"Here, taste this." I twirled some of the pasta around a fork and brought it to Henry's mouth. He took a bite, and bless him, he rolled his eyes to the back of his head; a clear sign that he had entered into a state of nirvana.
"Holy fuck that is amazing. You cooked that?" He took the fork from me and tried to put it back into the pan, but I swatted his hand away.
"Um, no need to be so surprised asshole."
"It's just, I've never had anything in my life that tasted so amazing. What is it?"
"It's called cacio e pepe which means 'cheese and pepper.' It has few ingredients, but it's actually hard to make it taste really amazing. Traditionally you should use a pasta called tonnarelli, but that's hard to find here. What you can't skimp on is the cheese. It's essential that you use aged Pecorino Romano cheese. And, well, I know the guy who sells to the restaurant, and he's trying to convince me to switch to a different producer in Italy, so he gave me some to try out. It's good, right?" I used a different fork and transferred some to two of the plates I had preheated.
"Sam, I am officially having my first official foodgasm. Or maybe second, those shrimp we ate at the restaurant were unfucking believable too."
"Don't forget the shrimps that you had in Spain..."
"They don't even compare. Seriously, this is incredible." He looked down at the two bowls I was preparing and then back up at me. "Is that all you're giving me because that's not enough, I need, like, double that amount." He pointed at one of the plates and then looked at me with a very serious expression, like I had just stolen his puppy or something. I laughed, and then combined both portions on to one plate, handing it to him, and put another, human-sized portion on to the now empty plate in my hand.
The salad was already on the table, but I grabbed a bottle of prosecco from the fridge and we moved a few feet over to the small table that was in my kitchen. It was hard to initiate a conversation because he was literally shoveling food into his mouth. He caught me staring at him and slowed down a bit. He might have been embarrassed, but frankly, I think there can be no better compliment to the chef, so I just smiled. When he was nearing the end of the pasta, or at least, what was on his plate, I ventured to ask him a question.
"I know you said you don't want to talk about it, and you don't have to, but I'm curious, does your program give you any resources to manage this sort of stuff?"
"We need to speak to a psychiatrist twice a year, but we all know how to bullshit our way through that, so if we don't really want to talk about it, we don't have to. Must of us don't, myself included. And I don't mean what we're doing now, I mean, I just don't think that talking about it to a shrink helps much."
"Have you ever tried it?" I poured myself another small glass of prosecco, offering some to him as well, but he declined.
"Therapy?"
I nodded. He thought for a moment, "I guess not, I mean not regularly. When stuff like this happens I usually just drink and go to a dark place for a few days, sometimes a few weeks, and then I pull my head out of my ass and move on until it happens again."
I nodded again. "I can understand the appeal of that approach, but it doesn't seem very sophisticated, especially for a surgeon."
He swallowed, and then took a sip of water. After putting the glass down, he ran his fingers through his hair and then took a deep breath.
"She had two kids, Sam. She was on the way home from the grocery store with a cake for one of their birthday parties. She died on the day her daughter turned five."
"And you feel responsible?"
"I am responsible, she died because I didn't see the injury to her superior mesenteric artery."
"Did you look for it?"
"Yes, we didn't see anything."
"So you didn't miss it. You looked, and it wasn't there."
"Well, obviously it was, because it clotted off and her bowel died."
"It's not within the realm of possibility that whatever happened wasn't visible or that it happened after surgery?"
"Well of course it's 'in the realm of possibility,' but given the extent of the damage it should have been apparent at the time of her surgery on Friday."
"But you just said that it wasn't. You looked, there was no sign of damage."
"I get what you're saying, but I don't think you understand. I operated on her. It was my job to assess her for damage. She had this small hematoma on her duodenum, which meant that she clearly had sustained some intraabdominal trauma. The injury to the SMA was there, I just didn't see it."
"You didn't see what was invisible?"
"Sam... I can't explain it any better than this. I should have seen it."
"Why?"
"Because that's my fucking job!"
"It's your job to see things that aren't there?"
"No, it's my job to fix people when they get clobbered in a head on motor vehicle accident. It's my job to make sure that I've excluded every possibility, that I've looked under every stone."
"Knowing what you know now, and that her whatever..."
"...her SMA..."
"...right, her SMA was injured, what would you have done differently in the operation on Friday? How would you have figured it out?"
"We could have done an intraoperative perfusion study to see if she had a clot in the SMA."
"What if the clot wasn't there yet, what if it formed later when she was laying in the hospital bed after surgery? Would you still have been able to detect it?"
"Well, no, I mean, there could have been a filling defect I guess, but no, if the clot wasn't there at the time, we wouldn't have seen it."
"Was there any indication to do the other study? Would everyone have thought you were crazy if you'd told them to do it?"
"I don't know, probably. My attending had scrubbed out at this point, but he examined the duodenum and SMA with me and didn't think there was anything else there."
"So someone who has more experience than you also thought that she was ok and basically told you to finish?"
"Well, yeah..."
"And you still think this is your fault?"
"Sam, she died with my hands in her gut. I killed her. If I'd seen the injury to her SMA, she'd be eating leftover birthday cake right now."
"Maybe. Or maybe not. Maybe the car was traveling 5 miles an hour faster and she would have died on impact, or in the ambulance. Or maybe you decided to do the perfusion study and detected the clot and while trying to repair it something else happened and she bled out. Or maybe another clot formed somewhere else or traveled to her lungs or to her brain and she died that way. Or maybe you didn't hear your phone while we were at the movie, so you didn't go in, and yeah, she still died, but it didn't happen while you were there. You'd feel differently, right? All I'm saying is that you're holding yourself to a ridiculously high standard. 'To see what isn't there?' Really? If that's your goal, you're setting yourself up for disappointment, and probably alcoholism."
He rubbed his fingers thoughtfully over his lips without saying anything.
"You know what really sucks about all of this?" he asked, putting his hand on the table and leaning in to me.
"Tell me?"
"I've mostly been thinking about myself and how I feel. How her death has affected me. I mean, I've thought about her family, obviously, but mostly I'm just angry at myself."
"Now we're getting somewhere. Self-directed anger is something I am a bit of an expert at; seriously, if they handed out awards for it, I would be, like a triple gold medalist. Do you know how often I think about Sara? It's every day. Did I make the right decision? Is she happy? Is she alive? Would she have been better off with me? These thoughts started eating me alive to the point that I actually stopped eating. And you know what helped? Talking with somebody, with lots of somebodies. For years. Over and over again. Until it stopped controlling me. And even after all that talking, I'm still not over it, but it doesn't rule my life. All I'm saying is that if this is a predicament that you are likely to find yourself in over and over again throughout your career, it seems really short-sighted to not develop the tools that you will need to deal with it. It's kind of like purposely going camping in the rain without a tent."
He nodded his head and looked quizzically at me. "You know, that's a fairly cogent argument and a valid criticism of my approach. But seriously, when would I find the time? I hardly see you as it is and I genuinely like you."
"I think if it mattered enough to you, you'd be able to find the time. Or, the next time that you are forced to meet with the psychiatrist you could just tell them the truth, that you're interested in talking with someone and I'm sure they'd help get you connected."
He moved the empty fork back and forth over the parmesan dregs on his plate then looked over at me and the small, unfinished portion of my pasta. "You going to eat that?"
"Seriously dude. I'm going to start making you lunch, this is ridiculous, it's like you are carbo loading for marathon only you do this every day!" Nevertheless, I picked up my plate and handed it to him and he gulped it down in two bites.
"Do you want some dessert? I made chocolate chip ice cream sandwiches, or there are just plain chocolate chip cookies if that's your thing."
His eyes went wide at the mention of even more food, but all he did was nod. When I got up to carry his plate over to the counter he grabbed my wrist and pulled me on to his lap. He wrapped his arms around my waist and I wrapped mine around his neck.
"I'm absolutely too full to engage in even entry-level darts, but I just wanted you to know that I plan to annihilate you in a triple round later this evening." He pulled me closer to him and turned his face up to me, inviting me to kiss him thoroughly, which I did.
"I look forward to it."
"I forgot to ask, how was the Halloween party?"
"It was ok, I didn't stay long and mostly hung out with Zack who was dressed in a very skimpy loin cloth."
"What did you go as?"
"Do you want to see?"
"Sure!"
I hopped off his lap and walked into my bedroom, pulling the white Marilyn Monroe dress from the dirty laundry pile. I pulled off the bulky sweater but didn't bother changing out of my running shorts. I managed to zip myself up in the back and sashayed back into the kitchen, doing my best to exude Marilyn-level sex appeal. I approached him from behind and started singing "Happy Birthday Mr. President" in a very Marilyn-esque voice. I had zero tone, but Henry didn't seem to mind. At the end of my song, he applauded and kissed me, biting my bottom lip.
"Can you do the iconic pose over the subway grate?" he asked, lowering his voice into the panty-ripper octave.
I smiled and did my best to spin around, letting the full skirt come out around my as I pushed my hands down to push the dress back into position. He laughed and pulled me into his lap, kissing me on the nose.
I wrapped my arms around his back, massaging his hair at the base of his neck.
"Can I stay here tonight?"
"Of course Blue, you don't need to ask, you are always welcome here."
"I've got to get up super early..."
"Uh, yeah, Blue, I think I've figured that out by now."
"You mentioned something about chocolate chip cookies?"
"How can you possibly think about eating anything else right now, I'm so full!" I put my hands over my baby food belly, causing him to laugh.
"Oh I can think of a lot of things I'd like to eat right now, but let's start with the chocolate chip cookies, ok?"
I walked to the freezer to grab the desserts I had made, pulling out two and then walked back to the kitchen table. He made himself useful by putting the dirty plates in the dishwasher and tidying up the kitchen counter. I took a bite of my chocolate chip cookie ice cream sandwich and marveled at how easy we moved in each other's spaces. There was something about him that just seemed to fit perfectly in my kitchen and it gave me a warm, fuzzing feeling, which counter-balanced the cool of the ice cream.
He came and sat down at the table, taking his ice-cream sandwich in hand and took a gigantic bite. "Fuck me this tastes so good." I took one more bit of sandwich, and then wrapped the rest of mine in wax paper and put it back in the freezer. I grabbed his hand and led him into the living room so that he could relax on the couch and watch some TV while I sketched him using the drawing pad sitting in front of him on the coffee table.
I figured I would call the composition "Blue Eyes Eats Chocolate Chip Cookie Sandwich."