I know it’s bad when Clarence pulls me aside in the middle of a shift to question if I need some personal time after I snapped at a one of the physiotherapists for not seeing a patient immediately after I placed the order. I’ve never been that kind of doctor — the kind that lords over everyone else, wielding my authority like a blade. I’m a team player, and I have a deep respect for all the disciplines I work with and their individual workloads.
After the torture of this set of shifts, the last place I want to be right now is walking back into the hospital. I should be on my way to Hastings bar to meet up with my brothers instead. Jude’s game is on tonight and we were going to eat wings, drink beer, and watch our brother kick ass on the ice.
But a panicked resident paged me because the attending on call was busy and they needed help with a patient admitted with asthma exacerbation.
Needless to say, I’m not happy to be here. And that feeling intensifies when I walk onto the unit, heading straight to the patient’s room, only to see Heidi come strutting out with a confident smile on her face that makes her so beautiful, I stumble. She might be beautiful, but she still reminds me of too many painful things to count.
“What are you doing here?” I bark, and she turns, surprise colouring her face.
“Mateo wasn’t maintaining his oxygen saturation levels. Dr. Chang was worried and wanted a second opinion. Rodriguez is the on-call attending but he’s caught up with a multi-trauma in the ER, so I offered to help.”
“Shouldn’t you be at home? Your shift ended hours ago.”
I should be focused on the patient, not the woman in front of me, but all my frustration is bubbling over inside of me. And if Mateo was still in the woods, she wouldn’t have left his room smiling.
Heidi folds her arms across her chest. “He’s better, in case you’re wondering, not out of the woods yet, but I think he’s stable. I upped his Ventolin and switched to nebulizers, and he’s now maintaining 94 percent with only one liter O2 in between.”
Out of the corner of my eye, I see the other resident, Dr. Chang, approaching. He pushes his glasses up on his nose, and I can tell he’s nervous. Probably because he can tell I’m not pleased.
“Dr. Donnelly, I’m the one who had you paged. I’m sorry, I know you’re not on call, but the instructions we have are to call you if the attending on call is not available. And I couldn’t think of how to improve Mateo’s numbers.” He shifts back and forth on his feet, and I force myself to take a deep breath in and out. He’s only a first year. He did exactly what he was instructed to do, and he doesn’t deserve my piss-poor attitude.
“It’s fine, Dr. Chang. You made the right decision calling me in. But apparently —” I look to Heidi “— someone beat me to it.”
She lifts her chin defiantly, and I’ll be damned if the fire in her eyes doesn’t turn me on even as it pisses me off.
“What was I meant to do, not help a sick child when I knew I could?”
“And how did youknowyou could?” I ask sharply.
“I spent one of my rotations working at a pediatric asthma clinic,” she retorts. “And the other night, I was watching a lecture series with Dr. Cara Andrews from the University of Vancouver’s Cystic Fibrosis Research Program. It included a section on using nebulizers in specific circumstances. I know she was referring to cystic fibrosis patients, but the strategy seemed appropriate for Mateo as well.”
God-fucking-damnit. Cara again.
“Next time, don’t experiment on my patients with protocols that are not designed for their condition. You may have been lucky this time, but that’s not an appropriate practice,” I snap. “Let’s see his latest numbers and make sure you haven’t made things worse.”
We turn as a group to the screen outside of Mateo’s room that displays his continuously monitored vital signs. Sure enough, he’s stable. As stable as a five-year-old with viral induced asthma can be. I look back at Dr. Chang,notHeidi. I don’t want to see the triumphant look that I’m certain is on her face because her judgment call was correct — that Cara’s fucking lecture was correct. “Monitor him all night. Keep the nebs going every four hours, don’t try to wean off the oxygen until the morning. He and his family need sleep and they won’t get it if his monitors are alarming every few minutes.”
The other resident nods and then scurries away, leaving me alone with Heidi. She’s still holding her defensive posture, and her eyes are still sparking with energy.
“You got lucky, Dr. Morgan. But I mean it. Don’t ever assume that what works for one group of patients will automatically work for another, unless you have the data to back it up.”
“I did.” Her chin lifts. “Like I said, I spent a rotation at an asthma clinic. They still use nebulizers there. So when I thought of Dr. Andrews’ strategy, I compared it to my experience at the clinic and made the call.”
I grind my teeth at yet another mention of Cara’s name. At this point, there’s nothing else I can say. If I take her explanation at face value, she weighed her options and made a good call. “You never answered my other question. Why are you still here so long after your shift?”
Her eyes drop to the floor as her body tenses. I feel my own spine straighten in response, even as I wonder what the hell she’s going to say.
“I was looking at job opportunities in other parts of the island.”
That’s not at all what I thought she would say. Frankly, I’m surprised douchebag Thad would be willing to move for her.
“Clarence made it clear you have a job here when you finish your residency. And our surgical program is top tier.”
What the hell am I doing, trying to convince her to stay? My response baffles me.
“I’m weighing my options.” Her chin lifts in defiance and a small part of me grudgingly admires her strength. Until her next words settle like a lead weight in my gut.
“The workplace environment is important to me, and I don’t particularly want to start my career in a place I’m no longer wanted.”
