Saturday morning, June 5, North Stamford

Jake

I say goodbye to the kids in the early morning, trying to follow Jess’s advice not to make a big deal about their departure. When I kiss Jamie on his forehead, he lazily opens one eye for a few seconds, then curls back into a deep sleep, and I can’t help but wonder if he’d even remember me if I suddenly vanished from his life forever. Emma seems equally oblivious, shrugging off my hug with a sleepy “G’bye dad.” 

“Maybe we’ll see you next weekend?” Jess suggests, trying to sound upbeat as she walks me to the door.  

“Sure.” I swallow the knot that’s formed in my throat and fight the urge to ask her to reconsider.

“Did you get any sleep last night?” She reaches over to adjust my tie.

“Not much,” I admit. “But I’ll stop on the way to pick up some coffee.”

We share a moment of awkward silence, both realizing this is it – the start of our trial separation. How often will I revisit this moment in the years to come? How many times will I re-script the scene, coming up with the heartfelt words, the impassioned plea that now escapes me?

“So…” Jess finally says, brushing her lips across my cheek. “Take care of yourself, okay?”

“Yeah.” I look into her eyes, wishing I had something more meaningful to say. But I don’t. “You too.”

Half an hour later, I drag my partially caffeinated ass through the employees' entrance of Greenbeck Derm. Erin's waiting for me at the nursing station, all bright-eyed and looking like an Irish setter puppy. How can anyone be so perky on a rainy Saturday morning?

“Good morning, doc!” she chirps. “Are you ready for another thrilling day at Greenbeck Derm?”

I thank her for coming in on the weekend to help with the Replacidin study. “What do you have for me?”

Her grimace says it all.

My first patient, Jean Clark, is a middle-aged woman with a petite frame, dark wiry hair and the pointy facial features of a toy poodle. As she speaks, her watery gray eyes roam constantly, as if she’s looking for the nearest escape route. After we’ve established that her husband is a high-profile Manhattan attorney (specializing in personal injury and malpractice law), I start explaining the risks and benefits of participating in the Replacidin study.

“But what about this growth on my face?” she interrupts anxiously.

“Sure,” I say, figuring we may as well get this part of the session over with. “Let’s take a look.”

I hand her a mirror and we both inspect the pinhead-sized white dot on her cheek.

“It’s called a milium, Jean,” I explain. “They’re quite common, really. And completely benign.”

“But are you sure it’s not a skin cancer?”

“Absolutely.”

She seems slightly disappointed. “But how did I get it?”

“There are several causes,” I say, going down the list. “Sun damage. Inflammation. Mechanical factors such as friction and rubbing. It’s part of the normal aging process, which” – I’m quick to add – “is barely evident on your skin. I can tell you take exceptionally good care of it. What’s your secret?”

Jean primps in front of the mirror, suddenly pleased with this encounter. Just one well-placed compliment can set the right tone, and that’s critical in this job.

We spend the next few minutes going over a cosmetic skin care routine that includes several Greenbeck products. Then we move on to her laundry list of “problematic” areas.

“Yes,” I say when she finally reaches her furrowed brow. “That’s the area we’ll be treating with Replacidin. Those lines are called rhytids or frown lines. They’re a common trouble spot, because they make people feel…” I wait for her to fill in the word.

“Angry.”

“Right. Angry, or too serious. Botulinum toxin injections soften those nicely, but they only last a few months. Replacidin, on the other hand, lasts for up to a year.”

“And what about these lines?” she asks, pointing to the wrinkles that radiate outward from the corners of her eyes. “They make my face look so… tired.”

From her tragic tone, you’d think she was talking about the loss of a family member. “Those are called crow’s feet,” I explain. “We’ll be able to make those melt away with Replacidin in the future, but for now, that area's not part of the study.”

"So then what else can you do to make me beautiful?" she demands, crossing her arms.

Shit. This is going to be a long morning.

We tour her face, to the small red blood vessel clusters on her nose (pulsed dye laser), creases around her mouth (soft tissue fillers), moving to her jaw line (non-ablative laser skin tightening) and neck (liposuction plus a mini-lift). We’re about to move to the V of her chest (intense pulsed light, chemical peel) when Erin pops her head in to give me one of her looks, the kind of expressive furrow that only a Replacidin-free forehead can make. This one means: “We’re running behind, so move your ass.”

“But these are all things to work on in the future,” I add with a smile. “For today, let’s just start by getting rid of that milium. Then we can finish enrolling you in the Replacidin trial. How does that sound?”

Ten minutes later, Mrs. Clark leaves with a small dot Band-aid on her face and a bag full of brochures and cosmetic samples. She looks like a kid leaving a candy store with her stuffed goody bag. If only happiness were really that easy to find.

“Nicely handled,” Erin teases before we move on to the next patient. “Another life saved.”

I spend the remainder of the morning working my way through a dozen more variations of Jean Clark, answering all sorts of cosmetic questions while screening them for inclusion in the REST study. It takes just over three hours, but by noon, I’ve recruited nine candidates.

“Is this the last one?” I ask Erin, puzzled by the amused expression on her face. “I don’t think I can take much more of this. Why aren’t you exhausted?”

“Oh I am,” she answers, her grin widening.

“Then what’s with the cat-who-swallowed-the-canary smile?”

She hands me the next chart. “You’ll see.”

“Why? What’s behind door number one? A grizzly bear?”

“Close. You’ll see.”

From the way she says this, I’m pretty sure I don’t want to see, but I knock and then open the door anyway. My jaw must drop when I see Briana Caulder, sitting demurely on the exam chair, because she greets me with an amused expression of her own.

“Sorry to disappoint you,” she announces, reminding me of how thin our walls are, “but I’m no grizzly. I don’t even wear fur.”

“Mrs. Caulder,” I say, making no effort to hide my surprise. “It’s nice to see you again.”

We exchange a quick hand shake, followed by an awkward moment of silence.

“So…” she finally says, edging forward in her seat. “You must be sort of surprised to see me.”

“You’re right about that,” I agree, working to keep my tone neutral. “Our last visit didn’t exactly end on a positive note.”

“Yeah, well…” She nibbles on her lower lip, then breathes out quickly. “I’d like to apologize for the way I behaved back then. I know it’s no excuse, but I was feeling pretty stressed out last week. I mean, the last thing I needed to deal with was a face full of zits.”

“No need to explain,” I reply, sounding gentler than I’d intended. “We’ve all been there.”

I set down Briana Caulder’s chart, noticing how different she looks. Gone is the flashy arrogance that hit me last week, like an overpowering blast of perfume, as soon as I walked through the door.  In its place, I now sense the kind of polite, cautious vibe usually given off by someone on a first date or job interview. She’s even dressed more modestly today, wearing a simple white cable-knit sweater and jeans. Little if any make up -- just a touch of pink lip gloss. I think of how Roy Caulder described his wife’s physical beauty last week. He wasn’t exaggerating.

“So…” I shift my attention to her perfectly smooth forehead. “Are you here to discuss our Replacidin wrinkle study?”

“That’s right. Nina Greenbeck contacted me over the weekend to ask if I’d be interested. I’m not sure it’s for me, but I’d love to hear more details about the treatment.”

“I’ll be happy to fill you in, but first…” I reach above her to turn on the exam light, inhaling her perfume – the scent of freshly cut gardenias with a hint of vanilla. “Let’s check to see if you’re an appropriate candidate.”

The harsh glare of halogen light bounces off flawless skin. “So,” I say, noticing that the blemishes on her chin have vanished. “It looks like those steroid shots worked out nicely.”

“Oh… yes, they did.” She gives me another smile, this one warm and genuine. “Thanks so much for your help last week. Again, I’m sorry I gave you such a hard time. I was just, you know… really upset about the way my skin looked. We had a big social event planned, and…” She trails off shyly as I turn off the overhead light.

“I understand how it is,” I say, not quite ready to let her off the hook yet. “Your husband called last weekend to fill me in on the details. He was pretty upset too.”

She winces at this reminder, then glances down at her hands. “Yeah, he mentioned that. Listen, I’m also sorry you had to deal with that call. Roy’s sort of a control freak. You know… the kind of person who thinks he can fix everything with a phone call.”

I scan the front page of her chart, noting the consent section has been left empty. “There’s no need to explain, but for future reference, would you like me to discuss your medical care with your husband or any other person if they request information?”

That question seems to catch her by surprise. “What kind of information are we talking about?” she asks, her tone becoming guarded.

“Most family members want to know about treatments, potential side effects, the significance of certain diagnoses... that sort of thing. That information is very sensitive, so we don’t give it out without your written permission.”

She nods slowly. “Then let’s keep my information private, okay?”

When she looks up to make eye contact, I notice something else I hadn’t picked up on before. A hint of anxiety, maybe even fear. And, surprisingly, trust.

It’s the kind of look Emma used to give me right after a tumble, once I’d finished reassuring her that it was only a scrape – that everything would be okay.

“Fine,” I agree, making a note in the chart. “So if your husband calls again…?”

“He won’t. But if you want me to spell things out: My medical information is none of his business. And off the record, you were right about the birth control. I was taking something. I’ve switched to something else. And I definitely don’t want that in the chart.”

Erin picks this awkward moment to interrupt, sticking her head into the room. “Doctor Goodwin?” she asks cautiously. “Do you need me for anything?”

I glance up, noting her concerned expression, and once again take in my surroundings. That’s when I notice how little space now separates me from Briana Caulder. Somehow, I’ve managed to drift close enough to touch her.

“Thanks, Erin,” I say, “but we’re fine. I was just getting ready to review the Replacidin consent form with Mrs. Caulder. I’m running a little behind.”

“Okay,” Erin agrees, but I catch the note of warning in her voice. “I just wanted to remind you that we still have one more study candidate waiting.”

“We won’t be long,” I reassure her.

“All right then.” Erin glances quickly at Briana, then shifts her attention back to me. “Well… I’ll be right outside if you need me for anything.”

As she turns to leave, she doesn’t need to say the words on her mind for me to hear them, loud and clear.

Be careful, Doc.

*

“But why would she lie about the birth control?” I ask, staring at a small wisp of cobweb dangling from my bedroom ceiling. I’m talking to the one person who I knew would be wide awake at this hour: my med school roommate and best friend, Josh Carpstein. Over the past few months, our late-night phone conversations have become a ritual.

Although it’s well past midnight, I’m nowhere near falling asleep, and, tucked away in his call room somewhere in the bowels of Massachusetts General Hospital, Carpstein isn’t either. He’s still wired after having just finished an emergency aortic dissection repair. I, on the other hand, just concluded a stressful procedure of my own: an awkward late night phone conversation with Jess in which she sounded more like a stranger than ever.

“I mean, why would she lie about something like that?”

“How the hell should I know?” Carpstein snaps in a Staten Island accent so thick you can almost smell the landfills when he speaks. “The real question is: why do ya give a shit?”

“I don’t know. I just think there’s something wrong. You should’ve heard the things her husband said on the phone last weekend. I’m telling you, Carp – the man’s not stable. No wonder she was stressed out about having a few zits on her face. He probably threatened to beat her if she didn’t clear up before their big party.”

Josh coughs loudly into the phone. “Hey, slow down a bit,” he says, his voice sounding gruff with the beginnings of a cold. “That’s a pretty big jump to make, don’tcha think?”

I rub my burning eyes, pressing the phone receiver closer to my ear. “Maybe, but it’s just the feeling I got talking to her.”

“I see. And you don’t think this feeling could have something to do with the problems you and Jess’ve been having?”

I let the question hang in the air, debating how to answer.  It’s vintage Carpstein: blunt, insightful, and brutally to the point. “Maybe,” I confess, stifling a yawn. “But that’s irrelevant, isn’t it? I mean, I’m her doctor. If she’s in some kind of domestic abuse situation, shouldn’t I intervene? Isn’t that my responsibility?”

“Is she a minor, senior or mentally impaired?”

“No but…”

“But nothing. Then you’re under no legal obligation to report anything, even if there were something to report. Which,” he clears his throat for another gravelly cough, “it definitely sounds like there ain’t.”

“Look… I know how it sounds, but I just have a feeling.”

“Feeling, shmeeling. Let me ask you something. Did she tell you her husband was beating her?”

“Not in so many words...”

“And did you see any physical evidence to suggest abuse. You know – a black eye, bruises, scratches, any sorts of defensive marks?”

“No,” I admit sheepishly.

“So then basically, you’re pulling this whole thing outta your ass.”

“I don’t know that I’d put it that way, but –”

Carpstein lets out a loud cough to interrupt me, sounding like he’s in desperate need of some Robitussin. “You wanna know what I think?”

“No, but you’re going to tell me anyway.”

“Damn straight! I think this has more to do with what’s going on between you and Jess. You’re just looking to make some kinda emotional connection with another woman.”

“That’s total bullshit.”

“Oh really? So this patient isn’t attractive?”

“I didn’t say that.”

“No,” he notes slyly. “You told me a few minutes ago that she looks like a friggin’ swimsuit model.”

“Okay, she’s attractive,” I admit. “But that still doesn’t change the fact that she looked… well, scared. Almost terrified.”

“Yeah, well she probably is terrified. Terrified of being stuck in a shitty marriage, with some control-freak, a-hole of a husband. That still don’t make her the victim of spousal abuse.”

“I guess not.”

“Then let me ask you something else: why are you obsessing about this chick?”

“I’m hardly obsessing.”

“Yeah, well… it sounds like you’ve been giving her an awful lot of thought.”

“That’s ridiculous.”

“Is it?” He pauses to let the accusation sink in. “Listen, Jake: I’ve known you for a long time.  The day you met Jess, you forgot about all other women. I mean, they just became invisible to you. Chicks who were interested used to ask if you were gay and I’d say nope – just taken. But tonight things sound different. Tonight…” I can practically see him shaking his head up in Boston. “You haven’t even mentioned Jess. Not once.”

I don’t even try to respond. Instead, I stretch out my legs against the down comforter, suddenly wanting to end this conversation.

“So what’s goin’ on?” He asks after a long pause. “Is it over?”

“Of course not!”

“Then why the hell are you talking to me now? Why aren’t you talking to your wife?”

“I thought I told you: Jess took the kids to her parent’s house in the Cape.”

“That’s not the whole story and you know it.”

I wish I had an easy come-back answer, but I simply don’t, so I stay silent, my eyes wandering back to the thread of cobweb floating from the ceiling.

“Do you still love her?”

“It’s not that simple.”

“Yes it is. Do you love her?”

“Of course.”

“And does she love you?”

Out of all the people who could possibly burst my emotional dam, I would have considered Josh to be the least likely, but here I am, stretched out in an empty bed, about to spill my guts out to him. I lower my head, digging my chin into my chest.

“I’m not sure anymore. She wants to. I can sense that much. It’s just… there are too many things getting in the way. Too many problems, too much baggage. It’s not just work, or that stupid fucking affair that –”

“Whoa,” Carpstein interrupts. “I wouldn’t call what Jess did an affair. From what you described, it barely qualifies as a hook up.”

“Yeah, well whatever you want to call it, it sure did enough damage to our relationship. But that’s beside the point. I’ve forgiven her. I can even understand why she did it, but that still doesn’t change the fact that we’re stuck in the same place. It’s like she can’t even look at me without feeling…” I swallow hard, almost choking on the word. “Disappointed. I never thought I’d make her feel that way.”

Josh remains silent for a while, processing my emotional dump. Then, he says something that reminds me why we became such close friends in the first place.

“She loves you, man, and you’ll work through your problems.”

“How do you know that?”

“I just do. Besides, if the two of you can’t make it, then what hope do the rest of us have? Don’t forget – I was there right at the beginning, so I should know.”

“Thanks,” I say, swallowing another painful lump in my throat. “That’s definitely what I needed to hear.”

“Don’t mention it. Now I have a suggestion for you. Instead of moping around in that empty house of yours next weekend, why don’tcha come up to Boston and hang out? It’ll give you a good excuse to see your family.”

“Maybe,” I agree. “If I can get enough of the REST study done this week.”

“Screw the study! This is your life, Jake. This is it. Do you get what I’m sayin’ here? You’ll just have to make the time!”

I glance over at a framed picture of Jess and the kids, perched on top of my wobbly night stand.

He's right. Fuck the study. Fuck the Greenbecks. Fuck it all.

“Yeah,” I say. “I hear you.”

***

© Copyright 2025 graymartin. All rights reserved.