The Tie That Binds

Lucas Neuman was completely, utterly out of his element. And he was not happy about it.

He’d had a vague idea of where the Phoenix Children’s Hospital was located. Didn’t everybody? So, without checking the address or consulting a map, he’d driven to the area he had in mind, only to find himself facing the Samaritan Medical Center. Eventually, putting his faith in the posted signs, he came to suspect that the children’s hospital was on the same grounds as the medical center. Hadn’t Rachel said something like that? He thought so. And he eventually discovered it was true. But the damage had been done—his mood was turning ugly fast.

He had parked where indicated, then taken the elevator to the appropriate floor. At least, he hoped it was the right one. He certainly didn’t want to stop and ask for directions, but he didn’t relish the idea of wandering through the hospital hoping to eventually find his way.

Stepping into the corridor as the elevator doors opened, Lucas felt a momentary rush of something close to…panic. He didn’t like hospitals, anyway. Who did, right? But he couldn’t control what went on in a hospital, he probably couldn’t even understand what went on in a hospital. And today’s visit wasn’t a social call.

He was nervous about that, too. How should he present himself? Charming or aggressive? Aggressive or charming? He tried to decide on a plan of attack. Selecting a strategy might afford him some degree of control. He knew full well that his control was slipping, that he was about to teeter into the discomfort—okay, hysteria—that hospitals engendered in him. He had to find an advantage for dealing in this foreign place.

As he moved down the corridor, toward a large reception desk, he was startled at the comfortable environment he encountered. Soft lighting kept the area bright, but not overbright. Flower arrangements and painted murals added subtle, cheerful color. Silently bubbling aquariums full of colorful, slow-moving fish served as focal points in the various seating areas. Seating areas, Lucas noted, where the chairs looked like something a person could actually sit in.

Glass partitions marked off patients’ rooms, allowing for privacy without sacrificing the open feeling. Lucas could see that miniblinds would be pulled when full privacy was required. Yet somehow, despite the low-key and easy atmosphere, Lucas also felt the efficiency and sharp attention that permeated the air. He felt it keenly.

Charming or aggressive? He smoothed imaginary wrinkles from his impeccably tailored clothing, forced the frown from his forehead. And his mouth. This time, to hide his discomfiture, he chose charm. Confident charm. That—and his professional aura—should do the trick.

“Hello,” he said, flashing a smile of even white teeth at the nurse’s assistant sitting behind the reception counter. “I’m to see Evan Campbell at three. I’m early. I would like to look in on Michaela Neuman.” Saying the name was bizarre in its newness. Even Rachel hadn’t put the two names together. It shook him.

“Well, sir,” the young woman sputtered, “Michaela…she’s…she’s not in her room right now. She’s with her mother.” She was clearly torn between her sense of duty to Lucas and that which she owed to Rachel and her daughter. She pointed toward a nearby corridor. “You could wait over there if you like, so you’ll see them when they get back.”

Lucas glanced in the direction she’d indicated, feeling the annoyance rising. He didn’t find these answers acceptable. What the hell does she mean, Michaela is not in her room? How could she be off somewhere with her mother?

“Where is Michaela? I thought she was too sick to go anywhere.” He injected sufficient sneer into his voice to suggest that he was questioning the young woman’s competence. Or honesty. Or someone else’s—like Rachel’s.

“I’ve tried to explain, sir….” Her voice trailed off.

“Excuse me, Kristen,” came another voice, “do you need some help?”

“Thank you, Nurse Linda,” the assistant responded, her relief evident. “This gentleman has an appointment with Dr. Campbell, but he is asking to see Michaela Neuman as well. I’ve tried to explain.”

“That’s all right. I’ll talk to him.”

Lucas noticed he was being discussed as if he weren’t there, a treatment he found supremely insulting. Any effort at charm was abandoned.

“Yes.” He directed himself toward this newly arrived woman, assuming she had some degree of authority. “I want to see Michaela Neuman, but I’m told she isn’t here. How can that be? Where would she go? If she really is so sick—”

“Don’t doubt that for a second, Mr. Neuman,” the woman said sharply. That she used his name surprised Lucas; he knew he hadn’t yet revealed that bit of information.

Seeing that he was taken aback, Nurse Linda continued, “Oh, yes, I know who you are. Furthermore, I know why you’re here. I’ll answer your questions. But make no mistake, Mr. Neuman—Michaela’s welfare is my first concern. I don’t know that you and I share that bond. Now, come with me.”

Lucas struggled to maintain his stern exterior and prevent his genuine, warring emotions from taking over. He couldn’t swallow his sense that Rachel had played him for a fool—and yet, that didn’t seem like Rachel.

Not seeing any other option, he did as he was told. He followed the nurse to a seating area off to the side of the reception counter.

“Your explanation?” he prompted, aggression in full swing, rudeness fast approaching.

She turned to face him. “I’m Linda Tafoya, head nurse during the day. I won’t say it’s a pleasure to meet you because that would be a lie. You see, Mr. Neuman, I really do know who you are.”

Folding her arms across her body, she said, “I consider myself Rachel’s friend. And Michaela’s, too. I know how important your visit today is, no doubt better than you do. Of course Michaela is here, in the hospital. She hasn’t been anywhere else for longer than I care to consider. She is too sick to go very far and you need to realize that right now, before you stay one second longer. She isn’t in her room right now because, every afternoon, Rachel takes her from the ward—just down the hall—in order to spend some personal time with her. We support what she’s doing and we go out of our way to grant her that privacy, to respect that privacy.”

“Oh, I see.”

“No, I’m sure you don’t. But you will. She usually comes back by about two-thirty, which would be any minute now. Because I know they’re wrapping it up, anyway, and because I know why you’re here, I will let you in on their private retreat. Respect it for what it is.”

Lucas was sure that Linda Tafoya was very nearly the same age as he, she was not particularly tall, she was attractive in a neat, organized way. Nothing about her was imposing, but he couldn’t ignore the note of command in her voice. She was in charge. “Okay.”

She stared at him a moment longer, sizing him up, Lucas could tell. “Right,” she said, pointing toward another corridor. “There’s a lounge area, three doors down on the right. It’s a bit like an atrium—you can see into from the hallway. You’ll know it when you see it. Tell Rachel that Linda sent you.”

She nodded in the designated direction and left him alone. He stood then, noticing a sign posted by the door next to him. It read, “Rachel Neuman, RN Head, Pediatric Nursing.”

Lucas was stunned. His eyebrows returned to their frown position. Rachel had not explained what she did for a living and he hadn’t exactly explored the question deeply. Now he had the answer.

Recovering from this revelation, he began to move down the corridor.

He counted the doors, stopping when he reached a glass enclosure. The area was pleasantly lit—possibly by skylights. He could hear—and now see—birds playing in the fountain that sat outside the glass, in the enclosed courtyard. He pushed open the door, scanning the seats. He spotted Rachel immediately. She sat with her back to him, her mane of chocolate-colored hair still caught in that morning’s ponytail. He could hear her voice, murmuring softly, not able to distinguish the words but suspecting she was telling a story.

She held a child on her lap—Michaela, he knew. He couldn’t see her from where he stood. He could only see part of a shoulder, a typical looking shoulder except for the IV pole positioned behind it. He could see that the pole was actually attached to what looked like a child’s stroller, rather than to a wheelchair. But the child was definitely on Rachel’s lap.

He approached them quietly, almost reverently, finally understanding that he was violating something personal—something that, until now, had never had anything to do with him. His bravado collapsed. He couldn’t breathe—again. He was pulled toward the scene, toward Rachel and Michaela, by a force he wouldn’t contemplate.

“Y todos vivieron muy felices.” Rachel finished her story, one she had created especially for Michaela. In this story, as in all of those Rachel told, everyone lived happily ever after.

Rachel sighed, pulling her daughter into a more comfortable position on her lap, resting her own head lightly against Michaela’s.

It was then that she saw him. Her eyes widened in recognition, her pulse quickened in a reaction she was powerless to stop.

“Hello, Rachel,” he whispered, “Linda sent me.” He’d had no intention of explaining his presence that way. Somehow, unconsciously, he had known it was the right thing to do.

“Hello, Lucas. We were just having our story time.”

He came around in front of them, his eyes intent on the child, his heart thundering in his chest. He squatted down in front of them in the stance of a baseball catcher.

“This is Michaela,” Rachel said, gently stroking the delicate fuzzy head that rested against her shoulder.

“Hi, Michaela,” Lucas answered, his voice breaking, his mouth dry.

“¿Quién es, Mamá?” The child looked at her mother, quietly curious, waiting for an explanation.

“El se llama Lucas, Michaela, pero es su padre, mija,” Rachel replied gently.

Lucas caught his breath. While his knowledge of Spanish was shaky at best, he knew he had just been introduced to his daughter. He didn’t speak, knowing he couldn’t trust his voice, knowing it wasn’t his turn to speak yet.

Michaela regarded him solemnly, as only a child can. She took in every aspect of his appearance. “¿Por qué…” she began.

“English, mija,” Rachel reminded her. “He doesn’t speak Spanish.”

Michaela changed track, easily resuming in English. “Why is he here?” Again, the honesty of childhood sparkled.

“He’s going to see if he can help you.” Michaela didn’t question what Rachel meant by this. Evidently, the little girl knew what kind of help she needed.

“He looks like me on the outside, Mamá.” Lucas noticed that, although she spoke English, Michaela retained the Spanish pronunciation of Mamá. It was, of course, part of Michaela’s heritage. It was natural to her.

“Yes, Michaela,” Rachel answered, “he does. We need to know if he’s like you on the inside, too.”

It was that simple, Rachel thought. And that complicated.

Lucas’s head was reeling. It was all so much to take in. Bone marrow transplants, which they abbreviated as BMT, were a new concept in his world.

“We need to draw a blood sample,” Dr. Campbell advised Lucas. “Rachel tells me you would prefer a DNA-based test, which is my preference, as well. Without giving you all the boring details, I’ll just say that we tend to get more accurate information more quickly when we use the DNA test over the serology test. There are three levels of investigation we do on the sample. In your case—” he handed him a paper which Lucas recognized as a consent form “—we’d like permission to run all three levels straight away. We know our chances of a match are strong with you, and if we proceed this way, we’ll have the information that much sooner.”

Lucas nodded, thinking it couldn’t really make any difference to him. He understood, however, that urgency was involved, that speed could make a difference to Michaela.

“Furthermore, if you are a match, we’ll want to get you in as quickly as we can. There’s no point in dragging it out.” Dr. Campbell handed Lucas several brochures. “These have diagrams and such. I would recommend that you look at them. The donor procedure itself is not the worst thing you’ll ever experience, but it isn’t the most comfortable, either.”

He went on to describe how the bone marrow would be extracted from Lucas’s hip under a local anesthetic. He would be able to stay in the hospital overnight if he wanted, but he should anticipate a certain degree of tenderness in the area afterward and should not plan to drive himself home.

“How will Michaela get the transplant?” Lucas wanted to know.

“Well, I’m not her doctor. You’ll want to talk to Dr. Graham for the specifics of Michaela’s case.” Dr. Campbell removed his glasses and was pinching the bridge of his nose with his fingers. “That said, the recipient usually receives it through an IV. The chemo she’ll have prior to it will be worse for her than the actual BMT procedure. But she will be fragile for some time afterward. Essentially, she’ll have no immune system and she may very well have side effects from the chemo again.”

“So,” Lucas pondered aloud, “this is what Rachel meant when she said it would get worse before it gets better.”

“Probably,” Dr. Campbell agreed, reaching to push the buttons on his intercom. “Yes, Kristen, this is Evan. Is Paul Graham around?”

A few seconds later he spoke into his phone again. “Yes, Paul. Evan here. Listen, Lucas Neuman is in my office, talking to me about the bone marrow transplant. Do you have a few minutes to talk about Michaela?”

Scant minutes later another man let himself into Dr. Campbell’s office. Lucas found himself standing and shaking hands with Paul Graham. Paul was blond and blue-eyed and noticeably fit. He had a gentle manner, but Lucas felt himself squirm under the intensity of the man’s blue gaze. Lucas had no idea how old the man might be; his appearance gave nothing away.

“I’ve got brochures for you, too,” he began, handing Lucas another handful of leaflets. “These give some general reference information, but as far as Michaela is concerned, well…hers has not been an easy case. She didn’t respond as quickly to chemotherapy as we might have hoped. AML, the kind of leukemia Michaela has, tends to spread to organs throughout the body. The longer it takes to get remission to occur, the more likely this kind of spread is. That’s why her BMT is so important. On the one hand, it’s not an unusual procedure at this point in treatment, but she needs it more than most. Without it…” He shrugged, letting his silence finish the sentence.

They had talked for a few more minutes, Lucas understanding that either doctor would be available to discuss the situation with him again, if he felt the need. Lucas was also aware of their disapproval—a very sure knowledge that they didn’t like him, despite having just met him.

The busyness outside Dr. Campbell’s office briefly dazzled Lucas and it took him a few minutes to get his bearings. Then he decided he wanted to look in on Michaela and maybe speak with Rachel again.

His attention was diverted, however, by a cluster of people moving along a corridor and coming to a halt at the reception desk, a few feet away from him.

“Muchas gracias, Doña Raquel, muchas gracias.”

Lucas watched as a woman clutched Rachel’s hands, offering her thanks. She was Hispanic, her jet-black hair showing a few impressive streaks of white, her black eyes sharp and bright with unshed tears.

“De nada, señora.” Rachel answered, continuing on in hushed Spanish tones that Lucas could neither follow nor understand.

“What’s the commotion?” Dr. Graham’s voice came from behind him, followed quickly by a chortle of laughter.

“Ah, yes,” Dr. Campbell said, smiling at Lucas, nodding his head toward the ruckus. “Today, Tómas goes home. He is a fan of Rachel’s, I’m afraid.”

Lucas searched the cluster of people, seeking someone who might be considered a patient. He finally spotted a boy, perhaps thirteen years old, sitting in a wheelchair, a hand and a leg encased in plaster. Or fiberglass, or something, Lucas corrected. Whatever they make casts out of these days.

The young boy, blushing furiously, clearly had eyes only for Rachel. She handed him a bouquet of balloons, speaking to him in Spanish, and posed for a picture with him. Lucas supposed the woman must be the boy’s mother.

Lucas’s first glimpse into Rachel on the job left him uneasy—and grudgingly respectful.

The group eventually arrived at the elevator, freeing Rachel to make her way over to Lucas when she saw him.

“Hello,” she said, smiling lightly. “How did your meeting go?”

“Fine, fine,” he answered. “I met Dr. Graham as well as Dr. Campbell. Dr. Graham is Michaela’s doctor for…this?”

Rachel nodded.

“Right,” Lucas resumed. “Anyway, they gave me my marching orders and a whole lot more, right here.” He held up the handful of papers. “I’ll be back in the morning.”

“I might see you then,” Rachel said, making to leave.

Lucas’s hand shot out, as if to grab her, a motion she evaded. “Um, wait, Rachel.” Now that he had her attention, he wasn’t sure what to say next. “So you’re a nurse.” It wasn’t particularly elegant or profound, but he had succeeded in extending the conversation.

“Yes.”

“How long…how long have you worked here?”

“This is the first and only place I’ve ever worked Lucas. I’ve been here five years.”

“Five years,” he repeated stupidly, understanding the significance of that time period. She had obviously started working here just when they had separated. When she’d finished school.

“Yes, Lucas. I interviewed for a position while you were in Las Vegas. It was one of the things I was doing…that week. I took the position as head a couple of years ago. I certainly wasn’t hired as head.”

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