Compromised, page 16
part #1 of MetroGen Forbidden Love Duets Series
“I didn’t think they had women in their department. They run faster from cards than my ex did with my alimony,” Frantz said.
“They have a first-year fellow. If you didn’t notice her before, no surprise. Wait till you see her now.”
Franz glanced up. “Sometimes I wish I spent more time outside the OR.”
“She’s stacked like a brick house. Think Marilyn Monroe with brown hair. Or Jessica Rabbit.”
Michael hoped there was a new brunette on cardiology who wasn’t Angela.
“A brick house? Who sang that originally?”
“The Commodores,” Michael answered, since this was the type of surprise questions medical students could get hounded over. Earlier this month, he’d spent twenty minutes getting quizzed on the various sports curses of Cleveland.
“You would know that, wouldn’t you?” Austin said and went on. “The other first-year fellow says they clearly took it into consideration when she matched here.”
Michael’s vision turned red. No way they weren’t discussing Angela, whatever her hair color was.
“You can see this in scrubs?” Frantz asked, clipping part of the mesentery. “Or did they invent skimpier scrubs for horny guys to appreciate a good rack?”
“No, she’s not showing skin, though there’d been a rumor she was knocked up. Now you see her new dresses and start wondering if she looks better on her knees or her back,” Austin said.
Michael bit the inside of his cheek and noticed movement around them. The CRNA as a woman, the circulating nurse and the nursing assistant were women, and so was the scrub tech.
He willed calm and patience. Austin would dig his hole deeper.
Still, Michael’s neck twitched from the strain of not exploding.
Austin noticed. “Something you want to contribute, Harper? She your type, or are you more of a stick guy like Weiss? Pitcher or catcher?”
“I thought Weiss’s game was basketball, not baseball. Besides, I prefer my women close enough to touch instead of going full creepy stalker on them. Have you ever spoken to her?”
“I don’t care much about what she has to say, though I’d be willing to let her touch me with her mouth.”
“Then I hear there’s a sex doll in OB right up your alley,” Michael answered and had the satisfaction of the OR going silent. He could sense every ear straining in his direction, because no one could resist a verbal beat down. “Want me to rotate the camera?”
“Yes, fifteen degrees clockwise,” Frantz said. “Have you met this cardiology fellow, Harper?”
“Yeah, our paths crossed in OB. Her name is Dr. Perkins by the way,” Michael rotated the camera. “She kept a woman with inoperable peripartum cardiomyopathy alive long enough to deliver. I saw their perimortem C-section.”
“See, can’t be too smart. Only OB would be crazy enough to do a perimortem C-section. Pussies,” Austin mocked.
The temptation to throttle Austin was overwhelming, except someone beat Michael to it.
In a display of uncharacteristic clumsiness, the typically surefooted circulating nurse tripped over the bucket of bloody lap pads from when they made the original incisions. The bloody bundle landed on Austin’s feet, soaking through his OR shoe covers.
“What the fucking hell?” Austin growled, jerking backward on the trochar he was holding.
“Watch out,” warned the scrub tech, dodging his motions, lest he contaminate her.
Now, Michael couldn’t confirm this from his vantage point, but it appeared the scrub tech did a leg sweep and knocked Austin onto the OR floor.
It might have been an innocent mistake because Austin had been off balance.
However, Austin didn’t see it that way. He’d landed ingloriously on his butt, hands on the ground, fully contaminated.
“You fucking tripped me, you bitch,” Austin spit out, jumping to his feet. He might have been tempted to throttle her.
Which, unlike calling her bitch, would have been an unforgivable sin to deliberately contaminate the surgical field.
“Oh, sorry, doctor,” the scrub tech said, her expression hidden by her mask.
“Wilson, take a break. You’re out. Get out of here and cool down.” Frantz glanced around and saw the women surrounding him glaring daggers. “We will have a word later about your language. Harper, move to first assist.”
Michael wasn’t imaging the sets of satisfied eyeball acting passed between the OR staff.
Per his new role, Michael lifted his hands and walked around to the other side of the table, now next to the scrub tech. She had already scooted over to give him more room. “You want me to take both?”
“No, you’re only gonna do one,” the tech said, much more skilled than he was to handle two trochars.
Frantz could tell he’d better make nice or risk the same fate as Austin. “To be clear, I am sorry about his language. I reserve the B word for the ex-wife.”
“Of course, sir,” the scrub tech said, and Michael wished he knew her name.
“Did OB really do a perimortem C-section?” Frantz shifted gears.
“Yes, I got to perform CPR during it, and I held the incision open.”
“Interesting,” Frantz was reexamining Michael under a new light. “Took serious balls. Or ovaries I guess. Because I respect women, and I’m not going to end up like my resident if your hand slips.”
“Bachelor Eleven was about to lose his temper. It was best Austin took a break. I’d hate to have blood on the sterile field.” The tech winked and established that she too watched New Day Cleveland.
“I hate blood loss, though it’d be exciting, Taylor,” Frantz said.
The tech, whose name was Taylor, snickered. She must have been Frantz’s regular scrub tech for her to fear no retribution for her actions. Good scrub techs were worth their weight in gold. It was her business to anticipate his plans and needs before Frantz voiced them. From Frantz’s perspective, the med students and residents were interchangeable pairs of scrubs.
“Austin had better be careful then,” Taylor said.
“He’ll learn or get a concussion next time. By the time he finishes residency, he’ll be fine. Not as good as me, because no one is ever as good as me,” Frantz said.
The ladies behind him rolled their eyes, impressed by his humility.
“All right. Harper, I need you to tell me two things. First, what is the blood supply of the left colon, and why are you called Bachelor Eleven?”
Michael correctly identified the left colonic and left sigmoid arteries as branches of the inferior mesenteric artery before telling a truncated version of his personal history, embellishing as necessary for his captive audience.
Chapter 28
Angela was post call in the cardiac ICU, and one of the ER interns insisted on paging her to the ER for a chest pain consult.
“This guy is having a heart attack. I think it’s a non-STEMI. He’s cardiac troponin negative. His EKG is normal, but he’s having a heart attack. Figured we’d get the ICU consult early,” the ER intern explained. “I like your scrubs.”
Again? Angela was going to kill Stella Magi for making her buy fitted scrubs. Most of the attendings owned several pairs, so it did appear more professional. However, these had special ‘boob’ cut outs for Angela’s assets.
She should have worn her white coat. Something about the presence of her boobs made the male residents—and attendings—get easily tongue tied. Or spout stupid gibberish like this.
She snapped her fingers in front of his face to refocus him. “How do you diagnose a non STEMI heart attack?”
A STEMI was a ‘ST elevation’ on EKG, showing damage to a ventricle from a clogged artery. A non-STEMI was a heart attack that didn’t show up on the EKG and could easily be missed. Those patients were typically closely monitored by repeating cardiac troponins, which were evidence of heart damage.
“You get cardiac troponin with EKG. I think it’s too early for it to have risen. He’s got all the signs. Thank you for coming down,” the resident said, only slightly more on task.
“How long has he been having the pain for?”
“Four hours, but you’ve got to see him. He weighs six hundred pounds, His HDL is 25, and his triglycerides are insane. He’s a heart attack on fire screaming ‘I’m having a heart attack. Save me. Save me.’” The intern, whose name she had decided not to learn, gestured wildly.
“I appreciate the imagery. Why exactly did you weigh him and draw a lipid profile before you paged me?”
The intern got sheepish. “Okay, actually, he’s a bariatric surgery patient, so it was part of his chart.”
“Ah, now I understand. Let’s see if he is having a heart attack.” Angela got up and went to the curtained space alone. “Hello, Mr. Cummings. I’m Dr. Perkins from cardiology. The ER called me down here because you were having left-sided chest pain.”
The large man pointed to his life side with difficulty. “It’s been like this for hours, doc. Can you give me something for it?”
“We can give you something in your IV. It’s best if we don’t let you eat or drink for now. I’m sorry. Is it okay if I remove your gowns to listen to your heart?” She set her stethoscope in her ears.
Mr. Cummings nodded. Due to his size, he had two gowns wrapped around him and she had to shift some of his fat to the side to get to his heart. After listening, she noted the incisions on his abdomen. “I saw Dr. Kandal’s name on your chart. Did she do a procedure lately on you?”
“Yep, she’s the best, and I’m going to be skinny,” the large man said.
“Still on a liquid diet?”
“I’ll be on purees soon. I already lost twenty pounds since the surgery last week,” he said proudly despite the pain.
“You had the gastric sleeve done? How’s your reflux doing?” Angela asked. Many of her patients were or would be bariatric patients.
“I can’t say it’s fun. It’s been way worse than usual.”
“We’ll get you meds for it through your IV. They’re going to get a CT and call Dr. Kandal’s team. You might be with us for a bit. She might fit in some extra therapies while you’re here.”
“So I’m not having a heart attack?”
“I don’t believe so since your heart isn’t showing any evidence of heart damage. We’ll know more after we get the CT,” Angela assured him.
She caught the intern in the fishbowl. “It’s not a heart attack. Here’s my list of stuff to order.”
“You want a CT and reflux meds?” The intern read the list in confusion. “You have X-ray vision and can see his coronary arteries?”
“I don’t need X-ray vision, but you do need to use your eyes. He had bariatric surgery last week.”
“Oh, seems like he needs it.” The interns attention was back on her body.
“He had a sleeve gastrectomy.” Angela wanted slap him on the side of the head. This guy must not have dated much in medical school. Or internship thus far.
“And?” the intern was torn between trying to disagree with her and stare at her.
“Medical school and the ER might have trained you to believe everyone who is fat and having chest pain must be cath’ed in ninety minutes or less. This doesn’t excuse you from your duty to examine the patient or think about his history. Sleeve gastrectomy increases reflux a lot and can mimic a heart attack. Worse, there’s a chance for splenic vein thrombosis. After his CT, get in touch with Kandal to let her decide if you’ll need to anticoagulate.”
“Oh,” the intern murmured. “What a great catch. Smart and beautiful.”
“I’m post call. Go write the orders,” she said. “Stop staring at me. NOW!”
The intern jumped up and ran to do her bidding outside of the fishbowl. At least his survival instincts were intact. He’d be getting plenty of mockery from his coworkers after his public reaming out.
A silver-haired ER resident nearby, Zac Newport, gave her a cocky smirk. “Oh, burn, Queen of Hearts.”
“His resident should have trained him better,” Angela said, pointing at Newport, who was his senior. She’d given him a similar set down a few months ago.
Newport was openly admiring her shape with his light grey eyes. He seemed fun and flirty, the type of adrenaline junkie who dyed his hair and did other ER doctor activities like hang gliding, rock climbing. “I can be trained.”
“Then you better teach him to do a better physical exam. It would have saved him a lot of grief.”
“He probably wanted to spend time with you, who is both smart and beautiful,” Newport teased her.
“It’s the post-call angry vibe,” Angela patted the tight bun she’d also mastered for her call. “Better fitting scrubs and neat hair.”
“I’m up to hear more. Dinner?” Newport suggested.
Angela almost swallowed her tongue. A tiny amount of her was interested. There was nothing wrong with taking Newport up on his offer. Michael had turned her down in the worst way, and it might have been time to exorcise him.
“Can you stop hitting on the cardiology fellow? Not the time,” Doyle grumbled, coming up behind her.
Several residents did double takes. Marcus Doyle discouraging flirting and dating in the hospital?
Doyle took her elbow and escorted her to the consult room. “My apologies for my unprepared intern and the horny one. They’re being guys, though your scrubs are lovely. I don’t blame them for making excuses to talk to you, though they could work on their subtlety.”
“Thanks, I think.”
“I wanted to ask you for a favor, though.”
Angela crossed her arms over her chest. Doyle was notorious for asking her to pitch in for ER patients. He wasn’t alone, since most of the other services had asked for similarly small favors. She put them on warning that they’d better be ready to donate a kidney if she needed it. “How many favors are you going to owe me by the end of the year? Your list is getting long, and I’m cranky.”
“It’s not that kind of favor. It’s about Stella.” His green eyes were more serious than she’d expected.
“Yes?”
“You two are friends, and I’d like to think we’re friends. So could you feel her out for her thoughts about me?”
“I thought her thoughts were clear the last time I saw you at Kandal’s house,” Angela said.
“Yeah. I want to do the right thing, which is a ring.”
Angela’s jaw dropped. “Oh. I am not in. I am not feeling out Stella to see if she’d consider marrying you. You want me to read an EKG? I’d be good.”
“Please, can’t you give me an in?” Doyle gave her puppy dog eyes.
“Well, she wants you to pick her and her pick you because it’s what you both want,” Angela said.
“This advice isn’t too helpful.”
“I do better with EKGs. If you want Stella to consider you, then let her know you want to be considered. Remind her of your good points. You’re nice. You’re fun… and other good qualities which I am certain you have. Start there.” Angela decided not to mention he was probably excellent in bed and made good marriage proposals to his previous three doctor ex-wives.
“I have plenty of good qualities,” Doyle assured her. “Thanks for the help.”
Angela decided to get a cup of coffee, hoping the weird hormonal signal she was sending out would disappear. It didn’t.
A second-year surgical resident bumped into her at the coffee cart and asked for her number. He was followed by a male nurse from the ninth floor asking for the same when she got skim milk and a packet of raw sugar.
She laughed it off and gave them both the number for Panera. They had a good chance of running into her there if they wanted to put effort in to catching her.
Even if she knew she’d already been caught.
None of them gave her a tenth of the electricity she felt by being in the same room with Michael.
The best thing to was finish her sign out and go home. Spending time with Taussig tonight after the Kandal kids dropped her off would have to do instead.
Unlike the resident and nurse, Angela didn’t get the luxury of hanging out to flirt longer because she got paged up to the Neuro-ICU, which was fortunately part of the ICU, her original destination.
A page to the Neuro-IC was new. Cardiology owned the cardio-ICU, were fixtures in the general ICU, and very rarely got called to neuro-ICU.
The nursing staff directed to her a radiology reading room.
“Hey, Dr. Perkins. Someone paged me,” she said, entering the room with multiple images of the brain and a doctor in scrubs.
The doctor turned around. “Dr. Perkins, glad you came.”
“Dr. Casserty?” Angela said. He seemed to be looking past her at one of the CT slices of the brain displayed on the wall. “How can I help you?”
The neurosurgeon refocused on her. “Your scrubs look nice.”
“Right. And your clinical question is?”
“Yes. The EKG. Here. And the cholesterol. My patient had a stroke, and these are his CT angiograms. I saved his life by removing the clot.”
Angela evaluated the EKG and the lab work. “He’s in atrial fibrillation, which would increase his risk of embolic stroke needing neurosurgery intervention. He could benefit from some warfarin for the likely clot, and his cholesterol isn’t too horrible. Is he on a statin?”
“Why do you think people go into a-fib?” Casserty asked absently. Atrial fibrillation was a condition where the top of the atrium ‘vibrated’ rather than squeezing blood to the ventricles.
“Umm, age? Lack of exercise?” Angela suggested the current prevailing theories about the poorly understood causes of A-fib. “Confused conduction system?”
“Is it because the heart doesn’t know what it wants? Or does it do what it wants no matter what you had planned? Or, magically, it decides it wants to misbehave.”
“The heart goes into a-fib because of magic?” Angela echoed.
“It could be. Magic.” Casserty tapped on his prosthetic leg. “I grew up with one leg and became a neurosurgeon. Did I lose my leg because of magic or science?”
