many respects, it was rude and unempathetic of her to ignore him like this. She had to know he would be beside himself with concern.

Robin Cook's books