This chapter takes place around the time of "Midnight," starting a week or
so before Graduation day.
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"Uh, Dr. Romano," Abby said tentatively, "As I might have mentioned, I need to take the boards next week, and, um, I was thinking that maybe it would be a better use of my limited time if I stayed home studying, rather than going to the Pediatric Emergency workshop . . ."
Taking in Neela's dubious expression, she asked, "Think he'll buy it?"
"Uh uh," the younger medical student replied, shaking her head sympathetically.
"You're biased. You don't want to be stuck alone with him."
"True," Neela admitted, with an endearing lopsided grin.
The women were waiting near the Admit desk, so that Abby could talk to Romano. He'd finished his shift a while ago, but just when Abby thought he was going to leave, he went into the lounge. Since several other people were in the lounge too, she decided to try to catch him on the way out. No way would he cut her a break with an audience present.
Finally, the lounge door opened, and out came Pratt and Lester, followed by Dr. Romano. Grinning, Pratt slapped Lester on the back and asked loudly, clearly intending to be overheard, "So, how's it feel to whip the 'Big Boss'?"
'Oh great,' Abby lamented to herself, 'Couldn't Lester have lost one stupid chess game? Now Romano will be more pissy than usual.'
Momentarily, Lester's eyes seemed to focus inward. Abby often got the impression that the young man had a lot going on inside his head – some of it quite strange – and he took a moment to pick out what he deemed an appropriate answer. Abby and Neela had become accustomed to this, having learned that his responses were usually worth the wait.
More interested in razzing Romano than in Lester's perceptions, Pratt didn't wait. He went on, "I mean, how's it different than beating the rest of us poor slobs?"
Lester said candidly, "I gloat less."
Romano gave a fleeting grin at the quirky response, but quickly turned it into a scowl, aimed at Pratt, as he walked toward the ambulance bay doors. Abby couldn't tell if he was really mad or just putting on a show, but she decided to take her chances. She caught up with him near the doors. "Dr. Romano," she began, "I, uh, have to take the boards in a few days . . ."
Romano stopped walking, turned to her, and sneered, "Yeah, I remember. I don't know what the hell you were thinking the first time when you punted 'em."
'Can't he at least PRETEND it's not common knowledge around here that I flunked?' Abby thought, sighing. She said, "Well, I'm concerned . . ."
"Don't be," Romano interrupted, "If you've got a modicum of gray matter, they're a snap." Raising his voice a little, he added, "I mean, Pratt passed them – how hard could they be?" smirking when the resident looked over.
"MORRIS must've passed," Romano continued, derisively, then paused as everyone within earshot marveled at this perplexing fact. Spying Luka Kovac, who'd entered through the nearby doors, Romano snarked, "Hell, this guy passed the boards, and I'm not even sure he speaks English."
Luka muttered something in Croatian. Romano narrowed his eyes and demanded, "What?"
Smiling at Abby, Luka responded, "I said, 'I'm sure you'll do fine. Piece of . . . pie." He delivered the last word with a knowing grin that made Abby laugh out loud.
Recovering from her mirth, Abby realized that Romano was getting away. He called to her over his shoulder as he headed out the door, "Don't be late for our road trip tomorrow!"
Crap. Abby briefly considered running after him, but decided against it. She had a sneaking suspicion that the little shit knew exactly what she wanted to ask him, and that this was his way of blowing her off. Turning back toward Neela who was waiting expectantly at the desk, she announced, "I am so screwed."
-OOOOO-
Five days later, on her way back from the workshop, Abby felt somewhat less screwed. She was flopped in the backseat of the rental car, with notes and books spread around her, as Romano drove and Neela dozed in the passenger seat. In a rare show of assertiveness, Neela had laid claim to the passenger seat for most of the trip, so as to keep Romano and Abby from fighting over the radio. Grinning, Abby remembered the panicked look on her friend's face each time Romano let go of the steering wheel to change the station when Abby selected something he didn't like.
Although not as restful as locking herself away at home to study, the trip had provided great opportunities for review. Going into it, Abby felt pretty confident in her knowledge of psychiatry, obstetrics, and emergency medicine. The workshop activities had helped her beef up on pediatrics and related fields, and sharing a hotel room with Neela gave her a chance to pick the whiz kid's brain about everything else. Additionally, Romano supplied clear explanations of trauma diagnoses and surgical procedures whenever she asked, though, of course, he wrapped them in sarcasm.
Dealing with Romano during the workshop proved to be less painful than Abby feared; he'd been rude, but somewhat less obnoxious than usual. She surmised that the intensive workload provided a focus for Romano's manic energy, leaving less available for bullying med students. Amusingly, he was also possessive about his personal punching bags: when another workshop participant picked on Neela, Romano verbally eviscerated the guy, concluding his tirade with, "I get to abuse them; you don't."
Abby had to admit that it was kind of fun to watch, when one isn't on the receiving end.
It was also interesting to watch Romano and the other doctors during the practicum segment, when they worked up clinic patients. Romano was, by far, the least warm-and-fuzzy participant. But Abby was surprised to conclude that, when she was a child, she probably would have preferred his approach: gruff, confident, with just a touch of humor. The oh-so-perky demeanor that some of the other doctors put on – as if a trip to the emergency room was like a trip to the circus – would have freaked her out. Then again, thanks to Maggie, she'd been a bit oversensitive to inappropriate affect.
As Abby mused, the car slowed to a halt, as did all the other cars around them. Romano began grumbling, then swearing colorfully, which woke Neela. They were still a couple of hours from Chicago traffic, with no signs of road construction, so Abby figured the delay was probably due to an accident. There really wasn't much to do but sit back and wait until it was cleared.
Unless, of course, one has the patience of a lit bottle-rocket. Romano first opened the window and craned his neck out, but couldn't see around the SUV ahead of them. Then he put the car in park and got out to stand next to it. Apparently he still couldn't see, so he walked over to the median, stepping onto the grass just in time to avoid being flattened by a pair of ambulances speeding past on the left shoulder of the road.
When he returned to the car, Abby commented, "It was thoughtful of you to leave us the keys before trying to get yourself killed."
Ignoring her, he reported, "Looks like something big, maybe a half-mile ahead. The way the road bends, I can't see clearly."
As Abby pondered, 'What is it with men and their need for instant information about everything?' one of the guys in the SUV ahead of them climbed onto the top of his vehicle. He called down to his buddies, "It's a crash – big yellow school bus and a truck or something."
Romano pulled the car over onto the right shoulder and drove up to a place where an entrance ramp widened the road enough that an emergency vehicle could get around them, if necessary. Though unsure whether he was motivated by humanitarian reasons or by the fact that he couldn't sit still for five minutes, Abby wasn't surprised when he turned off the engine and said, "Well, are you coming?"
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Arriving at the crash site with Neela and Abby trailing behind him, Robert wondered if they were too late to be useful. Several ambulances were already on the scene, their crews treating and evacuating patients. Surprisingly, nobody prevented the trio from wandering around the wreckage, despite the fact that they weren't wearing medical attire. They approached the school bus – which was twisted, nearly broken in half, with a U-Haul truck embedded in its side – and ducked in through the emergency hatch in back.
There was only one passenger left in the bus, a boy in his early teens, wearing a nondescript blue sports uniform. A doctor and an EMT were attending to him. It was obvious why he hadn't been removed with the others: his right arm and leg were pinned where the side of the bus was now compressed to the buckled floor by the U-Haul.
Robert came closer and realized that the boy's limbs were not just pinned, but crushed, mangled within the twisted metal. He felt a chill, but forced himself to maintain clinical detachment in order to assess the situation. The weight of the truck provided pressure, slowing blood loss, but that wouldn't save the kid for long. He needed to be extricated, pronto.
Robert successfully suppressed his emotional response until his gaze reached the boy's face. Dark hair plastered against sweat-slicked pale skin, the kid's eyes were open wide – shocky and scared. Making eye contact, Robert felt himself getting pulled into the same state of mind. Amidst rising panic and nausea, he struggled to think clearly. As if at a distance, he heard the other doctor speaking into a radio, describing the case:
"Fourteen year old male, David Witold, right lower extremity crushed to mid tib-fib, right arm partially amputated, hand and forearm crushed, elbow dislocated and fractured, with compound fractures above and below the joint. Administered blood, fluids and morphine. To evacuate, we'll need to complete the amputation. Beginning disarticulation above the elbow."
Robert hadn't been sure how tuned in David was to what was happening, but the kid blanched even further at the word 'amputation' and started shaking his head. Caught up in his own visceral reaction, it took Robert a moment to fully digest what the other doctor had said. When he did, he objected, "No. No, you're not disarticulating above the elbow. The joint and upper forearm might be salvageable."
The doctor, a young man who looked tired beyond his years, shook his head and replied, "There's too much damage – protruding bone, probably impeded blood flow. It's standard procedure for a field amputation to cut above the damage – deviating would increase risk of complications, and in his condition . . ." He trailed off, pushing his glasses up on his nose, and asked belatedly, "Uh, who ARE you?"
Robert fished his County ID out of his pocket and showed it, at the same time taking a look at the other doctor's ID badge and smirking to himself, 'Hmpf – a resident. I can make short work of him.'
Taking an aggressive posture, Robert got in the other man's face and persisted, "Maybe the joint can't be saved, but hey, here's a novel idea: why don't we let an orthopedic surgeon make that call in an OR, instead of having a second year internal medicine resident decide it in the back of a school bus?"
"But . . ."
"A below-the-elbow procedure will give him much better prosthetic options than above-the-elbow, and I think that's worth a little effort on our part. The only reason you THINK it's higher risk is 'cause you don't know how to do one. Why didn't they send somebody who knows what they're doing?" Despite a few inches of height differential, Robert successfully stared down the younger man.
Sounding rattled, the resident responded, "Uh, I was just doing a ride- along. There'll be a surgeon coming with the chopper, but we can't wait that long to extricate. I, uh, need to talk to my supervisor . . ."
"You go do that," Robert brushed him off. Then, turning on the EMT who was hovering nervously a few feet away, he barked, "You – come here. Make yourself useful. You got gloves?"
As Robert, Neela, and Abby gloved up, Robert smiled smugly at how easily he'd cowed the resident and EMT. It felt a bit like the old days when he enjoyed his reign of terror at County General.
Then David reached up, tugged on Robert's jeans, and begged, "Mister, don't let him cut off my hand. Please!"
Oh damn. Apparently, the kid had grasped that Robert was arguing with the doctor who'd mentioned amputation, but obviously he didn't fully understand the situation. Shoulders losing their cocky set, Robert knelt down next to the kid and said gently, "I'm sorry, son, but your hand is gone. There's nothing we can do about that."
He maintained eye-contact with David, though he desperately wanted to look away, as distress flooded the boy's features. David shook his head in denial for a moment, then his eyes filled with tears and he whispered, "I want my Mom."
Abby pulled out her cell phone and turned it on, but then frowned, "I can't get a signal in here."
Neela suggested, "If you give us the number, we'll call your mother once you're out of here, and she can meet you at the hospital." David complied.
Noticing the boy's vitals fluctuating, Robert said, "I need to put a tube down your throat to help you breathe. First, we'll give you some medicine that will make you sleep . . ."
"No. I wanna be awake."
Quietly, Robert assured him, "No you don't. Trust me, you don't."
David looked at him quizzically, then slowly nodded. Abby pushed the sedative into his IV.
-OOOOO-
Twenty minutes later, Robert was sitting in one of the school bus seats, eyes closed, leaning forward, his forehead pressed against the cushioned back of the seat in front of him. He'd folded himself in there shortly after they loaded David onto the helicopter, and he had no intention of moving until the sound of rotors had completely faded into the distance. And maybe not for a week or two afterward. On the plus side, he was pretty sure that he wasn't going to throw up.
The extrication had gone as well as could be hoped. Under his direction, Neela and Abby kicked ass. Though neither of them had much surgical experience, their rapport with each other under pressure was uncanny. The promised surgeon arrived just as they were finishing. A Tiger Woods of a woman who undoubtedly sent the Affirmative Action officer of her hospital into cartwheels of joy, she nevertheless seemed competent – she surveyed their work approvingly, without challenging Robert's method.
Which was good, because once David was stable and ready for transport, Robert felt his stoic façade crumbling fast, as the impact of what he'd just done caught up with him. The visit from his old friend the chopper hadn't helped matters, either. Not all the emotions he was experiencing now were bad – there was pride and relief at the success of the procedure – but mixed with anxiety and snatches of memory, it was all overwhelming:
. . . please don't let him cut off my hand, mister . . . whirring buzz of the bone saw . . . pieces of a body left behind . . . propeller flashing overhead . . . do we have the arm? . . . across the roof, something familiar yet suddenly alien . . . no don't clamp it, i don't want to live like this . . .
Robert shivered and curled up tighter in the seat. Someone slipped in beside him, and a minute or two later he heard Neela's soft voice near his left shoulder asking, "Dr. Romano, are you alright?"
He nodded, or tried to, the seat-back preventing his head from actually moving much. Eyes still closed, he pushed himself back into the seat and mumbled, "Yeah, I'm fine."
When he opened his eyes, the first thing he saw was Abby's face, peering over the seat-back. Startled, he jumped, almost elbowing Neela with his prosthesis, and swore, "Shit!"
Abby smirked at him. 'When did she become such a little smartass?' he mused, more fondly than he cared to admit.
Still feeling a bit spacey, his thoughts drifted back to the previous day, when they were seeing clinic patients for the workshop:
The third kid in a row had become frightened by Robert's arm, leaving him speculating, cynically, that the workshop coordinators were deliberately funneling timid children his way to test him. This thought pissed him off royally, as it underscored his subordinate position.
At County, less than one in five young kids seriously wigged. And, there, he could pass off those cases to other doctors. He did so, figuring that if the kids were scared and hurting to begin with, they didn't need him making things worse. Here, however, passing them off wasn't an option. So, he let Abby and Neela do the hands-on examinations, sometimes even leaving the room and supervising through the two-way mirror in the adjoining observation room.
This latest child, a mildly developmentally delayed six-year-old named Grace who presented with symptoms of a possible shunt infection, stared at the door he'd exited, as if her constant vigilance could prevent the monster she'd narrowly escaped from barging back in and devouring her. Watching through the mirror, Robert bit his lip, annoyed at himself for letting it get to him.
"Is he coming back?" Grace asked warily.
Neela pursed her lips, shooting a glance toward the mirror, then she smiled and said gently, "If Dr. Romano needs to come back in, he'll knock on the door first, so he won't startle you."
"He's scary," the girl whimpered.
Her mother tried to hush her, but Abby spoke up cheerfully: "He sure is!"
At the others' surprised expressions, she explained with a conspiratorial grin, "He's our boss, and he's kind of grouchy, and he yells at us a lot."
Neela laughed, and Grace looked like she was almost ready to smile. Abby continued, "But I'll tell you a secret: he's much nicer to little kids than to grown-ups. He wouldn't be mean to you."
Grace looked down and murmured, "His hand is scary."
Over the mother's embarrassed politically correct noises, Abby explained, "Dr. Romano lost his real hand in an accident. He uses the plastic one to help him work."
"It made a weird noise."
"That's because it's got a motor inside, like a robot. Cool, huh? But don't worry, it only does what he tells it to do, so it can't hurt you."
Grace didn't seem convinced that this was "cool," but Robert noted that she'd calmed down considerably. When he re-entered the room, she watched him apprehensively, but did NOT do the thing he dreaded most from pediatric patients: burst into tears.
After Grace and her mother departed, he regarded Abby with upraised eyebrows. She shrugged and said dryly, "I decided that little Gracie didn't need to know about your ass-grabbing phase."
Back in the school bus, seemingly apropos of nothing, Robert giggled. Abby looked him over appraisingly, then held out her hand and said, "Keys?"
Though annoyed at her tone, Robert concurred with her assessment that there was no way he should be operating a moving vehicle. He fumbled a bit before managing to put the car keys into her outstretched hand. Then he held out his upturned palm in a similar gesture, and sighed, "Cell phone?"
As Abby and Neela went off to fetch the car, Robert climbed out of the bus and leaned against it. He drew in a deep breath, mentally bracing himself, then slowly dialed David's number.
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The day before Graduation . . .
Neela Rasgotra was in a corridor off the ER, trying to gather 19 of her closest relatives into a cohesive group. They'd insisted on the grand tour, but escorting so many people without letting them get in the way of the staff was quite a challenge. Honestly, it was like herding cats. In passing, she caught Gallant's eye. He shot her an amused but understanding smile that melted the edges off her stress.
Most of her stress, of course, had nothing to do with her adequacy as a tour guide. She hadn't yet told her parents about her decision to withdraw from the residency match. She dreaded even broaching the subject. Of course, that was part of the problem. She needed to figure out whether she was pursuing a career in medicine for them, or for herself. Some of her rotations, such as the pediatric surgery rotation she'd just completed, had been terrific. But she was disturbed by how easily she was thrown when things didn't go her way – such as in NICU and Geriatrics. Maybe that meant that she wasn't really committed to being a doctor. Maybe it meant nothing. But she owed it to herself to sort this out before proceeding.
Trying to psych herself up, she murmured, "How bad can it be?"
Bad.
She recalled Dr. Romano's reaction a couple of weeks ago, when she told him that she was having second thoughts about her career choice. He blew up at her. It wasn't pretty. Still, Neela knew that his response was as much about him as it was about her. He took a certain amount of vicarious pleasure in nurturing her surgical career; she was threatening that. Understanding this made his wrath both easier and harder to endure.
To his credit, he handled things better the next day. He apologized for being so hard on her, and grudgingly admitted that if she had to "flake out", this was a good time to do it – after medical school but before she committed herself to several years of a residency program. He advised her to withdraw from the match unless she was reasonably certain she could go through with a placement. Taking a year off wasn't nearly as bad as quitting an internship, which would raise red flags for any future matches.
Dr. Romano was obviously hoping that she would eventually come to her senses and go back to medicine, and was trying to make things easier for her when that happened. Neela supposed she should find this presumptuous, but it was actually kind of reassuring that someone was thinking about the practical details while she struggled with her professional crisis. And the approval-seeking little girl in her – the one she was trying hard to squash – was glad that he still liked her.
After taking a quick head-count, Neela guided her family into the Admit area and pointed out people as if they were tourist attractions, narrating, "This is Jerry. He makes this whole place work, and he's very large. That's Frank. He works with Jerry and recently had a massive heart attack and shouldn't be eating that donut . . ."
Incongruously, Frank smiled like a kid caught with his hand in the cookie jar. As the group proceeded past the translucent board, Neela continued, "Here is Dr. Romano. He's the director of the Department. You'll meet him at dinner tomorrow, at which time he's promised not to embarrass me too much."
Neela's voice rose in a slightly pleading tone at the end of the last sentence. Her mentor's evil grin was not reassuring. But before she could dwell on this, another "attraction" presented itself:
"And this is a naked patient. Now if you'll come this way . . ."
-OOOOO-
After the ceremony . . .
Neela sat pensively on the bench of her favorite "sulking place" near the hospital wall. She knew that her family was waiting to take her to dinner to celebrate her accomplishment, but she needed a few minutes to herself first.
'It's over. I'm officially a doctor. Bloody marvelous.'
It was hard to believe that, yesterday, her greatest worry was how to break the news to her parents that she'd withdrawn from the residency match. Now, this concern was dwarfed by a much more important worry.
Suddenly, she wasn't alone. Dr. Romano ducked around the wall, irritatingly buoyant, and exclaimed, "There you are! I've got a whole tribe of hungry Injuns looking for you . . ."
He smirked at her pained expression. Then he studied her more closely and his smirk faded. "What's wrong? Dad disown you?"
"No," she responded, "I haven't told them yet."
He cocked his head inquisitively at her.
She blurted out, "Michael's been called up for service in Iraq. He's due in Texas in two weeks."
Michael had received the notice yesterday, but, in typically "gallant" fashion, wanted to let her enjoy her graduation day before telling her. Then her family started hinting that they might change their flight home, lengthening their visit, so she had to know. He showed her the letter right after the ceremony.
Neela thought she saw sadness tugging at the corners of Dr. Romano's mouth for a moment. Then he looked at her sideways with a glimmer of mischief and said, "And you're all broken up about this on account of he's such a nice guy . . . ?"
She smiled a little and admitted, "We've been seeing each other for a couple of months now. I know the administration doesn't approve of residents having relationships with med students, but we were very careful to make sure that he was never directly supervising me – a lot of the time I was on my pediatric surgery rotation anyway."
Romano's expression was unreadable. She fretted, "I know we should have informed . . ."
Cutting her off, he broke into a grin and chuckled, "A discreet relationship. At County! I don't think anyone's ever done that before."
Neela smiled, glad that he wasn't angry.
He went on, taunting, "No 'snogging' in the exam rooms? . . . No snit fits, hurling supplies at him when he looks at another woman? . . . No quickies in the handicapped restroom?"
Blushing furiously, Neela stammered, "Of course not."
"Well, that's gotta be a first," he laughed.
Seeing how thoroughly he was enjoying her embarrassment, she said, "I take it back. I'm not sorry I didn't inform you sooner."
"Heh. Yeah, I could've tormented the two of you for weeks."
This remark brought home how little time she and Michael had left together, and how much she feared for his future. Romano must have read this on her face, because he went on, still teasing but more kindly: "I'm not sure, but I think the casualty rate in Iraq is actually a bit lower than at County."
As they walked back into the hospital, she shook her head ruefully, smiling at his weird attempt to comfort her. In companionable silence, they walked toward the area where her family was waiting.
Michael appeared in the hallway ahead of them, probably looking for her. He seemed a little harried. She'd introduced him to her family as her boyfriend, then left him to fend for himself with them. Oh dear. She felt guilty about that, but then he noticed her and his face lit up with a perfect smile; she forgot all her cares and found herself beaming back at him.
The spell was broken by Dr. Romano's voice from beside her, calling out, "Hey, G.I. Joe – I promise to torture Pratt if he hits on her."
Tearing his gaze away from Neela, Gallant grinned and obligingly offered the straight line, "Uh, so, what'll you do if he doesn't hit on her?"
"Torture Pratt."
Neela in the middle, the three doctors proceeded in the direction of the cacophony of voices that heralded Neela's extended family.
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Author's notes: Thanks for continuing to review, even though my updating speed is slow as molasses! Yes, tv-crazy, in chapter 13 the reason I had Robert say "Mum" was for Ella's sake. Sorry you found it distracting, kimbari. I'm a yank, so I'm sure I do muck up british-isms sometimes!
Obviously, in this chapter, I'm playing around with the order of events as they happened on the show. But I think my changes make sense. My theory is that the army would not have called Gallant to active duty so conveniently after the Demerol fiasco, unless he requested it and they were planning on calling him up soon anyway – like at the end of his internship. Furthermore, I think that if Neela had Romano mentoring her, albeit imperfectly, not only would the Demerol fiasco never have happened (can you imagine Romano telling a medical student that she's a doctor for a day? Ha!), but she might also have been a little more proactive in dealing with her residency qualms.
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"Uh, Dr. Romano," Abby said tentatively, "As I might have mentioned, I need to take the boards next week, and, um, I was thinking that maybe it would be a better use of my limited time if I stayed home studying, rather than going to the Pediatric Emergency workshop . . ."
Taking in Neela's dubious expression, she asked, "Think he'll buy it?"
"Uh uh," the younger medical student replied, shaking her head sympathetically.
"You're biased. You don't want to be stuck alone with him."
"True," Neela admitted, with an endearing lopsided grin.
The women were waiting near the Admit desk, so that Abby could talk to Romano. He'd finished his shift a while ago, but just when Abby thought he was going to leave, he went into the lounge. Since several other people were in the lounge too, she decided to try to catch him on the way out. No way would he cut her a break with an audience present.
Finally, the lounge door opened, and out came Pratt and Lester, followed by Dr. Romano. Grinning, Pratt slapped Lester on the back and asked loudly, clearly intending to be overheard, "So, how's it feel to whip the 'Big Boss'?"
'Oh great,' Abby lamented to herself, 'Couldn't Lester have lost one stupid chess game? Now Romano will be more pissy than usual.'
Momentarily, Lester's eyes seemed to focus inward. Abby often got the impression that the young man had a lot going on inside his head – some of it quite strange – and he took a moment to pick out what he deemed an appropriate answer. Abby and Neela had become accustomed to this, having learned that his responses were usually worth the wait.
More interested in razzing Romano than in Lester's perceptions, Pratt didn't wait. He went on, "I mean, how's it different than beating the rest of us poor slobs?"
Lester said candidly, "I gloat less."
Romano gave a fleeting grin at the quirky response, but quickly turned it into a scowl, aimed at Pratt, as he walked toward the ambulance bay doors. Abby couldn't tell if he was really mad or just putting on a show, but she decided to take her chances. She caught up with him near the doors. "Dr. Romano," she began, "I, uh, have to take the boards in a few days . . ."
Romano stopped walking, turned to her, and sneered, "Yeah, I remember. I don't know what the hell you were thinking the first time when you punted 'em."
'Can't he at least PRETEND it's not common knowledge around here that I flunked?' Abby thought, sighing. She said, "Well, I'm concerned . . ."
"Don't be," Romano interrupted, "If you've got a modicum of gray matter, they're a snap." Raising his voice a little, he added, "I mean, Pratt passed them – how hard could they be?" smirking when the resident looked over.
"MORRIS must've passed," Romano continued, derisively, then paused as everyone within earshot marveled at this perplexing fact. Spying Luka Kovac, who'd entered through the nearby doors, Romano snarked, "Hell, this guy passed the boards, and I'm not even sure he speaks English."
Luka muttered something in Croatian. Romano narrowed his eyes and demanded, "What?"
Smiling at Abby, Luka responded, "I said, 'I'm sure you'll do fine. Piece of . . . pie." He delivered the last word with a knowing grin that made Abby laugh out loud.
Recovering from her mirth, Abby realized that Romano was getting away. He called to her over his shoulder as he headed out the door, "Don't be late for our road trip tomorrow!"
Crap. Abby briefly considered running after him, but decided against it. She had a sneaking suspicion that the little shit knew exactly what she wanted to ask him, and that this was his way of blowing her off. Turning back toward Neela who was waiting expectantly at the desk, she announced, "I am so screwed."
-OOOOO-
Five days later, on her way back from the workshop, Abby felt somewhat less screwed. She was flopped in the backseat of the rental car, with notes and books spread around her, as Romano drove and Neela dozed in the passenger seat. In a rare show of assertiveness, Neela had laid claim to the passenger seat for most of the trip, so as to keep Romano and Abby from fighting over the radio. Grinning, Abby remembered the panicked look on her friend's face each time Romano let go of the steering wheel to change the station when Abby selected something he didn't like.
Although not as restful as locking herself away at home to study, the trip had provided great opportunities for review. Going into it, Abby felt pretty confident in her knowledge of psychiatry, obstetrics, and emergency medicine. The workshop activities had helped her beef up on pediatrics and related fields, and sharing a hotel room with Neela gave her a chance to pick the whiz kid's brain about everything else. Additionally, Romano supplied clear explanations of trauma diagnoses and surgical procedures whenever she asked, though, of course, he wrapped them in sarcasm.
Dealing with Romano during the workshop proved to be less painful than Abby feared; he'd been rude, but somewhat less obnoxious than usual. She surmised that the intensive workload provided a focus for Romano's manic energy, leaving less available for bullying med students. Amusingly, he was also possessive about his personal punching bags: when another workshop participant picked on Neela, Romano verbally eviscerated the guy, concluding his tirade with, "I get to abuse them; you don't."
Abby had to admit that it was kind of fun to watch, when one isn't on the receiving end.
It was also interesting to watch Romano and the other doctors during the practicum segment, when they worked up clinic patients. Romano was, by far, the least warm-and-fuzzy participant. But Abby was surprised to conclude that, when she was a child, she probably would have preferred his approach: gruff, confident, with just a touch of humor. The oh-so-perky demeanor that some of the other doctors put on – as if a trip to the emergency room was like a trip to the circus – would have freaked her out. Then again, thanks to Maggie, she'd been a bit oversensitive to inappropriate affect.
As Abby mused, the car slowed to a halt, as did all the other cars around them. Romano began grumbling, then swearing colorfully, which woke Neela. They were still a couple of hours from Chicago traffic, with no signs of road construction, so Abby figured the delay was probably due to an accident. There really wasn't much to do but sit back and wait until it was cleared.
Unless, of course, one has the patience of a lit bottle-rocket. Romano first opened the window and craned his neck out, but couldn't see around the SUV ahead of them. Then he put the car in park and got out to stand next to it. Apparently he still couldn't see, so he walked over to the median, stepping onto the grass just in time to avoid being flattened by a pair of ambulances speeding past on the left shoulder of the road.
When he returned to the car, Abby commented, "It was thoughtful of you to leave us the keys before trying to get yourself killed."
Ignoring her, he reported, "Looks like something big, maybe a half-mile ahead. The way the road bends, I can't see clearly."
As Abby pondered, 'What is it with men and their need for instant information about everything?' one of the guys in the SUV ahead of them climbed onto the top of his vehicle. He called down to his buddies, "It's a crash – big yellow school bus and a truck or something."
Romano pulled the car over onto the right shoulder and drove up to a place where an entrance ramp widened the road enough that an emergency vehicle could get around them, if necessary. Though unsure whether he was motivated by humanitarian reasons or by the fact that he couldn't sit still for five minutes, Abby wasn't surprised when he turned off the engine and said, "Well, are you coming?"
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Arriving at the crash site with Neela and Abby trailing behind him, Robert wondered if they were too late to be useful. Several ambulances were already on the scene, their crews treating and evacuating patients. Surprisingly, nobody prevented the trio from wandering around the wreckage, despite the fact that they weren't wearing medical attire. They approached the school bus – which was twisted, nearly broken in half, with a U-Haul truck embedded in its side – and ducked in through the emergency hatch in back.
There was only one passenger left in the bus, a boy in his early teens, wearing a nondescript blue sports uniform. A doctor and an EMT were attending to him. It was obvious why he hadn't been removed with the others: his right arm and leg were pinned where the side of the bus was now compressed to the buckled floor by the U-Haul.
Robert came closer and realized that the boy's limbs were not just pinned, but crushed, mangled within the twisted metal. He felt a chill, but forced himself to maintain clinical detachment in order to assess the situation. The weight of the truck provided pressure, slowing blood loss, but that wouldn't save the kid for long. He needed to be extricated, pronto.
Robert successfully suppressed his emotional response until his gaze reached the boy's face. Dark hair plastered against sweat-slicked pale skin, the kid's eyes were open wide – shocky and scared. Making eye contact, Robert felt himself getting pulled into the same state of mind. Amidst rising panic and nausea, he struggled to think clearly. As if at a distance, he heard the other doctor speaking into a radio, describing the case:
"Fourteen year old male, David Witold, right lower extremity crushed to mid tib-fib, right arm partially amputated, hand and forearm crushed, elbow dislocated and fractured, with compound fractures above and below the joint. Administered blood, fluids and morphine. To evacuate, we'll need to complete the amputation. Beginning disarticulation above the elbow."
Robert hadn't been sure how tuned in David was to what was happening, but the kid blanched even further at the word 'amputation' and started shaking his head. Caught up in his own visceral reaction, it took Robert a moment to fully digest what the other doctor had said. When he did, he objected, "No. No, you're not disarticulating above the elbow. The joint and upper forearm might be salvageable."
The doctor, a young man who looked tired beyond his years, shook his head and replied, "There's too much damage – protruding bone, probably impeded blood flow. It's standard procedure for a field amputation to cut above the damage – deviating would increase risk of complications, and in his condition . . ." He trailed off, pushing his glasses up on his nose, and asked belatedly, "Uh, who ARE you?"
Robert fished his County ID out of his pocket and showed it, at the same time taking a look at the other doctor's ID badge and smirking to himself, 'Hmpf – a resident. I can make short work of him.'
Taking an aggressive posture, Robert got in the other man's face and persisted, "Maybe the joint can't be saved, but hey, here's a novel idea: why don't we let an orthopedic surgeon make that call in an OR, instead of having a second year internal medicine resident decide it in the back of a school bus?"
"But . . ."
"A below-the-elbow procedure will give him much better prosthetic options than above-the-elbow, and I think that's worth a little effort on our part. The only reason you THINK it's higher risk is 'cause you don't know how to do one. Why didn't they send somebody who knows what they're doing?" Despite a few inches of height differential, Robert successfully stared down the younger man.
Sounding rattled, the resident responded, "Uh, I was just doing a ride- along. There'll be a surgeon coming with the chopper, but we can't wait that long to extricate. I, uh, need to talk to my supervisor . . ."
"You go do that," Robert brushed him off. Then, turning on the EMT who was hovering nervously a few feet away, he barked, "You – come here. Make yourself useful. You got gloves?"
As Robert, Neela, and Abby gloved up, Robert smiled smugly at how easily he'd cowed the resident and EMT. It felt a bit like the old days when he enjoyed his reign of terror at County General.
Then David reached up, tugged on Robert's jeans, and begged, "Mister, don't let him cut off my hand. Please!"
Oh damn. Apparently, the kid had grasped that Robert was arguing with the doctor who'd mentioned amputation, but obviously he didn't fully understand the situation. Shoulders losing their cocky set, Robert knelt down next to the kid and said gently, "I'm sorry, son, but your hand is gone. There's nothing we can do about that."
He maintained eye-contact with David, though he desperately wanted to look away, as distress flooded the boy's features. David shook his head in denial for a moment, then his eyes filled with tears and he whispered, "I want my Mom."
Abby pulled out her cell phone and turned it on, but then frowned, "I can't get a signal in here."
Neela suggested, "If you give us the number, we'll call your mother once you're out of here, and she can meet you at the hospital." David complied.
Noticing the boy's vitals fluctuating, Robert said, "I need to put a tube down your throat to help you breathe. First, we'll give you some medicine that will make you sleep . . ."
"No. I wanna be awake."
Quietly, Robert assured him, "No you don't. Trust me, you don't."
David looked at him quizzically, then slowly nodded. Abby pushed the sedative into his IV.
-OOOOO-
Twenty minutes later, Robert was sitting in one of the school bus seats, eyes closed, leaning forward, his forehead pressed against the cushioned back of the seat in front of him. He'd folded himself in there shortly after they loaded David onto the helicopter, and he had no intention of moving until the sound of rotors had completely faded into the distance. And maybe not for a week or two afterward. On the plus side, he was pretty sure that he wasn't going to throw up.
The extrication had gone as well as could be hoped. Under his direction, Neela and Abby kicked ass. Though neither of them had much surgical experience, their rapport with each other under pressure was uncanny. The promised surgeon arrived just as they were finishing. A Tiger Woods of a woman who undoubtedly sent the Affirmative Action officer of her hospital into cartwheels of joy, she nevertheless seemed competent – she surveyed their work approvingly, without challenging Robert's method.
Which was good, because once David was stable and ready for transport, Robert felt his stoic façade crumbling fast, as the impact of what he'd just done caught up with him. The visit from his old friend the chopper hadn't helped matters, either. Not all the emotions he was experiencing now were bad – there was pride and relief at the success of the procedure – but mixed with anxiety and snatches of memory, it was all overwhelming:
. . . please don't let him cut off my hand, mister . . . whirring buzz of the bone saw . . . pieces of a body left behind . . . propeller flashing overhead . . . do we have the arm? . . . across the roof, something familiar yet suddenly alien . . . no don't clamp it, i don't want to live like this . . .
Robert shivered and curled up tighter in the seat. Someone slipped in beside him, and a minute or two later he heard Neela's soft voice near his left shoulder asking, "Dr. Romano, are you alright?"
He nodded, or tried to, the seat-back preventing his head from actually moving much. Eyes still closed, he pushed himself back into the seat and mumbled, "Yeah, I'm fine."
When he opened his eyes, the first thing he saw was Abby's face, peering over the seat-back. Startled, he jumped, almost elbowing Neela with his prosthesis, and swore, "Shit!"
Abby smirked at him. 'When did she become such a little smartass?' he mused, more fondly than he cared to admit.
Still feeling a bit spacey, his thoughts drifted back to the previous day, when they were seeing clinic patients for the workshop:
The third kid in a row had become frightened by Robert's arm, leaving him speculating, cynically, that the workshop coordinators were deliberately funneling timid children his way to test him. This thought pissed him off royally, as it underscored his subordinate position.
At County, less than one in five young kids seriously wigged. And, there, he could pass off those cases to other doctors. He did so, figuring that if the kids were scared and hurting to begin with, they didn't need him making things worse. Here, however, passing them off wasn't an option. So, he let Abby and Neela do the hands-on examinations, sometimes even leaving the room and supervising through the two-way mirror in the adjoining observation room.
This latest child, a mildly developmentally delayed six-year-old named Grace who presented with symptoms of a possible shunt infection, stared at the door he'd exited, as if her constant vigilance could prevent the monster she'd narrowly escaped from barging back in and devouring her. Watching through the mirror, Robert bit his lip, annoyed at himself for letting it get to him.
"Is he coming back?" Grace asked warily.
Neela pursed her lips, shooting a glance toward the mirror, then she smiled and said gently, "If Dr. Romano needs to come back in, he'll knock on the door first, so he won't startle you."
"He's scary," the girl whimpered.
Her mother tried to hush her, but Abby spoke up cheerfully: "He sure is!"
At the others' surprised expressions, she explained with a conspiratorial grin, "He's our boss, and he's kind of grouchy, and he yells at us a lot."
Neela laughed, and Grace looked like she was almost ready to smile. Abby continued, "But I'll tell you a secret: he's much nicer to little kids than to grown-ups. He wouldn't be mean to you."
Grace looked down and murmured, "His hand is scary."
Over the mother's embarrassed politically correct noises, Abby explained, "Dr. Romano lost his real hand in an accident. He uses the plastic one to help him work."
"It made a weird noise."
"That's because it's got a motor inside, like a robot. Cool, huh? But don't worry, it only does what he tells it to do, so it can't hurt you."
Grace didn't seem convinced that this was "cool," but Robert noted that she'd calmed down considerably. When he re-entered the room, she watched him apprehensively, but did NOT do the thing he dreaded most from pediatric patients: burst into tears.
After Grace and her mother departed, he regarded Abby with upraised eyebrows. She shrugged and said dryly, "I decided that little Gracie didn't need to know about your ass-grabbing phase."
Back in the school bus, seemingly apropos of nothing, Robert giggled. Abby looked him over appraisingly, then held out her hand and said, "Keys?"
Though annoyed at her tone, Robert concurred with her assessment that there was no way he should be operating a moving vehicle. He fumbled a bit before managing to put the car keys into her outstretched hand. Then he held out his upturned palm in a similar gesture, and sighed, "Cell phone?"
As Abby and Neela went off to fetch the car, Robert climbed out of the bus and leaned against it. He drew in a deep breath, mentally bracing himself, then slowly dialed David's number.
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The day before Graduation . . .
Neela Rasgotra was in a corridor off the ER, trying to gather 19 of her closest relatives into a cohesive group. They'd insisted on the grand tour, but escorting so many people without letting them get in the way of the staff was quite a challenge. Honestly, it was like herding cats. In passing, she caught Gallant's eye. He shot her an amused but understanding smile that melted the edges off her stress.
Most of her stress, of course, had nothing to do with her adequacy as a tour guide. She hadn't yet told her parents about her decision to withdraw from the residency match. She dreaded even broaching the subject. Of course, that was part of the problem. She needed to figure out whether she was pursuing a career in medicine for them, or for herself. Some of her rotations, such as the pediatric surgery rotation she'd just completed, had been terrific. But she was disturbed by how easily she was thrown when things didn't go her way – such as in NICU and Geriatrics. Maybe that meant that she wasn't really committed to being a doctor. Maybe it meant nothing. But she owed it to herself to sort this out before proceeding.
Trying to psych herself up, she murmured, "How bad can it be?"
Bad.
She recalled Dr. Romano's reaction a couple of weeks ago, when she told him that she was having second thoughts about her career choice. He blew up at her. It wasn't pretty. Still, Neela knew that his response was as much about him as it was about her. He took a certain amount of vicarious pleasure in nurturing her surgical career; she was threatening that. Understanding this made his wrath both easier and harder to endure.
To his credit, he handled things better the next day. He apologized for being so hard on her, and grudgingly admitted that if she had to "flake out", this was a good time to do it – after medical school but before she committed herself to several years of a residency program. He advised her to withdraw from the match unless she was reasonably certain she could go through with a placement. Taking a year off wasn't nearly as bad as quitting an internship, which would raise red flags for any future matches.
Dr. Romano was obviously hoping that she would eventually come to her senses and go back to medicine, and was trying to make things easier for her when that happened. Neela supposed she should find this presumptuous, but it was actually kind of reassuring that someone was thinking about the practical details while she struggled with her professional crisis. And the approval-seeking little girl in her – the one she was trying hard to squash – was glad that he still liked her.
After taking a quick head-count, Neela guided her family into the Admit area and pointed out people as if they were tourist attractions, narrating, "This is Jerry. He makes this whole place work, and he's very large. That's Frank. He works with Jerry and recently had a massive heart attack and shouldn't be eating that donut . . ."
Incongruously, Frank smiled like a kid caught with his hand in the cookie jar. As the group proceeded past the translucent board, Neela continued, "Here is Dr. Romano. He's the director of the Department. You'll meet him at dinner tomorrow, at which time he's promised not to embarrass me too much."
Neela's voice rose in a slightly pleading tone at the end of the last sentence. Her mentor's evil grin was not reassuring. But before she could dwell on this, another "attraction" presented itself:
"And this is a naked patient. Now if you'll come this way . . ."
-OOOOO-
After the ceremony . . .
Neela sat pensively on the bench of her favorite "sulking place" near the hospital wall. She knew that her family was waiting to take her to dinner to celebrate her accomplishment, but she needed a few minutes to herself first.
'It's over. I'm officially a doctor. Bloody marvelous.'
It was hard to believe that, yesterday, her greatest worry was how to break the news to her parents that she'd withdrawn from the residency match. Now, this concern was dwarfed by a much more important worry.
Suddenly, she wasn't alone. Dr. Romano ducked around the wall, irritatingly buoyant, and exclaimed, "There you are! I've got a whole tribe of hungry Injuns looking for you . . ."
He smirked at her pained expression. Then he studied her more closely and his smirk faded. "What's wrong? Dad disown you?"
"No," she responded, "I haven't told them yet."
He cocked his head inquisitively at her.
She blurted out, "Michael's been called up for service in Iraq. He's due in Texas in two weeks."
Michael had received the notice yesterday, but, in typically "gallant" fashion, wanted to let her enjoy her graduation day before telling her. Then her family started hinting that they might change their flight home, lengthening their visit, so she had to know. He showed her the letter right after the ceremony.
Neela thought she saw sadness tugging at the corners of Dr. Romano's mouth for a moment. Then he looked at her sideways with a glimmer of mischief and said, "And you're all broken up about this on account of he's such a nice guy . . . ?"
She smiled a little and admitted, "We've been seeing each other for a couple of months now. I know the administration doesn't approve of residents having relationships with med students, but we were very careful to make sure that he was never directly supervising me – a lot of the time I was on my pediatric surgery rotation anyway."
Romano's expression was unreadable. She fretted, "I know we should have informed . . ."
Cutting her off, he broke into a grin and chuckled, "A discreet relationship. At County! I don't think anyone's ever done that before."
Neela smiled, glad that he wasn't angry.
He went on, taunting, "No 'snogging' in the exam rooms? . . . No snit fits, hurling supplies at him when he looks at another woman? . . . No quickies in the handicapped restroom?"
Blushing furiously, Neela stammered, "Of course not."
"Well, that's gotta be a first," he laughed.
Seeing how thoroughly he was enjoying her embarrassment, she said, "I take it back. I'm not sorry I didn't inform you sooner."
"Heh. Yeah, I could've tormented the two of you for weeks."
This remark brought home how little time she and Michael had left together, and how much she feared for his future. Romano must have read this on her face, because he went on, still teasing but more kindly: "I'm not sure, but I think the casualty rate in Iraq is actually a bit lower than at County."
As they walked back into the hospital, she shook her head ruefully, smiling at his weird attempt to comfort her. In companionable silence, they walked toward the area where her family was waiting.
Michael appeared in the hallway ahead of them, probably looking for her. He seemed a little harried. She'd introduced him to her family as her boyfriend, then left him to fend for himself with them. Oh dear. She felt guilty about that, but then he noticed her and his face lit up with a perfect smile; she forgot all her cares and found herself beaming back at him.
The spell was broken by Dr. Romano's voice from beside her, calling out, "Hey, G.I. Joe – I promise to torture Pratt if he hits on her."
Tearing his gaze away from Neela, Gallant grinned and obligingly offered the straight line, "Uh, so, what'll you do if he doesn't hit on her?"
"Torture Pratt."
Neela in the middle, the three doctors proceeded in the direction of the cacophony of voices that heralded Neela's extended family.
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Author's notes: Thanks for continuing to review, even though my updating speed is slow as molasses! Yes, tv-crazy, in chapter 13 the reason I had Robert say "Mum" was for Ella's sake. Sorry you found it distracting, kimbari. I'm a yank, so I'm sure I do muck up british-isms sometimes!
Obviously, in this chapter, I'm playing around with the order of events as they happened on the show. But I think my changes make sense. My theory is that the army would not have called Gallant to active duty so conveniently after the Demerol fiasco, unless he requested it and they were planning on calling him up soon anyway – like at the end of his internship. Furthermore, I think that if Neela had Romano mentoring her, albeit imperfectly, not only would the Demerol fiasco never have happened (can you imagine Romano telling a medical student that she's a doctor for a day? Ha!), but she might also have been a little more proactive in dealing with her residency qualms.