Hey everyone :) I am posting another update so quickly because I took a poll on twitter and it was decided ;) the last update was kind of short. So here we are; chapter 15. Enjoy!
"Take a seat Maisy. I'd love to hear how you're doing at the moment."
She kicked off her shoes and grabbed the cushion and laid down on the couch as if she were at home and about to watch TV. Olivia hid a smile; she was happy that the little girl felt comfortable enough to treat her office like a home space.
"I'm just tired," she sighed.
"In what way?," Liv asked, swinging her legs around, slinging them over the arm of the chair she sat in, figuring if Maisy could get comfortable, so could she. "Sleepy tired or tired in your brain?"
She thought for a moment before shrugging. "I don't know…" she smiled, "Olivia, I like it when you get comfortable too, you look like a big kid," she giggled in spite of her bad mood.
Olivia grinned back at her. "Good, well let me tell you, kiddo, I'm tired too. I'm tired in my brain and I'm also sleepy tired so I'm gonna relax with you today."
"How come you get tired in your brain?," she wondered curiously.
Liv thought about how to be a little diplomatic with her but also wanting her to understand that her feelings were completely valid. "Sometimes life makes us tired in our brain," she admitted. "Sometimes its work or maybe someone could say something that's upset me— or maybe I've said something that hasn't been nice or kind — it could be lots of reasons."
Maisy brushed her brown hair from her eyes. "I don't think you could ever be mean to anyone, you're too nice."
Olivia just smiled. " What's bothering you at the moment?"
She shrugged. "I dunno… Mom and I have been watching Gilmore Girls together every night and sometimes during the day if there's not much to do which has been fun and she said that she's getting me a huge surprise for my birthday in a few months so I'm trying to be excited about that, but it's a little bit away."
"Oh, that is exciting, you're turning 12! I bet Mom has something amazing planned. Your Mom is such a good, dedicated Mom, Maise, she is going to really pull out all the stops, I just know it."
Olivia already knew that Holly was planning on buying her daughter her very own dog that she had been asking for for such a long time. Olivia had shared with her the studies of positive correlation between mental and physical well-being and animals.
"Mom said it's been a big year for us so she is going to give me a big surprise."
"Well — I can't wait to hear all about it."
"Olivia can I ask you a question? It's okay if you say no. Mom said that maybe it was inappropriate to ask."
Maisy had her attention. "You can ask and I will tell you honestly if I think it's inappropriate."
"Uhm…" she paused and shrugged, "no, its okay nevermind-"
"No, no, ask me, go ahead, I'm all about being honest, sweetheart, and I will be very honest with you."
"Okay," she let out a breath of air as if she were almost ashamed to ask. "I got a special award at school even though I haven't been there very long. It's our end-of-year award night and I am getting a big honour. They don't tell us what it is until the night but I was wondering if you would like to come and see me get my award because I know you're not really my friend-"
"Wait, I'm not your friend?" Olivia widened her eyes as if it was news to her. "I thought we were friends! You're my friend."
Maisy laughed, her cheeks flushing. "Well I mean, you get paid to listen to me…"
"But you're still my friend and I care very much about you and even if I didn't get paid I'd still care about you and I'd still want to check in to see how you are and see if you need to talk," Olivia admitted honestly. "So, why don't you tell me when the award night is and I will be there; promise."
"Yeah?" Maisy sat up, "really?"
"Really!" Olivia grinned at her. "You should be so proud of yourself, getting an honour at school when you've been struggling so hard in other areas. You are such a beautiful, brave spirit Maisy - you deserve this."
"Thank you Liv. I wanted to ask Dr. Trevor too, but I think that's too strange, right?"
Olivia smiled, "You leave Dr. Trevor to me, if he can be there he will be there, I know him."
"Cos he's your boyfriend," Maisy teased.
Liv laughed, "he's my friend who's a boy and also my co-worker," she replied.
Maisy giggled more and said nothing else about it.
/
Olivia opened up her emails after Maisy left and took a deep breath and yawned to herself. She was starting to get a little bit hungry.
There was an email from Professor Carisi. "Hi Olivia, I'm looking forward to having you onboard with us next week. Would love to have a catch up and was wondering if you've got time to come and sit in on a consult with one of my patients this afternoon at 3:15? It would be a good opportunity for us to meet and have a de-brief afterward as I've had a cancellation. No pressure, I know things are probably quite busy up on level 4.
Kind regards, Dominic"
"Shit," she muttered. She emailed him back right away.
"Hi Professor, I would love to but may have to shift a few things around. I'll get back to you within the hour to let you know if it's feasible. Thanks for the opportunity.
Kind regards, Olivia."
She locked her computer and got up and crossed the hall to see if Trevor was around. He was in his office alone with the door ajar. She knocked lightly before pushing it open. "Hey, come in…" he was eating a sandwich and had a chopped salad open beside him ready to start on it. "How'd it go with Maisy?"
"Good, she didn't really want to delve too deeply in anything — oh while I forget, she invited me to come to some award night because apparently she cleaned up at school even though she's only been there for about six months," Olivia flashed him a smile. "She said she wanted to invite you too but wondered if it was lame, so I said if you're not working, I would bring you."
Trevor laughed, "That's kind of cute, why does she want us there?," he was a little perplexed.
"Don't you understand that we are a safe-haven to these kids sometimes? I would say Maisy trusts you, you saved her from having to see all those different vulture doctors that were forcing Mom's hands for tests and all those other unnecessary things. You keep an eye on things and you treat her like a person, not an illness, Trevor, you're very good at building a connection with your patients. It's no wonder they love you."
He gave her a lingering smile that quite frankly made her stomach flip-flop; in the good way.
"And Maisy thinks of you as her friend," he replied.
"Yeah, she doesn't have any friends at this point and maybe it's misplaced, but I adore this kid and I want to cheer for her wins, it's what she deserves at this point so I wouldn't miss it and I hope you'll come with me."
"I will," he smiled. "If you get me the details, I'll make sure I'm free."
"Now, the other question, I just got an email from Dominic Carisi, is it Sonny or is it Carisi?!," she wondered, confused by the fact that Trevor had referred to him twice as Sonny.
"Sonny is a nickname or I guess a less formal name, maybe call him Dominic unless he tells you otherwise. What did he say?"
"He actually invited me to sit in with him this afternoon with a patient and then catch up afterwards to debrief and officially meet. So I wanted to know what time your patient is? I don't want to leave you hanging."
"Are you kidding Liv?" Trevor laughed, "don't worry about me, go ahead and sit in with Dominic, you can't say no to that. If you're not here to sit through the appointment with my patient, I'll manage with the help of a nurse and you can sit in next time."
"Are you sure?" Olivia asked, "I feel kind of bad…"
"Nope," he shook his head, "definitely don't feel bad. Consider yourself ejected from my appointment," he winked. "Go sit in on Dom's one."
"Thanks for understanding, Trevor," Olivia smiled at him. "I hate to run but I actually am starving and I have to see a couple of the kids."
"Do you want half a sandwich?," he asked, nodding toward the other half, "you can have it, take some salad too—"
She softened at his kindness. "No, no, you eat it, Trev, it's okay. I'll get something soon. I might go down before I head over to Cardio."
"Suiiiit yourself, but the offer stands," he replied. "I'll even save you some and put it in your little office fridge."
"I don't have an office fridge," she replied giving him a quizzical expression.
He laughed, "you do now, I just got a new one, so I'll move my old one in to your office and find a place for it in one of your cupboards so you don't have to worry about people checking out your food and being tempted to eat it."
She laughed, "Are you serious? That would actually be so good, I could buy a whole pack of coffee cans and never have to go downstairs again."
"You are so funny, Liv," he laughed. "Are you okay with me going in and finding a place for it?"
"Yeah, of course. Thanks Trev, do you want some money for it?"
He cocked his head in reproach. "No, Liv, I don't want money from you, don't be silly," he replied.
"Okay thanks, well, I better run, I'll catch up with you later."
"You're gonna smash it with Dom, I promise," he winked. "Oh and I forgot to say, Sarah is back, poor thing, she went back to school and then she picked up a cold and now… she's in the high care isolation room. Feel free to go in and see her, but fully-suit up."
"Oh shit, really?" Olivia pouted, "poor kid, okay I'll go see her."
He nodded at her as he did sometimes, with a half-smile as if to acknowledge her in a soft way. It was a little adoring look that she realised she had become so fond of.
She set off down the hall in what he deemed as his favourite outfit of hers. She wore her wide-legged black pants with a nude coloured camisole under a white blazer. She wore a lot of chunky gold jewellery that jangled as she walked and her hair fell in to a curl both perfectly in place and yet as if it had a life of its own.
He needed to tread carefully, the weekend had spooked her, he could tell, but he was hook, line and sinker in love and there was no more pretending or playing it off any longer.
/
Olivia felt her hands tingling as she approached the reception desk. "Hi," she smiled, masking the anxiety that took up shelter within her bones. "I'm Dr Olivia Benson from high care on level 4, Professor Carisi is expecting me, I believe," she told the expectant receptionist.
The young girl smiled, "sure, did you want to go to the lounge? It's down there to the right," she pointed to a corridor looking a little like a flight attendant giving out safety instructions and showing passengers the exit.
Olivia had no idea what to expect with Dominic Carisi, all she knew was that if he was anything even similar to Franklin, she'd bail on the idea of reacquainting with cardio. She was already tempted to run out the door and back to the lift.
"Thank you, will you let him know I've arrived though?," she wondered.
"Sure Dr. Benson, I'll send him an alert now."
She thanked the receptionist and headed down the hall to the Drs lounge feeling slightly out of place as she murmured a hello to someone she had never seen before.
She took a seat and pulled her phone out and saw a new message from Charlotte. She gave a short sigh. She was done with the fighting and had all but given herself the permission to grieve for something that she thought she had. She spent a lot of time feeling guilty and being guilted but Trevor had made her see that it wasn't all on her shoulders and that Charlotte had been a little crafty in turning Olivia in to the villain in her version of events.
She opened the message: part of the problem was that she was never quite sure which version Charlotte she would get.
"Hi Olivia, I hope you're doing okay. I just wanted to check in on you. Be well, keep busy. I do miss you. Xxx"
When Charlotte was being kind, Olivia worried, it usually meant that she could almost expect that she would start leaving her aggressive messages if she didn't respond within Charlotte's own personal allotted period of time that she didn't ever share. Olivia liked time to think over her messages in order to respond carefully and thoughtfully so as she didn't give her ex any hope for reconciliation, but not so much coldness that she sounded heartless or like she didn't care about her at all.
"Olivia," she heard her name at the doorway. She looked up like a deer caught in headlights, like she had been caught doing something wrong. She almost leapt up off the seat, looking at the tall, slim man who smiled warmly.
She had not been expecting him to look so young.
"Hi, I'm guessing you're Professor Carisi?," she asked with a smile, trying to mirror his warm tone and inviting demeanour. He had slightly greying hair swooped back in an almost vintage-type way and his smile was cute, not Trevor cute, nobody could be that cute in her opinion, but still; charming and kind.
Notably, he, like Trevor, wore a white coat and for that she laughed interiorly.
"In the flesh, so good to finally meet you, I've heard a lot about you!" He extended a hand to shake it.
"Oh really? I don't know if that's a good thing or a bad thing," she chuckled nervously.
"Only good, I promise. Follow me, we'll go and have a seat in my office until Henry McLintoch and his Mom arrives." Olivia followed him in silence just across the hall to a large examination room with a lot more equipment than Trevor's had. "We do everything from this room, I usually call a tech in to do an ECG," he motioned toward the bed, "they bring in the portable unit. We do all the usual vitals and if it's necessary, I do weight check if we are worried about any retention."
"Oh great," Liv nodded.
He pulled a chair around beside him at the desk. "Take a seat if you like," he motioned to it as he sat down at his own swivel chair. Liv did as she was told. She felt so nervous despite the doctor being friendly and nice. She really hadn't experienced that before for someone in such high esteem.
"So, can you tell me about Henry? What we're dealing with?"
"Sure," he smiled and double clicked on the patient's profile. "He's six. He has a coarctation of the aorta, the narrowing of the aorta is in the aortic arch which as you know, is most commonplace," he glanced at Olivia, not wanting to assume, but figured she was following along easily.
She seemed to be, she was reading over his shoulder; he didn't mind. She was serious-faced and concentrating. "So, how's the pressure on the left side going? Is he coping okay?"
Sonny smiled, happy that she understood the symptoms and the impact on his patient. "Its so-so, but it wasn't picked up in infancy so we're kind of scrambling to get the finer details. I suspect Ductal coarctation, and at this stage, I really want to get a good look at what we're dealing with before I can make further assessment. So, I figured, two sets of eyes are better than one."
"I appreciate you asking me to sit in on this one," Liv replied, pulling her eyes away from the screen. "Are you going to do a cath? Or are you gonna start mild with an echo and MRI?"
"I'm not sure, I think I'll get you to have a good look at him, his symptoms and I'll let you assess him as well and you can tell me what you think and put a quick case together for me. I really work best collaboratively with this kind of stuff and am happy for other ideas, so, if you're happy to do that — it doesn't have to be formal, just your thoughts and your reasons for them."
"Are you sure? I don't want to step on your toes, Professor."
Professor Carisi flashed her a grin at her formality. "Call me Sonny, Dominic is my legal name, but I go by Sonny. You can drop the professor stuff, it makes me feel a little embarrassed."
Olivia laughed. "Not me, if I was a professor, I'd expect only to be referred to that. I'd even refuse my own name," she joked.
They both laughed and it released a little tension that was starting to gnarl her shoulders.
"Drunk on power is your go-to? I didn't see that coming. Good for you, we need more women in this field, Olivia, I hope that you'll enjoy working with me and the other doctors."
"Thanks, me too," she replied. His words could have floored her but she did wonder if he would live up to them. In her experience high powered male doctors saw little value in female specialists, in Franklin's words it was because women were more suited to home-making and regardless of how career-driven they were in youth, they'd eventually feel the pull to take time to have children and quite frankly, being a highly-sought after surgeon didn't exactly allow for it.
A little chime on his computer made him turn to look. "Ah, Henry is here. You can wait here if you like, I'll go bring them in."
"Okay," Olivia agreed.
She watched the doctor get up and took her phone out to place it on silent. She slipped it back in to her blazer pocket and waited, feeling cautiously optimistic about her role in the appointment.
She only wondered if he would live up to his talk.
/
"How do you think he's going in terms of his breathlessness?" Sonny asked Emmaline, Henry's young Mom who seemed more than just a little bewildered.
"He's alright," she replied, "but he can't really play much with his friends when they do physical education, he complains of feeling dizzy." Henry sat on his chair holding on to a large Optimus Prime transformer.
Sonny tapped a few notes in to his computer. He looked at Olivia, giving her an opening to ask her own questions.
"And would you say that his breathlessness lessens when he is sitting in one spot? Is it only when he is active, or is it also when he's sedentary, like eating dinner and watching TV?," she asked kindly, smiling at the little boy who stared at her curiously.
Emmaline looked at her son and thought for a second, "no I think it's mostly when he's active. He doesn't really notice it, or I think maybe he doesn't know much else? The GP just kept telling me it was asthma so I'm glad I pushed for a referral." Olivia felt for the young Mom. She didn't look much older than about 25.
Olivia smiled encouragingly. "You did a good job," she told her, "sometimes we trust everything everyone is saying and if you never had any other reason to believe that your family doctor was wrong, it can be difficult to push for more, but you know your own baby and we'll get to the bottom of it."
The Mom nodded, her eyes glassing over for a moment. Sonny appreciated Olivia's warmth, her ability to connect emotionally with the patient's mother immediately. She turned to Henry, "hey Henry, how do you feel today?," she wondered.
He looked up at her again, peeling his eyes from the transformer that he was manipulating back in to place. "Good," he replied.
"I like your Optimus Prime transformer. Did Mom get you that?," she asked.
He nodded, "Yeah I got it for being brave when I had my needles," he told her slowly. Emmaline put an arm around her son and gave him a little squeeze. "You were very brave, baby," she added, planting a kiss upon his blond hair. The mother sniffed, brushing a tear from her eye.
Sonny leaned over and pushed his small box of Kleenex toward otherwise of his desk.
"Sorry," she apologised. "It's just been a lot."
"Don't be sorry," Sonny replied, "this is your son, you have every right to be upset, but Olivia is right, we're going to get to the bottom of it and then once we've diagnosed the severity, we are going to collaborate and figure out the best way to treat him so that he can hopefully breathe better and live his best life."
Emmaline nodded, trusting in the pair across from the desk.
"Do you have some supports at home?," Olivia wondered.
"Yeah, my parents have been amazing and my sister too. I'm really lucky," she took a Kleenex and wiped her eyes.
"Well, I'm very glad to hear that." She smiled at Henry who finally clicked all of his transformer pieces in. "Henry, would you like to come over here and show me your transformer? Could I possibly have a closer look?," she asked him softly.
The little boy considered it for a moment. "I have another patient who is your age and he loves transformers, he has Blaster do you know that one?"
"Uhuh! He turns in to an old time-y radio."
Olivia and Sonny both laughed, "they just know how to make you feel old, don't they?" Sonny asked rhetorically.
Emmaline laughed too. Henry reluctantly slid off his chair and slowly made his way around to see Olivia. She got off the chair too and got down on to the carpet, kneeling before the small boy. He passed it to her. "Oh wow, can you show me how he transforms from the truck to the robot?"
While Olivia held it, Henry popped out bits and pieces of it, "you gotta do this bit like that," he explained, "and then you pull this bit out but you can't turn it too much because you'll break his leg." Olivia showed her undivided interest in what he was doing.
"Wow and look at that," she remarked, "Dr Dominic, look at how well Henry constructed his robot from truck, why don't you show Dr. Dominic…"
Proudly, Henry took it and circled around her to show the professor. He figured out that Olivia was trying to get a closer look at Henry, checking on any signs of low oxygen and to get a closer look at the way his chest heaved when he inhaled and exhaled. He took notice of the same things and feigned deep interest in the child's toy.
He already knew Olivia was an asset to work with, she knew how to get information from her patients without even trying hard. She had a warm, direct approach and figured out quickly how to earn the patient and carer's trust.
"Thanks for showing us that, that's so cool. Next time you'll have to bring any other ones you have. Maybe Dr. Dominic and I will become experts just like you?"
Henry giggled.
"Hey, do you think that while we have you here, could Dr Olivia and I have a quick listen to your heart?" Sonny asked craftily.
He peeled his little blue eyes from the transformer up to Sonny. "Mmm okay, I guess."
Sonny smiled, "thank you so much, Henry, Dr. Olivia and I are going to do our best to take away that awful feeling you get when you can't breathe or play as good as your school friends."
"I can't play with my friends because I'm too slow," he remarked with a slight sadness to his tone.
"No, you're not slow! You just have a heart," Olivia placed her hand over her own chest, "that works a little different to your friends, but we are gonna do our best to fix it so you can play and keep up and no one will exclude you anymore."
Sonny took his stethoscope from his desk and put it around his neck. "Honey, would you like to give your transformer to Mommy to hold for a moment?," Emmaline suggested.
"No," he replied.
"That's okay, we can multitask," Olivia replied. She felt grateful she'd thought to bring her own stethoscope. She pulled it from where it hung around her neck and waited for Sonny to finish before she listened too. "Sweetie, I'm just going to take this arm for a second," she added, taking his wrist, quietly taking his pulse.
She glanced at Sonny knowingly before pulling the flat disc away from the little boy's back. "Thanks Henry, that was a big help, you can sit back down with Mommy and Optimus Prime now," she smiled at him.
"Henry had an ECG done yesterday at a lab closer to home," Sonny informed Olivia, "so we're not gonna put him through that again today, but I was thinking that we might see how we go with an echo today if you've got the time, Mrs. McLintoch?"
"We'll make the time, I just don't know how we're gonna go keeping him still, he's kind of — a little fed up at the moment," she told them.
"We might be able to give him a mild sedative to just keep his anxiety as low as possible if you feel like that would be a more appropriate action. I don't want to stress him out," Sonny suggested.
"Okay, I dont want him to stress out either. That might be a good idea. Could we get it done here?"
Sonny nodded, "yeah, of course. I'll get my best tech on to it to do it as quickly as possible for him and then I'm thinking that Olivia and I will check out the results and then based on that, we'll figure out the next course of action," Sonny assured the Mom.
"Will he be okay?," she asked bluntly.
Before Sonny could say a word Olivia smiled, stepping in, not wanting anyone to speak too freely in front of the small boy, who in her opinion, from her very little observation so far, seemed to be a withdrawn. "I think that we can all be assured that Henry here is in the best of care and that it's best for us to wait for the results so we can give you a better idea of how his treatment will look in the future and maybe we can do that at a time where Henry has other activities to do," she looked pointedly at him.
Emmaline got the drift immediately. "Yeah, that's a good idea, thank you, I guess I'm just worried."
"For reference, most children with this particular congenital defect do happen to get along just fine as long as it's picked up on and in this case, we're all here discussing it, so… you can bet that we're right on track to patching your son up."
"Thanks Dr Carisi and Dr Benson. I feel grateful that Henry has not one but two wonderful people taking care of him."
"Its our pleasure," Sonny beamed at her. "And you, my little friend," he turned to Henry, "go easy on Mom, okay? Mom's lookin' out for you and trying to make you feel better. We're looking forward to seeing you again soon!"
"Okay," Henry shrugged.
"Nice to meet you Henry," Olivia told him. "I'll see you soon and I hope you'll have another transformer to show me next time."
"There's certainly no shortage," his mother joked.
Olivia laughed.
"If you just wait in the waiting room, I'll get someone to organise the echo and they'll come and notify one of us when we're ready to give the sedative."
"Thank you," she smiled, getting up and taking Henry's hand. "Wave bye bye, honey," she told the little boy.
He waved but didn't look back.
/
"How do you think that went?" Sonny asked Olivia as she got up and closed the door behind the Mom and child. She assumed a set across from him where Emmaline had sat. "I think it went well, I feel for Mom though - she seems young and overwhelmed and behaviourally Henry is quite withdrawn but I guess that's to be expected."
Sonny smiled, "and medically? How do you think he appeared?"
"A slight mauve tinge around the beds of his nails and the very corners of his mouth so his oxygen is probably suffering a little which was also reflected if not a little unreliably on his SATs and also his pulse was pretty fast. His breathing was okay in my opinion, but he was also quite sedentary, probably still too fast for doing nothing."
Sonny beamed proudly, happy that she covered pretty much every single base he wanted her to pick up on plus a mind for his mental well-being as well. "Excellent. I picked up on all of that as well. Sorry, Olivia, I know this might feel like it's a test and I don't want it to feel that way but-"
"No," she held up her hand and smiled, "you've barely seen my credentials and apart from working in a cath lab back home, I don't come with a great lot of experience in thoracic surgery since my surgical internship and for a few months after, I fully understand."
"I know that Trevor absolutely believes in your talent as a surgeon and Franklin Bancroft hand-picked you to work underneath him on his surgical team-…." Sonny's voice trailed off but she was no longer hearing him over the ringing in her ears at the sound of Franklin's name spoken so freely, so casually as though he was just a person that they both knew and admired on the periphery.
Olivia's mouth went dry. She tried to swallow twice and cleared her throat.
Sonny jumping up out of his seat centered her, "are you okay?," he asked quickly, "let me get you a glass of water…" faster than she had a chance to respond, he was out of the door. She coughed a few times and sucked in air as if she was gasping for it; as though her throat was on fire, burned out by the sound of that man's name.
He hand-picked you to work beneath him…
Sonny re-appeared placing a cold cup of water from the water dispenser outside of his door. "Are you okay?"
Olivia nodded and sucked down the cup of water. "Sorry," ignoring her racing heart and trembling hands, she laughed to cover her instantaneous panic attack. "I guess I just aspirated, maybe I should be coming to see you instead — learn how to breathe," she joked.
He laughed, "just sip the water for a few seconds, you should be able to clear your throat, I hate it when that happens; choking on your own spit."
"Yeah, it's borderline humiliating," Olivia plastered on a smile; the one she gave to others when she needed them to believe that she was fine.
"Its okay. I was just saying, I guess I feel like you have a really warm vibe about you, you're good with the patients and the parents and your assessment is spot on… so pending the echo, which, I should probably organise…" he turned to his screen and typed a few things and excused himself to make a phone call.
He spoke to someone about getting Henry squeezed in and notified the person that a nurse should be available for a sedative. He hung up and turned back to Olivia, "sorry, I'd forget my head if it wasn't screwed on," he smiled. "So if you're happy, I'll send you a copy of the echo and when you get the chance, if you want to have a look at it and make an assessment about what you would do as the next step."
"I can tell you now based on Henry's discomfort around us and the stress that his Mom mentioned, if it doesn't seem severe and we can get a clear picture, I'd probably be more inclined to want to proceed with a catheterisation because doing an MRI can be a hideous process for a child without fully putting them under a general anaesthetic and that comes with its own risks, only to have to do it again later if its necessary to widen the aortic arch. At least the catheterisation can be purely explorative and if while we're there we need to take action, we can do it and it's just a one time thing."
Sonny nodded slowly. "Mmmm yeah, that's a good thought. I was thinking that the younger the patient, the lower their tolerance for treatment. Babies are fun, toddlers can be okay, but at that age where they're beginning to understand the world, it's harder, you know?"
"Yeah…" she agreed, "I guess that's the place I'm coming from too."
"Okay well, when I get the echo results, I'll send you a copy and you can let me know how you feel about the severity of it — if it's still rather inconclusive, would you opt to go through with the catheterisation."
"Yes," Olivia told Sonny decisively. "I would go down that route for sure, but I would also suggest that Mom and Henry come to see me for a pre-meeting before you go ahead because I think they would benefit from a social worker or someone to talk to just to get some emotional support," she bravely told him with a slow smile, glad that she actually felt comfortable enough to speak plainly and without hesitation.
Sonny laughed but nodded, "well, I certainly won't argue with that."
Olivia continued, "I just think Emmaline McLintoch is quite young and while she has the support of her family, she may not have the emotional capacity to understand exactly how she can support her son and sometimes parents have a habit of panicking in front of their kids so it becomes a learned behaviour, you know?"
"Yeah, I did notice you veered the conversation away from discussing anything including the severity of his condition in front of him."
"Sorry, I didn't mean to overstep but-"
He shook his head, "no, no, I appreciate the therapist in you that understands exactly what should and shouldn't be discussed bluntly in front of Henry, sometimes us doctors forget because we are all about the condition."
"I know, I can be like that too, I guess — I recently had a patient who struggled with the anxiety of her condition because Mom and the specialists were talking about things a little too openly and her distress was through the roof."
"Ooh, good learning curve for all of us. Maybe we all need the reminder to be gentle with conversation in appointments when children are present," Sonny agreed.
"I'm guilty of it too, or at least I was when I was a treating medical doctor," she commiserated.
"So, Liv, can I ask what made you want to leave Cardiology? And what's made you shift your mind in to wanting to join as at the cath lab."
She thought about how to answer it. She had practiced her answer in her head a few times but she figured that she had nothing to lose. "There is a lot to it, but my first surgery we lost a patient and I should never have been allowed to lead that surgery but I was pushed in to it and the overseeing surgeon walked out after directing me to do something that I've since learned was absolutely not the right thing to do and I was left to tell the family their child had died during a routine procedure."
She saw Sonny's face sallow, his cheeks suddenly drew inward.
"I want to make it very clear," she told him holding his gaze, "I was absolutely not in the wrong, I didn't do anything that I wasn't supposed to, it was something to do with another undiagnosed heart deformity and I was cleared immediately but there was an insurance claim made and the overseeing surgeon had to pay it out but … I wasn't supported, there was no follow up for how I was dealing with it and …" Olivia shrugged, "I just didn't have enough trust in who I was working for, I guess and that was before the politics set in."
"Olivia, I'm really sorry," he said gently, "that's absolutely awful and I'm sorry Bancroft did that."
"It wasn't Bancroft," Olivia blurted out quickly. She was always so frightened that telling anyone of his despicable behaviour would work out worse for her than for him. Sonny just cocked his head as if to tell her that she didn't need to cover up for him.
"Its okay that it was him, this conversation won't leave my office. I've heard he's kind of an asshole from more than person anyway."
"I don't have anything to say about him," she replied tensely.
"Regardless of who it was," Sony began, playing her game, "it shouldn't have happened. I can understand why it scared you off."
"It was also the politics; the comments, the sexism… all of it, I didn't really like how it made me feel. So far, I am really enjoying working here. I help out Trevor and we have a good working relationship bouncing things off one another and I like helping out where I can medically when its necessary and I guess the medical side of me still hopes to be able to help fix my broken little ones when they come in to see me."
He smiled. "There's no sexism in my department and if there is I want to know about it," he told her. "I am probably one the youngest in my field and I've had some push back over my taking over this department, so I hope that maybe in the future you might gravitate to what you feel you are the most skilled at and if that's here with us, we could always use the help, if it's in therapy then that's undervalued too in my opinion."
"Thanks Sonny, thanks for letting me be honest with you."
"Of course."
"I really don't want to have to run, but I do have to see a patient before I leave today, but I'm looking forward to working with you and I'm going to keep an eye out for the echo results…"
"Sure— and hey, if I have any other interesting cases or surgeries, catheterisation or otherwise, would you be interested in standing in? I wouldn't expect anything of you — not unless you wanted a role, but you could just watch."
She thought about it for a second, "I'd think about it, for sure."
"Great, thanks for coming to meet me, I know you guys are really busy up there. Say hello to the big guy for me," he smiled, referring to Trevor.
Olivia laughed. "Will do. Oh, he's thinking of referring someone for a right heart cath, I think… he was so glad you took over because I think there was some bad blood between him and the last head of department."
They both laughed. "So good to meet you, have a good afternoon, Sonny."
"Bye Liv."
/
Olivia got back up to high-care ward with a spring in her step, feeling positive and full of hope, like perhaps this time she might be able to take some real interest in treating patients as a heart specialist once again.
She tried to caution herself not to get too excited since not only did she have to prove her worth, but she had to trust Professor Carisi, that he didn't just talk the talk and that his departmental issues were overlooked to put a happy face on things that were a little less visible on the surface.
She passed Trevor on her way in. He stood at the nurses station looking over a patient chart. She couldn't help but to notice his eyes lighting up as he spotted her, a grin crossing his face and the tension falling away. He put the chart down and crossed the hall to meet her. "How'd it go?," he whispered. He knew that she wasn't keen on everyone knowing what she was doing.
"Good!," she grinned back. Trevor was happy, he rarely saw excitement from her; pure joy spreading across her beautiful face.
"Great! I can't wait to hear all about it. Want to catch up after work for some sushi?" She wanted to say no, but she had no idea why she was trying to sabotage the feelings that the beautiful man before her had for her.
"Sure. I finish at 5:30 but I have some notes and if I have the patient results that I just saw, I'll want to look at them and write Sonny a bit of a finding report."
"Sounds just fine. I'm really happy for you," he told her in a hush, "I really knew you'd like Sonny."
"Yeah, he seems great," she replied. "So, I'm a little behind, is everyone doing okay?"
"Yeah, but actually, are you going to see Sarah? She's a mess, she's very unwell and she is just so emotional and there's only so much I can do to combat the feelings of a tween."
Olivia smiled, "leave her with me, I'll go see her. I have a two hour block to get around to some of the kids — anyone else that needs a little extra TLC today?"
Trevor shook his head, "Nah, everyone is really good actually. Sarah's parents might end up arriving soon but it's just one visitor at a time given the severity of her infection."
"Okay, thanks Trev, see you later." He couldn't help glancing at her with a fond smile as she passed the nurses station, waving at Meaghan. She made her way down til she reached the isolation unit, sanitising at the sink just on the inside of the airtight doors.
Olivia grabbed a fresh pair of gloves, a sanitary gown to put over her clothes and grabbed from the mask box. She finished fastening her mask on until she reached the second room, letting herself in.
She pushed back the curtain slightly as she heard the young girl coughing heavily, struggling to produce any mucus. She could tell the coughing had come to hurt from the relentlessness. "Easy, easy," she quickly made her way to Sarah, who was doubled-over, red-in-the-face. Olivia dragged the oximetry machine around to the side of her bed and switched it on. She rubbed the young girl's back.
"Sarah, I'm gonna give you a paddle on your back okay? See if we can help you get some of that up…" She nodded, moaning a little in pain. Olivia cupped her hands and began to clap against her back quickly and steadily hearing the hollow sound that she listened for. "You let me know if I'm being too rough, I don't want to hurt you, but I don't need you to panic, we'll work on getting all that gunk up."
She knew the panic, when Sarah breathed in, her chest gurgled in a way that made her sound as though she was choking which she knew was enough to make her feeling like she was drowning from the inside out.
"Take some deep breaths, honey," Olivia told her, "breathe slowly and deeply and know that you're okay, we aren't going to let anything happen to you…" she slowed the percussing to a halt.
"Okay, take a big, deep breath in," she made eye contact with her, "and then I want you to push all of your air out and huff a cough as you go," she knew Sarah knew the drill, but still, Olivia demonstrated it for her, hoping to be a little calming for her.
Sara nodded, her face wet with tears, worked up. She tried to get some mucus up but failed. "Again," Liv told her, "as deeply as you can breathe," when she failed a second time, Olivia insisted, hearing it moving closer to the surface. She handed her a barf bag, "one more time, sweetheart, use this," Sara weakly took the bag and huffed loudly until Olivia heard the wet sound of the mucus coming breaking up. She rubbed her back. "Good job, honey, get it all out, keep going if you need to… you did so good."
Sarah weeped and whimpered, exhausted from the coughing with an aching rib cage and sharp pains in her collarbones from the strain. As she continued to cough up more mucus, Olivia grabbed her a cloth to help wipe her face down which was hot and red from the coughing and from being so worked up.
She began to calm down and Olivia elevated her bed so that she was no longer laying so flat. She wondered why nobody had done that already. "Here, give your face a wipe," she smiled encouragingly at the young girl who was sniffling, trying her best to stop crying.
"I know it's really tough, you're battling this really nasty lung infection, love, but you'll get through it, I promise."
"I know," she sniffled. "I hate it."
"Oh, I understand," Liv sat beside her bed. "I can imagine how frustrating it must feel to always be sick and to always be back here."
"I just want to be normal," she sobbed. "I just wanna be normal like my friends."
Olivia got up and hugged her tightly. "You are every bit as normal as your friends, my girl, you just require a little bit more cotton wool around you so that you don't get sick, but that doesn't define you."
When Sarah pulled away, wiping her face again, Liv sat back down. "It feels like it does right now," she muttered bitterly.
"It must be pretty boring here, huh?"
She nodded, "And I miss being at home with Mom and Dad."
"I'm so sorry, Sarah, you've had a terrible run of health this year, it will get better, I promise. Dr Trevor is working so hard at getting you that special trial medication and hopefully that will make things a little easier on you," she tried to encourage her. "And also, every day we have so many different trials and treatments coming up, we are going to keep you healthy long enough for you to start seeing some of those, sweetheart," she promised her.
It was a promise she could keep because Trevor had confided a few days earlier that Sarah had been approved for a trial drug that could extend the lifespan of a cystic fibrosis patient.
Sarah just nodded and wiped her eyes.
"You know what? It seems like you've had a pretty awful day, so is there anything that you can think of that you and I could do that might make things feel a bit better? I have some games in my office, or we could just talk … or," she showed Sarah her phone, "we could listen to music and work on some art, or if there's something you would like, I can do my best to make it happen."
"I just feel sad," she replied after some hesitation.
"I know you do, its okay to feel sad, I told you that, it's okay to feel like things are a bit hopeless. We all have days like that, but every day is a new day, Sarah."
"Maybe we could play a game and listen to some music."
"Okay, why don't you tell me what kind of a game you want to play. I have UNO, I have Exploding Kittens that one of my other patients bought me as a gift for my office, that's always a fun one…"
Sarah was able to laugh, "what's that game? It sounds awful."
"Its a very very silly and enjoyable card game. Would you like to try?"
Sarah thought for a moment and nodded. "Thanks Olivia,"
"You're welcome sweetheart and while I'm out, would you like me to get you anything to eat? I can get you some … snacks? Maybe some chocolate? Or a soda?," she winked.
A slow smile spread across her face, "Could I have some juice? And maybe some ice cream? For my throat."
Olivia laughed, "Yeah of course. What about Jello, I hear Jello is good for the throat too."
"Oh yeah, Jello would probably help," Sarah nodded. Olivia smiled, happy that she could turn her mood around. "OK, I'll be back very soon and I'll bring you something to ease the cough for a little while."