“Hannah Banana!” I said. “How’s it going on the hoo-ha service? Did you deliver any babies yet?”
“Oh my gosh! I love it! My first call night I delivered three, and it was as miraculous as everyone says,” Hannah burbled, her big hazel eyes alight. We all loved Hannah. She never lowered herself to the level of the rest of humanity by saying derogatory things about others, unless the person in question was a full-on troll. Even then, she sounded about as menacing as a toddler armed with a wet noodle.
“Are you serious?” Georgia howled. “All we’ve done on pediatrics so far is listen to recordings of heart murmurs.”
Graham, who had been assigned to the internal medicine service in the adjacent veterans hospital, weighed in. “The med students do everything at the VA,” he said. “All the blood draws and EKGs. Whether we have any idea how to do them or not.”
“So, it’s one procedure after another all day?” Georgia asked.
“Well, no,” Graham admitted. “I spend a lot of time in the smoking room with the old guys.”
Emma looked alarmed. “You don’t smoke,” she said.
“I know,” Graham said. He smiled at her: an easy, happy smile. “But I like listening to them tell their stories about the old days. They’re great guys. Some of them were on the beach at Omaha, or they fought in the Mekong Delta. They know stuff we can’t imagine.”
“Well,” Georgia said. “I’m bored. The good thing is that I can definitively rule out peds as a career. I need more action. Speaking of which, let’s leave the Casanovas over there and head out. We can take the Cam.”
We glanced at the guys. They seemed to be making progress; they had moved from the bar to an inexplicable grouping of club chairs clumped in a curvilinear arrangement facing the bathroom doors. The chairs had once been chenille-covered but now were so thread-worn and grubby that patches of stuffing had emerged, resembling scattered mold spores. This did not deter the guys at all. They were clearly misrepresenting themselves as clean-cut, functional doctors, judging by the rapt, admiring expressions on the undergrads’ faces.
“That’s going to end badly,” I pointed out. “Let’s go.”
After we purloined the Cam’s keys, there was a brief skirmish over who was most fit to drive. (Hands down, this was Emma, who rarely drank alcohol.) En route to a more glamorous locale, I found myself daydreaming about Dr. X. Since our interaction in the garage last week, I had watched him eagerly at the hospital, memorizing every curve and plane of his beautiful face, every intonation of his words, but we had not once been alone together and he did not seek me out. Still, when he looked at me, I could discern an extra layer of meaning in his glances; his face didn’t convey the same interest when he spoke to Ethan, the other med student on our service.
It would have been splendid to be able to drop a little conversational bomb with the girls: Did I mention that my chief asked me out? They’d blow my eardrums out with their excitement. But it would have been foolish to bring it up now, after some generic flirtation. The entire hospital, down to the last comatose patient, would know every detail in about thirty seconds if I told my friends, and then thirty seconds after that, it would get back to him and he’d think I was a delusional blabbermouth.
—
“Good morning, ladies,” intoned a male voice. Graham. He sounded unusually . . . upbeat. Graham was the stoic variety of guy, big and quiet, although sometimes he’d pipe up with a zinger that would leave the rest of us howling. His father was rumored to have a business empire worth gazillions from the manufacturing of some widget, but Graham dressed like a homeless guy and didn’t display any overt signs of wealth, so it was hard to say whether this was accurate. I glanced up at him from my location on the living room carpet, where I was curled up against Georgia.
“Hope everybody slept well,” Graham said.
“Why are you so chirpy, Graham?” Georgia groaned. “It’s the crack of dawn!”
“It’s eleven o’clock, George. I’m starving. I couldn’t wait any longer to wake you guys.”
“To make us breakfast?” Georgia mumbled hopefully, having fully returned to a prone position with her face smashed back into the hideous shag carpet.
“Uh, no,” Graham said. “Let’s go to Twig and Leaf.”
“Graham, you don’t even have a couch. How are you living like this?” I queried, looking around the desolate space.
“Oh, this isn’t my place. It’s Mack Wolfson’s, but he already left. C’mon, princess,” he said, nudging Georgia with his toe. She looked like she might bite him, so he hastily shifted to Hannah. “If we can find it, the Caminator is rolling out in five.” He strolled out.
“What the . . . ? Has anybody ever seen Graham so peppy?”
Hannah abruptly leapt to her feet, startling everyone. “Wait, Graham!” she called. “Where’s Emma?”
With a trace of envy, I noted the glow in Graham’s voice as he answered.
“She’s with me.”
—
Twig and Leaf was, predictably, packed with bleary-eyed students. While waiting for a table, I sidled over to Emma and gave her a discreet but enthusiastic nudge. “What’s going on with you and Graham?” I whispered. “I thought you said it was over?”
“Can’t hear you,” Emma shouted. “What’s over?”
Graham looked at us. “Um,” I said. Vivid morning sun streamed in through the restaurant’s big windows, animating everyone’s features and lighting up Graham’s ugly, migraine-inducing striped shirt. He smiled at me.
After an eternity, a booth finally opened up and we dive-bombed in, not bothering to wait for it to be cleaned.
“Oh, Zadie,” said Graham, draping an arm around me. “I heard something interesting about you and your chief resident yesterday.”
“What?” I said, excited.
“He was talking to somebody in the cafeteria. I think the term he used was ‘cerebral jailbait.’”
I beamed, and then bit my lip. “Wait. Is that good?”
Graham grinned at me. “I think it means he—”
I was beginning to inflate with wild, inappropriate hope when Graham was interrupted. Over the years, Georgia had earned the nickname “Princess Spills-a-Lot” by virtue of her perpetual clumsiness, and true to form, she managed to knock over a mug of somebody’s used coffee before Graham could finish his sentence. A cascade of dark liquid went airborne and dumped itself onto my chest. I looked down. I was wearing a pale pink shirt made of fine cotton, which was now translucent and plastered to my breasts.
“Aw, HELL no!” hollered Georgia, aghast. “Dude! I’m sorry.”
A table of raucous undergrad frat guys facing us pointed out the obvious. “Wet T-shirt!” chortled one dolt in delight. Whistling erupted.
I sat frozen. I had on a very thin bra that provided no cover in this spectacle, and since it was summer, no one had a jacket to offer me. I folded my arms across my chest. Across from me, Graham blinked. He fluttered his head violently like a dog shaking off water (Breasts! So mesmerizing!) and stood. The next thing I knew, he had pulled off his own shirt and draped it across me. “Thanks,” I whispered, meeting his warm eyes. “Maybe I’ll duck into the bathroom.”
Graham nodded. “I don’t need that shirt back,” he offered.
Georgia agreed. “Please don’t give it back to him,” she said. “It’s straight-up Flock of Seagulls.”
“Georgia, you’re wearing an orange tuxedo shirt,” Graham pointed out.
Ignoring the banter, I slid out, creating a rustling rearrangement in the booth. Georgia followed me, disregarding the belated arrival of a waitress with some towels. We waded through the catcalling undergrads, not looking back at the table where Hannah was patting Graham on his magnificent bare chest and Emma was staring ahead, an empty look on her pretty face.
Chapter Eight
THE MENTAL FORTRE
SS
Emma, Present Day
Zadie followed Buzzy’s ambulance so I’d have a way to get home after we turned him over to the surgical team at the hospital. She waited outside, apparently deterred by the thought of entering the ER in her bathing suit cover-up, a worry that also occurred to me. But I had no choice: Buzzy’s makeshift airway was too precarious to leave in the otherwise very capable hands of the EMTs. He regained consciousness in the ambulance as his oxygenation improved, so I made the call to sedate him. God knew what he must have thought, awakening to a searing pain in his throat as I hovered over him, half-naked and bloody.
When we pulled up to the ambulance entrance, I hesitated: Mary Sarah had given me my cover-up, but it was sheer and hot pink, and I was still barefoot. Could I dare hope that no one would recognize me out of context?
Everyone recognized me. I jogged alongside the gurney as the EMTs hustled us into the ER, collecting a crowd of fascinated onlookers as we went. The ER expected us, of course, and they knew the basics, but EMTs don’t give any identifying information when they call in over the radio. Therefore, no one was expecting to see me, one of their busiest trauma surgeons, arriving in a bikini with one of the city’s most prominent citizens who’d just had his throat ripped open with a steak knife.
It takes a lot to break the concentration of ER doctors. But my attire seemed to be doing just that. Everyone’s mouths fell open as they caught sight of me.
“Where’s the trauma team?” I asked the ER attending, who was sponging Betadine over Buzzy’s throat in a belated attempt to sterilize the area before replacing the tube with something more stable.
“Trauma’s not taking him,” she replied, ripping open a cric kit.
“They’re not? Who is?”
“He is,” she said, motioning to a guy who had just entered the room, his back to us as he donned a sterile gown.
“Who’s that?”
“Well, we had quite the discussion about which service should wind up with this patient,” she said. She nodded to a nurse, who began injecting medication into Buzzy’s IV. “There was some disagreement over what kind of patient he is: Trauma? ENT? Internal medicine? We paged trauma, but they refused, on the grounds that an emergency surgical procedure doesn’t constitute a trauma.” She eyed the hole in Buzzy’s throat. “Perhaps arguable, in this case. Then we tried internal medicine, but they declined because everyone always wants them to admit everything, and they’re sick of it, yada, yada. ENT agreed to do the scope—they should be here in a sec—but they refuse to admit because specialty services always refuse to admit. So general surgery’s gonna wind up with him in the SICU.”
“Oh,” I said, starting to add an apology on behalf of my trauma colleagues, when the guy in the yellow gown turned around.
“Have you met Dr. Xenokostas?” asked the ER doc. “He’s new. Hepatobiliary surgeon, but he’s taking general call today. Nick, this is Emma Colley, one of our trauma guys.”
Nick and I stared at each other with identical expressions of shock.
I mumbled something lame about not being dressed for the occasion and bolted from the ER before Nick could say anything, my heart hammering a furious staccato beat. Zadie must’ve attributed my silence to distress about the emergency procedure, because she yammered on and on about my coolness under pressure during the ride home, thankfully sparing me from having to talk. Even though it was barely afternoon, I went to bed as soon as I got home, closing the blackout curtains in my room and pulling the covers over my head.
I loathed Nick. Not only because of what he had done to Zadie, but because he was an incarnate reminder of all my worst failings. It was one thing to know on an intellectual level that I’d have to see Nick again, and another to encounter him when I wasn’t expecting it. I tossed, wide-eyed, to a silent slideshow of hazy, jumbled memories and pushy flashbacks, tormenting me every time I closed my eyes: me, holding a man’s large, still, cold hand and feeling the weight of immeasurable shame descend upon me.
—
In the year 49 BC, Julius Caesar commanded his army to march across the shallow green waters of the Rubicon River in the north of Italy, committing himself to a treacherous course of action from which there would be no return. Caesar himself recognized the irrevocability of his decision, uttering the famous phrase “alea iacta est”—the die is cast—and in the process, he gifted the future with the well-known idiom “crossing the Rubicon.” We’ve all heard it, even if we don’t know its origin. I certainly didn’t when I was twenty-four. Nonetheless, that is exactly what I did. One day, I made a fateful decision that cast my life neatly into two halves: Before and After. Unlike most people’s Rubicons, my own personal point of no return was not subtle, or gradual, or something I didn’t recognize until it was too late. It was an obvious demarcation, a clean line in the sand. I knew what I was doing when I stepped over it.
What I didn’t know, and didn’t see until it was too late, will haunt me forever. It has taken me an immense amount of mental discipline to get to the point where I can function without allowing these memories to surface. I’ve had to build a mental fortress, a no-fly zone where none of it can get in.
And now my wall was crumbling.
—
Everything seemed slightly better by Monday, as I fixed yet another cup of the world’s most popular drug. This was already my second cup of coffee today, but that was fine. There was some good information about the health benefits of caffeine—decent research about decreases in the incidence of Parkinson’s and some forms of cancer and heart disease, and even things like headache reduction. So having multiple doses in a day was okay. But I knew from experience that any more than four cups and my hands might shake. Too much adenosine antagonism.
My God. I was boring even inside my own head. When alighting on a particular subject, other people’s minds did not fill with a torrent of evidence-based analysis of risks and benefits. Even if they were trying to avoid thinking of something else. Actually . . . what did other people think about?
“Wyatt?” I asked. “If I say the word ‘coffee,’ what comes to mind?”
Wyatt looked up. He had arisen unusually early and was searching for something in the kitchen junk drawer, probably his keys, which he refused to keep in a designated location. “Sex,” he answered promptly. He flashed his gleaming symmetrical teeth at me and resumed his mauling of the tidy junk drawer.
“What? Why sex?” I asked. I knew his keys were not going to be in the junk drawer, but I restrained myself from going over to reorganize. Now I’d face having to choose between being late to the hospital or leaving the junk drawer in a state of violated disruption, both of which would cause me some anxiety.
“That’s the male default mode,” he answered, triumphantly holding aloft a small rectangle of purple plastic. “Looky here, muffin! I found that Zip drive you needed. It was in the junk drawer.”
I sighed. “That’s where I keep the old ones,” I said. “Have you looked for the keys in the pants you were wearing yesterday?”
Wyatt tapped his forehead. “Brilliant!” he shouted, as if that wasn’t where he always left his keys. As soon as he left the kitchen, I whirled around and quickly lined up the contents of the junk drawer in their bamboo divider. Whew.
I acknowledged to myself that my behavior was even more type A than usual. This was probably secondary to stress and poor sleep over the weekend. But you have to endure.
Usually, I responded to adversity by manning up: I stayed calm, I calculated the most advantageous response to a situation, and I carried it out with maximum efficiency. The only flaws in the system occurred when I was faced with the emotional vagaries and unpredictable behavior of other humans. People who respond irrationally throw me off. But in this case, things were further complicated by unusual circumstances.
This time, the irrational person was me.
Chapter Nine
&n
bsp; TRAUMA SEASON
Late Summer, 1999: Louisville, Kentucky
Zadie
After the tantalizing burst of weekend bliss, I was back on call on Tuesday and again on Friday, trying to avoid staring at Dr. X every time we rounded together. It had only been a few days since breakfast at Twig and Leaf, but it seemed like a hundred years.
On the A Team, we established a rhythm. Ethan, the other student on the service, met me every morning at five o’clock to preround, give or take half an hour. Summer was trauma season, so this tended to be on the earlier side. Ethan was an ideal trauma partner; he didn’t care about getting procedures, he had a keen wit once you got to know him, and he was blazingly honest. We covered for each other, each of us double-checking the other’s work. In addition, Ethan showed up every morning with a delicious homemade vanilla cappuccino for me, and I’d given up on trying to get him to stop.
Clancy and Dr. Kalena and Dr. X met us at six o’clock to get an update on overnight events, although it seemed that most of the time Dr. X knew everything anyway. (Did he live here? Did he have spies?) Then we rounded again, for the third time, with Dr. Hollister, the attending surgeon, followed by formal trauma rounds in the TICU with Dr. Markham, the department chair.
On this particular morning, our OR day began with a laparoscopy—a surgery done via long slender instruments inserted through small incisions—on one of the patients who was suspected of having some complications related to his initial surgery. He’d had a steady and stubborn decline despite all indications that he should have been thriving, and Dr. X, who suspected Clancy of possibly having nicked the bowel during the first case, had scheduled a quick look with the scope. As Clancy finished writing orders, Dr. X got the ball rolling by prepping the patient, allowing me to make the initial laparoscopic incisions.
“Nice,” he said, as I carefully incised through the skin near the patient’s navel. “You have good hands. I’ve noticed that you’re good at keeping your cool,” he continued. “You’re fun to have around this month.”
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