6. Charlie
CHAPTER 6
CHARLIE
U sually, after two weeks of working with someone who wanted to test their boundaries with him, Charlie would have put them back in their place, but Megan Bright was different. She just wouldn’t give up. He didn’t understand why they couldn’t just work together normally — side by side, without having to constantly needle each other. But Megan was determined to do all the needling she had energy for, and Charlie was getting tired of it.
They didn’t have as many cases together anymore, but every once in a while, their attending would find a way to stuff them in a room with only one patient between them. Charlie suspected this was more for their attending’s amusement that anything, mostly because of the way Dr. Ralter would hover around in nearby rooms or the hall. He was always on the same floor anyway. The man’s sense of humor was starting to irritate Charlie, who had long since accepted the fact that he himself did not have one.
Their current shared patient was a woman in her seventies, who presented with a headache, drowsiness, weakness, nausea, and blurred vision.
“I think my headache is because I can’t see so well,” Mrs. Jackson said. “I tried to get an appointment with my optometrist, but they’re booked out for the next six months. I’ve gotta get something for this headache. It’s making it so I can’t hold down my breakfast.”
Charlie examined her eyes for abnormalities but didn’t see any. Her temperature was normal, and so was her blood pressure. While he continued to check her, he went over everything he’d ever memorized, trying to match the symptoms to something. But every time he thought he’d found the answer, something else would rule it out. Megan Bright watching over his shoulder was not helping matters.
“Mrs. Jackson,” she said while Charlie went over the list of symptoms one more time. “What kind of heat do you have in your house?”
“Electric,” the patient answered.
Charlie knew what Megan was getting at. She suspected carbon monoxide poisoning, but the fact that the patient answered electric made Charlie feel smug about it. He couldn’t help himself.
Then Mrs. Jackson amended her answer. “But our electric’s been out the last couple days, so we’ve been using a space heater.”
Now Megan looked smug, and Charlie sighed deeply. He was about to lose again.
“What kind of space heater do you have?” he asked the patient.
“Oh,” she said with a slight smile. “Kerosene. It works really well. Heats a whole room in minutes.”
“Damn it.” Charlie ripped off his gloves and threw them away. “Get her on oxygen. She’s your patient now, Bright.”
As he walked away from the room, he could hear Megan explaining the condition to the patient. His outburst was going to get him into trouble with the people who criticized his bedside manner, and they’d be right to get on his case about it. The trouble was, Charlie Sullivan hated to lose. It was a bad personality trait, but he’d come by it honestly. His father did not go easy on him when he lost because Sullivans never lose . Any loss at all felt like outright failure.
Dr. Ralter must have heard the two of them because he assigned them another patient together later that week. Either that or their attending was a fan of betting on fights between his residents.
The patient was a middle-aged man whose young wife was in the room, hovering, worried. “He’s pretending it doesn’t hurt as much as it does,” she said to Megan, who was palpating the man’s lower right quadrant. “He was screaming while we were at home. Now he’s barely grunting.”
Megan asked the patient, “Any cramping?”
The man nodded.
Charlie took the time to read the patient’s chart while he observed his competition. Something jumped out at him. “He has a fever, too.” He grinned to himself. “Get him a CT scan, Bright. It’s likely appendicitis. I’ll put money down that he’ll be in surgery by this evening.”
The patient’s wife gasped, and Megan turned back to address her. “It’s a good thing,” she assured her. “We caught it in time. The surgery is pretty routine. He’s going to be fine.”
Charlie narrowed his eyes at Megan. She couldn’t even let him have this one win without jumping in to be the hero. He dropped the chart on the desk and headed out to the break room. He needed to breathe for a few, but shortly after he sat down, Megan entered the room.
Charlie shook his head. “Don’t you have other patients to comfort? I’ll be in to do the real diagnosis in a few.”
She sat down across from him with her brown bag and thermos. It was the same lunch she ate most days, and Charlie took a moment to judge her for being boring.
“You know,” she said through a mouth full of sandwich, “diagnosis isn’t all there is to medicine. Studies have shown that environment and treatment make a pretty big difference, too.”
“Without diagnosis, there is no medicine.” Charlie stirred the dressing into the grilled-chicken salad he’d had delivered.
“You act like I’m abandoning one in favor of the other,” Megan said. “I’m not. The one who’s doing that is you.”
“I simply disagree that they’re equally important.”
“Even if they aren’t, that doesn’t mean you should completely abandon one of them.”
“I haven’t,” he said.
“I beg to differ,” she countered.
He could feel his own mouth tug into a half smile before he said. “Beg all you want, Bright. I’ll enjoy the sight of you on your knees.”
Her face turned the same shade as the raspberries in his salad, and she floundered a bit before she managed to respond. “I bet you would.” She stood and moved across the room, away from him. “Pervert.”
Charlie laughed to himself. “Not a pervert,” he muttered. But he couldn’t help imagining her cheeks turning red for other reasons. Did she have to be so beautiful? That was the biggest problem, truly. It wasn’t that he was in love with her. It was lust as far as the eye could see. He sat silently convincing himself that was true, while he punched down every warm, respectful thought he had about her.
The next patient they had together was a burn injury. Truth be told, neither one of them had been assigned this patient, who happened to be a man Charlie’s father once golfed with. Kayla had been assigned to him. But Charlie and Megan were both there to “help and advise,” which meant they were one-upping each other every chance they could get.
They stood behind Kayla disagreeing on treatment for no good reason, bickering like an old married couple.
After thanking them for their help ten times over, Kayla had finally had enough. “Guys, I think Mr. Stewart and I could use a little alone time? I’ve got it from here.”
Megan nodded and started out of the room, but Charlie couldn’t resist one more jab. He handed his card to the patient. “This is my personal number,” he said, allowing a sliver of pride to creep into his voice. “Both of these residents are relatively new and inexperienced, and while I’m sure they have great potential, they haven’t got legacy experience. If you have further questions, please feel free to contact me.”
The gentleman glanced down at the card. “Jon Sullivan’s son, huh? I certainly do know of your father’s reputation. Well, thank you for this.” He pocketed the card. “I’ll be sure to follow up if I need to.”
Charlie left the room behind Megan, who turned back to give him a dirty look. “That was practically poaching.”
“Not at all,” Charlie said. “He’s still Kayla’s patient. I’m just offering a consult if he needs one. He’ll be more comfortable with a familiar name.”
“That’s called nepotism,” Megan snapped, “and it’s a dick move.”
“Oh, stop being so protective of Kayla. You’re babying her, and I doubt she appreciates it. You baby everyone, you know. Some people prefer to be treated like competent adults.”
Megan shot back. “I’ll treat you like a competent adult when you start acting like one.”
“You don’t think I’m acting competent?” he asked. She was so angry and walking so fast that he had to jog to catch up to her.
“No, I don’t think you’re acting like an adult.”
He finally stepped alongside her and kept pace. “So you’re saying you’d like our conversations to be a little more adult ?”
She swung the file she held with one hand and smacked him on the arm with it. “Don’t be disgusting.”
“Disgusting?” He grinned at her. “Do you always blush when things disgust you?”
She blushed even deeper at that. “This could qualify as harassment, you know.”
“Nah. I’ve only responded to your comment that I’m too childish by attempting to act more like an adult. You gave a valid criticism, so now I’m trying to address it. There’s nothing harassing about that.”
“It’s practically malicious compliance!” Now, not only were her cheeks bright red, but she was scowling, too. It was an expression she rarely wore, and Charlie rather liked it on her. That fire in her eyes peeking out from behind her glasses, her downturned lips just begging to be bitten. He wanted her to make that face every time she talked to him. She was like an angry bunny rabbit with her adorable, impotent rage.
He countered, “How can I maliciously comply when you have no authority over me?”
She stopped and whirled on him backing him into a wall. “Oh, you’d hate that, wouldn’t you? If I had any authority at all, it would really drive you crazy.”
He pushed forward but she wouldn’t let him past. “You seem to have a modicum of authority right now, Bright, and I can assure you, I do not hate it.” He smiled down at her, and her faced turned red again as she glared up at him.
Just then, Dr. Ralter passed them in the hall. “Break it up, kids,” he said. “We have a potential acute meningitis in room 202.”
Charlie looked down at Megan one last time. He wanted so badly to just grab her and kiss her hard. He wanted her to be furious with him. It took him until he was halfway to the exam room to figure out why. If she was furious with him, then she had to be thinking about him, and he wanted her to be thinking about him as often as possible. He wanted her to obsess over him, and if he had to get that through her anger, he would. It was far, far better than having her look over at him and feel nothing. He didn’t want to be just another fellow resident to her. He wanted to be someone special. And if she wasn’t going to fall in love with him, then at least, the two of them could be arch rivals. At least they would be something to each other that way.
They entered the exam room behind Dr. Ralter to find an attractive woman in her mid-twenties. Keith and Amy were already there. Dr. Ralter gave them all a rundown. “Ms. Philipps presented with a week of past illness that started out looking typical of upper respiratory viral infection. Days later, her headache became extreme. She does not usually get migraines, but this headache seems to be as bad if not worse than a typical migraine. Stabbing pain on both sides, and it does not respond to fluids or NSAIDs. Who’s my Sherlock for the day?”
“How are her vitals?” Charlie asked.
“Normal,” Dr. Ralter answered.
“Fever?” Megan asked.
Dr. Ralter shook his head. “All right, both of you are on this. You’re my Sherlock.” He pointed to Charlie and then Megan. “And you’re my Walton.”
“Watson,” Amy corrected.
“It’s Watson,” Keith agreed.
“Whatever.” Dr. Ralter’s patience was clearly faltering.
The patient groaned and held her head. They were not making things better, the room full of residents, that was for sure. Megan turned to her and asked, “What’s your pain level on a scale of one to ten — ten being the worst pain you’ve ever felt?”
The woman massaged both her temples for a moment, but then seemed to decide against it. “Seven or eight, I think,” she answered.
Megan glanced through the patient’s files. “All her labs are normal, too.” Then she turned to Charlie, of all people, and asked, “Do you think it really could be meningitis?”
Charlie had to hand it to her. “It could be. I think we should do a lumbar puncture. What do you think?”
“I think you might be right,” Megan said, and the others in the room nodded in agreement.
Ms. Philipps squirmed on the exam table, still holding a hand to her head. “Is meningitis bad?”
“It’s not great,” Charlie said.
“It’s going to be okay,” Megan reassured the woman. “We’ve got a great team and the most advanced equipment money can buy.”
And Charlie kicked himself a little for not thinking of reassuring the patient himself. Their attending was watching carefully, and he had just failed yet another bedside-manner test. He decided to ask one more question, just in case. “So you’ve been sick for a week, and you say the headache started a few days after that?”
The woman nodded.
“Do you… happen to drink caffeine every day?”
Again, she nodded. “Two or three times a day, usually, for work.”
“And have you been drinking caffeine since you got sick?”
“No,” she answered. “I’ve called in. I need sleep, not caffeine.”
Charlie nodded. “Rest is a good idea, but…” He turned back to the others and did his best not to smile. “Can we hold off on the lumbar puncture for now? I think I have a solution that will cost significantly less.”
When he got the go-ahead, Charlie jogged to the cafeteria and ordered one coffee to go. He grabbed a fistful of creamer packs, and headed back to the exam room. It was caffeine withdrawal. He was all but certain. It wasn’t meningitis, and he was certain the patient would be more than pleased with his diagnosis.
He gave her the coffee and they let her sit in the waiting room drinking it. Thirty minutes later, Charlie and Dr. Ralter went to check on her. Her headache was completely gone.
“I didn’t know you could have withdrawal from caffeine,” the woman said.
“You can indeed,” Dr. Ralter answered. “Charlie here has just saved you from having to have a lumbar puncture, which should make you very, very happy. Lumbar punctures are no fun at all.”
The woman smiled at Charlie and thanked him. Then she asked for his number. He declined. It wasn’t just the ethical implications of such an exchange. More that for now, all Charlie could think about was Megan Bright. Whether he hated her or wanted her didn’t seem to matter in the end. His obsession was undeniable, and it wouldn’t make him the greatest date for anyone, no matter how attractive they were.
He told himself he was too busy with his residency to be starting any kind of relationship anyway. The contentious one he had with Megan was the only relationship that might help to further his training rather than hinder it. He’d never wanted to win against anyone as badly as he wanted to win against her. She was a worthy adversary, and she motivated him to be the best he could be. Yes, right now, she was the one relationship he would allow himself, and that decision was final.