Repatriate

Chapter One

Busted

The summer morning was magnificent—warm, with a bright, cloudless sky that made Ally Hamilton wish she had a job that took her outside. Maybe that was her problem—too many hours indoors, taking care of sick people and not taking care of herself. Maybe. Or maybe it was just her. Lately, that idea had been growing stronger, making it harder to blame her troubles on everyone else. Yet she felt so powerless to do anything, to make changes, to get help. She didn’t know where to begin. Most of the time, she felt overwhelmed.

Pushing the thoughts aside, she locked her car and headed toward the ER, nodding politely toward people loitering by the entrance, greeting the security guard by name. The halls were already lined with stretchers, the patients lying in them hooked up to monitors and IV bags, wearing neck collars and little else. It was not a promising sign.

In the locker room, Ally opened her purse and pulled out a small pill holder, then spilled the contents into her palm. Four white tablets, just enough to get by. She looked at them, studying the details. The white, shiny finish. The round shape. The size. The size amazed her. How could such a tiny thing, about the size of a mini-M&M, hold so much power?

She didn’t want to take it. She didn’t want to need it. But no way could she make it through a twelve-hour ER shift without it. No way could she go through another day like yesterday. She’d run out of medication, and a third of the way through her twelve-hour shift, the withdrawal symptoms had started. Yawning, runny nose, sweating, anxiety. Before the shift ended, her heart was racing, and her bones ached so badly she could barely stand to finish suturing a trauma patient.

Afterward, instead of unwinding at home and regrouping for today’s adventures in ER Land, she’d had to go to the ATM and withdraw the last of her savings. She’d made an emergency stop to see her source, only to be chewed out because it was so late. Yet she’d walked out with a few oxycodone and a sense of relief. She’d make it through another day. Tomorrow she’d worry about tomorrow, because today, she just didn’t have the energy.

Ally knew she was running out of options. She was nearly broke. The people she could turn to for money were starting to ask questions. And one of her most reliable sources for pills, a friend of her late grandmother, was starting to get a little anxious about their arrangement.

Drugs were always available in the ER, and the temptation to steal her patients’ medication sometimes overwhelmed her. Somehow, she was always able to resist that urge. Even though she was out of pills, even though she’d have to spend her time after work making calls and desperately cruising the streets of Scranton, looking for someone who’d sell her what she needed, she didn’t cross that line. She would drive and call, and suffer, because diverting medication from her patients was a criminal act, and even though she’d already broken the law hundreds of times because of her drug problem, she wasn’t that desperate. Hopefully, she’d never reach that point. She was trying to wean herself off, cutting back a little at a time, but the withdrawal symptoms kept sucking her back in.

Her physician’s assistant license had taken her five years to earn. She’d spent grueling hours in the library and the operating room learning and honing her skills, time she could have been relaxing or having fun. She refused to jeopardize all she’d worked for by stealing controlled substances.

Was she jeopardizing it by being impaired? She didn’t think so. The pills barely fazed her anymore. She experienced no high, no euphoric feeling after taking them—just relief. She’d avoid the agony of withdrawal for another four or five hours. Then the fear would begin again.

After popping a tablet into her mouth and swallowing it dry, she returned two to the holder and tucked another into the zippered pocket on the fanny pack she wore at work. Patting the bag and sighing with relief, she changed into scrubs and her work sneakers, fastened the fanny pack, and looked at the clock. A quarter of eleven. She was early, but that would give her time to scout the ER, to figure out who was doing what and where she needed to begin. Being early put her in control in a place that was typically so out of control she couldn’t rein it in.

Before she could take a step, the door to the staff lounge opened, and Ally met the squinting eyes of Dr. Reese Ryan, the ER director, as she stepped into the room. Behind her, Dr. Jessica Benson, the director at another local ER, wore a somber expression.

Instantly, Ally tensed, on high alert. Hi. What’s up? she asked as she took half a step back, glancing from Reese to Jess with a small smile, trying to disguise her fear.

Jess closed the door behind her as she stepped in and leaned against it.

Take a seat, Reese said with a wave of her arm. Ally backed into a recliner, while Reese pushed a rolling desk chair toward Jess and leaned into the counter along the wall.

Reese bit her lip and raised her arms as she spoke. Ally, this is really hard for me. I brought Jess with me because she has a lot of experience with matters like this, and I thought she could help. Reese paused and nodded toward Jess, and then she gazed at Ally again.

Ally felt her blood draining, but she fought to remain still on her perch at the edge of the recliner, waiting for Reese to continue. She knew exactly what was happening, and she didn’t even care. In fact, she was almost happy. Reese was going to fire her, and Ally was relieved. She could finally stop pretending, let go of this burden she’d carried for so long. She audibly sighed as Reese spoke.

I’m concerned that you have a problem with pills. I’m assuming pills, because of your shoulder. Opioids of some kind. I’ve seen it, and some of the other staff members have too. You start off your shift okay, and then three or four or five hours in you start yawning and sweating and running to the bathroom and looking like total crap. A few minutes later it’s all better. I’ve seen you slip a pill out of your pocket and pop it into your mouth, and fifteen minutes later things seem to be back to baseline.

Reese was rambling, her nerves obvious to Ally, who knew her well. That somehow made Ally even sadder than Reese’s confrontation. Reese, whose nerves of steel made her a phenomenal critical-care doctor, was on edge over this conversation.

Even though Reese was anxious, she was a professional. Reese had a job to do, and Ally sat back and waited for the knife she knew was coming.

Probably twenty years ago when I started practicing, I wouldn’t have recognized the signs. I wouldn’t have been suspicious about this at all. Now with all the problems with overdoses, we’ve all become more aware. We’ve had training to look out for things like this, and I’m suspicious, concerned about you. It looks like something’s going on.

Reese stopped talking and stared for a moment. Ally swallowed her anxiety and was about to speak when Reese started again.

If I’m way off the mark here, I apologize. I’m not standing here in front of you to insult you or anger you. I’m standing here because I’ve known you well for a long time. I consider you a friend, but I’m also the director of the ER, who has to make sure that every single person who puts on a white coat and drapes a stethoscope around their neck is mentally and physically competent to do the job, every time they walk through the door. So I’m looking at you as your friend and as your director, and I’m asking if you have an opioid problem.

Looking from Reese to Jess, Ally could see they knew. It was in their eyes, in the slight challenge of their posture—leaning forward, arms bent. As if suddenly sensing this revelation, Reese lowered her arms. Jess remained still but studied her. And who knew better than Dr. Jessica Benson, who’d been in the same position Ally was in just a few years ago? In addition to working in the ER at Garden Memorial Hospital and directing the department, Jess lectured on addiction. Her specialty was addiction in professionals.

Ally could argue with them, make excuses, try to convince them what they knew in their hearts was a lie. Or she could just tell them the truth. Tell them and lay down the terribly heavy load she’d been carrying for months.

Ally sat back in the chair, looked from Reese to Jess and back again, and nodded. The tears rolled down her cheeks, but she couldn’t find her voice. Reese handed her a tissue and, kneeling beside her, squeezed her hand.

Ally sniffled and wiped her eyes, then cleared her throat. It’s gotten out of control. I need help.

Jess joined Reese on the floor. That’s why we’re here.

I don’t know what to do.

Jess hugged her. That’s okay, Ally. I do.

Chapter Two

You’ve Got This

Six Months Later

Ally was already awake when the alarm began its obnoxious beeping. She rolled over and gently tapped the button to silence it and then stayed in that position, staring into the blackness of her bedroom. Dawn was breaking, and the outline of the morning was creeping around the drawn shades.

A new dawn, a new day. A new job and perhaps a new life awaited her on the other side of the thick comforter that protected her from the February frost. Yet even though she’d been staring at that same ceiling, that same wall, that same window for hours, talking herself into getting out of bed, she wasn’t quite ready to face it all.

Arching her back, she stretched, and an involuntary groan escaped. It had been six months since that fateful day when Reese and Jess had confronted her in the staff lounge, since she’d admitted she had an opioid problem. The days after that—all one hundred and eighty-four of them—had been surreal. Days and nights of a medical detox program, meetings and counseling, art therapy and psychodrama and psychoanalysis. She’d experienced things she could never have imagined when she’d been just a normal young woman living her average life.

Now, like most people in recovery, she’d been measuring her sobriety by counting sunrises and sunsets, focusing on the positive instead of the body aches and anxiety that had taunted her in the beginning and the cravings she battled still.

Every day was different. At first she had focused on the physical aspect of her disease, on all those miserable withdrawal symptoms that caused her to continue seeking drugs long after her doctor stopped prescribing them. Supervised withdrawal in the hospital was no easier, but at least she had support there—IV fluids to keep her hydrated, and medication to settle her stomach. Shoulders to cry on and people to support her and encourage her, to tell her to hang in there and it would get better. Next came the mental anguish—embarrassment that her friends and family and coworkers knew about her problem. How could they ever trust her again? How could she face them, carrying around this shame?

She still faced the stigma, the real and imagined, but she’d been learning to deal with it.

Next, she had to confront the spiritual issues of her recovery. How she’d fallen so far and how she was going to prevent herself from another stumble. And what the fuck she was going to do with the rest of her life.

This day presented an even greater challenge than the previous one hundred and eighty-three. Today, she had to leave the womb of recovery—where she was buffered from temptation by amazing people and a sterile environment, surrounded by positivity and kindness—and return to the cold, heartless world.

You’ve got this. She repeated the mantra in her head, and again out loud, several times. Her father had been telling her this since she was a toddler, encouraging her—sometimes goading her—toward her goals. Ballet, golf, school projects, work—the subject area didn’t matter. Her father had taught her she could do anything. Most of the time, she believed him. Sometimes, she wondered if that was good or bad. That thinking had caused her to ignore her pill problem by telling herself she was different. Not like those people, the ones who came to the ER after hours begging for pills, telling her their doctor was off for the night and they just needed a few pills to last until morning. She wasn’t like the ones who couldn’t stop, who were weak or broken and disgraceful. Not until she was.

Perhaps if she’d been weak and admitted her pain instead of pushing through it, or asked for help instead of trying to fix it on her own, the past year of her life would have been different.

You can’t go back, though, she thought. Only forward, and today forward meant starting a new job, which meant she had to get out of that bed.

You’ve got this.

Throwing back the blankets, Ally scurried across the cold floor and into the bathroom, where she flipped the switches for the lights and the heat. As she stood on the thick rug, brushing her teeth, she eyed herself in the mirror. She’d cut her blond hair when she’d left the halfway house the week before, and the look still startled her. Her hair had been down her back since she could remember, and now the tips perched on the tops of her shoulders. She still wasn’t sure if she liked the new cut or not, but she couldn’t do anything about it except give it time. Her blue eyes were dulled by lack of sleep, so she smiled and looked for some hint of life in them. She supposed it was there, if she stared hard enough, but she wasn’t worried. Happiness was not the priority right now. Staying alive, working on herself, and working on her new job were the goals. Happiness would come. She hoped so, anyway.

It had been a long, long time since she was the happy, carefree Ally she’d once been. Three hundred and ninety-eight days, since she was now in the habit of counting. Just over a year since her family’s Christmas ski trip to Utah, where a tree and multiple broken bones in her shoulder joint had ended her former life. The woman who was born of that accident had pain, and anger, and frustration, and addiction, and she hadn’t had any room for happiness with all those other feelings crammed into her consciousness.

Slowly, with her therapist’s help, she was purging the negative feelings. Hopefully, some positive energy would fill the void they left behind.

When she finished with her teeth, Ally pulled on comfy sweatpants and a T-shirt, then headed to the gym in the lobby for her morning workout. Taking care of her body was a good habit she’d worked on in recovery, and the proximity to a gym made it easy to stick with it. An hour later, after an invigorating cardio routine, she hopped into the shower, then wrapped her hair in a towel and her body in a long, soft robe. Retracing her path, she crossed her bedroom and entered the living room, and a few steps later she was in the kitchen of her tiny apartment. Technically speaking it was just two rooms, since the living room and kitchen were combined, but it provided six hundred square feet of peace and quiet, her own haven. The apartment was one of the penthouses in a building her father owned, and she was the superintendent. For tax purposes, she could live there rent-free, and considering the current state of her finances, that arrangement was a godsend. Buying oxycodone on the street was like sending twenty-dollar bills through a shredder, and she was broke.

Prior to the injury that had splintered her world into chaos, she’d been contemplating buying her own house. It had just made sense. She had spent her whole life in Lackawanna County, with its rivers and mountains, and didn’t see a reason to ever leave. The four seasons were amazing, and she could do things outside in every one of them. Approaching thirty, and with a good job, she needed to invest some of her salary, and what better place than a house? Thank Goddess she hadn’t made that leap, because by now it would have been in foreclosure.

Pouring water into the Keurig, she stared through the etching of frost on her kitchen window. It was the first of February, and Mother Nature had obviously been following the calendar, for she’d dusted Scranton with an inch of snow. Across the Keyser Valley, Ally saw chimney smoke dancing in the air. In the distance, the sun had cleared the mountains to the east and chased the darkness away. And just to the south of that sunrise, the ski slopes on Montage Mountain snaked down from the peaks, the paths lit by muted trail lights. Ally shuddered at the image and closed her eyes.

Too late. For an instant she was transported across the country, to that other ski slope. In her mind she saw the child cut in front of her and pictured herself turning evasively, losing control, tumbling as her skis flew one way and her body the other. She had stopped with a crunch, and a bolt of white-hot pain had seared her shoulder, ten feet off the slope and against a rather large tree.

Shaking off the memory, she poured her coffee and added cream and honey, then returned to her bedroom. As she opened the door to the walk-in closet, she shook her head. A class on organization would be helpful. The space was stuffed full, with everything from sporting equipment to schoolbooks, and even some clothes, though not as many as most of her friends owned. Since she wore scrubs to work—at least she had in the past—she didn’t have much need for things other than jeans and sweats and a few sweaters.

Looking in her closet the day before, she’d placed a frantic call to her mom, who picked her up for an emergency trip to the outlets. Pulling one of her purchases from a hanger, she removed the tag and pulled it over her head. The shirt-dress, in a dark blue corduroy, complemented her eyes, and Ally smiled at herself in the mirror as she tied a colorful scarf around her neck.

There it was. A little life, a little joy from one of life’s simplest pleasures—looking good in a new dress.

You’ve got this, she told her reflection. Maybe if you say it often enough, you’ll start to believe it. It sounds like a reasonable plan.

After pulling on boots, she finished her hair and makeup, then spun before the mirror, assessing herself. She’d regained most of the twenty pounds she’d lost during her ordeal, and her skin looked healthy. Time would tell about the new hair, but she had to admit it looked okay, parted to the side and hanging straight down. Maybe she’d try a new look and cut it all off. She wasn’t out at work, except to a few people like Reese, but she knew there were rumors about her and a paramedic she’d dated for a few months in the fall before her injury. If she buzzed her hair, that would probably confirm the suspicions. It would give people something to talk about besides the drugs, though, so it might be worth it.

The thought made her laugh, and she chuckled all the way to the kitchen, where she toasted a bagel to eat with her yogurt. Pulling up The Scranton Times on her iPad, she read the news while she ate, and when she was done, she found herself suddenly filled with dread. Her heart pulsed wildly, the kind of panicky rhythm she could feel in her throat, and her head spun.

C’mon, Ally, she said, again and again, as she closed her eyes and took some deep breaths. She’d practiced a ton of yoga during her recovery, and she repeated the breathing technique she’d perfected. Finally she gained control and opened her eyes.

It was twenty after eight. She had forty minutes to make a fifteen-minute drive, but the thought of staying in the apartment threatened to bring back the panic, so she grabbed her purse and her warmest coat and headed out the door.

Her phone beeped as she waited for the elevator, and she checked the text. How’s it going? Reese Ryan asked.

Ally hit dial, and Reese picked up immediately.

Coming or going? Ally asked.

I just left. I’m in the long line at Dunkin’ so I can stay awake for the next few hours. Ella has a meeting, and I’m in charge.

How is your family? Ally asked as she abandoned the elevator and headed down the wide, central staircase to the lobby.

That’s a very good question. One I would have expected you to ask a week ago, when you were released.

Ally knew she should have called Reese, but she’d been avoiding it. With a sigh, she apologized. I just feel weird.

Oh, really? About what? Reese asked lightly.

Ally laughed. You’re a jerk.

Right back at you.

It’s so safe when you’re in there. Not much temptation. No judgment. Tons of support. Now, reality’s setting in.

That’s why you have friends, Ally.

Ally had lost touch with most of her friends when she’d been using drugs. There weren’t enough hours in the day to search for drugs and use them and foster relationships. But Reese had always been there, and she still was. I know. I’m so grateful to you for the intervention. And for hooking me up with Jess. She’s been such a lifeline.

She says you’re doing great. Starting your new job today.

Jess had been calling Ally since the beginning. Daily for a while, and now at least a few times a week. Ally went to meetings Jess chaired and listened to her podcasts on impaired professionals, learned how to meditate and practice mindfulness with Jess’s help. And she was in so much better shape than when she was admitted to rehab.

She supposed what was bothering her was the mess she had to clean up.

Yes. New job. Today. I’ve got this.

A journey of a thousand miles begins with one step.

I know. And I’ve taken a lot of steps in the right direction. Maybe I just don’t know where to go from here.

Back to the ER?

Ally sighed and asked a question whose answer she dreaded. What are they saying about me, Reese?

Ally, no one’s even mentioned you in months.

Ally wasn’t sure if that was good or bad. I can’t imagine anyone will let me live this down.

Fuck them.

She was sure Reese meant that remark to be affirming, to tell her she didn’t need anyone’s approval. All it did was affirm that they disapproved.

Yeah.

We’re having a birthday party on Sunday. Steph turns three.

Ally laughed at the image of Reese’s little girl. Wow. Then she realized she’d missed a significant chunk of this child’s life, someone she really adored and loved. Do you think she’ll remember me?

Only one way to find out.

Ally smiled into the phone. I’ll be there.

Stop avoiding the people you love.

Ally reached the lobby and crossed the marble foyer without seeing another soul. At the front door, she paused and looked through the glass. The world awaited her. It was good she didn’t have to face it alone.

I will.

Their landscaping crew had shoveled the walk and plowed the lot, but Ally picked her way across anyway, mindful of falling. Her shoulder didn’t need any more trauma. In a minute she was at her car and deposited her bag on the seat. After turning on the Jeep’s engine, she scraped the snow and ice from her windows and sat behind the wheel for a moment while the engine warmed.

A garage, she said aloud. That’s my new purpose.

The traffic was awful, made worse by the slushy roads, and Ally found herself saying a prayer of relief when she arrived at the headquarters of Hart Home Health and Hospice half an hour later. She’d made it safely and was five minutes early.

The office was in an old mansion in the Green Ridge section of Scranton, one that had been converted for commercial use before the zoning laws had changed. Ally glanced at the sign, which consisted of four overlapping Hs, and winced. That was at least one H too many. Beside it was another very familiar sign. This House Protected by Hamilton Security Systems. Her father’s company was everywhere.

Someone had shoveled the sidewalk in front of the building, and Ally had no trouble with ice as she made her way to the massive front door. It was at least ten feet tall, made of wood and surrounded by a frame of leaded-glass panels. After ringing the bell, she glanced around. The porch was empty, but she could imagine a rocking chair or two placed here in the summer months. It would be a great vantage point to watch the children from the neighboring houses enjoying the play sets Ally noticed in every yard.

She had no more time for contemplation as the great front door opened, and a man who nearly filled the space looked out and grinned at her. Greg Hart was almost as wide as he was tall, and he had more hair in his long, gray beard than on his head. Wearing a baggy sweater and khaki pants, he didn’t look the part of the savvy businessman Ally knew he was. At first glance, he was intimidating, until she noticed the twinkle in his eye and that radiant smile.

Ally! Good morning! I’ve been waiting for you.

Ally knew she was a few minutes early, and he couldn’t have been waiting long, but she didn’t take the comment critically. Good morning, Mr. Hart. Chaos on the roads this morning, she said as she followed him into the vestibule, where he took her coat and draped it on an ornate coat tree in the corner beside a half dozen other pieces of outerwear.

Don’t I know it! he said in his booming voice. "I’ve had calls from a dozen caregivers already, and I haven’t even finished my coffee! I’m afraid our patients will have to have a little…patience this morning. As good as we are, Four H cannot control the weather!"

Ally smiled politely, even though his back was to her. That would be a feat, she replied.

Maybe in the next stage of my life I’ll work on that, he retorted, then waved his huge arm. Follow me. I’m going to show you around the office and introduce you to the staff. Even though you’ll be here for only a few days of orientation, these are the men and women you’ll be talking to every day. They’ll do your schedule, help you with billing, stock your car with supplies, and, in general, help you get the job done. They’re here for you, so I want you to know who they are, and I want them to know you.

Sounds great, Ally said, trying to pepper her reply with enthusiasm. It was hard, though. She’d been a PA in the ER for almost six years, taken part in codes and emergency surgery,