Terminally Ill Read online

  “Well, they’re more likely to give that. We certainly can’t do it in the FMC.”

  I rotated slowly to look at him. Sweat matted a few curls to his temple, and he was breathing a little fast from his performance. He smiled at me while I said, “Do you really think any gynecologist is going to do a conscious sedation on her for a Pap smear?”

  “No,” he admitted, “but if they do decide to do it, they’ve got access to an OR.” He shrugged. “You’re welcome to try and do the Pap yourself, Hope. I’m just telling you what I would do.”

  I liked the man. I mean, he was singing opera in the FMC on a Friday afternoon. But I had a bad feeling about this that went beyond “Pap tests are yucky.” Still, I slowly walked around the room for a referral form and began filling it out.

  Stan said, “Atta girl. One of these days, you’re going to figure out how to make your life easier.”

  I stopped laboriously copying out my patient’s date of birth and address, since they were too cheap to buy us an addressograph that would enable us to stamp the patient’s information on the form. “What are you talking about?”

  Stan grinned. “You know. Instead of walking uphill both ways in the snow, you could just say, ‘Oh, someone just offered me a ride. I’ll take it.’” He sighed when I still looked blank. “Isn’t that what the Tao of Pooh is talking about? You should go with the flow instead of fighting all the time?”

  “I wouldn’t know. I’ve never read it,” I snapped.

  “You should. It’s a good book.”

  Dr. Levine called out, “Now, now, Stan. Someone’s got to stand up for the poor and the indigent.”

  “That’s right, Dr. Levine,” he shot back, but under his breath, he added and said, “As long as it’s not me, as soon as I’m out of the FMC.”

  I couldn’t think with all the hoo-hah going on in here. I finished writing up the slip and walked back in the room, wondering if I was just imagining everything.

  I threw open the examining room door. Kaitlyn gasped and glanced at me, terrified, from where she still perched on the examining room table. Kameron crossed her arms and tapped her foot, glaring at me.

  No. I hadn’t imagined the weird vibe here.

  Who was having sex with Kaitlyn? Was it the same person who might have sex with Kameron soon?

  My first instinct was to run and call Children’s Aid, or whatever the Montreal equivalent was. But if the sisters would tell me exactly what was going on, I’d have a stronger case.

  I smiled at Kaitlyn, even though tears stung my eyes. I blinked extra hard and said, “I’m going to refer you to a gynecologist, in case they’re able to do conscious sedation.”

  Her lower lip wobbled and her eyes slid away. “Thanks.”

  “Thank God,” Kameron burst out. “I was, like, going to die of old age before you got back here.”

  I ignored that. “It seems like there’s a lot of stuff going on in your lives. Do you think you two could come back for counselling?”

  “No way,” Kameron shot back. “Just give us the pills, and we’re out of here.”

  I held up my finger. “I’ll look. Do you think you could come back in two weeks, when our drug rep might have some more for you?” I didn’t quite cross my fingers behind my back, but I had no idea when, or if, drug reps bothered to make it to the FMC to drop off free samples.

  “We can’t miss school,” said Kameron.

  “Yes, we can,” Kaitlyn said suddenly.

  Kameron goggled at her.

  Kaitlyn said, “If it’s important.” She held my eyes for a second before she glanced back down at her lap again.

  This was almost too good to be true. Maybe I had made some inroads after all.

  Kameron stood up, fisting her hands on her hips. “Oh, great. You can’t be serious.”

  Kaitlyn shrugged without meeting Kameron’s eyes. “You don’t have to come.” Up until now, she’d acted so meek, so much more like the younger sister.

  “I’ll write you a note for school,” I said, eager to build on this fragile bridge, just as Kameron said, “Oh, I’m coming, all right. You better believe I’m coming.”

  “Is there anything else you want to tell me? Anything else going on at home, or at school, that you need help with?” I made eye contact with Kaitlyn.

  She dropped her eyes immediately and swung her legs. She banged her heels against the metal examining table, making a hollow boom. She jumped before she shook her head in a violent no.

  I turned to Kameron. After a long moment, she shrugged. “Whatever.”

  Now there’s a ringing endorsement.

  “I need to check on one more thing,” I said.

  Kameron rolled her eyes. “You might be able to find another box of pills hidden in a drainage pipe somewhere?”

  “Something like that,” I said. “Hey, are these the right phone numbers in your chart?” They said the home number was right, and neither of them had cell phones. They’d only listed one next of kin, Verna Rosenberg, with the same home number. I tapped their mother’s work number. “That’s our hospital number. She works here, at St. Joe’s?”

  Kaitlyn nodded without looking at me. Kameron flashed me a grin that was more teeth than lips and nodded her head.

  Her smile bothered me, but triggered another memory of her not looking quite as cheery. “Is that why you came to church last weekend?” I asked Kameron.

  She jerked her head up, startled now. I said, “I saw you in Peter the Preacher’s video. You were with a man in a leather jacket. Is that your father?”

  Kameron’s blushed progressed all the way down to her upper chest before she managed to say, “No, that’s Jeremy.”

  “Oh. Well, it was nice of Jeremy to take you to church at work with your mom, anyway. I guess he’s a friend of the family?”

  The breath hitched in Kaitlyn’s throat. When I turned to look at her, she’d grown very still, but she didn’t lift her eyes to mine or make any other sound.

  Kameron crossed over to the window. The sky was cloudy with rain. I didn’t speak, and finally, she mumbled, “Our mother’s boyfriend.”

  Huh. “What’s Jeremy’s last name?”

  “Theroux,” said Kaitlyn.

  I made sure she spelled it out for me before I headed back into the FMC conference room, Dr. Levine was packing up his papers and humming under his breath. Stan was scribbling notes in what was no doubt his final chart, since he was the first one out the door, any given day. Omar smiled at me from where he was filling out his patient records.

  Dr. Levine looked over his shoulder at me. “Hope, I’ve got to get hopping. I’ve got a date tonight. We’re going to the opera.”

  “Dr. Levine, I’m so sorry, but I have a bad feeling about the two girls in there. I think they’re being abused, probably by their mother’s boyfriend.”

  “Oh, hell,” he said, and sank down into his seat.

  “I’m calling Children’s Aid, or whatever it’s called in Montreal.”

  “The DYP. Director of Youth Protection,” said Dr. Levine, like he was on autopilot.

  “I don’t have a strong case, but I don’t like the story. The younger one asked for the pill, even though she’s a premenarchal virgin. The older one won’t tell me who her partner is. She’s under the age of consent unless it’s someone less than five years older than her, and she’s petrified to have a Pap test.”

  Dr. Levine rubbed his forehead and nodded. “That’s good enough for them to investigate. They’ll decide what they want to do. Could I have the chart?”

  I hadn’t had time to write much, but he scanned it. “That’s funny. The mother’s work number is St. Joe’s.”

  “I know.”

  Dr. Levine shook his head. “Well, our duty is to report and activate the DYP. They’ll decide about interviewing them and gathering information. Do you want me to come in to tell the patients what’s going on?”

  I looked at him. To me, he was a teddy bear of a man, maybe fifty years old, a bit o
verweight, tanned, with lots of laugh lines. To them, he might represent the enemy, assuming Jeremy was around the same age. “I think I’m okay. I appreciate the support, though.”

  It turned out that Dr. Levine wasn’t too familiar with child abuse reporting. “Let’s check online,” he said, which was code for “I have no clue,” but I was down with that. Dr. Callendar would have made it seem like my fault. Through the government website, I saw that yes, indeed, Quebec’s child protection was lined up through different “youth centres” or Centres jeunesses scattered across the province and within the city of Montreal. By now, I was getting used to this decentralized/fragmented care. But when I found the actual provincial website, first of all, it was in unilingual French, so I was glad that I understood the language. Secondly, it broadcasted its mandate and mission and even its library services in the sidebar, but I had to go to submenu to find out how to actually report a child, and then it depended on the area of Montreal. By the time I’d navigated that, Dr. Levine frowned and said, “I think for English Montrealers, you can go through Frukshank.”

  “Frukshank?” I repeated. It sounded like a swear word to me.

  He smiled. “Try searching for Frukshank Montreal. I bet that’ll do it.”

  This time, the website was in English and I quickly spotted the “NEED HELP?” bar at the top and bottom of the webpage. There, they listed a single phone number. Phew. I called it.

  “Frukshank Child and Youth Services, how may I direct your call?” said a wispy woman’s voice.

  “I’d like to report a potential case of child abuse.”

  “I’ll page one of our agents, who will get back to you as soon as possible. Could I have your name and phone number, please?”

  “I’ll give you two.” I gave both the phone extension and my pager, just in case the agent was slow getting back to me.

  I hung up. Stan shoved his last chart aside, stretched, and shook his head. “You’re always getting into trouble, eh?”

  I stared at him for a second. “I think these children are in trouble. That’s our job, to report it.”

  He held up his hands. “I’m just saying. You know how some people are sh—uh, magnets for trouble?”

  “Yes,” I said. My tone was not inviting. I did not look at Dr. Levine, not wanting to attract his attention to Stan’s take.

  “Well.” Stan spread his hands out, scooping the air with his big palms like that said everything.

  “And you’re not?” I said.

  He shook his head. “I’m the opposite of trouble. I see the patients, I do my best, and then I’m home free.”

  “And if you saw a potential case of child abuse?”

  His eyes flickered toward Dr. Levine, but he didn’t actually turn to look at him. “I’d report it. But I wouldn’t go looking for murderers on my day off.”

  “You’ve made that very clear.” I remembered the time I asked him for help with the first murder, and he told me to call the cops instead.

  “Look. I’m just saying, Hope. There’s a fine line between helping people and getting enmeshed in their troubles, you know what I’m saying? I’m just looking out for you.”

  “Thanks,” I said, and turned away. It hurt that Stan, who’d always been…well, not a big brother, exactly, but someone who kind of pointed me in the right direction—okay, a big brother figure—was telling me it was my fault. I knew it kind of was. I’d gotten a few e-mails and Facebook messages and a call from my med school friend, Ginger, basically saying, WTF? Aren’t you tired enough from your residency without risking your life twice?

  But this had nothing to do with murder. It was my job as a doctor, and maybe as a citizen, to step up. One of the surgeons at Western had pointed out that before ultrasound and CT, we used to take patients to the OR for appendicitis and, when we opened them up, seven out of ten actually had appys. So we were overcalling it, but that was better than missing a few, letting them rupture and cause pelvic abscesses. We had to overcall instead of undercall.

  Now I had to risk overcalling instead of undercalling child abuse.

  Tori’s quiet voice cut through the room. “Stan, you know it’s our duty to report it if we have any suspicion of child abuse.”

  I glanced up at her, grateful. I hadn’t heard her enter the room, but now she stood in the doorway, holding a chart, before she closed it behind her. Tori does not mess around, but when she speaks, people tend to listen. Dr. Levine was nodding in agreement. He said, “If you didn’t report it, Hope, I would have to.”

  Stan smacked his chart on the table and made a big show of pulling on his lined windbreaker. “I’d report it. But if anything else happened—if the girl ran away, if she asked for help defending her against the stepfather—I wouldn’t start running around with a gun, you know what I’m saying?”

  “Loud and clear,” I said coldly. I’ve never touched a gun in my life.

  “Good work, doctor,” he said, and stomped out of the conference room. He slammed the door behind him.

  “I think you’re brave,” said Dr. Levine, before Stan’s footfalls had faded down the hallway.

  I turned to look at Dr. Levine, startled.

  “It’s much easier to stand on the sidelines and point your finger instead of jumping into the fray.” He smiled faintly. “You wouldn’t catch me doing it.”

  Brave. I thought about that. It sounded a lot better than stupid. “Thank you, Dr. L.”

  “No, thank you for standing up for the people who have no voice.”

  I considered that, too. Of course the murdered people had been silenced, and children—well, they have voices. Kameron is really quite loud. But does anyone listen to them? My spine straightened. “You just made my day.”

  “You’re saving people’s lives,” he said, so softly that I almost wasn’t sure I’d caught it properly.

  It’s funny. When I dreamed about becoming a doctor, I imagined doing CPR and shocking people’s hearts. I knew about the boring bits like taking blood pressure and writing prescriptions. I considered delivering babies, providing abortions, and even pronouncing people dead. But I’d never pictured myself intervening in a case of child abuse.

  Dr. Levine finished flipping through the other pages of my nearly blank chart. “Are there any other children at home who might be at risk?”

  I blanched. “I never asked. I’d better go do that right now.”

  Dr. Levine tried not to look at his watch. I felt guilty. “What time is your show?”

  “We don’t have to be there until 7 p.m., but I rented a tux. I have to go pick it up.”

  I tapped my fingers on the table. I’m no good at sitting around doing nothing, and last time, Kameron had done a runner. “Let me tell them what’s going on. If Frukshank calls back here, can you forward the call to my room?”

  Dr. Levine cracked a smile. “Will do.”

  I made a detour before I walked back in the examining room and shut the door. “Okay. I have one more question. Do you have any other brothers or sisters or other children at home with you?”

  They exchanged a look. “Yeah. Our baby sister,” said Kameron. “Why, what’s up?”

  I made a point of sitting down, since I was breaking the worst news around. “How old is she?”

  Kameron shrugged. “Well, she was born on Valentine’s Day, so that’s…what, almost nine months? Yeah. Something like that.”

  I closed my eyes for a second. A baby. A baby at home. “Is anyone hurting her?”

  Kaitlyn twisted on the examining room table, making the paper rustle again. I turned toward her, but started to wind a lock of hair around her finger, blocking her face.

  “What are you saying?” Kameron burst out.

  I turned back toward the louder sister. “I think you know what I’m getting at, but there’s no easy way to say this.”

  “You’re a dork?” burst out Kameron. “You’re wasting our time? We just want the fuckin’ pill.”

  I handed Kaitlyn the box of pills I’d shove
d under my arm. “That’s the good news.”

  “Amen to that!” said Kameron, standing up. “C’mon, Kay, let’s go. She can’t hold us here anymore.”

  “What’s the bad news?” said Kaitlyn, breaking her silence. She didn’t move. The way her big, pale blue eyes tracked me, I felt even more guilty, even though this was the ultimate “I’m doing this for you own good.” I took a deep breath before I said, “I’ve paged the Director of Youth Protection, the Frukshank Centre.”

  “You’ve got to be kidding me,” said Kameron.

  Kaitlyn burst into tears and covered her face.

  Kameron shook her elbow. “We outta here. C’mon! Kaitlyn. Katie. Kay-kay. We gotta go!”

  Kaitlyn cried and cried.

  The phone on my desk rang. I picked it up. “Dr. Hope Sze.”

  “Did you call Frukshank Child and Youth Services?”

  “Yes.”

  “Do you have something to report?”

  “Yes. Two girls and a baby. I’m afraid they’re being abused.”

  “How old are they?”

  “Fourteen, thirteen, and nine months.”

  “All right. Well, let me take the details. You’re a doctor?”

  “Yes. I’m a resident doctor in family medicine at St. Joseph’s Hospital.”

  Kaitlyn burst into a fresh round of tears. Kameron yelled, “This is bullshit!”

  “Excuse me, I can’t hear you,” said the woman.

  I winced. “I’m sorry, I’m with the patients right now. Could I call you back from another line?”

  In the seconds it took me to get off the phone with Frukshank, Kameron dragged Kaitlyn off the examining table, gave me the finger, and slammed the door shut behind them.

  I rushed down the hall, but I could already hear them clattering down the stairs. I couldn’t force them to stay. The smart thing to do would be to head right back into the office and call Frukshank back.

  But one thing stood out in my mind.

  I’d asked if anyone was hurting the baby, and they hadn’t answered.

  I didn’t even know the baby’s name.

  I hesitated, but the baby’s name decided me. I sprinted down four flights of stairs, sailed down the hall, and surveyed the parking lot for two brunettes.