Chapter 14
FOURTEEN
DREW
When I get to the clinic Friday morning, there’s a sharply dressed young man leaning on the reception desk, talking to Celine.
“Oh, Dr. Malone,” Celine says. “This is Ryan. He’s an elective medical student, visiting from . . .”
“McMaster University,” Ryan supplies, stepping forward to shake my hand. “It’s such a pleasure to meet you, sir.”
I groan inwardly. Since I became the department chief, I’ve had med students appearing out of nowhere to work with me.
They all want reference letters for their residency applications, and it’s gotten overwhelming.
A few months ago I told the med education office to stop placing visiting students with me, but somehow, they keep showing up.
It seems the good folks in the education office have ignored my instructions.
As I shake hands with Ryan, I glance over his shoulder at Celine. She gives her head a tiny shake, which tells me all I need to know.
Celine does not like Ryan, which means he’s probably the type of med student who treats secretaries like dirt. Unfortunately, this is a fairly common trait in wannabe neurosurgeons.
Ryan follows me to the workstation in the back, where I introduce him to my resident, Dr. Lucy Sun.
“I thought I’d take the first patient,” Lucy says, looking at the list on the computer. “I’m just reviewing the scans.”
“Sounds good.” Lucy’s probably my favorite resident in the program. She’s bright and hard-working, and she doesn’t have a God complex.
“Ryan, do you want to shadow me for the first few patients?” she offers.
Have I mentioned that I love Lucy?
“Oh, thanks, Dr. Sun, but I was planning to work with Dr. Malone,” Ryan says.
I’m this close to telling Ryan that there’s no point. He’s failed the secretary test, so there’s almost zero chance I’ll recommend him for a residency spot here. He can do us both a favor and stop sucking up.
But in an admirable show of restraint, I don’t say any of that, and Ryan sticks to me like a bad rash.
At around ten-thirty, a couple of patients don’t show up and we get a break. It would be the perfect time to sit down with Ryan and teach him something, but I can’t bring myself to do it.
“I’ll be back in a minute,” I say, shooting Lucy a look of apology as I escape down the hall.
But it isn’t really an escape, because Ryan follows me. “Okay if I come with?” he asks. “Are you going to the ward?”
“Getting coffee, actually.” I’d been planning to buy tea, but there’s no way in hell I’ll buy herbal tea in front of Ryan.
“Sounds good,” he says enthusiastically.
As we walk past the ER waiting room, I spot a woman with a blonde ponytail. I can only see the back of her head, but from this angle she looks a lot like Ally.
I give my head a shake. Now I’m imagining her everywhere.
Fortunately, there’s no line at the coffee shop. I order a vanilla latte, and Ryan asks for the same. After I tap my card, we step to the side to wait for the drinks.
“You know, I’m really interested in neurosurgery,” Ryan says.
“Me too,” I reply.
He laughs awkwardly. “And I’d love to do residency here, so I’d appreciate any tips or advice . . .”
“Sure, I’ll keep it in mind.” I pull out my phone to discourage further conversation, and text Ally to confirm we’re still on for tennis tomorrow.
Back at the clinic, I stop at the reception desk to give Celine the latte. She looks a little confused—I’m not in the habit of leaving mid-clinic to buy her coffee—but she takes it with a smile of thanks.
“But—you didn’t get a drink for yourself?” Ryan looks confused as we walk back to the workstation.
“I don’t drink coffee, Ryan,” I say with a shrug. “But life’s a lot easier if you keep your assistant happy.”
There. Now the kid can’t say I didn’t teach him anything.
My phone vibrates in my pocket. I pull it out and see that Ally’s replied to my text.
Alexandra: Can we reschedule tennis? I fell off my bike this morning and got a bit scraped up. I’ll need a couple days to recover.
Me: Of course. You okay?
She doesn’t reply right away, and I think back to the woman I saw in the ER waiting room. She really did look a lot like Ally.
“Dr. Malone, I’ve got a case to review if you have a minute,” Lucy says.
“Sure,” I say absently. “Actually, no. Lucy, I have to go deal with something. I’m leaving you in charge.”
Lucy’s eyes widen in surprise. She’s a senior resident, so leaving her to run a clinic isn’t crazy, but it’s not something I’ve ever done before. I’m not exactly known for giving my residents autonomy.
“Okay, Dr. Malone,” she says.
“If you think someone needs to be booked for surgery, have them wait for me to review,” I tell her. “I’ll be back as soon as I can. Anyone you’re happy with, you can send home. I’ll read your charts later.”
“Got it. Thanks.”
“Uh, Dr. Malone—” Ryan begins.
“No, Ryan, you can’t come with me,” I say, pre-empting his question. “Dr. Sun is in charge, understand?”
Ryan nods. “Of course.”
When I get back to the ER waiting room, there’s no sign of Ally. I try to call her, but she doesn’t pick up. So I head to the low acuity zone, where they treat the walking wounded. Ally said it was nothing major, and hopefully that’s true.
As usual, the ER looks like a disaster area: chaotic, noisy, and crowded.
The low acuity zone is basically another waiting room, with rows of chairs facing a TV that’s playing the news.
A sign under the TV states that ‘chairs are for patients only’, and almost every chair is occupied.
There are a few curtained cubicles off to one side, to give patients the illusion of privacy when they finally get seen.
I spot Ally almost immediately, sitting at the end of a row talking to a nurse. As I walk closer, I notice her left forearm is wrapped in gauze and her pants are ripped at the knee.
“If you want to leave before you see a doctor, you’ll have to sign out against medical advice,” the nurse tells her.
“That’s fine,” Ally replies. “Is there a form or something?”
Oh, there’s no way. She looks pale and exhausted, and she’s clearly in pain. For all I know, she could be badly injured.
“Ally,” I begin.
She looks up and blinks in surprise. “Oh. Hey, Drew.”
“You can’t leave,” I say simply.
“But it’s apparently a five hour wait,” she argues, gesturing to a sign at the nursing desk. “And I just have a cut on my arm, which the nurses have already bandaged, so I don’t see the point—”
“You might need stitches,” the nurse puts in. “And the triage note says you fainted.”
What? Ally failed to mention that bit when she texted me.
“Ally, you can’t leave,” I repeat. As arguments go, it’s not the most eloquent, but it’s clear and to the point.
“I didn’t actually faint,” Ally explains. “I was a bit dizzy at triage because my arm hurt, so I had to sit down. But they said my vital signs were fine, and I feel a lot better now.” She picks up her backpack and stands. “Do I have to sign something?”
The nurse—Kelly, according to her ID badge—looks up at me nervously. “Uh, Dr. Malone said you can’t leave.”
Kelly seems like a very sensible nurse.
Ally sighs, but before she can argue the point, the ER doctor appears.
“Hey, Drew,” Dr. Sophie Kaminsky says curiously. We don’t get a lot of neurosurgical consults in the low acuity zone, and she’s clearly wondering what I’m doing here. “Did we ask you to see someone down here?”
“No,” I admit. “Ally’s my girlfriend.”
Sophie’s eyebrows fly up. “Oh. I see.”
“She fell off her bike and cut her arm,” I explain. “And she apparently fainted at triage. And now she wants to leave, but I’ve told her . . .” I hesitate for a moment. Maybe I’ve been approaching this the wrong way.
I take a deep breath and turn back to Ally. “I’m asking you to stay and get checked out. Please. For my peace of mind.”
“Oh.” Ally looks taken aback. “Um, okay. I guess.”
“Great,” Sophie says, turning to the nurse. “I think Ally’s next to be seen, right Kelly?”
“What?” Kelly says. “Oh, right, yes.”
“Perfect,” Sophie says. “You can put her in a cubicle. She’ll need an ECG and cardiac labs. And prep a suture tray, please.”
“Of course,” Kelly replies, smiling at Ally. “You can come with me.”
I pick up Ally’s backpack and we follow Kelly to one of the curtained cubicles.
“You can hop up on the stretcher,” Kelly says. “I’ll be back in a minute.”
As soon as the curtain closes behind her, Ally turns to me.
“Drew, we cut the line,” she whispers nervously. “There’s no way I was next to be seen.”
“Sure you were. They triage by urgency, Ally.”
“But Drew—”
“Okay, you might be right,” I interrupt. She’s definitely right, and the optics aren’t great, but if I had to do this over I wouldn’t change a thing. “It’s professional courtesy, Ally. Sophie knows that if someone in her family needed a neurosurgeon, I’d help her out.”
“But a bunch of people out there heard what happened,” Ally says. “What if someone complains?”
“No one will complain,” I reassure her. “But if someone does, I’ll deal with it.” And I’ll suggest the complaint be escalated to the VP of Clinical Operations, who called me directly when his mother had a head injury last year.
“Okay,” she says reluctantly. “How did you know I was here?”
“I saw you in the ER waiting room this morning, but at first I assumed you were someone else. When you texted that you fell off your bike, I put it together.”
She nods. “But it’s Friday. Aren’t you supposed to be running a clinic?”
“Trying to get rid of me?” I ask lightly.
“No,” she says quickly. “But you must have patients booked, so—”
“The senior resident’s seeing them.” And if I didn’t have a resident, the clinic patients could be rebooked. “You want a hand getting onto the stretcher?”
“I’m okay, thanks,” she says, climbing easily up onto the stretcher.
The curtain swishes open again, and Kelly reappears with equipment to draw blood. As soon as that’s done, a tech appears with an ECG machine and explains the procedure.
“ . . . you’ll have to lift your shirt so I can put the stickers on,” the tech tells Ally. “I can get you a gown if you’re more comfortable—”
“It’s fine,” Ally says. “Go ahead.”
Fuck. I stare resolutely at the curtain until I hear the machine whirr as it spits out the tracing.
“All done,” the tech says brightly, and she disappears with her machine.
“Are you okay if I stay?” I ask. Sophie’s probably going to want to examine her, and since Ally and I aren’t actually in a relationship, I really shouldn’t be here.
But Ally nods. “Yeah. I mean, I’ll be fine if you have to go back to the clinic. But if you can stay . . . I’d appreciate it.”
“Yeah. No problem.”
Before I can say more, Kelly reappears to set up a suture tray. As soon as she leaves, Sophie Kaminsky arrives.
“Hi Ally,” she says, pulling the curtain closed behind her. “I’m Dr. Kaminsky. I understand you fell off your bike?”
“Yeah.” Ally looks embarrassed. “I work here, and it happened right next to the parking lot. I skidded on some gravel as I was turning toward the bike rack.”
“Did you hit your head?” I ask. “Were you wearing a helmet?”
“No. I mean, no I didn’t hit my head, and yes, I was wearing a helmet.” Ally huffs out a sigh. “I’m not an idiot, Drew.”
Sophie’s lips twitch a little before she reverts to professional mode. “Okay. So you didn’t lose consciousness when you fell?”
“No. I just cut my arm, there was something sharp on the edge of the bike rack. It tore right through my sleeve.”
“Okay, I’ll have a look at that in a minute,” Sophie says. “Tell me what happened when you fainted?”
“I didn’t actually faint,” Ally insists. “When I was at the triage desk, I stood up too fast and got dizzy. A nurse helped me sit down, and I was fine.”
“So no chest pain, palpitations, anything like that?” Sophie asks.
“Oh, no, I’m fine.”
Honestly. Even if Ally had the plague, she’d probably still say she was fine.
“Any chance you could be pregnant?” Sophie says. Her eyes stray toward me, as though I might have some insight into the question.
Ally’s cheeks have turned a little pink. “No. Really, it was just because of the pain in my arm. And I forgot to eat breakfast. There was a small flood in my apartment this morning, and I was distracted.”
“I see,” Sophie says, keeping her expression carefully neutral. I’m sure she’s wondering why my possibly pregnant girlfriend is living in a flooded basement apartment north of Duke Street.
Because I’m sure as hell wondering that.
Never mind that Ally’s not actually my girlfriend, and she’s not pregnant. And that Sophie probably doesn’t know where Ally lives. And apartment floods aren’t uncommon, even in places south of Duke Street.
“Ally’s going to stay with me until her apartment’s sorted out,” I say. “Obviously.”