Jane opened her eyes and immediately registered that something was different. The room was light. It was usually dark when she got up in the morning these days. She looked at the clock. 7:10.
"Damn!" She was late. She had forgotten to set the alarm, and too many busy days and too many late nights studying had finally caught up with her.
Jumping out of bed, Jane pulled on her clothes, ran a quick brush through her hair and, putting on her coat and mittens as she ran, was out the door by 7:13 and hurrying down the snowy sidewalk
For the first time since starting her med students rotations last year, Jane looked forward to going in to work. She hated being late. She didn't want to miss a single minute of her ER rotation and, more important, she didn't want to disappoint Dr. Kovač .
Dr. Kovač. Jane smiled to herself. He had made all the difference. She could see his smile, feel the touch of his hand against hers as he guided her in some new procedure. She could hear his voice, 'That's it Jane ... excellent ... " and then the smile again, which she could never help but return.
How could her life have changed so much in one short week? A week ago she'd been just Invisible Jane. Unnoticed, barely tolerated by whichever resident or intern had the bad luck to get stuck with her that day.
But suddenly, Dr. Kovač had taken an interest in her. The first day she'd thought it was a fluke, just some long overdue good luck. Dr. Pratt was busy, he'd told her, she would work with him. But the next day it had happened again, and the next.
He was just teaching her, of course. She was a promising medical student and he was trying to help. That was all. He'd never been anything but professional with her, never asked her about her personal life or talked to her about his. But she could dream ... dream big. She knew she wasn't imagining it that his smiles were warmer, his eyes brighter when he spoke to her than to anyone else. And everyone in the ER knew that things were not going well between him and Sam. When they worked together on a case the tension in the room was obvious. And then he would look at her, and smile, and relax again.
Realization struck her suddenly, dizzying. Of course he was professional with her. He was her supervisor. As long as she was on her ER rotation he couldn't be anything more to her than a teacher, a mentor. The rules on that subject were very clear. But in another two weeks her rotation would be finished. She would move onto neurology, and Luka would no longer be her supervisor. Then things would change. Their relationship would change. Why hadn't she thought of it before? Suddenly Jane was counting the days until the end of her rotation. She wanted out of the ER, so she ... and Luka ... would be free to move onto something better for both of them. He was much older than her, she knew that. But Sam was only a year or two older than she was. And Abby ... she'd heard the rumors that they had dated a few years back. Abby was only a year older than she was, an intern. Luka liked younger women. And he liked her. It was hard to believe, but he obviously liked her.
Jane was snapped from her thoughts by the feel of her foot against a slick patch on the curb. She skidded awkwardly and a moment later was sprawled on the pavement.
She lay for a moment getting her breath back, then got slow to her knees, wincing, and then to her feet. "Fall to outstretched hand..." How many of those had she seen on her ER rotation so far? As often as not it meant a sprained or broken wrist. But no, her wrists were a bit sore, but not sprained and certainly not broken. Her mittens had protected her hands from the rough blacktop. But ... damn it ... the left knee of her jeans was ripped open. Jane folded the torn flap of fabric over and looked at it. She was good with suturing skin, but she'd never sewn denim before. She would have to learn. She couldn't go to work with torn pants, and she only had one other pair.
Limping slightly, Jane hurried as best she could the last 50 yards across the ambulance bay and into the warmth of the ER.
The other medical students were already gathered at admit for their morning meeting. 7:25. Pulling off her coat and mittens, Jane quickly joined them. Dr. Pratt was there, describing some interesting case from the night shift, and Dr. Kovač was there too.
"You're late, Jane," Dr. Pratt said, and, at the same moment, Dr. Kovač said, "We were worried, Jane."
Jane addressed her answer to Luka. "I overslept. I'm sorry, it won't happen again."
"It happens," Luka said with a smile. And a glare from Dr. Pratt as he continued describing the SSRI overdose and how it was treated. Jane tried to listen, it was interesting, but a moment later Luka interrupted again. "You're bleeding!"
Jane was startled. "What?"
"Your knees."
She looked down. She hadn't even noticed that she'd skinned both knees, her concern had been for her pants. But the fabric was now not only torn, but bloodstained, and the stains were spreading. She shook her head. "It's nothing. I'm ok. I slipped on some ice."
"Did you hurt yourself?"
"Just skinned my knees. They're fine." Jane couldn't tell him that she was more worried about the pants than the knees.
"Well, go get cleaned up and grab yourself some scrub pants from the storage room."
"But the meeting..."
"I'll fill you in later." Another one of his warm smiles, and again, Jane found herself smiling back through her pain and worry.
xxxxxxxxxxxxxxxxxx
The morning flew by, with Dr. Kovač seeing that every new chart and ambulance arrival provided Jane with a new diagnosis to observe, a new skill to learn, or, at minimum, at old one to practice. Carbon monoxide poisoning, kidney stones, fractured ribs and shattered ankles. A baby with possible meningitis; he let her do the LP, she'd done them on adults before, but never on a such a tiny patient.
At around 1 the morning flood of patients had slowed to a trickle. "Why don't you go grab some lunch, Jane?"
"I'm not really hungry yet," Jane said.
"It's slow. Haven't you learned yet to take advantage of slow times to take care of yourself? I need to catch up on my charting. By the time you get back there should be some new patients for you."
"Ok," Jane agreed reluctantly, and headed for the elevators. She would spend 15 or 20 minutes walking the halls, sitting in the bathroom, riding the elevators. She couldn't tell him that she had no money for lunch. With her grocery budget at a tight 10 dollars a week, cafeteria meals were out of the question. Her first few weeks on rotations she had brought peanut butter and crackers, or an apple for lunch. But she'd quickly found that packing a lunch, especially such a scanty one, was even more noticeable, and embarrassing, than simply going without. Her supervisors rarely noticed that she hadn't taken a lunch break, or, if they insisted, she would simply leave the department for a while. It wasn't as if anyone ever offered to eat with her.
After 20 minutes, Jane returned to the ER. Her stomach was tight with hunger, but she was used to that. She was eager to get back to work, eager to spend more time with Luka. She found him in exam 2. He greeted her with his usual smile.
"That was fast," he said.
Jane shrugged. "No lines."
"Well, I'm glad you're back. This is Raul Fernandez, 8 years old. Exertional dyspnea and swelling in his wrists and ankles. Neither he nor his mother speaks much English. Your Spanish is pretty good so why don't you finish the HP. I need to check on a few patients. When I come back you can give me your assessment."
"Ok." Jane turned to her patient. "Hola Raul. Me llamo Jane."
Raul gave her a hesitant smile.
"No te estas sintiendo tan bien?" The little boy pouted and shook his head."Bueno, voy a tener una mirada en sus munecas y tobillos. Lo prometo que no lastimara,"
Raul nodded again and she began to examine him, carefully explaining in her 'pretty good' Spanish, what she was doing. But Raul giggled now at some of her questions, and Jane knew she was stumbling over some of her words ... she suddenly couldn't seem to remember the grammar. Her ears buzzed and whistled, making it hard to hear through her stethoscope. And what she did hear puzzled her.
About 10 minutes later Dr. Kovač returned. "So, Jane, what do we have here?"
"Eight year old boy, arrived with his family from Ecuador in September. Five day history of dyspnea and arthralgia. His mother brought him in for a sore throat 3 weeks ago, his chart shows that he was prescribed amoxicillin for a strep infection. She says he had frequent sore throats in Ecuador."
"Good. Physical assessment?"
"Ummm... low fever, 100.3, satting at 98. Resps ..." She suddenly couldn't remember the vitals. She hadn't written them down. Numbly she plunged on. "Lungs are clear, I think I heard a regurge murmur ... not sure though." Jane trailed off. The whistling in her ears was back. was asking her something, but she couldn't hear him. "What?"
"Listen to his heart again."
"I ..." How could she tell him that she couldn't hear well enough? That there were spots and flashes of light before her eyes? She had to tell him something. He was looking at her, talking to her. A moment of pain in her sore knees as they buckled, and everything was black.
