Ren moved her token, claimed the last victory point, and smiled as the scores tallied up. A moment later the message from Axe appeared.
That’s only one point. Close only counts in horseshoes.
Ren laughed out loud, the sound strange in the otherwise silent on-call room. She curled up on the bottom bunk with her back against the wall and her legs drawn up, her computer balanced on her knees. She’d hoped all evening that no one else would come in to share the space, and she’d been lucky. She was alone, as she’d hoped. The hours had passed so easily, as their victories bounced back and forth, first Axe winning, then her. She liked to win, but she liked to play even more, especially with an opponent like Axe who was never predictable and always forced her to vary her strategy. Axe wasn’t just smart—she was perceptive. If Ren hadn’t learned long ago how to avoid making the obvious draw or building on a predictable series of moves, she’d almost think she was telegraphing her play. But she wasn’t—any more than she telegraphed her plans, or feelings, in person. Axe just sensed what she was thinking…somehow.
She texted back: It counts when you’re the one closest to the pole
It’s stake…and you say that now. Not what I heard earlier :-)
If it wasn’t close, what fun would it be?
Not as much fun as this.
A warm feeling spread through Ren’s chest. Axe enjoyed playing with her, maybe as much as she did. Silly, that she cared about what someone she’d never met thought about her. But it was such a change, to have a friendship with someone, after finding over and over again she was bad at it. Maybe if they actually played in person…No. She already knew how that would turn out. She wouldn’t know the right things to say, or not say, and she wouldn’t be what she was expected to be. Just not right, somehow. She understood she was the odd one, the one who didn’t fit. But here, she could be herself, and all that mattered was what she said and how she played. Here Axe liked her.
Another game? Ren asked.
Bummer. Can’t, Axe texted. Work in the morning.
Work. Not school. Not class. So at least Axe wasn’t a teenager, most likely. Not that it really mattered. They were just gaming friends. Ren sighed. She didn’t sleep much. She was like Sax that way, never seeming to need much sleep and always being just a little bit wired. She knew sleep was important, though, for her and everyone else. NP. Will catch you again soon
for sure. later
later, Ren texted with just a bit of sadness. Missing someone whose face she’d never seen, whose voice she’d never heard. Maybe that made her kind of pitiful. But there it was.
She thought about trying to sleep, but she wasn’t the least bit tired. If she got two or three hours, she’d be fine. She set her computer on the narrow desk tucked against the wall at the foot of the bunk beds, left her backpack in the middle of the bed to claim her spot, and walked down the hall to the ER.
The charge nurse, Linda O’Malley, watched her coming, and when she stopped to look at the intake board, said, “Surgery?”
Ren nodded.
“I was just about to call a consult. Who are you covering?”
Ren perked up. “I’m covering A service, but I’m not busy right now.”
Linda glanced at the on-call board. “This is just a routine unreferred patient who needs to be cleared for discharge. Perkins is the attending on call—he wants the patient seen by a resident before we send him home.” She lifted a shoulder. “Kim Rae is covering consults, but she’s down in radiology getting an a-gram on a cold foot.”
“No problem. I can take it.”
“Great. He’s in four.”
Ren turned to pick up the tablet from the rack of patients to be seen, then reminded herself that she ought to be working on her communication skills. The first step was to ask something about the other person. Studies had shown it didn’t even have to be a personal question—any question usually enhanced the positive response to the interaction. She wished she’d known that when she was twelve. Of course, she hadn’t really tested the theory herself. She cleared her throat. “How is your new baby?”
Linda smiled, her eyes shining. “Feisty and doing great.”
“You just came back, didn’t you?”
“Yes, after almost four mostly glorious weeks off. I miss her, but it feels good to be back.”
“Well,” Ren said, anxious to get to the consult, “it’s good to see you.”
“Thanks. It’s Ren, isn’t it?”
Ren paused, surprised. “Yes. Ren.”
“Let me know if you need anything.”
“I will.”
Maybe the studies were right. Linda’s warm smile followed Ren down the hallway toward room four. Most of her ER calls had been at night, and she’d found the quiet to be a silent comfort. Curtains were drawn, lights were dimmed, and voices were lowered. She caught muted bits of conversation and an occasional moan or sigh, but nighttime in the hospital always felt like some slip of time, tucked in between the chaos and bright lights of waking hours. She paused outside the closed curtain of cubicle four to scan the chart. A forty-three-year-old man complaining of headache after being hit in the head by a wild pitch during a summer league baseball game.
The kind of blunt injury to produce a hematoma or fracture. The ER resident had noted soft tissue swelling in his left temple region, but nothing else on exam. A notation said he’d had a CT scan a half hour before. The reading had been normal other than some suggestion of mild contusion. Not surprising after taking a blow to the head.
Expecting this to be a brief check and discharge, she slid the curtains back and stepped inside. A man looking his stated age lay on the stretcher, eyes closed, a faint pallor to his face. An IV line ran from a bag of saline hanging on a pole beside the bed to a catheter taped to his right wrist.
“Mr. Mancuso? I’m Dr. Dunbar,” she said as she walked over to the counter adjacent to the stretcher, set down her tablet, and leaned over the sink to wash her hands. “How’s your headache doing?”
“Worst headache ever,” he said slowly, with just a hint of a slur to his words.
Ren narrowed her eyes and turned to look at him more closely. The right lower corner of his mouth sagged. Subtle, but it was there. She looked around for a flashlight and found one in the cabinet above the counter. She needed to start carrying one. Leaning over the rail by his side, she said, “I’m just going to check your pupils. Can you open your eyes?”
He did, slowly, and she shone the light in first his left then his right. Anxiety fluttered through her stomach, and every muscle tensed. “Are you having any blurred vision?”
“No,” he said. “Don’t…know. Maybe.”
Definitely slurred speech now. Ren put the flashlight aside and grasped both his hands, one in each of hers. “Squeeze my hands. Hard as you can—I’ll tell you when to stop. Don’t worry.”
He did, except his right hand barely closed around her fingers. Now the tightness in her belly spread to her chest, and she had one paralyzing moment of terror. Then, as if a prism had slipped in front of her gaze, the world grew sharp and bright.
“I’m going to raise the back of your stretcher a little bit more.” She found the controls and put him upright, hoping to relieve some of the pressure in his head. She turned the IV down as low as it would go. “I will be right back.”
She dropped the tablet on the counter, slipped out of the curtain, and raced down the hall. Linda heard her coming and stood up. “What?”
“He’s got an intracranial bleed. He’s about to herniate. We need neurosurgery, right away.”
“Are you sure? The CAT scan—”
“I don’t care what the CAT scan shows. He’s got right-sided symptoms, and his left pupil’s blown. Get somebody. In the meantime…” She mentally flipped through the emergency protocol for intracranial bleed. The page came into view, the words scrolling through her memory. She reeled off the meds and dosages.
“Got it.” Linda didn’t hesitate, already on the phone while flagging down a PA who’d heard their conversation and stopped with a questioning look. “Kareem, you’re with Dr. Dunbar. Get the meds she needs started in four, stat.”
Ren jogged back down with the PA while a nurse wheeled the med cart to the opening of the cubicle and began to prepare the drips and drugs she’d ordered to help control his intracranial pressure until neurosurgery could get there and do a definitive procedure.
“What’s happening?” the patient muttered. “Fuck, my head hurts.”
Spasms started in his right hand, traveled up his arm, and suddenly his entire body began to shake.
“He’s seizing,” Ren said in a voice that came out steady and calm. Another page from the emergency protocol manual flickered into view, and she barked out instructions. “Call the code. Let’s get him intubated.” Within seconds, the room filled with even more people—starting IVs, drawing bloods, pulling out the intubation equipment. She paid little attention to who was around her, too busy watching the monitors, assuring the right meds were being given, adjusting dosages until the seizures stopped and he appeared stable. She spun around to look for Linda and came face-to-face with Honor Blake. “Is neurosurgery here?”
“On their way. Nice job, Dr. Dunbar.”
Honor didn’t seem at all surprised or taken aback by her perfunctory tone. Honor was the ER chief after all, and Ren was…Well, Ren was just a resident. She frowned. “I might’ve been a little bit slow in making the diagnosis. I read the results of the CAT scan first, and it threw me off. They read it as normal.”
Honor nodded. “That happens. Especially when the bleed is small and there’s some swelling around the site. That’s what you would expect with a blow to the head and a mild contusion. We’ll probably find out this is an epidural bleed. They expand quickly, and the symptoms accelerate fast.”
A big man appeared behind Honor. Ren recognized him. Kos Hassan, the neurosurgeon. At his side, Sydney Stevens, the senior neuro resident.
“I heard he seized,” Kos said. “Let’s get this guy upstairs.” He regarded Ren for a second. “Who are you again?”
Ren tensed. “Ren Dunbar. Senior surgery resident.”
“Huh. Okay, then. You want to scrub with us?”
“I do.” She glanced at Syd, who in this instance was her senior. “If there’s room?”
“Sure,” Syd said. “I’ll get the consents from his family, if you help get him upstairs.”
“Of course.”
Syd gave her a long look, then smiled. “Thanks.”
Ren relaxed, pleased. She’d done her job, of course, and that was what mattered. But she liked Syd’s smile too. Maybe she’d be able to do this after all.
* * *
Dani slept in a tank top and boxers on top of the sheet with the windows wide open. She still woke up sweaty and restless a little before the sun came up. Maybe part of the hot and unsettled feeling was due to her crazy-ass dreams. Something to do with a cliff and a woman with wings—but definitely not the fairy princess kind of woman—one who led her on a chase through foggy forests that turned into deserted city streets, and then the woman—fairy…whatever the hell she was supposed to be—dragged her into the mist and kissed her. A freaking hot kiss and then…she flew away. Looking like some dark bird against the moonlit sky. Totally WTF? and typically frustrating.
How come every time she was in the middle of a sexy dream, something would happen to interrupt, and her subconscious would go veering off in some other direction before the finale. She sighed. Probably a metaphor for her life that she hadn’t yet deciphered.
She sat up and ran her hands through her hair. The damp strands just touched her shoulders. An inch longer than she usually wore it. She needed to find time to get it cut. She needed to find time to get to the dojo. She needed to find time to get a life, but that wasn’t gonna happen this year. Not during the busiest, most important year of her residency. Not now especially, when she had the crazy-ass idea to try for the Franklin. She probably should give that up. She would, maybe, if she wasn’t always hearing her mother’s urgings to reconsider and her father’s subtle frustration. If she didn’t think, hope, achieving something they could understand and appreciate would somehow change things. Somehow make her not the disappointment. The one no one could understand.
And she was going to have to do something to figure out exactly what she needed to do to win the stupid thing. Every time she got to this point, she wanted to think about anything but, and she instantly thought of Raven. A game and some easy chat with Raven, that’s what she needed. She grabbed her phone and winced. They’d just said good night a few hours earlier. Raven was almost always around, no matter the hour, but Dani still didn’t want to chance waking her up. And she knew Raven was a she—not because of anything Raven had said, just…because of a feeling. Yeah, right. Like she was so good at those—still, she trusted this one. And she was going to let Raven sleep.
She left her phone on the bedside table, shed her clothes, and padded down the hall to the bathroom. She’d been under the shower three minutes and was just contemplating doing something about the lingering arousal left over from the unrequited lust of her dreamscape when the bathroom door banged open and Zoey exclaimed, “You are not gonna believe this.”
“Naked in here,” Dani shouted. “Taking a shower.”
“What, you think I don’t know that,” Zoey said. “What do you think I’m doing in here?”
“Interrupting me?”
“You’re taking a shower, what’s to interrupt?”
Dani rolled her eyes. Like she was going to say something to that. Not.
“Go away, and I’ll be out in ten minutes,” she said instead.
“Who needs ten minutes in the shower,” Zoey said. “Nothing takes ten minutes. Besides, I want to talk to you.”
Annoyance killed the last of her flagging arousal, and Dani surrendered. “All right, what do you want, then?”
Before Zoey could answer, Syd Stevens said, “What are you guys both doing in the bathroom?”
“What, is there some kind of party I don’t know about,” Dani yelled. “I’m taking a shower. Zoey is bothering me. Why are you here?”
“Because I’ve been up all night, I needed coffee, and there’s cinnamon rolls downstairs.”
Dani hurriedly rinsed the rest of the soap from her hair and turned off the water. “Get out, both of you. I’ll be downstairs in two minutes.”
She opened the door of the shower a few inches. “Wait—hand me a towel.”
Zoey handed her a towel. “Hurry up.”
Grumbling, Dani wrapped a towel around herself and hustled back to her bedroom. She pulled on jeans, T-shirt, and beat-up loafers and finger-combed her hair. By the time she got to the kitchen, Zoey had poured three mugs of coffee, and Syd was sliding cinnamon rolls into the toaster oven.
“I don’t need mine toasted,” Dani said. “Thanks for the coffee.”
“Wait five minutes, Dr. Impatience,” Syd said. “The payoff’ll be worth it.”
“Nothing’s worth waiting five minutes for, when you really want something,” Dani said.
Zoey rolled her eyes. “You’ll change your mind someday.”
“And you complain I’m always thinking about sex,” Dani said, grinning.
“Never mind the cinnamon rolls,” Zoey said, holding up her phone and waving it in the air in Dani and Syd’s direction as if they could actually read the blue bubbles on the text screen. “I’m trying to tell you something important.”
“What?” Dani asked.
“I got a text from the chief a few minutes ago. I’m getting pulled from transplant to general surgery.”
“Um, so,” Syd said, sounding only slightly mystified. “What’s the crisis?”
Dani felt a chill. A real chill. “Let me guess. You’re going to A service.”
Zoey narrowed her eyes at her. “What did you do?”
“Me,” Dani said. “Nothing. Why does it always have to be me?”
Syd grinned, and Zoey pointed at her. “Because it usually is.”
“Got a point,” Syd said, setting the rolls on the table.
“Hey!” Dani shot Syd a wounded look. “You’re supposed to have sympathy for me. Fellow transfer and all that.”
Zoey snorted. “As if anybody cares about that anymore.”
Dani grimaced. “I bet they do. Maybe not the residents, but…never mind. Is it A service?”
“Yes.”
“Well, that makes sense then,” Dani said. “Mike’s leaving, and the new chief doesn’t have a lot of clinical experience. You do.”
“I don’t want to spend the next four months babysitting,” Zoey said.
Syd snorted. Dani rolled her eyes. “You’re saying Quinn Maguire asked you to babysit a fifth year resident?”
“Well, no, but…”
“You’re not gonna have to babysit Ren,” Dani said, feeling unexpectedly protective. “I made rounds with her yesterday. She’s smart. You’ll—”
“Supersmart,” Syd put in. “She just scrubbed on a case with me and Kos. Very brainy. Pretty good hands too, for somebody who’s been in the lab all that time. I think she said she was dissecting beef hearts under the microscope or something.”
Dani swiveled in her chair to stare at her. “Wait a minute. Ren just did a case with you? Last night.”
Syd nodded. “Yeah. Well, this morning really. She saw a patient in the ER with a developing epidural hematoma. Really fast pickup too. If she hadn’t seen him and made the diagnosis right away, the guy could’ve died.”
Syd had left general surgery to go into neuro and launched into a lot more detail than Dani really wanted to hear just then. Not that it wasn’t an interesting case, but what interested her a lot more was figuring out what the hell Ren was doing in the emergency room in the middle of the night when she wasn’t even on call.
“I don’t get it,” Zoey said. “If she’s so good, why pull me then?”
“It makes sense,” Dani said. “I was just thinking earlier today, if I was Quinn, that’s what I would do.”
Zoey sighed. “So she does need a babysitter.”
“No,” Dani said. “That’s not what I meant. It’s just that when you have a new chief who doesn’t know the residents, it helps to have a senior who supports them and can ride herd on the juniors. The other residents all know you. And, well, you’re the best resident in your year.”
Syd said, “Aww. That’s really sweet.”
“Shut up,” Zoey said, a blush coloring her cheeks.
Dani ignored the teasing. “And you’re not going to have any reason to steal cases from her, since you want transplant. Like I said, perfect choice.”
While Syd and Zoey went back to discussing the neuro case, Dani kept turning over and over in her mind the question of what Ren was doing in the ER in the middle of the night. The only answer she could come up with was that Ren was making an all-out push to show she was clinically up to speed. To make an impression. As if the lab experience wasn’t enough. Of course, Dani could think of a lot of reasons Ren might want to do that, but the biggest one was she wanted to be competitive for the Franklin. Dani’d figured the other residents in her year all had a good shot at it—probably better than she did, but Ren suddenly joining the field changed things. She never liked starting a game against players she didn’t know. Maybe she needed to change that.