Chapter 27

One Month Later

“Mommy, I need to go potty!”

I had been so excited for Leah to be toilet trained. I thought it would herald a new golden era in which Ben and I wouldn’t argue over who was going to be wiping up Leah’s poop. I thought of the fortune I would save on overpriced pull-ups. It didn’t seem like there could possibly be a downside.

Yet somehow, there is.

Leah needs to use the bathroom all the time , except when we’re actually toilet-adjacent. When we took her to Chuck E. Cheese to celebrate her fourth birthday a couple of weeks ago, she needed to use the toilet on the way to the restaurant and on the way back, but never while we were actually at the bathroom-equipped restaurant. And when I picked her up from the preschool five minutes ago, she seemed affronted by my suggestion that she use the potty before we leave. But now that we’re in my car, she suddenly needs the potty. Immediately .

“Sweetie,” I say. I’m trying not to lose it. I’m so sick of changing urine-soaked clothing. “Can’t you wait until we get home? We’re almost home.”

“No!” Leah wails. “I need to go nooooooooooowwwwwwwwwwwww!”

I glance back at her and see that she’s clutching her crotch—the universal sign of needing to pee. I think there’s a reasonable chance that she might be able to hold it. And the only places we can pull over are stores where we’ll undoubtedly be told the toilet is staff only.

We could also try the gas station coming up, but that only has a porta potty. Leah is not a fan of the porta potty. When I took her to one once during a carnival, she looked utterly horrified. “Mommy, this is ‘sgusting !” she gasped when she saw the hole filled with shit. As if she hadn’t just been sitting in her own shit on a daily basis one month earlier.

So I drive as fast as I can, speeding through yellow lights, all in a desperate race against Leah’s bladder. “Mommy, I need the potty!” she sobs. As if I could snap my fingers and make a toilet appear.

When I pull into the garage, I realize that I’ve lost the race. The familiar smell of urine wafts across the car, and when I look back at Leah in her car seat, I see a circular stain on her crotch.

Damn it !

“Leah,” I say sharply, “this is why I told you to go at the preschool!”

She looks up at me, her lower lip trembling. “But I didn’t have to go then.”

I sigh.

I unbuckle Leah from her car seat and bring her into the house. She walks extra slowly because she’s covered in urine. When I get into the living room, I see Ben sitting on the couch with his laptop, eating from a jar of peanut butter. He immediately notices the urine stains on Leah’s legs and jumps up. “Another accident?”

I nod miserably. “It’s all over her car seat.”

Ben leans in to kiss me on the lips. “Okay, I’ll go clean out the car seat. You take care of Leah’s clothes.”

I smile gratefully at him. Over the last month, Ben has gotten much better at helping out with Leah-related chores without my having to ask. It also hasn’t hurt that we started going to marriage counseling two weeks ago. I always thought that kind of thing was bullshit, but amazingly, it really helps. Just knowing that a third party is going to be listening helps us to talk things out more rationally. Also, in all honesty, knowing that a third party is going to hear about everything bad that I say helps keep me from saying bad things. The marriage counselor, on his part, has congratulated us both on being really dedicated to making the marriage work .

“But first…” I nod at the jar in his hand. “Let me have a scoop of that peanut butter.”

He grins at me. “Don’t you want to know what flavor it is first?”

“That’s okay,” I say. “I’d rather live dangerously.”

Ben scoops out some peanut butter from the jar. It’s brown and roughly the normal color for peanut butter, so that’s a good sign. He puts the spoon in my mouth and I let the peanut butter dissolve. I taste a hint of vanilla. And honey. And cinnamon.

“It’s really good!” I say. “What flavor is it?”

“French toast,” he says.

“I want to try!” Leah yelps.

A minute later, the three of us are still standing in the living room, eating peanut butter. Even though Leah is still covered in pee.

_____

“This is for you, Dr. McGill.”

I have to say, I’m a sucker for presents. When a patient brings me a present, I always get really excited. Especially if that present turns out to be food, which it usually does. Usually they bring me chocolate or cookies or something along those lines. A few times, I’ve gotten candles. Once, I got a huge jug of vodka.

Today Robert Hopkins has brought me a plant .

I don’t love plants. Not to say that I’m not a nurturing kind of person, but I’m not good at nurturing plants. I’m already having enough trouble taking care of the human being I created—the last thing I need is a plant to worry about. I know all you have to do is water them, but even that’s too much trouble. (And aren’t you supposed to give them food? I know that’s counterintuitive because of, you know, photosynthesis, but I know there is such a thing as plant food.)

And this is not just a plant. It is a ginormous plant. The plant easily weighs more than Leah does and she’s a good forty pounds. When I take it from Mr. Hopkins, I have to grunt with the effort of holding it. The pot comes up past my knees and the leaves run well above my head. It’s like something you would find in a jungle. What am I supposed to do with this plant? How am I even supposed to get it home?

Mr. Hopkins beams at me. “My wife picked it out. Do you like it, Dr. McGill?”

“I love it!” I hate it. “Thank you so much.”

Actually, maybe I shouldn’t be so enthusiastic. I don’t want another of these things.

“We both wanted to thank you,” he says. “You’ve helped me more than any other doctor I’ve ever been to in my whole life. ”

“Really?” I’m so flattered. Maybe I’m really making a difference here at the VA. “What did I do that helped so much, if you don’t mind my asking?”

“You prescribed me Prozac!” he says.

Oh.

Mr. Hopkins spends the next ten minutes raving about Prozac. And apparently, his wife likes it a lot too, because not only is her husband a lot more mellow, but it’s also killed his sex drive. “She likes that I’m not always pestering her anymore.” Win-win.

My next patient is Mr. Herman Katz.

I know Mr. Katz is a nice man, but I can’t help it—I cringe when I see his name on the schedule. What’s wrong this time? Did he get a papercut? And is he worried the papercut is going to get infected? And that the infection will spread up his whole arm and he’ll need IV antibiotics? And then the IV antibiotics won’t work and the infection will evolve into a cancerous tumor? Is that what I’m going to be reassuring him about today? Because honestly, I’m not sure I have the strength.

“So what’s bothering you today?” I say to Mr. Katz.

“Well, Dr. McGill…” His bushy white eyebrows knit together. “I had this episode. It was sort of weird and I thought I should come get it checked out.”

“Sure,” I say. “What happened?”

“So yesterday,” he says, “I was mowing my lawn and all of a sudden… well, it was like this curtain dropped do wn in front of my left eye. And everything was dark for, I don’t know, maybe a minute. Then it just went away.”

Holy crap. I think Mr. Katz may have a real medical problem .

“That is a little concerning,” I say carefully. “Has this ever happened to you before?”

He shakes his head. “No, never. Do you think it’s something really bad? Do you think it’s cancer?”

There are things out there that are as bad or worse than cancer. Either way, that’s not what I think Mr. Katz has. Amaurosis fugax , or transient painless loss of vision in one eye, has a lot of causes, but based on his cholesterol and the contents of his grocery cart the other day, I’m betting that Mr. Katz had something called a Transient Ischemic Attack or TIA. That’s like a stroke that lasts less than a day (and usually much less than that) and doesn’t show up on imaging.

I’m not any great expert at the ophthalmic exam, but everything looks fine in his eyes. However, I notice that he has a whooshing sound or “bruit” over his left carotid artery. This is indicative of a blockage in the artery.

“I’d like to order some tests,” I tell him. “Including an ultrasound of your carotid arteries. And I’d like to refer you to our Eye Clinic.”

His eyes widen. “What do you think is wrong?”

“I think it could have been a mini-stroke.” Patients seem to prefer the term “mini-stroke” for a TIA. It’s as good a term as any. “But I’m not sure yet. We need to check out your eyes before we jump to any conclusions.”

Honestly, Mr. Katz looks so worried that I want to give him a hug. Part of me wonders if he would have come here in the first place if he knew that I wasn’t just going to tell him everything was fine like I usually do.

_____

Between you and me, I strongly consider dumping the giant plant in the garbage on my way out. Except I can’t because it’s too big to fit in any of the garbage bins.

I lug it out to the elevator, my arms actually trembling with the effort of holding it. This thing is way heavier than Leah. And there’s no good way to hold it without the branches and leaves smacking me in the face.

Just my luck, the first elevator that comes belongs to George the elevator guy. I consider making an about-face but I recognize in this one situation, it might actually be useful to have George pressing the buttons in the elevator for me.

I start to climb inside but George holds up a hand. “Wait,” he says. “I don’t know if I can let you in with that thing.”

I stare at him. “ What ?”

“You might need to take the service elevator,” he says. “It looks hazardous.”

He’s got to be kidding me .

“Please?” I say. “I’ll be really careful.”

George looks me up and down. Finally, he sighs. “Fine. But just this one time.”

Does he think that I’m going to make it a habit of carrying around a gigantic plant? Christ, I sure hope not.

The elevator seems to be traveling painfully slowly. I’m trying to keep the plant from slipping out of my fingers, debating if I should just put it on the ground for the duration. That’s when the elevator doors open and Dr. Ryan Reilly strides in wearing scrubs and a jacket. I’m not entirely sure he sees me though, since my face is concealed by leaves and branches.

“Hey, George!” Ryan says.

To my utter shock, a huge smile breaks out on George’s face for the first time in the entire year I’ve known him. Ryan holds out his hand and George gives him an enthusiastic high five. What. The. Hell?

“Did you catch the Knicks game last night?” Ryan asks him.

“You know I did!” George says. “Man, that game was too close for comfort.”

“You kidding me? I knew the Knicks had it all along.”

They chat about the Knicks game for another minute while I stand quietly, hoping Ryan doesn’t notice me. Except at one point, he glances over in my direction and winks. A month ago, that wink might have done something for me—but right now, all I can think about is how I’m going to get this stupid plant home.

“So what’s with the man-eating plant?” Ryan asks me as he gives George a parting fist bump and we exit the elevator in the lobby.

I shift my grip on GinormoPlant for the hundredth time. “A patient gave it to me.”

He rolls his eyes. “Give me that.”

I don’t protest when he takes the plant out of my hands. “I have a question for you.”

“Shoot.”

“What is your cut-off percentage of stenosis to do a carotid endarterectomy?”

He looks at me thoughtfully. “Is your patient symptomatic?”

“He had a brief episode of monocular blindness.”

“And how stenotic is he?”

“Don’t know yet.” I shrug. “I just ordered the carotid ultrasound.”

He shakes his head at me. “You’re asking me for a consult and you didn’t even get the ultrasound yet? For shame, Jane. Call me when you actually get the study done. You don’t even know what you’re dealing with.”

“Say he’s at seventy-five percent,” I say.

“Seventy-five percent?” He nods. “Yeah, I’d do it. If he was otherwise a good candidate. ”

The last thing I want is to push Mr. Katz into a surgery. But at the same time, amaurosis fugax is a great indication for a carotid endarterectomy. Ryan knows it too—I’m sure he’ll do the surgery if the ultrasound shows what I think it will.

He hands me back the plant when we get to my car. He smirks at the way I struggle to get a grip on it. “Good luck with that,” he says.

I stick out my tongue at him, then feel embarrassed at having done something so childish. Leah must be rubbing off on me. Or else Ryan just brings out that side in me.

“So things are better with Pip, huh?” he says.

“Ben,” I murmur. “And… yes.”

“Okay.” He nods. “If he’s a jerk to you, let me know and I’ll go beat him up or something.”

I snort, imagining Ben and Ryan in a fight. They’re about the same size, but judging by Ryan’s biceps and the fact that my husband hasn’t been to a gym since before Leah was born, I think he might destroy Ben. Now, at least. In a year, that might not be the case.

“See you later, Jane,” Ryan says. “Be good.”

Be good? I’m always good. Well, except for that one time.

Getting the plant into my car is no easy task. It’s much too tall to fit on the seat, so I end up putting it on the floor, where it still doesn’t really fit. The position of the pot is extremely precarious, but I’ll just have to drive carefully. I recognize that my car will be just one short stop away from having dirt all over the floor, but that’s okay—maybe it will block out the faint odor of urine that still clings to the back seat.

After the plant is safely packed away in the car, I turn to watch Ryan walking to his car. I follow his steps, waiting for his body to jerk or for him to trip over his own feet. He does neither. He walks with certain, steady steps through the melting snow.

I’d think his diagnosis was a mistake if I hadn’t seen it myself.

I get in the car and drive as carefully as I can to Mila’s preschool. At every red light, I hold my breath and glance nervously at the plant. But by some miracle, I make it to the preschool with the plant still upright. It took about twice as long as usual, but I made it.

I grab the plant from the floor of the front seat and yank it out of the car with me. I make my way carefully across the parking lot toward my daughter’s preschool. I’m eternally grateful when another parent is coming out as I’m coming in and can hold the door for me.

“Mila!” I call out. “I bought a present for you…”