Chapter Four

“Do you hate all celebrities, or just Wren?”

Madison sighed as she flipped through the chart at the nurses’ station. “I don’t hate anyone.”

Annie snorted, typing at the computer at a rapid pace, then pausing to consider her, dark eyes disbelieving. “You were cold. Which is not like you to be with a patient.”

Everyone danced around Madison these days. It was exhausting on a lot of levels. But it also worked because it had been so long and now Madison had forgotten how to really connect with anyone or talk normally. She came to work. She did her job. She went home.

Annie was the only person who didn’t do any of that. Frankly, Madison was grateful for it. It was the only interaction that wasn’t medical that she enjoyed these days. The memory alone of interaction brought Wren’s face back into her mind. Not Wren Acker, plastered on magazines and done up on red carpets. But Wren in that room, gazing earnestly at her as she apologized, blood in her hairline and exhaustion smeared in black smudges under her eyes.

No. She definitely had not enjoyed that interaction.

“I was not cold,” Madison retorted.

Annie looked up from the screen. “You were cold.”

“Was not.”

“Were too.”

“Was not.”

Annie smirked and gave her attention back to the computer. “Were too,” she sing-songed. “You,” she said normally, “are polite to patients. Efficient, yes, but calming. Soothing, even. They all love you.” Her brow furrowed as she clicked on something on the screen and the printer whirred to life. Around them, the ER buzzed on, nurses snapping up charts, patients being wheeled past to scans and wards. “Mrs. Farrel asked how she could leave you a good review on her way out just now. But you were not like that with Wren. So.” She met Madison’s eye again. “You hate famous people? Famous person bump into you on the street and not say sorry?”

Well, that was too close to what had happened for Madison’s comfort. “Don’t be ridiculous.”

Perhaps she’d sounded too stressed by that, because Annie paused after grabbing her stack of papers from the printer. “You have a beef with Wren Acker, don’t you?”

Madison took a second. Annie stared straight at her. She glanced around. Other ER nurses were beside patients or in treatment rooms. Doctors were busy, running about. Casey was on the other side of the room, deep in conversation with someone who had their leg raised at a horrible angle. Her gaze swept back to Annie. Annie, who didn’t treat her like a fragile little flower. Annie, who had been beside her since she was a horrified intern who’d thought she was going to kill anyone she had touched.

“Yes,” she finally said.

A long, slow grin unfurled on Annie’s lips. “This is fantastic.”

Madison had instant regret.

“Tell me everything.”

“It’s not even that interesting.”

“The longer you drag this out, the more interesting I’m going to think it is.”

“Annie—”

“Wow. Must have been something amazing.”

“It wasn’t—”

“Ooh boy.” She fanned herself with her pile of papers. “Raunchy?”

Madison narrowed her eyes. Annie grinned. “Fine, we were at camp together one summer when we were kids. That’s it.”

Eyes wide, Annie’s fanning stopped. “Really? You two go way back?”

“Not even at all. We knew each other for a few weeks, that’s all. We were joined at the hip and then she turned out to be awful, and we didn’t speak for the rest of camp.”

“How was she awful?”

“I don’t even remember.” Madison was not a good liar, so she kept her eyes on the chart she’d long ago finished filling out. “We didn’t click, I guess.”

“Huh. Wren Acker, mean girl? She never seemed like it. She has that wholesome thing going on.”

She definitely did. Something that had irked Madison forever.

“I wouldn’t say mean girl, she just wasn’t nice to me.”

“Is that why you sicced her mother on her for two days?”

Madison pressed her lips together. “No.”

“I can see you trying not to smile.”

“I don’t know what you’re talking about. It’s protocol to insist a concussion patient be with someone for forty-eight hours.”

“She barely counts as concussed. Plus, I usually try to recommend it to patients out of earshot of the overbearing parents.”

“Must have slipped my mind.” Madison flipped the chart closed.

“Sure it did.” Annie snorted. “There’s a podcast about celebrity run-ins. You should listen to it.”

Just the thought of a podcast made Madison twitch. “Not a chance. Podcasts sound great in theory, but I hear about four words of them. I tried once and had to restart it seven times before I just gave up.”

“ADHD?”

“Oh, yeah.”

The phone rang. Thank God. Madison wanted out of this conversation. The phone call did not last long, Annie taking down information and asking questions as Madison signed another chart.

“Motorcycle accident,” Annie said as she hung up. “Less than five minutes out.”

She reeled off the stats she’d been given.

Wren Acker forgotten, Madison immediately started moving toward the bay where they met the ambulances. “Prep triage room three and alert Doctor Friedman.” Miryam deserved something interesting after being a celebrity babysitter.

Annie was already moving.

Tugging on a gown, Madison straightened her back. Her job, she could do. Without thinking of any drama, nor ridiculousness. A motorcycle accident would require all her attention, regardless. They were never easy. She snapped gloves on, and when Miryam appeared, tied her gown at the back for her. The woman bounced on her toes.

“Any information?” she asked.

“Forty-five years old. Unconscious at the scene. Wearing a helmet. Internal bleeding.”

Miryam sighed. “At least there was a helmet.”

“Probably wouldn’t be coming in if there wasn’t.”

They shared a grim look. The sound of traffic from the busy nearby roads was loud out here, buildings rising up around them. The sun was warm, though thankfully they were under shade, but Madison wished for winter suddenly.

“That was my first celebrity,” Miryam said.

Madison almost sighed. She liked working with residents. She really did. But she was meant to not be thinking of Wren.

“Oh?” was the non-committal response she chose.

“She was nice.”

It took everything in Madison not to roll her eyes. She hummed an answer.

Miryam kept going. “My bubbe loves her. Has seen all her movies. She was devastated when she went to TV, thought she was betraying everything she knew. Now all she does is rave about that show and how excited she is for the second season.”

Sirens wailing. Madison heaved a sigh of relief. Wren Acker would fade back into a distant memory that Madison revisited occasionally to apply fertilizer to her grudge.

The ambulance wailed louder, rolling up the ramp, and Miryam and Madison both started moving.

She was never going to see Wren Acker again.

On the road beyond, a bus went past, Wren’s face plastered on it. She was staring dramatically into the distance while Trinity Dray stood behind her shoulder, gazing in the opposite direction.

Fine, she was never going to see Wren Acker in person again.

That was final.

* * *

“Push adrenaline,” Madison said, hours later in an entirely different patient‘s room..

The nurse on medications in the room filled with organized chaos did so immediately, Miryam at the head of the bed where she had the patient bagged and intubated not pausing what she was doing. The nurse running compressions called, “Switch!” and another nurse on the opposite side of the bed took over, ensuring neither fatigued too much and the compressions remained effective.

Madison glanced at the clock. The patient had been coding for over a minute. She glanced at the monitor.

“He’s still in VT. Shock again.”

“Charging…clear.” Everyone stepped back from the bed and the nurse on the defibrillator swept her gaze over the bed to ensure no one was touching it, then pressed the button.

Madison didn’t tear her eyes from the monitor. “Come on,” she murmured.

There was an agonizingly slow moment in which time, as it always did in these moments, seemed to pause. Sometimes Madison thought she could live in this moment, waiting to see if it had worked. The silence in the room stretched so taught that it felt as if she lifted a finger and sliced it down, she could snap it.

That moment was nothing. A second. Less than that.

But nothing seemed to drag on so long, ever, as here in the ER between shocking a patient and the moment she and five other people stared at a screen, waiting to see if it achieved what it needed to. The longer the patient took to respond, the more shocks needed, the less likely they were to come back. Madison felt as if the patient slipped further and further away from her.

Except today.

Beep.

Normal sinus rhythm appeared on the screen and Madison breathed out, relief tingling down her entire body, exploding into her fingertips.

Relieved sounds came from all over the room.

But they weren’t finished yet.

“Doctor Friedman.”

The patient was starting to fight the intubation, not yet conscious but body struggling to take over. Excellent. Miryam disconnected the mask and pulled out the tube, supporting the patient’s chin as she did so. She nodded to the nurse who stepped in to take over monitoring the patient’s airway and, fingers trembling as she clutched each end of the stethoscope around her neck, Miryam stood next to Madison. Madison’s hands were shaking too.

Everyone in the room would have slightly shaky hands. She’d been doing this a long time now, had run countless codes. It never stopped the adrenaline kicking in full force and causing the shakes.

“You’re up,” Madison said, with a reassuring smile.

Miryam’s eyes widened, and then she nodded. Madison handed the code chart she’d had in her hands to her, patted her shoulder, and then slid out of the room.

There was no one to update yet; no one had come in with the man who’d been brought in straight from work. Family was apparently en route, and if Friedman wasn’t free when they arrived, Madison would do the updating.

As she stepped out the door, she sucked in a breath and rolled her head on her shoulders, trying to loosen them up.

She’d been on her way to something when the code had been called and she’d been first in the room after the nurses. What was it?

Biting her lip as she racked her brain, she sidestepped to lean against the wall. She dug out the pocket-sized notebook in her scrub pants and ran a finger down the list of things she had there, some scratched off, some annotated, all in her ridiculous writing that was so messy she shocked herself every time she could understand it. It was in a shorthand she’d invented to protect patient privacy and to make writing faster. Casey had looked at it only once, and gone cross-eyed trying to make sense of it.

“Madison, bed four is demanding you appear so they can sign themselves out against medical advice.” Annie said the sentence while walking past her, eyes not lifting from the tablet she was engaged with.

Madison huffed to herself, grabbing a pen from her pocket and adding that to the bottom of her list.

“I sent one of the residents to take care of it,” Annie said over her shoulder as she disappeared around a corner.

Pen paused over the pad, Madison called out, “You’re the best, thank you!” then gleefully crossed out what she’d started writing.

“Madison, can we have a word?”

Madison looked up from her work. Kevin Wu, the chief of the hospital, was standing in front of her, hands in his lab coat pockets. She already knew what this would be about. She glanced back at the pad of paper and saw nothing that she couldn’t delay for five minutes. Damn.

“Of course.”

She followed him through to a small conference room behind the ER that was almost always empty, used mostly for staff development or evaluations. He held the door open for her and stepped inside, sitting at the fairly small, round table. It shone in the fluorescent light, highly polished even after so many years.

“How’s everything been?” he asked, voice level as always as he rested his folded hands on top of that highly polished surface.

He was a kind man. A good boss to have. Incredibly fair, almost to a fault. He worked hard and he worked long hours. He’d been chief when she’d started here, his hair now flecked with gray, lines cobwebbing out from his eyes that crinkled drastically when he smiled, adding to the charm he carried easily.

And there—light, but definitely there—was that pity in his eyes that was in everyone’s.

Trying to keep it neutral, she took a deep breath. “Everything’s been going well. The presentations at the conference last week seemed to be well received. Have there been any issues with my performance?”

He leaned back into his chair, shaking his head. “Absolutely not. I was asking on a more personal level.”

She nodded, her sidestep not having worked. “All is fine.”

Her smile was too tight, she knew. But it was what she managed.

“I’m glad to hear that.” He didn’t believe her. “While there haven’t been any issues brought up with your performance, HR has some concerns.”

She knew this. HR had highlighted the concerns with her a few months ago. Several times.

“Starting with the good news, you have a lot of unused vacation. We’re obliged to make you take that at some point.” He smiled, those creases jumping out. “Can’t say no to a vacation, can you?”

She didn’t want a vacation. That was the last thing she wanted.

“And the bad news?”

“You’ve been logging far too many hours. And I know that what you have officially logged is less than what you’ve been putting in. We’re liable these days if you go over—although I know that back when you first started, and definitely when I did, it was expected to go over so much. And there are issues now; those hours are still necessary at times, and extra pay can’t be given—”

“I have no issues with my pay.”

She really didn’t.

“I assumed you didn’t. But Madison, you can’t be putting in these kinds of hours. It raises performance concerns—” he raised a hand to interject, as she’d already opened her mouth “—which we don’t have with you. But burnout is real. I need you to pull back.” He hesitated, hand lowering as if he wanted to put it over her own, then thought better of it. “Or at least try to. Go home on time after some shifts. Stop sleeping here so often. Don’t take every on call you can.”

In her pocket, her hand flicked the small fidget cube she kept in there over and over. “Okay.” She smiled. “Of course.”

He didn’t appear to remotely believe her. Which she couldn’t blame him for, really. “I’m glad to hear that. Take a vacation too, please?” He stood up, hands back in his pockets and smiling too kindly. The type of kindly smile that always edged into her chest. “I was in Mexico last year. Can’t recommend it more.”

The smile she gave was again far too tight. Her honeymoon had been in Mexico. Her chest tightened in response to her smile, and she stood up. “Of course. I’ll look into it. Really.”

“I’m glad. You’re the best we have on staff, which I probably shouldn’t say. I’d hate to see you burn out.”

She nodded, also tightly, and smiled back. “Thanks, Chief.”

He let himself out, the door swinging shut, and her thumb clicked and clicked on the cube. She grabbed her notebook and jumped to the first thing on the list, then headed out to the shift she should have left four hours ago.