by Malone, Cara
“I’m just going to get my resident to sign off on your scan,” Chloe said, then she pulled her cell phone out of her pocket and handed it to Dolores. “Why don’t you give your son a call while you wait? I’ll be back as soon as I can.”
“Thank you, dear,” Dolores said, her thin fingers shaking slightly as she accepted the phone and Chloe showed her how to dial. Then she pulled the curtain around the bed to give Dolores privacy and went looking for Dr. Stevens. Chloe wasn’t sure whether to hope that she would still be dealing with her unresponsive patient, or that she wouldn’t.
In the end, Chloe found her standing near the ambulance bay, tapping notes into a tablet.
“Did he live?” Chloe asked quietly as she approached.
“Huh?” Dr. Stevens answered, distracted.
“Your last patient,” Chloe said. “Is he okay?”
Dr. Stevens looked at her this time, let out a small, frustrated sigh, then asked, “You need something?”
“Yes,” Chloe said, pulling up Dolores’ chart to show her the history and physical exam notes she’d taken. “I think she needs a CT-”
She didn’t get to finish her sentence, however, because a siren whopped and the ambulance bay doors slid open. Someone barked, “Incoming! We got a GSW here,” and just like that, Chloe lost Dr. Stevens’ attention. She wondered if she’d get to finish any of her sentences in the next few months or if she should get used to verbal shorthand, like GSW for ‘gunshot wound’.
She was about to step away from the door and go looking for another doctor who could order Dolores’ scan when Dr. Stevens yelled, “Barnes, I need you.”
Chloe’s heart leapt into her throat but she went to the gurney and Dr. Stevens pointed to the blood stain that was quickly blooming across the front of the patient’s shirt.
“Pressure,” she snapped and Chloe put both hands on his sternum to stop the flow of blood.
It was hard to maintain an even amount of pressure as the gurney moved and she walked with it over to one of the open beds. She couldn’t take her eyes off her patient – his eyes were closed and his brow was furrowed in pain, but other than the obvious injury, he looked like anyone who might be walking down the street on a sunny fall morning.
“Robbery gone bad,” one of the paramedics was saying as Dr. Stevens and the two EMTs lifted the patient onto the bed and Chloe lost her grip on the wound. Was this the face of a criminal? Someone pulled the stretcher out of the way and Chloe stepped forward, quickly applying pressure again as the paramedic added, “Tried to be a hero, should have just handed over the money.”
Chloe hadn’t noticed the man’s clothes before, but now she saw that he was wearing a green vest, like the cashier of a convenience store or maybe a gas station attendant. There was a lot of blood and the vest would be unsalvageable, but her hands on the wound seemed to be helping.
“He’ll be okay,” Dr. Stevens said to the paramedics. “Thanks, guys.”
Then they were gone, heading back to their ambulance for the next call of the day, and Chloe could feel her pulse pounding in her ears. Without the EMTs to help, she suddenly felt responsible and terrified. She asked, “What do I do?”
“Keep him from bleeding out,” Dr. Stevens said, and while it wasn’t the most specific advice, Chloe focused all of her energy on keeping even pressure on the wound. Dr. Stevens yelled toward the nurses’ station for help but someone was already running toward them. Veronica. She didn’t look so unaffected anymore.
“I booked an OR,” she said as she dropped a handful of gauze pads on a nearby tray table and started cutting the man’s shirt open. He grimaced and Dr. Stevens was checking his breathing and vital signs, then Veronica started packing gauze around the wound. “You can let go now.”
“Stay here,” Dr. Stevens said to Chloe as she and Veronica shoved the bed into motion and they headed for the hallway. Chloe wasn’t sure she could have walked if she wanted to, and as she watched her patient disappear down the hall, she suddenly became self-conscious. It felt like there were a lot of eyes on her – both patients and other medical students – and she couldn’t help thinking that Ivy or Megan would have been more confident in that tense situation. They almost certainly would have begged to join Dr. Stevens in the OR.
Chloe took a shaky breath and carefully removed her bloody gloves, then looked around for her tablet, which seemed to have disappeared in the madness.
“Looking for this?”
Ivy was standing behind her, holding the tablet out to Chloe. It was clear from the look in Ivy’s eyes that she was pretty jealous of what had just happened. Students weren’t supposed to be part of emergency cases like that, but it had just been a matter of being in the right place at the right time – or maybe, as Chloe saw it, in the wrong place. She took the tablet and headed back to the nurses’ station to look at the schedule. There had to be someone here who could order Dolores’ CT scan for her, and Chloe just didn’t have the time to process the complicated emotions running through her about her first gunshot wound patient.
* * *
Chloe got tapped to be on call for the first Saturday night of the ER rotation, something she was not looking forward to because that seemed like the most likely night of the week for all manner of weird and pulse-pounding cases to come through the Emergency Room doors.
After she checked in with the nurse on duty – a cheerful, young guy named Scott – Chloe headed to the call room to get a little rest and wait to be needed. When she got there, she found that she was not the only one on call.
“Ivy,” she said with a smile as she opened the door and saw her study buddy - and then, “Oh gosh, I’m sorry!”
Ivy had just pulled off her scrub top and was in the middle of changing, naked from the waist up but for a small white bra. Chloe ducked back into the hall, embarrassment coloring her cheeks as she counted to ten and tried for modesty’s sake to erase the image of Ivy’s petite frame and smooth skin from her mind. Then she cautiously opened the door again.
“You decent?”
“It’s not a big deal,” Ivy said, sounding a little irritated at Chloe’s modesty on her behalf. “We have to change in front of each other all the time in the locker rooms.”
“That’s true,” Chloe said. “I just didn’t know anyone would be in here.”
“It’s a call room,” Ivy pointed out. “There’s always someone in here.”
“Yeah,” Chloe said, glancing down at her shoes and wondering what was making her feel so dumb and tongue-tied. It had been a week and she still hadn’t completely put the embarrassment of the breast-touching incident out of her mind.
Ivy was right, though – they’d been in the locker rooms with the other girls in their rotations enough times that there should be no modesty left about things like changing into a new pair of scrubs. But she and Ivy had never been alone in a tiny call room together. The room was nothing more than a pair of bunk beds pushed up against the wall, a small dresser containing spare linens, and a window that looked out on the parking lot. It felt oddly intimate despite its utilitarian aesthetic.
“So you’re on call tonight too?” Chloe asked to fill the silence.
“Yeah,” Ivy said. “I was just going to get some sleep, but since you’re here do you want to go over the notes from this week’s lecture?”
“Okay,” Chloe said. Anything to dispel the sudden strange tension in this little room.
She sat down on the bottom bunk while Ivy retrieved a thick binder from her backpack, which she’d hung from a hook on the wall by the door. Her straight black hair came to just below her shoulders and Chloe wasn’t sure she’d ever seen it out of the usual ponytail Ivy wore. It framed her round face nicely. Ivy sat down at the other end of the bed and laid the binder on the mattress between them.
“I didn’t catch all of it because Dr. Stevens talks so fast,” Ivy said apologetically. “I recorded the lecture to transcribe when I eventually find the time, but for now my notes will have to do.”
“I’m sure they’re fine,” Chloe said, a yawn building in her jaw. The past week had been more intense than most of her previous rotations and the simple act of sitting down made her body start to acknowledge the exhaustion she’d been fending off. “What do you want to review?”
“I thought we could go over the main points of the lecture – we can review the five most common diagnostic errors,” Ivy said, and then Chloe could no longer hold back her yawn. She put her hand over her mouth and tried not to be rude, but Ivy added, “Unless you’re too tired.”
“No, go ahead,” Chloe said, determined to be a good study partner. “Number one – vague symptoms.”
They only got through the first two points before Chloe felt the urge to yawn again and her eyelids grew heavy. If there was one thing she’d learned over the past year of rotations, it was that sleep was a precious commodity and the opportunity to catch a few winks should not be squandered. But Ivy was at the top of their class and if she could pass up sleep in favor of a little more review time, then Chloe wasn’t going to start whining about how tired she was. She struggled to keep her eyes focused and her jaw locked to prevent any more yawning, but it was all in vain.
“Chloe,” Ivy said a minute later, her voice cutting through the fog as Chloe realized her eyes had been closed.
“Hmm? Number four-” she said, shaking her head to clear away the sleepiness.
Ivy sighed and said, “This is pointless. You won’t remember anything we reviewed if you were half asleep at the time.”
“Sorry.”
“It’s okay,” Ivy said. “Let’s get some sleep. I’ll take the top bunk so I can keep studying without bothering you with my reading light.”
“Okay,” Chloe said. She couldn’t help feeling like she’d let Ivy down, but at this point she was too tired to care. Ivy gathered up her notes and hoisted herself effortlessly into the top bunk, then Chloe got up to put her white coat on the hook beside Ivy’s backpack and turned off the lights.
Ivy was laying on her stomach on the top bunk, propped on her elbows with a textbook already open in front of her and using her cell phone as a flashlight to read by. Chloe shook her head slightly – if she had to guess, Ivy put in more than eighty hours a week ever since they started med school, but it was paying off for her.
“What?” Ivy asked, noticing her gaze.
“Have you ever heard the term ‘workaholic’?” Chloe asked.
“Have you seen the average med school GPA of a surgeon?” Ivy asked in return, her dark eyes challenging Chloe.
She shook her head and kicked off her shoes, then crawled into the lower bunk and lay down on her back. Suddenly her eyelids didn’t feel quite so heavy as she stared up at the bed above her. In all the time she and Ivy had been study partners, she’d never felt quite so alone with her as she did in this small, dark call room.
After a minute or two, during which time Chloe heard a couple pages being flipped, Ivy asked quietly, “You still awake?”
“Yeah,” Chloe said, and for some reason her heart was beating a little faster than usual. Ivy wasn’t one for small talk and even after three years Chloe knew very little about her. She couldn’t guess what she wanted to talk about now, unless it was work-related.
“Do you think I’m doing okay in the ER?” Ivy asked, then she leaned over the edge of the top bunk to look at Chloe as she added, “I like to get feedback directly from the chief resident, but Dr. Stevens is always so busy. I just don’t know where I stand.”
“Oh,” Chloe said. It was work-related. It had only been a week and Chloe was struggling just to keep her own footing, let alone keep tabs on the other medical students. After a moment of consideration, she said, “It’s so crazy in there it’s hard to notice anyone else, but every time I see you, you’re on top of things. I might not be the best person to ask, though – Dr. Stevens says I’m slow and I spend too much time with the patients.”
“Hmph,” Ivy grunted. “She says I do the opposite.”
“You are fast,” Chloe agreed. Ivy moved out of Chloe’s sight and didn’t ask any more questions, and Chloe assumed that she’d gone back to studying. Chloe tried to go to sleep, but then she blurted into the darkness, “Remember how you grabbed my boob on the first day?”
Her own mouth dropped open in surprise. Why on earth did she bring that up? Her heart started pounding as she waited for Ivy’s reply.
It seemed like an hour passed between that ridiculous question and Ivy’s answer, then finally she said, “I plead the fifth. Go to sleep.”
“Okay,” Chloe said. That was probably for the best. She turned to the wall and closed her eyes, murmuring, “Goodnight, Ivy.”
When she woke up next, her pager was vibrating on her hip and the top bunk was empty.
* * *
Over the next couple of weeks, Chloe was always on her feet, rushing from one patient to the next in the Emergency Room and doing her best to stay out of Dr. Stevens’ way. Her next night on call was with Megan and the one after that was with a medical student she didn’t know well and who wasn’t interested in chatting. Chloe kept waiting to catch her stride in the ER, but by the end of the first month of the rotation she still didn’t feel like she belonged there.
She’d already been through four different departments during her third-year rotations, and after emergency medicine she only had three more before graduation. The medical licensing exam was approaching rapidly and after that, everyone in the program would begin applying for residencies. Megan and Ivy – and almost everyone else in the program - knew exactly what their career paths looked like and where they wanted to apply.
Chloe, on the other hand, was floundering.
She had known from an early age that she wanted to be a doctor because she loved helping people, but she’d hoped that her specialty would reveal itself to her during medical school. Even after a year of rotations, though, she was no closer to knowing the answer. She’d been adept in every department she’d rotated through, but none of them ignited a passion in her like she saw in Megan and Ivy.
Her forte was clearly not in the ER, nor was it a good place to look for guidance – the most feedback she got from the perpetual motion machine that was Dr. Stevens was, “Don’t just stand there – call Ortho to set the broken tibia in bed six.”
Ivy seemed determined to follow in Dr. Stevens’ rapidly moving footsteps, seeing as many patients as she possibly could with robotic precision, and Megan was rarely available for the kind of heart-to-heart chats they used to have when Chloe first moved in with her. When she wasn’t at the hospital, she was with Alex, and when she was with Alex, Chloe didn’t want to interfere.
It felt like Chloe saw less of Megan and Ivy now than she did when they were all on separate rotations. When the three of them did happen to be in the same room together, Ivy and Megan were busy competing over everything, like who could place an IV fastest or who did the most physical exams that day.
One relatively quiet Monday morning in early October, Chloe was working with a fourteen-year-old boy named Austin. He and his mom, Jaclyn, had been in the ER for about an hour before a bed opened up for him and based on the symptoms that Chloe had noted as she took a patient history, she suspected that Austin was suffering from appendicitis.
She had just laid Austin back in the bed and was palpating his stomach to double-check her work when the curtain was yanked back and Dr. Stevens popped her head in to bark, “Barnes, see me at the nurses’ station as soon as you’re finished here.”
“Why?” Chloe started to ask, wondering if she’d done something wrong.
But Dr. Stevens flipped the curtain closed again and Chloe’s fingers found a tender spot on Austin’s lower right abdomen. He groaned and shoved her hand away while Jaclyn held up an emesis basin for him, but Austin pushed that away, too.
“Well, I’ve got good news and bad news,” Chloe said, taking off her exam gloves and dropping them into a trash can near the bed. “It looks like appendiciti
s, which will require surgery. The good news is that I see no indication that your appendix has burst, which means the surgery will most likely be done laparoscopically. That’s a low-risk surgery with a small scar and quick recovery time. I’ll just go confirm the diagnosis with my resident and we’ll get an operating room booked. If you have any questions, the surgeon will be along shortly.”
“Thank you, Chloe, we appreciate it,” Jaclyn said, patting her son’s hand as he recovered from the pain of the physical exam.
Chloe smiled and slipped through the curtain, closing it again behind her. She liked the kind of patients she could get to know, and who weren’t in too much pain to tolerate a little bit of conversation.
Dr. Stevens was waiting for her at the nurses’ station. Just the sight of her standing in one place rather than chasing gurneys through the ER or rapidly tapping notes into a tablet sent a chill down Chloe’s spine. Dr. Stevens had never asked to talk to her before – if anything, she was upset whenever Chloe needed something because it slowed her down. The chief resident was every bit as competitive as Ivy and Megan, except she was only competing with herself.
Chloe wondered what she could have done wrong. She was so meticulous with her patients she would know if something happened to one of them, and ever since Dr. Stevens’ first day warning, she tried to keep busy even when there wasn’t much going on. Maybe in her exhaustion she’d accidentally stood near the nurses’ station too long, talking to Veronica or Scott, who she’d befriended in rare slow times when they went around changing bedsheets and restocking the bedside supplies together.
“You wanted to see me?” Chloe asked as she approached.
“I’m just waiting on Chan,” Dr. Stevens said impatiently. “I want to talk to you together.”
“Oh,” Chloe said, confused. What did Ivy have to do with this?
She looked around and found Ivy skillfully inserting an IV at bed five, and while they waited, Chloe told Dr. Stevens about Austin’s appendicitis so that he could get scheduled and prepped for surgery. Then Ivy came over, head held high and showing no sign of the insecurity Chloe felt.