Terminally Ill

By Melissa Yi

Magic? Dr. Hope Sze steers clear of magic.
But when “Elvis the Escape King” chains and nails himself inside a coffin and lowers himself into Montreal’s St. Lawrence River, he can’t break free.
So Hope restarts his heart and saves his life. But now Elvis demands to know who sabotaged his stunt.
Hope hung up her amateur detective badge two months ago in order to tend to cancer patients on palliative care. The only cases she solves right now are case studies on pain and over-stuffed emergency rooms.
Which gets just the tiniest bit boring.
Hope could escape Montreal any day now. She could transfer to Ottawa to join her beloved ex-boyfriend, Ryan. No more unspeakable Montreal drivers and stymied medical care. No more working with the charming yet infuriating Dr. Tucker.
Hope the Escape Artist can afford to act generous. As parting gift to Montreal, city of festivals (and murderers), she could help Elvis out. Just asking a few questions won’t hurt anyone.
Right?
And so Hope plunges into her most unconventional and, possibly, her most terminal adventure yet. Where the magical art of escape and the dastardly art of crime vie for centre stage, and the better man may lose. Forever.

Publisher's Weekly review: "Montreal physician Hope Sze is looking for simple entertainment when she attends escape artist Elvis Serratore's show, but when Elvis nearly dies in mid-act, Hope's medical skills are available to save his life. She is less enthusiastic about his plea for her to use her detective skills to find out who tried to kill him by sabotaging his equipment. The subject of unwanted fame as a sleuth, Hope struggles with a too-complex love life, is faced with an ominous death at the hospital at which she works and becomes concerned about a young patient whose requests have deeply disturbing implications. She soon learns that if she does not seek out mysteries, the mysteries will seek her. The most recent installment in a series comprised thus far of three novels and a radio play, this novel demonstrates familiarity with the conventions of mysteries without being constrained by them and with the realities of Canada's medical world. Although the tone is light, the author is not afraid to introduce darker themes. The three intertwining mysteries and Hope herself provide a narrative by turns entertaining and insightful."

• Language: English
• Publisher: Olo
• Release date: Feb 1, 2014
• ISBN: 9781927341254

Melissa Yi

Melissa Yi is an emergency physician who lives with her family outside of Cornwall, Ontario. She publishes articles in the _Medical Post_ and further fiction under the name Melissa Yuan-Innes."One of the more impressive entries is Melissa Yi’s moving 'Indian Time,' about Mohawk Fred Redish’s painful attempts to visit his young sons under the care of his white mother-in-law."--Publishers Weekly"Indian Time" was named one of the best short mysteries of 2010 by criminalbrief.com

Book preview

Prologue

His breath whistled inside the coffin .

He heard the crowd cheering, although the plywood walls surrounding him dampened their yells. He could hear and feel the rumble of the crane lifting him and the coffin into the air.

He started to undo the chains on his wrists. Usually, those were the easiest.

He slid his wrists inward to gain a little slack, then twisted them to pop his wrists free.

The chains tightened on his wrists instead.

Meanwhile, the crane lowered his coffin into the St. Lawrence River.

Water splashed, and then he could hear the abnormal silence of the water surrounding the coffin.

He bent his wrists again.

The chains tightened once more.

Step two. He reached for the lock pick pinned on his left sleeve to jimmy the padlock on the chains. He always placed the pick on the inside cuff, where it would blend into his costume and he’d be able to reach for it blindly.

The pick was missing.

He reached for the second lock pick secured to his right shirt sleeve, groping the fabric of his wetsuit to make sure he would not mistake the metal pick for a seam.

Nothing.

His heart hammered faster than usual, and his hard, hot breath seemed to fill the coffin. The wood underneath his body felt cold and damp, like water was already seeping inside.

He refused to panic. He could escape the chains. He always had and always would. They had built fail-safes into his act, including a fake chain with a middle cuff that made it easier to undo.

Using his fingertips, he skimmed blindly along the chain on his chest, only to realize that someone had removed the trick middle link.

He was handcuffed, chained, and nailed inside a coffin. In a river.

With no escape.

On Hallowe'en.

1

Harry Houdini almost died in Montreal, on Hallowe'en, in 1926, at 1:23 p.m .

I swear I had nothing to do with it.

The magician named Harry Houdini was notoriously hard to restrain, let alone kill. Plus, he died over 80 years ago, and I don’t exactly own a time travel machine.

My name is Hope Sze. I'm a resident physician, which means I’ve finished medical school and I’m bumping my way through what used to be called an internship year. That means I'm supposed to give life, not take it. And just because I’m doing my palliative care rotation this month doesn’t mean everyone around me has to die.

But somehow, a lot of them do. Or come awfully close.

I’m getting ahead of myself. Possibly, I’m just losing my mind. Ever since I moved to Montreal and became the detective doctor who accidentally tracked down two killers, I’ve had to stop pretty regularly to ask myself, Hope, are you cuckoo for Cocoa Puffs?

This time, the saga started un-magically, on the day before Hallowe’en, in the bowels—I mean the emergency department—of St. Joseph’s Hospital, a community hospital tucked in the Côte-des-Neiges sector of Montreal, Canada.

Dr. Huot had assigned me the palliative care consultations in the ER, since she knew I wanted to finish family med and specialize in emergency medicine when I was finally, officially, The Doctor.

I glanced at the consultation note that Dr. Callendar had scribbled out the previous evening. His handwriting was so terrible, almost all I could make out was that the patient was 67 years old, which was quite youthful for my service, and that she was supposed to be in Hallway 19. I turned sideways to squeeze through a few areas where the stretchers were two abreast, but I ended up squinting at Hallway 27-30 instead. I swear, so many patients are crammed in the lobbies, it should be like a hotel where they have plaques marking Hallway 1-5 left, Hallway 6-20 right.

I could lend you my GPS, said a forty-something white man who pretended to hand me his shiny, black phone. He smiled like he meant it, making his eyes crinkle. I’ve got St. Joe’s on here. Maybe there’s an app for finding your patients.

I laughed. That would come in handy. We’ve got sheets of paper tacked to the wall denoting Hallway 8B and stuff like that, but I still get disoriented in all the beige corridors clogged by stretchers. A few of the administrators occasionally give up their offices for isolating patients with contagious diseases like MRSA and VRE, which just adds to the chaos.

The man held out his hand and said, Hi. I’m David Watson.

Hi. I’m Hope Sze, I said automatically, forgetting to add Doctor in front of that. Well, my name badge said it for me, and if I left my title out, maybe he’d assume I was a nurse and let me chase down Madeline Campeau, my 67-year-old with metastatic ovarian cancer. Although I have to admit, I took his hand, partly to be polite, and partly because I’d rather greet someone who smelled subtly of cologne instead of used diapers.

He shook my hand firmly but not too hard. Now, you folks are great down here. No complaints. Mr. Watson’s grin widened, and he leaned forward like we were best buds.

I let go of his hand. Thanks, I said, even though he was buttering me up like the ocean’s last lobster. We folks were doing our best in the midst of a never-ending hurricane. I suppose in some books that’s great, even heroic, but the average health care patient will never see it that way. That goes double for a family member. I waited for the but.

It came. Mr. Watson added smoothly, But I know my mother, Mary Kincaid, would feel even better on the ward, in her own bed.

I nodded. Studies show that patients can seem completely demented in the emergency department—confused and unsure of the date or time of day, or the opposite, dramatically agitated and hallucinating—a shift that’s mainly caused by a change in environment. Get them returned to their own homes, and they’re back to playing cards at 10 a.m. and eating mushy beans at noon, no longer imagining that Great Aunt Helen is riding an elephant into the room.

I tried to smile comfortingly at his mother, who was lying on the stretcher, between her son and the wall. I could see the resemblance to her son, especially the blue eyes, and someone had taken the time to paint her nails coral pink. Her blanket and blue hospital gown had dipped, revealing her jutting collarbones and ribs. Her sunken cheeks, and especially her eyes, had a yellow cast. So she was jaundiced and admitted to internal medicine. It didn’t take a detective doctor to deduce that she probably had pancreatic cancer. My heart throbbed with pity. I wish I could help, Mr. Watson. But if she’s already been admitted, she’ll be up on the floor as soon as there’s a bed.

That’s the problem, you see. There aren’t any beds. That’s what they keep telling me. He took his mother’s manicured hand in his, very gently.

They’re right, I answered. In order to contain health care costs, governments and administrators look at the number of beds in each hospital. Each bed and each room needs a nurse, needs to be cleaned, etc.—so they just close beds, sometimes entire wards, sometimes hospitals. Nursing home beds are expensive. Better close them down, too. And what about psych wards? Ah, those crazies just need to go back to their families and they’ll feel a lot better. Shut down that hospital stat.

Voilà! Costs contained. But of course, people keep getting sick. Cancer, car accidents, psychosis, old age and other pesky things like that. So people keep coming to the emergency room, the one place in the health care system that never shuts its doors.

Then patients are too sick to go home, but there’s no room at the inn. So what happens?

They’re admitted, but really, they’re just clogging up the stretchers and hallways of the emergency department with nowhere to go.

I really want her to get a room, Mr. Watson said, patting his mother’s hand and smiling at me.

I wish I could help you, I said, smiling back, because that was about all I could do. I glanced at the consult sheet in my hand. I had to get moving, or I’d never make it back to the palliative care ward. On cue, my pager beeped.

I checked. The floor wanted me.

Mr. Watson said, I can see you’re a busy woman. Thanks for taking the time. He held out his hand.

I shook it, even though I don’t usually shake hands twice within five minutes. This time, I felt something rasp against my palm.

I jumped back, stifling a yell before I realized he’d placed something in my hand. I extended my fingers, frowning, and found myself $20 richer.

I can’t accept this, I said, handing the bill back to him. Sure, after four years of $17,000 med school tuition per year, I paused for a millisecond, but my first instinct was Nein. (I’d picked up a few words in German from someone named Tucker.)

Mr. Watson held both his palms up in the air and refused to accept it, while he flashed his white teeth at me. It doesn’t matter if you can’t do anything for my mother. I know how hard you work. You deserve a little something. Get yourself a coffee.

I shook my head. I could lose my license over this. I didn’t know that for sure, but I wouldn’t want a run-in with the College of Physicians and Surgeons over twenty bucks. I shoved the twenty at Mr. Watson’s chest. Thank you for the sympathy, though. What I do suggest is that you write to your Member of Parliament and tell them about your mother. I was parroting what a urology resident once said. It put the onus back on the patient to do something besides complain about our wait times. Although I have to admit, Mr. Watson wasn’t just complaining, he was literally putting his money where his mouth was.

Mr. Watson kept his palms up in surrender mode, shaking his head at the bill. Already been there, done that. I phoned my M.P., Tweeted him, and e-mailed him. No reply. My mother’s been here for over 24 hours.

I’m really sorry to hear that. I placed the bill on his mother’s stretcher. She watched us with wide eyes, still silent. My pager went off again: DUPLICATE. As I moved away, I said, What’s your mother’s diagnosis?

She’s got pancreatic cancer.

I’m sorry, I said. That’s often a death sentence because it’s the kind of cancer that gets picked up late.

She’s hanging in there. The doctors only gave her three months, and she’s still with us at six.

Wow, I said, suitably appreciative. Well, good luck, Ms. Kincaid and Mr. Watson.

He nodded. It’s been a pleasure meeting you, Dr. Sze. He pronounced my name pretty much right, kind of like Tse, which made the pleasure all mine.

Likewise, I said, waving at him. His mother’s mouth opened in a silent O, but she still hadn’t said a word.

Since we were barely outside the ER’s swinging doors, I hurried back to the nursing station to answer the floor’s page. One of the palliative care patients had fallen and Dr. Huot wanted to speak to me.

While I waited on hold, Roxanne, one of my favourite ER nurses, pushed her charts aside to make room for me on the desk. She was wearing a long-sleeved shirt with thin, multicoloured stripes under her pink scrubs, a sign that the weather was turning colder. I saw you in the hall. You met David Watson?

Yep. Is Mary Kincaid one of your patients? In Quebec, the default is for women to keep their last names after marriage. It makes it easier for the government to track you. But it means that all these little old ladies who come into the emerg, who have been calling themselves Mrs. Married Name for decades, are bamboozled when you refer to them as Mrs. Maiden Name. So I call them Mrs. Married Name and use Maiden Name on the paperwork.

Roxanne grinned, stretching out her arms into a V for Victory. Not today, but she was yesterday. David was in then, too. He works for a big pharmaceutical company, you know.

No, I didn’t know. The automatic doors flew open again, to let a patient in, and I glanced at Mr. Watson. He was now talking to Andrea, my other favourite ER nurse. Andrea shook her head and pointed at the door with her clipboard, but Mr. Watson kept talking.

Meanwhile, the phone came alive in my ear again when a nurse from the palliative care ward said, Sorry, we can’t find Dr. Huot, but she did say she wants to meet you on the floor at 1 p.m.

That’s fine, thanks. I have to page her after my consults anyway. I hung up and picked up my consult sheet.

Roxanne smirked at me. Did David give you money?

He tried. I felt weird thinking of him as David instead of Mr. Watson. He was probably almost as old as both of us put together. I paused. He gave you some, too?

Fifty dollars.

Fifty? He only gave me a twenty. I didn’t know if I should be shocked or offended.

I know. I could see the green from here. Her brown eyes laughed at me. But he had no idea who you were, so I guess he’s just trying everyone.

Did you take it?

She shook her head. We’re not supposed to take money from patients. But some people did.

I was trying to wrap my head around the scale of this. Some people. How many people did he offer?

Let’s just say…all of them.

My head spun. Was that what we were coming to? Canada was supposed to have a public health care system, where we were all treated equally, but in reality, did bribery win? Maybe not, since Mrs. Kincaid was still lying in the hallway. Who took the money?

Aw, I’m not going to tattle on them. You can use your detective skills there.

No, thanks! I said. Everyone wanted to tease me about detective-ing, no matter how much I insisted that a) I’d never earned that title, b) whatever sleuthing I’d done, I was now retired, or c) tried to laugh along with them.

But if they were going to ask me about it, maybe I should ask a few questions about Mr. Watson, take a peek at Ms. Kincaid’s chart...

No. I caught myself. If I were going to hang up my magnifying glass for good, I couldn’t start nosing around about bribes. I’d cut the curiosity right out of my brain. Cold Turkeys R Us. Just like an addict nipping my addiction in the bud. Ooh, that could be a bad marijuana joke.

This was getting complicated. I said, Can you point me toward Hallway 19?

Yeah. Go through the doors and take a right, not a left. She sifted through the mass of clipboards on the desk and shoved one at my midsection. You want to take a look at her chart first?

I glanced at the nursing notes for Madeleine Campeau and read, awaiting CT abdo, physio. Fentanyl patch? Exactly what I needed to know. You’re a genius.

I know. Her laugh cackled through the air, and I was smiling when I left the nursing station and took a hard right with the chart in my hand.

The woman in Hallway 19, abutting the waiting room, was asleep despite the fluorescent lights shining in her face and the blare of the nearby TV.

It’s about time, sniffed her family member, a grey-haired woman who wore a small fur hat, which seemed a little odd for the end of October while in the throes of global warming.

My cheap-o cell phone buzzed. I ignored it, but later, when I was writing up my consult, I checked the screen and found a message from Tucker: Residents’ lounge! 12:30.

My heart double-thumped in my chest, even though I told it to be quiet. By the time I reviewed my two consults with Dr. Huot and squeezed in ten minutes on the elliptical trainer in the hospital’s mini gym, it was 12:29, and I was running up the stairs to the residents’ lounge on the second floor, wondering if this was a joke.

Dr. John Tucker usually avoids the lounge’s blasting TV, abandoned trays of half-eaten pasta, and the yahoos known as our colleagues. But when I punched the code in the resident lounge’s door and flung it open, Tucker called from the TV corner, Hey, Hope. You made it just in time!

Shh! said Sébastien, one of the second-year family medicine residents, who was sitting on the edge of one couch, leaning so close to the TV that it looked like he wanted to meld with it.

Tucker rose to meet me. He squeezed my arm and pointed at the screen. His hand lingered on my triceps.

I tried not to notice the warmth of his fingers, even though I felt like his fingerprints marked me through my shirt sleeve and white coat. I didn’t want to push him away, but I didn’t want to draw back either. So I turned toward the almighty TV, along with everyone else.

An escape artist named Elvis was going to get chained up and nailed into a coffin before they dropped him into the St. Lawrence River, just south of Montreal.

2

My jaw dropped. Oh, no, he isn’t! I said, unconsciously channelling every black sister in a sitcom .

Tucker burst out laughing. I was wondering when that would get a rise out of you! He rubbed my back, circling my scapulae, before he let his hand drop.

I twitched my shoulders, trying to ignore how he made me feel. His eyes dropped to my chest, so I crossed my arms over my breasts in case I’d gotten what one of my friends called T.H.O.’s, or titty hard-ons.

Quiet! said one of the med students, a guy with thick brown hair and thicker glasses speckled with dandruff. We all leaned in to listen to the newscaster.

Elvis Serratore, the twenty-year-old escape artist from Winnipeg, will attempt to escape from this vampire-like experience on—you guessed it—Hallowe’en. Tomorrow afternoon, come down to the Old Port to see Elvis in chains at 1:23 p.m., the day and time that the great Houdini died 85 years ago. Elvis lives, at least for now. Back to you, Brian.

Isn’t that amazing? said Tucker. Don’t you want to take off and watch him tomorrow?

I stared at Tucker. His brown eyes shone brighter than a bride’s, and his short blond hair looked flatter than usual. Maybe he’d forgotten his hair gel because he was so thrilled about Elvis. He was still watching the TV, even though the news had switched over to the weather report: rainy and cold, thank you very much, although I suppose we should be grateful it wasn’t snowing yet in Montreal. One up for climate change.

The rest of the crowd whooped.

That guy is badass! said Sébastien.

A med student, a delicate-looking blonde, shook her head. More than that. He knows what he’s doing. My cousin is from Winnipeg, and she’s seen Elvis do the Houdini water escape from a tank. She almost cried. He’s not just some poser who’s doing a publicity stunt. She poked her plastic soup spoon at Sébastien’s face for the last two words, as if she wanted to enucleate his eyeballs.

I kept my distance from her. Med students with pointy objects can be dangerous, even if they don’t want to remove your eyeballs on their lunch hour. I pulled my sandwich out of the fridge while they argued whether or not Houdini was the best escape artist ever and everyone else should just give up now.

Even if Elvis knows how to get out of chains, I said slowly to Tucker, between bites of my cream cheese sandwich, how’s he going to get his hands and feet free fast enough to break open a coffin that’s nailed and chained shut, and fight his way out of a freezing cold river?

That’s the art of escaping, said Tucker, rubbing his hands together. Man, I love that stuff. I used to do card tricks, but this is big time.

I paused. Tucker was always surprising me. I had no idea he loved magic, but now that he mentioned it, I could see him as a little kid dressed in a miniature tuxedo, making a twitchy, pink-nosed rabbit appear in a hat. But I digressed. Not for me, I said, turning toward the door. The residents’ room was starting to feel oppressive, and not just because of the usual smell of rotting spaghetti.

Hope, c’mon. It’ll be fun. He followed me out the door.

So have fun. I bit into my Royal Gala apple. It was starting to go soft, but residents couldn’t be choosers.

As soon as the door shut behind us, he lowered his voice. Are you on call tomorrow for internal medicine? You could call in sick.

I stared at him before I remembered to chew and swallow. In case you’ve forgotten, I can’t afford any sick days. I had missed way too many work hours after not one, but two murderers, tried to off me.

Tucker had the grace to blush, although he didn’t drop his eyes. I didn’t forget. You’re not supposed to take any days off. But they can’t help it if you’re sick, right? And you’re on palliative care. Who’s going to miss you?

I shook my head. I can’t believe you’re saying this. I was on call on Sunday, not Saturday, but playing hooky was as foreign to me as diving in the Seychelles. As the palliative care resident, I covered internal medicine call on nights and weekends.

Hope, I’ve lived in Montreal my whole life, and I’ve never seen an escape artist. Elvis is only doing it here because Houdini almost died in Montreal. You know that story?

I shook my head again, checked my watch, and headed for the central set of stairs. I had six minutes to climb three flights and make it back to the ward to meet Dr. Huot, the palliative care specialist, at 1 p.m. Yeah, yeah. Something about a McGill student punching him in the belly. I never understood that.

Tucker pushed open the staircase door for both of us. He hit him before Houdini was ready for it. Houdini was lying on a couch and the guy started pummelling him before he even got up. Houdini was already in bad shape. He’d fractured an ankle when they were hauling him upside down in a pulley, for his water torture cell escape, so he was wearing a splint and a leg brace. I guess Houdini was slow to get up from the couch and didn’t have time to tighten his abdominal muscles for protection, like he usually would. He performed anyway that night, but he spent the intermission in a cold sweat. He still managed to finish his performance that night and the next, but when he took the train to Detroit—

I stepped up my pace on the last flight of stairs. Somehow, I didn’t want to hear about Houdini’s suffering, even though it was so long ago.

—he was in agony. Terrible stomach pain. He shook with chills for half an hour. Still, he was determined to perform his show. He climbed on stage with a fever of 104 degrees Fahrenheit.

I had to smile as I punched open the door at the fifth floor landing. Only a doctor would feel the need to clarify that it was Fahrenheit, even though it obviously wasn’t Celsius. Even Harry Houdini couldn’t survive if the water in his cells started boiling away at 100 degrees Celsius. Still, I was hooked on the story.

Of course, Tucker grabbed the door and stopped right there, door open, with a smirk bigger than any of Gaspard Ulliel’s, this French actor that one of my roommates used to crush on.

So what happened? I said to Tucker. Belatedly, I lowered my voice, since we were less than five feet from three different admitted patients’ doorways.

Tucker grinned and leaned against the wall, ignoring the soiled laundry bins lined in the hallway across from us. He performed. Collapsed at intermission. But he managed to get up and finish the show before he blacked out again. Tucker paused. The next day, they took out his appendix. It had ruptured. They gave him an ‘experimental serum’ and opened him up again on post-op day four, but sepsis swarmed all over him. He told his brother, ‘I can’t fight anymore.’ And he died on October 31st, at 1:23 p.m.

I said stupidly, I thought he died in Montreal.

Nope. A good ten hours away, in the motor city. But a lot of people blame Montreal, because the guy who punched him here might have ruptured his appendix.

I frowned. The appendix is a long, skinny tube of flesh attached to the large intestine, but it often gets blocked and infected, either stoppered up by a fecolith (a tiny ball of poo) or lymph tissue. I’ve never met or heard of a patient who ended up with appendicitis after trauma, although I hadn’t looked it up, either. Do you think that’s likely?

Tucker opened his mouth, but before he could answer, I glanced behind the bulky palliative care secretary, whose desk faced the hallway, and spotted Dr. Huot sitting at the nursing station table. It’s bad news if the staff beats you back from lunch, so I whispered, Gotta go.

Knock ’em dead, he said, which was kind of a bad word choice, considering all the murders I’d been mixed up in, so I made a not-quite-obscene gesture at him and took a seat at the table.

Dr. Laurence Huot set her fountain pen beside the chart. It’s good to see you, Dr. Sze. She beamed at me, pleased with her own wit: most people pronounce Sze just like the word see.

You too, Dr. Huot. I wished I’d brought my water. I felt dehydrated and over-examined by Dr. Huot’s hazel eyes, which were magnified by her tortoiseshell glasses. I was trying not to say anything about her haircut. Overnight, she’d gotten her prematurely grey hair trimmed into a severe bob just above the ears. The bangs, cut razor straight well above her eyebrows, reminded me of the times I’d tried to trim my own bangs.

We have a few minutes to do some teaching about some common problems in palliative care, she said in her moderate French accent. What is your approach to constipation? Every time she asked a question, she punctuated it with a radiant smile, like the angels were touching down in front of her, which feels a bit weird when you’re talking about laxatives.

I avoided her eyes. Well, you know. I usually use Colace. I know it’s not that effective. But almost everyone tolerates the ubiquitous translucent red capsules.

She beamed at me like I was a particularly clever and adorable baby. Docusate sodium! The stool softeners. She wrote that down on a blank piece of paper. Now. Which other ones do you use?

Metamucil.

She glowed at me. Wonderful. Psyllium seeds and other fibres, such as methylcellulose and calcium polycarbophil, can work well, as long as the patient is well-hydrated. Which other medications do you prescribe?

Senekot.

She nearly chortled with glee. The stimulant laxatives can be very effective, although chronic use can be associated with hypokalemia. What else?

Um, lactulose?

This is a different class. Lactulose is a sugar, so it draws water into the bowels through osmosis. She wrote that down too, in big, loopy handwriting. Slowly, painfully, we made our way through the classes of laxatives. Now, don’t forget basic bowel hygiene. The most important things are to increase fluid and fibre intake. Have you ever noticed, in the morning, that after you eat, you must go to the bathroom?

Now that she mentioned it, absolutely. I stared at her with round eyes.

The gastrocolic reflex, she said, writing the words with a fond and tender smile, as if she’d rescued a newly born kitten. Now, you may keep this paper for your files.

Um. Okay. I don’t keep too many papers around, but I could transcribe the notes on to my phone.

Then you may go see our newest patient, Mr. Bérubé. He is a patient diagnosed with end stage lung cancer.

Thank you, Dr. Huot.

"No, thank you, Dr. Sze. She bent over the wheeled wire rack of patient charts and handed me Mr. Bérubé’s. When you finish, we can review your case and drink fresh coffee." She bestowed one last beatific grin on me as she pointed at the teeny staff room on the south side of the nursing station, which was barely big enough to hold a coffee pot and a sink, but somehow they’d managed to cram a microwave and two chairs in there as well.

That’s very kind of you, but I don’t drink coffee. I’ve never had staff offer me a beverage. More proof that Dr. Huot was not of this world.

I read the chart quickly. His small cell lung cancer had spread to his liver, bones, and brain. His wife had brought him to the emergency room complaining that he was up all night and prone to falls. One of the emergency doctors, Dr. Chia, had diagnosed him with a low sodium caused by his cancer, so we were slowly correcting his sodium levels, as well as employing the pain management and constipation remedies I’d started learning in my first week on palliative care.

I nodded at Ricky, the palliative care secretary, as I took a right out of the nursing station. She pushed her glasses up her nose and picked up the phone, ignoring me.

I have a terrible sense of direction, but even I can’t get lost on the palliative ward. There are only eight beds, but each room is private, a luxury in this day and age. Palliative care takes up one small wing of the fifth floor, which is otherwise swallowed up by the active internal medicine ward.

I headed to room 5656, on the left side of the hallway, just past the central staircase that Tucker had recently run back down. For a second, I braced myself for Tucker to throw open the staircase door and say, Boo! but I guess he had to get to his clinic, because I passed by unmolested.

I pasted a smile on my face and