Irregular Heartbeat

by Chris Zett

  Ms. Miller took a deep breath. “As long as you don’t prod here again, I’m fine. What’s it? What will happen now?”

  Diana looked at her with what she hoped was her most reassuring expression. “I’ll just discuss this with my colleague, and one of us will be back soon to let you know. Just rest for a minute.”

  Ms. Miller nodded and closed her eyes.

  Dr. Barnes stepped past her and held the curtain open. When Diana followed, she led her to a large counter with a computer terminal. A couple of nurses interrupted their conversation midsentence and scattered in different directions.

  Diana looked at Dr. Barnes to find out if her new boss was the cause of their sudden exit.

  Her face showed no reaction. “So?”

  Diana smiled. “I think it’s appendicitis.”

  Dr. Barnes merely raised her eyebrows.

  Couldn’t that woman just say what she wanted from her? Diana hated guessing games. “Do you want a more elaborate answer?” When she nodded, Diana continued without hesitation. “The presentation is classical for an appendicitis, as is the age. But she’s a young woman with a boyfriend and without regular contraception, so we have to rule out an ectopic pregnancy. A urinary tract infection could cause the symptoms, but the result of the clinical examination isn’t really typical for that. She could just have some indigestion or the first manifestation of a chronic inflammatory disease like Crohn’s, but I think that’s the least likely diagnosis.”

  Dr. Barnes’s expression was still neutral. “What would be your next step?”

  Any med student and probably most fans of Grey’s Anatomy could answer that question, but Diana had promised herself to play by the rules, even the unwritten ones, this time. If Dr. Barnes wanted to quiz her, she’d smile and answer. “I would take blood tests, at least for leukocytes, C-reactive protein, and hCG, and a urine stick. Ultrasound. I’d give her some pain medication while we’re waiting for the results and have her fast. And depending on the outcome, I’d inform either surgery or OB.”

  Dr. Barnes nodded. “We’ll do that. Have you performed an ultrasound examination before?”

  Diana shook her head. “The radiology department did them.”

  “Now it’s your responsibility.” Dr. Barnes twisted her lips in a mixture of a snarl and a grin. “It’s a useful skill, but you can’t learn it from journals.” She started to walk but kept on talking.

  Diana clenched her jaw and hurried after her.

  “Learn the basics and practice a lot. You can often get a much faster diagnosis than waiting for the lab results.” She went on about the different uses of ultrasound in the ED as she grabbed a portable ultrasound machine from an unused treatment room. On their way back to the patient, she stopped a nurse and ordered some morphine for Ms. Miller.

  Diana made a mental note of the dosage.

  Dr. Barnes set up the ultrasound next to Ms. Miller and pointed out the basic features to Diana. Then she turned to the patient, who watched the machine warily.

  “Ms. Miller, I’m Dr. Barnes.” Her voice was marginally warmer than before. “I’m going to do an ultrasound examination to see what we’ve got here. We think it’s appendicitis, but we need to check a few things before we can call surgery. You’ll get something for the pain.”

  Ms. Miller flinched at the mention of surgery but lay back as the nurse administered the medication.

  Dr. Barnes quickly examined the patient. Appendicitis, as Diana had suspected. She helped Diana to reproduce the same result. She leaned in close to place her hand over Diana’s, gently angling the probe in the right direction. Her touch was warm and soft, unlike her demeanor so far.

  When Diana managed to find the enlarged appendix with its dilated walls, she grinned with pride. Only an hour into her first day, she had already learned something new and useful. And her aloof boss was actually a good teacher.

  Dr. Barnes’s explanation of the surgery to Ms. Miller pulled Diana out of her thoughts.

  “Don’t worry, Ms. Miller.” Dr. Barnes smiled and patted the young woman’s hand. She seemed genuine, just a little stiff. “It’s a routine procedure, and our surgical team works hard to keep pain and scaring to a minimum. You’ll be back on your feet soon.”

  Over the course of the next few hours, they repeated the examination, medical quiz, and teaching routine again and again with different patients. Most cases were as easy as the first one, but Dr. Barnes never seemed satisfied with her performance. Every time Diana thought she had made a favorable impression, Dr. Barnes fired more questions at her. When Diana didn’t come up with an answer or an alternative diagnosis fast enough, she had to endure another snide remark. She started to really hate Dr. Barnes’s cold gray eyes. Not that they were unattractive or anything, quite the opposite, but they remained the most expressive feature in her artificially smooth poker face.

  Finally, the night shift arrived, and Diana was free to go.

  “Dr. Petrell.”

  Dr. Barnes’s voice stopped her from opening the locker room door. Diana’s hand clenched around the doorknob.

  “Don’t forget. Seven a.m., sharp.”

  Did she think Diana was a child who couldn’t keep track of her appointments herself? She turned around to tell her that she didn’t need the reminder, but the corridor was empty. Arrogant bitch.

  Diana entered the locker room and closed the door with more force than necessary. At least they wouldn’t change at the same time. She needed a minute alone to decompress. Reining in her temper all day had left her shoulders tense, and a headache spread its tendrils from the knots in her neck to her forehead. She sighed as she changed out of her rumpled scrubs. If only she had brought a comfortable pair of jeans instead of her formal first-day-at-work outfit, which hadn’t impressed anyone.

  Diana closed her eyes for a moment and leaned her forehead against the locker. The cool metal brought only minimal relief. Her fingers twitched, aching to beat a rhythm on the metal, to convert her tension into music. Instead, she forced herself to turn around and leave.

  She had survived her first day. Why should her second chance be easier than her first?

  Chapter 2

  Emily woke with a racing heart. Had there been a noise? Listening for a minute, she couldn’t detect anything. Her bedroom and the rest of the apartment were completely silent; not even the neighbor’s dog barked. The predawn twilight cast long shadows without movements. She was alone.

  Her heartbeat slowed, but why was she still breathing so fast? Several diagnoses ran through her mind. Pulmonary embolism, panic attack, acute coronary syndrome. Yeah, right. She rolled her eyes. More likely, it had been a nightmare. As she untangled herself from the sweaty sheet, she became aware of the throbbing between her legs. Or maybe you missed the obvious, Dr. Barnes: arousal.

  She groaned. Not that dream again. What had triggered it this time? She shrugged; it wasn’t important.

  Yawning, she rolled over to get some more sleep.

  The sounds of passing cars turned into the sea lapping against the shore; the solid mattress transformed into shifting sand, and the soft cotton sheets caressed her skin as the ocean breeze had that night. She took a deep breath. Salt, sweat, and her own arousal still smelled the same. Only smoke was missing.

  Don’t go there. She moved to her other side, willing her brain to go back to sleep, preferably a dreamless one. It didn’t comply. It never did.

  When she closed her eyes again, stars twinkled above her, brighter in her memory than they could have been that night. Sparks and smoke from the big fire on the beach flickered through her peripheral vision. The crackling and hissing of the logs, the laughter of the other students, the lingering taste of the rich Merlot on her tongue. Everything rolled over her like breaking waves until the tide threatened to pull her under, and she struggled to escape the overwhelming memory.

  Her pulse beat in
her neck and temples as if the drums were within her. Some students had been playing for hours around the fire, keeping a hypnotic rhythm, slowly accelerating and decelerating seemingly without direction. Players had been coming and going, drifting in and out without breaking the sound tapestry. A new player wove in and added another layer of rhythm. Emily immediately sensed the difference. It was no longer a soothing background. Suddenly, it demanded her full attention.

  At first, she couldn’t discern the dark shapes sitting on the big logs until her eyes adjusted to the flickering light. And then she saw her.

  She sat with her back toward Emily. The big drum between her legs was barely visible from behind. Broad shoulders and muscular arms drew Emily’s gaze. Around one well-defined biceps coiled a sinuous shape, glittering emerald green in the glow of the fire. It snaked over her right shoulder to her back, then widened to a scaled body before getting lost in her black tank top and the darkness enveloping her. The rhythmic movement of her shoulders, arms, and hands was mesmerizing. Muscles and tendons shifted under her skin, taunting Emily to name them, but she had momentarily forgotten everything she had learned in anatomy class.

  Emily lost all sense of time as she concentrated only on those hands. Her blood pounded in the same cadence as the drum. The vibrations emanating from it touched her skin. The hands played on Emily now. Her skin burned, and her breasts became heavy beneath the stranger’s touch. Or was it her own? Fingers glided over a stomach taut as a drum and buried in the wetness between her legs. The rhythm quickened. The other drummers tried to keep up with her, but failed. The stranger’s hands flew faster than anyone else’s. Emily’s hands flew as well. Hours, days, or only minutes later, her playing climaxed and Emily with it.

  Emily woke again with a racing heart, her limbs weak with lassitude. The relief brought by the orgasm mixed with shame and regret. Why would her stupid libido replay that scene on the beach over and over again?

  After nearly fifteen years, she had thought she was finally over her eye-opening experience. Periodically, the dream reminded her of the moment she had admitted to herself that she was a lesbian or at least attracted to a sexy pair of arms and a tattoo. Not that this revelation had translated into her everyday life. Work was her main focus; reading came second. She had a friend to spend an evening out occasionally. A lover wasn’t part of the plan anymore after her two short relationships during college. The short time with her boyfriend had taught her that she wasn’t into men, and her girlfriend had shown her that she didn’t need the distraction of a relationship.

  The alarm clock startled her out of her musings and compelled her to head toward the bathroom. Without waiting for the water to heat, she stepped beneath the cold spray of the shower, as if it could banish the dream and the lingering feelings of dissatisfaction and loneliness.

  After changing, Emily immediately headed to the staff lounge. She needed a coffee. Extra large. She didn’t like the bitter taste, but her usual Darjeeling tea wouldn’t be enough today. Her trip down memory lane had left her exhausted.

  Dr. Petrell was already sitting on the couch, one leg tucked underneath her, studying the screen of her laptop.

  Since their first meeting on Monday, Dr. Petrell had beaten her to work every day this week, a feat Emily grudgingly admired. She’d been afraid a resident starting in the middle of the year would be rusty and would slow down the well-oiled machine of her ED. Despite receiving special treatment by the chief of staff, Dr. Petrell hadn’t even shown a hint of entitlement. Instead, she had worked hard to get up to speed.

  When Emily sat on the couch on the opposite side of the table, Dr. Petrell looked up and smiled. “Good morning, Dr. Barnes.”

  “You weren’t late on the first day.” Emily flinched, and the still-too-hot coffee nearly spilled over. She placed her mug on the table, wishing she could lay her head next to it. Why had she admitted this now? She must have been even more in need of coffee than she had thought. Telling newbies they were late was her first-day ritual. Maybe it was her way of passing on her own frustration at being the one who got all the extra assignments, such as playing babysitter for new residents. Whatever it was, it usually felt good. But not this time.

  Dr. Petrell didn’t question her or demand an apology. She only said, “Okay,” with the same friendly tone she used on everyone. Her gaze seemed to want an explanation, though.

  Emily blew on her coffee and took a small sip to buy some time. When the taste registered, she almost spat it out. “Ew! Who brewed this?” She went to the fridge for some milk or creamer to make it tolerable.

  “It’s left over from the night shift.” Dr. Petrell laughed and held up her travel mug. “I brought my own, or I’d have warned you. Don’t you usually drink tea?”

  “Mm-hmm. Sometimes I need more caffeine.” Emily sniffed the milk. Drinkable. She doctored her coffee and returned to the couch. Time to direct the conversation to work. “What have we got?” She gestured toward the laptop.

  “Nothing.” Dr. Petrell handed it over. “I’m sure the waiting room will fill up soon enough, but the night shift managed to clear the board.”

  Emily checked the computer program herself. Every patient in the ED was ready to either go home or to another department. Shit. No work to distract her. Now she had to have “the talk” with Dr. Petrell.

  She was a competent resident, never complained, and was always professional with the patients. The first few days Emily had watched her closely and could detect only minor mistakes, nothing life-threatening so far. She had to admit that Dr. Petrell was as good as the other residents she had trained herself. Maybe even better because she brought a maturity to the work that could only be gained through time. The ten or more years she had on the other residents put her closer to Emily’s own thirty-six and made working together easier. Why was it so difficult to tell her that?

  “The next cases are yours alone. Call me to sign off on them or if you need help. I’ll be in my office.” There. She had said it all. Well, most of it. Between the lines. Somewhere.

  She handed back the laptop, took her mug, and stood. Ignoring Dr. Petrell’s open mouth, she fled the room.

  Emily clicked refresh on her screen for the thousandth time today. She grinned. Cyberstalking, only completely harmless. Still nothing new. How long could it possibly take to write a few notes? She reached for her mug to keep herself from checking the digital file again. Empty. Should she go and get another coffee? It would give her a reason to pass the nurses’ station to check on Dr. Petrell’s progress. But she was one cup short of a heart attack already.

  She looked around her tiny office to find another distraction. Her journals were stacked and sorted by publication date; her textbooks were freshly dusted, and the box of pens had been neatly divided into blacks and blues. Her digital to-do list was empty.

  Waiting for Dr. Petrell to finish with her patients had been surprisingly productive for Emily. She had answered all her emails, written two case reports, finished an article, and peer-reviewed another. A warm feeling of accomplishment made her smile. Dr. Wallace would be proud of her when she published another article.

  Today had been one of the rare days without a real emergency or an overflowing waiting room. Dr. Petrell hadn’t needed her help, but she had dutifully reported on every patient before sending them home. Now it was close to the end of day shift, and Emily was bored out of her mind.

  Water. She jumped up and squeezed past the desk. She could get a bottle of water from the vending machine in the waiting room. That would get her past the nurses’ station.

  Just as she reached for the door handle, someone knocked.

  She opened the door and came face-to-face with Dr. Petrell. Were those eyes brown or green? That wasn’t something she should care about when she looked at a resident. Heat rose to her cheeks. Her stupid fair complexion always gave her away, no matter how much makeup she used. She took a step back and
returned to her desk.

  “Come in. Sit.” Emily gestured to the visitor’s chair, concentrated on opening the digital files, and hoped her blush would fade fast.

  “I’ve just finished with the last patient.” Dr. Petrell recited the symptoms, the diagnosis, and the proposed treatment.

  Signing the discharge order without looking at the patient was a temptation. A simple cold did not warrant the attention of two physicians. But frustration with her extra duties was no reason to do them only halfway, and it was finally something to do. She sighed and rose. “Let’s have a look.”

  “Dr. Barnes! Diana!” Courtney stormed into her office without knocking. “We have multiple victims from a pileup coming in.” The second-year resident’s voice rose higher with every word in either trepidation or anticipation. Probably both. She turned on her heel and ran back toward the treatment area.

  “Don’t run!” Emily shook her head. She had told her repeatedly that running around the ED was unprofessional. When would Courtney finally learn some restraint?

  Dr. Petrell chuckled but sobered when they followed Courtney. She didn’t comment on the news that her evening plans would be derailed.

  Emily made quick work of her checkup on the cold victim and joined her waiting colleagues, residents, and nurses.

  On the opposite side of the room, Dr. Petrell stood without joining in on in the chatter and speculation of the team.

  Emily took the opportunity to study her. Several strands of her dark brown hair had escaped her short ponytail, which, combined with her healthy complexion, gave her a much younger appearance. The wrinkled blue scrubs hung loosely over her long-sleeved shirt and revealed no hint of her figure. Dr. Petrell’s lips lifted in a half-smile, and her right hand drummed on her thigh in a complex rhythm, faster than Emily could follow. It was hypnotic, and Emily stared longer at Dr. Petrell’s thigh and her long, muscular fingers than politeness allowed. They reminded her of something or someone. The link hovered at the edge of her consciousness.