Tim Murphy - Christodora

“You seen this?” Blum asked.

She scanned it, eyes widening. “Another Kaposi’s sarcoma report out of St. Vincent’s? In a thirty-two-year-old guy?”

Blum nodded. “Another homosexual.”

Ava handed Hector the memo. “Here’s your first task, Hector,” she said. “Xerox this for me.” Hector took the memo and left the office.

She turned back to Blum. “This is, what? Case seven in the past few months?”

“Eight.”

“What the hell do you think this is? This cancer is, like, a few old Jewish and Italian men, once in a blue moon.”

“I wonder if it’s hep B — related,” Blum said. “It’s rampant in the gay community.”

“A virus-linked cancer,” she mused.

“Either that or too much disco or nitrites or sex or something.”

This bugged her. “Not funny, Blum. You know my brother’s gay.”

“Hey, I’m serious about the nitrites! What the hell could it be? And you know L.A.’s reporting a bunch of PCP cases in homosexuals.”

“Pneumocystis, yeah,” she said. “I read about that.” Hector returned with her copy of the memo. “What’s your take on this, Hector? If it’s community based, it feels epi to me.”

Hector looked down. “I haven’t been following it,” he all but mumbled. God, this boy is uncomfortable in his own skin! Ava thought. Then again, hey, he was, like, twenty-five, he was a kid.

She told Blum to call a meeting if and when the next KS case came in; she couldn’t spend more time on this today — she had multiple meetings to make, projects to push along, briefs to plow through. And all by three o’clock, then Emmy! She set up Hector in a windowless office — well, frankly, it was a large closet — a few doors down. Then she plunged into her day with gusto. She bore down on her folder, scratching out flowcharts on her pad as she picked through briefs, calling in Rosemary a few times to dictate a memo to her.

“You’re going too fast for me!” Rosemary complained at one point.

“I have a lot on my plate today!” she snapped back.

Then she put in several calls around the office and around town to float various questions and ideas. Where was that old late-morning sluggishness? Her mind seemed to move along, click, click, click, ticking off tasks, making amazing connections that had never occurred to her before. She’d felt this sort of mental efficiency all week, but it really seemed to have hit critical mass today. As she read and worked, she sat in her chair in a manner that felt, to her, provocative, legs crossed, bobbing one foot, one hand pulling back one feathered wing of hair, imagining a shiny barrette there. She was the naughty deputy health czar, like in some Times Square blue movie!

At eleven, she had the Wednesday briefer with Renny and the other deputies. En route, she pulled Hector out of his glorified closet. “Come on in and listen to the poobahs and learn how the sausage is made, Hector,” she said, taking his arm as they walked toward the conference room. “It’s your internship, after all.”

“I’m nervous,” he whispered. And yes, his skinny arm was shaking! “I get nervous in groups.” She felt another maternal surge toward him. She’d thought she’d be annoyed to have to find tasks for this intern, this special pick of Renny’s, but she actually already liked having him around. He wanted to go into tropical diseases! How noble! She hoped a summer in the health building wouldn’t drain him of his idealism.

“You probably won’t have to say anything,” she told him, squeezing his arm. “Just look admiringly at me when I say things.”

He looked at her, confused. She winked to show she was making a joke of sorts.

“Oh,” he said. He laughed a little, relieved.

Lauren led with the latest data on the slow outbreak of drug-resistant TB in the homeless shelters. Lauren fumbled around the truth of the matter, which was that patients weren’t completing the course of drugs they were prescribed. Ava simply had to break in, and she did, summarizing a study she’d just read out of Minneapolis on the efficacy of directly observed therapy — where you hold the meds and make the patient show up daily and take them in front of you, to be sure they’re taken — in wiping out a similar strain of first-line-resistant TB.

“These are precisely the areas,” Ava said, rushing — there was a certain soberer affect she assumed in these meetings, her voice a bit lower and slower, but today she couldn’t keep the excitement, the speed, out of her voice—“where we could benefit greatly by having a monthly NYC convocation, flying out some of the investigators of these studies in smaller cities for a few nights in New York. Show them a good time, get a block of Broadway seats out of the mayor’s office, let them know they’re in good hands and they’re not going to be knifed on the street, then basically hole them up here during the day — or in, say, a catered meeting room at the Sheraton — and pick out of them how they implemented these programs. Then we’ll figure out how to scale them up for New York — size problems.”

Renny was leaning in, engaged, but she noted that Lauren had wheeled her chair back from the table a bit, was regarding her in a civil pose but with murderous eyes behind her glasses.

“The funny thing, Doctor,” Lauren began — and, uh-oh, she was calling her “Doctor” and not “Ava,” which signaled chilliness and maybe a hint of bite, and not collegial warmth—“is I was just about to brief on the Minneapolis directly observed-therapy study and more or less make the same suggestion that we have the investigators come to New York. Or deign to visit them.”

Uh-oh. She caught Hector’s terrified eyes — though a touch intrigued, perhaps? Renny cleared his throat. Awkwardness hung in the room. “Either way!” Ava finally chirped. “I’ll be happy to throw my beret up to the sky in the middle of downtown Minneapolis.” She smiled sweetly, innocently, at Lauren.

Everybody laughed. “You’re gonna make it after all, Aves,” Blum cracked. The boys liked her far more than Lauren, she knew that much. Lauren had no choice but to smile along like a good sport.

“Lauren, talk to the support staff about getting the Minneapolis people here,” Renny said. “And Mary Richards here can decide if we’ll take them to A Chorus Line or Sugar Babies .”

Everybody laughed again. This was quite a bit of humor for these dry health types! She ducked her head down, smiled. Renny’s crack was a reminder that he liked her, was amused by her. Easily now she could touch his arm after the meeting and set up a lunch date. She managed to be quiet for the rest of the meeting, excepting her own briefings, of course, but her mind was racing. Out of any half-baked idea floated in the room today, she might squeeze a truly great one! And that’s why, whereas before she’d occasionally jotted down a word or two on her pad, today she was sketching out a flowchart of the meeting, graphic style, to try to capture who said what and what it led to and how it all looped back and connected. Blum was sitting next to her, and at one point, she caught him looking at her pad quizzically.

“What the hell is that?” he whispered.

“I’m capturing ideas,” she said.

“Rosemary’s taking notes, though,” he whispered back. His eyebrows scrunched down, toward each other. “You okay, Aves?”

Oh God, it was because Blum, her best friend at Health, knew; he knew about that period about a year ago, because she’d confided in him, knew about the crying, the anxiety, the inability to concentrate, the insomnia, Sam’s worry over it, Emmy’s fearful sensing of it, the Valium, then the having to roll back on the Valium, the new drug that finally seemed to make things better over the course of a few months. That’s the thing about sharing this stuff with your work friends — they’re always looking out for you and for signs, signs.