My hands were still shaking ten minutes later.
I paced the resident's room. It was smaller than Room 14. It was also dominated by a bed. But the door locked and I could be alone. So no one could see me gasping. The whites of my eyes. My heart throbbing in my throat, choking off my words.
Breathe.
I checked my watch. Twelve minutes. Long enough for them to subdue Reena. I should be back there. I should be running it.
Instead, I was alone with my panic attack.
"CODE WHITE. EMERGENCY ROOM. CODE BLANCHE, SALLE D'URGENCE."
The words had echoed through the room. Men in white uniforms had descended. For one wild moment, I'd thought they were coming for me.
"Two of Ativan? She's allergic to Haldol," Nancy had said.
I'd nodded yes and bolted.
Some doctor I was, yelling at Tucker, telling him to respect me and my decision to return to work.
I couldn't even do psych.
Hell, I was too busy being psych.
Something about the room, the screaming, the loathing emanating from the two women threw me off.
Breathe.
I pressed my back against the white concrete wall and forced myself to take my own pulse, pressing my fingers against my carotid while I stared at my watch.
One hundred and twenty-four beats per minute.
Normal is usually between sixty and one hundred.
Breathe.
Well, at least pressing on my neck and providing some vagal stimulation might slow me down.
Lame medical humour.
Breathe.
I took my pulse again. One hundred and twenty-six.
Come on, Hope.
I glanced at my watch. Sixteen minutes away. Long enough for them to start asking, "What happened to the resident?" Nancy would have given medication already.
Even though the emerg doctor was always in-house, and the psychiatrist was presumably on the way, I had to get back there.
On top of everything else, I felt terrible about dropping Mrs. Lee's envelope. I hadn't even realized I'd brought it into the room. It seemed like a violation of Mrs. Lee's privacy, although all it showed was her name and address. For all they knew, she could have been sending me Jehovah's Witness flyers.
Breathe.
Count: one twenty-two.
Better. Come on.
Even though I still felt sick, I unlocked the door leading back to emerg and stood just inside it. The acid green walls of the room seemed to push in on me. I could hear someone flushing the toilet of the staff washroom across from me. The opposite side of the resident's room faced the main hospital hallway, so I could hear people talking in stereo, from the emergency department on one side and St. Joe's passers by on the other.
"—got to make a phone call—"
"I told him, no way. You want to, you do it."
"They're going to tap it under ultrasound. You might want to be there."
The key to the resident's room dangled from my hands. It was attached to a foot-long stick painted bright yellow, to prevent someone from accidentally walking away from it.
Footsteps approached the residents' room. "—think she's in here."
My breath hitched in my throat. I threw open the door and stepped into the hallway. My favorite emergency doc, Dr. Dupuis, gave me a quizzical look. He was pointing at the conference room just beyond both the resident and staff room. It had nothing to do with me.
I smiled at him and, even though I still felt nauseous and clammy and like I wasn't in my own body, I pushed past him. Back to the salt mines.
First I just took a good look at everyone to see if hell had truly fallen into a hand basket while I'd disappeared.
The unit clerk popped her gum as she sent a fax through. One nurse asked another, "Did you see the old chart?" as they both stepped aside for a janitor to empty the trash can. Someone had abandoned a chest X-ray on the light board. Even after a week away, I could spot the congestive heart failure at twenty paces.
I heard loud, angry women's voices from Room 14 before it went silent.
When Dr. Dupuis passed by me again, he said, "Don't worry about it" and kept walking with no other explanation. Still, I felt better, especially when Nancy emerged from Room 14 and said, "She's calmer now."
Forty minutes later, after Dr. Gatien had talked to Reena alone and signed off the chart, he called me into the psych office. I knew I was in trouble even before he tented his fingers and said, "Rapport is a very important part of psychiatry."
I nodded. The less talking I had to do, the better. I was just grateful the med students weren't around to witness my humiliation.
"It is perhaps even the most important part. Rapport, through talk therapy, preceded the medications we rely on so heavily today."
I waited for him to get to the point. He was French. It might take a while.
"This is why I want you to consider very hard what you might have done to alienate this patient. This—" He picked up the chart and read off the name. "—Ms. Reena Schuster."
I squeezed my eyes shut. I wondered if beads of sweat had broken out on my forehead like in the movies. I resisted the urge to check. Better not draw attention to it.
"You may not have done anything, of course. It may have been a case of transference. However, it is unusual to get transference from the first moment. I'm not saying it's your fault."
Like hell you're not. But it was only a replay of what I was saying to myself.
"I am simply saying that some reflection is in order. She's calm now. She doesn't need to be admitted. Nancy told me a Code was necessary. Nancy is a woman who knows what she is doing."
Meaning that I didn't. That was certainly true. Tucker's voice rose in the back of my mind. Grinding yourself to powder.
"Dr. Sze?"
I jammed a smile on my face. "Yes. Thank you." I started to stand.
"About Mrs. Lee."
My heart dropped into my stomach. "Yes."
"It's natural to feel sympathy toward her. However, it is unwise to get involved with patients, if you understand my meaning."
I paused. "Yes. Thank you." He frowned at me, so I belatedly added, "Dr. Gatien."
This time, I managed to leave the psych office and close the door softly behind me.
A familiar brown envelope sat beside the printer in the psych corner of the nursing station. I'd abandoned it during my panic attack.
I flipped over the envelope. Mrs. Lee's handwriting stared at me again.
Nobody else wanted me to do this. And, for the first time, I seriously doubted I could do anything for Mrs. Lee, even offer basic words of comfort.
I could return the file to her unopened and say I was sorry. No can do. No harm, no foul.
Instead, I tucked the envelope under my arm so I could open it in private.