Mostly Happy

A Short Story

The afternoon shift starts at twelve-thirty. I get in at twelve-fifteen because I like to settle. The mornings are Janet’s. Janet has been here fourteen years to my eleven and she looks at the clock at twelve twenty-eight and is already standing up. The kettle in the back is still warm because she always makes a fresh one before she goes. That’s the kind of thing she does. You just notice the kettle is warm.

I make my coffee and sit down and pull up the afternoon.

Wednesdays are well-child visits and follow-ups. Dr. Marsh likes the rhythm of Wednesdays — short appointments, mostly happy. Today we have a six-year-old at two-fifteen, that’s Henry Coletti, I’ve known Henry since he was a week old. We have a teenager at three for a sports physical. A four-month for the Andersons at three-forty-five. A new-family intake at four — the Briggs, just moved to the area, two-week-old boy. That’ll be their first time meeting us.

That’s a Wednesday.

The phone rings at one-oh-four.

I pick up on the second ring, the way I always do.

“Hi, this is Patty, how can I help?”

It’s Caitlyn Garrett. I know her voice before she says her name. The Garretts have been with us three years — first one was Tyler, second one is Marie. Caitlyn had her in for the four-month a week ago Friday.

“Patty, hi, it’s Caitlyn Garrett, sorry to bother you, I just — I wanted to ask about something with Marie.”

“You’re not bothering me. What’s going on with our Marie?”

“She’s just — she’s been crying a lot. Like, a lot. And it’s not — I don’t know how to describe it. It doesn’t sound like her normal crying. It’s higher. Like a screaming sort of cry. And she’s not settling like she usually does. I’m a little worried.”

“Oh, honey. When did it start?”

“Maybe Saturday? Sunday? It’s been a few days now.”

“Okay. So you had her in for her four-month a week ago Friday, is that right? Let me pull up — yes, last Friday. So she’d be about eight days out from her shots.”

“Yes. Could that —”

“Some babies do have a fussy week after their four-month, Caitlyn. It’s actually their little bodies building up that protection. The pitch of the cry can sound different too — they’re working hard. Is she feeding okay?”

“She’s feeding fine. She’s wetting diapers fine. She just — she’s so unhappy.”

“I know. I know. It’s so hard when they’re unhappy and you can’t fix it. Are you and Brian getting any sleep?”

“Not really.”

“Listen — try a warm bath in the evening, dim the lights early, even a little lavender lotion on her chest. You can give her infant Tylenol if you want, the dose is on the bottle. Sometimes that just helps them settle. Anything else changed? Eating differently, any rashes, any vomiting?”

“No, none of that. Just the crying.”

“Then it really does sound like she’s just having a tough week. Some babies do. My Megan had a couple of stretches like that and I just about lost my mind, but it passed.”

“Should I bring her in?”

“You know what, let’s keep an eye on her for now. If she develops a fever, or if the crying gets worse, you call me back right away and we’ll get her seen. But it really does sound like a normal post-shot fussy week to me. Dr. Marsh sees a lot of these.”

“Okay.”

“Try the warm bath tonight. Call me back tomorrow if you’re still worried, all right? I mean it. I’m right here.”

“Okay. Thank you, Patty.”

“You take care.”

I hang up. I make a note in Marie’s chart. Mom called re: fussy stretch, baby otherwise well, reassured, advised call back if symptoms change. I close the note. The Coletti appointment is at two-fifteen.

I drink my coffee.

---

Henry Coletti comes in at two-twelve. His mother Sarah is with him. They’re early. Sarah is always early.

I see them through the glass before they push the door open. Sarah has her hand on Henry’s shoulder and Henry is walking next to her, looking at the floor.

I stand up when they come in.

“There’s my Henry! Look at you, look how tall you’re getting!”

Henry doesn’t look up.

“He’s having a quiet day,” Sarah says.

“Oh, that’s okay. Some days are quiet days. I have those too.” I lean over the desk. “Henry, sweetheart, can I tell you something? Do you remember when you were itty bitty, when you were just learning to walk? You used to come right up to this desk — right up to where you are now — and you used to tell me everything. You used to say Patty, Patty, guess what. And then you’d tell me what you had for breakfast and what your dog did and everything that happened that morning. Do you remember that?”

Henry does not answer.

Sarah’s hand tightens on his shoulder. I see the tightening. I think she’s just keeping him close.

“He used to be such a chatterbox,” I say to Sarah. “Such a chatty little thing. He’d talk to anyone who walked through that door. Do you remember when he made up that whole story about his dog flying? I had to listen to the whole thing.”

“I remember,” Sarah says.

“He still talks at home, though.”

Sarah looks at me. Her face is doing something I don’t quite catch. She is a tired woman. Sarah works full time and Henry has a little sister now.

“He talks at home,” she says.

“Oh, good. Good. That’s the main thing, isn’t it. Some kids just save it up for home.” I look back down at Henry. He is looking at the carpet. The carpet has a pattern of little blue diamonds. His free hand — the one Sarah is not holding — is at the edge of the desk, and one finger is going along the wood grain, slowly, back and forth, the same inch of wood, over and over. “Well, Henry, I’m glad you came to see me today. Are you going to get a sticker after?”

Henry nods, very slightly, at the carpet. The finger keeps going.

“What a good boy.”

Sarah signs the clipboard. She hands it back without looking at me. She and Henry sit by the window. Henry sits very still, his hands in his lap now, fingers folded together. Sarah opens her phone but she doesn’t look at it. She holds it. She looks at the side of Henry’s head.

Such a quiet day for him. He used to come right up to this desk.

I sit back down.

---

The phone rings at two-forty-one.

“Hi, this is Patty, how can I help?”

“Patty, it’s Megan. Megan Walsh.”

Megan Walsh. Oh.

“Hi honey, how is everybody?”

“Patty, I’m sorry, I — I’m trying not to panic. Liam has a fever of 103. It’s been 103 for two days. And he’s just — he’s not himself. He’s not making eye contact. He’s not — Emma was trying to make him laugh and he wouldn’t laugh. He always laughs at Emma.”

Three days post-MMR. I can see the note. I had her in last Thursday.

“Okay. Let’s take a breath. Where is he now?”

“He’s in my lap. He’s just lying in my lap.”

“Okay. 103 is high but it’s not unusual after the fifteen-month — that’s one we see a real fever response on, the MMR can run a temp for three or four days. The eye contact thing — babies have off days, especially when they’re not feeling well. When Emma had a fever at his age you couldn’t get a smile out of her for a week, remember?”

“This is different, Patty.”

“I hear you. Are you giving him fluids? Is he taking the bottle?”

“He’s taking the bottle. Not as much as usual.”

“That’s actually pretty normal for a fever. As long as he’s wetting diapers we’re okay. Have you been alternating Tylenol and Motrin?”

“Yes.”

“Good. Listen — if his temperature goes above 104, or if he becomes really unresponsive, like you can’t rouse him, take him to the ER. Don’t wait. But it sounds to me like he’s fighting it off and he’s just feeling miserable about it. Dr. Marsh is booked solid today and tomorrow — let me see what I’ve got — I have Friday at nine-thirty. Would that put your mind at rest?”

“Friday is two days away.”

“I know. If anything changes between now and Friday you call me, or you take him to the ER if it’s bad. But honestly, by Friday morning, my bet is the fever’s broken and you’re going to feel silly for worrying.”

There is a long pause on the line.

“Okay,” she says. “Okay, Friday.”

“Nine-thirty Friday. I’ve got him down. You tell Brian we’re thinking of you. Give Emma a kiss.”

“Okay.”

“You hang in there.”

I hang up. I make a note in Liam’s chart. Mom called, post-MMR fever day 2, child otherwise well, reassured, F/U Friday 9:30, ER threshold discussed. I close the note. The Andersons just walked in. I stand up.

“Becca! Look at that gorgeous little Lila!”

---

The Andersons go through. The teenager and his dad go through. I check insurance cards, take co-pays, schedule next appointments. Three different mothers hear that their kids are getting so big. I refill the sticker drawer because we ran low. I check the coffee in the back.

Dr. Marsh comes out between patients at three-twenty and asks me to call the Pearsons about their lab results. I leave a message. The doctor says thanks Patty and goes back in.

We’re moving.

---

The phone rings at three-fifty-three.

“Hi, this is Patty, how can I help?”

“Patty. It’s Joanna Reyes.”

Joanna Reyes is one of my first families. She was twenty-six and pregnant with Mateo when I started. Mateo is eleven now. The Reyes family is the family I think of when I think about how long I’ve been here. Mateo had the booster round five weeks ago. Five and a half. I remember because Joanna had been putting it off and finally came in. It was a Tuesday.

I can hear that Joanna has been crying. She is trying very hard not to be crying now.

“Joanna. What’s going on?”

“Patty, Mateo had — last night — I think he had a seizure. I don’t know. It was a few seconds. His eyes went blank, his whole body got stiff, and then he was back. And he’s had this tic, in his face, for about three weeks, and it’s been getting worse, and last night he had this — this episode — and I don’t know what to do.”

“Oh honey. Where is he now?”

“He’s at school. He went to school. He seemed fine this morning. He doesn’t remember it.”

“Okay. I’m glad he’s okay this morning. Listen — tics in kids his age are common. They come and go. The episode last night — Dr. Marsh is going to want to hear about all of it. She’s at a conference Thursday and Friday so she’s not in tomorrow or the day after — let me see what I’ve got — I can get you in Tuesday at nine-forty. That’s the first available with her. In the meantime, if you see anything that looks like a clear seizure — a full one, more than a few seconds, with him not responsive — you take him straight to the ER. Don’t wait.”

“Tuesday.”

“Tuesday at nine-forty. And Joanna — write everything down between now and then. When the tic happens, how often, whether anything triggers it, what he ate, how he slept. Bring all of that to the appointment. Dr. Marsh is going to want it.”

“Okay.”

“How is Lucia? How’s the baby?”

There is a pause. Long enough for me to hear it.

“They’re fine,” Joanna says. “They’re fine.”

“You give them a hug for me. And try not to spiral. Try. He’s at school. He’s having a normal day.”

“Okay. Thank you, Patty.”

“Tuesday at nine-forty. You call me anytime.”

“Thank you.”

I hang up. My coffee is cold. I make a note in Mateo’s chart. Mom called re: facial tic x 3 weeks and possible brief episode of staring/stiffening last night, no recurrence, ER threshold discussed, F/U Tuesday 9:40 w/ Dr. M. I close the note.

The Briggs intake is in four minutes. I straighten the new-family folder I put together for them, check the pen, put a little smile on.

---

The Briggs family is sweet. Emma Briggs is twenty-eight, this is her first, the baby is two weeks old and Emma keeps looking at him like she’s not sure he’s real. The dad is at work. I get them set up — insurance card, driver’s license, welcome packet. I tell Emma we’re so glad to have them, Dr. Marsh is wonderful, the practice has been here for twenty-six years and we’re just a real family. Emma’s eyes get a little teary and she apologises. I tell her, honey, you do not apologise for crying in front of Patty. I cry at commercials.

She laughs and fills out the new-patient forms. The baby — his name is Caleb — sleeps in his carrier through the whole thing. He has dark hair. A lot of it. He looks like a tiny old man.

“What a beautiful little boy.”

“Thank you.”

“He’s going to be just fine here. We’re going to take such good care of him.”

Dr. Marsh comes out to meet them and brings them back. I watch Emma stand up with the carrier, both hands underneath, careful as if it might come apart.

The waiting room is empty.

I look at the screen.

---

Tomorrow we have a heavy morning. Eight o’clock is a follow-up — a new one, Dr. Marsh must have added it after the visit today. Henry Coletti. The note next to his name says developmental. Sarah and Dr. Marsh have been working on a plan for him, we have a referral going through. Eight-thirty is a four-month for the Davis baby. Nine is a two-month. Briggs, Caleb. Two-month well-child. Emma must have scheduled it with Dr. Marsh in the back. The baby I just met. Already on the books.

I write a sticky note for the morning shift — Briggs two-month at 9, new family yesterday, mom Emma is sweet, dad couldn’t come, first baby. I stick it on the monitor.

I turn off my desk lamp, pick up my bag, take my cardigan from the back of the chair. The kettle is cold now. I’ll wash the cup tomorrow.

The waiting room is empty. The chairs are in a row. The little wooden train table by the window has a toy on it — Henry’s, he must have set it down and forgotten. A little wooden cow. I pick it up. It’s worn on the corners from years of small hands. We’ve had this cow as long as I’ve been here. I put it back in the basket. He’ll be back in the morning.

I lock the front, turn off the lights in the waiting room. The hallway light I leave on for the cleaners. Janet’s lamp at the back is already off.

In the parking lot it’s almost dark. I get in my car and start the engine. The radio comes on in the middle of a song I half know.

Tomorrow at nine, Caleb Briggs. Two-month.

I back out.

Behind me, through the dark glass, the schedule is still lit on the screen. Briggs, Caleb. 9:00. The two-week-old with the dark hair. Tomorrow morning will be his first real round. Already on the books.

I drive home.

---

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