by Sarah Morgan
“After three dates, I’ve lost my sense of humor. That’s it. I’m done.”
All she wanted was fun and a little human company. Was that too much to ask?
“You decided to give love a chance. Nothing wrong with that. But someone like you shouldn’t struggle to meet people. What’s your job? Don’t you meet anyone through work?”
“I’m a dog walker. I spend my day with handsome, four-legged animals. They are always who you think they are. Although having said that I do walk a terrier who thinks he’s a Rottweiler. That does create some issues.”
Maybe she should stick with dogs.
She’d proved to herself that she could do the whole online dating thing if she had to. She’d ticked it off her list. It was victory of a sort.
Nat opened the window wider. “Report him to the dating site so he doesn’t put any more unsuspecting women in the position of having to jump out the window. And look on the bright side. At least he didn’t scam you out of your life savings.” She checked the street. “You’re clear.”
“Nice meeting you, Nat. And thank you for everything.”
“If a woman can’t help another woman in trouble, where would we be? Come back soon.”
Harriet felt a tug deep inside.
Friendship. That was perhaps the only F word she liked.
Feeling a flash of regret that she would never be going anywhere near this restaurant ever again, because she genuinely liked Natalie, Harriet held her breath and dropped onto the sidewalk.
She felt her ankle twist and a sharp, agonizing pain shot up her leg.
“You okay?” Nat dropped her shoes and her purse and Harriet winced as they thudded into her lap. It seemed that the only thing she was taking away from this date was bruises.
“Never better.”
Victory, she thought, was both painful and undignified.
The window above her closed and Harriet was immediately aware of two things. First, that putting weight on her ankle was agony. Second, that unless she wanted to hobble home in bare feet, she was going to have to put on the stilettos she’d borrowed from the pile of shoes Fliss had left behind.
Gingerly, she slid the shoe onto her foot and sucked in a breath as pain shot through her ankle.
For the first time in her life she used the F word to express something other than fear.
Another box ticked in project Challenge Harriet.
CHAPTER TWO
ACROSS TOWN IN the trauma suite of one of New York’s most prestigious hospitals, Dr. Ethan Black and the rest of the trauma team smoothly and efficiently cut away the ripped, bloodied clothing of the unconscious man to expose the damage beneath. And the damage was plenty. Enough to test the skills of the team and ensure that their patient would remember this night for the rest of his life.
As far as Ethan was concerned, motorcycles were one of the world’s worst inventions. Certainly the worst mode of transport. Many of the patients brought in following motorcycle injuries were male, and a high proportion had multiple injuries. This man was no exception. He’d been wearing a helmet, but that hadn’t prevented him from sustaining what looked like a severe head injury.
“Intubate him and get a line in—” He assessed the damage as he worked, issuing instructions.
The team was gathered around, finding coherence in something that to an outsider would have seemed like chaos. Each person had a role, and each person was clear about what that role was. Of all the places in the hospital it was here, in the emergency room, that the teamwork was the strongest.
“He lost control and hit an oncoming car.”
Screaming came from the corridor outside, followed by a torrent of abuse delivered at a high enough pitch to shatter windows.
One of the residents winced. Ethan didn’t react. There were days when he wondered if he’d actually become desensitized to other people’s responses to crisis. Working in the emergency room brought you into contact with the most extreme of human emotions and distorted your view of both humanity and reality. His normal would be someone else’s horror movie. He’d learned early in his career not to talk about his day in a social situation unless the people present were all medical. These days he was too busy to find himself in too many social situations. Between his clinical responsibilities as attending physician in the emergency room and his research interests, his day was full. The price he’d paid for that was an apartment he rarely saw and an ex-wife.
“Is someone caring for the woman on the end of that scream?”
“She’s not the patient. She just saw her boyfriend knifed. He’s in Trauma 2 with multiple facial lacerations.”
“Someone show her to the waiting room. Calm her down.” Ethan took a closer look at the man’s leg, assessing the damage. “Whatever it takes to stop the screaming.”
“We don’t know how serious the injuries are.”
“All the more reason to project calm. Reassure her that her boyfriend is in good hands and getting the best treatment.”
It was a typical Saturday night. Maybe he should have trained as an ob-gyn, Ethan thought as he continued to assess the patient. Then he would have been there for the high point of people’s lives instead of the low. He would have facilitated birth, instead of fighting to prevent death. He could have celebrated with patients. Instead his Saturday night was invariably spent surrounded by people at crisis point. The victims of traffic accidents, gunshot victims, stabbings, drug addicts looking for a fix—the list was endless and varied.
And the truth was he loved it.
He loved variety and challenge. As a Level 1 Trauma Unit, they had both in copious amounts.
They stabilized the patient sufficiently to send him for a CT scan. Ethan knew that until they had the results of that scan, they wouldn’t be able to assess the extent of his head injury.
He also knew that it was difficult to predict what the scan would show. He’d had patients with minimal visible damage who turned out to have massive internal bleeding and others, like this man as it later turned out, who had a surprisingly minor internal bleed.
He paged the neurosurgeons and spoke to the man’s girlfriend, who had arrived in a panic, wearing a coat over her pajamas and terror in her eyes. In the emergency room everything was concentrated and intense, including emotions. He’d seen big guys who prided themselves on being tough, break down and sob like a child. He’d seen people pray when they didn’t believe in God.
He’d seen it all.
“Is he going to die?”
He handled the same question several times a day, and he was rarely in a position to give a definitive answer. “He is in good hands. We’ll be able to give you more information when we see the results of the scan.” He was kind and calm, reassuring her that whatever could be done was being done. He knew how important it was to know that the person you loved was receiving the very best care, so he took time to explain what was happening and to suggest she call someone to come and be with her.
When the man was finally handed over to the neurosurgical team, Ethan ripped off his gloves and washed his hands. He probably wouldn’t see the patient again. The man was gone from his life, and he’d probably never know about the part Ethan had played in keeping him alive.
Later, he might check on his progress but more often than not he was too busy focusing on the next priority to come through the door to think about those been and gone.
Susan, his colleague, nudged him out of the way and stripped off her gloves too. “That was exciting. Are you ever tempted to take a job in primary care? You could live in a cute small town where you’re caring for three generations of the same family. Grandma, Grandpa, parents and a big bunch of grandkids. You’d spend your day telling them to give up smoking and lose weight. Probably never see a drop of blood.”
“It was what my father did.” And Ethan had never wanted that. His choices were the focus of lively arguments whenever he was home. His grandfather kept telling him he was missing out by not following a family throu
gh from birth to death. Ethan argued that he was the one who kept them alive so that they could go back to their families.
“All these months we’ve worked together and I never knew that about you.” Susan scrubbed her hands. “So you come from two generations of doctors?”
They’d worked together for over a year but almost all their conversation had been about the present. The ER was like that. You lived in the moment in every sense.
“Three generations. My father and grandfather both worked in primary care. They had a practice in upstate New York.” He’d sat, five years old, in the waiting room watching as a steady stream of people trooped through the door to speak to his dad. There had been times when he’d wondered if the only way to see his father was to get sick.
“And your mother?”
“She’s a pediatrician.”
“Jeez, Black, I had no idea. So it’s in the DNA.” Susan yanked a paper towel from the dispenser so vigorously she almost removed it from the wall. “Well, that explains it.”
“That explains what?”
“Why you always act like you have something to prove.”
Ethan frowned. Was that true? No. It certainly wasn’t true. “I don’t have anything to prove.”
“You’ve got a lot to live up to.” She gave him a sympathetic look. “Why didn’t you join them? Doctors Black, Black and Black. That’s one hell of a lot of Black right there. Don’t tell me, you just love the warm fuzzy feelings that come from working in the emergency room.” Through the door they heard the woman yell fuck you and exchanged a wry smile. “All those cute patients enveloping you with endless love and gratitude—”
“Gratitude? Wait—I think that did happen to me once, a couple of years ago. Give me a moment while I cast my mind back.”
He didn’t feel as if he had to live up to anything.
Susan was wrong about that. He walked his own path, for his own reasons.
“You must have been hallucinating. Lack of sleep does that for you. So if the rare dose of gratitude isn’t what does it, it must be the patients who curse you, throw up on your boots and tell you you’re the worst doctor that ever graced god’s earth and that they’re going to sue the hell out of you. That works for you?”
The humor got them through days that were fraught with tension.
It sustained them through the darker shifts, through witnessing trauma that would leave the average man on the street in need of therapy.
Everyone in the trauma team found their own way of dealing with it.
They knew, as most people didn’t, that a life could change in an instant. That there was no such thing as a secure future.
“I love that side of it. And then there’s the constant buzz of working with adoring, respectful colleagues like you.”
“You want adoring? Pick a different woman.”
“I wish I could.”
Susan patted his arm. “In fact I do adore you. Not because you’re cute and built, although you are, but because you know what you’re doing and around here competence is as close as it gets to an aphrodisiac. And maybe that’s driven by a desire to be better than your daddy or your granddaddy, but I love it all the same.”
He shot her an incredulous look. “Are you hitting on me?”
“Hey, I want to be with a man who is good with his hands and who knows what he’s doing. What’s wrong with that?” Her eyes twinkled and he knew she was winding him up.
“We are still talking about work?”
“Sure. What else? I’m married to my job, same as you. I promised myself to the ER in sickness and in health, for richer and for poorer and I can tell you that living in New York City the emphasis is definitely on poorer. But don’t worry—I wouldn’t be able to stay awake long enough to have sex with you. When I leave this place I fall unconscious the moment I arrive home and I’m not waking up for anyone. Not even you, blue eyes. So if you’re not here for the love and positive feedback, it has to be because you’re an adrenaline junkie.”
“Maybe I am.” It was true that he enjoyed the fast pace, the unpredictability, the adrenaline rush that came with not knowing what would come through the doors next. Emergency medicine was often like a puzzle and he enjoyed the intellectual stimulation of figuring out where the pieces fit and what the picture was. He also enjoyed helping people, although these days the doctor-patient relationship had changed. Now it was all patient satisfaction scores and other metrics that appeared to have little to do with practicing good medicine. There were days when it was hard to stay in touch with the reasons he’d wanted to be a doctor in the first place.
Susan stuffed the towel into the bin. “Know what I love most? When someone comes in all bandaged up and you never know what you’re going to find when you unwrap it. Man, I love the suspense. Will it be a cut the size of a pinhead or will the finger fall off?”
“You’re ghoulish, Parker.”
“I am. Are you telling me you don’t like that part?”
“I like fixing people.” He glanced up as one of the interns walked into the room. “Problems?”
“Where do you want me to start? There are around sixty of them currently waiting, most of them drunk. We have a guy who fell off the table during his office party and hurt his back.”
Ethan frowned. “It’s not even December.”
“They celebrate early. I don’t think he needs an MRI but he’s consulted Dr. Search Engine and is insisting on having one and if I don’t arrange it he is going to sue me for every cent I’m worth. Do you think it would put him off if I tell him the size of my college loans?”
Susan waved a hand. “Ethan will handle it. He’s great at steering people toward the right decision. And if that doesn’t work he’s good at playing Bad Cop.”
Ethan raised an eyebrow. “Bad Cop? Seriously?”
“Hey, it’s a compliment. Not many patients get one past you.”
Backache, headache, toothache—all commonly appeared in the department, along with demands for prescription pain meds. Most of the experienced staff could sense when they were being played, but for less experienced staff it was a constant challenge to maintain the right balance between compassion and suspicion.
Still pondering the Bad Cop label, Ethan walked to the door but his progress toward the patient was interrupted by the arrival of another patient, this time a forty-year-old man who had suffered chest pains at work and a cardiac arrest in the ambulance. As a result, it was another thirty minutes before Ethan made it to the man with the back injury, by which time the atmosphere in the room was hostile.
“Finally!” The man stank of alcohol. “I’ve been waiting ages to see someone.”
Alcohol and fear. They saw plenty of both in the emergency room. It was a toxic mix.
Ethan checked the records. “It says here that you were seen within ten minutes of arriving in the department, Mr. Rice.”
“By a nurse. That doesn’t count. And then by an intern, and he knew less than I do.”
“The nurse who saw you is experienced.”
“You’re the one in charge so it’s you I want, but you took your sweet time.”
“We had an emergency, Mr. Rice.”
“You’re saying I’m not an emergency? I was here first! What makes him more important than me?”
The fact that he’d been clinically dead on arrival?
“How can I help you, Mr. Rice?” He kept it calm, always calm, knowing that in an already tense environment a situation could escalate with supersonic speed. The one thing they didn’t need in the department was a bigger dose of tension.
“I want a fucking MRI,” the man slurred. “And I want it now, not in ten years’ time. Do it, or I’ll sue you.”
It was an all-too-familiar scenario. Patients who had looked up their symptoms on the internet and were convinced they knew not only the diagnosis but every investigation that should be performed. There was nothing worse than an amateur who thought he was an expert.
And the threats and t
he abuse were just two of the reasons emergency room staff had a high burnout rate. You had to learn to handle it, or it would wear you down like the ocean wore away at rocks until they crumbled.
In the crazy period between Thanksgiving and Christmas, it was only going to get worse.
Anyone who thought it was the season of goodwill, should have spent a day working with Ethan. His head was throbbing.
If he’d been one of his patients, he would have demanded a CAT scan.
“Dr. Black?” One of the residents hovered in the doorway and Ethan gave him a quick nod, indicating he’d be there as soon as he could.
As attending physician, everyone looked to him for answers. Residents, interns, ancillary staff, nurses, pharmacists, patients. He was expected to know it all.
Right now all he knew was that he wanted to get home. It had been a long, miserable shift and that didn’t seem likely to change anytime soon.
He examined the man thoroughly and explained calmly and clearly why an MRI wasn’t necessary.
That went down as well as he’d thought it would.
Some doctors ran the tests because at least then the patient left happy. Ethan refused to do that.
As he listened to a tirade describing him as inhuman, incompetent and a disgrace to the medical profession, he switched off. Switching off his emotions was the easy part for him now. Switching them back on again—well, that was more of a challenge, a fact borne out by his disastrous relationship record.
He let the abuse flow over him, but didn’t budge in his decision. He’d decided a long time before that he wasn’t going to let his decision-making be ruled by bullying or patient satisfaction scores. He did what was best for his patients, and that didn’t include subjecting them to unnecessary testing or drugs that would have no impact or, worse, a negative impact on their condition.
“Dr. Black?” Tony Roberts, one of the most senior pediatricians in the hospital, was standing in the doorway. “I need your help urgently.”
Ethan issued instructions to the resident caring for the patient and excused himself.
“What’s the problem, Tony? You have an emergency?”