Chapter 4: ICE


Pandolf, California

April, 2025

Garcia rode in an unmarked car on black highway. 

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

“We help you and you help us, right?” snapped the man.

“Yes sir.”

“Which airport?”


“SFO is a bit of a hike, but OK.”


Back at the lab, Shelly Narayan cleared her desk to leave.  There was nothing to do because she had been unable to ask the rushed Garcia how to proceed with her experiment.

Or had he simply forgotten their appointment?

What did he mean by calling her fundraiser Martian Green.

He’s just another hurdle, she thought, in her professional journey — to emulate her mentor in medical school, one of the first women of color to become a pelvic surgeon.

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

But at least there, she was operating and not at the Women’s Health Clinic, its crowded waiting area, cramped exam rooms, assembly line of “jiffy” Pap smears and talking to patients, about weight gain, their libido, rocky relationships, and health issues uniquely female.

After each encounter, 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 on the screen — like the video games you kids play. Yesterday, I had to finish modules for billing and compliance before I could even log in to learn about this new implant for depression.”

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

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


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. 

He was a noble contrast to Dr. Brickstone at Hunterview, the community hospital.

After every Cesarean, Brickstone would admire the newborn in the warmer with the same effusive speech. Never once thanking her for her help, he then turned to the waiting computer. 

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

Brickstone was tall, square jawed and handsome, his robust frame sculpted by dawn workouts. He could discuss sports with anyone anytime.

 At Hunterview, she critically observed that Brickstone had a worshipful gaggle of women, from patients to nurses, making him something of a rooster to his clucking hens.

SuperDoc Brickstone, she thought, he will deliver your baby, fix your sink, change your tire — but not a poopy diaper.

One evening, driving home from Hunterview after being on-call, she fell asleep and rear-ended a Pandol 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 masses, a large (mega-bus) and small (energy-efficient car)— which left the bus riders unaware there was an accident. Her vehicle suffered expensive damage.

She didn’t tell her parents.

Her father mock-boasted about his training days 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 days when men were men.”

She rolled her eyes.

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. Lucky was pale white with freckles and cornsilk hair straight out of a shampoo ad, like her own mother. 

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

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. At their apartment, 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,” she explained, “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 recently moved in together. 

“No.” Shelly 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 told her.

“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, loud music, swarms of people like the pandemic was ancient history, where her housemate could turn on the firefly sparkle and become the brightest spot in the gathering. 

In the meantime, Shelly made polite conversation mostly with strangers and patiently waited for Lucky to leave. Then she was the designated driver for a carful of drunk people.

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.

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

“So yes,” Lucky told her, “My test scores weren’t great in medical school so here I landed. It’s all good. The long-distance with Harry is just temporary and I found you, Shelly. Some of your patients have sad stories.”

She continued, “I see men doing hurtful things to women. I remember feeling glad it wasn’t me, thinking I was different. But you know what: I’m safe because I’m with Harry. 

“Harry and I have good times,” she said wistfully, “like parties at the top of a skyscraper someplace… but I mostly…”

“Mostly what?”

“Just hang out, look good,” she answered quietly.

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

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

Lucky drained her glass of wine and yawned.  “Ok, I’m off to bed. Shelly, 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 grinning face popped into the screen. “It is the men who should worry about crossing Lucky’s path. Look what happened to me.”

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,” Shelly said. “Why do people want to inhale salty ocean and then sit on a hot beach with gritty sand stuck to their sweaty skin? 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 vacationmeans?”

Lucky’s smile vanished.

“OK,” said Shelly. “Sorry, that was not gracious. Thanks for inviting me. But…”


“I also don’t need to go to places like Rome — India has an equally ancient civilization — or travel to Rio when my Spanish is bad. Then I have this healthy fear of germs.”

“You get your thrills in your career,” Lucky said, “making a difference for mankind. I admire that. Still, we need to find you a nice man…or woman?”

Shelly ignored her.

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 to her.

So, she was surprised when her parents planned to go to Goa, an Indian sea resort, just the two of them. 

“What, you didn’t invite your kids?” she joked to them.

She adored Lucky, always so balanced and a counterpoint to her stress.

 One day she complained to her, “Lucky, It was so busy I missed lunch. Then this nurse took forever to come and help me with this huge patient who needed a pelvic exam. There was this doc on a cable show telling an obese man to ‘zip your mouth, get off the couch and start starving.’”

“That is terrible,” said Lucky. “This world keeps getting meaner.”

“So, I was afraid I would laugh. My bladder would explode because I had no time to even go to the bathroom.”

“It was kind of you to not laugh.” 

Shelly continued.  “Now if I was like that Dr. TV, I could tell those patients who no longer want sex to ‘just fake it if you don’t feel it.’ People are dying of cancer, and they are wasting my time with their sex life. I’m being honest, Lucky, sex counseling seems like a worthless waste of my time.”

Lucky looked pensive. “Shelly, I appreciate that you are honestly sharing your feelings with me. But that’s problematic. 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.” 

“You’re right,” Shelly agreed. “When I grumble about long days in the clinic, talking and talking, Dr. Nepski says that in the future, my scientific and 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 might not be the best surgeon, or the most creative thinker or a good leader.

“But,” Shelly continued, “Thatclinic is 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.”

Thanks, Lucky,” Shelly said, “True, this crowded disorderly mess of humanity that I have to talk to for hours in the clinic is notsomething I’ll ever have the ‘smarts’ for. But you do, Lucky.”

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


Like 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 was her soothing electronic partner as she translated their complicated 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, feeling her entire body untense. 

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,” she said. “How like a man.”

Falling asleep, Shelly remembered a recent visitor at the lab. Tailed by his proud son, the senior Dr. Nepski had whizzed around and stopped to inquire about her new experiment. 

Deep forehead furrows bespoke his advanced age. His 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 the brick sprawl in rural California.

Now, she walked the mile from her apartment toward silent, dark rows of woods, and the sunset flamed the tall buildings orange.

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 host had led her into main dining area with lighted fountains and massive chandeliers. 

An unseen piano played.

She passed 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, and crystal glassware similarly 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 pleasuring on pastoral landscapes in the other.

Their dinner group included plus-ones like Dean 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 horsemeat, the dish’s namesake and forerunner.

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

Sitting beside the Baluyns and also crowning the head of their long dinner table — was the Nepski family. 

Sam Nepski’s mother’s face was expressionless when Shelly took her turn to introduce herself.

She wondered. Did Mrs. Nepski think that she was just another brown worker in the increasingly diverse medical workforce and not like Lucky, a Midwest vision of blue eyes, milky skin and cornsilk hair?

Does Mrs. Nepski even see me?

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. She detected the magic of Botox, laser abrasions and skin fillers. 

Remembering medical school, she also remembered a fellow medical student who particularly annoyed her, Karen. Classically perfect in skin and figure, Karen 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 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. 

Older than Madonna and Child, the mother-baby dyad 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, the senior Nepski, 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. “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, a star salesman.”

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 exchange shuffled into nonsense. She awoke, 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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