by Melissa Yi
No. Maybe I could have saved him.
I wrenched my head to the side, like I was the one with the seizure.
"Yeah," he said. "I know."
Then he disappeared with an armload of charts, because we still had to hustle to see the living.
The perfect emergency doctor: one who never dwelled on death.
What did that make me, the murder magnet? I tried to shake that off by picking a happy memory, as one therapist had suggested. I closed my eyes and imagined petting Roxy, Ryan’s foster dog. I could sink my fingers into the thick, black fur of her shoulders. She would sit before settling on the ground with a sigh, rolling on her side, paws up to make room for tummy rubs.
Dr. Chia dropped into the chair beside me, looking too tired to move. A male police officer nodded at her sympathetically before collaring Dr. Dupuis into the conference room for questioning.
Dr. Dupuis laid down his stack of charts, and I felt momentarily defeated at the prospect of trying to work my way through them solo after graduation.
"Are you okay?" I asked Dr. Chia. I’d avoided her since my first, dreadful shift with her in July, and I usually wouldn't ask staff any personal questions, but I had to make an exception on the world’s worst night shift.
She nodded. Even that seemed to take an effort. "But I’m too tired to drive home."
"You want my call room? I probably won’t use it." Even so, I felt a pang. Hard to give up the potential of a quiet room and a bed with clean sheets.
Dr. Chia shook her head. "I can always find a call room upstairs."
"With the plastic-covered pillows," I said, since that was my friend Anu’s number one complaint. They covered the pillows to protect them from patient bodily fluids, but every time you turned over, the plastic creaked under your ears and woke you up. Personally, if I ever got to sack out, I was so tired that I blocked out the ear noise, but the springs poking my back or the mattress sagging in a U shape made for a restless few hours.
That won a smile out of Dr. Chia. "Nothing makes for a better night’s sleep."
Even in the middle of the night, I admired the shape of her eyes, the point of her chin, and the gloss of her shoulder-length hair. She had a delicate kind of beauty, combined with intelligence and determination. I could see why Dr. Dupuis would chase her. Honestly, if I hadn’t messed up our first shift together, I’d like her too. Of course she was four times better-looking than Dr. Dupuis, but beautiful Asian woman/nerdy white guy seemed like a common scenario.
Good thing Tucker was cool, and I never felt model-worthy. My parents always prized brains over beauty.
I scooped up another SORE THROAT chart. When I emerged, Dr. Chia had disappeared, presumably to find a bed upstairs. I labored to enter the throat swab on SARKET, keeping an eye on the conference room door.
The police probably wouldn’t interview me, since I never made it out of the ER for Patrick’s code, but if they needed me, I’d make myself available. Maybe they’d even drop a few details about the case. Unlikely, but a girl can dream.
Julie, the petite preposée/orderly rushed up to take the swab from me, her eyes so wide that I could see the whites around them. "Can you believe it? Patrick's dead!"
I nodded. "Horrible." When there are no words, only the trite ones will do.
"He was such a good guy!"
I nodded. Patrick had seemed very sweet.
"And a badass."
"He was?" I remembered his hands trembling when he had to handcuff Lori Goody. Was Julie rewriting history to make him seem tougher, now that he was dead?
Julie swiped a label out of the blue plastic basket on the table and affixed it to the swab, nodding slowly. "My boyfriend was...you know." She raised her eyebrows, gave a silent whistle, and glanced at me out of the corner of her eyes.
I nodded, even though I wasn't sure what she meant. Hot? Insane? Both?
She tossed the label backing into the garbage, still talking. "Jesse screamed a lot, except when he was high, but sometimes he was okay. Once he bought a little Transformer toy for my son. You know Bumblebee? The black and yellow one?"
I didn't, but I nodded again. The way she said "my son", it sounded like Jesse wasn’t the biological father.
"Yeah. Jason was crazy about Bumblebee. He called it Bumbee. He played with it until it broke, and then he cried. He was only three, you know? He'd pick it up, and it still wouldn't work, and he'd freak out all over again. I told him I'd buy him a new one, but he'd have to wait, because my job doesn't pay much, you know?"
Plus she probably gave her money to the boyfriend, to keep him high instead of hollering. But I murmured, "I know." Working as a preposée doesn't mean raking it in, either. Both things were true. It squeezed my heart that her son had to wait for what sounded like a cheap toy.
"Jesse was pissed off that Jason broke Bumbee and was moping around about it. ‘Get over it, you little sh—’" She stopped, cheeks coloured. "I mean, it got on his nerves. Plus I was in a bad mood. It was right before I went on the rag, you know?"
I was forced to nod again, even though I was never particularly "hormonal," and I didn't like the implication that women were incapacitated once a month. Still, in November, I'd come across one of the other female residents, who was normally sharp and strong and decisive, riddled with menstrual cramps on the resident room couch. She really was incapacitated.
"So Jesse was yelling when he drove up to St. Joe’s to drop me off in the front circle. That was...I mean, I can handle it. But this time, he kind of—he hit me in the face. Not hard," she added right away. "Just to shut me up. I was shouting at him. It was my fault, you know?"
I stared at her. I'd run out of nods.
"Patrick flew out of the front doors. He made Jesse get out of the car. He told Jesse he wasn't allowed to hit people, and that he could press charges. He said all sorts of stuff. And you know how tall Patrick is—was. Jesse wouldn't look at him the whole time he was talking, but he heard it, and Patrick made him sign a piece of paper that he was trespassing and wouldn't come back on hospital property. He was a badass."
Yes, he was. Go, Patrick, go. I had to know more. "So what happened to Jesse? He stopped driving you to work?" He obeyed Patrick?
"Yeah." Julie's face fell. She started playing with the throat swab, rolling it back and forth on the counter. "I had to walk. We didn't have the extra money for bus fare. It took too long, so I couldn't pick Jason up from day care any more, but I signed the papers that Jesse could pick him up too, because he worked nights, so he was home in the daytime. He could get Jason."
My skin prickled. I could hardly breathe. "And did he?"
"Yes, but—" She broke eye contact and started shuffling her feet. "Don’t you already know about this? Everyone knows about this."
"I don't. I only came to St. Joe's in July, and I've been away for a research block. No one told me anything."
She tapped the throat swab on the counter, three quick little raps that sounded like the beginning of SOS in Morse code. "It's too hard to say."
"Okay. You don't have to talk about it."
Tears filmed her eyes. "I don't think I can. I didn't mean to—I just wanted to say how great Patrick was."
And she rushed away, barely remembering to deliver the throat swab to Amber, who had walked up to her with her hands open.
16
What happened to little Jason?
Four police officers exited the ER, talking amongst themselves. They’d managed to cover Dr. Chia, Dr. Dupuis, both nurses, and maybe even Charles Packard. Although I hadn’t gone outside, I heard that the parking lot was also cordoned off for investigation.
I eyeballed these officers’ backs, wondering if they already knew about Patrick’s conflict with Jesse. I wouldn’t accost them before I gathered the whole story—I didn’t even know how long ago Patrick had confronted him—but I had trouble concentrating on my next patient’s SORE EAR, knowing that Patrick had made at least one enemy at work.
I don't want an
incident, Patrick had said when he hesitated to cuff Lori Goody.
Did he mean Jesse? Had something gone wrong after Patrick played the hero? Patrick still had his job, so he hadn’t been fired, but he could have been on probation. I should ask Charles Packard.
"I’m allergic to penicillin," said the 40-year-old man with the SORE EAR, who’d yelped when I pulled on his pinna to get a good look at his red right eardrum.
"Of course you are," I said. High dose amoxicillin was first line for otitis media. It worked over 90 percent of the time, and sometimes kids even cheered that they were getting the "banana medicine." Only ten percent of patients who claimed they were allergic to pen turned out to be truly allergic, but between the scads of the supposedly allergic and the parents who asked for "something stronger," I ended up giving a mini-lecture every time I saw a SORE EAR. "What’s your reaction?"
"I don’t know. I was a baby. My mom told me never to take it." He scratched his head.
I tried to ignore the flakes of dandruff shining on his scalp that might be wafting their way toward me. "Can you take Cefuroxime or other antibiotics called cephalosporins?"
"I don’t know. I got a rash with something that sounded like that. Is it on my chart?"
I shook my head. "Only the penicillin." I was not going to probe any further at 3:30 a.m. "We’re supposed to allow 48 hours with an ear infection, to see if your own immune system can kill the bacteria. So I’ll write you some ear drops for pain in the meantime, and you can start these antibiotics at the 48 hour mark."
His lip jutted forward in a way that made it clear he’d run straight for a 24-hour pharmacy. "The one with a B worked the last time."
I sighed to myself as I entered the prescription for Biaxin. In Halifax, they reviewed the evidence, and then the family and emergency doctors agreed not to give antibiotics to not-very-sick kids and adults before 48 hours. Overprescription promotes antibiotic resistance, which means that antibiotics will stop working, and Scandinavian studies showed that some patients can fight off the ear infections themselves. But in the chaos of Montreal, I resorted to giving a conditional prescription, trying to educate the patients I encountered, still knowing that many would hit the pharmacy before I hit the sheets.
While I printed and signed the ear prescription, I noted that Dr. Dupuis had managed to plow through what seemed like a dozen patients. SARKET labeled our patients as red (me) or him (black), so at a glance, everyone could marvel that he’d buzzed through three patients to every one of mine, even though he'd run a code in the parking lot and I'd started an hour before him.
"Don't worry about it," he said, when he noticed me silently toting up the patient census. "You're here to learn. Plus you were attacked twice. You should go home. Anyone you see is a bonus."
"Thanks," I said, picking up the next chart for KNEE PAIN. "Could I ask you something off-topic?"
He nodded so curtly that I glanced at his feet. Tucker had taught me bit about body language, namely to watch people's lower halves.
They may mouth the correct platitudes, but their feet will point where they're actually thinking. For example, if a woman squeals, "I'm so excited for you! We'll be like sisters!" while her stilettos pivot for the door, brace yourself for a little sibling rivalry.
Dr. Dupuis's feet had turned toward the call rooms. I glanced at the secretary’s desk, where the resident room’s key still lay on the Plexiglass window ledge. Dr. Chia hadn’t taken me up on my bed offer.
Ha. I suspected that instead of heading for the plastic pillows upstairs, Dr. Chia had zonked out in Dr. Dupuis’s bed like a very welcome Goldilocks. I smiled to myself. Proof there was life in the midst of carnage.
He wanted to protect Dr. Chia. If only he knew that I’d never ask about his romantic life. Not only would that be hideously embarrassing for all three of us, but I couldn’t risk him replying, "How’s yours?" I still hadn’t heard from Tucker or Ryan.
Still, overall, good news for me. He’d rather talk about anything than Dr. Chia. Which included murder.
"Did Patrick Warren have any enemies?" I asked, straight out.
Dr. Dupuis brought up some lab work to scroll through as we spoke, maybe to avoid my eyes. "Not that I know of."
"Right. That's what I thought, too. But no one's a hundred percent."
He shrugged, closed the window, and opened another. "Is that everything?"
"No." I cleared my throat, which provoked a short coughing fit. So unprofessional. I needed water and throat lozenges and sleep.
He entered some orders as he waited for me to speak.
I nodded my head at Julie, who had disappeared into the stock room. "What happened to her son? You know who I'm talking about?"
"Yeah. Jason." He frowned and made brief eye contact with me.
"What happened to him? And when did it happen?"
Dr. Dupuis shook his head. "Why are you digging this up?"
"Julie told me that her boyfriend, Jesse, hit her in front of the hospital. Patrick was on duty. He ran up and told him off, so she thinks Patrick is—was—a superhero, but got too upset to tell me what happened to her son."
He sighed. "Jesse beat up her son after he picked him up from day care. She had to take him to the Children's."
The Children’s Hospital. The beating was severe enough to require medical attention. I sucked in my breath and tried to count at least one blessing: if she took Jason to the Children’s, it meant he had survived the beating.
I’d heard of this circle of abuse. The father hit the mother, who hit the oldest kid, who hit the middle kid, who hit the youngest kid, who beat the dog. Once Jesse couldn't beat Julie anymore, he attacked her son.
I focused on the most relevant question. "Where is Jesse now?"
"Last I heard, he was in custody."
"Good." Jesse wasn’t a suspect if he was incarcerated, which would turn this into a dead end, but at least he was serving time for beating Jason. Still, I’d have to verify that he was in jail. "When did you last hear about him?"
"Maybe two years ago."
"Two years ago," I repeated. That was ages. Jesse could have been sentenced and released already. "What’s his last name? Do you know?"
Dr. Dupuis pressed his lips together. "Hope, I know what you're doing."
I nodded. It wasn't like I was trying to hide it. I was trying to find Patrick's killer. Who the hell wouldn't?
"This is not and should not be your priority. First, you need to look after your own health. Next, if you insist on staying, you're here to do your job as a resident."
I felt sick. I always worried about being good enough. Medicine requires every last one of your brain cells and then some. How could I possibly compete when I was always trying to do three things at once?
Dr. Dupuis waved away my expression. "I'm not trying to shame you. I have no issues with your performance. You're still looking after patients and answering questions better than most residents. But you need to look after yourself. Get into shape mentally and physically. When that's over, you can take on the world. Not now."
"Dave." My cheeks got hot, calling him that, but he’d first introduced himself to me as Dave Dupuis, and the nurses first-named him all the time.
He stared back at me, partly startled by my use of his own given name.
"Patrick was shot in our own parking lot. How can I not take this on?"
"By delegating it." He looked me straight in the eye. "We did the best we could to save his life, but your job is not to become a vigilante or a homicide investigator. Your job is either to go home and rest, or stay here and work on our living patients. If you keep splitting yourself in different directions, you will be ground to powder within the next six weeks."
Now my face flamed. His words socked me in the gut. Yes, I needed to learn how to delegate. As a med student and resident, my job had been to
a) Drink from the fire hose of knowledge;
b) Suck it up; and
c) When higher-ups asked me to jump, I'
d leap into the air faster and more gracefully than anyone else, and do it twenty times in a row, until my competition crumbled.
Except this wasn't sustainable. One of the ortho residents had smiled when I asked about his gruelling half-decade residency program. He said, "It's fine if you accept you won't have a life for five years."
I couldn't smile back, because I'd already forgone a life for eight years of high school plus a summa cum laude university degree, even less of a life for four years of medical school, and now I was enduring up to three more years of worst life in the history of lives.
So once again, God was right. I had to delegate.
And I’d already begun. Tucker searched for Ryan at this very instant, because I was physically tied to St. Joe's tonight. That hurt.
Could I drop Patrick's case? Could I say to myself, Oh, I've delegated this. The police are handling it. Time to check on bunions.
Was that what normal people did?
"I hear you," I said finally. "I know you're...wise."
He grinned. "Not really. Just been around the block a few more times."
I managed a minute smile in return, partly because he got unraveled about Dr. Chia. It made him more human than deity.
"So go see some more patients."
Ah. The perpetual punchline. Yet in my brain, I agreed with him. I'd try to delegate. Until 8 a.m., a scant few hours away.
What could happen in less than five hours?
17
I grabbed a chart for FATIGUE, another winner of a complaint in the dead of night. Dr. Dupuis nodded in approval as I rolled my WOW toward exam room number one on the ambu side.
When I raised my fist to knock on the door, I started to cough again. I paused to recover. Following Dr. Dupuis’s lead, I used the forced downtime to check on my patients’ results.
Alyssa Taylor’s CT had come back.
I rolled my WOW to the desk to call UC's trauma team. A male resident answered, sounding harried. "We're stuffed. She can see plastics in the morning. Anything else besides facial trauma?"