A White Coat Is My Closet (36 page)

Damn
, I thought,
this has the potential to be a great day.

I
SWIPED
my identification card to open the gates of the doctor’s parking lot. At that time of morning there were still lots of empty spaces, so I was able to commandeer one close to the stairs. I bounded down the two flights and again swiped my card to enter through one of the secure employee entrances. The hospital was a labyrinth of corridors, stairwells, and hallways. The pediatric ward was on the fourth floor of the north tower, so I had to navigate through the south tower and climb another two flights of stairs before even arriving at the glass-enclosed bridge that connected the two towers and allowed four lanes of traffic to pass underneath.

The sun had just crested the roof of the shopping mall that covered five acres east of the hospital, scattering spectacular colors across the carpeted floor as its light passed through the glass walls of the bridge. As I walked quickly through the beams of juxtaposed light, I couldn’t help thinking Sergio would take great delight in attempting to use the display as the background for a canvas.

Though Sergio had never had formal art lessons, he really was an accomplished artist. Some of his work had been displayed in a number of local galleries, but none of the galleries were prestigious or well known. Most either doubled as coffeehouses or were small, quaint locations funded mostly by local artists who themselves were attempting to create a little name recognition. The reputations of these artists were built mostly by word of mouth, but some of them were gaining popularity. Very few people broke into the art world as instant successes. Shit, most artists were dead before anyone ever knew who they were. For Sergio, art was a passion I knew he dreamed would someday bring him both success and fame.

I pushed through the double doors that led onto the pediatric ward and walked up to the nurses’ station. As was typical of our rotation, Diane had been on call the night before. She looked a little haggard as she leaned on the counter.

“Rough night?” I asked, pushing a cup of fresh coffee into her hand.

Some of the fatigue chiseled deeply into the lines of her face lifted. “Actually, we only had three admissions, but one of the kids was pretty sick.” Her voice lilted with a soft laugh. “And you know, it only takes one for your night to go down the toilet. Four-year-old admitted from an outside ER. Leukemia. New diagnosis. Came in with a white count of forty-five thousand, lots of blasts, and pretty damned anemic. Had a hemoglobin of just five and a fever of 102. She was a little unstable, but we were able to draw some diagnostic labs before we gave her antibiotics and began to transfuse her up. She’s already had two units of blood, five hundred milligrams of vancomycin, and is looking a ton better. Dr. Carroll is the oncologist on this week. She came in early and has already talked to the family. The kid’s name”—Diane consulted her notes—“is Riley. She’s going for a bone marrow biopsy and a spinal tap this morning. If we confirm the diagnosis and specific subtype of leukemia, she may start chemo as early as tomorrow. Hopefully, it will be one of the low-risk types that carries a good prognosis. Nice family.”

I looked over Diane’s shoulder and read her notes. Leukemia was the most common type of cancer in children. If indeed Riley had ALL, which was acute lymphocytic leukemia, her prognosis was pretty good. In my mind, I tried to recall the details of leukemia, as I was sure that it would be a hot topic for discussion during rounds.

Blood was comprised of many different cell types. Leukemia occurred when a specific type of white blood cell began to replicate out of control. This process was problematic for the body. First, these aggressive cells crowded out the production of the other cells the bone marrow should be making, and second, the white cells that were being produced weren’t functional. In a nutshell, the cancer cells muscled out the mature, healthy, functioning cells.

That explained Riley’s anemia. The cancerous cells her body was producing had so overwhelmed her bone marrow that she was unable to create new red blood cells. In addition, the role of mature white blood cells was to protect the body from infection. Because Riley’s blood had been mostly overtaken by immature, aggressive white cells, she had an insufficient number of functioning white blood cells to protect her and was at significant risk for developing a serious infection.

“You’re a star, Diane.” I gave your shoulder a squeeze. “You had a shitty night, but not only were you able to wrap it up, you put it in a package and tied it with a bow.”

Even under the strain of big-time sleep deprivation, she beamed at me. She understood I was both paying her a compliment and thanking her for great work. I continued, “Now, if you want to prove yourself as being truly stellar, you’ll volunteer to work the next twelve hours and offer to let me go catch up on some much-needed beach time.” I had to duck as she retrieved a reflex hammer from her lab coat pocket and swiped it at my head.

“Okay, okay.” I grabbed her swinging arm and drew her into a hug. “Choose to stay within the ranks of the mediocre. That’s your call. I just thought I’d give you the chance to rise to greatness. Seriously, though.” I squeezed a little tighter so I could look over her shoulder at the list of patients she was holding. “Let me know what I can do to help you get out of here. You did a great job with Riley.”

“Wow.” She gave me kind of a pensive, suspicious look. “You show up bearing coffee, compliments, and with a genuine offer to help. Someone’s in a good mood. Who tickled your ass with a feather?”

Keeping the mood light but being careful not to disclose even a hint of personal information, I smiled mischievously. “That’s the secret; I have my own feather.”

She smiled sheepishly and shook her head before refocusing on the patient list. “I don’t know, based on your mood, it’s either a damn big feather or you have more than one.” Her cheek lifted a little on one side, and as she looked at me out of the corner of her eye, she gave me a cockeyed grin. “One of these days I’m gonna have to give myself a little peek into your closet to find out what other things you’re hiding.”

Her comment forced a hearty laugh from deep within my chest. I knew she intended the double entendre, but I was unwilling to take the bait. “If you come over to go rooting through my closet, it’s only because you’re hoping my vacuum comes with attachments for self-pleasure.”

She laughed too. “If it’s your vacuum, I’m sure that it was designed for self-pleasure. The question is, does it pick up dirt?”

I went from laughing to smiling smugly. “That’s yet another good thing about me—there’s never any dirt.”

Diane reached again for her reflex hammer.

I stepped well out of the way of her blow, turned, and headed for the residents’ office. “I’m gonna go print up a patient list for myself. I have to review it before chief rounds. Call me when you’re ready to sign out and let me know if there’s anything I can do to help you tie things up.” I shot a smile over my shoulder. “That offer was and still is legit!”

As I walked away, I couldn’t help but feeling a little self-conscious. Diane and I had worked together for more than two years, and in many respects had really bonded. Sharing an internship year was like surviving boot camp together. We’d been through the thick and the thin and had supported one another during some of our most harrowing times. On more than one occasion, we’d had to convince one another not to quit. I remembered during our second month of internship, when the two of us were assigned to cover the general pediatric ward together, one of the patients under our care had died. Though by every conceivable measure the death had certainly been unavoidable, neither of us could shake feeling we had somehow failed. As newly licensed doctors, we both felt a tremendous commitment to protecting our patients. By supporting one another, Diane and I had gotten through both the grieving process as well as the guilt and, ironically, had probably grown into better physicians as a consequence.

Having endured this process together, we had really gotten to know one another. When sharing a foxhole, a number of secrets get disclosed. As interns, Diane had confided in me how, the summer before, her heart had been broken when she discovered her fiancé had been sleeping with her best friend. Originally, she had committed to beginning her residency at Denver Children’s in Colorado. At the last minute, however, she’d decided that staying in the same community where her ex-fiancé lived would only result in additional heartache. She was a highly recruited candidate, and when our training program ended up having an unexpected vacancy, she’d pulled up stakes and signed on. She arrived two days before we were scheduled to begin. The decision had been so last minute she hadn’t even had time to arrange for housing. She packed a suitcase, checked into a hotel, and showed up the first day ready to work. No one was aware of her predicament other than our residency director, who ended up being instrumental in helping her to find an apartment. Three weeks into our internship, on her first day off, she flew back to Colorado, rented a U-Haul, and drove all her belongings back to Los Angeles. She was so upbeat none of us suspected what a difficult transition she was going through. It was only late one night, when the two of us were working together, that she tearfully shared her story with me. I pulled her into a tight hug, gently stroked her hair, and whispered to her that she was amazing, that she was wicked smart, incredibly cute, and had a sense of humor to rival mine. I told her that her fiancé must have been a huge asshole to have cheated on her and that he had lost the best thing he could ever have hoped to have. Also, I assured her as I kissed her forehead, she deserved so much more.

She’d pushed herself off my chest and looked up at me through tear-soaked eyes. An embarrassed smile crept across her face. “You’re just saying that to try to convince me not to abandon your sorry ass during this godforsaken internship.”

“Damn! Am I that transparent? And here I thought I was succeeding in buttering you up.” I pulled her back into a tight hug. “Does this mean you’d be unwilling to pick up a few of my call nights?”

She drew her fist back and punched me playfully on the chest. “Typical man. Appealing to my vulnerable side with the singular intention of exploiting me later. First thing in the morning, I’m going to march right up to Human Resources and bring charges against you. You’re contributing to a hostile work environment.”

I laughed and squeezed her tighter. “When I show them the bruise on my chest, they’ll know which one of us was being hostile.”

After a few more moments locked in my embrace, Diane again pushed herself out of my arms, wiped her tears on the sleeve of her scrubs, and tried to push the emotion out of her voice. “Okay, now you’ve heard my pathetic, woeful story. What’s yours, Zack? Is there a lucky girl out there who gets the privilege of resting her head on these rock-solid pecs on a regular basis?” She gave my chest another playful punch to accentuate her point. “You’re always so mysterious about your personal life.”

I immediately became self-conscious. Here we had just shared a very intimate moment, during which she had confided in me the details of an incredibly painful experience, and when she turned her focus on me, I suddenly felt naked. Rather than be forthcoming about who I was, I instinctively felt compelled to hide, to seek refuge behind my traditional walls. In that instant, I didn’t even know what I was afraid of anymore. Hiding just became second nature. It was an indoctrinated response. I wasn’t necessarily fearful that Diane would think any less of me if she knew I was gay, but every fiber of my soul nonetheless screamed it had to remain secret. That divulging it would mean being immediately ostracized. That my peers would assume my competence as both an individual as well as a doctor had been a façade, and in reality, I was somehow defective. A rational part of me acknowledged the ridiculousness of my trepidation, but an emotional part of me regressed to a pathetic little child, paralyzed by the prospect of being outed.

In an attempt to deflect the question, I took a step backward and intentionally flexed. “Do you really think they’re rock solid? Our call schedule has been so hectic I haven’t even had an opportunity to work out.” I looked up at her and forced a smile. My intention was to give the impression that I thought we were just joking around. “Lucky thing you can’t see my calves. They’re a little skinny.”

She looked at me, but rather than being taken in by my phony levity, her expression, though void of judgment, remained intense. She let the moment drag out a little longer, then her facial features relaxed. “You can be guarded with me if you want, Zack but you don’t have to be. I’m not sure what you feel like you have to hide, but I hope you know that with me, anyway, you’re safe. We’ve all had painful experiences in our lives. God knows you just got a firsthand glimpse into one of mine. The point is this: being friends means being able to share some of that pain. Given all of the things we’ve been through together, I hope you believe you can trust me. Sharing some of your pain with me might make it a lighter burden to carry.” Her smile brightened. “You decide, Zack. When you’re ready, you know I’m here.”

It was hard for me to look directly at her. My voice caught just a bit, but I still managed to answer. “I do trust you, Diane. I guess I’m just not sure if I trust myself.” I smiled and looked at her. “But if I ever succeed in getting my shit together, I guarantee, you’ll be the first to know.”

She continued to smile and just shook her head understandingly. “Zack, I think you already have your shit together. The problem is that you think being friends means just sharing the good stuff. Sometimes being friends also means sharing the shit, whether you have it together or not.” She caught my gaze and her smile broadened. “Even if you think yours doesn’t stink.” She patted me on the arm. “Just know that I’m here.”

That conversation had taken place more than a year before, and though I was certain Diane suspected I was gay, I had never actually admitted it to her. A bunch of times I had wanted to. A few times, I had even come close. But in the end, I always ended up rationalizing to myself that it wasn’t necessary. That it was prudent to keep my professional life completely separate from my personal life. I forced myself to ignore how both ridiculous and hypocritical it was to cling to such a rigid restriction, because in every other regard, we were living in one another’s back pockets. We shared laughs, we shared tears, we shared frustrations, and we shared disappointments. Hell, we’d even shared morning breath. I’d been more personal with some of my colleagues than I had been with some of my closest friends, and yet one part of my life remained carefully cordoned off. They could have their suspicions about my sexual orientation, but I’d be damned if I’d offer confirmation. Some of my gay friends thought living such a double life would be extraordinarily difficult. I’d been doing it for so long it was second nature. Sadly, I was a master at keeping people at arm’s length while simultaneously having them believe we were incredibly close.