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"I'm sorry Naomi. I estimate you'll have a year, maybe more with medication, but your condition is currently terminal."
Naomi stared numbly at the brown panel wall next to Dr Stiles' head, the light shifting as cars drove past outside. Approximately half a million people are expected to require palliative care per year, worldwide. She wondered how many of them were driving to work as usual today, how many were about to sit in their doctor's office and receive the same news as her. To be truthful, she didn't feel much - after her work for Delphi, this was apt punishment. Perhaps Adam had been correct after all, and whatever God was out there believed medicine was only serving to contradict His great plan. Or maybe it was karma, some sort of cosmic imbalance being righted through her death.
A hand squeezed her shoulder, and clothes shifted as someone sat next to her.
"Are you okay, Dr. Kimishima? It can be difficult to hear news like this, no matter your experience in the field."
Naomi flicked her eyes to the young nurse beside her. The blonde's eyes were sad, though she was clearly trying hard not to cry. Nurse Thompson had always been that way, hiding how she felt from those she cared about. Naomi supposed she should be grateful. The social expectations surrounding grief confused her on her good days and she certainly didn't have the spare patience to comfort someone when it was her death they were discussing.
"What are my medication options?" Naomi asked. Focusing on the medicine allowed her to ignore the uncomfortable coiling in the pit of her stomach, allowed her to ignore the ice crawling through her veins. Derek adjusted his glasses and cleared his throat, glancing down at her chart.
"Well, you can have cyproheptadine, that can combat the excess serotonin…and then we can start you on aripiprazole for the dopamine. I'd want to get your bloods done regularly though, and have you keep in touch with a psychiatrist in case the aripiprazole doesn't work and you do experience any psychotic symptoms."
Naomi clasped her hands in front of her. Derek sighed, taking his glasses off.
"Naomi, I'm speaking to you as a friend now," he began. "I think you should transfer to a different hospital. A local one, I mean. Something smaller than Caduceus."
"Why so?" Naomi asked, studying Derek's face. He seemed…sorrowful, if she could guess. Interpreting faces didn't come naturally to her.
"You need to rest. Stress will only make your condition worse." Derek's brow furrowed. "I'll be working with Caduceus to find you a cure, I promise. But I need you to live to see the day we do that, and reducing your workload will go a long way to doing so."
"I understand." A beat. "Do you have recommendations then, Dr Stiles?"
"I have an old friend, he works in a hospital in Portland. It's still a major trauma centre, but it wouldn't be as intense as Caduceus. I could pull some strings to transfer you."
"Seeing you in a consultant's chair suits you, Derek," Naomi teased. The younger doctor blushed, hand coming up to scratch at the base of his neck.
"It's nothing, really."
"We appreciate everything you've done to help Caduceus, Dr. Kimishima," Angie added.
"After Delphi, I owed you it." Naomi remarked drily. "Helping Caduceus combat the hell-spawn they created was the least I could do."
"Yes, well," Derek laughed nervously. "Maybe don't go around transporting bio-weapons in your body in the future."
"I'll try not to." Naomi smirked. The phone on Derek's desk buzzed, and he pressed the answer key.
"Sorry, I do need to get this. Angie, can you show Naomi out?" The nurse nodded, standing up. Naomi followed suit. "Hello, Dr. Stiles speaking. Yes, I believe I had put him on metaprolol following his appointment with me-"
The door shut as they left the office, the only noise in the empty hallway being the sound of Angie's shoes on the floor. Birds flew past the open windows, nesting in the luscious green trees in the courtyard. Naomi had forgotten how pretty this branch of Caduceus was. The constant miserable rain and men shouting at their dogs in England had really put a dampner on the windows available in the European branch.
"I'm glad he decided to specialise in cardiology," Naomi said as she caught up to the nurse. "His ambition will go a long way in that field."
"I'm glad too," Angie said. "As a teen I was always so anxious about specialising in anything cardio related, it felt like too much responsibility. But I know that with Derek by my side, things will be easier."
"So you two are finally together then?"
Angie blushed furiously as she pressed the button for the elevator. "Not as such."
Naomi leaned on her cane as they waited. She blinked as her vision swam slightly, presumably from her heart rate rising. It always seemed to do that from minimal exertion these days. She hoped the medication would help - if not, she was going to become exceedingly familiar with a new specialist in Maine very quickly. Maine. Abruptly, Naomi realised that despite being with Caduceus for so many years, she hadn't ever been to that side of the US. A new hospital had opened there, if her memory served her correctly - an eastern branch of Caduceus, in Maryland. It had caused quite the uproar in Europe, with the board arguing they required another branch in mainland Europe more than the US required a second one on the east coast. Still, that was where the funding had been placed despite the many qualms, with promises of more to come in the future. Oddly, Naomi now wondered if she would be there to see a new European branch at all.
The elevator dinged, and Naomi stepped inside. Angie held out a small, blue sheet of paper.
"You don't need me to walk you all the way, but here's your prescription. Pop to the pharmacy downstairs before you leave and they can probably fill you up."
"Thank you," Naomi took the paper from Angie.
"Don't be a stranger, ok?" The girl's eyes began to water. "We do care about you as a friend as well as a colleague. If you need anything at all…"
"I know," Naomi answered. "I appreciate it, Nurse Thompson. Your mother would be so proud of you."
The elevator doors slid closed in front of her. Naomi closed her eyes and sighed heavily, leaning back against a bar on the wall. A year was all she got? There was so much she had planned to do after leaving Japan, so many things she wanted to try and places she wanted to visit. She supposed she should make a bucket list. Perhaps she could convince Derek to traipse around with her to complete it. There was someone she would rather have invited, but seeing as the two of them parted ways and he presumably was arrested, he was not an option.
There certainly was something strange about confronting one's own mortality. The stark reminder that although she despite the power she possessed, despite being the "Devil Doctor"; she was human. When breaking news such as what she had received today to patients, she could often lack tact - in part, this was why she had picked up the work with Delphi so easily. There was no need for the emotional cushioning when your patients were drugged up and tortured. Morally, she couldn't agree with it. Ethically? Well that was where it became complicated. Was preventing her own suffering more important than preventing the suffering of the many tested on by Delphi? Did they deserve what had happened because they were Sinners? There was a point during her time with the organisation that she had believed Adam's teachings. She blindly followed what Blackwell and Williams told her to do, and she trusted they were only doing it to help. Did that now mean she deserved this death, this ironic crusade of GUILT against her own body? It was through her own hand she had become infected after all. This was her penance, for the children who had suffered at the hands of an organisation she had once believed in.
She did see a therapist, initially. After GUILT was handled, when she would get nightmares about the boats and breakouts. It was never about the children though - it was a fear that she would become a Sinner, or that she wouldn't escape a breakout and instead would die, suffocating in a thick plume of GUILT-contaminated smoke. It was entirely selfish, and she knew it. The therapist told her that she had been brainwashed, and it wasn't her fault that things had happened. Naomi begged to differ. She had stayed for a few months before deciding to give Delphi up to Caduceus Europe, and stayed a few weeks more to ensure she was fully paid before she did. The therapist tried to get her to sit in her feelings, to analyse what they actually were. Naomi stopped turning up shortly after that.
It wasn't that she was denying her feelings - she assumed that she was feeling guilt, anger, fear, sadness, all of those tick-box emotions one was expected to feel after a "series of extremely traumatic events" as the therapist had put it (though perhaps that was primarily due to the incessant exercises she was forced to complete, and less that she could actually feel them). She just didn't see the point in giving herself grace when she consciously had chosen to hurt people.
Which brings her back to thinking of her illness. There wasn't a name, Derek said. It was quite possibly genetic, maybe autoimmune, maybe a new mechanism they hadn't discovered yet. No treatment, no cure, just management of the primary symptoms. No medication would result in psychosis, muscle tremors, insomnia, manic episodes and more symptoms which quite frankly Naomi hated the sound of. This would be her life for the next year, or until her heart finally gave out. Derek had suggested they could possibly implant a pacemaker, but it would entirely depend on what was causing her heart to fail. Otherwise? A cocktail of drugs to keep her alive. How miserable. Ah, at least her humour was already wry. It would hopefully be less noticeable if the medication caused emotional numbness.
The elevator doors pinged open, and the monotonous buzz of background noise filled her ears as she stepped out onto the ground floor of Caduceus. There were plenty of people - doctors, nurses and healthcare professionals alike - scattered around the floor, moving this way and that as they hurried about their day. It pulled Naomi out of the bubble she had been in since the moment Derek told her the results of her test. She sighed and rubbed her temple. Life waits for no one.