If it had occurred to me that Alyssa would be in the resident lounge, I definitely wouldn’t have brought my food there. I can’t eat in front of Alyssa—it gives me indigestion. But instead I burst in on what is practically a party.
First of all, Connie is there, also eating a fast food burger that Alyssa clearly bought for her. And along with her is Alyssa, a pale man in his thirties with thinning black hair, and an incredibly cute toddler who is walking around the room with a French fry in each hand. The toddler has a visibly runny nose that is dripping nearly into his mouth.
“Oh,” I stammer, unsure if I should stay or not. As much as I was looking forward to some time away from Alyssa, I feel like it would be rude to leave. I force a smile. “Hi.”
Alyssa nods at me. She makes no motion to introduce me to her family.
I sink into one of the chairs, keeping my food on my lap. It’s so deeply fried that it’s hard to eat, but I force myself to take in a few bites.
The whole time, I can’t stop watching Alyssa’s kid. He’s very cute, mostly because he looks nothing like Alyssa. He takes a bite of one fry then alternates with the other fry. And then every minute, he runs to his mom for a kiss. I wish I were one year old. Life is so simple when you’re a kid. You don’t even know how good you have it. Lucky bastard.
The kid’s runny nose is bothering me though. He’s come to Alyssa for a hug at least a dozen times and not once has she made a motion to wipe it off. Alyssa is so anal that I sometimes worry if I have one hair out of place, she’ll reach over and pluck it out of my skull. How is she letting this runny nose go unchecked? Even I want to wipe up the snot, and trust me, I’m a huge slob.
Eventually, Alyssa’s pager goes off and we all jump like a foot in the air. “You better go,” she tells her husband.
He nods. “Do you think you’ll be home for lunch tomorrow?”
“Probably not,” Alyssa says. “My interns are still really slow.”
Hey, Alyssa, said interns are sitting right here! And are not deaf!
Admittedly, we are pretty slow though.
Her husband picks up their child. He flies into a sudden panic when he realizes he’s leaving. His tiny round face turns bright red, and he reaches outstretched little arms in Alyssa’s direction, hollering, “Mommmmeeeeee!!!!!”
It’s sort of heartbreaking, actually. Her husband raises his eyebrows at her, but Alyssa shakes her head.
“Just go,” she says. “It’ll be easier.”
After Alyssa’s son has been dragged screaming from the room, the snot bubbling from his nostrils, she turns to us, her interns. I see whatever sadness she had is magically being converted into fury.
“Are you still eating?” she snaps at me.
“No,” I say, quickly tossing my fried something (still not sure what the protein was) into the trash besides me.
Thankfully, my own pager goes off at that moment. And I’m almost happy to hear that Carla Canady is refusing her insulin shots because it gives me an excuse to get the hell out of there.
_____
“I don’t need the shots,” Ms. Canady says to me. “I’m fine. Seriously.”
“Your blood sugar is 326,” I say.
“That’s not so high,” she says.
It horrifies me that she said that. A normal blood sugar is around 100. A sugar of 326 is really high. Maybe not high enough to send her into a diabetic coma, but pretty damn high. High enough that if she keeps walking around like that, she’s going to end up being a frequent flyer at that hospital.
“I really think you should take the insulin,” I tell her. “Having uncontrolled diabetes can make you really sick.”
Ms. Canady just snorts and looks away from me.
“I mean, you have a daughter, right?” I say. I think of Alyssa’s son being wrenched away from her. “You want to be in good health for your daughter, don’t you?”
“I’ll be fine,” Ms. Canady says.
That’s when we both hear it. The bellowing voice from the other side of the curtain, loud and pleading. It’s Mrs. Jefferson.
“Please, honey, take the shots,” Mrs. Jefferson says. I feel like I can nearly see her puff of white hair behind the curtain. “I have diabetes too and I used to be just like you. I never took care of it and one day I woke up half blind. You don't want to be blind. My kidneys have failed and my body has fallen apart because I didn't take care of my diabetes. I only got one leg now. My other leg—it’s gone.”
I see Ms. Canady staring at the curtain, her eyes wide. Mrs. Jefferson goes on: “I have a daughter too and I want to stay alive for her. I just want to see her and my grandbabies, but instead I’m stuck here in the hospital. Please, honey, take care of your body. Don’t let yourself fall apart like I did. If I can convince you to do anything, please take your insulin and take care of yourself.”
Ms. Canady and I are both looking at the curtain, waiting for any other words of wisdom to emerge from beyond the partition. But Mrs. Jefferson is silent.
“So,” I say hopefully. “Will you take your insulin shot?”
Ms. Canady rolls her head away from the curtain. She looks me straight in the eye.
“No,” she says.
I tried. Nobody could say I didn’t try.
Chapter 21
At around midnight, I get a page I’ve never gotten before. It’s a nurse I vaguely recognize with a no-nonsense New York accent. “Dr. McGill,” she says. I don’t hear the scare quotes when she says “Doctor,” which makes me feel good about myself, until I hear what she has to tell me: “Mr. Hoffman just died.”
I stare at the phone, my heart pounding. “What? Why didn’t you call a Code Blue?”
The nurse sighs. She’s like a nurse version of Alyssa. “The patient was Comfort Care. Terminal colon cancer.”
“Comfort Care” means just that. The patient is no longer being treated medically, but we are keeping him comfortable until he passes away, which is expected to be imminent. Pain medications are all right, but CPR or antibiotics are not.
“So what do I do?” I ask. It seems like my work is over if the guy’s dead. I mean, that’s what I’m here to prevent.
“You have to come over here and declare him dead.”
“Oh.”
I march over to the floor where Mr. Hoffman is located. I somehow expected things to be a little more somber because a man just died, but it pretty much looks like business as usual. Two of the nurses are having a loud conversation about laxatives.
The nurse who called me, Kaitlin, is waiting for me at the nurse’s station. I’ve worked with Kaitlin a few times before, and have always been incredibly intimidated by her. She’s got at least two decades on me in age and experience, and it shows on her thin, lined face. She always wears her gray-laced black hair in a tight bun that reminds me vaguely of Julia, and today she’s wearing solid purple scrubs.
“Dr. McGill?” she asks. None of the nurses know us by our names yet—we probably all seem identical to them.
I nod.
Kaitlin crooks her finger at me and leads me to Mr. Hoffman’s room, which is the last one in the hallway. The lights are dimmed inside and it’s very quiet, at least for a hospital room. There isn’t one machine beeping or alarming. I’ve never met Mr. Hoffman before, but he looks like he was pretty sick (obviously). He’s got huge hollows in his cheeks, gray stubble across his chin, and his toothless mouth is parted in a silent O. Just before a really sick patient dies, their mouth often opens that way. It’s called the “O sign.”
Kaitlin folds her arms across her chest and waits for me to proceed. I stand there for a minute, biting my lip.
Finally, I break down and ask, “Um, what do I do?”
Kaitlin raises her eyebrows. “You’ve never done this before?”
I shake my head.
She sighs. “Okay, feel for his pulse. But you won’t feel anything.”
I press my fingers into the grove of his wasted wrist where the radial artery runs. At first I
almost think I feel a pulse, but then I realize it’s my own pulse. “Okay…”
“Now you listen to his chest and make sure you don't hear anything. You won’t.”
I place my stethoscope on Mr. Hoffman’s still chest. Silence.
“And now you check his pupils.”
I reach out and lift his eyelids up with my fingertips and shine a light in his pupils, which are slightly obscured by his cataracts. They don’t budge.
Yep, this guy’s dead all right.
The next part of the process involves paperwork, which is now my area of expertise. Essentially, I am discharging this patient. But instead of discharging him to “home” or “nursing facility,” I check off the box to discharge him to “expired.” Even I can’t screw this one up.
As I’m flipping through the sign-out given to me on Mr. Hoffman by the intern taking care of him, I notice that under “code status,” he has written: “Full Code.” Full Code means that in the case of Mr. Hoffman going into cardiac arrest, a Code Blue should have been called.
We were supposed to try to save him.
And then I have a heart attack.
“Kaitlin!” I scream.
She drops what she’s doing and rushes over to where I’m sitting. “What’s wrong?”
I point out where the intern had written Mr. Hoffman’s code status. My heart is pounding. If we were supposed to try to save this guy, then… well, it’s not my fault. They told me he was Comfort Care! Why oh why didn’t I check the sign-out before I let him just die? Wait until Alyssa finds out about this…
“Oh,” Kaitlin says, looking unconcerned. “Mr. Hoffman’s definitely Comfort Care. That intern is the biggest idiot in the hospital.”
Then she flips through the chart and shows me where the patient signed the Do Not Resuscitate paperwork. I’m relieved, mostly that I didn’t accidently kill someone tonight. And that apparently the biggest idiot in the hospital isn’t me. (Alyssa may beg to differ.)
As I flip through Mr. Hoffman’s chart, I think about the fact that a man just died. I mean, he died. His life just ended right in front of me. And weirdly enough, I don’t feel that sad about it. If I’m being entirely honest, I don’t feel sad at all. I rented The Joy Luck Club last month and I cried way more in five minutes of that movie than I did over the death of a real human being. That’s pretty messed up.
I should definitely feel sadder over this.
I mean, someone should feel sad. Like I said, a guy just died. He had no family with him, nobody shedding a tear. Someone at least should cry a little bit. I should cry a little bit. If I cried over The Joy Luck Club, I definitely should be able to cry right now. I really should.
Come on, Jane! Cry!
I sit there for a minute, waiting for tears to come. Even just a single tear. But I can’t cry. I’m really just not very sad over this.
Screw it.
I flip to the front of the chart, where Mr. Hoffman’s emergency contacts are listed. He has one: his daughter, Carol. I dial the single number provided.
The phone rings several times, but nobody picks up. I’m about to give up when the perky voicemail recording clicks on: “Hi, this is Carol! Leave a message.”
“Oh, hi,” I say, a little thrown by the message. “Um, this is Dr. McGill at County Hospital. I just wanted to let you know that… your dad passed on. So, um, if you have any questions, you can just give us a call. Thanks.”
As I hang up the phone, it occurs to me that I just left a voicemail that this woman’s dad died. What the hell is wrong with me?
“Did you just leave a voicemail that someone’s dad died?”
I look up and see Sexy Surgeon perched at the nurse’s station, staring at me with an amused look on his face. My cheeks grow hot. “I didn’t mean to…”
He laughs. “Wow, that’s pretty classy. I thought you medicine interns were supposed to be all sensitive and shit?”
I glare at him. “What are you doing here, Ryan?”
“Looking for you,” he says with a wink. I notice he’s got a little indentation on his forehead where his surgical cap cut into his skin, and his hair is adorably tousled. I wonder how long he’s been in surgery today. “Found you just in the nick of time, I think. It’s clear you’re in need of a break.”
“I don’t have time for a break,” I protest.
“Fifteen minutes,” Ryan says, putting his hand on my arm. And the second he touches me, I lose all ability to think rationally. I shall follow Sexy Surgeon to the ends of the Earth, if he so desires.
Fortunately, he only seems to want to go as far as the elevators. On the way to the elevators, we pass a skinny kid with disheveled brown hair and deep circles under his eyes. He looks young—even younger than me. Something about him screams out “medical student,” especially the way he seems vaguely frightened of Sexy Surgeon.
“Dr. Reilly,” the student says, his eyes widening. “I’ve been looking for you.”
“You found me, Ed,” Ryan says, rolling his eyes in my direction. “What’s going on? How was the emergency cholecystectomy?”
“Long,” Ed replies, rubbing his eyes. “Listen, I’m not on call, so… is it okay if I head home? It’s after midnight.”
Ryan looks him up and down, his eyes narrowing. “Didn’t you get the text page I sent you about the infected graft that’s coming up to the OR?”
“Yeah, but…” Ed looks at me, as if I might help him out. Fat chance, kid… I got my own troubles. “I’m not on call, so…”
“You’re not on call,” Ryan repeats, running the words over his tongue. “So… I guess that means you have no interest in learning?”
Ed’s mouth falls open. “I… I’m supposed to be here at 5 a.m. tomorrow to pre-round. I just…”
“It’s up to you,” Ryan says with a shrug. “Obviously, I think you should go to the surgery and learn something. But if you’d rather go home and go to sleep…” He says the words go to sleep rather contemptuously. Sometimes I wonder if Ryan ever actually does go to sleep. “It’s your decision, Ed.”
Ed just stares at him for a minute. I can tell he really wants to tell Ryan to go to hell, but he doesn’t dare say it. Finally, he mumbles, “I’ll go to the surgery.”
“Good boy,” Ryan says, a slow grin spreading across his face.
I wait until Ed is gone and we’re inside the elevator before I say to Ryan, “You’re a complete asshole. You know that?”
Ryan laughs. “Why?”
“You could have let that med student go home.”
“Well, that’s no fun.”
I glare at him. “Like I said, you’re an asshole.”
“At least I didn’t leave a voicemail to tell someone her dad died.”
He’s got a point. Asshole.
When we head up in the elevator, I expect that Ryan is leading me to the call rooms and that our 15 minutes will be spent making out (nothing wrong with that). But instead, he takes me up a flight past the call rooms, to a door that appears to open to the outdoors. When he pushes it open, I realize that he’s taken me to the roof of the hospital.
It doesn’t look like we’re supposed to be up here. It’s mostly pipes and vents, although there’s a single garbage bin that seems to be filled mostly with cigarettes.
The July night air is pleasantly cool up here and I feel a breeze lift the hairs that have escaped my ponytail. Ryan takes my hand in his as he leads me to the edge of the building, and I can’t help but enjoy this sweet gesture. Holding hands with him makes me feel like we’re in a relationship or something, and he’s not just some guy that I make out with when either of us has a free minute.
“You’re not afraid of heights, are you?” he asks me.
I shake my head as I look down over the edge of the building at the tiny cars and people milling about below us, oblivious to the fact that we’re looking down on them. It’s a little dizzying, but there’s also something really peaceful about it. Being above it all, you know?
“Don’t
jump,” he says.
I stick out my tongue at him.
He grins. “What? You’re an intern. I think it’s worth saying.”
The sad part is that he’s probably right.
“Do you come here a lot?” I ask him.
“Yeah,” he says. “I like to spit on the people walking by.”
“Very funny.”
His blue eyes widen. “It’s true. They usually think it’s rain.”
“You don’t really.”
“Watch me.”
I hear Ryan starting to hock up some spit, and I smack him in the arm. He smiles winningly at me then leans forward to kiss me.
And then we’re kissing on the rooftop of a hospital. His body feels warm and firm against mine, and I can feel his hands sliding under my scrub top, touching my bare skin. He starts kissing me more hungrily, pushing me up against what I think is a drainpipe. This is so very hot. I don’t want this to ever stop.
And then, of course, our pagers go off. Simultaneously.
I check the number on mine then fumble for my phone. The reception on the roof isn’t very good. I notice that Ryan isn’t bothering to even attempt to answer his page.
“Don’t you need to call them back?” I ask him.
He winks at me. “Nah.”
I sigh as I hold my phone up in the air, trying to see if I can get more than one bar of reception.
“I probably should go,” I say. “I’m covering about a million patients, plus I’ve got the biggest service in the hospital already.”
“Is that so?” Ryan asks.
“It’s so,” I confirm. “So don’t even think about trying to dump Mrs. Coughlin back on me.”
“I’d say there’s zero percent chance of that happening.”
“Really? How come?”
“Because she’s dead.”
I lower my phone and stare at Ryan. He isn’t smiling or doing anything else to indicate that he’s joking. “Are you serious?”
The Devil Wears Scrubs Page 14