The new kid on the block
By Elisa
Abby took a deep, deep breath and then mentally counted to three. 'Ready, steady, go!' she mentally said as she pushed the doors of the ER open.
The loud noise of the bustling hallway hit her like a slap in the face. She looked around and saw only people dashing away. No one noticed her or, if they had, they obviously did not care. A spasm to her stomach painfully reminded she had not been able to eat or keep anything down in the previous twelve hours. Her stomach was fisted in a tight knot. She sighed as the dreadful gut feeling she had been having since that morning did not seem intentioned to leave. She just knew that ER rotation was going to be tough.
She tried to shrug off her presentiments and concentrate on finding the, uh, oh was it called again? Oh, 'Emergency services admittance coordinator' or something similar. He or she would direct her to the Chief of the ER, who, in turn, would tell her which resident would be supervising her for the next eight weeks.
She tried to stop a nurse to ask her where the admittance guy was but she was too much in a hurry. Actually she just shoved Abby out of her way as she yelled "Code brown to Curtain Area Three!"
".Malik, start the guy in Two on an IV."
".where do we keep Ativan?"
".I think we ran out of it."
".started her on a liter of saline and intubated on the field. BP's 140/95 and pulse ox."
".lab results on Rose Tierney."
".we need a surgeon in Trauma One. Stat! Page Benton."
".oh, not! Not another rectal. I didn't go into medicine to."
That was the ER and, oh boy, it was hectic. She almost felt overwhelmed by it. Abby shook herself. 'You've been a nurse for ten years, girl, you can do this. Go get this admin guy and get started.' She clenched her teeth as she pep-talked herself and her jaw was firmly set. Right then a nurse, who Abby recognized from a twin delivery, wheeled a patient on a gurney. The poor man looked like he was in an awful lot of pain.
"Coming through!"
This time Abby was quick enough to dodge on her own. The hallway was crowded, though, and the nurse could not help elbowing Abby lightly in the stomach as she pushed the IV hanger.
"Oh, sorry! Hey, you my labor nurse from OB, right? It's Abby, isn't it?"
Abby smiled. "Yes."
The nurse smiled back but soon got back to her patient. "Hey, we need some morphine, here. A doctor would be appreciated. Ugh! Doctors, they're never there when you need them. No matter if they're attendings, residents or even med students only. They all crawl somewhere and hide out when they actually have the chance to show their god attitude is actually partially justified at least. This place would be a mess if us nurses let them on their own. Go figure."
She told her little rant to no one in particular, although she was turned to Abby as she did so.
"Hey, I said I need someone who can fill out prescriptions, here!" the nurse called out again, tapping her foot impatiently.
Abby did not let the chance slip. She hopped in front of the gurney and said "Uhm, I can actually do that, Carol." She had remembered he nurse's name at last.
"What?" Carol gaped.
"Uhm, I am a third-year." Abby squirmed, feeling forced to give reason for her being a medical student "I crossed to the dark side, what can I say?"
Abby let out a brief, nervous laugh. Carol said nothing to this.
"I'm about to start my ER rotation." She further explained. "Uhm, so, was it morphine you said you need? Where's the prescription pad?"
"Your resident will give you one." Carol replied bluntly and walked away.
Abby sighed. She had the impression she had just made an enemy out of Carol, who previously had seemed to like her fairly enough, instead. She hoped it was nothing personal, though. Maybe Carol just did not like doctors and med students. She had looked pretty resentful of them with her little speech from before. Abby just shrugged. She was used to not having many friends at work, or anywhere else for that matter.
She finally spotted the admin desk, and the fat man behind it had to be her man. She quickly walked up to the admin desk and cleared her throat.
"Excuse me?"
"Just wait in chairs, miss. A doctor will see you as soon as possible."
"Uhm, no, actually I am a third-year, I am start-"
The fat guy cut her off brusquely. "Yeah, like I haven't heard that one before. Chairs is that way."
Abby sighed again and was about to go in the direction the admin guy had pointed her, when she saw a good-looking, dark-haired doctor come up her way. She stepped in front of him.
"Sorry, I am a third-year, and I need to see the Chief of the ER, a, uhm, Dr. K. Weaver. I don't know what the k stands for." She laughed nervously.
The guy smiled reassuringly. "That's Kerry Weaver. And, uhm, I am Luka Kovac. Please to meet you, miss." he outstretched his hand a bit self- consciously.
Abby smiled and volunteered her name. She liked the guy. He sounded foreigner and the name pointed in that direction as well. He was cute and looked a bit lost. Maybe he was new too. "Lockhart, Abby Lockhart, but please, call me Abby. I'm more comfortable with that, since I'd probably be your scut puppy for the next couple of weeks."
Luka chuckled and Abby smiled. Maybe she was having a better luck with the rest of her coworkers. "So, what about this Kerry Weaver? She was supposed to give me the tour, show me around, the usual staff, you know."
"Oh, yes." Luka scratched the back of his head. "I think Dr. Weaver is caught up in a management meeting. But, err, I think I could show you around, if it's okay with you." He paused and scratched his head again. "Abby."
She smiled. "Sure. Perfect. I mean, I'd rather not wait again."
Luka smiled back. "Okay, then follow me. So." he looked around and scratched the back of his head yet again, looking meditative this time. "Well this is the admin desk, but you already know that, I guess. Here we keep the charts, it's the chart rack," he pointed to it "And over there there's the board. When you're on you sign your name there. And don't ever forget to erase it when you get off, otherwise nurses will keep turfing you patients imperturbably. They're evil."
Abby smiled. "I know. I was one before."
"Oh." As he realized his faux-pas, Luka's mouth was a perfect circle.
Abby chuckled. "Hey, don't sweat it. It's okay. I'm one of the good guys now, remember?"
Luka smiled, still a bit embarrassed.
Right then a black, male nurse rushed to them and grabbed Luka by the arm. "Your pneumonia patient's gone into respiratory arrest, Dr. Kovac."
The doctor dashed away with the nurse, and Abby was alone again. She turned to the fat admin guy again. "You know where I can find a lab-coat by any chance?" she asked, hoping to speed things a little bit at least.
"Can't give you one. Your resident will."
"And would you happen to know who that is, huh?" Abby asked, irritated.
"No. Dr. Weaver knows it, though."
"And when is she due back from that meeting?"
The burly guy shook his big, chubby head.
Abby sighed, frustrated. That man who was supposed to help people get around the ER was a big, walking lack of information. Luckily a redhead, petite, female doctor breezed by and asked the inept clerk "You got anything for me, Frank?"
Frank took a pencil he kept tucked behind his ear and pointed at Abby. "Third-year."
The doctor looked up at Abby and smiled welcomingly. "Oh, you must be Abigail Lockhart. You're the only one started today. The bulk of you med students arrived yesterday. I am Kerry Weaver, Chief of Emergency Services. So, has anyone showed you around already?"
"Please call me Abby. Uhm, this foreign guy, Luka what's-his-name started giving me the tour but a patient crashed and now he is nowhere to be seen."
"Oh, you must be talking of Dr. Kovac. He's from Croatia. Well, come with me please."
Abby followed her into a room whose sign on the door read 'doctors lounge'.
"So," Kerry said, opening her arms in a showing gesture, " This is the lounge. Here you can hang out, catch up on paperwork or do whatever you want. You'll find fresh, free coffee here as well but, if you happen to know it was made by one of your fellow doctors instead of a nurse, I strongly advise you not to drink it. That's the coffee pot, over there. Next to it you'll find almost always stale donuts, but after a while you won't find them so bad. Of course you can keep your own food in that fridge, but make sure it's always labeled, otherwise it's like saying it's up for grabs. Nurses are pretty possessive of abandoned food around here."
Then Kerry dug her hand into a big box, while pointing to the opposite wall. "That's the lockers. You take an empty one. Make sure it's clean before you put your stuff in. Things grow to life on their own in there, most of the times."
Abby nodded, owning up to all this. She had once left a half eaten tuna sandwich in her locker up in OB and all her stuff had covered in snot- green, disgusting mould.
Kerry dumped a lab-coat, a pager, and a yellow walkman with headphones in her arms. Then she shook an ID tag in front of her nose.
"Never forget to wear your pager. You also need to put a picture of you on that nametag. Not that security is tight around here. It has happened already to me to see a gangbanger blow the brains of a patient in front of me."
Abby squirmed and swallowed uncomfortably. She already knew that working in the ER definitely was no walk in the park, still.
"Put the headphones on. It's a tape of the guided tour of the ER. It will tell you all the information you need. It's a bright thought. I must confess it is an idea of mine. Simple but effective, don't you think?"
Abby nodded, looking skeptical, though.
"Okay, this is it. Come to get me when you're done with the audio-tour."
She nodded again and Kerry crutched away with an amazing quickness for a disabled woman. She surely did not look like her handicap impeded her the slightest. Abby put the headphones on and switched on the tape, which started blurting out information, in Weaver's high-pitched voice, about a place she could never get in time before the tape passed on to the next one.
After about twenty minutes she gave up and looked for Weaver. "Uhm, Dr. Weaver? I, err, I am finished with your audio-tour."
"Oh, that's good. Exhaustive, isn't it?" luckily she wasn't looking at Abby as she spoke, because the med student's face gave away her real opinion. "Well, it's time to introduce you to your supervisor, although I don't know where he is at the moment, he must-"
A young, bubbly doctor, wearing jeans and a top scrub, zoomed past them, but, when he spotted Abby, stopped and made a quick u-turn.
"Whoa, whoa, whoa! What's this? New hospital meat without Dr. Dave's seal of approval?" he quipped, grinning foolishly to Abby.
Abby chuckled. Dr. Dave? What was with that guy? Kerry frowned instead. "Dr. Malucci." she growled and Abby could not help noticing how the word 'doctor' sounded like an insult coming out of her lips. "Dr. Malucci, this is your new student, Abby Lockhart."
Dave shook eagerly her hand. Abby smiled. This guy looked nice and funny, it would be good working with him. On the other hand it was more than obvious that Dr. Weaver did not think much of him, but, from the little she had gathered up to that moment, Abby would not exactly describe the Chief of the ER as funny. Sense of humor did not have to be her strongest suit for sure. Abby shook herself as she realized Weaver was talking to her.
"Initially I had planned to assign you to Dr. Carter, he is an excellent teacher, but I thought that Malucci would benefit from some responsibility. However, if you have even the smallest problem with him, feel free to let me know that, Abby."
She could tell the doctor found that possibility very likely. Weaver left them and a blonde girl came up to her and Dr. Dave.
"Don't believe a word she said."
Abby looked blankly at her.
"I'm Lucy Knight, fourth-year, and Carter's student. Dave's funny at least. Carter treats me like shit."
"You heard that?" Dave butted in "You're a lucky girl. So come with me. Let's get you started, miss Abby Lockhart, shall we?"
As Dave walked away, Abby in tow, Lucy called out to her "Don't let him give you any crap! Med students do not have to give anyone sponge baths, not even to a resident, even if a patient puked all over him!"
Abby frowned. "What did you make her do, Dave?"
He assumed an angelic air who would not fool a child and said "Me? Nothing. That was Carter."
Abby had not met this Carter person yet, but she thought that trick was something Dave would definitely do. He looked like a merry prankster to her, and, as she watched him winking conspiratorially at a Latino nurse she recognized from OB, he had to be a bit of a wanna-be Don Juan as well. He was hitting non-stop on all the female staff, except, understandingly, Weaver.
"So," Dave was telling her as they walked side by side, "You know how to start an IV, I suppose."
Abby smiled, confident. "Of course. I was an OB nurse for ten years."
"Mighty fine. You look too young to have worked ten years already, though." He smiled charmingly.
She smiled, amused. She had always been a good judge of characters. "Are you hitting on me, Dave?"
"Me? Noooo!" he shook his head vigorously. Abby let out a chuckle. "You're a student, I'm a resident, it would be against the regs."
"You don't strike me about being a guy who stick to the rules, Dave."
"You're right. Trouble is my middle name."
She smiled and Dave drew a curtain open. "So, Mr. Wyatt, meet Abby Lockhart. She will take very, very good care of you, Mr. Wyatt."
Abby said hello to the old man. Dave scribbled something on a chart and ordered her "Start him on an IV and do a stool guaiac. "
Abby's face looked blank.
"Oh, right. You don't get much of these in OB. Stool guaiacs, rectal exams, it's all the same. As we say around here, Abby, glove up and dig in."
Abby cringed. Dave left her and she swiftly inserted an IV needle in Mr. Wyatt's vein. Then she put on her gloves and sighed, getting ready for her grim task.
"Hey, go easy on me, young lady!"
"Sorry."
"Ouch! That hurts!"
"Won't happen again."
"Ahi!"
A young, good-looking doctor drew the curtain open and looked, amused, at the unfamiliar brunette with her arm up to her wrist in a man's anus. "Everything alright here?" he asked.
"The hell it is, doc! This young lady pokes around my innards like I am some goddamn fag used to have things shoved up my ass!"
"Uhm," the doctor glanced at her nametag, "Abigail."
"Abby."
"Well, Abby, haven't you forgotten to use the lubricator, by chance?"
Abby looked embarrassed. " Dave told me nothing about any lubricant."
The doctor sighed. "Typical Dave. Heaven forbids if he does something using his head. Here," he tossed her an ointment "Use this, everything will go a lot more smoothly with it, believe me."
"Well, thanks Dr. ."
"Carter, John Carter. Anytime, Abby. And call me if Dave pulls any more of this crap, okay?" he smiled warmly.
Abby smiled back. "I will."
Carter made to leave but stumbled across the IV pole. Abby suppressed a laughter. Dr. Carter looked a bit of clumsy. He was funny.
"Sorry." He put the needle back into place and then looked up to Abby "You started this IV? Neat job. My student was clueless even with these basic procedures when she started."
"I was in OB, as a nurse." she explained.
"Oh, I'm glad you switched teams."
Abby smiled. Carter looked a decent guy, but she could understand what Lucy was coming from as well. With the ointment she proceeded to complete the rectal exam without further incidents. Then Dave got back to check on her.
"Good job, Abby. I have this feeling we're gonna get along just fine, the two of us."
Right then, a paramedic rolled in a patient, who was looking pretty in bad shape. Dave clapped his hands once and licked his lips in anticipation. "Well, well. You're gonna taste what real medicine is about. Let's go make ourselves useful, okay?"
Abby followed Dave into Trauma Two, where Weaver was already. "Glad you showed up, Malucci." She greeted him curtly.
"What have we got?" Dave asked, unperturbed, evidently used to the chief giving him the cold shoulder. He looked pretty impervious to criticism.
"Forty-one year old male. Motorcycle versus delivery truck. Wearing a helmet. Blood trauma to the chest and abdomen. BP 110 over 70, pulse 110. Paramedics couldn't get a line in his fuels, he's a tough stick." "I'll try." Dave volunteered, then changed his mind "Why don't I let you do that, Abby? You're a magician with needles, or so Carter thinks." Abby hesitated. "Uhm, okay. You're not kidding tough stick, nothing but track marks." "CBC, Chem 7, type and cross for four. Let's get a portable C spine, chest and pelvis." Kerry ordered a long string of tests, bustling about the gurney. "I'll slide around you Abby." Dave said and felt the man's belly. "Right upper quadrant tenderness, withguarding. Let's get an abdominal CT with contrast." "Mmm, major bleed out from an injury to the side." Kerry stated. "What is this suggestive of, Abby?" Abby squirmed. Her mind was completely, disappointingly blank. "Uhm, I don't know." "Internal injury." Carol anticipated Kerry.
The EKG flat-lined and gave off a long, monotone beep.
"Okay, let's shock him. Charge it to two hundred!"
Carol did it and Abby took the paddles. As soon as she put them on the man's chest a nasty smell of burning filled the trauma room.
"You gotta spread the paddles with gel before doing that, Einstein." Carol snapped snarkily.
Weaver sighed.
"Hey, this is a teaching hospital, " Dave pointed out to Carol "She's here to learn."
When the trauma was over, Abby got out of the trauma room, tossed away her gown and gloves and leaned against the wall, letting out a big sigh. Dave came up to her.
"What's up?"
"I made a fool of myself during that trauma."
"So? What's the big deal? I do that all the time and the chief just loves me."
Abby smiled and watched thankfully Dave who was leaning against the wall next who her. She had not been wrong about him, he really was a good guy. He could have just treated her like a scut puppy, and instead he actually tried to teach her something and, here he was now, wasting his time to cheer her up. Maybe he just wanted to hit on her or maybe he just was a decent guy. His eyes, which she carefully inspected as he juggled with his feet a ball of paper Malik had kicked to him, told her the latter hypothesis was the right one.
He met her inquisitive stare. "You like what you see? Come on, you're a med student, you're supposed to screw up! Otherwise how us docs are supposed to feel almighty and perpetually right?"
She let out a small chuckle. "So, in what other way do you want me to screw up now? I can even kill a patient if I try really hard."
"It's pretty slow now. Take a little break."
"I can do whatever you ask me to, Dave, I am the queen of screw-ups, believe me."
"We make a fine pair, then. Look, take a break when I told you to, coz things can heat up really quickly around here and you won't know when you could have another one later."
"Okay."
Abby went out in the ambulance bay to have a cigarette. Lucy was already there, sprawled out on a bench. Abby walked up to her.
"Hey."
"Hey."
"You on break too?"
"Yeah, my feet are killing me. Friendly tip: never ever wear heels at work."
Abby smiled. "I'll keep that in mind." Then she sat down next to her, shaking her pack of cigarettes. "You want one, Lucy?" she offered.
"No. I don't smoke."
"Smart girl. I try to quit every other day but you know what? Last cigarettes are the best."
"So, how is you first impression of the ER? You're not exactly a newbie, though. Carol told me you were an OB nurse before."
"Yup, but OB and the ER are two worlds apart. And, speaking of Carol, I think she hates me."
"Nah, she's cool. Covered for me when I messed up on my first day in the ER. I couldn't even hook up an IV. What a real bungler!"
"Must be me then. And, if that can console you, I was a complete dumbass in a trauma."
"We all are. I mean, we are med students, that's what we do. We screw up and learn from our errors. That's what it is all about."
"I guess."
"Take me, for example." Lucy further explained. "This is my second ER rotation. I chose to do another one because I screwed up royally the first time around."
"You're obstinate, aren't you?"
Lucy chuckled. "Yeah, you can say that out loud."
Carter popped his head out of the doors and barked. "Lucy! You've been on break for almost half an hour. Get your ass in here! Now!"
Lucy sighed, and turned to Abby. "Sweet, ain't it? Gotta go. Mr. Congeniality claims me. He can be such a schmuck when he wants to."
"He seemed a nice guy to me."
"Don't let those big, brown puppy eyes of his fool you!" she called out as she walked backwards towards the entrance of the ER. "It's the beginning of the end!"
Abby smiled. Lucy seemed kind of sweet, although she was a bit too young for her to hang out with. And perky. Abby was way too cynical for her. Besides the fourth-year had a bit of a know-it-all complex. She took a last, long drag out of her cigarette and then stubbed it out on the concrete. Then she headed inside.
As she pushed the door open, someone from the inside pushed it the other way. That person was a lot stronger than Abby, though, so the door slammed on Abby's forehead.
"Ouch!"
A very sorry and apologetic Luka Kovac stood in front of her. "I'm so sorry, Abby." He said, as he steadied her with his strong, big hands.
"It's nothing, really." She protested but Luka did not listen to her and, taking her by the hand, he dragged her all the way to the lounge.
There he gently shoved her on the couch and started looking for an icepack. Then he carefully put it over her forehead, caressing repetitively the already forming bump.
"It's already swelling up, damn." He stated, feeling guilty.
"I don't care if I look like Frankenstein's less nice little sister, Luka, really." She tried to reassure the overreacting, concerned doctor.
"Wait a sec. " he exclaimed, lighting up. Luka got up from the couch and went to the fridge. He took out something and poured it over a piece of cloth. Then he put it on Abby's bump.
"Ugh! This stinks! What is it?"
"An old Croatian remedy. Vinegar and lemon. It will prevent that nasty bump from making you swell up like a gigantic pumpkin, Abby."
"Thanks, Luka."
"Don't thank me. It was Dr. Benton's to go with his salad."
As Abby got out of the lounge she bumped into Carter, missing another collision merely by inches. He pointed at her swollen forehead. "Hey, what happened to your head?"
"Had a little run-in with Luka. Literally."
"Already making friends, huh?"
"It was an accident."
"It was a joke."
"It wasn't funny."
"Okay. Look, I am going to Doc Magoo's. Wanna come with me?"
"Dave could need me."
"He is currently very busy with a Scandinavian flight attendant with a rash on her butt. Go figure. Coffee and pie is on me, okay?"
"Can't say no."
They got, out crossed the street, entered Doc Magoo's and sat in a booth by the window. Abby looked on the menu, deciding what to take.
"Wanna split a sundae?"
"Sure. So, how do you like the ER so far?"
"It's the question of the day. It's okay, I guess, but so damn hectic. Really different from OB. It threw me off, I'll have to admit it."
"It tends to do that a lot. What about the people?"
"Dave and Luka are okay. Lucy is kinda sweet."
"Wait until you get to know her better."
Abby pretended she had not heard that remark, "Weaver's pretty stiff, but I guess she has to be. She is the chief after all."
"She's okay too. You gotta meet Dr. Green yet, he's an attending and has been at County forever. You're gonna like him. Then there's Dr. Finch, the pediatrician, but she's sick, and Dr. Corday and Benton from surgery. The staff is pretty friendly here."
"I guess so. Except Carol. She hates me."
"Nah, can't be. She's really nice. Must be a misunderstanding."
"I think she doesn't like my being a nurse-turned-med-student. Don't know why."
"She tried medical school once herself but stuck to nursing in the end. She scored pretty good on her MCAT, though. Was one of the top of her class."
"Mmm."
"You'll work it out."
"I hope."
Both their pagers went off simultaneously.
"Must be a big emergency."
They walked back into the ER, finding Kerry barking orders, getting a mass casualty protocol going on. The place looked even more hectic than usual, with nurses, orderlies and doctors rushing to and fro like crazy bees.
"There was a massive pileup on the 55." Carol explained.
"Abby" Kerry barked, "Jump in, but stay supervised."
As paramedics kept rolling in patients, to the sound of the blaring sirens, and Carter triaged them in the hallway, Abby stuck to sutures, as Dave had told her to. She was in the suture room when Dave came looking for her.
"Abby, I have the perfect patient for you. Tia Aznar, twenty-six years old, seven months pregnant. Chief complaints are consistent with an urinary tract infection."
He tossed her the chart. "Get back to me for the discharge."
"You not gonna supervise me?" she asked, perplexed.
"You know a lot more about pregnancy and its complication than me, Abby. Va con Dios!"
With that he dashed away. Abby sighed, flipped through the chart, and headed to the patient's room. A Latino girl was lying in the bed, unmistakably pregnant. Abby grimaced when she saw that Carol was the nurse.
She introduced herself to Mrs. Aznar and the woman explained her what her symptoms were. Abby felt self-confident for the first time that day: she was in her element and knew exactly what to do. How come that when she was in OB she always knew what was the right thing to do? Anyway Dave was right, it looked like a classical urinary infection. She then told Carol what tests she wanted done.
"Call me when you have the results, okay?" she asked the aloof nurse.
A brisk, cool nod of the head was the only answer she got. Abby sighed. She wished they were not at odds. She had done nothing to Carol to deserve that kind of treatment, after all.
Carol came looking for her as she was with another patient. In the very moment the nurse approached the bed, the patient got sick and threw up all over the bed. Mechanically Abby reached out for the dirty sheets and balled them to throw them away. Then she took the clean ones to replace them but Carol stopped her.
"Nurses' job."
"Oh."
"Lab results on Mrs. Aznar."
Abby quickly flipped through them and frowned, concerned. "Uh-oh."
"What?"
"Mrs. Aznar's glucose level's skyrocketing and her insulin is bad too. This is suggestive of gestational diabetes. It can cause problems to the fetus."
"You gotta tell her."
"Shouldn't I fetch Dave?" Abby asked, edgy.
"You kidding? The guy's got the sensitiveness of a dead skunk. You should see how he delivers patients the bad news. No way. You're the one."
"Uhm, okay. I'll be just a minute."
Carol found her at the vending machines, an hour later. She planted in front of Abby with her legs parted and her hands threateningly on her hips. Her voice was sharp when she spoke "What the hell happened to "I'll be right back"? I can't believe I actually started to think I've been right about you. That woman needs her doctor to tell her something, anything, and you run away? Are you even gonna look at me?" Abby turned to her, looking embarrassed. "Oh, I've been trying to decide what drink to get. I've been standing here trying to choose between cherry soda and, uh, ginger ale. And you know what? It's a toss-up. I mean, either way I get a cold drink, right? And it would be almost impossible for me to kill someone with this decision, but... I still can't make it." her voice cracked "I think I'm in trouble here." Carol came up to her. "Look, I don't think these kinds of things are easy for anyone. And if it's any consolation, one of the reasons I never liked you is because you're already better at this than most of the doctors that come through here; and to be honest, I kinda liked being the only smart, strong chick in the joint." Abby almost smiled. "You sort of just complimented me." "Little bit." Abby spoke, taking a breath, "Okay, I'm gonna have a ginger ale." "Good start." Abby pushed the button and fetched her drink. "And...that diabetes isn't going anywhere on its own; so, let's tell her and start treatment right away." "That's my girl. Let's go." And, to Abby's great amazement, Carol slipped an arm friendly over her shoulder and said "Wanna see a picture of my girls? They've grown so big."
Later on, Abby plopped satisfactorily a chart in the rack by the board. Dave came looking for her. "You need to change the dressing of a wound in Exam Two. I've already jotted down the instruction for you." "Thanks, that's nice." Abby started sorting through the instruction "Take two Daves as needed, apply to sensitive area..." What's this crap?" Dave then stepped from around the corner "Whazzup.... Oh, come on, Abby; give me one good reason why you won't go out with me. "Let's see, you're a doctor. So, you've got the god-complex, the cockiness, the whole "married to the job" thing. You're cute, but you're very, very aware of it. You have no idea what I'm like, so all of your feelings for me are coming from" she pointed to his groin " Down there. But most of all, I'm looking for the real thing; and you're nothing but a little boy who's not used to being told "No." So there's a bunch of reasons. Pick your favorite. And now, if you will excuse me, I'm gonna got sit down because you're so sexy my knees are weak." Dave just stood there, bewildered, watching her walk away. Luka came up to Abby, chuckling "I'd go with the "god-complex". You really zinged him, Abby." "Oh, yeah." She said with a lot of self-satisfaction. Then she checked her watch. "You off?" "Yup." Right then Dave returned to the charge. "Explosive hemorrhoids in Three, Abby." "My shift ended ten minutes ago!" she protested. Dave shook his head. "Your name's still on the board." Abby sighed. Luka raised his hands in a gesture that meant 'What can you do? That's the way it is.' "Remember what I told you before?" "You were right." "That's because I'm old and wise." Luka smiled. "You're not old." "I certainly feel so. And tired and stressed out as well." "You need to unwind, then. How about going to the movies? With me? How does that sound to you?" Luka was pretty taken aback by her out-of-the-blue offer, but as in a pleasant surprised way. "Uhm, your plan sounds good to me. I'm off in half an hour." "Good. See you in a few. My hemorrhoids are waiting for me." He smiled and called out after her "Erase your name off the board!" "I will!" As she headed to her grim destination, Abby could not help feeling cheerful despite the unpleasant task she was about to carry out. She smiled inwardly. She felt that her experience in the ER was going to be a lot better than she had initially thought.
Fine
By Elisa
Abby took a deep, deep breath and then mentally counted to three. 'Ready, steady, go!' she mentally said as she pushed the doors of the ER open.
The loud noise of the bustling hallway hit her like a slap in the face. She looked around and saw only people dashing away. No one noticed her or, if they had, they obviously did not care. A spasm to her stomach painfully reminded she had not been able to eat or keep anything down in the previous twelve hours. Her stomach was fisted in a tight knot. She sighed as the dreadful gut feeling she had been having since that morning did not seem intentioned to leave. She just knew that ER rotation was going to be tough.
She tried to shrug off her presentiments and concentrate on finding the, uh, oh was it called again? Oh, 'Emergency services admittance coordinator' or something similar. He or she would direct her to the Chief of the ER, who, in turn, would tell her which resident would be supervising her for the next eight weeks.
She tried to stop a nurse to ask her where the admittance guy was but she was too much in a hurry. Actually she just shoved Abby out of her way as she yelled "Code brown to Curtain Area Three!"
".Malik, start the guy in Two on an IV."
".where do we keep Ativan?"
".I think we ran out of it."
".started her on a liter of saline and intubated on the field. BP's 140/95 and pulse ox."
".lab results on Rose Tierney."
".we need a surgeon in Trauma One. Stat! Page Benton."
".oh, not! Not another rectal. I didn't go into medicine to."
That was the ER and, oh boy, it was hectic. She almost felt overwhelmed by it. Abby shook herself. 'You've been a nurse for ten years, girl, you can do this. Go get this admin guy and get started.' She clenched her teeth as she pep-talked herself and her jaw was firmly set. Right then a nurse, who Abby recognized from a twin delivery, wheeled a patient on a gurney. The poor man looked like he was in an awful lot of pain.
"Coming through!"
This time Abby was quick enough to dodge on her own. The hallway was crowded, though, and the nurse could not help elbowing Abby lightly in the stomach as she pushed the IV hanger.
"Oh, sorry! Hey, you my labor nurse from OB, right? It's Abby, isn't it?"
Abby smiled. "Yes."
The nurse smiled back but soon got back to her patient. "Hey, we need some morphine, here. A doctor would be appreciated. Ugh! Doctors, they're never there when you need them. No matter if they're attendings, residents or even med students only. They all crawl somewhere and hide out when they actually have the chance to show their god attitude is actually partially justified at least. This place would be a mess if us nurses let them on their own. Go figure."
She told her little rant to no one in particular, although she was turned to Abby as she did so.
"Hey, I said I need someone who can fill out prescriptions, here!" the nurse called out again, tapping her foot impatiently.
Abby did not let the chance slip. She hopped in front of the gurney and said "Uhm, I can actually do that, Carol." She had remembered he nurse's name at last.
"What?" Carol gaped.
"Uhm, I am a third-year." Abby squirmed, feeling forced to give reason for her being a medical student "I crossed to the dark side, what can I say?"
Abby let out a brief, nervous laugh. Carol said nothing to this.
"I'm about to start my ER rotation." She further explained. "Uhm, so, was it morphine you said you need? Where's the prescription pad?"
"Your resident will give you one." Carol replied bluntly and walked away.
Abby sighed. She had the impression she had just made an enemy out of Carol, who previously had seemed to like her fairly enough, instead. She hoped it was nothing personal, though. Maybe Carol just did not like doctors and med students. She had looked pretty resentful of them with her little speech from before. Abby just shrugged. She was used to not having many friends at work, or anywhere else for that matter.
She finally spotted the admin desk, and the fat man behind it had to be her man. She quickly walked up to the admin desk and cleared her throat.
"Excuse me?"
"Just wait in chairs, miss. A doctor will see you as soon as possible."
"Uhm, no, actually I am a third-year, I am start-"
The fat guy cut her off brusquely. "Yeah, like I haven't heard that one before. Chairs is that way."
Abby sighed again and was about to go in the direction the admin guy had pointed her, when she saw a good-looking, dark-haired doctor come up her way. She stepped in front of him.
"Sorry, I am a third-year, and I need to see the Chief of the ER, a, uhm, Dr. K. Weaver. I don't know what the k stands for." She laughed nervously.
The guy smiled reassuringly. "That's Kerry Weaver. And, uhm, I am Luka Kovac. Please to meet you, miss." he outstretched his hand a bit self- consciously.
Abby smiled and volunteered her name. She liked the guy. He sounded foreigner and the name pointed in that direction as well. He was cute and looked a bit lost. Maybe he was new too. "Lockhart, Abby Lockhart, but please, call me Abby. I'm more comfortable with that, since I'd probably be your scut puppy for the next couple of weeks."
Luka chuckled and Abby smiled. Maybe she was having a better luck with the rest of her coworkers. "So, what about this Kerry Weaver? She was supposed to give me the tour, show me around, the usual staff, you know."
"Oh, yes." Luka scratched the back of his head. "I think Dr. Weaver is caught up in a management meeting. But, err, I think I could show you around, if it's okay with you." He paused and scratched his head again. "Abby."
She smiled. "Sure. Perfect. I mean, I'd rather not wait again."
Luka smiled back. "Okay, then follow me. So." he looked around and scratched the back of his head yet again, looking meditative this time. "Well this is the admin desk, but you already know that, I guess. Here we keep the charts, it's the chart rack," he pointed to it "And over there there's the board. When you're on you sign your name there. And don't ever forget to erase it when you get off, otherwise nurses will keep turfing you patients imperturbably. They're evil."
Abby smiled. "I know. I was one before."
"Oh." As he realized his faux-pas, Luka's mouth was a perfect circle.
Abby chuckled. "Hey, don't sweat it. It's okay. I'm one of the good guys now, remember?"
Luka smiled, still a bit embarrassed.
Right then a black, male nurse rushed to them and grabbed Luka by the arm. "Your pneumonia patient's gone into respiratory arrest, Dr. Kovac."
The doctor dashed away with the nurse, and Abby was alone again. She turned to the fat admin guy again. "You know where I can find a lab-coat by any chance?" she asked, hoping to speed things a little bit at least.
"Can't give you one. Your resident will."
"And would you happen to know who that is, huh?" Abby asked, irritated.
"No. Dr. Weaver knows it, though."
"And when is she due back from that meeting?"
The burly guy shook his big, chubby head.
Abby sighed, frustrated. That man who was supposed to help people get around the ER was a big, walking lack of information. Luckily a redhead, petite, female doctor breezed by and asked the inept clerk "You got anything for me, Frank?"
Frank took a pencil he kept tucked behind his ear and pointed at Abby. "Third-year."
The doctor looked up at Abby and smiled welcomingly. "Oh, you must be Abigail Lockhart. You're the only one started today. The bulk of you med students arrived yesterday. I am Kerry Weaver, Chief of Emergency Services. So, has anyone showed you around already?"
"Please call me Abby. Uhm, this foreign guy, Luka what's-his-name started giving me the tour but a patient crashed and now he is nowhere to be seen."
"Oh, you must be talking of Dr. Kovac. He's from Croatia. Well, come with me please."
Abby followed her into a room whose sign on the door read 'doctors lounge'.
"So," Kerry said, opening her arms in a showing gesture, " This is the lounge. Here you can hang out, catch up on paperwork or do whatever you want. You'll find fresh, free coffee here as well but, if you happen to know it was made by one of your fellow doctors instead of a nurse, I strongly advise you not to drink it. That's the coffee pot, over there. Next to it you'll find almost always stale donuts, but after a while you won't find them so bad. Of course you can keep your own food in that fridge, but make sure it's always labeled, otherwise it's like saying it's up for grabs. Nurses are pretty possessive of abandoned food around here."
Then Kerry dug her hand into a big box, while pointing to the opposite wall. "That's the lockers. You take an empty one. Make sure it's clean before you put your stuff in. Things grow to life on their own in there, most of the times."
Abby nodded, owning up to all this. She had once left a half eaten tuna sandwich in her locker up in OB and all her stuff had covered in snot- green, disgusting mould.
Kerry dumped a lab-coat, a pager, and a yellow walkman with headphones in her arms. Then she shook an ID tag in front of her nose.
"Never forget to wear your pager. You also need to put a picture of you on that nametag. Not that security is tight around here. It has happened already to me to see a gangbanger blow the brains of a patient in front of me."
Abby squirmed and swallowed uncomfortably. She already knew that working in the ER definitely was no walk in the park, still.
"Put the headphones on. It's a tape of the guided tour of the ER. It will tell you all the information you need. It's a bright thought. I must confess it is an idea of mine. Simple but effective, don't you think?"
Abby nodded, looking skeptical, though.
"Okay, this is it. Come to get me when you're done with the audio-tour."
She nodded again and Kerry crutched away with an amazing quickness for a disabled woman. She surely did not look like her handicap impeded her the slightest. Abby put the headphones on and switched on the tape, which started blurting out information, in Weaver's high-pitched voice, about a place she could never get in time before the tape passed on to the next one.
After about twenty minutes she gave up and looked for Weaver. "Uhm, Dr. Weaver? I, err, I am finished with your audio-tour."
"Oh, that's good. Exhaustive, isn't it?" luckily she wasn't looking at Abby as she spoke, because the med student's face gave away her real opinion. "Well, it's time to introduce you to your supervisor, although I don't know where he is at the moment, he must-"
A young, bubbly doctor, wearing jeans and a top scrub, zoomed past them, but, when he spotted Abby, stopped and made a quick u-turn.
"Whoa, whoa, whoa! What's this? New hospital meat without Dr. Dave's seal of approval?" he quipped, grinning foolishly to Abby.
Abby chuckled. Dr. Dave? What was with that guy? Kerry frowned instead. "Dr. Malucci." she growled and Abby could not help noticing how the word 'doctor' sounded like an insult coming out of her lips. "Dr. Malucci, this is your new student, Abby Lockhart."
Dave shook eagerly her hand. Abby smiled. This guy looked nice and funny, it would be good working with him. On the other hand it was more than obvious that Dr. Weaver did not think much of him, but, from the little she had gathered up to that moment, Abby would not exactly describe the Chief of the ER as funny. Sense of humor did not have to be her strongest suit for sure. Abby shook herself as she realized Weaver was talking to her.
"Initially I had planned to assign you to Dr. Carter, he is an excellent teacher, but I thought that Malucci would benefit from some responsibility. However, if you have even the smallest problem with him, feel free to let me know that, Abby."
She could tell the doctor found that possibility very likely. Weaver left them and a blonde girl came up to her and Dr. Dave.
"Don't believe a word she said."
Abby looked blankly at her.
"I'm Lucy Knight, fourth-year, and Carter's student. Dave's funny at least. Carter treats me like shit."
"You heard that?" Dave butted in "You're a lucky girl. So come with me. Let's get you started, miss Abby Lockhart, shall we?"
As Dave walked away, Abby in tow, Lucy called out to her "Don't let him give you any crap! Med students do not have to give anyone sponge baths, not even to a resident, even if a patient puked all over him!"
Abby frowned. "What did you make her do, Dave?"
He assumed an angelic air who would not fool a child and said "Me? Nothing. That was Carter."
Abby had not met this Carter person yet, but she thought that trick was something Dave would definitely do. He looked like a merry prankster to her, and, as she watched him winking conspiratorially at a Latino nurse she recognized from OB, he had to be a bit of a wanna-be Don Juan as well. He was hitting non-stop on all the female staff, except, understandingly, Weaver.
"So," Dave was telling her as they walked side by side, "You know how to start an IV, I suppose."
Abby smiled, confident. "Of course. I was an OB nurse for ten years."
"Mighty fine. You look too young to have worked ten years already, though." He smiled charmingly.
She smiled, amused. She had always been a good judge of characters. "Are you hitting on me, Dave?"
"Me? Noooo!" he shook his head vigorously. Abby let out a chuckle. "You're a student, I'm a resident, it would be against the regs."
"You don't strike me about being a guy who stick to the rules, Dave."
"You're right. Trouble is my middle name."
She smiled and Dave drew a curtain open. "So, Mr. Wyatt, meet Abby Lockhart. She will take very, very good care of you, Mr. Wyatt."
Abby said hello to the old man. Dave scribbled something on a chart and ordered her "Start him on an IV and do a stool guaiac. "
Abby's face looked blank.
"Oh, right. You don't get much of these in OB. Stool guaiacs, rectal exams, it's all the same. As we say around here, Abby, glove up and dig in."
Abby cringed. Dave left her and she swiftly inserted an IV needle in Mr. Wyatt's vein. Then she put on her gloves and sighed, getting ready for her grim task.
"Hey, go easy on me, young lady!"
"Sorry."
"Ouch! That hurts!"
"Won't happen again."
"Ahi!"
A young, good-looking doctor drew the curtain open and looked, amused, at the unfamiliar brunette with her arm up to her wrist in a man's anus. "Everything alright here?" he asked.
"The hell it is, doc! This young lady pokes around my innards like I am some goddamn fag used to have things shoved up my ass!"
"Uhm," the doctor glanced at her nametag, "Abigail."
"Abby."
"Well, Abby, haven't you forgotten to use the lubricator, by chance?"
Abby looked embarrassed. " Dave told me nothing about any lubricant."
The doctor sighed. "Typical Dave. Heaven forbids if he does something using his head. Here," he tossed her an ointment "Use this, everything will go a lot more smoothly with it, believe me."
"Well, thanks Dr. ."
"Carter, John Carter. Anytime, Abby. And call me if Dave pulls any more of this crap, okay?" he smiled warmly.
Abby smiled back. "I will."
Carter made to leave but stumbled across the IV pole. Abby suppressed a laughter. Dr. Carter looked a bit of clumsy. He was funny.
"Sorry." He put the needle back into place and then looked up to Abby "You started this IV? Neat job. My student was clueless even with these basic procedures when she started."
"I was in OB, as a nurse." she explained.
"Oh, I'm glad you switched teams."
Abby smiled. Carter looked a decent guy, but she could understand what Lucy was coming from as well. With the ointment she proceeded to complete the rectal exam without further incidents. Then Dave got back to check on her.
"Good job, Abby. I have this feeling we're gonna get along just fine, the two of us."
Right then, a paramedic rolled in a patient, who was looking pretty in bad shape. Dave clapped his hands once and licked his lips in anticipation. "Well, well. You're gonna taste what real medicine is about. Let's go make ourselves useful, okay?"
Abby followed Dave into Trauma Two, where Weaver was already. "Glad you showed up, Malucci." She greeted him curtly.
"What have we got?" Dave asked, unperturbed, evidently used to the chief giving him the cold shoulder. He looked pretty impervious to criticism.
"Forty-one year old male. Motorcycle versus delivery truck. Wearing a helmet. Blood trauma to the chest and abdomen. BP 110 over 70, pulse 110. Paramedics couldn't get a line in his fuels, he's a tough stick." "I'll try." Dave volunteered, then changed his mind "Why don't I let you do that, Abby? You're a magician with needles, or so Carter thinks." Abby hesitated. "Uhm, okay. You're not kidding tough stick, nothing but track marks." "CBC, Chem 7, type and cross for four. Let's get a portable C spine, chest and pelvis." Kerry ordered a long string of tests, bustling about the gurney. "I'll slide around you Abby." Dave said and felt the man's belly. "Right upper quadrant tenderness, withguarding. Let's get an abdominal CT with contrast." "Mmm, major bleed out from an injury to the side." Kerry stated. "What is this suggestive of, Abby?" Abby squirmed. Her mind was completely, disappointingly blank. "Uhm, I don't know." "Internal injury." Carol anticipated Kerry.
The EKG flat-lined and gave off a long, monotone beep.
"Okay, let's shock him. Charge it to two hundred!"
Carol did it and Abby took the paddles. As soon as she put them on the man's chest a nasty smell of burning filled the trauma room.
"You gotta spread the paddles with gel before doing that, Einstein." Carol snapped snarkily.
Weaver sighed.
"Hey, this is a teaching hospital, " Dave pointed out to Carol "She's here to learn."
When the trauma was over, Abby got out of the trauma room, tossed away her gown and gloves and leaned against the wall, letting out a big sigh. Dave came up to her.
"What's up?"
"I made a fool of myself during that trauma."
"So? What's the big deal? I do that all the time and the chief just loves me."
Abby smiled and watched thankfully Dave who was leaning against the wall next who her. She had not been wrong about him, he really was a good guy. He could have just treated her like a scut puppy, and instead he actually tried to teach her something and, here he was now, wasting his time to cheer her up. Maybe he just wanted to hit on her or maybe he just was a decent guy. His eyes, which she carefully inspected as he juggled with his feet a ball of paper Malik had kicked to him, told her the latter hypothesis was the right one.
He met her inquisitive stare. "You like what you see? Come on, you're a med student, you're supposed to screw up! Otherwise how us docs are supposed to feel almighty and perpetually right?"
She let out a small chuckle. "So, in what other way do you want me to screw up now? I can even kill a patient if I try really hard."
"It's pretty slow now. Take a little break."
"I can do whatever you ask me to, Dave, I am the queen of screw-ups, believe me."
"We make a fine pair, then. Look, take a break when I told you to, coz things can heat up really quickly around here and you won't know when you could have another one later."
"Okay."
Abby went out in the ambulance bay to have a cigarette. Lucy was already there, sprawled out on a bench. Abby walked up to her.
"Hey."
"Hey."
"You on break too?"
"Yeah, my feet are killing me. Friendly tip: never ever wear heels at work."
Abby smiled. "I'll keep that in mind." Then she sat down next to her, shaking her pack of cigarettes. "You want one, Lucy?" she offered.
"No. I don't smoke."
"Smart girl. I try to quit every other day but you know what? Last cigarettes are the best."
"So, how is you first impression of the ER? You're not exactly a newbie, though. Carol told me you were an OB nurse before."
"Yup, but OB and the ER are two worlds apart. And, speaking of Carol, I think she hates me."
"Nah, she's cool. Covered for me when I messed up on my first day in the ER. I couldn't even hook up an IV. What a real bungler!"
"Must be me then. And, if that can console you, I was a complete dumbass in a trauma."
"We all are. I mean, we are med students, that's what we do. We screw up and learn from our errors. That's what it is all about."
"I guess."
"Take me, for example." Lucy further explained. "This is my second ER rotation. I chose to do another one because I screwed up royally the first time around."
"You're obstinate, aren't you?"
Lucy chuckled. "Yeah, you can say that out loud."
Carter popped his head out of the doors and barked. "Lucy! You've been on break for almost half an hour. Get your ass in here! Now!"
Lucy sighed, and turned to Abby. "Sweet, ain't it? Gotta go. Mr. Congeniality claims me. He can be such a schmuck when he wants to."
"He seemed a nice guy to me."
"Don't let those big, brown puppy eyes of his fool you!" she called out as she walked backwards towards the entrance of the ER. "It's the beginning of the end!"
Abby smiled. Lucy seemed kind of sweet, although she was a bit too young for her to hang out with. And perky. Abby was way too cynical for her. Besides the fourth-year had a bit of a know-it-all complex. She took a last, long drag out of her cigarette and then stubbed it out on the concrete. Then she headed inside.
As she pushed the door open, someone from the inside pushed it the other way. That person was a lot stronger than Abby, though, so the door slammed on Abby's forehead.
"Ouch!"
A very sorry and apologetic Luka Kovac stood in front of her. "I'm so sorry, Abby." He said, as he steadied her with his strong, big hands.
"It's nothing, really." She protested but Luka did not listen to her and, taking her by the hand, he dragged her all the way to the lounge.
There he gently shoved her on the couch and started looking for an icepack. Then he carefully put it over her forehead, caressing repetitively the already forming bump.
"It's already swelling up, damn." He stated, feeling guilty.
"I don't care if I look like Frankenstein's less nice little sister, Luka, really." She tried to reassure the overreacting, concerned doctor.
"Wait a sec. " he exclaimed, lighting up. Luka got up from the couch and went to the fridge. He took out something and poured it over a piece of cloth. Then he put it on Abby's bump.
"Ugh! This stinks! What is it?"
"An old Croatian remedy. Vinegar and lemon. It will prevent that nasty bump from making you swell up like a gigantic pumpkin, Abby."
"Thanks, Luka."
"Don't thank me. It was Dr. Benton's to go with his salad."
As Abby got out of the lounge she bumped into Carter, missing another collision merely by inches. He pointed at her swollen forehead. "Hey, what happened to your head?"
"Had a little run-in with Luka. Literally."
"Already making friends, huh?"
"It was an accident."
"It was a joke."
"It wasn't funny."
"Okay. Look, I am going to Doc Magoo's. Wanna come with me?"
"Dave could need me."
"He is currently very busy with a Scandinavian flight attendant with a rash on her butt. Go figure. Coffee and pie is on me, okay?"
"Can't say no."
They got, out crossed the street, entered Doc Magoo's and sat in a booth by the window. Abby looked on the menu, deciding what to take.
"Wanna split a sundae?"
"Sure. So, how do you like the ER so far?"
"It's the question of the day. It's okay, I guess, but so damn hectic. Really different from OB. It threw me off, I'll have to admit it."
"It tends to do that a lot. What about the people?"
"Dave and Luka are okay. Lucy is kinda sweet."
"Wait until you get to know her better."
Abby pretended she had not heard that remark, "Weaver's pretty stiff, but I guess she has to be. She is the chief after all."
"She's okay too. You gotta meet Dr. Green yet, he's an attending and has been at County forever. You're gonna like him. Then there's Dr. Finch, the pediatrician, but she's sick, and Dr. Corday and Benton from surgery. The staff is pretty friendly here."
"I guess so. Except Carol. She hates me."
"Nah, can't be. She's really nice. Must be a misunderstanding."
"I think she doesn't like my being a nurse-turned-med-student. Don't know why."
"She tried medical school once herself but stuck to nursing in the end. She scored pretty good on her MCAT, though. Was one of the top of her class."
"Mmm."
"You'll work it out."
"I hope."
Both their pagers went off simultaneously.
"Must be a big emergency."
They walked back into the ER, finding Kerry barking orders, getting a mass casualty protocol going on. The place looked even more hectic than usual, with nurses, orderlies and doctors rushing to and fro like crazy bees.
"There was a massive pileup on the 55." Carol explained.
"Abby" Kerry barked, "Jump in, but stay supervised."
As paramedics kept rolling in patients, to the sound of the blaring sirens, and Carter triaged them in the hallway, Abby stuck to sutures, as Dave had told her to. She was in the suture room when Dave came looking for her.
"Abby, I have the perfect patient for you. Tia Aznar, twenty-six years old, seven months pregnant. Chief complaints are consistent with an urinary tract infection."
He tossed her the chart. "Get back to me for the discharge."
"You not gonna supervise me?" she asked, perplexed.
"You know a lot more about pregnancy and its complication than me, Abby. Va con Dios!"
With that he dashed away. Abby sighed, flipped through the chart, and headed to the patient's room. A Latino girl was lying in the bed, unmistakably pregnant. Abby grimaced when she saw that Carol was the nurse.
She introduced herself to Mrs. Aznar and the woman explained her what her symptoms were. Abby felt self-confident for the first time that day: she was in her element and knew exactly what to do. How come that when she was in OB she always knew what was the right thing to do? Anyway Dave was right, it looked like a classical urinary infection. She then told Carol what tests she wanted done.
"Call me when you have the results, okay?" she asked the aloof nurse.
A brisk, cool nod of the head was the only answer she got. Abby sighed. She wished they were not at odds. She had done nothing to Carol to deserve that kind of treatment, after all.
Carol came looking for her as she was with another patient. In the very moment the nurse approached the bed, the patient got sick and threw up all over the bed. Mechanically Abby reached out for the dirty sheets and balled them to throw them away. Then she took the clean ones to replace them but Carol stopped her.
"Nurses' job."
"Oh."
"Lab results on Mrs. Aznar."
Abby quickly flipped through them and frowned, concerned. "Uh-oh."
"What?"
"Mrs. Aznar's glucose level's skyrocketing and her insulin is bad too. This is suggestive of gestational diabetes. It can cause problems to the fetus."
"You gotta tell her."
"Shouldn't I fetch Dave?" Abby asked, edgy.
"You kidding? The guy's got the sensitiveness of a dead skunk. You should see how he delivers patients the bad news. No way. You're the one."
"Uhm, okay. I'll be just a minute."
Carol found her at the vending machines, an hour later. She planted in front of Abby with her legs parted and her hands threateningly on her hips. Her voice was sharp when she spoke "What the hell happened to "I'll be right back"? I can't believe I actually started to think I've been right about you. That woman needs her doctor to tell her something, anything, and you run away? Are you even gonna look at me?" Abby turned to her, looking embarrassed. "Oh, I've been trying to decide what drink to get. I've been standing here trying to choose between cherry soda and, uh, ginger ale. And you know what? It's a toss-up. I mean, either way I get a cold drink, right? And it would be almost impossible for me to kill someone with this decision, but... I still can't make it." her voice cracked "I think I'm in trouble here." Carol came up to her. "Look, I don't think these kinds of things are easy for anyone. And if it's any consolation, one of the reasons I never liked you is because you're already better at this than most of the doctors that come through here; and to be honest, I kinda liked being the only smart, strong chick in the joint." Abby almost smiled. "You sort of just complimented me." "Little bit." Abby spoke, taking a breath, "Okay, I'm gonna have a ginger ale." "Good start." Abby pushed the button and fetched her drink. "And...that diabetes isn't going anywhere on its own; so, let's tell her and start treatment right away." "That's my girl. Let's go." And, to Abby's great amazement, Carol slipped an arm friendly over her shoulder and said "Wanna see a picture of my girls? They've grown so big."
Later on, Abby plopped satisfactorily a chart in the rack by the board. Dave came looking for her. "You need to change the dressing of a wound in Exam Two. I've already jotted down the instruction for you." "Thanks, that's nice." Abby started sorting through the instruction "Take two Daves as needed, apply to sensitive area..." What's this crap?" Dave then stepped from around the corner "Whazzup.... Oh, come on, Abby; give me one good reason why you won't go out with me. "Let's see, you're a doctor. So, you've got the god-complex, the cockiness, the whole "married to the job" thing. You're cute, but you're very, very aware of it. You have no idea what I'm like, so all of your feelings for me are coming from" she pointed to his groin " Down there. But most of all, I'm looking for the real thing; and you're nothing but a little boy who's not used to being told "No." So there's a bunch of reasons. Pick your favorite. And now, if you will excuse me, I'm gonna got sit down because you're so sexy my knees are weak." Dave just stood there, bewildered, watching her walk away. Luka came up to Abby, chuckling "I'd go with the "god-complex". You really zinged him, Abby." "Oh, yeah." She said with a lot of self-satisfaction. Then she checked her watch. "You off?" "Yup." Right then Dave returned to the charge. "Explosive hemorrhoids in Three, Abby." "My shift ended ten minutes ago!" she protested. Dave shook his head. "Your name's still on the board." Abby sighed. Luka raised his hands in a gesture that meant 'What can you do? That's the way it is.' "Remember what I told you before?" "You were right." "That's because I'm old and wise." Luka smiled. "You're not old." "I certainly feel so. And tired and stressed out as well." "You need to unwind, then. How about going to the movies? With me? How does that sound to you?" Luka was pretty taken aback by her out-of-the-blue offer, but as in a pleasant surprised way. "Uhm, your plan sounds good to me. I'm off in half an hour." "Good. See you in a few. My hemorrhoids are waiting for me." He smiled and called out after her "Erase your name off the board!" "I will!" As she headed to her grim destination, Abby could not help feeling cheerful despite the unpleasant task she was about to carry out. She smiled inwardly. She felt that her experience in the ER was going to be a lot better than she had initially thought.
Fine