by Barbara Ebel
“Call the OR,” a tall, slender doctor shouted. “Tell them we’re coming straight up.”
After gathering all the ancillary equipment attached to Sean, a group of people in scrubs wheeled the stretcher past Dustin. Blood hung from one pole and went straight into a large bore IV in Sean’s prominent vein in front of his elbow. An endotracheal tube jutted out from his mouth and a respiratory therapist squeezed on an Ambu bag to deliver oxygen to his lungs. But there was so much blood on the sheets, Dustin couldn’t fathom how much remained circulating around to the major organs of his best friend.
They rode an elevator to the second floor and Dustin stopped short as Sean and the ensemble disappeared behind the main door of the OR. He wrung his hands so tight, he glanced down to check for skin damage.
Soon Sean’s wife arrived and Dustin told her what happened and consoled her. But as the minutes ticked by, more family members appeared, so he slithered to the background, letting them have their space. After two hours of pacing and then sitting and jumping up every time someone exited the OR doors, he sat more still and his cell phone rang from his captain.
“How is he?”
“He’s in surgery and I don’t have one update.” Dustin clenched his jaw. He had never killed a man and dreaded asking the question. “What about the guy I shot?”
“He’s dead, Dustin. Taken to the morgue. He was a thirty-five-year-old. Going to the courthouse to pay his annual property taxes; apparently had a beef with the police over being temporarily locked up in the past for a domestic violence charge. We just learned he had a minor psychiatric history as well. He came around that bend to park and I guess he just snapped when he saw you two because of his beef with cops. You and Sean were in the wrong place at the wrong time.”
“Sean was.” Dustin turned and talked facing the window. “If I hadn’t been giving him a cup of coffee and discussing our weekends, we would have been in the station already. And that lunatic would have missed his opportunity.”
“Thinking about ‘what ifs’ won’t help you. So drop that train of thought. Shit happens or doesn’t happen and it has nothing to do with whether we make a right or a left turn.”
He let a silence pass. “I’ll call if the doctors tell me anything.”
Dustin hung up, sat in the corner, and hunched over looking at the tile floor. He placed his phone on the seat next to him, but it immediately dinged with a text message. He grabbed it and stared. It was from Annabel.
“Sorry you were so tired and stressed on Saturday. Hope I didn’t add to it because of dragging you to the dog show. Maybe you caught up yesterday with some R&R? Are you okay?”
He shook his head. You are sleeping with someone else, he thought, who you actually flaunt in front of me, and my best friend has been shot in the chest and may not live. No, I’m not okay. Dustin squeezed his eyes shut and covered his face. His lips trembled and he quietly sobbed into his own hands.
CHAPTER 18
Becky rounded up Annabel and Stuart in the hallway and asked them to take their lunch hour. They threw their white jackets on a chair, opened the front door, and stepped out to appreciate the fresh air.
“Those scones didn’t hold me very long,” Stuart said. “I’m ready for a fat burger.”
“Not me,” Annabel said. “I’m going light. Maybe their lunch special will grab my attention. All I know is that it feels revitalizing to get outside for a walk, away from strep throats and runny noses.” She inhaled and exhaled two big breaths.
“Are you over whatever was disturbing you?”
Annabel turned her head sideways and scowled.
“You’re right. We only have four more days to tolerate Gillespie.”
“So it is Gillespie?”
“Me and my big mouth. Being a student, I’ve often wondered about this. The board-certified, practicing physicians that teach and mentor us are approved staff through different university departments. They are human just like everybody else, and there are bad apples who shouldn’t be in the positions they have. I bet it’s political just like everything else is. What if you suspect a doc of not being on the up and up? I bet it would take an act of God to ‘fire’ them or let them go in a non-accusatory manner.”
“But, Annabel, there are lots of doctors we won’t like and patients won’t like either. Their practices don’t rise to the top. Their reputation and word of mouth about them spreads and serves to cull them out.”
They crossed an intersection, and when they came to their lunch place, they settled in a booth. “However, I bet you’re correct. Bad, dangerous, or inept doctors probably keep practicing way longer than they should before they are somehow weeded out.”
“My dad knew a surgeon who quit medicine after a huge malpractice suit.”
“There you go. I hope, however, he wasn’t a decent doc unjustly sued.”
“According to my dad, he deserved it.”
Annabel checked out the lunch special and then remained silent waiting for the waitress. She still had not heard from Dustin, but who contacted who during their relationship was never an issue. He should be back on day shift this week and maybe it was time that she pop him a hello and get a sense if anything was wrong. After all, she perceived a problem, but sensing it didn’t make it true.
The waitress appeared and Annabel ordered the special of grilled shrimp and pasta. She took out her phone and texted Dustin while Stuart ordered.
“Sorry you were so tired and stressed on Saturday. Hope I didn’t add to it because of dragging you to the dog show. Did you catch up yesterday with some R&R? Are you okay?”
After pressing “send,” she did not regret sending it. By ending it with a question, the message required a response. She took a deep breath and set the phone next to her placemat. Based on Dustin’s history, she should hear back from him by the time she and Stuart landed back at the pediatrician’s practice.
Stuart kept his head low while he ate his burger and Annabel savored the tasty shrimp. Her thoughts kept flashing back to the private exam she witnessed earlier as well as other moments when she disliked being in the exam room with Gillespie. On top of it, her mind darted to Dustin and monitoring her phone. Darn, she thought, why couldn’t she eat in peace and let her troubles take a backseat?
When they finished, Annabel and Stuart paid at the register. Uneasy and fidgety, she pocketed her iPhone after no communication from anyone. Maybe Dustin was wrapped up with work. Fat chance, she thought. It only takes a minute break to read a message and text someone.
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The students stepped outside from the restaurant to an overcast sky and a sultry afternoon. As they approached the corner, Annabel stopped. “I just remembered something. Remember my neuroblastoma patient from last week, Stephanie Miller?”
“I believe so. The father brought in his daughter’s urine sample.”
“She’s first on the afternoon schedule. Things got rough for her and her father last week and I vowed I’d give her a stuffed animal to add to the one she carries around.” She pulled at her long, wavy hair and looked around.
“This area is not a shopping mecca,” Stuart frowned.
“What about that card and stationery store across the street? They sell small gift items.”
“It’s worth a try. Let’s hurry or we’ll be late.”
They bounded across when the coast was clear, admired the storefront, and went in. Two shelves in one aisle were filled with small to medium-sized stuffed animals. “She had a panda, so I want to find something that would be a good match. I also promised her something she could give to her father.”
“Doubly kind,” Stuart said. “Good thing you remembered.”
A white leg with a black foot stuck out from a pile and Annabel plucked the rest of it out. “A baby cow with a cute face.”
“How about this one? An owl with big expressive eyes.”
Annabel nodded and paid in a hurry at the counter.
“You may be the first medical student,”
Stuart said back on the sidewalk, “to buy a small outpatient child a present, as well as a parent.”
“The circumstances presented themselves. It’ll never happen again, I’m sure.”
“There should be two points extra credit at the end of our pediatric test for this question, ‘Did you do any philanthropy for a patient during your rotation?’”
“Leave it to you to bring up a test!”
They came to the post with a prominent sign, “George Gillespie, M.D. and Heather Clark, M.D.” and stepped into the office. The waiting room buzzed with infants crying and young children playing.
Stephanie Miller stood between her father’s legs, patting on his knees. She grabbed her panda from the chair beside him as Annabel and Stuart approached.
The students nodded at Mr. Miller first. Annabel put the bag in front of her and crouched down. “Look what we brought you, just like I promised … two stuffed animals.” She lowered her voice. “One for you and one that you can give your dad.”
She filtered through the tissue paper in the bag and pulled out the animals. “A baby cow and an owl.”
Stephanie glued her eyes on the toys, which lit up her face. She studied them first and then took them in her arms and cuddled all three stuffed animals at the same time. Stuart lowered himself to their level and he said in a whisper, “Which one are you going to give to your dad?”
“The cow. I heard Mommy say that Daddy isn’t eating or drinking enough because I’m sick. Cows give milk, so my new baby cow can give him pretend milk.”
“You’re an amazing little girl,” Annabel said.
The door opened and a nurse called Mr. Miller and his daughter back into an exam room. “Thank you,” Mr. Miller said, looking back at Annabel.
“You’re welcome.”
Annabel and Stuart followed, peeled into their small room, and put their jackets back on.
“Now comes the part where Dr. Gillespie doles out more test results to them,” Annabel said.
“Then those stuffed animals you just gave her are worth their weight in gold.”
The students stopped speaking to each other as they diligently followed their attendings into the first afternoon appointments. Stephie was up on the table pointing her two animals at the cow in her father’s lap.
“The MRI results are back,” Dr. Gillespie said. “Fortunately, there is no indication that Stephanie’s tumor is more advanced than we thought. Her orbital bones are involved, which I suspected because of the bluish color around her eyes. In summary, it is not a low-grade tumor where surgical excision alone would suffice, yet it hasn’t majorly progressed either. I’m going to recommend her to a pediatric oncologist where, I believe, she only needs minimal treatment with chemotherapy and/or radiation to decrease the tumor size. After that, we have the best surgeon with the university who can remove the rest of the tumor.”
Mr. Miller wrinkled his brow. “She doesn’t deserve this.”
“You’re right about that. But, Mr. Miller, one of the most important goals with a neuroblastoma is to make a timely diagnosis and to try and alleviate the potential for more metastatic disease. We are doing that.” He glanced over at Stephie, who stayed absorbed with her toys.
Stephie’s father let out a loud sigh. “Okay, I guess we have no choice.”
“My office will call the oncologist’s office about the referral and they will call you to make an appointment. I want to continue seeing Stephie to manage her primary care and progress.” He stole a glance at his patient. “My role will be as the captain of the ship.”
Stephanie smiled at him. “I can jump off of here,” she said.
Annabel stepped over. “Here, Stephie, hop down on the step.”
The three-year-old slipped off to the step and bounced to the floor. She stared wide-eyed at Annabel.
“I won’t see you again,” Annabel said, “because I don’t work here like the doctors and other people. You be brave about your medical treatments. Bring panda and owl with you for your appointments because you can hug them whenever you feel like it.”
Stephie gently placed her stuffed animals back on the table and gave her a hug. Annabel closed her eyes as she embraced the little girl back. She wished she could do more, like have her come face-to-face with Oliver and be licked in the face.
“Thank you so much,” Mr. Miller said. “You’re going to make a fine doctor.”
Annabel only smiled. All she wished for them was that Stephie zipped through the medical care and surgical removal of her neuroblastoma and got to enjoy life like a three-year-old should.
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Because of Dustin’s career so far, he had more insight than most laypeople into the dynamics of trauma cases that fled into the OR. Loved ones would accumulate in the waiting room and a waiting game would begin. Heads would turn whenever OR personnel came out to talk to someone and fingers would cross as visitors hoped no terrible news was headed their way.
And so it was for Dustin. More than two hours had elapsed since Sean vanished into the bowels of the OR with more physician and nurse manpower hanging on to his stretcher than he had ever witnessed. He tried to rationalize the amount of time his colleague was gone. He was hopeful because staff was back there still trying to remedy his colleague’s condition as best as possible. On the other hand, perhaps the situation was taking so long because the damage done was too extensive and they kept running into more and more trouble with his case.
Dustin sat and crossed one foot over his knee and eyeballed the sole of his shoe. He swore, in the last few hours, he caused measurable wear to both of them by pacing back and forth. Even the tile floor had dirty rubber sole marks. After some time, a janitor came by, emptied the trash cans, and mopped the floor. He swished the wet mop a second time over Dustin’s footprints.
He went over to the fake plants and leaned against the wall, thinking how much Sean meant to him. His friendship rated high on his list, along with his mother, and as much as Annabel had meant to him. With consolation, he thought about Solar. At least at home he had someone to talk to. It might be viewed as crazy, he thought, but yes, his bird mattered.
But no one could replace Sean. And, obviously, no matter what, his buddy would not be fit for work for quite some time. A bullet to the chest could have damaged his lungs or ribs, or worse than that, his heart. But no one could survive a bullet straight into heart muscle and right into the “chambers.” The shots must not have pierced Sean’s heart.
Whether his colleague stayed in the hospital in the near future, or at home, he must carve out lots of time to go visit him. Hopefully, Sean’s wife would understand and be supportive of him sitting by his bedside a good deal of the time.
Dustin spotted him coming out, his demeanor unmistakable. The head trauma surgeon in charge of Sean’s team swung through the doors and lowered his mask like a flag being lowered to half mast. It was all he had to see to know the terminal fact, as the man in blue scrubs with clues of blood on them, approached Sean’s wife. He said little to her and she broke down with pitiful crying. Immediately, she was surrounded in a circle by loved ones.
Dustin’s heartbeat slowed in mourning. He fought to be brave and not shed a tear when the surgeon came over.
“I’m sorry,” the surgeon said. “We did everything we could. Sean was hit in the chest, the bullet grazing major blood vessels. Give my condolences to the police force.” He lingered appropriately, waiting if Dustin had any questions.
Dustin extended his arm for a handshake. “Thank you.”
The surgeon left while the family moved to the “family room,” where they would have more privacy. He sank into the cold chair and took out his iPhone. Right away, Annabel’s message popped back up. Her communication was the last thing he wanted to see as he called the captain and reported the bad news.
As he headed back to his car, and the short drive back to the station, the day’s events echoed in his head like an exploding bomb. He passed the coffee shop and wished he had never stopp
ed there earlier. But “what ifs” served no purpose, like his captain said.
He hated to think this way, but Sean was also his main confidant, who stuck by him through thick and thin. His partner doled out personal advice better than his own mother who, after all, he couldn’t tell everything. They would have had another “Annabel” discussion today had it not been for the mad man’s shooting.
That was it. He would try and bury his relationship and his memories of Annabel along with his best friend. Physically, they would be gone, but emotionally … that would take some time.
CHAPTER 19
It was mid-afternoon and the pace in the office had not let up. Since Stephie Miller and her father had left, kids with colds and allergies and skin infections had come and gone. Annabel ran cold water into a Styrofoam cup and drank the whole thing. She had a view of the hallway where a nine year-old girl stood on the scale and the nurse wrote down her weight.
Dr. Gillespie stopped outside the door. “Aren’t you beautiful!” he exclaimed to the girl. The nurse walked ahead and George tapped the girl’s ponytail. The youngster smiled and mother and daughter followed his staff straight into a room.
George waddled through the hallway and examined the girl’s chart outside the door. “New patient,” he said to Annabel. “Let’s introduce ourselves to Mrs. Klondike and her daughter, Tabitha.” He sprang into the room before she acknowledged him.
Tabitha sat sideways on the exam table. A sketchpad the size of an iPad was in her hands and one hand was busy moving about a pencil.
“Wow,” said her mother, Margaret. “We used to wait in Tabitha’s old pediatrician’s office at least a half hour.”
Tabitha glanced up and paused doing her artwork.
“I’m sorry to hear that,” Dr. Gillespie said. “Tabitha is too special to wait for a doctor.” He diverted his attention to the young girl. “You are a stunning nine-year-old. Are you drawing something?”
