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  Sam listened to the familiar creak of the chair while Lacey rocked in it and squeezed his eyes tighter against a burn.

  “I don’t want to do it myself, Sam.”

  “I should have never asked you.”

  “I think I asked you.”

  “I don’t remember. Do we have to talk about this right now?”

  “We do. I doubt you want to talk about the other thing, and I won’t lecture, I promise. I just want to talk about the clinic, Sam. Just to talk about it. Because it’s something I like, and I feel as if I have to remind you that it’s something you like, too.”

  He found himself listening.

  He’d met Nina at a time when he’d already been struggling with his place and his views on the clinic. The reasons he and Lacey had begun the work were starting to lack meaning. The more shifts he picked up at the hospital to avoid confronting Lacey about clinic work, the less connected he felt.

  He was good at patients.

  He had patients at the hospital, not at the clinic. At the clinic he only had problems and obstructions.

  Nina had brought those problems into even more relief. Working in the fields, seeing her work, being with her, dividing up the time in the ER or at the urgent care—that was starting to feel good, feel better.

  After his date with Nina, after not stopping to think, for a moment, for a minute—it reminded him how far he had to go. With himself. With Nina.

  He heard Lacey adjust in the rocker. “It was last summer, when your dad was trying to recover from that resection to reduce the size of the tumor in his liver to give him a little pain relief. Kat Wells had covered a bunch of shifts for you so you could take care of your dad, so to give her a vacation, you went to Camelot to cover for her at the medical home low-income clinic she had opened there with her group.”

  “I know.”

  “Yeah, I do, too. You came back so excited. You loved the patients. You loved that it was one-stop for them—checkups, simple X-rays, prescriptions. Everyone knew everyone, you told me. There was better patient compliance on treatment because they trusted everyone, always saw the same people. You were burned out on the urgent care, how people from our own neighborhood were going there to get regular management for their blood pressure and stuff. You wanted to do for our neighborhood what Kat had done.”

  “I was crazy, I think.”

  “No, you weren’t. And if you were, I was, too. You took me to the diner, with that legal pad where you had written down that first crappy business plan after grilling Kat for what she said was hours. You knew I had been unhappy at the hospital for a while.”

  Sam was struck by it suddenly.

  How it had felt, working for Kat, working with Lacey early on.

  There was something that felt like it had with Nina—something collaborative and personal that made every day expansive and big.

  It’s no wonder he proposed.

  It was Nina, but it was also him. It was him on the verge of understanding what he needed and wanted. Lacey was quiet.

  Sam pulled his knees to his chest and rolled to his side. Looked at Lacey, who was gazing into the middle distance.

  She looked happy.

  He wondered how much of her happiness had to do with him, what they were doing or had done. How she felt about all of this.

  “You didn’t have any idea what you were talking about,” Lacey said, “but I could see it. I could see how it would really help people in this neighborhood. How much we needed something like that here. It wasn’t long before it didn’t matter if you knew what you were talking about, because I did. I went to the conference. I dragged you with me to meet with the regulators. You dragged me with you to look at real estate.”

  “I’m fucking up, Lacey. The deeper we got, the less help I was. When I worked for Kat, I was there as a doctor, I saw patients. I didn’t think about the building and the equipment. I didn’t think about how you hire a scheduler. A nurse. A fucking cleaning service.”

  “I know. But it doesn’t matter. I think about that stuff.”

  “And I don’t think.”

  “Look. Don’t make me go all come-to-Jesus, okay? I’m kind of tired of it, actually, when it comes to the Burnsides. You totally suck at administration, I’ll give you that. But you don’t suck at leadership. You’re a really good family doc, Sam. Plus, we read all those studies together, about how local providers have the best outcomes with local people.”

  The rocker creaked again.

  “What happened?” she asked. “With Nina?”

  “I’m not sure I want to talk about it.”

  “That’s obvious. But you’ve been holed up here since Sunday, when I first started calling you. You wouldn’t even let Mike in on Monday. You’ve called off. But you’re telling me you’re going to go water for Nina?”

  “For Paz Farms.”

  “What happened?”

  He rolled over on his back. He focused on a cobweb that stretched from the corner of the room to a blade of the ceiling fan. “I proposed.”

  “Oh my God.”

  “Yeah.”

  “Marriage? You proposed marriage? To Nina?”

  “Yeah.”

  The creaking stopped. “What’d she say?”

  “Fuck you, Lacey.” He didn’t mean it, though. He wasn’t angry.

  “Right.” Lacey nudged the mattress. “I’m sorry.”

  “Don’t be. What kind of idiot proposes after one date?”

  “You would’ve married Mishelle Mowry your sophomore year if you could’ve gotten it to take.”

  He had to laugh. Possibly because Lacey was right.

  “You even told everyone you were going to marry her.”

  “I was a kid.”

  “And then when she broke up with you after she went on that Kennedy history trip to Dallas and made out with John Stebbins on the bus, you locked yourself in the high school concession stand until your dad came with a bolt cutter.”

  Sam heard another set of feet.

  PJ. Great.

  “Are we playing This Is Sam’s Love Life? Because I was pretty fond of Mae Jin. When you were in med school. She was that art major who did the thing with beeswax painting.”

  “Encaustic.”

  “What?”

  “The painting style was called encaustic. What the fuck are you doing here?”

  “Where goes Lacey, so goes my nation.”

  “And you’re giving me a hard time about my love life?”

  “No, dude. I learned it from you. Except I might suggest a somewhat longer game.”

  “Because that’s working so well for you?”

  “Hey,” Lacey said. “I’m right fucking here.”

  “Sorry,” said PJ, and Sam realized he really sounded sorry. He should ask him how he did that.

  “And lovely to hear that you’re playing a game with me, by the way.”

  “Shit, Lacey. I am not. I’m so totally not.”

  Then the room went blissfully quiet while PJ suffered and Lacey was mad, or whatever she was.

  “I’m sorry, Sam.” Lacey put her hand on his shoulder and he opened his eyes.

  “I’m sorry I’ve blown off the clinic.”

  “I know you are.”

  “And that my brother’s such a creep.”

  “It’s okay.”

  “I’ll meet you there today.”

  “That would be awesome, thank you.”

  “After I do the thing at the plot.”

  “Yeah, okay.”

  “After we meet, will you take me to see Tay?”

  Lacey squeezed his shoulder and ran her other hand through her crazy, messy hair. He’d actually tried to get her to date him a couple of times, once before she had Nathan, and once when Nathan was a baby.

  She was pretty, smart, and had always been around the Burnside place. Of course, she had famously been PJ’s sitter, though until recently he hadn’t taken how PJ felt about her seriously. It would have been so easy if he could have falle
n for Lacey.

  If completely unfair to her in every way possible.

  “Yeah, we’ll go see Tay, for sure.”

  He sat up, squeezing his eyes shut against the wave of dizziness from being in bed for so long. PJ was sitting in the rocking chair now, looking depressed.

  He was so stuck with these people, whether they understood him or not.

  “Okay, you guys can get the fuck out now.”

  PJ leaned back in the chair and crossed his long legs. He was wearing leather pants in the middle of summer, fucking leather pants, and a T-shirt that had such a deep V-neck Sam wondered why he was bothering to wear a shirt at all.

  “Mike, too?” PJ asked, and let his sunglasses slide from his hair to the bridge of his nose.

  “Mike’s here?”

  “Yeah,” Lacey said, “he came in with me. He’s doing your laundry and took out your recycling.”

  “Like an intervention,” PJ said.

  “Jesus.” Sam rubbed his hands over his face.

  “So Paul and I will be going,” Lacey said, “and text me when you’re coming in and we’ll get some stuff done, then we’ll go to the hospital for evening visitor’s hours.”

  PJ stood up and hooked his arm through Lacey’s. Gave Sam a thumbs-up.

  “Go.”

  “We’re going, bro. Tomorrow night we’re getting pizza at Betty’s—Sarah, Lacey, Nathan, Betty, Daniel, and me to Skype with Des, just so you know.”

  “Fine.”

  “I’ll drag you there myself if you don’t show up. It’s early. Five o’clock.”

  “Perfect.”

  “Hefin will probably be there with her, too, so you’ll have to be nice.”

  “The nicest. Get out of my bedroom.”

  Lacey dragged PJ out.

  “Sammy!”

  Mike. With a basket of laundry.

  “Shove over, Sammy, I need to fold your shorts.”

  He watched Mike, with his thick, hairy arms, concentrate on folding underwear into neat piles, while whistling through his teeth.

  “I messed up with Nina.”

  “Figured.”

  “I don’t know how to fix it.”

  “Grovel, brush your knees off, repeat.”

  “Yeah?”

  “Yeah, even then it’s fifty-fifty.”

  “Fuck!” Sam yelled at the ceiling. The cobweb fluttered.

  “That’s about right, brother. So you’re gonna go water her plants?”

  “Yeah.”

  “Hoping to run into her, all casual-like?”

  “Yeah.”

  “Then hit the showers, you smell like death and look worse.”

  “You’re seriously folding my underwear?” Sam heaved himself out of bed and snagged a towel from another basket of clean laundry he hadn’t noticed.

  “You get yourself hitched up to the love of your life like I did, and you’ll be surprised at what you learn is civilized behavior.”

  “I proposed.”

  Mike stopped folding and whistled, low. “Shit. I guess I don’t blame you for trying to lock it in, but that was a high-casualty mission you assigned yourself.”

  “I didn’t actually think much about it. It just—came out.”

  “I thought we talked about that.”

  “Yeah, but she …”

  “I seriously do not want to hear how your little head contributed.”

  “Yeah, okay.”

  “I don’t know if groveling’s gonna work.”

  “Me neither.”

  “You’re a doctor. There’s not something you can give her to erase that particular moment in her memory?”

  “Jesus, Mike.”

  “You know what? I’ll ask my DeeDee what you should do. She’ll know.”

  “Yeah?”

  “She cuts hair for a living, man. She hears all kinds of weird shit people do. She’ll know.”

  Sam went to go to the bathroom again, then stopped. “Everyone’s going to know, I guess.”

  “Oh hell yes, they will. I’d run this like a campaign, if I were you.”

  “I don’t want to. I just want this to be about Nina. About me and Nina.”

  “Love’s not like that. Listen to the wisdom of a happily married slob. Love’s one of those things that’s only possible when you suddenly care that everyone else in the entire fucking world is happy. You see her, and something about her makes you want to do good, make people happy, hope that everyone you ever knew is happy, because you’re so goddamned happy that otherwise it’s not fair.”

  Sam was realizing that Mike was absolutely right, but he still had to ask. “That true?”

  “Why the fuck do you think I’m here folding your shorts, Sammy? Not for my health, I’ll tell you that.”

  Chapter Seventeen

  Sam prodded at the tops of his ears, hoping that the pain from the sunburn he got late this morning would wake him up enough to pay attention to what Lacey was trying to tell him.

  “Stop messing.” Lacey put down the papers she was going through.

  “They hurt.”

  “You should have worn sunscreen.”

  “I did. I just missed my ears.”

  Lacey put her head down on the desk, and Sam leaned back, trying not to feel sick. Seeing his name on so many regulatory documents, realizing how much he was accountable for, looking at the huge numbers associated with this clinic, more zeros than he had seen together in his life, looking at the thick stack of employee folders—what was he doing?

  What he loved best about this clinic was exam room one.

  Exam room one had a door. A new door, installed with new stainless pneumatic hinges that made the door open and close without slamming.

  It had waxed linoleum tiles in a golden color Lacey had called maize and freshly painted ivory walls because Sam had said he wanted white, but Lacey had said plain white was too institutional. She was right; the walls looked clean, but they glowed, and there was even a large framed photograph in here, right where a patient could see it from the perspective of the exam table.

  The picture was a professional one of the little park in southside, kids grinning and hanging from the equipment, a mom—a woman he knew from high school, actually—watching them with a coffee and a smile.

  Exam room one had a sink and a counter, soft gray cabinets hung and filled with supplies. The exam table was a splurge, one of the new universal access ones, wildly expensive but Sam insisted; it was comfortable and reinforced for patients of all sizes, and raised and lowered with a quiet lift to accommodate the different ways patients could move.

  The chair for a family member was comfortable, he’d tried it himself. Lacey had insisted on a shelf for patients’ clothes or their purse. His rolling exam stool was snugged up next to a discreet supply cart, ready with phlebotomy and basic crash supplies.

  Exam room one was done, set up as a prototype for the others, for inspectors and auditors; eventually it would, of course, be for patients.

  It was the room he could breathe in, because this room represented the endpoint of the dream, the whole reason for the dream. Everything else was almost incomprehensible—programming, quality assurance, hiring, grant writing.

  He knew what he was supposed to do in that room.

  He had some dreams there, some imagination.

  Yesterday he’d spent the whole morning with Lacey, and after a series of gut-churning conference calls regarding their insurance, credentialing, and licensing, they’d put together a preliminary appointment book with their newly hired staff—two RNs, four CNAs, two NPs, a family practice resident from Lakefield State University’s program, and Sam. Lacey would be the full-time administrator.

  Sam was dismayed to discover he would only have patients two days a week one week, and one patient a day the alternating week, with twice monthly weekend calls.

  Because, like Lacey, he was actually a full-time administrator.

  They’d gone back and forth, moving hours around, but every time Lacey
found more practice time for him, she’d remember how the human resources stuff would change in the winter, how she would need him for that project.

  “I’m sorry I missed the interest holder’s meeting.”

  “You said.”

  “I am sorry.”

  Lacey kept her head down, talking into the surface of their new conference table. “It’s fine. I’ve been to all the meetings. They know me. The thing is, there are plenty of people who don’t know you yet.”

  “That seems bad.”

  “It’s fine. It’s not like I didn’t know what this would be when I signed up for it, Sam. It’s fine.”

  “What do you mean?”

  Lacey sat up. “I mean that I knew that the best thing about partnering with you would be physician support. As a nurse, I’m used to it. I’ve been a clinical nurse leader at the hospital for years, I’ve saved patients from physician error multiple times, I have my own doctorate and am an advanced practice nurse and can prescribe medications, but there are some interest holders and investors and people pledging to the clinic—and even regulators and state auditors and feds—to who none of that would matter unless I had a doctor by my side. More than half the FQHCs like we want this to be are founded and run by nurses, but most of what I’ve learned is that there is some physician lurking somewhere.”

  “You’re saying I’m a figurehead?”

  “Pretty much.”

  Same pushed the heels of his hands into his eyes. “Thank God.”

  “Well, a figurehead who’ll get in as much trouble as I will if we fuck this up.”

  “I’m sorry.”

  “Just. Stop. It’s going to get worse before it gets better. As soon as we have some kind of documentable income stream and are billing we can talk about hiring an administrator to help me.”

  “What’s our timeline again?”

  “For full federally qualified status?”

  “Yeah.”

  “Five years or so? We’ll open sometime in the next three to six months as a low-income clinic …”

  “Right.”

  “With the help of a couple of the uncompensated service sectors from the hospital and the providers we’ll have billing here. Finish all of our sector analyses over the next two years, trying not to go under, using the start-up grants from NHS.”