With a sudden impulsivity born of a nagging confusion about Ava and her training, Noah woke up the sleeping machine. It was easy, by merely typing 1 six times in lieu of a security code, which he knew from his first visit that Ava had never bothered to install. Expecting he’d have to go to documents to search, Noah was surprised to find the screen filled with an uncompleted letter to Howard Beckmann of the Nutritional Supplement Council. Unable to help himself, Noah began reading the letter. What caught his attention was the reference to the 1994 Dietary Supplement Act, or DSHEA, in bold letters. This was a law that Noah knew all too well, as it promoted quackery for profit by giving the supplement industry free rein to avoid effective monitoring by the FDA.
To Noah’s utter dismay, the letter talked about the need to launch political and personal defamatory targeting of those few congressmen and senators who had voiced opposition to the DSHEA and wanted to repeal it or significantly amend it. As engrossed as he was in reading, he was totally unaware when Ava appeared in the doorway. He wasn’t even aware when she charged into the room and looked over his shoulder.
“What do you think you are doing?” she screamed. She grabbed Noah’s arm and spun him around in the swivel chair to face her. Her face was a ghostly pale blue, as the only illumination in the room was from the central computer screen.
“I was just going to...” Noah began, but in the press of the moment, he couldn’t decide whether he should be truthful, and his hesitation enflamed Ava even more.
“That is personal correspondence you are reading,” Ava yelled, pointing over Noah’s shoulder. “How dare you!”
“I’m sorry,” Noah managed. “I thought you were going to be occupied for a time, and after our discussion downstairs, I had it in mind to look at your resident case log, or at least see if you had one.”
“Of course I have one,” Ava snapped irritably. “So you are still looking down your nose at where I got my anesthesia training. That adds insult to injury, making this violation of my privacy even worse. I can’t believe you.”
“I’m sorry,” Noah repeated. He started to get up, but Ava reached out and forced him back down on the computer chair.
“I’ve trusted you,” Ava yelled. “I’ve opened my home to you and this is how I’m rewarded? If I were a guest in your apartment, it wouldn’t even dawn on me to go into your computer.”
“You are right,” Noah said. “I don’t know why I did it. Well, maybe I do. I think you are a terrific anesthesiologist and have said so many times. But there are some... I don’t know exactly how to word this... but I have some misgivings that I’d like to get off my mind.”
“Like what?” Ava snarled.
“Maybe this isn’t the best time to talk about this,” Noah said. He tried to stand again, but Ava wouldn’t let him. She was in a rage, hovering over him.
“It’s now or never,” Ava snapped. “Explain yourself!”
“It’s just a few little things,” Noah said with a sigh. “Like with the Gibson case, it seemed you were struggling with the video laryngoscope. Now, I know the patient’s head was bouncing around from the cardiac massage, but it just looked like you weren’t as familiar with the instrument as I would have guessed.”
“What else?”
“On the same case, I wondered why you hadn’t secured an airway some other way, like with a needle tracheostomy with high-pressure oxygen.”
“Anything else? Let’s hear it all!”
“With the Harrison case I keep wondering why Dorothy Barton told me you hadn’t turned off the isoflurane as fast as you should have.”
“Are you saying you take her word over mine?” Ava questioned with disbelief.
“No, not at all. It’s just... what can I say? They are misgivings. That’s the only word I can think of, and I’d rather get them off my mind.”
“I’m the anesthesiologist, not you,” Ava said angrily. “When I got in on the Gibson case the patient had already arrested. A needle tracheotomy wouldn’t have sufficed, especially since I didn’t know what the problem was and couldn’t be sure that expiration would have been adequate. An endotracheal tube would have been immeasurably better, and I came close to getting one in. As for Miss Barton, I think her problematic personality speaks volumes. I turned that damn isoflurane off the second I suspected malignant hyperthermia. But you know something, I shouldn’t have to justify my professional behavior to you. My anesthesia peers went over these cases, and they were discussed at our rounds. You, of all people, are supposed to be on my side. This is absurd.”
“I am on your side,” Noah said. “I’ve been on your side from the beginning. As proof, look how I handled both M&M Conferences. I couldn’t have been any more on your side than I was. I wouldn’t have done that if I didn’t believe in your competence.”
For the first time since Ava had surprised Noah, she broke off, angrily staring at him. She was furious and breathing heavily. A moment later, she looked back down. “You shouldn’t have gone into my computer, especially reading my correspondence. I have a right to privacy in my own home.”
“I know,” Noah admitted. “I’m sorry. You are perfectly justified to be upset. I don’t know what came over me. It won’t happen again.”
“It better not,” Ava warned. “And now I want you to leave.”
It was Noah’s turn to be shocked. He had not expected to be dismissed, even though he recognized he was guilty of a serious faux pas. The idea of returning to his depressing apartment seemed harsh punishment indeed.
“Are you sure?” Noah pleaded.
Ava nodded. “I need some space to calm down. I’ve been betrayed before by a cunning, scheming husband, and I don’t like the feeling.” She backed up, giving Noah some room.
“I haven’t betrayed you,” Noah said, getting to his feet. “I think you are a great and exceptionally motivated anesthesiologist. And certainly my personal feelings for you haven’t changed one iota.”
“I want you to leave,” Ava said. “Violating my trust and questioning my training feels like a betrayal.”
Noah did not want to leave. He’d missed her terribly over the previous four days. For a moment, they just stared at each other, with Noah trying desperately to think of a way to make amends. He’d been caught with his hand in the cookie jar and was now being banned to his room. “You’ll call or text if you change your mind?” Noah said. “I can just come back.” Inwardly, Noah cringed. It was a pitiful, pleading comment, and he hated himself as soon as it escaped his lips.
“I’m not going to change my mind,” Ava said.
Twenty minutes later, when Noah entered his apartment and collapsed dejectedly onto his tiny couch, he was furious with himself for not resisting the temptation to go on Ava’s computer. How could he have been so stupid? And then, to make matters worse, how could he have been even stupider to bring up his misgivings about her professional performance as an explanation? It had been like adding fuel to a goddamn fire.
“You are fucking hopeless,” he said out loud to himself while he knocked his head multiple times with the knuckles of his fist. He knew he was terrible at navigating relationships, but this evening’s performance was a study in ineptitude, especially since they were just getting over a major misunderstanding, for which he now realized he was as guilty as she was. He should have responded to her initial text and let her know how he felt.