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Haley Wright smiled fondly at the man who had just popped the question—for the third time that week. "It's sweet of you to ask, but I'm afraid I can't."
He sighed heavily. "Already married, huh?"
He responded that same way every time she turned him down. "No, still single." It was the same reply she always gave him. "Just too busy to get married right now."
"I could make things easier for you," he suggested hopefully. "I'm a great cook. I can even do the laundry."
"As much as I appreciate the offer," she said, making a note on the pad in her hand, "I still have to decline."
Edgar Eddington, a sixty-two-year-old Caucasian male presenting with congestive heart failure and cirrhosis of the liver, nodded in resignation against the pillow of the hospital bed in which he lay. "Can't blame a guy for asking a pretty young doctor."
Smiling, Haley looked over her notes to make sure she had everything she needed when she presented her patient to the other students, the residents and the attending physician when they made rounds a short time later. Assuring herself that she had checked everything she was supposed to know about Mr. Eddington for that morning—she hoped—she held her notebook at her side and smiled at the patient. "I'll see you in a little while, Mr. Eddington."
He winked, a flirtatious smile lighting his illness-ravaged face. "I'll look forward to it, doctor."
She had told him several times that as a third-year medical student, she wasn't yet entitled to be called doctor, but his answer to that was always, "Close enough." Many patients on her internal medicine rotation tended to call anyone in a white coat "doctor," making no distinction between the students' shorter, hip-length white coats and the physicians' longer coats, which fell almost to the knees. While she had been instructed to politely correct the misidentification, she was not expected to argue with the more stubborn patients.
Hurrying toward the students' room in hopes of snagging a free computer on which to write her notes, she was still smiling a little in response to Mr. Eddington's outrageous flirting. She never failed to be impressed by his bravely cheerful attitude even in the face of the pain he suffered in what both he and the medical staff realized was the final stage of his life. He had weeks to live, at the most, but during the days she had worked with him, she had never once heard him complain.
She was assigned to monitor three patients during the month she would spend on wards in the Veterans Administration hospital near her medical school campus. When one patient was discharged, she picked up another, so she always had three.
Every morning at six, she visited each patient to record any problems noted during the night, to make note of the vital signs that had been taken every two to four hours and to ask if they had any questions or concerns. She always did a physical exam—checking head, eyes, ears, nose, throat, heart, lungs, abdomen, blood flow, pulses in the hands and feet—writing down what she observed. Because she'd been doing those exams for only a week during this, her first rotation, she tried to look more confident than she actually felt.
After she had seen her assigned patients, she had to write notes on each before rounds started at 8:00 a.m. It wasn't easy getting it all done in time, but she knew better than to be late or unprepared when her resident or attending physician asked her a question during rounds.
Aware of rapidly passing minutes, she rushed into the students' room, hoping a computer there would be free. If not, she would have to find an available one somewhere on the floor, and she had very little time remaining before rounds. To her relief, only one of the two computers was being used. Sandy-haired Ron Gibson looked up from the keyboard with a grin when she stumbled into the room. "Running late again?"
She glared at him. "That's easy for you to say. You only had two patients to see today. I had three."
"Maybe if you didn't spend so much time flirting with Mr. Eddington…"
Plopping into the uncomfortable chair in front of the spare computer, she snorted. "Says the guy who can usually be found flirting with the nurses."
"What can I say? They love me."
Sadly enough, it was true. Ron was most definitely the nurses' pet student. His infectious grin and twinkling blue eyes helped him get away with things no other student would even attempt. He was also a favorite with his patients, treating them with respect and sincere concern.
Haley had always known Ron would be a good doctor, even though his sometimes lackadaisical attitude toward class work and studying had frustrated her. They'd both been active in a five-member study group which had drifted together their first semester of medical school and had met frequently afterward, becoming close friends during the first two years of classes. Still, spending so much time together had inevitably led to occasional tension. Haley was aware that she and Ron had contributed perhaps more than their share toward that friction.
It was just that he was so skilled at pushing her buttons, she thought as her fingers flew over the computer keyboard. He liked to tease her about being the perky "cheerleader" of the group, a moniker he used whenever she tried to convince him to take their studies more seriously. It frustrated her that his stated motto had always been, "If it doesn't work out, walk away." Her own had always been, "If at first you don't succeed, keep at it until you do."
Those opposing viewpoints had led more than once to nervous sniping. Fortunately, they had cleared the air between them a couple months ago, and they'd been getting along much better since. She could say honestly that she considered him one of her closest friends.
Pulling her notebook out of one of the stuffed pockets of her pristine white coat, she concentrated on typing her notes. SOAP notes, they were called. S for subjective, or what the patient said about his condition overnight. O for objective, which included readings of vital signs, lab work and physical exams. A for assessment, a brief statement of the patients' descriptions and conditions. And P for plan, the recommended course of treatment as prescribed by the resident physician.
A wadded sheet of paper hit her in the back of the head and tumbled to the floor. She didn't even look around. "Stop it, Ron. I'm running out of time."
He laughed softly. Despite her irritation with him, her lips twitched in a wannabe smile. It was a common response to his—okay, she would admit it—his sexy, low laugh. Acknowledging his appeal didn't mean she was particularly susceptible
to it, she assured herself, as she had on more than one occasion during the past two years. Ron Gibson was a walking heartbreak if she'd ever met one, and she was too smart and too busy to let herself fall into that trap.
"You know you'll be ready for rounds," he said as he gathered his own notes to stuff into the pocket of his slightly crumpled white coat. "You're a resident's dream of a med student."
It was the student's job to make the resident look good in front of the attending, and Haley acknowledged that she always tried her best to do so. That was her nature—Ron could call it "cheerleader" if he liked, but it was important to her to see others succeed, just as it was for her to do well, herself.
"Yes, you certainly do."
Was that a dig? She shot a suspicious look over her shoulder, but couldn't tell anything from his bland demeanor. "It would be better for you if you didn't always have to be the class clown. Your resident spends the whole time during rounds worrying about what you're going to say in front of the attending."
His expression turned instantly innocent. "I've been perfectly well behaved during my presentations."
"Mmm. Doesn't prevent everyone from worrying about when you're going to stop being perfectly well behaved and let your real self show," she muttered, returning to her notes.
He laughed again as he ambled out of the room. "See you on rounds."
Even as she concentrated on finishing her work, she dwelled on thoughts of Ron during the next few minutes. She found it ironic that out of their entire study group, she and Ron were the only two who'd ended up on the same rotation, so they saw each other every day during rounds and lectures.
She'd hoped to share the experience with her best friend, Anne Easton. But Anne was on surgical rotation—a demanding, time-consuming block—in addition to starting a new life with her husband, who now made his home with his wife here in Little Rock when he wasn't traveling for his job. Haley and Anne hardly had a chance to see each other lately. Nor had Haley seen much of Connor or James, their other two study partners. Connor and James were on a separate semester schedule, meaning she wouldn't do any of her rotations with them this year.
She couldn't say she missed the mind-numbing overload of lectures and exams that had taken up the first two years of medical school, but she did miss her friends. Which, perhaps, explained why she was always happy to see Ron every morning, despite her frequent annoyance with him.
Funny how conflicted her feelings were about Ron, she mused, folding her notes into the patient history and physi-cals—commonly referred to as H & Ps—and slipping them into her pocket. Anne had once commented that Haley and Ron were like squabbling siblings—and yet that description had never felt quite right to Haley. She refused to concede that the sparks she and Ron set off were at all sexual—but "sisterly" wasn't the word she'd have chosen, either. She'd settled for thinking of him as an attractive, interesting, complicated and often annoying friend.
She supposed that was close enough to the truth.
Rounds began promptly at 8:00 a.m. The residents and students were always relieved when the attending physician showed up either on time or a few minutes late. Having the attending show up early caused panicky, last-minute completions of notes and charts. No one wanted to be caught unprepared.
Though this was Ron's first rotation, and first real experience with hospital rounds, he felt more comfortable with the process than he might have expected. He liked the attending quite a bit. Dr. Cudahy was a seasoned hospitalist who was cordial and considerate to her patients and associates. Her first lecture to the three students on this team—Ron, Haley and Hardik Bhatnagar—had included a reminder that all the patients they would see in this facility had spent time serving their country and in return deserved to be treated with gratitude and respect, no matter what unhealthy lifestyle choices they might have made.
Along with his two classmates, three residents, Dr. Cudahy and her nurse, Ron entered the room of the first patient they would be seeing—Haley's flirtatious Mr. Eddington. The thin, wan man winked at Haley, who stood beside his bed to begin her presentation. A warm, answering smile reflected in her amber eyes when she spoke to the assembled group.
Haley was good at presenting, Ron thought with a touch of pride for her. She looked comfortable and confident as she gave a brief summary of Mr. Eddington's condition, his experiences during the night and the resident's plan for continued treatment. She was able to answer the attending's questions with only a glance at her notes, which made both her and her resident look good. Ron gave her a surreptitious thumbs-up when they left the room to move to the next.
Hardik sailed through his presentation of his first patient, but stumbled during his second stop. He'd forgotten to note the new antibiotic that had been started during the night, and as a result, his resident had to step in to answer the attend-ing's questions, leaving Hardik embarrassed. It happened to all of them, of course; Dr. Cudahy even deliberately tried to stump them at times, just to keep them humble and on their toes. Ron still felt bad for his classmate—and hoped he didn't make the same mistakes with his own patients.
Ron kept his presentations brief and to the point, despite his urge to crack a few jokes to make everyone laugh. Which, of course, made him think of Haley's comment that everyone was just waiting for him to display his "real" self during rounds. Had she only been teasing? Or did she really believe the serious and proficient side of him was only an act?
Haley looked good today, he mused, watching her present her final patient. Georgia McMillan, an sixty-eight-year-old retired Air Force nurse, was being treated for pneumonia in addition to emphysema and congestive heart failure, all common to this facility's population. Many of the veterans had been or were still heavy smokers, leading to a high incidence of lung and heart diseases among other smoking-related ailments.
Letting Haley's presentation drift past him, Ron concentrated instead on how fresh and professional she looked in her spotless, short white coat over a melon-colored top with tan pants. Her collar-length, honey-colored hair was neatly restrained with a brown headband, and her makeup was flawless and understated—not that her pretty, girl-next-door face needed much enhancement.
He realized abruptly that the group was moving toward the door, leaving him gazing rather stupidly at Haley. He recovered quickly, sending a smile of gratitude toward the patient who allowed the students to gawk at her and learn from her suffering. Ms. McMillan batted her eyes at him in return, making him chuckle as he stepped out of the room.
When all the patients had been seen, Dr. Cudahy led them to a conference room for a teaching session. The residents and students followed like ducklings trailing a mother duck— which was the way Ron had come to think of them during the past week. Dr. Cudahy had informed them yesterday that she would be discussing hospital-acquired infection today. The students had been expected to research the subject on their own last night so they could participate in an intelligent discussion of the subject. Ron had spent several hours in front of his computer and textbooks, and hoped he would be ready if the attending tried to trip him up with a difficult question.
He took this training more seriously than some people gave him credit for, he thought with another glance at Haley.
Haley was tired when she arrived home, but that was nothing new. She would take the weariness after a long day on the wards any time over the grueling schedule of classes and exams that had made up the first two years of medical school.
Posted January 19, 2011
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Posted August 22, 2010
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