Regina was hunched over the large textbook of emergency medicine, reviewing the most common procedures she would be expected to perform routinely as a resident in Saint Xaviers emergency department. Not that she didnt know them and could probably do most of them in her sleep but that was just the way Regina was. She spent the last seven years working to get to this point, first medical school with its long arduous hours of studying, followed by her grueling days as a lowly intern taking histories and physicals, drawing blood, running specimens to the lab for tests and other menial tasks that residents no longer did.
She survived all that, paying her dues along the way. Now, she was poised to begin the last leg of her journey and finish her final residency with a specialty rotation through emergency and trauma medicine which was why she had, much to her parents dismay, moved to New Jersey, of all places. Regina packed her bags and left Leicester, Massachusetts a year ago and headed to Saint Xaviers Medical Center, which was well known for its emergency and trauma departments. Even more dismayed than her parents was her boyfriend, Derrick, whom she had met at the end of her last residency at the medical center six months ago.
He had been the lead-investigating officer in a horrific car accident that killed several teenagers at the local high school. The oldest had been eighteen and the others ranged in ages from fifteen to seventeen. The two fifteen year olds ended up in the pediatric intensive care unit before they died several days later. Regina had been asked to brief the officers involved on the nature of the injuries and that had been when she had met Derrick.
He hung around after the meeting and very simply asked her out. Normally, Regina would have refused but the offer of friendship was a welcome balm to the frightening revelation she arrived at months earlier. All it took was a single pointed question from her mother about her choice of friends and why she insisted on spending so much time with one woman in particular. No, Regina hadnt been prepared for the onslaught of conflicting emotions or the outright rejection she knew she would suffer from her family. So she did what she thought was the most prudent thing at the time and buried those feelings telling herself it would pass and forgetting about everything but her studies.
When she met him, Regina had been up front telling Derrick she couldnt make any commitment to him at this point in her life and hed said that he understood, at least she thought he did at the time. Lately, he had been pressuring her to change her specialty to something less demanding so they could spend more time together.
Regina picked up her head as she heard a car door slam and then heard the knock at her door a minute later. She opened the door and gasped as she saw the bouquet of red roses held out to her.
"What are these for?" She asked, taking the vase from him, closing her eyes, as she smelled the fragrant flowers.
"Does there have to be a reason?" He asked, leaning forward and kissed her.
Regina walked into the kitchen to put the roses in a vase. She watched as Derrick unclipped his service revolver and set it on the table. She started to ask him to put it somewhere out of sight, but thought better of it, remembering his angry outburst the last time she brought up. Involuntarily, she flexed her wrist, feeling the stiffness from where he grabbed her.
Derrick followed her into the kitchen and leaned against the wall. "We need to talk Regina."
She looked up at him wondering what was on his mind. "Uh oh. Those are probably the four most dreaded words to be heard in any relationship."
"Be serious, Regina." He snapped. "I wanted to know if you thought about what I said the other night."
She stopped arranging the roses and set her hands on the counter. So this was what the roses were for. It was not an act of kindness or an apology, not a peace offering, but a bribe. She turned slowly toward him and her eyes were flashing a warning, which he completely missed. "You mean my quitting emergency medicine before I start? Yes, I have, Derrick and the answer is no."
Pupils dilated and his eyes darkened in anger. "I don't see what the big deal is Reg. Its still medicine youd be practicing."
"Derrick you dont understand. Ive spent the last seven years of my life struggling to get to this point. This is my last residency and I want to do it in emergency medicine. This is what Ive always wanted to do." She turned around and leaned against the counter folding her hands in front of her. "Saint Xaviers has got a great level three trauma center. Its perfect."
Derrick pushed off the wall and walked toward her.
"Yeah for you it is. It sucks for me. Ill never get to see you." He ran a finger through her blonde hair pushing it behind her ear. He trailed his finger along her cheek and down to her chin, turning her face to meet his. He bent his head forward and captured her lips, softly at first, and then with more force, pulling her against him.
Regina put both her hands on his hips and pushed him back. She pulled away, gasping a little for breath and looked up into his dark brown eyes. She wasnt used to this forcefulness and it left her feeling unsettled.
"Derrick this is my career." She turned to the sink and started washing her hands. "Im not going to do my last residency in something I have no interest in"
Derrick sighed and leaned back against the counter. He ran a callused hand through his hair. "What about us Regina? Were never going to see each other. Why is it that our relationship always takes a back seat to your damn career?"
She dried her hands and dropped the dishtowel on the counter. This wasn't going well.
They had no plans to do anything tonight and Derrick's unannounced visit after the argument theyd had the other night irritated Regina. He had been doing more of that lately, showing up unannounced, expecting that she would just drop everything for him. She planned to spend the night alone and go to bed early since she was starting her first day tomorrow at Saint Xaviers as a third year resident in their emergency department.
"Derrick, I told you when we first met that a relationship wasnt going to be easy. Im not going to give up something that Ive worked so hard to get." Regina said. She brushed past him out of the kitchen, needing to put some space between them.
Derrick shoved the rest of the roses into the vase and set them on the table as he followed Regina out to the couch and sat beside her. He laid a hand on her thigh and squeezed it. "I dont want you to give it up. Just find something that will demand less of your time. Thats all."
Regina crossed her arms. "Derrick I have never once asked you to take a less dangerous assignment on the force or to not work the overtime you do. Why should it be different for me?"
"Because I want the woman I love to be home with me not spending hours helping people who you dont even know." Derrick reached into his pants pocket and pulled out a small black box.
Regina felt her mouth go dry and her heart pounded faster in her chest. "Derrick no, please dont." She pushed herself up into the corner of the couch her pupils dilating as she watched him open the box revealing the diamond ring sitting in the black velvet cushion. It might as well have been a ball and chain to wrap around her neck.
Derrick turned to face her and smiled. "Well, what do you say? Yes or no, Regina? I asked your father. He thought it was a great idea."
Regina felt herself shaking. "Y You asked my father?"
"Yeah, you know, asking for his daughters hand in marriage, all that stuff. I know your parents are into that." Derrick moved closer.
"Derrick." Regina was rubbing her hands over the fabric of her denim shorts, smoothing it out over her well-muscled thighs. "I I wasnt expecting this."
Derrick nodded his head. "I know. I figured it would help you feel more comfortable about making a decision if you knew I was serious."
Regina closed her eyes and took a long slow breath to calm her ragged breathing. Abruptly she jumped off the couch and walked to the window. She leaned her head against the glass looking out onto the lawn outside the apartment. Every fiber in her being was telling her to run. Oh god why does this feel so wrong?
"Derrick, I cant do this; not now."
He looked up at her. "Alright, well take some time, but my offer stands, Regina." He made it sound like a business deal.
"No Derrick." She couldnt look at him. "I cant do this."
"What do you mean you cant do this? You mean now or what are you saying?" Derrick set the box down and walked over to her. "Regina, look at me." He demanded.
She tore her eyes away from the grass and met his gaze reluctantly.
"I think you feel this way because you just havent been in love before. I know its scary, but youll get used to it." Derrick reached out with his hand and ran his thumb over her pulse point, which was beating rapidly. He smiled at this and leaned over claiming her lips.
Regina pulled away. "Derrick no, please dont. I cant do this not now, not ever. This isnt right. Youve made it clear that you dont support my career choice and thats just the tip of the iceberg."
Derrick raised his arms up, his voice getting louder now. "So you're telling me you think our relationship is a mistake?"
"Derrick, please dont be angry. Its not you, its me." Regina said suddenly wishing she were far away from here and Derrick.
"What do you expect me to be? Regina in relationships you have to learn to compromise and make sacrifices. You know, Regina, I think youre just being selfish." Derrick said, his voice thick with anger.
"Selfish? Derrick I'm just saying I don't want to jump in blindly. Can't you understand that?" Regina asked. Of course he couldnt understand. How could he understand something that she could hardly put words to herself? Regina had never been an anxious person but right now she felt like she was on the verge of a panic attack. She could hear the blood rushing in her ears and her heart was racing. God, what had she gotten herself into? If she said yes she knew without a doubt that she would be making an awful mistake, one that would most likely end up killing her one way or another.
Derrick didn't hear her words. He walked over to the table where he set the vase of roses down earlier. Looking at them, he felt the blood pounding in his ears. He thought the roses would tip the odds for him, nullify the fight they had about her residency. After all, girls loved that stuff and what a perfect way to lead into popping the question. How could she tell him no? Well, this will teach her to play games with me.
He wrapped his hand around the neck of the vase and picked it up. Regina was still standing staring out the window ignoring him. Derrick curled his upper lip in a snarl and hurled the vase at the doorway, striking the corner of the wall. There was a sharp, high-pitched sound of the impact and the vase shattered, sending shards of glass flying into the air.
Regina flinched when she heard the impact, but the sound didn't register fast enough for her to duck and get out of the way. She cried out as the jagged fragments of glass tore into the skin of her upper arm and back. She stumbled forward, clutching her arm and turned around staring at Derrick.
His face was twisted in anger and his chest was heaving. Regina staggered backward. Her heart pounded in her chest and her breath was coming in short gasps as she struggled not to hyperventilate. She could feel the growing burning sensation from the glass imbedded in her arm and her back. Regina felt something warm and sticky on her arm. Looking down she stared at the dark red blood pulsing down her arm in rivulets and dripping from her fingers, pooling on the hardwood floor at her feet. Oh god, that's my blood.
Suddenly, she felt very warm and the room seemed to close in around her. Come on Regina, its just a few cuts -- you can handle this. She felt the coolness of the wall as she pressed her back against it in an effort to stay on her feet.
"Oh shit. Reg, Im sorry. Im sorry." Derrick was walking toward her holding his arms out.
Regina looked at the gash in the crook of her elbow. "You son of a get me a dish towel." She ordered him reigning in her emotions and squeezing her upper arm tightly to staunch the continuous flow of dark, red blood.
Derrick stared open-mouthed at the growing red stain on the front of Reginas white cotton shirt. "W what?"
"Get me a clean dish towel." Regina said through gritted teeth. She watched as he ran to the kitchen and returned holding the dishtowel, his face turning a pasty, white color.
"Derrick, tie it around my arm. Here." She said, releasing her arm as he fumbled to wrap the towel around her bicep and cinched the knot tight.
"I Im sorry, Reg. I didnt mean to hurt you." Derrick said. His hands were trembling and his brow was glistening with nervous perspiration.
"You should have thought of that before you threw the vase. Get your keys. You have to drive me to the emergency room. I need stitches." Regina said, wincing at a sharp stab of pain.
"B but the blood youll get it in the car." Derrick said. He was panicking now. He hadnt bothered to drop the police cruiser off, but had come straight here.
Not believing her ears, Regina pushed past Derrick. "Then get out of my way." She grabbed her keys and wallet from the kitchen table and left Derrick standing in the condo gaping at her.
Her arm was throbbing and blood still pulsed slowly from the wound in her arm. Regina opened her car door and blinked as she saw the afternoon sun glint off the jagged piece of glass sticking out of her arm. Regina jammed her keys into the ignition and started the car. She closed her eyes and took a deep breath; her hands were trembling as she clutched the steering wheel.
"Come on, Regina," she said. "Its a five minute drive down the hill to the ER. You can do this."
Regina threw her car into drive and drove down the hill toward the hospital. She glided through the yellow light ignoring the elderly couple that was crossing the street. She swung her car into the parking lot reserved for emergency department patients and families. She turned off the ignition and a fresh explosion of pain ripped through her arm as she pushed the car door open. Tiny lights weaved and danced in her peripheral vision as Regina stumbled toward the doors of the emergency room.
Alex ran hard and fast. Her feet pounded over the hard-packed earth of the hiking trail that snaked around the South Mountain Reservoir. It was here that she found peace, running until the rhythmic thudding of her feet muted the sights, sounds, and smells of the day that replayed in her mind.
It became her daily routine after Lana died. She never slept through the night anymore so rising at dawn was a welcome diversion to staring at the shadowed ceiling in her bedroom. She would drive her newly repainted cobalt blue Cherokee to the park that was just minutes from the large medical center she worked at. At thirty-five, Alex was young to be the chief attending at the level one trauma centers emergency department, but she was one of the best.
It was early in the morning and the sun was rising in the eastern sky sending ripples of light of the wind blown waves of the large lake. Alex adjusted her stride and with one arm lifted her body over the fallen tree. A gray squirrel chattered angrily and shook his tail at her, indignant at the interruption. Alex wore a UMDNJ gray tee shirt and maroon shorts with white trim. She was a strikingly beautiful woman with intense blue eyes, high cheekbones, a mane of dark hair, and an athletic build. There was fierceness to her personality, borne out of the years of indoctrination into a male dominated medical profession, with its preconceived notions and prejudices towards women.
On her fourth lap around the lake, Alex dropped to the grass and furiously pumped out forty military style push-ups. Her routine complete she rolled over onto her back and sucked in the warm humid air as she gazed up at the light blue morning sky. Slowly, she sat up, stretching and pushing herself into an upright position and walked back to her Jeep.
Driving the relatively short distance down the winding two-lane road, turning left onto Old Town Road, Alex arrived at the medical center in less than fifteen minutes. She pulled into a parking space reserved for the emergency department medical staff and got out of her Jeep. She armed her vehicle listening to the double high-pitched beep as it locked automatically.
The locker room was empty as Alex showered and changed into a pair of blue scrubs. Looking at her watch she quickly braided her hair, pulling it back it back off her face. A quick look in the mirror and she stepped out of the locker room and into her the emergency department to start her day.
Alex set her pen down and closed her eyes. She felt someone sit down beside her and she turned her head. She recognized the curly blonde-haired, fair-skinned nurse who straddled the chair next to her.
A worried expression crossed her face. "Hi yourself. Drink this." Sandy ordered and shoved the cup of orange juice into her hand. "Your hands are shaking. Did you eat anything today?"
Alex shook her head and downed the orange juice setting the empty cup on the counter. She picked up her pen and started writing orders in the next chart.
Sandy turned her chair so she was facing the doctor and regarded her quietly as Alex signed off on the chart in front of her. Her physical features were striking, to say the least. She was tall, lean, with dark hair which she wore braided most of the time, and had blue eyes that could cut any overly cocky resident down to size with a mere glance in their direction. Alexs dark moods and brooding nature kept most of the staff at the emergency department firmly at bay, but Sandy was thick-skinned and the doctors dour personality didnt scare her.
She had been a nurse in the emergency room for over fifteen years and seen her share of physicians come and go. Most of them became burnt out with the high caseload of violent traumas, junkies who stumbled into the department blitzed out of their minds, and all of the AIDS patients they treated on a regular basis. Alex was more than capable of handling any situation, but when push came to shove in the wild chaos they often found themselves in, Alex was one of the few doctors Sandy had ever seen who could control the situation and run the trauma team like a veteran field general.
Sandy had never seen Alex look quite as haggard as she had in the past several months and it frightened her. She leaned closer to the doctor so only she would hear her words.
"Its been eight months, Alex. You hardly eat or sleep anymore." Sandy shook her head. "Dont give me that look." Icy blue eyes glared at her from underneath rumpled bangs. "You can fool the rest of the staff, but I know you better than that. Have you looked in the mirror lately, Alex? Youve lost weight, and pardon my French, you look like shit. What are you doing to yourself Alex?"
Alex sighed and shook her head looking down at the triplicate order form folded in half in the chart. "Im fine, Sandy," she said as she unfolded it. That was a lie. She knew Sandy was right. Since Lana died, she had been going though the motions, day to day, just barely keeping her head above the water. If she were honest with herself she would have admitted that she was probably close to being clinically depressed. Many nights she just didnt bother to go home and stayed in the on call room at the hospital because she couldnt bear the stark emptiness of her house. It was a bleak reminder of a past that she would give anything to forget.
Alex rubbed her temples and winced as a sudden wave of emotion flooded her leaving an empty ache in her chest. Her senses reeled as she watched herself in her minds eye, climbing up the stairs to the second floor. It became their ritual during that last month. Lana would be lying curled up in the hospital bed waiting for her to come home. Alex would drag herself home after her shift in the emergency department was over and sit behind her in the bed just quietly holding her after she had given her another dose of morphine.
The nurse from the hospice pulled her aside the week before and told Alex that if Lana had any family the time to call them was now. Family. The only family Lana knew was Alex and Dana. And as much as Alex hated to admit it, she knew Lana still loved Dana.
Alex opened the door to the bedroom and felt her skin crawl. There sitting on the bed next to Lana was Dana. She looked up as Alex stood in the doorway trying very hard to process what she was seeing. An empty syringe lay on the nightstand next to the bed.
"What did you do Dana? My god what did you do?" Alex felt her legs carry her to the side of the bed and practically collapse underneath her as she knelt down. She felt a pulse in Lanas neck and grabbed Danas wrist with her other hand. "What did you do to her?" She growled.
"What you were too afraid to do Alex." Dana pulled her arm out of Alexs grasp. "She called me two weeks ago and asked me to come down. She didnt have the heart to ask you to do this."
Alex stared in disbelief. "I was increasing her morphine each day. She would have " Her words trailed away as she looked up at Dana. "You bitch."
Dana shook her head. "You see, Alex, it really didnt matter that you took her away from me. In the end, she wanted me by her side when she left this miserable existence. Not you." Dana stood up and pulled her leather jacket on. "Oh, and dont worry, Alex. I took care of all the arrangements. Nobody will know about this." She picked up the empty vial and syringe from the nightstand. She walked around the bed to Alex. "Ill leave you alone to say your goodbyes." Dana started to walk away then stopped and turned back. "Oh, and Alex, if it hurts too much, I brought a little something to help numb the pain." She tossed a clear plastic bag at Alex and closed the door behind her.
Alex laid her head on the bed and held onto Lanas hand. Goddammit, it did hurt too much.
"Alex?" Sandy shook her elbow. "Hey, where did you go off to?"
It had been so easy for her to take those pills and walk through the next several days in a drug-induced haze, one that almost ended her career two days later. Alex shook her head keeping her eyes closed until the pain slowly ebbed away. She almost let her defenses down but somehow managed to shove the bitter memories of the past eight months far into the back of her mind.
"I appreciate your concern, Sandy, but Im fine. Really I am," Alex said, as her attention was drawn to a figure down the hall.
Her instincts prickled and Alex pushed her chair back to get a better look. She stood up from the desk, her eyes focusing on a blonde haired woman walking slowly down the corridor leaning against the wall as she neared the desk. She was wearing a white tee shirt that was stained red with blood.
"Jesus, Alex you havent heard a word I said," Sandy complained.
"Sandy, get me a stretcher," Alex said. She was moving around the desk towards the woman, her arms coming up instinctively to catch her as she stumbled and fell. Alex cradled the limp form in her arms, lowering her gently to the floor.
"Its ok, Ive got you," she said as the blonde-haired woman slumped into her arms.
Regina was jostled awake. She blinked her eyes open and saw fluorescent lights passing overhead. She was vaguely aware of several faces looking down at her and voices talking around her.
The movement stopped suddenly and she heard a low voice behind her. "Ok, nice and easy." Regina felt herself lifted up and settled down onto something hard.
She tried to sit up and several pairs of hands gently held her down.
"Easy there," she heard the voice again. "What's your name?"
"Regina. Regina Kingston," she said. Her mouth felt dry and the words didn't seem to come out right.
"All right, Regina. I'm Dr. Margulies. We're going to take care of you."
Regina rolled her eyes up and saw a pair of blue ones looking back at her. She was aware of a very cold sensation throughout her body and the voices around her getting farther away.
A nurse with short blonde-haired finished taking her blood pressure again. "Her pressure is dropping. One hundred over fifty."
"Let's get a peripheral line in and start a bag of Ringer's lactate. Sandy we need to cut her shirt off. There's a lot of blood and I can't see anything," Alex said.
"Here, get these on." Sandy slipped her hands over Alexs head slipping the fluid shield mask over her head and tying it for her.
"Thanks," Alex said, settling it on her face with one hand. "Give her five milligrams of morphine and five of valium in that IV Sandy."
Taking only a moment, Sandy inserted the IV catheter into the back of Reginas hand and set up the IV drip.
"Ok, youve got her meds on board Alex,. Sandy said, as she injected the pain killer and sedative into the IV line.
They rolled Regina onto her side to slip the blood soaked garment off of her. Regina saw the lights blur, getting fuzzier around the edges right before everything faded out and she slipped from consciousness as the medication took hold.
"Whoa. We've got a bleeder here." Alex clamped a gloved hand above the gash in Regina's upper arm slowing the rush of blood. "Get me some pressure bandages." She peered closely at the cuts scattered over the young woman's back. "Sandy, I'm going to need some long nosed tweezers. She's got glass imbedded in these cuts." Alex looked up as Sandy handed her the lap sponges. "Do we know what happened?"
"A guy just came in claiming that hes her fiancée. Hes pretty agitated and hes not making much sense right now." Sandy said.
Alex shook her head. "Give me some 3.0 silk." She held the lap sponge against the wound and soaked up the blood. She peered closer at the cut on Regina's arm. "Sandy, I need a clamp; it looks like the glass nicked an artery."
Alex took the instrument that was handed to her and gently clamped the artery. She then picked up a long nose tweezer, grasped the jagged piece of glass, and gently removed it from the wound. She irrigated the wound with sterile water, probing it with her fingers feeling for any more glass. Satisfied there was no more glass in the wound, she sewed three stitches to close the tear in the vessel.
"Sandy, help me turn her so I can stitch up her arm," Alex said.
Together they repositioned Regina onto her back. Alex strapped Regina's arm onto a padded armrest. She pulled a rolling stool over and sat down next to her patient's outstretched arm.
Alex raised her head as she heard a loud noise from outside the corridor followed by some angry shouts. The voices drew closer and closer to the trauma room door until the door banged open and a tall, muscular, brown-haired man dressed in a police uniform stormed into the trauma room. Alex set down the instruments and glanced at her patient who was still unconscious.
"Get him out of here," she barked, launching herself off the stool. Derrick was almost as tall as she was and he moved toward her, pushing Sandy out of the way and onto the floor. "Get security in here now," Alex shouted.
Alex put herself in between her patient and the man in front of her. "You cant be in here," she said, pointing her finger at his chest.
"The hell I cant. Shes my damn fiancée. Isnt there a doctor here?" Derrick was inches from Alexs face.
Alex blinked and clamped down hard on the anger that threatened to boil over and erupt from her. "Im Dr. Margulies."
Derricks eyes narrowed as he immediately recognized her name. "I dont want you taking care of her."
"Hey-" Sandy started to protest.
"Its alright, Sandy." Alex pulled her gloves off and held out a hand to Sandy to pull her up from the floor.
"Derrick?" Reginas voice rasped. His yelling roused her and she was trying to pull herself up out of the fog she was in.
He pushed past Alex and leaned over Regina. "Im here, love. Im getting you another doctor."
"Derrick." Regina opened her eyes and tried to focus on him. His image was fuzzy and distorted. "Youre not my fiancée. Get out of here," she said, her voice thick from the medication.
"Honey, you dont mean that. Youre in pain. Let me take care of this." Derrick looked around the room and glared at Dr. Margulies. "What are you looking at? I told you to get out of here."
Alex crossed her arms. "Its her choice, not yours. Apparently she disagrees with you." She stepped back over to the stretcher, standing beside Derrick. "I suggest you do what she asks."
"Like hell I will," Derrick growled.
"Derrick, please dont do this. Go away." Regina struggled to push herself up.
Alex reached out a hand and laid it gently on Reginas shoulder. "Stay down."
"Dont you touch her." Derrick tried to hit Alexs hand away from Regina.
Alex blocked it with her other hand and twisted his arm behind his back. "Ive had just about enough of you." She growled twisting his arm up higher behind his back, forcing him to bend over at the waist. She guided him to the door and pushed him into the arms of two waiting security guards. "Get him out of here." Alex shut the door and walked back to the stretcher.
The doctor looked back at the woman lying on the stretcher and sighed. "Sandy, Ill see if someone else can finish this up. Shes stable. Ill be right back."
"Dr. Margulies?" A quiet voice said from behind her.
Alex turned around. "Yes?"
"I trust you. I dont need another doctor to take care of me," Regina said.
Alex looked down at the floor and took a breath. "Alright. Sandy give her five more of morphine," she sat back down on the stool.
In a few moments, the wound in Reginas arm was expertly stitched and wrapped securely with gauze. Dr. Margulies quietly pulled the gloves from her hands, throwing them into the medical waste container. She walked to the supply cabinet and retrieved some more bandages and antiseptic to finish cleaning and suturing the several smaller gashes on her patients back.
Regina blinked her eyes open. She was aware of the pungent smell of antiseptic in the air around her. Suspended above her was a large domed light shining brightly down at her. She picked her head up and groggily looked down at herself. Her shirt was gone and she was covered with a white sheet. The pillow's plastic covering crinkled as she lay her head back down. She rolled her head over to her left and saw the bulky bandage covering her upper arm. She heard a movement behind her.
"Derrick?" She called his name hoarsely.
"Hes gone now," Dr. Margulies said.
Regina craned her head around and recognized the dark haired woman who pushed Derrick out of the room before. She was holding several packages in her hands. Regina cleared her throat and shook her head.
"Ugh. Did I pass out?" She wiped her hand over her eyes.
"No," Alex said, chuckling softly. "Its the medication in the IV. I had to put a lot of stitches in, so it was better if you werent awake." She sat down on the stool and unbuckled the strap from around Regina's arm. She lifted her arm up and gently laid it across Regina's stomach.
Regina closed her eyes and swallowed, trying to keep her emotions in check. She remembered hearing the vase shatter and seeing the enraged look on Derrick's face as she turned around. Fear, which was what she had felt when she had seen his face. She felt a hand on her shoulder.
"You ok?" Alex asked.
"I I don't know." Regina answered honestly. For the first time in her life, she knew what it was like to truly be afraid of someone.
"Do you want to tell me what happened?" Alex asked.
Regina opened her mouth to try to say something but a sob choked off her words. She turned her head away and covered her face with her hand.
Alex sat quietly watching her. She shifted her weight on the stool uncomfortably, interlacing her gloved hands, and looked down at the blood stained booties covering her sneakers. She hated these situations. Even with all her medical training, it seemed like she could never find the right words to say to someone. But, Alex quickly reminded herself that nurses and social workers could better deal with the mental and emotional stuff. She stuck with the physical; its what she knew best.
"Listen. I've got some other cuts I need to look at. Do you think you can roll over onto your side?" She asked.
Regina sniffed and nodded her head. Slowly, she lifted herself up off the stretcher to turn onto her side. She felt a pair of hands under her arms supporting her as she lowered herself back down. "Thanks."
Alex pulled the sheet off her back revealing several more deep cuts a couple of which had glass embedded in them. "You're going to feel a prick here. I'm injecting a local anesthetic so you won't feel too much pain," she said.
Regina nodded her head and stared ahead of her.
Alex looked up from her work. "Do you remember what happened, Regina?"
She nodded her head and took a deep breath to calm her racing heart. "We had a fight." Regina said. She wiped more tears from her face.
Alex finished stitching up the last cut on Regina's back. She sat back on the stool and looked at the clock on the wall. "Is there anyone you want us to call to come pick you up?" Alex asked.
Regina sat up slowly wincing at the pain in her arm and her back. She rubbed her face trying to make herself feel more awake. "What time is it?" She asked.
"Almost midnight," Alex said. She was busy writing out two prescriptions for Regina.
"No. Its all right. I can drive myself home." She said.
Alex stopped writing and arched an eyebrow in surprise. "You sure there's no one you would rather stay with tonight? Until things settle down, that is."
"No, its alright. Derrick doesn't live with me." Regina said.
Alex noticed Regina looking around the room. "I'll get you a scrub top to wear home. We had to cut your shirt off of you when you came in," she said.
"Oh," Regina said.
"Here's a prescription for an antibiotic and something for the pain. You should take it easy for a couple of days, no heavy lifting," she said as she handed both pieces of paper to Regina.
Alex stepped out of the triage room and walked to the desk. "Sandy, can you get our patient a scrub top to wear and call a cab for her too."
Sandy looked up and nodded. "Going home to the boyfriend, huh?"
"No, apparently they don't live together. Good thing for her I guess," Alex said.
"She ought to get a restraining order on the bastard. Screw giving him a second chance." Sandy shook her head in disgust.
Alex shrugged and picked up a stack of charts, all patients she had taken care of today, and headed to an empty room to finish writing her notes.
Regina arrived home around one in the morning. Her apartment door was unlocked and she slipped inside quietly, not sure if Derrick would be waiting there or not. She was relieved when she discovered that the apartment was empty and quickly locked the door and slid the chain into place.
She ran a hand through her disheveled hair and took a shaky breath as she surveyed the shattered vase with the mangled roses lying on the floor in a puddle of water. Carefully, she walked around the broken glass and into the kitchen where she looked at the remnants of their uncooked dinner.
"What a waste," she said as she scraped the spoiled meat into the garbage bag. Next, she put some dish gloves on and went about the tedious task of cleaning up the glass that covered a wide area of the room. As she cleaned the mess up, Regina felt the numbness to the events slowly recede to be replaced with a growing anger. Angry that she hadn't seen the signs and afraid because she knew Derrick would not give up that easily.
A car door slammed outside her condo and Regina felt her heart rate accelerate. She peered out the blinds and sighed when she saw one of her neighbors walking up to their door. Regina went back to cleaning up as her brain replayed the echo of another door slamming years ago. She clenched her jaw to hold back the tears that threatened to fall from her eyes.
She sat on the bed in her bedroom clutching her teddy bear as she listened to the angry voices downstairs.
"How dare you bring that filth into my house. Youre a disgrace to your family. How could you do this to us?" Her mothers voice rose, exaggerating the already southern twang in her voice.
"Mom, please. Dont do this. Im still your son. I love you." Jeffrey pleaded.
"Those are just words and you dont know the meaning of them." There was the sharp staccato sound of a hand striking a face and those hateful words that she would never forget. "Get out of my house. I dont have a son anymore."
Regina listened to the footsteps as they climbed the narrow steps up to the second floor. They grew louder and she heard a soft knock on her door.
"Reggie? Its Jeff." She slid off her bed and opened the door. She bit her lip as she saw the red imprint of her mothers hand on his cheek.
"Hey now, dont cry." He pulled her into a big hug and held her tightly. He pulled back and looked at her. "Now you listen to me. You follow those dreams of yours. Dont let her tell you differently." He hugged her again and kissed her forehead. "Ill write you when I get settled somewhere."
"Where are you going?" She asked.
A shy smile played at his mouth. "Tom and I have a place out in San Francisco."
"I love you Jeff. Ill miss you." She squeezed him tightly.
Regina gripped the chair next to her and swayed slightly as the raw emotions ripped through her unexpectedly. "God where did that come from?" She asked the paper mache woman standing on her entertainment center. The woman remained silent holding the staff and water jug in her arms.
Regina was exhausted by the time she slipped gingerly into her bed and tried to find a comfortable position that didn't cause her to wince with the pain of her recently sewn up cuts.
Amazingly, Regina woke up on time. She washed herself the best that she could without getting her arm and back wet. Listening to the weather report, which promised a hot and humid day, she selected a pair of khaki shorts and a white cotton blouse, which she rolled the sleeves up on. Under different circumstances, Regina would have been more enthused about her first day in the emergency department, but the recently sewn up gashes in her arm and back were starting to ache and she was stiff from the sleeping in an awkward position.
Regina padded into the bathroom to take some more ibuprofen before she left for the pharmacy. The memory of last night continued to play on in her head like a broken record as she dumped the pills out into her hand. She looked up at the mirror as she swallowed the pills washing them down with a drink of water. Red rimmed green eyes with dark circles looked back at her.
"God, I look a mess." She ruffled her hair and splashed some cold water on her face. She stopped on her way out the door and hit the message button on her answering machine that was flashing that she had two messages. She heard the beginning of a message from Derrick and hit the delete button, let the next one begin and instantly deleted it as well.
An hour later Regina stepped out of the air-conditioned interior of her Mustang and walked into the doctors entrance of the sprawling medical center. Regina took a breath as she stepped off the elevator and turned around to get her bearings. Her heart beat rapidly in her chest and she mentally chastised herself for feeling like a fledgling intern again.
She pushed open the door and walked down the long white-walled hallway through a set of doors leading into the emergency department. Reginas first impression as she walked into the brightly lit department was that it was much larger than she recalled. An expansive nurses station sat in the middle of the department surrounded by twelve glass-enclosed trauma rooms. There were separate rooms set aside for fractures and sutures. She recognized the room she had been in last night. Several of the rooms were occupied with the curtains drawn to maintain the privacy of the patients. Regina could hear the soft whooshing sound of a ventilator and the repetitive beeping of the alarms as she walked toward the nurses station.
Twelve monitors were housed on an island behind the desk displaying vital signs of the patients hooked up to monitoring equipment in the various rooms. She recognized one of the nurses as the one whod been taking care of her last night.
Regina walked over to her. "Hi. Youre Sandy, right?"
"Yes, what are you doing here? Is everything alright, no problem with the stitches?" She asked, standing up to glance at Reginas arm.
"Oh, no." Regina said. "I start my residency today in the emergency department. Is there a locker room where I can change?"
After a moment of shocked silence, Sandy walked around the desk. "Sure. Its over here. Youre early, rounds dont start for an hour."
Regina shrugged. "I didnt want to be late."
"Good idea." Sandy said, watching the young woman walk away from her. She looked so young and innocent. God help her she thought.
Regina chose a locker by the far corner of the room. She opened it and set her backpack inside the bottom. Regina turned around and flipped through the pile of light blue scrubs, selecting a small top and bottom. Each department involved in patient care in the medical center was assigned a different color. Walking back to her locker, she unbuttoned her blouse and slipped out of her shorts, hanging them on one of the hooks in the locker. She slipped the well-starched garment over her head and pulled it down over her arms wincing as she felt a tug on the stitches. Regina pulled on the scrub bottoms and tucked the top into the waistband. She sat down on the bench and pulled out a new pair of white sneakers from her backpack. Prior experience taught her to keep a set of sneakers to be used only at work. It didnt take more than one patient emptying their bladder or otherwise onto your feet to convince you that this was more than a good idea.
Regina slipped her white lab coat over her scrubs and clipped her id badge to the left lapel. She dug in her backpack and pulled out several pens, and her stethoscope all of which she slipped into one of the pockets. Regina closed the locker and slipped her lock through the hole in the latch securing her valuables inside; she then walked back out into the department and spotted another resident who had been at orientation with her the week before.
"Hi Marcus." Regina said, as she walked toward him. He was fidgeting with his clipboard and managed to drop half of its contents on the floor.
Regina stooped and gathered up several of the scattered papers. She handed them to Marcus noticing that his hand was trembling slightly as he took them from her.
"Hi Regina. Hey do you know what attending we have for this residency?" He asked, quickly reshuffling his notes and slipping them back under the clip.
Regina shook her head. They could have Attila the Hun for all she cared. She was here and that was what mattered. "No not yet." She said looking around the department.
"God I hope its not Dr. Margulies." Marcus said, rolling his eyes up to the ceiling.
"Why do you say that?" Regina asked, suddenly remembering the name of the doctor who had taken care of her last night.
"Lets just say the words pit viper pale in describing her personality. I think she has residents and interns for breakfast." He replied.
"Oh, Ill keep that in mind." Regina said.
She jumped as a glass door to one of the trauma rooms burst open and a tall figure dressed in blue scrubs and a bloodied isolation gown strode toward the desk. She realized as the woman ripped off her fluid shield mask and her surgical hat that it was Dr. Margulies. She stepped directly in front of Regina and grabbed the phone from the desk, punching in several numbers and impatiently tapping her black sneaker on the floor.
"Radiology?" Her voice was low and menacing. "This is Dr. Margulies in the ER. I ordered a stat x-ray twenty minutes ago to rule out a c-spine fracture. I want somebody up here now." There was a pause as she listened and then she waved her hand in the air in front of her and slammed it down on the desk. "I dont give a damn if youre short staffed. Get someone up here or get me your supervisor." She slammed the phone down and shook her head. "Sandy when is bio-med getting up here to fix our portable x-ray unit?"
"Weve called twice Dr. Margulies. They know we need it fixed stat." Sandy said and picked up the phone again.
Alex turned her head and regarded the two residents standing beside her at the desk. She read the names on both their id badges and looked back up at their faces. Regina took a step back away from the fiery intensity radiating out of the doctors eyes. The anger in the pale blue eyes faded and Alex focused on the shorter woman standing before her. Their eyes met briefly and there was a moment of startled recognition as Alex placed Regina and nodded her head imperceptibly at her. "Sandy you didnt tell me the new residents were here already." She said.
"You were busy." Sandy replied, without looking up.
Alex looked down the hallway and spied a portable x-ray cart sitting just inside the ER doors. "Come on, you two can help me get this x-ray taken." She headed off toward it leaving Regina and Marcus standing at the desk.
Sandy looked up and groaned. "Damn it Alex, some radiology tech is going to come in here screaming that we stole his portable unit again."
"Then they should stop leaving it inside my department when they decide theyre going on break." Alex said.
"Shes kidding right?" Marcus asked, turning his head to look at Regina.
"Somehow, I doubt it." Regina said, trotting off after the taller doctor.
Walking out of the trauma room, Regina walked over to the sink. She pushed the foot pedal down and shoved her hands under the stream of tepid water. She soaped her hands and pulled several paper towels from the dispenser. Turning her head, she watched as the transporter wheeled the patient out of the trauma room; the boy was being taken up to the operating room for surgery. Regina dried her hands off and wondered if the kid realized how lucky he was that he hadnt suffered a complete spinal cord injury. He would be spending six to eight weeks in a halo brace that would prevent him from moving his neck but he would recover most if not all of his physical capabilities.
"Dr. Jack and Dr. Kingston." Regina jumped at her name.
Dr. Margulies was standing at the counter scribbling notes on the patients chart. "I dont have all day to spend with you two lets move it." She flipped the chart shut and shoved it under the thin mattress of the stretcher as it passed by her.
Regina cast a glance over at Marcus who was busy drying his hands and muttering something under his breath.
"Dr. Jack, if you think your time would be better utilized on another service, youre more than welcome to make the transition." Alex fixed him with her steely blue eyes. "Just make sure you put the request in this week."
Marcus mouth dropped and he stammered helplessly. "N no thats not what I " He swallowed the rest of his sentence as he met her gaze.
Alex slipped her pen back in her pocket and picked up two large packets of paper. "These are sample trauma cases. Read them." She shoved them over to Regina and Marcus. "The next month youll each be on call every other day. There are two other ER doctors who youll work with but Ill be primarily responsible for evaluating your performance."
Sandy walked over and handed Alex a slip with lab values on it. "Damn. When is ICU going to have that bed ready?" Alex asked as she read it and started walking toward one of the rooms.
"How the hell did she hear what I was saying?" Marcus asked Regina, his eyes wide with a look of fear.
Regina shrugged her shoulders in response.
Alex turned when she realized that neither of the residents followed her. "Hey. Im not going to shout over to you two. Move it."
Regina and Marcus left the desk and quickly caught up with her. Alex was slipping on a surgical hat, mask and gown as she talked. "While youre on this rotation it is your immediate responsibility to assess, resuscitate and stabilize any patient brought in here. You determine if we need to call the trauma team." She stepped into the glass-enclosed room and adjusted the ventilator settings, then stepped back out. "If youre not sure, or if youre in over your head, you call me. There are no heroes in this place. We work as a team. Any questions?" She asked as she looked at both of them.
Regina shook her head, feeling slightly overwhelmed at the awesome sense of responsibility being laid at their feet. She looked over at Marcus who was staring numbly at the packet of reading material in his hands.
It was late afternoon by the time Regina had a chance to escape the emergency room and walk down to the cafeteria. She selected a tuna sandwich, a piece of fruit and a lemonade drink. She walked to the register and handed her id badge to the cashier to be scanned. The woman was probably in her late fifties with salt and pepper hair and blue eyes that twinkled when she smiled.
"I havent seen you before. You must be new here." She said, giving Regina an apprising look as she handed the id badge back to her.
"I just started today. Im working up in the emergency department." Regina said. "Im Regina." She said sticking her hand out.
"Connie." The woman smiled at her and shook her hand warmly. "Good luck to you child."
"Thanks." Regina smiled and slipped her fruit into her lab coat pocket.
Her arm was throbbing and she was exhausted. Regina left through a side entrance of the hospital and walked toward the parking lot. She had seen a small pond and some picnic tables when she drove into the doctors lot earlier in the day and decided it would be a quiet place to go and think.
Regina picked an empty table behind the pond shaded by a large oak tree. She lowered herself gingerly onto the wooden bench, closing her eyes thankful for the momentary quiet around her. She slipped off her starched lab coat, setting it on the bench beside her and massaged her arm gently.
She shook her head in disgust as she inspected the purplish bruise running down the inside of her elbow. When she flexed her hand, she realized that her fingers were swollen and grimaced. She and Marcus had spent most of the morning listening to Dr. Margulies rattle off vital information about the department, who to call for certain tests, what was acceptable practice and what wasnt. Together they saw twenty patients during the morning and admitted three to the hospital for further testing.
Regina removed her sandwich from the plastic container and started eating. She suspected she was still in shock from last night, feeling mostly numb about the situation and not having allowed herself time to think about it so far. Twisting the cap off her lemonade, she brought the bottle to her mouth and swallowed the sweet fluid. She guessed that Derrick must have tried to call her during the night. She had been so tired she hadnt even heard the phone ring.
Regina hung her head and rubbed the back of her neck, trying to ease the tension she felt starting in her shoulders. Looking back at what happened last night Regina realized with a sickening clarity just how blind she had been to Derricks controlling nature. She should have seen the signs. She was a doctor after all. At first his need to spend as much time with her as he did was flattering, but it was becoming a problem. When Regina asked for space, Derrick accused her of trying to break off the relationship. She shook her head in disgust that she allowed herself to get this involved with him. At the time she had been grateful for the friendship, but Regina knew she let her own insecurities dictate the course she had set out on.
Her relationship with Derrick spiraled downward after she told him she had chosen emergency medicine as her specialty. He had been so angry, questioning her priorities, wanting to know how he could be expected to put up with those ungodly hours and the stupid phone calls from junior residents and interns who couldnt handle splinters and hangnails. She was shocked when he brought up the issue of a family, reminding him that neither of them had even brought up the topic of commitment or marriage for that matter. Had he sensed something and used it to try to manipulate her? Regina watched as a blue jay dive-bombed a squirrel, eating a scrap of food on the wood chips. She would deal with Derrick later. Right now she needed some time to figure out how she was going to tell him she wanted out of this relationship without all hell breaking loose.
"Hey, I thought your doctor told you to take it easy for a couple of days?"
Regina snapped her head up and opened her eyes. Dr. Margulies was lowering herself down onto the bench directly across from her.
She was so distracted she hadn't even heard the crunch of footsteps on the wood chips. "Oh. Uh yeah you did." She said. A flush crept up her neck as she raised her eyes to meet the doctors.
A fleeting smile passed over the face of the woman sitting before her. "How are you feeling?"
Regina pulled her eyes away from Alex's. "My arm is pretty sore. Otherwise not bad."
"That was a pretty serious cut." Alex let her eyes rest on Regina's arm. She furrowed her eyebrows together and picked up Regina's hand, turning it over and inspecting it. "You should get your arm elevated when you have a chance. Your fingers are starting to get swollen."
Regina swallowed, trying to compose herself as she felt the doctors warm hand wrapped around her own. Maybe it was the lack of sleep or the deep ache she was feeling in her arm right now that made something so simple as that touch send a jolt through her body. She cleared her throat, finding her voice finally. "When I'm done here I will. Thanks for taking care of me last night."
Alex looked up releasing Regina's hand and shrugged her shoulders. "That's what we're there for." Her eyes took on a far away expression then focused back on Regina. "Why didnt you tell me you were a resident last night?" Alex asked, suddenly serious.
Regina stopped chewing and stared at the doctor sitting across from her. She lowered her head and took a drink from her bottle swallowing the piece of the sandwich. "I I dont know. It didnt seem important at the time." She said.
Alex regarded her for a minute unsure of where the sudden sense of protectiveness had come from. "Has he ever hurt you before?" Alex asked.
Regina shook her head. "N no, he hasnt."
"I know its none of my business and you can tell me to butt out if you want, but youd probably be better off without him. This isnt an easy rotation and I cant make any allowances for personal issues." Alex said, looking up directly at Regina as she finished her words.
Regina was indignant. If she wanted special consideration she would have told this woman she was a resident last night and begged off her first day. She hadnt and this doctors assumption that Regina would ask for allowances pissed her off. "I wasnt expecting any special considerations, Dr. Margulies." Regina said.
Out of the corner of her eye, Regina recognized a man heading toward them. "Oh no." She moaned, feeling her heart rate pick up.
Alex saw Regina's body stiffen and looked up. "What's wrong?"
Regina swung her legs over the bench and scrambled to her feet watching Derrick approach her. She could feel the anger radiating from the rigid set of Derricks body. She didnt want a confrontation here, not at work, and especially not in front of the chief attending.
"Regina, I've been looking all over for you. Why didnt you call me back?" Derrick demanded, walking right up to her and taking her hands in his.
Regina felt herself recoil at his touch. "Derrick we need to talk, but not here." She said stepping away from him and pulling her hands out of his grasp. She was mortified that he had come to the hospital, essentially bringing her personal problems to work.
Derrick's eyes flashed and he swept his gaze over to the woman who was sitting at the table across from Regina. "You? Regina what are you doing with her? Don't you know who she is?" Derrick reached out to pull her away from Alex.
"Derrick, Dr. Margulies took care of me last night and shes the chief attending in the emergency department." Regina glared at him.
"That piece of trash took care of you last night, didnt she?" He turned to Alex. "I told you I didnt want you treating her."
Regina was aware of the doctor standing up from the bench. Frantically, she searched for something to diffuse the situation before it deteriorated any further.
"Derrick, it was my choice, not yours!" Regina said at him.
"You and I need to talk right now." He stepped forward, took hold of Regina's arm, and pulled her away from Alex. He pointed a finger at Alex. "You stay away from her."
Alex clenched and unclenched her fists as she watched Derrick lead Regina away. She battled back her anger. This isn't your fight, stay out of it Alex. Angry with herself for letting her defenses down, she turned and walked away, feeling the sting of tears in her eyes from his hateful words. All she wanted to do right now was find a hole and crawl into it. Her long legs carried her quickly across the parking lot heading toward the safety of the hospital walls.
Regina walked far enough with Derrick to get them out of earshot of any other staff members.
"Derrick, you had no right to say that about her." She said, as she yanked her arm out of his grip. The movement caused a shot of pain across her back.
"Yes I did. Dont you remember the kid that died last year in the emergency room? She was taking care of him." He pointed in the direction of the retreating doctor. "The hospital suspended her and put her on probation for being on a controlled substance at the time. She is trash. All the more reason for you to switch your residency."
Regina pointed a finger angrily at his chest. "I am not quitting my residency Derrick." She remembered the incident. She had been doing her pediatric residency at the time. Reginas eyes narrowed as she realized that none of the details about the whole episode were released to the staff. "Derrick that information is confidential. How did you find out she was on probation?" Regina was furious. She didnt need Derrick stirring up trouble for her.
"Come on Regina, Im a police officer. I just called in a couple of favors. I knew I remembered her from somewhere. The story was all over the papers for a week. It was the mayors son, for Christs sake. They should have yanked her license, instead they suspended her." Derrick said, as if this justified his actions.
"Derrick, those kids were drunk and shouldnt have been driving in the first place. Besides we dont know the whole story."
Derricks eyes narrowed and he leaned closer. "What? Has she been pleading her case with you or something?"
"Derrick, I can't believe you. You completely flip out last night, throw a vase, I end up at the emergency room and youre concerned with who I talk to at work." Regina rubbed her arm, acutely aware of the dull ache starting in her elbow.
"I know, I know. Regina, I'm sorry." Derrick tried to put his hands on Reginas arms, but she stepped away from him. "I don't know what happened, but I promise you it won't ever happen again," he said.
Regina stared at him and laughed. "Youre right about that. Just go away Derrick."
Derrick pled. "You cant do this Regina. I didnt mean to hurt you."
"Derrick." Regina replied, brushing his hand away from her. "You did hurt me. I needed I don't know how many stitches because of you. Please Derrick, just leave. I dont want to see you anymore."
Derrick stepped closer to her.
"Don't, Derrick." Regina held a hand up to stop him.
"Don't what?" He asked, frowning.
"Just stay away from me Derrick. Last night and today convinced me of one thing about you."
"If you're going to call someone trash you should start by looking in the mirror. Goodbye Derrick." Regina turned and started to walk away from him.
Derrick lunged after her, catching her arm and spinning her around to him. She cried out feeling her stitches pull in several places. "Regina, you don't mean that. Last night, it was an accident. I'm sorry."
"Derrick, last night was no accident." Regina lifted her head up and met his eyes. "It was a big red warning flag screaming at me to get out of this relationship." Regina looked down at the hand that was holding her arm. "Now let go of me."
"Regina, please." Derrick pleaded.
"Now, Derrick." Regina yanked her arm out of his grasp.
She walked away without looking back, weaving her way through the maze of parked cars in the doctors lot, and headed back to the emergency department entrance. Her legs were shaking by the time she walked through the automatic doors and the blast of cool air was a welcome relief.
Regina walked over to the nurses station and sat down at the desk, letting her heart rate settle back down. She looked up and saw Sandy at the other end of the desk.
Relieved, she waved to get her attention.
"Hi Sandy." Regina said.
"How are you doing?" The nurse stood and walked over to Regina sitting down beside her.
"Ok," Regina said, but not feeling the least little bit like she was.
"Youve got guts coming in here after what happened to you last night; most people would have stayed home." Sandy said. She creased her brow, thinking. "Hey, that guy was in here looking for you."
"I know. He found me outside." Regina shook her head feeling miserable about the awful things Derrick had said to the doctor. "I told him to get lost."
Sandy smiled at her. "You go girl. You deserve better than that."
"Did you see Dr. Margulies pass by here?" Regina asked, running a trembling hand through her hair.
Sandys eyes widened. "Boy did she ever. She looked pissed off."
Regina groaned and lowered her head into her hands. "Im afraid Derrick said some things that really upset her."
"Better to just stay out of her way, Dr. Kingston. Dr. Margulies is no picnic to be around even on her good days."
"Why?" Regina asked, leaning her elbow on the desk. She was curious about the woman.
Sandy shook her head. "Not for me to say. Shes an excellent doctor but shes had a bad time of it recently."
Regina finished her notes on the patients that shed taken care of today, then pulled the stat order tabs up on the charts and set them in the rack by the unit clerk. It was five oclock in the afternoon and the emergency room was quiet. The lull before the storm, Regina mused to herself. She walked through the emergency room in search of Dr. Margulies. She wanted to talk to her to tell her that Derrick had no right to say what he had, and that he was wrong. Lord knows she didnt need to have her attending upset at her for something totally unrelated to work.
Regina asked around and found that Dr. Margulies was probably outside by the ambulance bay. She stopped in the lounge and picked up the two bottles of water shed left in the refrigerator with her name on them. Experience taught her to not leave anything unlabeled; it was a sure guarantee that it would become community food. Regina walked outside and grimaced as the oppressive humidity hit her in the face, deciding to pull her lab coat off and sling it over her shoulder. Looking around, she recognized the lone figure sitting on the concrete wall high above the loading docks, with her elbows on her knees and head bowed forward. She was surprised to see a cigarette dangling between the fingers of the doctors right hand.
Regina considered letting her be and just walking way. Maybe it was better to just leave well enough alone, as Sandy warned her earlier. She took a breath and made up her mind walking up the grassy hill toward the brooding figure. Regina sat down about an arms length away from her.
"Dr. Margulies," Regina said carefully. "I thought you might want something to drink; its pretty hot out." Regina set the water bottle down beside the doctor and sat quietly for a moment, watching the woman beside her. Dr. Margulies made no move to acknowledge that Regina was even there. A white plume of smoke trailed up from the concrete as she sat motionless. Her dark hair that was braided earlier hung loosely around her shoulders and hid her profile.
Alex lifted her head up, looking straight ahead. "Thanks for the water," she said. Her voice sounded quiet and tired. She took a drag from the cigarette and crushed it out on the concrete.
Regina wasn't sure, but she thought she could see the sparkle of tears in the corners of the doctors eyes when she brushed her hair behind her ear. Suddenly realizing she was uncomfortable sitting this high above the pavement below, Regina leaned back.
She regarded her companion for a moment. "I'm sorry for what Derrick said to you before."
"Everyone is entitled to an opinion," Alex replied, without looking at her.
Regina looked up at the sky, watching the clouds billow and roll overhead, as she considered what to say to her, then lowered her head and looked down at her feet dangling over the cement wall.
"I I just didnt want any of this to affect our working relationship."
Alex nodded her head slowly, taking the words in. "It wont unless you allow it to, Dr. Kingston."
"Well, good: I just wanted to get that, uh, settled," Regina managed. She was silent as she recalled what Derrick said in the parking lot. Now that she thought about it, she remembered seeing the doctors picture in the paper.
"Dr. Margulies, can I ask you a question?" Regina looked back up at her.
The doctor knew this question was coming. It always did, it seemed. "Yeah," she answered.
"What happened with the kid that died last year?"
Alex looked over at Regina. She took a breath and let it out slowly. "You know about the kids that were killed in the car accident?" Regina nodded her head.
Alex sighed, her shoulders slumping forward. No matter how hard she tried, it seemed like she could never leave her past behind. "I was called in to help out in the emergency room that night. There were too many critical patients and the accident it took all our resources. I made the decision to crack the kids chest and try to repair the ruptured arteries in the emergency room. There was too much damage around the heart. I couldnt control the bleeding: the trauma team was backed up and we were on our own in the ER. He bled out, before the OR team could get to him." Alex realized she had been unconsciously rolling the water bottled back and forth in her hands, and stopped.
"So you weren't supposed to be there," Regina concluded.
Alex blinked. "No, I lost someone close to me and I took some time off to " She waved her hand, dismissing her thought. "That doesn't change the fact that I put my hands on that kid and made decisions that I had no business making that night." Her voice had fallen an octave lower. "I took some sedatives to help me sleep before I got called in."
Regina watched Alex lower her head and close her eyes. "Was it someone close to you, Dr. Margulies?" Regina didn't know why she asked the question, but knew she wanted to know the answer to it.
Alex shook her head and wiped a tear away with her finger. "Shit." Alexs voice cracked.
Reginas eyes widened with surprise when she looked at the doctors face. "I I'm sorry. I didn't mean to get you upset. If youd rather not talk about this, I understand."
Alex held up a hand to cut her off. "Its all right. You might as well know the whole story. Youll hear it courtesy of the hospital grapevine soon enough. I uh, my partner-" Alex stopped and took a breath, not trusting her voice just yet. She hadnt been prepared to talk about any of this. "Lana. She'd been sick." Alex lowered her head again before she continued. "She was in remission from breast cancer. It recurred in her other breast." Her hands were shaking as she wiped her eyes. "They caught it too late. It already metastasized to her liver."
Her voice changed and she pushed down her emotions, falling into her safe and sterile clinical assessment of what occurred. "They started with radiation and then chemotherapy. Nothing worked, the tumors were too advanced."
Regina moved closer and laid her hand on Dr. Margulies forearm. Alex wiped her eyes again and stared straight ahead, her jaw muscles clenching. "Lana decided she didn't want to go through with any more treatments. They were worse than the damn cancer. She died last November, two days before the accident."
Surprisingly, Regina felt anger well up inside her. "Jesus, how could they call you in to assist in a multiple trauma two days after you lost your partner?"
Alex gave a short bitter laugh. "As far as the hospital was concerned thats a right reserved for married couples only."
Tears welled up in Reginas eyes. "I'm so sorry," she said, moving her hand down the inside of the doctors forearm and squeezing it gently.
Alex tensed at the gesture and then forced her body to relax. It was the first time she could remember anyone ever consoling her after Lanas death. Even Sandy, someone that she worked with for years, maintained a safe distance after the funeral, never quite sure what to say to her. And yet, here someone who she hardly knew was comforting her. Alex found herself looking down at the blonde head at her shoulder and wondering who this woman was who could move beyond her carefully cultivated emotional defenses.
Regina sat beside Alex for a while, but finally she stood up. "I I should go. Im sorry for your loss." She felt exceedingly awkward and nervous as she looked at the back of the doctors head. She opened her mouth to say something else, but decided better of it and quietly walked back down the hill toward the emergency department.
Regina opened the door to her one bedroom condo and walked across the living room to her kitchen. She set her backpack in one of the chairs and pulled a bottle of water out of the refrigerator. Twisting the cap off, she took a long drink of the cold water and padded across the living room to check her messages. She looked at the light - one blink, and one message. She sighed, knowing it was probably her mother calling.
Regina listened to the message on her machine and groaned.
"Hi dear, this is your mother. You need to call us as soon as you get in. Derrick called. He was terribly upset. What happened? Please call me."
She slumped down onto the couch and stared at the wall. She couldnt believe Derrick called her parents house. What did he think he was doing? Did he honestly think that by calling her parents it would make her feel any differently about what happened? Regina tilted her head back against the couch and covered her eyes with her arm.
"I dont need this, not now," she said. Regina looked over at the phone and contemplated not calling. She still had plenty of reading to do before she was on duty tomorrow. "Might as well get this over with. If I dont call, lord knows she will."
Regina picked up the cordless phone and dialed her parents number. It rang three times and her mothers breathless voice answered.
"Hi mom. Its Regina."
"Oh good. What happened dear? Derrick was an absolute basket case on the phone last night. I could barely understand him?"
"He called last night?" Regina asked. She felt bile rising in the back of her throat as she thought of Derrick on the phone with her mother while she was in the emergency room. You should get an academy award for your performance Derrick.
"Why, yes, dear. He was very worried about you."
Regina snorted. I bet he was, she said to herself. "What did he tell you?" She asked.
"He said he asked you to marry him and you two ended up having a terrible argument." Her mother said.
"Thats it?" Regina asked pacing back and forth across the carpeted living room.
"Why yes dear. You dont sound very happy whats wrong?"
Regina pulled the sneaker off her left foot with the toe of her right. Bending over she slipped the other one off and tossed it in the corner. She decided not to tell her mother about the vase. No need to bring that up right now.
"Regina? Are you still there?"
"Im here mother." Regina said looking up at the ceiling. "Mom, Derrick and I have broken up."
There was silence on the other end of the phone. "Thats nonsense. Why would you do that Regina?"
"Derrick and I have different priorities right now. Its just not going to work out," answered Regina.
She heard her mother sigh. "Regina, I dont understand why you had to choose medical school, of all things. Youll never have a normal life working those crazy hours. How will you ever have a family?"
"Mother." Regina ran her hand through her hair and closed her eyes. "Mom, lets not get into this again. Its what I want to do. Its ok for Michael and Jeffrey to have careers "
"Michael has a family to support. He should have a career," her mother replied sharply.
"And what about Jeffrey, mom? What about me?" Regina asked.
"Dont you dare throw that in my face. You know we dont discuss your brother. What he does is is a disgrace." Her mothers voice cracked.
"Jeffs not a disgrace, mom. He chose a different lifestyle, thats all," Regina said, biting back tears.
"Dont you dare defend what your brother does to me!" Her mothers voice was shaking. "We just want whats best for you. Derrick loves you. He wants to take care of you. Whats wrong with that?" her mother asked, having regained her composure.
Regina was silent. Hot tears ran down her face. Whats wrong with that? I dont love him, thats whats wrong. "Mom, Derrick wants someone to be home to take care of him. Hes made it clear that he doesnt want me practicing medicine and I wont give up my career for anyone." Regina leaned against the wall and closed her eyes.
Even now it was the same old double standard she had argued about with her mother since she could remember. It was ok for the men in the family to be successful, but a woman, ha, her mother counted success by how long you were married and how many kids you had. Regina rubbed her face wishing that she wasnt having this conversation. She was a fool to think she was going to get support from her mother, despite what had happened to her last night.
"Regina sometimes you have to make sacrifices when youre in love." Her mothers Southern accent was beginning to annoy her.
"I know that mom, but I dont love Derrick, not at all."
"Dont say that, dear. Youre just upset. Give it time."
"Mom, did Derrick tell you that I had to go to the emergency room last night?" Regina asked.
"I didnt think you started until today?" Her mother asked.
"Thats right," Regina said, letting her mother think about her answer for a minute.
"What are you saying, Regina?"
"Mom, Derrick flipped out. He picked up a vase and threw it at the wall when I told him I didnt want to get married. I got hit with the glass from it." A small cry escaped her lips. "I needed stitches in my arm and my shoulder."
"Oh well, now dear Im sure it was an accident. Derrick wouldnt hurt you intentionally."
"How can you defend him? I cant believe youre saying this." Regina was shaking her head and pacing back and forth around the room again. "Whose side are you on anyway?"
Her mother was crying now and she heard muffled voices before her fathers gruff voice came through the phone line. "Regina, what did you say to your mother? Shes crying."
Regina sniffed and wiped her tears off with the back of her hand. "Dad."
"Oh great, youre both crying. Whats going on?" he asked.
Regina rubbed her forehead, wincing at the pounding she was feeling behind her eyes. "Derrick and I are finished." She heard her father start to say something, but Regina cut him off. "Dad, please, I cant talk anymore, not now. Ill call you later in the week. Bye." Regina ended the connection and set the phone down in its cradle.
She was furious with Derrick for calling her parents and manipulating the situation to his advantage. Regina walked into her bathroom and opened her medicine cabinet. She pulled out a bottle of ibuprofen and dumped two of the pills into the palm of her hand. Tossing them into her mouth, she filled a cup with water and took a swallow, closing her eyes as the pills slid down her throat.
She walked back out to the living room and snorted in disgust at the pile of reading she still had left to do. For a moment, she gave half a thought to just crawling into bed and falling asleep, but knew if she didnt read the information, she would probably pay for it the next time she was on duty with Dr. Margulies. With a resigned sigh, Regina opened the packet and started reading the trauma protocol for blunt abdominal injuries.
"Alex, wake-up." The knocking at the door came again more insistent this time. "Alex come on, wake-up."
Alex groaned and rolled over, her arm shielding her eyes from the light in the hallway. "Ugh. Turn the damn light off," she said, her voice hoarse from just waking up.
Sandy opened the door wider, letting more light into the small exam room, and looked at the doctor sprawled out on her back on the hard exam table. She could never understand how anyone could fall asleep on those things. "We've got a trauma coming in. They're ten minutes out."
"All right, I'm coming." She was still groggy and drifting between wakefulness and sleep.
Sandy leaned her head against the door and watched as the doctors breathing deepened and turned regular again. She sighed and hung her head, then grinned evilly.
"Hate to do this to you, friend." Sandy walked over to the sink and filled a cup with cold water, then stood of good arm length away from Alex. "Alex, this is your last chance. Get up." She waited a second, then tossed the cup of water onto Alex's face and scooted back toward the door.
In a blur of movement, Alex exploded off the exam table wiping her face, and muttered several colorful explicatives. She glared at Sandy through tousled bangs, curling her lip menacingly. "A simple hand on the shoulder would've worked nicely, Sandy," she stated.
Sandy laughed and shook a finger at her. "Oh, no. The last time I woke you up that way, you almost broke my hand off. This way, I have some time to get away from you." Sandy flicked the light switch on and let the door bang behind her she walked out.
Alex grabbed a towel off of the shelf and wiped her face dry. Noticing the v-neck on her scrub top was riding dangerously low on her chest, she reached to the back with both hands to pull it down, then, stretched her arms high over her head. She felt several vertebrae satisfyingly pop as she arched her back.
"Ah. That's better." Finally, she sighed, walking out of the room and heading down toward the trauma room.
Passing the nurses station Alex grabbed an isolation gown from one of the bins and started pulling it on. Glancing over the desk, she saw a couple of medical students, hovering around a computer. Alex changed directions, walked up behind them, and clamped her hands down onto their shoulders.
"Hey boys, what are you watching over here?" She peered over their shoulders and caught sight of the internet site they were looking at. "Nice anatomy." She yanked them both back, turned them around and pushed them ahead of her towards the trauma room. "I think this might be more educational for you, that is if youre still interested in being doctors that is."
"I uh, we just typed in " Andy stammered helplessly.
"Shut up, Andy." Alex propelled them both forwards. "Im sure youre patients would love to know what you spend youre down time doing in between cases."
The emergency room doors banged open as the paramedics wheeled their patient into the emergency department. Alex quickened her pace and jogged over to meet them, both medical students on her heels.
"What do we have?" she asked them.
"A 43 year old male, involved in a motor vehicle accident. He was unconscious at the scene but his vitals were stable. Pulse is thready, blood pressure is 110 over 80. His respirations are shallow. We couldn't get a line in at the scene." The paramedic rattled off the vital information as he wheeled the stretcher quickly down the hall.
"Sandy, which room?" Alex asked the nurse as she pulled a fluid shield mask over her face and grabbed a pair of gloves from a box on the nearby wall.
"Two," she answered.
They wheeled the patient into room two and expertly lifted him onto the exam table. Alex then bent over him, feeling for his carotid pulse and listening to his breathing. She wrinkled her nose and shook her head.
"God, he smells like a distillery," she said in disgust, smelling the liquor on the mans breath.
She flipped her stethoscope over her head and adjusted the earpieces in her ears. One of the ER technicians got busy cutting the mans clothes off his body and Sandy hooked the EKG leads up to the wall monitor to record his hearts rhythm.
"I've got decreased breath sounds on the right side. Let's get a CBC, tox screen and a blood gas," Alex ordered.
"Alright, I need two large bore peripheral lines, make them 14 gauge. Let's run ringer's lactate wide-open and get a catheter in him. Sandy, I need a chest tube, 32 French."
"Got it," Sandy grabbed the sterile kit and turned around, bumping into one of the medical students. Glaring up at him she snapped angrily, "Andy, draw the blood. Come on get with it here."
"Sorry," he mumbled, as he pulled on gloves and reached for a blood gas kit. Sandy ripped open the packaging and set the kit on the instrument tray next to Alex. Quickly drawing the blood and avoiding further criticism, he carried the blood out to the satellite lab in the emergency department to complete the tests.
Dr. Jameson, medical director, pushed open the door and strode into the trauma room. "Everything under control in here Dr. Margulies?"
Alex nodded her head without looking up. "Yup, we're just fine in here Dr. Jameson." She glanced over at the bedraggled emergency technician. "Tommy, wake up and help me roll this guy over to his left side." The medical director watched for several seconds then turned on his heel and walked out of the room obviously feeling snubbed by Alexs indifference at his presence.
Tommy quickly moved to Alexs side and helped her roll the man over. The doctor picked up the syringe and checked the bottle containing one-percent lidocaine. She quickly injected several sites on the patient's upper ribcage. Without hesitation, Alex took the scalpel from Sandy and quickly made a small incision through the skin above the rib. She grabbed the Kelly clamp that Sandy held out and pushed it slowly through the lining around the lung. When she felt the instrument break through the fibrous membrane, she opened the clamp to enlarge the hole.
She slid the clamp out, holding the incision open with her fingers. Blood trickled from the opening and ran down the mans back, staining the sheet underneath him red. Alex picked up the chest tube with the clamp and pushed it through, then held it still while Sandy connected the other end of the tube to suction. The tall dark haired doctor then sutured the tube in place, closing the skin edges of the incision around the tube and tying the suture ends around it. They watched as the bloody fluid flowed through the tubing and into the container on the wall.
Alex looked up a she finished dressing the area. "Let's get a chest, a cross table C-spine on this guy." Alex continued her evaluation of the patient, checking his pupils, and looking for any obvious signs of trauma on his body. She ran her hands along the mans head and neck, checking for any abnormalities. His reflexes were normal and he groaned when she rubbed hard on his sternum and tried to swipe her hand away.
"This guys lucky," she said, pressing into his abdomen and getting no reaction from the intoxicated man. Alex shook her head. For as long as shed worked in the emergency room, she had seen more drunk drivers come in from serious auto accidents and walk away with barely a scrape. It always seemed like it was the other person involved that fared worse.
Andy slipped back into the room and handed the lab results to Sandy. "The blood tests are back," Sandy said, looking over the results.
Alex looked at the results in the nurse's hand and nodded her head. "Blood gas is okay. Hamatocrit is good. All right, let's keep him on a hundred percent oxygen by mask." She looked up at the monitor watching his heart rate for a minute. "Let me know when he wakes up. His blood-alcohol level is pretty high, so itll be awhile. Were keeping him here for observation. Let me know if anything changes in his condition."
Alex walked out of trauma room two after having written several orders in the patients chart. She looked up at the clock on the wall and rubbed her eyes with her hands. Two more hours to go, she thought. She walked over to the desk and sat down to finish writing her note on her patient.
The unit clerk spoke to her. "Alex, the police officers are here. They want to know if they can talk to the guy involved in that car accident."
"No, they can't," she said, continuing to write in the chart.
"Well, thats not being terribly cooperative now, is it?" A male voice asked.
Alex jerked her head up and stared into dark brown eyes. It took a moment, but she recognized the officer as the same man who she had forcibly removed from a room the night she had taken care of that new resident, the same one who harassed her in the parking lot. She stood up, pulling herself up to her full height above the desk counter top forcing him to look up at her.
"Here's his blood alcohol test," she said, shoving the chart under his nose. "Does that make it clearer why he's not awake yet?" She glanced over at his partner.
Sensing the animosity between the two, the other officer stepped forward. "Uh, doctor "
"Margulies," Alex said, ignoring Derrick.
"Im officer James and this is officer Black."
"Did he say anything when he came in here?" Derrick asked, making a note in his notepad.
"No. He was unconscious at the scene and he hasn't woken up yet. How are the people in the other car?" Alex asked.
"Dead," Derrick said, not looking at her. "Do you have any coffee around here?"
Alex pointed down the hallway. "It's in the staff lounge." She looked at her watch and decided that she needed something to eat and headed down to the cafeteria to raid whatever was left over.
Derrick walked into the staff lounge. He spotted the coffeepot and sniffed at it warily, then poured himself a cup and sipped at it. Not bad. He looked around the lounge, which was presently empty. He'd been working a lot of overtime the past week, by choice since Regina refused to return his telephone calls. She'd come around, he thought, just needed some time to simmer down and realize that it was all just a misunderstanding. He hadn't really meant to hurt her - just scare her a little. Besides, her mother adored him.
Derrick walked over to the round table in the middle of the room, sat down propping his feet up in the chair next to him.
"Hi." Derrick looked up startled. He watched as the curly blonde-haired nurse walked over to pour herself some coffee.
"Hi," he said. He watched as she turned around. "Long shift?"
"Yeah. Almost over," Sandy said, eyeing him from across the room as she poured herself some coffee.
"Did that guy wake up yet?" Derrick asked, leaning forward in his seat and removing his feet from the chair next to him, so that he could push it out to Sandy.
She ignored his attempt at politeness and headed toward the door. "No and I wouldn't bother waiting around either. He'll probably start to feel his well deserved hangover sometime tomorrow."
"Well, I'll leave my card at the desk," Derrick said.
"You do that." She satisfied her curiosity by walking in to get herself a cup of coffee. Sandy recognized the police officer as the man responsible for the new residents injuries, and frankly, she didnt trust him.
Derrick watched as the door closed behind her. "Bitch."
Alex walked back into the ER sipping soda through a straw, and headed over to the desk to speak to the white team's resident that was covering the next shift. Before she got there, Dr. Jameson intercepted her, motioning her to an empty room. He was dressed in an expensive Italian suit and obviously was on his way out.
"I need to speak to you about that patient who coded in here yesterday. QRM is sniffing around and I need to give them some answers so they can write their damned report." He handed her a copy of the notes from the code sequence in the emergency room.
Alex set her soda down and read through them briefly. Frowning, she looked up. "So, what are they questioning?"
"They're concerned about our mortality rate in the emergency room, Dr. Margulies. You know how we're rated against our competitors. We've had an unusually high trend recently and corporate is on my back to do something about it." Dr. Jameson ran a hand through his graying hair.
Alex shook her head and snorted. "This guy was in full arrest when he came in. He'd been out for over forty-five minutes before we called it. I know he was young, but damn it, we did everything there was to do, followed every procedure by the book." She fed Dr. Jameson's words back to him, recalling her meeting before the committee when they decided her fate six months ago. "What would you like me to do? Get on my cell phone to god and ask him if he can stop filling beds in the eternal care unit?" Alex threw the report on the gurney in disgust and stared at Dr. Jameson.
"Dr. Margulies." His voice was low and even. "I appreciate your frustration with corporate's perception of what is going on here, but I have to remind you that you only just got off probation and some people still consider you a liability to the institution. The only reason they decided not to bust your ass out of here was because of the stellar work you had done up until that time and your, um, extenuating circumstances."
Alex had both hands on her hips. The anger welled up inside and she stepped closer to her director until she was inches from his face. "My extenuating circumstances." She said the words slowly, letting the fury build inside her. "None of the other medical staff that lost a spouse would have been dragged in here two days after the funeral to assist in a multiple trauma." She stepped closer to her medical director, close enough to see his pupils dilate in response to her physical proximity.
"You knew damn well I wasnt in any shape to be treating patients, but you called me in anyway."
Dr. Jameson took a step back and held up a hand. "Dr. Margulies, this will get us nowhere. Our personal lives have no bearing on the quality of care we deliver to our patients; the simple issue was you used poor judgment in making the medical decisions that affected that boy's life. Besides, the board sided in your favor anyway. They revoked your colleagues privileges after he admitted that you told him that you had taken sedatives before you touched the kid." He spread his arms out. "So, it seems that justice was served."
Alex forced herself to take a breath, not realizing that she had been holding it. "Fine. Tell corporate we'll do a retrospective review of the mortalities in the ER over the past six months." She looked up at Dr. Jameson, still feeling the pounding of the blood in her ears. "Will that satisfy them for now?"
"Yes, Dr. Margulies." He turned and headed toward the door, stopping before he opened it. "I'll need you to present that report at the next mortality and morbidity meeting."
Alex watched the door swing shut. She knew now that Jameson used the whole situation as a way to get back at her for blowing his comfortable scam with a drug company. The medical review board was incredulous at the punishment that her medical director was calling for under the circumstances. They said that it had been a no win situation. Too many critically injured patients came in from the same accident and the trauma team had been overwhelmed. It was determined that there had been a breakdown in calling in additional staffing when the call came into the ER.
Alex had done everything medically within her power to try and save that boy. Even now she could remember every detail as if it had happened yesterday. There had been more tubes coming out of the boy than she cared to remember. Once shed recognized the abnormal heart rhythm on the monitor, and performed a pericardiocentesis, and with a large needle drew the gathering fluid out of the membranous sac around the heart. Sandy, thank god, had been there, and shed documented the whole trauma sequence as it played out. Sandy also called the OR and notified the trauma team that they needed them as soon as possible. A frantic surgeon on the other end of the line told Sandy that no one was available. Alex and her team were essentially on their own. So, Alex did the only thing she could when the boy went into cardiac arrest: they coded him and she cracked his chest to try and repair the damaged blood vessels, and massage his failing heart. Again, the OR was called said they would be ready in fifteen minutes. Fifteen minutes had been too long.
Afterwards, Jameson insisted that she should never have performed an emergency thoracotomy, to buy additional time, since the OR had been backed up. In the end, it was the only decision the medical review board said she could have reasonably made. The hospitals policy backed her up on it, but the damage had already been done as news of the high profile death and word of her suspension made the front page of the local newspaper.
And now Jameson was doing this to her. Without looking, Alex cocked her arm and swung her hand down in a vicious arc, sending the large cup of soda flying across the room and spattering on the wall.
Alex walked quickly down to the locker room. One of the junior residents saw her and tried to ask her a question. A look that must have shot daggers at him sent the resident scrambling for cover, mumbling something about another time being better. Alex opened her locker, pulling out her clothes and her waist pack. She shed her hospital scrubs, slipped a t-shirt over her black sports bra, and threw on a pair of black running shorts. She shoved her sneakers on her feet and balled her scrubs up, throwing them viciously into the dirty linen basket.
Alex stormed out of the hospital and headed toward the road. The sun was already up and it looked like it was going to be another hot day. She stretched for a few minutes and then jogged up the slowly rising incline of Old Town Road. By the time she reached the hill leading into South Mountain Reservation, she was in her normal rhythm.
She veered off the divided road and trotted up the dirt embankment toward the trail she often used. Alex kept her stride loose, absorbing the shocks of the uneven ground with ease. She ran easily in the cool darkness underneath the canopy of maples far above.
The trail veered left and she hurdled over a fallen tree and headed toward the shimmering glow of the lake as the sun peeked over the treetops. Stopping by a large rock, she paced back and forth gulping in the humid, summer air, letting her respirations ease back a bit.
She climbed up on top of the rock and gazed out over the water. After a moment, Alex sat down, stretching one long, muscular leg out in front of her and wrapping an arm around her other knee. She rested her head on her forearm and watched the sun rise, letting the solitude of the place soothe her jangled nerves.
Much later, after driving home in a daze mostly from exhaustion, Alex unlocked the front door to her townhouse and walked across the tile floor. There were no messages for her on the answering machine, not that she expected any so, she trudged up the stairs to her bedroom. Flopping down on the bed, Alex linked her hands behind her head and stared up at the ceiling.
She rolled onto her side and opened the drawer of the night table, fishing out the two pictures that she kept there. A sad smile creased her face as she looked at the first one. It was a picture of Alex and Lana sitting together looking very much relaxed, lounging on the benches in front of the town hall in Provincetown, people watching. The second was taken a year later in the same spot with Lana sporting a red baseball cap over her cleanly shaven head.
Lana had shaven all her hair off the night before in a final act of defiance and control against the disease that had taken so much from her already. Alex had sat at the edge of the tub, chin on her hands watching, as the clipper neatly removed the thick brown hair in wide swaths. When she was done Alex had taken her in her arms and hugged her. Later they had made love; Alex realized now, for the last time. That night had been the beginning of a lot of lasts in their relationship. Closing her eyes, Alex tried to shut out the lonely, desolate feeling that too often threatened to overwhelm her. It was a long time before sleep finally delivered her from the ache she felt deep inside.
Regina checked her watch. It was nine in the morning and she still had some time before her appointment at the follow-up clinic to have her stitches taken out. She returned the book she was reading on emergency medicine to the rack in the medical library, and Regina allowed herself a small smile as she recalled several admissions that she was involved in over the past two weeks. She handled them all fairly well and even managed to get a grumbled nice job from her usually taciturn attending. It was a rarity to see Dr. Margulies smile and most of the staff kept their distance from her. Picking up her bag, Regina walked out of the medical library and headed up the back staircase.
Stopping by the emergency department, Regina saw Sandy standing at the desk, busily scrawling notes on one of the flow sheets. "Hi Sandy."
The nurse looked up from her work and smiled. "How are you doing?"
Regina smiled. "Pretty good. No major catastrophes."
Sandy watched as one of the guys from materials management lifted a brown carton of medical supplies off his cart and set it on the ground by the supply closet. Without a look back, he hastily pushed his cart down the hall and disappeared around the corner.
Shaking her head in disgust Sandy looked over at Regina. "He sets it right underneath a sign that says, No boxes or stretchers in the hallway." She walked over to the box and started to lift it.
"Here, let me help you with that," Regina knelt down, took hold of the other side of the box and helped Sandy lift it up onto a chair. They carried the box into the supply closet and set it on one of the shelves to be unpacked later.
"How are you making out working with Dr. Margulies?" Sandy asked, knowing the attendings quick temper if her residents were unprepared.
Regina shrugged her shoulders indifferently. "I guess ok. I havent had my head lopped off yet, so that must be a good thing."
Sandy laughed. "Oh yeah, you dont want to be around when she goes on one of her tirades."
"Hello ladies." Regina froze, feeling her hair prickle on her arms.
Turning around, Regina saw Derrick standing dressed in his police uniform, leaning against the doorframe.
He let his eyes roam over Regina's body and smiled at her. "Can I talk with you, Regina?"
Regina looked over at Sandy and back to Derrick. "Uh, yeah. I have a few minutes, Derrick."
"Good. Let's take a walk then," Derrick replied. Regina squeezed by him and crossed her arms in front of her, walking down the hallway ahead of him.
Derrick placed a hand on her shoulder and turned her around to face him as they reached the end of the hallway. Regina found herself looking up into his smiling face. "I missed you Regina," he said, trying hard to make himself sound apologetic and sincere.
Regina swallowed and looked down at her feet. "Derrick, why did you come here?"
"Well, considering you wouldn't answer any of my messages, I figured this would be the best place to find you. We need to talk, Regina," Derrick lifted her face up with his fingers and studied her.
"Derrick, please don't do this." She backed away from him.
"Regina, listen to me. We could have something really good together. I made a mistake. I said I was sorry, what more do you want?" He moved closer to her, spreading his arms out in a plea.
Regina took a step back shaking her head. "Derrick, there's nothing that we have to say to each other." The young resident pushed the door to the locker room open and walked to her locker. She spun the lock several times and pulled it open, then reached inside and pulled out a black jewelry box. She turned and held it out to him. "Take it."
"No, Regina, Im not taking it back. We belong together." Derrick took the box from her and set it on the top shelf of her locker and closed the door. "I love you, Regina." Derrick slipped his arm around her waist and pulled her close.
Regina tried to pull away, but he tightened his grip. "Derrick, stop it!" she said, pushing at his arms.
"Keep your voice down, Regina. Nobody else needs to hear our business," he hissed at her.
"Derrick let go, you're hurting me." Regina glared up at him.
Derrick pulled her roughly against him and grabbed hold of her lower jaw between his thumb and index finger. "Regina, stop playing games with me." He put his other arm around her and pulled her close, pushing his mouth against hers and forcing his tongue inside.
She jerked her head away from him, wiping her mouth in disgust. Hot tears rolled from the corners of her eyes. "You bastard. Im not playing games. Go away, Derrick."
Derrick pulled back. "Youve had your fun Regina. Its time you start paying more attention to me than you do to this damn hospital."
"How dare you think you can just order me around. I dont love you, Derrick, and Im sure as hell not going to marry you."
Angrily, he shoved her away from him. Losing her balance, Regina stumbled back into the sink behind her, crying out as her back slammed into the corner of the porcelain sink. She slumped onto the floor in a heap, holding her back.
Derrick stood over her with his hands on his hips. "When you come to your senses, you let me know, Regina."
As Derrick turned and walked away, she said, "I already have, Derrick."
Regina sat on the floor until the throbbing in her back and neck subsided enough for her to move without gasping for breath.
Moments later Sandy poked her head in the door. "Dr. Kingston? I saw Derrick leave. Are you oh my god! What happened?" Sandy ran and knelt down beside Regina.
The resident shook her head and lifted her arm up. Sandy grabbed hold of her hand and pulled her into a hug. "Oh boy, youre in trouble here kiddo. We need to call security."
"No, please dont. I thought if I told him no, he would leave me alone," Regina sniffed, wiping the tears from her eyes.
"I have to notify security, Dr. Kingston. Its hospital policy."
"But Derrick's a police officer, Sandy."
"I know, but he can't keep doing this to you." Sandy put her hands on Regina's shoulders, steadying her.
Regina nodded her head. "I've got to go. I'm going to be late for my appointment at the clinic."
Sandy walked Regina down the back hallway. "Go on. I can fill out the forms and then well talk to security."
"Sandy - " Regina started to object.
"No arguments," Sandy answered, holding up her hand.
Regina sat in the small waiting room of the clinic. The walls were painted a putrid green that was fading and in desperate need of a new paint job. Cold air was blowing out of the overhead vents and she sank down in her chair folding her arms over her chest to warm herself. Regina tilted her head back against the wall, taking shallow breaths; her back hurt where she struck the corner of the sink, when Derrick shoved her.
Listening to the giggles coming from around the corner, Regina picked her head up and saw two boys running around the furniture chasing each other.
"Mason, Thomas - stop running around and come sit by me." A tired-looking, middle-aged woman told them sternly. Both boys slowed and looked over at her, before they gave up their game and crawled up onto the chairs next to her. Studying the woman for a moment, Regina noticed the shunt underneath the skin of her forearm and realized that the woman was suffering from kidney failure and was on dialysis.
Regina looked up as another woman picked up her child and walked toward the desk when the nurse called her name. Closing her eyes, Regina tried to make some sense of the jumble of thoughts whirling in her head.
Regina opened her eyes and looked up. "That's me."
"You can come with me. I'm going to put you in this room." The small blonde clerk looked in the chart as she directed Regina into an exam room. "Let me see oh, you're getting some stitches removed. Ok, just take your shirt off, and put that gown on."
Regina set her bag down on the plastic chair and unbuttoned her shirt. She winced as she brought her arms behind her back to pull the sleeves from her arms. Slipping the gown on, she sat on the exam table. She was glad the stitches were coming out. They had been itching mercilessly the past three days.
She felt her heart rate accelerate when an image of Derrick towering over her in the locker room flooded her mind. She shook her head in disbelief that this was happening to her. Thankfully, her parents were taking their annual vacation and wouldnt be back for another week. She couldnt bear to have to listen to them tell her how Derrick was a good man and that she should consider settling down with him. If only they knew what he was really like.
Regina picked her head up as she heard movement outside the door. There was a knock and the handle turned, pushing the door open a crack. She heard the woman from the waiting room asking a question, and the door pulled closed slightly.
A voice she recognized as Dr. Margulies' came through the door. "Just make sure you give Jeremy the inhaler treatments two times a day. The humidity will tend to make his asthma worse, so you don't want to miss any treatments." There was a pause and she heard the attending's voice again. "If theres a problem, just bring him back to the emergency room."
The door pushed open and Regina watched as Dr. Margulies entered the exam room. She was wearing sneakers, blue scrubs and a lab coat.
"So, Dr. Kingston how are you doing today?" Alex walked over to the sink and washed her hands. She looked back over her shoulder at Regina. "Bet you're glad those stitches are coming out."
Regina nodded her head and watched as the doctor pulled out two plastic packages from the drawer next to the sink. She swallowed, feeling her throat go a little dry. She hadnt expected that Dr. Margulies would be covering the clinic. Usually the residents did the follow up visits with the patients.
The doctor pulled some gloves out of the box on the wall and slipped them onto her hands; one ripped and she pulled it off. "No wonder." She opened the cabinet above the sink and pulled out a box of large latex gloves, slipped on a pair and turned around. "So which do you want me to take out first, the ones on the back or the arm?"
Regina shrugged. "It doesn't matter."
"Alright. Let's do your back first. Your arm is going to take a bit longer, and those stitches on your back won't feel very good on that hard table. Go ahead and lie on your stomach," the tall dark-haired doctor directed, as she opened the package and set the tweezers and scissors on the sterile towel that was covering the metal instrument tray.
Regina rolled onto her stomach and turned her head to stare at the wall. She felt the cool air on her skin as Dr. Margulies pulled her gown open. There was a moment of dead silence in the room and Regina turned her head around to look back at the doctor, who was looking down at Regina's back with an odd expression on her face.
The older doctor looked up at Regina and took a breath. "That's a pretty nasty bruise you've got there." She ran a finger around the edges of the purplish discoloration on Regina's skin. When she pressed down gently, she heard a sharp intake of breath as Regina winced in pain.
"You're lucky this wasn't any higher or you might have broken a couple of ribs."
Regina lowered her eyes, unable to meet the doctors steady gaze. "I fell," she explained. She heard the wheels of the stool squeak as Dr. Margulies sat down and positioned herself next to the exam table.
Regina felt the tape peeled away from her skin as she removed the gauze bandage. "You're going to feel a few tugs as I do this," the attending told her.
Alex snipped away at the knot and gently removed the stitches with the tweezer. When she finished, she dabbed some antiseptic on the site. "Sorry, that was a little cold," she noted, seeing Regina flinch.
"It's ok." Regina's voice was muffled, as she had tucked her head into the crook of her elbow. She closed her eyes when she felt the tugging again as the stitches were removed from her left shoulder blade.
"Ok. Now, the arm is probably going to be a little more uncomfortable; the flesh is more sensitive there." Dr. Margulies set the tweezer and scissor on the tray. "You can roll onto your back and let your arm rest here." Alex pulled out an armrest from the side of the table for Regina to put her arm on.
The resident closed her eyes as Alex started to unwrap the gauze bandage from around her arm. She knew that there would be a fresh bruise from Derrick's hand gripping her there. There would be no mistaking the old yellowish green mark from the cuts that ran down the inside of her elbow from the imprint of his fingers. It was too sore for it not to be. She felt the cool air against her skin as the bandage was removed and heard the doctor shift her weight on the stool.
"Regina," Dr. Margulies voice was low and gentle. "What happened today?"
She jerked her head up and looked at Alex startled. "How " Regina stopped and looked as the doctor just sat there, holding the rolled up gauze in both hands, watching her face.
"Those bruises on your back are fresh. Probably less than two hours old, I would guess."
Regina nodded her head in acknowledgement and looked up at the ceiling, trying not to cry. God, don't be such a baby, she told herself, but the tears started down her cheeks anyway.
Dr. Margulies watched in silence, debating with herself. "Was it him again?"
Regina nodded and wiped her eyes. "Sorry. I didn't mean to get upset. I just I told him I didn't want to see him anymore. He showed up today and " She let her voice trail off, suddenly feeling very tired and overwhelmed.
The doctors eyes widened in shock. "Here?"
Regina nodded her head.
"Thats it. Im calling security." Dr. Margulies stood up to walk to the wall phone, but Regina stopped her.
"Sandy already called them. Im going to file a report after Im done here."
Dr. Margulies turned around, nodding. "First things first. Let's get these stitches out and then we'll talk."
Talk, Alex snorted to herself mentally. Yeah, what are you going to say that will make a difference?
Alex finished removing the stitches and placed a couple of butterfly strips over the areas that werent completely closed yet. Looking up Alex held her hand out and helped Regina sit up. "Go ahead and get dressed. When youre done, my office is down the hall on the left. We can talk there."
Dr. Margulies washed her hands and walked into the small office. Sitting down behind the desk, she finished making some notes in the chart before her. She ticked through some of the options available to Regina in her head, sighed, and looked up as Regina appeared at her door.
"Sit down." Alex pushed her chair back to give Regina some room to sit in the chair next to her desk. She signed the note discharging Regina from her medical care, then looked up at the blonde haired woman sitting before her and considered what to say.
"Have you thought about what you want to do?" she finally asked.
Regina looked down at her shoes and fidgeted in her chair. "I don't know. He's a police officer. He's got a lot of connections at the courthouse."
Dr. Margulies leaned across the desk. "Regina, he doesnt have any right to do what he's done to you, no matter who he is."
Regina looked up and met clear blue eyes looking back at her. "I know."
The tall dark-haired doctor leaned back in her chair, her brow creased in concentration. "Listen, Sandys right. You should get a restraining order against him."
Regina gripped the armrest of the chair. "Im afraid its just going to make him angrier."
"Its better than nothing. Legally, it will give you some rights," Dr. Margulies said. "At least think about it.
Two days passed since Derrick confronted Regina in the locker room. Holding the black jewelry box in her hand now, she stood in front of her locker and pondered how she would give it back to him. She was sure she didnt want the ring. It had been bought for all the wrong reasons and the sooner she gave it back to him, the better. Until then it was just a bitter reminder of his need to control and manipulate her. Setting the box inside, she shut the door and walked down to the security office to file her complaint against Derrick.
Regina met Marcus as she walked out of the security office after completing the report. It took her those two days to get the courage together to do this. It ended up being a rather unsettling experience as the older security officer questioned her extensively. By the time Regina was finished, she felt that she was the one who had done something wrong, not Derrick.
"What were you doing in security?" Marcus asked, sensing that something was wrong, from the distressed look on Reginas face.
"Uh, I cant find my car keys. I think I dropped them outside somewhere," Regina said.
Marcus took the statement at face value and left it at that.
Walking through the busy hallway by the hospitals main entrance, they heard a hospital code for a patient emergency, announced over the intercom system for the emergency department. Seconds later their pagers beeped and the ERs stat page was visible on both their displays. Marcus cursed under his breath.
"God, she never leaves us alone," he complained.
Regina cast a wary glance at her colleague. Marcus was growing increasingly more vocal about the fact that he didnt like the emergency medicine rotation and disliked Dr. Margulies even more.
"Marcus, why did you pick this for a specialty rotation if you hate it so much?" Regina asked, as they both ran up the stairs to the first floor.
He didnt get a chance to answer her as they entered the emergency department. Regina squeezed past a patient sitting slouched in a wheelchair. One of the medical students was taking a history and she cringed at the hesitation that she heard in his voice. She looked over at Marcus. "God, were we that bad when we were medical students?"
He looked at her blankly; totally unaware of what she was talking about. "What?"
Regina waved her hand. "Never mind, Marcus."
Sandy practically ran into them as she came out of the supply room, carrying a set of restraints.
"Good, youre both here. Weve got a guy in trauma three whose pumped so high on cocaine he already broke one set of restraints," the nurse said, her eyes pleading for help.
"Thats why you paged us? Isnt that securitys job?" Marcus asked, obviously annoyed that his lunch was postponed for something that he believed was beneath him. Regina and Marcus quickly pulled on their masks, gowns and gloves before they slipped into the room.
Sandy ignored his comment, pushed the door to the trauma room open, and immediately ducked as a tray loaded with instruments sailed across the room crashing against the wall.
Several curses followed and then Regina heard Dr. Margulies voice. "Sandy, I hope those restraints youve got in your hands are leather." She was struggling to pin the wild-eyed mans arm down to the stretcher. One of the other nurses was fighting to keep his other arm pinned down to his side.
"Sorry. I brought a double set to tie him down with." She approached the large, drug- crazed man warily.
"Hear you have a party going on down here, Dr. Margulies." Marcus stepped over the scattered instruments and looked distastefully around the chaotic room. One curtain hung by only a few hooks and the rod holding it to the ceiling swung precariously overhead.
"Are you here to give commentary or to help Dr. Jack?" Alex growled through clenched teeth as she finally pinned the patients arm to his side.
One of the ER techs kicked the tray and scattered instruments out of the way. "Tommy, forget about that stuff." One of the other nurses in the room told him. "Help me hold is arm down, so I can tie it."
Regina walked up to the end of the stretcher and took a restraint that Sandy handed her. She slipped it around the mans ankle very carefully and then cinched the loop tight, tying a knot around the rail of the stretcher.
"Sandy, come up here and lets try these damn restraints again. Where the hell is security anyway?" Alex ducked as the nurse on the other side of the stretcher lost control of the patients arm and his fist sailed across, aimed at her head. "Damn it, Thomas, help Maggie hold that arm, before someone gets hurt."
"Theyre on their way," Sandy said, as she struggled to wrap the restraint around the mans wrist. All the while cursing, as he writhed and bucked against the arms holding him down, causing the side rails of the stretcher to rattle.
Marcus tied the other arm down to the bed and stepped back. "You need a line in him?"
Alex looked up at him. "That would be our usual protocol, Marcus. Make sure that restraint is secure before you stick him."
Regina stepped up beside Marcus. "Can I help with anything?"
"Help Dr. Jack put a line in this guys arm," Alex said.
"I can get a line in without any help," Marcus snapped, as he opened the package containing the needle for the IV.
"I know you can Dr. Jack, but you need someone to immobilize his arm, unless of course you can do both at once," Dr. Margulies said.
Regina grasped the mans beefy forearm as Marcus jabbed the needle in. The man grimaced and his fist clenched as Marcus searched for the vessel.
"Marcus, wait," Regina said, pulling the strap of the restraint down, trying to tighten the knot that was quickly working its way loose from the mans violent struggling.
The patient on the stretcher grunted and convulsed violently, ripping his arm out of the restraint and striking Marcus. It happened so fast that Regina hardly had time to think. On instinct, she lunged for his flailing arm as Marcus unsuccessfully tried to keep the needle in place.
Regina felt the sharp sting of the needle plunging into her forearm, as Marcus tried to re-insert it. Yelping in surprise, she yanked her arm back.
Everything seemed to slow down around her as Regina stepped back from the table and stared at the needle that was imbedded in her arm and the clear tubing that was filled with blood from the patients artery. Her heart raced and she backed up to the sink. Around her she could hear shouts and loud noises but they seemed far away now. She pulled the needle out of her arm and looked at the blood welling to the surface of the puncture site.
Marcus looked at her and blinked as he retied the restraint. Regina could see his mouth form the words oh shit, and she knew she was in trouble. Very slowly she turned around to the sink and started washing the small puncture site vigorously. She felt the contact of a warm hand on her shoulder and she looked up to see Dr. Margulies standing next to her, a worried expression on her face. "Let me see."
Regina turned her arm over, felt the strong hands grip her forearm and squeeze hard around the site.
"Youch!" She wrenched her arm away and glared at the dark haired woman.
"You need to make it bleed first," Dr. Margulies explained, staring hard at her.
"You could have warned me," Regina retorted, rubbing the reddened skin on her forearm gingerly.
Dr. Margulies turned away from Regina and held her hand out. "Sandy, give me his chart. Hurry up." She flipped through the record and muttered to herself angrily.
"Whats wrong?" Regina asked, acutely aware of the sound of her own blood racing through her ears.
Dr. Margulies turned the chart around and pointed to some scribbled notes on the white history form. Regina read the words, comprehension dawning slowly along with a sinking feeling in her gut. The letters HIV+ stared back at her. She swallowed, and then looked up at the doctor standing in front of her. "Oh no." Her mouth was suddenly very dry and a chill ran up her spine.
"Come on, we need to start the post exposure treatment." Alex put a hand behind her back and started to guide her from the room.
"W wait." Regina turned around, holding her hands out in front of her. "This is a high risk exposure right?" She tried hard to control her voice.
Dr. Margulies let her hand fall to her side. "Yes - it is." She looked back at Marcus who was standing helplessly by the stretcher. "Dr. Jack, you can finish in here. Make sure his restraints are secure before you try again." Marcus face turned crimson at the remark. "Sandy, page Dr. Washington and get him up here now. When the IV line is in the patient, give him .5 milligrams of Narcan to sedate him."
Sandy nodded, quickly tying off the last restraint. "Thomas get the leads on him now so we can hook him up to the monitor. Maggie," she said, turning to her colleague. "Get the IV in him, and Marcus, you hold his arm this time."
The remaining team continued doing what they needed to as Dr. Margulies led Regina from the room. Walking down the crowded corridor, Alex held her hand up stopping one of the nurses coming at her with a chart. "Get Dr. Alfonso. He can handle it." Pushing open a door to a darkened exam room she flicked the light on and held the door open, ushering Regina inside. Alex rummaged through one of the file cabinets and pulled out a couple of forms that she handed to Regina. "You need to read this and sign it. Its the consent form for treatment."
Regina took the papers and stared at them blankly.
"Ill be right back." Alex left Regina alone in an empty exam room, while she disappeared to procure the supplies that she needed.
Regina sat quietly reading the consent form for treatment. Her mind was racing and it felt like her heart was pounding so hard that she thought it was going to jump out of her chest.
She tried not to think about the blood inside the tubing, or how long the needle had been in her arm, releasing the infected fluid into her body. She knew the virus unalterable course all to well. There was no grace period if she was infected. Mononucleosis-like symptoms would develop between six days and six weeks after infection and in three weeks the HIV antibodies would be detectable in her blood stream.
Regina shook her head. Of all the stupid things to have happen; a bloody needle stick, she thought. Picking up the pen, she held it in her hand as she read the last few lines. Her hand was trembling and it took all her concentrated effort to sign her name legibly on the line at the bottom of the page.
The door opened and Regina looked up as Dr. Margulies walked in. Alex was carrying several empty vials for blood. Sitting down in front of Regina, she set the vials on the tray next to her. They rolled back and forth making a gentle clatter of glass on metal. Pulling a length of rubber tubing from her lab coat pocket, Alex held it in both hands.
"Were going to run a complete blood count with differential, urinalysis, and chemical profile with liver function tests," Alex said, rattling off the list of standard blood tests used for blood exposures.
The door to the room opened and an ER tech walked in, oblivious to Alex and Regina sitting in the back of the room. Alex pivoted in her chair. "Hey, do you always just barge into a room like that?"
The young woman stopped in her tracks and stared at Alex. "I I just needed to get a central line kit."
"Next time knock, first," Alex snapped. The woman stood awkwardly unsure of whether she should leave or not. Alex tilted her head. "Hurry up and get what you need and get out, now."
The woman quickly retrieved the kit she was looking for and made a hasty retreat from the room.
Regina held her arm out flinching a little as Alex slipped the rubber tubing around her bicep cinching it tightly. She flexed her hand several times and waited as Alex uncapped the syringe and felt for an artery with skilled fingers. Her eyes flicked up to the doctors, meeting briefly, and darted back to her arm.
"Not bad for a doctor," Regina said, after the needle penetrated her skin and dark red blood ran freely into the tube.
Alex looked up in surprise. "Did I hurt you?"
"No, no," Regina said, laughing softly, trying to break some of the tension she was feeling inside. "Just an inside joke among the nurses. They all think we do a terrible job of drawing blood."
Regina watched the blood fill the tube then turned her face away as another thought made her catch her breath. "The lab in the hospital is going to run the tests right?"
Alex looked up as she pulled the vial off and replaced it with another one. Undoing the band, she removed it from Reginas arm. "Yeah - they do." Taking in Reginas worried look, Alex took a stab at what was bothering her. "If you want, I can run the tests myself, that way no one else has to know."
"Would you?" Regina asked, her eyes brightening. "I mean its not that I dont trust them its just that - well - you know how some things dont stay confidential even when theyre supposed to," she said, and her shoulders hunched slightly as if a weight was settling on her again.
Alex nodded her head, knowing all too well how rumors, false or not, got started and traveled like wildfire through the large medical center. "Ill take care of it. Dont worry."
"Thanks. That makes me feel a lot better," Regina said.
Alex blinked and scribbled some notes on the form in front of her. She took a breath and set her pen on the table. "Do we need to do a pregnancy test?" Alex asked her quietly. She felt awkward asking the question but it was necessary.
Regina jumped at the question. "Pregnancy? No, no, Im not pregnant."
Alex nodded and looked away. "The medication has some strong side effects. Just wanted to make sure."
Regina nodded and ran a hand through her hair. "So, what am I going to be taking?" Her voice trembling slightly as her emotions threatened to overwhelm her.
"Zidovudine and Lamivudine. Theyre more effective if you take them in combination." Alex explained.
"What are the chances -" Reginas voice trailed off and she didnt finish her question.
"About one in three hundred," Alex said, and then quickly added, "the research says the medicine lowers the risk by eighty percent." Standing up, she walked to the door. "Well test your blood in six weeks, then again in three and six months."
Regina looked up and took a shaky breath. "So if I make it to six months Ill be free and clear?"
Alex looked down at the floor. "Hopefully."
Regina nodded her head slowly, a faint smile lighting her face. "Then Ill chill a bottle of champagne, just in case."
Alex straightened her shoulders and looked at Regina. "You do that." She managed a small smile and walked out. She headed to the desk that ran the length of the nursing station and reached over the counter, pulling out the labels she needed for the vials of blood. She wrote down the information and looked up, watching as Sandy walked over to her.
"How is she?" The nurse asked.
Alex shrugged her shoulders. "Pretty shaken up." She stared down at her hands. "Damn, I shouldnt have let Marcus put that line in. Hes got such a damn cocky streak in him, thinks he knows everything."
"Alex dont blame yourself. That could have happened to anybody. That guy was out of his mind on drugs. It was a freak accident." Sandy sighed. "I wouldnt be surprised if that kid walks out of here today and doesnt look back."
Alex snapped her head around, a look of shock and worry on her face as she looked at the nurse. "She seems a lot tougher than that Sandy."
"Well see. She wouldnt be the first resident who ditched out, lord knows others have run from less than what shes been dealing with," Sandy said.
Alex realized that Sandy was also referring to Reginas ongoing problems with her boyfriend. The thought of him hurting Regina again made Alex think of several very painful things that she could do him. "Let that jerk come in here again and Ill make him wish hed never met her."
Sandy raised an eyebrow. "Since when do you care so much about your residents personal lives?"
"I dont," Alex answered quickly. "Shes a nice kid and she deserves better that that." Alex picked up the vials of blood and slipped them gently into her lab coat pocket. "If anybodys looking for me Ill be in the lab."
Sandy stood at the desk with a thoughtful look on her face as Alex walked away. "You say you dont care, Alex. Well see."
After she left the emergency room, Regina walked numbly up the back stairwell listening to her footsteps echo on the metal stairs. God, what a wretched day, she thought.
She walked onto the pediatric unit to check on a little boy that they admitted the day before. After reading his chart she just leaned back in her chair and closed her eyes, trying to fight back the tears. Damn, why did this have to happen? It was like some cruel joke was being played on her.
Thinking back, she hadnt realized how much Derrick had been manipulating her all along. That was until he proposed to her. A marriage proposal, of all the stupid things, she shook her head in disgust as she recalled him digging in his pocket for the box. She was glad she was walking away before she got caught in a worse situation. Regina suspected that Derrick was capable of much worse than what he had already done. She never expected him to get so angry, thought that he would give up and walk away, but his male ego prevented such a gesture of defeat.
So, she had six months of waiting, praying to god that she didnt develop the antibodies for HIV. What the hell was she going to do if she did? Would they still let her treat patients? How could she even tell her family? The thought struck Regina as ironic and she stifled a harsh laugh as she pictured herself telling her mother she was HIV positive. Gee mom, you were always so terrified your son would bring home the dreaded disease and disgrace you even more.
"Dr. Kingston?" A voice called out behind her, by the tone of it she could tell she hadnt heard it the first time.
Pushing her morose thoughts aside, she swiveled her chair around, and looked at the nurse. "Yes?"
"The kid you admitted yesterday is in room nine. I cant get him to calm down. Hes been crying and calling for his mother for an hour now." By the tone of the nurses voice Regina could tell that she was at the end of her rope and looking for someone to bail her out.
Regina frowned. "Have you called his mother to come in?"
The nurse folded her arms and her face darkened. "I would but we dont know where she is. She hasnt been back and her phone is disconnected."
"Oh." Regina stood up and walked toward the nurse. "Let me take a look at him."
"Actually, I wanted to know if we could give him something to calm him down."
Regina looked at her as she stepped around the corner of the desk, carefully avoiding a young girl who was walking down the hallway, dragging an IV pole along behind her.
"Page his primary doctor. I cant change his medication. Im not on his case anymore, you know that."
"I cant get a hold of him," the nurse said.
Regina walked down the carpeted hallway and into the cramped room, painted in a light blue color with a border of animal caricatures running around the top of the wall. Standing in the metal crib with the rails pulled up around him like he was in jail, was a light skinned, curly toe head with baby blue eyes. Both of his legs were wrapped in bulky bandages from his hips down to his feet. His voice was hoarse and he was wheezing as he sobbed and hopped back and forth on his bandaged legs.
"Momma!" The air whistled through his irritated throat. "Momma!" He wailed and rattled the bars with his chubby hands.
The nurse walked to the crib and looked at him sternly. "Justin, you have to calm down, sweetheart, youre gonna hurt yourself."
Regina pulled a pair of gloves onto her hands and walked up to the crib. She lowered the rail down and stepped close to the distraught child holding her arms out to him. "Whats wrong, Justin?" She asked.
He teetered on his feet and then crashed into her, wrapping his arms tightly around her neck. "Momma! I want my momma!" He cried and hiccupped into her shoulder.
Regina felt the heat coming off his fever-wracked body and wrapped her arms around him, cradling him against her chest. "Im sorry, love." Regina stroked his back, walked over to the rocking chair, and sat down. "Mommas not here Justin. We have to try and find her for you. Ok?"
The blonde head pulled back, wise blue eyes regarding her for a moment, and Regina felt the odd sensation that she was holding in her arms someone who had been this way before in life. Justin scrunched down against her and tucked his head under her chin. His wailing slowly stopped and his sobbing subsided to muffled whimpering and hiccupping. Regina looked up at the nurse who was staring at her. "Has social work called the DYFS yet?" The nurse nodded her head and slipped quietly from the room, relieved that the kid was no longer screaming.
Regina tilted her head back against the chair and rocked gently. She looked down at the blonde curls resting against her chest and smiled sadly. "Oh Justin, I think I need this as badly as you do." He snuggled closer and stuck his thumb in his mouth, clutching her around her neck with his other hand. Regina lowered her cheek to his head and let the tears roll down her cheeks unchecked.
After Justin cried himself to sleep in her arms, Regina stood up from the rocking chair and carried him back to his crib. She bent over, unwrapping his arms from around her neck and laid him gently onto his back.
"Youll be ok Justin," she whispered, and pressed her lips against his forehead. Justin squirmed and opened his eyes. His two chubby little hands reached up and held her cheeks.
"Flutterby kiss," he whispered, and Regina watched as he lifted his head and blew a kiss at her. She ran her hand over his curly hair and smiled sadly at him, then slid the side rail back up into place and walked out of the room.
Continued - Part 2
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