The Devil Wears Scrubs (14 page)

“I wanted to talk to you about the distribution of patients today,” she says.

“Oh?”

She nods.
“I just… I think it’s a little unfair.”

I’m guessing she doesn’t think it’s unfair that I have eight patients and she has one.
I suspect the unfair part is how there’s a tiny chance she’ll have to do more work than me today.

“You think so?”
I say.

“I mean, an admission is a lot of work,” Connie points out.
“You already know all your eight patients, but it’s going to take me forever to get through three admissions.”

“Well, I think Dr. Westin is worried about me going over the cap,” I say.

“Yes, but isn’t Mrs. Coughlin being transferred to surgery soon?” she reminds me. “Plus you have a couple of other possible discharges for tomorrow, right?”

I set my jaw.
I know what she’s doing and I don’t want to let her do it. The attending decreed that she’s got to take three admissions today. And damn it, she’s going to do it! “Not that many discharges,” I say.

“Yeah, but if I take these three patients, I’ll have four,” she says.
“And if you have three of yours go home tomorrow in addition to Mrs. Jefferson, you’ll only have five. I mean, what’s the difference if you have one more than that? You definitely won’t hit the cap.”

“Well, not necessarily…” I say.

No!
I will not give in!

Connie studies my face for a moment.
“Jane,” she says. “You seem really unhappy.”

I look at her in surprise.
Well, yeah, I’m unhappy. I’m an intern. But I didn’t know I was so visibly, notably unhappy that other people would feel compelled to comment. “Well, I mean, it’s been a rough week…”

“You just don’t have a very good attitude,” she says.
“I think that’s the problem.”

Oh, is
that
the problem?

“I was really looking forward to this year,” Connie says sadly.
“I really wanted to learn as much as I could. And I feel like your bad attitude is just… it’s
ruining
it for me.”

My jaw falls open.
I’m
ruining
her intern year? Is that really what she’s accusing me of? I don’t even know what to say. I want to tell her she’s full of shit (much like my finger used to be), but the truth is, I feel a little guilty. I hate the idea that I might be making everyone around me unhappy.

“
So what are you saying?” I ask her.

“I’m saying you should do your fair share of the work,” Connie says, folding her hands across her chest.
She’s wearing red nail polish, and unlike me, her fingernails aren’t bitten to shreds.

“It’s not even my decision,” I say.
“Dr. Westin was the one who made the decision. This is what
he
wants.”

Connie raises her eyebrows at me.
“Only because you complained this morning.”

I did?

“I talked to Alyssa about it,” Connie says. “She said if you agreed, we’d split today’s admissions evenly, two each. That would be more fair.”

My cheeks burn.
If I made a similar request of Alyssa, she’d have given me the glowering of a lifetime. But she could never say no to Connie, naturally.

I know I promised myself I would say no, but I don’t want Connie going around telling everyone that I’m not a team player.
I
am
a team player. Also, I’m apparently a pushover. “Fine,” I say. “We can split the admissions.”

“
Fine,” Connie says. The bitch doesn’t even say
thank you
.

And somehow, I don’t know how, I end up doing two admissions while Connie does one.

It’s nearly 7
p.m. by the time I leave the hospital. I try not to think about the fact that I’ve spent 13 straight hours at the hospital, and focus more on which spectacular TV dinner I’m going to eat when I get back to my room. I also fantasize a lot about my bed.

Back in my suite, I shove a package of frozen f
ettuccine alfredo into the microwave then hit the bathroom to wash the hospital off my hands. Except before I make it into the bathroom, I find something taped to the bathroom door. It’s five pages long and I’m pretty sure it’s from Julia. I rip it off the wall.

The first page is a schedule of when each of us has to clean the bathroom.
Okay, fair enough. It says: Jane—Tuesdays and Saturdays, Julia—Thursdays and Sundays. And then a list of major holidays and who will be cleaning the bathroom during each of these holidays. So… does this mean we’re cleaning the bathroom
four times a week
? Is she kidding me? It’s a tiny bathroom and the only people who use it are the two of us. How does it require such frequent cleaning?  And when exactly am I supposed to do this cleaning, considering I practically live in the hospital?

The next three pages are detailed instructions on how to clean the bathroom.

The final page is a photocopy of the receipt from a local drug store for cleaning supplies. She spent $89.34 on bathroom cleaning supplies. Why do we need “bleach foamer”? And why are all our cleaning supplies “organic”? It’s not like we’re going to
eat
them.

At the bottom of the receipt, Julia has written my share: $44.67.
That’s seriously more than my food budget for the month. She has
got
to be kidding me. I make minimum wage. (Although admittedly, minimum wage is somewhat lucrative when you’re working like a billion hours a week.)

I am not paying for her stupid organic cleaning supplies.
No way. No way in hell.

Oh, who am I fool
ing? I am definitely going to end up paying her.

_____

At some point, I start
watching television in my bedroom and drift off. What ends up waking me is a pounding noise at the door to the suite. Rubbing my eyes, I stumble in the direction of the door and fling it open without even asking who it is. As soon as I see who’s standing there, my eyes fly open and I’m instantly awake.

It
’s Sexy Surgeon.

“
Hey,” he says. He’s wearing his scrubs, which I think is the only outfit I’ve ever seen him in. Lucky thing he looks so good in them. He squints at my face. “Did I wake you up?”

“
A little,” I admit.

It occurs to me at that moment that Julia is going to throw a fit if she realizes he
’s at the door. The fact that she’s not complaining at this very moment is evidence that she’s not here. But she’s probably got hidden cameras installed somewhere. Or at the very least, a spy situated in the hallway. Maybe there’s a sniper out here, who’s ready to pick Ryan off at any second.

I grab hi
s arm. “Get in here, quick,” I say.

He looks at me in surprise, but follows me inside. I don
’t let go of his arm until we’re safely inside my bedroom with the door shut.

“
Okay,” I say, letting out a breath. “We’re safe.”

Ryan raises his eyebrows.
“We weren’t safe out there?”

“
My roommate,” I explain, waving my finger in a circle to demonstrate Julia’s loony behavior.

“
Gotcha,” Ryan says. He grins at me. “Nice room.”

“
Thanks.”

“
I like the skeleton,” he says.

“Thanks.”

He grins wider. “He’s not going to get jealous and start haunting me, is he?”

I roll my eyes.
“No.”

“
Because I know intern year can get pretty lonely so I wouldn’t blame you if you and Skelly over there… well, you know…” He winks.

I put my hands on my hips.
“Did you come here to make fun of me?”

That wipes the smile off his face.
“No,” he says. “I didn’t.”

He bridges the two-
foot gap between him and me. He lowers his lips onto mine, and now we’re kissing, and there are no pagers to go off, elevator doors to open, or anything to keep this from happening. We fall onto my bed and he gently pushes me down against the pillows, then climbs on top of me.

“
You’re so sexy, Jane,” he breathes in my ear. And I almost believe him.

At first, I
’m scared this is going to go further than I want it to (I just met him a week ago!), but he’s actually very respectful.

Surprisingly
respectful.

What he does with his lips on mine is very intense, but he doesn
’t make any move to push me further than that. His hands move up and down my chest and my thighs, but he doesn’t try to get up my shirt or down my pants. His lips stay mostly on mine, although they make little excursions to my earlobes and that extra-sensitive area at the base of my neck.

We make out like the ship is going down, like we can
’t get enough of each other, but after an hour or so, the kisses become less hungry and more gentle, and we’re cuddling more than kissing. I wouldn’t have taken Sexy Surgeon for a cuddler. He just seems too busy. But it’s nice to lie in his arms like we have all the time in the world, feeling the warmth and comfort of his body against mine. I could lie here forever.

“
I’ve got to go,” he says, as if on cue.

“
Now?”

“
I’m on call, actually,” he says. He fishes into his pocket and retrieves his pager, which he’s apparently been concealing from me.

I stare at him.
“Seriously?”

He shrugs.
“I’ve got an intern. He’s handling most of it. But I told him I’d meet him in the ER...” He checks his watch. “About fifteen minutes ago.”

“
Seriously?”

He shrugs again.
“Let him wait. He’s just an intern.”

“
Thanks a lot.”

Ryan grins,
then he pulls away from me and adjusts the drawstring on his scrubs. “I’m going to hit the bathroom, then I’ll leave.”

My breath catches in my throat.
“No! You can’t.”

“
I can’t leave?”

“No, I mean, you can’t use the bathroom.”

Ryan stares at me like I’ve lost my mind.

I blush.
“My roommate is super weird about the bathroom. Can’t you just use it at the hospital?”

He rolls his eyes.
“Come on, Jane. Just let me go pee.”

I’d like to let him—I really would.
But the consequences of that could be dire. I show him Julia’s Bathroom Manifesto. “Look what she put on the door!”

He takes the pages from me, and laughs as he flips through.
“Whoa, you weren’t kidding. She’s nuts.”

“
See?”

“
I’m still going to use the bathroom though,” he says. He cuts off my protests with a kiss. “We’re going to live dangerously for a change.”

Our compromise is that he goes to the bathroom and I stand guard outside.
He insists I’m being just as crazy as Julia, but I swear, he hasn’t seen that evil glint in her eyes. If I’m going to be sleeping in the same apartment as her, I need to protect myself.

Call #3

My first admission of the day is pregnant.

On the Medicine service, we’re not supposed to admit pregnant patients. They’re supposed to go to OB/GYN. But this one is okay. Mostly because it’s a man. And he’s pregnant not with a fetus but with a lot of fluid that can’t get through his liver because his liver is hard as a rock thanks to years of drinking.

He really looks pregnant though.

His name is Jorge Sanchez and his belly is tense with fluid. His belly button has gone from innie to outie. His testicles are
huge
—I’m talking elephant testicles here. The plan is for me and Alyssa to drain the fluid in his belly then make sure it isn’t infected. I’m supposed to be telling him about this.

Except
like every other patient at County Hospital, he speaks no English.

So I’m stand
ing in Mr. Sanchez’s room, waiting for the translator phone to come through for me with someone who speaks Spanish. The phone is sitting on Mr. Sanchez’s night table, the speakerphone filling the room with the music of Taylor Swift, the same song over and over. I am starting to believe that we are never, ever, ever going to get that translator on the phone. I have literally been waiting for ten minutes, just standing here and twiddling my thumbs. 

Every
once in a while, I try to ask Mr. Sanchez a question. I did, after all, take four years of Spanish in high school. Someone told me that Spanish would be a useful language to know, which it definitely would be, if I could actually remember more than a handful of words.

“
Uno momento mas
,” I say to Mr. Sanchez.

“
No me importa esperar
,” he says.

“Huh?” I say.

This translator better come through soon. Alyssa is supposed to meet me here in five minutes to do a paracentesis with me, meaning we’ll remove his belly fluid. If I don’t have consent from him by then, I don’t know what she’ll do to me and I’m scared to find out. I’m sure Connie would have had the translator on the phone five minutes ago. Connie probably would have taught Mr. Sanchez English by now.

“
Puedo tener un vaso de agua
?” Mr. Sanchez asks.

“Huh?” I say.
How do you say “slower” in Spanish?

He tries saying it slower but I still have no idea what he’s saying.
How do you say “this totally blows” in Spanish?

A hea
vily-accented voice comes out of the speakerphone: “Hello?”

“Hello!” I say.
“Are you the translator?”

“Yes, I am,” the voice confirms.

I lunge forward excitedly, in an attempt to get closer to the phone. Unfortunately, in my eagerness, I trip over a wire. The phone goes crashing to the ground. I stare at it for a horrified second before scooping it up off the floor. “Hello? Hello?” I cry into the receiver.

I lost the connection.

This is one of those moments where you can do one of two things:

1.
       
Burst into tears, shaking fist at the heavens, and yell out, “Nooooooo!!!!!!!”

2.
      
Laugh.

Somehow, against all odds, I start to laugh. I cover my mouth with my hand so that Mr. Sanchez doesn’t see and I attempt to stifle my snickers. It’s not funny. But I guess it sort of is. In a really horrible kind of way.

At that moment, Alyssa poke
s her head into the room. “Jane,” she says. “Did you get the consent done yet?”

Screw this.
I don’t need a translator to get consent. “Give me a minute,” I say.

I take the consent out of my pocket and put it down in front of Mr. Sanchez.
“Es una consenta,” I explain. “Necesita… um, sign. Sign-a.” I make a motion like I’m signing a form. “Necesita put una needle in su estomago. Por la agua in su estomago.” I pantomime fluid gushing out of the stomach. “Um, comprende?”

Mr. Sanchez looks up at me, then down at the paper.
I have no idea if he had any clue what I just said, but he signs the consent anyway. Thank you, Mr. Sanchez!

I come out of the room, holding the consent up like a medal.
Alyssa seems unimpressed by my ability to obtain a signature. “Did you get the supplies?” she asks.

“Um.
No.”

She sighs.
“Okay, go get them.”

I stare at her.
“What supplies do we need?”

Alyssa raises her eyebrows.
“Really, Jane. Come on, you should know this by now.”

I should?
I’ve been an intern less than two weeks. This is my first peritoneal tap. Why should I know this?

When it becomes obvious that I’m not going to magically know what supplies are needed for the tap, Alyssa starts ticking off what I need to get: “We need a red top tube, a purple top tube, a 25 gauge needle, a 20 gauge needle…”

I scramble to write everything down, knowing I’ll get my ass handed to me if I forget a single item. I run to the supply room, and stock up on two of everything, figuring I’m sure to mess up at least once. I return to Mr. Sanchez’s room, my arms brimming with supplies. Alyssa looks over the contents of my arms, probably secretly hoping I’ve forgotten something. I haven’t.

“All right,” Alyssa says.
“I guess we can start.” She eyes my face. “If we’re worried about peritonitis, how many PMNs are we looking for in the tap?”

Say what?
I have no idea what she’s talking about, and I don’t even know what the order of magnitude should be for the answer. Finally, I take a wild guess: “A hundred thousand?”

Alyssa couldn’t look more shocked.
“Are you kidding me?”

I try again: “Ten thousand?”

Alyssa gets these little pink spots on both her cheeks. “How could you do a paracentesis without knowing the number of PMNs diagnostic of peritonitis?”

It’s probably a rhetorical question but I feel compelled to answer: “I
figured I’d look it up after?”

A
lyssa’s lips become a thin, red line. “Go find out right now. Don’t come back before you can tell me the answer.”

Cursing to myself, I run out of the room to figure out the answer to the question.
I don’t want to miss the entire tap, so I’ve got to get an answer fast. Luckily, I see Connie at the other end of the hallway. Connie did a paracentesis a few days ago, so she surely knows the answer. Hopefully, she doesn’t hate me so much that she’ll refuse to tell me.

I race down the hall, yelling, “Connie!”
She turns and her face sours considerably when she sees it’s me. “Hey, I have a question.”

“What is it?” Connie asks impatiently, doing an excellent impression of Alyssa.

“You did a paracentesis, right?”

Connie nods warily.

“Okay, so how many PMNs is the cut-off for peritonitis?”

I’m holding my breath.
Connie shrugs. “I don’t know. My patient didn’t have peritonitis.”

“But how do you know he didn’t if you don’t know the cut-off?”

Connie gives me a dirty look. It’s becoming clear that she has no idea what the answer to the question is and also that this conversation isn’t going in a positive direction. Luckily, Nina walks by at that moment. Nina, my savior.

“Nina!” I say.
“Do you have a second?”

She holds her index finger and thumb about a millimeter apart.
“I’ve got this long. What’s up?”

“Have you done a
paracentesis?”

Nina nods.

“Great!” I say.
“So how many PMNs is the cut-off for peritonitis?”

And guess what?
She has no idea. Neither do the next three interns that pass by. Yet somehow nobody but me has been thrown out of the room for not knowing.

Finally, I give in and go to a computer to look it up.
The computers have a ridiculously slow internet connection, but I finally find out from Wikipedia that the answer is 250. (I’m embarrassed that I wasn’t even remotely close in my guesses.)

I
return to Mr. Sanchez’s room, armed with my answer. “Two-hundred-and-fifty!” I gasp heroically as I burst into the room.

“Right,” Alyssa says.

She places a
Band-Aid over the puncture site on Mr. Sanchez’s belly. I can’t even believe it. I missed the whole goddamn thing. She threw me out of the room for
nothing
, and I missed out on my procedure. This is so, so unfair.

Alyssa is
not going to get away with it. Not this time.

Hours Awake: 5

Chance of Alyssa getting what’s coming to her:
Like 5%?