Outlier, Chapter 7
Chapter 7
Reid was now an expert on renal-transplant patients.
Especially when it came to all the ways they could die.
The planes of Reid’s face were washed with hollowing light from the screen of the laptop. He had spent the past two hours exploring the labyrinthine underwater caves of medical databases, wading through nautical miles of journal articles and case studies. The computer was the only source of light in his office; he hadn’t taken the time to switch on the overhead lights before diving in.
(Luke is sick.)
Reid was immersed in cell death and system failure. He shuddered at the relative barbarity of conventional surgery - the only ‘knives’ in a stereotactic procedure were orchestrated gamma rays resolving a dissonant malignant target. His was a civilized world of therapeutic light and sound. Physical invasion was a last resort. What Luke had gone through, on the other hand…so many times… His medical file read like a horror novel. Or a telenovela script.
Focus.
The kidney transplant had to be the key. The ways it could kill were legion. Assuming the patient even lasted until the surgery, let alone through it, the immediate post-operative period required constant vigilance against not just organ rejection, but also an onslaught of bloodthirsty hoards with such pagan names as venous thrombosis, arterial stenosis, lymphocele, and ischemic tubular necrosis.
(Luke could die.)
And even should the transplant take, living with a foreign body within your borders meant a lifetime of tribute paid to immunosuppressive masters. Subjugation required leaving your gates permanently open to any passing virus, bacterium, or fungus looking to pillage. It didn’t help that your new masters’ sense of humor was gratuitously cruel - the very drugs necessary for tricking your defenses into accepting the nonnative kidney were at the same time stealthily attacking it. And those drugs that weren’t destroying your kidney directly were waging war on other parts of your body - bones, heart, blood, eyes. Brain.
And their weapons weren’t bronze-age, but atomic. Reid had just finished reading a study finding renal-transplant patients to be four times more likely to develop the deadliest skin cancer. The odds were even worse if you were male.
(His skin is so pale…)
Eventually, of course, the kidney fails.
There were always stories of transplants from healthy, living donors lasting thirty years. But the average was much closer to ten, and Darwin only knew the provenance of Luke’s black-market organ.
(Seven years ago…)
“Focus!”
The sibilance of the word wound through the stillness as Reid rubbed his temples and squinted at the screen.
Corralling his concentration had never required so much effort. Not once - no matter how cute the kid or pathetic the story - had there ever been this degree of difficulty divesting himself of irrelevant thoughts. Irrelevant feelings. Heartless, hardheaded, stiff-necked, rock-ribbed - this was who he had to be. There was no other way; there never had been. He hadn’t become director of one of the best neurosurgery programs in the country at thirty-two by becoming emotionally invested in his patients. Neither had he made it into Harvard at 14 by letting himself be sidetracked by the distractions of youth. He certainly hadn’t survived Harvard at 14 by not being able to tune out nonessential stimuli. He was no good to his patients if he couldn’t give them everything he had, everything he was. Every last one of his multitudinous talents, all applied with single-minded purpose - that was what his patients deserved.
What Luke deserved…
But Reid couldn’t help Luke if he didn’t close his h…mind to him. He had to disconnect.
Why can’t I disconnect?
He got it now, why it was ill-advised to treat a loved…family mem…person to whom one was attached in some unspecified way. In fact, here was yet more support for the hypothesis that forming attachments to humans in general was dangerous folly - you never knew when you’d have to treat one of them. Reid’s operating principle had thus been confirmed. He now had solid, legal grounds for halting the renovation and firing Norm. Clearly, it was a matter of Luke’s best interest.
(I can’t lose him.)
Reid closed his eyes. He gritted his teeth as he shook his weak inner self by the metaphorical shoulders. You will lose him if you keep this up. The only way you can help him is if you’re firing on all cylinders. So focus the fuck up.
He turned back to the evidence. If only he could have performed a more complete examination on Mr. Snyder. As he’d feared suspected, by the time Reid had entered the room Luke had been in the tonic phase of a grand mal seizure. At that point Reid could do nothing but help the orderly position Luke on his side as he lost consciousness, holding him as his eyes rolled back, arms extended, legs and jaw working with aimless violence. Reid could only listen as the jagged, rhythmic whines and yelps sliced through them both. He felt the muscles of Luke’s shoulders jerk under his hands; with his knee and thigh pressed behind Luke on the bed, Reid fought the lurches of Luke’s lower back. When it was over, Reid gently rolled Luke onto his back, lifting his lids and fingering his bruised tongue. A nurse had entered; he left her to change Luke’s clothes, his sheets.
Reid had come directly here, to his office. He’d employed every available tool - his experience, his computer, his phone. Hardly one to be satisfied dealing with a temporary replacement, Reid had insisted that Luke’s vacationing nephrologist be found and brought to a phone. Reid’s relentlessness had quickly become the stuff of legend at the resort, eventually resulting in the disgruntled doctor’s being handed a courtesy phone as he dripped Dead Sea mud on the polished tiles of the hotel lobby.
The nephrologist had wondered why Reid had been so quick to discount alcohol withdrawal - it could have explained both the hallucinations and the seizures. But Reid had discounted it, immediately. He was sure the labs would come back clean - which could, of course, mean only that the alcohol had already left Luke’s system. But Reid refused to order further tests in that direction, no matter how strident the mud-caked doctor’s counsel. Not that he needed it, of course, but this time Reid had special reason to know that he was right. He, as well as anyone, knew how cryptic chronic alcohol abuse could be. His uncle Angus could function flawlessly when he put his mind to it, convincing child services time after time that he was a fit guardian. But Reid could always tell. As with everything, he had learned to excel - at gauging not only state, but degree. How bad it was, how long it would last. How drastic the evasive maneuvers should be. Reid knew all the signs - his detection abilities had by necessity become finely tuned. He’d written algorithms of survival.
Had Luke been drinking, Reid would have known it. For better or worse, he was attuned to Luke.
Which was why Reid should have known better - why he shouldn’t have immediately assumed that Luke had been drunk. Why he shouldn’t have immediately withdrawn. He supposed his past had been at play there, as well - he’d never since had tolerance for drinking or drinkers, and the thought of opening himself to someone who-
What the fuck does that mean?
Open. The word reeked of weakness. Open meant defenseless. Vulnerable to assault. Reid’s career - his very existence, if such a distinction were meaningful - was predicated on invulnerability. His patients, his research, his sanity - all demanded that he be impenetrable to attack, from frontal to sneak, by belt or by patent-leather shoe.
But Luke was already in. Since the first time Reid had laid eyes on him, Luke had been casing the joint, searching for structural faults, colluding with the contractor. For months he’d been prying open fissures, squeezing himself in as they widened, leaving more and more of himself behind. From stolen plans he’d discovered a design flaw in Reid’s death star, setting off a chain reaction of creative destruction. And then - not only was Luke forcing a radical transformation, but he’d managed to infest the building materials of the remodeled Reid. Ironically, Reid’s structural integrity was now dependent on Luke’s presence; he had permeated and replaced Reid’s constituent parts like groundwater mineralizing bone. Extermination was no longer an option (if it ever had been). There would be no getting him out.
Until Luke died, of course. Reid had opened himself to someone who might die. At any time, in so many ways. Reid would lose him.
But not today.
Reid re-focused on the case study he was reading. A renal-transplant patient had presented with a four-minute grand mal seizure, fluctuating headache, elevated blood pressure, visual hallucinations…
Why me?
Reid tried to sit on the thought, but it shimmied out. It climbed up his side and slipped into his ear, burrowing back into his mind. (At least it didn’t take the other route.)
Why had Luke hallucinated about him? Why had he imagined conversations in which they’d shared such personal, if fictional on Reid’s part, information? Why had he been so hurt when he’d thought Reid had forgotten - or had been pretending to forget?
Does he suspect?
Reid fought to keep the words in front of him in focus.
Is he feeling it too?
Reid forgot to breathe. He pictured Luke’s face as he’d touched his cheek to feel for fever. He’d seen the sadness. The open wound.
Feeling what, exactly? What are you feeling? How much longer are you going to analyze the data? When are you going to admit that the results reached significance a long time ago-
His exhale was audible as he processed the sentence he’d just read.
Checkmate.
He picked up the phone.
______________________________
“I'm sorry, did you just say there’s a wait?” Reid’s voice slithered, like a snake coiling before a strike. Stopping mid-stride, he pivoted down a side corridor. “I don’t care if Bob Hughes himself is halfway through a scan - I want Luke Snyder to get an MRI right. Now.” He slammed open the stairwell door, climbing three stairs with every step. His voice dropped to a dangerous level. “He’ll be there in five minutes.”
Forty-five seconds later Reid opened the door to Luke’s room. Luke was on his side, his back to the door, a fragile figure wrapped in a stiff white sheet. His hair was still damp, his breath shallow.
(Luke is sick.)
Reid slowly walked toward the bed. He wanted to climb onto it, to cover Luke with his body, to dig with bare hands into Luke’s flesh, into his brain, and pull out the sickness. To absorb it into his own body.
I can’t lose him.
This time, Reid couldn’t silence the thought. Just trying to imagine a world without Luke, a life without Luke-
My life without Luke.
Reid tried to catch his breath, but the squeeze was like a vise. He fought back, thinking at first that he was about to lose himself to a panic attack. Not an option. Gradually, though, he realized his body wasn’t under attack so much as it was being shaken awake. He could feel his cells vibrating with awareness; by the time he’d reached Luke’s bed, Reid’s most fundamental particles were resonating with collective resolve.
I don’t want a life without Luke.
What that meant - the specifics of what and why and how - that could wait. First, Reid had to fix him.
I can save him.
Luke’s strained breathing eased; he turned onto his back. A slow, sleepy smile bloomed. “Hi.”
Reid’s heart felt as if it were trying to break through permafrost. “Hi.”
Luke frowned, though remnants of his smile remained. He blinked.
“Luke?”
He blinked again. “I…I can only see half.”
Reid ignored the fact that it was becoming physically impossible for him to draw a breath. He took out his penlight. “Tell me exactly what you see.”
Luke stared intently at Reid’s close face as the light flashed. “It’s like…it’s like I’m seeing half of what I should. In each eye. There’s only…half a circle. Two of them. Two of you.”
“Which side can you see?”
“Um, the left.” He sounded a small laugh, the puff of breath catching Reid’s chin. “I hadn’t realized Noah’s condition was contagious.”
Reid forced himself to smile. “Sounds like a different type of cortical blindness. Called homonymous hemianopsia.”
“Well listen to you, sounding all doctor-like.” With a softly cheeky smile, Luke peeked from beneath his lashes. “Does that mean you’re my doctor now?”
“I am.” As before, his voice was steady, careful.
“Well, doctor, you’d better tell me this isn’t permanent. ’Cause I kinda liked seeing the whole picture. This is…it’s like looking through broken binoculars.”
“Don’t worry, it’s not permanent - not if I’m right about what’s wrong with you.”
“Good thing you’re never wrong.” The smile banked before flickering out again. “I must be pretty sick to need a neurosurgeon…I feel like I should be more freaked out. Why aren’t I more freaked out?”
A wedge of hair was stuck to Luke’s forehead. The fingers of Reid’s left hand twitched.
“Because you’re probably enjoying something called postictal bliss. It occasionally happens after a seizure like the one you had earlier - it's all part of the recovery period. You can think of it as the silver lining.” Or the precursor to another seizure.
“A seizure. Wow. That definitely does not sound like something I should be smiling about.” Grinning, he stretched, lifting his arms over his head. Reid watched the sheet make shifting shapes as it slid down his torso, revealing a thin gown pulled taut.
Luke froze mid-movement, mid-grin. “You called me Luke.”
“I did.”
Luke lowered his arms. He tried to sit up. “Why, Dr. Oliver…” His grin was fast approaching goofy. “No, I get it - this is another hallucination, isn’t it? How do I know you’re real?” He reached for Reid’s arm, just missing it as Reid stepped back. “Or…oh no,” Luke’s eyes widened playfully. “Is this the afterlife? Did I make it to heaven? Oh my g…Dr. Oliver, have you been telling the truth this whole time? Are you…are you actually God?”
A smile slipped through. “How I hate to disillusion you, but you are very much alive - and very much still in Oakhell.”
“But you’re still very much a god, right?”
“In this and every reality.”
“Good to know I have a constant.” Still grinning, Luke’s eyes narrowed. “Wait…so then why did you call me Luke?”
“You’re my patient.”
“So?”
“So…it’s a well-defined relationship.”
“Really. Huh. I, of course, have to continue addressing you as ‘Dr. Oliver.’”
Reid wondered if the sparkle in Luke’s eyes was a symptom. “I’m sorry, was that in the form of a question?”
“Right. So, then…does that mean I’m ‘Mr. Snyder’ again once I’m all fixed and no longer under your care?”
“Exactly.”
“You’re serious.” Luke crossed his arms.
“As an empty fridge.”
“You would really go back to calling me ‘Mr. Snyder’?”
“Absolutely. It’s the natural order of things.”
“Yeah.” Luke’s smile wavered, withered. “I guess it is.”
The vise tightened.
“Then…I guess I’d better enjoy it while I can.” Luke licked his lips.
Reid watched.
“Say it again.”
The door opened before Reid could respond. Within the minute, Luke was enveloped in parental arms. Reid stepped to the head of Luke’s bed, watching Lily bury her head in Luke’s shoulder as she rocked him, listening to her chants of “my baby.”
He watched Holden smooth away the damp hair on Luke’s brow.
“Dr. Oliver - can you tell us what happened?” Lily looked up as Holden spoke, her hands making circles on Luke’s back.
“Luke…” Reid cleared his throat. “Luke has had several episodes of generalized seizures in the past two hours. There have been visual and auditory hallucinations, and he’s currently experiencing vision problems. We’ve given him medication to control the seizures and to lower his blood pressure.” As he spoke, he raised the half rails on one side of Luke’s bed before walking around to the other side.
“I…what…his vision? Luke had seizures?” Lily stood, swaying, her hand gripping Luke’s shoulder.
Holden moved behind her. “His kidney?” he asked softly.
Reid unlocked the casters of the bed with his foot. He began to wheel Luke toward the door. “That’s what we’re going to find out.”
Lily stepped to the side, a hand covering her mouth. “But…Luke…is he-”
Reid reached for the door. “I’ll let you know once my diagnosis has been confirmed.”
Holden held the door open as Reid maneuvered the bed. Luke squeezed his mother’s hand before letting go.
“Wait-doctor…” Lily followed them down the hall. Reid continued to roll Luke, ignoring curious nurse eyes. “Did you say hallucinations? What kind? What was he-”
Reid could feel Luke’s sudden scrutiny. “They were conversations.”
Lily, keeping pace, frowned. “Conver…I don't…how do you know they were hallucinations?”
Reaching for the elevator button, Reid looked at Lily. “Because they were conversations with me.”
Lily’s mouth was still open as the elevator doors closed.
The otherwise-empty elevator descended slowly. When Reid finally looked down at Luke, the blush was still there.
“So…” Now Luke cleared his throat. “Where to?”
“MRI.”
“Ah. Kidney?”
“Brain.”
The elevator dinged. Reid wheeled the bed down the corridor, stopping in front of a wide-eyed technician.
“It’s Luke Snyder’s turn now.”
Bobbing her head and mumbling something about being right back, she retreated through a set of doors.
Luke seemed to be attempting origami with the edge of his sheet. “Um, these…these conversations.”
Reid stepped from behind Luke’s head to the side of the bed.
Luke’s eyes darted up briefly. “Which ones? Which ones weren’t real?”
Reid caught Luke’s gaze. “Before the board meeting yesterday, we hadn’t spoken in seven days.”
Luke flinched. “What? Are you…”
“Not since Noah’s surgery.”
Luke’s open mouth formed a progression of silent shapes. “What do you…you mean all of them? Everything we…” Luke looked to the side, seemingly lost in false memories. “Wait, but then how did I know about Annie Judd?”
“There is no Annie Judd. Never was.”
Luke’s attention snapped back to Reid. “What? What are you…you’re saying that wasn’t real? It felt so real…” Luke fingers crawled into the hair on either side of his head. “So…my brain just, what? Made her up?” His fingers tightened. “Like it made up everything…” He looked down at the wrinkled sheet covering his lap. “I’m really sick, aren’t I?”
Reid wanted to touch him. He almost did. “Nothing I haven’t seen before.”
Luke’s eyes lifted. Reid watched what little light remained be snuffed out. A weak smile lifted a corner of Luke’s lips as he dropped his hands. “Right. Of course. Nothing special.”
Reid tried to swallow, but the squeeze had migrated to his throat. He managed to push words past. “I wouldn’t say that.”
Luke raised his head.
“It’s not often that this brain-dead backwater provides a patient worthy of my diagnostic genius.” Reid eyes were clear. Open. “I’d say you’re pretty darn special.”
Luke held Reid’s gaze, his expression a muddied mix of tentative and searching.
“At the very least you’re currently lit by the reflected glow of my divinity.”
Luke slowly smiled. A small but distinct spark caught in his eyes. “That would mean I’m special only when I’m around you.”
The doors swung open, the woman returning to wheel Luke away. As she was doing her best to avoid making eye contact with Reid, she missed the way he was looking at Luke. The way Luke was looking back.
“I’ll be with you the whole time.”
Luke nodded as he disappeared behind the swinging doors.