Ella
A kid comes in on a stretcher before Susan and I can even start a conversation. The paramedics seem confident he’s a lost cause.
A certainty builds inside me, though. I will not lose this kid.
He's maybe nineteen, hit by a car crossing Penn Avenue, and his abdomen is rigid and distended while the EMTs rattle off vitals that paint a grim picture.
I hear all the words from my clinicals, from exams I failed. But today their meaning resonates. Tachycardic. Hypotensive. Altered consciousness. Internal bleeding, almost certainly, and he needs blood before he needs anything else.
"O neg, two units, now," Susan calls out, and I'm already moving.
This is the thing about me that doesn't make sense on paper.
I can't pass a multiple-choice test to save my life.
I transpose numbers. I second-guess written answers until I've erased holes through the Scantron.
But put me in a room with a patient who is actively dying, and my hands are steady, my mind is clear, and I know exactly what to do.
I grab the blood from the rapid infuser, check the unit number against the patient's band twice, because shortcuts kill people, and spike the bag while the other nurse named Aarthi preps the second line.
She's fast. I noticed that about her yesterday: precise hands, no wasted movement, and a face that gives away nothing even when things are bad. She’s new like me, but I haven’t had a chance to talk to her.
"Pressure's dropping," McKenzie says from the monitor. The third nurse in my hiring class has her fingers on the kid's radial pulse, and her voice is steady, but I can see her jaw tighten.
She's from Louisville and has a drawl that comes out when she's stressed, which means every word right now has about four syllables.
"Squeeze the bag," Susan tells me, and I'm already squeezing it, forcing the donated blood in as fast as gravity and my grip will allow. The kid's skin is gray. His eyes are half-open, and seeing nothing.
The attending materializes and starts calling for imaging, surgical consult, the whole cascade that happens when somebody’s belly is full of blood. I stay focused on my line, on the flow rate, on the kid's face. I watch his color. I watch his breathing.
"Second unit's ready," Aarthi says beside me, and we swap bags without a word, like we've been doing this together for years instead of two shifts.
It takes eleven minutes. The surgical team takes him upstairs with enough volume on board to keep his pressure stable, and the attending pauses at the nurses' station to look at our little trio of new hires.
"Good work in there," Dr. Reed says, and he's looking at me when he says it.
Susan squeezes my shoulder on her way past. "Quick hands, honey. Real quick."
I nod, wash my hands for the third time, and feel absolutely nothing about the compliment because I was just doing the obvious thing.
Aarthi finds me restocking the supply cart twenty minutes later. "You were a machine in there," she says, leaning against the counter with a coffee cup that says WORLD'S OKAYEST DOCTOR, which she claims she bought to annoy her parents. “Was that your first spleen situation?”
"I just handed them blood."
"You handed them blood at the exact right speed with zero hesitation while a teenager was dying. That's not nothing, Ella."
I shrug, because I don't know what to do with praise that contradicts the running narrative in my head. The narrative says I'm the one who graduated late, the one who can't test, the one whose biggest accomplishment is being related to a hockey player. The narrative is very loud.
McKenzie appears with a coffee from the vending machine. "Y'all. I need to decompress. That child's mama is in the waiting room, and I almost lost it."
We huddle by the supply cart, three new hires in identical scrubs, drinking terrible coffee in the fluorescent purgatory of Mercy Hospital's emergency department.
McKenzie tells us about her first code back in Louisville—she cried in the bathroom for twenty minutes, and when she came out, her preceptor handed her a biscuit and said, "Now do it again. "
Aarthi tells us her mother called during her lunch break yesterday to remind her that her cousin Priya had just been accepted to Johns Hopkins Medical School.
"My brother's face is on the vending machine," I offer, and they both stare at me.
"I'm sorry, what?" McKenzie turns to look at the vending machine in question, where Jason's face is indeed grinning from a beef jerky advertisement plastered to the side panel. "Oh, my GOD. That's Rookie from the Fury? Rookie is your brOTHER?"
"Unfortunately."
Aarthi snorts. "So that's why Susan called you Baby Rookie on your first day."
"I will pay you both actual money to never call me that."
"How much money?" Aarthi asks. "Because my student loans would like a word."
This is nice. This is something I haven't had in a long time—maybe ever.
Friends who see me as Ella, not as Jason's tagalong.
They know I'm good in a trauma bay, they know I drink my coffee black, and they know I have student loans that match theirs.
For the first time since arriving in Pittsburgh, I feel like a person instead of an appendage.
Around four, the ER hits a lull that Susan says is unusual. McKenzie is charting. Aarthi is restocking. I pull out my phone and open the NCLEX practice app, figuring I can squeeze in a quiz while things are quiet.
The first question is about fluid resuscitation in hemorrhagic shock.
I literally just did this. I just did this with my hands, in real time, on a real human being who is currently alive because of the blood I pushed into his veins.
The question asks me to identify the correct order of interventions from a list of four options.
I read them. I read them again. The words blur and rearrange themselves.
Option B and Option C look identical to me.
I know—I KNOW—the answer, but the way it's written on the screen doesn't match the way it lives in my brain, and I second-guess myself, change my answer, and get it wrong.
I try fifteen more questions. I get nine of them wrong.
The app cheerfully informs me that my score falls below the passing threshold and suggests I "review foundational concepts." I close the app and shove my phone in my pocket and stand there for a moment in the hallway where, a few hours ago, I helped save a life.
I can do the work. I just can't pass the test about the work.
The rest of my shift passes in the blur of a busy ER. I help with a dislocated shoulder, two lacerations, and a woman having a panic attack who just needs someone to sit with her and breathe.
That’s an easy one for me. I hang with her and complain about my brother, and she laughs at my jokes. But I don’t think there’s a multiple-choice question about this bedside manner.
I clock out at seven, change in the locker room, and think about my route home. It’s a two-mile walk or a 40-minute bus ride with multiple transfers.
The January sky is gray-black and heavy, so I decide to split the difference and walk to the 67 stop, boarding a bus that smells like wet wool and old piss.
I lean my head against the window, watching Pittsburgh scroll past, and feel the exhaustion settling into my bones like concrete.
When I let myself into the apartment, it's quiet.
I glance to the left and see Jason's door is closed, which means he's either asleep or not here. I can’t remember if they had a game today. The living room is dim, lit only by the television, playing a low-volume sports highlight show. There’s no head sticking up above the back of the couch, but as I step further into the room I see Bernard is lying there.
He's in sweatpants and a T-shirt that strains across his chest, with an ice pack balanced on his hip. He looks up when I come in and makes a face that might be a smile if it weren't laced with residual mortification.
"Hey," he says carefully.
"Hey."
I am instantly reminded of the feel of his erection against my ass and of my plan to cash in on his offered favor.
My stomach growls. Loudly.
I glare toward the kitchen, mentally cataloging the contents of the fridge and calculating what punishment my brother would cook up if I curbed my hunger with his stash of special food.
My brother's caveman diet is sacred territory, and I'd sooner poke a bear than touch his elk cubes or whatever artisanal protein he's hoarding this week.
"There's meatballs in the fridge," Bernard says, reading my dilemma. "I brought back extra from Gianna’s. Help yourself."
"Seriously?"
"Yeah, of course. They're mine, not his. Top shelf, red container."
I find the container and dump a generous portion into a bowl. I’m too tired and hungry to care how it might look for a plump girl like me to be wolfing down a giant bowl of meatballs.
Bernard has already felt what I’ve got going on here. But I do plan to ask him to undress me and plunder my lady-cave…
The microwave hums while I grab a fork and glance back toward the living room, where Bernard is trying to adjust his ice pack without moving too much.
"Hang on," I tell him.
I go to the freezer and pull out a fresh one. At least these guys seem to stock the good ice packs.
“Yours looks done." I swap the melted pack for the fresh one, positioning it properly against his hip flexor without thinking. "Did you stretch after your skate?"
He blinks up at me. "No?"
"Stretch after your skate, Bernard."
"Yes, ma'am."
The microwave beeps. I retrieve my meatballs, which smell obscene—garlic and basil —slow-cooked beef in a tomato sauce that makes me want to weep. I settle into the armchair across from him, and eat three meatballs in rapid succession before I'm capable of human speech.
"These are incredible."
"Gianna's the best. That's our spot—me and the guys. She takes care of us." He shifts on the couch, winces, then repositions the ice pack. "How was work?"
"Good. Hard. I helped with a trauma case."
"Yeah?" He's watching me with an expression I can't quite read. Like he's not sure where the conversational landmines are. "Was it intense?"
"A kid got hit by a car, ruptured an organ. We got blood into him fast enough for surgery."
I say it plainly, and Bernard stares at me. "Jesus, Ella."
"It's the job."
"That's a hell of a job."
I eat another meatball. He watches the TV.
The silence between us is different than before.
It’s warmer somehow, less loaded. Or maybe more loaded, but in a different direction.
I'm aware of his body on the couch, the bare feet pointed toward me, the way the television light catches the curve of his bicep.
I'm aware that twelve hours ago, that arm was wrapped around my chest.
“How was it with Grentley and Tucker last night?” I keep thinking about how awkward that must feel for the team dynamics. But I have no idea what led to the first guy’s divorce.
Bernard grunts. “Tuck’s babies were there. I think the actual babies make it all less …” He drifts off without naming the team mood.
“Twins are brutal. I’m sure everyone sees that.”
He nods. “Yeah. Anyway, we lost.”
“Bummer.” I finish my food and set the bowl on the ottoman. I look at Bernard Houser, who is pretending to watch a hockey highlight reel and absolutely not succeeding at acting chill.
"So," I say. "About that favor you owe me."
His head turns. I watch the wariness settle into his features. "Yeah. About that. Listen, I really am—"
"I don't want an apology."
"Okay." He shifts upright on the couch, the ice pack sliding. "What do you want? Name it."
I take a breath. I rehearsed this approximately forty-seven times during my shift—in the supply closet, on the bus, in the elevator—and it still feels unhinged when it leaves my mouth.
"I want you to deflower me."
The silence that follows is so complete I can hear the gel in his ice pack shifting.
Bernard's mouth opens. Closes. Opens again. He looks like a man who has just been told something in a language he doesn't speak and is trying to translate it in real time. His eyes dart to Jason's closed door and back to me.
"You—" He stops. Swallows. "I'm sorry, I thought you were going to ask me for a ride to work or something."
I hold his gaze. I don't blink.
He runs a hand through his curls, staring at me like I just defibrillated him without warning. Then something else crosses his face—a different kind of alarm.
"Wait," he says. "How DO you get to work?"
"I take the bus."
"The bus."
Bernard sits fully upright, the ice pack falling to the floor forgotten. "You're taking a public bus in the dark. Early in the fucking morning. To a trauma hospital."
"That is correct."
"In Pittsburgh. In January."
"Bernard, I work in an emergency department. I see worse things inside the building than anything that happens at a bus stop."
"That is not comforting, Ella."
"I haven't even been exposed to hepatitis yet. And I've had all my shots."
He looks at me like I told him hockey was canceled. Like the concept of a woman voluntarily riding public transit to a job where teenagers arrive spurting blood is more alarming to him than the fact that I just asked him to take my virginity, which, I realize, he has not actually responded to.
"Bernard."
"Yeah?"
"Did you hear what I said?"
He opens his mouth. Nothing comes out.
I pick up my bowl, carry it to the kitchen, and rinse it in the sink. “If you owe me, then that’s what I want,” I tell him over my shoulder, then walk down the hall to his bedroom—my bedroom, temporarily—and close the door.