Chapter 8 Alaric
Eight
Alaric
I’m already late when my pager goes off again.
Behavioral health consult needed. There’s a mother in triage with a teenager who won’t speak.
I check the clock—eight minutes until the leadership meeting on the other side of the hospital.
If I try to hand this off, it’ll most likely sit until I can return. If I go now, I’ll be late.
I go.
The kid’s half-vanished inside an oversized hoodie, strings pulled tight so only the tip of her nose shows. Her sneaker taps a nervous beat against the floor. The mother sits beside her, twisting a tissue into white threads.
I drop onto a crouch so I’m eye level. My knees pop. “Hey,” I say. “I’m Dr. Dempsey—Ric’s fine, if you’d rather. You don’t have to talk if you don’t want to. We can just breathe.”
No answer. The sneaker keeps tapping.
I glance up at the lights. Too bright. The air too dry. “Want me to dim the lights?” Nothing. “Is it too loud in here?” Still nothing. I try one more. “We can step outside if it feels crowded.”
The foot stops. A tiny nod.
“Okay. Let’s take a break.” I pull the curtain aside. The mother stands, clutching her purse strap, and follows.
We stop in a quiet alcove near the vending machines. The atmosphere here is softer, the air less busy. “Here’s the deal,” I say. “You get to pick. Sit or stand. Stay or walk.”
“Walk,” she whispers.
“Good call.” I match her pace down the hall. One lap. Two. Gradually, her shoulders unclench.
“It’s the teacher,” she says suddenly, voice muffled. “She keeps calling on me.”
“Even when you ask her not to?”
A small nod.
“My dad says it’s just a phase,” she adds.
“And your friends?”
“They stopped texting back.” Her words hitch.
We stop near a bulletin board full of outdated posters. “When the panic starts,” I ask, “what does it feel like?”
“Like my chest’s on fire.”
“Hard to breathe?”
“Yeah. Like I’m running and not going anywhere.”
I pull a sticky note from my pocket and click a pen.
“Let me show you something.” I draw a small square, holding it out so she can see.
“In for four,” I count along the first line.
“Hold for four.” Second line. “Out for four. Hold again.” I tap the last corner.
“You can trace this whenever your chest gets too tight. Nobody has to know you’re doing it. ”
She studies the note, finger hovering over the ink. “Okay,” she whispers. She slides it into the sleeve of the hoodie.
The mother exhales, her shoulders shaking. “Thank you,” she says, voice frayed. “Thank you so much.”
“She did the hard part,” I tell her. I nod toward the kid. “Keep the sticky. Tomorrow morning, a social worker will check in. Same time. And reach out to the teacher who insists on calling on her during class. Bring in the principal if you need to.”
They both nod. As they leave, I catch a glimpse of the yellow note peeking from the cuff of the hoodie.
I rub the back of my neck. The wall clock says 9:12.
The leadership meeting started twelve minutes ago.
I pull my phone from my coat pocket and type one-handed to the leadership message group while I walk toward the stairs.
Running two consults behind. Save me a chair. — Ric.
The message sends. I take the stairs two at a time, pulse running on overload.
When I hit the second floor, I can see the glass wall of the boardroom and the reflection of my own rushed outline.
Through it, the long table is full—CEO, CMO, heads of departments, and Liz at the far end, near the screen.
She’s in a charcoal dress, hair pulled back in a knot.
I open the door as quietly as it will allow. It still gives a soft thud that makes three heads turn.
Hudson glances up, one eyebrow lifting like a punctuation mark. “Nice of you to join us, Dr. Dempsey.”
“Sorry,” I mutter, sliding into the last open chair beside Radiology. My heart hasn’t caught up with my body yet. I flip the agenda over and pretend to read, hoping no one notices the sweat cooling between my shoulder blades.
Liz’s gaze flicks to me long enough to register I’m here. No smile. No judgment either. Just a quick read and back to the presentation.
After a moment, Roger Hudson stands before the group.
The projector clicks through slides while he moves through the first few topics—new equipment, volunteer recruitment, department budgets.
My breathing steadies, and for a second, it almost feels normal, like the morning chaos hasn’t followed me in here.
Then the CMO clears his throat. “Before we move on, I’d like an update on accreditation, specifically, CME compliance.”
Hudson nods toward Liz. “Liz has reviewed the files and can give you a full report.”
Every head turns. Liz doesn’t flinch. “All departments have been audited for CME completion and renewal schedules. Most are on track. A few shortfalls remain, but plans are in place to address them.”
The CMO leans back. “Plans are nice. Actions are better. What’s being done?”
“Surgery is booked for an advanced trauma refresher next month. Imaging registered for an online diagnostic series. Pediatrics is attending the regional update in March.” She glances down at her notes. “Behavioral Health was the farthest behind and is attending a conference in Kauai next month.”
A stylus freezes mid-tap. Laptops pause. In the glass wall, I count three reflected faces aimed at me and one at the clock.
I feel it before I look up, the shift in the air. The CMO’s gaze lands on me. “Farthest behind and now you’re off to Kauai, Ric?”
Heat crawls up my neck. I rest my palms on the table, careful not to curl them into fists.
“We’re short psychiatrists and therapists.
I’ve been covering crisis consults. That’s why I was late today.
And that’s how I got so far behind on my CMEs.
Liz came to me with a solution, and I realized I needed to get it done. ”
The CMO’s mouth twitches, not quite a smile. “I somehow doubt staffing shortages prevent you from opening your email. And now, you have your own travel agent? Kauai should be…restorative.”
Restorative? I’ll be earning credits, not vacationing. I have nearly sixty days of paid time off accrued but no time to use them. All I do is work.
A few people shift in their chairs, pretending to read their notes. Hudson murmurs something to change the subject. The meeting moves on, but the burn doesn’t fade.
When it finally ends, chairs scrape and conversation bubbles up again. I gather my papers more slowly than I need to, giving myself a minute to breathe. Liz unplugs the HDMI cable, winding it in perfect loops. Her posture’s still straight, and I can see tightness in her shoulders.
I step closer. “You put me on display.”
She looks up fast, eyes bright. We’re nose to nose, and her perfume is clean citrus. I hate that I notice it.
“I answered a question,” she says.
“In front of everyone.”
“I didn’t name you. And I know Misty sent you nearly a dozen emails. Nothing I said was a lie.”
I laugh once, sharp. “Next time you want to throw me under the bus in front of the leadership team, at least warn me before you announce it.”
Her chin lifts a fraction. “I wasn’t doing your job, Alaric. I was doing mine.”
The way she says my name registers in a way I wish it didn’t.
She used to call me Ric, but she doesn’t anymore.
I start to walk away, then stop. It would be better to be angry with the CMO.
He’s my boss. He’s the one who clearly doesn’t get it.
Yet attacking Liz is my answer. Is it cowardly?
Absolutely. Is it effective? Not at all.
But now, I don’t have anything to say that won’t sound like an excuse. “Enjoy running the place,” I manage.
“Enjoy running yourself into the ground,” she fires back.
I leave before I say something worse, the words trailing me like static.
When I reach the hallway, my phone buzzes again—two new consults, both marked urgent. I shove it into my pocket and start moving, the echo of Liz’s voice still ringing in my ears.
By the time I reach Behavioral Health, the caffeine in my system has worn off, and the fluorescent lights hum behind my eyes like bees.
The waiting room’s packed—one patient arguing with the receptionist, another pacing near the vending machine.
A nurse intercepts me halfway down the corridor.
“Dr. Dempsey, the teenager from this morning’s back. Said she can’t breathe again.”
I take a breath of my own, long enough to dissipate the leftover heat from the meeting. “Okay,” I say. “Let’s get her a room.”
Behind the curtain, the girl is curled in the chair again, hood up, hands shaking. The sticky note’s balled in one fist. The nurse clips on a pulse ox, and we watch her numbers climb, right along with her panic.
“What caused this?” I ask her mother.
“She said she’d go back to school, and it started again as we drove up,” she replies.
I crouch. “Hey,” I say gently. “Remember the square?”
A weak nod.
“Good. Let’s slow it down. In—two, three, four. Hold—two, three, four. Out—two, three, four. Hold—two, three, four.”
When her breaths even out, I drop my voice. “Pick a color,” I tell her. “Find three things that match it.” Her eyes begin moving around the room. “Let’s check her chart,” I murmur to the nurse. “See if she’s already on something for anxiety.”
Her eyes dart—ceiling tile, blanket, the edge of my badge. Shoulders ease another fraction.
Her mother’s hand shakes around a tissue.
I slide the box toward her. “She’s okay,” I say quietly.
“Let’s take the rest of the day off from school.
Tomorrow, our social worker will meet you both, and they can help you figure out how to manage the school and other issues.
If she feels this tight before then, call. ”
I turn toward the girl and meet her eyes before I go. “We’re going to sort this out,” I assure her. She gives me another nod.
Outside, the corridor noise rushes back in—a phone ringing, a gurney rattling by. I glance at the clock. It’s one thirty. I haven’t eaten since dawn.
In the break room, the coffee’s burned but hot. I’m halfway through a cup when my pager goes off again. Room six—agitated patient. I dump the rest in the sink and head out, bitterness on my tongue.
When I arrive, room six is chaos. A man’s pacing, muttering about cameras in the ceiling. A resident’s frozen by the door.
“Step out,” I tell her.
She disappears like she’s been waiting for permission.
I keep my distance, hands visible. “Hey, I’m Ric. Rough day?”
“They put something in the meds,” he says, voice shaking. “I can feel it crawling.”
“Feels like bugs?”
He nods.
“Yeah. That sounds awful.” I point to the chair. “Sit. Let’s figure out how to make it stop.”
He hesitates, then sits. We talk until his pulse slows enough for the nurse to step in with a shot of fast-acting sedative. His breathing evens, eyes growing heavy.
I order a complete workup on him, checking for drugs and alcohol in his system as well as blood work for electrolytes, kidney function, and infection markers. When the nurses have him covered, I step into the hall and scrub a hand over my face. My phone buzzes again—with an email from Liz.
Coverage for your week off.
Let me know if you need adjustments.
That’s all it says. I don’t open the attached file. I’m sure it’s fine.
The rest of the afternoon blurs—patients, paperwork, interruptions that bleed together.
By six, the clinic’s finally quiet. I stretch, bones popping, and check my email.
I now look over the coverage Liz arranged, detailed down to the minute.
These are the locums I would have requested.
I’d get them here on staff if I could. Maybe I should take a day or two off after the conference and just relax.
A knock hits my doorframe, and when I look up, Liz stands there, folder under one arm, her hand braced on the wood. Her hair’s come loose, a strand curling near her cheek. “Can I come in?”
I nod. “Door’s open.”
She steps inside and sets the folder on my desk. “Backup copies, in case the email bounced. And some shorter CME modules if you’d rather stay local.”
I lean back. “You didn’t have to.”
“Hudson asked for actions, not promises. I wasn’t trying to embarrass you.”
“I realize that. It’s the CMO who doesn’t get it.” I sigh. “I’ll go to the conference. I’ll just try to fly under the radar next time.”
Her mouth curves, not quite a smile. “Good luck with that.”
I swallow pride that tastes like rust. “Thanks.”
She nods, leaves the folder, and walks out, heels clicking down the hall.
I sit for a long minute, and my pulse finally slows.
Then I pack up, slide the folder into my bag, and flip off the light.
The walk to the parking lot feels longer than usual.
Outside, snow melts around puddles that mirror the sodium lights above.
I climb into my car, rest my forehead against the steering wheel, and breathe…
In for four. Hold for four. Out for four. Hold for four.
The same square I drew this morning.
For the first time all day, the air goes all the way down.