Chapter One
The piercing sound of a pager goes off, echoing around the room as my adrenaline spikes. It’s a sound every resident has learned to love. It’s a sound every resident has learned to hate. It wakes me from a deep sleep—sleep I only fell into a short while ago based on the hands of the clock on the wall.
I reach over and grab my pager at the same time as I see feet swing down from the bunk above me.
“It’s mine,” Cameron says, jumping down to grab his lab coat. When he opens the door to leave, light from the hallway illuminates my body and he stops to laugh. He nods at my pants. “Dude, must have been one hell of a dream you were having.”
I look down at my tented scrub pants. Then I grab the pillow from under my head and chuck it across the room at him only to have him dodge it before he closes the door behind him.
I lay my head back on the cot in frustration. I’m still tired. I’ve only had a few hours of sleep since yesterday. And it’s Saturday night which means the ER will be busy. It’s the calm before the storm. I should try to go back to sleep. But my mind is stuck on a case I had earlier. And my body needs a release. I could take care of it myself, but what’s the fun in that when I have Gina? I pull my phone out of my pocket and send a text.
Me: MHO. Room 1320. STAT!
Gina: MHO?
Me: Just get here quick.
Gina: On my way.
Not two minutes go by before the door opens. Gina walks into the residents’ on-call room, looking around before she asks, “What is it, Kyle?”
The side of my mouth rises in a cocky smile as I nod to my crotch. “Lock the door and come join me.”
She does what I ask, stripping off her scrubs and undergarments, dropping them on the floor as she makes her way to me. My dick jumps in my pants in anticipation. I’m already hard as a rock. I won’t last long. I pull my scrub top over my head as Gina peels my pants and boxers off me.
She climbs on top of me, straddling me. She sinks down on me without any foreplay, swallowing me inside her tight walls as I palm her breasts. She moves up and down, undulating her body on me until my balls tighten. I grab her hips, digging my fingers into them as I hold her still while I empty myself into her.
She tilts her head to the side with a sly smile. “Well, that brought new meaning to the word ‘quickie’,” she says.
My pager goes off and I reach for it. I’m needed in the ER. “Shit,” I say, practically dumping Gina off my lap in my haste to get up. I’m on Dr. Manning’s service today and he’s a real ball-buster. “Sorry, Gina. I’ll make it up to you next time.”
I quickly dress and then pick up her clothes and throw them to her on the bed as I head across the room.
“Kyle?” she asks, as I’m reaching for the door. “What’s MHO?”
I smile and then wink at her. “Major hard-on.”
Her laughter trails behind me as I close the door and run through the halls to the emergency room.
I try not to feel guilty about leaving her hanging like that. About using her for a quick release. I tell myself we both know the score. We agreed long ago that this thing we have would be nothing more than booty calls and stress relief. It’s not about feelings or emotions. It’s about sex. Whenever and wherever.
As second-year residents, we are slaves to the hospital. We’re married to the job. Relationships don’t work for people like us. People who work eighty-hour weeks—more if you count the hours we troll for cases and finish up paperwork off the clock. I remind myself that this is what we do for each other. Service our carnal needs. She took care of mine just now. It’ll be her turn later. Tit for tat, so to speak.
I round the corner to the ER and find one of the male nurses struggling to hold up a man who appears drunk. And homeless by the looks of it. I go over to help as Dr. Manning comes up behind me.
“Took you long enough,” he gruffs, as he skirts by us on his way to curtain one.
“Sixty seconds,” I tell John, the nurse. “It took me exactly sixty seconds to get here. And that’s pretty damn impressive considering what I was just doing.”
“Or who,” John says, laughing as we hoist the man’s languid body onto a gurney in curtain two.
It’s no secret what Gina and I have going on. It’s not that uncommon for interns or residents to hook up with each other given our rigorous schedule. Hell, it’s not uncommon for attendings for that matter. They are just more discreet about it than we are—usually because they are sleeping with residents.
John gets the man cleaned up while I go wash my hands and check in on another patient. When I return to curtain two a while later, what I see amazes me. John has washed our patient down, helped him shave, and combed his hair. With the man in a hospital gown instead of ratty clothing, he almost looks like the doorman of my building. He could be anyone. A banker, a construction worker, a father.
I shake my head knowing we’re all just one bad circumstance away from being in his worn and battered shoes.
John hands me his chart. Willie James is the name written at the top. “Mr. James has a ten-centimeter laceration on his right shoulder that will require stitches. Says he fell down the stairs at the subway station. He also has some sores on his feet that I cleaned up, and he appears dehydrated which should come as no surprise.”
I do my assessment and look over his chart. Then I order a few tests to rule out diabetes. A lot of homeless people have sores on their feet, but if he’s diabetic, they could be life-threatening. “Also, hang a banana bag and hand me a suture kit. I can go ahead and stitch him up while I’m here.”
Now that Willie is cleaned up and getting hydrated, he’s more coherent.
“You look like my son,” he says.
“Really?” I ask, throwing in a stitch. “What does he do?”
He shrugs, making me have to pull the needle away. “Dunno,” he says. “Haven’t seen him in years. But I’d like to think that maybe he’s gone on to do something like you. Your father must be very proud of you, son.”
“I like to think he is,” I say.
By the time I’m done with him, I’ve learned a lot about the man, and we’ve had a good conversation. It’s amazing to me how people will open up to you if you just listen to them.
“Thank you, Dr. Stone,” he says, grabbing my hand to shake it. “Do you know you’re the only doctor who has ever treated me like a person and not an animal?”
I try not to show him pity. But I have a hard time not showing my anger over his statement. “If that’s true, it makes me ashamed to be called a doctor.”
“You are the future,” he tells me, before nodding at an attending walking past us. “Not them. They are old and set in their ways. You can change the world if you put your mind to it.”
I smile and nod my head. “I plan to, sir.”
He laughs, and then he looks at me like a proud father. “I don’t doubt you will, son.”
“I’ll check on you later, Mr. James. If your tests come back alright, you’ll be free to go in about an hour.”
I stand at the nurses’ station, making notes in his chart. I look over at Dr. Manning and watch him interact with another resident. Willie is right. He’s old and set in his ways. I vow never to become a bitter, empty soul like he has. Never to be so consumed with medicine that I forget why I’m here in the first place.
Gina swats me on the ass on her way by. She must have been paged here. She’s doing a rotation in the PICU now. But the week after next, we’ll be back working together again when we both start a four-week OB rotation.
Cameron, Gina and I are all emergency medicine residents. We spend most of our time in the ER, but we also rotate around to other areas. While it’s been fun to be largely on the same rotations as my friends, Cameron has no interest in doing a second rotation with ‘the vagina squad,’ as he likes to call it. We all had to do one our intern year and that was enough for him. Cameron chose plastics, while Gina and I have chosen OB as our second-year elective rotation.
Gina winks at me as she escorts a toddler on a gurney into the pediatric wing of the ER. I know that wink. It means she wants payback later. I check my watch. It’s almost ten o’clock. She’ll have to wait. It’s bound to be a long night. Saturday night tends to bring out the crazies. I watch her walk down the hall, her long legs striding next to the gurney. Her thick brown hair is pulled up into a ponytail, and I watch it bounce from side to side with each step she takes. I do love brunettes. Always have.
Over the next hour, I deal with several minor cases. Food poisoning. Puncture wound. Dislocated shoulder. By midnight, I’m able to clear Mr. James for discharge, happy to find out he most likely doesn’t have diabetes.
I walk into the ambulance bay, catching him on his way out. I’m glad to see that John has outfitted him in clothes from the lost and found. But I know shoes and socks are hard to come by. Especially socks, we’re not allowed to give out used pairs. I pull out my wallet and grab a few bills.
“Mr. James,” I call after him.
He turns around. “Willie,” he says. “You’ve earned the right to call me by my given name.”
“Thanks, Willie.” I hand him several twenties. “Take this. Buy some good socks and a new pair of shoes.”
He looks at what I’m handing him, clearly wanting to accept it, but possibly letting pride get in the way.
“Son, why are you giving your hard-earned money to an old man like me? A complete stranger.”
“You said it yourself, Willie. I want to change the world. Just figured I’d start with you.”
He shakes his head in bewilderment. Then he nods at me and I can tell he’s choking back tears. “It’ll be a slow ride if you plan on doing it one person at a time,” he says.
“That’s exactly how I plan to do it. Slow and steady wins the race,” I say, putting the money into his hand.
He grips my hand along with the money. “Son, you don’t know this yet, but you’ve already won.”
He walks away, chin up for perhaps the first time in a long while. He thinks I’ve done him a favor. He thinks that by giving him eighty bucks, I’ve somehow improved his life. He has no idea how much it’s just brought to mine.
Before I go back inside, someone sitting on the bench outside the ER catches my eye. It’s a young blonde woman. A pregnant woman. Sitting alone in the dark. After midnight.
I walk over to her. “Miss, are you waiting for someone? Can I help you with anything?”
She looks up at me with teary eyes and a sodden face. “I . . . I’m bleeding,” she says, nodding to her protruding belly. “But it’s late and the clinics are all closed.”
“I’m going to get you a wheelchair,” I tell her. “You need to be seen right now.”
“But I don’t have insurance,” she says with tentative eyes.
I shake my head. “Doesn’t matter. We’re required to treat everyone in the ER.”
“You are?” she asks, looking relieved.
“Yes. What’s your name?”
“Uh, Elizabeth,” she stutters.
“Wait here, Elizabeth. Don’t get up. I’ll be right back.”
I quickly go inside to get a wheelchair and ask a nurse to come with me. I brief her on our way out. “Pregnant woman. Maybe early third trimester. Vaginal bleeding. Name’s Elizabeth.”
I help Elizabeth into the wheelchair, noting there isn’t any blood on the bench where she was sitting. That’s good.
“I’m Dr. Stone, and this is Jessica. We’re going to get you inside and see what’s going on. How far along are you?” I ask, as we wheel her towards an examination room.
“Thirty-two weeks.”
“And when did the bleeding start?”
“Earlier today,” she says.
“Can you tell me how much blood? Was there enough to soak a feminine pad? More?”
“I—I don’t know. I guess I used a couple of pads. It started out light. I noticed a few spots when I used the bathroom. Then it got a little heavier. Am I in labor?”
“We’re going to find out. Have you been experiencing contractions? Or have you had any back pain?”
“No contractions. And my back always hurts, so there’s nothing new about that.”
Jessica hands me a chart and I start on it while she helps Elizabeth from the wheelchair into the bed. “You say your back hurts a lot?”
“Yeah, but I think it’s because I’m on my feet quite a bit.”
“Are you a waitress?” I ask.
“No.” She shakes her head, looking embarrassed. “I walk dogs.”
“I see.” I make some notes in the chart.
I tell Jessica, “Order an H and H, coagulation studies, and get her started on fetal monitoring. And page OB to do an ultrasound.”
I turn back to Elizabeth. “Jessica is going to get you into a gown and then we’re going to run some tests to see what’s going on. Is there anyone you’d like us to call for you?”
She shakes her head and looks at the ground. “No. There’s no one.” Then she looks up at me with a forlorn face. “It’s too early, right? Thirty-two weeks is too early to have my baby. So much can go wrong.”
I walk over next to her and put my hand on hers. I notice her skin is velvety soft as I rub my hand on it to reassure her. I look down into her blue eyes, pooling with unshed tears. “We’re going to do everything we can to make sure you make it to full term. But if this baby wants to be born today, there might not be much we can do about it. Thirty-two weeks is early, but not too early. Plenty of babies born at thirty-two weeks are healthy. Let us run the tests and then we’ll take it from there. Okay?”
She nods, sniffing. I turn to walk away when I realize she has a firm grip on my hand.
“Sorry,” she says, her cheeks pinking up. She releases me.
“You’re scared,” I say, reassuring her. “It’s okay to be scared. But know that you’ve done the right thing for you and your baby by coming here.”
“But I can’t afford this. All those tests you rattled off, they sound expensive. What if I can’t pay my bill?”
“Don’t worry, honey,” Jessica says, chiming in. “Before you leave, you’ll sit with someone from patient billing to work everything out. It’s not like they won’t let you leave if you can’t pay. Indigent people come in here all the time.”
I shoot Jessica an annoyed look before she leaves the room to place the orders. “What she meant is that you pay what you can. Believe me when I tell you they slash the prices for self-pay. It won’t be as bad as you think.”
Elizabeth stares at the door Jessica just walked through. “Does she think I’m indigent? As in homeless?”
“No. Of course not,” I say. “We deal with all kinds of people here. She didn’t mean anything by it.” I vow to pull Jessica aside and tell her to have a little more respect for future patients.
“Do you have an OB that you normally see, Elizabeth?”
She shakes her head. “I go to the free clinic over on 27th Avenue every four weeks. I was there last week and they said everything looked good.”
“Have you ever gotten an ultrasound?”
“Yes, when I was eighteen weeks.”
“And that was normal?” I ask.
“Uh, I guess so,” she says, tensing up. “What do you think is wrong, Dr. Stone?”
“Maybe nothing, Elizabeth. Some spotting can be perfectly normal during pregnancy. But there is no way to tell until we run the tests. Just hold tight and try not to worry.” I laugh at my words. “I know, easier said than done, but that’s what they always told us to tell patients when I was in med school.”
Jessica returns to do a blood draw and put Elizabeth into a gown.
“I’ll be back when we have the results of your tests, okay?”
“Okay.”
I close the door to give them some privacy. Then I turn my attention to the next chart that gets handed to me. However, I can’t help but let my mind wander back to exam room three. To the girl who said she has no one.
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