Of Flesh and Blood (7 page)

“Maybe you’ll get back to those flying lessons one day, huh?”

“Yeah, maybe next spring,” he said, though he knew the likelihood was slim.

“I would have preferred to drop it off in person. Give you a birthday hug and all. But I couldn’t find you at the hospital, and I knew I wouldn’t have time to drive out to your place tonight.” They hardly ever bumped into each other on the sprawling medical complex’s grounds. And Erin and her husband lived on a farm, twenty minutes outside of Oakdale in the opposite direction, with their twin sons, three dogs, and four cats along with horses, sheep, and too many other animals for Tyler to keep track of or count.

“Long day?” he asked.

“Too long.”

“Did you do a transplant?”

“Yeah. I did.”

Tyler picked up on his sister’s hesitance. “It didn’t go well?” he asked.

“The weather delayed the transport chopper.” She sighed. “The new heart had over five hours of cold ischemia before we got it re-implanted. A small miracle that it started beating at all.”

“How’s the patient doing?”

“Not great. I’m not sure she’s going to make it. She still has a balloon pump in her aorta supporting her circulation.” She exhaled and the receiver whistled in his ear. “She’s only in her twenties. A single mom. Two kids. They’re twins, just like Simon and Martin.”

“Don’t some donor hearts take a while to rebound after transplant?”

“Sometimes.” She paused. “I don’t know what will happen to those kids if Kristen doesn’t bounce back. The father is a deadbeat. And she has little other family support. Just one aunt who’s not in great shape herself.”

“Aren’t you getting a little ahead of yourself, Erin?”

Tyler was unaccustomed to reassuring his older sister. He seldom had to. Little seemed to faze Erin. Not the stress of her job, in which she literally held lives in her hands, nor the happy chaos of her home with its own zoo, tireless eleven-year-old boys, and an equally inquisitive and scattered husband, Steve, a chemical engineer who had given up his career to raise their
sons and run the farm. But ever since Erin returned earlier in the year from her stint as a volunteer surgeon at an African hospital, Tyler had noticed a change in his once-carefree sister. Less relaxed, she had begun to fuss over details that had never bothered her before.

“How are the menaces?” Tyler said, deliberately changing subjects.

“Busy. Exhausting. You know? Same as ever.” She chuckled. “They miss their uncle, though.”

“Yeah, it’s been too long,” Tyler said. “How about this weekend? Maybe they could sleep over Friday night?”

“I’m sure they would
love
to.” She paused a moment. “Will Jill be okay with that?”

“You know how much she loves Martin and Simon,” he sighed.

“And they, her,” Erin said. “I just don’t want to impose on either of you.”

“It’s no imposition. Your kids are fun. Both as crazy as their dad. Besides, Jill is tied up with her research grant renewal. I’m sure it will end up just a boys’ night out for us.”

“No R-rated movies this time, huh?”

“They hoodwinked me last time.”

“Uh-huh,” she said skeptically. “So you thought that slasher flick was rated G?”

“They told me PG-13,” he muttered. “But I’m onto them now.”

“Fair enough.” Erin cleared her throat. “Tyler, how are things at . . . your home?”

A few months earlier, Erin and Tyler had gone out to dinner to catch up. After a few beers and half a bottle of wine, Tyler had alluded to his strained relationship with Jill. Erin had not pried, but she had obviously not forgotten, either.

“Yeah, things are all good,” he said evasively.

“Great.” She laughed. “Anyway, I called to wish you a happy birthday, not to meddle.”

“Big sisters are supposed to meddle, aren’t they?”

“Especially now that Mom isn’t around to do it.”

Erin’s reference to their mother brought a momentary quiet. Eight years had passed, but the wound had yet to heal. Her death had left a void in the family that no one else could ever fill.

“Hey, Tyler,” she said with forced cheerfulness. “Why don’t Jill and you
come over Sunday for a belated birthday dinner? I’ll invite Dad and Liesbeth,” she said, referring to their maternal grandmother.

“I’m on call Sunday.”

“Weekend after?”

“Done.”

After he hung up the phone, Tyler couldn’t shake the sense that something, beyond the difficult transplant surgery, was troubling his sister. For a moment, he wondered if Steve and she were going through a rough patch, too. But he wrote the idea off as far-fetched. They had been married almost twenty years. Tyler had never met a closer, more affectionate couple. It had to be something else.
Africa?
he wondered again.

Tyler slipped into his bathrobe. He wandered downstairs and into the basement wine cellar that the previous owner had installed. Spacious with handcrafted cabinets, a tasting table, and sophisticated temperature and humidity controls, the elaborate cellar was wasted on Tyler and Jill. They kept only fifty or so bottles in a room meant to hold several hundred, and their collection consisted of mainly domestic wines that he imagined would have dismayed serious connoisseurs.

Tyler studied a row of bottles with little interest. He was considering cutting his losses and climbing into bed but, out of a halfhearted desire to mark the age milestone, reached for a bottle of pinot noir. He had just tucked it under his arm when the doorbell rang. Tyler glanced at the wall-mounted digital clock that read 10:12
P.M
. before he headed up the stairs.

He opened the door to find his father standing on the other side, still wearing the same blue suit as earlier. William McGrath extended a hand to his son. In his other arm, he clutched a wrapped rectangular box with a small red bow and an envelope attached.

“Dad?” Tyler squinted, unable to mask his surprise.

In the past year, his father had visited the house only a handful of times. Tyler never put much weight into Jill’s theory that it was her presence that kept William at bay. Tyler had few memories, even as a child, of time spent with his father. An inveterate workaholic, William had dedicated his life to the Alfredson, first as a kidney specialist and now as the senior medical administrator. The hospital was William’s home and, for all intents and purposes, his first family. For much of his childhood, Tyler had relied
on—without even realizing it—his maternal grandfather, Maarten Vanderhof, to fill in for his absent father. Maarten, not William, had inspired Tyler to choose medicine. Tyler had even followed his grandfather’s huge footsteps into the specialty of pediatric oncology, a field that Maarten had pioneered in the fifties and sixties.

“Happy birthday,” William said stiffly as he broke off the handshake and handed his son the present.

“Thanks.” Tyler was surprised at how pleased he was to see his father had not forgotten his birthday. Too embarrassed to show it, he looked down at his watch. “Dad, it’s after ten.”

“I meant to come sooner, but the day got away from me.” William cleared his throat. “I hope I didn’t wake you.”

Tyler held up the bottle of pinot noir to show him. “I haven’t reached the point of taking one of these to bed yet.”

“Maybe when you’re thirty-six,” William said in his usual dry delivery. He followed Tyler into the house. Despite his son’s objections, he insisted on stopping to slip out of his shoes before joining Tyler in the living room. “Where is Jill?” he asked, sitting down on a sofa.

“Writing a research grant.”

“Of course. The MS stem cell research?” William raised his eyebrow slightly. “Good. The controversy always spices up our Research Ethics Committee meetings.”

Tyler had heard, though not from his father, that William had to repeatedly defend Jill’s right to conduct studies within the ethical minefield that was stem cell research. “Don’t you have enough controversy without dragging Jill into the mix?” he asked.

William’s shoulders slumped. “Plenty.”

Again, Tyler noticed how tired his father looked. He could not believe how much the man had aged in the past year. “What’s the latest, Dad?”

“A few patients and staff members are unwell with a mysterious GI bug. Infection Control has suggested we may need to shut down a few outpatient clinics.” William waved away the concern and sat up straighter. And then he added, as if an afterthought, “Oh, and the Alfredson board is holding an extraordinary meeting in two weeks. I have to prepare for it.”

“Prepare for
what?
”

“The usual dog and pony show. No doubt it’s just another glorified photo op. You know that family. They like to appear involved in their namesake hospital.”

“But you said it was an ‘extraordinary’ meeting.”

“Gets them more publicity that way. I’ve been down this road before.” William pointed to the gift still in Tyler’s arm. “Open it. Please.”

Tyler separated the envelope, tore it open, and pulled out a generic birthday card. When he opened it a photo fell out and fluttered to the floor. He reached down to pick up the faded color snapshot. It showed a three-year-old boy wearing a red cowboy hat and mounted gleefully on a brown horse. It took Tyler a split second to realize that he was the boy in the picture, because he had no recollection of the occasion or the photograph. He turned it over and saw that his father had scrawled on the back:

Happy thirty-fifth birthday, Cowboy
.

Dad

Showing a hint of a smile, William shrugged. “Your mother would have wanted you to have it.”

In the last few years of her life, Jeannette had taken to the habit of including old photographs in the kids’ birthday and Christmas cards. That tradition had ended suddenly on a bitterly cold November morning, eight years before—the day his mother dropped dead of a burst aneurysm in her brain. She was only fifty-three.

“Open the present,” William said.

Tyler lifted up the box and tore off the wrapping paper. Underneath, he found a long wooden box. He unlatched the clasp and opened it. Inside was a bottle of red Beaucastel from Châteauneuf-du-Pape, 1970 vintage. Tyler suspected it had cost a fortune. He smiled gratefully at his father. “Older than me, huh?”

“You know the expression about wine?”

“That it gets better with age.”

William rose to his feet. “But it’s only true to a point. Sooner or later, all wines will spoil.” He nodded to the bottle. “In this case, with proper care, you still have a little way to go.”

“Will be interesting to see which one of us spoils first,” Tyler said. “Will you join me for a toast?”

“I can’t. I have an early meeting.”

“Well, thanks for dropping by, Dad. And for the bottle. It will be a huge upgrade to our cellar. I imagine it will embarrass the hell out of the other bottles around it.”

William showed a slight grin as he strode for the door. He stopped to slip his shoes back on. “Listen, Tyler, I know the Alfredson doesn’t hold the same relevance for you as it does me.”

Here we go!
Tyler thought, suspicious he was about to hear the real purpose of his father’s visit.

“The McGraths have been an integral part of the Alfredson for a hundred years,” William went on. “I think it’s fair to say that it’s in our blood.”

“This is not exactly news, Dad.”

“I suppose not. Nonetheless, I’m glad you and Jill have come back to work here.”

“And?”

William held up a palm. “Maybe not now, but at some point, you should consider a nonclinical role—”

“You mean medical administration? Me?” Tyler croaked. “You’ve got to be kidding.”

“In the next two years, there will be a new division head of pediatric oncology. In fact, the department head for pediatrics—”

“Don’t waste your breath.” Tyler raised a hand. “Why don’t you talk to Erin?”

William shook his head. “That would be pointless.”

Tyler couldn’t argue. Erin was as far removed from all things bureaucratic or organizational as possible. “Well, I’m certainly not interested, Dad.”

“At your age, I wasn’t interested either,” William said. “I thought administrators were all stuffed shirts and parasites. I didn’t care about budgets and expenditures. I cared about my patients. I wanted to make a difference for them. One day, though, I listened to my uncle’s advice. As a doctor, you make a difference one patient at a time. As a health-care planner, you can make a difference to the whole system.”

“Goddamn it, Dad! This is exactly why I didn’t want to come back here
in the first place,” Tyler said, suddenly unleashing a day’s worth of pent-up frustration. “I work at the Alfredson because it’s well staffed, well run, and doesn’t choose its patients based on the size of their parents’ wallets. But I couldn’t give a flying fuck about the McGrath family’s hundred-year medical dynasty or our destiny in the Alfredson’s future. For me it’s just a bunch of buildings with a lot of fancy bells and whistles, nothing more. You understand?”

“I think I do,” William said quietly. They stared at each other for a tense moment. “Tell me, Tyler. Are you sure the Alfredson would be such a world-class hospital with its open-arms policy of caring if our family had not been involved since its inception?”

“I don’t know,” Tyler mumbled sheepishly, aware that he had overreacted.

William nodded knowingly. “I realize you don’t have much interest in the place,” he said with a trace of hurt. “But it might be worth your while to have a brief look at its history. After all, history has an uncanny knack of repeating itself.”

I’ll give the old crackpot this much: She can spin a yarn
, Lorna Simpson thought as she leaned forward in the wingback chair, absorbed in Dot Alfredson’s telling of the initial encounter between Evan McGrath and Marshall Alfredson and the improvised appendectomy the young surgeon had performed over a century before, one floor above where the two women now sat. Lorna had never received the water she requested, but she had already dropped her pretense of teetotalling. Now, like Dot, she gratefully cradled a tall drink that was far more vodka than tonic.

After Dot finished her tale, Lorna held out her free palm to the other woman. “I don’t understand. Evan saved the life of Marshall’s only daughter. What possible reason could Marshall have had to hate the doctor?”