Luka gave Jane's cold hands a squeeze. "You're going to be an excellent doctor, Jane. What happened today … it doesn't change that. Every med student, every doctor in the ER has done something like that. It's part of learning to be a doctor. Sometimes we make mistakes, and sometimes those mistakes have tragic consequences. It doesn't stop when you graduate, either. We're doctors, but we're also human. We work under enormous pressure … we make mistakes."
"You don't make mistakes," Jane said. "You're always so calm. I couldn't ever be like that. I'll bet you've never … killed a patient."
Luka hesitated, looked down at the snowy street. "Of course I have," he finally said. "Everyone has." Jane waited for him to go on. A quiet sigh. "Just a couple of years ago. I wasn't feeling well; I shouldn't even have come into work that day. A young man came into the ER. I missed some very obvious symptoms; I didn't listen when the nurses pointed them out to me. I just wanted to get through the shift and go home. He had leukemia, he was septic when he came in, but I diagnosed it as the flu. Then I messed up an intubation;, he ended up deprived of oxygen for too long. He died a couple of weeks later in the ICU … he never even regained consciousness."
"Still, it's different for you," Jane said."You know that you can do a good job, you know you're a good doctor. It must have been … awful … what happened that day; but you've helped thousands of patients … saved so many lives. It's different when you're a student." She managed a faint smile. "You probably don't even remember what it feels like. You tell me that I can be a good doctor … I don't know. I don't see it. All I see is that little girl ... and she's dead because I was the one who took care of her. Maybe I don't even want to be a doctor, Luka. I don't know if I want that kind of responsibility."
Again Luka was quiet for a minute. He glanced at her, then looked away again. "I was an intern, just about your age. I was living in Vukovar. I told you about that, didn't I?"
"Yeah. You said you were there during the war."
"The city was under siege. Supplies were low, there were so many patients; the shelling never stopped. We did the best we could, but so many of the patients died … patients who might have survived if we'd had better equipment, more supplies. We had to make a lot of hard choices, sometimes letting patients die so that we could give what time and medicine we had to others … the ones who had a better chance. It was hard, but it was also … exciting. I knew that if I could function, do my best, in that kind of situation, that I could do anything. I knew I could be a great doctor."
Looking into Luka's face Jane could see the excitement in his eyes as he relived the moment. Tragic … horrible … but so obviously, as he'd said, exciting. A rush. The same rush she had felt earlier that day when the victims had begun pouring in. That was what emergency medicine was supposed to be about. Luka's eyes met hers for a moment, and she sensed that there was going to be more to the story. His voice softened, he looked away from her again.
"One day I went home after working a long shift. I was living with my family, my wife and two children in a small flat just a few blocks from the hospital. We needed some supplies from the market, so I went out again. While I was out … I'd just left, really ... a shell hit the apartment building. I ran back inside … our flat was on the top floor, it had taken the worst of it. My son was already dead. My daughter was very badly injured, she stopped breathing just moments after I got to her. And my wife, Danijela, she was also injured, bleeding very badly. At the hospital I'd dealt with situations like that every day. I knew the rules of triage, I knew about those hard choices. I should have taken Danijela to the hospital; her injuries were operable. If I'd gotten her there quickly, she probably would have survived. But at that moment I forgot everything. I couldn't think. All I could think about was that Jasna, my daughter, needed help; that she would die if I didn't help her. I started doing CPR … I sat there for hours, doing CPR on my dead child … and while I was doing that, my wife bled to death, just a few feet away from me. Like you, I called for help. Nobody ever came to help me." Luka had told his story quietly and calmly, but on the last few words, his voice broke a little. He cleared his throat and looked at her again. "And no, Jane, I've never forgotten that. I've never forgotten how I felt that day. I've never stopping wishing I'd made a different choice."
Jane swallowed hard, the pain in Luka's eyes striking her like a blow. He looked tired … older somehow. He had told her before that he'd lost his family, but she'd never imagined it had happened that way. But she knew he didn't want her sympathy. He'd told the story for her benefit. She shook her head, tried to think of something to say.
"So, how do you go on after something like that? How do you deal with the responsibility… knowing that your choices, your mistakes, mean that people live or die?"
Another quiet smile. "You focus on the 'live' part of the equation. You think about all the people you can help, and have helped; all the people who are alive because you were there."
"I just don't think I can," Jane said again. "I'm not … like you."
"You have to." Luka's voice became brisk and businesslike again. "What do you they say? When you fall off a horse you have to get right back on again? Well, that's what you have to do here. We're going to go back inside, you'll get cleaned up and warm up with a cup of hot coffee, and then you're going to start seeing patients again."
He rose and offered her a hand, pulling her to her feet. They started towards the doors. "It was my fault too, Jane," he said. "What I told Dr. Lewis was true. I should have been more careful, evaluated her more thoroughly before leaving you alone with her. I wanted to encourage you, let you gain confidence by dealing with patients on your own. I thought I was doing the right thing … " A small shake of the head. "And that's something else that never changes, Jane. We never stop second guessing ourselves. Every time a patient dies, I always wonder if there might have been something I could have done differently. Even when I know I did everything right, I always wonder."
They'd reached the lounge. Jane went to the sink to wash the blood from her face.
"What do you take in your coffee?" Luka asked her.
"Just sugar. What's going to happen to me now? I am in trouble, aren't I."
"Nothing will happen to you. There will be an inquiry, an M & M. But I'm your supervisor, so I'll answer most of the questions, do most of the talking. And if there are any repercussions, they'll be mine, not yours. Summer was my patient, you were working under my direction."
"I'm sorry."
"Don't be." Luka smiled and handed her the coffee. "It's all part of the job."
"You told her mother?"
A nod, but no smile this time. "Also part of the job."
Jane took a sip of coffee. "If you're trying to convince me to stay in ER medicine, you're not doing a very good job of it." She laughed a little, and Luka smiled into his coffee cup.
"It's not an easy job, Jane. But I think you'll find it's worth it."
The lounge door opened and Sam's head poked through it. "There you are, Luka. Dr. Lewis is looking for you."
"Tell her I'll be right there."
And suddenly Sam spotted Jane. Their eyes met again for a second and Jane saw the familiar coolness there. But Sam put on a rather unconvincing smile.
"What happened with your patient? The kid? Everything work out ok?"
"I didn't think you cared." Jane made her voice just as cool, not a difficult task.
Luka frowned. "What's going on?"
"I could ask you the same question," Sam snapped.
"About what?" Luka looked baffled, looked from Jane to Sam and back again.
"I told Sam I needed help." Jane said quietly. "She ignored me … told me to 'deal with it.'"
"Is that true, Sam?" Jane could see the tension in his back, in his jaw.
Sam shook her head, stepped fully into the room and shut the door behind her. "We had a lot of patients, Luka. It was a mass casualty situation. I can't drop everything to help every med student with a question. She wants to be a doctor; she needs to learn a little initiative."
"She needed help. Did you even ask her what the problem was? Stop to check?"
"She didn't," Jane volunteered. "She just … left."
Luka shut his eyes for a moment, took a deep breath. "Jane, go find some scrubs. Get changed and look over the charts in the rack. I'll be along in a few minutes."
"Luka …" Jane said hesitantly. She didn't want to leave. She felt safer, somehow, in his presence, as if he could protect her from the horrors of the afternoon.
"Go get changed," Luka said again. "Remember what I said about getting right back to work?"
"Ok …" Jane nodded and tossing her coffee cup in the trash, left the room.
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As soon as the door had closed behind Jane, Luka turned to Sam. "The patient died, Sam. A six year old girl died because you couldn't take 3 seconds to ask …"
"I didn't know, Luka." The cool look in Sam's eyes had given way to shock.
"You didn't ask. She's a student, she's been working in the ER for 6 weeks. You've been working in ERs for years. Why couldn't you give her a minute of your time? The worst of the flood of patients was over."
Sam shuffled her feet for a moment, then her face hardened and her voice grew hard too. "She hangs on you like a leech, Luka. Don't tell me you haven't noticed! And don't tell me you don't like it … you don't encourage it. I've never seen you give that much time and attention to a student."
Luka's jaw dropped. "You're jealous? Christ, Sam … you let a patient die because you're jealous of a 25 year old kid?"
"I'm a 27 year old kid," Sam said softly.
For a minute Luka didn't say anything. Then a sigh. "Look, Sam. This is a hospital. I work with all kinds of people; patients, residents, nurses … and medical students. Statistically, about half of them will be female, and a lot of those will be young and attractive. If you can't trust me to be professional … if you can't … trust me …" He shook his head and turned away from her.
"I want to trust you, Luka. But have you really not noticed how she's behaving? How you're behaving? You're with her constantly. You've never given that much attention to other med students."
"Other med students haven't needed that much attention. My job is to help people who need me, Sam. All of them." He started for the door. "I need to go find Susan. We'll talk more about this later."
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Jane was flipping through the charts in the rack when Luka approached. He still looked a bit tense, but he smiled at her, and she managed to smile back. She did feel better in his presence. "We have a 2 month old with a fever, a 9 year old with an ear ache …"
"I think we've seen enough kids today, Jane," Luka interrupted.
"40 year old man with a sprained wrist?"
"Sounds good." Luka took the chart from her and glanced over it. "Let's go."
As they started towards curtain area 1, Jane said quietly, "I guess things aren't going very well between you and Sam?"
"I'm pretty angry right now," Luka admitted. "What she did was very wrong. She should have stopped to help you."
Jane looked up at him for a moment and felt a rush of warmth as he smiled down at her again. And before she knew what was happening, the words spilled out. "I just want to say … I know you're my supervisor right now … but this is the last week of my rotation … and if things don't work out between you … I like you … I know you like me …" She felt her face grow hot. "I'm … I'm here for you like you've been here for me."
"Oh, Jane …" Luka sighed and pulled her into a quiet side hallway, put his hands on her shoulders. Was he going to kiss her? Embrace her? Jane trembled a little. But Luka just spoke quietly, looking into her eyes. "I do like you. You're an excellent medical student, and a great person. But that's all. If I ever gave you the impression that there was anything more, that I was interested in anything more, I'm sorry. Sam and I are going through a rough time right now, but we'll work it out. Relationships have ups and downs, you know that."
Jane shook her head. "I don't … not really." She was stammering a little.
"Well, anyway … I'm very flattered, Jane. But I'm with Sam." He still spoke quietly but firmly.
Jane looked at the floor, and her blush deepened. She pulled away from him. "Oh God … I feel so stupid! I thought …" She turned away quickly, so Luka wouldn't see the tears that were threatening to spill over again. "How could I have been so stupid!" God, this was humiliating!
"You weren't stupid. It was just a misunderstanding. Maybe I did give you the wrong impression. I'm sorry. Let's just forget about it, ok? Now, come on. There's a sprained wrist waiting for us."
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When was the day going to end? Luka kept her busy with a steady stream of patients. Nothing too complex, nothing that might shake her confidence again. Just enough to see that her mind was occupied every moment. He supervised her more closely than usual, never leaving her alone with her patients. He wasn't going to let another tragedy happen today.
And it helped a little. By focusing on her patients Jane could, for a few moments at a time, forget about Summer. She could remember the patients she could help, the lives she could save.
But she couldn't forget Luka. He was at her elbow every moment; encouraging her, his eyes and voice as warm as ever. She should ask him to let her work with another doctor. Maybe Dr. Pratt or Dr. Lockhart. It would be better for both of them. But she couldn't do it. As hard as it was to be near him, she knew it would be harder to be apart. And would he even understand why she wanted to go? He seemed to have forgotten those 3 humiliating minutes in the hallway. He treated her just as he always had, encouraging, warm, professional.
Jane could see that now. He had always been professional with her, a mentor and a teacher, nothing more. It was only her own dreams, her fantasies, her loneliness that had let her see something more in it.
But to let go of those dreams … the one thing that had made the rotation bearable … had given her something to look forward to. That was hard.
"Jane?" The voice she had heard so often these past three weeks. How long had she been standing there listening to Mrs. Melnick's chest? Or rather, how long had she been holding the stethoscope pressed against Mrs. Melnick's chest while she daydreamed. She forced herself to listen for a minute.
"Chest is clear, normal heart sounds."
"Good," Luka said. Then more softly. "You're doing great, Jane."
She managed a smile. 'Pull yourself together here, Jane!' she told herself firmly. 'You're falling apart over nothing. Luka lost his whole family and he picked up the pieces and went on. You lost nothing … there was never anything to lose.' Clearing her throat she said. "No evidence of pneumonia. Probably a viral bronchitis."
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Finally the last patient was dispo'd, the wretched day was over. Luka came out of the lounge with his coat on. "Have a good evening, Jane," he said. "Get yourself some dinner, and get a good night's sleep. Tomorrow will be a much better day."
"Thanks, Lu … Dr. Kovač. I will." And she watched, numb, as Sam came down the corridor and Luka put his arm around her shoulder.
"Good night, Jane," Sam said.
"Good night." And she pretended to busy herself with something at the desk so she wouldn't have to see them walk out together.
As soon as they were gone, Jane went to the lounge for her own coat. The room was empty. She slowly put on her coat. She didn't want to go home, back to her wretched little room and her books and her miserable dinner. But staying here would be even worse. And suddenly the tears that had been threatening all afternoon spilled over. She sank to the floor, leaned her head on her knees and sobbed.
God … for someone who's supposed to be a brain, you are so stupid, Jane! Didn't you learn it years ago? Invisible is better. No-one notices you, you don't get hurt. No-one gets hurt. You wanted to impress Luka, show him what you could do. And someone had died. She'd confessed her feelings to Luka … her heart had been broken. She's humiliated herself.
'Tomorrow will be a better day,' he'd assured her. And it would be. She hadn't learned any new skills today, but she'd definitely learned a valuable lesson. She would come back tomorrow, go back to being Invisible Jane. She would get through the days, get through her rotation. Do her job, don't make waves. And then she'd leave the ER and a few months later, leave Chicago, make a fresh start in Boston or Georgia or Kansas. She would start over. But Summer … Summer could never start over. More tears.
"Jane?" Jane looked up in surprise, embarrassed. She hadn't heard anyone come in. It was Tony LePazzi, one of the residents. She didn't really know him, but she remembered that he was the one who hadn't recognized her in the ambulance bay the other night. He sat down beside her. "I heard about what happened with the little girl. It's rough, I know."
"Yeah." Jane wiped at her eyes. "I did something stupid. But I'm ok now. I should probably get home."
"No, you shouldn't." Tony spoke firmly. "After such a lousy day the last thing you need is to go home and be alone." A hesitation, and his voice softened a little. "Maybe you'd like to get some dinner with me?"
Jane shook her head. "I … I can't."
"Why not?"
She cast about for an excuse. "I'm not dressed for going out." Jane motioned towards her borrowed scrubs.
"I wasn't suggesting anything fancy. I am just an intern, you know. My budget doesn't stretch to four star restaurants. We could go to Ike's, or that new Greek place around the corner."
No. Not Ike's. She'd gone to Ike's with Luka. "Greek food sounds good. Let me just wash my face first … tidy up."
"Ok. I'll meet you by the doors."
In the lady's room, Jane washed the tears from her cheeks and quickly brushed out her tangled hair. Then she stood and regarded herself in the mirror for a moment. That evening in the ambulance bay when Tony had first noticed her she'd been … almost … pretty. Was she almost pretty now? The last remnants of tears brightened her eyes, emotion made her cheeks pink. No, she wasn't pretty, but Tony seemed to like her, seemed to be interested in her. And no, Tony wasn't Luka Kovac. He wasn't tall and dark with an exotic accent. But he wasn't bad looking. And she knew he had a reputation for being one of the more compassionate residents in the department, and he was funny and a bit shy himself.
Jane was surprised to see her reflection in the mirror smiling at her. Maybe tomorrow would be a better day.
Tony was waiting for her by the doors. "Ready?"
"Yes."
"I hope you're hungry. Athena's makes the biggest damn gyros in the city."
"I'm starving," Jane said. She felt Tony take her mittened hand in his and they walked out together into the snowy evening.
