Code Blues

by Melissa Yi

  Dr. Callendar glowered down the table at me. "Now that everyone has finally arrived—" He glanced at the wall clock, which read all of 8:36 and was actually three minutes fast—"we can begin our introductions. Do you all know each other?"

  I shook my head. Dr. Callendar raised his eyebrows like it was a personal failing. "Introduce yourselves," he said, gesturing at the residents I didn't know.

  The first resident had rosy cheeks, a big smile, and a sea green yarmulke on his head, so he was obviously Jewish. "Hi, my name is Stan Biedelman. I'm from Montreal. I was going to be a lawyer, but then I saw a way of making less money for longer hours and decided to go into medicine."

  Great. I liked him right away.

  The other guy, who was thin, neatly-dressed, and Arabic-looking, said, with a moderate accent, "My name is Omar Hassan. I am from Oman."

  It was kind of like a poem. Omar Hassan from Oman. He and I exchanged small grins.

  Dr. Callendar stated, "Jenny Caldwell, also an R2, is on maternity leave."

  Cool. Tori gestured for me to go next. I said, "I'm Hope Sze. I'm from Ottawa. I did my undergrad at McMaster, med school at Western, and now I'm here, so I've been all over the place." I wanted to make a joke, like Stan, but couldn't think of anything clever.

  A flicker of distaste passed over Dr. Callendar's face. Perhaps one of my schools offended him. He turned to Tori with his biggest smile to date. "Dr. Yamamoto?"

  Her low voice to was a bit difficult to hear. I bent toward her as she said, "My name is Tori Yamamoto. I studied biology at the University of Alberta, and went to McGill for medical school."

  Dr. Callendar nodded approvingly. At what? Her quiet voice? Her Alberta-ness? Her sojourn at McGill? Her simple white T-shirt and khaki cargo pants?

  If I kept trying to second-guess Dr. Evil, I would go mad. I took some deep breaths. Happy thoughts. My mind turned to Alex, who'd said he was a soccer player. I'd never been into jocks, but it was a mild turn-on. Instead of a bulky football player, I'd found a lean guy with good legs and stamina to burn. Intriguing.

  Dr. Callendar launched into an orientation speech. It was really an excuse to lecture us about patient care, confidentiality, home care, following obstetrics patients even during our other rotations, blah blah blah. He seemed to scan me for a slip-ups (spinach in my teeth, less-than-alert expression), and it bothered me until I noticed he looked at the guys the same way. Maybe with a shade less animosity. The big compare-and-contrast was when he turned to Tori. His thin lips always stretched into a smile.

  Clearly, he made a pet out of every group in order to divide and conquer. I'd met people like that before. I was more interested in how Tori was taking it. I can't stand pets who preen and strive ever-harder to please the massa.

  Tori watched him, expressionless. A good omen.

  Dr. Callendar managed to drone through the entire introduction hour. "Normally, this time would be reserved for teaching and reviewing home care and obstetric patients. You will be expected to prepare presentations regularly." Another poisonous glance at me. "If you have any questions, you can page me through locating. Of course, I will see you every Tuesday morning. Now go see your patients."

  What a difference from Dr. "I'm your man, 24/7" Radshaw. Maybe it showed in my face, because Dr. Callendar shoved a piece of paper at me in dismissal. "Your schedule, Dr. Sze."

  I felt like sticking my tongue out at him. Like Red Green said, you can't stay young, but you can stay immature. Instead, I peered at my schedule. I'd already done two emerg shifts as a resident, but I was worried I'd enter the room and have no idea what to do. Luckily, I had only two patients in the next two hours. That should give me enough time to figure out each one.

  My first was an elderly woman who took a lot of medications and needed prescription renewals. Straightforward, right? Except I'd never met her before and I had little idea what half her medications were. At Western, we were encouraged to learn the generic names of medications instead of the catchy pharmaceutical brand name, which was probably a good idea to minimize branding in our head, but it meant that I was frantically flipping through my pharmacopoeia, trying to figure out what was what. After all, my signature was going on the prescription.

  In the ER, I'd rarely made new decisions on my own. If the patient was admitted, I continued whatever they were on before, adding or subtracting as needed and as directed. I added antibiotics for a pneumonia, or a raft of heart medications for a new cardiac patient, plus Tylenol, Gravol, and Ativan so we wouldn't get called for the average headache, nausea, or insomnia. For one dehydrated patient, I forgot to stop her diuretic, but the nurse caught it, and Dr. Dupuis just laughed. I could also handle the walk-in patient who came in for a single, relatively straightforward problem, like my woman with the UTI.

  This patient was different. She was supposed to be mine for the next two years. Plus she'd be using these meds until her next appointment with me. I wanted to get it right.

  Not to mention that if I could avoid another Dr. Callendar roast-me moment, it would be a big bonus. Luckily, a patient summary was the first page of the chart. Phew. Then I took a closer look. Her problem list hadn't been updated since 2005. On the next few pages, some of the handwriting was execrable. Eventually, I excused myself. It looked unprofessional to squint and frown at the chart and my pharmacopoeia when I was supposed to know what I was doing.

  I was in the conference room, trying to decipher the family history, when Dr. Callendar bore down on me. "Well?"

  I launched right in, more comfortable presenting patients after two emerg shifts under my belt. "I have a 77-year-old woman with diabetes, asthma, COPD, gout, osteoarthritis, peptic ulcer disease, and an MI in '02. She says she's here for a prescription renewal."

  "Let me see that." He grabbed the chart and read it, then threw it back at me. It flopped shut on impact. "So? No complaints?"

  "No."

  He bared his teeth in a grin. "Did you ask her about chest pain? Shortness of breath? Orthopnea and PND? Peripheral vascular symptoms? Abdominal pain? Pain in her joints? Tophi?"

  I shook my head. "I asked her if she had any complaints."

  "And you took her at face value? You did not do a complete review of systems?"

  I shook my head.

  "You know, Hope"—a faint, scornful emphasis on my name—"you may want to be the kind of family doctor who just pushes prescriptions, but that's not what we're training you for here. How can you figure out what medications she needs, and how you need to adjust her prescriptions, if you don't even ask her?"

  My skin did toughen up during medical school. But all the same, I felt a burning at the back of my eyes. I had to figure out what all the drugs did before I could decide if she needed them or not.

  "Family medicine is patient-centred. That means we focus on the patient." He jabbed a hand toward my clinic room. "Not on the chart, or on drugs, or your own ego."

  My ego. What did that have to do with anything? It was about the size of a dust mote right now.

  He had a point. I had an hour with this patient. I could have talked to her more. But he didn't have to be such a dick about it. I took a few deep breaths, willing the tears away. Dr. Dave Dupuis had taught me without relying on mortification.

  "Dr. Callendar?" Tori called from across the room. She had silently pulled up a chair at the opposite end of the table. "I wonder if you could help me with Mrs. Abramovitch. She has a lot of questions this time."

  "Just a minute, Tori." Dr. Callendar slapped my patient's chart, avoiding my eyes. "Think about it." He hastened over to Tori's side. "I know Mrs. Abramovitch very well. Has she been on the Internet again?" He chuckled and shook his head.

  In the hall, I took a few breaths while I was still out of earshot and eyesight of my patient. I didn't want to cry all over her. Maybe I should hit the bathroom for a few minutes of privacy. I looked around, but all I saw was the men's. Then I remembered that women's was in opposite wing, on the other side of the U. Another reason to cu
rse the FMC.

  A fake wood door opened in front of me. I reared back, clutching the chart to my chest.

  It was only Stan. He shut the door behind him at the sight of my face. "Hope. What's up?" His loud voice echoed down the hall.

  I turned away. "Nothing."

  "Bullshit." Stan gestured for me to come with him. I hesitated before following him down the hall, past the conference room, into an unmarked room on the left.

  It was someone's office. Charts spilled over the desk, photos were propped by the phone, and textbooks lined the wall. The last thing I needed was to get busted for trespassing, but before the door closed behind us, Stan asked, "Dr. Callendar raking you over the coals?"

  I nodded without meeting his eyes.

  "Look. Don't worry about it. He did the exact same thing to me when I was an R1. He's just happy to have someone new to yell at. He probably has a small penis. His problem. Okay?"

  I half-snorted a laugh. Stan's brown eyes were bright and interested. His features were too coarse to be good-looking, but his energy and confidence were appealing. I started to cheer up. "Doesn't he get to you?"

  Stan laughed. "He used to. When I was a medical student. When I found out I was going to be on his team this year, I said, 'God, no, not the demon team leader!' But I have him figured him out. He likes having someone to pick on. You should see him making fun of Omar's accent."

  "What?" My blood began to boil. It felt better than weepiness. "That's just wrong."

  "Yeah, he's a dickhead. But if you can handle the attitude, he can teach you a few things. He's worse than usual today, probably mad that he had to be a team leader. They brought him in because of Kurt." Stan's face dimmed. "They had to switch all the teams around."

  Kurt had left so many holes to fill. We found his body on Saturday morning. In the past few days, not only were people mourning, but they must have scrambled to find a new team leader and someone to take his patients.

  Dr. Callendar had stepped in. I still didn't like him, but at least he did that much.

  Stan cast a quick glance at the desk. "It's hard to believe Kurt's gone."

  I gulped. "Is this his office?"

  "It was. I guess it'll be Dr. Callendar's now. But he hasn't changed anything yet." He cheered up a little. "St. Joe's probably can't afford a cleaning crew. It'll stay like this a while. Man, I don't envy whoever has to go through all the papers. Kurt was always beavering away on something. Last I heard, it was spousal abuse. He wanted to set up a resource centre at St. Joe's. Even a hotline! I told him, who wants to run that?"

  I was still a few thoughts back. A cleaning crew would clean away any evidence. I stepped toward the desk.

  Stan sounded alarmed. "What are you doing?"

  "I'm just curious about his pictures. Everyone talks about him, but I never really knew him." I peeked at the framed photos on his desk. One of them was a picture of Dr. Radshaw, sans moustache, wearing a ragged red-and-white football jersey. He was hugging a girl with a dark bob. She pressed to her face to his chest, but I could tell it was the woman in purple scrubs, Vicki.

  I scanned the other photos: a black-and-white picture of a family, probably historical, and one of a mutt pressing its muzzle toward the lens. My heart twisted. I wondered who was taking care of the dog. I glanced at the wall, under the bookshelf, he'd hung his McGill medical degrees, which were written in Latin.

  "Uh, Hope. We should get back."

  "I know." I smiled at him. "Thanks."

  He was already turning the doorknob when I noticed McGill class photos hung alongside and over the doorway. The one by the light switch was for the class of 2011.

  I hesitated and pointed.

  "Yeah. He likes—liked—to keep the class photos from when he started teaching. Come on. Callendar's going to lynch us."

  "I'll cover for you."

  He didn't look reassured. We crept into the hallway. All the doors were still closed. No one had noticed our absence. Stan whispered, "Just think about how small his dick must be. Miniature. Okay?"

  "Okay."

  He pushed open the door to the conference room. I headed down the hall to my patient, but with every step, I recalled the class photo. Right by the light switch, where Dr. Radshaw would have seen it every day, Mireille's face smiled out from the middle of the pack.

  Chapter 10

  If Dr. Radshaw had hung up class pictures for years, it would have been strange for him to stop just because his ex-girlfriend was in one. In fact, they might have still been dating while he displayed it. I kind of liked that Dr. Radshaw had kept her around post-breakup.

  Still, he must have looked at it every day.

  When Ryan and I broke up, I didn't destroy our stuff, but I put it in a locked box in my parents' cold storage. I burned a playlist of "our" songs on to a DVD and deleted them from my computer and iPod. Slowly, painfully, I got over Ryan. Still, when I found dried rose petals I'd forgotten, pressed between the pages of my dictionary, I cried.

  Maybe Dr. Radshaw was less sentimental than I was. Heck, Mireille was a resident at his hospital. He'd see her in person all the time, never mind her picture.

  But the more I got to know about Dr. Radshaw, the more curious I got. I'd agreed to ask questions, partly for Alex, but now I wanted to know the answers, too.

  After I saw my second patient, I had to wait to review her with Dr. Callendar because he was too busy lashing Omar. "You don't understand. In Canada, we do things differently." He even exaggerated his pronunciation, as if Omar was retarded or hearing-impaired.

  Omar nodded. "Yes. Of course. Yes!"

  Dr. Callendar might have stepped into the breach, but he was still an asshole, same as Saturday morning.

  My eyes narrowed. Saturday morning. He worked the night shift on Friday—the same night Dr. Radshaw died in the men's change room. I'm not saying it was Callendar's fault, but maybe he accepted the team leader position out of guilt.

  Dr. Callendar stabbed a knobby finger against Omar's note. "I can't read your handwriting. Medico-legally, your writing has to be legible. It doesn't matter what you say it says, someone independent has to be able to read it if you go to court. You'd better practice. Do you understand me?"

  I snorted under my breath. This from a guy who squiggles so bad that he uses a stamp on his ER notes, and you still can't read them. He was born to belittle.

  Could he love it so much, he'd have killed Kurt to have free reign in humiliating residents?

  I watched him. The way his black hair stayed still as he shook his head, meaning he was vain enough to use spray or gel. The brackets around his mouth and across his forehead from frowning. The way the end of his nose turned up slightly, like a pig snout. He wasn't a big guy, but he had square shoulders and thick limbs. He probably packed some muscle under his lab coat. He might have been able to take Dr. Radshaw on.

  Nah. Team leader wasn't worth killing for.

  Still, if I did happen to find info that nailed Dr. Callendar, it couldn't happen to a nicer guy.

  Dr. Callendar's head jerked up. He snapped at me, "Do you have someone to see?"

  I held up my chart. "I'm just waiting to discuss my last patient of the day. Sir."

  He squinted suspiciously.

  I smiled back, partly because of a new brainwave.

  I had to search Dr. Radshaw's office before it became Dr. Callendar's. And before the police decided to seal it off.

  At the end of clinic, I had to stay late to write up my charts and fill out paperwork. Stan took off with a "See ya!" tossed over his shoulder. He was the only one. Tori and Omar's pens scratched alongside mine.

  Dr. Callendar cleared his throat. "Just leave the charts here. I'll sign them off afterward." He grabbed his briefcase and disappeared. Maybe he'd get stuck in the elevator.

  Omar was printing in his charts, his eyes wide with concentration. Even so, he finished before me. He closed the last one with a sigh of relief. "Good-bye. It was nice meeting you."

  And then there w
ere two. After a few minutes of scribbling in silence, Tori asked, "Are you almost done?"

  "Almost." One patient per hour should be yawningly easy, but after interviewing and examining the patient, enduring Dr. Callendar's whip once, returning to the patient to ask reams of questions, conferring a second time with Dr. Callendar (hit me again, sir!), and then writing out prescriptions and forms, I was running late. Again.

  At least Stan had showed me Dr. Radshaw's office. Lunch hour was a perfect time to spy.

  I considered shoving my forms aside and saying I'd come back to them, but I didn't want to attract Tori's attention.

  My second patient needed some physiotherapy for her shoulder. Dr. Callendar had informed me the waiting list was about six months long, so if I wanted to bump my patient up, I had to call the physio and personally plead my case. I dialed the number and left a message, but it was almost 12:15. No doubt she was at lunch.

  I was astonished by the mountain of paperwork I'd piled up on just two patients. For anything I wanted—blood tests, ultrasounds, CT scans, physiotherapy, consultation of specialists, quoi que ce soit, I had to fill out who I was, what I wanted, who I wanted and when, Dr. Callendar's name and billing number. Then, in the upper right hand corner, I was expected to write the patient's name, birth date, FMC chart number, and hospital number. On each sheet!

  That's a clerical job. Sure, I'm still learning, which is the excuse for paying me a pittance as a resident and charging me tuition on top of it, but why should I spend my ninth year of post-secondary education filling out forms?

  As a final insult, each chart had a patient card we could have stamped on to each form and saved ourselves half the time. "Why don't we have an addressograph?" I asked Tori.

  She laughed. "You should ask Stan about it. He tried to get one last year. They said it cost $1000. It's more cost-effective to have us fill out the form."

  Unbelievable. The entire FMC was an exercise in mortification. It boggled my mind that they'd rather have a dozen residents filling out paperwork instead of seeing patients. There's a shortage of doctors in Montreal. Subtract the paperwork, and even I, a fledgling doctor, could probably have squeezed in one more patient in this morning.