Judgement Call


Short Fiction by Lorna Thorpe

 

People view the heart as a puzzle.  I can’t fathom my own heart, they say, as if its workings take place at oceanic depths.  As a cardiologist, I once dismissed that sort of thinking as magical.  Yes, I’d allow, the heart is a wonder of engineering, each heartbeat involving a complex and co-ordinated sequence of electrical and mechanical events, but in essence, it’s a muscular organ, a pump.  Now I realise it’s an outlaw frontier, as chaotic as a physical heart in ventricular fibrillation, so anarchic it will open its doors to even the most fantastic thought, that you could get away with murder, say.

I met Lucinda at boarding school.  No one would have expected us to become friends.  While I squirrelled myself away with my books, Lucinda smuggled in bottles of vodka, shinned down drainpipes to meet boyfriends, regaled classmates with juicy details of her exploits.  I can still see her now, sat cross-legged on her bed in the dorm where icy fingers of night air crept through ill-fitting windows, her hair and sheets all dishevelled, telling a group of goggle-eyed girls about the handjob she’d just given a boy in his car.  Was I envious of her, even then?  Possibly.

Both passionate riders, it was a shared love of horses that brought us together.  I was competitive, and when it came to horses, so was the usually don’t-give-a-shit Lucinda.  On our first long ride we cantered across rolling downs until we reached a wooded valley where you had to lie flat along your horse’s neck to clear the low-hanging branches.  It had rained overnight; fat drops of rain fell from the trees and I pressed my face against my horse’s mane, inhaling the musky smell of equine sweat.  Finally, we emerged from the damp woods into a blinding blast of sunshine.

I used to think of that ride as a metaphor for how meeting Lucinda changed my life.  I’d been a solitary child, always on the periphery, happiest in my own company.  Walking the school corridors, a step or two behind Lucinda, I discovered a new world where playing second fiddle to the most popular girl in school afforded a status no amount of top marks could.  That sort of thing could go to your head, but I’d always wanted to go to medical school and although Lucinda tried to persuade me to go travelling with her, I stuck to my guns and headed off to university.

When Lucinda got in touch some years later, I hesitated.  I was working as a junior cardiologist, my life was exhausting, I was ambitious and on track to making consultant.  I had a small circle of friends.  No one excited me the way Lucinda had but I liked it that way.  I often thought of that first ride, how I’d returned to school tingling as if I’d ridden through a blizzard, and it scared me that another person could seemingly strip the skin off me.

The last thing I needed was to get sucked back into her orbit, but curiosity got the better of me and when she contacted me a second time, I agreed to meet her in a city bar.  Arriving a few minutes late I was surprised to see the perennially unpunctual Lucinda perched on a bar stool, several men buzzing around her while she flicked her hair and struck poses as if she was being photographed.  I’ve often replayed that scene, pictured myself turning around and walking away, often wished I’d paid more attention to the way that even as I smiled at the sight of her my stomach clenched, as if trying to form a shield.

Rome, New York, Buenos Aires … she had plenty of colourful stories about her travels.  But she saved her most surprising news until last.

‘I’m engaged to be married,’ she said, thrusting out her hand to show off an emerald ring.  ‘Isn’t that wild?’

The tables were lit by candles; the light from the emerald caught my wine glass and I was momentarily dazzled by a luminescent green flash.

James was a surprise, not the car crash I’d expected.  Where she was light and flighty, he was a bear of a man with unruly black hair and a beard at a time when facial hair wasn’t fashionable.  Grizzled, yes, but warm and solid.  He gave the impression he would protect her from anything.

She’d promised we’d hit it off and we did.  But let me make it plain; I was not the sort to steal another woman’s man.  It wasn’t a question of morals.  I’ve never understood the lather people get into when a politician or what-have-you commits adultery.  Not that I went in for affairs: had an opportunity for a dalliance with a married man ever arisen, I’d have turned it down.  I like order, and affairs are too messy by far.

So, although I felt an immediate attraction to James, I never considered making a play for him.  Apart from anything else, if Lucinda was his kind of woman, what chance he’d be attracted to me?  And as anyone who is truly competitive will tell you, it’s only worth competing if you stand a good chance of winning.

‘How does she seem to you?’

James and I watched Lucinda dance.  Evenings often ended up like this – we’d start off having dinner, then Lucinda, having barely eaten, would drag us off dancing.  That night the club was loud, packed, under the neon lights our drinks gave off a radioactive glow.

‘She seems to be having fun,’ I said.  By now she was surrounded by men, satellites to her whirling, fiery sun.

‘Yes, but…’

He didn’t need to finish.  We both knew what he meant.  Light and flighty had become bright and brittle.  She had always danced too hard, drunk too hard, laughed too hard; now she was too everything – too talkative, too euphoric, too quick to fly off the handle.  And not just on nights out; she was forever sniffing and running her teeth around her gums, her hair, usually so lustrous, often looked lank and unwashed. On top of that, James told me she was draining their bank account and had taken to disappearing for a day or two. It all added up to one thing: Lucinda’s cocaine use was becoming a habit.

‘I know we’re not compatible, not really.  I sometimes wonder whether I shouldn’t have chosen someone like you,’ he said, placing his hand over mine.

That was the moment. That was when my view of the heart flipped.  In retrospect he didn’t say he should have chosen me, he said someone like me.  But the charge when he touched me switched on the lights in an unexplored part of my being, plunging the part that had guided me my entire life into darkness.

I’d be discussing an angioplasty with a patient and the back of my hand, where James had touched me, would start burning.  Going through case notes with a colleague I’d picture James and I walking hand in hand by the river.  It was ridiculous, the stuff of B movies and cheap romance novels.  I hardly recognised myself.

Given my aversion to chaos, I should have stopped seeing them both.  But every time I got home with a ready-meal and a bottle of wine, I’d picture the two of them at the kitchen table and I’d put my coat back on and call a taxi.  By then I had an open invitation to drop in and I saw them at least three times a week.

If I’d only walked away, I might now be living a decent life.  We all might.  But at the time, I figured that if I was going to spend the evening thinking about them, I might as well be with them.  I convinced myself they wanted me there.  I told myself James needed an ally and that Lucinda, who clearly knew they wouldn’t last, was grateful to have a third person around.

You see, she couldn’t do her usual thing and discard him, because unlike her previous men, James was a decent guy, a good guy.  James adored her.  How could I have forgotten that, even as I sat at their kitchen table, watching his eyes follow her every move, how he’d leap to his feet if she stumbled, how he’d kiss the top of her head, eyes closed as if praying?  But forget it I did, because his love for her had no place in the Hollywood movie playing out in my mind, with its premise that I would be better for James than Lucinda, only he couldn’t see it.

 

‘She’s not here.  I haven’t seen her since yesterday afternoon.’

James looked as if he hadn’t slept for weeks.

‘Okay, but it’s not unusual for her to disappear for a while, is it?’

‘This is different.’

He tugged at his beard, checked his phone for the umpteenth time, jumped when the wind rattled the windows.

‘How so?’

He leaned his elbows on the table, buried his hands in his hair.

‘She’s been … it’s got worse.  I’m sure she’s addicted.’

‘Well, dependent maybe, but …’

‘Addicted, dependent, what’s the difference?  I tried saying … but she just laughs, you know what she’s … and then a couple of days ago I came home and found her crawling around the bedroom, all the drawers were open, underwear and sweaters everywhere.  Said she was looking for a gram of coke she’d stashed away for emergencies and then …’

He swallowed, checked his phone again.

‘Then?’

‘She flew at me.  Accused me of hiding it or getting rid of it.  She was like a wild-cat, clawing at me and spitting.  I don’t know what to do.’

Leave, I thought.  She’ll kill you both.  Oh, I wanted to say it out loud, but I knew he wouldn’t hear me and if he did, I was afraid that would be the end of that.  All I could do was comfort him.  I went to stand up but as I pushed back my chair, I heard Lucinda’s key turning in the lock.  I sat back down.  James collapsed with what I imagined to be relief, but before she’d reeled her way along the hall and into the kitchen, he’d gathered himself so that the James she’d see as she staggered through the door was solid James, I’ll-always-be-here-to-protect-you James.

Watching her skitter towards him, hanging her head in mock apology, I wanted to slap her.  This was going to end badly.  Someone needed to step in to help.

 

‘First, do no harm.’  Everyone knows that’s what doctors sign up to, only we don’t, because the Hippocratic Oath doesn’t feature that wording.  Which is just as well, because if we took that principle literally, we’d have no surgery, no biopsies, we might even stop taking blood to prevent bruising and for the sake of the poor dears who shake at the sight of a needle.  The truth is, most treatments come with risks; the physician’s role is to weigh up those risks against the benefits, but it’s not a precise science.  The judgement calls doctors make every day aren’t as arbitrary as rolling a dice but they’re less clear-cut than people might suppose.  And yes, those calls are often based on a gut feeling, that one patient isn’t in as much pain as they claim, say, or that another is unlikely to stick with their treatment plan.

From where I stood, there was a good chance Lucinda would end up in hospital, whether from overdose, cardiomyopathy, angina, tachycardia or heart attack.  But she’d have brought that upon herself. What about James, though, what was the stress of living with her increasingly selfish behaviour doing to him?

I’d belonged to the school that dismissed claims linking stress with heart disease.  It might be a risk factor, but where was the research, where was the hard evidence of causality?   But now my linking touchy-feely heart was running the show, I had to concede that a fair percentage of the atherosclerosis and fibrillations I saw belonged to people you’d either classify as Type A personalities, or who were taking care of sick or elderly husbands, wives, parents.

Studying an angiogram, I’d picture James in the operating theatre, the surgeon sawing his sternum and prising his chest apart to reveal a heart damaged beyond hope. Two lives at risk.  What a waste.  If you were a doctor and could save one of those lives, surely that would be the right thing to do.

 

***

 

Grief turned James into a shadow.  He slunk around, hugging the walls as if he wanted to disappear into the fabric of the house, as if he might find Lucinda there.

Of course, I had moments where I questioned my actions. Once or twice I went as far as admitting that, on the face of it, I’d done a bad thing.  But I’d done it for a good reason, to protect James, and anytime I doubted myself I’d remember that scene in the kitchen.  Anyway, in time James would recover.  The heart is tough. During a heart attack, the part of the myocardium starved of blood is damaged, but as long as you treat it in time, the muscle heals itself by forming scar tissue and while scar tissue can’t contract or pump, the rest of the heart keeps working.  I imagined the metaphorical heart working to a similar principle, the area of James’s heart once devoted to Lucinda eventually healing itself by forming a scar.

Hard as it was to watch James disintegrating, I made sure I was there to help him through it.  Several times a week I’d go over and cook for him.  I told myself any friend would do the same.  After all I’m a decent cook and I didn’t see anything wrong in the fact that I enjoyed being in his kitchen, felt at home in his kitchen, chopping onions or picking thyme leaves into a stew while he sat at the table drinking wine.

‘Lucinda was a lousy cook,’ he said, forking a glistening mouthful of boeuf bourguignon.  ‘She really was one of those people who can’t boil an egg.’

‘I know.  Remember the time she tried to impress us with a fish pie?’

‘God, it was inedible, everything mushed up into something that looked like baby food.  Tasted like it too.’

We both laughed.  It was good to laugh together, and I took it as a sign that James had turned a corner.

When we finished eating, he opened another bottle.  We always drank a fair bit but that night the wine seemed to go to both of our heads, and we somehow ended up on the sofa, kissing.  James’s lips on mine.  In my imagination this was the moment I came alive, as if I’d received the kiss of life.  In reality, I was so afraid I’d devour him with pent-up longing, I couldn’t relax.  I responded as a puppet might, making all the right moves without being inside of them, as if I was some distance away, working the strings.

The way he couldn’t look at me the following morning I thought I’d played my hand too soon and that we were destined to remain just friends.  But as luck would have it, I fell pregnant and James insisted on doing the honourable thing, so we married.

 

The moment I had what I’d wanted for so long, the guilt set in.  I started having flashbacks.  I could just about control them at first, flicking them away the way you flick away a wasp.  But some days they’d swarm thick and fast.  I put it down to hormones; everything would settle down once the baby was born.  Then one night, as I was getting ready for bed, I doubled over with cramps.  The blood clots followed.

The nurse scanning my uterus the following morning told me the foetus had been dead for some time.  Finally, the word I’d been fending off all those months slipped through a crack in my defences.  Killer.

A child might have brought the two of us closer; losing one drove us further apart.  Every moment of our life together felt as if it should have other-worldly choral music playing in the background.  One evening, sitting at the dinner table in silence, I realised that almost all our conversations in the past, all those conversations I’d taken as proof of our compatibility, had been about Lucinda.  Our concerns for Lucinda, our admiration of Lucinda.  Watching him push his food around I knew his heart would never heal, because he’d loved Lucinda with all of it.

I took to going on long hacks.  Kardia hadn’t been my first choice of horse.  I’d wanted a purebred Arabian but at the last minute I changed my mind and bought a crossbreed.  She was fine enough – steady, loyal and with the stamina for long rides – but I could never shake the feeling she was second-best.  We’d be riding along a stretch of disused railway track or climbing a hill on an ancient bridleway and I’d start wondering how much more exciting the ride would have been on the purebred.  Then we’d stop to take in the view over the sea and I’d reach down to stroke Kardia’s neck.

‘I’m sorry,’ I’d whisper into her mane, urging her on again until we were both breathing hard and Kardia started stumbling.

I dreaded returning to the house, dreaded the haunted look on James’s face, dreaded revisiting the image my mind insisted on replaying, of a woman counting pills into a pestle and mortar.  A woman who understood how controlled drugs interacted, and who had heard colleagues talking about an increase in overdoses involving cocaine cut with deadly fillers.  A woman so in thrall to the dictates of her heart she managed to convince herself she was acting in a patient’s best interests.

One afternoon I came home to find James slumped sideways in a chair.  My first reaction was that the blue of his face and neck matched the blue of the cushion that had fallen to the floor beside him.  Then I threw down my crop and ran to him.  Before I knelt to put my ear to his mouth, before I checked for a pulse, I could tell he wasn’t breathing.  Nevertheless, I dragged him to the ground, placed the heel of one hand on his breastbone, covered it with the other and began compressions.  I knew it was too late before I started, knew that even a defibrillator couldn’t bring him back now, but I kept going until my arms gave out.

Today I baked a cake.  I haven’t ridden since Kardia, always so reliable, shied and threw me, not long after James died.  But I need something to keep my mind occupied, so I cook.  The cupboards are full of jars of jam and chutney no one will ever eat; I make cakes and pies but never manage more than one slice.

Today’s effort was nothing fancy, just a sponge sandwiched with raspberry jam. I sat at the kitchen table, the same table where I’d ground those pills to a powder.  The first mouthful of cake was light and moist.  I congratulated myself on my baking.  But as I chewed, the cake grew in my mouth.  It became so dry I could hardly swallow, a fist of congealed sponge caught in my throat.  I almost choked.  Then the choking turned to sobs, the kind that turn your face red and blotchy, that don’t so much flush out as flood you with guilt.


lt-author-picLorna has published three books of poetry – DANCING TO MOTOWN, A GHOST IN MY HOUSE and SWEET TORTURE OF BREATHING. She has been shortlisted for the Fish Short Memoir prize. Before turning her hand to poetry, she had several short stories published – ‘Judgement Call’ is the first she’s written in some time.  Between 2014 and 2016 she was a Royal Literary Fund Fellow. Born in Brighton, Lorna now lives in Cornwall.