CHERISSE YANIT NADAL
Someday Find My Time
Liezl was three months into her twenty-seventh year when her vague anxiety over the static movement of her life became obsessive. Before then, thoughts about not measuring up to the success of her cousins were brushed aside by an easy refrain: I still have time. But once the truth of this refrain had altered, she could no longer prevent herself from fixating on her own failure.
It started on the day the new batch of first-year residents arrived on the floor, and she realized that ninety percent of the doctors in the cohort were younger than her. While she was accustomed to the crispness and the shine of the clothes they wore beneath their equally impressive lab coats, this cohort was brighter than those preceding it. And fuck, if she didn't feel the deficit of shine when she considered the flop of her maroon, poly-blend scrubs and the shabbiness of the worn-out threads of the gold embroidered word “volunteer” on her breast.
The deficit was underscored with a sharpness one day early in the cohort's arrival when Liezl waited for her coffee in a nearby cafe. Three interns sat at the table beside her. Each took a turn reading questions to the others.
The one who wore the dress with the red chevron stripes asked, “What would be a possible medical therapy for a patient with a BNP reading of 550 pg/mL, a mild edema presenting in the legs, and a blood pressure reading of 140-over-90, complaining of chest pain, nausea, shortness of breath, and a chronic cough?”
“I don't remember the options for pulmonary hypertension,” said the one who wore the gold tie tucked between the buttons of his shirt.
The third intern shrugged.
“Come on, guys,” said chevron stripes.
Liezl should have let it go and let the smugness continue to fill her chest, satisfied only with knowing the answer, but she didn't.
“It's not pulmonary hypertension,” she said. “Sounds like heart failure.”
Much later, it occurred to Liezl that she should have walked away after dropping her knowledge on them, but in the moment, she'd wanted the recognition. So she'd waited for one of them to say something.
Gold tie spoke first. “I'm fairly certain it's pulmonary hypertension, because of, I don't know, the hypertension.”
“It's CHF, though. She's right,” chevron stripes said.
“Fine,” said gold tie. “But there's no way she knows the meds for it.”
Because his tone of voice irritated her, Liezl said (and continued past the point her coffee order was placed on the bar), “You'd need to do the chest x-ray and the echo to be sure. And of course it would depend on the ejection fraction, but the first thing you'd want to give the patient is a beta-blocker: atenolol, carvedilol, metoprolol. Then, maybe address the BP with an ace-inhibitor like benazepril or lisinopril. And then lasix for the edema and the fluid in the lungs.”
When gold tie looked over at chevron stripes for an answer, she said, “I'd have to look it up. The answer isn't listed in the booklet.”
“She probably pulled that out of her ass. No way one of the college volunteers knows more than we do.”
The flattery of being mistaken for an undergrad did not mitigate the insult of being dismissed by the intern who, himself, couldn't be more than twenty-four. But while the “fuck you” that she held onto would have been satisfying to release on him, she thought the better of it. So, she turned to collect her coffee, which was being nudged in her direction by a first-year resident that she recognized by the sawed-off horn-rims and the nine-ray sun on his lapel pin. She should know his name, but not ever having worked directly with him, she called him what the younger nurses called him. The Filipino Malcolm X.
“Well done.” Malcolm X addressed her directly, but was loud enough for the interns to hear. “The echo would more or less confirm the diagnosis, and the attending would order a cardiac cath, but all those steps sound about right.”
“We pick up a few things on the floor,” Liezl said.
“And from your mom, certainly?”
Liezl glanced at the interns who displayed no pretense at polite ignorance. All three (and especially Chevron Stripes) sat, captive by the conversation.
“Yes, my mom is a good resource, but there's a lot to be said for observation.”
“I'll be observing her closely when I start my rotation with her in a couple of weeks,” said Malcolm X. “Everyone who's had her loves her.”
“That's what people tell me.” Liezl smiled, but tugged at her ear before saying, “How did you know she was my mom?”
Then, Gold Tie said, “Who the fuck is her mom?”
“The head of Cardiology.”
Liezl ignored the oh-shits that came from the interns and asked again, “How did you know?”
“You're the only volunteer on the fourth floor of the in-patient tower. The nurses have a lot of tsismis about you.” Then he added, “And the badge around your neck says Caagbay.”
She wondered if he would have called the information gleaned from the nurses 'tsismis' if she wasn't a volunteer. But she smiled and said, “I see.” And then, “I'm sorry, I didn't catch your name.”
He extended his hand and said, “Joel.”
“Your first name will mean very little to my mom when I tell her that I met you, Joel,” she said without shaking his hand.
“Dr. Dalisay.” His hand remained extended.
She took it. “Nice to meet you, doctor.” Then walked out the door.
The knowledge of his name had the peculiar effect of giving Liezl a heightened awareness of Joel's presence. In the early weeks of his cohort's arrival, she would not have noticed him as he passed her when she walked from the hospital's magnet high school (where she was a substitute teacher), nor would she have taken note of his presence on the fourth floor whenever he arrived. This awareness was amplified once he began working directly with her mother.
Liezl knew after meeting him that he was exactly the sort of resident that her mother would mentor with great care and attention. Beyond the traits he shared with her mother's previous favorites (she favored understated intelligence and quiet confidence over the cut-throat domination that ran through most residents), he already had the ability to make patients feel at ease, a clear-eyed earnestness, and the keen sense of utang na loob she'd known her mother would prize in him above everything. To others, it may have read as his “Filipinoness,” and they wouldn't have been completely wrong in this assumption. And it worked to his advantage which was clear to Liezl from seeing him interact with her mother for the first time.
When her mom asked her, from behind her office desk, when her next MCAT test date was, Liezl said, “I was thinking I'd take it in the Spring. Or maybe next Fall.”
“Anak ko,” she said, and Liezl had a good idea of what was coming next. “You have to decide already. Are you going to teach or are you going to move forward?”
“I'm not a teacher,” Liezl said.
“You've been at the magnet school for four years already. It's been two years since you've applied to any medical schools.”
Angry that her mother started this argument in front of Joel, Liezl didn't answer. So her mother continued.
“I won't be disappointed if you decide that you like teaching at that school, but you need to commit already. No more in-between. Look at your Ate Camille. She's making a little bit of money as full time now.”
“But she's stuck in Texas, and Nevada before that.”
“She knows what she wants to do.” Her mother folded her hands and lifted them to her chin as if in prayer. Then said again, “You need to decide something.”
“I'm going to take the test again and reapply, ma,” Liezl said. “It just takes time.”
“You're already twenty-seven, anak.” When Liezl didn't answer, she spoke again. “Dr. Dalisay, your cohort is quite young, isn't it?”
“It is,” he said. “Most of them went straight through, but I wasn't like that.”
“Weren't you?” Liezl asked.
“I was already thirty when I started.” Joel laughed a little. “Maybe I should have started sooner, but I knew it was a commitment.”
Liezl's mother was smiling when she said, “But you made the commitment eventually.”
And because of that, when Joel touched Liezl's elbow and said in a moment alone, “Twenty-seven is nothing. You've got time,” there was more sting in it than comfort.
Had Liezl been five years younger, she would have let her resentment get the better of her. The clear preference that her mother had with regard to Joel would have been enough to justify an acute and abiding hatred despite all of his pleasant qualities. But because he respected her observations where others in his cohort did not, her anger always turned. And because he asked for her opinion whenever she was present, the happiness of feeling useful outshone other emotions.
Nevertheless, she could not forget the difference in their rank. Her scrubs remained red. And while he sometimes wore blue scrubs in place of the pressed trousers and neckties, all of these were worn beneath the crisp white lab coat that told everyone that he was a doctor. The white coat ensured that he was seen; the red shirt ensured that she was not.
It was a state to which she was accustomed, and would not have given it more thought if Joel never felt the need to improve upon it.
Should she walk with him to the elevator, nurses or other residents would overtake him with question or greeting starting with, “Dr. Dalisay, if you have a minute,” leading to a conversation lasting longer than five.
In each case, before answering, Joel would say, “Have you met my friend Liezl?” after which the nurses would laugh (because all of them had), and to which the residents would always ask, “A volunteer?” with a tone that made her want to tear the red shirt from her body. Joel would then, as with the first time they met, tell his friends who her mother was. And because he said this with an abundance of energy and a smile that she could see through, she spoke none of her complaints. And even though she didn't want to, she answered questions like “Does she talk about procedures over dinner?” and “How old were you when you saw your first heart?” and even “Why aren't you following in her footsteps?”
Nobody noticed that her answer to the last question was never really an answer.
Liezl's cousin Camille came for a handful of days at the end of November and told no one but her. Though Camille was a different person from the girl who had her stomach pumped at another cousin's wedding, and different than the girl who left home because she felt she had no choice, Liezl was aware that the mistakes loomed bigger in Camille's memory than they did in the family's.
Liezl kept the visit secret out of loyalty, yes, but also to keep her mother from propping Camille's new life up on a pedestal that Liezl didn't want to climb.
But because Joel was exactly the man that Camille should fit with (better fit, certainly, than a crush on a man who already had a man of his own), Liezl arranged an introduction. And at first, she watched their conversation move quickly across the small restaurant table carrying a variety of subjects, only stalling five minutes into their conversation about The Lakers.
“I never really followed the team when I was living here,” said Camille. “I'd catch a game here or there when I lived in Vegas, but I've become obsessed since moving to Texas.”
Then Joel said, “Liezl says you're the reason she became a fan,” he said, tapping Liezl on the forearm then nudged her with his elbow.
Liezl expected Camille to say something in return, but Camille sat quiet with her chin resting on her fist until Liezl herself changed the subject.
Later, when Liezl and Camille were back in Liezl's apartment, Camille asked her, “Liz, was that a set-up?”
“Would you be mad if it was?”
“I would be if I was interested.” Camille crossed her legs beneath her on the couch.
“I don't know what you mean.”
“Come on. It's me. I know when I'm the third wheel.”
In the way that Camille was looking at her, Liezl felt as though there was something she'd done to Camille that cut deep-- something beyond the introduction, which she now had to admit had been a silly idea.
And because Liezl didn't want to sit with the discomfort she said, “You’re mad at me. Could you tell me why?”
With her elbows on her knees, Camille leaned forward and crossed her arms. Some moments passed before she answered.
“There were moments,” she said, her words choppy. “There were points tonight where the two of you-- though I guess it was mostly him-- were talking to me, but it felt like I was kind of irrelevant to the conversation.”
“That's not how I wanted you to feel.”
Camille hadn't shouted at her, but the shortness of the response made it feel as if she did. So Liezl said, “Really. I thought the two of you would get along.”
“Oh he's a good guy, ading. That much is clear.” She took a loud breath before continuing. “But, do you know why it's hard for me to come back home?”
“Because you think everyone hates you. But they don't.”
“You say that, but you don't know what I was like before Ate Altanette's wedding,” Camille said. “I didn't like feeling irrelevant. And, I don't know, tonight, you and that doctor reminded me of that time.”
Liezl wondered whether her mother would be so quick to hold Camille up as an example of success if she could see how fixated she was on the past.
“I'm not saying that it isn't sweet that you're trying to set me up,” Camille said, her tone shifting. “The man situation in Texas-- not so great. But maybe next time don't try to set me up with someone who's more interested in you.”
“He's not. He's just like that.”
“Then a guy who isn't such a big flirt,” Camille said. “I already know one of those. And that guy has a jealous boyfriend.”
When Liezl's mother heard (through Joel, of course) that Camille had spent a weekend on Liezl's couch, Liezl was not surprised when she said, “I'm glad, anak ko. I wish she would have come by to say hi, but it's good you young people went around.” But when her mother said, more quietly, “Umaasa ako na nagbigay siya sa iyo mabuting payo.”
“I didn't catch that, ma,” Liezl said, even though she did.
“Not important.” She waved her hand in the air in the way that Liezl had come to associate with every woman in her family. “Does she plan to move back?”
Liezl should have pressed her mother to repeat herself, but because she wasn't ready for an argument about the state of her life, she answered the question posed her. “We didn't talk about it.”
In the weeks that followed, there were moments when Liezl would sooner avoid Joel than seek him out. It had less to do with Camille's suggestion that he might have taken an interest in her than it did with the frequency at which her mother talked about his achievements. The awe with which the nurses spoke of him on the floor didn't help.
Her mother would note, “Dr. Dalisay made a good catch today-- infective endocarditis in a patient with hypertrophic cardiomyopathy,” right before asking, “But how was your day, anak?”
And one nurse made a point of telling her, “Talagang superstitious ni matandang babae in Room 420. Your friend comforted her na lang and finally got her to sign the consent.”
A younger nurse said to her one day, “You know how all the residents usually walk around like they were born knowing everything and like to talk like nobody could possibly know as much as they do?” The nurse waited for Liezl to nod before saying, “He's not like that. He listens to people. Like your mom.”
After she'd overheard her mother tell one of the attendings, “Dalisay is one of the most proactive residents we've had in a long time. He's a singular talent,” Liezl thought it was time that she dusted off her MCAT study guides. While she agreed that he was better than most, she didn't think 'singular' should be spoken with such finality in her mother's description of him.
Once back on her MCAT routine, she found more reasons to avoid him. Breaks were spent in empty stairwells with her notes and flashcards. Meals were spent in the hospital cafeteria pored over sample testing booklets. And when no lesson plan was left for her to implement at the hospital's magnet school, “for fun” she would go over her flashcards with the high school students she subbed for.
Occasionally, he caught her unoccupied. In the moments she saw him approach first, she greeted him with the easy pleasantness of “I'm glad I ran into you,” followed by a glance down at one of her sample questions and something like, “Does the limbic system include the limbic lobe or the associated subcortical nuclei? I thought it was both, but I'm not sure.”
But, if he caught her unaware, her reactions to him were less measured. She, like everyone else, found Joel to be a likable man. And because he came to her as though he had something to confide, it set her at ease. Even on days when all anyone could talk about (outside of patient care) had to do with something that he did. Even on the days she felt invisible.
“We had a clown in surgery this morning-- he still had his makeup on,” he'd say. Or “I had a patient who has no problem being a pin-cushion, but throws a fit whenever I ask her to pee in a cup.” Or, “Did you hear about last night's Code Green in Emergency?”
To the last, she'd answered, “I heard it had something to do with a couple.”
“The woman came in with acute abdominal pain-- appendicitis. But while the nurses were taking her vitals in Triage-Seven, the guy bursts in and asks her to marry him.” Joel shook his head. “She says no, and he proceeds to lose his shit. It took three guards to get him out.”
“Not at all,” he said. “This is the stuff they don't prepare you for in classes. Like, if you're there, do you get between the aggressor and the patient?”
“No. You do whatever it takes to protect your own safety,” Liezl said.
“If real life situations were on the MCAT, I'm sure you'd ace it.”
As soon as he'd said it, Liezl was annoyed. Bothered mostly by how obviously he was trying to reassure her, she said, “But they're not, are they?” And because she was caught up, added, “So I'll probably wind up having to take the test again while other people go on to become perfect little residents like you.”
His smile had only wilted slightly by the time she recovered and said, “I'm sorry. I didn't mean that.”
“I understand,” he said. “Testing and application periods are stressful.”
“Still. I'm sorry.”
“It's okay. Really.”
And after he nudged her with his bicep to emphasize the point, she nudged him back.
If Liezl thought that ostensibly studying for the MCAT would prevent her mother from commenting on her state of limbo, it only took one comment to disabuse her of the notion.
She happened upon Liezl studying in the hospital cafeteria one afternoon, and without greeting, she walked up to the table, flipped through Liezl's flashcards, and said, “This time, a test-tutoring service might be helpful.” The sting of this infantilization was only slightly mitigated by the soft pat her mom laid on her shoulder before saying, “If you need help, I'll pay. And maybe the fourth time will be better.”
Liezl supposed that after three mediocre showings and a two-year period wherein she did not test at all, that maybe this was warranted. It didn't make her feel any less a failure. And her appreciation of the offer didn't come easily either.
But, it was an offer that she knew she would be foolish to decline.
The closer her test date came, the more she felt the eyes of others on her as she studied. Once it occurred to her that the people around her might have an opinion of whether she had a good chance of passing or not, it was a notion she could not shake. The idea that any nurses, residents, or attendings might doubt her success on the pending exam made her self-conscious despite her knowledge that the likelihood that anyone gave a shit was slim. They would, however, eventually notice her aging in the red shirt while each successive cohort of residents would arrive younger and younger.
Less than a handful of weeks remained between Liezl and her coming test date when the frequency at which Joel ran into her multiplied. And because he happened upon her with a fair amount of regularity before this, it seemed to Liezl that she was always in his presence. Often, he would ask about her readiness to sit for the exam-- usually with a clear-eyed earnestness and a smile that she appreciated. Each time he asked, it set her at ease-- until, that it is, the pleasantness of this subtle encouragement no longer off-set the fear that those around her expected her to fail.
Despite this, she was able to accept his encouragement with grace up until he said, “If you need some extra help during this last big push, let me know. I'll make time.”
In different circumstances, she would have seen the offer for what it was. But so close to the test date with a string of failures behind her and a keen awareness of her mother's doubt in any pending success, all she could think or say was, “Oh my god, what is my mom giving you to keep me on track?” And then, “How much of a fucking failure does she think I am?”
“Hey,” he was quiet when he said it. And then again, “Hey.”
“Liezl.” The weight of his hand above her elbow was light. “Calm down.”
Pleasant as it was to feel his hand on her elbow, she pulled away from him. “You can tell her that I'm trying.”
“Everyone knows you're trying.”
“What's do you mean?”
He scratched the back of his head when he said, “That everyone knows that you're trying. That you've been working hard. Jesus.”
“But it's not enough, right?” she said. “That's why she asked you to help me.”
“She didn't ask me.” He loosened his tie. “The offer comes from me. Just me.”
She tugged at her ear. “Why, though? You don't have to.”
“Well, one: because you seem to be psyching yourself out,” he said. “And because I like you.”
“That's nice of you,” she said. “But I just think it'll mess me up.”
“Mess you up?”
“Yeah.” She tugged on her ear again. “It would be hard, not measuring up-- like studying with my mom.”
“I can't help it,” she said. “You're her perfect resident. You're everybody's perfect resident.”
“I don't know what that means, but fine,” he said. “And I don't see how that's a bad thing.”
In part, she felt like she owed him more of an explanation, but she couldn't quite articulate it herself. All she knew was that the intimidation of it would get to her, but all she said was, “You wouldn't.”
“I wouldn't,” he repeated. She didn't know if he was asking what that meant or not, so she didn't say anything. A few moments passed before he asked, “And the other thing?”
“What other thing?” she asked. “Me psyching myself out? I'll have to manage that on my own, I guess.”
“No, Liezl. I meant something else,” he said. “Christ, your mom is right. You're stubborn. This is why you get stuck.”
“Stuck?” The word lingered between then for a moment, and then she said with the force of a dry spit, “Thanks a lot. You're just proving my point.”
“Your help would just get in my way.”
She watched him as he took a breath and let it out. She was certain she imagined it, but, to her, he looked somehow shorter than he had when they started the conversation.
“Well, if you change your mind, you know where to find me,” he told her before walking away.
The week leading up to the MCAT passed with few appearances from Joel. When she sat for the test, she thought less about the mediocrity that once haunted her than she did about the strange and muted resignation she saw in Joel's face during their last conversation. In the weeks between the test date and the arrival of her score, she saw him very little on the floor. In the moments that she did, the easiness that once was there, had been replaced not by difficulty, but by something less easy. When her results came, and her score was above the range she wanted, her first thought was to tell him. But where his eyes had been clear above a smile he could see through, the expression in his eyes had become opaque and the lines of his smile had become stiff. So, she let the thought pass her by and kept the score to herself.
When she passed him on the floor, all she did was wonder about the difference.