Page 41 of Dread

I washed my hands. The water ran cold. Soap between my fingers, under nails, the twenty-second count that had been muscle memory since med school. My hands knew this work. They’d known it longer than they’d known anything else -- the mechanics of reduction, the feel of humeral head sliding back into glenoid fossa, the pop of relocation that sounded worse than it felt. I positioned. Explained. Counted down from three. On two, I tractioned and rotated and felt the shoulder seat itself with a solid, satisfying click that traveled through the boy’s frame and into my palms.

He gasped. Color returned to his face in a wave that started at his cheeks and moved outward. I splinted. Explained home care. Wrote the prescription for the anti-inflammatory his mother would fill and he would forget to take. The whole thing took twelve minutes. My hands never hurried. Never wavered -- the steadiness of a man who had reduced dislocations in worse light with less warning, and the fact that my brain was split three ways -- patient, parking lot, the particular coordinates of a house fifty yards from a chain-link gate where a child was eating breakfast at a kitchen table -- didn’t show in the work.

The boy left. Paper crinkling on the exam table, the smell of adolescent sweat and fear lingering in the room after the door closed. I stood at the sink and washed my hands again and found myself at the frosted window of exam room two without deciding to go there.

The window faced the parking lot, its frosted glass obscuring everything beyond it. I moved closer and found the clearer strip near the edge, enough to make out the tree line across the asphalt and the service road disappearing behind the building near the dumpsters. I searched what I could see of it.

No blue truck.

I should have preferred it that way. Instead, I found myself wishing it were still parked where we could watch it. A threat sitting in plain sight was one thing. A threat that had moved somewhere else was harder to account for.

I turned away. The fluorescent light hummed. The antiseptic bite in the air caught the back of my throat, sharp and chemical, and for a moment I missed the smell of the kitchen so badly it was physical -- coffee and the warmth of a house where someone had decided to stay.

Second patient. Diabetic follow-up. Sixty-eight-year-old man with an A1C that had improved from 8.2 to 7.1 in three months because his wife had taken away his ice cream and replaced it with fruit he pretended to enjoy. I checked his feet. Pressed my thumb into the dorsal arch, watched for capillary refill, felt for the loss of sensation that preceded ulceration. His pulse was strong. Skin warm. No breakdown. I wrote the refill for his metformin and told him the number was good and his wife was right about the ice cream, and he laughed like older men do when they’ve been outmaneuvered by someone who loves them enough to be ruthless.

Between his departure and the next chart, I was at the window again. Didn’t remember walking there. My body had apparently decided that the frosted glass was worth visiting on a schedule my brain hadn’t approved. I stood with my hands in my pockets and scanned the tree line. Saw nothing. The nothing brought no relief -- seeing nothing meant the threat was mobile, and mobile meant unpredictable, and unpredictable meant the odds changed every time I turned my back.

Patrice didn’t miss it. She’d been watching me pace the length of the clinic between patients for two days now, my footsteps carrying me past the same windows, the same doors, the same sight lines I’d memorized when Katy’s text arrived. She didn’t comment. Didn’t ask if I was all right. Set the next chart on the counter beside the sink with her capable hands -- short nails, no polish, a wedding band worn smooth from decades of hand-washing -- and moved to the front desk without a word.

The toddler came in at ten-forty. Ear infection, left side, the particular miserable heat of a child who had been up all night and whose mother had the hollow-eyed look of someone running on three hours of sleep and desperate caffeine. The girl was three, according to the chart. Blond hair in messy pigtails, one shoe missing, her small body curled against her mother’s chest like she was trying to disappear into the fabric.

I gentled my voice, same as I did with Ellie. Lower register, slower cadence, the tone that children responded to even when they were too miserable to acknowledge it. The otoscope light showed red and bulging, the tympanic membrane angry and fluid-filled, and I explained it to the mother in plain English while the toddler pressed her face into a shoulder that had been cried on enough times to know the drill.

Amoxicillin. Ten days. Warm compresses. Ibuprofen for the fever. The mother nodded, relieved, the gratitude of someone who had been handed a solution to a problem that had kept her awake and would now let her sleep. They left. The exam room held the smell of baby shampoo and fever sweat, and I stood at the sink and washed my hands and didn’t look at the window because looking at the window had become its own kind of compulsion, and compulsion meant the threat was winning even when it wasn’t present.

Patrice set the last chart on the counter at twelve-seventeen. Well-child check, no concerns, a routine that would take eight minutes if the mother had no questions and twelve if she did. I finished it. Documented. Signed the form with a signature that had gotten looser over the years, the T in Thomas barely connected to the rest, and closed the laptop with the finality of a man who had reached the end of his capacity for institutional light.

Locking up took four minutes. Front door deadbolt. Delivery door deadbolt. The cameras still running, the feeds still empty. I loaded my clinic bag into the truck bed. Got behind the wheel. Started the engine.

The drive back to the compound took twenty minutes if I didn’t speed. I didn’t speed. Both hands on the wheel. Eyes on the rearview every fifteen seconds, counting vehicles, making notes. A county maintenance truck. A sedan I didn’t recognize. A pickup loaded with lumber that turned into the hardware store lot and stayed there. I checked the mirrors again as I approached the compound, but nothing had remained behind me long enough to raise concern. Cotton was at the gate when I reached it, watching the road while he waited for my truck.

He pulled the chain and opened the gate. I drove through, and he closed it behind me before returning to his post. The house sat fifty yards ahead, familiar now in a way it hadn’t been a few weeks ago. Katy and Ellie were inside. After a day spent watching mirrors, camera feeds, and vehicles that might or might not matter, getting back to them was the only part of the drive I’d been looking forward to.

* * *

Something simmered on the stove while I stood at the counter with a wooden spoon in my hand and watched Katy set the table. She pulled plates from the cabinet, forks from the drawer, then added the blue cloth napkins she’d bought last week after the paper ones ran out. She moved through my kitchen without asking where anything belonged anymore.

I’d spent most of the day checking cameras and looking twice at every vehicle near the clinic. Here, with dinner on the stove and Katy setting a place for me at the table, I finally stopped looking for what might be outside.

Ellie sat on the windowsill. Not on the stool. On the actual sill, her small body wedged between the frame and the glass, her bare feet dangling above the floor, her hands busy with the rock collection that had somehow doubled since yesterday. She arranged them by color today. Or by texture. Or by some system known only to a seven-year-old’s geology that involved tapping each one twice and frowning at it before moving it half an inch to the left.

“This one’s from by the big tree. Not the maple, the other one, the one with the bumpy part on the trunk. It’s smoother on this side because the rain hit it more, I think, or maybe it fell in the creek once and the creek smoothed it, but I didn’t see a creek so that’s a hypothesis.” She held up a piece of limestone, pale and veined, and turned it in the late light. “Hypothesis means I’m not sure but I’m thinking about it. Ms. Keller says good scientists have hypotheses.”

Katy reached past her for the saltshaker. “Good scientists also wash their hands before dinner.”

“I washed them. See?” Ellie held up her palms, which were, objectively, not clean. There was dirt under the nails and crayon wax along the lifeline. Katy looked at them, then at me, and the corner of her mouth did the thing it did when she was trying not to laugh. I nodded toward the sink without breaking stride. That was the division of labor we’d arrived at without discussing it: Katy enforced, I supported, and somewhere in the middle Ellie learned that rules existed but were negotiable if you presented your case with sufficient enthusiasm.

She washed up while I finished dinner. Chicken thighs seasoned with garlic and paprika, rice, and green beans roasted until the edges browned. Nothing complicated, but Ellie inspected the chicken suspiciously before deciding it passed whatever standards she’d developed in the seven years she’d been alive.

She spent dinner explaining why a boy in her class was wrong about dinosaurs. Apparently, he’d announced that they couldn’t have been real because nobody alive had ever seen one, an argument Ellie considered both scientifically unsound and personally insulting given the number of dinosaurs she’d drawn lately.

“Nobody alive saw George Washington either,” she said, stabbing a green bean with her fork. “Is he fake?”

Katy covered a smile with her glass.

“Flawed comparison,” I said.

Ellie frowned at me. “Whose side are you on?”