Chapter 4: ICE

CHAPTER 4

Pandolf, California

April, 2025

Garcia now rode in an ICE unmarked car. 

“My son is waiting for me at the airport,” he said. 

“We help you and you help us, right?”

“Yes sir.”

“Which airport?”

“SFO, bit of a hike, sorry.”

“OK.”

Shelly Narayan was leaving the lab, frustrated because she had been unable to ask the rushed Garcia how to proceed with her experiment. Then he had been less than sympathetic after she explained that she was late due to her crazy schedule. 

Or had he simply forgotten their appointment?

“Martian green,” he had said about her fundraiser.

He was a challenge in her professional journey — to emulate her mentor in medical school — a pelvic surgeon who was one of the first women in her specialty. But first, she had to finish her Ob/Gyn residency, even if she would never deliver babies again. It was a quirk in the training system. 

Two nights ago on call at a community hospital, Hunterview, she had assisted surgeons in seven back-to-back Cesareans:  a blur of blood, screaming infants in warmers, cold operating rooms, tired parents and hurried attending doctors. 

But at least there, she was not at Pandolf’s Women’s Health Clinic, its crowded waiting area, cramped exam rooms and endless assembly line of “jiffy” Pap smears. There, she counseled patients about weight gain, libido problems, rocky relationships, and gyne issues uniquely female. After each patient, she loaded encyclopedic templates and text blocks into the computer’s electronic health record. 

Her doctor father complained, “I don’t have time anymore to talk to my patients, beta. I point and click my way through a maze of boxes — like the video games you kids play. Yesterday, I had to finish modules for billing and compliance before I could log in to learn about this new implant for depression.”

“Yes Papa. But you’re close to retirement. You don’t have to put up with that much longer.”

“You think I’m just ..too old to learn new tricks?”

“Ummm…”

Finally, to compete for the surgery fellowships, she did research. For that, Dr. Samuel Nepski had one of the best labs at Pandolf Medical Center.  Next year, he had found her a project in ovarian cancer .

He was such a noble contrast to Dr. Brickstone at Hunterview Hospital, a community OB, square jawed and handsome, robust frame sculpted by dawn workouts. Brickstone could discuss sports with anyone anytime. After every Cesarean, he would admire the newborn in the warmer with the same effusive speech. Never once thanking her for her help, he then turned his focus to the waiting computer. 

Painstakingly, Shelly sewed the mother’s skin together, striving for the best cosmetic result, the only resident Brickstone allowed to do this final step, the only thing the patient would see. 

“SuperDoc Brickstone will deliver your baby, fix your sink, change your tire — but not a poopy diaper,” she wanted to say, instead biting her tongue with his worshipful gaggle of women — from patients to nurses.

“Clucking hens and Rooster Brickstone,” she thought.

One evening, driving home from Hunterview after being on-call the night before, she fell asleep and rear-ended a Medical Center shuttle headed to San Francisco. 

Undisturbed, the bus driver and passengers moved on—  thanks to physics’ laws of momentum for a collision between a large (mega-bus) and small (energy-efficient car) mass —  which left the bus occupants unaware of the accident. Her vehicle suffered expensive damage. Now, she called for rides when she was sleep-deprived.

She didn’t tell her parents, Her father mock-boasted about his training before the reforms that limited resident hours decades ago, “the good old days,” weeks of thirty-six-hour shifts awake in the hospital with one night of sleep in between, “back in the day when men were men.”

Returning to her apartment, it was dark. Her housemate, Lucky was on call tonight. 

She had met Julia Malone, who went by ‘Lucky,’ over two years ago on Pandolf’s social media page. They had swiped into each other’s profiles on their phones and synced in person. 

Lucky’s father was also a doctor, a surgeon on the East Coast. Like Shelly’s mother, Lucky was pale white with freckles and cornsilk hair straight out of a shampoo ad. 

“You know that people spend hours and fortunes to have hair that looks like yours and you roll out of bed with it,” Shelly grumbled.

On Lucky’s side of the bathroom counter, makeup spilled like an art set: colored pencils, tubes of lipstick and mascara, compacts and bottles, alongside perfume, sunscreen, moisturizer and a lighted magnifying mirror. Her encyclopedic wardrobe hung in plastic sheets in two closets — more mirrors — many clothes never worn, next to shelves lined with airy shoe confections which could not be used for work.

A former college athlete, Lucky now sported scrubs and clogs and smelled of plain soap. Showers were quick. The stream was slow, water never more than lukewarm. Outdoors, Lucky always made time to put on wraparound sunglasses and a wide-brimmed hat.

“Because our skin is so white, everyone in my family gets cataracts and skin cancer, I wish I had a touch of your dark coloring. You don’t mind me saying that?”

They had just recently moved in together. 

“No.” Shelly had flushed and stiffened. “Actually, growing up biracial in Texas, I wanted skin and hair a little more like yours.”

Awkward silences rarely happened anymore. 

“You should stop straightening your hair. It’s pretty just natural,” Lucky recently said.

“With our long hours, I may just cut it short for a quick wash and dry.”

Her own side of the bathroom counter was rebelliously bare. As wearing glasses was more efficient, she put away her contacts. Who had time for makeup daily? Into the drawer went her makeup case. 

Lucky pushed her to come to parties, held mostly outdoors since the pandemic, music as loud as ever. A spirit out of The Great Gatsby, her housemate could turn on the firefly sparkle and become the brightest spot in the gathering. 

Shelly made polite conversation mostly with strangers and patiently waited for Lucky to decide to leave. Then she was the designated driver.

Lucky’s long-distance boyfriend, Harry, was a former ice-hockey player from their time together in a prep school. She  saw pictures of people like them, usually in the Style sections of the New York Times and Vanity Fair. The couple lived in a world of trust funds, no student loans and families who not only paid the full ticket but even donated money to their schools.

If it weren’t for the convenience of living on campus at Pandolf Medical Center, Lucky would not be “slumming” with her in their apartment.

“So yes,” Lucky said, “my test scores weren’t great in medical school so I ended up in residency here. It’s all good. The long-distance with Harry is just temporary and I found you, Shelly. Some of your patients have sad stories when you tell me about them.”

 Lucky continued slowly. “ I’ve had to think more about what it means to be a woman. I used to see men doing hurtful things to women. I remember feeling glad it wasn’t me, thinking I was special or better. But you know what: I was safe because I was with Harry. 

“Harry and I have good times, like going to a friend’s at the top of a skyscraper someplace… but I don’t party like some.”

Shelly frowned. “I see women do hurtful things to men too. Isn’t it best to stay away from people misbehaving in general?”

“Oh, now you’re talking about me? You’re no fun. Thanks for being my wingman last weekend.”

Lucky added, “Well, another reason I came to Pandolf was to get  some space from Harry because he’s the only person I’ve ever dated. Maybe I need to break it off.”

“Why?” Shelly said. “In cultures like my dad’s, people might be with only one partner their entire life.”

In a video call, Shelly’s mother observed, “Well, proximity is important for relationships. Now that Lucky and Harry are living in different cities, they may grow apart.”

“But I like them together,” Shelly protested.

“We’ll see.” 

Her father’s face popped into the screen. “Your mother’s right as always. It is the men who should worry about crossing Lucky’s path. Look what happened to me.” His wife groaned and affectionately pushed him away.

Business school gave Harry the leisure time to visit often. On vacations, the couple sailed, skied, and scuba-dived. 

“Maybe you could join us on a trip?” Lucky suggested. “Sometimes we go with groups.”

“No thanks, Why do people want to inhale salty ocean and then sit on a sweaty hot beach with gritty sand? Or ski in frozen cold, wrapped in a heat containment bun with high-tech eye protection only to break their leg going down something called a ‘black run?’  

“Don’t they know what vacation means?

“I also don’t need to go to places like Rome — India has an equally ancient civilization  — or Rio. My Spanish is bad. Then I have this healthy fear of germs. Have fun. I’ll get my thrills working.”

“Of course,” Lucky had said gracefully, “making a difference for mankind. I admire that. Still, we need to find you a nice man…or woman?”

Shelly ignored Lucky’s question.

When she was growing up, when Papa wasn’t working marathon hours, vacations were to places like Disneyland usually with extended family, or summer travels to Chicago and India to see “Uncles” and “Aunties,” many not even related. So she was surprised when her mother told her her parents planned to go to Goa, an Indian sea resort, just the two of them. 

Sharing hospital anecdotes with Lucky to relieve stress, Shelly complained one day, “It was so busy that I missed lunch. Then the nurse took forever to come and help me with the pelvic exam because this woman was huge. Waiting, I watched this doc on a cable show tell an obese man to ‘zip your mouth, get off the couch and start moving.’ I was afraid I would laugh. My bladder would explode because I had no time to even go to the bathroom.”

Lucky nodded. 

Feeling encouraged, Shelly continued.  “Now if I was that Dr. TV, I could tell those clinic patients who no longer want sex, ‘just fake it if you don’t feel it.’ People are dying of cancer and you are wasting my time with your sex life.”

“Shelly, that’s seriously problematic,” her housemate then said, “ it’s a good thing you’re going into surgery. You’ll be operating on people who don’t hear you say things like that. Or talk back to you. You’ll be entering their chemotherapy orders on the computer for a nurse who is actually compassionate.” 

Shelly agreed easily.  “You’re right. When I grumble about long days in the clinic, talking and talking, Dr. Nepski says that in the future, my technical skills will matter more than my empathy…or lack thereof.”

“And your smarts,” Lucky said. “You’re the smartest person I know.”

“Lucky, there’s more to it than numbers. The person with the highest GPA and standardized test score may not be the best surgeon, or the most creative thinker or a good leader.

“But,” Shelly continued, “That clinic is def not my skill set. When patients ask how I ‘stay so skinny.’ I want to say, ‘Just stop eating!’  Not helpful.”

“it’s also hard,” Lucky observed,  “to feel compassionate when you’re always stressed out and sleep-deprived.”

“True, but the crowded disorderly mess of humanity that I have to talk to for hours in the clinic is not something I’ll ever have the ‘smarts’ for. But you do, Lucky.”

“You could try harder. You might surprise yourself.”

Trying to put brakes on older patients’ long monologues, Shelly could be brusque: “Oh, I understand, this menopause is a bear, but we can’t stop the clock.” 

Or, “It’s natural to lose your libido so have you considered a therapist? We have a great service here at Pandolf.” 

And for the most common complaint: “Can I set you up with our Pandolf Weight-Loss Clinic?” Point-click-done, she had electronically transmitted an order:  “Ambulatory Referral Adiposity Management.”

But the expectant mothers stressed her the most. They worried about everything. She listened, adrenaline levels rising to meet theirs, asking questions and putting answers into the computer with matching anxiety. 

The “HatchPal” software in the computer was her soothing partner as she translated their complicated medical issues into elegant forms, detailed paragraphs and grids of problems and plans.

Speedily, Shelly completed physical exams and procedures, filling tubes and vials with swabs and body fluids, for which the label machine spat out bar-coded stickers. 

Doffing her gloves, then rubbing in sanitizer, Shelly moved to the next exam room. Always on time, she forgot patients’ names but not the case details. They knew her as “the little Indian lady” or “the quiet Mexican doctor.” 

Or a recent Customer Service comment from an expecting mom:  “It’s hard to tell what she’s thinking about when Dr. Narayan is with me — with her mask up to her eyeballs.”

Inside her dark apartment, Shelly called out for Lucky’s cat. Fighting their efforts to keep him inside, Livingstone would protest loudly at the back door. Then he would leap out and run across the neighboring balconies, down the black iron fire escape and into the dense strip of woods behind them.

Her skin began to itch. She was mildly allergic to cats. Life with Lucky required not just less closet space but also a nightly antihistamine pill. In bed, she briefly lifted the window a crack to let in the fresh air. Then a spitting irrigation spout misted the glass and splattered her forehead. Little chips of paint hit the floor as she slammed it back down.

Soft paws-falls meant Livingstone was back. Allergic or not, she rested her cheek against the fur of the purring animal and pillow.  

Livingstone was a large orange tabby with green eyes. Lucky had found him at a rural bed and breakfast near Acadia National Park in Maine. One of a feral litter, he was born in the backwoods near a scenic lighthouse on the rocky coast. 

Lucky mused about Livingstone’s ancestors, arriving on ships from the Old World to the East Coast, earning their passage by eating mice and fish scraps. One generation might start the journey and the next generation would finish it in the ports of the New World. 

The B&B owner had pointed out the father, a giant marmalade tomcat who made a brief appearance before running back into the trees. “Well, he always comes back. How like a man.”

Falling asleep, Shelly revisited memories of  Dr. Nepski’s  father who had just visited. Tailed by his proud son, the senior Dr. Nepski had whizzed around their lab and inquired about her new experiment. 

Deep forehead furrows bespoke his advanced age. Still, bright eyes, hawk nose and curious questions reminded her of Papa. 

“Exciting theory,” he said about her new experiment.

“My dad’s a rural doctor,” Shelly told him, triggering unexpected praise of her father’s service in an underserved community and “Your parents did a great job raising you.”

Pandolf’s CEO, Dean Baluyn, had invited the  lab team to dinner at the Provencale, a French restaurant tucked into the forest edge of the hospital campus. 

That morning, leaving Hunterview Hospital, the rising sun had dripped gold and reddened its brick sprawl in rural California. Now, she walked the mile from her apartment toward silent, dark rows of woods. The sunset flamed the tall buildings orange. Cool spring breezes echoed the bygone winter. 

Inside the marble entry of the restaurant, fresh cut flowers and exotic plants spilled colors and perfume. Local members of the Mather family had donated their art collection to Pandolf, now housed at the Provencale. A grand antique painting showed an aristocratic French couple in silks and frills flirting, the young woman on a garden swing.

The pricey Provencale was popular among senior medical faculty and affluent visitors. After a security check — security was intensive from hidden cameras to armed guards — the tuxedoed hostess had led her into the dining area with lighted fountains and massive chandeliers. 

An unseen piano  played. Passing tables draped with creamy linens in a spectrum of pastels, jeweled circlets holding rolled napkins, sky blue fine china — almost transparent —  with wisps of pink haze and gilt edging, crystal glassware edged with gold, Shelly followed the hostess into a private banquet hall. 

Ornately framed French oils also hung on the walls of this room, with sturdy peasants working the fields in one and leisuring on pastoral landscapes in the other.

Their dinner group included plus-ones like Baluyn’s husband who was an ER doctor. Shelly sat down next to Garcia.

“To the spirits!” Baluyn raised his glass. With bubbly Champagne and wines, ruby red and golden whites, from Bordeaux to Burgundy, the guests joined in.  

Some dissenters had beers and cocktails. An abstainer, Shelly nursed a fizzy  “limonade” and searched for vegetarian entrees in the menu. 

Today’s special was steak tartare, a raw beef and egg dish. With leaders like Genghis Khan, ancient Mongolian hordes on horseback conquered their empire and lived off horse-meat, the dish’s namesake and forerunner. She pointed it out to Garcia.

He murmured, “I bet that tasted better to a skinny, hungry young warrior long ago than to some modern guy sitting behind a desk all day.”

Beside the Baluyns and also crowning the head of their long dinner table — sat the Nepski family on both sides. 

Sam Nepski’s mother’s face was expressionless when Shelly took her turn to introduce herself. Did Mrs. Nepski think that she was just another brown worker in the increasingly diverse medical workforce? If she looked like Lucky, a Midwest vision of blue eyes, milky skin and cornsilk hair, would Dr. Nepski’s mother notice she existed?

The senior Mrs. Nepal reminded Shelly of patients in her medical school Dermatology rotation, with creamy skin taut on expressionless face and hair a daylight blonde that did not match her brown eyes: the magic of Botox, laser abrasions and skin fillers. 

Remembering medical school, she also remembered Karen, classically perfect in skin and figure, who had also never noticed or spoken to her. Sporting large diamonds, two in her ears and one on her ring finger from her rich fiancé, Karen had scored a spot in one of the nation’s most competitive Dermatology residencies.

“Well on her way to buffing the faces and figures of her wealthy clients,” Shelly then grumbled to her mother. “What a waste of medical training!”

Still, Sam Nepksi had his mother’s good looks.On television, Shelly watched him, a sharp dresser, blink modestly into the camera while he explained complex medical concepts.  The mother-baby dyad, older than Madonna and Child, was his world. In suit and tie, he lectured the public about pre-eclampsia, which can affect pregnant women at the end of their pregnancies, causing strokes, seizures and even death. Videos of swollen women, masked doctors, blinking equipment and endless tubes played. 

Thirty years ago, his father had done groundbreaking research into this pregnancy complication and his son now readily found friends, mentors and opportunities. He had millions in grants, dozens of publications and awards, as well as appointments to prestigious committees and boards. 

Garcia complained to Shelly that he thought the system was unfair, that their boss was merely a star salesman for Pandolf Medical Center. “Nepski is tall and handsome, yes, with the right touch of gruffness and long hair to be people’s picture of a doctor who finds cures for all their ills.”

At the Provencale dinner, Garcia had been quiet and eaten little. He left early But she had stayed behind to further explain her new experiment to anyone still sober enough to be interested. 

Now, cheek still against cat, Shelly fell into a dream where she and Sam Nepski were alone together in a cozy nook of the Provencale. Burning candles and soft lighting allowed for hushed conversation. Like the Cheshire cat in some timeless space, Livingstone watched from a shelf above.

“You and Garcia are two sides of the same coin,” she said to her dream Nepski.

He looked grave. “As with our world, it’s nothing and everything, death and life, we are on the other side of the unknown. Even the restrooms here: purple upholstery, ceiling-to-floor smoky mirrors, soft hand towels, low notes by Ravel for a left-handed pianist…”

Amid buzzing and blackness, their profound discussion shuffled into nonsense. She suddenly opened her eyes, reflexively grabbing for her phone in folds of bedding. 

Was there an emergency at the hospital? But  the Caller ID was Garcia’s number with a helical DNA background.

The time was 1 AM Sunday morning.

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