Lakeside Hospital Box Set

by Cara Malone

  Ivy took her breakfast over to the same table where she always sat. A few more early risers came in and ordered coffee to go, but Ivy was the only one who stuck around to eat and for the first time in three and a half years, she didn’t have a single notebook, textbook, or so much as a flashcard with her. She wouldn’t have any use for them today because they weren’t permitted in the testing center, but their absence made her feel somewhat naked. Unprepared. Now that was a thought she had to push away with as much vehemence as she could muster.

  I am ready for this, she said to herself over and over again as she finished the breakfast sandwich and drank one of the coffees. I’m going to crush it.

  Ivy was still repeating this mantra when a dark green Honda pulled up to the curb outside and honked impatiently for her. Ivy stood up, threw away her garbage, checked to make sure her stethoscope was still tucked into her lab coat pocket, then went outside.

  “Get in,” Dr. Stevens said. “I don’t think I’m allowed to park here.”

  Ivy obeyed, sliding into the passenger seat. She hadn’t even buckled her seatbelt before Dr. Stevens was pulling back onto the road and Ivy’s heart stuttered in her chest. This was it – she was on her way to take the medical licensing exam that she’d been preparing for all year and she didn’t have her lucky totem, Chloe, for support.

  “You ready?” Dr. Stevens asked.

  “I’m going to crush it,” Ivy said, then blushed. She’d repeated her mantra so many times while she was eating breakfast that it just slipped out and Dr. Stevens laughed.

  “That’s the spirit,” she said.

  “Thanks for driving me,” Ivy said, handing Dr. Stevens the second coffee just as she let out a large yawn.

  The testing center was located in a high-rise in Chicago, about thirty minutes away from campus, and if Ivy hadn’t succeeded in talking – or begging – Dr. Stevens into taking her, she would have had to worry about the expense and logistics of hiring a cab on top of everything else on her mind this morning. They rode in silence most of the way, Dr. Stevens sipping from her coffee and Ivy running through last-minute reminders in her head.

  When they reached the testing center, Ivy looked at it out the window, the building’s glass façade rising into the sky. She’d be on the sixth floor today, completely cut off from the rest of the world for the next eight hours in a secure testing facility. It was the moment she was born for and it filled her with terror.

  She unclicked her seatbelt and before she got out of the car, she said, “Meet you here again at six p.m.?”

  “I’ll be here.”

  “I really appreciate it, Dr. Stevens,” Ivy said, her voice wavering a little with the nerves that were rising in her throat.

  Dr. Stevens noticed and rolled her eyes, then said, “Take a deep breath. You’re the hardest-working medical student I know and you’re going to do fine. And quit with the Dr. Stevens stuff. You can call me Krys.”

  Ivy nodded, letting Krys’s words sink in – it was the first bit of mentorly advice she’d offered. Then Ivy took a deep breath and marched into the building. She repeated her mantra all the way up to the sixth floor and into the orientation room, where a handful of other students were waiting – some from her class, some who had traveled here for the exam.

  The room filled up quickly as a few dozen medical students all rushed in to find seats and get settled. Ivy saw a few familiar faces, people she’d been in rotations with and not bothered to get to know well enough to make eye contact with them now. She was busy repeating her mantra and a variety of diagnostic acronyms in her head. I’m going to crush it. I’m going to crush it. I am going to crush it.

  A few minutes before eight, Megan and Chloe slipped into the room together. Chloe caught Ivy’s eye and smiled, then looked away and followed Megan into the back row.

  Ivy forced herself to turn back to the front of the room. She couldn’t think about Chloe right now. Chloe was the absolute last person in the world Ivy should be thinking about for the next eight hours, and the only one who had the power to throw her off her game right now.

  The orientation room doors slid shut promptly at eight and one of the proctors came to the front of the room to welcome them all. Ivy looked around at her fellow students. A lot of them looked nervous, their knees bouncing and their hands squeezed into fists in their laps. She reflexively sat up a little taller, holding her head high as she listened to the proctor’s introduction to the exam.

  They would each have twelve mock patient encounters over the course of the day, each one lasting fifteen minutes. In that time, they would have to note the presenting complaint, take a focused patient history and perform a physical exam based on the complaint. They would be responsible for answering any questions that the mock patient had, establishing rapport with them, and coming up with a preliminary diagnosis. Then they’d have ten minutes to write all of it up in a patient note before going on to the next patient.

  Again and again and again, until every patient had been seen and the day was finally done eight full hours later. No wonder these poor saps look nervous, Ivy thought.

  When the proctor released them from the orientation room a few minutes later, Ivy stood and filed into the hallway along with everyone else. She saw a swish of blonde hair ahead of her and watched Chloe go to the end of the hall and stand in front of a door on the same side of the hallway that Ivy had chosen. She should have just kept her eyes on her own door but the temptation was too great.

  Ivy glanced at Chloe and found her staring right back. They were only four doors away from each other, close enough to watch Chloe’s plump lips mouth the words, Good luck.

  Ivy looked away from her then, mostly because they’d all been warned about communicating with each other during the day and she didn’t want any of the proctors to think they were cheating. A moment later, one of them announced loudly, “You may begin your first encounter now.”

  A dozen doors opened at once as the hallway full of future doctors took their first steps into the patient encounter rooms, but Ivy didn’t move. For just a few seconds, she closed her eyes and imagined that she was completely alone in the hallway – no Chloe, no Megan, no proctors. Just her in her white coat, with her stethoscope draped around her neck, ready to become a doctor. She let out a slow, measured breath, then opened her eyes and went into the room in front of her.

  It was just like every exam room Ivy had ever seen, with a sink and supply cabinets on one wall and an exam table straight ahead. Sitting on it was a rather pregnant woman.

  Ivy smiled and held her chin up as she closed the door softly and said, “Hello, I’m Dr. Chan. What brings you in today?”

  It was a quarter to six p.m. when Ivy finally left the sixth floor of the building and rode alone in the elevator down to the lobby, her white coat draped carefully over her arm. She was utterly exhausted and she’d never worked so hard in her life, even during hectic shifts in the Emergency Room and long hours standing at the operating table.

  She’d drawn upon every scrap of knowledge she’d obtained in the last three and a half years, every case study she and Chloe had run through, and every notecard taped to the wall in her apartment. She’d had a pregnancy, chest pains, bloody stool, sexually transmitted diseases, depression, fatigue, and everything else that the licensing board could throw at her, and while the exam had been a challenge from start to finish, she’d done okay.

  Maybe not as well as she would have if she’d stayed focused this year, but Ivy didn’t think that she’d have bad news to bring home to her parents when the results came next month. She knocked on the elevator’s wooden handrail just before she stepped out, not willing to take any chances, and then she looked around for a place to sit while she waited for Krys. Ivy’d had a hard time getting excited about the turkey sandwiches the licensing board had served for lunch, too keyed up by the break-neck pace of the exam to eat much, and now she was feeling weak and depleted, ready to take a long, well-earned nap.

  There was
a single row of about ten chairs in the lobby, lining the wall to the left of the elevators and facing the large windows that looked out on the parking lot. They would be an ideal place to watch for Krys’s green Honda if not for the fact that the one in the middle was already occupied by a certain redheaded rival.

  “Megan,” Ivy said, acknowledging her as she walked past and plopped down in the farthest chair in the row. She was too tired and her legs felt too much like jelly to find somewhere else to wait.

  “How’d you do?” Megan asked. She was eating a candy bar from the vending machine at the end of the hall and looking perfectly rested, as if the test hadn’t been the hardest trial of her life.

  “We’re not allowed to talk about it,” Ivy reminded her.

  “We’re not allowed to talk about the cases,” Megan corrected. “We can tell each other if we think we bombed it.”

  “Did you?”

  Megan laughed. “No, I think I passed.”

  Ivy looked at her for a minute, calmly eating her candy bar, and then instead of being vicious, she just said, “Good. Me too.”

  It was the first time she’d ever chosen not to go for Megan’s throat when she had the opportunity, and Ivy wasn’t sure if she was simply too tired to fight or if something else was at play. She glanced at the clock on the wall – five fifty-two. She had almost ten more minutes before Krys arrived and now she was stuck in the lobby with Megan, more than ready to go home.

  She asked, “You waiting for Chloe?”

  “Yeah,” Megan said. Ivy thought that was another very good reason to find somewhere else to wait for Krys, but her legs insisted on staying. Then Megan asked, “Hey, do you need a ride?”

  Ivy raised both eyebrows. Hell must have frozen over because her arch-rival just offered her a ride home. She said, “No, Krys is picking me up… thanks, though.”

  It was easier to say those words than she’d expected. Maybe it had something to do with the surgical rotation being over and no longer needing to compete head-to-head with Megan every day. Maybe it was because medical school was almost over and they were going into different specialties, meaning they’d never have reason to compete with each other again. Or maybe it had something to do with Chloe. Megan was engaged. Ivy had broken her heart. Maybe it was finally time to bury the hatchet because they’d both lost the thing they’d been competing over all these years.

  “Dr. Stevens?” Megan asked. “You two are friends now?”

  “I asked her for a favor,” Ivy said. “I was hoping to spark up some kind of mentoring relationship with her but that never really materialized. I begged her for a ride because I had no other way of getting here.”

  “I know we’re not the best of friends,” Megan said, laughing to offset the understatement of the century, “But all rivalries aside, you know Chloe and I could have given you a ride.”

  “I can’t really be around Chloe right now,” Ivy said. “It’s complicated.”

  “You like her,” Megan said.

  “She told you?”

  “No, but it’s obvious,” Megan said. “You’re such a stone cold bitch to everyone, but you’re different when you’re around Chloe.”

  “Thanks,” Ivy said, rolling her eyes.

  “Sorry,” Megan said. “But it’s true. I can tell she means a lot to you, and she’s a great girl.”

  “Yeah, well, I screwed that up,” Ivy said. “Look, I’m going to wait outside for Krys. She should be here soon.”

  “It’s freezing out there,” Megan pointed out, but Ivy gathered her coat and stood up.

  All the other students would be coming downstairs soon, including Chloe. Ivy had been so cruel to her the last time they spoke, she didn’t want to find the words to apologize while Megan and a room full of medical students listened.

  Ivy took a few steps across the lobby, her sneakers squeaking on the marble floor, and then Megan called after her, “She’s the forgiving type. I bet you could un-screw it up.”

  Ivy paused but didn’t turn around. She heard the elevator ding and the doors slid open, then she headed outside. It was dark and it had begun to snow. She pulled her coat tightly around her and kept her eyes on the road, waiting for the green Honda, while medical students poured out of the building, chatting nervously with each other about the exam.

  22

  Chloe

  Chloe rode down to the lobby with a handful of her fellow medical students. A few of them were standing quietly in the elevator, obviously thinking through their cases, but a couple of guys standing closest to the elevator doors were talking loudly and confidently.

  Chloe recognized them as Northwestern students – a couple of future surgeons, Tom Donoghue and Alan Riggs. Chloe had met them at orientation and worked with them a few times on labs and presentations, but mostly she tried to steer clear because they made a sport of playing the stereotypical cocky doctor persona. She listened to their conversation now, though, because it was hard not to in the small elevator.

  “That case with the pregnant chick? Gestational diabetes,” Riggs said, his arms crossed over his chest. “I called it the minute I walked into the room.”

  That’s what I figured, too, Chloe thought, although she’d taken a patient history and done a focused physical exam before she felt confident enough to write it in the patient notes. The woman’s name was Mary and she was in the third trimester of her pregnancy – or at least she was for the purposes of the exam.

  “Most of them were easy,” Donoghue said. “I didn’t even bother offering multiple diagnoses when they were obvious. Cholecystitis? Please - give me something hard.”

  Donoghue rolled his eyes, then caught sight of Chloe behind him and turned to face her.

  “Hey, blondie,” he said, wagging one eyebrow at her. “How’d you do?”

  He’d started calling her ‘blondie’ in their rare interactions after she’d been paired with him to do a literature review in their second year, and Chloe suspected it was because he’d never bothered to remember her name.

  “Time will tell,” Chloe said.

  He would assume that meant she did poorly, but he could think what he wanted. She’d learned quickly that it was easiest not to engage with these two since they clearly thought they were God’s gift to medicine and His gift to women. Thankfully, the elevator doors opened and rescued Chloe from this interaction. She’d actually walked out of the testing center feeling pretty decent about her performance and she had nothing to prove to these two.

  She walked out of the elevator behind everyone else and Megan waved to her from a row of chairs along the wall. While Chloe made her way over to her, she saw a flash of Ivy’s long, straight ponytail heading for the exit. When she’d seen her in the orientation room, Chloe had wanted to say hello and wish her luck, but she didn’t know if Ivy would want that. Now, she wanted nothing more than to check in with Ivy and find out how she’d done. They spent so many hours studying for this and once upon a time, Chloe had looked forward to discussing the exam with Ivy after it was over.

  But Ivy disappeared into the crowd and Chloe met Megan, asking, “You ready?”

  “Yeah,” Megan said. Then she nodded toward the exit and said, “Ivy was nice to me just now.”

  “Really?” Chloe asked, following Megan’s gaze. Ivy was standing on the other side of the glass, wearing her white coat on top of her jacket and shivering in the cold. “Should we offer her a ride?”

  “She said she has one,” Megan said.

  “What did you two talk about?” Chloe asked.

  Knowing Ivy and Megan’s history, it couldn’t have been anything other than the exam. But Megan threw Chloe complete off-guard when she said, “You.”

  “Me?” Chloe asked. She wanted details. Did Ivy bring her up, or Megan? What did she say? Did she seem like she missed Chloe? But the answers to all of those questions would only re-open the wounds that Ivy had inflicted after their Thanksgiving trip, and Chloe didn’t want that – not right now. She wanted to be happy th
at she’d finished the medical licensing exam, and that she was pretty sure she would pass. So before Megan could volunteer any details, she said, “Should we go home now?”

  On the ride back to Evanston, Megan and Chloe talked about the exam. Chloe told Megan what Riggs and Donoghue had said in the elevator and Megan said she’d diagnosed gestational diabetes in the pregnant woman as well.

  “What did you think about Jason?” Chloe asked.

  “Who?”

  “The abdominal pain patient,” Chloe said. “Riggs said he diagnosed cholecystitis and I was leaning that way too based on the symptoms, but the physical exam showed that the pain was middle or lower right quadrant instead of upper, so I changed my diagnosis to colitis.”

  “Riggs is a cocky know-it-all,” Megan said. “And he’s going to kill people if he thinks he can diagnose them with nothing more than his powerful male gaze. I said colitis, too.”

  Chloe smiled and they continued talking through the list of twelve patient encounters. By the time they arrived back in Evanston, they were laughing and telling each other all the little mistakes they’d made on account of their nerves.

  “I was so frantic to finish that abdominal pain one that I wrote ‘poop’ in my patient note instead of stool,” Megan said with a hearty laugh. “I didn’t even realize I did it until I was in the room with my next patient.”

  “The proctor had to come and get me out of the room on my first encounter,” Chloe said. “I had no idea how fast fifteen minutes would go by and I had so many more questions to ask.”

  By the time Megan pulled up in front of Chloe’s apartment, her lungs hurt from laughing. It had been a while since she’d enjoyed such a light-hearted moment and it felt good to laugh about it all and shrug the weight of the exam off her shoulders at long last.

  When Megan asked how Chloe thought she did, she said, “I think I passed.”