On the way in, she passed Lauren from TB control. They didn’t get along usually. But she surprised herself, exclaiming, “Such a lovely day, isn’t it?” as they passed. She seemed to surprise Lauren, too, who nearly winced. “Yes, it is,” Lauren replied. “I nearly didn’t want to come inside.”
“I had no choice,” she sang back. “I have a full plate today!” She stopped in the office kitchen for a second cup of coffee, then, carrying it with panache and a certain boom-boom in her step, she thought, swung into her own office. And there was a handsome young Hispanic man in a shirt and tie, square-framed glasses sitting on his face, in the chair in front of her desk with a stack of files on his lap — probably not a day over twenty-five!
“Oh!” she exclaimed. “Well, hello there.”
He looked up, startled. “Oh! Hello, Doctor.” He rose abruptly, some of the files slipping from his lap to the floor, and they knelt down to collect them together. “I’m Hector. Villanueva. From Columbia.”
“Oh, of course.” She smiled. “You’re my intern for the summer. Dr. Ferrer told me about you. Well, hello, Hector.” She extended her hand. “It’s nice to meet you. Please just call me Ava.”
He looked at her quizzically. “Are you sure?”
“I’m sure I’m sure,” she said. He was certainly handsome, she thought, settling behind her desk, but so shy and awkward! She could already tell. And those glasses! He had such large, lovely brown eyes behind them. Hadn’t he heard of contact lenses?
“I’m sorry I’m sitting here,” he said, even though he wasn’t sitting anymore, but was standing, nervously, the stack of folders in his arms. “Mrs. — um, Mrs. Conti said it was okay because she didn’t know where else to put me until you came in.”
“It’s fine,” she said, her mind already thrumming with all the different projects she could put him on. . and wasn’t this sweet, she already felt a bit maternal toward him! “I came up at Bellevue. I know how to work around distraction. I’m not one of those lab geeks!”
He laughed — awkwardly, she noted; oops, he probably was one of those lab geeks. “So how’s Columbia?” she asked. “Renny—” She caught herself. “I’m sorry,” she said, all mock contrite. “Dr. Ferrer said you were interested in infectious. I.D.”
He nodded soberly. “I am.”
“But why? Infectious is over, everything’s been figured out. Why not cancer or heart? That’s where the big work’s gonna be — and the big money.”
“Well—” he stammered. He was so nervous! Was she talking too hard, too fast, scaring him? “Well, in the developing world— infectious—”
“Oh, I get it! You want to do I.D. in the developing world. Oh, well, that’s a different story. Lots of work to do there! You’re from — where, the D.R.?”
“The P.R.,” he said. They both laughed a bit at the inadvertent wordplay. “We came here when I was thirteen.”
“Ah, sí, muy bien,” she said. “Maybe you can help me with my Spanish, among other things, because it’s not very good.”
“Sure, I’ll help you,” he said softly. She smiled. She hadn’t even been serious, but he’d taken her seriously. He was sweet. If only he’d lose those dorky glasses — he didn’t know how handsome he was!
She needed to bring them back on point — her busy day! Her meetings! The outlines and flowcharts she wanted to work through! “Let’s talk about what I’ve got on my plate and how you can help me out,” she began. And just then, speaking of I.D., Blum rapped on her door, came in, and handed her a brief, ignoring Hector.
“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.