THE NIGHTINGALE JOURNALS

A/N: Wow, there was some widespread confusion regarding Rosalie and Bella's tete-a-tete in the last chapter; thank you to everyone who let me know that they were confused. The significance behind their exchange is explained in this chapter. For future reference, Edward talks about the blog at the end of Chapter 2, and at the beginning of Chapter 4.

Things I own: 3 dozen homemade digestive biccies and 4 dozen homemade Hob Nobs. Just in case Rob decides to stop in for a spot of tea. One can never be too prepared.

Things I don't own: Anything Twilight. It all belongs to Stephenie Meyer.

Thanks to my beta, Trinity/TFX, who reads my chapters even when it is heartfail. ILY, bb. Thanks to my grammar beta Lupin4Tonks, who spit shines everything to a lovely sheen. Ladyeire72 and MyCrookedSmile deserve thanks for pre-reading to make sure I was clear this time. I love you all.

CHAPTER TWENTY-EIGHT: REVENGE IS A DISH BEST SERVED COLD

I look over at Edward, whose mouth is agape.

"Did she just say what I think she said?" he asks.

My response is subdued. "Yeah."

Dr. Rosalie Hale just told me that not only did she find out about my blog, but also that she is the one responsible for telling everyone about it. Ultimately, she told McCarty, McCarty told Edward, and invariably, she's behind Carlisle finding out, too. All the embarrassment I felt when Edward told me that he read my blog just came flooding back into my brain; I can feel my cheeks flush in response.

What is probably the worst part is that she admitted doing it not because she had a personal vendetta against me; she just wanted to put me in my place. She's from the school of thought that nurses are to do as they are told, not to use any independent judgment in patient care. She wants me to kowtow to all the doctors with whom I work, because, at the end of the day, I'm a stupid nurse, and she is a skilled, neurosurgeon.

From Dr. Hale's perspective, my problem is that I'm nothing more than a nurse aspiring to be something I'm not. From my perspective, she's just another arrogant neurosurgeon who's on a power trip.

Dr. Rosalie Hale is a fucking bitch. I hate that woman, I really hate her.

I'm trying valiantly to fight back my tears. I refuse to allow her to tear me down. Underneath it all, I am a good nurse, and I believe in the wisdom of my clinical judgment. Dr. Rosalie Hale can go fuck herself on the broomstick she rode in on for all I care.

The next thought that pops into my head catches me by surprise—I get a hunch that Dr. Hale must be sleeping with Dr. McCarty. Why would she have told him otherwise? It makes me more than a little sick to my stomach to think that discussing my blog might have been part of their pillow talk. I'm more than a little pissed at McCarty for being so stupid as to buy into her charms. She's just an ice queen in my book, but he must have his reasons. Well, aside from the fact that she has a spectacular pair of tits. I'm certain they aren't real.

My musings on exactly how evil Hale is have to wait, however; we have a critically ill patient to tend to.

The rest of the staff who came to help get the patient settled have all left the room, so it's just Edward and me at the bedside.

"I'm really worried about that right eye," he explains.

"Me, too. I'll watch it closely, though. Don't worry."

He chuckles without humor. "I'm not worried about you, Swan, I'm worried about the patient. It's normal for a doc to do that, you know."

I look at him, wondering where this tone is coming from. I've had just about all my tired brain can handle for one shift—I don't need Edward compounding anything here.

"I know that, Cullen, and I know that you are also incredibly committed to your patients. I'm just a little testy because I feel like everyone's been second guessing my nursing skills tonight, dammit!"

"I'm not!"

"Well, it sure sounds like you are!"

I watch Edward take a step back, pinching the bridge of his nose. He shakes his head and lets loose a deep sigh. "Just keep me informed on how things are going. I'll be in the dictation room."

"You know I will," I say to his back as he leaves the room.

I'm so pissed off right now, I need to breathe deeply to control myself. There is very little that gets to me in this job, but when someone questions my intelligence, or my nursing skills, they might as well punch me in the stomach. I just had three doctors—three!—call me out for my nursing judgment, and I'm way past the limits in my toleration. One more tonight, and I will crack, swear to god.

They wouldn't have assigned me a serious head trauma case if they didn't think I could handle it!

I'm so tired, I'm getting emo, and I can feel a tear start to prick in my eyes. This is the second time in a matter of minutes, and that alone is pissing me off; I hate crying.

I WILL NOT cry, I WILL NOT cry, I WILL NOT cry…

Maybe if I chant that enough, I'll start to believe it.

I sit down at the computer near my patient's bedside and begin to chart my assessment. I want it in the computer as quickly as possible, so everyone will be up to speed when they look at her electronic chart. As I'm charting her vital signs, I notice that her heart rate is starting to slow down. With each of her last four blood pressure measurements, the pulse pressure, or the difference between the top and the bottom reading, has widened, and her pressure is starting to get too high overall. The increases are subtle, but I get a bad feeling about it. It's not bad enough yet for me to page neurosurgery, but it is strong enough to raise my heckles.

Cushing's Triad.

Patients who have head trauma, a neurosurgical procedure, or a change in level of consciousness—for any reason—can easily slip into what's known as Cushing's Triad. It's a combination of three vital signs that show a patient's intracranial pressure (ICP) is climbing to dangerous levels. If the warning signs are left untreated, a person will likely die. The three hallmark signs of the triad are a slow heart rate, a widening pulse pressure with high blood pressure, and a change in respirations. Their breathing will slow down and become irregular, which often happens when a patient is near death.

My little patient appears to be starting to head down that path, and I'm worried. I page Edward, the resident, and the neurosurgeon; I'm not sure if I'd rather have Hale or McCullough handling this as the shit hits the fan. They're both equally bad to put up with, regardless of their skill as neurosurgeons.

As luck would have it, McCullough is the first one to answer the page.

Lovely.

"This is McCullough. What?" He sounds annoyed and tired. Great combo, right there. I grimace internally.

"You need to come look at the head trauma kid—I'm pretty sure we have Cushing's Triad going on."

"How wide are his pulse pressures?"

"It isn't that pressures are widening dramatically, it's just that it's starting to trend that way, and her heart rate has been slowing down. Her blood pressures are starting to increase."

"What does 'slowing down' mean?"

I sigh in frustration. "It means that she has drifted from the low hundreds to the eighties. Her systolic is in the 140s."

"How old is he again?"

"SHE," I clarify. "SHE is nine."

"Eighties for a nine year-old is unremarkable," he scoffs. "And I'm unimpressed by the systolic pressure. How long has it been going on?"

"About 30 minutes."

Edward and the resident walk into the room. I put the call on speaker so we can all hear it, and thus be on the same page.

"Wait a second—you page me at 2 AM and she's been trending for only 30 minutes? Jesus, did you leave your brain at home tonight?"

Edward opens his mouth to say something, but shuts it when I hold up a finger in his direction to quiet him.

I clear my throat to gather my wits. "Excuse me, but I've been a nurse in the Peds ICU for longer than you've been a doctor. I've seen Cushing's plenty of times, McCullough—often enough to sense when it is about to happen. The trend is clearly starting. I know if any other PICU nurse gave you this same story, you'd be all over it. I just know where this is going, and the earlier we can intervene, the better."

"Call me if it truly becomes a problem, then we can talk. I don't assess patients at 2 AM based on a nurse's hunches. I don't want to hear from you unless the kid herniates."

"If she herniates, it will be too late to save her!" I hear Edward chime in.

Goddamn it, Cullen, don't let him get to you. This isn't your fight.

"She isn't going to fucking herniate," he says with exasperation. He continues, as if I'm the only one in the room. He knows full well that I'm not. "There is nothing to worry that pretty little head of yours over. Leave the thinking to those of us with the big brains. I wouldn't want you to accidentally sprain something."

I'm livid. I hang up the phone, and I'm so angry that I'm shaking. James knows that this patient is at risk for Cushing's. My hunch is valid and sound. That asshole knows exactly how to push my buttons, and it makes me furious. I fucking hate being out of control. On top of that, I'm pissed off with Edward for trying to play the knight in shining armor. I can fight my own fucking battles with McCullough; I don't need to turn this into a pissing contest, for Christ's sake.

The only good news from this scenario is that with Edward here, we can intervene on behalf of the patient, even if McCullough refuses.

"First of all, what the hell did he say?"

"Not now, Edward; you heard all that you needed to hear. The patient is slipping into Cushing's, I just know it."

"Tell me what you've got."

"Her heart rate was in the low hundreds and has drifted to the eighties. Her pulse pressures are widening, and her systolic is in the 140s. Her breathing rate is decreasing. It's all subtle, but it's there. I know it."

"Have you checked her pupils recently?"

"Still equal, but sluggish."

"Okay, for now, put the bed at 30 degrees to help decrease the ICP. Get some hypertonic saline ready at the bedside, just in case."

I quickly fix the bed according to Edward's orders, then grab the saline. I have a feeling we're going to need it, so I spike the bag and get it ready to infuse. When you're in a rush, as you nearly always are if you need to infuse a hypertonic solution, it's best to have everything ready to go, to gain precious seconds that can save a life.

"Let's get the intubation cart in here, in case we need it emergently. It's the best way to keep her stable."

Before I even know who's responsible, the cart is here, as are a few more bodies.

I fucking love my colleagues. They always know just what I need, just when I need it.

"By the way, how long has it been since you've done a Glasgow?"

Edward's referring to the Glasgow Coma Scale; it allows us to quickly assess the severity of trauma to the brain based upon patient responses to stimuli.

"I did one before I paged you guys. She only opens her eyes to severe pain, she moans in response to stimulation, and she withdraws to pain. I rated her at 8."

At a score of eight or less, the patient is in imminent danger of respiratory failure.

"Shit. Why didn't you tell me that first? We need to intubate before she decompensates. Open the cart, we're going to do a rapid sequence intubation. I need a dose of fentanyl and versed, along with vecuronium."

Edward's criticism of my judgment stabs me like a knife to the heart, but I have no time to dwell on it.

The charge nurse is quickly drawing up meds for us as Edward grabs the appropriate size breathing tube and laryngoscope from the cart. We give the patient fentanyl for pain and versed to make her unaware of what's happening. We give these meds first, because intubation is not a comfortable procedure. Vecuronium is a paralytic that will keep her from moving while she is being intubated. It will also help to keep her ICP from increasing during a stressful procedure.

I open the endotracheal tube for Edward; I hold on to the tube on the outside of the packaging to keep it sterile. I watch his skillful hands slide the laryngoscope into place; it holds the back of the tongue out of the way, and allows him to visualize the trachea and larynx, where the breathing tube needs to be inserted. He gets it right where he wants it, and asks me for the tube. I hold it out for him, making sure it is still sterile, and he grabs it deftly from me. He makes this process look so easy, when I know the exact opposite is true. It can sometimes take two or three attempts, but with Edward? It's always the first time. The man has some amazingly skilled hands. It's all I can do to keep from ogling them during such a tense moment.

In a matter of seconds, the respiratory therapist uses tape to affix the breathing tube to the patient's cheeks, so it will stay in place, and hooks our girl up to the ventilator. One less thing to worry about for our sick, sick girl.

Once all the hard work is done, McCullough appears, as though by magic, through the door.

The minute Edward spots him, I see his body stiffen.

"You decided to intubate?" he says, with a taunting tone. "It's not often that my talents are rendered unnecessary."

"Yeah, her GCS is 8. Protocol says anything eight or less, intubate as a precaution."

"And you're basing your decision on the nurse who just has a hunch that this is Cushing's?" He puts a dramatic emphasis on the word hunch, as if that will prove my incompetence.

"No, I'm basing it on the vital signs and our assessment of the patient. If we waited until you got here, it might have been too late."

"There's no need to be melodramatic, Cullen. The patient is fine."

"Not according to the monitor, she's not," Edward counters. "She needs to get a ventric in place to measure her ICP."

James looks around the room in dramatic fashion. "Oh, you're the neurosurgeon now, are you?" He nods at the name embroidered in red on Edward's jacket. "Wait a minute, that clearly says 'PICU Fellow.'"

"Every minute you argue about my incompetence and overreaching is a second this patient doesn't have. Now, if you need me to page another neurosurgeon, I'm happy to do that. If you need me to get Carlisle Cullen here in the middle of the night, it will gladly be done. The choice is yours—treat the patient, or suffer the consequences of your choice."

James stands there for a moment, recovering from Edward's verbal slap. It only lasts for a brief second, then his smarminess returns in droves.

"It's sad, how you have to rely upon other people to fight your battles, you know?" he gives us a cheesy smirk. "All right, since your panties are in a bundle, get me the ventric equipment and a surgical kit, and we'll keep this girl from gorking out."

It's one thing to use gallows humor to keep yourself going on the night shift, among your colleagues. In front of a patient, however? Using such a derogatory tone, when she could be dying? I'm beyond disgusted. I can't believe I didn't see through his disguise when I met him. He can certainly turn the charm off and on when he feels like it.

James gets the ventric in place—I hate to admit that he's fucking good at what he does, but he really is—with Edward's assistance. Once I have the ICP set up on the monitor, we have a constant read on where our girl's pressures are. Typically, we have a protocol order in place to intervene if the pressure gets above a certain point. We'll usually give a bolus dose of mannitol or hypertonic saline, which affects osmosis. The fluid shift from the cells out to the hypertonic environment helps to lower pressures.

James is leaving the room when I hear Edward say, in a very soft, subtle tone, "McCullough—I need you in the hall. Now."

"Cullen, I really need you…" I start, in an attempt to keep him from doing what I know he is going to do.

"The resident can help you, Swan. I need to review the case with neurosurg."

I watch as Edward storms out into the hallway, James is barely out of the room before Edward lays into him. Everyone else quickly scatters back from whence they came, because it's clear the shit is going down.

God-fucking-dammit, Cullen, don't!

Although Edward has lowered his voice, I can still hear everything he's saying.

"I'm trying to figure out if you are just being a neurosurg asshat or if you really are this sloppy."

"What the fuck are you talking about?"

"Refusing to come immediately to the bedside for a kid who is developing Cushing's Triad? Seriously? What, were we ruining your beauty sleep?"

"In my clinical judgment, the child was no more at risk for Cushing's than she had been when I first assessed her. It's my opinion that she was in no danger. "

"Your opinion is no good if the kid ends up dying! Even if there is a remote possibility that it was happening, the onus is you on to figure it out. If she herniated, it would be our fault. And you know what? She's someone's little girl. She had a tragic accident. At the very least, think of how many lives could be disrupted if she went south. She deserves a chance to be a kid, and then to grow up. If it was my kid? I'd want you to do everything for her. Do you even care?"

"Please spare me your histrionics. I've seen hundreds of these types of cases, more than you'll ever deal with in your life. A 9 year old with a heart rate in the 80s and pressures in the 140s doesn't make me lose any sleep."

"You might not be losing sleep, but her family certainly is! What's the worst thing possible if you intervene early, hmm? You know that neurologically, it's the most prudent approach. I don't fucking care if it means you have to get out of bed. If you're paged by one of our nurses, you need to haul your ass over to the PICU. Got it?"

"You're trying to threaten me, Cullen? Are you that stupid?"

"The only idiot here is you. And believe me, if you refuse to follow up on the advice of our staff—any of our staff—you will go down."

"Well, Dr. Carlisle Cullen will hear about this little incident, of course. Straight from my mouth. You're messing with the wrong guy."

They stop talking, appearing to be at an impasse. I'm so anxious I feel like I have to throw up. I'm royally pissed at Edward for creating a scene; there were other ways this could have been handled, and we both know that McCullough's handling of the patient is only the tip of the iceberg in Edward's mind.

"Oh my god, you like her, don't you?" I hear James' snaky voice intone.

"Well, we're living together, yes."

"This doesn't have a fucking thing to do with that patient—you're just mad I dated her first!"

"Dated? Is that what you call it, McCullough? God, that's priceless," he chuckles without humor.

"What is that supposed to mean?"

"You know exactly what I mean. It starts with a bar and an inebriated girl, then ends with an alley."

God, I wish I could see their faces.

"She knew what she was doing. There's only one reason to go out back behind a bar."

"Are you sure about that?" he laughs again. "You're more of a fucking twat than I thought. Say one more denigrating comment to Swan and I will make an official complaint to the hospital board. Do you have any idea how unethical you were?"

"Well, it's my word against hers. No one will believe her."

"You don't think so? How about if the hospital's Medical Director backs me up on the accusation?"

"I told you before, don't you fucking threaten me. You'll regret it."

"It sounds to me like you're the one with the threats."

"Just you wait. When I get through with you, Cullen, even your successful, perfect daddy isn't going to be able to save your career. You're through at Seattle Children's."

I hear James stomping off down the hallway.

"Edward?" I call out from my room.

"Not now, Swan."

"Yes now, Cullen."

He lets out another deep, heavy sigh and walks into the room.

"How's the patient?"

"She's fine for the moment. Her pressures are down. The hypertonic saline helped. The ventric is draining off some of the excess fluid, so she's stabilizing. Her second steroid burst is due soon."

He glances over the patient, assessing her ventriculostomy, looking at the monitor. Dealing with everything in the room, apart from me.

I start out gently, to get him to listen to my reasoning. "You know that neurosurgeons are like hydras—cut off their head, and two more will appear in its place. You can try to get rid of McCullough, or even Hale, but someone equally as arrogant and unpleasant will take their place."

"I'll take that chance."

"There's no need. I put an Annoy-A-Tron in his pocket, and it's going to drive him absolutely nuts until he finds it."

"What the hell is an Annoy-A-Tron?"

"It's a little computer microchip that emits three different kinds of irritating noises. It's tiny, and hard to find, and is going to drive him to distraction until he figures out what it is."

"I have to admit, that is a pretty good trick."

"And it certainly is safer than threatening a colleague. Cullen, don't you dare jeopardize your career because you can't handle something from my past! Nothing you do is going to change what happened to me—it's all over now. I got over it, and you need to as well. You can't right a wrong retroactively; you know the world doesn't work like that!"

"Bella, the asshole essentially raped you, and he did it while taking your virginity. Nothing I can ever do will erase that from your past, but he needs to feel some kind of suffering for what he did to you!"

"Making him suffer is going to make it all better, is it? You know what? I won't feel any better. Being as low and dirty as McCullough is doesn't make you a better person, it just makes you more like him. You know that! You've always talked about wanting to live up to your father's example—in your career choice, as a PICU doctor, as a person. I can assure you, he would never put himself in such a vulnerable position by denigrating a colleague."

Edward looks like I just slapped him, his face a mask of acute pain. I feel terrible for bringing Carlisle into the argument, but I can tell that he isn't going to let this go, and he needs to.

"Isabella Swan, my father would not sit idly by and let the woman he loves more than life itself be torn apart by one of his colleagues, that I can assure you!"

I sigh deeply in extreme frustration. Edward Cullen is the most stubborn person in the universe, aside from me.

"But I'm fine, Edward! I've moved on! I have a job I love, with colleagues who are amazing, and the best man I've ever known at my side. Don't you see? I'm the one who has it all. James has nothing, and he never will. That's why he's so mean."

"It isn't right! He can't keep getting away with this stuff. Someone needs to hold him accountable! I mean, god knows who will be his next innocent victim. Do you want that to happen to another nursing student?"

"Look, if you can't let something like this go, then things aren't going to work for us in the long term. You can't fight my battles for me, and I don't want you to. I've survived on my own for nearly 30 years, and I am a perfectly capable individual. If you can't handle that concept, then you can't handle me. That's all there is to it. You need to think about this desire of yours to take care of me in that way, because I don't need it and I don't want it. Is that understood?

"Bella, you can't do this. Please, do not do this to us," he's begging me, and the tone of his voice kills me. "I can't stand it."

I decide impulsively what I need to do. It's the only way he'll understand.

"I'm going back to my old place after work, Edward. We need to talk about this after we've both had some time and distance."

I go back the patient's bedside and watch my little girl make it through the night, which is good. As good as we can expect with her injuries. The best part is that her ICPs have been under control, and I know we played a part in that. Her outlook is decidedly rosier than is mine.

~xXx~

I didn't sleep a fucking minute last night. I'm worried sick over Edward, and it feels wrong not to have him in my bed. Although it's very rare that something in my daily life causes me to cry, I spent several hours crying last night. I was already exhausted from all the fallout regarding Lauren Mallory; this certainly isn't helping.

We're getting a baby in from the ER with some kind of altered mental status. That is medical code for, "something's wrong with the brain, but we have no idea what it is." It could be a number of things, so the patient is being admitted for a spinal tap, an MRI, a central line, and cultures. The sooner we can find out exactly what's going on, the more likely we'll be able to save the child.

Naturally, Edward is going to be the one to perform the lumbar puncture, so I start getting the necessary supplies set up. My biggest job will be holding the patient still for him, so that there is minimal risk of damage to the spinal cord.

I know for certain that the baby is very sick, because he refuses to eat, his temperature is very high, and his hands and feet are cold and mottled. The cold extremities are a sign that the patient is clamped down—one of the ways the body preserves the most vital organs. When you get sick enough, your body saves the brain, the heart, and the lungs by sending the majority of its blood volume there.

There are a number of diagnoses that could apply to the patient right now, including, but not limited to, herpes that has infected the brain, meningitis, a head bleed, a brain tumor or mass, increased ammonia levels in the blood (due to liver dysfunction), encephalitis, or seizures. It's more likely to be a bug than the other issues, because of the high temperature and mottling. We'll need to get the kid started on all the procedures at once. I try to get everything ready that Edward might possibly need, so that we can get the process done as quickly and efficiently as possible.

As I'm getting the room set up, Edward comes flying in. He stops abruptly, looking at me. I can't help it; tears start to leak out of my eyes.

"Hey, Swan."

"Hey, Cullen," I reply, trying my best not to let my voice crack. "You look like shit."

He snorts in reply. "I was about to say the same thing to you."

"Yeah, I haven't been sleeping very well."

"Me neither," he admits.

Simultaneously, we both blurt out: "I'm so sorry, Edward." "It's all my fault, Bella."

I giggle in my nervous state.

"We need to get ready for the patient, but can we take a break together afterwards? So we can talk?"

I nod at him. "Yes, I'd like that."

He rocks back and forth on his feet, running his fingers nervously through his hair. "Good. Good. Yes, good."

I giggle at him, because he is so adorably self-conscious.

As we stand there, awkwardly looking at each other, the patient is wheeled in on an ER gurney. We start get him settled into bed, and a bevy of my colleagues try to come into the room to assist.

Before they can enter, Edward shouts out: "Hey, people, this is a universal precautions room as of right now. We have no idea what this patient has. Please get your gowns, gloves, and face masks on."

Everyone does what they're told, and in no time, we're ready to roll. They leave as swiftly as they arrived, and it's just Edward and me once again.

We've been together like this, face to face, a countless number of times. I love the intimacy and precision of doing procedures. We have a lot to get done, so I have several sets of gloves and sterile equipment ready for him.

"Let's start with the central line, so we can send the cultures. After that, we can do the lumbar puncture, and finish with the urine specimen. Then we can get this kiddo to MRI."

When kids get a bug, we often do what we refer to as pan cultures. It essentially means we culture everything that is able to be cultured to see what organisms grow in the lab. Since we have no idea what's really wrong with this kid, he clearly needs to be pan cultured.

I watch as Edward inserts the IV catheter into the baby's internal jugular vein. It's a great location for a central line, because it's hard for the babies to reach and fiddle with. As his fingers get to work, he periodically asks me for an instrument, and I'm already prepared to go. I love that we can understand each other so implicitly, no words necessary. He is really a marvel to behold, because his procedures are so much more than just a technical task. He performs it as brilliantly as if he was playing a musical instrument. I never thought of procedures as an art form until I saw Edward Cullen in motion.

The baby is so ill he doesn't need to be sedated for these procedures. We did give him some fentanyl before starting, but he hasn't uttered a peep. That's not a very hopeful sign, sadly. We position him for the LP, on his side in the fetal position. I hold his little arms and legs still, even though he is as floppy as a rag doll. I talk softly to him while Edward does his thing. Even if he is unconscious, I still feel like I need to soothe him. I know I would want to be, if I were in his shoes.

What happens next cascades like a series of dominos falling perfectly in rapid succession. In my mind, however, everything unravels very slowly, as if I'm watching a slo-mo instant replay. I feel the patient start to tense up, so I lean in to hold him more securely. I have only enough time to eke out a quick warning to Edward, and the patient sneezes right in my face. In my hurry to prepare the room, I didn't get a face mask with a splash shield, because there were none in the cabinet. I meant to ask the NST to hunt a box down for me later, but that doesn't do me any good right now.

Edward is startled by my shout and the sudden movement. I'm doing my best to avoid contact from any follow-up sneezes, while Edward is just trying to keep the spinal fluid samples from overturning. Somehow, in the midst of all this, I end up with the needle used for the spinal tap poking out from my collarbone.

Jesuschristshitdamnfuck

There are no swearwords good enough for a situation in which you've been sneezed upon AND had an accidental needle stick. This is doubly true when the patient has an unknown, but clearly very bad, disease.

It is a perfect storm for healthcare worker exposure: I am tired, I wasn't wearing the right equipment, and the patient wasn't as sedated as we believed. All it takes is one small stick of a needle. I wasn't paying attention. I just exposed myself to whatever it is this patient has. I know that whatever it is isn't something good, and I feel my stomach drop.

"Bella? Are you all right?"

I yank the needle from my neck, and I lose control. All the sadness, the frustration, the stress of the past few weeks takes its toll. I just can't contain my feelings any more. I start to cry. No, I'm actually sobbing. The kind of hiccupping, let-it-all-hang-out tears, where you can't stop even if you want to.

His concern is written all over his face, and I have to be honest with him.

"No," I manage to gasp out in between sobs. "I'm not. I just got stuck with a used LP needle and sneezed on by the sickest kid in the PICU."

END NOTE: Before you judge Bella, I need to emphasize that even the most careful of healthcare workers get accidental sticks. Yours truly has had two, one from a kid who had Hepatitis C. I was also coughed upon by a kid with a new trach—the loogie landed right in my eye. Fortunately, it all turned out fine for me, but the risks are very real no matter how many precautions you take. Add on top of that Bella's level of fatigue, she was just an accident waiting to happen.

"Personal penis" in the last chapter is thanks to FFCherry. (Of COURSE I'm going to give you credit for it, bb!). Thank you—there were many readers who really enjoyed the twist on that reference. :)

The Annoy-A-Tron is real, and you can get it at thinkgeek dot com. It is complete and total win. Uh, hypothetically speaking, of course…