Flowers in Her Hair

By Joseph Dixon

All her life, Lisa MacLean has been doing the right thing. Its just a matter of time before she has to pay the price.

Brilliant and successful, beloved by her patients, Dr. Lisa MacLean finds herself alone at thirty-six, spouseless and childless in an empty house in Northern California. Reeling from a bizarre lawsuit and a recent breakup, Lisa drifts through work at a drafty San Francisco hospital, visits old friends in the pot farms and vineyards of Mendocino, and drinks herself to sleep in the swirling fog of Marin County.

Redemption comes when Lisa opens her heart and assembles an unexpected and eclectic family: an orphaned six-year old girl; a mangy dog abandoned by her owner; and a nameless busboy who seduces Lisa with globetrotting stories. Reconnecting with her hippie backwoods roots and her ailing father, Lisa watches the odd pieces of her life fit together like a jigsaw puzzle, forming a picture she never expected.

• Language: English
• Publisher: iUniverse
• Release date: Jun 24, 2013
• ISBN: 9781450281089

Joseph Dixon

Joe Dixon is a writer and physician in California. Dixon’s experiences with the idiosyncrasies of two worlds-dysfunctional hospitals and the fog-drenched woods of Northern California-inspires and informs his writing.

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Flowers in Her Hair

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Joseph Dixon

iUniverse, Inc.

Bloomington

Flowers in Her Hair

Copyright © 2006, 2013 by Joseph Dixon.

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher except in the case of brief quotations embodied in critical articles and reviews.

This is a work of fiction. All of the characters, names, incidents, organizations, and dialogue in this novel are either the products of the author’s imagination or are used fictitiously.

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Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

ISBN: 978-1-4502-8109-6 (sc)

ISBN: 978-1-4502-8107-2 (hc)

ISBN: 978-1-4502-8108-9 (ebk)

iUniverse rev. date: 06/07/2013

CONTENTS

1

Not a Good Day

An Outrageous Gesture

Unexpected Kindness

Flowers In Her Hair

2

A Giant Sucking Sound

Little Crab Holes

Like Some Crazy Woman

Like Any Respectable Mother

3

A Big World

The Weirdness Of Lisa’s Life

The Coyote’s Only Reality

Someone’s Happy Family

The Girl Is Mine

On The Outside

He took a deep breath. Pure gold. He was back . . . back where he had started. He sat on the ground with his back against a thick tree trunk, took out a cigarette, and decided that this was as good a place as any to spend the last weeks of his life. Better than most, really. Jeff lit up, mixing the nicotine poison with clean West Marin air, and filled his lungs until he thought they might burst . . .

1

Not a Good Day

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In California, the leaves never fall, the trees never change, but everything else does. Everything changes except the trees. Lisa kept whispering the words to herself, trying to remember who had said them. She drifted down a sterile corridor with the speaker’s name on the tip of her tongue, and wandered absentmindedly into a large room. Lisa slowly flipped her fingers along a row of folders. A row of jackets, to be precise—film jackets crammed into the film library of the radiology department where Dr. Lisa MacLean worked: a dusty, overstuffed room in the back of a small, overstuffed department in the middle of an old, drafty hospital in San Francisco. She consulted the number scribbled on the battered scrap of paper in her hand and ran her fingers along another row of jackets, searching. Hundreds of thousands of films—broken ankles and brain tumors and strokes and mammograms—and she just wanted one folder.

Except that she kept tripping on her new shoes. The rubber soles made embarrassing squeaking noises on the over waxed floors, so she tried to walk lightly and softly, which was impossible. Twenty years earlier, little Lisa MacLean couldn’t even walk and chew gum; now she could navigate a 14 French catheter into the femoral artery, up the aorta, and into a tiny renal artery with great skill. But her clumsy feet still sent her tripping and sliding as she searched.

But she found her folder: moderately full, a bar code on the cover, and a series of scribbled diagnoses inside. She snatched it out quickly and deftly and spun it in her hand, causing her to truly slip, cartoon-like. As Lisa skidded across the floor, the folder jumped right out of her hand as if jinxed by contact with her skin. X-rays spilled across the floor, spreading under cabinets, and right up to the toes of the file clerk Juanita.

Dr. MacLean, why don’t you let me look for you? asked Juanita, typically exasperated.

Lisa smiled her crooked smile. I didn’t want to trouble you, really.

Juanita handed a stray film back to Lisa. That’s Dr. Sorrento’s jacket, isn’t it? Filthy bastard, I’m glad we don’t see him around anymore.

Juanita, Lisa answered, he’s very sick you know.

Hmm. Juanita went back to sorting files. He won’t be missed around here, she said over her shoulder.

Lisa scooped up the last film from the floor. A lost X-ray, she knew, was a lawsuit waiting to happen.

Clutching the folder close to her chest, Lisa walked, louder now, back to her office. Her office was really just a small desktop that held a few view boxes and three tiny drawers. She shared the room with two radiology colleagues. Lisa stuffed the torn paper into the jacket cover and threw the folder under the desk, eager to return to a stack of ultrasounds awaiting her interpretation. She hated falling behind, and she was determined to catch up quickly—except that the phone was ringing and she had this damn meeting with the lawyers downtown in two hours and it was not going to be an efficient day. The phone wouldn’t quit, so she picked it up. Dr. MacLean here.

Got an OB case for you in room two.

Lisa stared at her stack of work and dreamed briefly of Duke’s Barefoot Bar on the beach in Oahu before hurrying to room two, where she knew Jennie, her favorite ultrasound technologist, would be waiting. As she approached, Jennie was hanging fresh films from the printer and ranting into a phone. So you’re saying that Joey doesn’t get it at all, is that it? said Jennie. She stuck her tongue out, then covered the receiver and whispered fucking teachers to Lisa before resuming: "Well, maybe that’s crap. Maybe you don’t get it."

Lisa smiled and watched the action. Jennie had an endless reserve of venom stored just to protect her children. Right behind Jennie’s teeth, Lisa thought, two little glands had sprung up when the twins had popped out. Lisa had seen Jennie defend her kids against stupid teachers and an absent father for years.

I have to go. We’ll settle this tomorrow. Jennie hung up and exhaled slowly, fangs receding.

She looked up at Lisa, who grinned and asked, How are the kids?

Don’t ask. How’s the boyfriend?

Lisa lost her smile. "Don’t ask. Really, don’t ask.

Inside the adjacent, small, cold room a patient lay on a gurney. The patient rubbed her pregnant belly and stared at the ceiling, practicing her breathing. Jennie leaned over her and introduced Lisa as El doctor.

As Jennie scanned, ticking off the fetal organs in order, Lisa stared at the screen. The probe moved across the patient’s abdomen in waves, the fluid motion revealing the fetus in segments. Thoracic spine, lumbar. As the images flowed, up and down and over, placenta anterior, cervix. Lisa watched the little head move and the tiny fingers flex, and she fell into a dreamy trance. Thirty-four weeks of life floated and kicked and slept soundly with a wisdom Lisa envied. Four-chambered heart, kidneys. There was great comfort in this. Face, lips. Lisa got a direct view of the face, frozen for a moment and facing toward her. A little hand drifted up into the image and flexed its fingers. Waving. Looking right at Lisa from the dark wetness and waving. And then the probe moved on, femurs, three-vessel cord. Lisa felt the corners of her mouth rise slightly, her eyes glazed, and her precise mind wandered again.

Lisa?

Hmm.

The images stopped. Jennie looked over at her. You’re smiling again. Every time lately, you start smiling.

Lisa smiled harder. He waved. Didn’t you see it?

Jennie returned to her exam, the images started again. He’s a she, and it’s called fetal tone, not a wave. Bladder, liver. Jennie continued, When are you going to get it over with and have one of these yourself?

The words came out, effortlessly, carelessly. I can’t.

The images froze again, right on the fetal heart, steady and strong. She had barely whispered… so quiet… but Lisa couldn’t believe it. No one knew, not even her mother, and now Lisa had told Jennie, of all people. Lisa stared straight ahead at the heartbeat. Ventricles and atria. Relentless, with such a long road ahead. She felt Jennie lean over to her. Just for a second, Jennie’s temple on Lisa’s shoulder, and Lisa closed her eyes. Then, just as quickly, Jennie pulled away the probe and wiped the patient’s abdomen, speaking in Spanish, promising a picture to take home.

Lisa hurried back to her desk, shaking a bit. Not a good day. Jennie was there in a moment, avoiding Lisa’s eyes, handing her the films and paperwork. Lisa closed the door and leaned back, looking up at Jennie.

Don’t look at me like that, Jen.

Jennie’s face scrunched, her pudgy Latino features crinkling. Oh, shit, Lisa, really?

Yeah, really. And while I’m blurting everything out, let’s finish it. You can stop asking about Frank. Jennie’s face changed. Her ears actually perked. I haven’t seen him in two months.

No, get out! Jennie’s mouth fell open; she looked properly shocked.

You’re a big fat phony, Jen! Just go ahead and let that smile loose. You never liked him… no one did.

Jennie grinned. Of course I didn’t like him. Of course no one did. He’s an ass. But why haven’t you seen him?

Lisa closed her eyes. Because I kicked him out. It’s a long, messy story, and I have all this work to do and this stupid meeting with a bunch of lawyers.

Jennie’s eyes widened. You’re being sued too?

No, I’m not being sued. Lisa hesitated. At least I don’t think so. Actually, I’m not sure. I haven’t had time to even look at the films. I suppose they just need my testimony about a chest case. In fact, she had no idea what they wanted from her.

You need to get out. Jennie nodded. Yes, you need to go out with your friend Jen and have a few drinks and relax. I know, I’ve been there.

Lisa smiled. I know you’ve been there. You’ve told me a thousand times. What about the twins?

Don’t worry, Mom owes me. I went Christmas shopping for her boyfriend’s grandkids.

Lisa and Jennie shared a look. Believe me, doc, you don’t want to know.

What exactly did we do wrong, Jen? Lisa asked. Jennie mussed her hair. Okay, we figure it out tonight. Lisa turned back to her work and thought again about suntan lotion and rum.

Three hours later, a very nice man held an elevator door open for Lisa. He might not be so nice, of course—Ted Bundy was polite too—but Lisa gave him her crooked thank you smile as she bumbled into the elevator. She held the folder awkwardly in her right hand as she brushed her bangs from her face with her left. Meeting with lawyers was always a bit like meeting with the school principal. Her appearance was suddenly important to her. Straightening and taking a deep breath, she strode purposefully through the elevator door and went straight to a large, polished marble desk.

A beautifully dressed woman sat with perfect posture; she looked up and gave Lisa a perfunctory smile. May I help you? She wore reading glasses on the end of her nose, and a wireless headset. She had a tight brunette bun and impossibly perfect skin. The smile evaporated.

No, I’ve got it, Lisa answered, assuming the woman was referring to her awkward grasp of the film jacket. Her homely brown envelope, with ugly scribbles on the outside, smelled of dust and formalin. The woman before her smelled like a Vogue magazine. She looked like a model from Vogue too—Lisa recognized the blouse from a Nordstrom’s catalogue in her office. I’m Dr. MacLean. I have an appointment.

A brief smile from Ms. Nordstrom. Of course. Have a seat.

Lisa sat as elegantly as the film jacket would allow. Lovely paintings hung on the walls. The glass coffee table was spotless. And it was quiet. You could hear the purr of the air coming in through the vents in the ceiling and the bubbles in the built-in wall aquarium. Lisa crossed her legs and waited. She had no reason to be intimidated. She was the expert; they wanted her input. She was a successful professional, with her own lovely house, her new dream home. Her first house, after years of renting and school debts. A house on a hill, just across from foggy San Francisco, with water views and cool breezes. And lots of empty space.

She recrossed her legs and admired the faux antique clock adorning the color-washed peach walls that hoped to resemble those of a Tuscan villa. Lisa was developing an eye for interior design as she scrambled to develop a sense of her own style. There had never been time to think about style during long hours in emergency rooms and school libraries. After endless years of obsessive studies and work, she’d had no idea what to do with a house. But she had always known where she wanted to live. When she was a child, her parents would drive Lisa and her two siblings down from their farm in Mendocino to visit the city. A weekend of civilization, her father called it. Five of them, crammed into a small Chevy Nova, dressed like gypsies and talking to the hippies in Golden Gate Park. Lisa always insisted on a ferry ride to Marin county, and, when the tiered hill homes of Sausalito came into view, she would point her finger at the highest home and insist, as a mantra: That’s where I’m going to live.

Her father, holding her, would look down, all salt-and-pepper hair and Cassavetes face, and say, You have to work really hard to live there.

Lisa would stroke his razor stubble—she loved his stubble—and insist again: I always work hard, and I’m gonna live here and have only one kid in my family so there won’t be so much fighting.

Her father would grin and answer, But fighting is half the fun.

Dr. MacLean?

Lisa blinked and looked to her left. Ms. Nordstrom was gesturing. They’ll see you now.

She followed Ms. Nordstrom down another quiet hall—wrought iron sconces, she noted—and into a large office. It was more of a meeting room, with leather couches and large windows overlooking the East Bay. A view to die for: straight along the Bay Bridge and over Treasure Island to Berkeley and Oakland. Awed by the sight, she ignored her greeters for a moment. There were two, a fortyish woman in a fitted gray suit, and a younger man. The woman reached out her hand and Lisa put down her film jacket and said, Hello, I’m Lisa MacLean.

I’m Susan Cummings, Dr. MacLean. Lead counsel for this case.

And I’m Tom Berger. Tom was a sight. His suit looked to be Italian, and it might as well have been on a mannequin. Not a speck of dust on him, Tom’s shoulders were square, his tie flawlessly tied, and Lisa could see her face in his black shoes. As he sat back onto the couch, the outfit didn’t seem to move, and his crossed legs revealed silky, jet black socks with just a blush of auburn stripes. Fortunately, his face was boyish and silly like a puppy’s. Lisa felt better.

Susan opened, Thank you so much for coming down. I know you’re busy.

Lisa smiled. I do have a two o’clock biopsy, just so you know. Susan and Tom checked their watches, like twins in sync. Cartier, both.

I brought the films. How can I help you?

Susan continued. You’ve heard about Dr. Sorrento, of course.

Oh, of course. It’s awful. Sorrento had worked at Lisa’s hospital for twenty years. One week ago, her partner Calvin had shown her a CT scan of Sorrento’s chest, which showed a four-centimeter tumor in the left lung. And metastatic disease in the liver.

Yes, it’s terrible.

Yes. Actually, it wasn’t all that terrible. Don Sorrento was a good surgeon and every bit the bastard Juanita claimed. He yelled at everyone—nurses, administrators, even other doctors. Everyone except his patients, who worshipped him. Several of the nurses had filed complaints against him over the years. All in all, not as terrible as it might be.

Well, let’s see the films.

Lisa pulled out the CAT scan jacket, hanging the telltale film on a light box that the attorneys apparently kept for this purpose. It was nicer than the light boxes in Lisa’s office, actually. And right there, big and bad and ugly, was a spiculated mass adjacent to the aorta. It seemed to have tentacles, little arms of malignancy stretching like a cat yawning.

I remember when Cal first showed it to me. I couldn’t believe it.

That would be Dr. Mailer? asked Tom, scribbling on a pad.

Yes, Lisa answered, a bit confused by Tom’s scribbling. Yes, we just stared at it for a while. It’s hard to imagine a surgeon getting sick. Not that it was a surprise. He smoked all the time.

And that’s all you discussed about the case? asked Susan.

Well, he told me that Don was being worked up at St. Francis. They have most of his films. Two sets of legal eyes fixed on her. That’s all I have. Lisa’s lips tingled a bit, but she ignored the alarm bells for a moment longer. I didn’t even read the CT, so I’m not quite sure why you need me.

Susan and Tom glanced at each other, then Susan took over again. Where are the other films?

Other films?

Yes.

Lisa pulled out the typed reports. That is pretty much it. That’s all that’s in the system. Aside from some old films. Bone films from a skiing accident. Abdomen films for a kidney stone. Crooked smile. No more. Tom and Susan didn’t look happy. Is there something I don’t know?

Susan put her hands together slowly. Doctor, don’t you know why you’re here?

Lisa swallowed. Well, my life has been a bit crazy lately. I didn’t get to review your letter very carefully. Actually, she had lost it, just after she had written down the case number. The room was quiet. Lisa heard her heart skip. Why am I here?

Susan replied. Because of the other film. The one from last year. She paused, then enunciated, The one with the tumor on it, but smaller. When it was missed.

Missed?

Missed.

By whom?

By you, allegedly.

Lisa’s mouth formed a small circle and she stopped breathing. She looked down at the film jacket, which she hated with a passion. She hated the lovely room too. Lisa flipped the jacket upside down and dumped out all the films—smelly Kodak all over the Persian rug. She began sorting through the mess, shaking her head. I ran a computer search this morning. There were no chest X-rays from last year. But there, hiding behind the abdomen film, lurked an unmarked rectangular film of the chest.

Lisa hung it up quickly. Sure enough, there it was: a much smaller and rounder mass, just next to the aorta. Only a centimeter in size. Still resectable. Still treatable. Lisa pulled the film down and searched for a name imprint, for a date, for anything. This film was never registered.

Tom was up in a flash, suddenly animated as he stood next to Lisa. So it might not even be his X-ray. He looked even squirrellier up close, but he smelled like a Macy’s store.

Lisa grimaced. Sorry, but it’s his. Look at these. She pointed to two surgical clips in the left shoulder. They’re on the CT too. This is probably his film, but it was never registered. She flipped through the reports and sat down. And it was never read by a radiologist. What the hell’s going on here? "We’ll have to check with medical records. Maybe there’s a mix-up, but it looks like it’s Don’s film."

Susan hadn’t changed her grim expression. You were working the weekend this X-ray was allegedly taken. Susan squinted. So, Dr. MacLean, would you say that the tumor is visible on this first study?

Oh sure. It’s behind a rib, kind of hiding, but there it is. Lisa kept smiling; she felt quite helpful.

Be careful here, Doctor. Would you say that this is clear, that it is obvious?

Lisa hesitated. Susan and Tom were both scribbling away. They looked as if they were just getting started. Lisa lost her smile and pictured a light bulb clicking on over her head.

Am I being sued?

Tom and Susan looked up at her in unison and then at each other. Susan answered, Yes, by Dr. Sorrento. She went back to her notes.

Lisa’s mind went blank. All she could think of was Jennie. How did she know? she muttered. Susan and Tom continued scribbling; Susan glanced over at Tom’s scribble and added some more to her own scribble.

Susan, Tom, if you two don’t put those goddamn pens down and talk to me, I may have to toss something through that big window. The voice had come from nowhere; Lisa felt tingly all over. Susan’s eyes shot up. Her pupils dilated just a bit, and she snapped her pen closed. Lisa looked at Tom—one of his socks had fallen to his ankle. Lisa continued. I’m being sued.

"Yes." Susan stared directly at her.

For not seeing this mass.

Yes.

When it was small.

Yes.

And treatable.

Exactly.

Lisa closed her eyes. But I never saw this film.

Yes.

Until this moment.

Nevertheless, Susan replied, gesturing resignation with her hands.

But it’s not registered. It isn’t labeled. It wasn’t ever shown to me. It was never read—by me or anyone. Both lawyers looked puzzled. Lisa sighed. How can I be sued for missing something I never saw? They were quiet, still a bit shaken by her anger. How can I be blamed for a case I wasn’t involved in?

This time Tom answered. Dr. MacLean, you would be amazed. You can be sued for anything. Last year we had this poor ER doctor— He stopped suddenly. Susan was glaring at him as if he was about to give away a trade secret.

Lisa stood up. She knew the drill. Many of her friends had been through lawsuits. But a surgeon! Christ, with at least ten years of income left. Ten years of a surgeon’s income. They can take me for a fortune. Is he still married? Does he have kids? Lisa pictured Don in the parking lot, sneaking a smoke with the ER nurses. This can’t be.

Susan stood up. Excuse me?

I can’t believe Don’s going to take me to court.

Oh, probably not.

Lisa drew in her breath. What?

You’ll probably never see court for this. Susan suddenly smiled, rather badly. Lisa, you do have malpractice insurance for a reason. And they do hire us for a reason. Let us handle this for now. With any luck, you’ll never hear much about it. She narrowed her eyes. But let’s keep this conversation between us.

Tom was up. I’ll come by on Monday to double-check the hospital records. And to try and find the tech who took the film. He was all smiles as he gently led Lisa out into the hallway.

Tom guided her to the lobby, where Ms. Nordstrom handed her a glass of water and two Tylenol. I guess they all know the drill. The secretary helped her to the elevator, and Lisa crowded in with a host of blue suits and briefcases. Descending among the suits, Lisa suddenly remembered. Now, of all times, a memory leapt up and waved its hand, and Lisa actually slapped her forehead. She remembered who had made the comment about the trees in California—and, of course, it was Frank. It was the first thing she had ever heard him say, standing a few feet away from her in a noisy bar in Chicago. Frank was explaining to someone why he would never live in California. Lisa hadn’t liked the comment; her first instinct about him had been negative. She had ignored her instinct, like all the other warning bells over the past seven years, and she had actually suppressed the comment all this time. Out through the lobby and finally through the large glass doors, Lisa sat down on a bench, breathed deeply, contemplated her capacity for denial, and realized that she had no idea where she had parked.

Lisa wrapped her hands around a pint of dark beer. An old friend. She admired the creamy foam as it slowly settled, the impenetrable amber hue. It was her second beer. She sat in a noisy, lively room filled with young, beautiful singles—the downtown happy-hour crowd. The room pulsed with the electricity of familiar hugs, loud toasts, and loosened ties.

She was in a meat market, that’s where she was. Lisa hadn’t been in one for so long she had almost forgotten the expression. She was cozy with her beer, waiting for Jennie, in a room reeking of sex. Living as one half of a couple for so long, Lisa now found the odor—of single men and women and drinks and music—overwhelming. Her head spun a bit from the beer on an empty stomach and from the almost visible waft of pheromones.

Between the meeting with Tom and Susan and the sight of so many beautiful singles, Lisa was suddenly self-conscious. Minutes earlier, she had stood in front of the restroom