Alex snapped wide awake.
The telephone rang again. He rolled onto his left side, his back to Lisa, and picked up the phone. “Cutter here.” The clock digits glowed 2:32 a.m.
“Sorry to bother you, Doctor Cutter. Sam Riddell. I’m covering the trauma center. We just got a GSW to the head in and Kotell”—a clinic partner—“refuses to come in.”
“Refuses?” Alex was on the edge of the bed now, knuckling eyes with his free hand.
“Yes, sir.”
With Reynolds in Bethesda, backstopping the trauma center defaulted to him, although he doubted Reynolds would have come in. “Be right in.”
He drove deserted Central Avenue doing a slow burn. Refused to come in? What kind of bullshit was this? Alex picked up the car phone—a new addition he was rapidly learning to love—and found Kotell’s number in the programmed directory, punched “Dial.”
Kotell’s sleepy voice answered. “Hello?”
“Kotell, Cutter. Did you just get called by the trauma center?”
“Why?” He sounded incredulous.
“Why?” Another spike of anger. “Because I’m the one having to cover your sorry ass. That’s why. Why did you refuse to cover? You’re on call.”
“Damnit, Alex. Can’t we discuss this another time? I have a case in the morning and I’m trying to sleep.”
“Yeah? Well I was sleeping too, but because you’re too lazy to take your call, I have to do it for you. What do you think you’re doing?”
“Listen, you sanctimonious ass. Think about it. I bet you a thousand dollars the clinic won’t get paid a goddamn cent for that case. Some nigger gets shot at two in the morning, you know chances are overwhelming it’s crime related. I’m sick and tired of taking care of ’em. Let ’em all shoot each other and be done with it. That’d be fine with me. Besides, the resident is more than capable of handling a head wound without either of us standing in the OR with our thumbs up our ass.” Kotell hung up.
Alex slammed down the phone, almost hard enough to break the handset. A full surgical load—two craniotomies—scheduled for later today, and now he wouldn’t sleep until evening. Why did he put up with assholes like Kotell? Easy answer: the pay was too good.
He locked up his Audi in the empty Baptist parking garage instead of using the reserved “Physician On Call” spot at the trauma center ambulance bay. He decided to walk the two blocks between hospitals, because by time he finished the case, it’d be senseless to drive home and shower, only to turn around and come back downtown. His only consolation prize was a full choice of the prime parking stalls just outside the doors to the sky bridge. Still fuming, he trudged down the stairwell to the alley, the muggy night air residually thick with car exhaust from the previous day’s rush hour.
4:45 a.m. Alex sauntered out through the automatic glass doors of Trauma Center ER into the brightly lit parking lot. He took the ramp at a leisurely pace down to the deserted street. No sense hurrying now. A layer of clouds hid the stars. Dawn would begin soon. To him, this hour of the morning seemed the stillest of all twenty-four, a transition time between a sleeping city and a city ready to work. Feeling heavy and sluggish from fatigue, he continued the leisurely walk, enjoying the quiet solitude. The cafeteria wouldn’t open for another hour and fifteen minutes. His first case didn’t start until seven thirty. He wanted nothing more than to curl up and sleep, but that was impossible now.
In the middle of the block, he took a shortcut into the shadowy alley between two large medical center buildings. Glass crunched underfoot and the smell of rotting garbage filled his sinuses. Puddles in the rutted asphalt reflected light from the mercury vapor streetlight at the far end of the alley. For the first time in a week, he thought about his research, about his frustrated attempts to rekindle it and how they repeatedly failed for one reason or another. Yes, he was passing off chunks of tissue to his collaborator in Cell Biology, but their work was pedantic and unimaginative, just barely funded. The longer the gap without solid funding, the murkier his name would become in the minds of NIH. He needed to stay firmly on their radar if his research was going to succeed. He’d debated reaching out to his academic contacts to see what openings might be available, but the thought of packing up and moving and starting over again seemed too daunting. Worse yet, he hated to admit how much he’d become addicted to the quarterly bonuses. Yet he couldn’t shake the belief that the key to understanding the horrible disease of glioblastoma resided within the stem cells he saw in the tumors. No one had addressed this particular issue yet, and he still possessed all his lab books and journals from his previous job. Sooner or later, though, someone would come along the same path of research and, Alex believed, make a huge breakthrough. He despised himself for aimlessly floating along.
The surgeon’s lounge was empty when he arrived, yet one coffee pot contained what looked and smelled like freshly brewed coffee. He chose the most comfortable of the three couches and stretched out, the heels of his Nikes propped up on the arm. Eyes closed, he rested, knowing sleep would be impossible, but at least he could relax until the lounge began to fill up for the day’s schedule.
Sometime later, he heard hushed movement and cracked his eyes. Phil Chapman, an anesthesiologist, was pouring a cup of coffee. Phil glanced at him. “Sorry. I was trying to not disturb you.”
Alex sat up, working out a kink in his neck. “Wasn’t asleep anyway. You in the bucket or just getting started?”
Phil glanced at his watch. “In the bucket. Just finished a caudal up on OB. What’re you doing here so early?”
Alex decided on having a cup to help perk him up, so he poured one while telling Phil about the trauma center case.
First cup of coffee drained, Phil poured a second one. “Want another?” he asked, holding the pot at the ready.
“Naw. Limit myself to one on days I operate.”
“Why’s that?” Phil came over to sit at the end of the couch at a right angle to him.
“Causes a caffeine tremor in my hands. Never realized I had one until I took Rhoton’s microsurgery course in Gainesville. The first lab day we were doing a carotid anastomosis with 10-0 silk”—a suture thin enough to place through a human hair—“and my fingers were shaking too badly to do a good job. I couldn’t stop it, so I called over the instructor over, had him look through the observation side of the scope. Didn’t take him five seconds to tell me it was a caffeine tremor. Next day I skipped my morning coffee and, voila, the tremor wasn’t there. Now I limit myself to one cup when I have to operate.” He laughed. “Helps with the bladder issue, too.”
Chapman laughed, too. “We’re lucky. Our group is big enough to always have a rover who can spell us periodically. You guys aren’t so lucky.”
Alex stretched out again. “Go ahead, talk. I’m going to relax until the room starts filling up.” He decided to take a shower once people started to wander in, just to invigorate him. He kept shaving gear in his locker for just such occasions.