The Queen of Hearts(16)
Chapter Six
VERBAL EVISCERATION
Late Summer, 1999: Louisville, Kentucky
Zadie
An hour or so after Silver died, the TICU doors swung open and the rest of the team charged in for rounds. Dr. Hollister, the attending, looked remote and scary; Dr. Kalena looked remote and cool; Clancy wore a supercilious smirk; Ethan, the other med student on my team, looked tired; and Dr. X, who seemed restored to his usual hard-charging character, looked smoking hot, at least in my opinion. He noticed me and grinned, all traces of his earlier grimness gone. “Sadie. You ready to give us the lowdown on our unit players?”
“I think so,” I replied, grabbing my list, now inexplicably covered in a dense array of hieroglyphics. Could this be my own handwriting?
“Excellent. Fire away.”
I took a deep breath and looked around. Silver’s mother had arrived, ashen and out of breath, ten minutes after the last beat of his heart. A curtain pulled around his bed shielded them from view, but the sound of her weeping and the softer murmur of the hospital chaplain filtered out, blending with the babble from the people assembled for morning rounds. Bystanders had morphed from a few nurses into a crowd of about thirty people—surgeons, the other trauma teams, respiratory techs, physical therapists, social workers—who now all turned like a wheeling flock of birds, focused on me.
The chair of the Department of Surgery, Dr. Spencer Markham, cleared his throat. Trying to ignore everyone’s stares, and the terrifying lidless gaze of Dr. Markham in particular, I stood in front of Bed 1. I glanced at the patient; he was perfectly still except for the forced rise and fall of his chest. My audience rustled.
“This is hospital day twenty for Mirror Trauma,” I reported. “He’s the nineteen-year-old unbelted driver of a high-speed MVA, resulting in splenic laceration, open left femur fracture, closed shear injury of the brain, and multiple skin lacerations and abrasions. He is day twenty status post exploratory laparotomy for splenectomy, day twenty for left femur rodding by the orthopedic service, and is being followed by neurosurgery for his head injury. Vital signs—”
“Stop there, please, and tell us what procedure of this patient’s care you have forgotten.”
I froze. Dr. Markham was legendary for the verbal evisceration he performed on anyone who did not straight-up know their shit. He fixed me in an unblinking reptilian stare. Phantom ice water surged up around my scalp as the weight of dozens of other eyeballs bored into me too. What procedure is he talking about? I named all the procedures! Didn’t I?
“Let’s try this another way. Please recount the injuries again.”
Dr. Markham did nothing to disguise his disdain of yet another flailing student. Most of the audience kept their faces unrevealing, but I could discern an expression here and there: empathy mingled with fear (Ethan), pity (Emma), and undiluted schadenfreude (Clancy).
“Um. There was the splenic laceration, the femur fracture, and the closed head injury.”
“And?”
There was a long-entrenched belief among the surgery residents: you never admitted that you didn’t know. Even with Dr. Markham. Any answer, even a moronic one, was better than confirming that you were clueless. This position had filtered down to the medical students, resulting in many a ridiculous answer during various conferences and grand rounds. But try as I could, I could think of no other injury, and I couldn’t just make one up. I’d singlehandedly brought trauma rounds to a screeching halt.
Salvation came from an unexpected source. “I’m afraid this is entirely my fault, sir,” my benefactor said. “May I answer the question?”
—
Well, well, well. It seemed that someone should have instructed me that sutures needed to be removed somewhere between six and twelve days, depending on the body part in which they were located. Suture removal was definitely a third-year-student kind of job, so I was grateful that Dr. X had fallen on his sword for me during rounds.
I had no idea how Dr. Markham had been able to discern that the patient’s sutures were still intact beneath his molting and scabbed exterior, but once Dr. X volunteered he’d forgotten them too, Dr. Markham lost interest. Mirror Trauma would likely have slightly more pronounced scarring from all his scattered lacerations than he would’ve had if we’d remembered to remove the sutures promptly, but everyone recognized that this was the least of his issues, and we’d moved on to the next battered guy. After rounds, I sought out Dr. X and said simply, “Thank you.”
“Hey, it really was my fault,” he answered, pleased that I’d acknowledged his protection. “I sometimes forget that you guys don’t know your ass from your elbow in here.”
“I’m stellar at ass recognition, actually,” I said, which earned me a laugh from Dr. X and his counterpart, Dr. Ken Linker, the chief resident of Team B. They were conferring about issues likely to arise regarding the new patient admissions. The chiefs liked to touch base at a few points during the day, knowing that the afternoon sign-out to one another could be disrupted at any time by the thumping of the hospital’s trauma copters.
“Keep it quiet in here, X-man,” Ken said finally, and gave Dr. X a quick bro handshake. Ken’s team included Emma, who regarded being on the trauma service the way a normal person might feel about spending a month at a luxury resort. Emma could be a little weird.