Chapter 206: The Nurse Who Came Knocking
After returning to his office, Ethan immediately called Gianna.
Her response caught him completely off guard.
"I'm sorry, Doctor."
"There are things I simply can't tell you."
Ethan blinked.
"What?"
She hadn't said "I don't know."
She hadn't said "Nothing's wrong."
And she certainly hadn't said, "There's a traitor—abort the mission."
Instead...
She had said she couldn't tell him.
"The Marker comes before everything else," Gianna replied honestly. "If you invoke it, I can answer your questions. But until then... I can't."
She paused before adding,
"And I strongly advise you not to waste your Marker on this matter."
"...This matter that's directed against you."
Against me?
Ethan repeated the words silently to himself.
He was beginning to understand.
After exchanging a few more pleasantries, they ended the call.
Ethan stared at the phone for several seconds before reaching a conclusion.
This could only be the High Table making a move.
And from Gianna's tone, it was obvious she had been excluded from whatever was happening.
As for what the High Table was planning...
...or why...
He still had no idea.
What have I even done lately?
I've just been treating patients, saving lives, and quietly running my clinic.
So why have they suddenly set their sights on me?
He shook his head.
Whatever comes... I'll deal with it when it arrives.
Just as he settled back into his chair, there was a gentle knock at the office door.
Helen peeked inside.
"Two people have brought in a patient."
"They were referred by a family member of one of your previous patients."
"Send them in."
A woman pushed an elderly lady in a wheelchair into the room.
A man followed behind them.
Ethan found the man strangely familiar, though he couldn't immediately place him.
The man smiled first.
"Hello, Dr. Rayne."
"I'm Kevin Pearson."
"I don't know if you remember me."
"Oh—Mr. Pearson."
The memory clicked into place.
Kevin Pearson.
The actor from the Pearson family in This Is Us—Randall's adopted brother.
He had accompanied William to the clinic once before.
"Of course I remember."
"How's William doing?"
"Very well."
Kevin nodded.
"This time I'm here with a friend."
"This is Sophie Inman."
"And this is her mother, Claire."
Sophie? A friend?
Ethan silently chuckled to himself.
Your ex-wife is your ex-wife. It's not like I don't know the story.
From the moment she entered, Sophie had been quietly observing Ethan.
His résumé was undeniably impressive.
But...
He looked far too young.
Nothing like the miracle-working doctor Kevin had described.
Still, she showed no sign of doubt.
Instead, she placed a thick stack of medical records on the desk.
"Hello, Doctor."
"My mother has multiple sclerosis."
"These are all of her imaging studies from the past three years..."
"...along with the MRI she had last week."
Ethan opened the top report.
MRI of the Brain and Cervical Spinal Cord (with Contrast):
Multiple oval T2/FLAIR hyperintense lesions were present around both lateral ventricles and within the centrum semiovale, distributed perpendicular to the lateral ventricles.
Patchy hyperintense lesion noted at the C3-C4 level of the cervical spinal cord.
No obvious contrast-enhancing lesions observed on the current examination.
A classic pattern of demyelinating disease.
"There are no active enhancing lesions at the moment."
He looked up.
"Correct?"
"Yes."
Sophie nodded.
"But her right leg has become significantly weaker recently."
"She drags it when she walks."
"Her muscle strength is about Grade Four."
"Her EDSS score is around six to six-and-a-half."
Ethan glanced at her with mild surprise.
Her answers were remarkably precise.
Almost too professional.
He flipped through the older scans from three years ago.
Back then, there had been fewer lesions...
...but the distribution had already been typical.
"So..."
"It started as relapsing-remitting multiple sclerosis?"
"Yes."
Sophie answered immediately.
"She suffered two relapses during the early stage."
"She received high-dose methylprednisolone pulse therapy both times."
"About three years ago..."
"...her neurological function began declining continuously."
She paused briefly before continuing.
"Her neurologist believed she'd likely entered the secondary progressive stage."
Ethan studied the MRI report before looking up.
"The absence of contrast enhancement means there's no active inflammatory process."
"But her neurological function is still declining."
"That fits the clinical picture of secondary progressive multiple sclerosis—SPMS."
Sophie nodded.
Ethan set the report aside completely.
"What treatment is she currently receiving?"
"In the early stages, she was on interferon-beta."
"Later, she switched to fingolimod."
"Once the disease became progressive, the benefits were limited."
"So now it's mostly supportive care."
Her voice remained composed, but beneath that calm lay the exhaustion and helplessness of someone who had spent years caring for a loved one.
Ethan looked at her thoughtfully.
"You've done your homework."
"I'm a nurse."
Sophie answered matter-of-factly.
"And I've been taking care of her every day."
The room fell silent.
A thought suddenly crossed Ethan's mind.
She'd be perfect for the clinic.
If he remembered correctly, Sophie was the head nurse at a Manhattan hospital.
Professional.
Capable.
Exactly the kind of person he had been searching for.
A head nurse practically delivered to my doorstep...
He suppressed a smile and continued the examination.
"Let me confirm a few more things."
"How's her bladder function?"
Sophie answered without hesitation.
"She has mild neurogenic bladder symptoms."
"Cognition?"
"Mild decline in attention."
"No significant impairment of executive function."
Ethan nodded.
Her answers were concise and precise.
"If she suddenly developed severe weakness in both legs today..."
"What would be your first step?"
Sophie looked slightly puzzled by the question, but she answered immediately.
"Rule out infection first."
"Urinary tract infections and respiratory infections can both trigger a pseudo-relapse."
"I'd also order CRP and electrolyte tests."
"And obtain a contrast-enhanced MRI if necessary."
"If it's confirmed to be a true relapse..."
"...I'd consider high-dose methylprednisolone pulse therapy."
Ethan remained expressionless.
"And if the MRI still showed no enhancement?"
"Then it's disease progression, not a relapse."
"Steroid pulse therapy wouldn't offer much benefit."
Standing nearby, Kevin finally couldn't hold back any longer.
"Wait a second."
"Dr. Rayne..."
"We came here for treatment..."
"...not a nursing board examination."
"Of course not."
Ethan replied calmly.
Then he abruptly changed the subject.
"If you were the nurse responsible for managing a patient like this over the long term..."
"...what would you do?"
Sophie blinked in surprise.
"Establish regular follow-up visits."
"Use functional assessment scales."
"Provide psychological support."
"Educate the family."
"Managing a chronic illness is a long-term battle."
"It's not something that ends after a five-minute consultation."
Silence settled over the room once again.
Ethan couldn't help smiling.
It was the smile of someone who had just found exactly what he'd been looking for.
This wasn't simply a caregiver who had become knowledgeable through experience.
This was genuine professional excellence.
Exactly the kind of person Rayne Clinic needed.
Kevin looked back and forth between the two of them.
"...Did I miss something?"
Ethan ignored him.
"May I ask which hospital you're currently with?"
Sophie frowned slightly.
"Manhattan General Hospital."
"You're the head nurse?"
"Yes."
Ethan nodded.
He'd heard enough.
Now...
No.
First, let's treat her mother.
He walked over to Claire and crouched beside her.
His movements were gentle.
He performed a brief neurological examination.
Mild spasticity in both lower limbs.
Hyperactive knee reflexes.
Plantar stimulation...
The great toe extended upward.
"A positive Babinski sign."
He wasn't surprised.
Sophie quietly added,
"It's become progressively worse over the past two years."
Ethan nodded.
"Classic upper motor neuron findings."
"The spinal cord is primarily affected."
He stood and turned toward Sophie.
"Conventional medicine can suppress the immune response."
"It can slow disease progression."
"But it cannot repair myelin that's already been destroyed."
Sophie nodded.
She knew that better than anyone.
Ethan's expression became calm.
"But..."
"In certain circumstances..."
"...demyelination can be repaired."
Instinctively, Sophie shook her head.
"Once the central nervous system axons are damaged—"
She stopped mid-sentence.
Ethan had already placed his hand gently on Claire's shoulder.
A warm...
...quiet energy filled the room.
There were no machines.
No medication.
The doctor simply rested a hand on his patient.
For the briefest instant, the light before Sophie's eyes seemed to shimmer.
Her first reaction wasn't shock.
It was disbelief.
She blinked.
As a nurse, she had witnessed every tool modern medicine could offer.
Cardiac monitors.
MRI scanners.
Neurophysiological testing.
Immunotherapy.
But...
She had never seen anything like this.
Claire's fingers moved.
Not a spasm.
Not a reflex.
They bent and straightened slowly...
Deliberately...
Under her own control.
Sophie's breathing caught.
Her mother hadn't been able to make a voluntary movement like that...
...in three years.
"This..."
Her voice was barely audible.
"This isn't immune suppression."
"And it isn't normal neurological recovery."
She slowly looked up at Ethan.
For the first time, cracks appeared in the calm, rational composure that had never left her face.
It wasn't doubt directed toward the doctor.
It was her understanding of the world itself beginning to crumble.
"This..."
"...doesn't belong to conventional medicine."
Ethan met her gaze.
"The world..."
"...has never contained only one kind of medicine."
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