Perfect rivalry, p.10
Perfect Rivalry, page 10
“We’ve got a bit of a fever, but we’re doing okay.”
“And a stomachache too, I understand, right, Leo?” Honor said.
“A little,” he said softly.
“Can you show me where?”
Leo rubbed a hand over his lower abdomen. “Down here.”
“Okay. Thank you.” Honor glanced at Ren and raised an eyebrow. She’d been waiting for a surgical consult to evaluate the young boy, a renal transplant patient, who presented with a low-grade fever and complaints of abdominal pain. The transplant team was in the OR, and the general surgery resident covering the ER had been pulled for a second trauma alert. Ren had shown up in his place.
“I’ve Dopplered Leo’s kidney,” she said, smiling at the boy. “We can hear the blood flow, can’t we?”
Leo nodded vigorously. “Ren said that means that my kidney is working.”
Ren nodded. “It means that the blood flow to your kidney is working. We still have to wait for the results of the urine test, remember?”
The boy grimaced. “I know. But my pee looked good, right?”
“So far, but we need to look at it under the microscope too.”
“Right,” Leo muttered.
Ren switched her gaze to Honor. “CAT scan was backed up, but they’re ready for him now.”
Honor stepped to the bedside and said, “Can I listen to your abdomen too?”
“Yes, if you want to,” Leo said.
“I would.” Smiling, she settled her stethoscope in her ears and listened to the very quiet abdomen. Not much in the way of bowel sounds. “Let’s listen with the Doppler again—that’s the little probe.”
Leo nodded. “Okay.”
Honor rolled the gel over the lower part of his abdomen where the graft would be situated and touched the probe to his skin. A strong arterial pulse echoed from the machine. While she couldn’t be sure of what the venous outflow was like from the kidney, had it been obstructed, the arterial pulse would’ve eventually stopped. The CAT scan would give them a good view of the transplant, and with contrast, they should see more of the blood supply as well. She nodded and looked up at the boy’s father. “The CAT scan will tell us a lot more.”
He cleared his throat. “I can go with him, right?”
“Of course.”
“My husband should be here soon,” Martin said. “He had a seven o’clock counseling session, and I didn’t want to interrupt him until we knew something. Father Domingo Lopez.”
“Of course. Dr. Dunbar or I will speak to you both when he arrives,” Honor said.
“Thank you.”
“Ren, can I go over a few things with you while we get Leo ready to go to CT,” Honor said and stepped outside the curtain. Ren followed her down the hall a few feet.
“What are your thoughts?” Honor asked.
“Everything suggests that the transplant is all right. His CBC shows a shift in his white count, but normal for an infectious process. Not a lot of lymphocytes or anything suggesting rejection.” She was quiet for a second, her expression contemplative. “I think there’s a good chance he has appendicitis.”
“It would fit for the age and the history,” Honor said. “And if he does?”
“There’s going to be a problem if the graft is in the way. And there’s likely to be adhesions, so technically challenging.”
“Have you looked at his OR records from the transplant procedure?”
Ren took a slow breath. “I haven’t, and you’re right. I should have already,” she added quickly with a bit of a wince, “because they may have taken his appendix when they put in the graft. If that’s the case, it’s something else.”
“Check it. They may have left it. It would depend on where they put the graft and how pressed for time they might’ve been during that procedure. And you’re right, the CAT scan will likely give us a definitive diagnosis.”
Ren shook her head. “Still, I should’ve thought of it.”
“Well, next time you will,” Honor said. “And thanks for picking up the consult.” She paused. “You’ve been doing that a lot lately.”
“I was in the lab, and I’m often around,” Ren said with a deprecating shrug. “And that’s what I’m here for, right?”
“As long as you’re not overextending. A service is busy.”
“It is, and I won’t.”
“All right then, thanks.”
“I’ll go down with Leo to CT,” Ren said.
“Good. Call me with the reading.”
Ren went off to organize transport, and Honor scanned the board, which finally looked like it was under control.
A welcome voice said from just over her shoulder, “How’s it looking?”
The timbre of Quinn’s voice and the faint warmth of her breath against the side of her neck sent a shiver down Honor’s spine. She leaned back slightly until her shoulder touched Quinn’s. “We’re winning.”
Quinn grinned. “Aren’t you always?”
“Eventually.”
“Did Arly call you?” Quinn asked.
“No,” Honor said, turning quickly. “Is she all right?”
“Yeah, sorry. I didn’t mean to scare you. It’s one of those situations where she wants permission to do something, and she’s checking with the parent she thinks is going to say yes first.”
“Family conference time then. I’ve got about five minutes.” Honor linked her arm through Quinn’s. “Come back to my office.”
Once there, she shut the door partway and gave Quinn a quick kiss. “So, what did she want to do?”
“Are you ready for this? Apparently the Billie Eilish US tour has added the Wells Fargo Center to their schedule over Labor Day. Arly wants to go.”
“Really?” Honor said. “Billie Eilish? We should all go.”
“I don’t think that’s what she had in mind.” Quinn laughed. “She wants to go with Janie, Eduardo, and four or five other kids. Parents were not on her list.”
Honor sighed. “She’s never gone to anything like that alone. What do you think?”
“Janie’s older brother’s Raymond is going, sort of a de facto chaperone. He’s driving them all, so they’ll have an adult with them. I sort of hedged…No, I definitely hedged and said I needed to talk to you.”
“Oh, so if we say no, it’ll be my fault. Smart move, Maguire.”
Quinn grinned. “I’m learning.”
Honor sighed. “I suppose she can go as long as there’s a responsible adult. I know Janie’s brother Raymond. If he’s willing to drive them and keep an eye on them, I don’t think we have a good reason to say no.”
“I pretty much agree, and there hasn’t been much in the last year or so for them to do. It’s tough to say no.”
“All right then. We’re united.”
“Aren’t we pretty much always?” Quinn took her hand and kissed her knuckles, something she’d always done and that Honor still loved.
“While I’ve got you, there’s something else I wanted to mention,” Honor said.
“Problem with one of my residents, or one of my staff?”
“What makes you say that?”
“Because it usually is.”
“A resident this time,” Honor said.
Quinn frowned. “What’s going on?”
“Actually it’s the opposite of a problem. Ren Dunbar. She’s been seeing consults on a regular basis. Not stealing cases, but whenever we’ve been waiting on the consult and there’s been some delay, she’s been picking it up. She’s very bright.”
“Well yeah, we know that. So what’s the problem?”
“I just thought you should know, because considering the hours she’s keeping, I think she’s living at the hospital.”
Quinn blew out a breath. “Yeah, she practically does. Always has. Sax never seemed to sleep much either. But that’s who she is, Honor. She puts every bit of her energy into whatever goal she’s trying to accomplish. She wouldn’t be here if that wasn’t true.”
“I understand that’s normal for her,” Honor said, “but it’s early in the year, and if she keeps up this pace, she might burn out.”
“I’m glad you told me.” Quinn rubbed her forehead. “I may have created a couple of monsters lately.”
“What do you mean?”
“Well, I pulled Ren out of the lab and put her into the fifth year slot because I needed a strong resident there. Plus, if she’s ever going to move on clinically, she needs to get out of the lab. But of course she feels pressured to catch up to everyone.”
“You couldn’t help that,” Honor said.
“I know. But then I pointed Dani Chan toward a research project because she expressed interest in being competitive for the Franklin. So now she’s got a double load. If I’d known she was serious about competing for the award too, I could’ve gotten her started on something sooner.”
“So you’re worried that she’s not going to be able to handle everything.”
“Dani is an excellent resident. Not driven the way Ren is, but she hides her intensity. The two of them going head-to-head is going to present a quandary when we get around to voting.”
“Do they know that?”
“I don’t know. It’s not usually an issue. Most of the residents are too busy keeping their heads above water and looking toward the finish line to actively go for it. Hell, usually whoever wins is totally surprised. This year it’s looking different.”
“Well, all you can do is keep an eye on them.”
“Yeah,” Quinn said, rubbing her forehead. “There’s a lot of that going around these days.”
Laughing, Honor looped her arms around Quinn’s shoulders and pressed close. “I love you, you know.”
Quinn closed her eyes and sighed. “And lucky for me.”
Chapter Nine
Dani slouched in the corner of the lumpy, mustard-colored sofa pushed up against the wall in the OR lounge and propped her feet on the edge of the coffee table. She cradled the phone against her shoulder and dialed the dictation extension.
“This is Dr. Dani Chan, dictating an op note on Marsha D’Angelo, date of birth four, four, 1947, hospital number 100-3729. Attending surgeon, Ronald Chu MD, assistants, Dani Chan MD and Lawrence Chatell DO.” She closed her eyes and continued dictating, working her way through the case from the time they brought the patient into the room, prepped and draped, made the incision, exposed the vital organs, isolated the blood supply, resected the tumor, and repaired the large bowel. She felt someone sit down beside her as she finished up.
“Once the anastomosis had been completed, the abdomen was irrigated with two liters of sterile saline, a suction drain was placed in the left lower quadrant, brought out to separate stab incision, and the abdomen was closed in layers using Monocryl on the peritoneum, two-oh running Prolene on the fascia, and a running subcuticular three-oh Prolene on the skin. The drain was secured in place with a figure of eight, two-oh Prolene and attached to suction. After the application of sterile dressings, the patient was extubated uneventfully and transported to the recovery room. Thank you very much, Dani Chan, MD dictating.” She set the phone down and glanced to her neighbor. Zoey munched a Mr. Goodbar, her pea-green clogs on the floor beside her and her feet tucked beneath her.
“I didn’t even know they made those anymore,” Dani said.
“They’re in the vending machine,” Zoey said. “They must make them somewhere.”
“They probably ran out of everything else and found those in the back of some warehouse. Give me a bite.”
Zoey held out her hand with the half-unwrapped candy bar, and Dani leaned over and took a bite. It was good.
“Thanks,” she said, after she swallowed.
“I thought you had plans tonight,” Zoey said.
Dani grimaced. “Yeah, me too, but I haven’t heard from Ren.”
Her GI case had run pretty late, but she’d been hanging around killing time, and it was after six. She’d texted Ren but hadn’t gotten an answer. She hadn’t even been able to reach Raven to get a game going to occupy herself.
“She can’t be in the OR,” Dani said, “because I’ve looked and I didn’t see any cases running.”
“No, we finished all the cases about four—in fact I was just about to hunt her down myself so we can make sign-out rounds. I’ve got a date.”
“What, you and Dec are still at the dating stage?” Dani snorted. “You’re practically living together.”
“So what, we can’t have dates? That’s part of the reason we don’t live together. I told you, every night is date night with us.”
“Please,” Dani said, “spare me.”
“Well, you did ask.”
“I didn’t ask—I made a comment. That’s a statement not requiring a response.”
“Well, if you mock me, then there will be a response.” Zoey stretched out a leg and poked her with her toe. “You’re just in a bad mood because you were counting on getting some tonight.”
“I most certainly was not.”
Zoey cocked her head. “You sound serious.”
“I am serious. Dinner, I told you that.”
“Well, that’s the beginning of the evening,” Zoey said as if Dani was a little bit slow. “But then there’s after dinner, and after-after dinner.”
Dani shook her head. “No, it’s not like that.”
“Yeah, that’s what you told me. I’m wondering what it is like since you can’t find her.”
“Hey, be nice, I’m suffering.” Her phone vibrated beside her, and she grabbed it.
So sorry. I got stuck in the ER. Clear now. Still need to do sign outs. So sorry!
Dani let out a breath. No big deal. It’s still early. Seven?
Yes!
Zoey’s phone beeped, and she looked at it.
“Well, Ren’s appeared.”
“She was in the ER,” Dani said flatly.
“That’s not surprising,” Zoey said. “She literally lives there.”
“I noticed. I’m kinda glad I didn’t have to compete with her every single year of our residency,” Dani muttered.
“You can say that again. Doesn’t she ever get tired? Doesn’t she ever sleep?”
“I don’t know. I’m usually sleeping.”
Zoey laughed. “Or staying up half the night playing World of Warcraft.”
“I’m not playing Warcraft,” Dani said and grinned.
“Whatever.”
“Besides, that’s different. That’s relaxation, not work.” Dani frowned. “I haven’t even been able do that all that much lately. Super busy.”
“How’s your project coming?”
“Slow.” Dani grinned. “I’ll get there, though.”
“I know you will.” Zoey stood and stretched. “I should go, so we can finish sign-outs, and Ren can put you out of your misery.”
“I don’t think that’s exactly what I was hoping for.”
Zoey laughed. “I hope you have fun.”
“Yeah,” Dani said, half to herself. “Me too.”
She’d been looking forward to it all week. In between everything else she had to do on the floor and in the ER and working on her research project, she’d think about Ren and imagine spending more time with her. She hadn’t been as anxious to do anything like that in longer than she could remember. The only thing that really gave her any kind of thrill was doing a challenging case in the OR and knowing it had gone well and that she’d done a good job. That never got old, but sometimes it felt like there ought to be more.
This week she had the feeling maybe there was.
She still had a good forty-five minutes to kill and texted Raven again, hoping to fill the time with something more than the impatient jangling of her entire nervous system.
Hey, you around for a quick game?
After a minute or two, she figured she wasn’t going to get an answer. That happened. Online connections were hit or miss, and she wondered why she’d never made any move to find out more about Raven. Raven was a constant in her life, someone she communicated with almost as much as she did with Zoey, and yet other than her texts, she had no place to put her. No face, no image of her at work or play, no sense of who she was in the world. Except the last couple of times, when she sensed Raven’s excitement. That something had changed for her. Raven’d even said as much when she’d mentioned meeting someone. That probably explained why she wasn’t around as much. Dani laughed. What an idiot. Of course that’s why Raven had disappeared. She was probably in the middle of some hot love affair.
The twinge of jealousy came out of nowhere, and she shook her head. Boy, was that dumb. She certainly had no hold on Raven, but she missed her. That was real. And they were friends, in the way that the internet allowed for friendship, and she would miss her if she lost her. But that’s what happened. You connected and got really tight, you maybe shared some things, and then life went on, and the internet didn’t create enough of a fabric to hold things together. You drifted apart, and the cycle started again. She’d had it happen a few times, but Raven had always seemed different. More real. And that’s why she missed her.
Her phone vibrated. Raven replying.
Still at work, pretty busy. Can’t now but later on tonight or tomorrow
Dani grinned. Sounds good have fun tonight
?
Hey, Friday night. Got plans?
:-) Maybe
I’ll take that as yes
:-)
I mean it, Dani texted, and she did. Have fun and I’ll catch you soon
for sure
Dani slid her phone in her pocket and went to change. Ren would be ready soon, and the surge of excitement, along with the nerves, came back.
* * *
“Okay,” Ren said, “we’re done. Laila, I’ll meet you at six tomorrow for rounds?”
