I watch him until the last possible second, when he disappears out the door, and then I stand there alone, like the last leaf in autumn. Some nonsensical part of me wants to chase after him. To steal another minute of his time. Another glance. Another waft of his cologne drifting in my direction.
Instead, I stay rooted in place, a slow smile unfurling across my lips once I realize I’ll get more time with Connor.
Just as soon as he moves in.Chapter ThreeConnorTaking overnight call is like rolling dice. Occasionally, I get a night with no new admits and no emergent issues in the BICU. On those nights, I usually head home with my beeper, or occasionally, I opt for some shut-eye in the call room. Other nights, the BICU is more like a three-ring circus. Last night was the latter. Usually fellows and residents take the reins in handling overnight care, but the last week in June is tricky because residents are about to get bumped up a year and chief residents are graduating, so the hospital is notoriously understaffed. Fourth-year residents will soon find themselves in the big leagues, and even though they’re prepared to take on the task, the first few nights can be tricky. I’m forced to do a lot of hand-holding, especially because we don’t have our new crop of fellows yet.
When I left Natalie’s graduation and rushed back to the hospital, it was because the residents on duty were in over their heads. I walked in and found them standing in the center of the BICU, near the nurses’ station, knees quaking, their scrub pants in danger of new piss stains. They froze and looked at me with wide, expectant eyes.
It was Lois who strode over to me, filling me in while I yanked off my suit jacket and tie and tossed them onto the counter. She handed me a surgical gown, and by the time it was tied and covering my clothes, I’d been briefed.
Apparently, there were three new admits, all from the same house fire, meaning we needed all hands on deck. Two of the patients had burns severe enough that they needed to be rushed straight to the tub room. We started them on two large bore IVs and a morphine drip as the nurses started cutting away charred clothing.
I had residents pull labs while I assessed the third patient, who seemed lucky to have sustained only smoke inhalation, but his luck turned when his pulse ox dropped and his heart rate shot up—his airway was closing up from inflammation. He’d taken in too much smoke and soot and needed to be intubated.
I asked a resident to do it.
The guy fumbled with the laryngoscope, his hands shaking. He couldn’t see where to aim the trach tube. He swiped sweat from his brow and looked up at me, fear clouding his eyes. “You should just do it. I’ve only done a handful of these and I’m not ever good at it,” he said, trying to pass the tools over to me.
I told him to take a breath. The patient wouldn’t code while I was in the room. What probably felt like ages to the resident was in fact only milliseconds. He was fine. He could do this.
He tried again, blinking rapidly, concentration unwavering. I reached over and adjusted his angle, giving him better access so that this time, the trach tube slid down easily. A sigh of relief rippled through the room as the resident looked up at me. I nodded at his achievement before a nurse connected the Ambu bag. Before I left the room, I assigned the resident that patient for the remainder of the night. It was his job to continue with cardiac monitoring and ongoing pulse oximetry. I had other patients to take care of.
I ended up staying on my feet all night, barely stopping for a bathroom break or cup of water. There’s a lot of danger when it comes to burn injuries. Skin is an organ we take for granted, but not only does it create a barrier between the outside world and our bodies, it also helps with temperature regulation, immune defense, and vitamin production. It keeps us from becoming dehydrated, and it’s a storeroom for water, fat, and metabolic products.
Long story short: skin is fucking important. When a patient comes in with severe burns, we immediately assess the degree and the percentage of the body the burns cover. The higher the degree, the more likely it is the patient will need surgery.
That’s where I come in.I’m ready to drop where I stand when my colleague, Dr. Sandra Garza, arrives to swap places with me in the morning. I glance up at the clock and see the time: nearly 7:00 AM. The night flew by.
Dr. Garza smiles at me. “You look like hell.”