The tiny Surgery resident raises her eyebrows at Ethan, suppressing a smile, and follows Terry as he jostles past the smirking crowd in the doorway.
Ethan gives them a parting salute, and it’s just as satisfying as if he’d punched Terry into unconsciousness. The crowd at the door recedes.
Ethan turns to me. “Norah, what medication do you want to start Mr. Leeds on to make sure he doesn’t go back into atrial fibrillation?”
“What do I want to start him on?” I shake my head, confused. Why is he asking me?
“He’s your patient. What are you going to do next, Doctor?”
The word “doctor” echoes in my head, clouding my thoughts. Focus. I know this. “The treatment for atrial fibrillation is—”
“Amiodarone. An amiodarone drip,” Stuart says, twitching like a cocker spaniel ready to bound off its leash.
My lips pressed together, I blow a puff of air out of my nostrils. “Amiodarone. That’s what I was about to say.”
“Good work, you guys.” Ethan scribbles a note in the chart and hands it to the nurse. “You’re going to be fine, Mr. Leeds. The ICU team is going to look after you.”
There’s considerably less fanfare going on than I would have expected. I mean, I just saved a life. On my first day. Maybe I’m good at this after all.
“I don’t ever want that done again!” Mr. Leeds’s eyes haven’t lost their panicked sheen. “What she did to me, that shock treatment. Not ever again!”
Ethan nods reassuringly. “We won’t have to do that to you again. I promise.”
In the hallway outside the room, eager to make the most of this learning opportunity, I turn to Ethan. “Dr. Cantor, what’s the dose of amiod—”
His face has fallen. “What the hell were you thinking?” he hisses, glancing around to make sure no one else is in earshot.
Stunned, I step backward. “What?”
“You shocked a patient without sedating him?”
“I thought—”
“Listen, Norah,” he says, his eyebrows knitted together. “You have to wait for a senior resident for this kind of thing. Just because you read in a textbook that one of the treatments for unstable A-fib is an electric shock doesn’t mean you just do it without checking with a senior first. Do you have any idea how traumatic and painful that is for a patient? A dose of IV diltiazem would have worked just as well.”
Stuart, appearing behind us, folds his arms and grins smugly.
Ethan shakes his head, disappointment in every crease around his eyes. “You don’t use a fire hose when a water gun would do the job. I covered for you this time, but I’m not going to do that again, got it? This isn’t med school. This is residency at PGH. You can’t make mistakes like that.”
I nod repeatedly, my neck and ears burning with shame. I look, I imagine, like a terrified bobblehead doll.
Ethan turns toward the stairwell, glancing at his pager. As he walks away, he mumbles, “It’s gonna be a long year. Jesus.”
CHAPTER THREE
All around me is serene darkness, a blissful cocoon of nothingness. Then, suddenly, I’m falling, plummeting through space. My head drops and snaps back, and I’m awake. An attending—Dr. Something-or-Other from the Pulmonary Medicine department—is saying, “And that’s the most important thing to remember about ventilators. All right. Any questions?”
Vinegar stings my nasal passages. My salad, half-eaten, sits in front of me. The dim room is filled with rickety metal desks that creak loudly with every muscle twitch or shift of weight. These lunchtime lectures will occur several times a week, we’ve been told, and attendance is mandatory.
Seated next to me, Clark picks at the remnants of a plastic-wrapped ham sandwich. “Let . . . me . . . the hell . . . out,” he mutters, his eyes fixed on the wall clock above the door.
My voice is thin and desperate. “Only thirty more minutes,” I say. At 12:00 p.m., those of us who were on call last night can go home. I haven’t slept in twenty-seven-and-a-half hours. I’m shivering, and my head throbs. My limbs feel as though they’re only partially under my control, and my left eye is twitching.
At the back of the room, several second- and third-year residents whisper among themselves. They’re like the clique of popular high school upperclassmen that sits together in the lunchroom and rates the newbies on looks and, in this case, likelihood to accidentally kill a patient. I’m not positive, but I think I hear one of them mumble my name—“Kapadia”—and snicker. When I turn around, several of them avert their eyes. I wonder if they’ve made the connection to my father. There she is—the great Dr. Kapadia’s daughter, the one who defibrillated a man for no reason! Obviously she’s only here because of her last name. I shrink into my seat.
Ethan is scrolling through the news feed on his phone. Next to him, evidently engrossed in the lecture, is the other Internal Medicine chief resident, Francesca. A stout, robust woman with a frosted pixie haircut and a fervent gaze, Francesca strikes me as the type of person who approaches even mundane tasks—grocery shopping or ordering from a restaurant menu, for example—with the same level of intensity that most people reserve for crisis situations.
The lecturer says, “And one last word of advice for the new interns: remember to document everything. If you give the patient a packet of graham crackers, write a note about it in the chart. If you didn’t document it, it didn’t happen. Good note-keeping equals good doctoring. All right, good luck to you all this year. Make Philly General proud.”
The audience applauds, and the lecturer leaves the conference room.
“All right, everyone, listen up,” Ethan says, standing. “Our esteemed director of medical education, Dr. Fancy Forks, wants you all to know that Jake-O is visiting this week, so remember not to leave your uncapped needles lying around or wear open-toed shoes or do anything else to get us fined.”
The upperclassmen laugh. Francesca rolls her eyes at Ethan and chuckles. I look around the room in confusion and catch the other interns doing the same.
Ethan continues. “And, I’m sure this goes without saying, but if anyone asks if you’re working over eighty hours a week, remember the correct answer is, ‘No. Never. What the hell are you suggesting, you government clown?’”
More laughs from the upperclassmen.
Francesca stands. “Some housekeeping stuff: The call schedules are done and posted. Make sure you have your vacation requests in to Barbara by tomorrow. Interns, don’t get your hopes up about vacation requests; seniority rules, and you’ll get days off when it’s convenient for the rest of us. On a social note, Genetiks Pharma is sponsoring a dinner for us next Friday. Seven o’clock at Akira Hibachi on Walnut Street. Hope to see you all there, unless you’re on call, in which case you don’t get to go, sucks to be you. Any questions? No? Okay, class dismissed, then.”