Frost Bite

by S A Magnusson

  When I finished with the drawing, I looked at it for a little while. “I think I have it right, but it’s possible I don’t,” I said, turning it sideways for Josh to see.

  “It was more like this,” Josh said, pointing over my shoulder.

  I hadn’t even noticed him appear, and he grabbed the pen out of my hand, making a few markings that made the drawing of the tattoo clearer.

  “Are you worried that he’s in some sort of gang?” Josh asked with a smile. “He had to be in his seventies!”

  “Going after some seventy-year-old now, Stone?” Roberts looked over at me, grinning.

  “I figured I needed someone with experience. I get tired of all these boys fumbling around not knowing what they’re doing,” I said.

  Brad stared for a moment before setting off down the hallway.

  “The two of you…” Josh started.

  “None of your damn business,” I said.

  I stuffed the paper into my pocket and started to log into the computer to document when the sound of an ambulance coming into the bay caught my attention. Most of the time they didn’t pull in with sirens blazing, so when they did, it usually meant something significant.

  As I was a fellow, it was my responsibility to go to help the interns as much as I could, which meant that I needed to respond.

  Sometimes, it was easier when I’d been a resident. At least then I could pick and choose which cases I got involved in. As a pseudo-attending, I didn’t get that chance.

  Making my way toward the ambulance bay, I glanced at the trauma bay where the hypothermia patient had been, unable to shake the thought that something more was taking place, something I didn’t fully understand—and that those within the magical world might need to know about.

  I paused for a moment, tapping out a quick message on my phone, before heading into the ambulance bay. When they wheeled out the next patient, the EMT performing CPR when they did, I already knew it was going to be a long day.

  2

  It was late, and I was exhausted from the day, but I was still curious about the hypothermia patient. While sitting in the lounge, I popped into his chart. We still didn’t have a name, something that wasn’t uncommon for patients who came in unconscious, but considering how he’d survived the code—a kind we referred to as a megacode—I hoped to have uncovered a bit more.

  As far as I could tell, he was still alive. He’d been transferred to an intensive care unit bed, and with the nature of his cardiac injury, that wasn’t unsurprising. I wondered if he would ever fully recover. Sustaining an injury like his could be incredibly dangerous, and it was possible he wouldn’t pull back from it; many who suffered something of this magnitude didn’t recover as quickly as we ever hoped. What gave this guy a chance was the fact that his own injury had been sustained while he was hypothermic. It meant it was possible he’d have a much better outcome than someone else in a similar situation.

  Looking through the nurses’ notes, I saw he’d maintained a normal heart rhythm. If nothing else, it gave him a higher chance of survival.

  I was tempted to go and see what I could uncover about the man. Now, there was little doubt in my mind he had some connection or other to the magical world. The markings on his chest seemed too much like those I’d seen on a wand I’d once accidentally used. And there had to be something magical about that connection, though what was it?

  From his chart, sadly, I couldn’t tell anything else about him. Not a thing.

  I leaned back in the chair, looking around the lounge. It was empty—somewhat surprising at this time of day. Usually, there were other people here, if only to go after the food the hospital kept in for its attending physicians. Before, as a resident, I’d never been permitted into this lounge; the residents had their own and weren’t given access to this one, almost as if it was feared they might eat all the food. And seeing as how residents spent so much time in the hospital, it was also possible they would.

  With the lounge now empty, I savored the time by looking up my patients from earlier in the week. It was something I’d lately taken to doing, wanting to see if they’d either returned to the emergency room or been admitted; I liked to see if I’d provided the proper care for them. It was just my way of learning from my patients.

  There was one in particular, a young woman who had come in two days ago, and I glanced at her chart. She had returned to the EMR the next day, the complaint just the same as she’d reported when she first came in to see me. I skimmed the notes. She’d come in with an ankle injury, not uncommon this time of year when the ground could get slick with snow and ice, but she’d had bruising elsewhere on her body which had raised difficult questions. But they were questions she hadn’t wanted to answer.

  So, she’d turned up again the next day, and it looked as if she had another injury now, though this one was different. She’d slipped—again—and now had fallen and hit her head.

  Before I thought too much about it, I punched in her number, listening to the phone ring. Someone picked up, a timid-sounding voice coming from the other end of the line.

  “I’m trying to reach Mary Douglas,” I said.

  “Yes, this is she.”

  “Ms. Douglas, I’m Dr. Stone. I saw you in the emergency room at Hennepin General Medical Center the other day.”

  A long pause followed, and I partly expected her to hang up. It wouldn’t be the first time a patient had hung up on me when I called them.

  “Yes?”

  “I’m just making a follow-up phone call to see how you are feeling. When you were in the other day, you’d slipped on the ice, injuring your ankle.”

  “That’s right. I just slipped and fell. Nothing more than that.”

  “That’s what you said. I just wanted to make sure your ankle was coming along.”

  “It’s fine, Dr. Stone.”

  I could tell she wanted to get off the phone with me, and while I sat there, I scrolled back through her emergency room records. The ankle injury and the falls over these last two days weren’t the only times she’d been in to see us. Each time seemed to be for some musculoskeletal complaint, and they came in clusters.

  “It looks like you were in last night, too?”

  “Yeah. I slipped at home. I fell down the stairs. I’m so clumsy, you know,” she said.

  “How many stairs?” I asked her.

  “I told them last night.”

  “I know; I’m just trying to make sure our records are thorough. They didn’t document how many stairs you fell down.”

  “Does that matter?”

  “Well, we like to keep track of such things, mostly so we know if there’s anything more we need to be looking for.”

  “What sort of things would you be looking for?” she asked, still making a point of ignoring my question about the stairs.

  “Mostly it would be for ongoing headaches—anything that would make us worried about internal bleeding,” I explained.

  “There could be internal bleeding?”

  “Unfortunately. Anytime you hit your head, then we have to worry about that.”

  “They only told me I had to worry about a concussion. Nobody said anything about internal bleeding.” She sounded almost accusatory, as if her predicament was somehow our doing.

  “Well, concussions are one thing we worry about, but there are other things, too. So, have you had any problems with ongoing headaches?”

  “I’m fine, Dr. Stone. Thanks for calling,” she said. But her tone was cold, aloof.

  She went to hang up, but I couldn’t let it drop. “Look, if you’re not safe at home, you can always come in. There’s somebody here who’s trained to—”

  The line went dead, and I stared at it, wondering if I’d done enough. It was patients like her who always left me questioning whether I had. I had no idea what she’d been through, and no idea whether my read on the situation was right, but I felt like it was. I’d seen enough people come through and had enough personal experience with them to know t
hat someone like her—a woman dealing with an abusive situation—would hide it.

  If she came in again, I’d make sure to keep tabs on her myself. The electronic record had a way of flagging specific patients, and I triggered the flag on hers to remind me to check. If she came back again with another injury, I couldn’t let it go, could I?

  “Hey there, Dr. Stone.”

  I looked over to see Dr. Allen coming into the lounge. He was a younger physician, and had been attending for several years now, developing a reputation as someone incredibly caring, but with a knack for picking up on strange complaints. He was boyish, and a little cute, but not so much my type. But that didn’t mean I couldn’t flirt with him just a little bit.

  “You just got here?” I asked him.

  “I have the overnight.”

  “Well, that makes me feel a little bit sad I can’t be on with you.”

  He smiled slightly. “Hey, come on! No one really wants to take the night shift.”

  “Nights aren’t so bad,” I said. I glanced at the screen, closing down Mary Douglas’s chart. “Usually it’s the weird stuff that comes in at night. I kind of like seeing the weird stuff.”

  “You get plenty of weird stuff on all shifts, especially here,” he said.

  “Yeah. That’s true. I had a patient come in half frozen today.”

  “Hypothermia? It’s a little early to see the hypothermic patients come flooding in. We tend to get a bunch of them come February.”

  “Yeah. I’ve always wondered: why February and not sooner?”

  “Earlier in the year, those who need shelter haven’t burned all of their bridges. As the months go on, they tend to work their way through the various shelters, sometimes getting kicked out of all the possible options. Come February, we get to see one or two people a week. Then again, we get those who’ve had too much to drink and stumble and fall… all year round.”

  “The guy who came in today had a pretty serious megacode.”

  “At least you had a chance to practice. We have a good crop of residents, so I imagine they ran the code quite well.”

  “Well, I’d hoped they would, but it ended up being me doing most of it.”

  Dr. Allen studied me for a moment. “You are now responsible for their education, Dr. Stone. You deprive them of that opportunity when you do the work for them. Let them work through it on their own. It’s the only way they will gain the required knowledge—and confidence—for them to become skilled physicians.”

  “Even at the detriment of the patient?”

  He smiled slightly, shaking his head. “Of course not. Patient care comes first. We can’t have the patients suffering just because we want our new generation to learn, but if there’s the opportunity to let one of the interns or residents work through the complicated patients, you should make sure you take it.”

  I nodded. If I had any hope of working as an attending physician there when my fellowship was done, I needed to be able to do just what Dr. Allen was saying; he was one of those I most respected, and because of that, I needed to take what he said and use it.

  “Have a good shift,” I said, getting to my feet.

  Dr. Allen smiled at me. “Of course, I will. It’s all about one patient at a time.” The authenticity in his voice when he said it was almost disarming. He was sincere—something not all attendings were. I didn’t know him well, but I’d seen him interacting with patients firsthand and knew the way he talked was how he truly was.

  Stepping back out into the hallway, I pulled my phone out to look at the time, before deciding to head up to the ICU to find out how my patient was doing. I took the stairs, making my way through the back part of the hospital until I reached the unit. Much like in the emergency room, a steady hum of activity and noise was created by dozens of cardiac monitors occasionally beeping, or by the calls for nursing assistants and the steady, relentless sound of feet making their way across the linoleum. It wasn’t as dramatic or as loud as I’d encountered in the emergency room, but there was some of the same chaotic sense here.

  I found a familiar face sitting at the desk. “Dr. James.”

  Tom James was a friend from medical school who’d done his internal medicine residency before starting a cardiology fellowship. He looked up from the desk, pushing his glasses high up on the bridge of his nose as he flashed a wide smile at me. The lines under his eyes made me wonder just how long he’d been on call. I knew a cardiology fellowship could be almost as brutal as any surgical residency.

  “Hey there, Jen. What are you doing up here?”

  “I came to check on a patient I took care of in the emergency room today.”

  “Ah, the fibrillatory one! That was quite the resuscitation.”

  “You know how we do it down in the ER.” I made my way around the desk, taking a seat next to him. “Do we have any idea who he is?”

  Tom shook his head, turning to the computer and tapping the keys for a moment before looking over at me. “Unfortunately, we haven’t been able to get him awake enough to tell us anything about himself. His rhythm’s been stable enough since he got here, though; the amiodarone was a good call.”

  “Thanks. I wasn’t sure if he needed it at that point or not.”

  “I think it gave his myocardium a chance to stabilize. Hypothermia patients can end up with a shock myocardium, and by giving amiodarone, you probably headed off another ventricular arrhythmia.”

  “I did something right.”

  “The guy survived, Jen. You did everything right.”

  “I was kind of hoping to find out more about him and what happened to him,” I said.

  “You and me both. When he comes around, I can page you if you want,” Tom answered.

  I tapped my waist. “ER docs, Tom. We don’t carry pagers.”

  “So, how do you know when your patients get there?”

  “Seeing as how I’m always in the ER, there’s not a whole lot of chance I’m going to miss someone, is there?”

  Tom grinned. “I suppose not. I can call you if you want?”

  “Yeah. Why don’t you? Still have my number?”

  He fumbled around on the desk until he found a scrap of paper and pulled a pen from his pocket. “Just in case.”

  I gave him my number, then looked around the intensive care unit. Each bay was unique, glass doors making it so you could look inside, the patients angled so the nurses could see them from the central desk. The hum of ventilators and the beep of monitors gave a certain energy to the air.

  “Mind if I go in and check with him?”

  Tom waved his hand, turning his attention back to the computer, and I headed toward the ICU bay where the patient lay.

  He was hooked up to the heart monitor, a thin sheet pulled up to his neck. His eyes were closed, his head tilted off to one side. His breathing remained regular, and I wondered if he had any bruising from the resuscitation.

  I took a seat at the bedside, watching him a moment. He was older—far older, in fact, than he’d appeared at first. How much of that was from the effort it had taken for his magic to heal him?

  My gaze drifted to the monitor. His heart was steady but slow. Better than it had been, though.

  I remained curious about that tattoo. Getting to my feet, I pulled the sheet back, looking at his chest. There was evidence of bruising, though it already appeared to be healing. It was yellowed, as if it had been there a week already. My gaze lingered on the tattoos; what I’d thought at first was a single mark appeared to be several. He had one on each side of his chest, and as I peeled the sheets down, I saw another slightly below his navel.

  “What are you doing?”

  Startled, I dropped the sheet and stepped back, meeting the man’s gaze. He had silver eyes, and despite him having just come around, they seemed to emit a bright intensity.

  “You’re in the hospital, Mr.…”

  “Rorsch.”

  “You’re in the hospital, Mr. Rorsch. You were found outside in the cold, and your hea
rt had stopped. They brought you to Hennepin General Medical Center.”

  The man grabbed the sheet, pulling it up to his neck. “Well, who saved me?” He looked perplexed.

  “The entire hospital team had a hand in it,” I said, smiling. “You were in pretty rough shape, Mr. Rorsch. It’s lucky you got here in time and had you not, we might not have been able to save you.”

  “Who saved me?”

  “I suppose I did.”

  “And who are you?”

  “I’m Dr. Stone. I’m an ER physician. We had to do CPR, so your chest and ribs are going to hurt—likely for quite a while.” I watched his face as I said it, wondering if he might admit he had some magical connection, but he didn’t reveal anything. “We had to shock your heart a couple times, too.”

  “Will there be any long-term consequences?”

  That wasn’t the kind of question someone plugged into the magical world would ask, so maybe I was wrong about him… but if I was, then how had he recovered so quickly?

  “I don’t know. You were out for some time.”

  “What complications should I be concerned about?”

  “When your heart stops, there’s not a lot of blood flow going anywhere in your body, particularly to your brain.”

  “You are concerned I’ll have brain damage?”

  “The fact you’re awake now makes it significantly less likely, but it’s something we’ll need to monitor you for. And you had an unstable rhythm to your heart, though that might have just been the cold. As I said, it’s hard to tell at this point. It’s going to take ongoing monitoring to know what long-term consequences you might have.”

  He looked at me a moment before closing his eyes. At first, I thought he’d fallen asleep again, and with some of the drugs he’d likely been given since coming here, it wouldn’t be surprising for him to drift off again without so much as a goodbye. But instead, he took a deep breath. “My belongings,” he gasped, then, as if struggling a little for air.