Each team member had an idiosyncratic habit that erupted like a nervous tic during the final moments before a patient arrived. Susan, the charge nurse, fiddled with instruments and medication vials until they were just so, lining them up on the stainless steel tray like little soldiers at parade rest. The other nurse, sporting an oversized nose ring that almost made his spiked orange hair a nonevent, stepped on every moment of silence with idle chitchat. The respiratory therapist checked and rechecked her equipment, her demeanor grim, as always. And Megan, third-year pediatric resident, stood motionless, staring at the well-worn swinging doors, her gloved hands joined at the chest.
Gloves and goggles were the only common element of dress among the four persons standing in Trauma One. They were otherwise a motley crew. Megan was wearing a threadbare yellow smock over well-worn jeans and a green blouse, Susan favored loose-fitting floral scrubs, the other nurse a purple tie-dye creation, and the respiratory therapist wore dark blue scrubs.
Megan’s mouth felt dry. At its best, trauma medicine was an edge-of-your-seat display of exquisitely choreographed action and reaction. At its worst, it was bedlam. She didn’t care much for either image. After all, she was training to be a general pediatrician, not one of those emergency medicine types who suffered from adrenaline-seeking behavior.
A siren suddenly invaded her thoughts, and pulses of red light pierced through the room’s casement windows. A knot formed in her stomach, and then just as quickly uncoiled as the ambulance raced past their hospital.
She let out a heavy sigh, and hoped that no one noticed.
“Megan, what do you know about this kid we’re getting?” asked Susan. The charge nurse’s tone, as usual, bordered on interrogative.
“Not much. A four-year-old boy — his white blood count is off the charts, mostly lymphocytes. He showed up at our clinic in Guatemala and—”
Nose Ring turned to Megan, his eyebrows lifted. “Aren’t you going there next month?”
“I leave in a couple of days,” Megan said. “Can’t wait to get on the plane.”
Like other senior residents nearing the end of their training, she had the option to spend four weeks at the northern Guatemalan clinic in lieu of a second month in the E.R. She had jumped at the opportunity, but for reasons that differed from her colleagues who simply wanted a break from the hospital routine. Her reasons had more to do with healing her ragged spirits. She needed to get out of the E.R. and its daily reminders of her shattered romance with Luke McKenna.
She didn’t know much about the clinic, which was located in northern Guatemala and staffed by volunteers from University Children’s. Each year at least a dozen patients from the Guatemalan clinic arrived at University Children’s, usually for specialized surgical procedures. The patient arriving tonight was different; he was a diagnostic conundrum.
“Lotta short people down there,” Nose Ring said to Megan. “Except for the blue eyes, you’ll fit right in.”
“Yeah, well, I’ve always wanted to go someplace where short and muscular were considered chic,” Megan said. Despite her trim body — the only benefit of a work life that encroached on meals — she couldn’t disguise her natural muscularity, accentuated by a hyperkinetic nature that her father had channeled into gymnastics when she was a young girl.
Susan twirled her hand impatiently. “So about this kid…”
“Nobody’s really sure what’s wrong with him,” Megan explained. “They’re thinking he may have leukemia, but the lymphocytes don’t look typical of leukemia.”
“What do you mean?” Susan asked.
“They didn’t find any blasts — there were no leukemic cells in his blood. But who knows how good our lab is down there?” Megan shrugged. “Originally, he wasn’t scheduled to come through the E.R. He was supposed to be stable, a routine admission going straight to the ward, but he started having trouble breathing during the flight up here.”
The respiratory therapist looked up from connecting her oxygen line to a valve recessed in the wall. “How much trouble?”
“Enough so that the pilot called ahead to the airport, the airport called us, and we decided to send a transport team to pick him up. The team called in as they were getting ready to leave the airport, said he was on oxygen but still breathing on his own.” Megan glanced at the large, round clock on the wall — it was 7:03 P.M. “That was about twenty minutes ago.”
Susan scowled. “I’d like to know what genius decided this kid was healthy enough to fly up here.” She turned to Megan. “By the way, are you it tonight?”
Megan hesitated a beat, irked by where Susan had placed the inflection in her question. “Yeah, just me. I’m the only senior resident on duty.”
Her voice cracked on the last word, rising a few octaves.
Damn. Her voice had always had a husky, two-pack-a-day quality. What bothered her more, though, was its tendency to crack when she was nervous or upset.
Susan squinted at a sheet of paper taped to the far wall. “Who’s the trauma Attending tonight? If we have a kid coming in that we know next to nothing about, I want an Attending here.”
Megan didn’t have to look at the schedule. She knew that McKenna was the Attending — the supervising physician. He did the scheduling for the E.R., and she was sure it was no coincidence that, whenever she had trauma duty, he was the Attending covering the unit. The message seemed clear: He didn’t think she could handle the challenge of trauma care.
“It’s McKenna,” Megan said finally.
“McKenna,” Susan echoed, as if trying the thought on for size. “Good.”
“Ahh, the Iceman cometh,” the therapist clucked.
Iceman. The stories abounded, and most centered on Luke’s ability to think clearly and act decisively under extreme conditions that caused even his testosterone-endowed peers to wilt. McKenna did this, McKenna did that, McKenna wrestled a giant gorilla while doing a heart transplant…blah, blah, blah. It was one of those silly macho things.
She thought the nickname more strange than praiseworthy and sensed that Luke didn’t much care for it either, but then how would anyone know for sure? During the entire eight months of their now-broken relationship, he had rarely shared any feelings deeper than a rain puddle.
“That’s three times this week — you and him on trauma duty,” the therapist added. “Maybe a tiny flame still burns for the Iceman.”
The nurses’ heads jerked toward the therapist, then at Megan. An instant later they buried their faces in busy work.
Megan opened her mouth to respond, but just as quickly gave it up. Nothing she could say would dissuade them from imagining whatever they wanted.
But, God, I am sooo over him.
Looking back, it had been a foolish idea from the beginning. He was an Attending, she a lowly resident. Then there was the seven-year difference in their age, though Luke’s military career before medical school left a narrower gap in their professional lives. He had been an E.R. Attending for just three years.
And as it turned out, none of that mattered.
What did matter was that Luke had never given himself to their relationship as she had. He seemed unwilling to return the trust and emotional intimacy that she had offered to him so freely. The man was a jigsaw puzzle of conflicting images: decent, kind, but also distant and difficult to penetrate.
Three months earlier, while struggling through a difficult time, she had finally surrendered her hopes. But because her female counterparts at the hospital were so…so…enamored with him, from time to time they’d remind her of the relationship that she wanted only to forget.