My Penance

A fan fiction brought to you by Kapperz1212 and Fish Friend

Note: This is a fan fiction from the Point of View of Carlisle. All medical information in this is (in fact) true. We did our research. :D

Disclaimer: We do not own Twilight or New Moon or Eclipse.


The steady beat of the monitors to my right told me that the surgery was going fine. Though I had yet to remove the appendix itself, everything was set up correctly. All antibiotics had been given in advance, and the patient hadn't eaten anything prior to surgery. Though this case was severe enough to need a laparotomy (actually having to cut through the abdominal wall to be able to access the appendix), the woman was otherwise perfectly healthy, and had a strong body. I was confident this woman would make a full recovery.

As I removed the appendix, and inserted the stub, I couldn't help but smell something… off… in her blood. It smelled…misbalanced. I leaned closer to the patient under the pretense of needing a better view, and inhaled deeply, attempting to discern what was bothering the medicinal instincts of my nose.

My heightened senses finally registered why it was off: her red blood cell count was worryingly low.

I readjusted myself back to the upright position, scrolling through the list of what this could mean. She hasn't been to the hospital for anything chronic for at least ten years, I recalled from the medical records I had glanced over before scrubbing in.

I did remember that she had been in because of several miscarriages in the past year or so. She was married, I knew, and probably wanted children. Don't all the women? I thought with a sigh, thinking of Esme. Were all of the miscarriages connected to the low count in red blood cells? Most likely. I peered down at the woman again, my fingers nimbly executing the stitching of her wound. Then I noticed the faint rash around her abdomen.

I made a checklist in my mind, counting off the symptoms as the possible ailments rolled through my head. What malady had the symptoms of rash; recurrent miscarriages and low count in red blood cells?


So the woman had anemia. Undiscovered, untreated anemia as it was. She didn't have anything further wrong with her disregarding this anemia and previously problematic appendix. There had to be something behind it, something lurking just beneath the surface of her notice, of doctors' notice.

As I snapped the latex gloves from my hands and let the mask over my mouth gather at the base of my chin, I felt my forehead furrow in contemplation.

What shared the symptoms of unexplained anemia?

There was chronic illness. But it was highly improbable that she had that; chronic illness being when there's a steady string of recurring problems. She had none of those. She would have been in to be reviewed by doctors much more frequently.

The next option was liver failure. That was an entirely different ordeal, and would have to be part of a multi-system failure. Since the liver was in charge of helping produce enzymes for digestion, doctors can gain insight into the beginning or later stages of liver failure by inspecting the large or small intestine. I had seen the intestines, and knew they were perfectly healthy.

I leaned onto the sterile sink, eyeing the patient, scrutinizing her entirety as the anesthesiologist removed the tubes from her throat and secured another bag of drip medication to the IV.

Kidney problems were another probability. The kidney sometimes regulated blood pressure if something was significantly altered about the body's chemistry. But her blood pressure had been normal. There was a chance that the reading had been misconstrued…

The kidney also helped with Vitamin D. Severe Vitamin D deficiency was often an alert for a kidney problem. But her skin was normal, and her bones weren't weak. She had never broken a bone in her life. It was blatant that her kidneys were fine…

Was it possible for this woman to have an early stage of leukemia? Leukemia could affect the red blood cells and decrease them. No, she couldn't. Leukemia had many other symptoms, and she had reported no joint pain, and she didn't have bruises, which you could gain from Leukemia.

No other symptoms, so no leukemia.

My expression went rigid as the next thought crept into my mind, ringing with almost undeniable possibility.

There was another quite unusual disease that could easily have been the catalyst to this lack of red blood cells.

Celiac disease was a possibility. Celiac disease prevented the small intestine from absorbing certain nutrients. The suffering patients can't tolerate Gluten, a staple part of wheat, barley, and rye. And if they continue eating gluten without realizing that their body cannot absorb it for nutritional value, they can become very malnourished.

Well, this girl certainly had a misbalance about her blood, evidence to the fact that an imbalanced amount of necessary nutrients were being absorbed.

But did she have the other symptoms? The pain from the appendix could have overshadowed the abdominal pain of it, yes. She had the rash over her abdomen. What were some other symptoms? There were recurrent miscarriages, which she most definitely had. The other main was severe weight loss or gain. What had her medical charts shown about her weight, at her last scheduled doctors appointment? 115 it had read. And now this girl couldn't be more that 100. That was 15 pounds she couldn't spare.

I was as close to certain as doctor's can be, that this girl had Celiac disease. I made a memo in my mind to test the carbohydrate and sugar levels of the girls' blood once she had recovered from surgery.

I pushed through the swinging double door, shaking my hair from the net that had constrained it. If I had not smelled what was off in her blood, this girl would have wasted away to nothing. Had I saved this girl from suffering? Without my higher caliber senses thanks to the state I had been in for almost the past half-century I would never have smelled the difference. The monster within me had aided me once more in this line of work. And would it count towards redemption in the eyes of god? The fact that I was putting this curse to good use? Using it to benefit the health of those more fragile than I?

I could only pray and wait for judgment day, hoping that my debt to humanity had been repaid.

As I walked out into the stark white hallway, taking off my smock and discarding it in the trash, I couldn't help but wonder what would have happened to the small girl had I not detected the potentially fatal disease. Where would she have ended after being confronted at the pearly gates?

I heard Dr. Snow's footsteps against the linoleum floor as he entered the cafeteria. He poured himself a cup of coffee before settling into the chair on my left. "Carlisle." He nodded. "Good evening, Hector." I offered him a warm smile. His face, full of the creases and folds that life had bestowed upon him, was dripping in exhaustion.

"You look like you could use a good night's sleep." I commented.

He chuckled heartily, "Couldn't we all?" If he only realized the irony of the statement, as I laughed and nodded in response.

He paused and slurped at the caffeine in his hands before breaking the momentary silence; "I have one last surgery before my shift is over."

"ER, I assume." Planned operations weren't typically scheduled into the late hours of the night. I glanced swiftly down at my wristwatch; it was 12:43 A.M. "Yeah, some kid got into a fight with his dad and punched through the car window. It'll take a couple of hours to remove all of the shards of glass." He sighed heavily and emptied what was left at the bottom of his cup. "Kids and their tempers these days." He shook his head disapprovingly and scooted his chair out. He rose and smiled kindly down at me before retreating into the operating wing.

Hector Snow had been at the Forks Regional Hospital since his residency as an intern. His heart and soul had been poured into this place since day one. He was as dedicated as he was determined. He treasured human life in a way that you didn't see very often these days. Hector Snow's steady hands and calm reason made him a great doctor and an extremely skilled surgeon.

Hector was getting on in age though. He had to be about sixty-eight by now, most likely preparing for retirement. I chuckled quietly as I thought of old age and retirement. Now that I was over three hundred years old, I pondered when I might start to consider retiring. With that amusing thought I cleared the small table of the newspapers I had been reading and headed towards the Emergency wing myself.

I let my feet carry me through the hospital, gliding slowly underneath the fluorescent patches of light. I was caught up on paperwork, the ER didn't need me (empty tonight after the son with a handful of glass had been released), and I was done with scheduled surgeries. All I had to do was wait for my shift to end.

It was an interesting concept to contemplate. Me…the person, actually vampire, with all the time the world had to offer waiting for it to pass edgily, and merely just a few hours at that.

Was I bored? No, but my mind or hands weren't busied. Tonight I was on edge for some reason, particularly in a hurry to return to my family. Predominantly, Esme.

Instead of thinking about some of the other rather morbid topics that clouded my mind, like the poor 23 year old man in room 238 on Hospers, I focused on my rather successful surgery. I may have saved the women's life from more than one illness as it was, and I considered it a great feat.

My thoughts drifted to good and evil. Ice and fire. Heaven and Hell. Vampires and humans. The damned and the salvaged.

Would my profession as a potential savior to humans aid my family's and my redemption?

This brought my mind to a more pressing matter. Bella, and the decision she was so willing to make, between life and death, between certain forgiveness and pining salvation…and voluntarily, at that. Edward had more than enough reasons to keep her human, though Bella had just as many to rebut.

One of the points Edward had made an ordeal about was redemption and virtue.

Ah, redemption. Such a simple word, yet it is so much bigger than what it seems. Deliverance, salvation, rescuing, liberation, whatever you fancied to call it. Trying for a fresh start, repent for your wrongdoings, for your sins. Edward believed that once your three days of torturous hell ended, a new type of hell began.

A hell as solid as the one that burned somewhere beneath our feet, a hell with no redemption. That was where one of his problems lay. His lack of faith for the Almighty.

Perhaps instead it was his lack in the belief of gray matter, to Edward everything was black or white, live or die, it couldn't shift somewhere in between. It was necessary to be human if you treasured the hope of salvation, if you were another God would discriminate.

And then there was Bella's faith. It was a strong faith in Edward, in love. Debatably, almost a reckless amount of faith. How did she know that she would earn the gift of entrance to heaven, unlike so many of our kind? She didn't, though she trusted love to get her there. She trusted us to get her there. She trusted Edward to join her.

So much trust in such a small being, only an immensely large soul could hold so much. And a large soul required an even grander heart, which we were all positive that our dear Bella possessed.

A buzzing from the pager in my pocket dragged me from my dwellings. I sighed, and glanced at its blinking screen.

Incoming trauma from a car accident, possibly spinal injury.

And so I rushed off to the trauma bay, deciding I could spare a good deed of mine from my line of work for Bella and Edward. And so I prayed redemption for the both of them, bargaining amusedly with the chip I felt I had earned.