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thesimulationswarm · 1 year ago

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Balsam Prelude and Chapter 1: Some Kind of Noble Calling

This is a story about trauma. What trauma does to a person, and what trauma does to a community. And how, in the midst of it, people find their way to joy, delight— even love.

Pairing: Joel Miller x original female character Summary: After the events of tlou, Joel and Ellie try to establish a “normal life” in Jackson, but neither of them are any good at normal. A town doctor tries to care for residents who have experienced unspeakable trauma, and struggles to overcome her own past at the same time. Joel finds himself drawn to her, as their lives become increasingly intertwined. Meanwhile, outside Jackson, troubling things are happening... Rating: explicit 18+ MDNI Word count: 6k Warnings: slow burn, I promise there will be smut but not yet, f/m relationship, not a reader insert, canon-typical violence, descriptions of medical situations, descriptions of trauma and PTSD, Ellie and Joel figuring out how to be family, Tommy and Joel figuring out how to be family, angst, fluff, based on show Jackson because I haven't played tlou part ii, this is the first fic I've been brave enough to put out in the world so be kind.

Series Masterlist

PRELUDE

The boy struggled to work the crowbar; his fingers were so cold he couldn’t really feel them and his grip kept slipping. Finally, though, the old wood splintered around the bolt latch and gave way. He pushed through the door of the shed and fell to the ground inside, spent.

The cold hurt. He was so tired. He’d gone past ordinary hunger, to that desperate place beyond. So now that he was out of the cutting wind, all he wanted was to go to sleep.

Coco had followed him in. She sniffed at the boy’s face, and he felt the warm breath on his skin for a brief, lovely moment. Then she padded away toward the back wall of the small room.

“Come back here, girl,” the boy called out. But she didn’t come back. Was she leaving him now, too? He just wanted to burry his face in her fur and smell her smell as he drifted off. If his father couldn’t be here with him, at least the dog he’d loved could.

He heard a brief, sharp bark. He lifted his head. Coco was sitting by a metal rack on the wall, pointing her nose at something on the second shelf.

“What is it, Coco?” She barked again, still pointing.

He moved slowly, regretfully, as he pulled his aching body up again. She was pointing at an old shoebox, and didn’t stir as he approached.

He brushed the cobwebs away and lifted the lid. It was full of small, dark brown packages. He lifted one close to his face, to examine it in the light coming through the open door.

MEAL, READY TO EAT, INDIVIDUAL, it read. CHICKEN A LA KING.

CHAPTER 1: Some Kind of Noble Calling

“You need to take her to Dr. Conner,” Maria said brusquely, as soon as she’d walked in the room. Ellie was curled listlessly on the couch, face flushed and mottled and hair slicked down with sweat.

“Dr. Conner? Where is he?” Joel asked.

“She is on 2nd street, top of the hill.”

He nodded and looked away from Maria’s icy face. Just what he needed, for her to add sexism to his list of sins. He squatted down to lift Ellie in his arms, held back a groan as his knees popped, and headed toward the door. He was always surprised at how little she weighed, given her sheer force of nature.

“I can walk. I’m not dead yet,” she whined at him hoarsely, squirming against his hold. It was half-hearted, and he kept his grip.

“Not happening.”

Dr. Connor’s was a narrow, two-story building, and the windows were covered with dark curtains. The sign above the door was painted simply with a red cross on a white background. He knocked but didn’t wait, yanking the doorknob and shouldering through the entryway.

Inside was bare, with a row of wooden chairs and a hand-written sign instructing visitors to take a seat. Two doors stood closed, and Joel was eyeing them to determine which he should open next when a breezy voice called from behind one.

“If you’re breathing and not bleeding out, hang on and I’ll be there in five.”

He sighed and set Ellie on a chair before dropping down beside her.

“Nicer than the FEDRA clinics at least,” Ellie deadpanned, her voice creaky and strained.

He looked around the little waiting room. It wasn’t exactly impressive, but if you’d only ever seen a QZ medical facility it must've seemed like the height of luxury.

“There used to be places like this. You got to see the doctor in a room by yourself instead of a big ward with half the neighborhood lined up.” He paused. “It was nice. Especially if you had somethin’ going on you didn’t want to share with everybody you knew.”

She quirked a sweaty eyebrow at him. “Like what?”

“Pass.”

They looked up in unison as a door creaked open and a woman strode in, dressed in jeans and a canvas apron. She was small, tawny-skinned and dark-haired. Younger than he’d expected, although not young-young on second inspection—the start of lines spreading out from the corners of her eyes, a resigned slope of her shoulders. In her 30s, maybe: the last generation to remember life before.

“Please, follow me.” The woman gestured into a small room with a bright overhead light. She pointed Ellie to a cot covered with a faded, flowered sheet and Joel to a stool beside it.

“I’m Nina, I work as a healer,” she said, extending a hand first to Ellie—who limply grasped it—and then to Joel.

He kept his arms down by his side.

“I thought you were an actual doctor,” he said sharply.

He didn’t come here for one of Maria’s communist friends to do some crystal healing, align Ellie’s chakras or some shit.

She gave him a small smile. “People call me that because I’m the closest Jackson has, and I’ve been treating people for years. But no, I’m not old enough to have finished medical school 20 years ago.” Her voice was mild, even friendly, but her eyes asked a question: Are you going to be a problem for me?

He set his jaw but sat back on the stool. He’d at least see if she could help.

“It’s Ellie, isn’t it?” Nina moved closer to Ellie and smiled brightly at her miserable face, looking her up and down. She pulled an old glass thermometer out of a pocket and held it up for Ellie to see before popping it in her mouth. While she waited for it to take a measurement, she slid her other hand down to grasp Ellie’s wrist and held it lightly, watching the numbers on her watch as she felt for a pulse.

“When did she start feeling bad?” She nodded her head slightly in Joel’s direction—Ellie had her mouth full—but kept her eyes on her patient.

“Two days ago. Hit her like a ton of bricks. She’s had fever and chills, and won’t eat anything. Barely takin’ sips of water when I beg her to.”

“Sore throat?”

“Says it feels like knives.” Ellie nodded bleakly to confirm.

The doctor—or the healer, or whatever the hell she was—pulled the thermometer out and nodded at it. She raised both hands to Ellie’s neck, but paused before touching her.

“I’m just going to feel here for your lymph nodes, Ellie.”

She waited to see confirmation in Ellie’s face before continuing, running her hands carefully down below her jawline.

The exam went on, through the familiar steps: Open your mouth as wide as you can, that’s good, now I’m going to check your ears.

He had a sudden, clear memory of sitting in the pediatrician’s office. Watching Sarah as she sat on a paper-covered table.

He could smell the disinfectant and powdered latex, and see the silhouette of her doctor standing there. He was a gray-haired man, always friendly in a fake-feeling way, who whore a crisp white coat over a shirt and tie. Made him feel self-conscious, looking down at his dirt-caked boots and browned forearms.

Sarah used to sit on that exam table and cry when she had to get shots. Not all hysterical or fighting to get away like some kids—just silent tears that slipped out of the corner of her eyes.

He remembered how, when she was five years old, she’d swallowed a penny and he’d rushed her over to the clinic. It wasn’t like her to do something like that: she was thoughtful and sweet even at that age, a rule-follower to a fault. His heart had jackhammered in his chest as he had visions of her intestines puncturing or her being rushed to emergency surgery.

The doc explained patiently that these things usually “passed” on their own. With a little chuckle he gave him a plastic bowl that fit inside the toilet and instructions to check it for the next week to make sure the penny came out the other end.

He recalled the rush of relief and the flush of embarrassment. Watching the doc laugh and feeling like a moron for having gotten himself so worked up.

“Earth to Joel,” Ellie croaked. He turned to see two pairs of eyes on his: Ellie’s red-rimmed and liquid brown, the doctor’s—he was now noticing— so dark they were almost black.

“Sorry,” he mumbled.

“Most likely it’s strep throat, although there’s no way to tell for sure without tests I don’t have,” the doctor said. “I’ll give you some antibiotics, and if it is strep, it will start to get better right away.”

“What if it’s not strep?” Joel asked, heart in his throat.

She smiled. “Then it’s a virus, and she’ll get better on her own.” Her tone was reassuringly confident. Joel watched her disappear briefly out the door, then return with a paper packet she pressed into his hand.

“Take these twice a day. Even if she starts to feel better, do not stop the medicine until it’s all gone. I know we’re all used to stretching supplies, but it doesn’t work that way with antibiotics—she’ll get sick again, and worse.” She looked to him for acknowledgement, and he nodded.

“Keep pushing her to drink fluids.” She turned to Ellie now, who was hunched over and looked about ready to pass out. “You’re dehydrated, kiddo. It’s part of why you feel so bad right now. If you don’t drink, it’s only going to get worse.” She spoke pointedly but gently, and Ellie shrugged an assent. “And if you aren’t feeling better in two days, come back and see me.”

It was late when Tommy got home. Pretty much every part of his body hurt after the day’s work— fixing freeze damage to their well system— and he had been dreaming of crawling into bed with Maria.

Not the way he sometimes dreamed of crawling into bed with her, even now with her looking like she’d swallowed a watermelon. Maybe he’d have the energy for that in the morning, but tonight he just wanted to feel her in his arms and time his deep slow breaths with hers.

She was already fast asleep, so he moved as carefully as he could, lifting up the covers and sidling in behind her. She was curled on her left side and he tucked his body tightly against hers, his arm snaking gently around her bare belly. When he was lucky he could feel the baby kicking against his hand in this position, although right now both baby and mama were at rest.

He lay there, willing himself to relax into sleep. But there was too damn much on his mind these days.

This winter had been brutal, even for Wyoming. The town had held together with a lot of hard work and ingenuity. But out there in the countryside, others had not been so successful. He’d heard awful stories: starvation, cannibalism, raiding parties far and wide. The patrols kept running into trouble, and although so far the groups had been small enough to handle, who was to say they’d stay that way?

Tommy knew that people in Jackson looked to him and Maria to keep them safe. It was more responsibility than he’d ever had before in his life, really. He was proud of himself— and scared shitless.

He breathed in Maria’s smell, nose pressed against the nape of her neck. He tried to count all the blessings in his life, savoring each one. It was a trick he used sometimes, to make his thoughts shut up. This incredible woman who had saved his life. The baby she was growing for them. This town. A full stomach. A warm bed. Joel doing so good, for once, with that kid of his.

Although Joel was maybe not the best topic to think about, if he wanted to sleep tonight. Not that he wasn’t grateful, or happy to have him nearby and safe. But his feelings were complicated. Sometimes he hated to admit how much of a hold his big brother still had on him. Made him feel like a little boy, hungry for approval. And at the same time reminded him of the lowest points in his life.

If he was honest with himself, he’d felt a lot of relief along with the guilt and sadness when he’d left Boston. He’d felt the same when he cut off radio contact.

Something had changed with Joel though, lately. He was still a bitter man, tightly wound and full of pain. But Tommy had seen moments of tenderness from him that he thought he’d never see again. Even moments of joy.

He felt the prickle of tears in his tired eyes. He knew he was being naive, that a little bit of good couldn’t undo all the darkness that they’d been through. But he clung to the hope still, as he started to drift off to sleep: him with his baby, Joel with his girl—maybe they would all be okay.

“Tommy!”

He turned with a smile as the doc walked up, clapping a hand against his back. “Hey Dr. Connor! How’s it been?”

“I’m going on your next southwest patrol,” she said. Announcing, not asking, as she had a frustrating tendency to do.

He took a sharp breath through his nose. “Nina—“

“It’s time to harvest willow bark. I need enough for the next year, for all of Jackson.”

“I understand, I really do. But this winter has been rough and people are desperate. We’ve had some kind of trouble almost every patrol. It’s just too dangerous to stop and hang around out there.” He used the most authoritative tone he could muster, trying to stare the small woman down.

“And people won’t be any less desperate until we’re well into April. By then the trees will be in full leaf and we’ll be out of the window for harvesting. And I’ll have half a dozen angry locals wanting to know why I don’t have the tea for their arthritis or their heart condition.”

She fixed him with a dark stare, and he fiddled with the frayed edge of his jacket cuff.

She knew how Jackson worked, and if he said no she could and would bring it up at the council meeting. Where she would no doubt whip up the town’s crotchetiest and most infirm—who had nothing better to do than sit in on every meeting of every committee—into a rage over herbal tea. Shit.

He nodded curtly. “Friday at dawn. If there are any signs of trouble before we hit the riverbank, we’ll have to turn back.”

“I really appreciate it Tommy,” she said with what she surely thought was a winning smile. Which he did not return: he was not in the mood.

Marisa stirred the stockpot of oatmeal gently between customers, to keep crust from forming on top. She stared out at the dining room and watched the clusters of people. Some were deep in conversation; some wolfed down their breakfasts so they could hurry on with their days; others looked half-asleep still.

A group of teenagers were tucked way back in the corner, as far as they could get from the adults, clearly enjoying their morning bullshit session. She remembered doing that just a few years ago, with Anya and Jamal, when her dad wasn’t around to see her goofing off. He believed that if teenagers had energy to run their jaws, they had energy to work.

The new folks came in with a blast of cold air.

They were an odd pair. The girl was rude and mouthed off too much, but she had a lot of energy and seemed like fun. The kind of kid Marisa had always been fascinated by, when she was that age. Wishing she could move in the world with that kind of confidence.

The man, though, gave her the willies. He was intense and stern, like her dad. He never smiled, although he did at least say please and thank you. She couldn’t hardly believe he was Tommy’s brother. Tommy was his exact opposite, gentle and friendly.

She used to think Tommy was cute. She still did, really, but she didn’t think about him much lately. She was too busy daydreaming about her Beloved.

She called him that after an old romance book she’d found in an empty house and hidden under her mattress. The book took place during the Civil War, and the buxom narrator fell in love with a dashing soldier. She wrote letters to him every day, addressed to My Beloved. The soldier in the book had beautiful blue eyes, just like Marisa’s Beloved.

Tommy was out there now, talking with Dr. Connor. He looked unhappy. Dr. Connor could do that to people. She was always so nice when you were sick or hurt and went to see her. But out in the real world she could be mean as a snake. Or maybe she was more like a fox: someone sly, someone you had to watch.

Brandy Burkholder had started working with her last summer, after a several month campaign. Nina had eventually determined that she was serious about learning to practice medicine, despite the fact that she wasn’t terribly serious about anything else. She was an outgoing sixteen-year-old with a pretty smile and a flare for the dramatic, and she came by on Tuesdays and Thursdays to help Nina with various tasks.

Today it was supply inventory. Every other week she went through what she had, checked her levels on common medications and herbs, and looked through her equipment for signs of damage or wear.

Nina enjoyed inventory, even if what she had to inventory was often pathetic. There was something calming about lining up all the bottles, looking over her orderly shelves, and counting all the pills and needles and rolls of gauze.

And there was some extra excitement this afternoon: they were going through a bag of random medicines and gear to see what could be salvaged. Anya and Clemons had found in an empty house on a hunting trip earlier that week.

Brandy held up an orange plastic bottle of pills from the haul. “Dox—y—cy—cline,” she sounded out carefully. “That’s an antibiotic, right? So it goes in the cabinet above the sink?”

“Hold up. What’s the date on the bottle?”

“Um, let me see.” She squinted to read the fading print. “Damn. It’s from 1999. This is an antique!”

Nina shook her head. “Toss it. Expired tetracyclines can be toxic.” It was a shame— she really could have used it.

She pulled out a bottle of Benadryl tablets, and pried open the lid. Some of the pills had swollen with absorbed moisture and cracked, but they were mostly intact and there was no mold. She added it to the keep pile.

Brandy showed her a box of individually packaged 22 gauge needles. The plastic wrappers were warped and brittle and had cracked open along the seams. But the needles inside were straight and sharp. She would sanitize them in the autoclave and they’d be good as new. Another keep.

A bottle of cough syrup had hardened to a shiny paste— toss. Two inhalers were empty—toss again. Half a tub of vaseline went in the keep pile. Then she found something really good at the bottom of the bag: an almost-full bottle of Valium.

“Isn’t this the stuff that bored housewives used to get high on?” Brandy asked, smirking.

“Yes, and that’s why it goes in the locked cabinet,” Nina said pointedly. She didn’t need Brandy getting any ideas. “But more importantly, it’s the best treatment when someone’s actively having a seizure. It’s also very helpful for setting bones.”

“Sweet! There was some good loot in that bag.”

Nina looked over the shelves appraisingly. “Yes, but it’s not enough. This all has to last until Mo comes by in April.”

“Are you going out to meet him?” Brandy’s eyes sparkled at the mention of the smuggler. Nina knew how people talked about him: the dashing Robin Hood who stole from FEDRA and gave to the people. But it’s not like he gave them anything: they paid him, in valuable farm goods like butter and honey, for every last thing.

Nina didn’t say anything about that to Brandy, though; let the kid have her fantasies. She also didn’t mention the fear that kept her up at night— that next time she went out to meet Mo, he wouldn’t show. She knew it was only a matter of time before his line of work caught up with him, and that when it happened they would be shit out of luck. Jackson did a lot of things well, but manufacturing antibiotics wasn’t one of them.

“Yep, April ninth. Three weeks after the equinox,” was all she said.

The sun was melting into the horizon, bathing the street in golden light and purple shadows. Joel was walking to the saddler when he saw the woman up ahead and quickened his pace.

“Hey! Dr. Connor!”

She turned as he approached and raised an eyebrow. “So I’m enough of a doctor for you now? How’s Ellie?”

“Well, she’s a hundred percent better. Givin’ me shit and drivin’ me crazy.”

“I’m so glad to hear that.” The doctor seemed genuinely pleased. “I’m sure you deserve whatever shit she’s giving you,” she added.

“Look,” he said, furrowing his brow. “I wasn’t very fair to you the other day. And you helped us out anyway. I appreciate that.”

She looked at him, meeting his eyes with an intensity that startled him. There were those deep brown irises he’d noticed in her office, framed by thick black lashes.

Then she smiled, holding out her hand to him. Her grip was surprisingly firm as they shook. “You’re not the first person to doubt my expertise. I appreciate you putting your daughter in my care.”

He looked over her shoulder, at the reddish sky reflecting in the window of a supply depot, and took a breath. “I know people don’t pay for things here or anything, but I feel like—I mean, I would like to give you something at least. For the medicine.”

She waved dismissively. “I’ve seen you go out on patrol. You keep Jackson safe, I keep Jackson alive. We all do our part.”

She laid a hand on his stiff shoulder and gave him a pat. Then she turned and headed back in the direction she’d been walking, before he could figure out how he ought to respond. He watched her for a moment, her dark curls swinging over a denim jacket, his shoulder tingling with a phantom pressure where her hand had been a moment ago.

Jackson made him real fucking uncomfortable, sometimes.

He didn’t like owing people favors, and he didn’t feel like he belonged in a town where everyone was so nice all the time. The doctor was case in point— he’d been mean to her when they’d first met, and that hadn’t been right. But he’d tried to be nice to her too now, and it still felt weird as hell. Maybe he’d entirely forgotten how to be nice.

He walked on, hands shoved in his pockets. If he was honest, he didn’t want to be living here. In the house across from his little brother, like some kind of post-apocalyptic sitcom. It brought back all kinds of things he didn’t want to think about.

He was going on patrol Friday and he was looking forward to it. At least out there he knew what to do with himself. Stay alert, keep moving, assess the situation, maintain control— with force if needed.

Ellie looked over her shoulder to make sure no one was watching, then quickly opened the door below the red cross and slipped inside. She sighed with relief to see no one inside the waiting room, and sat down with her backpack clutched to her chest.

Dr. Connor stepped into the room, thankfully alone, and smiled warmly as she pointed Ellie toward a door. Ellie darted in and jumped up on the cot, then looked down at her sneakers. One had a bit of rubber starting to come loose around the toe, and she gently wiggled it with her other foot. She heard Dr. Connor close the door behind her, and then the expectant silence.

“How can I help you today, Ellie?”

Her cheeks burned, and she found she couldn’t look up. Why did the town doctor have to be beautiful? For an old person, but still. She kept studying her feet, as she heard the scrape of a chair being pulled over and the soft thump of Dr. Connor sitting down a few feet away.

When the doctor spoke again, her voice was soft. “I’ll ask you a few questions. All you have to do is say yes or no. You don’t even have to speak, just shake your head. Okay?” Ellie exhaled, then nodded.

“Did someone hurt you?” Ellie shook her head no emphatically.

“Are you having a problem with a private part of your body?” Ellie paused, then nodded once.

“Is it your related to your period?” Head shake. “Are you having pain?” Head shake. “Itchiness?” Nod. “Discharge?” Ellie felt like her cheeks were going to catch on fire as she nodded again.

“Are you sexually active?”

“No!” Ellie shouted, looking up at Dr. Connor with a startled stare.

“It would be okay if you were. You wouldn’t be in trouble. And I wouldn’t tell anyone—not even Joel.” Her voice was even and conversational, as if she were talking about the weather and not about fucking.

“Well, I’m not,” she snapped. “I don’t know why this is happening. It’s never done this before.”

“Have you ever taken antibiotics before?”

She thought for a moment. At FEDRA school they gave you pills sometimes if you were sick, but they never even told you what they were. Some of the kids said they were sugar pills, and some of the kids said they were tranquilizers designed to make you behave. She shrugged. “I don’t actually know.”

“Did your symptoms start after you began taking the pills?” Ellie nodded.

“I’ll want to do a quick exam to be sure, but yeast infections can be a side effect of antibiotics. Your vulva actually has a lot of bacteria living in it—good bacteria.” Ellie raised her eyebrows and fixed the doctor with a horrified look, but she ignored her and went on speaking.

“It’s like a garden with lots of different plants growing side by side. The plants are healthy, and there are enough of them that they fill up the space and keep the weeds out. The antibiotic got rid of the bad bacteria in your throat, but it also wiped out the good bacteria in your vulva. It’s like we picked all the good stuff from that garden, and now there’s good soil and plenty of space for bad stuff to grow. That’s allowed the yeast to take over—it’s actually a fungus.”

“Like cordyceps?” Ellie asked, eyes widening.

“Yes, like cordyceps. But it’s a different species, and unlike cordyceps we have medication that will kill the yeast. You’ll be back to normal in no time.” Ellie felt relief wash over her.

Wednesday morning was for house calls. As she left the dining hall, her supply bag bouncing heavily against her left hip, she ran into Ellie and Joel on their way in. The girl smiled sheepishly and looked away; the man twitched a corner of his mouth and held the door for her. Which for gruff types like that, new to civilization, was as good as a pledge of everlasting fealty.

She watched her breath fog through the cold March morning as she walked, feeling vaguely anxious.

Miss Nora’s house was on the corner, a low redbrick ranch. She let herself in, knowing Miss Nora’s son was out prepping the fields for planting, and headed into the living room that doubled as Miss Nora’s bedroom these days. She was sitting up in her bed, carefully knitting a big orange sweater. “Dr. Connor! So good of you to come by.”

Nina leaned in, letting Miss Nora plant a papery kiss on her cheek. “You know you can call me Nina,” she said, pulling her stethoscope out of her bag and sitting on the edge of the mattress.

She gave her brightest smile, trying to hide any trace of the dismay she felt every time she walked in there. Miss Nora was 67, and until last fall had looked a decade younger than that. Now every week she seems to age another 5 years, her face growing gaunter, her hair thinner, her skin more sallow.

Her son Jamal, ever diligent, tried to tempt her with all her favorite foods, but she would push the plate away after a bite or two. He fought with her over it, convinced that if she would just force herself to eat she would regain her strength.

Nina, on the other hand, was not so optimistic. She thought Miss Nora’s body was shutting down: the lack of appetite was only a symptom of something much more serious.

She suspected cancer, but couldn’t say for sure what kind. Obviously, it was affecting the liver or the common bile duct, based on her yellowing eyes and skin. But that could be a metastasis from a solid tumor somewhere else. She once again felt the woman’s abdomen gently, palpating for a mass. Still nothing. Not that it mattered, ultimately—even if she could magically intuit that it was, say, pancreatic cancer, she wouldn’t be any closer to being able to treat it.

At least her lungs still sounded clear. Nina pulled the stethoscope from her ears and slung it around her neck. “Are you ready for your breathing treatment?”

The woman nodded enthusiastically as Nina carefully packed the pipe she’d brought with dried leaves.

It was old, crumbly, and low quality, and it was hell to get ahold of. But like the opium she kept carefully hidden away in her locked cabinet, marijuana was one of the more potent herbal medicines in her arsenal.

She had nothing else to offer Miss Nora.

She saved Maria for her last stop of the morning. Maria could have easily come to her clinic, even 7 months along, but Nina wanted to confer with her anyways. And she loved Maria’s house—with the late morning light pouring through the windows she could almost believe she was in the suburbs of her childhood.

Maria was making tea when she arrived, and they sat in the living room with a mug each. The steam felt good against her face—while they were out of the worst of the winter, the wind was still brutal on these mornings as she walked from house to house.

After a little small talk she eased Maria backwards on the couch and pulled out her Pinard horn, rolling it between her palms for warmth. Nina had carved it herself out of maple wood, shaping the little trumpet painstakingly to match the illustrations in an old midwifery book.

She could still remember the sense of triumph when, years ago, she first pressed it into a woman’s belly and heard the fetal heartbeat buried inside. People thought medicine was some kind of noble calling—and there were moments when it felt that way to her, too. But more often she was driven by that magic feeling of the body yielding up its secrets to her.

Everything looked good on the exam, despite Maria’s “advanced maternal age.” The same as it had been every week of her pregnancy so far.

Still, Nina worried.

There was a lot that could go wrong bringing a baby into the world, for both baby and mother. Maria was her friend, and she knew how devastated she would be if she lost the child. She also knew how much Maria meant to Jackson, and she worried about the impact of losing Maria even more.

“I’d like your thoughts on something.”

Maria fixed her with one of her looks. “It’s usually not something good when you say that.”

Nina sighed. “I had a patient come in yesterday with what was almost certainly the clap. I treated him, but the man in question was married, and I have reason to believe he didn’t get it from his wife.”

Maria’s brow shot up. “Jesus, Nina. That’s not something I want to know about.”

“I would rather not have to know about it either. But we need to know about it. Both women he’s sleeping with could have infections.”

Maria’s expression hardened as she listened.

“And if the women have other partners, who knows how many people in Jackson are affected? Gonorrhea isn’t just a drippy dick. People could have pelvic inflammatory disease, ectopic pregnancies, miscarriages. Babies can be born with infections.”

“Do you know who the other woman is? You could treat her, too,” Maria offered.

“I… have my suspicions. But I’m not 100%. And he wouldn’t tell me anything.”

She thought about Derek Starkey sitting in her clinic, head buried in his hands. Starkey’s wife, Jenna, had given birth to their first kid last summer. They’d always made a beautiful couple: Starkey was a big guy, tall and broad, with ruddy cheeks and icy blue eyes. Jenna was tough and sweet, with a blonde ponytail and freckles across the bridge of her nose. The son they doted on took after them both, depending on the day.

She was inclined to hate Starkey’s guts.

A guy who couldn’t take it when his wife wasn’t dressing up as prettily as she used to or wasn’t as available as she once was to him, because she was busy caring for his infant child. Marisa Robinson, who worked with Starkey in the kitchens when he wasn’t on patrol, was younger and needy and made puppy dog eyes at him while he kneaded dough with his big strong arms. It was a tale as old as time: another shitty man behaves badly.

She struggled to hold onto her resolve, though, as they spoke. Starkey’d been barely sleeping since the kid was born. Every night in bed he was flooded with images of terrible deaths. He saw his child infected, shot, decapitated, drowned. All those monstrous things he’d seen over the years and had been powerless to stop, and which he now felt powerless to protect his beautiful boy from. Life in Jackson had given him a measure of peace, which had seemed like enough when it was just him and Jenna. But it felt too horribly tenuous now to trust. And Jenna didn’t get it. She slept like a rock between feedings. She told him to get over himself, had no time to talk him down from his panic attacks. Someone else had been willing to hold him while he shook with fear.

“Then we have to tell the wife, at least.”

Nina shook her head. “I keep going back and forth on it. It might break up a marriage, and that could have reverberations throughout the community. And the other woman, there could be consequences for her, too.” She thought of Marisa’s controlling father, who always creeped her out.

“But also the next time someone has symptoms like this they might not come to me, because I wouldn’t be a safe person to tell. Then this stuff would spread around town and we wouldn’t even know.”

Maria gave her an exasperated look.

Nina wasn’t sure what she had expected. It would feel so nice to off-load this problem onto Maria. But her friend was maybe too absolutist to navigate this one. Or else there just was no way to resolve things that would feel right.

“I’m going to have to think on it some more,” she said, as she packed her supplies. “I’m sure I’ll figure something out.”

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