By Lynne Norris
Please see part one for all disclaimers.
Regina stepped out of the fracture room and walked toward the sink. She just finished casting a fifteen-year old boy’s wrist fracture and was discharging him. She rolled her eyes and failed miserably at stifling a chuckle as she listened to his mother yelling at him for using his bed as a trampoline again. It reminded her of the pillow fights she used to have with her older brother when they were kids.
Sandy looked up from the lab work she was reading and smiled, hearing Regina’s infectious laugh as she walked over to the desk.
"You look like you’re feeling better these days." She noticed that the healthy color in Regina’s face had returned.
"Mm." Regina nodded her head as she hung over the desk, reaching down to snag a piece of chocolate. One of their former patients dropped the box off as a small token of appreciation for what the staff had done for him. "The medication that Alex gave me works wonders. Just a little nausea but I haven’t gotten sick in days," she said, as she popped the candy into her mouth and bit into it.
Regina was feeling exceptionally good today. Alex drew her blood two days ago for the six-week blood test and slipped her results into her locker enclosed in a white envelope with Regina’s name written on it in black ink. Regina picked up the envelope as she had changed into her scrubs earlier that evening and felt a warm tingle of hope inside her chest as she read the results.
"Ooh, that was good." Regina said, licking the chocolate from her fingers and eyeing another piece.
"Ah, ah." Sandy swiped the box away from her. "I will not have the two of you on a perpetual sugar high all night. Alex is bad enough when she gets ahold of this crap."
"Where is Dr. Margulies anyway?"
Sandy rolled her eyes and pointed down at the end of the corridor. "Jameson got ahold of her. He’s been looking for someone to bail him out of doing the budget for the department."
"Ugh. Why?" Regina asked.
Sandy leaned over the desk closer to Regina. "Rumor has it there’s more budget cuts coming. Guess he doesn’t want to be the bad guy."
"Think she needs to be rescued?" Regina asked, a mischievous glint lighting up her eyes. Sandy leaned forward as Regina whispered to her.
Alex crossed her arms and let her gaze fall just over the shoulder of the medical director standing before her. He was talking incessantly about the budget due at the end of the month. It was obvious that he was looking for someone to take the burden from him. Dr. Jameson had been the medical director for ten years now and was firmly entrenched in the old school of practicing medicine. It went something like this, Alex mused: ‘if it feels good, do it’ - without too much thought given to fiscal responsibility. Once again, just like he did every year, he was talking about the upcoming budget and how difficult it would be to make the mandatory 7% cuts that the administration handed down to all the departments.
It had been a quiet Saturday evening in the emergency department so far and he had cornered her when she stepped through the doors of the emergency department. Alex was listening with half an ear, her attention focused on the torrential rain coming down outside. It had been raining hard all day and many of the low-lying roads had been flooded, so people seemed to be staying indoors which meant they were staying out of trouble. Too bad, Alex mused; she could have been otherwise preoccupied instead of stuck here, listening to her medical director drone on.
She pulled her attention away from the rain running down the outside of the window and fixed him with an icy stare. "Listen, Jim," she said, reaching the end of her limited patience with his whining. "If you spent as much time working on the numbers as you’ve just spent complaining, you might be done with it by now."
He stopped mid-sentence and stared at her. "You know Alex, you might want to be a little more cooperative than that. It might just be your job that ends up being cut," he snapped.
An eyebrow arched in amusement. "I doubt that. They’re looking at outcomes, numbers and productivity. I think we’ve already cleared up any misperceptions on that." The M and M conference the week before had made it obvious who was to blame for the poor outcomes and productivity slump.
Alex felt a vibration at her waist and looked down at her beeper. She frowned at the extension listed in the LCD display and looked in the direction of the nurse’s station. Sandy was holding a phone up pointing to it.
"I’ve got a phone call I need to take," she said, hoping that it wasn’t Dana calling again.
"This isn’t over by a long shot Margulies," he hissed following her as she walked to the desk and took the phone from Sandy.
"Who is it?" Alex asked, turning her back to the seething doctor standing behind her.
Sandy gave her a weird look. "Sorry, didn’t ask."
Alex frowned and put the phone to her ear. "Dr. Margulies here."
A soft voice giggled. "We thought you needed rescuing." Regina’s voice floated through the phone line.
Alex laughed. "Thank you. I did, no actually I still do," she corrected as she looked up and saw the doctor standing next to her. "Hang on a second." She covered the mouthpiece of the phone and looked at him. "Jon, our conversation is over. Its one of my patients."
He shot Alex a threatening look as he walked away in search of another victim. Alex watched him skulking past the trauma rooms.
She took her hand off the mouthpiece. "Where are you?" she asked, her eyes twinkling mischievously.
"Room five," Regina said.
"You’ve got three seconds," Alex said as she watched Dr. Jameson walking down the corridor. "He’s looking for someone else to commiserate with about the upcoming budget he has to do." Alex drawled. There was a squawk at the other end of the line and a click. Alex set the phone in its cradle and sat down in a chair chuckling.
Regina ducked as she saw Dr. Jameson walk by the room. She scooted over to the interconnecting door and slipped through to the next exam room. Regina waited until she saw the tall blonde-haired doctor’s head turn the corner and then made a beeline for the nurse’s station. She slid around the desk and slumped into one of the rolling chairs, letting it roll back away from the desk, looking decidedly relieved that she had eluded the medical director for the moment. Alex winked at Regina as she met her eyes.
Regina smiled and turned her chair as she heard her name.
"Thanks, Dr. Kingston." The boy whose arm she had put a cast on waved at her as he walked past the desk. His mother was less enthusiastic, still berating him about the use of the bed as a trampoline.
Alex glanced at Regina. "Another happy customer."
Regina smirked. "I don’t think his mother appreciated me telling him about the pillow fights I had with my brother growing up. It was a good diversion while I set the break."
"Uh oh." Sandy said, looking up from the desk.
"What uh oh." Alex looked up dismayed. "Ah shit, he’s coming back. Come on, let’s get out of here." The doctor grabbed Regina’s arm and pulled her out of the chair.
"Wh…where are we going?" Regina asked, completely startled by Alex.
"Away from here. I’ve had enough of budgets and him for one evening," she said nodding her head in Dr. Jameson’s direction.
"Hey! That’s no fair." Sandy called out from behind them. "Don’t leave me here alone."
Alex turned around and waved. "We’re not, you’ve got Marcus and Dr. Jameson to keep you company. We’ll bring you back something from the cafeteria." She grinned at her.
Alex released Regina’s arm as they turned the corner and opened the door to the stairwell. Regina walked through the door and trotted down the flight of gunmetal gray stairs, holding the door open at the bottom of the stairs for Alex. They entered the mostly empty cafeteria, which wasn’t unusual, given the lateness of the day and the fact that it was a Saturday.
Regina headed to the self-serve yogurt machine. She checked it out earlier and noted happily that it was double dutch chocolate, one of her favorites. Holding a Styrofoam cup underneath the dispenser, she made a neat swirl of yogurt in it. She shook some sprinkles over it then stepped aside, watching as Alex filled her cup and poured a liberal amount of chocolate syrup over the top, followed, too, by chocolate sprinkles.
She turned and noticed Regina’s look. "What?"
"Have a little yogurt with that chocolate syrup why don’t you," Regina said, with a smirk on her face.
"Thanks, I will." Alex dug her spoon in and sucked the yogurt off of it, savoring the taste as she swallowed.
"I figured you for a health nut or something the way you run every day," Regina shrugged, walking to the register to pay.
Alex snorted and followed her to the register. "Uh, uh. My treat for rescuing me from hell." Alex handed a bill to the cashier. "Remind me to get some for Sandy before we go back up. She’ll kill me if I don’t."
Regina walked to a table in the back of the cafeteria and sat down. Alex sat down across from her with her back to the wall, and they both worked on their yogurts for a few minutes in silence. Sitting back, Alex crossed one of her legs over the other and regarded Regina from across the table. She suspected the resident’s good mood was related to the most recent set of lab results.
"Did you get the envelope I left in your locker?" The semi-reclined doctor asked, referring to the one she had slipped through the metal slats earlier in the day. She had found herself uncharacteristically nervous as she had waited for the results of the HIV-Antibody Test in the lab.
A smile broke across Regina’s face and she patted the pocket of her scrubs. "Right here. Thanks. I really appreciate you taking the time to run these tests yourself."
Alex waved it off. "Its no problem. I’m glad I could do it for you. Your CD4 cells look good," she said, referring to the white blood cells in the body that played a critical role in coordinating the immune system’s response to infection. If the number of CD4 cells started to decline it would be a sign that Regina had contracted the disease. She had breathed sigh of relief when she had read the lab values before sealing them in the envelope.
"Six weeks down," Regina said, wishing that it had been six months already.
"I’ve got a good feeling about it." Alex scraped the bottom of the cup and looked up, catching the look of nervousness on her colleague’s face.
"God I hope so," Regina said, feeling the uneasiness settle heavily in her chest at the prospect of having to deal with HIV. "I can’t even think about what I’ll do if it ends up being positive."
"Don’t. We’ll cross that bridge when we have to." Alex caught her breath. The words were out before she had a clue where they had come from.
Regina looked a little startled by Alex’s sincere words. "T…Thanks Alex."
"You’re welcome." The older woman leaned back against the booth and ducked her head, suddenly interested in the bottom of her cup.
The rain had been coming down steadily all day. Three inches had fallen and many of the roads were flooded; orange detour signs directed the white Ford Explorer through a maze of back streets. Andy looked nervously over at his wife, who was trying her best not to cry out from the strength of the contraction that she was experiencing. He reached his hand across the console and squeezed her hand gently.
"It’s gonna be alright Laura." He wished he felt as confident as his words sounded. This was the third detour he was making to get around the flooded low-lying roads that led up to the large medical center.
The contractions had started two hours ago and had progressed much more rapidly than Laura’s obstetrician had expected them to. Andy turned the wipers on high as another sudden torrential downburst of rain marred his view of the road. He fiddled with the controls, turning the A/C on to help defrost the windows faster.
"Andy," his wife called his name in between gasping for air as she endured another contraction. "How much farther? I feel it…pressing…oh god…it hurts," she cried out, pushing back against the seat.
"We’re almost there Laura. Just hang on another five minutes," Andy said, licking his lips nervously. He recognized a street sign through the torrents. "Finally." He turned on his left turn signal and proceeded up the steep hill.
The medical center was on the left just below the top of the steep incline. Andy couldn’t be sure but he thought that he heard the wail of a siren in the distance. He couldn’t tell if it was behind or in front of them. He didn’t see any lights so he signaled his left-hand turn.
As he started across the wide intersection his wife cried out. "Andy no!" The last thing he remembered as he looked up was the shape of a large vehicle spinning out of control, heading directly toward the front side of the truck. Jerking the wheel hard, he watched in horror as time seemed to slow down as it sometimes does when things goes terribly wrong.
There was an ugly noise of metal impacting and crumpling as the two vehicles collided with each other. The sheer force of the collision drove the truck up over the curb and rammed it violently into a telephone pole.
The incessant chiming of the bell telling him a door was ajar pulled him out of the blackness he was swimming in. Andy blinked his eyes and winced as he felt a sickening grinding of bones as he shifted his arm. Looking down, he almost passed out as he saw his left arm bent at an impossible angle. He heard the sound of the rain drumming on the roof of the car and felt a steady dripping of cold water on the back of his neck.
"Laura?" Pushing the deployed airbags out of his way, he turned his head and focused on his wife. "Laura, oh god, Laura, talk to me." He reached out with his right arm and touched her face.
"Mm. Oh…ah…Andy it hurts. Oh god, my leg." More awake now, Laura clutched her stomach and cried out. "The baby, Andy. I can’t feel it!"
Her cries shocked him out of his daze. "Laura, I’m gonna get us help. You hold on. I promise you’ll be ok, the baby’ll be ok." Andy pushed against the door but it was jammed shut. Turning his head, he saw that the back door was open on the passenger side. Painfully, he unhooked his seat belt and reclined his seat. Using his legs and his good arm he pushed himself backwards. Each movement caused a blinding hot streak of pain to shoot down his arm and he bit his lip to keep from crying out. It seemed like it took forever but finally he managed to get himself out of the truck.
He leaned against the side of the vehicle forcing himself to stay upright, panting from the exertion and the searing pain in his arm. Thunder continued to rumble and continuously overhead as the storm raged on around him.
Stumbling in front of the ambulance, he glanced up at the window. He couldn’t see the driver, but shattered glass from the windshield littered the pavement and spatters of rain-diluted blood glistened and rolled down the white hood of the emergency vehicle. Clutching his arm to his side, he staggered across the grass toward the glowing blue sign that pointed to the emergency entrance a hundred feet away.
"Please…I need help."
The unit clerk at the desk looked up, his eyes widening as he saw the man leaning heavily against the desk. His clothing was wet and he was clutching his left arm through a bloodied and torn shirtsleeve. The woman the unit clerk had been talking to backed up, her face turning ashen at the sight of the man’s obviously broken arm.
One of the nurses walking down the hallway saw the woman stagger back. Running up behind her she caught the slumping woman as she started to pass out. "I need some help here." Maggie called out, staggering underneath the weight of the woman.
Dropping the linens he was stocking, Thomas ran over to help Maggie get the woman in a wheelchair. Smelling salts quickly brought her around and Thomas wheeled her into one of the treatment rooms.
Maggie quickly grabbed some a package of gauze from a cart, ripped it open and held it firmly over the man’s bleeding arm. "Let’s get you into a room, so one of the docs can look at this."
Meanwhile, the unit clerk looked quickly around the emergency department for help. "L…let me get one of the doctors."
"No you don’t understand. My wife," Andy grimaced and shook his head, clutching at the desk for support. "We…had an accident…she’s in labor."
"Where is she sir?"
The man shook his head and ran a hand through his wet hair. "Outside… I…I told you we had and accident."
The clerk frowned. "She’s in the car?"
"Yes! Please get a doctor." The man’s voice was getting louder.
The clerk stood up from his chair looking decidedly uncomfortable. "Sir, where is your car?"
"Old Town Road."
"Ok. I’m going to call the paramedics." The clerk picked up the phone and started punching in the numbers.
"What? No, please y…you’re an emergency room. Send someone…out…she can’t wait for the paramedics."
"Sir, let’s get you into one of the rooms so we can take a look at the arm," Maggie urged him.
"No, my wife, please – she needs help."
"Sandy." The clerk looked around and called for the charge nurse. "I need you over here. Now."
Hearing her name and the tone of the clerk’s voice she stuck her head out from one of the rooms. "What’s wrong?"
"This man’s hurt and his wife is injured out in their car. They had an accident," the clerk said, taking a step back as Sandy approached the desk.
"Please, you’ve got to help my wife. She’s trapped in our car. She’s in labor." Andy was near tears and the pain was making him feel light-headed.
"Sir, we’ve called the paramedics. They’re on their way," Sandy assured him. "Let me get you into a room." She stepped closer to help Maggie.
He slammed his hand down on the counter rattling the plastic clipboard next to him. They both jumped back. "You’ve got to be kidding me. You’re a damned emergency room!"
Startled by the angry voice, Regina dropped her stethoscope as she walked out of an exam room towards the sink. Retrieving it, she stuffed it into her pocket and shoved her hands under the stream of water from the faucet.
Sandy shifted her weight from one foot to another and looked over her shoulder for one of the doctors. She felt a wave of relief wash over her as she saw Alex and Dr. Jameson walk out of one of the rooms. She called their names. They looked up from their conversation and quickly headed over to her.
"What’s the problem?" Dr. Jameson looked down at her id badge. "Sandy."
Sandy gave them a quick explanation of what had happened motioning to the man standing across from her.
"Did you call the paramedics?" Dr. Jameson asked.
"Yes," Sandy said and cringed, knowing the man on the opposite side of the desk was frantic with worry over his wife and didn’t give a damn about hospital policies, only that his wife was hurt and their unborn baby’s life might be in danger.
Dr. Jameson looked at the man’s arm. "Sir, come with me and we’ll get that arm taken care of."
The man took a step forward and stopped. "I don’t care about my arm. My wife is hurt out there! She needs help."
"Sir, we will take care of your wife when the paramedics bring her in. Now please, let us help you." Dr. Jameson lowered his voice.
Regina finished washing her hands at the sink and threw the paper towels into the waste container. Deciding that she would look outside and see if the ambulance had arrived, Regina walked down the hall.
It was dark and rain was pouring down in sheets as Regina stepped through the doors to the ambulance bay. Stepping down to the pavement, she looked out at the road. A gust of windblown rain blew her hair in her face. Wiping it away, Regina flinched as a flash of lightening illuminated the darkness. For a haunting moment she could see the sports utility vehicle smashed up against the utility pole on the grass and the flashing light of an ambulance winking faintly as it hung precariously from its roof.
"Jesus." Stepping forward, she stopped and turned back to the emergency room door, torn between what she knew she should do based on policy and the oath she had taken as a doctor. Regina ran a hand through her hair and gnawed at her bottom lip.
Knowing she was crossing a line and going against what she knew the hospital’s policy was Regina sprinted toward the vehicle. Damn, damn, damn. She peered through the shattered window and saw the young woman slumped against the door. A quick glance at the dashboard shoved up against the seat and Regina knew that at least one of the woman’s legs was likely broken if not crushed.
Leaning closer, she called out and felt the woman’s neck for the carotid pulse. "Ma’am? Can you hear me?" She got a mumbled response.
"Thank god. You hold on, we’re gonna help you." Regina knew there was not much she could do without equipment. Glancing at the ambulance she ran to the passenger door and tried unsuccessfully to open it. Hopping up on the runner, she peered through the glass. All she could see was darkness and the crimson blood that was being washed down the hood of the ambulance.
Regina ran back through the drenching rain, shaking water from her hair as she ran through the entrance of the emergency department.
"Alex!" She ran up to her and laid a wet hand on her forearm.
"What?" Her attending asked, turning around and arching an eyebrow as she saw Regina’s wet hair and rain soaked clothing clinging to her body.
"I saw the wreck Alex. It’s bad. The truck is up against a pole." Regina’s eyes plead with her.
"Regina, we can’t go out there," Alex said, pulling her eyes away from the young resident’s and turned toward Sandy. "How long ‘til the paramedics get here?" she demanded.
"They’re twenty minutes out. Some of the local roads are flooded and they have to take a detour."
Alex looked down at her hands. "Shit." She closed her eyes, weighing the options. The hospital’s policy was clear about doctors not providing medical care outside of the facility while on duty. The woman was in labor, most likely badly hurt. The ambulance was twenty minutes out. Damn, sometimes, she decided, the scales are tipped for you.
"Alright," she sighed, against her better judgement. "I’m going to check on the woman."
Dr. Jameson walked out of the fracture room having turned the man with the fractured arm over to one of the residents. "Dr. Margulies, don’t be a fool. You can’t go out there. The hospital will be liable."
"Someone may be badly injured. What’s more important?" Alex spread her arms wide as she walked backwards away from him.
Jameson started to open his mouth then stopped and an evil glint flashed in his eyes. "Fine, you go right ahead."
Regina ran after Alex. "I’m going with you."
Alex spun around. "No you’re not." She put a hand on Regina’s arm. "You stay here. There’s no sense in you getting in trouble too." Dr. Margulies walked away from her charge and out into the driving rain.
Regina put her hands on her hips and looked down at the floor. Taking less than a second to make up her mind, she ran into the storeroom pulling out one of the trauma kits that the paramedics used to stock their rigs. She hoisted the bright orange bag over her shoulder and ran toward the door.
Dr. Jameson blocked her, his neck veins bulging and face turning red as he watched his chief attending defy his authority as she disappeared into the darkness. "You’re stealing hospital property, Dr. Kingston. You could be terminated for that."
Regina lifted her chin defiantly. "It’s not considered stealing if you’re using supplies to help a patient Dr. Jameson." She brushed past him, knocking him in the stomach with the bulky kit slung over her shoulder.
"Just remember I make the rules!" he shouted after her. "Go play the hero with your friend and see what kind of trouble you get into."
Alex was soaked by the time she ran up the hill and got to the ambulance. It was facing the wrong way and from the looks of it the rig must have spun into the truck and hit the street sign. The front window was shattered. Glass crunched under her sneakers as she jogged across the pavement. Wrenching open the passenger side door, she crawled inside, wincing as shards of glass bit into her ankle. She grimaced as she pressed her fingers against the driver’s neck, checking his pulse, knowing that there was nothing she could do for him now. Backing out of the ambulance, she ducked reflexively as lightning flashed and thunder clapped overhead.
Alex ran through the grass toward the truck.
A woman’s voice filled with pain and fear reached her ears. "Andy?"
"I’m Alex Margulies. I’m a doctor," she answered the woman. She flicked on the flashlight she had brought with her and directed the beam over the interior of the sports utility vehicle. The air bags had deployed and the woman was still in her seat belt. Alex shrugged out of her lab coat and crawled inside the back passenger door of the vehicle, hunching down beside the woman. The dashboard had been pushed in by the force of the collision and was pinning the woman’s legs. "What’s your name?"
"Laura…oh god," she hissed as another contraction hit her. "It’s coming. Oh god…please, it hurts."
"Does anything else hurt, Laura?" Alex asked, noticing how pale she looked.
"My left leg," came the shaky reply.
"Alex?" Regina was at the door peering in at her.
Alex lifted her head and shot a steely glance at the resident. "Dammit Regina, I told you not to come out here." Seeing the stricken look on Regina’s face and realizing that it was too late anyway now that she was there, she gave up. "Oh never mind…is there a neck collar in that kit?"
Regina ripped open the Velcro straps and opened the canvas pack. "Here," she handed the collar to Alex.
Alex carefully slipped the collar around the woman’s neck.
The woman let out an agonized scream and clutched her abdomen. "Oh god it hurts!"
Alex pushed herself up and spoke softly to the woman as she examined her abdomen. She felt the baby sitting low and guessed the seat belt was restricting its movement into the birth canal. "Laura, I need to release the seatbelt."
"Try and stay still Laura." Alex instructed, as the woman strained to lift herself back as the belt released.
"I need to lay back…baby’s…coming," Laura gritted her teeth against another contraction.
"Ok, Laura listen to me. I’m going to move the seat back very slowly. I need room to be able to check on the baby." Straining, Alex reached down underneath the seat and pulled the handle up. With her other arm she slid the seat back. She moved the flashlight over the woman’s body and stopping when she saw her lower leg.
"What’s wrong?" Laura asked.
"Your leg’s broken Laura," Alex told her.
"I can’t really feel my foot," Laura said quietly, closing her eyes as she rested between contractions.
"Regina, I can’t get down by her legs. See if you can open the passenger side door and get down there. We need to stabilize the fracture."
Regina tried pulling on the door but couldn’t budge it. "Alex I can’t get it to move," she called out. A flash of lightning crackled overhead and Regina yelped, ducking as thunder ominously rolled through the dark sky.
Alex quickly slid out of the back passenger door. Grasping the door handle and the window frame, she braced herself and pulled back with all her strength, the door groaning in protest as it gave way to her.
The doctor grabbed Regina’s arm, pulling her close so the woman wouldn’t hear her. "We’re going to have to put a tourniquet on her leg. She’s got a compound fracture and she pumping out arterial blood. If she loses too much we’ll lose the baby too."
The resident nodded and squeezed herself in between the dashboard and the front seat, bending over to look at the leg. She caught her breath as she saw the pearly white jagged pieces of bone protruding through the skin of the woman’s shin. Alex handed her a length of rubber tubing and Regina tied it above the gash in the woman’s leg. The pulsing of blood slowed considerably and Regina slipped an air cast over the lower leg to stabilize the fracture site.
"I’ll be right back, Regina." Alex ran to the ambulance and yanked open the rear door of the rig, stepping up into the vehicle. She picked up the backboard, jumped down out of the ambulance and ran back to the truck.
Laura moaned as another contraction started. Regina looked up as Alex returned and looked in on her. "We’re going to have to lay her back so we can check on the baby."
Nodding in agreement, the taller doctor held up the backboard she had retrieved from the back of the ambulance while Regina had been busy with the woman’s leg. She crawled in the back seat as Regina pulled up on the handle to lower the seat back. Alex slid the board behind Laura to support her spine.
"I’m going to start an IV. Regina, you need to check the baby. I can’t fit down there." Alex indicated the small space that Regina had wedged her torso into.
The blonde stared up at her mentor, swallowing nervously. She wiped her wet bangs out of her eyes with her forearm. It was one thing to deliver a baby in the hospital with all its modern, hi-tech equipment; this was another story entirely. Regina prayed that she would hear the sound of the sirens from the recently dispatched paramedic unit, but the only thing that reached her ears was the drumming of rain and the continual rumble of thunder overhead.
Laura cried out again as another contraction took hold.
"I need scissors, Alex," Regina said, hoping her voice didn’t betray how nervous she felt. This was probably one of the few times in her life she wished that she was much taller than her five foot four frame.
"Here." And the scissors were in her hand.
"Laura." Regina waited for the woman’s eyes to focus on her. "I’m going to cut your underwear. We need to get it off so we can check the baby."
"G’head." She sounded groggy and Regina realized she was quickly slipping into shock.
Regina pulled the garment away and examined the woman. She looked up at her attending. "This baby’s not going to wait for the paramedics. Alex, I don’t know if I can -"
"Easy. You’re doing fine," A comforting voice rumbled in her ear from above her. Alex was kneeling in the driver’s seat holding the flashlight over Regina giving her what little light she could.
Regina could see the perineum distending and knew the head would be crowning with the next couple of contractions. She could hear the woman breathing hard and felt her tense under her hands as another contraction started. "You’re doing great Laura."
Regina looked up at the woman. "Ok, Laura try and relax. I can see the head. That’s it -you’re doing great."
The woman screamed again and clutched at Alex’s hand, making her wince as her fingers were squeezed in a vice-like grip. Rain drummed down on the roof of the truck filling it with its incessant noise, and in the distance, the wail of a siren could be heard from the approaching ambulance.
Regina felt a wave of relief go through her as the ambulance approached. Finally.
Laura screamed again and Alex looked over Regina’s shoulder as she watched the resident gently guide the head out. The shoulders and the rest of the body followed minutes later.
"It’s a boy." Regina breathed a sigh of relief, as she leaned over and gingerly settled the baby on his mother’s stomach. Laura opened her eyes briefly and mumbled something that Regina couldn’t quite understand. The resident squirmed back out from the tight space she had been hunched in, grimacing as she saw the blood covering the front of her scrubs.
Alex was looking around for something to wrap the baby in when the ambulance finally pulled up behind them. A young paramedic stuck his head in the wrecked vehicle and blanched when he saw the scene before him.
Alex pinned him with her eyes. "Get blankets, a clamp and scissors, now."
Looking down at the infant, the attending checked his pulse and breathing satisfied that he was all right for now. Returning seconds later, the paramedic handed Alex everything she had asked for. The dark-haired doctor quickly clamped the cord and cut it, giving orders to the resident at the same time. "Regina, take the baby into the emergency room and call the Intensive Care Unit. I want one of the neonatologists to check him out." Wrapping the baby in the blanket, Alex reached across the seat and laid him in Regina’s arms. "Go on. Tell Sandy we’re going to need an OR for this lady."
Sandy met Regina at the door and took the baby from her, listening as Regina told her about the woman in the truck. Within minutes the emergency room was once again chaotic as the paramedics and Alex wheeled the mother into one of the rooms and residents from the neonatal unit arrived to take over the care of the newborn.
Regina was standing in the hallway with her arms clamped tightly over her chest, shivering as she watched the surgical team wheel Laura off to the operating room.
"Here." A blanket was tossed over her shoulders and a set of dry scrubs was thrust around in front of her. Taking the scrubs, Regina turned around to see Alex looking down at her. Blue eyes twinkled for a moment and then turned predatory as they looked up and fixed on someone else.
"You know, Dr. Margulies," Dr. Jameson said, his voice oozing sarcasm, "you just solved all my problems for me. You put the hospital at risk for the last time. I just talked to the surgeon and that woman is going to lose her leg. You were the one who put the tourniquet on it."
Regina opened her mouth to protest. "Don’t interrupt me," Jameson snapped. "I’ve already contacted the medical review committee. You are suspended starting immediately."
"You can’t suspend her," Regina jumped to Alex’s defense. "She didn’t-"
"Regina don’t," Alex warned, holding a hand out to stop her.
Looking between the two doctors, the young resident stepped forward. "I put the tourniquet on her leg, not Dr. Margulies."
A wicked smile crossed the medical director’s lips. "Fine. You’re both suspended, immediately."
Regina’s mouth dropped. "B…but she didn’t do it."
"She’s your immediate supervisor. You both are going down," he said triumphantly. "Have a nice day ladies." Looking back at his nemesis, Dr. Jameson laughed. "You won’t be so lucky this time," and walked away.
Regina turned to say something to Alex but she had already slipped away. "W…where did she go?" she asked turning around.
Sandy who stood at the desk nearby and witnessed the entire scene, pointed at one of the empty trauma rooms.
Regina headed to the locker room, scrambled out of her filthy scrubs and jumped into the shower washing off the blood and grime from the delivery. She threw on the set of scrubs Alex had given her and headed for the trauma room.
Regina stood by the window, looking in at the curtain that was pulled across the room, the bright procedure light was on over the table casting a shadow of someone sitting on the stretcher. Pushing the door open, she slipped quietly into the room, looked around the curtain and saw Alex sitting on the treatment table with her back to her. She was hunched over in an awkward position, her leg bent underneath her, and she peered intently at her ankle.
"You can come in, Regina," Alex said quietly.
"How did you know it was me?" Regina asked, as she stepped up beside the doctor.
"No one else would have followed me in here."
"Oh. Alex I...I’m sorry. I didn’t mean to get you in trouble."
"It’s not your fault, Regina."
Regina hung her head, feeling miserable about the whole situation. "What happened to your ankle?" she exclaimed, as she saw blood seeping out from under a wad of gauze Alex held on it..
Alex shrugged. "I must have cut it on the glass getting into the car."
"Let me see." Regina pulled Alex’s hands away and carefully lifted the gauze. "You’re going to need stitches," she said, looking up at the woman.
"I know." Alex held up a package of three oh silk and handed it to Regina.
"You want me to do it?"
Alex nodded her head. "I can’t reach it very well."
Regina walked to the sink and washed her hands, pulling out a set of sterile gloves from an overhead cabinet. Filling a syringe with lidocaine, she walked back to Alex and injected the medication around the site. The resident pulled the gloves on and took the silk out of the package that Alex had opened for her.
Regina looked up at her. "You ready?"
Alex leaned back on her hands and closed her eyes.
"Don’t like getting stitches, huh?"
Alex shook her head. Regina smiled to herself and started stitching the wound closed.
"You have gentle hands," Alex said, breaking the silence in the room.
Regina looked up and their eyes met. She held Alex’s gaze and then ducked her head, turning her attention back to the gash; she felt her ears turning red from the heat of the blush working up on her face.
"Thanks." Regina finished closing the wound and then wrapped it in a sterile dressing. When she was done she peeled her gloves off and stood at the end of the table looking down at her hands. "You know, what you did back there was the right thing to do. I’m just sorry I got you in trouble, Alex."
"Don’t be. If I had to do it again I would." Alex smiled and leaned forward, picking her sneaker up off the table. She turned serious as she pulled it back on her foot.
"Listen, Jameson wants me out. I know that." She held her hand up at Regina’s protest. "Let me finish. They will probably meet with us separately in a day or two. Just tell them exactly what happened. You’ll be ok. I promise."
"What about you Alex?" Regina asked, feeling herself close to tears now. I only wanted to help and now we’re both getting in trouble for this. It’s not fair.
"Don’t worry about me."
Regina wished she believed her as she watched her walk out of the room.
The chief attending walked to the open office door and leaned on the doorframe. "What do you want Margulies?" he asked, without looking up.
Alex walked into Jameson’s office, stood over his desk, and stared at the top of his head. "You can take my privileges away, right now. No meeting. Just leave Dr. Kingston out of this. She has nothing to do with you and I."
"Hmm. Interesting." He leaned back in his chair and laced his fingers behind his head, surveying the woman standing in front of him. "Actually, I think it’ll be fun to watch you squirm as you see your little friend get hung out to dry."
He wasn’t sure how she did it. But all he saw was the door to his office slam shut and then felt his body lifted out of his chair. The two diplomas hanging on the wall crashed to the floor with the impact of his body. When the room stopped spinning, Dr. Jameson found his back pinned against the wall, with Alex’s hand wrapped around his throat and her knee shoved up painfully against his groin.
Her voice purred in his ear. "I’ll say this one time. You take my privileges away and leave Dr. Kingston alone. Are we clear?" She pressed harder with her hand and her knee.
She felt his throat work as he swallowed. "Crystal," he squeaked.
Alex pulled her badge off her lab coat and threw it on his desk. "Have the paperwork filled out. I’ll sign it tomorrow." Without another word she left the office.
Regina unlocked the door to her condo and walked in, locking it behind her. Everything ached in her body and she felt like she was getting sick. She looked at the blinking light on her answering machine and headed into the kitchen, ignoring it for the moment.
Feeling thirsty, she opened the refrigerator and pulled out a can of soda. The tab opened with a pop and hiss of bubbles, and she took a long, drawn-out swallow. Alex said everything would work out but in the pit of her stomach Regina felt her guts churning and her head was starting to throb.
The message machine blinked its red light incessantly, demanding her attention. The petite blonde woman sighed, knowing it was either her mother or Derrick calling and truth be told she really didn’t feel like dealing with either of them right now. Blink. Blink.
"Oh, alright." Regina gave in and hit the button.
"Hi, Regina its mom. I just wanted to remind you about our plans to have you come up here this weekend. Please call. We really want to see you since you won’t be up for the holidays. Call us on Friday before you leave."
"Great, just great." Regina slid down onto the couch and held her head between her hands. "Gee mom, sorry I can’t come home this weekend because I have to go to a hearing to see of I lose my privileges as a resident at the hospital." Well, this ought to drop me right down to Jeffrey’s rung of the ladder. Regina looked up. Jeffrey? Oh where did I put that number?
She was on her feet and rustling through papers on the kitchen table. "Damn." She put her hands on her hips and looked around the room. Walking into her bedroom, she flicked on the light and yanked open the drawer to her nightstand, emptying its contents on the floor and quickly started sorting through it. "Aha!" Holding the piece of paper in her hand, she looked at the clock. California was how many hours behind Eastern Standard Time?
"Come on, Jeff, pick up." Regina paced her living room, listening to the phone ring on the other end of the line.
"Uh, hello." A hoarse voice answered.
"Jeffrey? It’s Regina."
"Oh. Regina, no, this is Darryl. Hang on a second." She heard muffled voices in the background.
"Regina? What’s wrong?" Her brother asked.
"How do you know something’s wrong?"
"It’s two in morning out here Reg. Or did you just forget the time difference again?" Her older brother was awake now and sitting over the edge of his bed.
"Shit. I’m sorry. I guess both."
"Both? You’re confusing me Regina. Have you been drinking?"
"No. I uh, listen. I’m in trouble. At least I think I am," Regina motioned with her hand as she walked restlessly around the room.
"What did you do now?"
"It’s a long story. Um, well we saved a woman tonight who was in a car accident. We delivered her baby in the car, but she’s going to lose her leg. The hospital is suspending us and they might take our privileges away." Regina took a breath.
Silence at the other end of the phone then, "Jeff, you there?"
"Eyah. What the hell happened?" He asked. "Ok, this time give me the details and slow down."
Regina spent an hour detailing out what happened earlier that evening. "I’m sorry Jeff. I know you have to go to work in the morning."
"It is morning. Don’t worry about it. You’re my sister and the only member of my family who still talks to me. Hey, thanks for the anniversary card; Darryl thought it was really sweet."
Regina smiled briefly. "You’re welcome. So what do you think, Jeffrey? Can they suspend us and take our privileges away?"
"Well, based on what you told me about the hospital’s policy, they could suspend you. But considering the circumstances, the weather, the ambulance being delayed, the fact that the woman was critically injured and in labor…" He hesitated and took a breath. "It would be a poor choice to make scapegoats out of two doctors who saved her and the baby." Jeffrey was in full legal mode now. "Hospitals revoke privileges when doctors practice bad medicine and make mistakes that, based on the situation, they shouldn’t have. You know that, Regina. Do yourself a favor: get that policy before you go into that meeting, and fax it to me. Upon hearing his sister’s agreement, he continued. "So you sound pretty upset about this Dr. Margulies. Is he a friend of yours?"
"No - Alex is the attending I report to while I’m on the residency," Regina explained. She started to tell Jeffrey that Alex was a woman but stopped. It wasn’t relevant anyway.
"Alright, well call me later today. Let me know what happens. You have my pager number?"
"Yeah I do," Regina said, holding the piece of paper.
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