"I'll take care of discharging Mrs. Richmond so you can get to noon conference on time."
"In full disclosure, we don't have noon conference today. I think it was supposed to be a lecture by Dr. Kevin Collins, but no one caught the schedule gap until it was too short notice to find someone else to fill in," Karen admitted.
Ellen shook her head with seeming frustration. "I'll still take care of the discharge. Mrs. Richmond can be a bit demanding, so it is probably easier if I just handle it," she said.
Karen wasn't sure that it wasn't a trap and she wasn't meant to insist it was fine and she would do it. But demanding was an understatement where Mrs. Richmond was concerned, and she just couldn't take anymore. Anyway, apparently her neighbor, Alice Morgan had a major heart attack overnight and was in the CCU on a balloon pump. She had run into her son Winston earlier and had promised she would stop by. If she let Dr. Burgess discharge Mrs. Richmond, she would have time to do that before she met her father for lunch. "Thank you, I appreciate that. I'll take care of the other two discharges right after lunch," she said.
XXXXXXXX
Lucy Coe Stanton got into the cab in front of the Port Charles Hotel full of frustration. First Dr. Newman's office hadn't been able to work her in for a pregnancy confirmation the same morning, so she was forced to go to the Emergency Department. Then, Rex hadn't picked up his phone, so she was forced to call a cab. Finally, to make matters even worse, while waiting far too long for said cab in the lobby of the Port Charles Hotel she had bumped into the ever-insufferable Amanda Barrington.
"Where to?" the cab driver asked.
"GH," Lucy said.
"Excuse me?"
"I guess you're not from around here. Port Charles General Hospital: you can let me off at the Emergency entrance," Lucy said.
XXXXXXXX
Dr. Monica Quartermaine pushed the door open to the Physician's Lounge with a sigh. Despite her own exhausting night of STEMI call, and the earlier drama with Dr. Jones, she had gotten her intern out the door before noon. The compliance department would be so proud of her. Or they should be, but somehow Iris Sneed didn't seem to be proud of anyone.
With another sigh, Monica removed her white coat and hung it on a hanger in her locker. She reached back in for her pea coat and her purse. As she walked out of the Physician's Lounge on her way to the Physician's Parking Garage, she found her thoughts returning to Tony.
October 11, 1997
Dr. Monica Quartermaine stepped into the North Stairwell from the fourth floor and started to descend four flights. It was a few minutes after nine so she should be home in time to help Alan divide and conquer and get their children to all of their Saturday morning activities.
When she passed the third-floor exit, she saw Dr. Tony Jones trudging upward. He looked so tired and worn and her heart went out to him. She knew the past few years had not been kind to him. "Good morning," she offered brightly.
"You must be loving this! Did you and Bobbie plan this?" Tony screamed.
Monica had no idea what he was referring to. "Tony, forgive me, but I just am not following," she said.
"It wasn't enough for me to lose BJ, no, you had to help Bobbie take Lucas away!" Tony fumed. He shook his fist as he spoke.
Monica cautiously navigated around Tony's ranting form and took a few steps further down the stairs. She didn't think she had helped Bobbie take Lucas. While she understood why Bobbie needed time away after the end of her marriage, she had encouraged Bobbie to stay in Port Charles so Lucas would have access to both parents. Ultimately though, Bobbie had opted to take a travel nursing position at a hospital in Atlantic City, NJ and the court had granted permission for her to take Lucas with her. "I know it must be hard to not see Lucas. I truly can't imagine, and I am sorry that it all ended up this way," she finally said.
"Oh, yeah, you're so sorry that you and Alan are still plotting with Bobbie to destroy me. Well, you tell Alan that there is no way I am losing another child! I lost BJ. Bobbie stole Lucas! Well, I'll be damned if I let your nephew and Carly steal my baby! You tell Alan that!"
Monica decided that there wasn't anything else helpful she could say. So, she merely silently but quickly descended the stairs and exited the stairwell.
When she reflected on that scene and the one, she had witnessed several hours earlier she was struck by the degree of escalation that had occurred in less than a week. She was afraid of the degree of further escalation that might ensue before Carly actually gave birth.
XXXXXXXX
Scott Baldwin stepped into Main Lobby at Port Charles General Hospital with a takeout bag from Kelly's Diner. It was probably less awkward if he called Eve to come collect her lunch before he met Karen for lunch. Or maybe it would be less awkward if he wasn't dating one of his daughter's fellow interns. Of course, that raised the question of whether he was truly dating Eve. He shook his head as if to clear it and then pulled out his cellular phone.
He was just about to place his call when someone collided with him from behind.
"Hey! Watch where you're going!" A shrill, but frustrated, female voice called out.
"Uh, you bumped into me!" Scott asserted as he turned into a whirlwind of familiar brown hair. "Lucy? What are you doing here?" he asked.
"Not that it is any of your business, but I am here to confirm my pregnancy," Lucy Coe Stanton said.
Lucy was pregnant? Scott found himself smiling despite his current frustration with Lucy. He knew how much she wanted a child. He was happy for her. But then another thought occurred to him. Lucy being pregnant likely meant she was pregnant with Rex's spawn. "You and Rex are having a child?" he asked with trepidation that was quickly turning to terror.
"Again, not that it is any business of yours, Pal!" Lucy said before she started off with long strides in the direction of the East and West wings.
Scott could only shake his head.
XXXXXXXX
In the Port Charles General Hospital Emergency Department, Dr. Howard Osmer shrank back when he saw Amy Vining approaching. He found most of the nurses intimidating at best; but Ms. Vining took that to another level.
"Here, this next one has your name written all over it," Amy Vining said as she handed over a clipboard with a stack of papers. "This one is so simple even you shouldn't be able to mess it up," she added as she turned to walk away.
Howard shook his head. It wasn't his fault that Emergency Medicine wasn't exactly his area. Unfortunately, based on his previous rotation evaluations, Internal Medicine, Obstetrics, and Pediatrics weren't exactly his areas either. So, with a sense of dread, he picked up Lucy Coe Stanton's chart and headed for room 21 down the back hall of the Emergency Department.
XXXXXXXX
Sometimes pediatricians deserve hazard pay! Dr. Buzz Stryker concluded as he stepped from Sarah Webber's room. He was quite certain that any possible organic explanation for Sarah Webber's symptoms had been excluded. Beyond that he was becoming more and more convinced that malingering was at the top of his differential. Meanwhile Sarah's grandmother was convinced that all the physicians were idiots missing some significant explanatory diagnosis.
"I don't suppose you're discharging Sarah Webber?" Pediatrics Nurse Manager, Grace Benton asked as she came down the hall to join him.
Buzz shook his head dejectedly. "Unfortunately, she is still vomiting," he said.
"Ok, well, in that case, I guess I can move her into 5520. Audrey asked me again this morning about her having a private room and that should be open once Jesus Hernandez moves upstairs to the Pediatric Hematology Oncology Unit for his chemotherapy," Grace said.
"Yeah, sure," Buzz said but then he had an idea. "Isn't 5520 one of the rooms with video capabilities?" he asked.
"Yes, why? Are you considering ordering a video EEG?" Grace asked.
Buzz hadn't considered that although he supposed if his initial suspicions weren't confirmed he probably should consider that. After all, Sarah had basically had every other test, why skip the video EEG? "I thought maybe we could just do the video part first and then based on that I'll talk to Dr. Lewis about the EEG."
Grace offered him a knowing look, but she didn't say anything more.
XXXXXXXX
Port Charles General Hospital Emergency Medicine Attending, Dr. Richard Carmichael's boyfriend was always reminding him that the latin root of doctor was from the verb docere which meant to teach. So, he really tried to channel that sentiment as he listened to Dr. Howard Osmer's rather disjointed presentation. He also tried to channel compassion. Internship had a steep learning curve. As much as he didn't want to believe he had ever been as awkward, ignorant, and just generally hapless as Dr. Osmer he suspected a few of the nurses in the Jacobi Hospital ED might challenge that. They might even be right.
"I think one challenge with Emergency Medicine, especially as an intern, is that you really need a lot of specialty specific history and exam skills and often you haven't had any exposure to that specialty since medical school so that makes it hard. So, let's focus now on how to take a good obstetrical history," Dr. Carmichael said.
Dr. Howard Osmer shrugged his shoulders. "Umm, ok, or you could just call radiology and tell them to just do the ultrasound," he said.
"Are you concerned about an ectopic pregnancy?" Dr. Carmichael asked. He hadn't heard anything in his presentation that concerned him about that.
"The patient said she needed pregnancy confirmation, so we need an ultrasound for that right?" Dr. Osmer said.
"Why don't you start with a quantitative serum HCG? You should also add a CBC and a type and screen with that if you are concerned about an ectopic pregnancy or threatened miscarriage. The reason radiology doesn't want to do the ultrasound without initial bloodwork is because if the HCG is above 1500 and they don't see anything in the uterus on a transvaginal scan then it is likely to be an ectopic pregnancy. Below that it could just be too early to see so it might be better to admit the patient overnight for monitoring, repeat labs, and then pursue the ultrasound when it is more helpful later," Dr. Carmichael explained. He also made a mental note that he personally needed to see the patient sooner rather than later.
XXXXXXXX
Ned Ashton picked up the phone and dialed Chase's cell phone. It was quarter of one so he should catch him before he returned to court for the afternoon session of his trial.
"Chase Murdoch," Chase announced himself more than answered.
"So, I might have been remiss in my best man duties because advance notice could be key, but I've had a lot on my mind," Ned said.
"About that, I think I've been a bit remiss in my friend responsibilities. My mom mentioned this morning that Carly was in the hospital. She was typing the prayer list for the bulletin at church and I guess it was on that. I wanted to call you, but I was in danger of being late for court at that point. So, how can I help?"
"If you're aware that today is your wife's twenty sixth birthday then we're good."
"After you averted last year's near mishap, I added it to my office calendar. I was going to send her on a surprise trip to see Bobbie for the weekend, but Bobbie nixed that. Don't tell Missy about that, it will make her more insecure. Between you and me, I don't completely understand that relationship."
Ned was sure he probably didn't either. He vaguely remembered that sometime in Fall 1987 Melissa had run away with her juvenile delinquent boyfriend who sold her into some prostitution ring in Miami. Apparently, Bobbie Spencer Brock Meyers had followed her, been arrested for prostitution herself, and by pure chance Scott Baldwin had been her assigned Dade County Public Defender. That had been discussed at the Quartermaine Thanksgiving table in 1987 because apparently after straightening out Bobbie's legal issues, Scott had flown back to Port Charles with her and Melissa, so he was sitting at the same table. It was almost two years after that when he actually met the infamous Melissa face to face when he and AJ went to lunch at Kelly's Diner.
"Sometimes parent child relationships are just complicated," Ned said. His certainly were.
"I guess," Chase said.
Ned heard the lack of understanding in his friend's voice. He just didn't get it and he probably never would. That was great for Chase, and Ned really meant that genuinely without bitterness, but it seemed that his own experience was much less atypical than he had presumed initially. "So, what exciting Birthday plans did you come up with?" he asked.
"After Bobbie flaked, I was going to send Melissa on a girl's trip with Alysha Reyes and Betsy Chilson. Do you know how impossible it is to coordinate three different nursing schedules? Anyway, apparently Josh is coming home this weekend, so I ended up just making reservations at the Grille for tonight."
"Who is Josh?"
"Melissa's brother, apparently Skeeter is no longer cool when you are nineteen," Chase said.
Ned wasn't sure that Skeeter was cool at any age, but he figured that would be impolite to say. "Ok, well, it sounds like you have a plan, good luck with that," he said instead.
"We'll see, but seriously, how is Carly? Is there anything you need?" Chase asked.
"Carly and the baby are both doing better after some IV fluids. Dr. Meadows will probably release her tomorrow."
"Ok, but no matter how busy it may seem like I am with this trial, I really want to be there for you guys if you need something."
"I appreciate that, really, I do," Ned said. He did. Sometimes friendships were just complicated too.
XXXXXXXX
As she walked along the Port Charles Riverwalk, Brenda Barrett knew she was much more escaping than shopping. She was also an incredibly crappy friend because she had drug Miguel all the way back to Port Charles and then abandoned him. Initially she had believed she would have childcare responsibilities. She hadn't had a photo shoot, so she had taken Katelyn to her Friday morning ballet class but then Monica had returned from hospital right before noon. So, after lunch, she put Katelyn down for her nap and Brenda was granted an unexpected reprieve. She should have called Miguel then, but she hadn't been able to face that, so she was just wandering aimlessly along the Riverwalk.
Lily had been Sonny's wife, and perhaps Sonny really had been the one she had really loved. Somehow, Brenda wasn't sure she really believed that though. Lois thought that was because Miguel was her friend and even when she had been "dating" him she had known that someone else held his heart. Lois was Miguel's friend too, and despite that she hadn't ever been in favor of their relationship. She had claimed that was because she was also Brenda's friend, and she knew there wasn't any future in the relationship for her. Or maybe there wasn't…
Miguel had become one of her best friends before they started "dating". In a way their friendship had only gotten stronger after they had accepted that they were really only meant to be friends. After Lily's death she had tried, and likely failed, but she had really tried to be a good friend to him by understanding that Port Charles held mostly bad memories for him. She knew it was a big ask for him to return to Port Charles, but she had done it and Miguel had complied. He was an amazing friend and she wasn't ready to face any of the fallout. She really was a crappy friend.
XXXXXXXX
Scott Baldwin rapped softly on the Scanlon back door which led into the kitchen. His collision with Lucy had kept him from reaching Eve before she had already left the hospital, so he had offered to bring her food to her.
Dr. Evelyn Lambert pulled the kitchen door open with a look of surprise. "You really didn't have to come all the way over here," she said.
"Hey! You have to eat, and I told you I didn't mind. Anyway, I have a deposition out this way at two o'clock," Scott said.
Eve raised an eyebrow. "You do?"
"Well it is in Moriches, but I just get back on Tower Road and poof I'm basically there," Scott said.
"You have clients in Moriches?" Eve asked as she finally took a step back and opened the door wide enough to allow him to step into the Scanlon kitchen.
"Contrary to popular belief, the law is meant to apply to everyone equally, even slum lords, so, yes I do," Scott said. He set the bag of food down on the kitchen table.
"You're defending a slum lord? I thought you had some principles!" Eve said as she rooted through the bag.
"I'm actually advocating for a five-year-old who is living in unsafe housing. I'm attempting to remind said slum lord that the lead abatement laws apply to him."
Eve finished pulling her grilled cheese and soup out of the bag. She met his eyes. "How high is the kid's lead level?" she asked.
"Umm, I think it is ok now, they did some kind of chelation and then the mom relinquished temporary custody to Ward House, but she wants to bring him home," Scott said.
"So, you're taking this case because you can relate?" Eve asked.
"Well, right now, I can but our firm always does a certain amount of fair housing pro bono work for families referred through Ward House."
"I see," Eve said.
For a moment Scott wondered exactly how much she really did see. Eve had always been guarded about her past and her childhood experiences.
XXXXXXXX
Lucy Coe Stanton shook her head as if that might somehow stem the tears that were flooding out of her eyes. "I don't understand…I've been sick…I can't even remember when my last time of the month was, so I know I'm late. How can you tell me I'm not pregnant?"
Dr. Richard Carmichael sensed that the question was largely rhetorical. But perhaps it deserved an answer anyway. He had pulled up her prior Emergency Department chart from July 30, 1997. That was the day she had presented with vaginal bleeding and been diagnosed with a complete spontaneous abortion. An ultrasound had been done by Dr. Kenda Reed roughly a week later which showed no retained products of conception. Dr. Reed had also dictated that she had advised her patient that given her age and obstetrical history, conception of a viable pregnancy was only likely to occur if donor eggs were used.
"I've read that sometimes those tests can just be negative. Some women never get a positive but then it shows on a scan. So, maybe I just need a scan," Lucy rambled on.
"Your serum HCG was undetectable so I'm afraid an ultrasound would be a potentially painful procedure with extremely low diagnostic and no therapeutic yield. In general, I advise against procedures that fit in those categories. I spoke with Dr. Reed's office. She has an opening on Monday afternoon that they could work you into if you wanted to discuss further options."
Lucy Coe Stanton bristled visibly at that suggestion. "How did you know I saw Dr. Reed? That visit was supposed to be confidential!"
"Your medical record is always confidential. However, when patients present to the emergency department, we often review any visits in the health system in the preceding ninety days that are relevant to the chief complaint. You don't need to follow up with Dr. Reed if you don't want to. I was just offering that as an option," Dr. Carmichael.
"Dr. Reed is a quack, a literal quack, and trust me, I should know, I have a duck at home! Sigmund, oh Sigmund!" Lucy Coe Stanton wailed and then she grabbed her purse and bolted from the exam room before Dr. Carmichael could say another word.
Dr. Carmichael just shook his head and realized he really had no idea what just happened.