Page 7 of Swan Song

“My name is Colleen Coyle, but everyone calls me Coco.”

“As in… Coco Chanel?” Leslee says dubiously, giving Coco the up-and-down.

Only if Coco Chanel wore Chuck Taylors and had a pierced nose, Coco thinks. “I’ll probably take one of the offers I already have,” she says. “But thanks anyway. Maybe I’ll bump into you up there.”

“No, wait!” Leslee says, practically jumping off her barstool. Coco has read her correctly: She’s a woman who wants only what she can’t have. “Bull is right, you should come work for us. Besides, I could use another woman around.”

“In that case,” Coco says, cheesing up the moment for all it’s worth, “you have yourself a new personal concierge.” She reaches across the bar and shakes hands with Leslee and then Bull. “Now, let me check on the other apps.”

As Coco heads for the kitchen, she hears Bull say, “How about that? I can’t believe our luck.”

“Me either,” Harlan from WAPA says. “She’s hot.”

3. Level 4

The patient who finally breaks Kacy is named Gideon, though Kacy calls him Little G. Gideon arrives in the level 4 NICU at UCSF Benioff Children’s Hospital as a twenty-four-weeker (technically, twenty-three weeks and six days), and, as with all babies this premature, he has only a 25 percent chance of survival. Little G weighs in at one pound, four ounces; he fits in the palm of Kacy’s hand. His lungs are the size of lima beans; he has no hair; his eyes don’t open; and, like most extreme preemies, he looks like a tiny, translucent doll.

What Kacy has learned during her seven years as a NICU nurse is that her itty-bitty patients are stronger and more resilient than most people realize. The human body wants to survive. Through the thimble-size bell of her stethoscope, Kacy can hear Gideon’s heart beating as rapidly as the wings of a hummingbird.

Kacy learns that Little G’s parents went through nine rounds of IVF and his mother suffered three miscarriages before she became pregnant with Gideon. Kacy has known some nurses over the years who grow impatient with the parents—their crying, their worrying, their questions that don’t have answers, their interfering, their praying, their self-blame, their pessimism, their optimism. However, Kacy excels with parents. She embraces Mama and Papa G, tells them, “We’re going to give Gideon the best care.” She wants to add, I will personally see to it that your child survives, but the head neonatologist on the unit, Dr. Isla Quintanilla, has gently reminded Kacy that the cruelest thing she can do is offer parents false hope and make promises she can’t deliver on.

Gideon has an umbilical venous catheter and is given trophic feeds to prepare his gastrointestinal system. He’s on a vent, but still, his O2 levels drop so low that Kacy fears they’re going to lose him right away. His lungs are too stiff to accept oxygen. But somehow, he hangs on.

On the second night of Gideon’s life, Dr. Quintanilla sneaks over to Kacy’s apartment on Filbert Street. Isla’s fiancé, Dr. Rondo, is the chief of pediatrics at the hospital. Rondo volunteers at clinics in Oakland’s underserved neighborhoods on Tuesday and Thursday nights, so for the past eighteen months, those are the nights Kacy and Isla make slow, torturous love, then order takeout, which they eat naked in Kacy’s bedroom. But on this night, when Kacy is halfway through her fusilli lunghi from Seven Hills, Isla says, “I don’t think Gideon is going to make it, Bun.”

Kacy sets the takeout container on her nightstand and goes into the bathroom; she takes a few deep breaths and starts her skin-care routine.

Isla stands in the bathroom doorway and touches Kacy’s shoulder. “Hey, this isn’t like you.”

“It’s exactly like me,” Kacy says. The smaller and weaker a patient is, the harder Kacy falls for him.

“I think you’re just upset about your dad,” Isla says.

Kacy douses a cotton pad with micellar water and tries to keep her expression steady. Kacy’s father, Ed Kapenash, had a heart attack a few weeks earlier; he was medevaced off Nantucket to Mass General, where he underwent bypass surgery. Kacy had been at work when it happened, so by the time she spoke to her mother, Ed was “out of the woods” and expected to make a full recovery.

Kacy is worried about her father, especially since he went right back to work and is refusing to retire until the end of August. But Kacy is bothered by something else as well.

She starts to remove her makeup. “When are you going to tell him? When are you going to leave him?”

Isla hisses like a balloon losing air. “It has to be soon. We’re looking at wedding venues in Napa this weekend, which means picking a date, which means it’s getting real, which means… yeah, I have to tell him.”

“Or don’t tell him,” Kacy says. “Marry Rondo. Give birth to four or five little Rondos. Hire a nanny to raise your kids or quit your job, because you can’t work sixty-hour weeks and be on call every other weekend while at the same time getting the kids to their fencing matches and oboe lessons. And we both know Rondo won’t be stepping down so he can ‘be more present at home.’”

“Bun, stop,” Isla says.

Kacy sighs. She doesn’t like herself when she dumps on Rondo; the dude is Mister Rogers with a medical degree. “Marry Rondo and live the dream.” She meets Isla’s gaze in the bathroom mirror. “Only you and I will know that the dream is a lie.”

“Bun,” Isla says. When Kacy bends over the sink to splash water on her face, Isla runs her finger down Kacy’s spine. “I’m going to tell him.”

That night, Kacy wakes up from a dream certain that Little G is dead. She calls the unit, and Sunny, her night-shift counterpart, says, “Little G is a tiny warrior. He’s doing great.”

Kacy wipes away a few tears, then goes back to sleep.

Like most extreme preemies, Little G is in the hospital for weeks and weeks. Kacy wishes she could put together a time-lapse film showing Gideon gaining weight, Gideon’s eyes opening, Gideon’s hair growing in, Mama and Papa G changing his diaper, Mama G reading him The Runaway Bunny, Papa G singing him “If I Had a Million Dollars” by the Barenaked Ladies.

Isla and Rondo look at wedding venues in Napa; they like Auberge du Soleil for the rehearsal dinner, the Charles Krug Winery for the reception. They go to a cake tasting; they register at Sur La Table. Isla assures Kacy that the wedding date is still more than a year away—she has plenty of time to back out, and she will, she will! It’s not as though the invitations have gone out; it’s not like she’s bought a dress.

Gideon comes off the ventilator and starts taking feedings by mouth. Kacy finally allows herself to imagine his future: Little G on a pitcher’s mound, Little G picking up his date for prom, Little G graduating from Stanford, Little G developing a new source of sustainable energy or becoming a civil rights attorney. He will do something that brings people joy, hope, peace of mind—and Kacy will have been a small part of it.

---