February 14, 2014
Although it was still dark when I left my apartment, the warmth and humidity surrounded me as I silently descended the stairs to my car in the parking lot. It may have been mid February, but I'd come to accept that, more often than not, shorts or a sundress were the most appropriate attire for a Houston Valentine's Day. I knew my navy crepe pantsuit would require dry cleaning by the end of the day at this rate. I regretted leaving my shoulder length hair unbound. The careful waves I'd created would be frizz before lunch.
It was only 1.2 miles from my apartment complex to the brand new McNair Campus of Baylor College of Medicine, where I would be seeing patients for the day, but with the heat and the business attire required for a full day in the ritzy Sports Clinic, a nice walk was the last thing I'd entertain this morning.
It was Friday. I know it's supposed to be the best day of the week, but I hated Fridays because I preferred OR days to clinic days. I hated Valentine's Day even worse. A real bad one several years earlier had turned me off the holiday permanently. It didn't help that I hadn't had even a prospect of a date for any one of them since.
I would finish my fellowship in June, and that was really the only thing on my mind. It was important to have a goal, and this had been mine for as long as I could remember. I had a few balls in the air as far as post-fellowship jobs went, but I coveted a position in this very department. They were actively recruiting another staff physician, and I thought I had an "in" as the current fellow, but I knew politics played an important role. I'd seethed quietly as they brought in multiple people to interview for the spot. My mentor, Dr. Carlisle Cullen, tried to downplay it, but I was hyper-alert. I had made many sacrifices to get to this place, and I could finally taste the reward.
Unsurprisingly, I was sweaty and breathless when I arrived at the back entrance for clinic staff. I was early and keyed myself in, jogged up a flight of stairs, then flicked on hallway lights as I moved toward the fellow's office. I wasn't the only fellow in the department, and we all shared the room. A rotational schedule had been made, allowing each of the subspecialties to use the clinic space on a designated day. Sports Medicine got Fridays, hence my distaste for that particular day of the week.
The Sports patients at Baylor tended to be wealthy aging Houstonians worried about their golf or tennis games. I had little patience for their whining, preferring to deal with young patients at the VA, who more often that not had injured themselves on active duty while serving in Iraq or Afghanistan. To be fair, this was one of the nicer aspects of my fellowship program. I got to spend time at both locations.
I was surprised to see the light on in my office when I turned the corner. I paused in the doorway and recognized Emmett McCarty, the Major Joint fellow. His curly black head was bent intently over the computer keyboard, and his massive frame was shoved into the hand-me-down brown leather desk chair. He must have heard my approach because he stopped typing and rolled his chair back from the desk to face me.
"You're early, Swan," he greeted. I shrugged and entered the cramped space. There was a padded, folding chair next to the door. It wasn't for patients. Any paying customer here would be counseled in one of the faculty offices. I shrugged in response.
"I was thinking about the cases for Monday morning, and I wanted to go over the charts before clinic. I woke up thinking about it and couldn't get back to sleep," I explained. Emmett grinned.
"It's 6:30 AM. Your clinic doesn't start for another hour and a half," he teased. I shrugged again.
"It is what it is, Emmett. I need to do it cleaner and better if I have any chance of getting the faculty job. What's your excuse? Rosalie kicked you out again, huh?" I shot back. Emmett huffed but wasn't seriously offended by my teasing. I'd know him for years since he had been a resident at nearby UT-Houston. He'd met his wife because of me; she and I had done internship together.
"No, we're fine. It's just that I needed to get some quiet work done on this JBJS article. Emma is usually up by 5, so I knew I had no chance of success at home. This computer is so much better than the one in the GME office at the VA; I thought I'd get a bit done before walking across the street in time for 7:30 clinic start over there. Rose is on a cosmetics rotation right now. That bitch doesn't go in before 9:00 on any day, including OR days!" Emmett's wife, Rosalie, was a plastic surgery resident. They had a three year old daughter, and I had no idea how they managed that with their schedules. I nodded at him because I understood his reasoning, but he was still taking up the space I thought I'd be able to use myself this morning.
"Sure, that makes sense, I'll just grab one of the computers at the nurses' station and review some charts there," I told him, turning to leave. He interrupted me.
"Swan, do you have any plans for tonight?" he queried. I snorted in response, surprised he'd bothered to ask. Most of the department had given up curiosity over my love life long ago. I didn't give them much fodder for gossip.
"What do you think, McCarty?" I snapped. He shrugged.
"There's more to life than getting the Baylor job, Bella," he told me seriously, using my first name to boot. I pursed my lips and rolled my eyes at him. He might be right, but I'd made the decision years ago to put my career first, and I'd learned spectacularly that you couldn't go back.
Emmett had staked his claim to the office computer fair and square, so I headed out to the nurses' station to use one of those computers to access the electronic medical records. I had an hour to work before the clinic staff started arriving, so I quickly pulled up Monday's OR schedule and began reviewing the patients' charts.
The first one was a 55-year old gentleman who had torn his rotator cuff playing tennis. I vaguely recognized his name as an executive with one of the local oil companies. The next one was a young girl, a 16-year old high school basketball player with a torn ACL. The last case was a man in his early 40's requiring sub-acromial decompression, a bit young for such a surgery. He was also the Offensive Coordinator for the Houston Texans. I wouldn't get to touch that guy; I'd be lucky to steady the scope for Carlisle while he did the case himself.
I reviewed the MRI images of the injuries and visualized the repairs, imagining I was seeing the inside of the joints on the cameras and moving my hands like I was moving the instruments. I must have been lulled into my zone because I was startled by a sudden sharp sound. My eyes popped open; I hadn't been aware they were closed.
"Good morning, Dr. Swan," Tanya's sour greeting brought me back to the present. Tanya was the clinic's nursing supervisor. She had once had a promising gymnastics career, which was cut short by injury. She turned her aspirations to sports medicine, but instead of focusing on caring for others who had suffered similar disappointments, she spent most of her days studying for her MRS degree. Unfortunately, she had set her sights on Carlisle, much to his chagrin. I worried for him because she was undeniably gorgeous, as blonde and buxom as they come.
I quickly logged off the computer and started gathering my things. I checked my watch, and it was 7:45. Emmett would have vacated the office by now, and I could escape there for the next few minutes. Tanya was glaring at me, but I saw the gleam in her eye. She was going to take the opportunity to ridicule me at least a little bit. I sighed when I heard her clear her throat for the second salvo.
"Big plans, tonight?" she asked innocently. I didn't look at her as I shoved my papers back in my shoulder bag.
"Sorry to take up your space, Tanya. Emmett was here working in the office this morning, too, so I had to spread out. I'll head back to the office now," I hoisted the bag onto my shoulder and turned away, but she wouldn't have it.
"You didn't answer my question," she persisted, intent on humiliating me. I kept my back to her and took several steps away, heading back toward the faculty hallway. I was happy to make her wait and considering not answering at all, but I was stopped in my tracks.
"Yes, I'm quite interested in the answer to that question as well," a smooth male voice interjected. I wish I could say the voice was unfamiliar. I wish I could say that I didn't recognize the rich baritone immediately, but I can't, even if it had been six years since the last time I'd heard it in person. I'd indulged in it many times on the television during that time. My head whipped back to its source instantly.
He was standing with his elbows on the counter of the nurses' station, his hands clasped in between. I hated myself for honing in on the ring finger of his left hand but felt relief when I saw it was bare. The expression on his face was amused, but there was a hard edge to his gaze that hadn't been there the last time I saw him. Our eyes were locked, and I was sure my mouth was hanging open unattractively. Tanya recovered first.
"Oh my God, you're Edward Masen," she gushed breathlessly. He cast his eyes down modestly, but I could tell he was enjoying her response. His eyes flicked back to me briefly and then focused on her. He could always recognize a sympathetic audience. He smiled at her indulgently and opened his mouth to answer, but I interrupted.
"What are you doing back here?" I demanded. "You shouldn't be back here without an escort." He stepped back from the counter and placed his hands in his pockets, his trademark smirk in full effect.
"Your lovely receptionist, Jessica, I believe it was, said I could come straight back. I wanted to avoid any scenes in the waiting area when your other patients begin arriving," he explained guilelessly. "She said Dr. Cullen was already in and happy to see me before the scheduled time." Now he removed his hands from his pockets and held them up in a gesture of surrender. The smirk remained.
I took a moment to study him. His copper colored hair was in disarray as usual, as if he'd just run his hands through it. A hint of a tan made his green eyes seem impossibly more verdant. He was wearing a white button up linen shirt untucked over a pair of jeans. I couldn't see his feet, but I knew he'd be wearing sandals or flip-flops. He'd once told me that he hated shoes and avoided them at all cost, a consequence of growing up used to Texas winters. I closed my eyes briefly hoping I'd open them and find this all a figment of my imagination.
Nope. Tanya was watching us now, looking back and forth curiously. She could obviously tell we had met before. She simpered and pushed her cleavage toward him.
"Yes, sir, Dr. Cullen is in his office. Dr. Swan will let him know you're here. Have a seat over here, and I'll get your vital signs and get you checked in. We can have you through in no time. We are quite practiced with VIPs here at Baylor. Everything will be discrete; don't worry," she told him. She motioned to a chair in the vitals area and turned her back on me. He reluctantly followed her instructions but kept his eyes on me. I broke eye contact and turned as fast as possible and disappeared down the hall toward Carlisle's office. Somebody better start explaining.
My office was empty, Emmett long gone, when I passed by. Sure enough, Carlisle was tapping away at his computer keyboard, probably trolling through his morning emails when I burst in.
"Did you forget to tell me about a VIP this morning?" I demanded without a greeting. Carlisle whipped around in surprise with his mouth slightly open and his reading glasses perched precariously on the end of his nose. When he saw it was I in the doorway, a startled frown appeared.
"Bella, goodness gracious, you startled me," he chided. "Yes, we have a VIP. Is he already here?" he asked. Carlisle tried to maintain the fellow-attending relationship, but we'd come to know each other so well over the last seven years, it was really futile. I had been a third year medical student when he arrived from Dartmouth as a brand new attending. We had navigated the department together. I mean, he tolerated me calling him by his first name. I was a lost cause.
"Yes, he's here," I confirmed impatiently. "It's Edward Masen. Why is he in my clinic?" Carlisle's frown deepened.
"Well," he drew the word out, obviously annoyed with me, "it's my clinic, and not yours for starters, but I think the answer you are looking for is that he has a chronic elbow tendonitis." He tried to glare at me, but Lord help him, he was too nice to scare anyone.
"Edward Masen plays for Atlanta," I perseverated. Now Carlisle just looked confused.
"Bella, I have never known you to be star struck. Hakeem Olajuwon was in here just last week, for God's sake!" Carlisle exclaimed. I shook my head in an effort to clear it and sank into the fabric-covered chair across from his desk. His confusion had turned to concern. His forehead was wrinkled, and the gray hidden in the blonde hair at his temples was more obvious. I sighed, realizing he would need some sort of explanation.
"I know him," I muttered. "I mean, I've met him before. I guess I was surprised to see him. But why is he all the way out here?" Carlisle looked at me appraisingly, seeming to turn over his answer.
"Do you know him from Rice?" he asked suddenly. That struck a little to close to the heart of the matter, so I just shook my head, not trusting my voice. Carlisle nodded.
"Of course not, you would have been long gone by the time he was the star pitcher at Rice University," he mused aloud, and I cringed to hear his assessment. I slouched in the chair. "You graduated in, what? 2005?" I nodded again. He was right on the money. "Masen made the All-Tournament team for the College World Series in 2007 and 2008. You were already at Baylor then. He's quite a bit younger than you."
I gripped the arms of the chair to keep from launching myself across the desk at my beloved mentor. It hurt to hear him describe it that way, all my insecurities confirmed out loud. I dug deep and pulled out my inner sarcastic.
"Sounds like you're the one who's star struck," I commented. Carlisle looked a bit abashed.
"Well, I really enjoy baseball, and I had just moved to Houston when he had his run at Rice. I was trying to fit in down here. You know it was a difficult adjustment," he looked at me meaningfully.
"I'm surprised we never discussed him before. I met you as a third year medical student in 2008; I should have used you to get tickets to a game!" He grinned at me, and we were back to normal, thank God. Little did he know that he had mentioned his interest in Rice baseball many times that particular spring. I had just blown him off and changed the subject repeatedly to avoid the conversation. I was extremely relieved he didn't remember.
"Anyway," Carlisle continued, thankfully forgetting to press me on how I knew Edward, "Masen has battled elbow tendonitis and had a poor post-season last year. He's been traded to the Astros, so he's a local now. Of course, he's here with us."
I opened my mouth to reply but had no idea what to say. So, Edward was back in Houston to stay. I knew he had to be happy about that. He was a hometown hero, and the fans would eat it up. He'd be the next Lance Berkman, if his elbow didn't stop him.
Which brought me back to the original point. Edward was out there with Tanya getting checked in right now. How could I possibly be professional? I didn't know about his trade, but I'd certainly kept tabs on him over the last six years. And I'd thought about him a lot. I exhaled slowly and looked back at Carlisle. He was unaware of my inner turmoil and was finishing up with his emails. His stance showed he was about to stand up from the chair. He looked up.
"I've spoken to Mr. Masen on the phone several times. He seems very laid back, so I don't think he'd have a problem with a fellow starting the exam. Do you want to go on and get started? That way we can get him in and out before the waiting area gets crowded." There was absolutely no way I could refuse without triggering major warning bells with Carlisle, and I really didn't want to discuss the past with him.
"Sure," I managed to say without my voice cracking and stood. I robotically walked back down the hall toward the nurses' station in search of our VIP patient.
I found Edward Masen seated on an exam table in the room closest to the back exit. At least Tanya was smart enough to make that arrangement. He could slip out the employee entrance when we were done and avoid the prying eyes of the public. As a 2012 Cy Young finalist, he was very recognizable.
He was seated on the crackly paper covering the table with his legs swinging over the edge. Flip flops were lying haphazardly on the floor by the table where he'd obviously kicked them off. He had removed his shirt, and his broad chest and strong shoulders were on prominent display. He was a bit tan for February, and I wondered what sort of tropical vacations he'd been enjoying. I gulped and forced myself to enter.
Tanya was trilling flirtily with her hand on his forearm. He was nodding at her ridiculous chatter and obviously staring at her chest. A strong emotion rose in me at the sight, but I pushed it down before I could examine it too closely. She had to be fifteen years older than him, and I contemplated pointing that out when she left, but I'm not that big of a hypocrite.
I cleared my throat loudly, and two pairs of eyes shot to me. Tanya looked angry and annoyed at the interruption, but Edward looked a little embarrassed, at least I hoped so.
"OK, Tanya, we're good here, so you can head back to the nurses' station and get ready for the rest of the schedule. I'm going to get started with Mr. Masen, and Dr. Cullen will be in shortly." I turned toward Edward and addressed him as if it were our first time meeting. "I'm Dr. Swan, and I'm Dr. Cullen's fellow. I'm going to be assisting him in the evaluation today." I desperately hoped that sounded levelheaded and professional. At least Tanya huffed and left without argument. We stared at each other in silence for what felt like several minutes. He broke it.
"Aren't you supposed to ask me questions and actually touch my arm?" he asked cheekily. I sighed and approached the exam table.
"Edward, I'm sorry about before. I was just surprised to see you. I hadn't heard about the trade," I admitted. He looked disappointed.
"You don't follow the Astros anymore?" he asked. I shook my head.
"No, I do, but sometimes I get really busy." I shrugged. "It's the off-season," I said in explanation. He nodded but I couldn't tell if he thought that was an acceptable excuse.
"You've done well. I've been happy to watch your success," I blurted, admitting more than I wished. He shrugged himself and didn't meet my eyes.
"Well, it's been good. I really liked Jackson and Atlanta, but I'm glad to be home in Houston," he finally said. I pulled myself together and addressed why he was here.
"Of course, so let's get this elbow back on track. Now give me a brief description of what's gone on with it," I fell back on my doctor persona and proceeded to take a history, taking refuge in my routine. Edward patiently answered everything, and I took notes on the tablet we used in the exam rooms. Once we were done, Carlisle still hadn't arrived, so I forced myself to stand right in front of Edward. I tentatively reached out to touch his left forearm but was forced to jerk my hand back when contact with his skin stung my hand. We stared at each other with consternation. Nothing had changed.
"Sorry," I murmured, and forced myself to compartmentalize and go through the elbow exam as I had done many times before. His skin felt so good under my fingers. I began at his shoulder, allowing my fingertips to carefully palpate the acromioclavicular joint, the head of the humerus, and its articulation with the scapula. Then, I placed pressure over the long head of biceps and tested his rotator cuff strength.
I kept my eyes fixed firmly on his arm and did not allow myself to look at his face. I tried not to remember other times I'd run my fingers over his skin. His chest seemed broader now, and maybe he was a little taller. It had been six years, and he'd only been twenty-one when I saw him last.
I moved onto his wrist, dutifully examining the joints above and below the one in question. I tested his flexion and extension strength and probed sensation in his fingers and hand. Then, I finally honed in on the elbow. Flexion and extension seemed normal, but his supination/pronation seemed slightly inhibited. He winced perceptibly when I palpated directly over the ulnar collateral ligament. The moving valgus stress test was positive, when I gently moved his elbow through various positions.
Finally, I withdrew my hands and stepped back. I thought I heard him sigh when we lost contact with each other, but I probably imagined that. When I finally got the nerve to meet his eyes, I looked at his face, and the smirk was back.
"What?" I demanded. He smiled broadly.
"I never told you which elbow was bothering me. You just assumed it was the left one," he said. I gaped at him.
"But, you're a left-handed pitcher. Of course, it's your left elbow," I exclaimed. His smile broadened.
"You remembered. It's been a while, so I'm flattered," he stated simply. I opened my mouth to argue, but was forced to look away before he could see my blush. Carlisle picked that moment to joint us. I handed him the tablet without a word, and he quickly glanced over it before looking up.
"Good morning, Mr. Masen," he greeted, shaking Edward's hand vigorously. Edward stayed seated on the exam table. "I'm so glad to finally meet you in person. I've reviewed all the information forwarded by Dr. Marcus, and I'm in complete agreement with his treatment plan. We'll stick with intensive physical therapy through the next 10 weeks. I know that puts you out of Spring Training, but I think it's the best course of action." Edward's face was deadly serious now, and he nodded gravely. My presence was obviously forgotten.
"That's what I discussed with Dr. Marcus, and I'm still on board with it. It's great to meet you, too," Edward answered Carlisle.
"Now, let me just take a look at this elbow and make sure there are no surprises." Carlisle took a step forward and reached for Edward's arm, but Edward shied back just a little.
"Dr. Swan has already given me a thorough exam," he objected with a small smile at me. Carlisle smiled, but I could see a tightening around his eyes. He didn't look at me.
"I'm sure she has. It's well documented here," Carlisle indicated what I'd entered on the tablet regarding the exam, "but as the attending physician, I'm obligated." Edward acquiesced, and Carlisle began his exam. He addressed me without looking up.
"Dr. Swan, why don't you go ahead and start on the other clinic patients, so we don't get too far behind?" Carlisle dismissed me, but I was glad to go. The whole thing was too overwhelming. I hoped he didn't think I'd been unprofessional with Edward. That last statement could have been construed as a double entendre.
There were already several exam rooms filled with patients, and I was instantly busy, moving from room to room. I tried to immerse myself in the mundane tasks of running clinic, but my mind was still reeling.
About twenty minutes later, I saw Edward standing at the end of hall when I exited one of the rooms. His hands were stuffed deeply into his pockets, and he was rocking slightly on his flip-flopped feet. Our eyes met, and we stared at each other, neither of us moving, for several seconds. He seemed to be waiting for something, me maybe. He raised his hand, but I wasn't sure if it was a good-bye or a beckoning. I turned toward the next exam room when I saw him do it, and did what I did best when it came to Edward. I walked away from him.