The Devil Wears Scrubs (22 page)

It’s clear I’m one of the last to arrive. The room is packed with the code team and there’s a nurse inside who is pumping on Mrs. Jefferson’s chest, her massive body bouncing with each compression.

I race over, yelling, “She’s my patient!
What happened?”

Naturally, nobody answers.
And that’s when I see Thomas Jefferson, standing outside the room, wringing his hands together and tugging on his funny little beard.

“Dr. Jane,” he says
quietly. His eyes are filled with fear.

I wince.
I promised him less than 24 hours ago that his wife would be fine. Now I can see them preparing to intubate her. She’s so far from fine, it’s not even funny.

“What happened?” I ask him.

“I came to bring her a snack,” he says, holding up a brown paper sack. “And I couldn’t wake her up.”

“S
till no pulse!” I hear someone yell from within the room.

Oh God.
She’s going to die. Somehow at that moment, I know it with absolute certainty. I look over at Thomas Jefferson and I realize that he knows it too.

“Can you stop this, Dr. Jane?” he asks me.
“Markie wouldn’t want all these people here. She’d just want to go quietly.”

I nod.
“Is that what
you
want?”

Thomas
Jefferson’s brow creases and I see the tears welling up in his eyes. “Yes, please.”

I close my eyes and brace myself as I walk into the room.
The senior resident is attempting to intubate her, and she’s still flatline on the monitor. I walk over to the resident who seems to be running the code and tap him on the shoulder.

“Hey,” I say.

The resident barely glances at me.
With a shaking hand, he’s holding up a cheat sheet of medications that can be used during a code. I’ve got an identical one in my pocket.

“What is it?”
he asks in a distracted voice.

“Her husband wants us to stop the code,” I say.

The resident turns back to me and I can see the relief flood his features.

“Oh, okay,” he says.
He addresses the crowd surrounding Mrs. Jefferson, which is substantial. There are so many people doing so many things to her that her body still seems to be in motion. “I’m calling the code. Husband wants us to stop.”

And just like that, it’s over.

I leave the room with everyone else, my heart still pounding in my chest. I see the miniscule Thomas Jefferson watching everyone exit his wife’s room. He catches me before I can get past him.

“
Thank you, Dr. Jane,” he says, although I don’t know what he’s thanking me for. I told him his wife was going to be all right and I was wrong. I let her die. I screwed up. I definitely don’t deserve to be thanked.

I don’t say any of that though.  I just nod.

He glances into the room. “Can I hold her hand as she goes?”

“Go ahead,” I say, even though the reality is that she’s already gone.

Mr. Thomas Jefferson goes back into the room and sits at his wife’s bedside. Her gown has been pulled down by the code team and he gently rights it for her. He picks her limp hand off the bed and strokes her smooth, unlined face with his other hand. With her eyes closed, she seems so peaceful.

“It’s all over,
Markie,” he says gently. He brushes away a strand of hair that has fallen in her face. “All your suffering is finally over. You’re free.”

I watch them for another minute before I race to the bathroom just in time to burst into tears.

Hours Awake: Oh, fuck it all to hell

A few hours later, we meet for rounds with Dr. Westin like nothing happened.

I’m all cried out.
My eyes are still puffy but everyone probably thinks it’s from lack of sleep. Nobody would believe I was actually crying over
a patient
. Even Thomas Jefferson has no idea. I was too embarrassed to face him again. In my head, I keep replaying that moment when I told him that his wife would be fine, that she’d definitely go home with him.

I
promised
him.

Alyssa sits next to me in Dr. Westin’s office.
She’s got a list of all our patients in front of her and she’s drawn a line through the name Marquette Jefferson.

As usual, Connie goes through her patients before I do.
She’s only got two of them left so it goes quickly. Then it’s my turn.

“My
, my, my, unfortunate business last night,” Dr. Westin says to me. “You’re quite the black cloud, aren’t you, Jackie?”

A “black cloud” refers to a person who generally has bad luck on calls.
I think the term could accurately be applied to my entire internship so far.

“Yep,” is what I
say.

“Very unfortunate,” Dr. Westin muses.

I wish he’d just move on.
Alyssa has already drawn a line through her name—why can’t we talk about something else before I start crying again?

“What did S
urgery say about the pneumothorax?” Dr. Westin asks.

I blink at him.
“What? What pneumothorax?”

A pneumothorax occurs when air gets into the space between the lung and the chest wall.
It can potentially collapse the lung, so if it’s bad enough, Surgery can stick in a needle or a tube to release the air.

But why is Dr. Westin talking about a pneumothorax?

“It was on Mrs. Jefferson’s chest X-ray,” he says. “Wasn’t it? Here, let me bring it up on my computer.”

I practically leap off my chair to get a closer look at the computer screen.
Within seconds, a picture of Mrs. Jefferson’s chest cavity fills the monitor.

And there it is, on the upper right side: a very clear pneumothorax.
A vein starts to throb in my temple.

“I see it!” Connie chirps.
“It’s on the right.”

“She had a PICC line put in recently, didn’t she?” Dr. Westin muses.
“That probably did it.”

I jerk my head up to look at Alyssa, who is silent.
Not acknowledging the fact that
she
was the one who misread the X-ray as negative.

And now that patient is dead.

My eyes fall again on her list of patients, at Mrs. Jefferson’s name crossed off the list.
Like she’s
nothing
. Like her death didn’t even
matter
. All the awful things Alyssa’s said to me this month flash through my brain until I start seeing red. And at that point, I just can’t stop myself.

“This is your fault,” I hiss at Alyssa.
My cheeks feel like they’re blazing. “
You
are the one who read the X-ray. You read it wrong! If you were competent at your job, that woman would still be alive right now.”

Alyssa stares at me, shocked by my outburst.
“Jane, I didn’t—”

“Didn’t what?” I burst in.
“Drop the ball?
Obviously
you did. You talk about high standards and being knowledgeable when it comes to total bullshit, but when it’s actually
important
and a person’s
life
is at stake, you don’t have a
clue
what you’re doing. You can’t even read a goddamn chest X-ray!”

Alyssa’s mouth is open.
She looks like she has something to say to me, but she can’t get the words out. Good. Because I’ve got one more thing left to say to her.

“You killed Mrs. Jefferson,” I practically spit at her.
“You deserve to lose your license.”

Everyone sits there in stunned silence for at least
60 seconds. Even I’m sort of stunned, to be perfectly honest. I can’t believe I said all that. I was thinking it, but I can’t believe I actually said it. But now that I did, I’m glad. She deserved every word of it.

Alyssa rises from her seat.
She’s taller than I am, and for a second, I’m slightly afraid she might hit me. I sort of deserve it. But she doesn’t. Instead she whirls around and storms out of Dr. Westin’s office.

We all watch her leave.
It’s only after she’s gone that I get an inkling that I did something kind of inappropriate. What was I
thinking
?

“That,” Dr. Westin says, “was incredibly unprofessional.”

I hang my head. “I’m sorry.”

Dr. Westin considers me for a moment
, contemplating my fate. I’m suddenly really embarrassed. Why did I say all that? I’m not five years old. I’m in control of my words. It’s not my fault! I’m just really, really tired.

“You need to go apologize to her, Jane,” he says.

I nod. I can’t believe he finally got my name right. And now he’ll remember it forever.

_____

I try paging Alyssa but she doesn’t answer.
That freaks me out a little, because unlike Sexy Surgeon, Alyssa always answers pages promptly. If she’s ignoring her pager, I must have really upset her.

I
end up searching the whole damn hospital for Alyssa. She’s not in any of the usual locations: the wards, the resident lounge, the call rooms, the cafeteria.

I’m about to give up when I remember that night when I declared that patient dead for the first time and Ryan took me up to the roof.
On a whim, I head up to the roof. At the very least, I’ll get some fresh air. I could use it.

As the door to the roof swings open, I immediately see her.
Alyssa. She’s leaning over the edge, facing away from me, holding her phone in her hand. She’s not talking to anyone though. She’s just looking at the phone. As I get closer, I realize she’s looking at a photo of her son.

My chest tightens.
She’s not going to jump, is she? If I drove her to do that, it’s a million times worse than whatever she did or didn’t do to Mrs. Jefferson. “Alyssa,” I gasp.

She whips her head around.
When I see her face, I notice that her eyes are red-rimmed.

“Are you okay?” I say, trying to sound gentle,
like the way I’d talk to patients on my psychiatry rotation.

Alyssa snorts and shoves her phone back into her pocket.

“I’m sorry about what I said,” I say, taking a careful step towards her. “Just… you know, don’t do anything crazy.”

Alyssa wipes her eyes.
“Don’t worry, I’m not going to throw myself off the building, if that’s what you’re thinking.”

“Oh,” I say, my shoulders sagging in relief.
“Alyssa, I shouldn’t have said that you… that you killed Mrs. Jefferson. You didn’t.”

I’m being honest
. Yes, Alyssa missed the pneumothorax. But now that I’m being realistic, that pneumothorax was admittedly pretty small. Mrs. Jefferson was a really sick woman, and as of now, it’s not clear that any intervention done for that pneumothorax would have made a difference. In all likelihood, she still would have died. If not today, then tomorrow. It was inevitable—even Mrs. Jefferson realized it.

“No, you had it right the first time,” Alyssa says.
“I did. I killed her. Or at least, I let her die.” She takes a deep breath. “That’s something I’m going to have to live with the rest of my life.”

I don’t know what to say to that.

“I hope it never happens to you,” she says.

We stand there in silence for a minute,
then Alyssa shivers with a passing breeze. She hugs herself for a moment then pushes past me to go back into the hospital and get back to work.

It feels decadent, but I stay on the roof for several minutes after Alyssa leaves.
After my meltdown in Dr. Westin’s office, I’m pretty sure nobody expects me back quite yet. They’re probably debating if they need to call a psychiatry consult on me.

That might not be an entirely terrible idea, actually.

I take Alyssa’s place on the edge of the roof, watching all the people milling about on the street.
None of these people have any idea that Mrs. Jefferson just died. They don’t even know who she is. Why would they?

But I know.
And I will always remember.

“Don’t jump.”

My breath catches in my throat and I whirl around. I should have known: it’s Sexy Surgeon. He’s standing at the door to the roof, still looking sexy as all hell in his blue scrubs, his short blond hair being tossed every which way by the wind. He’s smiling crookedly, which is better than the hateful glare he gave me last time I saw him.

“I wasn’t going to jump,” I say, shaking my head.

“It’s still worth saying,” he says, joining me at the edge. He gets close enough that I can feel the heat of his body. “I heard you lost a patient last night. I’m sorry.”

I nod.
I turn my face away from him so he can’t see the tears gathering in my eyes. Why do I keep crying? Nobody else here cries when they lose a patient. It must be the lack of sleep.

“I wish I could be more like you,” I say
bitterly. “Like, not caring when a patient dies. That would be much easier.”

“I care,” Ryan insists
, his blue eyes wide.

“Yeah, right.”

“I do.” He hesitates for a moment, then says, “Your patient, Mrs. Coughlin—she died on the operating table right in front of me. The reason I didn’t tell you wasn’t because I didn’t care. I
couldn’t
tell you because I felt so awful about it.”

I raise my eyebrows, daring to look at him.
He seems to be telling the truth.

“The surgeon who operated on her is a complete asshole,” he begins.

“Worse than you?”

“Way worse,” Ryan says.
“You have no idea. Anyway, I thought he missed tying off one of the vessels and I didn’t say anything because I was scared he was going to ream me out, and I figured I was probably wrong. Then she bled out and she died.” He closes his eyes. “She died right in front of us. It was horrible. And I kept thinking that if only I’d said something, she would have lived.” He pauses, and when he opens his eyes again, they’re wet. “She was a nice lady. It was hard to tell her family what happened. Really hard.”

So the Great Ryan Reilly is actually a human being.
Who would have thunk it?

“And,” he adds, “I’m sorry I got pissed off at you the other day.
I know I dropped a huge bombshell on you and it’s unfair that I expected you not to react.”

I nod.
“It was… surprising.”

“I’ll bet.”

We’re both quiet for a minute, staring down at the city below. I can just barely pick out individuals, going about their daily lives. A man hosing off the sidewalk in front of his store. A homeless man shaking a cup of spare change. A lady hailing a cab. Three people waiting for the bus to arrive.

“You know,” I say thoughtfully.
“I was just realizing that if you do make it to age 50, you’re in the clear, right? Probably, I mean.”

Ryan narrows his eyes.
“Yeah, so?”

“Well,” I say.
“That means when you’re 50, you can go ahead and get married and have kids.”

I think of Mrs. Jefferson’s husband sitting at her bedside as she passed on, holding her hand.
I want Ryan to have that when he dies. Everyone should have that.

“Great,” Ryan snorts.
“I’ll be the only 60-year-old dad at Little League. Just what I want.”

“You’ll just have to find some young, trophy wife to marry,” I say.
“But I’m assuming you’d do that anyway.”

“Oh, yeah, of course,” Ryan laughs.

“Your future wife probably isn’t even in kindergarten yet,” I add.

“Hell,” Ryan says, “she probably isn’t
born
yet.”

I warm up to the game:
“Her future parents probably haven’t even undergone puberty yet.”

Ryan laughs again, but then he
gets quiet for a minute, staring off into the distance.

“
Or maybe you’ll be available,” he muses. He smiles winningly and I feel his hand slip into mine. “What do you think?”

I roll my eyes.
“If you think I’m waiting for you 20 years, think again, buster. You’re not
that
good-looking.”

“You don’t have to wait for me,” he says, grinning.
“You can just dump whatever loser you’re with 20 years from now.”

I imagine Ryan Reilly
20 years from now. His blond hair will be threaded with gray and there will be crow’s feet around those blue eyes, but I can tell he’ll still be incredibly sexy. Maybe even more so. And he’ll be a great surgeon by then. Maybe he’ll be head of the whole surgical department. He definitely has it in him.

And me?
I’ll still be Dr. Jane McGill.

Hours awake: Lost track

Chance of
a happy ending: At least 50%