The Ranch (18 page)

Chapter 9

Sam worked with Zoe for several hours the following week, to acquaint himself with her current patients. There were a number of them he knew from covering for her on the odd night, here and there. But when he read all the current files of her most acutely ill patients, he was stunned by how many she handled. She had roughly fifty terminally ill patients, and there were more arriving on her doorstep every day, and sometimes every night.

They were brought in by friends, or relatives, or just simply people who had heard about what she was doing. They were all very sick, some who had AIDS, and others who didn't. She took care of all of them, and Sam was particularly touched by the children. There were so many little ones with AIDS. It made you grateful for every healthy child you'd ever seen. Sam knew why Zoe was particularly appreciative of Jade. She was a truly remarkable baby, and wonderfully healthy.

“I can't believe the number of patients you see every day,” Sam commented late one afternoon, “it's inhuman. No wonder you're tired all the time.” It would have been so easy then to just tell him she had AIDS. But it wasn't his problem, or his business. She had already decided she wasn't going to make it anyone's burden but her own, for as long as she could do it. She was planning to save money for herself to put aside for medical care and treatment, for nursing care if it ever came to that. The only real problem she had was Jade, and what to do with her when she died. It seemed awful to be thinking like that, but Zoe knew she had to. Part of her was still resisting it, but another part had already accepted her fate. It seemed an incredible end to a bright career, and if she let herself, she could dwell on her bad luck and ill fate, but she really didn't want to do that. She just wanted to enjoy whatever time she had. And she knew she might have years, even a decade, it didn't happen often, but it happened to some that way, and she was going to do everything she could to ensure that it happened to her. The trip to Wyoming was part of that, the rest, the scenery, the altitude, the air, along with the comfort of seeing her old friend Tanya.

“What about this one?” Sam interrupted her reverie to hold out a file to her. It belonged to an extremely sick young man. He had already entered the last stages of AIDS dementia, and Zoe doubted that he would last much longer. He had put up a valiant fight for months, and there wasn't much she could do now, except make him comfortable, and console his lover. She visited him every day. She explained it all to Sam and he shook his head. Hers was the most unorthodox of all the practices he worked for, but it was also the most creative in terms of treatment, and he was deeply moved by her compassion. She seemed to leave no stone unturned in seeking out new antibiotics, medications, ways of treating infection and pain, and even unusual holistic treatments. She did anything she could to beat the disease, right till the bitter end, and to comfort the patient.

“One of these days we'll get lucky,” she said sadly. But not soon enough for all of them. Or even for herself now.

“I think they got lucky when they found you,” he said, looking at her with ever increasing admiration. He had always liked her so much, and he liked her even more now. She was everything a physician should be, and most weren't accessible personally but she was. He wondered if it had anything to do with the lover who had died of AIDS years before. He wondered if she had loved anyone since then, and guessed that she hadn't. Surely not Dick Franklin. Sam would have liked to be closer to her. She had always been very open with him, and very friendly, but he never felt there was any interest on her part in being more than friends and business associates and collaborating physicians.

And particularly lately she felt she couldn't allow herself to be close to anyone. She was very careful to put a safe distance between herself and the rest of the world, even Sam, whom she had known since med school. She didn't want to mislead him or anyone, to lead them on, or provide a come-on. She wanted to make it clear to everyone that she was not available as a woman, only as a doctor. It seemed the only fair way to handle her situation. She had even thought about buying herself a cheap wedding band, and she forced herself not to think of the lonely path she was taking.

But as they worked on the last of the files, Sam glanced at her again and wondered if he could ask her out to dinner. There was still plenty to talk about, and he was in no hurry to go home. “Can I talk you into something to eat while we finish up? I thought we could go out for pasta in the neighborhood or something. Any interest?” he asked, nearly holding his breath and feeling stupid for it. She made him feel like a kid sometimes, and he liked that. He liked everything about her. He always had. And over the years, he had come to admire her more, and like her better.

“That sounds fine,” she said with no clue at all that he found her even remotely attractive. She had wanted to take him out anyway, to thank him for giving her the opportunity to leave town and have a real vacation. She felt a little guilty leaving Jade, but he had promised he'd keep an eye on her too, and stop in and see her and the au pair when he left the office.

“You're really a full-service on-call doctor,” she teased as she slid into the booth in a little Italian restaurant in the Upper Haight. She had come here for years, and she liked it. It was quiet, and the food was good, and it was the first time she and Sam had sat down and talked to each other over dinner since med school. They laughed about how long it had been. Although their paths had crossed regularly over the past eighteen years, they'd never really had time alone together, they were always working.

They both ordered ravioli, and he offered her wine but she refused, and then they settled down to talk about work again. They were halfway through dinner when he looked at her with his boyish grin, and something warm and friendly in his eyes that made her feel surprisingly easy with him, more than ever.

“Don't you do anything but work?” he asked gently. He admired her, but he felt sorry for her too. She did so much for so many people, and he knew firsthand how draining it was. But there didn't seem to be anyone to do anything for her. And he couldn't imagine her deriving any real comfort from her relationship with Dick Franklin, or anyone like him.

“Not lately,” she answered him, “except for Jade.” And then he wondered about something.

“Have you ever been married?” He didn't think so, and he realized he'd been right when she shook her head.

“Never.” She didn't seem in the least bothered about it. She was comfortable with her life, and happy with her daughter. Her life seemed enormously fulfilling.

But Sam was curious about it. “Why not? If you don't mind my asking.”

She smiled. She didn't mind at all. Except for her illness, she had no secrets from him. “I never really wanted to, when I was young. And the only man I probably should have married died over ten years ago. He contracted AIDS from a transfusion. Thanks to him, I started the clinic. He was in research and he was brilliant. He had bypass surgery at forty-two, and eventually it killed him. He didn't live a year after the transfusion. I thought about going into research with him. I'd always been intrigued with unsolved mysteries, and remote diseases. And then AIDS came along, and I got caught up in the physical-care end of it and not the research.”

“It would have been a real loss to a lot of people if you'd done something different,” he said gently, and he meant it. She was a fantastic physician. He knew about the doctor who'd died too, but he'd heard about him from other people. And he watched her as she told him. She looked sad, but not devastated, and he sensed that she'd recovered, although she'd obviously never found anyone who meant as much to her. “Before AIDS, I was fairly involved in juvenile diabetes. In its own way, that's another scourge like this one, although it gets a lot less attention.”

“I've always been interested in it too. And I guess I'm a scavenger of sorts, I love visiting other people'd practices, picking up little bits and pieces of information, and solving problems, doing what I can, and then moving on. It probably sounds irresponsible, but I've never wanted my own practice. That just seems like a lot of paperwork and red tape, and issues that have nothing to do with medicine or patients. I like doing hands-on work, I don't want to waste time with contracts and insurance and worrying about property, and all the politics established doctors get involved with. Maybe I just haven't grown up yet. I keep waiting for it to happen, I keep thinking that one of these days I'll want to associate with a group of docs and join their office, but I never do. What I see of most of them turns me off completely, except on a rotating basis, the way I do it with you. This way, I get to do all the good stuff.”

She smiled at what he said. It was a little bit like the philosophy of emergency room doctors. They wanted to deal with the patients and not the paper or the overhead or the problems. But in her case she would have missed the long-term relationships she developed. “You remind me a little of the Lone Ranger,” she said, smiling,“… who was that masked man, Tonto?… My patients love you. You do a great job. And I can't really blame you for avoiding all the crap that goes with an ordinary practice. I've really missed not having partners, it's so much more work like this. But I also like not having the headaches, the arguments, the petty jealousies, and all the problems. When Adam died, he made it possible to set up the kind of clinic I wanted, and do it exactly the way I thought it should be. But it's still awfully hard not having adequate help, except on occasion.” She smiled at him again, and he found himself wondering again how involved she was with Dick Franklin, but he was afraid to ask her.

“Were you planning to marry Adam before he got sick?” He was curious about her, about them, about the baby she'd adopted and why, and why she seemed so comfortable alone. She was an intriguing woman.

“Not really. I think we might have eventually, but we didn't talk about it. He'd been married, and he had kids. And I was busy building up my practice as an internist. I was in a practice with two other docs then, but I left it when I
set
up the clinic. I never felt compelled to be married, or even to be with anyone indefinitely. We saw each other a lot, and we were very close, but we didn't live together actually until he was dying. I took three months off work and took care of him. It was very sad,” but she looked as though she had made her peace with it, She was serious, but not grieving. It had been a long time since he'd died and a lot had happened in the meantime. She still saw his children from time to time, but she hadn't been close to them, it was only after Jade was born that she actually understood the extraordinary joy of having children. He asked her about that too, and she told him how it had come about. Jade's mother had been nineteen years old, unmarried, and had no desire to keep the baby. And her family had refused to take her in when they discovered that the baby was Asian.

“She's the greatest thing that ever happened to me,” Zoe said simply. And then she turned the tables on him. “What about you?” She knew he'd been married briefly in Chicago. “What happened with your marriage?” They had lost track of each other during their residencies, and by the time he came back to San Francisco, his marriage was behind him and he said very little about it, and it was rare for Sam and Zoe to take a night off, just to talk, like this.

“The marriage lasted for two miserable years, while I was doing my residency,” he explained, looking thoughtful. “Poor kid, I never saw her. You know what that's like. She hated it. She said she'd never get involved with another doctor. But she was genetically doomed. Her father was a big thoracic surgeon in Grosse Pointe, her brother is a sports doctor in Chicago, and after me she wound up marrying a plastic surgeon. She has three kids and lives in Milwaukee, and I think she's very happy. I haven't seen her in years. And when I first came back to California, I lived with a woman for several years, but neither of us ever had any interest in getting married. We'd both had bad experiences before, and neither of us was ready. You remind me a little bit of her actually. She's kind of a saint like you. She had a real need to make a difference, and she was always pressuring me about it. In the end, she did what she had to do, and I stayed behind. She's a nurse-practitioner in a leper colony in Botswana.” Zoe vaguely remembered hearing about her, but it was before Sam had done locum tenens for her, and Zoe had never met her.

“Wow! That's serious.” Zoe looked at him, fascinated by what she was hearing. “And she couldn't talk you into joining her?” Zoe thought it sounded vaguely appealing, but Sam clearly didn't, as he shook his head, with a look of horror.

“Not on your life.” He grinned. “No matter how much I loved her. I hate snakes, I hate bugs, I was never in the Boy Scouts, and I think camping trips and sleeping bags are sheer torture. I was definitely not cut out for a life serving mankind in the jungle. I like my nice comfortable bed at night, a good meal, a warm restaurant, a glass of wine, and the wildest vegetation I want to see is in Golden Gate Park on a weekend. Rachel comes over here about once a year, and I'm still crazy about her, but we're just friends now. She lives with the head of the leper colony, and they have a baby. She loves Africa and she says I don't know what I'm missing.”

“By not having children, or by living here?” Zoe was laughing, but it was quite a story.

“Both. She says she'll never leave Africa. But you never know. The politics over there get pretty scary. It's definitely not for me. She's a great gal, and she did the right thing. She left five years ago, and I don't know, the time has just flown. I'm forty-six years old and I guess I've just forgotten to get married.”

“Me too,” she laughed at him, “my parents used to go crazy over it. They both died in the last few years, so there's no one to bug me about it anymore.” And now she knew she certainly wouldn't be getting married. But talking about his own life suddenly made Sam feel braver.

“What about Dr. Franklin?” He felt nervous asking her, but he was curious. And she definitely didn't put out vibes that said she was open to invitations. He wanted to know if it was because of Dick Franklin, or if there were other reasons, maybe even someone else he didn't know about. It was hard to believe that a woman like Zoe only cared about her practice and her baby.