Irregular Heartbeat

by Chris Zett

  Dr. Petrell looked up and seemed to notice Emily’s gaze on her. Her fingers stilled. “I hate waiting.”

  Her throat was suddenly dry, and Emily had to swallow a few times before she could answer. “Who doesn’t?” She looked around to avoid staring as Dr. Petrell retied her messy ponytail.

  The automatic doors opened, and the first paramedics entered with their patient on a stretcher.

  Emily sighed with relief. She could return her focus from Dr. Petrell’s hands—and the connection she couldn’t grasp—to her job. Quickly, she organized the group into teams and assigned each to a patient. She had to suppress an inappropriate smile. Finally, some real work.

  Chapter 3

  Diana shoved her hands into her scrub pockets to avoid fidgeting and giving away her tension while she waited for the ambulance. The adrenaline triggered by the words pileup and multiple victims had flooded her with energy, and now she fought the urge to move to burn it off. She remembered and relished that feeling of harnessed power from when she was younger, but now something had changed, as if a new note had crept into a familiar song, slightly off-key.

  What if she got a patient she couldn’t handle?

  Shut up. You’ve done this before. It was true; she had successfully treated polytrauma patients, but that had been years ago. Her recent experience consisted of doing simulations and reading guidelines. She had never suffered from stage fright, but she guessed the dread churning in her stomach was exactly that. How ironic that she developed it now.

  When the first patient arrived, Diana followed her assigned team into the trauma room. She knew only Tony by name and Dr. Clarkson, who took the lead. Diana hadn’t worked with the attending yet, but she seemed nice enough and, more important now, exuded confidence.

  As soon as the paramedics had wheeled the stretcher into the room, everyone jumped into position and started working on the patient simultaneously. One of them recited the patient’s vitals and presumably some details on what had happened, but Diana only caught half of it as she fumbled with her face guard. She snapped on her gloves and rushed to the patient to help with transferring him to the hospital’s stretcher. As soon as he was settled there, the other staff cut away clothes, attached monitoring, and inserted needles.

  Dr. Clarkson systematically performed a quick body check. Everyone seemed to have found their part in the complex choreography without orders, and Diana looked for an opening for her to contribute something.

  “Dr. Petrell, get up here and start a central line.” Dr. Clarkson moved to the head of the patient and checked his pupils again before turning to one of the nurses. “Let’s intubate him.”

  Happy that she had something to do, Diana exchanged her barely used gloves for the sterile ones a nurse offered and slipped into a paper coat. Awareness of her colleagues’ movements receded as her focus narrowed to the small part of skin below the right clavicle. Disinfection, drape, needle, wire, central line, syringe with saline, suture. Everything she needed appeared like magic next to her hands before she could even think of the next step. She had never done this so fast. Proud of her accomplishment, Diana looked up to see what she could do next and met dark eyes glaring at her.

  “Finished? I need to get started here.” The X-ray tech elbowed Diana out of the way to place a digital detector under the patient, then turned, and shooed her away with a hand motion.

  Diana moved back with the rest of the team. Some left the room, but most flattened themselves against the wall, like Diana.

  Dr. Clarkson was the first at the monitor. “Pneumothorax.”

  Shit. Had she pierced his lung during the placement of the central line? Diana glanced at the monitor.

  No, the pneumothorax was on the left side and most likely caused by the impact of the car, along with the broken ribs. She exhaled and turned to Dr. Clarkson. “I can place the chest tube.”

  “Maybe next time. See if you can stop the bleeding up there.” Dr. Clarkson had already moved to the patient’s left side. “Tony, call radiology for a CT and get him a bed in the SICU. We need to move him along soon.”

  Suturing a superficial head laceration might be part of the team effort, but it seemed tame in comparison to the real work Dr. Clarkson did in stabilizing the patient.

  “Status?” Dr. Barnes entered the room with an older man whose green scrubs and cocky posture identified him as a surgeon.

  Without looking up from her work, Dr. Clarkson listed the patient’s vitals, his injuries, and their treatment so far. When had she done an ultrasound? Set his wrist? How had Diana missed this?

  “Nothing immediate for you, Richard.” Dr. Barnes stepped up next to Diana and leaned over her shoulder to check the patient’s pupils. Her body pressed into Diana’s back, its softness and warmth in drastic contrast to the coldness of her voice. Diana didn’t dare to move. “Liz, send him via a CT to the SICU. He can wait there for a spot in the OR if the neurosurgeons don’t claim him.”

  Dr. Barnes left as fast as she had come. When the door closed behind her, Dr. Clarkson exchanged a gaze with Tony, who rolled his eyes.

  “Aye, aye, Captain Barnes.” Dr. Clarkson chuckled and shook her head.

  Biting her lip to keep from laughing, Diana finished the suture. So she wasn’t the only one Dr. Barnes checked on constantly. Not even an attending like Dr. Clarkson was safe.

  She cleaned the suture site with a wet gauze and put a dressing on it. Good, the bleeding had stopped for now. She checked the patient for something else to do. Nothing else stuck out to her. “Want me to do the paperwork?”

  Dr. Clarkson nodded. “Most things should already be logged. But check it and clean up the text, please. I’ll see if I can reach his family.”

  By the time Diana had finished, the transport team had come and whisked away the patient. Dr. Clarkson looked over her shoulder and read the report, pointing out a few things she had missed, then signed off on it. She stood as close as Dr. Barnes had done, but Diana didn’t mind this time. Why did Dr. Barnes make her nervous?

  As a cleaner swept around their feet, Dr. Clarkson pulled Diana to the side. “Let’s have a look at the other rooms. Maybe we can help somewhere.”

  Finally, after a couple of hours, the digital whiteboard had cleared, and Diana looked for Dr. Barnes to see if she could go or if there was still work somewhere. She found her at the nurses’ station, talking to Dr. Clarkson.

  Dr. Barnes frowned. “What are you still doing here?”

  Why the hell did Dr. Barnes sound so annoyed with her? “Um, I just finished in room three. Do you need my help somewhere else?”

  “You know that you have to clear overtime with me. We take work restrictions seriously in this hospital.”

  Diana hadn’t known that, but she was too tired to argue. “I will do that the next time.”

  Dr. Barnes had been about to say something else when Dr. Clarkson interrupted her. “We just made our round through the trauma rooms. The night shift has everything under control now. You’re good to go.” She smiled. “And thank you for staying longer. Good work, Dr. Petrell. Have a nice weekend.”

  Dr. Barnes still frowned but didn’t contradict her colleague.

  Diana nodded to both of them. “Thanks. See you on Monday.”

  Her mind reeling, she went to the locker room. It hadn’t really been good work. She had been much too slow with their first patient, no matter how it had seemed to her at the time. And she had been so overwhelmed she hadn’t seen the big picture. If she had been alone, the treatment could have ended as a catastrophe.

  She peeled off her scrubs and wrinkled her nose at the smell of sweat, probably a mixture of her own and that of several patients. Rusty stains and smears covered them, but at least the hospital did the washing for her. She pulled on her jeans but then hesitated. The stains and smell extended to the long-sleeved shirt she wore underneath. No way would she wear that
home and risk soiling her favorite leather jacket. She looked around to check that she was still alone before grabbing a fresh scrub shirt to change into.

  Just as she had taken her shirt off, the door opened.

  Diana jumped back with an undignified shriek and scrambled into the scrub shirt. Maybe they hadn’t seen the tattoo. Closing the locker, she sneaked a look at the doorway.

  Dr. Clarkson regarded her with raised eyebrows. “Everything okay?”

  “Um, yeah. Just my shirt got dirtier than I expected, and I thought it was okay to borrow a scrub shirt. Is it okay?” Great. Now she had turned into a babbling fool.

  “Sure. Everyone does that.” She opened her locker and quickly undressed.

  Diana concentrated on folding her shirt in a way that made sure the stains didn’t touch anything else. “I’m sorry I wasn’t much help with the first patient, Dr. Clarkson.”

  The attending had finished dressing and turned around, smiling. “Call me Liz. Everyone does. You’re Diana, right?”

  Diana nodded. She shoved her shirt into her backpack, wishing she could ball up and stow her problems away as easily.

  “Don’t worry. We’ve all been there. It’s just your first week.” Liz dumped her scrubs into the hamper.

  “I thought I could do better.” And she had done better, years ago.

  “Then you will, the next time. Don’t overthink it. If you feel like it, we can talk on Monday and see how we can improve your training. Let’s get out of here.” Liz held the door open for her.

  “Thank you.” She didn’t just mean the door, and judging by the look Liz gave her, she understood.

  Diana’s cell phone blared and vibrated next to her ear. Who called in the middle of the night? Her pulse beat faster than the ringtone. Had she forgotten to do something important at the hospital? She grabbed the phone and answered without looking at the caller ID. “Petrell. Hello?”

  “Hey, Dee. Did I wake you, old woman?” Mel was difficult to understand over the background of music and voices.

  Diana let out a shaky breath. Not the hospital. Only her best friend and colleague. Former colleague, she reminded herself. “Um, yeah. How late is it? And you’re older, you know?”

  “Midnight. And don’t you know that it’s impolite to mention a lady’s age?” Mel laughed. “I was wondering if you wanted to meet for a beer?”

  A few weeks ago it would have been a normal time for her to go out, but now she only wanted to go back to sleep. “Rain check? Work was no fun today.”

  “That’s what I wanted to celebrate with you, your first week as a doctor.” The background noise faded as if Mel had stepped outside. “Want to tell me about it?”

  “Maybe later.” She yawned. “Much later. Why don’t you call me tomorrow morning? Or afternoon. If you really want to listen to me bitch about being on the bottom rung of the hierarchy again or my constant struggle to act like an adult or not fitting in with the other kids.”

  “Sure. At least it’s something new and not about your ex making stupid life choices again.” Mel sighed. “I wanted to ask you a favor, but it can wait. Tomorrow evening we go out and party.” The last sentence was a statement, not a question.

  Diana groaned. “Don’t you remember the last time we celebrated my first week as a doctor? We partied for two days, and I ended up going to work with a hangover. I can’t survive something like that again. I’m definitely not in my twenties anymore.”

  “Me neither. We’ll just stay clear of hard liquor and tattoo artists this time, and we’ll be fine.”

  Diana rubbed the small rod of Asclepius above her left ankle. “I’ll remind you of that tomorrow.”

  “No need.” Someone called Mel’s name, and the intensity of the background noise increased again. “I’ll let you get back to sleep now.”

  “Thanks. Enjoy your night.”

  This time, Diana put the phone on the charger in the kitchen where it belonged before she returned to bed.

  Taking a breath of the clear air, Diana stretched next to the entrance of Green Lake Park. Her muscles and tendons protested after a week of neglect. She had promised herself that she would keep in shape and take better care of her health during her second residency. At least she didn’t have to nurse a hangover after her evening out with Mel. They had kept the celebration low-key, eating pho in a small Vietnamese restaurant with a couple of beers instead of doing shots in a bar with women much too young for them. She’d had enough of that in LA, and she supposed Mel had secretly enjoyed the change of scenery as well.

  Diana tightened her shoelaces, then set off at a moderate pace. Most of the trees around her were still caught in winter’s sleep, but here and there a few light green buds had broken free already. She was looking forward to the blooming cherry trees at the other side of the lake.

  Diana swerved around a little girl and immediately collided with another woman going the opposite direction. Both grabbed each other and swayed until they found their balance.

  “I’m sorry.”

  “Sorry, I didn’t see—” Diana looked up. Dr. Barnes? What are the chances?

  “Good morning, Dr. Petrell.” Dr. Barnes shifted from foot to foot and didn’t look directly at Diana. She wore running clothes that looked brand-new. And who put on makeup to go running?

  “Good morning. I’m sorry, I was just so eager for my run. I’m looking forward to getting some sun.” Maybe this could be a good opportunity to get to know each other and ease the stiff atmosphere at work a little bit. Diana bounced on her toes and smiled. “Are you planning on using the trail around the lake too?”

  “No. I’ve got, um, sensitive skin. I could never run in the sun. I usually go to the gym over there.” Dr. Barnes pointed at the other side of the street, then tucked her hair behind her ear.

  Diana barely managed not to frown. Indoor running wasn’t what she’d consider her favorite workout. She wouldn’t exchange a beautiful lake and fresh air for a room full of sweaty people. It was a flimsy excuse; that’s why they had invented sunscreen.

  Or had Dr. Barnes told her that to prevent an invitation to run together? Welcome back to the world of hierarchy: Attendings didn’t socialize with residents. But maybe the reminder was necessary; she’d been about to ask Dr. Barnes to join her.

  Offering an empty smile, Diana nodded. “Okay. I’d better get going. See you tomorrow.”

  “Wait, please.” Dr. Barnes swiped at her hair again even though it hadn’t moved an inch. “If you have a few minutes, I’d like to talk to you about Friday.”

  Diana shrugged. This was certainly not the perfect setting for a critique of her work. But she should count herself lucky that it wasn’t within earshot of the other residents.

  “I watched you handle some of the minor injuries. You were thorough and unhurried—”

  “You mean slow. I know.” Diana didn’t want to listen to the polite paraphrases. She preferred her critique direct.

  “It’s true. You could have been faster, but what mattered to me more was that you didn’t miss anything. That would be unacceptable.” Dr. Barnes’s voice had turned cold with her last sentence. “Getting overconfident is a typical mistake of residents.”

  Diana nodded. There wasn’t really anything she could say. What was Dr. Barnes trying to tell her? Was it a warning that she was being watched, still on probation? Dr. Barnes could watch her as much as she liked; overconfidence wasn’t her problem at the moment.

  “You’re more mature than the others. I guess the age difference shows.”

  That sounded almost like a compliment, but Dr. Barnes didn’t do those. At least that’s what the other residents said.

  “Thank you.”

  “Maybe you lost medical experience, but your approach to work didn’t suffer from your break.” Dr. Barnes tilted her head and looked at her directly for the first time since the conver
sation had started. “What did you do in those nine years? Didn’t you say you helped a friend and lived on a farm?”

  Shit. Diana clenched her teeth and swallowed the rising anger. The almost-compliment had only been a prelude to the real question. “It’s complicated. And has nothing to do with my work performance.” She avoided Dr. Barnes’s eyes. Why hadn’t she thought of a better cover story? She had to end the conversation before she either lied or went against a direct order from her boss’s boss. “Dr. Clarkson offered to help me on Monday to improve my speed. Is that okay with you?”

  Dr. Barnes frowned. “Sure. If Liz wants to help you…”

  “Great. See you on Monday, then.” Diana hoped her tone didn’t betray her apprehension.

  Dr. Barnes just looked at her for a moment. Her features were carefully neutral, probably the same expression she wore at work when patients told her the weirdest stories. Then they softened slightly. “Enjoy your day off.” She waved her hand and left without a backward glance.

  Diana inhaled deeply, but the spring air that she had enjoyed earlier didn’t help clear her head. She gazed upward. The sun was shining; small fluffy clouds dotted the brilliant blue, and the temperature was comfortable. A perfect spring day. She wouldn’t let this encounter spoil her Sunday morning. She started her run, faster and faster.

  When she reached the lake and merged on the round trail, she slowed down and concentrated on her heart rate. This isn’t a race. You’ve nothing to prove. She chuckled, and an elderly couple sitting on a bench stared at her. Now that her embarrassment and, if she was honest, her anger with herself had faded, she could appreciate the irony of the situation.

  In the past years, she had been the one others tried to impress. Too many people had fawned over her. That had been one of the many reasons she had left her old life and returned to medicine. She wanted to be treated like a normal person again. And now that she was, she didn’t like it. Dr. Barnes had every right to question her.