"Damn," Dr. June Slattery said softly when the waiter approached her and inquired in French if she was ready to order. She turned
toward her husband. "Why can’t they talk English like the rest of the world?"
"Maybe because they are Quebeçois?" he answered.
June held out the menu to the waiter and pointed, "I’ll have this, thank you."
Her husband looked up at the waiter and gamely said, "Je voudrais... oh hell, come ce dice salmon?"
"Le saumon," June replied automatically.
"Why don’t you just order for me? You speak French better than I do."
"I don’t speak French. You know that."
He shrugged, pulled out his French dictionary, and struggled with the waiter to finish his dinner order. June stared out at the
plaza. Late afternoon sun slanted low over the rooftops, and the worn stones of the plaza radiated heat stored from the day. A young couple at a table nearby, heads bent
close to each other, caught her eye. The man—hardly more than a boy, really—reminded her of someone...
She turned her attention back to her husband. Their last dinner in Quebec City; tomorrow they would fly home, and she would be back
at work the next day. It had been a good trip. She had spent four days attending meetings and giving a paper at the International Burn Surgery Federation, and now the
meeting was over. A small, carefully-wrapped Inuit carving of a polar bear nestled in her purse, souvenir of a week well spent. All very enjoyable, she thought. Except for
the tiresome insistence on speaking French.
Looking again at the young couple, she suddenly realized that the boy reminded her of Ben, her older brother, dead now for so many
years. She pushed the memory resolutely aside and, lifting her wine glass, tilted her head at her husband. "Here’s to us," she smiled.
On a beautiful evening several weeks later, June was on "triple-witching call," covering general surgery, trauma, and burns
at the hospital. In the trauma call room during a few minutes break, she couldn’t stop thinking about two patients. The first was an 18-year-old male who had turned
over his all-terrain vehicle, sustaining multiple fractures and splitting his liver wide open. The liver laceration had stopped bleeding by the time he was in the trauma
room, and the team had elected to watch him rather than do surgery. But a patient on the mend could suddenly become unstable, the laceration bleeding again.
The second patient was Mrs. Yoder, a 35-year-old woman who was driving along the interstate three nights earlier when a semi crossed
the median and struck her VW neo-beetle a glancing blow. Now she lay in the SICU with a pelvic binder, a glorified corset, really, holding her shattered pelvic girdle.
This woman’s CT scan had shown some fluid in the abdomen, but neither her spleen nor her liver was injured. Was the fluid blood from her pelvic fracture? Maybe. Or
maybe her bowel had a hole in it, and the contents of her intestines were leaking into her abdomen, slowly poisoning her. June hadn’t liked the way her belly felt,
and she had asked the residents to get an ultrasound-guided tap to see what the fluid was. If it was bowel contents, they’d be going to surgery.
The trauma pager went off just then, and June jumped slightly, breaking her train of thought. She pulled the pager off her
waistband and squinted to read the alphanumeric message about a young man who had fallen out of a window. This patient was a transfer from one of the smaller community
hospitals, sent here because of an injury they were unable to deal with, probably a complex pelvic fracture. She headed down to the ER.
The physician on duty in the ER greeted her with considerable enthusiasm. "This guy’s so obnoxious we figure somebody
must have pushed him out of the window." The patient was restrained, disoriented, and combative, flopping like a gaffed fish in a net and cursing with enthusiasm. His
right leg was in a cast, and he had a pelvic binder on. Several jagged lacerations, neatly sutured, crossed his face, joining several older scars. A tattoo on his right
arm said "Born to Lose."
June supervised until she was sure he was stable, then left him in the care of the residents. Soon her pager went off again.
"Dr. Slattery, remember Mrs.Yoder, the patient in SICU? Well, you were right. The tap is pure bowel contents. Probably a small bowel injury. She doesn’t look
"Post her. I want her in the OR in half an hour."
After resecting the damaged portion of Mrs. Yoder’s small intestine and sending her back to her room in considerably better
shape, June sprawled on the lumpy trauma call room bed. Her pager went off once again. Every night on call at the hospital had its own rhythm, and this one was trauma
after trauma. She had only a few stolen moments in the trauma call room, and she kept going with candy from the vending machine outside the OR.
It was after 4 a.m. when the 14-year-old kid arrived, transferred from a rural ER. The hour of the wolf, when strength and will are
at the lowest ebb. The kid was alone, without parents, which was unusual. He held up his burned left hand for June to see—the back was burned completely, right down
to the wrist, although the palm was spared. He reached over to pull up his sweatshirt so she could see the neat line where the burn ended, just at the cuff, and she
noticed the healing wound on the back of his right hand. Another burn, this one maybe two weeks old. A mirror-image injury. He saw her glance at the back of his right hand
and smiled lazily at her.
"How did you get burned?"
"We were laying down carpet. The glue caught fire."
"And the other hand?"
"Same thing. Just clumsy, I guess." Again, that lazy smile. Something about this didn’t fit, and it bothered her.
The burn was superficial and should heal fine. June left instructions for the boy’s care and went over the list of the
evenings’ patients. The man with the liver laceration was still stable. Mrs.Yoder was doing well. The "Born to Lose" trauma admission was fine. All the
other traumas were tucked in. Everything was in order, but once again something stirred in the back of her surgeon’s brain.
It was too late to sleep, so she gathered her stuff from the trauma call room and went downstairs to her office. Settling into her
reclining chair, she leaned back in the dark and watched the full moon setting in the west. Faint pre-dawn light suffused the sky above the tree line. June thought of her
husband, asleep in their warm bed at home. She ran the list of patients mentally again, this time remembering the kid with the burned hand and the strange smile.
Suddenly she thought of her dead brother. Ben used to pour lighter fluid over his hand and set it afire, creating a fiery glove. He
claimed that it only hurt at the edges. She could still remember the sight of the long black hairs on the back of his hand burning individually like little candles just
before he blew the fire out. He would smile that lazy smile of his, so like that kid with the burn, and say, "Main ardente." Fiery hand.
He and his college roommates had acquired a long-necked, big-bellied Chianti bottle that stood almost three feet high. Ben would
pour a little lighter fluid into the bottom of the empty bottle, swirl it around, and drop in a match. Thwup! The small blue flame marking the advancing front usually
traveled about a third of the way up the neck of the bottle before subsiding.
Ben had led the way through high school, where they both joined the French Club, speaking only French at its meetings. And then to
Stanford, where first he, and then she, had lived in the coed dorm informally called "The French Quarter." No English allowed, only French spoken there. She
followed him everywhere he went. He was so bright that she felt like a faint shadow to his flame.
When he took a year at the Sorbonne, they maintained a detailed correspondence in French. Somewhere among her boxes, she still had
stacks of blue Aerogrammes with his tiny, precise handwriting covering every blank centimeter of the sheet. He used a 00 draftsman’s pen, filled with India
ink. Unfading. Waterproof. Letters replete with details of his classes, the architecture, morning coffee with a brioche or un petit pain in the square, afternoon
walks along the Seine.
But then he had died in a car crash, testing a prototype engine that he and his former Stanford roommate had developed.
She had begun medical school a year after that. Once she settled into her studies, she realized she carried her own inner spark.
Perhaps not as fiery or as unpredictable as Ben’s, but a steady, warm flame. She married a classmate. Decades passed, and she advanced through the ranks of academic
surgery. Ben, and those years at Stanford, and even the French language, had lain behind a cordone sanitaire, a kind of firewall, deep in her brain. Until tonight.
Suddenly the unease she’d been feeling about the boy with the burned hand took form. She sat upright and paged the resident.
"Make sure you get Psych to see that kid in the morning," she said.
"Why? He seems okay to me."
"He’s playing with fire. Next time he comes in, he may be an eighty percent-er who’s burned down the building he
lives in. Or he might self-immolate in his parents’ car. Trust me on this, call Psych."
She hung up the phone and leaned back in her reclining chair again. Closing her eyes, she let her mind drift.
Un âme perdue, she thought. A lost soul. She opened her eyes again.
La lune, she thought. La lune par la fenêtre. The moon through the window.