Chapter Four

Slamming the book shut, Regina jumped from her chair and walked hurriedly out of the medical library. Outside in the quiet corridor, she slipped into the staff bathroom. She vomited again for the fifth day in a row since she started taking the medication over a week ago. Leaning back against the door of the stall, she waited for the wave of nausea to pass, wiping a trembling hand over her sweaty brow. She moaned softly. "Oh, I need to get something to control this better."

So far she was able to get by without anyone noticing her sudden disappearances, but she knew sooner or later that someone would catch on and then she would have to deal with the questions that would undoubtedly follow. Leaning on the sink with her hands, she ran the water until it was icy cold, cupped her hand under the stream, then splashed it on her face and rubbed the back of her neck with it as well. Feeling her beeper vibrating against her waist, she cursed softly under her breath.

"Dammit." Regina looked down at the display and read the ER’s number. Fumbling with the button, she stopped the irritating sensation.

"Ok, ok. I’ll be there," she muttered. "Just need a couple of minutes." She leaned against the cool tile and closed her eyes against the dizziness threatening her.

Upstairs in the crowded and noisy emergency department, Alex examined and triaged another patient. "When did the pain start, Sally?" Alex leaned over the rails of the gurney and pressed her fingertips into the right lower quadrant of the thirteen-year old’s abdomen.

The girl winced and curled up into a tight ball on her side. "After I ate lunch."

"That was what, about two hours ago?" she asked, looking at the mother. The woman nodded.

"I’m going to order some tests and keep her here to observe her for a little bit," Alex told the mother.

"Do you think its appendicitis?" the woman asked.

"It could be but I don’t want to assume she’s a surgical candidate until I have the test results back." The attending started to leave the room, when one of the surgeons poked his head in.

"Heard you’ve got an appy here, Dr. Margulies. I can bring her up to the OR and take it out now."

She turned around and glared at him. "I’m not finished running the tests so I’m not sure it is appendicitis."

"Oh come on now." Stepping up beside the rails of the stretcher, he looked down at the sick girl. "I’m going to press on your stomach." His large hands pressed down into her tender abdomen. "Does this hurt?"

The girl cried out as he let go. "See! Classic rebound," he exclaimed. He looked down at the girl. "Do you think you could eat some apple pie?"

Alex pursed her lips and prudently stepped back. She heard the sounds of retching as the girl vomited into the emesis basin lying at her side, splattering the surgeon’s sneakers.

"I’ll book the OR," he said, looking down at his sneakers in disgust.

"You certainly will not." Alex grasped his elbow and led him out of the room. "You’ve got to be kidding me." She gestured angrily with her arms. "What kind of half-baked diagnostic test is that?" Several pairs of eyes looked up from the behind the desk in the emergency department. "You are not taking that child to the OR unless I say so." Alex leaned forward, her eyes narrowing as she stared down at the smaller, slightly bald-headed surgeon.

He shrugged his shoulders. "Have it your way. I’ll be here another hour. You’ll be calling me."

Alex shook her head in disgust and walked over to the desk. "Sandy, I need you to draw blood on the girl in room six. The orders are in the chart. Have the lab run a CBC with differential and a chem pro plus stat."

"Sure," The blonde haired nurse said, and winked conspiritally at her. "He’s an arrogant one, isn’t he?"

"I can’t believe he asked her if she wanted to eat apple pie. What an idiot." She looked at her watch and thumped her arm down on the desk in irritation. "Did Dr. Kingston return my page yet?"

The unit clerk looked up from the computer and shook her head. "No, I haven’t heard from her yet. I’m sure she’ll be down soon."

"I don’t need her now. I needed her thirty minutes ago."

The phone rang and the unit clerk turned away as she answered it. "I told you I was working all weekend. We need the money," the woman said.

Alex glanced down at the unit clerk and then looked over at Sandy. "Would you like to tell her boyfriend to stop calling or shall I?" Alex smirked evilly at Sandy.

"No – no, Alex." Sandy strategically pulled the phone out of Alex’s reach. "I’ll take care of it," she told her, waving her quickly away, knowing that if she let Alex intervene she would probably be short a unit clerk after today.

Marcus walked over to the desk and stood beside the Alex. "Dr. Margulies?"

Alex looked at the resident. "What is it you want Marcus?"

"Can you look at a patient for me?"

"Where’s Dr. Alfonso? Isn’t he supervising you today?"

"Yes, but he’s with a trauma patient in two. He told me to come find you."

Alex took the chart from him and flipped it open. "Fine, let’s go," she said, and started walking down the hallway.

"Dr. Margulies," Marcus said, hesitantly as they reached the room, "I’m really sorry about what happened to Regina last week."

Alex stopped, her hand about to push the door open to the exam room. "It’s not me you should be apologizing to, Marcus," she said, fixing him with an icy stare. After a moment of awkward silence, between them Alex stepped back and folded her arms over her chest. "So, tell me about this patient before we go in there."

Alex left Marcus with his patient after a brief discussion about the woman’s recent hospitalization, and the possibility that she might have a blood clot that needed to ruled out immediately with a Doppler study. She wasn’t the least bit pleased that he had needed as much guidance as he required and was beginning to wonder if he would be better off on a less demanding rotation.

Walking back down the hallway, she headed back into her patient’s room. Leaning over the stretcher, Alex checked the IV and felt the girl’s pulse. "How do you feel, Sally?" she asked, looking at the girl lying huddled under the blankets.

"A little better since I got sick."

Alex glanced over at the father who was watching her with his arms crossed tightly in front of him. "Her fever’s down. The blood tests will give us a better picture of what’s going on clinically. We’re going to observe her and see how she responds to the IV fluids. With the upper respiratory infection she had it’s quite possible that she has an inflammation of the lining around the intestines."

The man blinked and shifted his weight on his feet. "But it could be appendicitis?"

Alex nodded her head. "With her symptoms, it’s a remote possibility, but I’d rather not have her undergo surgery unless we’re absolutely sure about it." Alex turned to leave the room. "The nurse will be into check on her every hour. We’ll know if there are any changes that should be of concern."

Settling down behind a desk, Alex wrote some notes in the girl’s chart. Deciding she needed a cup of coffee to keep her awake, she stood up and walked to the staff lounge. On her way there, she ran straight into Dr. Kingston. Backing up a step, Alex folded her arms, blocking the shorter woman’s path.

"You didn’t answer my page," Alex accused her, staring down angrily at the resident. She was surprised and more than a little disappointed with her. Regina was one of her better residents and it was unusual for her not to be on top of things.

"I, uh, I’m sorry. I got down here as soon as I could," Regina said, feeling her face flush in embarrassment.

"That’s not good enough, Dr. Kingston. When I page you, I expect that you’ll at least return the call and let me know that you’re on you way. Even my first year residents know that."

"I…It won’t happen again," Regina said, feeling completely inadequate at the moment and stammering over her words.

"I don’t expect that it will."

A movement caught her attention. Alex cursed under her breath, and brushed past Regina. "Hey. Where are you taking this patient?" she demanded, stepping in front of the orderly and taking hold of the stretcher.

"The OR," he said, as if this were common knowledge. "She’s scheduled for surgery." He handed her the slip of paper.

After reading it, Alex crumbled the paper in her hand and threw it back at him. "Like hell she is." Her voice rose above the normal din in the emergency department. "Sandy, did those blood tests get back yet?"

"They just came in," the nurse called back to her, as she deftly avoided the man from housekeeping, who was mopping the floor around the desk.

"Let me see them." Snatching the lab report from Sandy, Alex read the lab values then picked up the phone. "Operator, page Dr. Allen to the ER stat." She slammed the phone back down into its cradle.

"Problem?" Regina came to stand next to Dr. Margulies, and looked up into doctor’s face.

"Yeah, I’ve got one of the surgeons poaching patients for the OR. This kid doesn’t have appendicitis." Alex turned around as she heard the ER doors bang open. Dressed in blue gray surgical scrubs, and an isolation gown thrown carelessly over his shoulder, the surgeon stomped down the hallway headed in her direction.

"This better be good Margulies. You pulled me out of scrubbing up for this case."

Alex bristled. "Dr. Kelly, there is no case," she said, crossing her arms and stepping in front of him. "What did you do? Sell the parents on the idea of removing the appendix to be on the safe side, and downplay the risks of anesthesia? You’re trying to steal this patient as a surgical case so you can pad your numbers."

Dr. Margulies stepped closer to the surgeon, pointing a finger at his chest. "She’s my patient and she needs to be observed first, not cut open. There’s no fever now and her white blood cell count is normal. She had an upper respiratory infection last week and you know damn well the intestines could be inflamed from that."

"Fine, you do that and I’ll speak to your medical director in the morning. You’re on thin ice here Margulies, remember that," the surgeon said, as he turned and stormed away.

"Dr. Margulies, he could be right." Regina’s voice was quiet.

Alex turned around, glaring contemptuously at the young doctor. "Dr. Kingston, I don’t recall asking for your opinion."

Regina took a step back and turned away. Alex’s words had been sharp and cut her deeply. She had only meant to diffuse things and ended up making them worse.

Regina picked up her stack of charts and walked toward one of the vacant triage rooms at the back end of the emergency department. She caught several people casting sympathetic glances her way and she was thankful when the door to the room closed behind her. Slumping into a chair, Regina pulled a pen out of her lab coat pocket. She stared at the wall twirling it back and forth between her fingers. Way to go, Regina. You really messed that one up.

Shaking her head, she pulled her chair up to the desk and opened the first chart. Putting her pen to the paper, she started to write, then stopped. Regina felt like she let Dr. Margulies down, but she would be damned if she was going to be yelled at in front of the entire department. Putting her palm against her face, she started to write.

It was several hours later before Regina was able to crawl out from underneath the mountain of paperwork she needed to complete. Most of it was filling out forms for the insurance companies and Medicare. It was amazing that with all the forms and questions that needed to be answered, that patients got treated at all some days.

Shuffling the papers together into an organized pile, she stacked them on top of the charts and carried them to the nurse’s station. Her attention was drawn to an angry voice behind her.

"Marcus," Alex said, as she bore down on the resident from across the department.

Wanting as much distance in between them and the angry doctor, several staff at the nurse’s station scattered out of the way. The resident looked up and recoiled physically as the tall imposing doctor descended upon him in all her fury.

"Y…yes Dr. Margulies?" he asked, trying unsuccessfully to sound confident.

Alex slammed the chart onto the desk and leaned over him, pinning him to the chair with her eyes. "Would you care to tell me about the patient in room four?"

Marcus reached for the chart to look at it, but Alex placed her hand down on the cover. "Ah, ah. Without the chart, Marcus."

He swallowed and looked down at his hands, which were trembling slightly. "He’s a forty-seven year old male. He complains of abdominal pain starting two days ago. No allergies, no recent illnesses or surgeries. I’m waiting for his lab results to come back."

Alex picked the chart up and flipped it open, setting it down in front of Marcus. "Very good, Marcus. I now know that you can copy the nurse’s intake," she said, pointing to the nursing flow sheet. "Did you ask this patient any other questions, or did you just assume the nurses would get it all for you?" Her voice rose higher with each word until she was shouting. Patients and staff alike averted their attention, embarrassed by the angry outburst.

"I…uh…I," he stammered.

"Enough! I want to see every single one of your history and physicals you write up before you put it in a chart." She turned to walk away, but stopped. "Oh, and Marcus, his medical history included illicit drug use and he’s been diagnosed with hepatitis C. Next time ask the damn questions yourself."

Alex stormed back toward the desk, stopping as Sandy held the phone up and pointed to her.

"Who is it?" Alex asked, obviously annoyed at the call.

Sandy mouthed a name to her and Alex rolled her eyes in disgust.

"I’ll take it in the staff lounge."

Regina listened to the heated exchange while she looked over two sets of lab results. Writing an order in a chart for a broad-spectrum antibiotic, she handed it to the unit clerk to enter into the computer. Taking a deep breath, she walked over to where Marcus was sitting.

Slumped forward over the desk, with his hands covering his face, Marcus shook his head and groaned audibly. Regina pulled a chair over and sat down beside the dejected- looking resident.

"Marcus, are you alright?" She asked. Her voice was quiet and gentle.

"Oh yeah, just great. Let me know if you see the other half of my ass that she just chewed off laying around anywhere."

Regina stifled a snicker and leaned back to look for the missing part. "I think everything is still intact, Marcus."

He shook his head and chuckled at Regina’s joke. "How do you deal with her, Regina? I mean, do you really like what you’re doing here?"

Regina sat up straighter and frowned at the question. "Well, yeah, I do, Marcus. Don’t you?"

He took off his glasses and rubbed his eyes with his fingers. "I used to think I did."

"What happened?" Regina rested her elbow on the desk and leaned forward.

"I’m tired of being responsible for people, Regina. I mean, I like to help them, but, I don’t know, maybe I’m just burned out right now. It doesn’t help having to deal with the likes of that bitch. I know I messed up in there. Its just, damn it, I can’t keep up with all this paperwork. She didn’t have to take me down in front of the whole department. That’s not right." Marcus put his glasses back on his face.

Regina squeezed his forearm in sympathy. "You’re a good doctor, Marcus. Don’t let her get to you. Shit, we all make mistakes."

"Yeah, I guess you’re right. Regina?" Marcus touched her arm as she stood up to leave.

"Yes?" She turned back to him.

"I’m really sorry about what happened last week. I should have listened to you before I stuck the guy."

Regina looked down at the floor and nodded her head. It was all the acknowledgement she could give him without becoming angry, and right now she really didn’t want to think about it. It was better to keep the whole incident tucked neatly away in the back of her mind. She walked purposely over to the desk and stood next to Sandy.

"Uh oh, I know that look, Dr. Kingston. What’s on your mind?" Sandy asked, while she printed out some discharge instructions for a couple of patients.

"Where’s Dr. Margulies?"

"In the staff lounge, taking a phone call." Sandy looked up at Regina. "You ok?"

"I’m fine," the young doctor answered. "Marcus isn’t."

Sandy nodded her acknowledgment of this. "Be careful Dr. Kingston, she’s not in a good mood."

"Neither am I," Regina replied, much to Sandy’s surprise.

Sandy raised an eyebrow and shook her head. Either the girl had a set of brass ones or she was crazy.

******

"When are you coming up here, Alex? You have to settle Lana’s affairs and you have power of attorney for her bank account," Dana complained from the other end of the telephone line.

Alex was leaning against the wall, arms crossed over her chest, with the phone cradled between a shoulder and an ear. "Dana, you know I’m coming up there in two weeks. What’s wrong? Are you running short on funds?"

"Very funny, Alex. Maybe you should be a comedian instead of a doctor," Dana retorted as she filed a nail with an Emory board.

Dana looked up as a solidly built woman with short-cropped, gel spiked, bleached-blonde hair that was spiked with gel walked through the door of her store. She wore several studs in one ear and a labrys hanging from the other. She was dressed in tight, faded, blue jeans and wore a white tee shirt. The woman flipped through several of the prints that were stacked on the floor and then turned her attention to the wall. Dana kept an eye on the woman. She didn’t look like she was interested in art.

"You know, you’re not the only one who loved her, Alex. Remember, you took her away from me - or have you conveniently forgotten that part of the story?"

"It was her choice to leave, Dana. I didn’t force her into anything," Alex said. She turned her back to the door as it started to open.

"Well, we all know how charming you can be when you decide you want something, don’t we, Alex." Dana’s attention drifted back to the woman, who’d walked to the back of the store. She was looking at the incense and candles that Dana kept on a shelf above the stereo system. The woman picked up a nearby book of matches and lit the candle at the right of the display.

Dana smiled to herself and walked over. She had a unique system for doing business. Four different colored candles stood on the shelf, each representing a specific drug: marijuana, heroin, cocaine, and ecstasy.

Dana walked past the woman and stepped through the curtained off hallway that led downstairs to the cellar. The phone connection filled with static as she walked down the wooden steps. "Alex…want…there…out the bank account." Dana winced as the quiet cellar erupted in a cacophony of yelps and barks as three German Shepard puppies awoke at once and circled around each other, begging for attention. "Shut up!" Dana growled and banged the crates with the key ring she was carrying as she passed them.

"I can’t understand you, Dana." Alex adjusted the phone. "Damn it, Dana. Are you listening to me?"

"Sorry love, bad connection," Dana said, enjoying the fact that she was really pissing Alex off. "Give me a second and I’ll be back upstairs." Dana unlocked the cabinet, pulled out a small, plastic bag of cocaine, and put it into a brown paper bag. She relocked the storage cabinet and walked back up the stairs.

Alex leaned her head against the wall and closed her eyes. She should have guessed that Dana was still selling drugs despite her insistence otherwise. "How can you still do that Dana? That store was Lana’s life."

Dana slipped through the curtain and took the fifty-dollar bill from the woman and handed her the bag. "Nice doing business with you," she said. "Don’t get righteous with me, Alex. Lana gave up any claim on this place the day she walked out on me. She left me to rot in jail - a dubious distinction you should have shared with me, Alex. You never paid for what you did. No, dear Alex has never had to pay for anything she’s done."

"This conversation is over, Dana. I’ll be up there in two weeks. Don’t call me at the hospital anymore. Goodbye." Alex hung the phone up. "Do you always listen to other people’s conversations?" she asked the person standing behind her as she turned around. If she was surprised to see Regina there, she didn’t show it.

Regina was standing at the counter with her arms crossed. "Not as a rule. Can I talk with you for a minute?"

"You’re here, talk," Alex said, still feeling anger and resentment at Dana’s phone call. Damn her, she knows just what buttons to push with me.

Regina unfolded her arms and walked to the table, putting her hands on the back of the chair and leaning into it. "I know I was wrong not getting down here right away when you paged me."

"You’re right about that, Dr. Kingston. You were." Alex fixed her cool gaze on the blonde.

Regina took a breath and launched in. "What I don’t agree with is the way you chose to tell me about it. I don’t appreciate being yelled at in the middle of department and in front of the other staff." Regina said. She took a breath, watching as Alex’s pupils dilated and her nostrils flared.

Knowing she just pissed the doctor off, Regina decided to go for broke. Why not? She’d be damned if she was going to let this woman walk all over her for the next four months. "It sure as hell doesn’t help anyone’s confidence knowing that if you make a mistake, retribution is quick and public."

"Is that all, Dr. Kingston?"

"No. Marcus didn’t deserve to have his legs taken off at the knees. You’re supposed to help the residents learn, not intimidate them." Regina didn’t wait for the doctor to respond. She spun on her heel and whipped the door open, slamming it into the wall, and beat a hasty retreat down the hall.

Alex stared at the door as it swung shut. She ran a hand through her hair and chuckled softly to herself. "Well, I’ll be damned." Walking out of the room, she headed to the administrative wing of the hospital.

Alex stood in the door of the director’s office, waiting patiently as she finished with a phone call. The blonde-haired woman waved her in and Alex sat in the leather chair facing the desk. She took the opportunity to look around the woman’s office, which was littered with reams of paper detailing the hospital’s vital statistics.

Dr. Cassandra Mitchard was one of the youngest Vice President’s at the five-hundred bed medical center. One of the first women at the medical center to break through the proverbial "glass ceiling" and wreak havoc on the old boy’s club. She didn’t subscribe to the fifth floor dress code to wear fashionable mini-skirts and pumps that satisfied the adolescent fantasies of the over fifty executive crowd. As Vice President of Medical Affairs, she learned quickly to play hardball, and ruled with an iron fist. Alex respected the woman from the moment she met her three years ago.

"It’s been quite a while since you’ve blessed us with your presence, Dr. Margulies," Cassandra said, giving her an appraising look. "What can I do for you?"

Alex sat forward in her chair. "I need some help, Cassandra. Dr. Jameson wants the statistics for the emergency room’s mortality rate for the last six months."

Cassandra nodded and leaned back in her leather chair. "And you want to know how you can put the little rat in his rightful place," she stated, as she let a wicked smile play at her lips.

"Subtle, very subtle." Alex tilted her head to the side and smiled at how easily Dr. Mitchard could read her.

"You can’t blame me for wanting a little revenge, Alex. He didn’t just screw you last year with that bogus charge. He dragged the entire organization through the coals. He thinks his political connections are strong enough to protect him but, he’s wrong. Dead wrong." She leaned forward and opened up a binder of reports and thumbed through the pages until she found what she was looking for. "Here, look at this. At first glance, Alex, you look like the grim reaper." She flashed her an apologetic grin and went on. "But, look a little deeper and you, Alfonso, Torres and Washington account for eighty-five percent of the emergency room department admissions a year. Do you know how many people came through our doors last year, Alex?"

"We had twenty seven thousand admissions into the emergency department," Alex replied.

"Exactly." She scanned the sheets. "You and Torres take the most severe traumas, partly because you are chiefs but also due to just blind luck. Your average acuity rating is three, with the most severe traumas being rated a four. That more than justifies the mortality rate that the two of you have. Now just for shits and grins, let’s take a look at what dear Dr. Jameson’s stats look like."

Alex shook her head. "You’re evil, Cassandra."

"No more than you, Alex. No more than you." The VP pointed triumphantly at the sheet in front of her. "Look. He sees approximately twenty- three patients a day. That’s an average of nine less than the rest of you. Now look at his mortality rate and his average acuity rating."

Alex sat back in her chair and stared at the doctor. "Shit."

"How you choose to present this information is entirely up to you, Alex. You can make these numbers say just about anything you want." Cassandra booted up her computer. "Do you have a computer you have access to?"

"Yeah, the medical staff office has two with Microsoft Office running on it," Alex said.

"Took them long enough," Cassandra responded. She pushed a disc into the floppy drive and copied several files to the disk. "This has all the information you’ll need. By the way, I’ll be at the next Mortality and Morbidity meeting. I hope you’ll make it worth my while to attend."

Taking the disk from Cassandra, Alex saluted her with it, and sauntered out of the fifth floor suite. Battle lines had been drawn.

******

As luck would have it, Regina was mercifully paired with Drs. Torres and Washington over the next two weeks and saw little of Dr. Margulies. When she did see the Chief Attending in passing, Regina felt invisible to Alex as she stared right through her, unseeing. Regina wavered between seeking Alex out and apologizing for yelling at her and deciding emphatically that the witch deserved her anger for lashing out at her and Marcus. After all, this was a teaching hospital and neither of them had done anything to threaten a patient’s life.

Today after the M and M conference the rotations changed again and she would be back with Dr. Margulies. Regina walked into the mahogany paneled conference room and took a seat next to Marcus.

"Hi Marcus." Regina nudged him.

"Hi, yourself. I hear we’re back with the queen bitch again today," he said, and yawned without bothering to cover his mouth.

"Ooh, nice tonsils Marcus," Regina commented.

"Sorry, I didn’t get much sleep the past few nights. As soon as they turn the light off I’m history. Wake me when it’s all over." Marcus crossed his arms and sunk down lower in his seat waiting for the lights to dim.

The conference room filled up with medical staff, and the hum of people talking over each other engulfed the room. After a few minutes, a rather tall, athletically built man wearing an expensive looking gray suit took the podium. He tapped the microphone and cleared his throat as if this would give him the attention of everyone gathered in the room.

"Excuse me," he said into the microphone. "We’d like to get started now."

"Ugh, he looks like a weasel with that moustache," Regina leaned over and said to Marcus. He opened his eyes and snorted.

A hand clamped down on both their shoulders and a deep baritone voice rumbled in their ears. "That weasel happens to be our medical director, Dr. Jameson."

Regina and Marcus turned in their seats to see Dr. Washington and Dr. Margulies standing behind them. Alex remained silent but her eyes met Regina’s and the young resident quickly faced forward in her seat feeling her face redden from the intensity of the look radiating from the doctor’s eyes. Oh shit, I’m in trouble.

A moment later, Regina watched as Alex walked past them to the front of the conference room and handed a carousel of slides to the man in charge of the audiovisual equipment. Studying the Chief Attending, Regina observed that Alex was dressed in a dark blue linen suit, quite unlike her usual attire of scrubs and lab coat, and although Alex seemed oblivious to it, she made a stunning impression to the crowded auditorium.

"Way to go, Kingston." Marcus nudged her, pulling Regina out of her quiet observation.

"I’m already toast with her." Regina waved her hand and sunk down in her seat next to Marcus.

They turned their attention to the medical director standing at the front of the room beside Dr. Margulies. "I’ll turn the microphone over to Dr. Margulies so she can get on with her presentation. I’m sure your statistics about the mortality rates in the emergency department will be most enlightening for us all."

"Oh, he is so smug," Regina said.

Marcus leaned over and whispered in her ear. "The rumor mill has it that he is trying to run Dr. Margulies out of here. Supposedly our illustrious chief attending has a notoriously high mortality rate. He’s using this to put one more nail in her coffin." Marcus closed his eyes again as the presentation moved forward. "As far as I’m concerned they can bury her alive."

Regina stared at Marcus and then focused her attention back to the drop down screen at the front of the conference room. Regina glanced around the room and noted that most of the medical staff that could attend looked fairly interested and others, mostly residents and interns were using it as a chance to catch up on their sleep.

"I’m sure they will, Dr. Jameson." Alex drawled, taking the microphone and striding confidently to the center of the floor. "So everyone knows up front, these statistics were compiled from Information Resource Management and the Office of Medical Affairs. They required very little modification because Dr. Cassandra Mitchard oversees the project." She looked around the room and smiled at Dr. Jameson who seemed to be a shade paler now, than when she started. "Well, if someone will dim the lights, let’s get started."

Alex calmly took the group through a quick but thorough explanation of the statistics as the slides flicked up on the screen. The atmosphere in the room seemed to intensify as the next several slides depicted each of the five doctors’ mortality rates in the emergency department. Regina cringed when she saw Dr. Margulies’ statistics outlined in blue showing her leading the way with thirty deaths for the previous year. A murmur went through the crowd and Regina found herself listening intently to the doctor’s strong voice as it carried through the conference room. Even Marcus roused himself from his slumber enough to focus on the doctor’s words.

"Myself and Dr. Torres have the dubious distinction of having the first and second highest mortality rates in the department respectively. Dr. Washington and our medical director, Dr. Jameson have the two lowest. I think what you will find most interesting is the average acuity factor combined with the number of the patients treated by each of us." Alex’s voice trailed off as she advanced the slides and she set the microphone in its holder on the podium.

A snicker came from behind them and Regina turned to see Dr. Washington’s shoulders shaking as he tried hard to keep from laughing out loud. Regina turned back to the screen and stared at it in shock. Marcus grabbed her arm and shook it to get her attention.

"Holy shit. Dr. Margulies just turned the tables on Dr. Jameson. Look, he’s still trying to figure out what the slide says," Marcus said, looking at the incredulous look on the medical director’s face.

"Jesus. He’s been taking the easy cases and his mortality rate is close to Dr. Margulies’," Regina said, as she studied the screen.

Regina missed Alex walking past and slipping in beside Dr. Washington. It wasn’t until she felt a light touch on her shoulder that Regina turned around and saw the doctor’s penetrating blue eyes watching her, did she realize that she was there.

"I need to speak to you later, Dr. Kingston," Alex said, as she stood up from her chair.

Regina nodded her head, keeping her tongue in check, as she surely would have choked on it if she tried to answer her at that moment. She watched as Dr. Margulies walked away, her long legs carrying her confidently out of the conference room.

"She needs to talk to you?" Marcus asked Regina.

"I’m dead, Marcus." Regina slumped lower in her chair. "You know that coffin you were talking about?" He nodded his head. "Well, keep it handy. I may need it later."

"Regina, what did you do?" he asked, growing concerned that his one ally was in serious trouble.

"I yelled at her after she reamed you out in the department." Regina twisted her hands and looked up at Marcus.

His mouth gaped and he stared at her. "Well, thanks, but what the hell did you go and do that for?"

Regina shook her head. "I don’t know. Call it temporary insanity. Anyway, wish me luck."

Chapter Five

Regina pressed the button on her watch, silencing the alarm she set to remind herself to take her medicine. She pulled the round metal pillbox from her scrub pocket and opened it. With a grimace, she popped two pills into her mouth and bent over the water fountain, pushing the button and sucking in the stream of cold water.

She took a break while she had the chance and walked up to the pediatric floor, heading toward Justin’s room. She had become quite attached to the boy since she admitted him to the hospital over a month ago. Regina felt the same gut wrenching feeling now, remembering the night of Justin’s admission as she had when the police officers told her the boyfriend had dunked Justin in scalding bath water as punishment for crying too much. A neighbor had called 911 when he heard screams coming from the apartment next door. Neither the boyfriend nor the mother had been to the hospital since Justin was admitted to the trauma unit.

Regina stopped outside the door and peeked into the room. Justin was sitting in his crib with his back to the door. She could see him clutching a small bear as he rocked back and forth trying to calm himself. Regina walked up to the crib and called his name softly.

"Justin."

The curly blonde head lifted and turned slowly. A wet tear stained face met hers and she slid the bars down. Justin turned around on his knees and crawled to Regina. His little hands reached out, grabbing the lapels of her jacket, pulling himself up so he was face to face with her.

"Regi." He had a hard time pronouncing her name and it came out with a hard g sound.

"Hi sweetheart." She gathered him into her arms and gave him a hug. "Let’s you and I take a walk."

A lower lip protruded in a display of protest.

"Justin, do you want to be able to play with your friends when you go home?" Regina asked.

Blue eyes blinked back at her and he nodded his head.

"Well, that won’t happen if everyone keeps carrying you around with them." She lowered him to the floor. Justin clutched her fingers and whimpered as he took a few tentative steps. Slowly, he gained confidence and he walked toward the door teetering on his still heavily bandaged feet. Regina patiently walked along side him as he made his way out of the room and headed to the nurse’s station.

"Ok, you have to be good," she said, picking up one of the toys lying on the desk to hold his attention.

The nurse sitting at the desk turned her chair around when she saw Regina and smiled at her. "He’s going to break your heart you know."

Regina looked up and smiled sadly at her. "He’s worth it. Aren’t you Justin?" She touched his nose with her finger.

He looked up at her and he stuck his fingers in his mouth, clutching the stuffed animal to his chest with the other hand. Unlike the other children on the floor, who gradually came out of their shells, as they got better, Justin remained quiet and withdrawn, responding cautiously to the affection that the staff displayed with him.

Regina felt a vibrating against her waist and looked down at her beeper. She tilted the screen so she could read the number. It was the emergency room. With a sigh, she picked up the phone and punched in the five-digit extension. A voice at the other end picked up.

"This is Dr. Kingston. Somebody paged me."

"Hang on let me check." Farther away from the phone, she could hear someone shouting. "Anybody call a Dr. Kingston?" She was put on hold and she bounced Justin on her knee getting him to giggle and clutch her jacket for support.

"Dr. Kingston?" The unit clerk got back on the phone. "There’s a patient coming in from a car accident. Dr. Margulies is with another patient and can’t take it."

"Ok, I’m on my way," Regina said.

She looked at Justin. His blue eyes blinked at her and his lower lip protruded into his hallmark pout. "Oh no," Regina chuckled. "You have to stay here. I’ll see you later Justin." She led him over to the nurse at the desk and handed him off to her. "Hey, any word on getting him foster parents yet?"

The nurse looked up at her and shook her head. "The mother showed up a couple of days ago. She went into drug rehab after the social worker told her they were going to find foster parents for him if she didn’t. The hospital is going to release him as soon he is ready to go home."

Regina’s jaw dropped. "When will that be?" She asked.

The nurse shrugged her shoulders "That’s up to the surgeons. They’ll probably look at his wounds today."

"Just like that?" Regina looked down at the innocent face staring back at her.

The nurse nodded her head and scooped Justin up into her lap.

Regina walked off the pediatric unit and headed to the back stairwell. She ran her fingers lightly along the metal banister as she trotted down the gunmetal gray stairs. She made her way down to the emergency department and jogged through the double doors. The unit was busy. All the rooms were full and there were two patients lying on stretchers in the hallway waiting to be transported to one of the medical floors. She saw Sandy bent over the two-way radio frantically scribbling notes in the admission log. Slamming the phone down, the nurse waved Regina over when she saw her.

"We’ve got an MVA, five minutes out. The guy took the steering wheel in the chest." Sandy hustled around the desk toward one of the trauma rooms. "He was conscious at the scene but they lost his pulse." Sandy looked over her shoulder at Regina who was following her. Stopping at the board, Sandy ran down the list of names, quickly making a decision about which patient she could move out of the emergency department to free up a room.

"Excuse me." Sandy and Regina turned around. "Can you tell me where my wife is? I got a call that they brought her here." Sandy pointed down the hall toward the nurse’s desk.

"The woman behind the desk can help you sir," she directed. Returning her attention to the board she made up her mind.

"Thomas!" She called out to the lanky emergency room technician. "Help me clear out room seven."

He glanced up at the charge nurse and with an aggrieved sigh pushed himself up from his chair at the desk.

"Now, Thomas," Sandy said, glaring at him. "We’ve got five minutes to set up for a major trauma. Get the patient into the hallway and call bed management. Tell them to get off their asses, we’re not a hotel down here." Sandy looked at Regina and flashed her a grin. "Don’t worry, we’ll be ready for you doc."

Regina slipped past the charge nurse and started pulling on an isolation gown then grabbed a fluid shield mask. She could hear the wailing of the sirens grow louder as the rig turned into the hospital’s drive and headed down the hill toward the ER entrance. Pulling on a pair of gloves, Regina met the paramedics at the doors.

"We need some help in here. We’re losing this guy!" The ambulance driver shouted frantically.

Regina’s pulse accelerated as her adrenaline kicked in. She caught a glimpse of dark brown hair and an ashen looking face.

"What’ve we got?" Regina asked, taking hold of the stretcher and running along side.

"Thirty-five year old male, head on collision, steering wheel to the chest, no seat belt on. He was conscious at the scene but we lost his pulse three minutes ago." The paramedic was already straddling the patient on the stretcher compressing his chest as he gave the vitals to the resident.

Sandy was just hooking up fresh tubing to the ventilator when they rushed the patient through the trauma room doors. The room was prepped. Two IV poles with bags of ringer’s lactate were standing at the head of the treatment table, EKG leads were laid out on a tray with a chest tube and blood gas kit nearby.

The paramedic stopped compressions and quickly scrambled off the stretcher. Five pairs of hands grasped the backboard. "On my count, one, two, three," Regina said. "Easy, easy." In one smooth motion, the patient was lifted off the ambulance stretcher and onto the treatment table. The paramedic resumed compressions. Sandy disconnected the bag they were using to ventilate his lungs with and hooked the endotracheal tube to the ventilator. Immediately, the rhythmic whoosh and beeping of the ventilator took over breathing for the injured man. Thomas quickly slapped the leads on the patient’s chest and connected the EKG wires to the cardiac wall monitor.

Regina slipped the stethoscope over the patient’s chest listening intently. "Stop compressions." She looked at the monitor. "We’ve got a normal rhythm." She could hear breath sounds on the right side, but the left was diminished. Sliding up to the head of the table Regina loosened the tape holding the endotracheal tube in place.

Withdrawing the tube, a couple of inches she grabbed hold of the paramedic’s hand and clasped it around the tube. "Hold it there." Slapping the stethoscope back down over the chest Regina confirmed her diagnosis. "He’s got a pneumothorax on the left. I need a chest tube kit and get a blood gas on this guy." She re-adjusted the endotracheal tube and then, moved the stethoscope now listening for the heart sounds. They were distant, almost muffled sounding.

"No pulse," Sandy said, her fingers over the carotid artery in his neck feeling for a pulse.

Regina looked up at the medical student standing by the foot of the stretcher. "Andy, start compressions."

Eager to help out the medical student ran over to the stretcher, crossed his hands over the patient’s sternum and started pumping on the chest.

Dr. Washington pushed the doors open and ran into the room already dressed in his protective garb. "What do we have?"

"He needs a chest tube on the left," Regina replied quickly, continuing her exam.

"Give me a scalpel," Dr. Washington said, holding out his hand. Thomas reached across the stretcher, handing him the instrument.

"Let’s get two peripheral lines going wide open. Sandy, get a Dopamine drip started. Thomas, draw blood for a CBC, lytes and tox screen, type and cross-match for four units." Regina ordered. "He needs a foley catheter and call radiology for a cross table c-spine."

Sandy ran to the code cart and broke open the plastic lock. She yanked out a handful of syringes and drug ampoules. There was a flurry of activity as Regina’s orders were carried out around her. One of the other nurses in the room inserted the IV lines while Sandy set up the drip that would sustain the patient’s blood pressure.

Regina was busy running her hands down the man’s head and neck looking and feeling for anything that might be abnormal. She noticed the obviously distended jugular veins in the man’s neck and immediately, she knew it meant that his heart muscle was damaged and blood was filling the sac around it effectively choking the muscle. "Sandy I need a fifty cc syringe with a 16-gauge needle and call the OR. Tell them we’ve got a possible cardiac tamponade coming."

Dr. Washington glanced up quickly. "You sure about that?"

"Yes, he’s got jugular distension and his blood gases aren’t responding with the chest tube."

Sandy tossed the packaged syringe to Regina then grabbed the receiver off the wall phone. Regina ripped the packaging off the syringe and land marked the tip of the xyphoid process at the end of the sternum with her gloved fingers as Sandy was dialing the number for the OR. Thomas leaned over and squirted betadine on the patient’s chest.

Her hands trembled slightly and she took a steadying breath as she checked the monitor again. "Andy, stop compressions." She was very aware of everyone’s eyes watching her and waiting. As the medical student stepped back, Regina pierced the skin, angling the syringe up towards the heart. She pulled back on the plunger, guiding the needle with steady pressure from her hands.

Crimson blood spurted into the syringe rapidly filling it and she held the needle steady.

"Nice call, Kingston." Dr. Washington looked up from suturing the chest tube into place.

"What’s his pressure?" Regina asked, feeling some of the tension slide away with the knowledge that she had made the right diagnosis and bought the patient a few more minutes. She knew the blood would keep re-filling the sac around his heart.

"Eighty over fifty." Sandy said.

Dr. Washington was just finishing suturing the chest tube in place when the surgical team arrived. To Regina it seemed like forever, but in reality it had been minutes since the patient arrived in the emergency department. Within a matter of seconds, they got a quick history and then patient was whisked away to the OR to try to repair the damage to the heart.

The quiet trauma room was in stark contrast to the chaos that was present minutes before. Regina’s shoulders sagged as the adrenaline left her body.

"Nice job, Regina." Dr. Washington stripped off his gloves and gown tossing them into the garbage, then walked out of the room following another stretcher as it was rolled past the room.

Sandy walked over to her and patted her on the shoulder. "Twenty-two minutes, that’s damn good, Dr. Kingston." Regina stared blankly at Sandy as she bent over to pick up the bloodied gauze and packaging that scattered on the floor. Sandy looked back up at her. "Dr. Margulies is the only one who has broken twenty minutes for getting them in and out of the ER as fast as that."

"I wasn’t aware there was a competition for fastest triage and transfer to the operating room." Regina said, rolling her eyes. Thirty minutes was their cut off in the ER, anything above that and they were wasting the so-called ‘golden moment’ and would most likely have their heads handed to them on a platter.

Dr. Jameson strode through the doors. "Dr. Washington just told me. Good pick up on the tamponade, Dr. Kingston."

"Thanks," Regina replied, as she pulled the bloodied gloves and isolation gown from her body. She threw the gown into the dirty linen bag and walked to the sink to wash her hands.

"I’ve known plenty of more experienced doctors who thought they could perform a thoracotomy in the emergency department. Usually it’s not a good idea." Dr. Jameson walked up behind her.

Regina leaned on the sink feeling a wave of nausea roll through her. She splashed some water on her face, only half listening to the medical director’s words.

"Ah, doctor Margulies." Dr. Jameson turned and eyed her as she walked through the doors. "I was just telling Dr. Kingston here about that unfortunate incident you had last year in the emergency department."

Regina looked up from the sink in surprise and saw Alex standing by the door still in her bloodied scrubs from the last admission. Her face was expressionless, arms folded across her chest as she looked at Dr. Jameson.

"Yes, I think that fiasco made it all the way to the medical examining committee." Dr. Jameson turned to Regina. "Did she share that with you yet Dr. Kingston? Well?"

Regina looked away from Alex suddenly feeling that she had unwittingly stepped into the middle of some battle. "I…I don’t know what you’re talking about," she lied.

"It’s quite an interesting story. You should share it with her sometime, Alex." His eyes flicked to the attending and narrowed. "Too bad you weren’t as competent as your resident here, Alex. Might have been a different outcome for the mayor’s son."

A hush filled the room and suddenly, the ticking of the clock and the drip of water from the faucet into the stainless steel sink seemed to grow louder. Regina moved away from the sink, muttered something about having another patient to check on, and made a hasty retreat from the room, leaving the two doctors facing each other.

Alex locked eyes with the medical director and for a moment, she contemplated sending him through the glass doors for his asinine remarks. She’d been exonerated of any wrong doing that night. In fact, the medical review board found the charges that Dr. Jameson made to be frivolous. Alex stepped closer to the medical director fixing her eyes on him. She could see his throat work as he swallowed nervously.

"Now’s your chance Alex. Nobody else is around," he said, goading her.

"Is that was this is about?" she asked, stepping closer so he had to look up at her. "You want me out of here. Well, you’re going to have to do a better job than this Jim," she drawled. "Besides, that’s ancient history." She turned and headed toward the door. "You know you’re dead wood as far as the administration is concerned. It’s just a matter of time before they ask for your resignation, you know, invite you to leave." She smiled over her shoulder as she let the door slam noisily behind her.

Regina walked unsteadily over to the nurse’s station thankful to have escaped the unfolding drama in room seven. The hostility between the two doctors was palpable and she was sure Dr. Jameson was trying to gain her support against Dr. Margulies. She heard rumors from the nurses that his job might be on the line and he was working hard to deflect any scrutiny away from him. She made a mental note to stay as far away from that situation as possible.

She entered her id number into the computer and flicked through several screens with the penlight until she came to her list of patients. She ran through the list, clicking on several names to check on pending lab results. Grimacing, she felt another wave of nausea sweep over her. Oh lovely, right on cue, an hour after every dose. Regina reached a hand out steadying herself against the monitor in front of her as she felt herself break out into a cold sweat. Damn.

Glancing up at the doctor, the unit clerk touched her arm. "You ok, Dr. Kingston?"

Regina nodded her head and swallowed hard. "Fine, just fine." She became aware of a warm presence at her back and turned her head slightly to see who was behind her. Her heart rate quickened as she saw the dark hair and the piercing blue eyes regarding her patiently.

"I need to talk to you," Alex said, looking down at her.

Regina mentally cursed herself, knowing that this was most likely her comeuppance for yelling at her chief attending. She kept her interactions with the brooding doctor to a minimum since that episode a couple of weeks ago in the hopes that she could avoid another confrontation.

Regina braced herself for the worst. "Ok." She turned slowly around so she was facing Alex.

Alex lowered her eyes for a minute and then looked back up at Regina. "Not here. In the staff lounge," she said, nodding her head in that direction.

Regina felt her stomach drop and her palms started to sweat. Shit. She waved her arm in front of her. "Lead the way." She was aware of several people giving her wary glances as she walked by them.

Alex held the door open for her and motioned her into the room. Regina walked past her and crossed her arms over her chest.

"Ok, so what did I do now?" she asked, turning to face Alex with as much bravado as she could muster. "It must be pretty bad since you didn’t just filet me out there in front of everybody."

Alex’s eyes widened slightly and she took a breath. "Sit down," she said, indicating the chair next to Regina.

"I’d rather stand, thank you," Regina said, feeling her heart pound a little faster.

Alex shrugged and sat on the stool. "Suit yourself." She folded her hands letting them hang down between her legs. "What makes you think you did anything wrong?" Her voice was quiet.

Regina let out a nervous laugh. "Dr. Margulies, I haven’t worked here very long, but I’ve learned one thing very quickly: You don’t talk very much, but when you do its usually because somebody’s screwed up and you’re here to let them know about it." Regina took a breath. Shit, why do I have to ramble so much when I get nervous? "So?" Her head was pounding and she desperately wanted to get this over with.

Alex rolled her eyes up to Regina’s. "I wanted to apologize for how I spoke to you that night in the in the hall. I was upset about something and I took it out on you. I’m sorry."

Regina groaned inwardly as the doctor’s mouth started to move. "Excuse me?" she asked, convinced she heard wrong.

"I said I wanted to apologize to you. I shouldn’t have spoken to you the way
I did. You were right." Alex repeated, frowning as she watched Regina’s complexion pale.

Regina closed her eyes and swayed slightly. Her stomach was threatening an all out revolt and she stepped back away from the chair and headed to the door. She could feel the color drain from her face as she ran past the doctor sitting on the stool.

"Dr. Kingston?" Alex raised her eyebrows, and turned on her stool as she watched Regina’s reaction in obvious confusion. The young doctor ran across the hall to the bathroom and pushed the door open.

Regina stumbled through the stall door. She braced herself over the toilet and vomited. At least when this happened in college it was because I’d been praying to the porcelain goddess, promising I’d never drink that much again. Regina flushed the toilet and stood up, steadying herself against the metal door. She staggered to the sink still feeling lightheaded and ran the cold water, cupping her hands and splashing it over her face with trembling hands.

"Regina?"

The resident jumped at the sound of her name, unaware that Alex followed her into the bathroom. She grabbed onto the sink to stay upright as the room spun with her sudden movement. Raising her head, she saw the reflection of Alex standing behind her with a concerned look on her face.

Regina groaned and bent over resting her head against the sink. "Oh god. Why is it you always see me at my worst?"

Alex stepped beside her and looked at her eyes closely. "Did…I…I upset you that much?"

Regina almost laughed. "Don’t flatter yourself. No it’s…" She didn’t finish the words as she stumbled back to the stall as another bout doubled her over. This time strong hands were there to steady her as she stood up and walked unsteadily back to the sink. "It’s the medication."

"How long has this been going on?" Alex demanded.

Regina leaned against the coolness of the tiles and closed her eyes. "A couple of weeks. I got something from one of the other doctors, but it hasn’t helped much," she said weakly.

"Why didn’t you tell me? I could’ve given you something to stop it," the taller woman said.

Regina opened her eyes and cocked an eyebrow at her. "No offense Dr. Margulies, but you weren’t top on my list of someone to ask for help."

Alex fingered the ties of her scrub pants looking at them intently. "I guess I deserved that, huh?" she asked, feeling badly that Regina hadn’t told her that the medication was doing this to her.

Regina nodded. "That and maybe a stronger dose of Haldol."

"Ok, point taken." Alex knew how most of the staff felt about her. She really didn’t care that much. She’d never viewed any of them as friends, so if they thought she was a bitch it was their problem. "Hey!" She stepped forward and caught Regina as she slumped to the floor.

"Ungh. Oh, this feels awful. It’s not usually this bad." The young doctor clutched her head, as the throbbing got worse behind her eyes.

Alex knelt down in front of her and lifted Regina’s chin with her fingers, looking at her face. "You’re probably dehydrated. I’m going to get you something that will take care of the nausea and then you’re going home."

Regina pushed her hand away, embarrassed by the attention she had drawn to herself. "I can’t go home. I’ve still got patients to see," she objected.

Alex shook her head. "Not today you don’t. Marcus and the others can take care of them for you. Come on."

Regina reluctantly let herself be pulled up from the floor and led from the bathroom toward one of the exam rooms.

"This is stupid," she complained, still feeling woozy and stumbling as her feet refused to cooperate. Alex wrapped one arm around her waist and the other was holding her elbow as she directed her to one of the stretchers.

"Lay down," she ordered, as she set Regina down on the stretcher. Alex rolled up the sleeve of Regina’s lab coat and wiped her skin with an alcohol pad.

"Hey, what are you doing?" Regina protested, struggling to sit up.

Alex put a hand on her shoulder and pressed her back down to the stretcher. "I’m giving you some IV fluid. It’ll make you feel better until I get the medication for you. Stay still." Alex felt for the vessel and slipped the needle inside holding it in place until she secured the IV catheter with some tape. "There."

Regina raised her head looking down at her arm in surprise. "You did it already?"

Alex grinned at her. "Yup. Relax." Hanging the IV bag from the pole she patted Regina’s shoulder. "I’ll be back in a little bit." She pulled a blanket out of one of the cabinets and tossed it over Regina’s legs.

Shivering, Regina reached down and pulled the blanket up over her shoulders. The fluids from the IV were making her chilly. The door opened and Regina watched as Sandy walked into the room.

"Hey, you ok, Dr. Kingston? Al…Dr. Margulies said to come check on you." She leaned over the rails of the gurney and felt Regina’s forehead.

"Yeah," Regina said. Her voice was shaky.

"Dr. Margulies is getting Marcus to cover your patients for you." Sandy smiled and stepped closer. "So what happened?" Sandy leaned on the rails of the stretcher with her arms crossed. "We thought you were a dead woman when she asked you to go into the lounge with her."

Regina shrugged. "It was so weird. I thought she was going to yell at me. She actually apologized for reaming me out in front of the department."

"She what?" Sandy asked. Her jaw dropped. "My god, hell must have frozen over. The infamous Dr. Margulies apologizes?" She started to say more, but the door opened and Alex walked in carrying a white bag from the employee pharmacy.

"Here, this will make your nausea better." She thrust the bag at Regina and shot daggers at Sandy, who squeezed Regina’s arm and backed quickly out of the room winking at her from behind Alex’s back.

"Thanks." Regina tried to sit up, but the room tilted crazily around her and she slumped back to the pillow with a groan.

Alex stood awkwardly at the side of the stretcher. She checked the IV bag and adjusted the flow of the fluids. "I took care of getting Marcus to cover your patients."

Regina looked up at her. "You don’t have to stay here, Dr. Margulies. I can take this out when it’s done." She motioned to the IV and letting her hand drop weakly into her lap.

"Stop with the ‘Dr. Margulies’, you’re making me feel old. Call me Alex." She gripped one of the rails on the gurney and looked down. "You look as white as a sheet. Besides, you didn’t drive to work, did you?"

"H…how did you know that?" Regina asked.

"I saw you this morning when I came back from running. You were walking across the street. You live up in the apartments on the hill?"

"Yeah, I do." Regina was a little shocked that Alex seemed to know this much about her. She blinked and took a breath, trying to get her vision to cooperate.

"Let me get my Jeep and I’ll give you a ride home," Alex said and left the room before Regina could utter a protest.

She must have closed her eyes and dozed off again, because when she opened them Alex was bending over her arm removing the IV.

"I need to get my bag," Regina said as Alex put a band-aid over the tiny hole left by the needle.

"Ok." Alex stood at the edge of the stretcher looking down at her.

Regina tentatively swung her legs over the edge of the stretcher and sat up. After a moment the wave of dizziness passed and she tried her legs, which surprisingly held her up, even though she felt like they were made of rubber.

At her locker, Regina fumbled with her lock and managed to open it after a couple of tries. She pulled out her backpack and slipped it over her shoulder, then shut the door and let Alex guide her out to her Jeep.

It was a cobalt blue Grand Cherokee with tinted windows, not one of the newer models, Regina noted, slightly surprised. Most of the doctors on staff drove only the newest cars. You could tell what the new models from the car dealerships were by just looking in the doctor’s parking lot. Alex pressed her remote and the Jeep chirped as it unlocked itself. She opened the door and helped Regina up into the leather seat. Shutting the door, Alex jogged around to the other side, and got in.

"Ok, just tell me which street you live on," she said as she pulled the vehicle out of the emergency entrance and drove up around the traffic circle to the light. She waited until it turned green and accelerated across the intersection, muttering to herself as she slowed to a stop as a family of Canadian geese started to cross the road that led into the development. Drumming her fingers on the steering wheel, Alex counted five of the little things.

Regina giggled as she watched them. "They’re cute."

"No they’re not." Alex said. "They’re nasty, dirty and make a mess."

"Yeah, I guess they do." Regina watched the last one of the little yellow fluff balls hop up onto the curb. "I’m the third street up on the left."

Alex nodded and turned on her signal before making the left turn. Regina pointed out her driveway and Alex pulled up to the garage and turned off the ignition. Opening the door, Regina stepped down out of the Jeep, grabbing hold of the door to steady herself as her legs threatened to give out on her again. Slowly, she made her way to the door of the condo, Alex following, carrying her backpack and the medication. Regina unlocked the door, pushed it open, and stepped inside.

"You can put my bag on the couch," she said, as she walked straight into the bathroom and shut the door.

Alex winced as she heard wretching noises from behind the door. A few minutes later, Regina walked back into the living room, wiping her face with a wet towel, holding onto the wall for support.

"It’s never been this bad." Regina made her way to the couch and sat down holding her head between her legs.

"Where are your glasses? I’ll get you some water."

Regina raised her head and squeezed her eyes shut as the sudden movement made the room swim around her again. "First cabinet on the right. Oh, I’ve got to stop doing that."

"Doing what?" Alex asked, looking back at her.

"Moving my head so fast. I keep getting dizzy."

She heard the sound of the cabinet door open and close, followed by the sound of running water. Footsteps approached her and the cushion beside her sank down. Alex picked the bag off the couch and handed Regina the glass to hold.

Regina’s hand trembled as she held the glass. She set it down on her legs, using both hands to keep from spilling it.

Tearing open the bag, Alex pulled out the bottle and tried removing the childproof lid. "They practically make these damn things adult proof," she complained as the lid flew off and skittered across the floor. She knelt down and retrieved it from underneath the chair.

"Here." She shook a pill out into Regina’s hand. Regina tossed the pill in her mouth and washed it down with a gulp of water. She tilted her head back and slumped against the cushion of the couch.

"I’m sorry, Alex."

"What are you sorry for?" Alex asked, turning to look at Regina’s pale and sweaty face.

"I’ve been nothing but one problem after another since I got on the rotation. You’ll probably be glad when I’m off it," Regina said. She wondered miserably how many residents had the dubious distinction of being driven home sick by their attending. She sunk down lower against the cushion of the couch at the thought.

Alex frowned and looked at the woman sprawled against the back on the couch. "That’s not true. You’re competent, you have good clinical instincts and you haven’t let any of this other stuff affect the quality of your work."

Regina was quiet for a minute taking it all in. "Thanks." She rested her head against her forearm and closed her eyes. They were quiet for a few minutes as Regina drifted in and out of wakefulness.

"Thanks for bringing me home, Alex," Regina said, before finally drifting off to sleep.

Alex waited until Regina’s breathing became strong and even, then stood up from the couch. She knelt down beside the blonde and moved her onto her side.

She propped a pillow under Regina’s head, slipped her sneakers off and pulled the green and blue checkered afghan off the back of the couch and covered her with it.

Alex gave her one last look before she slipped out the door, shutting it quietly behind her.

Regina woke several hours later in the dark. She lifted her head up and looked around her, trying to figure out where she was. Rolling over, she felt her legs tangle in the afghan.

Regina reached up and turned on the lamp next to the couch. Blinking her eyes, she looked around and realized that Alex had covered her with the throw and taken her shoes off for her.

Regina gingerly sat up and let her body adjust to being upright. "Wow. I don’t feel sick anymore." She laughed a little to herself and proceeded to go to the refrigerator, where she raided the leftover chow mien that she had from the night before.

Chapter Six

Regina picked up the phone and set it down for the third time that morning. "Damn." She muttered. "Come on, how many times have you gone over what you are going to tell him? Just do it," Regina chided herself. She walked around her living room one more time then grabbed the phone from the table. Dialing the numbers quickly, she waited as the phone rang.

She let the phone ring a fourth time. There was a click and she heard the familiar voice on the other end of the phone. "Police station, Officer Black speaking."

Regina waited a beat then spoke. "Derrick, it’s Regina."

"Regina." He said her name like he was testing it out. "It’s about time you called me."

She stuck one of her hands in her pocket and rocked back and forth on her feet. "Derrick, don’t start. I have your ring and I’m giving it back to you."

Regina thought about mailing it to him, but she wanted to put closure on this and not give Derrick the impression that he scared her, even though he did.

There was an audible sigh on the other end of the phone. "Regina, I think we should at least talk. It’s been a few weeks and things have settled down some. Let’s not rush into this."

"Derrick there is nothing for us to talk about," Regina insisted.

"Then keep the ring, Regina. I don’t want it back." Derrick clenched the pencil between his fingers.

"No, Derrick. I don’t want it." You’re not going to have anything to hold over my head, you bastard.

The pencil snapped in two and rolled across the desk. "Alright, well, could we at least talk civilized, maybe get a bite to eat?" He hoped it would give him a chance to win her back.

"I’m on call tonight so I need to stay close to the hospital."

"Let’s meet at the diner at the bottom of Dennison Avenue. Say one o’clock?" Derrick asked.

"Fine," Regina said and hung up the phone.

Regina arrived a few minutes before one and walked into the diner. She was glad they were meeting in public so Derrick would have to control his temper. She followed the waitress, sat down in a booth. She ordered a glass of lemonade, deciding that she didn’t want anything to eat because she was nervous, and her stomach was already in knots. Regina folded her hands in front of her and let her thoughts wander.

She honestly hadn’t given much thought to a restraining order, even though Alex and Sandy said it would be a good idea. It meant getting a lawyer and going to court. Both of which she didn’t really have the time or the money to deal with right now. She tapped her fingers on the table and looked out the window. Come on Derrick, hurry up and get here.

"Regina?" Derrick said her name and sat down across from her. He was wearing a blue button down shirt and khaki pants.

"Hi Derrick." she said, looking up and eyeing him warily.

"So." He put his hands on the table and looked at her. "You know it doesn’t have to end this way, Regina. I think we could work this out if you give me another chance."

Regina felt the old defensiveness creep up inside her, but she pushed it aside. "Derrick, you still don’t get it, do you?"

"Regina, I only want what’s best for you," he said, reaching out his hand to take hold of hers.

Leaning back, Regina pulled her arms off the table. "Derrick, that only holds true if it doesn’t interfere with what you want." She was tired of having to justify everything to him. She looked him straight in the eye. "Derrick." Her voice was steady. "I didn’t come here to fight with you. It’s over."

"I don’t want to fight, Regina. I just want us to be together."

Regina dug into her pocket and fished out the gold ring with the oval diamond set in it. She held it between her fingers, really looking at it for the first time. She decided it was a nice ring, but it didn’t change how she felt and it never would. With a gentle click, the ring was set on the laminated tabletop and pushed across to Derrick.

"Here. Take it, Derrick."

"Did you tell your parents?" he asked, picking up the ring and holding it between his thumb and index finger. "They’ll be upset, you know." He twirled it back and forth watching the light dance off of it.

"I know Derrick, but that’s my decision. They have no say in what I choose to do with my life," Regina said as she took a sip of her lemonade.

"I don’t think they would agree with that and you know it," he replied, fixing his eyes on hers. "Your mother-"

"My mother doesn’t know who I am." Regina shook her head. "Derrick, we don’t have anything else to discuss."

Mercifully, her beeper vibrated on her belt and she looked down at it. The display read the ER number with 911 following it. It was the code that the staff used in emergencies. She looked up at Derrick. "I’ve got to go, Derrick, it’s an emergency."

He stood up, a sneer crossing his lips. "Isn’t it always. Let me walk you out."

Regina stood up and left some money on the table. Derrick walked out behind her and waited as she got into her car. He raised his hand and stepped back, watching her.

Regina turned the key in the ignition and heard a click. She turned it back and tried again. "Dammit." She banged her hand on the steering wheel. She looked out the window and saw Derrick walking back toward his car. She opened her door and ran after him.

"Derrick!"

"What’s wrong?" he asked, turning around at her voice.

"My car won’t start. Can you give me a ride back to the hospital?"

"Sure, get in."

Derrick pulled out of the parking lot and floored the gas pedal, gunning the engine. Regina pressed herself against the door, staring out the window as they drove up the hill toward the hospital.

Regina jumped out of Derrick’s car and ran into the emergency room entrance. She pushed open the glass door and sprinted down the hall, just barely avoiding crashing into a patient being wheeled out of an exam room. She threw her backpack on a chair as she reached the desk. "Where’s Dr. Margulies?"

"Trauma one," the unit clerk said without looking up.

Grabbing a yellow isolation gown from a cabinet, Regina slipped it on and tied it behind her neck as she hurried down the hallway. Sandy came running out of the storage room, carrying some pediatric supplies and barely missed colliding with her.

"Sorry to call you in early, Marcus is out sick." She pushed open the glass door and Regina walked in ahead of her. Her eyes ran over the small form lying on the stretcher tethered to a multitude of lines. A small blue board was strapped to the child’s arm preventing him from displacing the intravenous line from his right elbow. She could see the sprawl of the EKG wires as they ran from his small chest to the wall monitor behind the stretcher and one small catheter tube snaked down from underneath the sheet to a bag hooked to the rail of the stretcher.

Alex looked up as Regina walked through the glass doors. "Good, you’re here." Alex’s eyes narrowed and Regina glanced quickly over her shoulder. Derrick was standing behind Sandy just outside the glass door looking at Regina.

"Do you want me to get your car towed, Regina?" He asked, his eyes flashing a challenge as he looked directly at Alex.

"No. I’ll take care of it. You can’t be here, Derrick." Regina said. She cringed inside, realizing that both Sandy and Alex probably thought she was still seeing him. Oh well, no time for that now.

She pulled a cap over her hair, tucking it in hastily. Moving around one of the medical students she walked to the head of the stretcher. She saw the blonde hair matted to the boy’s head and felt her stomach lurch as she recognized the bruised and mottled face under the tiny oxygen mask as she stepped closer to the stretcher.

Regina felt a shock course through. "Justin." She covered her mouth with a hand and stepped back shaking her head in disbelief.

"You know him?" Alex jerked her head up.

Regina nodded. "He was discharged from the pediatric service last week. They sent him back home to his mother and her boyfriend." She felt the initial wave of emotion ebb away.

Regina turned her attention to the wall monitor that showed his heart rate was a hundred and thirty beats per minute. She looked over at Alex, feeling her eyes on her.

"What are his blood gases?" she asked as she slipped a fluid shield mask over her face and squeezed the thin metal clips over the bridge of her nose.

"His oxygen’s dropped down to ninety-six percent." Alex pulled her eyes away from Regina and started inserting another IV. "Andy, get over here and hold his arm for me."

Regina slipped on a pair of gloves and stepped up beside her. "Jesus." She whispered as she saw the hideous purplish-blue bruises covering his chest and arms. She could see the distinct outline of an adult’s hand in the form of an ugly bruise around his upper arm.

She looked up at Alex and then down at the sheet that covered his pale body. She lifted it up and closed her eyes. Recently healed burn wounds lay open and oozing from the cruel hands that had grabbed his legs in anger. "Do we have x-rays on him yet?" She asked, swallowing a surge of anger.

Alex nodded her head, keeping her eyes focused on the tiny vein she was trying to pierce with a needle. "Ah, got it. Over there." She inclined her head toward the view box.

Regina walked over to the view box and flicked the light on with her elbow, careful to keep her gloves sterile. "He fractured his right arm and four ribs."

"He may be bleeding internally. His hematocrit is low. They’re typing and crossing his blood right now," Alex said.

Regina walked back to the boy lying on the table. "We’re going to have to put him on a ventilator if his oxygen drops below ninety percent."

Alex nodded her head slowly, looking at her. "I know. All right Regina, this is your show. Let’s do this quickly."

Regina leaned over the still form and stroked the blonde curls, leaning close to Justin’s ear. "Hey Justin, it’s Regina. I’m just gonna listen to your heart, sweetie." Regina placed the stethoscope to his chest and listened as his heart beating frantically inside. She moved it to both sides of his chest and closed her eyes. "His breath sounds are diminished on the left. He’s got a pneumothorax." Her eyes met Alex’s. "I can’t believe that bastard…"

"Not here, not now," Alex said, shaking her head.

Regina nodded her head grimly. "Sandy, I need a chest tube set."

"Got it." She opened it and set it down on the instrument cart next to Regina.

Alex slipped her hands over Justin’s shoulders and held him securely. Blue eyes opened slowly and tiny hands clutched at Alex’s hand trying feebly to push her away.

"No, no sweetie," Regina said. "She’s not gonna hurt you." Alex collected both his arms and hugged them over his chest with her larger one.

"Regi." A hoarse whisper of a voice floated up from below.

"Shh. You’re going to be ok, Justin." Regina looked up. "Sandy, give me the syringe with one percent lidocaine." Taking the syringe from the nurse, Regina leaned over. "Justin, you’re going to feel a prick here and…here," Regina said as she injected the sites with lidocaine. "It’s going to make you’re skin numb."

Regina took a breath and let it out slowly trying to calm her racing heart. She knew the boy was in serious trouble.

"You ok?" Regina looked up and saw Alex’s blue eyes peering at her through the clear plastic of the mask. She hated these cases, but now wasn’t the time to let her emotions take over.

"Fine." Regina swallowed and nodded her head. "Justin." Blue eyes rolled up to her. "We’re going to put a tube in your chest." Big tears welled up in his eyes and his lower lip quivered as he looked up at Regina.

"What medication does he have on board?" Regina asked, her voice wavered and she swallowed hard. Come on, Regina, she coaxed herself, reigning in the emotions battling inside her. Now’s not the time.

"Six of morphine for pain." Alex said. "I just gave him three milligrams of Diazepam to sedate him."

Regina lowered her head, satisfied with the amount of medication the child had in his system. She ran her fingers along the rib, feeling for the border of the pectoralis muscle in his chest. Using the scalpel, she made a single incision over the rib.

"Give me the Mayo clamp," she said, holding her hand out. She closed her hand reflexively as she felt its weight in her palm as Sandy handed it to her. She inserted it into the incision with the tips closed using slow, steady pressure until she felt the lining around the lung give way.

"Ow, ow, ow, Regi, it hurts! Make it stop," Justin cried out, straining against Alex’s arm.

"Andy, hold onto his legs." Alex directed as she felt the boy kicking beneath her.

Regina flinched as she opened the clamp so she could have room to insert the chest tube. She removed the instrument, grasped the chest tube near the end with it, and inserted the tube into the incision she made in his chest wall.

Regina looked back down at Justin. "It’s almost over baby. I’m sorry, sweetie." Sandy connected the end of the tube to the suction container on the wall, while Regina quickly sutured the tube in place and dressed the incision with gauze.

Justin whimpered and clutched at Alex’s hand with his fingers.

"Do we have a blood gas?" Regina asked, stepping back and looking at the wall suction fill with bloody fluid.

"I’m getting it." Andy said, as he drew the blood.

Looking at the rapidly filling container, Regina let out a breath. She felt anger welling up inside her as she caught a fleeting image of a man beating the boy that now lay beneath her on the table.

"Hurry up, Andy," Regina felt her anger at the situation getting the better of her.

"Easy, it’s coming," Alex said as she checked the IV in Justin’s arm and adjusted the flow. Blood arrived from the lab and Sandy checked the labels with one of the nurses to confirm the type and cross match. Alex hung the bag and piggybacked it with the already running IV line.

"Momma," Justin whimpered as he moved his head around restlessly on the pillow. He pulled the mask off his face and Regina bent over to retrieve it.

"Hey, sweetie. Momma’s coming," Regina said, choking on the vile words that she knew were most likely a lie.

Justin looked up at Regina and reached an arm out for her mask. He grasped the plastic shield in his little fingers and pulled it down.

"Hey," Regina said, leaning over him. "What are you doing?" Regina’s gloved hand gently covered his.

Alex looked up from across the room and walked back over to the stretcher. She watched the interaction her face devoid of any emotion.

Regina let Justin pull her down to his face. "Regi."

"I’m here, Justin." Regina said. "You’re gonna be ok."

"Flutterby kiss," Justin whispered and pecked her on the cheek.

"Blood gas is eighty-nine percent oxygen. His ph is seven point four," Andy said, from across the room.

Regina closed her eyes and swallowed the sob that welled up in her throat just as the alarm on the monitor started a high-pitched beeping. Looking up at the monitor, its alarm indicating the oxygen in his blood was dropping below a safe level, Regina hit the icon on the screen angrily with her finger silencing the shrill noise.

"Dammit." She turned away from the stretcher and blinked the tears from her eyes.

"Regi?" Justin’s voice was a whisper.

"Justin." Regina leaned back over his face and stroked his head. "We’re going to give you something to make you sleepy. When you wake up you’re going to have a tube in your mouth to help you breathe." She looked up at Alex. "Give him three more of Diazepam."

Alex nodded her head and drew the sedative into the syringe. She slipped the needle into the port on the IV line injecting the medication. Lowering the rail on the stretcher, she slipped her hands over Justin’s arms to hold him again.

Regina picked up the laryngoscope and the endotracheal tube from the tray and leaned over Justin’s head. Her head brushed Alex’s shoulder as she positioned herself over Justin’s face. Tilting his head back, she opened his mouth. Regina ducked her head and took a breath. It was a simple trick she learned in medical school to steady her hands when she was nervous. She inserted the scope, visualizing the anatomical structures in his throat as she guided it in.

"Regi…I’m…scared." Each word faded, becoming fainter as Regina inserted the scope guiding the tube down his trachea. She inflated the balloon at its tip to hold it in place silencing the words he was still trying to speak despite the tube being in his mouth.

"Ok, I’m in." She slipped thin white cloth ribbon around the tube and tied it behind Justin’s head so the tube was firmly in place. Sandy took the tubing from the ventilator and connected it to the endotracheal tube.

"Ok let’s take him to radiology. I want to scan his chest and abdomen." Alex said, walking over to the counter to pull the portable pulse oximeter and cardiac monitor off the shelf. "Come on, we’re taking him up ourselves." She slipped the tiny device that monitored the percentage of oxygen in the blood over Justin’s thumb. The soft red glow from its sensor reflected off the white sheets. "Stupid, red light always reminds me of ET."

She stared down at the boy’s pale face, and Regina unhooked the endotracheal tube from the ventilator and attached the ambubag.

"Yeah, me too," Regina said, as she started to squeeze the bag rhythmically.

Alex unhooked the EKG leads and hooked them to the portable monitor at the foot of the stretcher. "All set. Let’s go." Twenty minutes later, they were wheeling the boy to the operating suite from radiology.

Regina continued to squeeze the ambubag, ventilating the little boy’s lungs. She almost bumped into Alex when she stopped short and banged on the button that automatically opened the doors to the OR.

One of the scrub nurses looked up, startled to see the tall doctor and her smaller companion wheeling the stretcher into the large holding area. "Didn’t know you switched jobs to transport, Dr. Margulies," she teased.

Alex gave her a dour look and handed her the copies of the CT scan. "He’s got a lacerated spleen."

The scrub nurses took hold of the end of the stretcher and led them down the narrow hallway just outside the sterile environment of the operating suites. "We’ll take over from here."

Alex turned to walk away, hesitating as she saw Regina standing by the door watching as the stretcher disappeared down the hallway. "Hey, are you coming?"

Regina nodded her head and slowly stepped back from the door, her eyelids blinking rapidly to quell the tears threatening to overflow. She didn’t dare look up at the taller doctor as she walked back down the hallway to the emergency department, fighting the wall of emotions hammering at her tattered defenses.

******

It was almost midnight when Regina finally walked into the locker room. She slumped heavily onto the bench and stared at the floor. Putting her face in her hands, Regina ran her fingers through her hair. She was exhausted and every joint in her body ached. At last check, there was still no word from the operating room on Justin. All they could tell her was that he was still in surgery.

Peeling off her scrubs, Regina started changing into her clothes. She looked up as the door opened and watched as Alex walked in. The attending looked at Regina, hesitated and walked over to her locker, pulled out her clothes, and tossed them carelessly onto the bench. It was the time of day she hated most – her shift was over and there was nothing left to do except go home to her empty house.

Throwing her scrubs into the green dirty linen bag, Regina sat back down on the bench, and slipped her sneakers on her feet.

"You patch things up with what’s his name?" Alex asked, her voice muffled as she pulled her scrub top over her head. She kicked herself mentally as the words came out more harshly than she intended. What business is it of yours anyway, what Regina does on her own time?

"Huh?" Regina looked up surprised at Alex’s question. "Oh, Derrick. God, I almost forgot," she said, rubbing her forehead. "No we, uh, I gave him back his ring tonight. My car wouldn’t start so he gave me a ride back here."

Alex slipped off her bloodied scrub bottoms. "So, is that a good thing?" she asked, without looking at Regina.

Regina looked up at her and frowned, confused by Alex’s tone. "Yeah. Of course it’s a good thing." Regina averted her eyes as Alex bent over and picked up her shirt from beside her on the bench. Slipping her arms into it, Alex pulled it over her head.

Standing up abruptly, Regina grabbed her backpack and walked to the door. "Guess we’ll find out how Justin’s doing tomorrow."

Alex slipped on her shorts and glanced up at Regina. "Yeah, probably." Alex hesitated, she wasn’t one for giving non-clinical advice but in this case she made an exception. "Listen, I know it was tough for you working on that kid, but you’ve got to learn to separate yourself from what’s happening to do your job. Clinically, you were right on target with everything."

Regina looked down and nodded her head, knowing she frequently did allow herself to get too involved with her patients. "I’ll see you tomorrow," she said, feeling somewhat dejected by her attending’s appraisal of her performance. She pulled the door open and stopped short. Sandy was standing with her hand out, reaching to turn the handle on the door.

"Night Sandy," Regina said and started to walk past her.

"Wait." Sandy put a hand on Regina’s arm, pulling her back inside the locker room. "I thought you two should know. The OR just called down. The little boy that you worked on earlier-" Her voice wavered a bit and her face betrayed the emotions she was trying hard to hide. "He coded in the OR. He didn’t make it."

Feeling like someone punched her in the stomach, Regina sagged back against the wall, covering her mouth with her hand. "Oh, God," she choked out.

"I’m sorry, Regina," Sandy squeezed her arm in sympathy. "He just lost too much blood."

Regina turned her head away, embarrassed by her own lack of composure and yanked the locker room door open. She walked quickly down the hallway and pushed open the doors to the ambulance bay.

Blindly stumbling down the concrete stairs, she leaned against the brick wall gasping for air. She didn’t care about the wind, the rain pouring down around her, or the thunder rumbling menacingly overhead. The past few weeks had been an emotional drain and Justin’s senseless death brought it all crashing down around her. Suddenly unable to stand, she slid down the wall, feeling the brick scraping her skin through her shirt. She covered her face with her hands and let the hot tears course down her face.

Shivering, Regina looked up at the black sky from her crouched position. "You son of a bitch," she cursed. "How can you let someone do that to an innocent child? It’s just some sick game for you." Her only answer was a sudden increase in the downpour and Regina blinked the water out of her eyes.

She laughed sarcastically. "Like you would really answer me." Hugging her arms tightly around herself, Regina pushed up from her crouched position, and started walking up the hill toward the road. She just wanted to get home, away from this wretched place with all its pain, and suffering. She’d had enough and right now she felt cold and hopelessly empty inside.

She’d made it halfway up the grassy slope when she heard footsteps running toward her splashing through the ankle deep puddles.

"Regina?" Alex called out as she trotted up beside her and put a hand on her arm looking down at her. Rain dripped down her face in rivulets and her hair was plastered to her shoulders. Regina just shook her head, covering her face with her hand as a sob escaped her. Her body sagged against Alex as her emotions finally overwhelmed her.

Alex stood still for a moment, unsure of what to do, and then hesitantly wrapped her arms around the smaller woman’s shoulders. "You did everything you could, Regina. You know that," Alex said, as she rubbed her back. Don’t do this to yourself, Regina. There’s too many that you’ll lose over the years, please don’t do this to yourself.

Regina pulled away and wiped her nose with her hand. "God, he shouldn’t have died."

Alex stood in front of Regina looking down at her. She reached out a hand and brushed the wet strands of blonde hair from Regina’s face. "I know. Come on, I’ll drive you home. We’ll both get sick standing out here in this mess," she said, as the rain continued to pour down around them.

Alex walked beside Regina and pulled her into a hug with one arm as they walked towards her Jeep. Regina opened the passenger side door and put her foot in. "I’m soaked, Alex," she said, looking down at her drenched clothes.

Alex tilted her head and glared at her. "So am I. Just get in."

Regina slid into the seat and huddled against the passenger side door staring out the window on the short silent drive to her condo. The tears kept coming now as she remembered Justin’s sweet, trusting face looking back up at her from the stretcher.

The truck pulled into the driveway and the engine idled quietly as Alex put it in park, its headlights casting a bright light on the white garage door. The rain drummed on the roof of the Jeep and a flash of lightening lit up the pale interior. She turned and looked at Regina.

"Hey, Regina, look at me," Alex said.

Regina shook her head. "You’re right, you know. It’s my own fault, I just have to stop getting so close to my patients."

Alex put a hand on her shoulder. "No, that’s what makes you a good doctor, Regina. You do care and your patients know that. It just makes it harder when they die. It hurts more inside."

Regina sniffed and smiled faintly, wiping the tears from her face. "Do you still cry, Alex?"

"Not as much as I used to." No, the bad ones just give me nightmares, she thought wryly.

Regina shivered as a chill left goose bumps on her arms. "You must think I’m a basket case."

Alex shook her head slowly. "No, I don’t. You’ve had a hell of a few weeks. It was bound to catch up with you sometime." She noticed that Regina was shivering. "You should get inside and change into some dry clothes before you get sick."

"Yeah, I guess. Uh…do you want to come in, Alex?" Regina asked, realizing that she didn’t really want to be alone. "I don’t know about you, but I could use a drink right now," she offered.

Alex decided that a drink sounded really good at the moment. "You sure you want company?" she asked, not wanting to intrude.

"Yes, I do." Regina pushed the door open and stepped out onto the pavement. Slamming the door shut, she ran through the torrential downpour to the front door, unlocked it and slipped inside, feeling with her hand for the light switch just to the left of the door. She flicked it up, illuminating the room in a soft glow. Alex stomped her feet behind her on the mat outside the door.

"Alex, I don’t think you need to worry about getting anything wet. I’ve already taken care of that," Regina said, as she looked at the puddle of water forming around her feet from her saturated clothes. "I’m going to get changed. I’ll be right back," she said. Regina slipped off her wet shoes, dumping them by the door. She walked toward her bedroom, dropping her bag on the floor inside the room.

Alex took the opportunity to walk around Regina’s living room and looked at some of the pictures on her entertainment center. There was a framed picture taken several years ago, of what Alex suspected from the similarities was Regina’s parents and a brother. She noticed the diploma hanging on the wall from the University of Massachusetts where Regina graduated from medical school.

Walking out of the bedroom, Regina stood beside Alex. "Here." She handed her a pair of large scrubs. "Thought you might want some dry ones."

"Oh. Thanks." The doctor gladly accepted them.

"The bathroom is in the hallway off the bedroom," Regina directed.

Alex walked into the bathroom and shut the door. She was surprised by her reaction to Regina when she ran out of the locker room. If it had been anybody else, she would have left them to their devices, but something inside had sent her running after the distraught resident, without a second thought about what she was doing.

Looking at her face in the mirror, Alex ran a hand through rain soaked bangs, ruffling them. She emerged a couple of minutes later wearing the blue scrubs that Regina had given her. "I hope you don’t mind, I hung my wet clothes up over the shower rod."

"Not at all." Regina could feel the nervous energy from before wearing off and her body quickly reminded her that it had been hours since she had anything to drink or eat. She walked over to the kitchen and opened the refrigerator door.

Alex followed and leaned against the wall, watching as Regina then rummaged through the shelves. All right Einstein, you take the kid home cause she’s upset, now come up with something intelligent to say to her. She felt her back tightening up from being bent over the kid for most of the evening and she stretched backwards until she heard a pop.

"Ah. What was that?" Regina stood up and looked at Alex.

"Just my back. It gets stiff sometimes when I bend over a lot."

Regina nodded, understanding. "Do you want a beer?" She held two micro-brews in her hand.

"Sure." Alex took the proferred beverage, twisted the cap off and took a drink. "Mm. This is good," she said, looking at the label on the bottle. "I’ll have to remember this one. It’s got a smooth taste to it, not too bitter like some of them."

"Yeah I like this one," Regina agreed. "Sorry, I don’t have much in the way of real food right now. How about some chips?"

"Anything sounds good," Alex said, taking the bag that Regina handed her.

Regina opened her own and took a gulp as she walked past Alex and into the living room.

The young doctor flopped down onto the couch and stared up at the ceiling. She realized that this was the first time she had ever really been around Dr. Margulies outside of work, but she felt surprisingly at ease with her despite her colleagues’ typically unkind remarks about her. She wasn’t counting the first time they’d been here, because she’d been practically delirious from being dehydrated and nauseous all day.

Regina watched as Alex walked by her and sat down on the other end of the couch.

"You ok?" Alex settled onto the cushion and leaned her elbows on her knees, holding the beer in both hands. She could sense that Regina needed to talk about the evening’s events.

After years of working in emergency medicine, she had seen her share of patients die, young and old. Some died mercifully because they had been suffering, others because they had been stupid and then there were those that made you realize for a sickening moment just how fucked up this life could be sometimes. In any case, Alex learned quickly to put those emotions in a box and move on.

Regina shook her head and looked over at Alex, her eyes flashing angrily. "I want five minutes in a room with a baseball bat with that bastard."

Alex shook her head. "No, the punishment should fit the crime. He should be drawn and quartered." She looked at Regina, seeing the tears glistening in the corners of her green eyes.

"Is this the first kid you’ve had die because he was abused?" Alex asked carefully. She reflected upon her own reaction years ago to a similar situation: the boyfriend showed up just as Alex came storming out of the trauma room. Her mentor at the time, Dr. Washington, physically restrained her, but not before she broke the bastard’s nose and sent him crashing over a stretcher. That outburst got her suspended for three days.

Regina nodded her head solemnly, tilting the bottle back and draining her beer.

"I know you don’t want to hear this right now, Regina, but I’m going to tell you anyway," Alex began. "You’ll find a way to dull your senses. Somehow you’ve got to learn to put up a wall for everything that you have to deal with in there. Otherwise, it eats you up inside. You did everything you could for him, Regina. Sometimes it’s just not enough. We can’t save them all." She leaned back against the arm of the couch and sighed. "You’re good with the kids."

Alex knew that experiences like this sometimes left scars that haunted people and turned them away from what they were good at. She didn’t want that for Regina.

Regina lifted her head up, surprised at the unexpected compliment. "You think so?"

"Sure. The way that kid…" Alex raised her hand searching for his name. "The way Justin responded to you. You could tell he trusted you." Alex took a drink from her beer and toyed with the label. "You’re good at that, getting patients to trust you. That’s important."

Regina just looked at Alex and swallowed. "Thanks," she said quietly. She wasn’t expecting the compliment and she found herself feeling shocked. "I know it’s ok to get emotionally involved with your patients, but how the hell do you do that and stay objective? How do you keep that distance, Alex?"

Alex shrugged. "I don’t know. I don’t let them get that close, so I guess I’m not the best one to answer that question."

Regina saw something flicker in Alex’s eyes that she could only describe as profound sadness. What have you seen Alex? What have you been through that you keep yourself so protected? I see that in you. "Do you want another beer?" Regina indicated Alex’s empty beer bottle, letting her thoughts remain silent.

"If you’re having one, sure. I don’t want to keep you up," Alex said, handing her the empty bottle.

Regina shrugged. "I think I’m getting a delayed adrenaline rush from earlier. I’m wide awake now."

Alex gave her a knowing smile, before Regina turned away and walked into the kitchen. She closed her eyes enjoying the quiet sense of peace she felt at the moment. It was always difficult, Alex thought, to rid yourself of the sights and sounds that imbedded themselves in your memory. Some faded quickly and others lingered, coming back and haunting you with startling clarity, opening up vulnerabilities that you didn’t realize existed in your soul.

It had been a long time since Alex socialized with anyone at the hospital. Too many times conversations with her colleagues invariably led to their most current real estate deals, what luxury car they had just purchased or how the insurance companies were trying to cut into their profits. It was a game of one-upmanship and Alex had no desire to involve herself with that kind of meaningless interaction. Her experiences in the past taught her hard lessons about what that kind of money could buy you and how fleetingly transparent it all was in the end.

"Thanks." She reached out her hand and took the bottle that Regina offered her when she returned.

Alex leaned forward to set her beer on a coaster. The motion brought on a sharp pain in her back and she felt her muscles stiffen immediately in response. Shifting her position on the couch, Alex winced as she felt the muscles in her lower back clench into a painful spasm.

Regina reached out and put a hand on her forearm. "Are you alright?" she asked, watching as Alex struggled to hide the pained expression on her face. "It’s your back, isn’t it?"

Alex arched her back. "It’ll be ok."

Regina stood up and motioned for Alex to lie down. "Lie on your stomach. My brother has the same problem. I can usually work out the spasm."

Alex shook her head. "No, its ok." Her voice was strained and she grimaced as the spasm tightened again.

"You’re not a very convincing liar," Regina replied, standing before her with her hands on her hips. "Lie down. It’s the least I can do considering all the times you’ve helped me so far."

Alex grumbled in protest as she lowered herself down onto the couch, tensing momentarily as she felt the warmth of Regina’s hands through her scrub top. Regina started rubbing them over her lower back, slowly increasing the pressure and kneading deeper as Alex’s muscles gradually relaxed.

"So - you have a brother?" Alex asked. She hardly knew anything about Regina and she found herself curious about the young resident.

She turned her head as she felt Regina’s hands stop. "Actually I have two. I’m the second oldest."

"What do they do?" Alex felt the spasm start to loosen its hold on her strained muscles.

"Michael sells real estate and - " There was a slight hesitation in her words. "Jeffrey is a lawyer."

"Wow, a lawyer, a doctor and a real estate agent. Your parents must be proud of you all." Alex picked her head up and looked at Regina when she didn’t get a response. "Did I say something wrong?"

"N…no. Relax." Alex felt a hand on her shoulder as Regina pushed her gently back down and pulled her shirt out of her scrub bottoms. "I can’t get a good hold on your skin with your shirt in the way," she explained as she felt Alex stiffen beneath her.

She didn’t want to tell Alex about her family. Most of the time she wished that she didn’t know them. They had been so cruel to Jeffrey. In fact, she was ashamed of how they treated him when he told them he was gay. Regina wished she’d had the courage to stand up to her mother when she threw him out of the house. She still carried a lot of the guilt around with her about that time of her life. Pushing the painful memories away, Regina continued to rub and knead the tense muscles until the spasm relaxed.

Regina let her hands rest on Alex’ back and peered around at the older woman’s face. Smiling, she realized that Alex had fallen asleep. Regina bit her lower lip, deciding if she should wake her up, then shook her head when she looked at the empty beer bottles on the table. She pulled the afghan off the back of the couch and draped it over the length of Alex’s sleeping form.

The young doctor settled into the reclining chair across from the couch and opened the book she had been reading earlier, read several paragraphs, and then realized she’d no idea what she just read. She tried again to reread the page and felt her eyes closing.

With a promise to herself to nap only a few minutes, Regina closed her eyes and promptly fell asleep.

She felt a hand on her shoulder, and opened her eyes, seeing Alex before her. "Hey," she said and shook her head fighting off a yawn.

"Hey, yourself," Alex smiled at Regina’s sleepy eyes. "You should’ve kicked me off your couch."

Regina shook her head. "Uh, uh," she pointed at the empty beer bottles sitting on the table. "Besides you probably needed the sleep. What time is it anyway?" She stretched, arching her back.

"Just after two," Alex looked at her watch and yawned.

Regina pushed the leg of the chair down and sat up, studying Alex’s slim physique. "How’s your back?" Alex had changed into her shorts and top from the pair of hospital scrubs that she had given to her when they arrived earlier.

"Much better. Thanks," Alex replied. She started to slip on her sneakers, balancing steadily on one foot and then suddenly remembered Regina’s car. "Hey, do you want me to take a look at your car?"

"At two o’clock in the morning, Alex? Are you crazy, don’t you sleep?"

Alex’s response was a shrug. "I’m pretty good at fixing things, unless you’d rather get it towed in the morning."

A tingle of excitement ran up Regina’s spine. "You sure you don’t mind?" She gave Alex another chance to back out.

"Come on. I have some tools in the back of my Jeep."

Regina pulled her sneakers on. "You keep tools in the back of your Jeep?"

"Hey, when your odometer passes a hundred thousand, you will too," Alex said as she opened the door and stepped out into the darkness.

******

The rain tapered off and a light breeze was blowing. Back in the now deserted parking lot, the clouds overhead were breaking up and hints of moonlight peeked from behind them, splashing the two vehicles intermittently in a white light. Regina peered under the hood of her car as Alex ran the beam of light from the flashlight over the engine. To Regina, it looked like a mass of odd shaped containers and wires.

"Now I know why I stick to medicine," she commented as she leaned her elbow on the edge of the car, peering into the engine.

Alex smirked and glanced over at Regina. "It’s not hard to figure out an engine. It’s like making a diagnosis on a person. Just a different type of anatomy, that’s all." She leaned farther under the hood and aimed the beam of light deeper into the engine.

"Huh." Alex leaned over and peered at something. "What the…look at this." Alex shifted over and gave Regina room to lean over the spot she was looking at. Regina bent forward and peered into the engine following Alex’s finger as she pointed.

Alex held the flashlight in her left hand and pointed down at the distributor cap with her right. "You’re distributor cap wires were loosened."

Regina stared at the wires and then up at Alex. The breeze shifted and Regina inhaled the perfume that Alex was wearing. She blinked her eyes, opened her mouth, and suddenly forgot what she was going to say.

"I, uh, how could that happen?" she asked finally, as her brain started working again.

Alex looked back at the cap and reinserted the loosened wires. "Someone had to do this. These wires don’t come loose by themselves." She clenched her jaw, having a good idea about who that certain someone might have been.

Regina closed her eyes and sighed inwardly. "Derrick. He came in to the restaurant after I did."

Alex lowered her head and gripped the edge of the hood with her hands, turning her knuckles white. "Does he have keys to your car?"

Regina shook her head. "No, but he could open any lock with the tool kit he carries on his belt."

Alex turned to Regina and handed her car keys back to her. "Try your engine."

Regina slipped into the driver’s seat and stuck the key in the ignition. The engine turned over and rumbled to life. Stepping back out of the car, Regina walked over to Alex as she shut the car hood, and watched quietly as Alex wiped her hands off on a towel she had tucked into her back shorts pocket earlier.

"It doesn’t make any sense," Regina said, looking at her car as it idled quietly in the parking lot.

"Why not?" Alex turned to her. "It got your attention." Mine too, for that matter, she reminded herself. Alex lifted her head and let her eyes roam the darkened parking lot. Her senses prickled and she got the distinct impression that they were being watched. "We should both get home. I think we’ve had enough adventure for one night. What do you say?" Alex looked back at Regina who was still watching her intently.

"Yeah. Are you on this weekend, Alex?" The taller woman nodded her head as she walked over to her Jeep, which she had parked facing Regina’s car.

"Regina?" Alex said, her name quietly. "I’m going to follow you home."

Regina waved her off. "You don’t need to do that."

"Humor me," Alex said, but she wasn’t smiling as she said the words.

Regina pulled out of the vacant parking lot and onto the main road. The Jeep remained right behind her, its headlights shining in her rearview mirror. Because the roads were deserted, the drive to her condo took half the time it usually did.

Once into her driveway, Regina hit the remote she kept tucked into the sun visor and the garage door slowly slid up: she pulled in, turned the car off and stepped out.

Alex’s Jeep was sitting behind her with its headlights on. Regina went out to say goodnight, hitting the switch on the wall and ducking underneath the closing door. She watched the window lower on the driver’s side as she approached the Jeep.

"Thanks for everything, Alex," Regina said resting a hand on the car door. "I think I owe you a dinner for this."

Alex shook her head, embarrassed. "You don’t owe me anything, Regina."

Regina leaned on the Jeep, her arm touching Alex’s as she glanced up at the sky. "At least it turned out to be a nice night after all."

Alex eyes followed Regina’s movements, coming to rest on her profile.

"Look, there’s Orion’s Belt," Regina pointed overhead.

Alex shifted in her seat, following her finger, until she spotted the constellation. A soft chuckle rose out of her throat and Regina turned her head. "What?" Their faces were inches apart as they looked at each other.

Alex held her gaze a moment longer and then looked away. "It’s just been a long time since I bothered to look at the stars." She stifled a yawn, to hide her own nervousness at the growing attraction she felt toward the blonde-haired woman.

"You must be exhausted and here I am keeping you stargazing." Regina stepped away from the Jeep and stuck her hands in her pockets.

"Yeah, I should get going. ‘Night, Regina." Alex shifted the jeep into reverse and smiled at her as she let the truck roll back.

Regina watched as Alex backed the Jeep out of the driveway, waving to her as she drove off. She stepped back into the house, shut the door and locked it, sighing as she thought about the day and how it ended. Strange how things turn out sometimes.

Continued - Part 3

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