CHAPTER NINETEEN
Three Years, Two Months Ago
It’s five o’clock in the morning, Syria time. I’m awake, and I should be getting up for my shift in the medical tent, but I have jet lag, and my body aches like I’ve been awake for days, the pain centering in the tip of my shoulder, just where the blade meets the arm. The pain pulses and radiates, extending down my left side and into the pit of my abdomen, creating a perfect circle of agony.
The pulled muscle—or whatever the hell it is—just adds insult to injury. I spent last night awake, on and off, dreaming about Ash. I tried calling him, dialing him again and again from my phone, but he never picked up. The last call mechanically informed me that his number had been disconnected.
Gone. Almost like it never happened—the wedding, the honeymoon, the plan to leave together. It’s like none of it was ever real.
I turn over onto my left side and cry out from the pain. A full body cramp makes its way up from my leg to my shoulder, so I turn the other way instead. Lying on my right side, the feeling lessens, and I can close my eyes again, even though my teeth and fists are clenched tight. Like any good doctor in the field, I can work my way through the pain and wake up in time for a stiff coffee and some early morning appointments. There are people who need me more than I need to lie here.
Still, I don’t move my legs. It’s my third morning here. The first morning, the feeling was barely noticeable, just a low cramping in my side, poking at me on and off. The shoulder pain started just last night, and that’s the real bitch in all of this.
It seems like a physical manifestation of my guilt and regret, my fucking idiocy.
I belong here.
I am a doctor.
There is only this job, this place, and the burning ache, like a shot of lightning, wrapping its circle around my body, around my consciousness, taking over my thoughts.
I drift in and out of conscious thought, thinking of Ash’s crooked face and the heat of his body, the way he made me do things I never thought I’d do, the thrall he kept me in.
I’m free now. If I could only get free of my shoulder, float away from my body.
I absently wonder if it was the bus ride, or the sleepless nights spent at my mother’s empty inn, or the crying on the flight into Cairo that did it.
There’s a voice calling me from far away, one I barely recognize, and I can’t open my eyes. They feel heavy and hot. I have a sharp memory of my mother pressing a cool washcloth to my eyes when I was trying to fall asleep as a very young girl. Her hair was strawberry blond, like mine is now. I remember reaching up to touch it, twirling it between my fingers. She told me she was coming back very soon, and her smile looked sad. But it’s a silly memory. It isn’t right. My mother has red hair. I smile anyway and think of the washcloth against my head, delicate fingers smoothing down my brow.
It’s so good to be loved, better than anything else I know.
I choke out a sob and raise up my hands like I’m reaching for someone. Someone is calling me, but it’s not my name.
“Dr. Ash, we need you in the medical—”
“Collington,” I say, but it feels like there’s cotton jammed in my throat, and I can’t manage the squeak out the word. “Collington,” I try again, attempting to move my heavy muscles so I can get out of bed. My legs stick where they are, and I realize my arms are still raised. I put them down heavily and open my eyes. The room is spinning, and I’m dizzy, even though I’m still lying down. It’s the very tip of my shoulder that hurts, like someone has a chisel and they’re hammering it down between the bones.
The woman calling my name touches my arm, and I shudder, trying to pull away. Her cool hand goes to my forehead and then my cheek.
No, get up. It’s time to go to work.
“Dr. Collington—is that what you said? You have a fever. Were you exposed to anyone who was ill before you arrived?” The doctor—or nurse—speaks quickly, her words jumbling together.
I shake my head slowly, and now it feels like my whole head is filled with cotton. It’s a pulled muscle—or no, a pulled muscle doesn’t feel like this. There’s a part of my brain that wants to generate an answer, pulling out some information I learned a long time ago when I was a candy striper with Natalie at the hospital.
“Does anything hurt, Dr. Collington? We need you out there today, but you can have medical leave if—”
I point to my left shoulder and then down to my abdomen, my eyelids barely fluttering open. There’s something I should know. “My shoulder. The tip. It’s...”
Shit.
My eyes open wide, and I sit up straight, adrenaline flooding my body. I’m counting backwards from the time I left to the time I got here, picturing a calendar in my brain.
I grab the woman’s arm and look at her scrubs. She’s a nurse. “Get the doctor,” I tell her. “Any doctor. It doesn’t matter. We need an ultrasound machine.” The nurse backs up like she’s scared, but I grab her arm hard, and she comes to. I nearly collapse with the pain, but there’s enough energy coursing through my body to keep me conscious.
I’m breathing through it, my gut clenching through the pain. There’s a chance I’m wrong, but even the nurse knows I’m probably right. There’s a bright, stultifying pang in my abdomen, and I fall back to the bed.
“Ultrasound,” I mumble. “Now...” I must pass out for a second, because when I wake I feel the chilly gel, the ultrasound wand. “I consent to whatever you have to do. Just make sure I live.”
After that, sounds and conversations come in bursts, and I follow them like a lifeline, like scenes from a TV show when I’m falling asleep but want so desperately to know what happens next.
“Measuring seven and a half weeks.”
“Left fallopian tube.”
“Rupturing as we speak.”
A weak heartbeat. Is it mine or—
“Get the medevac. We need to get her to Damascus.” A pause. A husky female voice, the gynecologist on staff. I’ve met her. “I don’t care how much it costs. A ruptured ectopic pregnancy counts as a surgical emergency, no matter where the fuck we are.”
After that, everything goes black, and I wake up in Assad University Hospital, a tiny incision on my left side held together with stitches and glue. They tell me I was conscious on the way to the hospital, talking about my husband and telling them to call him, but there was no working number listed. But I don’t remember that ride at all. Instead, the repeated image, false memories imposed over real ones, of cool hands against my forehead.
“Hush now. I’ll be back, girl.”
In Damascus, a very good surgeon removes my left ovary and fallopian tube, and with it, an amniotic sac and a tiny embryo that would have lived if only it had implanted in the right place. It even had a heartbeat on the ultrasound, for a brief moment in time, a tiny flicker that ended as soon as it had begun.
I don’t cry. Instead, I eat ice chips, try to talk with nurses and doctors using hand gestures. There is silence. And the hushed voice of the doctor who removed my ovary, telling me about the scarring she found, about the very real possibility that I’d never have children of my own, asking if there’s anyone she can call, if my husband has another number. She holds my hand in hers, even though I can see that she’s uncomfortable when I shake my head and say that no, there’s no one I would like to call. No one at all.
Slowly, methodically, I fill out paperwork during the week I’m in the hospital on IV antibiotics and bedrest. I won’t quit Doctors Without Borders, but I will bury myself even further away, somewhere cold and punishing and nowhere near Damascus. The day the transfer comes through, I get an email from Ash on my phone. I read it, and then delete it.
And after that, I don’t bother to read his emails at all.
Instead, I create memories of Ash, tucking them away until it seems harmless to think of him from time to time while I clean my tiny apartment in the Ukraine.
It’ll all be over when I get home, I tell myself. I have myself convinced of it. And soon enough, Ash’s letters and emails quit coming. And he seems like a memory, frozen in time, more than ever.
Maybe I should read his explanations.
Maybe I should go back in time and wait for him to tell me he loves me. But this cold apartment is my reality for three years, and the distant memories of a tall, redheaded man are a warm, golden daydream before everything broke and I realized who and what I was.
Present Day
The locker room is empty when I come in for my shift.
“Good,” I groan. I slump down on the bench at the back of the room and close my eyes. It’s like I woke up with a tequila hangover and then had six or seven people beat me with boards.
A brief memory flashes through my mind, but I can’t grasp it before it’s gone. I shudder with fear and an old longing I absolutely cannot place.
Stomach virus? Gastritis?
A wave of nausea hits me, and I think about the chicken and white bean chili Ash made me last night. It had smelled absolutely horrible when he was cooking it, like he’d taken every spice in my cabinet and combined them in a screaming mess of smells. But it tasted excellent going down, especially when I smothered it in cheese and sour cream and ate it with chips.
My stomach clenches, and I can barely breathe.
An image—light and sound—flashes through my mind violently. I could hear a flicker of a heartbeat, nausea and pain sweeping over me.
No.
My stomach lurches.
“Food poisoning. Maybe the chicken was—”
Oh fuck.
I crawl over to the trash can in the corner and dry heave once, and then again. I almost wish I could vomit because my whole body feels hot, bloated, and swollen. All at once, everything seems like it’s on fire—my ass and my stomach and even my breasts. I heave hard again and finally empty the contents of my stomach. A wave of relief so powerful comes over me that I thank God, the universe, and the hospital administration for the trashcan in the corner and my ability to vomit into it. I sit back onto my haunches and look up to see one of the nurses staring down at me with her hand on her hip. My pulse speeds up, and my gut tightens like I might start the process all over again.
I push the memory from my mind like I have for the last three years. It’s not something I can think about. Not something I like to think about.
I ran.
This would never catch me.
This hasn’t caught me. It’s not possible.
“You okay?” The nurse looks at me quizzically, cocking her head to one side.
Why does it feel like I got caught doing something I shouldn’t?
I nod and wipe my mouth on my sleeve. Fortunately, the only thing that comes away is drool. It wouldn’t be a good look for a resident to be sitting in a corner of the locker room, with vomit smeared all over her face.
“Stomach virus? It’s not the season for them.” The nurse comes over and helps me to my feet. I look down at her name tag. Zelda. Why didn’t I know that before? I’ve seen her dozens of times.
I shrug. “Zelda, thanks. I’d really prefer to just work my shift. I’m feeling a lot better now—just gross and like, a little dizzy and buzzed—kind of like I’m—”
“Drunk?” She takes my arm, and shamefully, I lean against her, my head spinning. She’s wearing some kind of vanilla-scented perfume, and that makes me want to barf all over again. But there’s nothing left in my stomach to come up.
It was cold in the hospital room when I woke up, and it hurt, not like the shoulder, but like a profound emptiness that could not be filled.
I knit my brows together and look over at her. Beneath the reddish purple dye job, her roots are brown, and her eyes the same color. She’s maybe ten years older than I am, but somehow she’s still hip with her tiny diamond nose piercing and messy, purple-hued bun.
“How did you know? How I feel, I mean?”
It was all pain. One moment of a heartbeat flicker. No hope—all signs of life were gone.
“That’s how it was with my first one. With the second, it was more exhaustion that nausea. But they say it’s different every time.” She raises an arched eyebrow at me. “Maybe we should run your bloods and—”
“The first one what?” I already know the answer. It strikes me that I’ve seen this nurse before, walking out of the hospital day care with a little girl about four years ago.
And each time I see her, a pang of longing, deep and angry.
She’d be three now.
“The first kid.” She starts walking me over to the door, and I freeze. “The first one was a boy. You’ve seen Ella, right? Looks just like her dad. He’s one of the nurses in pediatrics. Their dad, not the boy. The boy is seven—”
I start counting on my fingers, rewinding the days and trying to remember when I started my last pack of pills. I envision a calendar in my head and almost vomit again when it pops up in my mind.
“That’s not—this isn’t possible. I have endometriosis. I lost my left ovary and tube three years ago. The OB said that IVF was my only—”
“Oh.” She walks me out of the door and down the hall to the lab. She leans in close and brushes my hair back over my shoulder. “You know what you didn’t say? ‘This isn’t possible because I didn’t have unprotected sex with my boyfriend.’”
“Husband,” I croak. My throat feels like someone forcibly opened my throat and poured acid down my gullet. Actually, that’s just about what happened, except my angry stomach was the person.
She shoves a cup into my hand. “Pee in this. Then we’ll take your blood if it’s positive. Should be able to tell how far along you are.”
“Oh God.” I look at the cup in horror. “Okay. Everything is going to be okay.” Zelda pats me on the shoulder. “Give me the stick and I’ll test it myself. I’d be five weeks. Take my blood, and schedule me for an ultrasound—tomorrow.” Zelda shrugs and hands me a pregnancy test, and I head into the bathroom next to the lab. As soon as I complete the test, two parallel pink lines show up.
My heart starts beating fast, vision failing, twisting and turning.
In my line of work, I’ve seen plenty of faint lines, lines that indicate tiny amounts of hormones circulating in a body. But this line is bright fucking pink and appeared in less than ten seconds.
Is there pain?
There’s no pain.
I close my eyes and put my hand to my stomach. By five weeks, there’s an amniotic sac, and a tiny yolk that will nourish the embryo until the placenta is done growing. The embryo itself is “no larger than a grain of rice.” I remember that from my bio text book in college.
And I remember it from the ultrasound picture. The doctor who removed her gave me the picture to keep. I keep it with Ash’s letters.
It had been so strange to me back then. The endometriosis was always there, looming, barely helped by birth control.
Scarred.
Despite the lingering feeling of nausea, a warmth spreads through me as I straighten out my clothes and look back at the pink lines on the test. The sensation lasts only for a few moments. When I look in the mirror and straighten out my hair, the grief rushes over me in a wave so powerful, it almost knocks me down. I sob and put my hand to my stomach, a ghost of the old pain coming back.
It’s strange—since I started seeing Ash again, the pain hasn’t hit me like this. It’s like that empty space was finally starting to fill up.
It seemed fun, when we’d gotten together again. It seemed almost inconsequential that Ash was still working with criminals in town, even if it was only peripherally. He’d assured me that his business would be clean from now on—there were just a few details to work out, and then he’d make his gym legit. A crushing weight settles over me, and I throw the empty cup in the trash. I slip the pregnancy test into one of the lab’s plastic bags as I walk out the door and move briskly down the hall. By now, someone’s surely paging me for the day.
Zelda appears from nowhere and stops me as I turn the corner. “Hold out your arm,” she orders me. I do as she says, and she takes my blood while I stand in the hallway. “Repeat in forty-eight hours. We can get you in today for an ultrasound.”
“Tomorrow is fine. There’s no pain. It was—it was ectopic last time.”
“Got it.” She pats my hand.
I smile wanly, and she nods and then vanishes back to the lab where she draws and catalogs blood all day.
I don’t think she’ll spread secrets, but there are secrets in my life far more damning than this one.
The secret husband.
My mother’s failing business.
Every bit of illegal shit that happened in New York.
What’s one more secret? I’ll add it to the pile and deal with it when it becomes a reality, if it becomes a reality.
I put on a clean lab coat and bag up the vomit, tossing it conveniently into one of the medical waste containers as I move along to the emergency room. Before another episode hits, I stop at the pharmacy and pick up some anti-nausea meds.
Hope is of no use. It’s not a certain thing.
There’s no time for starry-eyed fantasy. I’m a medical professional. And I know as well as anyone that this embryo might not make it past the first twelve weeks. If it lasts beyond that and I start showing, then I can let that warmth take me over again. And then, and only then, can I tell Ash.
We’re your typical husband and wife, and this child—no, this collection of cells—won’t make it any different.
Wait and see.
As I move throughout my day, I find myself wondering if it might be a boy, like Zelda said. I still have that buzzed, humming feeling, and I wonder if it has to do with the new resident I’m harboring.
Best not to think about it. Not until it starts to matter.
Still, I find myself patting my lower belly, even though it’s not really anything yet. Just a collection of cells, a tiny thing.
I’ll see if it’s in there tomorrow, but there are no guarantees of anything at all.