Part Three

 

Chapter Four

Slamming the book shut, Regina jumped from her chair and walked hurriedly out of the medical library. Outside in the quiet corridor, she slipped into the staff bathroom. She vomited again for the fifth day in a row since she started taking the medication over a week ago. Leaning back against the door of the stall, she waited for the wave of nausea to pass, wiping a trembling hand over her sweaty brow. She moaned softly. "Oh, I need to get something to control this better."

So far she was able to get by without anyone noticing her sudden disappearances, but she knew sooner or later that someone would catch on and then she would have to deal with the questions that would undoubtedly follow. Leaning on the sink with her hands, she ran the water until it was icy cold, cupped her hand under the stream, then splashed it on her face and rubbed the back of her neck with it as well. Feeling her beeper vibrating against her waist, she cursed softly under her breath.

"Dammit." Regina looked down at the display and read the ERís number. Fumbling with the button, she stopped the irritating sensation.

"Ok, ok. Iíll be there," she muttered. "Just need a couple of minutes." She leaned against the cool tile and closed her eyes against the dizziness threatening her.

Upstairs in the crowded and noisy emergency department, Alex examined and triaged another patient. "When did the pain start, Sally?" Alex leaned over the rails of the gurney and pressed her fingertips into the right lower quadrant of the thirteen-year oldís abdomen.

The girl winced and curled up into a tight ball on her side. "After I ate lunch."

"That was what, about two hours ago?" she asked, looking at the mother. The woman nodded.

"Iím going to order some tests and keep her here to observe her for a little bit," Alex told the mother.

"Do you think its appendicitis?" the woman asked.

"It could be but I donít want to assume sheís a surgical candidate until I have the test results back." The attending started to leave the room, when one of the surgeons poked his head in.

"Heard youíve got an appy here, Dr. Margulies. I can bring her up to the OR and take it out now."

She turned around and glared at him. "Iím not finished running the tests so Iím not sure it is appendicitis."

"Oh come on now." Stepping up beside the rails of the stretcher, he looked down at the sick girl. "Iím going to press on your stomach." His large hands pressed down into her tender abdomen. "Does this hurt?"

The girl cried out as he let go. "See! Classic rebound," he exclaimed. He looked down at the girl. "Do you think you could eat some apple pie?"

Alex pursed her lips and prudently stepped back. She heard the sounds of retching as the girl vomited into the emesis basin lying at her side, splattering the surgeonís sneakers.

"Iíll book the OR," he said, looking down at his sneakers in disgust.

"You certainly will not." Alex grasped his elbow and led him out of the room. "Youíve got to be kidding me." She gestured angrily with her arms. "What kind of half-baked diagnostic test is that?" Several pairs of eyes looked up from the behind the desk in the emergency department. "You are not taking that child to the OR unless I say so." Alex leaned forward, her eyes narrowing as she stared down at the smaller, slightly bald-headed surgeon.

He shrugged his shoulders. "Have it your way. Iíll be here another hour. Youíll be calling me."

Alex shook her head in disgust and walked over to the desk. "Sandy, I need you to draw blood on the girl in room six. The orders are in the chart. Have the lab run a CBC with differential and a chem pro plus stat."

"Sure," The blonde haired nurse said, and winked conspiritally at her. "Heís an arrogant one, isnít he?"

"I canít believe he asked her if she wanted to eat apple pie. What an idiot." She looked at her watch and thumped her arm down on the desk in irritation. "Did Dr. Kingston return my page yet?"

The unit clerk looked up from the computer and shook her head. "No, I havenít heard from her yet. Iím sure sheíll be down soon."

"I donít need her now. I needed her thirty minutes ago."

The phone rang and the unit clerk turned away as she answered it. "I told you I was working all weekend. We need the money," the woman said.

Alex glanced down at the unit clerk and then looked over at Sandy. "Would you like to tell her boyfriend to stop calling or shall I?" Alex smirked evilly at Sandy.

"No Ė no, Alex." Sandy strategically pulled the phone out of Alexís reach. "Iíll take care of it," she told her, waving her quickly away, knowing that if she let Alex intervene she would probably be short a unit clerk after today.

Marcus walked over to the desk and stood beside the Alex. "Dr. Margulies?"

Alex looked at the resident. "What is it you want Marcus?"

"Can you look at a patient for me?"

"Whereís Dr. Alfonso? Isnít he supervising you today?"

"Yes, but heís with a trauma patient in two. He told me to come find you."

Alex took the chart from him and flipped it open. "Fine, letís go," she said, and started walking down the hallway.

"Dr. Margulies," Marcus said, hesitantly as they reached the room, "Iím really sorry about what happened to Regina last week."

Alex stopped, her hand about to push the door open to the exam room. "Itís not me you should be apologizing to, Marcus," she said, fixing him with an icy stare. After a moment of awkward silence, between them Alex stepped back and folded her arms over her chest. "So, tell me about this patient before we go in there."

Alex left Marcus with his patient after a brief discussion about the womanís recent hospitalization, and the possibility that she might have a blood clot that needed to ruled out immediately with a Doppler study. She wasnít the least bit pleased that he had needed as much guidance as he required and was beginning to wonder if he would be better off on a less demanding rotation.

Walking back down the hallway, she headed back into her patientís room. Leaning over the stretcher, Alex checked the IV and felt the girlís pulse. "How do you feel, Sally?" she asked, looking at the girl lying huddled under the blankets.

"A little better since I got sick."

Alex glanced over at the father who was watching her with his arms crossed tightly in front of him. "Her feverís down. The blood tests will give us a better picture of whatís going on clinically. Weíre going to observe her and see how she responds to the IV fluids. With the upper respiratory infection she had itís quite possible that she has an inflammation of the lining around the intestines."

The man blinked and shifted his weight on his feet. "But it could be appendicitis?"

Alex nodded her head. "With her symptoms, itís a remote possibility, but Iíd rather not have her undergo surgery unless weíre absolutely sure about it." Alex turned to leave the room. "The nurse will be into check on her every hour. Weíll know if there are any changes that should be of concern."

Settling down behind a desk, Alex wrote some notes in the girlís chart. Deciding she needed a cup of coffee to keep her awake, she stood up and walked to the staff lounge. On her way there, she ran straight into Dr. Kingston. Backing up a step, Alex folded her arms, blocking the shorter womanís path.

"You didnít answer my page," Alex accused her, staring down angrily at the resident. She was surprised and more than a little disappointed with her. Regina was one of her better residents and it was unusual for her not to be on top of things.

"I, uh, Iím sorry. I got down here as soon as I could," Regina said, feeling her face flush in embarrassment.

"Thatís not good enough, Dr. Kingston. When I page you, I expect that youíll at least return the call and let me know that youíre on you way. Even my first year residents know that."

"IÖIt wonít happen again," Regina said, feeling completely inadequate at the moment and stammering over her words.

"I donít expect that it will."

A movement caught her attention. Alex cursed under her breath, and brushed past Regina. "Hey. Where are you taking this patient?" she demanded, stepping in front of the orderly and taking hold of the stretcher.

"The OR," he said, as if this were common knowledge. "Sheís scheduled for surgery." He handed her the slip of paper.

After reading it, Alex crumbled the paper in her hand and threw it back at him. "Like hell she is." Her voice rose above the normal din in the emergency department. "Sandy, did those blood tests get back yet?"

"They just came in," the nurse called back to her, as she deftly avoided the man from housekeeping, who was mopping the floor around the desk.

"Let me see them." Snatching the lab report from Sandy, Alex read the lab values then picked up the phone. "Operator, page Dr. Allen to the ER stat." She slammed the phone back down into its cradle.

"Problem?" Regina came to stand next to Dr. Margulies, and looked up into doctorís face.

"Yeah, Iíve got one of the surgeons poaching patients for the OR. This kid doesnít have appendicitis." Alex turned around as she heard the ER doors bang open. Dressed in blue gray surgical scrubs, and an isolation gown thrown carelessly over his shoulder, the surgeon stomped down the hallway headed in her direction.

"This better be good Margulies. You pulled me out of scrubbing up for this case."

Alex bristled. "Dr. Kelly, there is no case," she said, crossing her arms and stepping in front of him. "What did you do? Sell the parents on the idea of removing the appendix to be on the safe side, and downplay the risks of anesthesia? Youíre trying to steal this patient as a surgical case so you can pad your numbers."

Dr. Margulies stepped closer to the surgeon, pointing a finger at his chest. "Sheís my patient and she needs to be observed first, not cut open. Thereís no fever now and her white blood cell count is normal. She had an upper respiratory infection last week and you know damn well the intestines could be inflamed from that."

"Fine, you do that and Iíll speak to your medical director in the morning. Youíre on thin ice here Margulies, remember that," the surgeon said, as he turned and stormed away.

"Dr. Margulies, he could be right." Reginaís voice was quiet.

Alex turned around, glaring contemptuously at the young doctor. "Dr. Kingston, I donít recall asking for your opinion."

Regina took a step back and turned away. Alexís words had been sharp and cut her deeply. She had only meant to diffuse things and ended up making them worse.

Regina picked up her stack of charts and walked toward one of the vacant triage rooms at the back end of the emergency department. She caught several people casting sympathetic glances her way and she was thankful when the door to the room closed behind her. Slumping into a chair, Regina pulled a pen out of her lab coat pocket. She stared at the wall twirling it back and forth between her fingers. Way to go, Regina. You really messed that one up.

Shaking her head, she pulled her chair up to the desk and opened the first chart. Putting her pen to the paper, she started to write, then stopped. Regina felt like she let Dr. Margulies down, but she would be damned if she was going to be yelled at in front of the entire department. Putting her palm against her face, she started to write.

It was several hours later before Regina was able to crawl out from underneath the mountain of paperwork she needed to complete. Most of it was filling out forms for the insurance companies and Medicare. It was amazing that with all the forms and questions that needed to be answered, that patients got treated at all some days.

Shuffling the papers together into an organized pile, she stacked them on top of the charts and carried them to the nurseís station. Her attention was drawn to an angry voice behind her.

"Marcus," Alex said, as she bore down on the resident from across the department.

Wanting as much distance in between them and the angry doctor, several staff at the nurseís station scattered out of the way. The resident looked up and recoiled physically as the tall imposing doctor descended upon him in all her fury.

"YÖyes Dr. Margulies?" he asked, trying unsuccessfully to sound confident.

Alex slammed the chart onto the desk and leaned over him, pinning him to the chair with her eyes. "Would you care to tell me about the patient in room four?"

Marcus reached for the chart to look at it, but Alex placed her hand down on the cover. "Ah, ah. Without the chart, Marcus."

He swallowed and looked down at his hands, which were trembling slightly. "Heís a forty-seven year old male. He complains of abdominal pain starting two days ago. No allergies, no recent illnesses or surgeries. Iím waiting for his lab results to come back."

Alex picked the chart up and flipped it open, setting it down in front of Marcus. "Very good, Marcus. I now know that you can copy the nurseís intake," she said, pointing to the nursing flow sheet. "Did you ask this patient any other questions, or did you just assume the nurses would get it all for you?" Her voice rose higher with each word until she was shouting. Patients and staff alike averted their attention, embarrassed by the angry outburst.

"IÖuhÖI," he stammered.

"Enough! I want to see every single one of your history and physicals you write up before you put it in a chart." She turned to walk away, but stopped. "Oh, and Marcus, his medical history included illicit drug use and heís been diagnosed with hepatitis C. Next time ask the damn questions yourself."

Alex stormed back toward the desk, stopping as Sandy held the phone up and pointed to her.

"Who is it?" Alex asked, obviously annoyed at the call.

Sandy mouthed a name to her and Alex rolled her eyes in disgust.

"Iíll take it in the staff lounge."

Regina listened to the heated exchange while she looked over two sets of lab results. Writing an order in a chart for a broad-spectrum antibiotic, she handed it to the unit clerk to enter into the computer. Taking a deep breath, she walked over to where Marcus was sitting.

Slumped forward over the desk, with his hands covering his face, Marcus shook his head and groaned audibly. Regina pulled a chair over and sat down beside the dejected- looking resident.

"Marcus, are you alright?" She asked. Her voice was quiet and gentle.

"Oh yeah, just great. Let me know if you see the other half of my ass that she just chewed off laying around anywhere."

Regina stifled a snicker and leaned back to look for the missing part. "I think everything is still intact, Marcus."

He shook his head and chuckled at Reginaís joke. "How do you deal with her, Regina? I mean, do you really like what youíre doing here?"

Regina sat up straighter and frowned at the question. "Well, yeah, I do, Marcus. Donít you?"

He took off his glasses and rubbed his eyes with his fingers. "I used to think I did."

"What happened?" Regina rested her elbow on the desk and leaned forward.

"Iím tired of being responsible for people, Regina. I mean, I like to help them, but, I donít know, maybe Iím just burned out right now. It doesnít help having to deal with the likes of that bitch. I know I messed up in there. Its just, damn it, I canít keep up with all this paperwork. She didnít have to take me down in front of the whole department. Thatís not right." Marcus put his glasses back on his face.

Regina squeezed his forearm in sympathy. "Youíre a good doctor, Marcus. Donít let her get to you. Shit, we all make mistakes."

"Yeah, I guess youíre right. Regina?" Marcus touched her arm as she stood up to leave.

"Yes?" She turned back to him.

"Iím really sorry about what happened last week. I should have listened to you before I stuck the guy."

Regina looked down at the floor and nodded her head. It was all the acknowledgement she could give him without becoming angry, and right now she really didnít want to think about it. It was better to keep the whole incident tucked neatly away in the back of her mind. She walked purposely over to the desk and stood next to Sandy.

"Uh oh, I know that look, Dr. Kingston. Whatís on your mind?" Sandy asked, while she printed out some discharge instructions for a couple of patients.

"Whereís Dr. Margulies?"

"In the staff lounge, taking a phone call." Sandy looked up at Regina. "You ok?"

"Iím fine," the young doctor answered. "Marcus isnít."

Sandy nodded her acknowledgment of this. "Be careful Dr. Kingston, sheís not in a good mood."

"Neither am I," Regina replied, much to Sandyís surprise.

Sandy raised an eyebrow and shook her head. Either the girl had a set of brass ones or she was crazy.

******

"When are you coming up here, Alex? You have to settle Lanaís affairs and you have power of attorney for her bank account," Dana complained from the other end of the telephone line.

Alex was leaning against the wall, arms crossed over her chest, with the phone cradled between a shoulder and an ear. "Dana, you know Iím coming up there in two weeks. Whatís wrong? Are you running short on funds?"

"Very funny, Alex. Maybe you should be a comedian instead of a doctor," Dana retorted as she filed a nail with an Emory board.

Dana looked up as a solidly built woman with short-cropped, gel spiked, bleached-blonde hair that was spiked with gel walked through the door of her store. She wore several studs in one ear and a labrys hanging from the other. She was dressed in tight, faded, blue jeans and wore a white tee shirt. The woman flipped through several of the prints that were stacked on the floor and then turned her attention to the wall. Dana kept an eye on the woman. She didnít look like she was interested in art.

"You know, youíre not the only one who loved her, Alex. Remember, you took her away from me - or have you conveniently forgotten that part of the story?"

"It was her choice to leave, Dana. I didnít force her into anything," Alex said. She turned her back to the door as it started to open.

"Well, we all know how charming you can be when you decide you want something, donít we, Alex." Danaís attention drifted back to the woman, whoíd walked to the back of the store. She was looking at the incense and candles that Dana kept on a shelf above the stereo system. The woman picked up a nearby book of matches and lit the candle at the right of the display.

Dana smiled to herself and walked over. She had a unique system for doing business. Four different colored candles stood on the shelf, each representing a specific drug: marijuana, heroin, cocaine, and ecstasy.

Dana walked past the woman and stepped through the curtained off hallway that led downstairs to the cellar. The phone connection filled with static as she walked down the wooden steps. "AlexÖwantÖthereÖout the bank account." Dana winced as the quiet cellar erupted in a cacophony of yelps and barks as three German Shepard puppies awoke at once and circled around each other, begging for attention. "Shut up!" Dana growled and banged the crates with the key ring she was carrying as she passed them.

"I canít understand you, Dana." Alex adjusted the phone. "Damn it, Dana. Are you listening to me?"

"Sorry love, bad connection," Dana said, enjoying the fact that she was really pissing Alex off. "Give me a second and Iíll be back upstairs." Dana unlocked the cabinet, pulled out a small, plastic bag of cocaine, and put it into a brown paper bag. She relocked the storage cabinet and walked back up the stairs.

Alex leaned her head against the wall and closed her eyes. She should have guessed that Dana was still selling drugs despite her insistence otherwise. "How can you still do that Dana? That store was Lanaís life."

Dana slipped through the curtain and took the fifty-dollar bill from the woman and handed her the bag. "Nice doing business with you," she said. "Donít get righteous with me, Alex. Lana gave up any claim on this place the day she walked out on me. She left me to rot in jail - a dubious distinction you should have shared with me, Alex. You never paid for what you did. No, dear Alex has never had to pay for anything sheís done."

"This conversation is over, Dana. Iíll be up there in two weeks. Donít call me at the hospital anymore. Goodbye." Alex hung the phone up. "Do you always listen to other peopleís conversations?" she asked the person standing behind her as she turned around. If she was surprised to see Regina there, she didnít show it.

Regina was standing at the counter with her arms crossed. "Not as a rule. Can I talk with you for a minute?"

"Youíre here, talk," Alex said, still feeling anger and resentment at Danaís phone call. Damn her, she knows just what buttons to push with me.

Regina unfolded her arms and walked to the table, putting her hands on the back of the chair and leaning into it. "I know I was wrong not getting down here right away when you paged me."

"Youíre right about that, Dr. Kingston. You were." Alex fixed her cool gaze on the blonde.

Regina took a breath and launched in. "What I donít agree with is the way you chose to tell me about it. I donít appreciate being yelled at in the middle of department and in front of the other staff." Regina said. She took a breath, watching as Alexís pupils dilated and her nostrils flared.

Knowing she just pissed the doctor off, Regina decided to go for broke. Why not? Sheíd be damned if she was going to let this woman walk all over her for the next four months. "It sure as hell doesnít help anyoneís confidence knowing that if you make a mistake, retribution is quick and public."

"Is that all, Dr. Kingston?"

"No. Marcus didnít deserve to have his legs taken off at the knees. Youíre supposed to help the residents learn, not intimidate them." Regina didnít wait for the doctor to respond. She spun on her heel and whipped the door open, slamming it into the wall, and beat a hasty retreat down the hall.

Alex stared at the door as it swung shut. She ran a hand through her hair and chuckled softly to herself. "Well, Iíll be damned." Walking out of the room, she headed to the administrative wing of the hospital.

Alex stood in the door of the directorís office, waiting patiently as she finished with a phone call. The blonde-haired woman waved her in and Alex sat in the leather chair facing the desk. She took the opportunity to look around the womanís office, which was littered with reams of paper detailing the hospitalís vital statistics.

Dr. Cassandra Mitchard was one of the youngest Vice Presidentís at the five-hundred bed medical center. One of the first women at the medical center to break through the proverbial "glass ceiling" and wreak havoc on the old boyís club. She didnít subscribe to the fifth floor dress code to wear fashionable mini-skirts and pumps that satisfied the adolescent fantasies of the over fifty executive crowd. As Vice President of Medical Affairs, she learned quickly to play hardball, and ruled with an iron fist. Alex respected the woman from the moment she met her three years ago.

"Itís been quite a while since youíve blessed us with your presence, Dr. Margulies," Cassandra said, giving her an appraising look. "What can I do for you?"

Alex sat forward in her chair. "I need some help, Cassandra. Dr. Jameson wants the statistics for the emergency roomís mortality rate for the last six months."

Cassandra nodded and leaned back in her leather chair. "And you want to know how you can put the little rat in his rightful place," she stated, as she let a wicked smile play at her lips.

"Subtle, very subtle." Alex tilted her head to the side and smiled at how easily Dr. Mitchard could read her.

"You canít blame me for wanting a little revenge, Alex. He didnít just screw you last year with that bogus charge. He dragged the entire organization through the coals. He thinks his political connections are strong enough to protect him but, heís wrong. Dead wrong." She leaned forward and opened up a binder of reports and thumbed through the pages until she found what she was looking for. "Here, look at this. At first glance, Alex, you look like the grim reaper." She flashed her an apologetic grin and went on. "But, look a little deeper and you, Alfonso, Torres and Washington account for eighty-five percent of the emergency room department admissions a year. Do you know how many people came through our doors last year, Alex?"

"We had twenty seven thousand admissions into the emergency department," Alex replied.

"Exactly." She scanned the sheets. "You and Torres take the most severe traumas, partly because you are chiefs but also due to just blind luck. Your average acuity rating is three, with the most severe traumas being rated a four. That more than justifies the mortality rate that the two of you have. Now just for shits and grins, letís take a look at what dear Dr. Jamesonís stats look like."

Alex shook her head. "Youíre evil, Cassandra."

"No more than you, Alex. No more than you." The VP pointed triumphantly at the sheet in front of her. "Look. He sees approximately twenty- three patients a day. Thatís an average of nine less than the rest of you. Now look at his mortality rate and his average acuity rating."

Alex sat back in her chair and stared at the doctor. "Shit."

"How you choose to present this information is entirely up to you, Alex. You can make these numbers say just about anything you want." Cassandra booted up her computer. "Do you have a computer you have access to?"

"Yeah, the medical staff office has two with Microsoft Office running on it," Alex said.

"Took them long enough," Cassandra responded. She pushed a disc into the floppy drive and copied several files to the disk. "This has all the information youíll need. By the way, Iíll be at the next Mortality and Morbidity meeting. I hope youíll make it worth my while to attend."

Taking the disk from Cassandra, Alex saluted her with it, and sauntered out of the fifth floor suite. Battle lines had been drawn.

******

As luck would have it, Regina was mercifully paired with Drs. Torres and Washington over the next two weeks and saw little of Dr. Margulies. When she did see the Chief Attending in passing, Regina felt invisible to Alex as she stared right through her, unseeing. Regina wavered between seeking Alex out and apologizing for yelling at her and deciding emphatically that the witch deserved her anger for lashing out at her and Marcus. After all, this was a teaching hospital and neither of them had done anything to threaten a patientís life.

Today after the M and M conference the rotations changed again and she would be back with Dr. Margulies. Regina walked into the mahogany paneled conference room and took a seat next to Marcus.

"Hi Marcus." Regina nudged him.

"Hi, yourself. I hear weíre back with the queen bitch again today," he said, and yawned without bothering to cover his mouth.

"Ooh, nice tonsils Marcus," Regina commented.

"Sorry, I didnít get much sleep the past few nights. As soon as they turn the light off Iím history. Wake me when itís all over." Marcus crossed his arms and sunk down lower in his seat waiting for the lights to dim.

The conference room filled up with medical staff, and the hum of people talking over each other engulfed the room. After a few minutes, a rather tall, athletically built man wearing an expensive looking gray suit took the podium. He tapped the microphone and cleared his throat as if this would give him the attention of everyone gathered in the room.

"Excuse me," he said into the microphone. "Weíd like to get started now."

"Ugh, he looks like a weasel with that moustache," Regina leaned over and said to Marcus. He opened his eyes and snorted.

A hand clamped down on both their shoulders and a deep baritone voice rumbled in their ears. "That weasel happens to be our medical director, Dr. Jameson."

Regina and Marcus turned in their seats to see Dr. Washington and Dr. Margulies standing behind them. Alex remained silent but her eyes met Reginaís and the young resident quickly faced forward in her seat feeling her face redden from the intensity of the look radiating from the doctorís eyes. Oh shit, Iím in trouble.

A moment later, Regina watched as Alex walked past them to the front of the conference room and handed a carousel of slides to the man in charge of the audiovisual equipment. Studying the Chief Attending, Regina observed that Alex was dressed in a dark blue linen suit, quite unlike her usual attire of scrubs and lab coat, and although Alex seemed oblivious to it, she made a stunning impression to the crowded auditorium.

"Way to go, Kingston." Marcus nudged her, pulling Regina out of her quiet observation.

"Iím already toast with her." Regina waved her hand and sunk down in her seat next to Marcus.

They turned their attention to the medical director standing at the front of the room beside Dr. Margulies. "Iíll turn the microphone over to Dr. Margulies so she can get on with her presentation. Iím sure your statistics about the mortality rates in the emergency department will be most enlightening for us all."

"Oh, he is so smug," Regina said.

Marcus leaned over and whispered in her ear. "The rumor mill has it that he is trying to run Dr. Margulies out of here. Supposedly our illustrious chief attending has a notoriously high mortality rate. Heís using this to put one more nail in her coffin." Marcus closed his eyes again as the presentation moved forward. "As far as Iím concerned they can bury her alive."

Regina stared at Marcus and then focused her attention back to the drop down screen at the front of the conference room. Regina glanced around the room and noted that most of the medical staff that could attend looked fairly interested and others, mostly residents and interns were using it as a chance to catch up on their sleep.

"Iím sure they will, Dr. Jameson." Alex drawled, taking the microphone and striding confidently to the center of the floor. "So everyone knows up front, these statistics were compiled from Information Resource Management and the Office of Medical Affairs. They required very little modification because Dr. Cassandra Mitchard oversees the project." She looked around the room and smiled at Dr. Jameson who seemed to be a shade paler now, than when she started. "Well, if someone will dim the lights, letís get started."

Alex calmly took the group through a quick but thorough explanation of the statistics as the slides flicked up on the screen. The atmosphere in the room seemed to intensify as the next several slides depicted each of the five doctorsí mortality rates in the emergency department. Regina cringed when she saw Dr. Marguliesí statistics outlined in blue showing her leading the way with thirty deaths for the previous year. A murmur went through the crowd and Regina found herself listening intently to the doctorís strong voice as it carried through the conference room. Even Marcus roused himself from his slumber enough to focus on the doctorís words.

"Myself and Dr. Torres have the dubious distinction of having the first and second highest mortality rates in the department respectively. Dr. Washington and our medical director, Dr. Jameson have the two lowest. I think what you will find most interesting is the average acuity factor combined with the number of the patients treated by each of us." Alexís voice trailed off as she advanced the slides and she set the microphone in its holder on the podium.

A snicker came from behind them and Regina turned to see Dr. Washingtonís shoulders shaking as he tried hard to keep from laughing out loud. Regina turned back to the screen and stared at it in shock. Marcus grabbed her arm and shook it to get her attention.

"Holy shit. Dr. Margulies just turned the tables on Dr. Jameson. Look, heís still trying to figure out what the slide says," Marcus said, looking at the incredulous look on the medical directorís face.

"Jesus. Heís been taking the easy cases and his mortality rate is close to Dr. Marguliesí," Regina said, as she studied the screen.

Regina missed Alex walking past and slipping in beside Dr. Washington. It wasnít until she felt a light touch on her shoulder that Regina turned around and saw the doctorís penetrating blue eyes watching her, did she realize that she was there.

"I need to speak to you later, Dr. Kingston," Alex said, as she stood up from her chair.

Regina nodded her head, keeping her tongue in check, as she surely would have choked on it if she tried to answer her at that moment. She watched as Dr. Margulies walked away, her long legs carrying her confidently out of the conference room.

"She needs to talk to you?" Marcus asked Regina.

"Iím dead, Marcus." Regina slumped lower in her chair. "You know that coffin you were talking about?" He nodded his head. "Well, keep it handy. I may need it later."

"Regina, what did you do?" he asked, growing concerned that his one ally was in serious trouble.

"I yelled at her after she reamed you out in the department." Regina twisted her hands and looked up at Marcus.

His mouth gaped and he stared at her. "Well, thanks, but what the hell did you go and do that for?"

Regina shook her head. "I donít know. Call it temporary insanity. Anyway, wish me luck."

Part 4

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