by Radclyffe
Syd knew it. At this point in their training, everyone had a pretty good idea how they ranked, and false modesty was not a surgeon’s trait. After four years together, everyone recognized each other’s strengths and weaknesses. Everyone knew how the pack had sorted itself out. True to the chief’s predictions, a quarter of the interns in their group had switched to other specialties before the first year was over. Pathology and anesthesia were two of the most popular choices when a surgical intern decided surgery wasn’t really for them—that the hours and the stress and the punishing training weren’t what they’d signed up for. At least in anesthesia they were still working in the OR, frequently in the heat of emergencies, but unlike in surgery, at the end of the day they could go home and not think about the patients any longer. They wouldn’t be on call every second or third night for five years and a few more of fellowship training and wouldn’t be called in from home at all hours for the rest of their lives. They could manage families and take vacation and maybe even stay married for more than a few years. Pathology was a little more removed from surgery, but the challenge of ferreting out the nature of disease and helping to make decisions about treatment remained. And the lifestyle was one of the best in medicine considering the patients were either already dead or at least missing organs on someone else’s watch.
Half were gone by the end of the second year, either by choice or because they hadn’t made the cut. Their ranks diminished even further over the next two years through natural selection, and the five who remained were the alphas of their year. The Three Musketeers were the top dogs. Exactly which of them—Syd, Jerry, or Dani—was at the pinnacle was still a question, though. They each had their special skills.
Dani was the brainiac, her memory like a steel trap. When attendings asked for the potential causes of a patient’s symptoms on rounds, her list was always the longest. Most of the time that kind of encyclopedic knowledge wasn’t critical, but every now and then, some patient would present with strange, exotic symptoms and Dani would be the one to nail it. Her cool intellect was balanced by her hot temper, both of which would suit her well in oncologic surgery, where the battle with cancer required a fire in the blood. Jerry was fearless and quick to act, the kind of decisive personality you’d want to have in the midst of a chaotic scene, unflappable and seemingly impenetrable to the possibility of failure. Of course he was trauma all the way, even though he knew he’d be disadvantaged in the race for a fellowship, coming from a program that didn’t have a level one trauma rating.
Syd knew her strengths—and she could barely take credit for them. She was blessed with good hands, the one thing that couldn’t be taught. She had more operating experience than anyone in her year and probably more than some fifth years, because she’d been able to do from the onset what more senior residents couldn’t. She had a feel for the instruments, for the tissue, for the rhythm of the blade and scissors and needles passing through flesh. She was fast and she was good, the perfect combination for a surgeon. She planned on being a pediatric surgeon, and when every single organ that she’d be operating on was a tenth or even a hundredth of the size of the adult counterpart, good hands were an absolute essential.
She also refused to admit defeat. She didn’t believe in giving up, not until everything she could think of had been tried, and maybe some things she’d never tried before. That kind of fortitude was key when dealing with the nearly hopeless cases that premature infants and sick newborns and kids with chronic diseases presented. She had the other essential skill too—the hardest skill to acquire. She knew when to stop. She’d learned that lesson a long time ago.
“You think we’ve got any chance at this place?” Jerry said, the undercurrent of anger vibrating in his voice.
“Oh, sure,” Dani said dismissively. “They’re going to just let us walk right in like we’ve been there the whole time. Good luck with that.”
“We’ll just have to prove ourselves,” Syd said quietly.
“Yeah? How?” Dani leaned on the horn again, the Bug’s nose an inch from the ass end of a cement mixer. “Frickin’ hell, we’re going to be late at this point. Terrific.”
Jerry said, “Told you to take the back route over to Germantown Ave.”
“Bite me,” Dani snapped.
“Down, Tiger. Save it for the competition.” Jerry had coined Dani’s nickname the first day they’d all claimed lockers and excitedly changed into their green scrubs, as if the ritual would really make them doctors and not scared rookies right out of med school. Dani had a huge tiger on her shoulder that she later explained was a symbol of her birth year. She might have been third generation, but her family still kept its Chinese roots alive.
“Besides,” Dani said, ignoring him, “it’s going to be worse for Syd than the rest of us.”
“True,” Jerry said before Syd could protest, “since everybody knows Syd was set to be chief.”
“We don’t know that,” Syd said.
Sure, she wanted it, hoped for it, but who would be named chief resident in their last year was far from certain. The chief’s spot was bestowed on the one resident each year whom the staff felt had progressed to the point where they could treat patients with minimal supervision and operate independently. The chief resident determined which of the other residents scrubbed where, had the first choice of cases, and almost always had their pick of fellowships or staff positions at the end of the final year. Along with the perks came the pressures of attending responsibilities, but every resident craved the time when they could reign in their own OR. Syd had had a good shot—maybe the best shot—to be chief, but now…in a new place where no one knew her, coming from a program without a high-powered reputation, there was no chance that was going to happen. She’d be lucky if she could get a fellowship at all.
She’d be lucky, they’d all be lucky, if they made it through the next year with much of anything to show for all their efforts.
“Turn right on Spring Street,” Syd said suddenly.
“What?” Dani said. “Why.”
“Trust me. Just do it. You can cut around Vine Street, which is going to be a parking lot, and take River Drive in to Mt. Airy that way.”
Dani pulled into the bus lane and careened around the corner. “Fuck—we are so going to be late.”
“No, we’re not,” Syd said, the cold calm she always felt when facing an emergency settling in her stomach. She’d faced much worse than this before. Much worse.
Ten minutes later the Bug hurtled down a wide tree-lined avenue toward the medical center. With a little luck…
“What the hell,” Dani said. “There’s no fricking parking around here.”
“There’s a sign at the next corner that says Visitor Parking,” Jerry said.
“Probably a mile away.” Dani pulled into the ER lot, swerved into a fire lane, and slammed on the brakes.
“They’ll ticket you if you leave it here,” Syd said.
“Like I care.” Dani pushed her door open. “Come on. We still have to find the place.”
Dani and Jerry jumped out, and Syd followed on the run. They were in this together, after all.
* * *
PMC Hospital
6:15 a.m.
“It’s about time,” Hank groused when Emmett, Zoey, and Sadie arrived.
Emmett settled at the round table in the center of the cafeteria with her team and regarded her younger brother impassively. “Did you finish making rounds?”
“I saw everyone in the unit,” Hank said. “Sadie has the floors.”
Emmett gave him a look, and he cringed. “You know that.”
“Yes, Hank. I know that.” As the senior on trauma, Emmett was in charge of the residents assigned to the service, and she knew exactly who was responsible for which patients. She’d waited all year for this month, when she’d get the chance to have more responsibility, when she’d be directly reporting to the trauma attendings, just like a trauma fellow, and when she’d have a chance to show she had what it to
ok to be chief resident in July. With no chief resident on the trauma unit this month, she had the chance to perform as if she was one. She assigned her team to their daily assignments, oversaw all the floor work, and scrubbed on the cases that the trauma fellows didn’t scoop up first. There was a limit to her power, but she wasn’t complaining.
Zoey, a year behind her, was her second in command. Sadie, a second year, had advanced to the point where she was ready to start doing some of the complicated cases with supervision, but still caught her share of scut work. Hank, a fourth year medical student, got the majority of scut and, if he managed to keep things running smoothly and worked quickly, he’d have time to stand at the far end of the OR table where he could see and maybe hold a retractor. A med student’s life was one of service.
Emmett took a big bite of her chocolate glazed doughnut, brought up her patient list on her tablet, and pointed at him. “Run it.”
Hank reviewed the most recent blood work, X-ray findings, fluid balance, pending labs or procedures, and game plan for the day of each of the eleven patients in the trauma intensive care unit, while Emmett and the others updated their information. If an attending or one of the fellows called them for a status report, any of them could answer.
When he finished, Emmett said, “Fairfax’s chest tube should be ready to come out. He’s been twenty-four hours with no air leak. As soon as you see this morning’s portable X-ray, if the lung is up and there’s no sign of air leak in the Pleur-evac, get the tube out and send him to step-down.”
“Can I pull the tube?” Hank said.
“You can help Sadie. Make sure you get a film three hours after the tube is out and then get him out of there. It’s Friday, which means a full house by morning.”
“Right.”
“Sadie,” Emmett said. “You finish on the floors?”
“Of course,” Sadie said curtly, not making eye contact. Her wide, usually sensual mouth was pressed into a hard line.
Inwardly, Emmett sighed. Okay, so she’d made a mistake going home with Sadie a few weeks ago. She’d just come off thirty-six hours on call and a bunch of them had been unwinding at the Catfish, a bar a few blocks away from the hospital. She’d had a beer or two, but she clearly remembered Sadie had been the one to put out the first signals, and they’d ended up in bed. Once should’ve been the end of it, but once had turned into three times before she realized Sadie was going out of her way to catch her alone when they were on call, and the signs of getting serious had all been there. Sadie was looking for something a lot more long-term than Emmett. As soon as she clued to that, she’d shut things down, and now Sadie was pissed. Bad read on her part, but they still had to work together and the work was what mattered.
“Okay, Sadie, let’s hear it.”
Sadie reeled off a stripped-down version of all the information Hank had provided on the stable patients who had been moved to regular care floors. Many were ready to go home.
“I’ll confirm the list of discharges for you,” Emmett said when Sadie finished, “and you can take care of that first thing this morning.”
Sadie stiffened. “I thought I was doing the triple tubes with Dr. Maguire.”
“Zoey will cover that. I need you free to cover trauma admitting while the two of us are in the OR.”
“Great,” Sadie muttered.
“Hank, Sadie, get started on wound checks and dressing changes.” Emmett finished her coffee and rose. She wanted to eyeball the patient she was operating on that morning herself, just to be sure everything was in order. “And don’t forget the meeting this morning. It’s mandatory.”
Wordlessly, Sadie scraped back her chair and charged away, Hank hustling along in her wake.
“Nice work, hotshot,” Zoey said. “You know what they say about not crapping where you—”
“Yeah, I know.” Emmett tossed her cup in the trash. “I screwed up, but she’ll get over it.”
“Yeah, and in the meantime, the rest of us have to put up with her mood.”
“I said I screwed that one up.”
“Maybe if you screwed a little less—”
Emmett’s trauma beeper went off and Zoey’s followed. “Speaking of crap.”
“Hey,” Zoey gasped as they ran, “better than sitting through a boring staff meeting about some new HIPAA regulation or other bullshit.”
“True.” Emmett skidded around the corner to the ER, ran smack into a wall, and fell on her ass. The wall fell on top of her. A really nice smelling wall with unfortunately sharp elbows, one of which landed in her solar plexus.
Someone cried, “Oh, hey, I’m sorry,” but Emmett was too busy trying to suck air into her aching lungs to answer.
Chapter Three
“Hey,” Syd said again. She pushed herself up on one arm and, feeling like a human pretzel, tried to disentangle her legs from the person on the floor. Her right knee throbbed and the palm of her left hand stung—probably scraped—but she was basically in one piece. The person she’d run into had cushioned her fall. She couldn’t even remember seeing anyone in her path before she crashed. “I’m really sorry. Are you okay?”
The face a few inches away from hers twisted into a grimace and cobalt blue eyes widened, the pupils dilating in pain…or maybe anger. Beneath her, firm breasts pressed into hers and the erratic, desperate thud of a heartbeat pounded against her chest. Features swam into focus and Syd’s breath caught. It couldn’t be…but it was. Some faces were impossible to forget. Some moments were impossible to forget, even when you told yourself you had. And at the moment, all that mattered was the panic etched across the handsome face. Syd finally got her legs free and shifted to one knee to give the woman beneath her some space to breathe. Only she wasn’t breathing—her diaphragm was paralyzed from the blow to her solar plexus. She must feel like she was suffocating. “Don’t try to breathe. Your body will know what to do. Just relax. Don’t fight it, relax.”
Emmett thrashed in full fight-or-flight mode. The absence of air, the tightness in her chest, and the rush of blood thundering in her ears triggered every primitive survival instinct she had. Her brain screamed to lash out but she couldn’t move. She couldn’t…breathe.
“Look at me,” Syd said, cupping Emmett’s chin. “Look at me. You’re all right. Wait. Don’t fight.”
Something about the soothing voice, the cool firm fingers on her jaw, cut through Emmett’s panic. She latched on to the coral green eyes that were all she could see and struggled to make sense of the calming sounds. Words took shape. Relax. Don’t try so hard. Foreign words. Relax. Don’t fight. Wait. Anathema to everything she was. She gripped the wrist close to her face, held on to the firm, unyielding arm. Held on to the strange refuge offered by the steady, sure gaze. A stream of air flowed into her chest. Filled her.
“Okay,” Emmett gasped. “I…am…okay.”
Syd eased back and let go of Emmett’s chin, placing her palm instead on a flat, hard midsection. No sign of pain registered in Emmett’s face, but she’d taken a pretty good hit. She’d be sore later. “Are you hurt?”
Emmett took a deep breath. Breathing had never felt so good. “No.” She held up a hand. “Give me a minute.” She turned her head, found Zoey among the people standing around her and staring. “Answer the alert. I’ll be…right there.”
Zoey leaned down. “You sure? Nothing’s broken?”
“I’m good. Go.”
Zoey sprinted off, and Emmett pushed herself to a sitting position. “Sorry about that.”
She squinted at the other faces peering at her, settled on the blonde who’d floored her. The sculpted face, the shoulder-length golden hair, the piercing, amazing, unforgettable eyes snapped into sharp view. Emmett almost gasped again. She knew her. Some women you never forgot, even when there was no reason to remember them and every reason not to want to. She knew Syd recognized her too. Under her scrutiny, Syd’s lips parted soundlessly and her cheeks flushed. She looked older and more tired, but then, didn’t they all.
“In a minute, Jerry,” Syd said.
Emmett took in the big guy who was trying hard not to look amused and the impatient, smaller woman with jet-black hair pulled back into a careless, short ponytail, and wary brown eyes. Actually, suspicious, sharp eyes.
Dismissing them, Emmett turned back to Sydney. “Syd? What the hell?”
“Emmett,” Syd said flatly and climbed to her feet. She hadn’t expected the past to follow her here, but then, didn’t it always. “Are you sure you’re not hurt?”
Emmett shook her head, rubbed her midsection, and smothered a wince. She was going to have a bruise the size of California. “I’m okay. Sorry about that. What are you do—”
“My fault,” Syd said quietly, aware of Jerry and Dani right behind her. She could practically feel their probing gazes on the back of her head. “Uh, we were looking for the Strom conference room…auditorium, rather. Is that around here?”
“A minute’s walk.” Emmett rose, tucked in her scrub shirt, and pulled together her shreds of cool. Knocked on her ass, by Sydney Stevens of all people. Four years disappeared in a millisecond and she was sitting back in that conference room with twenty other nervous med students, waiting for the interview that might determine her future. And then this blonde in scrubs had flown in, announcing she was there to take them all on a tour of the hospital. She’d tried to hide her annoyance, but she’d clearly wanted to be somewhere else. Like the OR.
She looked a little like that right now, like she wanted to be somewhere else. Emmett shook the memories away. “Take this hall all the way to the end, turn left, and you’ll see a sign by a set of double doors about halfway down the next hall.”
“Thanks.” Syd backpedaled. “Well…sorry again.”
“Don’t mention it.” Emmett frowned. All three of the visitors looked jumpy. Weird. “Look, I’ve got to get to the trauma unit, or I’d show you—”