White Line Fever

All month, they rush into the hospital led by wild-eyed companions wearing gardening clogs, baseball hats, barbecue mits—weekend accessories. They're flummoxed, shocked. They're scared as shit. One minute they're deadheading irises or grilling burgers and the next their husbands or daughters are clutching their necks, clawing their tongues, unable to talk. A man in his 60s, tall with a thin, regal nose and lips swollen like boiled hot dogs, dances his hand through the air, then pokes Kathleen in the arm with his forefinger.

"A wasp!" the wife shouts, as if they're playing charades.

Wasp nests are overflowing that July, populating like roadside thistle. No one's immune to a severe allergic reaction, not even those who have been stung before. All sorts of circumstances change a body's chemistry. This is a lecture Kathleen gives over and over. Taking anti-inflammatory drugs. Exercise. Drinking. Yes, beer counts. All of those can increase a body's chances of an allergic reaction to a wasp sting.

"What is an allergic reaction anyway?" the wife asks.

It's the body fighting itself, Kathleen explains. "An overreaction to stuff other people can handle but the person with allergies—somehow they perceive it as a threat." She snaps off her gloves. "Dust mites. Pollen. Wasps."

"That makes sense," the wife says, nodding. "He's always been a bit of a drama king."

 

They were related by history, which is worse than blood. It meant choices were made and somewhere along the line, in his case anyway, choices were unmade. A messy fight. Ugly things said. That's what people try to picture: the end. Once it's over, no one cares how it began. The beginning of the unraveling, maybe. What happened, exactly? The staff has trouble picturing the head of orthopedic surgery with his pants puddled around his ankles, his stethoscope draped around his neck like a scarf, like a metal and rubber aphrodisiac.

Kathleen never talks about it at work, but she leverages everyone's dismay to get the upper hand. All month, she's felt superior as the nurses whisper in her wake. "Look at that: chin up and full of grace." What they should say is hackles up and full of something. Kathleen isn't exactly sure. Bitterness? Emotional vertigo? Herself?

 

A teenager stumbles in, shoved through the doors by a pack of burnt, dazed boys, shirtless, reeking of lake water and pot. One of them pries open the boy's engorged lips, like a lion tamer unclenching a jaw. "Fucking A, you gotta see his tongue," he says.

Kathleen tries not to wince at the sight of it, like a leftover holiday ham, puffy and picked at. It takes all four boys to construct a single sentence, and Kathleen pictures, out of the blue, a barn raising. They'd been at Smithville Lake and stopped at QuickTrip on their way back. In the parking lot, the boy—his name is Austin—thought something stung his jaw, a mosquito. A flying ant?

"Ten minutes, and he's like this," one of them says. Austin's wheezing grows more clipped and then, suddenly, vomit gushes all over him, streams of muddy liquid dripping down his chest like rivulets.

"He's gotta make it." This is what Kathleen hears as a nurse corrals them in the waiting room, asking if perhaps they have t-shirts in the car they can put on.

Before they get Austin epinephrine or steroids, anything close to the standard of care, Kathleen knows he won't make it. She yells orders. They need to intubate him, start an IV. Her voice is quick and shrill. "Move, God damn it, " she shouts uncharacteristically at a nurse who looks like she's walking underwater, but it's really Kathleen who feels stuck, like she's standing in tar, like someone's dragging on her ankles. In the middle of that sluggish fog, she and Austin connect, just for a second. He has watery brown eyes with curly, black lashes, the kind that belong on a stuffed animal, and they lock into hers like they're the only two people in the room, and he's willing her to save him, to get him back to the lake with that pack of troublemakers, where they'll smoke too much pot and drink too much beer and laugh like it's never going to end. Only they both know, in that one sickening second, that it's already over.

 

Kathleen stands next to a woman with a knifed box of Cheerios taped to her tank top and fake blood stuck to her chin, crusty and brown like old catsup. She's shooting tequila with a man wearing a pig nose and a baseball hat that reads Carpe Diem.

Callie falls into Kathleen and tells her a slurry, shaggy dog story about how she wanted her going away party to have a Halloween theme since she wouldn't be in Kansas City in October but she hadn't thought about no one being able to find orange masks with fake blonde comb overs in the summer so everyone got creative.

"It almost made me cry," Callie says, clutching a can of beer. "How creative everyone got."

Kathleen is pretty sure everyone just went on Pinterest for ideas, including Callie, who is wearing a mortar board with Pecan sandies glued to a bikini top, but she hugs her and appreciates everyone rallying in honor of her best friend's decision to rush a holiday so she can go teach rich Kuwaiti children instead of poor American kids. Kathleen pictures Austin in Callie's class, unpacking The Lord of the Flies. Catcher in the Rye. She imagines a clarity engulfing him, one of those moments where the ideas fall into place like tumblers in a lock.

"I need to get drunk," Kathleen tells her.

"Your garden-variety-TGIF drunk?" Callie asks. "Or your screw-everything-blackout drunk?"

"That one," she says.

"It's not too late to switch to ear, nose, and throat," Callie says. "You're only a year into this."

"I can't talk about it," Kathleen says. "If I let it out, it won't stop."

"She needs a drink. Plural." Callie grabs a man's arm, dusty and sunburned with the tattoo of a bicycle wheel on his tricep. That arm has been places, Kathleen thinks.

"I'll join you," bicycle arm says. "My girlfriend dumped me yesterday after I got back from putting my cat down." He leans back and grabs the bottle of tequila from the Serial Killer and pours it into the dregs of Kathleen's wine. "You can't make that shit up."

"Which hurts worse?" Kathleen asks.

He thinks for a second, chugging straight from the bottle. "Well, because she was an epic snuggler, I'm going to have to go with Midnight."

"That's an unusual name for a woman," Kathleen says.

He has the type of smile that detonates his face. He taps her stethoscope. "This is an unusual costume. I'm trying to figure it out. You're not going for hot nurse. It's more—I don't know—end-of-a-12-hour shift nurse? Tired-feet nurse?"

"I'm a doctor," Kathleen says. "This is what I wear to work."

"Wait, me, too." He points to the sign in front that says "slow," the one in back that reads, "stop."

"You're a street sign?"

"I prefer 'detour artist.'" He leans back on the table and Kathleen notices his veins snaking through his muscles, dream veins in her world.

"Is that the proper name?"

"Well, not everyone likes a detour, so the artistry is in making sure it's timed right. Efficient," he says. "And personally? I try to make it pleasant. Smile at people. Nod. Make it less aggravating."

Kathleen wonders if he has any more pot.

"So you hold the sign?" she says. "The slow, stop sign. But philosophically."

"Highway flagger." He pours more tequila into her cup. "That's the proper name."

 

Kathleen watches a child's rash spread across her chest and down her arms like a special effect in a movie. Her mom is unduly calm, the type of worn-down calm that comes from a life of crappy odds, low expectations, and thin mattresses. No one ever reports a good night's sleep.

They, the ubiquitous "they," have kicked her off Medicaid because she makes too much, but Kathleen says the hospital has a sliding scale for payments, not to worry about that now. "Let's just get your sweetie taken care of." Kathleen tells the nurses to administer cortisol, epinephrine, all the allergy roadblocks, and then asks the girl, who is flat-faced, past fear, where she was playing when she encountered the wasp.

"Sleeping," she says. "They come in my bedroom."

Kathleen has never known anything as simple as a tear in a window screen. Her life has been carefully constructed to impress, built from private schools, deep bank accounts, and wide safety nets. This is what happens when your grandfather patented a lightweight aluminum engine for lawn mowers in the 1950s, then marketed it like a boss. Her family is rich, a fortune all tied up in manicured lawns, a recession-proof revenue stream because the Joneses will always want trimmed crabgrass.

The girl's mom doesn't react to this confession of sub-standard accommodations. No concern about what Kathleen might think about her parenting. I should get that fixed. She looks defiant. Open, broken windows? What did you think two people who rode the bus to the hospital would have?

Kathleen thinks about her own mom and how she's never known anything as complex as an ER visit without insurance. She wonders if deep down, under her Tori Burch tunic and Dolce and Gabana sunglasses, her mom would have the pluck to navigate this woman's world, even for a morning, and decides no. No. The paltry pantry, the hunt for bus change, the thin mattress: those alone would do her in.

Kathleen's mom spends virtually all of her time with church friends. Country Club Catholics who organize fish fries and golf tournaments—definitely what Jesus would do. In Med School, Kathleen's mom tried to convince her to go into obstetrics or podiatry, anything but trauma because, from her vantage point, working in the ER is akin to running the ticket counter of an urban bus depot. "You're just getting people from A to B, right?" her mom says. "Patching them up until they get into see their real doctor?"

Kathleen knows this little girl doesn't have a real doctor. She has other things, though: round cheeks, a scar on her knee, and a mom who can navigate public transportation. She has a screen with a hole the size of her fist, and sometimes she sticks her hand through and waves to people passing by.

 

The memory replays over and over as if it's unfolding in real time. Austin's parents stumble into the ER like closing-time drunks, small and wiry with deep tans and dry, colorless hair. They look like brother and sister, like trailer park trash, like they would, right there in the middle of Truman Medical Center, slash their own wrists if it meant their boy would be okay. The dad keeps flashing his insurance card around like it's the winning lottery ticket, telling nurses, doctors, the transportation crew, that they are fully insured—union insurance—as if the staff might just triage Austin into no-man's land if that weren't the case. The same nurse who corralled Austin's friends into the waiting room barrels toward them. That nurse, with her cottony, blue-grey hair and matching eyes, always makes Kathleen crave warm cookies and milk, so she gives her time to bring the parents down from hyperventilation to excessive breathing and then Kathleen swoops in. She shepherds them to the ER's private room, the one that makes people avert their eyes, reassess their idea of what it means to have rotten luck.

Dawn and Rick sit side-by-side, their arms knotted together, bracing for the news. Rick's eyes are closed, and he is willing himself, Kathleen can tell, not to vomit. Dawn looks straight through Kathleen to the other side, where her baby doesn't come home again because she's a practical woman who sees what's what. Kathleen respects this pair more than she imagines possible, so she holds Dawn's hands, with her brittle, uneven nails and slim gold wedding band, and explains first the truth and then a lie. Austin did not make it. Despite swift injections of epinephrine, anaphylaxis shocked his body, choking his organs of blood, causing this 14-year-old boy, with his grimy ankles, funky lake fumes, and candy-stained lips, to die.

"He went quickly and painlessly," she says because telling them he writhed and flailed as he slowly choked to death wouldn't do anyone any good.

 

TJ rents a room from a septuagenarian, retired schoolteacher who is teaching herself Spanish by watching game shows all day and night. She knows impractical phrases like "Give me another spin," or "One more throw." He has the master suite, with an attached bathroom and a tiny balcony overlooking the neighbor's above-ground pool, so cluttered with paraphernalia—noodles, loungers and, inexplicably, an oversized float shaped like a black swan—that it looks like a child's bathtub. TJ owns an Ikea bed with a storage frame and pullout drawers, a lime green papasan chair perched on a wicker base, and a 60-inch flat screen TV with surround sound. It makes her feel like she's in college again, like she's on a vacation back in time.

Mrs. Beckinsale has never let him have ladies sleep over—those are the actual words he uses, "ladies" and "sleep over"—but when she learns Kathleen is a doctor, she agrees. "She's got heart palpations, so I think she figures you might save her a trip to the ER some night," he says.

Sometimes after work they lie on his bed and watch movies, comedies with flimsy plot lines and stiff dialogue. TJ loves them. He loves how he knows they'll have a happy ending, but not how they'll get there. "They remind me that there are a lot of ways to get to happy," he says, free of irony, free of snark, and that's when Kathleen realizes she's in unfamiliar territory with this one.

He tells her he learned how to kiss by watching movies in high school, when he was too shy to date. He's standing beside the bed now, still wearing his neon yellow safety vest and grimy t-shirt.

"You know in Princess Bride how Westley holds Buttercup's head between his hands? That was my specialty." He demonstrates for her and then makes her guess the all-time best movie kiss, but she comes up blank.

"Not one?" he asks.

She shakes her head.

The best kiss, he says, is when Ennis and Jack reunite after years of being apart and Jack slams Ennis into the wall and claws his face.

"That's how bad he wants that kiss."

"I never saw the movie," she says, and TJ can't believe—can not for one second believe— she hasn't seen one of the top five love stories of all time, maybe top three, so he finds Brokeback Mountain and they lie in the dark on his bed, Mrs. Beckinsale's hysterical Spanish show in the background, and as the color drains from the sky and the cicadas come out to sing, they watch two misfits fighting to belong.

 

Her work husband, Denny, a heavyset R.N. from Hope, Kansas, who also writes an advice column syndicated in rural papers, does not support her new relationship. He thinks she should either forgive Dr. Bones his transgression—"One-time-only pass for bad behavior" —or spend time dating herself. Mostly the latter. The unspoken price of their friendship—and his never-say-no coffee fetching—is that Kathleen has to hear his opinions, which are rehearsals for future Dear D columns.

"Look for subtext," he says, stirring powdered creamer into Kathleen's mug. "That's where you find the questions you should be answering. In this case, why are you dating someone so much younger and—I'm gong to go there!—so much less educated? If you start dating a middle school crossing guard, don't call me for bail."

"That sounded good," she says. "I mean, the middle school crossing guard part was out-of-bounds, but you're right about sub-text."

"Listen, I understand a rebound as much as the next fellow, but this guy? He doesn't even rent an apartment. He rents a room. And his job is to hold a sign all day. How does he fit into this?" Denny waves his hands around Kathleen and the ER.

It's about sex, she tells him, and shares her theory that less education means better sex. "I may systematically prove it. Write a paper about it in a year."

"Okay," Denny says like she's on to something. "A lot of the other docs around here are publishing, so why not you, right?"

"TJ doesn't bring his work home with him," she says. "I mean once you put the traffic sign down, you're through. You're not checking it at home. You're not reading journal articles about wrist stress among highway flaggers. You've got head space."

"That needs to be in the title somewhere." Denny says. "Head space."

Kathleen sips her coffee and nods. "Head space: A statistical analysis of the correlation between education and skill between the sheets."

"Maybe," Denny says. "Maybe."

 

Kathleen can't say no to dinner at the Club because it's her father's birthday. But she can say no to the vice president of sales at American Century Investment Funds, who her mom has casually, coincidentally, invited to dinner, her father's milestone 65th be damned. They sit next to each other with teeth-gritting smiles.

He is nice in the way that suggests he was taught good manners and knows how to behave in front of a potential date and a Kansas City strip. He is handsome in the way that suggests he got laid a lot in college but primarily because he was the frat president's wingman. He is ambitious in a way that indicates his father has connections and his parents have expectations that include a wife and a manicured yard.

"Did you know my grandfather invented the lightweight aluminum motor in lawn mowers?" Kathleen asks, just to watch her mom's brow furrow. She feels 16 again, buzzed at the club, deliberately pestering her parents. One hour with them, and she's time traveling. The only difference is she's drinking legally, not from booze she and Callie sweet-talked out of the bartender.

"Kathleen, why in the world do you think Payton would be interested in that?"

"I bet you've got a nice looking lawn," she says.

Payton smiles. Did he imagine a double entendre? She feels his knee fall into hers. Kathleen lets it rest there and at odd points over wine, the rest of her steak, and a conversation so dry it could have taken place at the Federal Reserve, she leans into his knee. Just to mess with him.

At some point near the coffee, her mom misreads everything and announces Kathleen is recently single.

"I'm dating, actually," she says. "They haven't met him yet. TJ. He's a highway flagger."

Payton looks confused.

"You might have passed him," she says. "He's working Shawnee Mission Parkway and Nieman right now."

"She's not normally this abrasive," her mom says to Payton, who smiles politely in a way that suggests he's done battle at the club before.

 

She drives to the QuickTrip on Highway 7 in Independence, Missouri, and sits in the parking lot sipping a Grape Crush. Kathleen watches packs of kids swoop in and out like feral cats. They have giant sodas, sunburned noses, and bad ideas. They careen around cars on skateboards. They plug one boy's nose while he chugs a soda. They ask a man to buy them beer, and he turns out to be the band teacher at their school.

"Come on now," the teacher says, shooing them away. "You kids get home. ASAP. You ought to take up trumpet. Come see me in the fall."

She can picture TJ coming here on his work break, getting a Big Gulp lemonade, some beef jerky, and ten minutes of AC. She thinks she sees Rick pull up in a black pickup, but when the man steps down from the cab, she sees a belly, firm and protruded, wiry chicken legs, and realizes she's mistaken.

She has their address, written on a Post-it note and folded into her wallet behind her license, but she doesn't have the courage to drive by, so she sits there, in her scrubs, hoping to catch a glimpse of someone. Dawn. Rick. Austin's friends. She wants to see them do something normal: pump gas, buy a soda, flip off a miscreant whose skateboard almost pummels them.

She's ill-equipped to navigate this world and its collateral pain. She was raised on certainty, the kind that comes from a choreless childhood, a life of pressed shirts and Aspen ski trips. She thinks about how the fingertips are one of the most sensitive body parts, so she takes her earrings off, simple pearl studs, and pierces the post into her pinky, then her ring finger, and so on. It doesn't hurt as much as she thought it would, so she shoves the post between her forefinger and the nail and there, finally, she finds it: a ragged, searing sting that pulls something from deep within her. She keeps pushing until she vomits and then drives home, forcing herself to breathe in the sour smell, like rotten fruit.

 

She has become one of those women who thinks about a man. So disappointing, really. Daydreaming about his grimy neck, his thick finger tracing her cheek. She can't remember what used to take up that brain space. What thoughts are now refugees, wandering around her gray matter, hoping to find a home? One with NPR and a newspaper.

Kathleen tells Denny she's pretty sure TJ is officially more than a rebound.

She tells him about TJ's smell: flammable, like car exhaust, tar, and Sonic slushees, the blue kind, and how it turns her on. The surgeon smells like anti-bacterial soap and day planners and always made her feel like she needed to buckle down and finish some paperwork.

Nurse Denny, in sky blue scrubs the color of his eyes, tells her TJ is not a rebound at all. "He's something altogether different. I'm just not sure what."

"Dear Confused in KC. Every rebounder needs to ask herself: what am I really ricocheting from? What bounced me here, and how do I get control of the ball?" Denny raises his eyebrows. "What do you think?"

"Not everyone will get the sports analogy."

 

Kathleen learns all about TJ's job. She's never had a friend with a blue-collar job. Not really. She loved their cleaning lady growing up, but she's certain Sofia didn't consider them friends. She thinks about Hector, who mans the grill at the hospital cafeteria, but a daily five-minute flirt over flames and grease isn't really a friendship, even if he did slip her a joint last week after she said it had been years and good God wouldn't that feel amazing.

TJ has to think on his feet, dodge drivers who are texting, putting on make up, eating burritos. He has to be resourceful in the summer heat, dipping towels in coolers of ice and wrapping them around his neck, using old school zinc oxide as a sunscreen because it creates, "like an extra layer of skin, like a shield from the sun."

"A barrier," she says as he kisses her on her nose.

The orthopedic surgeon wouldn't last five minutes on Shawnee Mission Parkway guiding traffic around road work. After two years together, she knows how he'd act. Slow. Stop.

She can picture him, yelling at the drivers, his fist raised high. "I graduated from Johns Hopkins, damnit."

 

The heat explodes in August, persistent and annoying like a heckler. She no longer worries about the car crashes, the DUIs, the 20-something, blonde beauty whose mom finds her on the floor of her bathroom, grey and listless, a needle sticking out of her arm like an arrow. They'll make it. The ER is designed to treat self-inflicted damage. It's the seemingly inane that now fills her with dread. The rotten luck she worries about: the rashes, the swollen tongues, the throat closing in on itself.

The mom doesn't speak English, so her daughter translates. Kathleen typically speaks in code, heavy on the body language so the parent can tweak the message according to temperament and age. Kathleen wonders if the girl is softening the blow for her mom, who's twisting her purse strap around her forefinger so tightly it's turning purple.

"She'll be fine," Kathleen smiles at the mom as the nurse starts the girl's IV and taps a needle bigger than her palm.

Kathleen makes small talk with the girl and learns she lives in Austin's neighborhood. She almost asks the girl if she knows Austin, but luckily something stops her because later, driving home, trying to shake the hospital smell like alcohol wipes, like fear mixed with mashed potatoes, she imagines the girl asking, "The boy who died? That one?"

 

TJ says he has a surprise for her after work. She pictures massage oil and good beer, so she can't make sense of the card table set up next to his bed, the white tablecloth, the proper dishes—where did those come from?— and the single rose tilting over in a mason jar. His TV is turned to the music channel, spa jazz. His hair is still wet from the shower. He's wearing khakis and a short sleeve, button-down shirt, soft green the color of young grass.

Kathleen looks down at her yoga pants and t-shirt and notices the antiseptic smell of hospital soap trailing behind her like too much perfume.

TJ holds a chair out for her with a flourish of his hands, then pours her a glass of wine. As Kathleen sits in the makeshift dining room inside a bedroom, inside the home of a woman who sits inside a Spanish-language world of game shows, all of which sound unnecessarily happy, she thinks about Russian nesting dolls, how she feels like the smallest one, stuffed inside other people's worlds.

Kathleen scans the room, trying to see if any other surprises lurk nearby. There are take out Chinese boxes on his dresser, next to a grocery store pie. He's swept his room, tidied the milk crates holding his socks and underwear. She notices, suddenly, the room smells like Christmas, like craft store pinecones, like manufactured revelry. He tells her that ever since they met, his world feels like it's finally unfolding, that it's open and full of new ideas and possibilities. He sounds like he's reading from a college brochure.

"I feel like we can make something of this." He's completely scrubbed the road tar and car exhaust from his hands, which are pink and raw and look smaller without the dirt.

Nothing in here feels real, not the boxed pie or his baby-clean skin or his flowery speech. But the sheen of it all feels familiar. Kathleen knows spit polish. It was like milk growing up. She also knows the drain of keeping up the shine. Fighting something you shouldn't be fighting, shouldn't have to fight, really.

That's when she realizes she's not sure how she got here, in this room with this man. She remembers a med school professor who studied white line fever, the hypnotic feeling that happens when you arrive someplace but have no memory of the journey. It's like there's two of you, the professor said at the time, and this is exactly how she feels now.

Kathleen and TJ lock eyes, and she's certain they're seeing the same ending: the one where the pretending finally wears thin and she breaks—they both know she's the weak one—and she ghosts him because it's easier, blocks his texts, then finds her way back to the real Kathleen, the one who lives under the protection of good manners, a trimmed lawn, and NASDAQ. The one whose specialty is to tape 'em and leave 'em. The one they both know is likely to raise her fist, flip off some highway flagger who's baking on the highway, just doing his job, trying to reroute her.