A/N: This chapter also hasn't seen a beta, save for a sleepy me on antibiotics.
Chapter 3 – Santana
My face felt so hot when I exited the room that I almost thought myself the next victim of spontaneous human combustion. I felt my hands tremble and my chest heave with shaky breaths. Dear God, that had been incredibly embarrassing.
I was guiltily aware of the fact that my motivation to greet this new patient had not been purely medical - but I most certainly hadn't meant to walk in on her shirtless. To make matters worse, her shirtless self had been extremely nice to look at - the urge to leer at her had been almost as strong as the embarrassment that had made me look away.
I felt horrible, like a pervert. She was clearly less than aware of her situation, and especially unaware of the fact that when you were in a hospital room, there was always a good chance of some sort of hospital stuff randomly busting in. When you enter a patient room for the first time, you could at least have the common courtesy to knock, I scolded myself.
The image of her exposed cleavage, of the bra with the cute polka dots that she had been wearing, of her very toned abdomen still lingered on my mind. It was probably gonna get permanently burned into my retina, for a multitude of reasons. I wondered how much she must work out to have such nice abs - maybe she had a job that required physical fitness, like an acrobat or a dancer.
I mentally slapped myself for this train of thought - thinking in more detail about her body was hardly appropriate right now. Something that would be appropriate right now was apologising. Why had I not apologised right after bursting in? But I was so embarrassed and wanted to play over the incident as coolly as possible ... a strategy that had now earned me the questionable pleasure of having to bring up the subject a second time.
I let out a little sigh because those random five minutes of utter incompetence that I kept having were frustrating me to no end. Whenever I thought that I was a well-adjusted adult, a productive member of society and finally free of all the awkwardness of teenage hood, situations like that came around and everything I had every learned about how to behave in certain social situations went out of the window in the blink of an eye.
In contrast to me, Ms Pierce had seemed far more relaxed about everything. I couldn't be sure whether that was because she was just too sick right now to care, or whether she was that socially confident. Once I had gained the confidence to look at her during our conversation, I immediately noticed the way in which she had curiously eyed my every movement and the impression she gave me of being easily able to analyse me by just looking at me. Maybe she really was confident - in her ability to handle humans, in her ability to read me, in herself, in the way she looked. Maybe she just didn't freaking care about me walking in on her and I was currently busy massively over analysing everything.
Knowing myself, that last thought was actually by far the most likely. I rolled my eyes at myself and noticed that I had absentmindedly wandered back into the nurses' turf. Kurt just silently stood there, grinning from ear to ear.
"Did she ravage your body right on the spot or why did you almost run into a few walls on your way here?" he asked once he noticed that my mind had returned to the here and now.
"Not funny, Kurt. I kinda made an idiot out of myself in front of her. If there ever was any possibility that she'd be interested in me, I sure messed up all of my chances now."
"Oh honey, stop it with the self-pity already. You are such a drama queen and you don't even realise it. Tell me then, which earthshattering event took place that will forever have thwarted your fateful love that was not meant to be?"
I wanted to snap at Kurt's biting sarcasm but stopped myself. It was probably good to have someone around who could put me in my place. Perhaps as a defence mechanism against the self-esteem issues that plagued me for a big part of my life, I had developed a somewhat smug and arrogant attitude in my teenage years. I actively tried to let go of it, but so very often it was just easier to attack the shortcomings of other people, rather than tackling your own issues. I took a breath and decided not to openly react to Kurt's sarcasm.
"Stupid me waltzed into her room without knocking and ran straight into her taking off her shirt."
"I have problems picturing you doing anything straight, hun." Kurt chucked at his own joke, which he used entirely too often, "And seeing a hot young woman take off her shirt has convinced you to join a monastery somehow, or what exactly is the problem?"
"You know a monastery could never handle me," I replied not without a trace of self-satisfaction in my voice, "but no, my sexuality remains firmly intact. Thanks for caring, though. And despite your limited knowledge of the female gender, you should know that being seen shirtless is something intimate for us. It's totally embarrassing to walk in on that. And I even checked her out before I looked away!" My voice had grown more hysterical than I would have liked it to, but I hoped that it would suffice in conveying my problem to Kurt.
"Smart girl," Kurt didn't look distraught by my unfortunate adventure at all "and, what did your checking turn up? Is she as fit as she's pretty?"
"Kurt!" I playfully wiggled my index finger at him "that really wasn't the major issue here!" He seemed rather unmoved by the dramatic faces I made to underline the gravity of this mistake of mine. I gave him a shy smile and quietly added, "But yes, she's fit. Way fit."
"Then I hereby urge you to go for it, Santana. As for the subject of your supposed mistake that you try so insistently to make me talk about - don't sweat it, hun. If a doctor walked in on me taking off my pants, I doubt that I'd care too much. Doctors see people without clothes at work every single day. Why would I think that I'm so very special that this doctor must have special interest in me of all people? I think that sort of thinking requires either a sense of entitlement or some unhealthy sort of self-awareness. And judging from the short span of time that I spent with this Pierce woman, I think she has neither. Does this argumentation satisfy your over-analysing mind?"
Even though I shot him an indignant look, Kurt had a point. A very good one, to be honest. I could easily have provided this argument myself, though - coming up with a few sound arguments was not the problem. Convincing the mess that was my psyche to actually apply rational thinking to something was the problem. Even though my mind absolutely agreed with Kurt, there was still an uneasy feeling in the region of my stomach that made it impossible for me to relax.
"So what's the mighty doctor's opinion on the girl's health? Believe it or not but she didn't come to the hospital to expose herself to you."
"I think she's alright - just as you said, she suffers from a cold. Probably fainted due to pericarditis. I say we keep her here for the weekend and if everything is okay by Monday, she can go home. If you could just give her a 12-channel ECG right now, and then send her down to the ultrasound room. I'll be giving her a quick echocardiography ... Oh shit."
This time, Kurt didn't even bother with his usual smirk, he actually laughed out loud. I probably didn't need to explain my sudden realisation to him. Me giving the Pierce woman an echocardiography meant that I'd ask her to take off her shirt, lie down next to me and then I'd wiggle the transducer of the ultrasound device around her left boob until I found the heart underneath it.
"Dear God, why did I tell her about it? I can't even postpone it until tomorrow because I'm doing the Saturday shift! I told her I'd give her an echocardiography today and then I kinda sort of stroked her legs under the blanket, like I often do with elderly patients. I didn't even think about any of this, really. Now she must think I'm only trying to get into her pants. Not that I would mind getting into her pants - but I don't want her to think like that about me."
"Santana, honey, I've told you what I think about this. I'll just be leaving you alone while you're busy entangling yourself in your own twisted thoughts. Somebody out there is anxiously waiting to get their ECG so they can finally head for the ultrasound room. And since we wouldn't want to keep them waiting, I'll send them down immediately."
Kurt made a chirping sound and disappeared in the general direction of the ECG device. Writing an ECG would take him less than five minutes and the way to the ultrasound room was neither long nor complicated. There was basically no time left for me to get entangled, as Kurt had put it.
Grabbing a pen, I quickly filled out an echocardiography form for one Brittany Pierce and with that thing in hand, headed towards the ultrasound room. It was located a few stories below us, in the area where patients that had just arrived at the hospital were being managed. I opened the door to the ultrasound room and, just as I had expected, no one was still working in there at this hour. While I waited for the ultrasound device to boot, I turned to the computer located in the room. I searched for my patient among my ward's current inhabitants and quickly found her.
Her full name was Brittany Susan Pierce, she was a few months younger than I was and had never been admitted to our hospital before. It was a bit creepy that I could just look up possibly sensitive information on her with a few clicks while she didn't even know my first name. It felt unfair, like I wanted her to be able to access the same kind of information about me. Not that I thought she'd be particularly interested in the dimensions of my left kidney - I just wanted things to be equal between us.
The ultrasound device made a jingle to announce that it was done booting and I covered the stretcher on which patients lied during ultrasound with a fresh disposable sheet. Over the rustling of the paper, I almost didn't hear a timid knocking on the door. When I opened it, Brittany Pierce stood shyly in the door frame; her blue eyes big, innocent, searching.
"Hey, I'm here to get some sort of ultrasound done ... an echo-something. You're the doctor from earlier, right? Did I find the right room?"
I felt my shoulders fall slightly as it became obvious that she didn't remember my name. You shouldn't be that disappointed, I thought to myself, you only mentioned it in passing and it bears no significance to her. Fighting down the unpleasant feeling bubbling in my gut, I forced out a smile, nodded and motioned for her to enter the room.
"So have you ever gotten your heart examined via ultrasound?" I asked her. Maybe she knew what was happening. That would hopefully make it less awkward.
"No. I've only been to the hospital once, when I broke my wrist as a kid. They let me go once they had given me the plaster, though." Agh, curses, there was no escaping the awkward.
"Okay," I said slowly. I took off the lab coat and threw it over a clothes hanger on the wall. The small ultrasound room always heated up immensely in a short amount of time and I really didn't need any more sources of heat than were already standing in the room.
"So what I want to do is look at your beating heart, live and in real-time. To do that, I will put this ultrasound transducer to a few places on your upper body and the resulting image will be visible on this screen then. In order to see something, one needs to have gel between the transducer and the skin. It's a bit cold and icky, but perfectly harmless. Apart from that, the ultrasound won't hurt or anything and you just need to lie there still. Is that okay?"
"Yeah, sure," she shrugged, "you had me at 'doesn't hurt'."
"I'll have to ask you to take off your shirt. The bra is usually okay, you can keep that on. Just put your clothes on that chair there." Alright, that sounded sufficiently professional. Brittany smiled and eagerly pulled her shirt over her head before I had finished speaking. Well, she certainly wasn't shy.
"Lie down on this stretcher, please. Lie on your left side, tucking your left arm under your head and your right arm flat on your right side."
She walked over to the stretcher while I put on gloves and sat down next to the ultrasound device on a little stool. I put some gel on the transducer and held it above her like some sort of impending doom.
"Okay, here we go. Don't freak, it'll get kinda cold and wet on your chest now."
My hands trembled just as badly as they had when I first learned how to do ultrasounds. I set the transducer down onto her skin, between her breasts, just slightly to the left of her sternum. After wiggling the transducer around for a bit, I managed to get a very nice and clear picture. My eyes were now trained on the screen of the ultrasound device, away from her body and my interest for all things medical took over again, laid itself over my embarrassment and washed it away.
Just as I has expected her heart was in very good condition, beating efficiency and regularly, with all the valves intact. I then switched to a transducer position that would allow me to actually verify my hypothesis on her fainting. The position was on the left side of her rib cage, slightly below and left of the left breast. Rearranging the transducer gave me a slight, tingling sense of embarrassment again - but it was lighter this time; her actual diagnosis being more interesting to me than her hot body.
Out of routine, I measured how much of blood contained in the heart would be pumped out with one beat and I examined the flow over the valves. Measuring the speed of blood flows always came with a weird audio representing the speeds, which would never cease to sound very alien-like to me. As I adjusted some settings to only examine the speeds currently relevant to Brittany's heart, the weird audio got louder and Brittany turned her head to look at me with a very dreamy and curious expression.
"What is that sound?" she asked.
"It's an audio representation of how fast blood flows in and out of your heart. I can look at different sections of the heart and check for unusual speeds. For example here," I turned the screen so Brittany could see it, "we have the left chamber of the heart and the aortic valve. The left chamber gets blood with a lot of oxygen from the lungs and pumps it into our biggest artery, the aorta. From there, it feeds all our different organs. The aortic valve separates the left chamber from the aorta. If the speed of blood we measure here is unusually high that means the aortic valve doesn't open completely and the blood has to be squeezed through a much smaller hole at higher speeds."
"And you can see all of that information in that little grainy line there?" Brittany seemed to genuinely interested, "Does my valve-thing open completely?"
"Yes, I look for sharp spikes of the graph in this place," I point it out to her on the screen "but your graph is nice and smooth there, so your valve is opening fine."
"Wow, and to think you can know so much about my heart by pointing this little thing to my chest."
She seemed excited about my field of expertise, interested in what I showed her. I was overcome with a wave of joy and pride, and happily went on to show how to examine the rest of her heart.
"And now," I said about fifteen minutes later, "we get to the part that I'm actually interested in, the pericardium. The pericardium is the fibre that surrounds the heart muscle, pretty much like a shopping bag. My theory is that your pericardium has an inflammation, caused by whatever caused your cold. If that is true, there is a good chance that the pericardium will produce a little liquid, just like we sweat a lot when we have a fever. That liquid then pools between the pericardium and the heart muscle, and we can see this pooling of liquid via ultrasound. Remember what colour liquids have in ultrasound?" I felt like a teacher, and I loved it.
"Black! And the heart muscle is dark grey-ish!" Brittany answered eagerly. She seemed almost insulted by having to answer such an easy question.
"So we're looking for something black that's outside of the heart muscle. Here, this is where the heart muscle ends and this fine grey line here is the pericardium. And what do we have here?"
"A black shape, like the crescent moon. Pooled liquid!" She almost did a little happy dance on the stretcher because she just found out that her heart was being sick right now. Her childlike ability for excitement and joy was extremely adorable.
"Exactly! Wow, you should be doing my job, you don't even need me!" I quickly measured out the pericardial effusion that I had spotted almost twenty minutes ago and printed a picture of it.
Brittany pouted. "Of course I need you! If it weren't for you, I might have thought that the liquid was outside of the pericarium," I smiled at her troubles pronouncing the word, "how can you be so sure it's inside and not outside?"
"That's because I know very well what the healthy state looks like, so I can spot things that are different somehow very easily. Learning how things look normally is always the first step of medical learning. So we're kinda doing it the wrong way around for you right now."
"Well, maybe I should have a look at a healthy heart then."
"Do you think you'll get more ultrasound lessons soon?"
"No, I mean like, right now."
"But how would that work? I can't have you examine another patient for legal reasons."
"I'll just examine you! Your heart is healthy, isn't it?"
For the first time in quite a long while, I felt embarrassed again. I wasn't too sure whether I could handle Brittany with an ultrasound transducer all over my half-naked self. But she looked at me so expectantly, with a hint of bashful thrown in, that I didn't find it in myself to disappoint her.
"Okay," I said and got up from my little stool, putting the transducer away. I walked over to a wall where a dispenser for paper towels was next to a sink, grabbed a few towels and handed them to Brittany. "You can clear that weird gel off of you with these". She quickly wiped herself off and then jumped to her feet. Without bothering to put on her shirt again, she pulled on a pair of gloves and disposed of the used towels.
"Shirt off! Lemme get to that heart of yours!" she chanted happily.
Either Brittany was dangerously innocent and asexual, or she was toying masterfully with me. I wasn't sure which interpretation of her behaviour I preferred. My hands were trembling as I cautiously pulled my shirt over my head and dropped it on the chair next to Brittany's. The sight of our shirts next to each other pleased me, probably way more than it should have.
Under Brittany's impatient eyes, I positioned myself on the stretcher. Once I was lying correctly, I began instructing Brittany, who had by now claimed the small stool like it was an emperor's throne.
"There's a bottle of gel to your left. Put some of it on the trans-"
"What is that stuff anyway?" Brittany interrupted, "some sort of lubricant?"
I snorted loudly at Brittany's question. She either didn't notice her innuendos or she tried to kill me with them. Then Brittany seemed to laugh at my rather unattractive snort; a cheerful, beautiful laughter. It didn't make me feel ridiculed at all, so I smiled widely at her when I finally answered, "No no, nothing like that. It basically erases the echo resistance between the transducer and your skin. Without it, the picture would be much worse due to a bit of air remaining between your body and the transducer."
"Mhmm," Brittany was already very busy searching the correct transducer position on my rib cage. She kept brushing over my boob awkwardly and I helped her find the right spot. Turning her eyes to the screen, Brittany suddenly grew very quiet. Her brow furrowed ever so slightly and light wrinkles formed on her nose.
"Do you have a nice view?" I inquired softly.
"Yes, I do. It's amazing in fact. Like I have your life force directly in front of me." Brittany looked at the ultrasound device in such awe; I found it hard to disturb her. But we had been in here for far too long; Brittany wasn't my only patient and if I wanted to get home before midnight, I had to get back to work.
"And, what about my pericardium?" I thought I should at least address the reason for her fingering my boob unconsciously with hands sticky from ultrasound gel before ending our little session.
"It definitely looks different from mine ... Is this here where the muscle ends? And where do you see the perivaium?"
"Yep, that's where the muscle ends. And the pericardium is directly on the muscle, you can't see the tiny space between them that is always there. But you can see how the border of my heart muscle is much smoother than yours. Yours looks more ragged because of the inflammation and the liquid in there." I cleared my throat loudly. "So, that wraps up our little ultrasound lesson."
Brittany looked like she had just snapped out of a trance. She jumped up to get me some paper towels, and then just as eagerly put them onto my chest. I was pretty sure that even I had to be blushing by now. Trying to look as unfazed as possible, I got up and quickly put on my shirt and lab coat.
"Well, Ms Pierce, that certainly was an unusual ultrasound. But we did support my theory pretty soundly. I'll be looking at your ECG up at the ward later but I think it will show the same thing we have just seen. My plan for you is that you'll have to stay here over the weekend, then we'll do some check-ups on Monday and if those are okay, you can go home then. Is that alright with you?"
I had a hard time deciphering the look on Brittany's face. She nodded slowly. I gave her a soft smile and told her to go back to her room and that I'd come by again in a bit. Finally, she put some clothes on again and that immediately made me get less tense. She curtsied cutely and skipped out of the room.
After staring at the door through which she had just left for a minute more, I turned towards the computer in the room with a furrowed brow to type out the result of Brittany's examination. I had problems finding the correct words, though, because this woman had left my mind a complete mess. And I still hadn't apoplogised.
A/N: I really hope I can get the next chapter out as fast as this, what with me having guests over and going to Uni again. But I think that Brittany's easier to write, so maybe that evens out :)
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