Asher #3
As a general rule, patients with ectopic pregnancies are either uncontrollably terrified they’ll die, or pretty blasé about
the whole thing.
This one is the former.
Her name is Amelia, and her partner—Boyfriend? Friend? Husband?—is at her side, dutifully talking her down from the ledge. The man looks vaguely familiar. Maybe just a generic white guy, though. As a member of the generic white guy club, I feel free to judge that this guy is particularly generic.
“It’s going to be okay, baby,” he says. “It’ll all be fine.”
Tears streak down her face, but she meets my eyes when I knock on the open door. “Are you the doctor?”
“Yeah, hi, I’m Doctor Foley.”
She nods and, with the help of her boyfriend, explains that she thinks she’s six weeks pregnant, but started spotting this
morning and had some mild pain on her right side that’s now resolved. The ultrasound I reviewed before walking into the room
isn’t convincing. There’s no pregnancy anywhere, meaning it’s either too early to see it in the uterus, she’s in the middle
of a miscarriage or it’s an ectopic I can’t see.
I explain all this, tell her we need more time for things to declare themselves, and her tears slowly dry.
The boyfriend kisses her hand. “See, baby? It’s gonna be fine.” He checks his phone while I explain the next steps, his brows
drawn together.
“So I might have to have surgery?” she asks with a sniffle.
I lift a shoulder. “Maybe. It’s hard to say at this point.”
She eyes me for a moment, and I sense her hesitation.
“What is it?” I ask as gently as I can.
“It’s just . . . Have you done this surgery before?”
I take a slow breath and try hard to let that roll off me, throwing on a smile and my trusty self-deprecating armor instead.
“Nope. But I YouTubed it before I came in here, so I think we’ll be all right.”
She lets out a wet chuckle.
I force myself to laugh with her. That joke works every time. “Yes, I’ve done this many times, but again, you might not need
any surgery at all.”
“But if I do, it might be a different surgeon?”
The muscles in my neck cramp. “That’s correct.”
She glances at her boyfriend, then proceeds to profusely thank me even though I did nothing, and she clearly didn’t trust
me enough to do anything anyway.
Is it something about my face that makes people question my competence? Do I have imposter tattooed on my forehead?
Or maybe I’m reading into it. She doesn’t know anything about me. Why do I care if she doesn’t believe I could remove an ectopic
pregnancy half asleep in an overheated OR with hi-def speakers blaring Nickelback?
Stranger’s opinion doesn’t matter.
Except it sort of does.
Reframe the negative.
As I leave, my phone dings with another page—my patient upstairs is ready to deliver. It only takes me three minutes to reach
the room, but I enter a world of chaos. Gabriela stands between the screaming patient’s legs, begging her not to push yet.
The family is bouncing excitedly around the room while the respiratory therapist keeps reminding them to back up . . . give
her space . . . “No, don’t step on that!”
Cynthia, angel that she is, merely sighs as I enter the room. “Thank god.”
Hey, at least Cindy Loo finds relief in my presence.
My patient is—understandably—quite agitated. “Doctor Foley! Get it out of me!”
“Gabriela, you can let her push now.” I slip into my gown and gloves as quickly as possible, but the baby is out in a single
push, squealing on the patient’s chest before I’m fully dressed.
The family crowds around, and I sneak beside a rattled Gabriela to help.
“Here.” I hand her a collection tube from the delivery table. “Get the cord blood.”
She nods. The dad stands beside the patient. The patient’s mom is behind him, crying. Beside her, near the patient’s knees, is a woman I assume is her grandmother. She’s dressed as if she’s attending an upper-crust lunch with a group of old, rich ladies—a cream power jacket and matching skirt.
Gabriela tries to squeeze the chunky umbilical cord into the tube to collect the blood, but when she unclamps the cord, the
remaining blood pressure within pushes the cord from the tube and it flops like an unmanned water hose, spraying blood everywhere.
A jet of it slashes across my throat before showering the grandma and her white confection of a power suit with bright scarlet.
Gabriela gasps. “Oh, my god. I’m so sorry.”
The entire room pauses for two seconds. Even the baby stops crying.
Then the grandma heaves in outrage, the patient starts cry-giggling and I succumb to uncontrollable laughter.
After grabbing the cord, Gabriela freezes. She holds it in the air like a torch. I’m laughing too hard to help. My head drops
behind Gabriela’s back to hide it.
“Doctor Foley,” she whispers over her shoulder. “Help.”
“I have never—” the grandma sputters. “How dare you?”
“I’m so sorry,” Gabriela says. “It was an accident.”
“I’m sorry, Grandma,” the patient says through a chorus of hiccup-giggle-tears.
The baby screams.
Tears blurring my vision, I exchange places with Gabriela, who scrubs out to help the grandma clean up. Behind me, she’s profusely
apologizing.
“At least it’s just the baby’s blood,” she says. “It’s sterile. It won’t hurt you.”
“This is Chanel, child. I assure you, I am hurt.”
I’m dying.
And maybe this is why I’m not taken seriously. I am physically unable to stop laughing in hilarious situations. If that’s the case, I get
it. It’s a character flaw I will never overcome.
The placenta plops into a basin. The rest of the process is a breeze, and Gabriela and I sneak out, leaving the family to
their happiness. Or their affront, depending on which of them you ask.
“I’m so sorry,” Gabriela whispers.
“It’s not a problem.” I squeeze her shoulder once in reassurance and head toward Pod B.
“I’m so lucky it was you,” she says, following me. “If that had been Doctor White, I’d be yelled at until next week.”
Hmm. Maybe I should do more yelling. But I don’t even know how to yell at people. How does one get to that point of anger?
I stop in the hallway and face her. “So you’re saying you should be in trouble?”
Her dark eyes widen. “It was an accident.”
My head tilts. “So . . . You don’t think you should be in trouble.”
“I don’t know what the right answer is.”
I laugh. “There isn’t a right answer. I just want to know what you think. You say the other attendings yell at you, but I
don’t. How would you prefer your training to progress, Gabriela? Do the strict standards for perfection help you, or do they
increase your anxiety? Would you prefer that type of education, or my more laid-back style? Or do you need something in the
middle?”
The panic on her face settles into thoughtfulness. “Maybe . . . the middle?”
Okay. This is feedback I can use. A teachable moment.
“So the next time the cord is still that full, let some blood drain into the bucket before you try to fill the tube. The stream will be easier to control. See? You live, you learn. I’m not going to yell at you, though, especially since it was hilarious. ”
A grin lights her face. “This is Chanel, child,” she says in an affected accent.
I laugh again, picturing it. “Priceless.”
Her eyes go a bit starry. “I love working with you, Doctor Foley. I hope you know that.”
Aw. Well, that’s another little boost, isn’t it? Two residents in one day. What’s happening?
“Thanks,” I say. “I like working with you, too.”
“You—um—may want to do something about—” She motions to my neck, where the blood she sprayed—the blood I’d forgotten about—is
now drying.
With a quick thanks, I head toward the dressing room for the second time. I pass the lockers lining the walls and the benches
covered in street clothes to reach the shower stalls at the opposite end, sinks across from them.
Wow. My reflection is ghastly. A strip of blood makes a perfect line across my throat, like I’ve had a shave with Sweeney
Todd.
As I scrub it away, I consider Gabriela. Perhaps it isn’t what I’m doing, but what I’m not doing, that contributes to my reputation.
Joke less, advise more. I can do that. Well, the advising part anyway. That’s easy, right?
But then I remember the patient in the ER, fearful of me being her surgeon just by sight alone.
I don’t fuckin’ know.
One step forward, two steps back.
Tired of analyzing it. Ready to get out of this place.
Luckily, my last stop of the day is to room four—my patient, Juliana, was admitted in labor half an hour ago. I enter to find her grunting through a contraction, but managing it well. Her husband rubs her back.
I freeze upon entry.
That’s the same man from earlier. Generic white guy. I knew he looked familiar.
And this is the worst.
His gaze meets mine, and he gives his head a subtle shake before his wife grimaces in my direction.
“Doctor Foley, can I have an epidural now?”
I blink away my visceral disgust to grin at her. “Of course, Jules. Go for it.”
After a quick rundown of the plan and what to expect, I bid her good-night and assure her my partner on call will take care
of her if anything arises.
She’s grateful, and I do my best not to look at the father of her baby. Outside the room, I head for the elevators, internally
cleansing my mind.
Wife in labor. Girlfriend in the ER with possible life-threatening condition. Both of them technically his fault.
I shouldn’t judge. Maybe they’re in an open relationship. Maybe they’re polygamists.
Or maybe he’s a cheating asshole.
The elevator door catches before it closes, sliding open to reveal the man on the other side. He’s wearing the most sickening
smile.
“Hey, Doc. Just so you know, Jules doesn’t know about Amelia, and I really plan to keep it that way. Man to man, thanks for
not saying anything.”
I tilt my head. “I’m not legally allowed to say anything.”
“Right, well—”
“But man to man, I think you’re a piece of shit.”
He stiffens. Every line of his generic face hardens. “It’s not really your business, is it?”
“Nope. So get your hand off the door.”