by Radclyffe
Syd sighed. “I guess I better. I’m on call tomorrow night, and I should probably get out of here for a little while.”
“I’m about an eight-minute walk from here,” Emmett said carefully, picking her way through a minefield. “I’ve got a car. I can give you a ride home.”
“Oh,” Syd said quickly, “that’s really nice of you, but—”
“You do realize you’re nowhere near the subway line, right? You’ll have to grab a bus to get there?”
“On second thought,” Syd said, “a ride sounds perfect.”
* * *
After Emmett dropped her off, Syd was too wired to sleep. The trip that had taken her, Dani, and Jerry almost an hour during morning rush-hour traffic had sped by in less than half the time after nine at night. Emmett had been strangely quiet the whole ride and let her out in front of her house with a quick see you in the morning. A second later she was gone. Syd was grateful she hadn’t had to say much. Emmett had an almost mystical ability to get her talking about things she rarely thought about, let alone spoke of, without her even knowing she was going to say anything at all. She chalked her inattentiveness up to the crazy events of the day, certain she’d have a better handle on things in the morning.
When morning arrived a little after four on the heels of uneasy sleep and tangled dreams, grumpy didn’t begin to describe her mood.
She walked into the bathroom she shared with Dani and turned on the shower, resolved to stop worrying about Emmett and to concentrate on getting herself and her fellow residents back on track.
As the warm water sluiced over her face and down her shoulders, she admitted that might be easier said than done. Every time she let the weariness sneak in or relaxed her guard just a tiny bit, Emmett seemed to slip past her barriers. The past-Emmett and the present-Emmett blurred into one, no matter how many times she told herself they were completely different people, just like she was. She didn’t need that kind of distraction at work, and she definitely did not need the encroachment of the past into her life now, not after she’d so carefully and consistently shut it down.
She twisted off the water, stomped out, and grabbed a towel. “Done,” she muttered. “Done with thinking about what’s over and done, and done with thinking about Emmett McCabe.” She stared at her face in the mirror and pretended she didn’t see the shadows under her eyes. Slightly bedraggled and definitely not at her best. She narrowed them and glared. “You’ve been through all this once, and that was enough. Hear me? Done.”
“Hey!” Dani called from the other side of the door. “Did you score already?”
“What? No!”
“Then who are you talking to?”
Syd wrapped a towel around her torso and opened the door. “Myself. What if I had been in there with someone?”
“I would have opened the champagne, because it would have been like the first time ever.”
“We don’t have any champagne,” Syd grumbled, refusing to let Dani draw her into another conversation about the state of her nonexistent sex life. She twisted around Dani and hurried down the narrow hall to her room. Dani trailed along and waited in the doorway while Syd pulled on faded navy Franklin sweats and a matching tee.
Syd eyed her roomie. “What are you doing up so early?”
“Hungry,” Dani said. “That burger was, like, a year ago.”
Syd shook her head. Of course. “So are you cooking?”
Dani grinned. “There’s cereal.”
“Tell me it isn’t Cap’n Crunch.”
Dani’s grin widened. “Nope. I’m on a health kick. It’s Grape Nuts.”
Syd made a face. “I’m not eating that stuff straight out of the box. And we probably don’t have any milk.”
“I think there might be pizza,” Dani said as they walked downstairs to the kitchen.
“Please.” Syd set up the coffeepot, and the promise of caffeine lightened her mood enough for her to feign civility. “How’d the case go last night?”
“It was fun.” Dani swung her way onto the counter, settled in with a box of cereal between her knees, and methodically poked handfuls into her mouth.
Syd winced and tried not to watch. She found the remains of a loaf of bread in the refrigerator and made a slice of toast. She checked the half-empty jar of jam and decided since she couldn’t see anything white or green on the surface it was probably okay. Pulling out a chair at the table, she sat down to eat. “Who did you make an enemy of?”
Dani made an innocent face. “I have no idea what you mean.”
Syd snorted. “Whose case did you steal?”
“Oh. Sadie’s.”
“That’s a way to win friends and keep your service happy,” Syd commented.
“Sadie,” Jerry said, walking into the kitchen looking like Syd’s twin in his Franklin sweatpants and T-shirt. “She’s hot.”
Dani laughed. “Trust me, bud, you do not want to go there.”
“Why not?” Jerry stuck his hand into Dani’s cereal box and managed a handful before she pretended to yank it away.
“Because”—Dani held up a finger—“one, she’s a right royal…witch, and”—holding up a second finger—“two, she’s got a thing going for Emmett McCabe.”
Syd coughed on a bite of toast that went down wrong and hurried to get a cup of coffee to hide her outburst. Zoey and Sadie. Emmett got around. Maybe their brief affair had just been one of many.
“Not what I heard,” Jerry said. “The thing with McCabe is a flameout. Besides, Sadie’s bi.”
Syd turned with her coffee and leaned against the counter, feigning casual she didn’t feel. “And how do you know all that?”
Dani smirked. “I overheard one of the OR nurses talking about Sadie and McCabe.”
Jerry shrugged. “One of the PMC guys told me.”
“Really, Jer?” Syd said. “You’ve been bonding with the guys by discussing the female residents and who they’re sleeping with?”
Jerry looked from one to the other. “And you two haven’t?”
Dani and Syd spoke simultaneously. “Of course not.”
“Don’t worry, I never talk about you two.”
“Not if you want to live,” Dani muttered.
Jerry laughed, poured coffee into a travel mug, and headed for the hall. “Gotta shower. Be ready in ten.”
“So,” Dani said, fixing her own coffee. “You believe it? About McCabe and Sadie?”
“Don’t know, don’t care,” Syd said. “All I care about is getting the cases I need and staying far away from everybody else’s drama.”
“Good luck with that,” Dani said.
Syd didn’t need luck. All she needed was to remember what she’d worked for, for the last five years. She pitched the dregs of her coffee in the sink. “See you at the car.”
Chapter Fourteen
Syd’s decision to keep her conversations with Emmett McCabe limited strictly to surgery, to focus on the present and leave the past where it belonged, really wasn’t all that hard to do when she was too damn busy for the next few weeks to do anything but work. Every surgery resident from intern on up recognized the new order of things, and a not-so-subtle pervasive aura of competition permeated every encounter. Residents ignored the hundred hour per week limit, stayed well past their in-house on-call time, haunted the ER and trauma admitting area trolling for new cases, and scrambled to be the best informed on rounds and in the OR.
Syd got to the hospital before five every morning, and even Dani, who was a master at sleeping until the last possible moment, wasn’t complaining about leaving the house at the butt crack of dawn. Dani and Jerry were just as determined as Syd to outperform their PMC counterparts. Syd doubted she actually could outperform Emmett, but she was going to be damn sure she wasn’t in her shadow. They were both fourth years, and maybe Emmett’s experience with tertiary referral cases and major traumas surpassed hers, but she’d done more cases overall. She had the numbers, and she had the advantage in OR experience.
&
nbsp; Her days settled into routine, as much as anything about surgery could be routine. She met Morty in the ICU at five and reviewed the a.m. vitals, overnight labs and X-rays, and notes from consulting services involved in her patients’ care. If new problems had arisen during the night, she made sure Morty had ordered appropriate follow-up tests. Then she paged Hank for floor rounds. Hank turned out to be a sweetheart and a smart student, and even though she didn’t really need to see the stable patients before rounds with Emmett, she liked teaching Hank and he was super grateful. Med students were like puppies. Willing to do anything for attention and eternally bonded to their pack leaders. Training a med student guaranteed she’d have a resident who would have her back for life.
She made sure to stop by the OR and double-check the board for any after-hours add-ons or cancellations before heading to the cafeteria. Emmett would decide who scrubbed on which cases, but she wanted to make sure she was up to speed on all of them. By the time she, Morty, and Hank met Emmett in the cafeteria for formal rounds at six, the service was buttoned up. So far, Emmett had been fair in the allocation of cases, even though she could have taken all the majors for herself.
Today they only had two cases scheduled, and Syd was hoping Emmett would offer her a choice, as she sometimes did. She wanted to get in on the exploratory laparotomy scheduled for ten. The patient had been showing signs of sepsis and they’d ruled out everything except possible small bowel ischemia. With the rising white count, persistent fevers, and a suspicious collection on the abdominal CT, Quinn had decided to take a look. It was the kind of case where anything might happen—a gangrenous gallbladder, perforated small intestine, an abscess from almost any source.
She finished her second coffee just as they ended rounds. Now was the time, before Emmett assigned anyone to the cases.
“Hey, Emmett—”
“So, Syd,” Emmett said, looking pleased, “I’ve got a lead on a place for you.”
“Really?” Syd mentally shifted gears. Dani and Jerry agreed moving was a good idea, but no one had the time to look for a place. Syd was more than ready never to ride down Broad Street with Dani at the wheel again. For some weird reason, she still wasn’t sleeping very well, and the transportation situation was getting to be a real problem for all three of them. They were rarely ready to leave the hospital at the same time, and with only one car, she and Jerry were often left spending the night in the hospital or braving the subway system in the middle of the night. Neither one of them liked doing that.
“Right about now, I’d be willing to live in a trailer.” Syd narrowed her eyes. “It’s not a trailer, is it?”
Emmett laughed. “No, but…”
“But what?”
“Well, I don’t know how much you’ve seen of the neighborhood around here, but a lot of places are twins, you know, connected?”
Syd frowned. “I know, same for the Northeast. Why?”
“Because the place that’s opening up is the other half of the house where I live.”
Syd carefully put down her coffee. “Where you live. With Zoey and…”
“And me,” Hank chimed in eagerly. “That would be so cool.”
“Right. So cool.” Syd pressed her lips together. So, so not cool.
“Well, I know the landlord hasn’t listed it yet, so,” Emmett said, “if you’re interested…”
No. No way did she want to live practically in Emmett McCabe’s lap. No, no, and no. Syd swallowed. “I’ll talk to the others as soon as I can and let you know.”
“Sure,” Emmett said a little hesitantly, as if she’d expected Syd to be a lot happier than she appeared to be.
Any other time, Syd would be ecstatic someone else had done the legwork. Dani and Jerry would be too. A place within walking distance, big enough for all of them, would be perfect. Except for that one little glitch. Attached twins weren’t known for their soundproofing. She could just imagine sharing a common wall with Emmett and Hank and Zoey. Emmett and Zoey. No, no, definitely not. But it wasn’t fair to Dani and Jerry to just dismiss it out of hand, either. She didn’t really even have to ask them. If they could afford it, they’d definitely want it. So was she going to hang her friends up just because she might possibly overhear a strange noise and imagine something that might not even be happening? She wasn’t given to flights of fancy. It wasn’t as if they’d all be sharing backyard barbecues or anything. God, she hoped not.
“Really, thanks,” Syd said, trying to sound more enthusiastic.
Emmett’s pager sounded and she checked it. “Hold on everybody, that’s the chief.” She dialed an extension and waited a couple seconds. “McCabe…Morning…Okay, sure…Uh-huh. Right. I’ll get someone up there to get him ready.”
She ended the call and glanced at Syd. “That was Maguire. The OR just called and they moved up the ex lap to eight opposite the triple tubes. We’ll have to cover them both.”
“Okay,” Syd said. Now she’d probably end up doing the triple tubes, which was really a second year resident’s case, but…not her call.
“Why don’t I take Morty and we’ll do the triple tubes,” Emmett said. “You can scrub with the chief.”
“Really?” Syd straightened. “Sure. I better head up to the unit and get him ready to go. We saw him on rounds this morning, but I’ll check nothing’s changed.”
Emmett smiled. “Go ahead. I’ll be around if you need me.”
Syd rose and lifted her tray. “Thanks, Emmett.”
“No problem. Hank, why don’t you go with Syd.”
“Okay,” Hank said eagerly and jumped up to join her.
“So,” Syd said as she and Hank double-timed through the halls, “what do you think we might find?”
“Well…” Hank launched into a pretty decent differential diagnosis.
“Good,” Syd said as she hit the button for the intensive care unit. “Let’s say you find an abscess. Then what?”
“Um, drain it, and maybe put in a percutaneous drain?”
“Maybe?” Syd shook her head. “There are no maybes in surgery.”
Hank frowned. “Okay. If the bowel’s not involved, we leave it alone. If there’s perf or a lot of inflammation so that we can’t tell, then we do a proximal colostomy to divert.”
“Good,” Syd said. “So you’re sold on surgery next year?”
“Totally.”
“Any thoughts about what you’re going to do?”
“I was thinking I’d stick with general. I kinda like doing a little bit of everything.” Hank paused. “What do you think?”
“It’s a good plan. You can always change your mind and think about a fellowship halfway through.” She grabbed the patient’s chart from the rack. “And you’re staying here, right?”
He grinned. “Well, yeah. That’s the plan.”
“Well, yeah.” Syd laughed.
A moment later Maguire came in.
“You scrubbing in, Stevens?” Quinn asked.
“Yes. His latest H and H is ten and thirty-one. White count eighteen thousand. Platelets were normal this morning. Lytes looked good.”
“How about his blood gases?” Quinn frowned as she swiped through the patient’s records. “His last chest X-ray looked a little cloudy on the right side.”
“He had a repeat portable scheduled for this morning. I haven’t seen that yet. His blood gases were normal, though.”
“Hank,” Quinn said, “head down to X-ray now and dig out that film. Bring it up to the OR with you.”
“I’m on it,” Hank said and took off.
“I’ll see you in the OR,” Quinn said.
“Right.”
Syd went directly from the intensive care unit to the OR and checked the assigned room. The nurses were just opening the instruments on the back tables. Anesthesia was setting up their med pumps and checking their gas lines in preparation for anesthetizing the patient.
“Are we ready for an eight o’clock start?” Syd asked the circulating nurse.
“W
e should be,” he said, opening a pack of sterile sponges and dropping it onto the scrub nurse’s table. Syd waited while the two nurses opened the band holding the stack of sterile lap pads together and counted them individually. The scrub nurse then continued counting the instruments.
“What size gloves do you wear, Doctor?” the circulator asked.
“Sevens, thanks,” Syd said. “And our student wears an eight.”
“Thanks,” he said absently as he pulled gloves and opened them onto the table. He poured sterile saline into two basins and left to get another pack from the autoclave. Syd walked back to the holding area to check if they’d called for the patient.
“We’re about to call for him now,” the charge nurse in the pre-op area said. “We’ll be taking him straight back.”
“Okay, thanks.” Syd circled back to the ICU to help transport the patient.
By the time Quinn started the scrub, the patient was anesthetized and Syd was prepping the abdomen. When she’d finished draping, she stepped around to the left side of the table, the traditional location for the assistant when the surgeon was right-handed. Quinn would stand on the right-hand side.
Quinn came through the doors, bumping them open with her shoulder and keeping her hands up in front of her so any water would drip off her elbows and not down onto her sterile hands. The scrub nurse dropped a sterile towel over her outstretched arm and she dried off. As she walked to the table, Quinn said, “Stevens, come around to the right.”
Syd’s heart did a little jog in her chest, but she didn’t let her excitement show. She stepped up to the table, Quinn moved across from her, and Hank slid in next to Quinn. The scrub nurse moved her tables up next to Syd where she could pass Syd the instruments with no one in between them. Their shoulders touched. Surgery was an intimate affair.
“Are we ready?” Syd asked.
The anesthesiologist said, “Looking good.”
“Midline incision,” Syd said, looking up at Quinn.
“Sounds good to me,” Quinn said.
Syd held out her hand. “Scalpel.”
The scrub nurse slapped the knife handle into her hand. There was nothing quite as exhilarating as the feel of an instrument settling solidly in her palm, of closing her fingers around it and knowing that she now had control of everything that was about to happen in that room. She wouldn’t be alone, and she couldn’t do it alone, but the first move was hers, and with that, so was the responsibility. She put the knife two inches below the sternum and made the incision down the middle of the abdomen, curving gently around the umbilicus and stopping several inches below. With the sponge in her free hand, she pressed down on the edges of the incision and Quinn did likewise. They applied pressure simultaneously and the subcutaneous tissue parted enough that she could use the electrocautery to cut down through the subcutaneous tissue to the thin strip of dense fascia dividing the column of abdominal muscles. She lifted up with forceps, Quinn did the same, and she made a small incision entering the abdominal cavity. Cloudy yellow fluid immediately seeped out.
