Grace
APRIL, YEAR 1
An hour-long PowerPoint barely scratches the surface of the issues encompassing female sexual dysfunction. Regardless, I furiously type into my Google Doc while third-year Mila Tischler lectures from the head of the conference table.
The slides on orgasmic dysfunction and hypoactive sexual desire remind me of my own sexual repression. The memories of what I did for Matt still make me want to vomit. I can’t believe I did those things simply out of fear he’d leave if I didn’t. Even when they hurt. When they made me cry.
A great cost, but a priceless lesson learned: love is a figment and believing in it will hurt you.
Why do I allow him so much power over me? Years later, and the whisper of ice queen still reverberates in my subconscious. It’s illogical, and I want to heal. I want to move past it, but I just…can’t. Instead, I drown out the voice with overindulgent color-coded notes.
Some insults simply cut too deep to heal. Some insults bleed forever.
As usual, Julian sits across from me, listening without taking notes. Nothing but the Slytherin mug sits before him. No notebook. No laptop. Not even a pen.
He’s wearing glasses.
They are not hot.
Yes, huh. He’s got Clark Kent vibes, girl.
Ugh. How is it fair that glasses make him cuter?
Where’s my spare kryptonite?
Beside me, Kai leans in to whisper suggestive jokes in my ear again , distracting me as I stifle my giggles. It draws attention to both of us, but I’m not the only one with immature behavior. Several people snicker behind their hands at Persistent Genital Arousal Disorder, a phenomenon in which women experience physical arousal unrelieved by orgasms.
It isn’t funny. It’s not. But when Mila describes cases of women suffering dozens of unprovoked orgasms each day, everyone’s maturity drops to the level of twelve-year-olds.
The last slide displays a picture of Michael Scott from The Office holding his World’s Best Boss mug beside a quote bubble that reads, “Sex is like a good cup of coffee. It’s all in how you make it, or how you take it.”
“That’s what she said,” Asher quips from the back of the room.
I cover my face as laughter finally takes hold, and several others follow suit.
“Any questions?” Mila asks.
My hand shoots in the air.
“Of course,” Julian mutters across the table, sipping his black-as-his-soul coffee.
I ignore him and ask her to clarify several points in the lecture, typing her answers as she gives them. People are accustomed to my questions at this point, but Julian still harasses me about it.
Four questions in, he lets out a loud sigh, widening his eyes at me behind black-rimmed wayfarers.
I glare at him. “What?”
“You realize the longer you ask questions, the longer we all have to be here.”
“Forgive me for wanting to learn during this educational event.”
The stares in the room bounce between us. Even the attendings settle in for our argument like it’s a normal, expected part of their day.
He rolls his eyes. “Right. Because your questions aren’t strategically designed to show off how much you already know.”
That’s not true! I stiffen in my seat. “My questions are designed to elucidate portions of the lecture I found difficult to understand, Julian .”
He tilts his head. “Was it the desire, the arousal or the orgasm part that confused you, Sapphire ?”
I glare at him. “What exactly did Palpatine promise you that you just had to join the dark side?”
The no-smile appears, dark eyes flaring as he stares at me. “Your silence.” Then he points at the Michael Scott slide. “Along with endless cups of good coffee.” He says it even-toned, eyebrow perked, and takes a single sip from his Slytherin mug.
Alesha bursts out laughing, as do several other residents and Dr. Levine.
Kai bends toward me, stage-whispering, “He won that one.”
It takes every shred of self-control in me not to laugh, to smile, to stand up and run my hands through that perfect hair until he looks like I kept him busy in my bed for the last three days.
Kai’s voice drops to a true whisper. “Look away, darling. You’re staring. Intensely .”
Mila closes her PowerPoint, and the room rustles with people rising to take breaks, but Julian and I are still linked by our staring contest, and I’m transported back to several weeks ago when he leaned in close enough that his heat prickled all along my body.
The walk of shame only applies if you fuck me.
Why on earth did he say that? Why did he put that image in my head? Why won’t it leave my head?
Goose bumps rise along my arms, and that black hole gaze finally pulls away from me when Maxwell taps his shoulder.
After the lectures conclude, I head to St. Vincent. My senior for L&D this month is my least favorite so far. Arista Herrera is a chief resident who has the worst case of senioritis I’ve ever witnessed. Utterly checked out, she lazes in our call room on TikTok while I run the floor by myself.
The OB hospitalists who serve as our oversight at Vincent are less than friendly. They range the gamut from cold and haughty (Dr. Narayan) to cold and hippie (Dr. Scarlett) to cold and sassy (Dr. Echols). Dr. Nguyen is the only pleasant one, but his retirement in a few months means he’s reducing his shifts.
All four despise our faculty attendings for their lack of supervision, accusing them of abandoning us so the hospitalists are forced to do more work. The residents are stuck in the middle of the politics, ignored by our core faculty who care little for us and abused by the hospitalists who, by all appearances, loathe us.
Without my senior for guidance, the game I play balancing it all has become treacherous. I’m walking a tightrope, and it’s only a matter of time before I fall. The ASCOM internal hospital phone snapped onto the waist of my pants barely stops ringing—nurses requesting med orders, informing me of triage patients, signing out on ED consults. I call Asher often since his schedule on GYN surgery is a little more free, and he’s always willing to help me untangle the knots.
I stand at the nursing station where the screens display the fetal tracings from all twenty-five labor rooms on this floor. I’m most concerned about my patient in twelve, who has a raging case of meth-eclampsia. She’s kind and thankful despite withdrawing from her drug of choice, but loopy from all the meds.
Judging by the heart tracing, the baby isn’t too happy.
“Gosh, Dr. Rose,” one of the nurses says in a falsely sweet voice. “You’ve lost weight.”
That’s because I’m so anxious, I can’t eat, and I’ve gotten most of my calories lately from Starbucks and Mountain Dew, but thanks.
“Yeah.” I glance at my scrubs, hanging loose from my body. Even my bras are a little too big.
“What’s your secret?” she asks.
Um. Not having time to eat? Running around this hospital for thirteen hours each day? Generalized anxiety disorder? Take your pick.
I glance at her. She’s about my age, and the badge clipped at her chest declares her name to be Ariel. She’s thin as a thirty-gauge needle, so I can’t imagine she’s trying to lose weight. Some game is at play here, one I don’t understand.
I paste on a smile. “No secret. Just…working a lot.”
“Oh. Well, maybe not enough since you forgot to put in the induction orders on twenty-two.”
“Oh shoot. Sorry.”
Her sweet smile does nothing to hide the iciness in her eyes. “Maybe you could do it now instead of saying something snotty like you usually do.”
My teeth grind. These women hate me. I’ve done nothing but work and try to be friendly, but I’m quiet and socially awkward, and I wear anxiety like an itchy body suit, so I think I come across as snobbish. Their cattiness is at a maximum. The night resident told me they complain about me behind my back. Maybe they believe the rumors, too.
I sit at the computer without saying anything and put in the standard induction orders—the ones she could have done herself in the same amount of time it took to berate me. When I glance at the tracings, twelve’s heart rate has decided to take a nosedive into the eighties—not reassuring.
I meet the nurse in the room. What’s this one’s name? Krystal.
The patient is screaming, “Get it out of me! Get it out!”
Nine months into training, and I’m pretty immune to all this. The screaming. The heart rate decelerations. The bleeding that sometimes looks like someone turned on a faucet. I used to have a spike in my own heart rate, a flush of sweat under my arms. Now, I’m only hoping she’s a good pusher so I’ll have time to eat some peanut butter before the next disaster.
“Will you call Dr. K and Dr. Narayan?” I ask the nurse.
She nods.
The patient is nearly crowning, and the father of the baby shouts, “Oh shit! What’s that?”
“That’s your baby’s head.” I gown up, pulling a stool between the patient’s legs.
Backup nurses flood the room, but Dr. Narayan is down in the attending lounge eating lunch, so I doubt she’ll make it.
Two involuntary pushes, and the baby screams out her first breath. Distracted by the newborn on her chest, the patient doesn’t react as I deliver the placenta and evaluate the laceration. This is my least favorite part of delivering babies—putting together the mashed hamburger meat left behind.
After numbing her, I go to work.
“Hey, Doc. Make sure to put in an extra stitch for me.” The dad winks and laughs.
I look at him, blink twice and turn back to the laceration.
“No, but really,” he says.
The sleep and food deprivation finally hits me when I meet his gaze and give a tight smile. “How small do you need it?”
The nurse assessing the baby snickers, and I return to my work while the dad flushes red.
Dr. Narayan makes it to the bedside when I’m a few stitches in and guides every throw. At the computer desk afterward, I’m flying through my notes and orders when she appears beside me.
“Dr. Rose, can you follow me?”
Startled, I save my work and trail after her, suppressing the sensation that I’m being called to the principal’s office. Short black ponytail swinging, she opens the door to her office and ushers me inside. She doesn’t offer a seat, so I don’t take one. Instead, we stand beside the door.
She crosses her arms. “You need to stop butting into deliveries.”
Taken aback, I gape while the familiar acidic corrosion of anxiety filters through my insides. “I was trying to help.”
“It’s my job to take care of patients. Your job is to help me. It’s inappropriate for you to be delivering patients without an attending physician present.”
“She would have delivered in the bed—”
“All of you residents do the same thing. You need to learn your place.” Her sharp gaze bores into me. “Where is your senior?”
“Oh, I—”
“It doesn’t matter. How about your attending? Isn’t he supposed to be here when you have patients actively laboring on the floor?”
“She went from four centimeters to crowning. The nurse called him—”
“I’m tired of taking on liability for you all to work reckless and unchaperoned, and you need to be trained. It’s their job to train you, don’t you agree?”
I curl my lips inward, biting hard. It’s my understanding that she is meant to be my chaperone while I’m working in this hospital, but I don’t know all the closed-door arguments that’ve led to this level of bitterness.
It’s like I’m a kid whose parents are divorcing, and each parent wants me to take their side when both of them are wrong. Meanwhile, I’m crying in the corner for someone to please buy me some cotton candy. After her tirade, which I’m sure was cathartic for her, but ruined my entire day, I whip out my phone and open the Pit It or Quit It message stream.
Me: Narayan’s in full Narayan mode today if you know what I mean
Alesha: So average day then?
Raven: I’m sorry! Your day will get better.
Julian: Or it will get worse, and you’ll have to drown your sorrows in textbooks.
Kai:
Kai: $100 says studying is her stress relief
Me: At least I knew the answer when they asked us about pap smears earlier, Julian.
Julian sends a picture of him in surgery with Dr. Ryan, followed by a jewel emoji.
Julian: Your hostility can’t touch me, Sapphire. I took out a uterus today.
Me: That’s a diamond, not a sapphire.
Everyone else congratulates him, but I growl. Of course the attendings let him assist in a hysterectomy when he’s supposed to be covering L&D. He’s the golden child, so let’s all shower him in gifts.
I open another message.
Me: Thanks for taking the time to teach me repairs in December. I’m finally starting to feel good about them.
Asher: You’re a vagician!
Me: Ha. Don’t know about that. It could’ve been better.
Asher: Practice makes perfect, sweetie-kins.
I chuckle and put my phone away, then settle down to chart. Beside me, the nurse is complaining that she had to work all three of her twelve-hour shifts in a row this week, and I quell the resentment that I’m on my nineteenth twelve-hour shift in a row.
If I complained, I’d be told I did it to myself.
You chose this.
Sometimes I can’t remember why.
The image of my poised, respected future self has never felt further away.
Even my confidence in my repair is short-lived when Dr. Narayan calls a C-section on another patient and chastises me the entire operation for my poor surgical technique. The more she complains, the shakier my hands grow, until I’m unable to tie down a single suture without multiple attempts.
Afterward, she eyes me meaningfully. “You need work, Dr. Rose.”
“Yes, Dr. Narayan.”
“There’s expired suture for practice in the resident lounge. I suggest you start there.”
At shift change that evening, Arista barely listens as I sign out to the second-year covering nights, Ellyn Peterson.
I don’t know Ellyn all that well, but she gives me an encouraging smile when Arista leaves without saying goodbye.
She folds the list I printed for her and sticks it in her pocket. “Vincent’s tough. Just think of it as a strength-building exercise. Everyone treats residents like trash, especially female residents.”
I manage a half-hearted laugh. “I’d like to give them a taste of their own medicine.”
She lets out a resentful chuckle. “Wouldn’t recommend it. You’ll learn fairly quickly that when you treat people the way they treat you—” she eyes me closely “—they get real fucking offended.”