Downright Dead

by Barbara Ebel

  “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.”

  “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 boy Arthur,” Mrs. Moran said.

  Andy nodded and said, “Glad you had that mother-son bonding.”

  “And Teri held him.”

  “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 und
er 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.”

  The two women wasted no time. Annabel trotted down the empty upstairs corridor into Dustin’s room. His curly hair was more kempt than before and he wore his uniform.

  “I apologize,” he said. “People have been coming and going and only now I was going to text you.”

  “They’re discharging you?! I wish I could have hitched a ride to your place and brought you back street clothes to change into.”

  “No problem. No one will mess with me on my way home.”

  “The uniform doesn’t seem to afford you any extra protection.”

  He shrugged his shoulders. “Maybe so.” He closed the gap between them and wrapped his arms around her; she hugged him back and closed her eyes.

  “What did the cardiologist say?”

  “He said my heart checks out fine and there is no sequela except for the bruising and pain to my chest wall … for which he’s prescribed pain pills.”

  “So you better take it easy.”

  “He wrote an absentee prescription as if I’m a little kid who needs to present it to my teacher so I can take off from school. Actually, seriously, he did, but I spoke earlier with Chief Erickson about the doctor’s orders. I’m officially off for the whole weekend, not just Sunday.”

  Annabel smiled and wiggled her head. “Doesn’t mean you can do anything exertional.”

  “Oh, I get it. Shucks. But it does mean we are going to kick back on Sunday. Whatever time you can parcel out for me.”

  “Besides the work I have to do, which includes studying and working on a presentation, we can chill together. Don’t forget that my new dog is included in this plan too, and our two pet species are set for an introduction.” She put her hand on her hip and pursed her lips. “And by the way, how are you getting home?”

  Dustin pointed behind her. She turned to see a paunchy, middle-aged man wearing an officer’s uniform, the same as Dustin’s.

  “Annabel, meet my partner, Sean. Sean, meet Annabel.”

  Annabel had met Dustin’s last partner, Edgar Banks, but not Sean.

  Sean extended his hand to Annabel. “Nice to finally meet you. Now I’ll be able to visualize you when he speaks about you over diner dinner.”

  “Or breakfast, or lunch,” Dustin said.

  Annabel laughed and twisted her mouth. “You two have more interesting things to talk about than me.”

  Sean raised his bushy eyebrows. “You are …”

  “All right,” Dustin butted in. “Guy talk needs to stay in a safety deposit box shared between two guys.”

  Sean shrugged and hooked his thumb in his belt.

  A nurse came in, followed by an orderly with a wheelchair. The RN handed Dustin a stack of paper she went over with him in advance. The orderly motioned Dustin into the chair.

  Dustin looked up at his partner. “Don’t worry. I’m not that frail. It’s hospital policy to transport patients to the front door. They’re covering their asses in case I trip on a floor tile.”

  “My,” Annabel said, “you learned a lot while you were in here for one day.”

  They cluttered the corridor and the elevator and Annabel stepped out from the elevator on the OB floor.

  “Hey,” Dustin said before the door snapped shut, “we still haven’t finished watching Gone with the Wind.”

  “We can finish it on Sunday!”

  -----

  Kristin’s arm was extended on the table, her head bent as she fiddled with her right topaz earring. For the OB team, rounds were finished and the day as good as done. Annabel’s time with the anesthesia resident had proved fruitful and she extrapolated exactly what she would use for her “drug shortage” slides. Kristin was so helpful, however, that she continued talking even though they both could go home.

  “The FDA plays a big part in this,” the senior resident said. “They are the gatekeepers, protecting the public from potentially unsafe drugs products. They are the ones who discover a company’s noncompliance with current good manufacturing practices or cGMPs. The reason may be because the company in question owns manufacturing equipment that becomes antiquated, or a sudden loss of personnel overseeing compliance issues, or a host of other reasons. In other words, they may not be intentionally noncompliant.”

  Annabel nodded. The FDA was a superpower and important to the public.

  “Or, a manufacturing company may decide to close down a certain facility due to business reasons, or a subcontractor supplying products to the pharmaceutical manufacturer has a problem on their end. Think about it. What if the factory of the supplier of the local anesthetic bottle is hit by a hurricane? Even though the local anesthetic can still be produced, its availability will grind to a halt.”

  “Causing the cascade of problems we must deal with,” Annabel said.

  “At least my specialty has the American Society of Regional Anesthesia and Pain Medicine and they keep us current on drug shortage problems and suggest other methods of pain relief.”

  Annabel sat up tall. “Thanks again. I’m going home soon.”

  “And what’s going on with your boyfriend?”

  “He’s home. We don’t live together. The cardiologist instructed him to take the weekend off.”

  “Living together can have its advantages. My husband and I did it for a year before we married.”

  Annabel admitted to herself … she liked her own independence. She was growing closer to the police officer. Living together was something she hadn’t considered, and with her hours, and with his shifts, that would probably be a certifiable psychotic idea.

  -----

  It was so perfectly quiet in the lounge that Annabel procrastinated and figured she would work a few more minutes. Kristin had left. Dr. Harvey and Dr. Gash were gone too.

  Pam came in and scribbled something on the board behind Annabel’s back.

  “Where are the night docs?” Annabel asked.

  “Down in the ER.” Pam cleared her hoarse vocal cords and went into the restroom.

  That wraps it up, Annabel thought. Kristin had been so helpful that all she had to do was make some fancy slides at home with pictures, type in the bullet points, and her lecture would be almost ready. By tomorrow, it would be, she promised herself, and then she would have a few days to review it and be armed for any questions. Or at least some questions. She counted on Dr. Harvey bailing her out if someone stumped her with an impossible query.

  She closed her binder and packed her bag. At the round table where she’d been sitting, she ditched her iced tea cup and napkin, and brushed off cookie crumbs. Looking down at her scrubs, she decided to wear them home and not change. It was easy to make a habit of that. If the driver tonight asked her a sexist question, she would change the subject. Inside the locker room, she folded her blouse and pants, and overstuffed her backpack, ready to go home.

  Since she had off on Sunday, tomorrow, Saturday, would be the last day of her first week. She sighed with uneasiness because then there was only one week of obstetrics left before veering off into gynecology. At this point, was she as prepared as she should be as far as her test-taking?

  She glanced at the board and saw Emmett’s name down in the corner where the RNs usually noted which orderly was helping out. Pam had not written in the night orderly, but maybe he was running late.

  At the nurses’ desk outside the room, Annabel paused with her back pack clinging to her shoulders. She tore open a peppermint from the candy dish on the counter and popped it in her mouth as she contemplated. The day had turned out not to be as exciting as it had started. There just wasn’t
much obstetric volume and, for the only afternoon delivery, one of the RNs had chased her out of a room in favor of a “real obstetrician.” Dr. Gash stayed oblivious to her absence, so she left it at that.

  She dragged herself down the hallway, her eyes glued on the lobby, when a door flew open and Emmett tripped over an IV pole he was pushing. He righted himself and his bulging eyes fell on Annabel.

  “She needs help! Come on!”

  Annabel’s anxiety rose in her throat and her pulse quickened. She didn’t need board certification in obstetrics to figure out that her skills, or lack thereof, were needed. A young woman swayed back and forth on the bed inside like waves were rocking her in a boat. Her eyes were fastened on the skull of a head trying to exit her genital canal.

  Annabel’s legs were frozen to the floor.

  “She needs you!” Emmett exclaimed.

  “Me?”

  Annabel and Emmett jerked their heads up and down the barren corridor, and then their eyes met. Yup, it was up to her.

  CHAPTER 28

  Annabel and Emmett sprang into the room. Annabel grabbed an OB delivery kit from the cabinet above the sink. Emmett scooted the rolling tray table near the end of the bed.

  She ripped open the package on the table, exposing the drapes and shiny instruments. Emmett pulled the adhesive off another packet and Annabel rushed her arms into the blue gown and then gloved. The orderly tied her up in the back.

  “I’m Annabel,” she said, remembering an important point previous attending doctors had told her: “See one, do one.” Besides the shoulder dystocia delivery, she had witnessed one full vaginal delivery from the beginning to the end. She better recall every last detail.