by Melissa Yi
The order screen took so long to load, I tried a different menu. No dice.
Maybe the system itself was borked. Certainly Dr. Chia had struggled with SARKET, and I was no expert in the new EMR system. Tucker and I got a day of "super training" before we were thrown in with it. "You're young, you'll figure it out," our trainer told us. "You should see some of the old guys."
That wasn't especially helpful, although Tucker told him the system was "cool."
Tucker thought everything new and different was cool. He was a human personification of ADHD: very hyper, minimal attention. I sometimes worried that his interest in me would flag now that he was no longer fighting over me with Ryan.
I breathed in. And out.
If Tucker did fall out of love with me (and who could blame him?), there was nothing I could do about it.
In the meantime, I finally managed to enter Midazolam with a custom comment to give it in 2.5 mg doses. There.
I grabbed the COUGH chart and popped into the hall between the nursing station and the ambulatory zone to see the elderly smoker with a temperature of 38.2 and a sat of 94 percent. She wasn't wheezing, but her lungs were tight, so I ordered Ventolin and Atrovent and Prednisone and an Xray.
I decided to wait for her film and see how she responded before I gave her antibiotics or stepped up to IV steroids. Tucker was using ultrasound to try and detect pneumonia independent of X-rays, but I didn’t feel as confident wielding the ultrasound wand, and I wanted to move onto the next chart. Our wait time had ballooned to 12 hours again, even with Dr. Dupuis practically cloning himself so he could see more patients simultaneously.
Speaking of which, where was Dr. Dupuis? It was cool to run the ER for a few minutes, but after that, I wanted God in the wings.
I trotted through the ambulatory and acute sides, glancing into each room.
No Dr. Dupuis.
No Dr. Chia.
No guard.
A terrible feeling crept along my shoulder blades. They shouldn't have gone to the parking lot.
Two men tried to kill me in the parking lot.
Now, I'm a paranoid kind of gal ever since 14/11. Guns to the head will do that to you. If someone got me a cake and a stripper burst out of it, I'd fall on the floor screaming before I cheered his or her G-string.
Something else nagged at me. I’d read a Statistics Canada report on family violence. Murder-suicides are uncommon in Canada, but 95 percent of them are committed by males, and most of them killed their current or former spouses, including common law spouses.
Tonight, two men grabbed me in the parking lot when I was wearing Dr. Chia's lab coat.
And if I read the vibes correctly, Dr. Chia had or would soon have an ex-common law spouse.
I'd thought it was cute that Dr. Chia and Dr. Dupuis were hooking up. But what if Mark the millionaire didn't find it so charming?
The most dangerous time for a woman is when she's leaving her partner. The beloved Toronto family doctor Dr. Elana Fric was killed by her husband two days after she served him with divorce papers.
And I'd let Dr. Chia step out into the night immediately after I'd been attacked.
I approached the middle aged secretary with the punk pixie cut. "Could you page Dr. Dupuis?"
She straightened the cuffs on her white coat. "Don't you have his cell number?"
"No—"
My phone rang.
I didn't recognize the 613 number on my screen.
My heart stilled. That was the area code for Ottawa.
Ryan.
No. It wasn't Ryan's number, which I had memorized.
Nor was it Tucker's 514 number.
Maybe Tucker had picked up a new phone in Ottawa. But why? And how would he manage to do that after 2 a.m.?
"Yes. Hello," I said.
"This is the Ottawa Police, returning your call. Is this Hope, ah, Zee?"
I tried to shift from hyperventilating to slow, calm breaths. "Yes. Hope Sze. You have information about Ryan Wu? Is he okay?"
"I'm calling to gather more information. My name is Gordon McLaughlin. How do you pronounce yours again?"
"You can pronounce it like the letter C."
I heard his chair creak. "Great. Sure. Dr. C. Aren't you the one who found a dead body outside the stem cell lab—"
"Yes, yes." I tried to cut him off.
"—and ran a code on him? With your dog?"
Oh. Maybe he’d even worked on that case, and it was good he’d remembered it. "Exactly. I was with Ryan Wu at the time. It was his foster dog, Roxy. And it's Ryan who's gone missing today."
"Missing, huh?"
"Yes. His parents can't find him."
"Aren't you the detective doctor?" He laughed a bit to himself.
I pretended to laugh too. "Well, you're the real detective. That's why I'm calling you." My friend Ginger told me I'm too blunt. You've got to learn to stroke them, Hope. Not that way, she added, at my scandalized look. Just be...friendly, all right? Smile at them. Flatter them a little.
WTF. I was never good at that, even before I got PTSD.
How did you learn that on peds? I'd asked Ginger, who was in pediatric residency.
You have to handle the parents.
Time for me to handle the police. Even if I sucked at stroking strangers, I'd do it for Ryan.
I'd do anything for Ryan.
I love you I love you I love you.
"Why are you calling me from Montreal?" said Officer McLaughlin.
"His parents called. I didn't know if they'd called you."
"When was the last time you saw him?"
My heart dropped. "Ah...two weeks ago."
"You think he disappeared two weeks ago?" His voice sharpened.
I started swearing in my head. In English. Which made it riskier that I’d let a swear slip. "No, I want you to talk to his parents. They're the ones who saw him more recently, so...I have his mom's phone number. Cheryl Wu." I rattled off the number.
He marked it down. "When was the last time they saw him?"
"She called me today because she couldn't find him."
"Yes, but when was the last time she saw him? Or anyone saw him."
More internal cursing. "I, ah, don't have the exact time, so if you could contact Cheryl and Rick Wu, they'll be able to give you more details."
Well, of course a cop wouldn’t let you skate by like that. By the time I finished talking to Gordon McLaughlin, he knew that Ryan was my ex, I’d had zero in-person or virtual contact for two weeks, and all I had was his mother's phone call to get me all riled up.
"This isn't a lot of information, Dr. Sze," he said.
Gnashing of teeth. "I know. I'm sorry to bother you. I know how it sounds."
"The Ottawa Police Department is very busy, you know."
"I'm sorry. I remember how helpful you were when we found the body, and I don't want anything to happen to Ryan Wu." I decided to be as honest as possible. Stroking be damned in the middle of the night. "I can't talk to him any more because he's blocked me. I know it sounds weird, but I'd never forgive myself if something happened to him because of me. I've made so many enemies."
"That you have." I heard his chair creak. "Okay, Dr. Sze."
"Okay?" The hairs on my neck rose. I hardly dared hope, even though it's literally my name.
"I'll look into it. I can't promise anything, though."
"That's all I want! Thank you, Dr. McLaugh—I mean, Officer McLaughlin!"
He laughed. "Call me Gordon."
When he hung up, I hurried toward the next case, CHEST PAIN in room 3. The electrocardiogram was normal, and the patient seemed to be a sleeping roll of blankets—in other words, no sign of agony. I touched him lightly on the shoulder. "Monsieur Elmi."
He rolled on his back and gave an extra-loud snore.
"Monsieur Elmi. Jacob."
The overhead pager blared, "CODE BLUE, PARKING LOT. CODE BLEU, STATIONNEMENT."
13
What?
"Sorr
y, I have to go," I snapped at Jacob Elmi, who snorted in his sleep but otherwise seemed unimpressed as I dashed to the residents' room for my jacket.
I'd never done a code in a parking lot before. Part of me cringed at the idea of risking my kidnappers again so soon. Two bodysnatchers could nab me during code chaos, and no one would glance up from the cardiac monitor.
Could those two men have attacked Dr. Chia, Dr. Dupuis, and Charles on their way to her car?
If so, they hadn't only been grabbed like me. They must have been shot or stabbed, because a Code Blue means your lungs and/or heart have stopped working.
What if more than one of the St. Joe's trio had collapsed?
This could be three victims at once—or more, if bystanders had been caught in the crossfire.
I wouldn't head out completely helpless. As I sprinted toward the resus/eye room hallway, I armed myself with a scalpel in my right pocket and, in the left, an 18 gauge, 1.5 inch needle, capped but mounted on a syringe.
I'd have to unwrap them, so they weren't ready-to-go weapons, but better than nothing. Lori Goody had taught me that.
Ten feet ahead of me, Roxanne pushed the steel crash cart, laden with medications and a portable yellow cardiac monitor, in front of patient reg. She was easy to spot in her neon blue parka and nearly-matching gloves.
I ran ahead of her, hand already extended to help her drag the cart over the extra mats that had been put down to absorb the snow and ice and mud in the hallway. "Can you believe this? Did you hear what the case is? Or how many people?"
She seemed to veer the cart away from my fingers, catching my attention even before she said, "You can't come, Hope."
"What are you talking about? A Code Blue? That's my jam!"
Why else had I volunteered to stay up all night, unless I got all the cool cases? I was the solo emergency resident on call. Unlike the daytime, when the hospital teemed with staff, every code here belonged to me.
"Not this one." Roxanne jerked her head back toward the ER doors, signalling me to leave. "You've got to keep running the department. Dave and Val are out there. He told everyone to make you stay in."
I ignored that. "Dave and Val are giving orders? So it's not them? Is it Charles Packard, the security guard? Or someone else, like a patient who collapsed after driving in with a heart attack?" You always heard about those cases, but I’d never done one.
Her stride hitched. She didn't meet my eyes. "It's asystole. That's all I know."
No heart beat, no electrical activity. The worst prognosis, but an incomplete diagnosis, and she hadn’t answered who it was. "A new patient, or—?"
"It's not safe for you, Hope. Stay in. That's an order, and you're slowing me down." She shoved the cart over a mat for emphasis. Less than two metres, and she’d be out of here.
My eyes narrowed. I paused before the double doors, blockading her and the crash cart.
Roxanne and I had always been friends, but now she ordered me around like a Shih Tzu.
She was the same size as me, pretty much, and impeded by the crash cart. Would she really call a Code White on me, containing me in here?
I glanced at the empty security guard booth to my left. Dr. Chia and Dr. Dupuis had picked up Charles Packard on their way out, and we hadn't located Patrick.
Which meant that Roxanne had no guards here to back her up in a Code White. Julie, the overnight preposée, was petite as well.
In other words—and I couldn't believe I was thinking this about my favourite nurse—I could take her.
Roxanne's brown eyes flashed. She said nothing, but her thin arms tensed as if she envisioned using the crash cart to ram me into the glass doors.
Of course, the glass doors would open as soon as I stepped onto the rubber mat. I could outrun her crash cart and deal with the consequences later. My quads tensed in anticipation.
"Hope. Stay here with your patients. Dr. Dupuis and Dr. Chia have got this."
True. Two fully-licensed MD's already ran the parking lot code as we spoke. Meanwhile, someone else could arrest in the ER while I rushed out into the snow, into the kidnappers' arms.
But this was a Code Blue! Also known as #lifegoals.
Roxanne glowered at me. Her arms flexed again.
She and Dr. Dupuis and Dr. Chia were telling me no. Three people I liked and respected.
Roxanne was part of my tribe of "small, fierce women," as author Charles de Lint put it. I didn't want to fight with her.
And she was right. I was slowing her down.
That's the ER's biggest no-no. Don't get in the way. You're putting a life at risk.
If nothing else, I've figured out that my PTSD, post-14/11 judgment is...impaired.
It pissed me off that they were blocking me on this, but if three people I respected were telling me to fuck off...
I moved out of the way.
"Thanks," she tossed over her shoulder as the exit door parted for her crash cart.
I didn't answer as I strode back through the doors to the resus hallway. What could I say?
You're welcome. It's my pleasure to skip out on a code for the first time in my life. Let's do it again soon, okay?
I closed my eyes and took deeeeeep breaths, my fists still clenched, my hair on points.
How was I supposed to learn like this? I'd be running codes solo soon. I needed every bit of experience I could wring out of this horrendous night shift.
I tried to remind myself—in-hale. Ex-hale—that, thanks to my shocking call karma and multiple murder cases, I had more medical experience than a set of triplets ten years out of residency. Whatever my life complaints were, they didn't include "I’m always deprived of the most insane cases."
I scooped up the CHEST PAIN chart and rolled my WOW toward stretcher 3. Monsieur Elmi woke up, grey hair askew, dark hands waving through the air, to tell me about his sharp chest pain, "like an electric shock!"
In other words, atypical pain, but he said he'd had an abnormal stress test a few months ago, at a hospital I'd never heard of. Guaranteed that it would take eons for that mini-hospital to respond to a chart request at night. In the meantime, I gave him aspirin, prn nitro, a chest X-ray, and serial troponins, etc. Next.
I had to don a gown and gloves for DIARRHEA. At least it wasn’t bloody. Yay.
The next one seemed straightforward, SORE THROAT, but the woman described a headache "like a spider squeezing my head" and numbness in both legs, complaints bizarre enough for me to hold her for Dr. Dupuis.
Good thing I'd spent most of my life in school for this thrilling learning experience. Right on par with a Code Blue.
I kept an eye on the hallway, waiting for any news, any footstep alerting me to the code team's return. Every passing minute, I wanted to dart out to the parking lot. I didn't even know what the case was, or how many people had been affected. I knew only one thing:
Asystole.
No heartbeat. No breathing. So they must have intubated the patient and tried epinephrine. What else?
I tried to smile at the punk rock secretary, who sat at her desk, facing the Plexiglass barrier, as I inquired, "What's going on out there? With the code?"
She pointed to the phone in her right hand and shook her head.
She couldn’t talk, she didn’t know, or both.
Great. I tried Amber, the nurse bitten by Lori Goody and rewarded with a Clavulin prescription. She gazed back at me, wide-eyed. "It's a young man. That's all I know."
A young man. Usually, that means drugs or trauma, although it could be a pneumothorax or sepsis. Congenital heart disease or arrhythmia, less likely, but still possible.
I picked up a chart for INSOMNIA. Every health care worker on a night shift has deliberate and prolonged insomnia. When I popped into the room, it was empty. The guy had gone home already. I wanted to scream.
The only good news was that our wait time had shrunk to five hours.
Then I heard footsteps in the resus hallway. My head snapped up.
Dr. Chia
clipped toward the nursing station, seemingly unbloodied and unharmed, but she met my eyes and shook her head.
Uh oh. My stomach plunged.
Roxanne bustled toward the ambulatory side, giving an almost imperceptible nod in my direction before we both turned away. I found it painful to even look at her. She’d been my friend from nearly the first moment I landed in Montreal, and now it felt like we played on opposite teams.
This time Andrea, my other favourite nurse, navigated the resus cart back into place in the resus room.
Dr. Dupuis brought up the rear, expressionless as usual.
No patient.
Empty hands.
No smiles.
I hurried into resus to buttonhole Andrea, who gave off a comfortable mom vibe and had taken care of me after my first murder case. Even more importantly, she hadn't told me off. I couldn't pretend all was hunky dory with Dr. Dupuis or Roxanne, and Dr. Chia would attract Dr. Dupuis the way I attracted mosquitoes in May.
"Was it Patrick?" I said. Past tense. They hadn't brought him in for blood work and an emergency thoracotomy, so past tense seemed appropriate.
She nodded.
I closed my eyes and tried another few unspoken Farsi swears. It didn't help. "What happened to him?"
"He...was shot in the throat." She busied herself with the IV pumps.
14
Patrick, the gentle, kind security guard, the good boyfriend—someone shot him in the throat?
My body jerked. This was not a trauma hospital. And Montreal was not a violent city in general. The last time someone got shot at this hospital was...14/11.
Even though I'd become somewhat inured to evil, I was shocked into silence tonight. This didn’t happen in Canada.
Oh, yes, it did.
Andrea nodded at me in solidarity.
I wanted to touch her shoulder, to tell her it was okay, but that would be a lie. Plus we don't generally touch each other, so it would feel awkward, even invasive.
I pressed a hand to my own throat, as if to shield it from any more stray bullets. My weary brain offered, That gives a whole new meaning to the complaint SORE THROAT, before I dragged it back on track. "Were you able to do anything—"