By Brian Willems.
The following is an extract from The Surviving Cells (Les Fugitives, 2026) by Brian Willems.
Ana is on her way to talk to Jonathan and his mother. They are already waiting for her in the conference room. In fact, they have been waiting for quite a while. Yet the doctor is not late because she has been seeing another patient. She is late because she has been sitting in her office, trying to figure out something else she can do, some other appeal she can make. She has come up with nothing. And now she needs to find a way to explain the situation to both mother and son.
One problem is that Ana does not lie to patients. She cannot tell Jonathan, for example, Good news, the CT has confirmed that it is only stage-II Hodgkin’s, so the treatment is fairly standard. There is no need to be overly concerned. She cannot say that because it is not true. Or at least it might not be true. At the same time, she cannot go into the conference room and tell the truth, which is that, for no reason that the doctor can explain without using profanity, she cannot get the approval for a procedure that could save Jonathan’s life. That would drive them both crazy, probably making Jonathan depressed, which would lower his body’s immune system, the very opposite of what he needs.
Yet the issue is not just what Dr Jovanovic is going to say, but how she will say it. Ever since med school, she has known that, were she to lie to a patient, they would see through her in a second. She is incapable of hiding the truth. Her face wants to tell the truth, even when her mind does not. Some would say that in her heart she does not want to lie, but the doctor would say it has little to do with her heart, whose primary function is to circulate blood, carry oxygen throughout the body, and then cart away the unwanted carbon dioxide. The heart is not the organ that is causing her face to expose her lies. No, the problem is her brain. Its primary function is seemingly to expose any lie through facial expressions completely out of her control.
(…)
In a semi-circle, there are six brown leather chairs that will need to be replaced next year.
The curtains are pulled closed to hide the view of the ground level of the hospital parking lot. Yet the sun still makes its way through the gaps, backlighting the three patients getting their treatment, and the three nurses accompanying them, turning them all into shadows. ‘Dr J,’ says one of the patients, not the only one to use this trick to avoid the risk of mispronouncing her last name, and the decision between saying the first letter as a ‘Y,’ like the doctor does, or as a hard ‘J,’ as in ‘justice,’ like Maggie, her daughter, does when she is not at home, along with pretty much everyone else.
Rubén is the exact person that Dr Jovanovic needs to see right now. A sixty-five-year-old Mexican American law professor, gleefully nearing retirement, with non-metastatic prostate cancer, caught early through regular checkups. A near-guaranteed chance of survival. ‘How’s my favorite oncologist?’ Rubén asks, like it is his job to cheer her up. But now, with Trump still talking about how immigrants are eating people’s pets, the first thing the doctor thinks when seeing Rubén is whether he has his papers, and she hates herself for it. The doctor approaches Rubén’s chair and nods to the nurse sitting on a stool, monitoring the IV pumping chemicals into his arm. The doctor purposely takes Rubén’s hand, the hand not part of the arm with the IV port in it, and steadies her gaze to ask how he is doing. He looks at her for a moment, before saying anything, as if he knew what she was thinking, and how bad she felt, and was welcoming her to his world.
‘Well, I’m doing just fine. Couldn’t be luckier,’ Rubén says, but his short-sleeved dress shirt hangs looser on his body than the doctor remembers. And is he more jittery than usual? Before, Dr Jovanovic would put his behavior down to weariness from the treatment, even though he knows the treatment is saving his life and that he probably has the easiest case in the room.
But now she’s not sure it’s just the cancer.
The doctor looks away, over at the other two patients. She does not know them, so she just gives each a quick, but heartfelt, smile, not sure of what stage of life or death they are at. Dr Jovanovic is not the only oncologist at the hospital, although she usually has an idea of all the cases going on at any moment. If she had to guess, she would say that the older white man with a shaved head and the cratered cheeks of skin cancer is a patient of Dr Benni’s. The young woman, however… The doctor cannot place her. Though usually, young women with cancer are so thoroughly discussed by the male doctors on the ward that they are hard to miss. This patient does not ring a bell. Yet she is looking at Ana like she wants to rip her head off. Was she abrupt with her once in the hallway, did she give her a gruff response while having a bad day? It would not be the first time, but she does not remember doing it to this woman. Perhaps the doctor really is getting too involved in her own case and is starting to blank out on what is happening around her.
Rubén squeezes her hand, cutting off her thoughts with a pained look on his face that she thankfully knows is just caused by a wretchedly upset stomach.
‘I am aware that you are afraid of its addictive properties, Rubén,’ the doctor says, ‘but Xanax really helps with the stomach issues and keeping your food down.’
Rubén laughs, but not like he has found something funny. More like he is sick of having to think about all the things he used to take for granted, such as not throwing up his food and having saliva in his mouth. But he is still trying hard to be in a good mood. He is trying to be lighthearted about everything, even his painful stomach, even his refusal to take Xanax, even the news. Rubén must understand that even the easiest cancer patients can have a rough time. And that he must let himself have a rough time rather than feeling guilty that his prognosis is so good.
Dr Jovanovic squeezes his hand back and then leans over to the nurse administering his treatment. ‘We’ll start him out at 0.25mg, twice a day, for the first week,’ she says to the nurse, even though she will have to get his own doctor to write the prescription. The nurse nods, not taking her eyes off the chemicals dripping into Rubén’s arm, perhaps nervous that Ana will find fault in her technique. Rubén smiles, then closes his eyes, and sinks down deeper into the fake leather chair, probably feeling a mix of gratitude for the relief that the Xanax will bring, as well as despair at admitting that he is bad enough to need it. His mask slips off his nose, he does not fix it, and no one tells him to.
She goes to the nurses’ station to confirm that Rubén’s doctor is Dr Benni, and she leaves him a note about the prescription. Over the top of the monitor, she can see that young woman, the one she does not know. The woman has not let the doctor out of her sight, her eyes open wide in anger. The doctor looks at the treatment roster. Rubén Cabrera, Richard Bergson, Elizabeth Headley. So that is who she is. It says that she is a visiting patient from out of state. There was a death in the family, so she is presumably here for the funeral, and at the hospital for just one treatment. Mystery solved. And her hatred is clear now too. It is not directed at Dr Jovanovic personally. It was nothing the doctor did. This is an anger aimed at all doctors, everywhere, in every department, at every institution, for everything they have ever done, for everything they will ever do. For both the good and the bad, the mistakes and the successes. The doctor knows this kind of anger very well. She has seen it many times before in her own patients, and usually for a good reason. In fact, even when it is not for a good reason, it is for a good reason. Yet the one person she has never seen with that expression is Jonathan’s mother, who is a cancer survivor herself. Even after her husband died, she did not get mad, did not sue the hospital for negligence, or write any of the doctors a spiteful email. She just took the bad news home with her and lived with it. Now she has even brought her son back to the same doctor, after everything that happened to his father. What is wrong with this family? You would think they would at least get a second opinion, or try their luck with someone else. Who knows why they are really here? Maybe Dr Jovanovic is the only doctor available on their insurance plan. Maybe they have been forced into dealing with the exact person now who could not save the father back then. But Ana did not pick up any hostile feelings in their previous meetings. They just seemed sad, resigned, and wisely guarding their strength, not wasting valuable energy on an argument they would never win.
It takes some maneuvering, but the doctor gets up from the computer without making eye contact with the young female patient again. She does try to connect with Rubén to give him a reassuring nod, but his face is scrunched up with the stomach pain he was hiding while they were talking. It is time for her to go. As she turns towards the door, she hears the distinctive footsteps of Dr Benni coming down the hall, steps that come from a short man overcompensating with too-long strides. Perhaps he has worked on his steps just as the doctor has worked on her facial expressions. Whatever it is, Dr Jovanovic leaves through a different door before he arrives, relieved that the patient from out of town will soon have a new target to sear with her justified rage.
ABOUT THE AUTHOR
Brian Willems was born in Minnesota, and now lives and works in Croatia, teaching literature at the University of Split and serving as director of its Studia Mediterranea centre. Brian’s poetry and prose have appeared in The Antioch Review, Poetry Salzburg Review, Things Magazine, Prague Literary Review and elsewhere. He is the author of the experimental novella Henry, Henry (2016), as well as several academic books, most recently Sham Ruins: A User’s Guide (2022), and is co-editor, with Nicol Barria-Asenjo and Slavoj Žižek, of Global Manifestos for the 21st Century, with a foreword by Yanis Varoufakis (2023). He translates from Croatian into English, including work by Jurica Pavičić, and Luka Bekavac’s Gallery of Fine Arts in Osijek: Studies, Ruins. He is co-editor of LOOK Editions, and has been a guest lecturer in the UK, USA, the Middle East, and continental Europe. The Surviving Cells is his first novel.
