The Anatomy of Perception

by AJ Rose

  Sputtering, I tried desperately to remember the question in that major info dump that changed my entire outlook in the span of thirty seconds.

  She’d run out of patience. “Distraction or someone to cover for you?” she demanded, not unkindly.

  “Oh, uh… distraction, but I might need covering if her tests show bad news.”

  “Fair enough. I’ve already assigned Dr. Clower to take over for you, so if you’ll meet me at the nurse’s station after you explain to your family why you’re leaving them for a bit, I’ll have work for you.”

  “What happened to Ballard? She was the one who took Isabelle to CT.”

  “I handed her a solo already. She was far too eager, and I needed to get her out of my personal space for a few hours.”

  “Oh. Okay, I’ll be right there.” I spun on my heel and went to tell Craig and his parents I was being taken off the case and put on another, but that I’d check in with them as often as I could.

  “You’re working at a time like this?” Craig asked coldly.

  “Craig,” Isabelle admonished. “Dane is fine, and he’s probably going crazy sitting idle in here with us. Let him go.”

  “It’s just because if something serious is going on, I’m going to need time off, so I’m wrapping up what I can with current patients and assessing who can take on the rest. I’ll be back in a few hours, I promise you.” I moved to grip his arm, but it didn’t ease his glare.

  “So you’re assuming it’s something serious,” he countered.

  “Craig, c’mon,” I tried soothing, but he jerked out of my grip. Unwilling to fight in front of his parents, who had more than enough going on, I shoved my hands into my lab coat and backed away. “I’ll be back as quickly as I can. I’ll have the nurses page me if anything happens, so I promise you, I’ll be here as soon as there’s anything new.”

  “Go,” Craig ordered, his jaw ticking and his eyes boring holes in my forehead.

  As I left, I heard Isabelle telling him not to be upset, that I was just doing my job. The job he begged me to do when they first arrived.

  Except she’s not your patient anymore.

  Shaking my head, I approached Dr. Kingsley, hoping for something new to take my mind off the feeling I was abandoning my family.

  “These three patients are yours, yes?” she asked, pushing charts at me. I checked them quickly and confirmed. “Okay, I’ll pass them around. Now, you can go back to the ER and do sutures and allergy shots.”

  I made sure to roll my eyes only after she turned away to give away my patients’ charts to residents whose families weren’t hanging in the balance. The debate in my head over whether or not to go back to the pit as ordered or wait with Craig was a short one. I wasn’t so sure I’d be welcomed at Isabelle’s side if I returned.

  Heaving a sigh, I trudged off. “The pit it is.”

  Hours later, I begged off, changing my status on the surgical board to out and letting the nurse’s station near the board know my schedule would be in question. I did, however, request being paged for Isabelle’s case, so I was comfortable moving through the main waiting room to the elevators that would take me to the cafeteria, where I could get dinner for all of us and bring it to Isabelle’s room.

  I didn’t make it.

  “Dane,” Sabrina said, walking toward me quickly and grabbing my elbow to haul me along with her, her face an inscrutable mask. She marched me across the lobby.

  “Hey!” I protested being so ruthlessly manhandled. She ignored me until I jerked out of her grasp, refusing to go another step toward the hall leading to the conference rooms, so we stopped in the least busy corner of the lobby waiting room. “What the hell, Sabrina!” She was a small girl, but small meant bony, so she had bony fingers. They’d dug into the meat of my upper arm, and I wouldn’t have been surprised to find bruises later. I kept my voice low so those waiting nearby wouldn’t hear.

  “Glenn Morgan. The name ring any bells?” she asked coldly.

  It did, but I couldn’t place it. I rubbed my head to ease the pressure building behind my eyes. “I don’t know. Maybe. Can you get to the fucking point? I’ve had a shit day and just want to get back to Craig and his parents.”

  Her expression went blank, like it did when she was talking to patients, her ironclad control very much in evidence. “Glenn Morgan, thirty-two-year-old white male with Crohn’s disease, here four months ago with a blockage in his intestine. You assisted Kingsley on the surgery to remove the blockage. Post-op notes said you were the resident who closed up.”

  It was starting to sound more familiar. Round, doughy-faced guy with thinning blond hair and a wife with a sunny smile who had been a great cheerleader for her husband. I nodded as more began to come back to me about the case.

  “Okay, is he back in? God, it’s really early for him to have another blockage. He’s having a really rough year if that’s the case.”

  “Oh, he had another blockage all right,” she ground out, her eyes flashing. “Dane, you left a gauze lap pad inside his abdomen.”

  If the cold that had wormed around my spine earlier had chilled me, this was like being dumped in a hole in a frozen lake with nothing but the black, killing depth to creep over me and steal my breath, my consciousness.

  “What?” I whispered, needing air. I bent at the waist and rested my hands on my knees. “I always count the instruments. I always make sure nothing gets left behind. Oh my god, I’m going to throw up.”

  “Stop,” Sabrina said, putting a hand on my shoulder. “I got your back, Dane. Seriously, get a hold of yourself.”

  “What do you mean?” I asked, doing yoga breathing as best as I could to get myself in some semblance of control.

  “The lap pad had wedged against his small intestine, crowding the intestine almost closed. It created another blockage, which I removed, along with a small section of necrotic tissue where the resulting infection had set in. I cut it all out, Dane, but as soon as I saw it, I stuffed another lap pad on top of it. When I cleared the area to close, I pulled out the retained pad with today’s packing and threw it away with the rest of the medical waste. I didn’t mention it during the surgery, and my assisting intern didn’t say anything. No one saw.”

  “Your attending didn’t see it?”

  Her eyes glittered. “It was my solo.” Then she broke into a near smile. “I was able to get it out with no one being the wiser, and as far as I’m concerned, he’s had another unfortunate blockage, and my notes will reflect that and recommend a closer observation of his Crohn’s disease.”

  Relief flooded my whole body, and I threw my head back with a groan at the near miss. “Thank you, thank you, thank you.” My gratitude could have swept the whole building away in its power, not just because she saved my ass, but because Mr. Morgan could have been seriously compromised or even have died from my mistake. I’d come close once or twice to messing up with a patient, giving them too weak a dosage of medication, or some other problem. On one occasion, I’d had a drug all ready to administer and double-checked the chart’s allergies to be sure I was in the clear only to find out if I’d injected it, the patient could have had a very dangerous interaction and been killed. It was close. I’d never done something so colossally bad as this, though, and it couldn’t have come to light at a worse time. Still, I was eternally grateful Sabrina was looking out for me. It was sort of unwritten code among doctors that we protected each other to avert disaster, but I’d hoped I wouldn’t ever be in a position to need such protection. “You’re a rockstar.”

  “Not so fast,” she snapped, holding up a finger. I looked around the waiting area, but no one was paying us any attention. “This is a serious mistake, Dane. This could have gotten the hospital sued. It could have cost you dearly. Worse, it could have killed that guy.” I bowed my head, chagrined beyond measure.

  “I know. And I’m beyond glad you were able to catch it in time. If you feel the need to report me to the chief, I will understand.”

  She s
macked the top of my head. “I just said I wouldn’t.”

  “Ow,” I complained, rubbing my scalp.

  “If you ever put me in this position again, I will do what I have to do. I’m not your babysitter, asshole, and if you don’t learn your fucking lesson from this, I’m not going out on a limb for you ever again. Get me?” She was dead serious.

  “Of course, Dr. Ballard. I appreciate you looking out for me now.”

  She cocked a hip and studied me, her face still fierce. I waited, knowing that even if she promised she had my back, she could decide putting her career on the line to cover for me wasn’t worth it. Hell, I wasn’t sure it was worth it. The more it sank in, the less certain I became that I should let her do this for me. She seemed to read it on my face.

  “Now, if I do this, you’re not going behind my back and tattling on yourself, either. If you get an attack of conscience, we go to the chief together, and we do it right fucking now, Dane. If you’re not sure about this, I’m not going to risk my career.”

  My stomach was a writhing mass of worms seeking a more hospitable environment, and I was honestly afraid I’d need to use one of the massive planters containing the indoor trees that reached to the two-story glass ceiling of the lobby as a puke bucket.

  I knew what I should do. March her to the chief’s office and confess everything, let Dr. Noble handle it so the hospital wasn’t exposed should a lawsuit emerge from the situation. I said as much.

  “Look,” she said, walking me to a further isolated corner. “As far as I’m concerned, it’s over, okay?” I nodded, but I wasn’t convinced, and I was still fighting rising bile. “I’ll do what you want me to, but I don’t think this is an issue. I’m as certain as I can be that Mr. Morgan will recover without ever having been the wiser. I’m going to order an extra antibiotic just in case, but that’s protocol anyway because I had to remove a portion of his intestine. He’ll be monitored more closely because of the Crohn’s and the nature of the surgery, not just because of this. If anything goes wrong, we’ll be right on it.”

  I snorted. “He wouldn’t have had to endure another surgery if not for me, Sabrina.”

  “You don’t know that,” she said gently. “That blockage could have happened as a course of his disease. And I can guarantee you—” she poked my chest with one bony finger and I put my hand on my sternum to block her “—this is not a mistake you’ll make again. Am I right?”

  “Absolutely not,” I swore. I would quadruple-check a patient’s surgical field for the rest of my career before closing them up, or I would hang up my scalpel.

  “See? So what good is it going to do to put a black mark on your file, worry the patient needlessly, and get legal involved when there’s really no reason to? You didn’t mean to do this. And you’re a good doctor, Dane Perry.”

  This right here, her unwavering support in the face of crisis, was why she was my friend. Whether we were terrified together when we’d first been allowed to cut, or when multiple traumas poured into the ER at once and we were in the thick of blood and screams while lives were on the line, we were in this crazy-ass career together. She had my back, and more importantly, she expected me to have hers. She relied on me. No one had ever done that before. Not to this extent.

  “If the scalpel were reversed, you’d do the same for me, yeah?”

  Without question. “Of course. You’re positive Mr. Morgan will be okay?”

  She smiled. “I’m ninety-five percent certain he’s going to be just fine; complications can happen with any surgery.”

  I blew out a breath. The instant relief from earlier that had been big enough to knock over the building was eclipsed by new relief that could have flooded the entire city of New York. All the tension bled from my shoulders and I found myself fighting a sting in my eyes. I sniffed, then moved to put my arms around her in the biggest, most grateful hug I could muster. For good measure, I kissed her cheek.

  Of course, she anticipated the kiss and turned her face into it. It was only a peck on the lips, but it embarrassed me nevertheless.

  She chuckled in my ear and crowed, “Aaahaaaa, gotta sneak in while your defenses are down.”

  “Funny. I don’t think I owe you that big. Craig would kill me.”

  “Au contraire, mon frère. And I intend to collect on this one.” Her eyes raked me up and down, and for the first time, her flirting made me skittish. She wasn’t so much flirting as planning how she would devour me. “You owe me, buddy.”

  If she’s even partly as calculating as Bianca, she has your career to ruin.

  Over her shoulder, I spotted Craig standing at the edge of the lobby, watching us. The shock of his expression morphed into betrayal and rage as I jerked away from Sabrina, intent on rushing to his side. Sabrina beat me to it, clapping him on the shoulder and telling him what a good kisser I was. He gaped after her, turned and glared at me, and then fled back to his mother’s room.

  My beeper went off. Years of slavery to that sound made me check the read-out: the nurses were paging me about Isabelle. Her brain scan results were in.

  “Don’t fucking touch me,” Craig said, his voice as animated as a piece of dead wood. He jerked his arm away from me as I tried to give him a reassuring squeeze.

  I closed the door to the loft behind us as the sun peeked between the buildings, stabbing shards of bright yellow into the living room and across the furniture. I squinted, cursing it. This was usually why I was glad I got to the hospital before it rose for the day. Too cheerful. Too… yellow.

  “Craig, I swear to you, it’s not what it looked like.”

  “I don’t care,” he said in that same blah tone as he climbed the stairs to our bedroom. Frankly, his flat affect had me more concerned than his misconstruing Sabrina’s stupid, ill-timed kiss. I was certain I could make him understand about her, but getting him to consider his own needs while his mother was sick would be a chore. He was exhausted, and while I was certain hours of sleep would do him good, he wouldn’t take them. He’d lie down for an hour, maybe two, then get up, shower, and be back at the hospital by ten to sit with his mother.

  She was diagnosed with stage 3 nodular melanoma.

  The most aggressive of skin cancers, it was one of the hardest to diagnose because it presented differently than the usual types of abnormalities, dissimilar to what people were cautioned to watch for when it came to moles or sun spots. It grew in little dome shapes, putting roots down through the skin and into the body, and when it punched through the subcutaneous layer, things got dangerous.

  Metastatic tumors, or mets, had been discovered on Isabelle’s right kidney and in her brain. The pea-sized brain tumor had been responsible for her seizures, but thankfully there was only one. The prognosis for the disease wasn’t great, with a thirty- to forty-percent mortality rate at Isabelle’s stage. For her particular case, the chief neurologist, Dr. Dearborn, wanted to remove the met in her brain to stop the seizures, and then hand her care over to a cancer specialist in their hometown. However, she and Lawrence expressed interest in being treated at Elijah Hope. After that was decided, they’d schedule another surgery to remove the tumor on her kidney, and then plan an aggressive regimen of chemo and possibly radiation.

  From what I could tell, Isabelle handled the news gracefully, although I wasn’t quite sure it had hit her yet. Craig stalked off, demanding space to think after giving his mother a kiss on her cheek. I sat with Lawrence and Isabelle for quite some time, answering their questions as they considered the options with which they’d been presented, and basically gave them room to talk it out in relation to how it would affect their lives. Brain surgery was a very serious decision, but after a while, they moved on to different subjects.

  “It’s a good thing we were in New York when this started, and that Dane could get us moved into testing so quickly,” Isabelle said, holding out a hand for me to take while she smiled. “We’re very proud of you, honey. You’re such a handsome doctor, too.” That made me look away as red staine
d my cheeks and embarrassment flooded my chest.

  “Bella, I don’t think being cute helps much in the operating room.”

  Thinking of Sabrina and whatever it was she thought she was doing to me made me bite my tongue, but that didn’t stop my internal grumble.

  It matters more than it should.

  “I’m just glad I was in the ER when Craig came running in. My attending surgeon assures me she will have the other residents take up my caseload for as long as I need, so I’m here with you every step of the way.”

  “Oh no, son,” Lawrence immediately said, concern furrowing his brows. “We can’t ask you to take off work. Besides, if you’re working, you’re here in the hospital. Maybe stick your head in once in a while to catch up. Or be available when the doctors come in to talk to us, so you can translate all those big words into something we can understand.”

  “Yeah, honey,” Isabelle agreed. “We don’t want you getting behind with your patients, or losing your place in your residency program. These cancer treatments can take months, right?”