by Barbara Ebel
“Apparently, you alluded to the paramedics you had some palpitations at the scene; they also noticed a short burst of an arrhythmia on their initial monitoring. Since then, there has been no new abnormal palpitations and I think the precordial pain you are experiencing is attributed to concomitant musculoskeletal injury. Also, your EKG shows only minor electrical changes. We’ll monitor you overnight, I’ll check the lab work we ordered, and run another EKG in the morning.”
“Okay, but I wish I had a book to read.”
Dr. Singh cracked a small smile.
After what seemed like hours, an orderly came in and wheeled him past the ER desk, where he picked up Dustin’s chart.
“Thanks,” Dustin said to the ER doctor. “By the way, my girlfriend is rotating through the hospital as a medical student.”
“What’s her name?”
“Annabel Tilson.”
“She’s a bright one. We’d love to have her here if she decides to go into ER medicine.”
“I’ll pass that on,” Dustin said, and wondered what specialty his possible future wife would go into.
-----
Annabel woke with a start and a scare. She pressed off the alarm clock, which fully snapped her out of an OB dream … a dream of her having a baby, but she was plagued with the complications she witnessed on her rotation and doctors were manhandling her … so much so that it felt like an ambush against her privacy. She shuddered. How did millions of women go through this experience of childbirth, with or without the sometimes necessary manhandling?
She put a one-cup coffee container into her machine and drank the result as she dressed. During her ride to the hospital, she said little to the morning driver. She didn’t want any type of repeat conversation like last night. When she arrived on the OB floor, Emmett wheeled a cart by on his way to the supply room.
“Where is everyone?” she asked.
“They went back a little while ago to take over a C-section from the night team because they’re leaving. You should probably go back there.”
“Thanks, Emmett. I’d better hurry and change into scrubs.”
“By the way, I heard from the ER group downstairs that your boyfriend showed up there last night. Nice to hear you have a boyfriend, but I hope he’s okay.”
“What? Are you sure?”
“You didn’t hear from him? The ER doc said he is a cop. Is that true?”
Annabel reeled from the news. “That’s him. Did they tell you anything else?”
“Nope, except that they put him in the hospital.”
“Oh my God,” Annabel said, thinking the worst. “He could’ve been shot two days ago. Now what?”
Annabel changed into scrubs. As soon as she got out of the surgery, she figured, she needed to find out where he is. She stepped out of the locker room and bumped into Stuart.
“How’s it going, Stuart? Were you in on that C-section?”
Stuart nodded while Annabel noted he needed a smaller size scrub set; another person could fit into the ones he wore. “We started not too long ago. The baby’s out, so you’ve missed that part. The fetus showed signs of distress in the labor and delivery room, so the senior resident took the mother back to the OR.” He spoke softer. “I’ll still be glad when this rotation ends. This is not my thing.”
“Things have improved for me, Stuart. The chief resident isn’t with us anymore and the attending is doing some teaching.”
“You’re lucky. Maybe I’ll see you tomorrow morning. I’m going home to bed.”
“Hang in there and get some sleep. And, by the way, I’ve been assigned to give the next grand rounds. I hope you don’t miss it.”
Stuart’s face showed more expression than Annabel had ever seen on him. He stared straight at her. “A medical student? I’d be scared to death. How did you pull that off?”
“I fell into it.”
“When you fall, you fall hard.”
Annabel grimaced. “We’ll see. More importantly, I’d better pass the OB exam.”
“Goes for the two of us.”
Annabel frowned, watching her brainy fellow colleague go into the male locker room. No matter what, Stuart always pulled off the top grades in the class. She donned blue booties over her sneakers and realized she was going back to her first C-section.
-----
Annabel scurried into the OR. At the top of the table, Kristin Fleming had the patient under a general anesthetic and worked at a frantic pace since the case was winding down and she had lots of catch-up to do. Since a C-section’s blood loss was double the amount of a normal vaginal delivery, Annabel noted the bloody lap sponges. The RN counted each one of them to make sure none were left in the patient and Dr. Thomas was on the side doing the newborn’s assessment.
Dr. Harvey glimpsed at Annabel. “Not much going on here now. Too bad also that it’s not an open abdominal case like you’ll observe doing gynecology. Then your attending will interrogate you about pelvic anatomy.” He looked carefully at the closure of the uterus, stepped back, and snapped off his gloves, which meant he was letting Caleb close the skin.
“Make a note,” he continued to Annabel. “If that is the case, you may need to point out the ovaries, uterus, and fallopian tubes to your gynecology attending. Also the patient’s bladder, cervix, sigmoid colon, round ligament, pelvic floor. You must be familiar with the vascular structures, including the branches of the internal iliac artery; the uterine artery, utero-ovarian artery, and the infundibulopelvic ligament. Shall I go on?”
“I’m thinking back to gross anatomy. Also the broad ligament, cardinal ligament, and sacrospinous ligament.”
His eyes sparkled at her; he enjoyed anatomy so much. “It appears you’re ready for that. Perhaps you could go tell this patient’s husband that his new daughter and wife are doing fine. Last name is Moran. And follow up with this patient in recovery. Get her post-op labs, etc.” He turned his head away and went to the chart.
Annabel went back out, looked at the board, and went into Room 6. A man in sweat clothes and crumpled hair sat forward on the recliner rubbing his thumbs together. His five-year-old daughter twirled in circles. She wore a dalmatian pajama set.
“Good morning,” Annabel said. “Mr. Moran, your new baby girl is testing her lungs back there in the OR and your wife is fine.”
He jumped up. “Hallelujah, I was getting worried.” He stepped forward, and before Annabel could brace herself, he gave her a hug. He crouched to his daughter. “Teri, your sister is here.”
The little girl hugged her father and stepped back. “I can help take care of her, Daddy.”
“I bet you will.”
“What’s your name?” the little girl asked.
Annabel leaned over and the girl tapped the pocket of her scrubs.
“I’m a student doctor. Annabel Tilson.”
“I’m going to be a doctor when I grow up.”
“Really?”
Teri bobbed her head up and down.
“There will be a lot to learn, and remember to ask questions.”
“What kinda questions?”
“Like what do muscles do?”
“Walk. And move,” she shouted.
“What do your lungs do?”
“Breathe.”
“I’m impressed. What does your heart do?”
“Love.”
Annabel rose. “Wow. You are going to make a spectacular doctor.”
The little girl’s face beamed and she scooted off into her father’s arms.
Annabel rushed out to the lounge where she typed in Dustin’s name on the computer and found his room number. She was still clueless why he was admitted, but she knew it was a privacy violation to check his electronic medical record. He was, however, not admitted to the ICU, nor was he in a regular floor room. His room number fell under intermediate care with monitored beds.
Dr. Harvey paused as he made his way to the locker room. He pulled a twenty-dollar bill from his wallet. “The coffee pot is empty. Wo
uld you mind going downstairs and buying the three of us extra-appreciated coffees from the lobby?”
“No problem. What kind?”
“Three flavored cappuccinos or their special coffee of the day.”
“Dr. Harvey, would it be a problem if I first stop by to see a patient that I know?”
“No,” he said, waving his hand for her to leave.
-----
Annabel scrolled her iPhone as she rode the elevator and looked for any message from Dustin since last night. There was nothing. She worried that something had happened bad enough to land him in the hospital, but also saddened that he didn’t call. Was she really his “girlfriend?” Was he possibly seeing someone else? Her gut told her no; he was sincere and trustworthy. He was secure in his attitude towards his job but also with her. His personality reeked of composure and confidence. She admired his self-reliance and his thoughtfulness, and how many guys could attempt to keep an exotic pet and care for it with the same TLC that Dustin did? He was pretty amazing.
She stepped off the elevator, put her phone away, and landed outside his room, where she gently knocked.
“No need to knock,” Dustin said. “Come in.”
His jaw fell as she entered. Annabel put on the sternest expression she could. “Dustin Lowe, I’m furious you didn’t tell me that you’re here but, on the other hand, I’m ecstatic that you appear to be okay from whatever it was that you didn’t tell me!”
Dustin covered his eyes with his hand and then peered out from under it slowly. Hooked up to the standard monitors, he was relegated to a thin hospital gown like her patients. “I didn’t want to bother you last night. I was going to let you know today. Besides, the cardiologist hasn’t been in yet this morning, so I don’t have a clue if he’s going to spring me.”
“Cardiologist?!”
She sat beside him on the mattress. He brushed his hand along her long fingers and then wrapped his palm around them. “I’m sorry I didn’t call, but you need to focus on your situation. Everything has been under control, I promise. I was working an accident last night and was rear-ended by another vehicle while I was sitting in my car and catapulted forward into a pole. Paramedics chaperoned me in because of a cardiac contusion. They wanted to monitor me overnight, that’s all.”
She squeezed his hand. “There are two kinds of patients. The first kind screams bloody murder about pain if they get an invisible scratch on their skin. The second type of patient can have a limb fracture or a huge gash requiring twenty stitches and they barely complain.”
He twisted his lips. “I’m the second one?”
She tapped his biceps. “You know damn well you’re the second one.” She leaned over and kissed him. He pulled her in and kissed her again quickly.
“So how bruised are you?”
He jockeyed up his gown and showed her.
“Ouch.”
Annabel turned to the heart monitor and watched the tracing. Then she put her fingers on his pulse at his wrist. “Are you feeling any heart palpations or irregularity?”
“No, doctor.”
She hit him again. “As far as I can tell, your heart rhythm looks good. But I’m no cardiologist.”
“Yeah, what the heck. The heart serves two purposes anyway. One is to beat and one is to love. As long as I have most of the first, but all of the second.” His eyes fell on hers and didn’t deviate.
She glanced down; she could swear her cheeks were reddening. “Funny you should say that because an astute little girl just related that very idea to me.”
“She must be very smart, like you.”
“Let’s get back to you,” she said with a roll of her eyes. “But I do need to go because I’m almost due back on the ward. Text me as soon as you know something. You do have your phone, don’t you?”
He nodded towards the night stand.
Annabel rose, leaned over, and hugged him. “I’m glad it wasn’t worse. You could have gotten killed. Your week has been one thing after the other.”
“You don’t tell me everything, but I suspect your weeks are as bad.”
She raised her eyelids and turned to leave. “You’re right about that.”
“By the way, you’re a knockout in that white jacket.”
CHAPTER 27
Annabel gripped a take-out container with the hot cups, and after going back upstairs, she snapped off one of the lids. Kristin walked in the lounge untying the blue mask that dangled off her neck.
“Mrs. Moran is all tucked into the recovery room. Your resident is still in there.” She tilted her head over Annabel’s cappuccino. “Mm. I could do with one of those.”
“Had I known, I would have been happy to bring you one.”
“I’ll put coffee on. I can sit for a short time because, right now, no patients are due for an epidural or they already have one.”
“What are your plans after residency?”
“I’m staying here at the University and I’ll be an anesthesia attending. At least I can start paying off some bills.”
“Good luck. You must like teaching.”
“I do. And I notice you’ve been writing notes when you’re in here besides reading from the OB manuals.”
“Dr. Harvey gave me the task of preparing grand rounds for next week. I’m covering a few topics: physician burnout, medical errors, and maybe drug shortages. He wants it succinct and short, not like what the department would expect from a doctor like you.”
Kristin gave her a questioning expression from the counter. The water stopped dripping and she poured.
“I guess you’re wondering,” Annabel said. “Ling was taken out of residency, so I was put in her place for the talk.”
“Would you like a little help? I could fork over some information to you today, each time we get the chance.”
“Would you? I’d be so appreciative.”
“Drug shortages are a real and present danger. Remember I had to substitute a local anesthetic for an epidural? Those bullet points would fit into your talk very nicely and doctors in training should be aware of the problem.”
Annabel became more excited about her lecture. “I’ll be in here as much as I can. I’ll even bring lunch up later.”
“Okay, then, that makes two of us.”
Annabel stirred her drink and heard a familiar voice.
“Well, did you get to see him?” Emmett asked, popping his head in.
“I sure did,” Annabel replied.
“Is he okay?”
“His chest smashed into his steering wheel at an accident site. That man works a dangerous job. I think he’ll be fine and, hopefully, the cardiologist is discharging him today.”
Emmett’s smile grew wider. “Happy to hear that.”
“And, Emmett, thanks again for letting me know.”
The orderly waved and ducked back out.
“Somebody dear to you?” Kristin asked.
“My boyfriend. He’s a police officer. He didn’t even tell me he was taken to the hospital last night. I found out through Emmett.”
“Emmett’s the first to find out about anything around here. Sounds like your boyfriend doesn’t just protect the public. He shields you from worrying about him.”
“That’s his nature, I suppose. He’d do that with anyone he’s dating.”
“But you’re the one he’s chosen to date.”
Annabel nodded and raised her beverage. Kristin reached over for a sugar packet.
“What’s your status as far as dating?” Annabel asked.
“I’m married. Only for a year. Don’t tell anyone, but I’m two months pregnant.” Her face lit up like a young girl in front of a birthday cake.
“Congratulations. At least you know from working here what you’re getting into.” The two women giggled and Kristin leaned in.
“When the time comes, however, I’ll steer clear of this place. I’m not baring my anatomy to my colleagues!” They laughed again.
“I don’t blame you.”
&n
bsp; “Grab a notepad. Let’s start working on your notes.”
-----
Annabel checked on Mrs. Moran’s postop labs and found that her patient’s hemoglobin barely budged from her preop value of 14 g/dl. It was a tribute to how skilled Dr. Harvey was as a surgeon and also how healthy her patient was.
Kristin may be having her baby months down the road at another hospital, Annabel contemplated, but there were many skilled attendings who stayed on board at teaching facilities. She thought back to her other rotations. Her psychiatry attending, Dr. Keeton, had been one of her favorites. But Annabel saddened when she thought of the woman’s tragic fate, which would have never occurred except that she loved her specialty.
It was amazing all the things she had witnessed, the patients and physician teachers she worked with, and all the things she had learned since she began the third year of medical school. That realization warmed her heart.
Since Mrs. Moran was out of the recovery room, Annabel went back into Room 6. Teri sat in the big chair kicking her feet up and down and her father sat at the bottom of the bed.
“You just missed our baby girl,” Mrs. Moran said.
Andy nodded and said, “Glad you had that mother-daughter bonding.”
“And Teri held her.”
“I bet your heart is welling up with that love you told me about earlier,” Annabel said, looking at the little girl.
Teri stuck out her arms and widened them. “This much,” she said.
Annabel turned her attention to her mother. “Dr. Harvey is most likely going to ask me to give a medical presentation on you, Mrs. Moran. You were previously in the OR, so I didn’t yet do a history and physical on you. Do you mind if I ask you questions?”
“Not at all, especially since my pain is still under control since the recovery room.”
“Thanks to Dr. Fleming and the nurses.”
-----
Two hours later, Dr. Fleming tugged at Annabel’s coat sleeve in the hallway. “I can run downstairs and bring us back lunch, if you’d like.”
Annabel glanced up and down the corridor looking for Dr. Harvey and Dr. Gash. “That would be perfect because then I could run over and see my boyfriend, who hasn’t told me a thing.”
