Chapter 3 #2
Jade squirms in her seat, as uncomfortable as ever being pimped in front of us, and especially by her father.
She bites her lip, clearly trying to think.
“Your patient is dying,” he says drolly. “Any moment now.”
“I’ll look it up and get back to you,” she offers.
Dr. Goodyear scowls. “My God, Jade, you had to pass this to be allowed in the clinical arena! You really don’t know?”
She shrinks back in her seat, and my heartstrings tug. If I were any closer, I’d be trying to whisper it in her ear. It must be horrible having a doctor father who’s just as hard on you as your classmates.
“Your patient’s brain function is declining,” Dr. Goodyear says.
Poor Jade looks completely blanked out.
“I—”
“Need to read more,” he says, turning back to his computer to pull up the algorithm.
As soon as his back turns, my watch buzzes quietly in the ‘Underlings’ group chat.
Kane: 15:2 is peds, Jade.
I swing my head around to see Kane slink into the row behind me, typing on his phone in the Tragic! app. He must be trying to balance clinical responsibilities while attending didactics. I wonder why he doesn’t get protected time away from the pager.
It’s usually a sign of a malignant or toxic program if residents can’t focus on their lectures and have to watch patients at the same time.
It’s especially shocking to see a program so malignant that the director torments his own son with this.
Jade immediately says, “It’s peds, Da—Dr. Goodyear.”
The algorithm finishes loading, reinforcing what she just said, and Dr. Goodyear releases another long-suffering sigh.
“Yes, Jade. If you plan on matching, study harder next time.”
She winces.
He flips through his presentation to a flatline EKG.
“What rhythm is this?” he asks Jade.
“Asystole,” she answers. “Push Epi and continue CPR.”
“Correct,” he says, moving on to his next victim. Staring at his computer, he flips to the next image. “Esther, what dose of Epi?”
Esther hesitates, and then my watch buzzes, all of us stealing glances down.
Kane
1 mg every 3-5 min
this was in my text last night btw
y’all look illiterate
I want to text back not now, asshole, but I’m too focused on learning instead. Annoyed faces twitch around me, frustrated by his sordid honesty.
Esther answers, and the next slide appears. There are squiggly lines, but not a completely flat line.
“It’s been two minutes,” Dr. Goodyear says. “What now, Ari?”
“It’s…” she peers briefly down, where Kane has texted,
Kane
Vfib. Shockable
Wait, no, I don’t think that’s—
Before I can warn her, she answers confidently. “Shockable rhythm.”
Dr. Goodyear frowns. “No.”
He turns an unimpressed head around. “What is it, Levi?”
“Pulseless electrical activity.”
Ari’s face has gone white as a ghost.
My watch buzzes on.
KANE
You guys need to know this stuff inside and out. In emergencies, you won’t have time to look things up, and you also can’t be misled by misinformation that’s everywhere but egregiously incorrect.
Especially medical TV. If you start shocking people when they flatline, I am personally going to come haunt you.
I whip my head back, where Kane is grimacing like he means it.2
The color returns to Ari’s face as Luke whispers, “Control your man, Percy.”
“Sorry,” I whisper back, but he ignores me.
Ari shifts away from me like I’m the one who texted us garbage, and then Dr. Goodyear drones on with the next squiggly line. “Hyacinth?”
“Vfib,” Hyacinth answers, “shock and continue CPR.”
“Correct,” Dr. Goodyear says.
Kane
Also, you guys shouldn’t be reliant on cheating. The resident won’t always be around to save you.
Luke suppresses a laugh, and I check my watch, but there’s nothing.
Two seats away, Jade covers her mouth, then giggles at something.
“How long do you continue CPR?” Dr. Goodyear asks Calypso.
“Two minutes,” she answers smoothly.
Calypso smiles down at her watch as Levi pats her on the back.
Kane
Would y’all fucking focus? If I can see y’all texting, then everyone else here can too.
“What about this one?” Dr. Goodyear asks nobody in particular. The next rhythm is spiky but smoother.
“Pulseless ventricular tachycardia,” Ari redeems herself, “Shock, continue CPR for two minutes, Epi every three to five minutes.”
“Very good, Ari,” he says.
“What’s it called when the pulse returns, David?”
“Return of spontaneous circulation,” he replies.
Wow, that was an easy one. Lucky him.
Luke snickers at something, and in the least subtle move ever, Hyacinth leans over her chair to read Jade’s phone. She whips it away, but not before Hyacinth’s fingers fly.
Hyacinth
Those bitches!
They made a new group chat without us!
Esther’s face drops.
Hyacinth
Jade bet $100 you’re knocked up already. That’s the only way she can imagine Kane liking you.
Ouch, I thought. Not just towards me, but to her brother too. What a twisted family.
Dr. Goodyear slams his computer closed, shifting over to the board, where he’s drawn every rhythm imaginable.
“Leviathan?”
“Aristotle?”
“Esther?”
“Adson?”
He runs through the list, quizzing us on each one. I count how many until it’s my turn, confidently identifying the one I’ll have as atrial fibrillation—not a shockable rhythm.
Behind me, Kane bristles in his seat, and I wonder what he’s thinking. Can he even tell he’s riling everyone?
“Persephone?” Dr. Goodyear calls, and I snap out of my reverie.
Ah, fuck.
It’s not the one I wanted.
I squint at the strip he’s pointing at, trying to think. It’s not… fast. Probably a heart block then. The rate is slow. But what about rhythm? It looks like beats are missed…
I wrack my mind for help, begging the sloppily memorized Anki cards to make a reappearance when I need them.
“Any day now,” he prompts.
“It’s…” I stall.
Kane
Mobitz type 1