(Saturday, July 23–Sunday, July 24)
The young man was dead, the unfortunate result of excessive speed combined with bald motorcycle tires and an unhealthy attraction to wind blowing through his hair.
Lauren discontinued chest compressions as her supervising resident, Dr. Stone, called it. “Time of death is 1452 hours.” Like his name, Stone was solid in both physique and character. Lauren glanced at the face of the dead man. Who had loved him? Who would grieve? She swallowed a lump in her throat. The staff transitioned from rescue efforts to cleanup mode, removing the debris that accrues during emergency interventions, drifting out of the room to check on other patients, write notes, or gossip at the nurses’ station. Soon, only Stone and Lauren were left in the room.
Stone ran his fingers through his dark crew cut and sighed. “Have you ever heard that Seinfeld bit where he says helmet laws are designed to protect brains that are too stupid to know to protect themselves?”
Lauren smiled grimly, recognizing the gallows humor that doctors used as their defense mechanism of choice. “Unfortunately for this guy’s brain, Arizona doesn’t have a helmet law.” Stone nodded in tacit agreement. “There’s a rare lull in the action right now. You should grab a bite to eat while you can.”
“Okay, thanks,” Lauren murmured, but she loitered in the room as Stone headed out to check on the other interns.
The patient’s head was no longer gushing blood. Lauren cleaned the gaping wound and carefully began stitching it up.
“There you are!”
Lauren started at the loud words in the quiet room. “Gotcha,” Ritesh said. Lauren had bonded with the five other emergency medicine interns at Phoenix Good Samaritan, but she was particularly fond of Ritesh, the handsome Indian with the mischievous sense of humor.
“No, you didn’t.” Lauren continued stitching up the gash. “Why did you practically jump out of your skin?” “Autonomic startle response of the sympathetic nervous system. Do you remember that little lesson from medical school or do you need me to review it for you?”
Ritesh grinned, then surprise registered on his face. “Whoa.
Are you sewing up a dead guy?”
“Keen observational skills. What was your first clue?”
“The fact that your stitches are so neat. They never look that good on real patients.”
In between stitches, Lauren launched a swat at Ritesh. “Did you come looking for me for a reason or did you just want to torture me with your witty repartee?”
“Oh yeah. There’s somebody here to see you.”
“Me? Is he tall, dark, and handsome? ’Cause that’s what I ordered.” “No, I wasn’t referring to myself,” Ritesh smirked. “She’s petite, blond, and gorgeous.”
“Liz? I wonder what she’s doing here.”
“I have no idea, seeing as I don’t know who Liz is.” “My sister.”
“Which explains the striking resemblance. Only she’s much nicer than you.”
“Only because she doesn’t know you yet.”
“So, are you going to go talk to her? Because if you’d rather stay in here treating the dead guy, I’d be happy to entertain her for you.” He wiggled his eyebrows suggestively.
“Quit with the eyebrows. She’s married.”
“So? I don’t discriminate against married women.” “Happily married.”
“I thought happy marriages were mythological like flying pigs or smart blondes.”
“Or funny Indians,” she retorted before worrying this joke was too politically incorrect, but Ritesh just laughed. “Can you tell her I’ll be out in a minute? I want to finish cleaning this guy up.” “Why? His dating days are over. Why don’t you just pull up the sheet and call the morgue?”
“Because somebody who loved this donorcycle-riding idiot is going to have to identify his body. And I don’t want their last image of him to be crushed skull fragments and exposed brain matter.” “You are such a marshmallow, Lauren. You should have been a social worker.” As he sauntered out of the room, he quipped, “Better not leave me alone with your sister too long. I might ruin the last happy marriage in America.”
Lauren took a few more minutes to adjust the patient’s longish hair to hide the stitches as best she could. She took a deep breath as she pulled the sheet up over the patient’s face.
The hospital cafeteria was crowded, nearly every table filled with hungry staff members or rundown-looking visitors. Lauren paused at the doorway to scan the room. Liz was always easy to spot in a crowd. Look for the table attracting the most surreptitious glances and…sure enough, there was Liz sitting in the far corner with Ritesh. Liz sparkled like a diamond in a box full of coal, somehow managing to look cool on this sweltering day, with her sleek hair, thin tanned arms, and crisply pressed white linen pants. Lauren wound between the small tables and cheap plastic chairs to make her way toward them.
“You know why they put nails in coffins?” Ritesh was saying. “No, why?” Liz asked.
“To keep the oncologists out.”
Liz’s laugh filled the entire room, its uproarious noise surprising from such a delicate beauty. When she spotted Lauren, she jumped up to give her a tight squeeze. Ritesh excused himself back to the ER, but not before tousling Lauren’s ponytail.
“Look at you dressed as a doctor,” Liz exclaimed as Lauren attempted to tame her hair. “You look so…grown up.”
Lauren glanced down at herself. Her scrubs were shapeless, making her feel like a green Pillsbury Doughboy. “Newsflash. I’ve been a registered voter for nearly eight years, in case you hadn’t noticed.”
“School is like a suspended state of adolescence. Now, you’re all professional and important.”
“Hardly. They say internship is the most humbling year of one’s life. It’s when you find out how little you really know.”
“I wish Mom and Dad could see you now. They’d be proud of you.”
“Yeah, yeah. They’d be proud of you, too.” Lauren started to eat the nachos Ritesh had left behind on the table. “What brings you to this neck of the woods?”
“I thought I’d drop in and see if you could take a break for a few minutes. Now that we live in the same city, we can do this kind of stuff.”
“True, true. I’m so happy to live close to you and Rose-ma again.”
“The Rose sisters are reunited at long last. We can go shopping and hiking and play tennis. Do you have to work tomorrow?” Lauren paused to think. She worked so many crazy hours that the days had begun to run together. “Nope. I have one whole day off.”
“I was hoping we could get together. Maybe take Rose-ma to Mass and do brunch afterwards. I have something I need to tell you both.”
“Is everything all right?”
“Yes, but I do have some news to share.”
“Why don’t you tell me now and put me out of my suspense?” “Because I want to tell you and Rose-ma at the same time.
Patience never was your strong suit,” Liz said.
“Dear Pot, please stop calling me black. Love Kettle,” Lauren said. Then they both laughed because if anybody had a problem with patience, it was Liz. Lauren resisted the urge to ask more questions.
“Your friend Ritesh told me you just lost a patient. Are you okay?”
Lauren let out a long sigh before answering. “It’s always tough. I have to keep reminding myself that we can’t save them all.”
“The world would be terribly overpopulated if you could.” Liz smiled before switching topics. “So, I got my official invitation for my ten-year reunion in the mail today.”
“Let me guess. Cowboy-themed. Wear your best Levi’s.” “Worse. A ‘gala under the stars’ coordinated by Lori Grimwood.” Liz made a face.
“Lori? I wouldn’t have thought she’d have the time. She’s been awfully busy since high school. Isn’t she on her third marriage?” “Yep, she’s been putting up some impressive numbers. Three marriages, five kids.”
“I ran into her a couple of summers ago in Tehachapi. When I told her I was in medical school, she said, ‘You’re still in school?’ I wanted to remind her that not everybody could be as productive as she is.”
Liz giggled. “Let’s hope most folks have matured after ten years. So will you come as my plus one?”
“You’re not taking Jake?”
“He’ll be working. I’ll hire a car and driver. We’ll arrive in style. It’ll be fun.”
“Remember all those times you didn’t want your little sister tagging along?”
Liz grinned. “Maybe I’ve matured after ten years.”
Lauren changed the topic. “Get this. I found out that Darcy already moved in with Michael.”
“Good,” Liz responded, surprising Lauren. “Those two deserve each other. And you deserve someone so much better than Michael. While you move on to something better, he’s going to be stuck with that bimbo. At least until they start cheating on each other.”
Lauren nodded, appreciating the logic of her sister’s opinions even while she struggled with her own mixed emotions about her ex-boyfriend.
“Someday soon you are going to meet the perfect man for you. I promise,” Liz offered with a smile.
Lauren’s beeper went off. “Sorry. I have to get back to the ER. Stat,” Lauren added, knowing the medical lingo would amuse her sister. “I’ll meet you at Rose-ma’s tomorrow morning at around eight.”
“Okay, go save some lives,” Liz ordered as Lauren rushed back toward the ER.
“Dust storm caused a multiple car pileup on the 101,” Stone told Lauren as soon as she pushed through the heavy fire doors into the ER’s staging area. “Several majors coming our way. ETA is five minutes. Stick with me. We’ll take the first one.”
Within moments, the ambulance entrance burst open with urgency as frenzied paramedics rushed in pushing a gurney. Lauren tried to keep up while they gave the patient report at a mile a minute, “Jamie Fuller…fifteen-year-old female passenger…probable fracture to left forearm…mother still being extracted from the vehicle.”
As Lauren hurried alongside the gurney into a trauma bay, she knew she should be assessing injuries, triaging by order of urgency. But all she noticed was the look of terror in the young girl’s eyes. “Hi, Jamie. I’m Dr. Rose. We’re going to take good care of you.”
“I want my mom,” the girl moaned through obvious pain. “She’ll be here any minute. Can you tell me what hurts?” Soon Lauren lost track of time in the intensity of the case, ordering X-rays, checking labs, setting a splint, and hooking up IVs. More than an hour passed before they had done all they could for Jamie, making her comfortable with a generous dose of morphine. Only then did Lauren find time to go look for information on the mother.
She checked several trauma bays before she found the one with the same last name: Fuller, Sarah. Her heart sank when she noticed CPR being administered.
“No response,” Stone was saying. “Time of death is…” “No!” Lauren interrupted impulsively. “There must be something more we can do.”
Most residents didn’t appreciate second-guessing from interns, but Stone merely shrugged his shoulders. “What would you suggest?”
Kevin, another intern, continued CPR. “Epinephrine.”
“Tried it.” “AED.”
“Three times already. No response.” “Internal heart massage.”
“She’s had catastrophic injuries. Who knows how long she was down in the field before the firefighters were able to extract her? You think cracking her chest is going to make a difference?”
“I don’t know, but we have to try,” Lauren pleaded.
“Okay, grab a Gigli saw and rib spreader. You’re going to assist with this one.”
Lauren hurried to gather up the necessary equipment. She returned to the bedside, nervously making eye contact with Kevin, whose case she had just hijacked. Unnaturally nice, Kevin smiled to communicate no hard feelings. Stone wasted no time in cutting an incision between two ribs on the left side and forcing the chest open violently.
“Okay, Dr. Rose, grab the heart and show it some love,” Stone said. “See if you can sweet talk it into restarting.”
This was Lauren’s first time touching the heart of a living patient. Feeling uncertain, she reached into the woman’s chest, located the heart, and began squeezing it rhythmically.
Nobody said a word, watching with anticipation. Nothing.
Minutes passed, but Lauren refused to give up.
Stone said, “I admire your effort, but it’s time to call it. We’ve done everything we can on this case. Other patients need our attention.”
Ignoring him, Lauren pumped the heart several more times, willing it to start beating. It did not. Finally, she withdrew her hand.
“Time of death is 1723 hours,” Stone said.
Her second dead patient today. Lauren fled the room, detouring into the supply closet as if she had an urgent need for gauze. Instead, tears came flooding out in long, silent sobs. She allowed herself the luxury of tears for only a few minutes before pulling herself together. She stopped in the restroom to splash water on her face, examining herself in the mirror. Her green eyes were still bloodshot, but she could credibly blame fatigue.
She dreaded returning to Jamie’s trauma room, but did not dawdle. After delivering the terrible news, she pulled up a chair and sat with the young girl while she bawled. “I can’t live without my mother. I can’t. I can’t.”
“Yes, you can,” Lauren reassured. “You don’t want to, but you can. And you will.”
Lauren took on several other cases that evening, but she returned to check on Jamie frequently. Shortly after midnight, Ritesh summoned Lauren out of Jamie’s room. “Shift’s over, Lauren. We’re all going over to the Tilted Kilt for some drinks. You ready?”
“You guys go on without me. I don’t want to leave until her dad gets here. We finally reached him and he’s driving back from San Diego.”
“How often do we get a chance to hit the town together?
Besides, I heard you owe Kevin a drink.” “More like a six-pack. Next time. I swear.”
“Maybe I should call your sister and see if she wants to fill your spot,” he teased.
“Maybe you should settle down with that nice Indian dentist your parents picked out for you.”
His eyes narrowed. “Wow. Now you have crossed the line.”
Lauren’s eyes widened. “I’m sorry, Ritesh. I didn’t mean to hurt your—”
“Ha! Gotcha again. You’re an easy mark today.”
She laughed, grateful for Ritesh’s ability to make her do so on a day like this.
“Good night, Marshmallow. See you tomorrow.” He waved over his shoulder as he departed.
Lauren returned to Jamie, whose hand she would hold for several more hours. When the father finally arrived, Lauren was forced to deliver the same terrible news twice in the same evening. Exhausted, physically and emotionally, Lauren was a few feet from the employee exit when she heard Dr. Stone call her name.
She turned as he rushed to catch her.
“I know you’re already way overtime, but there are a couple of detectives looking for you. They say it’s urgent.”
“Detectives? About which case?”
Stone shrugged his shoulders. “Shootings, stabbings, drunk driving accidents. The ER is a hotbed for crime victims. Take your pick.”
She walked back with him to one of the consultation rooms, which were mostly used for death notifications.
The two men stood as she entered. They looked fatigued, but then again, it was already well past dawn.
The older man stepped forward. He was probably in his fifties, his face lined with deep creases, as if years of worry had aged him prematurely. He compensated for his receding hair with a bushy gray mustache. “Dr. Rose, I’m Detective Wallace with the Scottsdale P.D. And this is Detective Boyd.” He indicated the younger man with a jerk of his head.
Detective Boyd was about six feet tall with broad shoulders and thick dark hair. Late twenties or early thirties. His startling aqua-colored eyes were many shades brighter than the navy suit he wore. He shook Lauren’s hand.
She pulled back. “May I ask why you want to see me?” “We should take a seat,” Detective Wallace directed.
Lauren sat on the small love seat in the room. Detective Wallace took the chair opposite her while Boyd continued to stand. “I’m afraid we have some bad news,” Detective Wallace said.
“Your sister, Elizabeth, was killed last night.”