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“Dr. Unavailable”

I had long ago accepted that people were merely passengers on my life's train journey—some staying for a few stops, others disembarking without warning. This philosophy felt painfully relevant as I stared at my phone's blank screen, the absence of Michael's name like a physical ache in my chest. Four days of silence now. Four days of composing texts I never sent. The quiet from my personal device stood in stark contrast to the persistent, reliable beeping of the IV pumps I monitored daily as a clinical pharmacist at Mercy West.

He had pulled away again, that familiar cold silence settling in like a Chicago January—bitter, unforgiving, and seemingly endless. Each time it happened, I told myself I was prepared, that I had built sufficient emotional insulation. Instead, each time, I discovered new depths to the hurt, new corners of my heart still vulnerable to the frost.

This feeling—the ghosting, the abandonment—sent my mind spiraling back, retracing the steps that had led me here. I hadn't always been this way, braced for inevitable departures. This was a lesson I had learned gradually, painfully, like a prolonged medical procedure without anesthesia.

It started after junior high school. I remembered the earnest promises to stay in touch, the exchange of phone numbers and addresses, the plans we'd never fulfill. Despite my efforts—the calls I initiated, the messages I sent—friendships dissolved like sugar in hot liquid. At first, I blamed distance, different schools, new social circles. I believed these were circumstances beyond anyone's control, not personal rejections.

The pattern only solidified through high school. Three years of building connections, sharing secrets, creating memories—all washed away by graduation. College brought the same cycle, only compressed: friendships that had taken years to build in high school now formed and fractured within semesters.

I made lists in my mind, tallying those who stayed against those who left. The math never added up to any logical formula I could discern. The closest friends—the ones who knew my fears, who had seen me cry—they vanished like morning mist. Meanwhile, casual acquaintances sometimes proved surprisingly durable, lingering at the periphery of my life for years without explanation.

Overall, people in my life seemed meant to replace themselves, like full environments changing with the seasons. It was a truth that resonated with cruel clarity even in my professional life.

"Lilly, discharge protocols for Johnson in 204," Dr. Levine said, sliding a tablet across the pharmacy counter. "And we've got a new admit in that bed by evening."

I nodded, reviewing the medication reconciliation: this was the rhythm of Mercy West—admitted, treated, discharged. One patient flowing out as another flowed in, their faces and names blurring together in the relentless cycle. The beds never stayed empty; there was always another person waiting to claim that temporary space.

"Same dance, different partners," I murmured to myself as I verified the final discharge prescription.

"What's that?" asked the pharmacy tech working beside me.

"Nothing," I said, forcing a smile. "Just thinking about patient turnover."

But I wasn't only thinking about patients. I was thinking about how the hospital's revolving door mirrored my personal life—people entering with urgency, their presence all-consuming while they remained, then vanishing as though they'd never existed at all. And then, the image came to me again: replaceable friends packed like medical pills, each in their neat little compartment, ready to be dispensed and discarded. I'd first seen it online—a dark, cynical meme that had made me wince with recognition. After some time, someone had taped a printout to the door of the central pharmacy, a grim joke among the healthcare workers who dealt daily with human transience. I remembered how we'd laughed, my colleagues and I, at this callous representation of our professional detachment. Yet now, standing alone at the dispensing counter, the image felt like a personal indictment. The joke had seeped from my professional life into my personal one, the boundaries blurring until I could no longer tell where one ended and the other began.

I glanced at my phone again. Still nothing from Michael. The screen reflected my face, and I saw in it the resignation that I'd cultivated over years of practicing this particular form of emotional triage.

Part of me wanted to text him again. To ask, simply: "Are you there?" But experience had taught me that begging for attention only prolonged the inevitable. If he wanted to contact me, he would. If he didn't, no amount of reaching out on my part would change that fundamental truth.

Outside the pharmacy windows, snow dusted the hospital grounds, covering everything in a thin layer of sameness. Patients came and went. Colleagues worked their shifts and disappeared. Medications were dispensed, their effects monitored, their doses adjusted. I was the only one remaining at the center of this constant circulation, watching as life flowed around me, touching everything briefly before moving on.

My phone remained silent as I verified a complex chemotherapy protocol. The patient was new, recently diagnosed, her eyes still bright with disbelief at her situation. I wondered how long she would remain in our care, how many faces she would come to recognize before she too was discharged—either to recovery or to somewhere beyond our help.

"All verified," I said to no one in particular, sending the order through the system with a decisive click.

The beeping of the IV pumps continued, each tone signaling medication flowing into veins, time passing, life continuing its inexorable forward motion. I tucked my silent phone into my pocket, feeling its weight against my hip like a small, cold stone—a reminder of yet another passenger who might have already departed from my life's journey without saying goodbye.