2. Chase
Chase
“Dr. Matthews.”
Judging by the tone of his voice, this isn’t Dr. Porter’s first attempt at getting my attention. The swift elbow Sarah delivers to my ribcage would also confirm that suspicion.
“I’m sorry, sir. Could you repeat the question?”
“No, I can’t. Because it’s already been answered. Perhaps you should sign out of your service today if you’re going to be so distracted.”
“No, sir. I apologize. I’m fully committed,” I reply, forcing myself to push every thought in my head aside until later.
Residency culture, especially here at Boston Memorial, feels a lot like the military in the way we’re expected to appreciate discipline and tough love.
We’re also expected to never miss a day of work, even if we’re running a fever or puking our guts up.
And being late, arriving with a disheveled appearance, or not giving one hundred percent of your focus to the task at hand is also not tolerated.
Since this is our first year—our intern year—it’s the worst. We’re the grunts.
Our workload is higher, tolerance for our mistakes is lower, and in an effort to weed out those who don’t belong here, Boston throws interns into the intimidating environment of the OR right away.
We don’t have roles that could endanger the patient, but we’re often grilled while we’re in the operating room about what’s being done, why it’s being done, and what complications we should keep an eye out for.
It’s not ideal, but matching at Boston Memorial pretty much means you can write your own ticket for fellowship—the next phase after a grueling residency. One I haven’t even allowed myself to think about because the timeline is too daunting.
“As I was saying,” Dr. Porter continues calmly, as though the case we’re about to walk into isn’t life or death.
“Our next patient arrived in the ER after falling from an eight-foot scaffolding. He has an open humeral fracture. What do we check first?” he asks, as we all quickly and methodically scrub in at the sinks next to him.
“You need to identify if any major arteries have been severed,” Sarah answers without hesitation.
“Assuming they haven’t, what next?” Dr. Porter asks.
He opens the door to the OR by pressing a metal plate with his elbow, keeping his hands up and in front of his face, signaling to the staff in the OR that he’s scrubbed in and is ready for his gown and gloves.
“Major organs, scan for internal bleeding or head wounds,” I chime in, keeping my hands in the same position until a scrub nurse comes over and helps me slip on my protective gear.
“Ah, so you are present today,” Dr. Porter says. It’s the closest to an acknowledgment that my answer was correct as I’m going to get, and I know enough to keep my mouth shut at the dig.
The patient is lying on the table while the anesthesiologist keeps an eye on him, and Dr. Porter resumes walking us through his steps.
Slowly.
“I can’t see a thing for all the blood,” he gripes. “Suction.”
An OR nurse complies, clearing out the visual field, and I swear I see Dr. Porter almost smile when he says, “Looks like the bone is through the skin.”
He delivers the news in a bored tone, one completely devoid of concern.
His ability to compartmentalize is a topic discussed frequently among us residents.
The OR is crowded, but Dr. Porter stays in control, moving us around like pieces on a chessboard so we each have a clear view of his greatness as he restores the body of the man on the table.
My colleagues eat it up. Being in the OR with Declan Porter is the highest honor in trauma surgery. But the experience always falls a little flat for me, even though becoming a doctor has been my dream since I was eight years old.
He tends to the arm, and I swear he yawns once or twice. Apparently, an open humerus fracture isn’t the mental stimulation he’s used to.
“Bring in the C-arm,” Dr. Porter barks at the X-ray tech.
“Yes, sir,” she replies, scurrying from the room to complete the request.
“Dr. Matthews, remove the Gelpi,” he then says to me, asking me to remove the retractor holding the soft tissue back so he could access the plate he’d just screwed onto the bone.
“While we’re waiting for the C-arm, Dr. Matthews, can you tell me how far proximal to the lateral epicondyle does the radial nerve pass through the intermuscular septum? ”
I feel singled out because of who my parents are, but there’s nothing new about that.
“Twelve to fifteen centimeters,” I reply quickly.
“Your mother would be proud,” Dr. Porter remarks, much to my embarrassment.
My mom is an orthopedist; my father, a neurosurgeon.
My parents were elated when I chose trauma surgery as my specialty, but it’s not like there were a ton of options. They always made it pretty clear that only certain specialties were considered real medicine, and anything that doesn’t include surgery isn’t on the list.
After the case, I scrub out and find a quiet corner, attempting to process what I just witnessed.
This one wasn’t nearly as bad as some cases where there’s so much blood and trauma you know they’re a goner from the start. It’s morbid as hell as we all look on as a life slowly slips away. Nine times out of ten, the only thing tethering the patient to this earth is Dr. Porter.
Trauma surgery ensures there’s never a dull moment, despite Dr. Porter’s reactions.
I thought I would revel in the constant adrenaline dump, but in reality, it leaves me mentally fried with not enough energy to do much more than watch a movie or sleep on my precious days off.
I can’t even remember the last time I went rock climbing or skydiving, and my dad made me sell my motorcycle when I got into med school, threatening not to pay my tuition if I kept it.
He enjoys controlling the purse strings, and all in all, it’s not a bad deal. If he’s paying them, bills are one less thing I have to worry about when I’m awake for thirty-six hours straight, trying to remember medication doses and the differences between a Meyerding and an Army-Navy.
As I make my way to our afternoon conference, determined to give it my full attention following a hearty lunch of an apple and a Rice Krispies Treat, I check my phone for the hundredth time, allowing my mind to briefly wander back to last night’s message to Logan.
He never responded, and as an overthinker, I’m afraid I may have gone too far with the emoji.
Having a gay best friend changed my comfort level around other guys, but I don’t know Logan well enough to be so forward.
Hell, I’ve only met the guy once. However, his silence has been weighing on my conscience because I can’t help but feel like I made him uncomfortable.
So, when I sit down, I fire off another message in our chat, hoping to clear the air.
Chase
Hey, man. I’m sorry if my last comment was too much. I forget not every guy is Hanlon. Guess I just miss the fucker. What do you say we grab that beer?
Feeling better after extending an olive branch, I slide my phone into my backpack and pull out my laptop as Dr. Jenkins approaches the table while the rest of my co-residents file in and take their seats.
“Hey, Chase,” Sarah whispers breathlessly.
“Hey,” I whisper back. “Did you just sprint here?” I tease.
“Thought I was going to be late. I had to run home at lunch, and the Life Flight chopper landed on the freaking highway after a multi-car accident. I had to be rerouted. I’m so pissed at myself for missing the medical housing application deadline earlier this year.
Living so far from the hospital blows, and the waitlist is two years long. ”
I know she wants me to commiserate with her, and I agree, it does suck that she missed the housing application—I love living in the medical housing apartments, even if my roommate is terrible—but my brain snags on something else entirely.
“Wait, the helicopter landed on the highway?” I ask, my thoughts immediately on Logan.
“Yeah. It was tight, too. There were emergency vehicles everywhere. The pilot had a super small square to land inside. It was kind of awesome to watch, honestly.”
Before I can ask more questions, Dr. Jenkins cuts the lights and begins discussing the patient cases we’ll see during afternoon rounds.
I’m guessing they’ll include some car accident victims.
I need to be all-in on this lecture, but all I can think about is Logan in that chopper.
Pulling out my phone, I fight the urge to fire off another message. I don’t want to come across as clingy, even though I know I am, which is another reason I miss Hanlon so much. He never made me feel bad about it.
It was Hanlon who made me more comfortable showing physical affection for my guy friends in the first place, and he was just as much of a cuddler as I was.
Okay, that last part’s a stretch, but he didn’t mind when I was all up in his space.
As soon as the lecture’s over, Sarah and I stand and begin packing our things as Dr. Jenkins flicks the lights back on.
“So, I’ll see you at study group tonight?” she asks. “I could really use some help with the tibial nail procedure guidelines.”
Sarah is incredibly nice. And gorgeous. And she’s smart as hell. Her path in life mirrors mine, and it would be super easy to picture a future with her, but I doubt my girlfriend of seven years would appreciate that train of thought.
I’m not even sure where it came from, to be honest. I’ve never once thought about stepping out on Kendra. I guess the recent increase in our arguments is taking a toll. We just can’t seem to get on the same page lately, despite what feels like a lifetime of good memories.
A night off from medicine to recenter my thoughts, shoot the shit, and check the social box sounds like just what the doctor ordered. Especially before I can give in to the temptation standing in front of me. I need to make that beer happen with Logan.
“Actually, I’m not going to be able to make it tonight,” I tell Sarah. “But I know Arjun could totally answer your questions.”
Sarah’s smile falters, but she recovers quickly, not pressing the issue.
“Okay, cool. I’ll check with him, thanks. See you tomorrow.”
She scurries out of the conference room, and I open my Messages app, pulling up the number Logan gave me all those years ago. Fuck appearing desperate… I am desperate.
Chase
Hey, it’s Chase Matthews. Heard about the highway landing. Sounds like you and I could both use a night off. Beer tonight? Derringer’s?
My co-residents are great, and I’ve made some incredible friends. There’s something about suffering through these hours and this stress together, knowing we’re doing something a lot of people only dream about, that really bonds us.
But most of them are just like me.
We all feel the weight of the world and our parents’ expectations on our shoulders. We eat, sleep, and breathe medicine. To be fair, we sort of have to if we plan to survive the next five to seven years, but I need something different tonight, and I think Logan can give it to me.