-Chapter Nine-
Day for White
Another day in the ER. I am stuck with the graveyard but I am happy because tomorrow's Susie's birthday and I'm throwing a surprise party for her. Gotta love them if you work here. The only one I missed was my own farewell. There was this big cake shaped like a cactus. Very nice, really. Too bad a trauma came in and I snuck out without having the chance to tell anyone. I hate goodbyes. A paramedic rushes in font of me. I grab William. "What's the bullet?" "Twenty-seven year old woman, altered level of consciousness, no evidence of trauma. Her husband brought her in." "Mr. Tureen, I'm Dr. Lewis. I'm going to be taking care of your wife." The man's falling to pieces "I don't know what happened. Last night she was fine, but I couldn't wake her up this morning." "Ok, William, the ball's in your court." "Uhm, Err. Could she have hit her head somehow?" "I don't think so." "Did she complain earlier about having a headache? Fever? Nausea?" "No, nothing. She was fine." "Head and lungs are normal. That's good. She's not having any trouble breathing. Pupils are mid positioned and fixed. Corneal reflexes still in tact. That's good." We check the young woman's condition. "We'll need to have a look at her head CT before we can say anything, Mr. Tureen." "Just do everything that you can. I have a really good insurance." We leave the woman as she goes to have her CT done. There's a lot of people needing sutures today. Why people don't pay more attention, say, when they open cans or work on their DIY? William is already in the suture room, busy with a weeping girl. My patient is an unconscious tramp who, by the looks of it, is very drunk. He has lots of green bottle glass fragments in his scalp. Looks like one of his buddies used him as a human tin opener. William's girl can't stop sniffing and crying. She's a drag. "It's a very minor cut, miss." William tries to reassure her. "It's not the cut!" she wines "I got home early and caught my boyfriend in bed with another woman! I wanted to throw him a plate but I dropped it on my foot instead." "Oh. I am sorry, miss. His loss, though." She keeps crying him a river. "Miss, look that young man over there." I watch his finger and see Carter trying to do a juggler's trick with three drug vials. He's crushed two already and he blows his hair off his eyes. He looks ridiculous. "He is a West Wing fan. See, there's always someone worse than you." She laughs through her tears. "Do you love him?" William asks seriously. "No, I could never love a West Wing fan!" William laughs, "You made a joke in the middle of your tragedy. That's very positive!" William has a way with people. Maybe Carter transmits his excellent bedside manners to his students. He certainly didn't get that from Benton. Haleh tells me that Mrs. Tureen's CT is back. William and I excuse ourselves from our patients and go talk to Mr. Tureen. He's stroking lovingly his wife's cheek. "Mr. Tureen? The CT confirms your wife suffered from stem brain infarction. I'm sorry to tell you she'll never wake up." "What? That's impossible, she was in perfect health!"
"This kind of things can happen to anyone. It could be congenital."
Right on cue, Mrs. Tureen stirs and blinks. Oh my God, she's waking up! This is a miracle!
"See? Told you she's as sound as a bell!"
I grab the CT and go looking for Carter. I need a second opinion. "Carter, take a look at this. Woman came in comatose, diagnosed with stem bleed infarction. She has just waken up on me."
"Wow! Hot stuff. Let me see.uhm, ah-ah! See that, Susan?"
"This little shmutz?" "It could be a warning leak from an aneurysm, trickled down and caused her brain stem to swell." "Should I do an LP?" "No, it would be a waste of time. Let's get an MRI right away, okay? I'm surprised you missed it though. I mean, even the best can make mistakes but even White could have spotted this." "The Pope is a lonely man." "What?" "Now that I am not infallible anymore. You really don't like White, huh?" "No, it's just that I don't think it's fair to treat him any different that all my other students. Benton doesn't agree with me." "I sense a little jealousy here." "What? Of Benton? Are you kidding me, Susan?" "No, I mean you were his student, he gave you a lot of crap and now he is a bundle of open arms with the new kid on the block. I'd understand if you felt betrayed." "Betrayal, jealousy, you're making it look like Benton and I have a love affair! Cut the crap, Susan!"
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I look around the hospital cafeteria, tray in hand, looking for a place to eat my lunch. I would have gone to Magoo's but the Public Health Office actually made it shut down yesterday. For failure to meet ministerial criteria for hygiene. Hurgh, I ate there for years. I look at my burger and suddenly I am no longer hungry. Finally I see there's a free seat at Peter and Elizabeth and Hicks's table. I join them. "Mind if I seat?" "No, Susan, please, go on." Hicks is on the phone and waves me hello. Elizabeth is eating some pasta while Peter doesn't seem the least interested in his lunch. Can't blame him if he keeps eating that health nutso stuff, salad and all that. He'll turn in a rabbit soon. The food is not a problem, though, he's just very absorbed in reading something. "What's so interesting to skip lunch, Peter?" "Carter's pre-assessment of White. He'll turn his final evaluation in three weeks." He replies laconically as usual. Talking with Peter actually makes me feel like I am taking out a foreign inhaled body from a human nose. Guess it expresses the difficulty of the process. "And that is." "Strict but fair I guess." "Come on, what does it say?" "It's really confidential information." "Oh, Peter! We're dying to know what a unbiased party thinks of your wonder student." Angela Hicks prods him. I like her, she is matter-of-fact and has a sense of humor, which is a quality most of surgeons lack. "From what you say, Peter, he can intubate a man with, say, this straw and the plastic knife of the cafeteria cutlery." She says raising the aforementioned objects. "You're exaggerating, Angela. Anyway, here it goes 'Good diagnostic skills, superior bedside manners, quick learner, though he still lacks some assertiveness. Overall a superior than average candidate. Will improve a lot throughout training.' That's it." "It's more than what you usually say, your pre-assessments are no longer than five words. 'Average, will improve throughout training.' Hell, for Carter final evaluation you just wrote ' Superior diagnostic skills, excellent bedside manners, quick leaner. Recommend high honors.' Something along those lines. And I remember it just because it was like a long praising rigmarole coming from you, Peter. And Carter still is your best student." Hicks says. "White's a promising heir to that title." I say. I like the kid a lot. Peter, who's being his usual laconic self, just nods. "I think Carter isn't liking your new teaching approach much, though. It indisposes him towards William and that's bad. You should talk to him, Peter." "What?" "In my opinion he feels like you're unreasonably favoring the kid." "Well, I am not. I simply thought that just because everyone keeps treating med student like slaves we do not have to do that. I mean, my residents treated me like a scut puppy at their beck and call, and I don't think my learning benefited from that. Why do not change the tradition if it's wrong?" "My sentiments exactly." Elizabeth interjects "You don't know what kind of bloody treatment those old tossels reserve to medical students in England, especially if they are women. I am afraid sexual prejudices are a lot more common in old Europe than they are here." "I agree, Peter," I say "I just think you should explain your reasons to Carter, that's all." "I don't have to justify myself with anyone. Carter'd better grow up and get used to it." My pagers goes off. "Looks like they're bleeping you, Susan." Elizabeth says in this very English way of hers. "It's the ER. Gotta go, bye."
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I look around for William. I have a rectal exam for him to do. I find him talking to the nurses. Haleh's telling them something and, from the looks of it, it must be really interesting. ". anyway we found out who he was just when his pager rang in the middle of the trauma because we were beeping him. We still don't know if he jumped on purpose in front of that train or if he fell. Carter was pretty shook. He was his roommate." "Wow. I thought that this kind of things were just urban legends." "No it happened for real. The kid's name was Dennis but I can't remember the last name." "Check it out on the Tribe site if you wanna, bro." Malik tells him before leaving. "Story time's over." I say "Rectal for you in Exam One, William." "Hurgh! Shit!" he grimaces. "Yeah, quite literally." I quip. He follows me reluctantly. "Yosh was gonna tell me about that med student who was stabbed. That must have bee a cool-" "It wasn't cool" I can't help shut him up quite brusquely "She was Carter's student and she died. That psycho stabbed Carter too and he suffered from pretty bad injuries himself. You know those back pains he has from time to time? It's from that incident." Not to mention his addiction, which I'm sure he wouldn't like me to tell anyone about. "Oh. I didn't know about it. Sorry, Dr. Lewis." "You're gonna see a lot of bad things around here, William, and you're not gonna like them a bit. The ER isn't exactly the safest workplace around." He stomps off to Exam One with a pensive look on his face.
Another day in the ER. I am stuck with the graveyard but I am happy because tomorrow's Susie's birthday and I'm throwing a surprise party for her. Gotta love them if you work here. The only one I missed was my own farewell. There was this big cake shaped like a cactus. Very nice, really. Too bad a trauma came in and I snuck out without having the chance to tell anyone. I hate goodbyes. A paramedic rushes in font of me. I grab William. "What's the bullet?" "Twenty-seven year old woman, altered level of consciousness, no evidence of trauma. Her husband brought her in." "Mr. Tureen, I'm Dr. Lewis. I'm going to be taking care of your wife." The man's falling to pieces "I don't know what happened. Last night she was fine, but I couldn't wake her up this morning." "Ok, William, the ball's in your court." "Uhm, Err. Could she have hit her head somehow?" "I don't think so." "Did she complain earlier about having a headache? Fever? Nausea?" "No, nothing. She was fine." "Head and lungs are normal. That's good. She's not having any trouble breathing. Pupils are mid positioned and fixed. Corneal reflexes still in tact. That's good." We check the young woman's condition. "We'll need to have a look at her head CT before we can say anything, Mr. Tureen." "Just do everything that you can. I have a really good insurance." We leave the woman as she goes to have her CT done. There's a lot of people needing sutures today. Why people don't pay more attention, say, when they open cans or work on their DIY? William is already in the suture room, busy with a weeping girl. My patient is an unconscious tramp who, by the looks of it, is very drunk. He has lots of green bottle glass fragments in his scalp. Looks like one of his buddies used him as a human tin opener. William's girl can't stop sniffing and crying. She's a drag. "It's a very minor cut, miss." William tries to reassure her. "It's not the cut!" she wines "I got home early and caught my boyfriend in bed with another woman! I wanted to throw him a plate but I dropped it on my foot instead." "Oh. I am sorry, miss. His loss, though." She keeps crying him a river. "Miss, look that young man over there." I watch his finger and see Carter trying to do a juggler's trick with three drug vials. He's crushed two already and he blows his hair off his eyes. He looks ridiculous. "He is a West Wing fan. See, there's always someone worse than you." She laughs through her tears. "Do you love him?" William asks seriously. "No, I could never love a West Wing fan!" William laughs, "You made a joke in the middle of your tragedy. That's very positive!" William has a way with people. Maybe Carter transmits his excellent bedside manners to his students. He certainly didn't get that from Benton. Haleh tells me that Mrs. Tureen's CT is back. William and I excuse ourselves from our patients and go talk to Mr. Tureen. He's stroking lovingly his wife's cheek. "Mr. Tureen? The CT confirms your wife suffered from stem brain infarction. I'm sorry to tell you she'll never wake up." "What? That's impossible, she was in perfect health!"
"This kind of things can happen to anyone. It could be congenital."
Right on cue, Mrs. Tureen stirs and blinks. Oh my God, she's waking up! This is a miracle!
"See? Told you she's as sound as a bell!"
I grab the CT and go looking for Carter. I need a second opinion. "Carter, take a look at this. Woman came in comatose, diagnosed with stem bleed infarction. She has just waken up on me."
"Wow! Hot stuff. Let me see.uhm, ah-ah! See that, Susan?"
"This little shmutz?" "It could be a warning leak from an aneurysm, trickled down and caused her brain stem to swell." "Should I do an LP?" "No, it would be a waste of time. Let's get an MRI right away, okay? I'm surprised you missed it though. I mean, even the best can make mistakes but even White could have spotted this." "The Pope is a lonely man." "What?" "Now that I am not infallible anymore. You really don't like White, huh?" "No, it's just that I don't think it's fair to treat him any different that all my other students. Benton doesn't agree with me." "I sense a little jealousy here." "What? Of Benton? Are you kidding me, Susan?" "No, I mean you were his student, he gave you a lot of crap and now he is a bundle of open arms with the new kid on the block. I'd understand if you felt betrayed." "Betrayal, jealousy, you're making it look like Benton and I have a love affair! Cut the crap, Susan!"
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I look around the hospital cafeteria, tray in hand, looking for a place to eat my lunch. I would have gone to Magoo's but the Public Health Office actually made it shut down yesterday. For failure to meet ministerial criteria for hygiene. Hurgh, I ate there for years. I look at my burger and suddenly I am no longer hungry. Finally I see there's a free seat at Peter and Elizabeth and Hicks's table. I join them. "Mind if I seat?" "No, Susan, please, go on." Hicks is on the phone and waves me hello. Elizabeth is eating some pasta while Peter doesn't seem the least interested in his lunch. Can't blame him if he keeps eating that health nutso stuff, salad and all that. He'll turn in a rabbit soon. The food is not a problem, though, he's just very absorbed in reading something. "What's so interesting to skip lunch, Peter?" "Carter's pre-assessment of White. He'll turn his final evaluation in three weeks." He replies laconically as usual. Talking with Peter actually makes me feel like I am taking out a foreign inhaled body from a human nose. Guess it expresses the difficulty of the process. "And that is." "Strict but fair I guess." "Come on, what does it say?" "It's really confidential information." "Oh, Peter! We're dying to know what a unbiased party thinks of your wonder student." Angela Hicks prods him. I like her, she is matter-of-fact and has a sense of humor, which is a quality most of surgeons lack. "From what you say, Peter, he can intubate a man with, say, this straw and the plastic knife of the cafeteria cutlery." She says raising the aforementioned objects. "You're exaggerating, Angela. Anyway, here it goes 'Good diagnostic skills, superior bedside manners, quick learner, though he still lacks some assertiveness. Overall a superior than average candidate. Will improve a lot throughout training.' That's it." "It's more than what you usually say, your pre-assessments are no longer than five words. 'Average, will improve throughout training.' Hell, for Carter final evaluation you just wrote ' Superior diagnostic skills, excellent bedside manners, quick leaner. Recommend high honors.' Something along those lines. And I remember it just because it was like a long praising rigmarole coming from you, Peter. And Carter still is your best student." Hicks says. "White's a promising heir to that title." I say. I like the kid a lot. Peter, who's being his usual laconic self, just nods. "I think Carter isn't liking your new teaching approach much, though. It indisposes him towards William and that's bad. You should talk to him, Peter." "What?" "In my opinion he feels like you're unreasonably favoring the kid." "Well, I am not. I simply thought that just because everyone keeps treating med student like slaves we do not have to do that. I mean, my residents treated me like a scut puppy at their beck and call, and I don't think my learning benefited from that. Why do not change the tradition if it's wrong?" "My sentiments exactly." Elizabeth interjects "You don't know what kind of bloody treatment those old tossels reserve to medical students in England, especially if they are women. I am afraid sexual prejudices are a lot more common in old Europe than they are here." "I agree, Peter," I say "I just think you should explain your reasons to Carter, that's all." "I don't have to justify myself with anyone. Carter'd better grow up and get used to it." My pagers goes off. "Looks like they're bleeping you, Susan." Elizabeth says in this very English way of hers. "It's the ER. Gotta go, bye."
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I look around for William. I have a rectal exam for him to do. I find him talking to the nurses. Haleh's telling them something and, from the looks of it, it must be really interesting. ". anyway we found out who he was just when his pager rang in the middle of the trauma because we were beeping him. We still don't know if he jumped on purpose in front of that train or if he fell. Carter was pretty shook. He was his roommate." "Wow. I thought that this kind of things were just urban legends." "No it happened for real. The kid's name was Dennis but I can't remember the last name." "Check it out on the Tribe site if you wanna, bro." Malik tells him before leaving. "Story time's over." I say "Rectal for you in Exam One, William." "Hurgh! Shit!" he grimaces. "Yeah, quite literally." I quip. He follows me reluctantly. "Yosh was gonna tell me about that med student who was stabbed. That must have bee a cool-" "It wasn't cool" I can't help shut him up quite brusquely "She was Carter's student and she died. That psycho stabbed Carter too and he suffered from pretty bad injuries himself. You know those back pains he has from time to time? It's from that incident." Not to mention his addiction, which I'm sure he wouldn't like me to tell anyone about. "Oh. I didn't know about it. Sorry, Dr. Lewis." "You're gonna see a lot of bad things around here, William, and you're not gonna like them a bit. The ER isn't exactly the safest workplace around." He stomps off to Exam One with a pensive look on his face.