JANUARY 11, 2000
Penn State University Medical Center
My name is Deborah Saint John, pronounced Sinjin where I hail from, namely, the sunny, languid, warm city of New Orleans. Emphasis on the warm.
Fucking January. What the hell ever made me come to Pennsylvania?
Iíll tell you what brought me here. No, it wasnít a guy or anything tasty like that. I was lured here by an offer to do my residency in emergency medicine.
I must have been out of my fucking mind. I was offered a residency at Louisiana State, but it was in psychiatry, not emergency medicine. I decided I had enough problems coping with my own craziness and would not opt to deal with othersí brands of lunacy.
Now you see how misguided I really was.
I like emergency medicine, actually.
I like it best on my days off, which are few and far between these days. Right now Iím living the typical life of a third-year resident, which means all work, no sleep makes Deborah a bitchy girl.
Needless to say, I feel bitchy a lot. And today is worse than most. I had to cover for someone last night. Iíve had no sleep for nearly two days. I got my period last night, right in the midst of stitching up some loser whoíd had a few too many and decided to play Speed Racer on an icy back road. By the time I was done with him, there was more blood from me than him on the floor.
What really pisses me off is, jerks like him will be back in my emergency room in no time. They never get it.
I have yet to meet any guys around here who make me want to take them home, even for an evening. My choices are limited to the other residents, all of whom are as bitchy and sleep deprived as I am, and the locals, who mostly have IQís that are less than my height. (72 inches. Yes, Iím an Amazon. That probably helps my sex life even less than fellow residents whose sex drive has been replaced by the need for sleep).
And to top it all off, Iím starving. I was getting ready to enjoy my power breakfast of two Hostess cupcakes and two Little Debbie Devil Dogs when I was paged. I had to work on some geezer with an obstructed bowel. Needless to say, I didnít have much appetite after that.
All I want to do is sleep and take a shower. In that order.
Iíve got ten more minutes on shift. In the normal world, that means itís almost quitting time. In the world of medicine, it means that there are ten minutes left for me to be paged and once again have my day shot to shit.
I wander to the vending machines to grab a substitute for my power breakfast. I made the mistake of setting the packages down in the on call room. Never do that. You leave food around here, itís considered fair game.
Iím not really hungry but I need to have something resembling a blood sugar level if Iím even to make it back to my apartment.
Iím in the midst of debating as to whether I should go for the Twinkies or the Dolly Madison Donettes when my pager goes off.
Maybe it will be a message from my mother.
No dice. Itís 911.
I had seven minutes to go.
"You get the one in Room 4," the triage nurse points at me, handing me the chart thatís been started.
"Lovely. You start an IV on him?" I donít see it in the paperwork.
"No, you didnít order one."
"Thatís because I havenít fucking seen him yet!" God, get a clue, would you?
"Dr. Saint John, weíre all tired," the triage nurse is trying to keep cool with me, but I can see her glaring.
"Sorry." I actually like her, her nameís Mel. White (with a period). And pissing her off is not in my best interest. The nurses have ways of payback that can make your residency a complete disaster. Iíve thus far been able to maintain a good rapport with them, but if I donít get some sleep soon, I might as well head back to New Orleans and apply for a job at K Mart.
"íS okay," Mel pats my hand. "Been a long night."
I start to read the paperwork in my hand when Mel taps me again.
"Oh, and Dr. SJ? Heís cute."
Paperwork gives the name as Richard P. Langly, birthdate June 28, 1965, male, caucasian, residence given as Washington DC.
What the hell is he doing here in the goddamn outback? Mustíve ended up here by accident. I think of Harrisburg as being a lot like hell-you donít come here by choice, you end up here.
Maybe he just needs a few stitches and I can send him on his way, still get home in time to watch reruns of ĎLonesome Doveí while I crash on the sofa.
Then I read the notes from the nursesí preliminary exam.
Iím not going home anytime soon.
I think to myself, what in the hell ever made me want to do this for a living?
Well, there was near-poverty in teaching Latin at a local Catholic school. Classics majors are not the most marketable employees known to God and man.
Then there was the fact that I discovered I really donít like kids that much.
So after two years of watching my mouth and making superhuman attempts not to murder any of my young charges, I applied to medical school.
At the time I received my acceptances, I felt that the gods were smiling on me, not playing the sort of cosmic joke I have since discovered that they are in fact having a good laugh on at my expense with.
It doesnít list the cause of this guyís injuries. Probably another bar fight gotten ugly, another loser with more muscles than brains trying to prove how much testosterone heís got.
I knock on the door of room 4.
A manís voice calls out, "Come on in."
Sounds pretty good for someone whoís supposed to be in as bad a shape as this guy is alleged to be.
The voice, though, came from a gentleman sitting in what is supposed to be the Ďcomfy chairí we provide. Shit, he looks old for 34, I think to myself.
"Not me. Him." The man points at the gurney.
I was afraid of that.
The long figure on the gurney is shivering. I turn to Sue Johnston, the nurse who is working with me.
"Get him some blankets."
Sue goes off in search of something to keep this boy warm while I check him over.
Heís a mess. His hair is stiff with blood and smells like meat left out overnight. (I should know. Iíve done it). A cursory exam of him proves that there isnít a spare inch of him that isnít mottled with bruises. The poor man looks like raw hamburger.
"Iím Dr. Saint John," I introduce myself.
He opens his eyelids as much as he can. Looks like he took quite a pounding.
Despite his injuries, he smiles a tiny, sweet smile at me. "Hi." That took all of his energy, I think.
Why are my kneecaps suddenly melting?
I really shouldnít have debated so long over the Twinkies or the Donettes.
"Iím going to be taking care of you," I say gently, settling my hand lightly on his shoulder (very lightly. I donít have X-rays yet and God only knows what kind of shape itís in).
He smiles that little sweet smile of his again, and looks right at me as best he can.
No, this has nothing to do with hunger...
Mel was right.
LANGLY, IN A GREAT DEAL OF PAIN
Wow, she has gentle hands.
And a nice voice. Love her accent. Course, Iím so dazed and confused right now, it could be William the Refrigerator Perry hanging over me for all I know, but I think I got enough still going on that I know a girl when I feel one.
Wish I could get a good look at her face.
"Letís get him all cleaned up and on some oxygen," I hear her accent again.
Iím shivering. But I donít feel quite so cold.
No, this is a good kind of shiver.
I get it again when I feel a soft hand on my shoulder. "Mr. Langly, weíre going to have to start an IV on you. Youíre big time dehydrated and youíre gonna need some antibiotics to boot. And soon as we get you a little better oxygenated, we can start feeding you some morphine."
Ah, there is a God.
Want to see her face, but not only are my eyes majorly messed up, but Iím blind as a bat on a good day.
I feel something warm near my face.
I open my eyes a little.
Oh man, even as messed up as I am, I can tell sheís pretty.
I want to look at her more, but I pass out cold.
Making a great impression here, arenít I?
"So how is he?" I ask the long cool drink of water who is apparently the MD in charge.
She leans wearily against the counter. "So far, heís severely dehydrated, badly bruised, has infections starting in several areas, and Iím positive that heís got several broken ribs and a broken arm, although since we screw up by committee here, Iíll have to have the radiology dudes confirm it. His shoulder is dislocated as well. Howís that for starters?"
Sheís a pretty girl. I bet sheís a knockout when sheís had a few hours of sleep and puts on a little makeup.
Too bad Langlyís too out of it to notice. Bet heíd go for her.
"We also have to check and make sure heís not hemorrhaging internally. It looks as if he took quite a pounding in the...abdominal area."
Is she blushing a little?
No. Couldnít be. Sheís a doctor. She sees this stuff all day long.
She is, though.
Two nurses and a young man she introduces as her intern ("just call him Ahab, he doesnít answer to anything else") proceed to work on Langly as she writes her orders.
In between catching glances at my boy, of course.
Sheís trying to be discreet about it, but something about her keeps drawing her eyes to him, and I donít think itís simply medical assessment.
"Iím going to radiology and Iíll be right back," she says, and I notice she is sweating. This is ironic; itís the middle of goddamn January in Pennsylvania and itís not much warmer than the outside in this frigging room.
I thought Langly was out of it, but as she opens the door, he moans sharply.
"Hey Ahab! Do you mind?" Her voice is sharp as she addresses her intern.
"I didnít do anything!" The young man protests vehemently, but Langly cries out again.
"Iím right here," I move closer to pat his hand.
He turns his head the small amount he is capable of. Opens his eyes ever so slightly.
"You mean Dr. Saint John here?"
He nods, a tiny but perceptible affirmative.
I look at him, then at her.
"I think heís gonna live."
DEBORAH SAINT JOHN:
Talk about feeling like youíre on the spot.
The older man has his eyes firmly fixed on me, as if he knows something and heís daring me to admit to it.
Christ on a crutch, I wasnít this uptight when I was doing my surgical rotation and the lead surgeon told me to sing. I thought he was joking, but he was dead serious.
I pulled myself together just enough to sing a rousing chorus of "Poisoning Pigeons in the Park" by Tom Lehrer. For which I received a solid round of applause, Iíll have you know.
There is a lot of humiliation in medical training, but nothing Iíve been taught ever prepared me for what I think is happening to me.
Iíve been kicked in the butt by...
"Um...uh...I have to run to radiology. Iíll be right back." I canít believe my voice is cracking this much.
"Dr. SJ, are you all right?" Sue Johnston raises her head momentarily to look at me.
I race out of the room with what minimal dignity I still have remaining.
The worst is about to happen.
I have become gossip fodder for the nursing staff.
And all because of...