Our first set together was miserable. He snapped at me over the smallest things, like when I got blood on my plain blue scrub top and I pulled out one of my old nursing ones that happened to have puppies on it. Apparently, that was unbecoming of a doctor, and he insisted I go ask one of my fellow residents if they had a spare set I could borrow.
He didn’t seem to have any problem with the colourful scrubs the nurses were wearing, so either he’s an elitist jerk or it’s just me.
But today is the start of a new set of shifts, and I’m determined to change the way we work together. I’m not the same person I was ten years ago. I’m not weak, easily manipulated, or low on self-confidence. I’m a fully capable resident, almost a doctor in my own right. I did not come all this way, go through all the shit I went through with Thad, only to have another arrogant man push me right back down.
“Donuts anyone?” I proclaim, dropping the box on the counter of the nursing station. In an instant, two of my fellow residents and three of the nurses swoop in and take one each, giving me their grateful thanks. I don’t see Dr. Donnelly anywhere, but I straighten my scrubs and check that my hair is pulled back all the same.
Choosing my favourite — the chocolate dipped with sprinkles, of course — I take a bite as I sit down at one of the computers to open an email that came through from my residency program adviser this morning. It’s nothing important, but there is one thing that captures my attention. A fellowship opportunity with a leading cystic fibrosis research team. It’s not something I’d seriously consider, not when pediatric surgery is my eventual goal, yet I read through the offer.
“Dr. Morgan, when you’re ready, I’d like to begin rounds.”
I quickly close the email and spin around on my chair to face Dr. Donnelly, who already has a deep frown on his face. He’s flipping a pen over his fingers, in what I’m realizing is somewhat of a tell for him. “Ready.” I stand up and gesture to the box where two donuts remain and with what I hope is a gracious smile. “I brought those in for everyone, if you’d like one. A bit of sugar is always a nice way to start the day.”
The sound of derision and abrupt shake of his head shouldn’t sting; it really shouldn’t.
“Who’s our first patient?”
Glancing down at my sheet and then up to the patient room we’ve stopped at, I reply, “Susanne Macintire. Twelve years old, came in with acute appendicitis. Post-op day one of a laparoscopic appendectomy, but she’s had a fever overnight.”
“Possible causes?”
“Surgical site infection, intra-abdominal abscess, peritonitis, or an ileus,” I supply promptly.
“Correct. Let’s go.”
Grabbing a pair of gloves from the box outside of the patient’s room, we enter. Susanne is small for her age, and she looks even smaller swallowed up by the bed. Her pale, clammy skin is the first obvious sign this little girl is not feeling well.
“Hey there, Susanne, I’m Dr. Donnelly. This is Dr. Morgan. We’re going to be taking care of you as you get better from your surgery, okay?” His voice is gentle, quiet, soothing, and I can see the relief on Suanne’s mother’s face as she listens to him. “I’d like to take a look at your belly; the nurses said you had a rough night and you’re not feeling so good. Is that right?”
The little girl nods, and her mom peels back the blanket. “Her fever wouldn’t break, even with medicine. They warned us about infection, especially since her appendix was, what did they call it…” her voice trails off.
“Ruptured?” I supply, and she nods gratefully.
“Yes. Ruptured. We had no idea Suzie was even sick. She never complained of pain or anything until yesterday.” Her hands twist together, and I reach over to supply a comforting touch.
“It’s okay. Appendixes are tricky, they can have problems and not let us know until the very last minute. The important thing is that Susanne is here, and we’re going to make her better.”
When I look over at the bed, Dr. Donnelly is looking at me, and for once he isn’t scowling. “Dr. Morgan, would you please come and take a look at this incision?”
I make my way over to stand beside him and give the scared little girl a comforting smile. Her incision is very red, and the skin around it is tight and shiny with inflammation. But when I gently palpate her stomach around the area, she doesn’t flinch, which is a good sign that it’s only a surface level infection. Still, there’s only one way to be sure.
We step away from the bed as Susanne’s nurse comes in to give her some medication. Her mother comes over to stand by us, and after Dr. Donnelly nods at me to go ahead, I tell them my assessment.
“There are clear signs of a postoperative wound infection. A course of antibiotics would be my first step.”
Dr. Donnelly nods. “Agreed. Let’s do twenty-four hours of IV antibiotics and reassess.” He straightens and starts to take off his gloves, but I’m not finished.
“Actually, I was also going to recommend an ultrasound along with antibiotics, to rule out any deeper sources of infection.”
“Deeper sources?” Susanne’s mom says, panic lacing her tone. “Like what? Did they leave something inside of her? I’ve seen those news stories.”
“No, Mrs. Macintire, that is an incredibly rare situation,” Dr. Donnelly says smoothly. “Susanne’s surgeon has performed this procedure hundreds of times. A wound infection over the incision is the most common complication, and unfortunately, a reality of being in a hospital no matter how hard we work to prevent them. I’m confident a course of antibiotics will have Susanne feeling better in no time.”
“But what about the ultrasound? Can we do that? What if Dr. Morgan is right and you’re wrong, and there’s something more going on?” She gestures toward the bed, her eyes watery. “She’s my baby. I…I can’t let anything happen to her. Please, do the tests. Make sure she’s okay.”
“Yes, Mrs. Macintire. We can do an ultrasound to be sure,” he says, stuffing his hands in his pockets. “I’ll put the order in with a rush on it, and in the meantime, we’ll start the antibiotics.” With a brief smile toward her, he turns on his heel and leaves the room. I murmur goodbye and hurry after him, ready to write the orders for Susanne and move on to the next patient.
“Don’t you ever undermine me in front of a patient and their family like that again.” His harsh voice is not exactly quiet as I come to an abrupt stop next to Dr. Donnelly just around the corner from Susanne’s room. I can’t help but notice the curious glances several nurses, staff, and even visitors are giving us. His anger is palpable, simmering between us like a pot of water about to boil over.
