Symptoms of a Heartbreak Read online

  “Hey, is this a private conversation?” Howard says in a flirty tone, handing one of the coffees to Arora.

  I must look shocked, because she sticks out her hand, suddenly formal. “I’m Sam. Samantha Howard. Your competition.” She winks. “Georgetown, magna cum laude. But you knew that already, I’m sure.”

  “You might be right,” I say. “That Kids Caring for Kids program sounds amazing.”

  “It’s now pairing up kids with shared cancer diagnoses from all over the world.”

  I’ve got my work cut out for me between Howard and Cho, who, as uncharming as he might seem, graduated from Yale, also magna cum laude, with a year in adult oncology already under his belt.

  This isn’t going to be easy.

  “Nice to meet you, Dr. Howard,” I say.

  “Call me Sam!”

  “Okay, Dr. Howard.”

  “No, really, you’re making me feel old.”

  Well, you are old. She must be, like, almost thirty. I can’t say that, though. “I, uh, okay, Dr. Sammy.”

  “Okay, then.” She laughs, and it’s this light, tinkling thing, and I kind of feel like I want to be her. “Just so you know: We’re gonna have fun this year.” Her eyes twinkle as she grins at me. “Think of it as a year-long slumber party. With less sleep and more blood.”

  Diagnosis: A unicorn in scrubs.

  Prognosis: Could be trouble!

  We roam through the main oncology floors—all linoleum and antiseptic, the same beige concrete-block walls and hunter-green pleather waiting room chairs that I remember from my mom’s office in pediatrics. There’s the constant thrum of nurses on rounds, chatting as they wheel patients and do paperwork. Orderlies run cleanup duty, and staff start the next batch of lunch deliveries. Every so often, the background beeping of an alarm goes off and running, the specter of death reminding us why we’re all here. I try not let it throw me, the way it used to when I was here for Harper. But my heart races every time it happens anyway.

  After some paperwork, Arora gives us a tour of the children’s floors. There are three of them (one of which my mom is in charge of—pediatrics, hence the nepotism worries), but in this special program, we’ll be focusing on the subspecialization of pediatric oncology, which has a separate wing. It’s where the really sick kids are. The cancer kids.

  The doors to the ward are stainless steel, cold, and foreboding. And familiar.

  “You need a special ID card to enter this area. Access is limited to those working or supporting children in the wing. They’re too fragile for us risk exposure,” Arora says solemnly. “And it’s not a fun space to spend a lot of time in if you don’t have to. Unfortunately—or fortunately?—for you all, you do have to.”

  We walk through the double doors and scrub down immediately, washing our hands and arms before moving forward.

  “The children in this ward are facing forms of cancer including melanoma, leukemia, sarcomas, and carcinomas, and especially localized disease, which we are seeing a significant rise in recently,” Arora says, drying his hands. Howard hangs on every word, while Cho makes frantic notes on his phone, and I hold my breath, bracing for memories of Harper. “The hospital is one of the premier centers on the East Coast for treatment of such pediatric ailments, with a forty-bed in-patient facility and an eighty-person out-patient capability. We meet state and federal requirements for the utmost in pediatric care, and some of our doctors have even been awarded the Pediatric Oncology Award by the American Society of Clinical Oncology. Make no mistake, being here is a privilege. Understand, too, that the competition here makes this already stressful experience all the more so. Remember this: While the people in this room right now are your rivals, they’re also the people you will need and learn to rely on.”

  My heart flutters—palpitations. The oncology wing looks the same as it did when I was six and here visiting Harper during her treatment for acute lymphocytic leukemia.

  The walls are painted a bright, cheerful but chipping yellow, with images of balloons and circus animals on murals here and there. The furniture and cabinetry haven’t been updated in a decade or more. The clown mural near the nurses’ station—with its blue hair and red nose—still scares me a little. Harper used to make me hold her hand and close my eyes when we walked past it. The hair on my arms stands.

  Harper was my first-ever diagnosis. She’d fallen off the swing after school at our neighborhood park. Her big purplish bruise wouldn’t heal, so I researched it online, then cross-checked it against my mom’s medical books. I remember calling her mom and insisting that Harper go to a special doctor called an oncologist. I even spelled it for her.

  We pause at the entry desk. I met Dr. Charles, the current chief of staff, for the first time when he was the surgeon supervising Harper’s chemo treatments. He called me a little doctor and took me seriously when I brought in information about treatment options. In the end, it didn’t matter. Harper died anyway.

  Arora continues on, telling us that the wing admits patients as young as three months old and as old as eighteen years old, and has a recovery rate of 90 percent. “That’s a number I’m pretty proud of,” Arora says, “and one that we will work really hard to maintain and improve.”

  “We’re playing God here,” Cho says gleefully. He’s slick, self-assured, maybe a touch too excited. Too thirsty, and always back for refills. “Controlling life and death.” It’s almost like he can feel the thrum of power, the way he’s drumming on the counter. “Each new technology brings us that much closer to giving every kid—even the worst off—a fighting chance at survival.”

  “That’s right, Dr. Cho,” Arora says carefully, like Cho might explode. “The technology is critical. But one of the biggest and best tools in our medical arsenal is hope.”

  “We have the power to shape things and shift things,” Howard adds, leaning in close to Arora. “A small sliver of light can lead the way. Our patients need our optimism.”

  I thought that, too, once. That hope would be enough. But now all I can really see is Harper’s face in my head. It takes hard science, the work of medicine, to really give a patient any chance at all. I ponder opening my mouth to tell them so, but Arora steps forward then, all business again.

  “Okay, time for us to get your system access sorted,” he says, taking a pointed step away from Howard. “You’ll get your rotation schedules this afternoon.” He heads into the administrative office, leaving us behind to worry in his wake. Well, I’m worried anyway.

  And like he can sense it, Cho pounces. “So you’re the genius, huh?” Cho asks, a weird smirk snaking across his face. “Can I offer you some advice?”

  I frown at him. Cho-splaining is clearly going to be a thing. Howard grins. She’s clearly reading my mind.

  “Do your best to stay on Davis’s good side. Oh, too late! Seriously,” Cho says, and in my head he’s hopping up and down like a leprechaun in a suit and tie, full of malicious glee. “She’s notoriously difficult. And we all know why you’re here—especially her. So I don’t think it will take much for them to cut you.”

  “And why do you think I’m here?” I ask. “Because I thought it was the advanced medical degree I earned. You know, like the one you have.”

  “Your ‘degree’”—oh my gods, he literally air-quotes the word “degree”—“might as well be in finger painting for all the good it’ll do you. You won’t last a month.”

  “Go ahead, Cho. Underestimate me. It’ll hurt that much worse when I kick your ass.” I feel weird about cursing in front of all these adults, but I have to show them I can hold my own.

  Cho does that weird smirk thing again. A list of things I’m going to tell Lizzie about him grows in my head. Like a tumor. Uh-oh. Med student syndrome is setting in already. My mom warned me that doctors tend to be the worst hypochondriacs.

  “Leave the kid alone, Cho,” Howard says.

  I appreciate her coming to my defense—but “kid”?

  “Oncology is difficult and exhausting�
�mentally, physically, and emotionally,” he says. “An eidetic memory is hardly going to be enough to get you by. You’re clearly too young for it.”

  “I don’t think you’re qualified to make that judgment. After all, my UMDNJ degree would state otherwise,” I say. “And I agree that my memory won’t be enough, so I’ll be using my intellect, too. It’s not about memorization. You have to be able to extrapolate and take decisive action.”

  “Listen, little girl, you think you get it,” he practically spits. “This job takes more than smarts. There’s an emotional maturity needed that can’t be taught.”

  “And are you going to be the big bad emotionally mature wolf of this whole thing?” I say. It’s like he’s reading from some script, eager to play the villain.

  “It doesn’t take a genius to see that you’re gonna crash and burn. After all, Mommy can’t save the day every time.”

  Grrrr! “You leave my mom out of this,” I say, seething.

  “I would, but then who’d drive you home when playtime’s over?” He grins like the wolf baring fangs, gleeful.

  Howard flashes us a serious look, one that warns us to stop.

  “Guys, this is going to be the hardest and most exciting year of our lives,” Howard says. “We’re in this together—the three of us. This is work, yes. But we’re in the business of healing, of saving lives. And having enough room in your heart to care is a big part of it. That’s something that can’t be taught. It can be grown, though. That starts with us. We’re going to need each other.” She side-eyes Cho big-time.

  Cho grimaces, and I try not to laugh. Or cry. Like it or not, I’m going to spend my days with him for the next year. We’ve got to get along. Or kill each other.

  Diagnosis: Standard narcissist.

  Prognosis: Going down.

  CHAPTER 5

  The Pizza Hut waiter sets a pie down on the table between me and Lizzie. Ugh, mushrooms. I definitely didn’t order mushrooms. I glare at Lizzie, who’s oblivious, staring down at her phone, and probably responsible for the offending topping. Yuck.

  “Into fungi today, are we?” I say to get her attention while I pick off the endless mushrooms, stacking them up on the side of my plate, leaving the good stuff, like peppers and pepperoni.

  Lizzie—Bizzie Bopper, as I’ve called her for the ten years I’ve known her—is my best friend, and one of only two non-Desi people here. (The other is my cousin-in-law Lisa, who’s Taiwanese and married to Sunil, my cousin twice removed.) But she fits right in, and she’s family, pretty much. Which is good, because she’s an only child.

  One of my little cousins races through the restaurant screaming, “You’re it, you’re it, you’re it!” Sonia Mamiji and the other aunties dig into a pile of garlic bread, ignoring their kids and the chaos they make, but my aunt Anya—Dragon Auntie, we call her—shouts at them to bring the volume down.

  I know this scene by heart, I’ve lived it so many times. Thirty-five of us are crammed at six big tables, piles of cheese and meat congealing in front of us, my mom standing at the center of the room waving her arms like she’s conducting an orchestra.

  This, in the Sehgal clan, is what you call “a small family party.” Meant to celebrate my first official day as a real doctor.

  I cringe. The sheer number and noise we bring confuses and confounds other unsuspecting diners, especially with all our musical chairs–ing around the room.

  “Ralphie!” Papa shouts to the manager from two tables away. “Can we get another jalapeño-and-onion pie?”

  “And a just pepperoni for the little ones,” Anya Auntie yells from across the room, glaring in our direction. She’s always glaring. Mom is annoyed that she didn’t show up for my big send-off this morning, but I was grateful to not deal with her disapproving grimaces so early in the a.m. “Those kids swiped the whole pie.”

  The frazzled manager hands off extra napkins and straws, then bustles toward the kitchen. Papa leans over Raju Mamaji’s Sprite with some vodka from his water bottle, pretending no one notices, even though the waiters know exactly what’s up, since we’re here at least once a month.

  My dad and uncle slap at each other, laughing, and Raju Mamu takes a big swig of the “water.”

  Vish slides into the seat across from me and starts inhaling his meatless thick-crust extra-cheese monstrosity.

  “Well, hi to you, too,” I say.

  “Too hungry for hellos.” He sets his new digital SLR camera on the table. He’s a wannabe photographer and filmmaker, so he never travels without it. Even to Pizza Hut.

  “Move over,” Taara says as she shoves into the booth, picking up a slice from her thin-crust veggie pie (because she doesn’t do grease). “This is pretty much the unhealthiest thing you could ever eat. You’d think a family of doctors would know that.”

  We all ignore her, not wanting to trigger the usual rant. Taara shoots a glare around the room, clearly wishing she was somewhere else.

  “Sit down. Stop running,” she barks at our six-year-old little twin cousins Dolly and Molly (yes, rhyming is a thing), five-year-old Shaiyar, and the baby of the group, Pinky, who’s two. They’re racing around the tables like they’re working a giant obstacle course, and the waiters bearing trays of pizza are just another hurdle in their game.

  They take one look at Taara, still glaring, and erupt with laughter as one of them crashes into a table or chair.

  My mom directs waiters balancing more pies to other tables, and my dadi and all the aunties sit at the outskirts of the group, gossiping as they pick at their pizza, ignoring the chaos, along with their kids.

  “Arre, beta, why are you eating Lizzie’s supreme?” Mom hovers over my head, waving her arms around, and the thick, musky scent of Shalimar and sweat descends like a storm cloud. The clang of the bangles she wore to match her fancy gold-worked salwar kameez, all for an outing at Pizza Hut, echo loudly over our family’s din. “Where is your barbeque chicken pie?”

  “Mother, it’s okay. I can pull the mushrooms off.” I use my arms to cover my plate, blocking her invasion.

  “No, I’ll get it, and let’s order another one. Onions, peppers, chicken?” She looks from me to my sister to Lizzie. “Do you need more garlic bread?”

  Nobody ever really needs more garlic bread. But those are apparently the magic words.

  “Yes, please,” Vish says, not looking up from his phone. “With cheese!”

  “Okay, two more pies and two orders of garlic bread. I’m on it.” My mom rushes off to go order more death on a plate.

  “I can’t believe Davis called you out,” Lizzie proclaims for the sixtieth time. She’s looking at the camera in her phone, inspecting her new look: a lacy shirt and black leather skirt, her blue eyes lined with kohl (Taara gleefully taught her how to do it), her usually stick-straight hair curled in big blond ringlets. “Dr. Davis is going down.”

  “Well, Saira was late,” Vish says, trying to be the voice of reason. He’s conflict avoidant.

  “She’s brown,” Taara adds, reaching over for more thick crust. “We’re always late.”

  “Not all of us,” Vish says, then turns to me. “Keep a low profile for a minute. Let it blow over. Davis’s rec—”

  “Is a big part of my grade,” I interrupt. “I know. She pissed me off.”

  “Yeah, but you’re a professional now,” Vish says. “Gotta get it together. And besides, you just started. Maybe all the doctors in training do have to earn the title. Like JV versus varsity, ya know?” He takes another huge chomp of his pizza.

  Lizzie flashes the phone at me again. “The white coat pic I posted for you got like two thousand hearts,” she says. “And I remembered to tag Princeton Presbyterian!”

  “That’s great,” I say. Lizzie’s been doing my social media, and as far as I can tell, she’s pretty good at it.

  “Yeah, I think it should be a good mix of doctor Saira and teenager Saira,” she says. “So we’ll get some good shots to post at the Fourth of July party, too.” She gri
ns. “Maybe of you and Vish, lovey-dovey.”

  Vish and I both groan. I am so not going to that party.

  “Oh, and once you finally have your license, let’s do a shoot of you going car shopping for something super fancy,” Lizzie says. “Like an Alfa Romero or something.”

  I frown.

  “I mean, what’s the point of living at home and making all this money if you’re not gonna blow it on something sexy and slinky?”

  Of course that’s when my older cousin Arun strides in from outside, shouting to my mother, “You want me to get the cake, Masi?”

  “Ohhh!” My mother spins around, frantic. “No! Don’t you dare. Nobody touches the cake but me.” She glares at my dad. “Especially not your uncle! Remember Taara’s twelfth birthday, when he dropped it?”

  “You’re the one who ordered slippery ice cream cake instead of platters of jalebi, like I told you to!” Papa shouts, then guffaws, as if what he said actually made sense and was funny. Raju Mamaji joins him, apparently already tipsy.

  Arun laughs—at them, not with them—then tucks into our booth, squishing Vish in farther. “You bring it up anytime there’s cake!”

  And there’s cake every time.

  Arun towers over us now. He grew like a foot after his freshman year at Rutgers and is very Ranbir Kapoor these days—all lean brown muscle and close-cropped hair. Lizzie’s already batting her eyes from across the table.

  “Eat, eat,” Mom says, rushing toward the restaurant door. “I will go get it!”

  “Arun, did you see that new Deepika movie they just released online?” Lizzie leans forward, showing too much cleavage, eager for his attention.

  He turns to Vish, already distracted.

  “I mean, she’s no Madhuri—” Lizzie continues. She’s nothing if not determined.

  “I haven’t seen it yet. I’ll check it out.” He jostles Vish’s shoulder. “I saw your game last week,” he says.