Monday Mornings: A Novel (25 page)

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Authors: Sanjay Gupta

Tags: #Psychological, #Medical, #Fiction

BOOK: Monday Mornings: A Novel
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Ty stirred a little soy sauce into his mix, dumped it into a shallow bowl, and sat down at the glass-and-steel table by the window. As he began eating with chopsticks—Ty believed this was healthier because it prompted him to eat slower—he looked out the rain-streaked window but felt none of the sense of peace that usually accompanied these quiet dinners alone. While most people needed to turn the television on to keep themselves company, Ty liked silence. He reveled in it.

Tonight was different. Ty was on edge. He was beginning a four-day weekend to mull things over, but he had a sense of being frayed, jumpy. He walked across the room, found his remote, turned on the television, and flipped until he found a basketball game. It was a desultory early-season game pitting the Pistons against the Mavericks. He watched for a few minutes as he ate. The game was in the second quarter, and the players seemed to be going through the motions, waiting for the fourth quarter when the game mattered. He pondered a job where you could do less than your best and no one died. Most jobs were like that.

Ty got up, walked across the room, and turned off the television. His sense of peace did not return with the announcers’ patter gone, and he realized in a flash why he was edgy. Ty wasn’t really alone. His constant companion these days was his accuser, the voice in his head telling him that he was not competent, that he had been fooling himself, that he had been fooling others. That he was nothing but an imposter. The by-product of this poisonous self-judge was doubt. Ty was racked by uncertainty. How could one case trigger such a strong reaction when he had sailed through his career so far? It seemed absurd, but he had tried laughing it off, sweating it off, and waiting it out, and the doubt remained. Ty had done some research, and he found a study showing that unconsciously attempting to avoid errors actually resulted in more errors. How could you possibly eliminate unconscious thoughts? It was like being told not to think about the pink elephant. It was like a negative feedback loop. The more he tried to squelch his feelings of doubt, they more they took center stage in his thoughts.

There was another reason Ty was edgy. It had been fifteen days since he had punted on the ETBS. He hadn’t performed an operation since. He’d been to clinic and to M&M, but he had avoided the OR with a deep fear that was a new and powerful force in his life. More than two weeks. It was the longest Ty had gone without performing surgery since he’d finished his training. The residents loved the extra experience in the OR, but every day Ty stayed in town and didn’t operate, he was succumbing to his cowardice. He hated the feeling. He hadn’t gone into medicine or surgery to walk away from the tough decisions. Just the opposite.

Ty looked out the window again. The rain had subsided. The storm was heading east. He could now see the moon, flickering between fast-moving clouds scudding across the night sky. Ty had an idea. He walked over to his laptop, typed in Delta.com, and then checked his watch. He rinsed his plate and put it in the dishwasher. Then he went to his room, threw a few things in an overnight bag, and walked out the door.

 

P
ark scheduled his radiation at night. He did not like to enter the hospital during the day as a patient. In this way, he did his best to keep these two identities separate. Sung Park, the doctor. Sung Park, the patient. He knew this thinking wasn’t entirely logical. He was both doctor and patient. He knew that. Even so, each night, one of his residents would pick him up at his house and drive him to Chelsea General; because of the risk of a seizure, his insurance company didn’t want him driving. His wife offered to take him, but she was needed to run the household, get the children to bed. It was simpler this way.

In a large room dominated by a hulking radiation machine, he would lie down on the gurney, which the radiation therapist called “the couch.” She fitted Park’s custom-made plastic mesh mask over his face and clipped it down. He’d overheard a younger cancer patient refer to this as his “Jason” mask, though he didn’t know why.

The top of the so-called couch then slid out, placing him under the oculus of the machine. It looked like an eye peering down on him, but the orb wasn’t “seeing” Park. This was the source of the high-intensity X-rays. The eyes of the machine were panels that the radiation therapist called arms, which made Park think of his word-power cassettes. “
Anthropomorphism: Giving human attributes to animals or nonliving things
.”

With the lights dimmed, the machine pivoted around Park, whose head was pinned looking straight up. The arms recorded where the small marks on the ears, neck, and forehead of the mask were located so the radiation would be aimed precisely. Once it started, Park heard a buzzing but felt nothing. Park had, of course, prescribed post-operative radiation therapy for his patients, but he’d never given it much thought. It was simply the standard of care.

As a patient, the process was full of wonderment for Park, a literal-minded individual who made a point of believing what he could see. As the machine arced around his head, he knew cells inside his brain were receiving a three-dimensional bombardment of X-ray energy. He knew photons were damaging the DNA of cancer cells that remained after his surgery—and some healthy cells. That way they wouldn’t be able to divide. But how did he know, really? The radiation was invisible.

Immobilized on the flat gurney, Park was uncharacteristically still for a man of movement, of action and accomplishment. Stuck under the formfitting mask, his mind was liberated, free to wander, to muse. There were always things to do. Musing was something Park had considered a waste of time.

Now he wondered about perception and reality. As he considered the invisible beams doing damage at a cellular level inside his head at that very moment, he thought of other aspects of his life that were invisible yet vital to his well-being. Love, for example. Surely, he knew his wife loved him, and he loved her. If Pat were gone, his life would be diminished. She was vital to his well-being. His children, too. His mother had died the previous year of a stroke, and he had experienced a profound sense of loss even though he talked to his mother only a few times a year. There was a love and bond between them, now forever severed.

With the lights dimmed night after night, Park’s mind wandered as Mozart’s “Violin Concerto no. 5 in A Major” played. He’d requested the song in part because it roused him at some spiritual level. He thought the music might trigger the release of dopamine and might help with his healing. Also, the song had played a profound role in his life. He was scheduled to play this piece at his tryout for Korea’s most prestigious music academy. His inability to master it had ended the violin career his parents dreamed he’d pursue and turned Park to science.

Park had always been a linear thinker. Input and outcome were directly correlated. If you applied more effort, you got more results. Life could be broken down into a series of simple algebraic equations. If x yielded y, then 2x would equal 2y. In this way, you could produce the results you wanted. Park’s dogged work ethic was the product of this belief, and he had used it in Korea, rising above his humble upbringing to receive admission into medical school and then being accepted into its most challenging field, neurosurgery. He had done it again in the United States by going through a second neurosurgical residency.

Lying on his back, the invisible beams striking his brain, Park was beginning to rethink this linear mind-set. His life had not followed a logical path. His inability to master a piece of music written for violin 250 years earlier in Germany had shunted his life from one track to another. His cancer, too, was the result of no direct input. His diet was good. He was fit from walking. He had not been exposed to high doses of any known carcinogen. One day he was living one life. The next day he was living a different one. He had undergone a profound change, and not as the result of any simple formula.

As a doctor, he’d heard other glioblastoma patients talk about how their lives were transformed the instant the cancer revealed itself. One minute, they were driving in a familiar neighborhood, and the next they didn’t know the way home. One minute, they were cleaning the garage. The next, the left side of their body ceased functioning. One minute, they were holding a conversation and the next, they found it difficult to speak.

Park had studied quantum mechanics as part of his undergraduate education at the University of Seoul, but he had been skeptical. How could one thing become something completely different under certain circumstances? Now he was beginning to view himself under this light. Maybe life wasn’t as much levers and pulleys that could be manipulated as it was a series of switches that turned on and off.

When Park rose from the gurney each night after the radiation machine stopped humming, there had barely been enough time to hear a single movement of the concerto. Still, he had spent the brief time pondering questions he had never even considered thus far in his life, and he left the hospital feeling oddly refreshed.

CHAPTER 30

 

S

ydney stood next to the makeshift stage and jumped up and down to ward off the cold. She was wearing shorts and her
CHELSEA GENERAL 10K
T-shirt, even though the temperature was only in the high forties. ABBA’s “Mamma Mia” pulsed from large, overmodulated speakers set up on either side of the windblown stage, and a woman stood in front of a group of runners, leading them in pre-race stretching. The song ended, and the DJ flipped on his microphone.

“Mamma Mia, it’s cold out here. Everyone keep moving! Before you head to the starting line, I want to hand the mike over to Morgan Smith, he’s the big cheese,
le grand fromage
, at Chelsea General, the sponsor that’s made this race possible. Put those frozen mitts together for Morgan Smith.”

Smith took the microphone to a smattering of applause.

“Thanks. My name is Morgan Smith. I’m the CEO at Chelsea General. Just want to welcome all of you here. Chelsea General is proud to sponsor the race. This is the eighth year of the Chelsea General 10K. Even though it’s cold, you all need to stay hydrated. There will be water stops along the course. Chelsea General will be with you every step of the way. And that’s the kind of hospital we are, too. From the best neonatal unit in the Midwest to outstanding geriatric care.”

Smith looked over toward Sydney, who gave him a wave as she hopped up and down on one foot, then the other.

“We’ve got a young doctor here—” Smith put a hand over his microphone and leaned toward Sydney with a look that made it clear he had forgotten her name.

“Sydney Saxena,” she called.

“We’ve got Dr. Sydney Saxena here. She’s going to tell you a little bit about saving lives.”

He turned and handed the microphone to Sydney. She blew on her hands, stiff and red with cold, and took the mike.

“Good morning. I’m Dr. Sydney Saxena. We’re all excited to run and get the blood moving. Just want to tell you, if you ever find a loved one, a friend, a stranger who’s not breathing or whose heart has stopped, you can help. Anyone can help. And it’s simple. Don’t worry about mouth-to-mouth. That’s good news, right? Chest compressions alone will keep the blood moving to the brain and heart until help arrives.”

Sydney remembered training as a lifeguard in high school, the dreaded fear of having to perform mouth-to-mouth resuscitation on something other than the rubber dummy, really only a head and chest. That was bad enough, its creepy pupil-less eyes staring straight ahead, its skin-colored lips tasting like the Listerine used to clean the “mouth” between would-be lifeguards.

Sydney looked out at the large pack of runners, jumping up and down to stay warm, stretching, talking. It was hard to know if anyone was listening. As she scanned the small group in front of her, she saw him. Bill McManus. He smiled and nodded at her. He still looked exhausted, but he looked more athletic in shorts and a long-sleeved T-shirt than he had in a wrinkled lab coat.

“So if you come upon someone who has stopped breathing, first, you or someone else needs to call nine-one-one. Then you need to see if there is a defibrillator nearby. If not, all you have to do is chest compressions. That will keep the blood flowing to the heart and brain. Find a spot between the nipples and push, arms straight, one hand on top of the other.” Sydney put her hands on top of each other, and straightened her arms to demonstrate. “And don’t be shy about the compressions. You want to push hard. Break a sweat. Keep going until medical help arrives. Any questions?”

Sydney looked around. McManus had his hand up. Sydney ignored the fellow doctor and tried not to laugh.

“Okay then. You’re all heroes in waiting. Good luck with the run today!”

There was a smattering of applause.

Sydney looked around for someone to take the microphone. She found the DJ bent under his table of electronics, wolfing down a powdered doughnut. He brushed the confectioner’s sugar from his hands. As she handed off the mike, she heard a voice behind her.

“You didn’t call on me,” McManus said. “I had a question.”

“I can only imagine what your question is, Dr. McManus,” Sydney said, emphasizing the word
doctor
. The hint of a smile played at the corner of her mouth.

“I was going to ask if you could do mouth-to-mouth if you wanted to.”

He grinned slyly, a fan of wrinkles framing his light blue eyes. Sydney shook her head, bemused, although she had an image of kissing this wiseass doc standing in front of her. To her surprise, she found the thought attractive. Kissing this Dr. McManus might just be enjoyable.

“You know,” McManus said. “When I was a lifeguard I dreamed of saving a beautiful girl in need of mouth-to-mouth. Someone like you.”

“I guess that makes you an optimist. When I was a lifeguard, I feared halitosis grandpa after a massive MI.”

McManus laughed. “I guess that makes you a realist.”

Grinning, the two doctors stood fidgeting in the cold for a moment. Something about this doctor sparked something deep inside Sydney. It was a feeling she had walled off after Ross had dropped her cold after their near-engagement dinner. Sydney knew if she waited a minute, she would be mad at Dr. Bill McManus for evoking this feeling in her. She viewed men who distracted her, who tempted her to expose her feelings, as duplicitous—malevolent plotters out to derail her professional life. She did not want to invest emotions in a relationship that was doomed to fail.

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