by Barbara Ebel
I wish, he thought, but refrained from saying so. He only narrowed his eyes at her. “Poring over textbooks has been our agenda together, but now that is over. I’ll talk to you soon. Besides later and tomorrow, I mean.”
“Absolutely.” She shook her head. “Just get better and finish your course of antibiotics. One thing I’ll never do again is ask you to go running with me.”
“Sitting on the ground and letting a tick crawl into my clothes is my own fault. We’ll hit the pavement together in the future. Okay?”
“All right,” she said. Immediately, she came up with an idea. To give him a present. “Go home now and take a nap because you don’t want to miss Dr. Enno’s lecture at three o’clock. I bet she’s going to be phenomenal.”
Bob pulled away and she went inside. Jeez, she thought, that was like an Irish good-bye and they were going to see each other again in a few hours.
-----
This morning, Dr. Schott and the residents had taken care of all their patients while the students had taken their test, so Annabel figured she had the time to pop into the cafeteria and grab a late cup of coffee. She tilted the black lever and poured from the big dispenser.
“No one will know it was because of you.”
Annabel looked over her shoulder. It was Donn, holding a to-go cup like her.
“What?” she said, not understanding the meaning of what he said.
“You shouldn’t suffer any repercussions from Jordan. It was because of you saying that he cheated on the mid-term exam that Dr. Mejia and I planted a department spy in the back of the lecture hall this morning to monitor him.
“As far as we’re concerned,” he hissed, “we consider any student cheating through their training to be guilty of breaking the Hippocratic Oath and to have accumulated the grounds to be kicked back out into the general public. The medical school board will see it that way too.”
Annabel remembered her hand was still pressing down on the pour knob and she let go.
“I saw him with an open book again,” she said, “and saw him escorted out. Dr. Mejia must be disappointed.”
“Between you and me, Dr. Mejia needs to be less enamored by the likes of him. The best doctors can come from the quiet, scholarly ones like Stuart, or the ones carrying a smile and a humorous personality like Bob, or a smart, dedicated one empathetic to her patients like you. Not cheaters.”
He sighed while she reached for the powdered cream and stirred some in her coffee.
“Society is full of defrauders and schemers and charlatans,” he continued. “There is no way I’m going to look the other way. I have a nest of students and residents who I feed every day. None of them will fledge away from my supervision if they can’t soar with the feathers necessary for flight and independently fly with character.”
Annabel paid for her coffee. “Too bad it happened. We know how hard college students and others in the workforce prepare to gain admission. His spot could have been filled by another capable, honest med student.”
“So true,” he said as they made their way to the elevator and the doors snapped open. “Don’t talk too much about this or malign him. Not that you would. But you never know if someone like him will hire an attorney and claim some type of discrimination for booting him out and make up some nonsense about his cheating.”
“I understand.” She sipped the weak brew and the doors opened on the medical floor.
“The lawsuit from the atrial fibrillation case, Mrs. Helm’s kids, was enough.”
“How do you think it will end?”
He half-smiled. “Our attorney says they are softening and there is less legal activity. Maybe as the family’s grief fades, so will their demands for retribution of what happened … which was natural and in God’s hands.”
“I hope so, Dr. Schott.”
It was too strange when they walked into the team’s office. Their numbers had fallen yet again.
They were on call and the group was down to two medical students, two residents, one chief resident, and an attending who supervised like he should: not too much and not too little.
After a discussion about the content of the final exam and how they think they fared, Stuart was the first one to ask. “Where’s Jordan?”
CHAPTER 29
By the time the group lugged up the hospital stairs, Stuart and the residents heard a shortened version of why Jordan wasn’t with the team.
Stuart was the most dumbstruck and perplexed. “His actions don’t make any sense. Why risk everything he’s worked for by cheating? He couldn’t have gotten by solely finagling all this time on exams. The guy isn’t dumb. After all the preparatory years it took to get into medical school and then to land in the middle of his junior year, he took a chance to blow it all? Doesn’t make sense.”
“He’s just an arrogant dumbass,” Melody said.
“For sure,” Annabel said, “but I agree with Stuart. From a psychiatry or psychology point of view, his actions don’t make sense. It’s like he ramped up his risk of getting caught so that he could fall flat on his face and lose his future career. For some deep psychological reason like he was afraid of success. Or maybe he realized more and more that his future lifestyle in medicine was going to be different than he thought and subconsciously wanted a way out.”
“What do you think, Dr. Schott?”
“I did not give any thought to the ‘why’ he did what he did. You two bring up a prudent subject.” He opened the door of the staircase and let the team step in front of him.
“There is something going on with him. Perhaps an excellent psychotherapist can get to the root of the what and why. I’m going to mention mental help therapy to Dr. Mejia because he’ll be talking to the medical school board. Even if Jordan is out of medical school for good, offering assistance or concrete suggestions to ‘turn him around’ is the right thing to do.”
Annabel and Stuart glanced at each other and concurred.
“One thing’s for sure,” Stuart said, “he’s not going to be any cardiologist.”
Donn took a big sigh as the ICU doors broke open and he herded them forward. “We didn’t make it to the unit early this morning. Let’s check how Jae Nixon is doing.”
They crowded through the doorway of Jae’s cubicle and perched themselves at the bottom of the bed.
“Will you look at this?” Dr. Schott said.
Not only were Jae’s toes and ankles flexing, but his right arm suddenly slinked over and stopped to rest on his abdomen. Donn reached for Jae Nixon’s bedside chart, scanned his overnight vital signs, and nodded.
Jae’s day shift nurse bustled in. “Out of the blue, he started moving purposefully around 3 a.m. That’s what the night nurse told me, but Dr. Enno hasn’t been in yet. Boy, is she going to be taken by surprise.” She stood there like she was seeing him move for the first time.
Annabel took a double take at Jae’s arm. “Dr. Enno is giving grand rounds later. Maybe she adjusted her schedule.”
She inched along Jae’s bedside, patted his tattoo, and wrapped her fingers around his hand lying on his abdomen.
Melody scanned the ventilator settings from the day before. “May I see his ABG results from this morning?” The nurse left and reappeared promptly with the lab result.
“He’s picked up on his own rate since I decreased his setting yesterday. Let’s evaluate his blood work.”
Donn peered over her shoulder. “Looking good. Pass this around. Mr. Nixon’s pH is normal and his oxygenation and CO2 is the best it’s been. We’re getting close to a full turn-around. His brain swelling has subsided enough to not be a major concern anymore and his urine output is perfect.”
Annabel gasped as she felt Jae’s fingers return a weak squeeze. She studied their hands. For a second, she thought she was out of line. It could be construed like the holding of hands between two best friends or loved ones. But, nonsense, she thought. If this human touch he was feeling was therapeutic for him, then it was as important as the vent
ilator, the IVs, and the medication they’d been giving him.
He hugged her fingers again with his own and then she darted her eyes to his face. Like a polar bear awakening from hibernation and slowly assessing his surroundings, Jae’s eyes both opened. Annabel couldn’t contain the squeal of excitement which escaped from her lips.
“Look!” she told her teammates.
“Jae,” she said, “you’re in the hospital because you’ve been very sick. Time to wake up!”
Donn and Melody moved further towards the head of the bed on the other side. Tentative smiles came over both of them. Donn grinned. He approved of Annabel talking to him … her words, her soft voice, her reassurance.
Jae struggled to keep his eyes open. He blinked multiple times, which seemed to help. The people around him became clearer. He widened his eyes further, stretching them awake, as if clearing the cobwebs away after being closed for so long.
“You’re making excellent progress, Mr. Nixon,” Donn said. “We’re right here for you … in the intensive care unit. Now that you’re awake, the next step will be to get you out of here. You can wish for that, okay? Make it your goal.”
Jae squeezed his eyes closed as if he took comfort in everyone’s words. His respiratory rate was adequately overriding the respirator. He slipped his hand out from Annabel’s and scrambled it up to the tubing from his endotracheal tube to the ventilator. He emphatically signaled. He wanted no more part of these artificial contraptions. They had served him well, but it was time to test the waters and see if he could totally breathe on his own.
His hand now wrapped around the endotracheal tube and he moved his head forward off the pillow slightly.
“Whoa,” Annabel said and glanced nervously at Donn for instructions.
“He’s ready, Dr. Tilson. You can pull it.” He looked at the RN and asked her to send respiratory therapy in.
“Wait, Jae, it will be much safer if I take your tube out.” She suctioned out the scarce secretions in the tube and peeled off the tape along his mouth and tube. She deflated the cuff - which helped lodge the tube in his throat – with a syringe, and pulled out while he gagged and sputtered to be rid of it.
“Take a deep breath. Show me what you can do.”
The respiratory therapist was next to her in a flash. “Nasal cannula or mask for a while?” he asked.
“Let’s give him a moment,” Donn said.
Jae coughed a few times and took deep breaths. He wiggled his fingers at them. “I’m fine,” he stuttered. “Breathing naturally feels so good. I don’t know how long I’ve been here and I have a million questions.” His eyes settled warmly on Annabel like he had known her a long time.
“All in due time, Mr. Nixon. All in due time.”
The team lingered at the doorway for some time as new bloodwork was drawn on Jae and they were assured he was fine with receiving oxygen just by a nasal cannula.
Like some script for a “magnificent five” medical team, the residents and students peeled away from the unit. They strolled past the grand windows of the waiting room.
“Dr. Enno is going to birth a canary when she hears about Jae’s progress,” Annabel said. At that, she laughed out loud because Solar also popped into her thoughts. “Sorry, I was thinking about a bird I know.”
“Yes,” Donn said. “He opened his eyes and you extubated him. And to top it off, he seems, at least so far, like his mental status is intact and no worse for wear.”
Donn cocked his head towards her. “What bird?”
Annabel was so bemused thinking about Dustin’s parrot, she grinned mischievously and couldn’t answer his question.
-----
Dr. Schott regretted the timing of their call day to correlate with Dr. Enno’s grand rounds. There was nothing he could do to change things around. He thought about asking Dr. Watt and Dr. Burg to stay at the hospital with him to help out since he’d be taking care of all their patients as well as any new admissions by himself. His seniority dictated that he should be the one to miss Dr. Enno’s talk, but he couldn’t let that happen to the rest of the team. Especially since her talk was born from the diagnoses brought forward from their own team ... of Bob Palmer and Jae Nixon.
Dr. Watt and Dr. Burg left separately and Annabel and Stuart crossed the parking lot together. The afternoon sky was bright with sunshine. For some reason, it made Annabel think of Easter Sunday when tulips blossomed and marigolds were as yellow as the sun.
Stuart clutched his car keys and since Annabel was hitchhiking a ride with him, she would experience a ride first hand in his 1984 black Jaguar Coupe. Besides studying all the time, he had at least held on to his main hobby of being a car enthusiast. She settled into the tan leather passenger seat, amazed at the pristine condition of the interior, and Stuart pulled away.
“What’s the number showing up on your odometer?” Annabel asked.
His eyes never left the road, but she could make out his proud smile, like a father at his kid’s winning soccer game.
“Eighty thousand, give or take a few.”
“Amazing. Don’t you hate to drive it, though? Accumulate more miles and chance making the body rusty and worn?”
“What’s the point in having a classic car if I don’t use it? I’m not Jay Leno and didn’t buy her to store her away. I’m gonna use this baby.”
“I would do the same thing, but I thought that would only happen with a minority of people owning old cars.”
“Probably so.”
She enjoyed riding in the Jaguar as well as his careful driving. There was more personality to Stuart than she previously guessed. Funny how many of the people you work with, she thought, have personal aspects to their lives that you never know about.
Stuart took the exit off the interstate. “I’ve been looking forward to Dr. Enno’s lecture for a week,” Annabel finally said. “And it’ll be reassuring to see Bob back at a clinical function. He’s been gaining his strength back. I’m hoping he won’t tire out too much by attending.”
“Since he also sat for the test this morning, you’re right. This is like a spring break’s amount of activity for him in one day. He’s having a heck of a first day out.”
The only parking outside the building was metered and Annabel shoved quarters into the machine. They both went inside to the second floor lecture hall, different from where they’d taken their test, although there were high tech screens and gadgets in the room as well. The absolute first thing they did was to scan the room for Bob.
Not seeing him in the crowd, they took seats in the middle of the room as a young man from the tech department helped Dr. Enno set up in front. Dr. Mejia was also seated in a forward aisle.
“Do you think we should tell her about Jae Nixon?” Annabel asked.
Stuart grimaced. “We should let her to concentrate on her lecture, in my opinion.”
“Okay. You are being more objective than I am. I won’t disturb her.”
Bob ambled in and gave them a subtle wave as he made his way into their aisle. He handed Annabel an envelope as he lowered himself next to her.
“What’s this?”
“I stopped at the department office and, on the way out, the secretary asked me to give this to you. It’s addressed to you.”
Perplexed, Annabel squinted her eyes. The envelope was sent to her care of the internal medicine department and the return address was from May Oliver, her lung cancer patient who had recently passed away. Her lips quivered with sadness when she realized May must have written it before her death and put the note in the mail herself or maybe her mother had.
She peeled it open and unfolded white stationery with a pale blue border. The handwriting was written in black ink, a feeble attempt at being neat and pretty. But May had nonetheless done her best with the circumstance she found herself in at the end of her cut-short lifespan.
The writing filled the paper like May had measured out her words to fit perfectly. She read from the beginning.
Dear Dr.
(student) Tilson,
I am happy with myself to fire this off to you, yet I believe you will be sorry to hear that I am no longer here.
I have no idea if doctors ever receive ‘thank you’ notes from their patients, but I suspect since you are in training, this will be your first one.
Thank you for your help in taking care of me and especially for your kindness which made it more personal for me … like we were friends and that you really cared. Going through the lung cancer was more difficult for me than the time I spent serving in Afghanistan and I found it ironic that I made it home from there only to be attacked at home by an adenocarcinoma. Particularly because I never smoked.
I’m writing several letters to people who made it easier for me in the end and perhaps allowed me to face death in a more refined way by thinking there are magnificent people in this world.
I did truly miss my dog in the end after that terrible tragedy at the dog day care center and I know you are missing your family pet as well. Maybe someday soon you will be able to own your own dog despite your training and career. Please give the endearing creature love from me.
Don’t lose touch with your kind heart as you continue to train. There will be more patients like me who will appreciate you. And don’t worry about me … I’m probably where I should be.
Sincerely,
May Oliver
A tear fell down on the note before Annabel could swipe it away. Bob’s fingers landed on hers for a moment and then he withdrew his hand back to his lap. She set the letter on her knee and wiped her tears. After giving Bob a short frown, she folded the keepsake and inserted it back in the envelope.
“Are you all right?” he asked.
She nodded. “May I make a request? If you and I get a dog like we’re thinking about, do you mind if we name her or him ‘May’ or ‘Oliver?’”
“Not at all, but I have a request too.”
His tone was pleasant and light and she figured he was trying to make her feel better.
“If we get a dog together, I will be the one absolutely responsible to make sure that he or she gets a monthly tick preventative medication. I have experience with the downfall of what can happen to either one of us otherwise.” He tried on a smile to see if it would work on her.
