The Doctor's Undoing

His expression turned instantly innocent. “I’ve been perfectly well behaved during my presentations.”

“Mmm. Doesn’t prevent everyone from worrying about when you’re going to stop being perfectly well behaved and let your real self show,” she muttered, returning to her notes.

He laughed again as he ambled out of the room. “See you on rounds.”

Even as she concentrated on finishing her work, she dwelled on thoughts of Ron during the next few minutes. She found it ironic that out of their entire study group, she and Ron were the only two who’d ended up on the same rotation, so they saw each other every day during rounds and lectures.

She’d hoped to share the experience with her best friend, Anne Easton. But Anne was on surgical rotation—a demanding, time-consuming block—in addition to starting a new life with her husband, who now made his home with his wife here in Little Rock when he wasn’t traveling for his job. Haley and Anne hardly had a chance to see each other lately. Nor had Haley seen much of Connor or James, their other two study partners. Connor and James were on a separate semester schedule, meaning she wouldn’t do any of her rotations with them this year.

She couldn’t say she missed the mind-numbing overload of lectures and exams that had taken up the first two years of medical school, but she did miss her friends. Which, perhaps, explained why she was always happy to see Ron every morning, despite her frequent annoyance with him.

Funny how conflicted her feelings were about Ron, she mused, folding her notes into the patient history and physicals—commonly referred to as H & Ps—and slipping them into her pocket. Anne had once commented that Haley and Ron were like squabbling siblings—and yet that description had never felt quite right to Haley. She refused to concede that the sparks she and Ron set off were at all sexual—but “sisterly” wasn’t the word she’d have chosen, either. She’d settled for thinking of him as an attractive, interesting, complicated and often annoying friend.

She supposed that was close enough to the truth.

Rounds began promptly at 8:00 a.m. The residents and students were always relieved when the attending physician showed up either on time or a few minutes late. Having the attending show up early caused panicky, last-minute completions of notes and charts. No one wanted to be caught unprepared.

Though this was Ron’s first rotation, and first real experience with hospital rounds, he felt more comfortable with the process than he might have expected. He liked the attending quite a bit. Dr. Cudahy was a seasoned hospitalist who was cordial and considerate to her patients and associates. Her first lecture to the three students on this team—Ron, Haley and Hardik Bhatnagar—had included a reminder that all the patients they would see in this facility had spent time serving their country and in return deserved to be treated with gratitude and respect, no matter what unhealthy lifestyle choices they might have made.

Along with his two classmates, three residents, Dr. Cudahy and her nurse, Ron entered the room of the first patient they would be seeing—Haley’s flirtatious Mr. Eddington. The thin, wan man winked at Haley, who stood beside his bed to begin her presentation. A warm, answering smile reflected in her amber eyes when she spoke to the assembled group.

Haley was good at presenting, Ron thought with a touch of pride for her. She looked comfortable and confident as she gave a brief summary of Mr. Eddington’s condition, his experiences during the night and the resident’s plan for continued treatment. She was able to answer the attending’s questions with only a glance at her notes, which made both her and her resident look good. Ron gave her a surreptitious thumbs-up when they left the room to move to the next.

Hardik sailed through his presentation of his first patient, but stumbled during his second stop. He’d forgotten to note the new antibiotic that had been started during the night, and as a result, his resident had to step in to answer the attending’s questions, leaving Hardik embarrassed. It happened to all of them, of course; Dr. Cudahy even deliberately tried to stump them at times, just to keep them humble and on their toes. Ron still felt bad for his classmate—and hoped he didn’t make the same mistakes with his own patients.

Ron kept his presentations brief and to the point, despite his urge to crack a few jokes to make everyone laugh. Which, of course, made him think of Haley’s comment that everyone was just waiting for him to display his “real” self during rounds. Had she only been teasing? Or did she really believe the serious and proficient side of him was only an act?

Haley looked good today, he mused, watching her present her final patient. Georgia McMillan, an sixty-eight-year-old retired Air Force nurse, was being treated for pneumonia in addition to emphysema and congestive heart failure, all common to this facility’s population. Many of the veterans had been or were still heavy smokers, leading to a high incidence of lung and heart diseases among other smoking-related ailments.

Letting Haley’s presentation drift past him, Ron concentrated instead on how fresh and professional she looked in her spotless, short white coat over a melon-colored top with tan pants. Her collar-length, honey-colored hair was neatly restrained with a brown headband, and her makeup was flawless and understated—not that her pretty, girl-next-door face needed much enhancement.

He realized abruptly that the group was moving toward the door, leaving him gazing rather stupidly at Haley. He recovered quickly, sending a smile of gratitude toward the patient who allowed the students to gawk at her and learn from her suffering. Ms. McMillan batted her eyes at him in return, making him chuckle as he stepped out of the room.

When all the patients had been seen, Dr. Cudahy led them to a conference room for a teaching session. The residents and students followed like ducklings trailing a mother duck—which was the way Ron had come to think of them during the past week. Dr. Cudahy had informed them yesterday that she would be discussing hospital-acquired infection today. The students had been expected to research the subject on their own last night so they could participate in an intelligent discussion of the subject. Ron had spent several hours in front of his computer and textbooks, and hoped he would be ready if the attending tried to trip him up with a difficult question.

He took this training more seriously than some people gave him credit for, he thought with another glance at Haley.

Haley was tired when she arrived home, but that was nothing new. She would take the weariness after a long day on the wards any time over the grueling schedule of classes and exams that had made up the first two years of medical school.

Pulling the band from her hair, she shook her head to loosen her tidy bob and headed straight for the kitchen in search of something cold to drink. Her apartment was an older one, and the appliances were almost as old, but at least the aging fridge worked well enough to keep her sodas cold, she thought, taking a big swallow of a diet lemon-lime beverage. The citrusy liquid flooded her throat with a satisfying bite, somewhat reviving her after being out in the heat of an Arkansas late-July afternoon. She’d grown up in this state, so she was accustomed to the oppressive, humid summer temperatures, but she still preferred the crisp, cool days of autumn.

Her phone rang just as she dropped onto her couch to prop up her aching feet for a few minutes before she made dinner. Seeing her mother’s number on the ID screen, she smiled when she answered. “Hi, Mom. What’s up?”

Haley’s parents still lived in Russellville where Haley had grown up, a one-hour or so drive from Haley’s Little Rock apartment complex. An only child, she was especially close with her mother, and they talked and saw each other as often as they could considering their hectic schedules. Her parents ran a busy restaurant, Pasta Wright, in Russellville, which kept them both running pretty much 24/7. Haley had worked in that establishment, herself, during her senior year of high school and for two years afterward before starting college, so she knew exactly how hard those days could be, though her parents still loved the work.

Her mom adored hearing about Haley’s medical school experiences. Janice Wright had always encouraged her daughter to pursue any career she desired. She wanted Haley always to be able to take care of herself, to be a modern, independent woman with many roads open to her. Haley’s dad had been just as encouraging for her to go after her dreams, pushing her out of the restaurant and into college as soon as they were all sure the restaurant venture would survive.

Her parents had offered to support her financially during her medical education by getting another mortgage on the house that was already collateral for their business, but she had refused to allow them to make that sacrifice. She would get by on loans, she assured them. If she was going to be an independent woman, she might as well start now.

“Have you heard any more from that young man you were dating last month?” her mother asked as the conversation wound down. “Kris?”

“No, Mom. I won’t be hearing from Kris anymore. I heard he’s seeing someone else now.”

“And you’re really okay with that? You seemed so fond of him.”

“I was fond of him. He’s a great guy. But it was never serious. We were just friends, hanging out and having a little fun. And it was my decision to go our separate ways. I’m staying busy with this rotation. After this one, I have pediatrics and then surgery, which involves really long hours. I just didn’t have the time or energy to devote to Kris—or anyone else—right now.”

Haley had known from the start that Kris wouldn’t be in her life for long. After dating him only a few months, she had tactfully informed him it wasn’t fair to him to continue the way they had been, with her too busy to see him regularly and too distracted by thoughts of school when they were together. When he hadn’t even bothered to argue, she’d realized that he was rather relieved she had made that decision for them. It wasn’t giving up, she assured herself, when that outcome had been predetermined from the beginning.

“Well—just remember you can’t work all the time. Have some fun when you can.”

Her mom had warned her several times that, as important as her career might be, it shouldn’t be the only thing in Haley’s life. One must stay balanced, she counseled, with family and other interests to fill the hours away from work.

“I’ll try to take a little time off when I can, Mom.”

Not that there was much time to take. Even with the first two years behind her, the next two would be busy in their own way. Long hours in rotations, preparing for Step 2 of the licensure exams, applying and interviewing for residency programs. Becoming the physician she wanted to be.

When the time was right, she would find someone to share her life with, Haley assured herself. In her experience, everything had a way of working out as it was meant to.

Which sentiment would only give Ron more reason to tease her about her “optimistic cheerleader” attitude, she thought with a grimace as she and her mom concluded their call.

She wondered impatiently why thoughts of Ron had popped into her head at just that moment.

As they had vowed to try to do regularly during the remainder of medical school, the study group members met for dinner after work the following week, a rare evening when all five were free for a couple of hours. It still felt odd to Ron not to see his friends in classes every day. Though they stayed in touch, this was the first time they’d all been able to get together to compare notes on their rotations that had started two weeks earlier.

Anne’s husband, Liam, and Connor’s wife, Mia, had been invited to join them this evening, but Liam was out of town on business, as he so often was, and Mia had opted to see a movie with her stepdaughter, instead. Ron suspected she’d done so to give the group a chance to share tales about their rotation experiences without worrying if they were boring her with their shoptalk.

They sat in a big, round booth with plates of seafood and glasses of wine on the table in front of them. “How are your rotations going?” Ron asked, including everyone in the question.

Connor Hayes spoke first. The father of eight-year-old Alexis, Connor had just celebrated his first wedding anniversary with Mia. Ron had attended that wedding, as had the other members of their group.

“I’m enjoying geriatrics,” Connor said. “Had my second hospice visit this afternoon. I can see how much good the hospice teams do for the families in the end stages of their loved ones’ lives. I really admire the ones who do it every day, especially the volunteers.”

“Are you considering geriatrics now?” Anne asked him.

Smiling, Connor shook his head. “Still planning family practice. It’s what I’ve always wanted to do, and I doubt I’ll change my mind during rotations.”

“My psych rotation is pretty interesting, but it’s not on my list of possible specialties,” James Stillman commented. “I don’t mind it for this six weeks, but I think I’ll be ready to move on to something else by the time the rotation ends.”

Twenty-nine-year-old James had already earned a doctorate in microbiology before he’d entered medical school. He had said once that he kept going to school to put off committing to any particular career, a sentiment Ron had laughingly agreed with.

After dropping out of college his first semester after high school, Ron had drifted for a couple of years, trying several unsuccessful jobs before deciding to give college another try. Applying himself to his studies that time, he had done well enough in his classes—particularly his science classes—that his faculty advisor had encouraged him to consider medical school. Ron had taken the MCAT, the medical school admissions exam, half expecting he wouldn’t do well enough to even be considered. No one had been more startled than him when he’d received a very high score.

Well—maybe his family had been more surprised. His dad had predicted Ron would drop out of medical school when it got too tough. His mother had worried aloud that Ron wasn’t doctor material, and that he’d only been setting himself up for disappointment. None of his siblings thought he’d ever make anything of himself; they’d expected him to settle for the same aimless and unfulfilling existence they led themselves.

He’d made it through the interviews and had been placed on the alternates list for admission. Even then, he’d waited to be told that he hadn’t made it in. Apparently, enough first-choice applicants had declined to open up a slot for him. Rather dazed to have gotten that far, he’d secured his loans and shown up for classes—only to be slammed by the reality of the commitment he had made when he found out just how hard medical school really was. He’d been unprepared for the long hours, the constant stress, the sleep deprivation, the massive amounts of information he had been expected to learn and access on demand. Several times, he’d almost chucked it all and taken to his heels.

Only a few things had kept him on course. His pride, which had made him reluctant to admit to his family that they’d been right about him not being cut out to be a doctor. His deep desire to enter a career in which he felt he could make a difference in other people’s lives. And the people of his close-knit and incredibly encouraging study group—including Haley, whose refusal to let anyone around her concede defeat had been as inspiring as it was irritating at times.