Chapter 1

Tangled Darkness

Leslie Schoen glanced at her desk clock for the umpteenth time in an hour—five minutes had vanished since her last check. Izzy should have called by now. If time had to drag, at least she was waiting in a cozy, lived-in room. Stacks of medical books, journals, and files insulated her downtown Portland clinic office from the outside world. The early twentieth-century building held high ceilings and finished wood floors. Art and her credentials covered the walls. She easily connected with clients face-to-face from her little nook—settled behind the desk with an open side extension facing the room. The cherry furniture complemented the floor and its oriental rug. Floor lamps and spacious windows provided end-of-day light, and comfortable leather chairs added to the room’s warmth.

With all appointments completed and phone calls returned, Leslie stared at her mobile, willing it to ring. She fed her day’s schedule through the shredder under her desk, noticing her inbox sat empty for once in a long while. Her eyes took in a neatly organized desk. The day’s appointments passed quickly. As a psychiatrist, she juggled mundane paperwork and intense personal connections. Whether managing prescriptions or leading an emotional therapy session, her job was never dull.

The phone rang as she rose for a view from her streetside window.

At last. “Hey, hon, what’s happened?” She sat again.

“I have the best news,” Izzy spoke in a hush. “I’m still in the exam room. The doctor’s coming back any minute.”

“What news?” Her heart skipped a beat.

“I’m pregnant.”

She sat forward in her chair, glued to the edge, as shock rippled through her limbs like a charge of electricity. A new reality formed in her mind: motherhood before forty—she’d just make it. “Oh. My. God.”

Izzy’s breathing punctuated the sudden quiet between them.

Leslie sprang to her feet. “Wait. I’m closing the door.” Damon materialized just as she stepped toward the doorway. His sharp-angled cheekbones, dark circles under his eyes, and overgrown curly black hair made him look tired and thin, older than his thirty-two years. She pressed her phone to her chest to cover the microphone.

“You heading out soon?” He extended a handful of envelopes.

“On the phone. It’ll be a while.” She accepted her mail and closed the door. “Izzy?”

“I’m here. They’re getting info about our next steps, reminding me of all the other times. I keep running through our false starts while I’m waiting.”

Their last pregnancy flashed through Leslie’s mind like an old-fashioned horror story. “What about the labs? The blood test?”

“This time, I hope it’s different.” Izzy paced her words. “But the number is sky-high. It’s a definite positive, along with my exam.”

“Oh, sweetheart, we did it!” She harnessed her energy by walking back and forth. “How are you? Tell me everything the OB said.”

“Hold on.” Izzy sounded out of breath. A door closed in the background. “Gotta go! I’ll tell you all the details at home.”

Leslie’s face relaxed as Izzy’s enthusiasm swept through her. She snatched her coat, reflecting on the challenges fertility treatment dwarfed: all she’d endured to get and keep her Oregon medical license, finish psychiatric training, and start her practice.

She grabbed her purse and noticed a Personal and Confidential envelope from her licensing board among her tossed mail. Tearing it open, she read the opening line with confusion before starting again.

You are hereby notified that the Oregon Medical Board has opened an investigation into your potential misuse of the patient sample medication: buprenorphine and/or Suboxone (the combination drug with buprenorphine).

She didn’t prescribe Suboxone.

Her hands shook as she read the letter for the second time and grasped the allegation—that she had swiped controlled drugs. Potentially addictive drugs. The board’s assertion baffled her. Where would she even access Suboxone—the potent opiate buprenorphine, a DEA Class III with serious abuse potential and street value? The allegation made no sense.

“Really? Who would do this?” Images of Bryce invaded her mind—her officemate whose addiction treatment program dispensed Suboxone samples. She considered Michelle, their nurse—eccentric perhaps, but her unwavering commitment to patients was clear. And Sloan worked longer hours than any psychologist she’d encountered, his office well-worn after decades of service. She reread the letter, her gut seeping dread.

The complainant is, at this time, unnamed in our investigation. Your written response, required within fourteen days, will precede a formal interview. Potential consequences of failure to respond include, but are not limited to, suspension of your medical license.

Leslie threw the notice—the lie—back onto her tidy desk. This inquiry would stress her family just as she and Izzy reached for their dream—the pregnancy. Was it a mistake? Samples placed in the main sample closet instead of Bryce’s private safe?

After three years, she knew her handful of coworkers well. Despite sharing Bryce’s lease and renting his employees’ services, she intentionally kept her practice separate from his. If narcotics truly had vanished—if this wasn’t merely an administrative mix-up—the allegation must’ve been instigated by someone in his practice.

Was this payback? No doubt, Bryce’s attitude toward her had soured since she questioned his billing practices after their office manager left.

Leslie glanced at her closed door. Damon worked directly across the hall, but was like the younger brother she had never been given. No chance it was him.

She rose and moved to her far office window, the accusation’s weight pressing against her chest. Taking measured breaths, she tried to focus her scattered mind while overlooking a blustery downtown Portland, Oregon, at dusk. Wind swept the leaves into small, helpless spirals, its faint whirring audible through the glass. While viewing the street from the third story, trees and people walking the sidewalk apace drifted further away like in a murky, surreal dream.

Bryce alone distributed Suboxone samples and other buprenorphine opiates in their office. Had she misjudged when agreeing to share both staff and a lease with an addiction psychiatrist and his rehab team? While her adult psychiatry practice shared similarities, her focus on legally connected mental health cases distinguished her from the group. Remaining outside Bryce’s practice created enough distance. People with opioid addictions dotted her client list too. Still, she rejected his practice of treating opiate addicts with long-term opiates. When tampered with and misused, buprenorphine—bupe for short—was potentially lethal.

She caught a glimpse of herself in the window’s reflection—her long bangs pulled to the side from a casual side part, the sunlit highlights in her chestnut hair dim. She scarcely recognized herself. The board notice drained the color from her face, making her cheekbones and narrowly defined nose stand out starkly. At thirty-nine, this transformation had descended without warning—her brown eyes appearing black above the tight line of her rounded lips.

She hurried back to her desk and texted Bryce, who was lounging somewhere on vacation.

Need a call, must talk.

With a quick sweep, she gathered her laptop case and other belongings for the trip home. As she opened the door, Damon stepped out of the main sample closet at the end of the hall.

“Time for home?” He offered a weary smile.

“Yeah.” Though they’d been on the same team for years, Leslie’s gut said, wait. Did she misread this kid? She hoisted her bags onto her shoulder.

“What’s going on?” Damon’s brows rose as she brushed past him into the hall. He’d always been good at reading her.

Keeping quiet around a once-friendly coworker tested her resolve. She used to find him approachable, but now her wife was the only confidant she craved. Tonight, of all nights, Izzy would be waiting at home, probably wondering what was keeping her.

“I can’t go there right now. I’ll see you tomorrow.”

“Wait.”

She stopped and turned.

“Hey.” His pitch dropped. “You’re worrying me. Did something bad happen?”

Maybe she should have asked him what he knew about opiate sample deliveries, but he looked exhausted, and she needed to collect herself before broaching such a sensitive topic.

“Sorry, I’ve got to go, Damon. Bye.”

***

As Leslie drove through downtown Portland in the six o’clock rush hour, steam rose from manhole covers like apparitions haunting the cracked sidewalks. Homeless tents lined Burnside Street leading to the bridge, markers of lost hope. She recalled a stint with her licensing board a decade earlier. The dump she’d inhabited alone, a barren apartment, matched her emptiness while getting sober under the monitoring program required to keep her medical license. Surviving those first alcohol-free years tested her resolve daily, but meeting Izzy at two years sober multiplied their individual strengths—one plus one became three. Their synergy, connection, and eventually marriage buoyed her through varied, sometimes brutal changes.

Having to bring Izzy this bad news during their pregnancy celebration simply stunk.

As she veered onto Sandy Boulevard, the fading early evening light threw the surrounding trees into an altered dimension. With no reply from Bryce, she turned into a northeast neighborhood and tapped her dashboard for a Bluetooth call.

“Doctor Bryce Nelson. Message at the tone.” Beep.

“Bryce, I need your input on an office situation. Reach me as soon as you can.”

His failure to respond to her text typified Bryce’s recent behavior. Since persuading her to attend rehab for alcoholism years ago, he’d changed so much. Her mind flashed on the moment he convinced her that a life of sobriety was essential if she wanted to keep practicing medicine.

Now, so much more stood on the line. Her expanding family depended on her. This allegation threatened more than just her career. The DEA might investigate her narcotics prescription authority, risking many of the anti-anxiety and insomnia medications she prescribed. At least they wouldn’t impinge on her antidepressant prescriptions. Legal charges? Jail or probation? Loss of her license? Who knew? With her board history, scrutiny would intensify for every practice decision she made. What would the charge do to her relationships with her office clan and her arrangement to share handling after-hours calls with her friend and colleague, Susan Blake?

Her throat tightened as a tear rolled down her cheek, her skin burning underneath. She wiped the droplet away as though denying her tears would deny the fear behind them. Clamping her lips together, the certainty of panic pooled in her limbs, tingling in her fingers. Her vision blurred. She pulled over to a curb just as a flood of emotions—fear, anger, worry, love for her wife, their home, and the life they built together—spilled over into sobs. She leaned against the steering wheel as her shoulders rocked and the tears streamed down at a steady pace. The specter of old demons clamped down on her chest. As her tearfulness waned, she let loose the tension in her hands and shook them.

Remembering others who shared her struggle, Leslie took a deep breath. Izzy and their pregnancy needed her attention. The two of them had already endured so much together. She and Izzy had seen enough loss in the last year to overwhelm a funeral director. Her lawyer would compose and send a response to the board within two weeks. She planned to call him in the morning and sat taller. She reached into her bag for a tissue and told herself to snap out of it.

The mirror reflected a face drained by the emotional blast, but some healthy color had returned to her cheeks. She brushed her hair back to graze her shoulders. This crisis screamed, “Call your AA sponsor,” but the woman left on her honeymoon two days before. In the meantime, Leslie texted another program friend to arrange a call.

***

Excerpt from Tangled Darkness by MM Desch. Copyright 2025 by MM Desch. Reproduced with permission from MM Desch. All rights reserved.