Come Home: a novel Part 19

"I'm hoping she will soon."

"I sent her a message on Facebook, but she didn't answer yet. I sent one to Victoria, too. She didn't answer, either."

Jill hid her annoyance at Victoria. "When did you do that?"

"When I was doing my homework."

Jill let it go. She didn't like the mult.i.tasking that Megan did, but she knew it couldn't be stopped. Her own mother used to say, do one thing at a time, but those days were long gone.

"Abby has lots of guy friends on her Facebook page. I was thinking that she could be with a guy friend. Maybe she's not really gone, or missing."

"You're right, that's what I'm hoping. Don't worry about Abby. Leave that to me." Jill tugged the comforter up, and next to Megan, Beef lowered his head onto his paws, closing his eyes. "You need to get a good night's sleep."

"Am I lame because I had a panic attack?" Megan asked, after a moment.

"No, of course not." Jill kissed her warmly on the cheek. "It's been a hard weekend, with the news about William. On top of that you have homework, the meet, Abby, and your Guitar Hero. There's a lot of emotion, all at once. It's too much for anybody to deal with, even somebody as strong as you."

"I thought I was having a heart attack."

"I bet. You weren't, it just felt that way."

"I thought I was going to die. You can't die from a panic attack, can you?"

"No, of course not." Jill stroked her cheek.

"I mean, what if I die tonight? In my sleep?"

"Honey, no, that can't happen." Jill was about to launch into a medical explanation, but stopped when she read Megan's expression. Her brow wrinkled deeply, and her lips clenched over her braces, in what was becoming a nervous habit. Megan was an anxious little girl in the body of a young woman, and she didn't need a pediatrician, she needed a mom. Jill gathered her up and gave her a big hug. "Everything's going to be okay, honey. Don't worry about a thing."

"Wanna lie down with me a while, Mom? Like we used to?"

"Good idea." Jill released Megan, then reached up and turned off the light, leaving them both in a soft, velvety darkness. "Move over, okay?"

"Sure." Megan s.h.i.+fted over in bed, and so did Beef, which left a skinny strip for Jill at the edge of the bed, only as wide as a balance beam, but familiar to mothers everywhere.

"Perfect," Jill said, meaning it, and she hugged Megan close, feeling her body relax.

"You sure I won't die?"

"Positive." Jill hadn't realized that when Megan was asking about death, she was asking about her own. "It's impossible. Don't worry about it, at all. Okay?"

"Okay." Megan paused. "Did you really kiss thousands of guys, Mom?"

"Millions." Jill laughed, and so did Megan.

Sam's silhouette appeared in the door. "What's going on in here? Sounds like you two girls need adult supervision."

Jill was about to answer, but Megan beat her to it, opening her arms to him.

"Sam," Megan called out. "Come in! Kitten needs hugs! Hugs!"

"Talked me into it." Sam walked over, piling into bed and giving Megan a big hug, and Jill watched Megan cling to him. Sam was a true father to her, not just the father figure that William had been, and it would kill Megan to lose him.

Jill had to find a way to make it work, when Abby came home.

If Abby came home.

Chapter Twenty-nine.

It was Monday morning, and Jill walked from the parking lot to the office, trying to switch mental gears. She'd worried about Megan and Abby all night, tossing and turning, but she'd have to put them to the back of her mind today. Flu season was like tax time for germs, and she'd need to focus at work. She'd called Padma about Rahul, and he was still feverish. She wished she'd ordered his bloodwork stat, just so she'd have the answer.

PEMBEY FAMILY PRACTICE, read the carved wooden sign in front of the large stone home, one of many on the street that had been converted to offices for doctors, lawyers, and accountants. Pembey was the town next to Jill's, only twenty minutes from her house, and a suburban practice had been just the ticket while Megan was still young.

Jill opened the door onto the waiting room, greeted by its freshened air and soothing blue decor. Big bay windows made it feel cheery, homey, and bright, even on an overcast day like today. Patients occupied most of the comfy blue-patterned chairs, reading magazines or typing into BlackBerrys, but none of the patients was hers. She didn't have anybody for half an hour, and she'd come in early to catch up on her charting and insurance paperwork, which was endless. Pembey Family took fifteen types of insurance, and Aetna alone was four of them.

Jill headed for the door leading to the doctors' offices and examination rooms, then spotted Elaine Fitzmartin standing at the intake window, signing in her elderly mother, Mary, who was an Alzheimer's patient of Dr. Thoma's. They were in all the time, and Jill liked them both. "Hi, ladies, how are you this morning?" she asked.

"Fine," Mary answered, turning with a sweet smile. "You look nice today."

"Thank you," Jill said, though she only had on her usual cotton sweater, khakis, and clogs. "How are you feeling today?"

"I did the crossword this morning, in pen. Do you do the crossword?"

"Not in pen, my dear. Good for you. Keep it up." Jill turned to Elaine, because she knew from taking care of her own mother that caretakers needed caretaking, too. "And how about you, Elaine?"

"We're fine, thanks. Much better now that Mom's on Memoril."

"Great." Jill didn't know much about Alzheimer meds. "And you, are you living on the edge, too? Doing crosswords in pen?"

Elaine smiled. "No, but I'm loving that book you lent me, the mystery. I can't put it down."

"Great." Jill noticed Sheryl, their office manager, eavesdropping from the file cabinets, but she ignored her. "You won't guess the ending, so don't even try."

"I always try, and I think I know who did it."

Jill smiled. "Don't skip ahead, like last time." She turned to Mary. "You're her mom. Tell her not to skip ahead."

"Oh, she never obeys me. She never obeys anybody."

"Then you raised her right," Jill said, and they all laughed. Behind them, Sheryl was motioning to Jill to finish the conversation.

"Excuse me, ladies, I've got to go. Take care." Jill opened the door into the hallway, and Sheryl swooped out to meet her, short and stocky in her blue scrubs, with bristly, short hair that was prematurely gray, from trying to control the universe.

"I need to speak with you in your office, right away."

Jill didn't break stride. "Okay, I have an idea. Why don't I invite you into my office to speak with me, right away?"

"That's not funny." Sheryl clutched a file folder to her chest.

"By the way, good morning." Jill opened the door into her office, a windowless white box that held her diplomas, licenses, reference books, and a neat desk with a struggling ficus plant. She spent as little time as possible here, preferring the examining rooms. She loved her patients, but didn't love working at Pembey Family, mainly because of Sheryl. "So what's up?"

"I need to speak to you about your stats, again. I know you're part-time, so I accounted for that." Sheryl pursed her thin lips. Her eyes were dirt brown, and she had the doughy features of a baby, without any of the charm. "I sent an email to John, showing that last quarter, you saw only between eighteen and twenty cases a day." Sheryl whipped out a printout of numbers, from the folder. "That's ten to twelve fewer than the average of all the other docs. Each doc needs to keep the schedule, and you need to see more cases a day."

"They're patients, not cases, and if you want to talk averages, their average age is two." Jill had explained this many times before. "I'm the only pediatrician here. I take longer because babies can't tell you where it hurts."

"Don't be funny."

"I wasn't being funny, just now. I was being funny, before." Jill gave up on the humor thing, and Sheryl's eyes hardened.

"The numbers don't lie. You take too long with the cases. You have to draw the line. Five minutes with each case, ten at the max, and twenty only if it's an annual. You're consistently running twenty minutes or longer, with each case."

"Sheryl, come on. Pediatricians don't work the same as adult docs, we can't." Jill had said this before, too. "Each visit, I have two patients, a parent and a child. I use the time it takes to give my patients the best care possible, and no more."

Sheryl gestured at the door. "Like with Mrs. Fitzmartin, you chat them up, don't you?"

Jill almost laughed. "Guilty as charged. I'm friendly with the patients."

"She's not your patient."

"I like her, is that okay with you? If I were keeping patients waiting, it would be different, but John wanted me to build a pediatric practice. The best way to grow is to provide quality care, including the relations.h.i.+p side. The statistics aren't the same for me."

Sheryl arched an eyebrow. "You don't follow any of the rules of Pembey Family, whether they pertain to a pediatric practice or not."

"Of course I do. Which rules don't I follow?"

"For starters, you answer questions by email."

Jill blinked. "How do you know that?"

"We monitor it."

Jill recoiled. "You read my email?"

"It's not your email, it's Pembey Family email. We own it, it's proprietary, and it's my job to monitor it."

"Since when?" Jill should have guessed as much, but somehow she hadn't. "Why do you care if I answer by email? We lose the exam fee?"

"It's a business, Jill. We don't encourage uncompensated phone or email advice. You're the only doc who gives out her intraoffice email, [email protected], which you're not supposed to do, either. All patient email has to go to me, at "

"Then it gets to me three days later."

Sheryl frowned. "Also, you're exposing us to lawsuits if your orders are misunderstood, or if a misdiagnosis is made because the case wasn't seen."

"I would never prescribe anything unless it was a patient I'd seen, and I don't use it for acute medical issues." Jill was so sick of hearing about lawsuits. Pembey had layers of CYA paperwork in case they got sued, and that was on top of the insurance-company paperwork. "I have to be available by phone and email. You can't tell Mom to chill out when her baby's sick."

"You're only hurting yourself, you know. Your bonus would be higher if you were more productive."

"Seeing more patients isn't necessarily more productive, and if money were all that mattered, I'd do cosmetic surgery for a living."

Sheryl's eyes narrowed. "You think everything is a joke, don't you?"

"No, I don't. I take my patients and my practice very seriously. I'm using humor to keep the mood light, and I'm failing, evidently."

"I have a sense of humor."

"Where?" Jill smiled, and Sheryl frowned.

"You act as if you're the exception."

"I am, because of what I do."

"Not so. You're the only part-timer we have. Why? That doesn't have anything to do with what you do."

"Yes, it does." Jill felt taken aback. Of all of Sheryl's complaints, she'd never heard this one before. "I do it to be home with my daughter. I love kids, even if they're mine, as absurd as that sounds."

"Megan's thirteen, Jill. I don't think she needs you to take her to playdates anymore. You'd be working full-time if you were committed to Pembey Family."

"I'm committed to my family, okay?" Jill felt herself flush. "I made a part-time deal when I got here, and I still don't get home some nights until eight."

"Every doc here works long hours."

"I'm sure," Jill said, though she never saw any of the four other docs. They all ran separate practices, and there was no time to interact with anyone except Sheryl. "But I'm the only woman, the only mom."

"So again, you're the exception."

"Yes." Jill wasn't getting anywhere. "Look, I have to do some charting, then get ready for Carrie Bryson, who'll be here any minute. She has a two-year-old and she emailed me last night, about his rash. She called the office first, for the after-hours program." Jill caught herself. "But I guess you knew that."

"Yes, and you told her that you could squeeze her in this morning. You have to stop doing that, too." Sheryl frowned. "She has to go through Donna. Donna is the appointment secretary."

"I emailed Donna and told her myself."

"That's not Pembey Family procedure. These procedures serve a purpose. If we don't know Carrie's coming in, we can't pull her file, and we can't make sure that the case is properly logged, coded, and billed."

"Donna wasn't available at midnight, when I answered the email. I know we have procedures, but they can't get in the way of the patients and the medicine. That's why we're here."

Rring! Jill's cell phone rang in her back pocket, and her heart leapt up. It had to be Abby; it wasn't the ringtone for Megan or Sam. "Excuse me." She reached for her phone and checked the screen. She didn't recognize the number but she wasn't taking any chances. "Sorry, I have to get this."

Sheryl was already stalking away. "Don't be long," she called over her shoulder, closing the door behind her as the call connected.

"Jill, it's Victoria, calling from home. Have you heard from Abby?"

"No," Jill answered, surprised. Victoria sounded less angry. Not warm exactly, but not as hostile as yesterday. "She hasn't returned my calls."