A Cut Above: A Lakeside Hospital Novel

by Malone, Cara

  She just rolled her eyes and let him have his moment because while he had several months of living at home ahead of him, she got to go back to Evanston and reclaim her autonomy at the end of the long weekend. The car ride wasn’t long and Victor talked about the graduation ceremony and his party the whole time.

  “I was surprised to see Aunt June,” he said. “I didn’t expect her to come all this way for my graduation, but I guess law school is a pretty big deal.”

  “Such a big deal,” Ivy said, mocking him purely by reflex, but then she conceded, “It was nice of her to come.”

  The farther they got away from the house, away from their parents, the less necessary it seemed to compete with each other. There was no attention to compete for when it was just the two of them in the car. By the time they got to the bus depot, they were chatting about their favorite bands and Victor was teasing Ivy because she had no idea what the latest TV shows were.

  “I don’t even own a TV,” she pointed out. “There’s no time.”

  “You should learn to loosen up, sis,” Victor said as he cut the engine. “You’ll burn out.”

  “Yeah, well,” Ivy said, leaning forward to flick the tassel hanging from the mirror. “I could say the same for you. Don’t study too hard.”

  She got out of the car and pulled her heavy bag out of the back seat, slinging it over her shoulder with some effort. The bus was only a few dozen steps away, then her textbooks would come out again and she’d study by the dim overhead light on her way back to Evanston.

  Ivy closed the car door and Victor leaned across the seat, grinning as he delivered one last piece of psychological warfare. “Don’t kill anyone, sis.”

  “I’ll try,” Ivy said, setting her jaw. Maybe it was Victor’s way of making it easier for her to get on the bus without feeling homesick, or maybe her little brother was just a jerk. For as long as she’d known him, Ivy had never figured that one out.

  * * *

  Ivy was practically sleepwalking the next morning, although she tried her best to ignore the fatigue. Her bus hadn’t arrived back in Evanston until close to two in the morning and she’d gotten barely three hours of sleep before her alarm clock announced its grating wake-up call to her. As she trudged across campus in the dark to grab a quick cafeteria breakfast before her first day in the Emergency Room, Ivy hoped that despite all their verbal sparring, Victor appreciated the sacrifice she’d made to watch him receive his law degree.

  She ate an energy-packed bowl of oatmeal with dried fruit and nuts, washed it down with two cups of coffee, then jogged the three blocks to Lakeside Hospital to clear away any lingering sleepiness. It worked, at least for the time being, and when Ivy walked through the sliding glass doors of the department, she held her head high and felt ready to conquer the day.

  The Emergency Room was small, segmented into a waiting area with about twenty chairs, a nurses’ station nearby to keep an eye on waiting patients, and a long row of hospital beds separated from each other by thin curtains. There were supply closets and a couple of offices behind the nurses’ station, and a hallway with swinging doors that led into the rest of the hospital.

  Ivy had been there in passing a few times, but never spent any considerable amount of time in Lakeside’s ER. At the moment, a few minutes past seven in the morning, it was relatively quiet with just a few parents holding fussing babies and small children in the waiting area and a couple of beds occupied by patients. Ivy knew it wouldn’t stay this quiet for long.

  She found a few of the other medical students who would share the rotation with her. They were gathered in front of the nurses’ station, trying to stay out of the way while they waited for the resident on duty to initiate them into their emergency medicine rotation.

  Chloe was there, smiling and chatting with one of the nurses like they were already best friends, and Megan stood beside her looking about as sleepy as Ivy felt. Their eyes met momentarily and if Ivy didn’t need to conserve her energy for later in the day, she would have made a quip about how unenthused Megan looked. Instead, she nodded at Chloe and then went to the other end of the nurses’ station, away from Megan.

  “Hey,” Chloe said, looking just as chipper as always. At least someone got a good night’s sleep. “How was your break?”

  “It was fine,” Ivy said.

  “Did you get a chance to rest?” Chloe asked, looking genuinely interested in the answer.

  Unfortunately for her, a woman in green scrubs marched briskly up to the nurses’ station and boomed, “Good morning, doctors!”

  It would have perked Ivy up even if the double dose of caffeine hadn’t already done its job. She stood up a little straighter and pulled a notepad out of the pocket of her white coat.

  “I’m Doctor Krys Stevens, chief ER resident, and your primary point of contact for this rotation,” she said, leaning over the nurses’ station and grabbing a tablet from a row of them plugged into a charging dock.

  She paused for just a moment to type rapidly on the tablet – probably notes on her last patient. She was thin but athletically built and her glossy, dark hair was pulled back in a utilitarian, no-nonsense ponytail. Ivy got the impression that Dr. Stevens was the type of person who never stopped moving when there was work to be done, and Ivy liked her immediately. She smiled and held her head high, waiting to find out what this resident could teach her. Ivy was always on the lookout for potential mentor figures.

  Dr. Stevens finished typing and tucked the tablet into the crook of her arm, took a quick breath, looking at the small group of medical students in front of her. To Ivy’s surprise, she smiled when she saw Megan.

  “Callahan, it’s about time you came to my department,” she said, and Ivy had to suppress a groan. They knew each other? She was already irritated at the idea of spending the next two months working in close proximity with her academic nemesis, and now it turned out she and the chief resident were friends. Great.

  So much for that mentoring idea.

  Dr. Stevens gave an overview of the department and the things that the students would be responsible for – shadowing the residents and attending physicians, taking medical histories and doing physical exams on non-emergent patients, and chasing down lab work. They would be working twelve-hour shifts, five days a week, with one night a week on call. While Dr. Stevens said all of this, her eyes kept going to the doors that led out to the ambulance bay. It was clear she wasn’t used to standing still or wasting time and that she wouldn’t accept that behavior from her new medical students, either.

  She ended her speech with a friendly smile and the warning, “If I catch any of you standing around with your thumb up your butt, it will not be pretty. There’s always something to do around here, even if it’s just changing bedsheets.”

  Megan smirked at this and Dr. Stevens didn’t miss a beat. She shot her a challenging look, then asked, “What are the ten most common complaints in the ER?”

  Ivy couldn’t help but smile – maybe Dr. Stevens wouldn’t be playing favorites after all.

  “Abdominal pain, nausea, vomiting, shortness of breath, chest pain, back pain,” Megan rattled off, then started to slow down. Ivy tried not to take too much joy in watching her struggle. “Fever, headache, injury, umm…”

  She glanced at Ivy, a threatening look that said she knew how desperately Ivy wanted to jump in and supply the final complaint. Ivy rolled her eyes and mouthed the answer to her. Altered mental state. She wasn’t sure Megan was going to accept this hand-out at first, but she turned back to Dr. Stevens and repeated Ivy’s mouthed words.

  “Good,” the doctor said, just as a set of red and white lights started flashing in the ambulance bay. Ivy could practically see Dr. Stevens’ pulse beginning to rise as she saw it. “Looks like you may have a chance to put that information to use right now. Stay out of the way, don’t get in over your head, and go find ways to help.”

  Then she pivoted on her heels and dashed over to the sliding doors, where a gurney was being whee
led in and a paramedic was steadily pumping an oxygen bag over the prone patient’s mouth. The medical students all just stood there for a moment, unsure how to proceed, and then a stout older nurse leaned over the counter and said, “What are y’all waiting for? Start working on patient histories and find out which doctors need an extra hand.”

  A few of them broke off from the group and Ivy glanced around for her first patient. Then Megan said, “I didn’t need an assist.”

  “Sorry, it looked like you were struggling,” Ivy said with an innocent shrug. She was poking the bear and she knew it, but it was kind of fun until she saw the disapproving look that Chloe was shooting her.

  She always stood up for Megan like she was trying to gain the approval of a big sister and seeing Chloe’s sweet face never failed to make Ivy feel bad about the snappish, competitive things she said to Megan.

  Not bad enough to stop, though, especially when Megan went out of her way to goad Ivy.

  “You do, too,” Megan said with false sympathy. “You look tired.”

  “I’m fine,” Ivy said. She reached over the nurses’ station to pick up one of the tablets and said, “I just hope it’s not too much of a distraction if your paramedic girlfriend shows up while you’re working. Think you can keep your eyes on your work?”

  Ever since Megan started dating that girl, she’d been less of an academic threat to Ivy. It should have made them less competitive with each other, but somehow it spurred Ivy on even more. Maybe it was because she couldn’t imagine making the conscious decision to split her attention like that during the most important educational experience of her life. How could anyone sit back and watch their class rank fall all because they’d caught the love bug?

  If it were Ivy, she never would have let herself fall for some paramedic. School came first and love would come when her career was established. But that was why Ivy had maintained her position at the very top of the class and Megan was now somewhere around the top quarter.

  Ivy was ready to be done with this conversation but as she walked past, Megan asked with a smirk, “Are you jealous that I have a girlfriend or are you upset that it’s not you?”

  Ivy sputtered and avoided Chloe’s gaze as she said, “That’s absurd.”

  Then she made a beeline for the first occupied bed she saw, yanking the curtain closed around her.

  “I’m Dr. Chan,” she said to the middle-aged man lying in the bed. She glanced at the name on his wrist band and asked, “What brings you in, Mr. Brownstein?”

  “I found blood in my stool,” he said and pointed sheepishly to a brown paper bag on the tray table beside the bed. “My doctor said to come to the ER and bring a sample.”

  Ivy tried not to show her disappointment. There were three other occupied beds in the ER and she could have picked any one of them, but she marched straight over to the guy who would need a rectal exam. Megan would die of happiness when she found out.

  * * *

  It was pretty easy to forget about her encounter with Megan by the time Ivy was finished with her first ER patient. Based on the exam and history, she felt confident bringing the relatively innocuous diagnosis of hemorrhoids to Dr. Stevens, so she counselled the patient on the typical course of treatment, then snapped her second set of gloves into the trash can and said, “I’ll need to review your case with the resident physician but you’ll be able to go home soon.”

  “Thanks,” the man said, not making eye contact as she pushed the curtain open.

  She started walking fast to find Dr. Stevens - if Megan was already friends with her, Ivy would have to impress the chief resident with her speed and diagnostic skills. She glanced down at her watch, trying to clock how much time she’d spent with the patient while she speed-walked over to the nurses’ station, and as she rounded a corner she ran smack into Chloe. She put her hand out to cushion the blow and found herself grabbing something soft.

  Her hand was on Chloe’s breast.

  Ivy’s mouth dropped open and she looked up for the first time since leaving the patient’s bed to find that Chloe was wearing an identical shocked expression. Ivy took her hand away and turned bright red, suddenly unable to close her mouth.

  “Sorry,” she sputtered. “I wasn’t looking.”

  “Me neither,” Chloe said, equally flustered. “It’s chaotic here. My first patient puked on my shoes.”

  “I just gave a rectal exam,” Ivy said, then quickly added, “I mean, not with this hand. And I was wearing gloves.”

  “Of course,” Chloe said.

  “I have to find Dr. Stevens,” Ivy said, positive that she would implode from embarrassment long before her patient got relief from his hemorrhoids if she didn’t leave this spot immediately. “Excuse me.”

  As Ivy marched away from Chloe, she felt blood rushing into her head and adrenaline in her veins, a new sensation that sort of made her want to do some jumping jacks to dispel the sudden surge of energy. It must have been a stress reaction brought on by the combination of extreme embarrassment and sleep deprivation.

  And it wasn’t entirely unpleasant.

  6

  Chloe

  Chloe went into the locker room, where she’d had the foresight to pack a second pair of sneakers. She was suppressing a smile by the time she got to the door and full-on laughing when she went inside.

  Having her study partner grab her breast had been both mortifying and comically absurd. Ivy Chan - over-achieving, single-minded and serious to a fault – had become tongue-tied and as red as a beet.

  So she was susceptible to emotion after all.

  Chloe let out one more indulgent snort, then retrieved her backup sneakers from her locker. They were worn down from several years of workouts and many miles around the halls of Lakeside Hospital, but at least they were clean. She changed as fast as she could, not wanting to incur the wrath of Dr. Stevens. Then she paused for just a second to compose herself in front of the full-length mirror mounted on the wall of the locker room.

  Her cheeks weren’t as red as she’d been expecting and that was a relief – she couldn’t get the image of Ivy’s shocked expression out of her head, or the sensation of her hand on her chest. It was an embarrassing accident that Chloe would no doubt be playing over and over in her head tonight as she tried to fall asleep. For now, though, she had to keep her mind on her work.

  When she returned to the Emergency Room, it was beginning to pick up. The waiting area was filling up with people all along the spectrum of emergency medicine - from worried parents whose crying kids were too sick to go to school this morning, to the indigent coming for care after a hard night. There were a few more patients waiting in beds after they had been triaged by the nurses, and every so often an ambulance would pull into the bay and sound its siren, prompting a flurry of nurses, doctors and students to circle around the incoming emergency. Dr. Stevens was right about one thing – Chloe could never imagine a time when there wasn’t something to do or someone to help in this hectic space.

  Chloe saw Megan walking over to the waiting area with a tablet in her hand, looking for her next patient. Ivy was nowhere to be seen, but that was probably for the best given their last interaction. Dr. Stevens was at a bed near the door, still working on the patient that had come in at the end of her introductory speech to the medical students. She was doing chest compressions and the guy wasn’t looking too good.

  Chloe didn’t want to think about what would happen if Dr. Stevens wasn’t able to help her patient. Chloe was probably the only medical student in the program who had made it this far through her rotations without deciding on a specialty for her residency next year – Megan had known she wanted to be a pathologist since her first year of medical school and Ivy had probably wanted to follow in her father’s footsteps since before she could even say the word ‘neurosurgeon’. Chloe didn’t know what she wanted, but she knew she couldn’t handle a career in a department like this, where death was so close at hand.

  She headed for the nurses’ stat
ion, where a plump nurse with an unaffected look on her face was working on one of the tablets. Chloe held out her hand and with a bright smile, said, “Hi, I’m Dr. Chloe Barnes.”

  “Veronica,” the woman said, slow to shake Chloe’s hand. Then she raised an eyebrow and asked, “First day?”

  “Sort of,” Chloe said. “I’m just starting my ER rotation but I’m a fourth-year medical student. How long have you worked in this department?”

  “Too long to waste time making conversation,” Veronica said. She handed Chloe a tablet from the charging dock and nodded at an elderly woman in one of the beds along the wall. “Bed seven’s as good a place as any to break your ER cherry.”

  “I, umm,” Chloe stuttered, wondering if she should tell Veronica that she had, in fact, already been vomited on and it wasn’t even eight in the morning. Instead, she took the tablet and thanked her, then headed for bed seven.

  She passed Ivy – marching fast but looking where she was going this time – and as she went, Ivy said, “Don’t bother making friends with the nurses – they change every twelve hours.”

  Chloe answered, “So do we,” but Ivy was already gone, heading to the waiting area to grab another patient like she was in the middle of a game show where the objective was to do the most patient histories by the end of her shift. Chloe wondered if Megan was competing in the same game.

  The patient in bed seven turned out to be a septuagenarian named Dolores Gaines. She lived in a nursing home and she’d been attempting to move from her bed to a recliner when she took a fall and was now experiencing hip pain. While Chloe noted all of this and did a gentle physical exam, Dolores told her that the nursing home staff had called her son, but that he wasn’t here yet. Dr. Stevens would need to order a CT scan.