Kyra hesitated before she dropped her last quarter into the vending machine. This would be her second bag of Doritos tonight, not exactly the way to live healthy. Then there was the bag of peanuts and the burrito she had wolfed down for dinner. At this rate, her arteries were going to be stiff as a board by the time she was forty.
Oh well, you gotta die of something. Kyra selected the Doritos from the vending machine menu and waited patiently for them to drop down. Just before falling to its destination, the edge of the bag got caught and hung tenuously from its slot. Kyra eyed the bag and her fingers curled into a fist.
You don’t fall…
you fucking die.
The bag trembled before it plopped down and Kyra smiled with satisfaction. Then she looked down at her clenched fist.
What is my life coming to? I’m threatening a vending machine…
Kyra was opening the bag when she hurt the announcement overhead: “Major trauma in five minutes.”
Kyra looked down at the Doritos regretfully and stuffed the package into the already overflowing pocket of her white coat. She sprinted in the direction of the trauma ER, ready for action. She was still a little shaken after what happened with Mr. Gates, but the man had survived and she knew that she was ready to handle this next patient. This time Joel wasn’t going to have to bail her out.
Kyra reflexively smiled when she thought of Joel. She had dated a lot of men in her life, but Joel was easily the sexiest guy she had ever met. The nurses were all wild for him, but he seemed not to notice, or maybe he didn’t care. Even before she found out what an amazing surgeon he was, she had thought that he was really cute—slim and lanky with an easy smile and light brown hair that curled slightly on the ends. Due to her own height, she preferred men who were over six feet and unfortunately, he fell an inch short of her cut-off, although he was still taller than she was in their bare feet. But really, it was the first time she saw him operate that she fell in love. He was just an intern back then, but he was more adept with his hands than some of the experienced attending surgeons.
And he cared about her very much; he made that very clear. Maybe he even loved her. She saw the way his eyes lit up when she walked into the room, and she appreciated all his efforts to impress her. Lately, Kyra had been getting the feeling that Joel wanted to take their relationship to the next level, whatever that was. Maybe moving in together, she wasn’t sure. The idea excited her immensely, but she had some misgivings. Joel was a great surgeon, but not a great boyfriend. He was too absorbed in his work. Maybe he loved her but he loved operating even more. As long as they were together, she’d always come in second.
To some extent, Kyra admired and respected Joel’s commitment. She supposed that if she had that kind of talent, she might feel the same way. Right now her work was the most important thing to her, but she hoped that someday in the future she’d make room for other things, like a family. Kyra couldn’t figure out whether she saw Joel as part of that future.
As Kyra approached the trauma ER, she saw one of the physician’s assistants Carol standing at the door, looking very pale. “Where’s the trauma?” Kyra asked. “Are they here yet?”
Kyra didn’t know Carol very well, so she was surprised when the older woman put her hand on her shoulder. Kyra could hear a nurse getting report on the trauma from within the room: 28 year old male involved in car versus concrete divider at roughly 60 miles per hour…
“Kyra,” Carol said. She was making eye contact with Kyra, like they were taught to do with the relatives of trauma victims. “Kyra, Joel is the trauma victim.”
She laughed. “What are you talking about? Joel’s upstairs.” As she said the words, she realized that it had been over an hour since she had seen him in the resident lounge.
“No, he’s not,” Carol said. “He fell asleep behind the wheel while driving home and he was hurt pretty badly.”
Kyra grabbed onto an alcohol hand sanitizer bottle that was hanging from the wall in order to steady herself. The bottle wasn’t as secure as she had thought and as it ripped from the wall, Kyra felt her legs giving way beneath her. She fell to the floor on her hands and knees, trying to keep breathing.
“Oh god,” Kyra whispered. She looked up at Carol, who was bending down beside her. “What… what are his injuries?”
“Sounds like multiple fractures and a serious spinal cord injury.”
“C-spine?” Kyra asked. She averted her eyes when she asked the question. She couldn’t bear the thought of Joel having a cervical spine injury. If Joel were a quadriplegic, even a partial quad, he’d never be able to practice surgery. You couldn’t do surgery without full use of your hands.
Carol nodded.
“Oh god,” she said again. She meant it this time. Kyra had never believed in any sort of religion, but now she prayed for Joel. Please God, don’t do this to Joel. Anyone but Joel. Do it to me instead. But not him, he won’t be able to take it. Please
don’t…
“Does he know?” she asked Carol.
“Are you kidding? I heard he diagnosed himself on the way over and was telling the paramedics what to do.”
Typical Joel. Kyra tried to smile, but instead felt tears rising to her eyes. She imagined the great surgery resident Joel Dergan operating a sip and puff wheelchair with his mouth and she couldn’t stop the tears anymore. No no no, don’t cry. That won’t do anyone any good.
“Kyra.” She heard the firm, deep voice from above her head. Kyra looked up and saw the face of her attending physician, Dr. Potter. Where were you two hours ago, when Joel was saving my ass? “Are you okay?”
Kyra scrambled to her feet, but couldn’t look the other doctor in the eyes. “I’m fine.”
Dr. Potter looked her over. “You’re going to sit this one out, Kyra.”
Her eyes widened. “What? But Joel needs—”
“Joel needs a surgeon who can cut without shaking,” Potter said, looking down at Kyra’s hands. “You’re in no condition to be operating right now.”
Kyra realized that the attending was correct in his assessment. She also knew that if situations were reversed, Joel would have been the first one scrubbed in to save her life.
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Even though he knew it might be the hardest thing he had ever done, Dr. Timothy Potter wanted to be the one to talk to Joel Dergan when he finally woke up. Joel had been in and out of consciousness the last few days, enduring surgery after surgery. When Joel first lost consciousness in the ER’s trauma room and Potter saw the large laceration on his scalp, he had been terrified to look at the head CT. He had seen a lot of traumatic brain injuries and he knew that if Joel had a bad intracranial bleed, even an emergent surgery might not be enough to save him from death or spending his life with drool dripping down his chin, struggling to form a simple sentence.
To Potter’s immense relief, the scans of Joel’s head were completely normal. A concussion at worst.
Potter couldn’t say anything equally positive about the rest of his former star resident’s body. Right after going through the scanner, Joel was taken straight to surgery. The first surgery was to keep him alive and stop all the internal bleeding. Potter himself had performed that one on the night of the accident. It always felt strange to cut into the abdomen of a person he knew, to see that despite their unique personalities, their insides were all the same. Joel may have been one of the most brilliant surgery residents he had ever worked with, but his abdominal cavity looked just like any other trauma victim’s. And it was a mess.
The next set of surgeries were on Joel’s spine. Potter had deferred that surgery to the experts, but he heard secondhand what the findings were. Joel’s spinal cord was completely severed above the C8 level, making him a complete C7 quadriplegic. “There’s no chance he’ll get any movement or sensation back below that level,” the surgeon had told Potter in a grave voice.
Potter had wanted to wait for Joel’s family to arrive, but when he heard that the resident was fully awake and asking questions, he knew he couldn’t delay talking to him. At the very least, Joel deserved to know what was going on.
Joel Dergan had been the best surgeon resident they’d ever had. He had an incredible talent and even though Potter tried not to show it, he secretly got a kick out of working with him—he picked up techniques so damn fast. Potter had always assumed Joel was destined for great things. Now Potter had to be the one to tell him that there was no chance he’d ever perform surgery again and he’d have to rely on a wheelchair for the rest of his life. It was funny how things worked out.
When Potter walked into the room, Joel was lying in bed. There was a tray of food on the side of his bed and a nurse was cheerily feeding him. Joel was barely tolerating this indignity and wore a scowl on his face. His surgeon’s hands were on his lap, motionless. His muscles were still flaccid, but in the coming weeks, his paralyzed fingers would likely begin to curl and grow stiff. Potter tried to avoid looking at the tube snaking out from under the covers, draining the urine from Joel’s bladder into a bag hanging off the side of the bed. He knew that Joel could no longer control his bladder or bowels and before he had awakened, Potter had examined him and seen the plastic diaper he wore under his gray hospital gown to avoid soiling the sheets. The covers went down to Joel’s ankles, exposing his feet, which had foam cushions strapped to them to keep them from arching into plantarflexion.
“Hi, Joel,” Potter said, trying to sound upbeat. “How are you?”
Joel glared at him. The young resident’s right cheek was bruised from the accident, there was minimal bruising around both his eyes, and there was a bandage covering the sutured laceration on his forehead that Potter himself had sewn up, although the facial damage was minimal. “I’d like a few answers, but nobody’s willing to talk to me.”
Potter turned to the nurse, “Would you excuse us?”
“Certainly,” she said. She took a white napkin and gently dabbed at Joel’s chin to clean it. He jerked away from her as she gave him a look as if to say, You need to get used to this.
“Well?” Joel said. He saw the older surgeon hesitating. “Don’t bullshit me, Tim. I want to know what’s going on. What’s my prognosis?”
“Joel…” Potter sat down on Joel’s bed, careful not to accidentally rest on his legs. “I’m going to tell this to you straight: I’ve talked to your surgeon and it seems like the paralysis you’re experiencing is most likely permanent.”
Joel didn’t say anything. It was probably what he had been expecting, but still, it had to be devastating to hear.
“The current plan is to figure out what your remaining function is and make the most of it,” Potter went on. He picked up one of Joel’s hands and slid his fingers into the palm. “Can you grab my fingers, Joel?”
Potter wasn’t sure if Joel was making an effort or not, but his fingers didn’t even twitch. He supposed it was consistent with the injury. “I can’t,” Joel said quietly.
“Joel, I know this must be very difficult for you and I just want you to know you have the full support of the surgery department.”
Joel lifted his light brown eyes. “There’s no chance I’ll be able to operate again, is there?”
“No, there isn’t,” Potter admitted. “Even if you get some movement back in your fingers, you’ll never regain full dexterity.”
“Then what the fuck am I supposed to do?”
Potter heard the desperation in the young resident’s voice. “First thing’s first,” Potter said. “We’re going to get you in a wheelchair and get you mobile again.” The thought of his star surgery resident being confined to a wheelchair for life was disheartening, but he tried to suppress his own response to the situation.
“Mobile in a wheelchair,” Joel clarified.
“Yes.”
“I’ll never be able to walk though…”
“There are machines that can help you stand,” Potter said. “Maybe even take a few steps. But they’re not functional, mostly just for exercise and your bones. You’ll need a wheelchair for all your daily activities.”
Joel laughed bitterly and shook his head. “Only two weeks ago, during a triple A repair, we infarcted this guy’s spinal cord. Turned him into a paraplegic. I said the exact same thing to him, that he’d be mobile in a wheelchair. Like it wasn’t such a bad thing.”
“Joel…”
“I can’t do this,” Joel murmured.
“What do you mean?” Potter asked. He almost didn’t want to hear the answer to his own question.
Joel stared at him with the same brown eyes that Potter had seen peering out from over a surgical mask a hundred times before. There were no tears in his eyes. “I can’t live my life this way,” he said. “I didn’t work my ass off for 28 years just to wind up like this.”
The words chilled the older surgeon. He patted Joel’s thigh, forgetting that the young resident could no longer feel that touch. “This is going to be okay, I promise you,” he said. “I know it seems like the end of the world now, but you’ll get used to it.”
“You really believe that crap?”
“Joel…”
Joel sighed. “I don’t want to talk about this anymore, okay?”
When Potter left the room, the first thing he did was find Joel’s nurse. She flashed Potter a wide smile until she heard what the surgeon had to say. “I want him on suicide watch,” Potter said. “Immediately.”
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The day Joel Dergan received his first wheelchair was the worst day of his life thus far. He had already known for over a week that he’d never walk again, but when his physical therapist Kelly brought that chair into the room, her freckled face broken out in a too-cheerful grin, the reality of it hit home. “This will be your wheelchair while you’re in the hospital,” Kelly told him.
My wheelchair. My wheelchair that I’ll need for the rest of my life. Joel felt sick at the thought of it. The chair was hospital brand: very bulky, with a high backrest, handles on the back, and detachable footrests. Kelly noticed the look on his face and added, “When you leave here, you can buy a chair that’s a little more sporty.”
“How am I going to be able to wheel it?” he asked. “I can’t move my hands at all.”
Kelly looked like she hadn’t considered that. “Well, if you’re having too much trouble with this chair, we’ll get a power chair for you to use.”
Joel hated the thought of using a power chair, but he knew he needed a chair that he could control on his own. Kelly was still smiling cheerfully at him, but he couldn’t return her enthusiasm. He couldn’t pretend that he wasn’t miserable. Ever since Potter had come to speak with him, there had been a nurse’s aid sitting by the door to his room—he wasn’t left alone for even a second. Potter probably thought he was suicidal and wanted him watched. Although the thought had crossed his mind, Joel didn’t know how he’d manage to kill himself if he couldn’t even use his hands.
“Did the nurse get you all set up?” Kelly asked him.
Joel nodded. About half an hour ago, his nurse had come in to get him ready for his first time in the chair. Yesterday, they had removed his indwelling catheter and were doing intermittent caths every four hours. He was still leaking a lot in between, but he hoped that would get better. He was wearing adult undergarments because his bowel program was still in its early stages and his nurse had to change those too. He was 28 years old and wearing diapers again.
“Fantastic,” Kelly said, placing her hands on her hips. “Now let’s get you dressed.”
Joel looked up at Kelly, with her reddish blonde hair and pert breasts straining at the fabric of her blouse. Under most circumstances in the past, Joel wouldn’t have minded at all being dressed by someone like her. But if it wasn’t bad enough dealing with the frustration of being unable to respond to someone like her anymore, he also hated the idea that she was dressing him because he couldn’t do it on his own. I was a fucking surgeon. Now I can’t even put on a pair of sweatpants by myself.
“Okay, lift your arms up,” she commanded him.
He could do that, at least. He raised his arms as high as he could get them over his head, which wasn’t much better than a ninety degree angle. He knew that his delts should have been working perfectly, so he guessed there was some fatigue component involved. Or maybe there was a psychological component… he felt weak when he saw his hands dangling lifelessly from his wrists.
Kelly pulled off his hospital gown and put his arms through a shirt. He tried his best to help her, but he knew he wasn’t doing much good. He had been told that he’d “probably eventually be able to dress himself completely.” But he sure as hell couldn’t do it now. Eventually, they told him, he’d learn to do things without his fingers. You’ll be amazed what you can do without your fingers.
Joel watched as Kelly pulled a pair of sweatpants over his legs, unable to even attempt to offer her any aid. He couldn’t help but blush slightly when she slid the pants up over his diapers. He knew she dealt with many spinal cord injured patients, but he still felt self-conscious about the fact that he had less bowel and bladder control than a two year old child. He looked down at his stomach, which was already beginning to look soft and flabby. He had no control over his abdominal muscles at all.
Last, Kelly put on his back brace, a bulky, white brace that dug into the parts of his back that he could feel. Once that was in place, she stepped back and rubbed her hands on her slacks. “Well, how do you feel?”
Joel didn’t know what to say. “Let’s try the chair.”
Kelly needed to use a wooden board to assist in his transfer. She placed one end of the board on the wheelchair (his wheelchair) and the other end on the bed. She then used the automatic bed controls to raise the bed into a sitting up position. He had only been sitting up this high a handful of times since he had been injured. “Are you okay sitting up?” she asked him. “Do you feel dizzy at all?”
A wave of vertigo washed over him as the room began to tilt back and forth. He swallowed hard. “Give me a minute,” he said.
“If you’re too dizzy, we can stop,” Kelly offered.
“No,” Joel said. He couldn’t lay in bed the rest of his fucking life.
Finally, the vertigo passed and Joel nodded his head that he was okay to go on. Kelly pulled his legs off the bed one at a time as she moved him so that he was sitting up in the center of the bed. He was trying to help her support his weight by slouching forward and pressing his palms against the bed, but he knew she was the one keeping him upright. She supported him with one arm as she moved one end of the sliding board under his butt.
“You okay?” Kelly asked him.
“I feel like I’m going to fall,” he admitted.
“I won’t let you,” she promised.
He had to lean into her slightly as she moved his upper body across the board. He felt very unstable, and moreover, he felt completely crippled. Crippled, Joel thought. That’s what I am now. That’s what I’ll always be till the day I die. I’ll need this wheelchair for the rest of my life. No, I’ll be lucky if I can use this wheelchair.
After Joel had traveled the length of the board and his butt was in the chair, he looked up and saw that there had been a witness to his first transfer: Kyra. He felt his face burn at the thought of her having seen how dependent he was now. He avoided eye contact with her as Kelly belted him into the chair to keep him from sliding down. He continued to slouch down in the chair until Kelly tied a second belt across his chest.
“Oh, you have company,” Kelly noted, straightening up quickly. She looked over Kyra’s scrubs and white coat. “Hi, Doctor. Are you with orthopedics?”
“No, I’m…” Kyra hesitated. Joel secretly hoped she wouldn’t say she was his girlfriend. “I’m a friend.”
“Oh,” Kelly said quietly. She looked down at Joel and he knew she understood what was going on. “Uh… I’ll come back, okay?”
With Kelly gone from the room, Kyra moved closer to Joel in his wheelchair. He could only look up at her. He didn’t feel any more mobile in the chair than he had felt in the bed a few minutes ago, since his hands weren’t coordinated enough to move the wheels. He hated the feeling of sitting in the chair, knowing he couldn’t stand up.
Kyra settled down on his empty bed. She crossed her legs and looked over at him. She was post-call today and looked tired, but still radiantly beautiful. God, she was beautiful. It was almost ridiculous that she was sticking around for this pathetic spectacle.
“Is this your first time in the…?”
Joel nodded. “Yes.”
“Well, it’s not so bad, is it?”
Joel couldn’t even dignify her comment with a response. He looked down at his legs, which Kelly in her haste had forgotten to place in the footrests. He attempted to lift his left leg up with his hands, but he was too weak. It hit him that maybe everyone was just humoring him when they told him he’d be independent someday. If he couldn’t even lift his leg into the legrest, how the hell was he ever going to manage on his own?
“Do you need help?” Kyra asked him.
“No,” he said. He felt uncomfortable about the idea of her touching his legs. “It doesn’t matter. I can’t wheel the chair myself anyway.”
Their eyes met. I saved your ass, Joel thought. I saved your ass so many times. Don’t think you’re better than me just because I’m in a goddamn wheelchair and you can walk, you fucking bi
“I should go,” Kyra said. “I’ve got a surgery in half an hour.”
“You’re post-call,” Joel pointed out.
“Yeah, but we lost a resident last week,” she reminded him. It was a cheap shot.
Joel watched her stand up. God, she was so tall. He saw the sympathy in her eyes and he had to look away. He wondered how long it would be before one of them had the nerve to end it. It would be over eventually. He was more sure of that than he was of the fact that his legs would never work again.