A/N: Usual disclaimers. I am not a medical professional. All my info for this story has come from the show or the internet. Sorry to be late again, but it's not so late. We had some family stuff happen today and I didn't get to the internet until later than I thought. Anyway, here is Chapter 10! I hope you like it, and I always appreciate hearing your thoughts. Next week, look for Chapter 11. As always thanks for reading.
Alex sniffed and shifted as he lay tangled in the floral sheets of April's bed. Early morning sunlight shone through the blinds of her bedroom window and right into his eyes. He reached up a hand and rubbed his eyes before he opened them and squinted around the room. He smirked and rolled over to look at the person sleeping next to him tangled up in the same tangled mess of sheets.
Alex Karev typically didn't wake up early. In fact, waking up early was one of this least favorite things to do in life. Alex also didn't usually wake up next to the girl he slept with. Not since Izzie and Lucy left. He was used to finding the other side of the bed empty. If he'd picked the chick up somewhere, they'd wake up first and skulk off, or if he was at their place he'd leave first. Of course that was before. Things were different with April. Everything was different with her.
Talk about role reversal. April Kepner did not sleep in. In the whole entire time Alex had known her, she was always one of the first ones in the house to wake up. Even when she'd been in the hospital, loopy with drugs, she'd tended to wake up early. Maybe it was the farm childhood or whatever. And April didn't generally snore either. At least she hadn't on those few nights he'd shared her bed when Amber was in his room.
But right now April was dead to the world, and for anyone else the little sounds she made as she inhaled would totally be called snoring. She was laying on her side facing Alex, resting her head on a curled up fist. Her hair was a wild mess on the pillow, and her mouth hung open slightly. She sighed and shifted curling closer to Alex, and making him groan. Damn her feet were cold. Reaching down he carefully tucked in the edge of the sheet beneath her feet and around her propped up right leg.
Holding his head up with his arm, Alex leaned closer to watch her sleep. She really didn't have any idea how hot she was. Even completely asleep, the sun light danced across her features, and made her look that much more beautiful. He couldn't help but feel slightly smug that he was the reason she was so tired. He'd worn her out. Oh, yeah.
The whole sex thing had been a surprise. April had been hinting about it for while, even before the whole Amber issue. And then that had forced them to share a bed, which in turn had made the topic of sex an even bigger elephant in the room. He could tell that April had been thinking about taking that step, but he'd never expected her to just go for it. Not in a million years. It was like she suddenly she'd either figured everything out or had given up trying, and just jumped in. Whatever it was, she'd come to her decision while Alex was away.
He'd gone to Iowa for 5 days, gotten his Mom set up with a homecare nurse, and set Amber back in school. Then Alex had come home, and April had acted weird, and then said that she wanted to screw...as close as she could ever get to saying that. Freaking awesome, though unexpected.
Alex thought, on a whole, that things had gone very well. At least she wouldn't have an awful or awkward first time story. He'd made sure of that. Because of his mistake in with her in the on-call room. And because, if you waited 29 years to finally get it on, at the very least you should be allowed to have a good first time.
April licked her lips and let out a long breath as her eyes slowly opened. She blinked drowsily, coming to wakefulness in slow stages. Yawning, she stretched a little and rubbed her eyes. When she realized that Alex was watching her, her face immediately flushed and looked down, as a shy smile played on her lips. Alex held back a laugh as she pulled the sheets closer to her chest. As if he hadn't seen everything already.
"Morning," Alex said, gently pushing a lock of hair behind her ear, and lifting her chin to face him.
"Good morning," April whispered when she finally made eye contact with him again.
"So," he joked. "Feel any different?"
She grinned and rolled her eyes, "I guess so."
Then her face fell slightly and she bit her lip. Behind her eyes, he could almost see her mind racing a mile a minute, analysing and reanalyzing. Or whatever. April sighed, opening her mouth to speak again. Alex held a finger to her lips. He had a feeling where this was going, and he wouldn't have it. April had no reason to be so nervous and apologetic all the time.
"Ah," He said quietly. "Don't do it. I know what you're gonna say."
Her brow furrowed in confusion, "What? How?"
"Okay, maybe not exactly, but I think you are about to try to apologize for something, because that's what you always freakin' do. Sometimes it seems like you just walk into a room and say you're sorry," Alex ran his hand down her freckled shoulder. "So just listen: You have nothing to apologize for."
April blinked, and stammered, "B-but I...I got the hiccups, a-and my leg..."
He grinned and tilted his head, "I told you not to hold you're breath, but whatever. It's really no big deal. They didn't even last that long."
"But-"
"Did you hear me complaining?"
"No," April said softly.
Alex let his hand roam lower, and lightly gripped her thigh on top of the flowery sheet. Raising his eyebrows suggestively, he continued, "And now we know exactly how to get rid of your hiccups. So next time, no worries."
Although the comment made April blush even more, it also caused the corners of her lips to twitch into a small smile. That's more like it. Alex really thought April needed to give herself more credit. Seriously. She'd turned out to be way more adventurous than he'd suspected. She told him she'd read stuff or whatever. She'd surprised him. A lot.
Somewhat tentatively, April reached a hand to his chest and began absently letting her fingers dance around on his collar bone. She still looked a little pensive as she spoke again.
"It's just-I know you're not new at this, and I am and I wish...I don't know. I feel bad if...you don't," Her eyes widened and she stared resolutely at her hand as it continued to move across his chest. April cleared her throat, "If you didn't have a good time."
"April," Alex murmured moving his hand to cover hers. "Who said I didn't have a good time? I had a great time. Freakin' A!"
Maybe she didn't yet know how to read the signs, or she was just too nervous to see, but it was definitely true. Alex thoroughly enjoyed their first time. It'd had been a while for him anyway, and even though he was by no means a virgin, the fact that April was had been an experience in an of itself for him. He felt kind of special or something. Because at this very moment in time, he was the only guy in the world who knew exactly what April was like in bed. How she looked. How she sounded. How she felt.
Watching April go through all the new experiences was kind of cool. Like when you got a present for someone for their birthday or whatever, and you watch as they unwrap it. You know exactly what they're getting, but there's something about seeing them get the surprise. Cool.
April still didn't look convinced, "I know my leg limits things and-"
It wasn't like that at all. Sure, it meant that they'd had to get a little creative in finding ways not to jostle too much or re-injure her leg, but it wasn't a problem at all. He didn't really mind taking care. In fact, it was something Alex was glad to do. Because of everything. He struggled to find words to explain why. Looking at April's eyes, he could see her insecurity. He'd at least have to try to say something. He couldn't not. Not when she looked like that.
Alex wrapped his arm around April and pulled her to his chest, revelling in the feel of her warm bare skin against his own.
"Look," he said slowly. "Your leg is never something you have to worry about with me. It's never something to feel bad about, okay?"
He sighed, still not quite sure if this was going to make any sense. This was why he hated talking about sappy crap like this. Emotions or whatever. They hardly ever made sense anyway. Alex ran his hand down the sheets to her thigh again, this time continuing down further to where her lower leg was propped up.
Through the thin fabric of the sheet, he gently slid one finger along the long vertical scar in the center of her knee, from her replacement surgery, and mumbled, "I figure...I, uh, I kind of owe this leg. I know getting hurt really sucks for you, and it's going to sound weird that I am saying this but I owe it. Because, it's like...without you getting hurt so bad, I would have kept on being too much of an ass to realize that you...that I-I care about you. That's what it took."
Alex pursed his lips to one side, and gently cupped the knee with his whole hand. This wasn't really coming out right, "And I've been, you know, happy and whatever...since we...since this, and...the leg just always makes me remember. It won't let me forget that I almost missed out on this...on you...so...I owe this leg. And it'll never be a problem for me. Ever."
Didn't really make sense, but whatever. He knew he sounded like a freakin' lunatic. Cosmic balance, symbolic reminder and bullshit, but that's the best he could explain it.
April gulped and let out a shuddering breath, "I-wow. Wow. Alex, that almost sounded sentimental. I'm afraid I'm rubbing off on you."
"Don't tell anyone."
She shifted and looked him in the eye, "I n-never thought of it like that...I mean...thank you. I feel...that makes me feel better. A lot."
"I know you're still getting used to everything," Alex whispered, thinking of her knee, their relationship or whatever, and now sex. "But you don't have to be sorry so much. You don't have to worry all the time."
April sighed and tapped his chest, "I'll try."
"Okay." That was something at least.
He kissed her forehead, "I dig you April. You are, uh, so...beautiful. And...it has as much to do with...like how you are, as it does with how you look."
Chuckling Alex continued, "Think of it this way: I don't screw people I'm not totally into."
April snickered and replied sarcastically, "So charming."
They laughed, and laid quietly for a moment.
April nuzzled closer to him and said, "You know...I should say the same to you. That you're...um ...Not just because of...you're so-"
She paused an her hand splayed out across his chest. Alex raised his eyebrows.
"Are you saying you think I am hot?"
"Y-yes. Yeah. O-obviously," April fumbled. "But, I think you are a better person than you think you are. And...well, I wish you could see you the way I do..."
"Me too."
Whatever. Alex had wanted to say that. That ever present word in his life had been on the tip of his tongue, but he'd taken pause. Because he was talking to April, and somehow that response didn't seem good enough. Alex still didn't quite understand her perspective on him, but he did appreciate the way she continued to have faith in him. He might be a douche a lot of the time, but having someone believe in him had made Alex try again.
It was getting late. As much as Alex might want to stay in bed with April all day, they both had crap to do. Life and all that. There would be other chances to sleep in. Sighing Alex pulled his body up a little.
Smirking, he ran his fingers gingerly over a mark on April's neck, "You're probably gonna need to, uh...wear one of those scarf thingy's."
Gasping, April's hand flew to the spot, "You mean I've got..."
Alex laughed at the look of mild alarm that crossed her features. He yawned, and pulled himself into a sitting position in the bed. He was just about to rise, when he felt April's hand on his own neck.
She smirked and giggled, "Alex, you might be in need of a 'scarf thingy' yourself."
Meredith sighed and slipped into a room on the pediatric floor, with her lunch in hand. Alex had taken to eating lunch in their with one of his cancer kids, and somehow the other 5th years in their little group had migrated along with him, though not without complaint. Cristina wasn't shy to point out that the cafeteria had more table space,that dermatology was more relaxing, and that April's office had better seating.
Today Meredith found Alex and Cristina perched on two chairs near the patient's bed. They were listening intently as the boy, Marcello, read to them from a stack of index cards laying on his bed tray.
Meredith scowled. They weren't. They couldn't be.
"Uh, if the patient is presenting with stomach problems and gastro...gastrointestinal distress what do you do?" the jaundiced teen asked.
"Oh, oh!" Cristina yelped. "Order an abdominal CT, paying particular attention to the lower tract. Look for blockages. Then-"
Meredith moved to an empty chair on the other side of the boy's bed. Patient rooms usually had two or three chairs, but the frequency of Alex's lunch time visits to the teen with the other residents meant that a miss matched variety of extra chairs filled this kid's room. Settling down and opening her lunch sandwich, Meredith chided her friends.
"Seriously guys? Really? Co-opting a patient to help you study for boards?" She turned kindly to the bed, "Marcello you don't have to-"
"I know Dr. Grey," he replied laying down the card he was reading from. "I like it though. Kinda interesting. Better than what's on tv anyway."
"Mer!" Cristina said gesturing in midair with a french fry. "It's boards! Oral boards. Cut throat, surgeon eat surgeon world. I mean, if any of us have any hope of getting attending jobs or fellowships here, we have to be the best. If any of us have any hope of getting attending jobs or fellowships anywhere we have to be the best. I am not used to not being the best. I refuse to let it happen. We have to keep an edge. If patients are willing to support that...then I see no problem."
"Yeah," Alex chimed in through a mouthful of burger. "Not all of us are blessed enough to have been offered the personal tutoring services of one certain Ortho attending."
Meredith shrugged. What could she say? Callie's study skills were legendary. She had no idea why she'd been picked, but she wouldn't complain.
"Or a plastic surgeon," he added, as Jackson slipped into the room carrying a cafeteria burger, and looking startled.
"What?"
"Oh, nothing. They're trying to rationalize using a patient to help them study for boards," Meredith explained.
Marcello covered his mouth with one jaundiced hand and laughed at the banter.
"Well," Jackson said, shuffling into another empty seat. "Whatever you do, don't try to use your interns. Bailey busted me this morning big time."
Cristina sighed and shoved the french fry into her mouth, frowning slightly. Meredith had a great deal of sympathy for her friend. Her marriage was still on very rocky footing. It was more than understandable that Cristina would be struggling to work on that and study for boards. Not that she'd ever admit to it of course. It was still worrying. Boards were very important. It could make or break a career.
Not that Cristina wasn't studying. She just seemed preoccupied. Absentminded. Even a little distant. Meredith was doing her best to support her person, but it was hard because she knew she couldn't fix Owen and Cristina's problems for them.
The doors to the room opened again this time revealing a bouncy Lexie, followed by a somewhat weary looking Kepner. April was back to working full days and down to limping with one crutch these days, but she had yet to be cleared for the OR, which Meredith knew was still a sore spot for the chief resident.
"What is this? A conference room?" Jackson complained as Lexie sat in the chair next to him, accidentally bumping his arm and nearly making him drop his food.
"This kid is our study buddy," Cristina shrugged, sliding her box of fries to Marcello, offering him the food. "We can't all be lucky enough to be in the plastics posse study club."
"Marcello is totally the better study choice," Lexie joked, which made the ill kid grin, and earned her a fierce glare from Jackson.
April had made her way to the chair nearest Alex. She sat gingerly and began eating fruit slices out of a plastic box. Alex immediately turned to face her with his brows furrowed, seeming to pick up on her mood. He leaned closer to her and whispered, "Everything cool?" April shrugged and nodded, and continued to eat.
Meredith smirked and took another bite of her sandwich. Right now, Cristina and Alex's love lives couldn't be anymore different. If her best girl friend was preoccupied in studying for boards because her relationship was failing, her best guy friend was preoccupied because his wasn't. Not that Alex and April had really ever come right out and called their 'dating thing' a relationship. Maybe they weren't ready to look at things that way. But Meredith figured, if it looked like a duck, walked like a duck and quacked like a duck, it was probably was a duck.
They hung out at work, and they hung out at home. They practically shared April's room. After Alex had returned from Iowa a few weeks ago, he'd never really moved back up stairs. Alex didn't even deny it when Cristina teased that he was 'shacking up with Kepner'. He'd only looked smug. Lexie had even hinted that April was likely no longer a member of the V club. Meredith thought that certain half heard sounds from the downstairs room supported her sister's hypothesis.
Duck.
People at the hospital were even starting to talk, even though at work Alex and April didn't seem to indulge in many PDA's. The changes in Alex's attitude and April's confidence alone was enough to set the gossip train going.
Duck.
But Meredith wasn't about to push them on explaining it. Especially Alex. Because it seemed like every time he got anywhere close to having a happy successful relationship, everything fell apart.
"There's so much to cover," April said wide eyed, joining in the conversation about their upcoming oral exams. "The American Board of Surgery could throw you any number of scenarios, and they always include one or two from outside your specialty, so you have to review everything. And then of course there's your interview, and applying for fellowships..."
Cristina rolled her eyes, "You don't even have to be taking them this year. Over achiever. Everyone said you could delay and take them with Lexie's year."
"I can handle it," April replied less than convincingly, as she crossed her arms.
"You could delay," Alex said quietly. "It might be better. Easier, you know, less to worry about."
"Oh," April replied darkly. "Thanks for the vote of confidence."
Trouble in duckland?
Alex scowled slightly and shrugged, "I'm just sayin'. It's been freakin' you out. Whatever."
April pouted apologetically and hunched down in her seat.
Lexie leaned forward, "Why don't you just...you know, wait? You don't have to go for boards this year on top of everything else."
She gestured vaguely at April's crutch as Jackson smiled sympathetically and added, "People would understand."
Taking another bite of her fruit, April sat up straighter and squared her shoulders, "I don't need people to understand anything! Well, anything other than that I'm the same doctor I was before. I can pass boards. I can. I'm not completely...my leg is...I wish I could just throw this stupid crutch off of a building. I can still do it! I don't want this to change my life anymore than it already has."
Her outburst shut the room up for a few moments, and Meredith was about to say that she understood. She knew that April was resilient and bouncy, and that most everyone had taken her recovery for granted. To be honest, Meredith thought that April was coping much better than she would have if she'd been the one whose leg was disfigured. But it was still clear that coming to terms with having a disability was an ongoing process for the red haired resident. Perky or not. Optimistic or not. Even in duckland or not.
Meredith was about to speak when Marcello spoke up, "You don't want to be a super senior."
"What?" Alex asked.
"I get it," Marcello continued, grabbing a fry from Cristina. "Dr. Kepner doesn't want to be the super senior. No one ever wants to be that one person who has to hang out an extra year or two. I know if...when I ever get out of here, and have to go back to my old school, that part is gonna suck. It did when I was here before. It sucks. Even if people do understand. All my friends get to move on."
April nodded and offered the teen a grateful close lipped smile.
Jackson shook his head, "It wouldn't be like that April. No one would make you feel bad. And hopefully, if we don't screw up, at least the four of us could get fellowships here. We wouldn't be leaving you."
"I am the chief resident this year," she sighed and lowered her eyes. "How's it going to look when they pick another chief resident from Lexie's year, and I am still floating around as a resident waiting to take my oral exams? It'll just prove what everyone thought was true before. I shouldn't even be chief resident."
Meredith winced and Alex and Cristina both ducked their heads. They hadn't exactly been tht supportive of April getting the job in the beginning. Not supportive at all. But April had slowly come into her own in the job, especially after the earthquake. The administrative side anyway. And the teaching side too.
Bailey had even taken to bragging about April's abilities in teaching in skills labs. In her own sassy way of course. She'd tell Meredith and the others that the interns who did April's labs always seemed so much more efficient than the rest. Better than the ones who took skills lab from them. "I wonder why that is?" But April's confidence, though improving, was obviously still lacking in terms of her position.
Meredith felt bad. She'd been all swept up in the mess of trying to adopt Zola, messing with the clinical trial and fighting with Derek, and Alex at the time April was picked chief resident. She'd been disappointed in not getting the job herself, and too wrapped up in everything else that was going on to even spare a thought to how April might be coping. She hadn't even congratulated her. Which was something Meredith liked to think she would have done. If not for the trial drama, and the baby and everything. She liked to think so.
If she'd known at the time how close the other resident would come to death in the next year, Meredith probably would have acted differently. It was a lot like the jealousy she'd felt towards Callie at the baby shower. Feelings like that didn't matter so much after a traumatic event. No one said anything and for a time, the only sounds that could be heard were the crunching sounds of everybody chewing.
Alex reached his hand to the arm of April's chair and said finally, "Okay. So..you're taking boards this year. Means you have a hell of a lot of OR time to make up, but you do schedule everything. That's really the big part. Because...basically the rest is just knowing stuff and talking. Right? You know stuff. You talk. You like to talk. No sweat. Shouldn't be a problem."
That made April and everyone else laugh. Alex seemed to know what to say, because for the rest of the meal April looked less worn down. As they continued to eat and talk, Meredith was stuck by how smart and funny Marcello was. And by how close he was to Alex. And to a lesser extent April too. Some patients you got closer to than others; it just happened that way. She knew that the kid was alone a lot and that Alex had taken it upon himself to keep the boy company. If Marcello's cancer didn't go into remission again, which did seem unlikely, it was going to be a hard loss for Alex. Real hard.
The sound of a beeper startled Meredith out of her thoughts and she watched Lexie leap into action and leave the room. One by one her friends filtered out of the room to do surgeries and catch up on patients, leaving Meredith with Marcello. Alex and April were the last to leave. Meredith smiled and watched out of the corner of her eye as Alex quickly grabbed April's trash from her hands and moved it to the garbage can along with his own.
Duck!
After April said her goodbyes and headed back to the clinic, Alex headed to the door. Before he left he turned to Marcello, holding his hands up, and said, "See you on my break tomorrow. Watch out dude, I've been exercising my PSP thumbs. Your reign of terror is coming to an end."
"Right," Marcello giggled. "Like you could ever beat me!"
"Later man, and don't forget, if you need anything, go ahead and call the nurses. They'll come. And if they don't you let me know. Or Dr. Robbins. We'll kick their asses."
"Alex!" Meredith chastised.
"I got it Dr. Karev. Peace."
Alex left and to Meredith the room seemed so much more quiet, with just Marcello and herself. She tossed her own stuff in the trash and rose to leave. She should probably get going too. Her lunch would be over soon, and she had a brain surgery that afternoon.
"I think I have to head out too, Marcello," she said as she opened the door. "I hope we're not bothering you, eating lunch and bickering. Let us know if you're ever to tired to have us, okay?"
"I'm always tired, but I don't mind. This is practically the highlight of my day. You guys are funny to watch. Way entertaining."
Meredith supposed they were.
April walked into the clinic carrying a stack of charts under one arm. She was able to move a lot faster now and only used one crutch, but she still felt awkward and frustrated by the whole thing. She also had to be a bit more careful. It was easier to inadvertently land wrong and twist her knee. It made her feel self conscious. She didn't want to fall flat on her face with the whole hospital watching.
Passing by a nurses station, April nodded in greeting. the nurse smiled and gave her a strangely knowing look. As she continued past, she could almost feel the other woman watching. Stupid gossipy hospital. April could swear that they all knew, somehow, just by looking at her that she'd started sleeping with Alex. Maiden voyage and all that. That's what they were whispering about. Or they were waiting for her to fail at being a surgeon. Like right after the merger. Maybe she was just being paranoid.
Well, let them whisper. She...she found that she liked...sleeping, and sleeping sleeping with Alex. More than April had thought possible. She'd been nervous that first time, but Alex didn't seem to mind her scars, or her jiggles, or even her brief, unfortunate bout with hiccups. And since then, it had only gotten better.
April didn't care if people did thought it was a bad choice or whatever it was they thought. Because it wasn't just about...sex. It was everything else too. She liked laying on her bed with Alex and studying for boards together. She didn't even mind when he left his dirty socks all around the room. Not really. Even if the hamper was right there. She didn't mind when he ate in her bed and left crumbs either. Even if there was a perfectly good night stand to eat on, if you had to snack in the bedroom. Right there. Stuff like that actually make her laugh most of the time. He made her laugh. April didn't regret waiting, and she didn't regret having Alex with her now.
It just sucked that it took becoming crippled for certain parts of her life to get going. It sucked that getting injured had kept her from performing surgery for almost 2 whole months! That was the real root of her stress. She was itching to get back to doing surgeries. She was technically cleared, but Hunt had yet to allow April to actually schedule herself any procedures. Now that she wasn't taking heavy duty pain meds, she hoped it would happen soon.
April had made the decision to go ahead and sit for boards this year along with all her peers. Because...because she wanted to prove to her self and everyone else that she could do it. That this whole leg thing wasn't going to get her down, or derail her whole professional life. That she had been a qualified surgeon before the earthquake, and that she was still one now. But, as oral boards approached April was beginning to become nervous. She would only just barely meet the minimum required surgical hours if she started right now, and if she didn't start doing procedures soon, she probably wouldn't even reach that.
Then again, Alex was always telling her now to worry so much. He could always make her feel better. About everything. Her leg. Her job. Herself. Things would work out. And...and maybe it wouldn't be so bad if she had to wait until next year to take the exam. If she had to.
Greeting her interns and looking down at the list of patients in the clinic, April pursed her lips and prepared herself for yet another ordinary day. As she pulled on the clinics medical gown, she sighed and shook herself. She was on her way to see a patient complaining of pain. She had to be professional.
April pulled her features into a friendly smile as she limped around the curtain and saw her first patient. She was immediately struck by how weird the guy seemed, and by the bruises and cuts that covered his body. the man had blood shot eyes that listlessly roamed around the room, and he skin was sweaty and grey.
"Hello, sir," April said, moving closer and pulling on her gloves with a snap. "What seems to be your problem?"
He listed to one side and coughed. "Hey Doc Lady! I got in a fight. See?" The man tilted his head and showed off a swollen black eye.
Ouch. He didn't seem to be reacting at all to the pain from any of his injuries, even though April suspected that he might have a broken hand.
"Sir," she said quietly. "Have you...taken any...illegal drugs today?"
He raised his head and lowered it once in an awkward nod. April decided to take that as a yes. If he had, it was no wonder that He didn't seem to feel any of his pain.
"Can you tell me your name?"
"Bob Marley," he lied, chuckling.
April shook her head, "Can you tell me what drugs you took?"
He turned and looked right at her then, with huge blood shot eyes, and a toothy smile. He shook his head. "All kinds of stuff, Doc Lady. Meth. Acid. I'm trippin' on all kinds of shit. Don't quite remember what..."
"Okay...Bob," April said, nodding. Most of the clinics cases were pretty dull, but they did occasionally get some cases like this. "Why don't you lay back and let me..."
"Doc Lady," he said sputtering and coughing. He held a hand to cover his mouth, and when he pulled it back April could see that it was filled with blood. "Doc Lady, this ain't my first fight. Bastard's broke my ribs."
"Dr. Olant!" April shouted immediately as she began to run her hands along his chest. Triple ouch. She felt the jagged edges of at least 3, maybe 4 damaged ribs. "Page cardio 911! And Dr. Hunt if you can get him."
The wide eyed intern popped his head into the around the exam curtain and nodded before he ran down the hall.
Broken ribs were not something the clinic was, strictly speaking, equipped to handle. Especially when someone was coughing up blood. That usually meant more internal damage. Recalling her own broken rib, April was amazed at how calm the guy was. He must be so high. Her rib had hurt a lot. And hers hadn't punctured anything.
Helping the man lay back on the hospital bed April asked, "If you know this is bad, why didn't you go to the ER?"
"No insurance. Heard this place was free."
She grabbed a pair of scissors from a medical tray, and began to cut his t-shirt from his body, "Well, this is enough of an emergency that they'd worry about insurance later."
"If you say so, Doc Lady," 'Bob's' chuckle dissolved into another bloody rattling cough. April held up a bucket to catch the blood. He suddenly passed out, taking more and more shallow gurgling breaths. She propped him to one side slightly so he wouldn't choke on his blood. Damn it.
Pulling her stethoscope from her neck April leaned down and listened to his breath sounds. Things didn't sound good. He had lots of internal bleeding. Damn it. Where were the attendings? Leaning on her crutch she pulled the bed curtain open.
"Olant! Any word on Altman or Hunt?"
He bounded back up to her, wincing, "I paged them. They are coming as soon as they can."
April bit her lip and tilted her head. This guy was bleeding into his chest badly. He'd fallen unconscious. Given how quickly he had deteriorated, and the fact that he had drugs in his system, 'Bob's' prognosis wasn't that good either. Time was critical. She needed to act now.
More interns hovered around the curtained area, as Olant paniced, "I don't think they are going to get here in time..."
Indecision plagued her again. But an ominous gurgle from Bob changed her mind. April turned to another intern and said, "Run go! Tell Hunt and Altman we are performing an emergency surgery in the clinic. Now!"
Taking a deep breath she turned back to the patient and waved a hand at Olant and the other interns. "Prep his chest guys. Standard trauma set up. Remember?"
"Us?"
"We've got to move. If we don't slow his blood loss, this patient will die."
The interns sprung into action, and April did too. They had just done a skills lab on dealing with trauma in non-ideal situations. She hoped that they could remember what they'd learned. April realized that she was about to do a surgery again. Finally. It just wasn't at all what she had in mind at all. No OR. No scrub nurses. No watchful eye of an experienced attending. Not at all how she'd imagined.
The space of this exam area was tight, not at all like the wide clean space of the OR. April would have to carefully consider each movement she made if she went ahead and did the surgery. For more than just the procedure. For her own mobility. An OR would be so much easier.
April turned to Olant as he prepped the surgical tray and spoke sternly, "Uh...Dr. Olant, I need you to listen to exactly what I say. You will hand me the exact surgical instruments I request as quickly as you can. You will move, when I tell you to move, where I tell you to go."
She softened her expression a little and added, "I need you to be a good set of legs in here for me. Okay?"
Olant nodded seriously and stood by her side.
"Thank you."
Bob twitched and gurgled again. April took a deep breath. She knew the procedure. She'd done it in the ER enough times before with Hunt. Only those times were before her injury. But...April squared her shoulders. The interns set up an IV and put the patient under. 'Bob' or whoever he was, was fading fast. Surgery again.
She had to do this. She could do this.
April held her hand out to Olant, "Ten blade."
