Chapter 14
DADDY’S DOCTOR DAUGHTER
Medicine has hierarchies based on competitiveness. If we compare them to the British aristocracy, the patients are exactly where they should be in importance: Kings and Queens. And beneath them, surgeons are the dukes, the ton, the aristocracy.
Lowest, akin to peasants, are specialties with the most open spots each year: pediatrics, family medicine, and internal medicine.
And what do these low-tier, proletariat specialties have in common? They’re all primary care.
And in the language of medicine, if something isn’t competitive, it can’t possibly be worth doing.
Clinical pearl #14: To medicine’s bottom of the barrel, worry not about your future job prospects: All you need to get into family medicine is a pulse!
THANATOS
KANE
The fluorescent green of the operating room beams like a beacon, beckoning me in as I scrub in for the place I equally loathe and love.
Love, because I’ve been chasing the O.R. for months, and finally, after weeks of begging, have the chance to do the simplest surgery ever: putting in a port for chemotherapy patients, a sewn-in tube for medication delivery.
Loathe, because I dread the ‘honor’ of waking up early for this yet again, the stifling congestion of a cramped room, the grueling drag of endless rounding and running the list, the relentless scrutiny of every mistake, and most importantly, the agonizing absence of my fake girlfriend.
I miss her selfless ambition, the way her nose scrunches and her eyes light up when she talks about delivering babies.
I miss her tender openheartedness, her reluctant inquiries about her enemy, Mousey (safe, in Bianca’s hands).
I even miss her relentless optimism, my only reprieve from my grisly, all-or-nothing nihilism.
To me, everything about surgery is too much.
The aggressive orange of the iodine is too tedious, though I understand why we need to prep. The monotonous, repetitive hours drain me. Brutal, continuous feedback exhausts me, even if I need it to grow.
But to Percy, life is never enough.
She’s tired, but she’s still excited to be there. She’s overwhelmed, but she can handle the challenge.
She’s not happy, but she’ll still pretend to be fine, because she’s convinced she’ll find her happiness out there somewhere; she just has to chase it.
I can see right through her peppy mask, and if I got the chance, I’d do everything in my power to make her the happiest woman alive.
But right now, I’m embracing my long day, spinning backward to enter, greeting the scrub tech on my way in.
“Good morning, Kelly,” I say, shaking off the last of the water from my arms.
Kelly spares me a bored look, tossing me my gloves, while my chief resident, Bovie, adjusts the lights over the sea of blue. The door swings open, and Jade, wearing her neon yellow Medical Student badge, strolls in. She looks at me, scrunches her nose in disapproval, and greets Kelly warmly.
It’s always a little jarring to see her here.
Just months ago, it felt like I was still braiding her hair for elementary school, and today, she’s braided it herself under her scrub cap, her mask is in place, and she’s striding into the O.R. with the confidence of someone who’s been here months, not weeks.
She doesn’t just dress like she belongs here. She acts like it, too.
“Welcome to surgery, Jade,” I tell her, and Bovie smirks.
“This is my last week,” she says flatly, “not that you would notice, since you’re rarely here.”
I swallow back my pride, stepping aside so she can gown up.
The rules of our operating room are these: the chief directs the operation. Resident gets first pass at suturing. And if he (or she) fails, the next shot goes to the medical student.
As in, if I embarrass myself, Jade will gloat about it over dinner for weeks.
Bovie knows this, which is why he’s got pep in his step as our scrub nurse, Lane, goes over who the patient is, who we are, and the basics of the surgery.
Hell, he was probably the one who invited her.
Just to turn up the pressure cooker of surgical residency up one more degree. Because we’re not worth noticing until we’ve burned out to an unrecognizable charred crisp, right?
Kelly hands me my instrument, and I angle it through the skin, Bovie on alert as I expose the greasy, slippery yellow layers of fat. Jade looks too, peering with sharp eyes.
“Any questions, student?” I ask.
A muffled, wheezing cough erupts from the other side of the drape, the anesthesiologist clearly enjoying my family’s freak show.
With the mask, I can’t see her press her lips into a firm line, but her eye creases show her displeasure. “None,” she answers primly. “Thank you.”
Normally, medical students at least pretend to have questions to show interest, but the hospital’s opinion of me is so low that Jade knows my evaluation of her is worth less than dust.
I alternate between cutting and burning, carefully weaving my way through flesh, the smell of charred cautery souring the air.
“I’ll take it from here,” Bovie says once I’m finished, either not noticing or not caring about Jade’s ambivalence, stepping around her to do the main tube insertion.
Jade lunges forward to see, damn near pushing me out of the way, and I sigh, letting her angle me off to the side. If we weren’t sterile, I’m sure she would have made it like old times, literally shoving me out of the way when annoyed.
On the mayo, Kelly takes one set of scissors and sutures out for me, and then immediately puts the backup pair beside them for Jade.
Lovely. Even in the hospital, everyone expects Jade to surpass me.
And at this point, I don’t know whether I’m so pissed off I’m no longer desperate to prove myself, or so beaten down I’m ready to give up altogether.
Though I suspect the programs I applied to say enough about my current level of motivation.
Jade and I watch him place the tube, Bovie’s hip hop music blasting in the background, while the patient’s even breathing beeps across the drape.
Eventually, Bovie turns to face me. “So, Kane,” he says, never one to pimp us as hard as the attendings, “are you couples matching with Percy this year?”
“No,” I tell him, “I think couples matches are just for M4s anyway, and either way, I wouldn’t want to influence her chances. She’s a much better applicant than I am.”
His jaw ticks. “Hmm,” he mutters, clearly disappointed with my answer.
I fidget, shifting from foot to foot. What did I even say? All I did was praise Percy.
This is what I hate most about residency. The performative ass-kissing that has nothing to do with medicine but influences my evaluations—and my future—anyway.
His disapproval drips through his next sentence. “Well,” he says between switching instruments, “I overheard you asking Dr. Millis for a letter of recommendation for Family Med residency.” His brows tick up. “Were you ever planning on telling me you were ditching us?”
Ah, fuck.
“Family med!” Kelly gasps. “Why?”
“Family med?” Lane echoes. “You’re ditching the O.R. entirely?”
Jade’s head snaps up, stunned.
An inquisitive head pokes around the drape, and then a younger one, as the anesthesiologist and student alike witness my colossal fuckup.
“For Family Med,” Bovie rumbles, shaking his head as he continues working. “He’s leaving surgery for outpatient visits,” he says, sounding like he’s just encountered true insanity for the first time.
Equal parts horrified and pitiful.
“Well, ah…”
Truth is, I was planning on telling him soon, but I’ve been so distracted with Percy it’s completely slipped my mind.
My gaze darts everywhere, trying not to meet anyone’s flabbergasted expression. I shouldn’t have to explain myself to all these people. Especially since I won’t be here anymore in six months.
“Sorry I didn’t tell you sooner,” I mumble, fumbling for any lingering excuse. But honestly, I didn’t want to tell him because I knew this was how everyone would react.
Shock. Horror. Disdain.
The fall from grace feels like my soul is dehiscing, unraveling in time with my reputation to expose my necrotic, black heart.
It hurts, it’s awkward, and I can’t wait to be out of this horrible room. To escape this mind-numbing, hopeless place.
Bovie’s mask frowns with him as the surgery drags on, disappointment radiating off him in waves.
“So much for the eldest Goodyear following in his father’s steps,” he says dryly, glancing at Jade. She hasn’t taken her eyes off me yet; her features morphing from confusion to a supercilious sneer.
“Why… Family Med?” she asks in a peaceful, blank tone.
Oh, she’s livid.
Considering she spent hours last year convincing me I could still be a surgeon even after my incident, she has a right to be incensed.
“I want more time to take care of Percy,” I lie, but Jade’s still glowering, and Bovie looks unconvinced.
“Surgeons can’t take care of their families?” Bovie asks.
My mouth goes dry.
I’m awful at this. Someone needs to suture my lips shut. It should probably be Percy.
“They can,” I stall, “but I…”
How do I politely say, I abhor surgical residency and would rather skin myself alive with a blunt instrument than stay here? “Think I will be much happier in a primary care specialty with standardized outpatient hours.”
That, and I don’t trust myself to match into a surgical specialty the second time. And I can’t handle the Scramble twice. I barely survived the first time. I’ve been ready to move on from this life for a long time now.
Bovie’s teeth grind. Kelly’s eyes narrow. Jade’s posture remains rigid, more riled than I’ve ever seen her. The wide-eyed medical student peeking out from behind the curtain looks like she would livestream this moment if it wouldn’t break HIPPO.
What would Percy say to fix it? I wish I had her effortless charm and not my bustling blunders. Bovie has kids, too. Dammit, I really should have told him sooner.
You should ask people about their families, Percy’s voice reminds me. People love talking about their kids.
“I want to spend more time with kids,” I blurt.
Now, his rising ire turns into full-on disbelief. “You? The demon? With children?”