Ann was sick of rounds with Dr. McKenna. She felt like she was presenting her patients to a brick well. There was no fun, no jokes, no pimping, no learning… just the strict facts of the patients. She was relieved that in a few days, the rotation would be over and she’d be switching to another team. She’d probably never have the opportunity to work with Joel again. Maybe that was just as well.
When Raj announced to the team that Joel was extubated and doing really well, Ann was thrilled. She immediately made plans to go visit him after rounds were over, already decided that she’d skip lunch to see him. She didn’t care that he had been angry at her—she wanted to see for herself that he was doing okay.
Ann ventured up to the ICU by herself and made a beeline for the room where Joel had been before. She worried that one of the nurses might question her, but she remembered Cody’s advice about making sure she looked like she knew where she was going.
Joel was sleeping when she got to his room, but the tube was out of his throat. When his chest rose and fell, it was under the power of his own diaphragm. He still looked pale and there were purplish circles under his eyes, but he no longer looked like he was on the brink of death. As she watched him, his eyelids fluttered and he opened his eyes. “Ann?”
“Hi,” she whispered.
He rubbed his eyes with the back of his wrist. “What are you doing here?”
“I wanted to see you,” she said.
He grabbed for the remote that controlled his bed and shifted the back so that he was sitting up. “I’m fine,” he said, barely looking at her.
“I was worried,” she went on.
“Look, you shouldn’t even be here,” Joel said. “You already got me in enough trouble. What if Dr. Howard sees you here?”
She frowned, confused. “What are you talking about?” She shook her head, her brows knitted together. “Why are you mad at me? What did I do?”
He looked at her a long time, as if contemplating something. Finally, his shoulders relaxed. “I’m not mad at you. I’m just an idiot. You’re great, Ann. You deserve to have a boyfriend who’s great.”
There was no point in tell him that she wanted him, because she knew he didn’t want her back. He was in love with that other woman who came to his apartment the other night. She could see it plastered all over his face.
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Joel was still feeling exhausted from what he had been through for the past few days in combination with the sedatives he had been given. He drifted in and out of sleep all day. Usually, it was some alarm going off that woke him or someone coming into his room. Whenever a nurse came into the room, he asked them to turn him—he was still too weak to turn by himself and he didn’t want to end up with a bedsore to remember this experience by.
Sandy came into his room in the evening with a tray of food. “I get to eat?” he asked, surprised. He had thought he was going to have to fight with them in order to get some food.
“We think you’re ready,” she said with a wink. She pushed the tray in front of him, which contained a small piece of meatloaf and mashed potatoes.
Joel used to controls to lift the head of the bed up. He picked up the fork like he usually did, but as soon as he tried to push the spears into the meat, it fell from his fingers. He swore silently and picked it up again. This time he dropped it before the fork even touched the meat. “Goddamn it,” he muttered under his breath.
He knew that he was still very weak from everything he had been through. This wasn’t the first time that his hand control had diminished after being sick. He was probably going to need some PT and OT before he left the hospital. He could probably eat now with hand splints, but he doubted they had any readily available in the ICU.
Sandy observed his struggle. “Do you… need any help, Dr. Dergan?”
The last thing he wanted was to be fed his food by a nurse he had to work with, but he had no choice but to swallow his pride. “Uh… yeah, I guess so.”
Sandy began to cut up the meat for him. “So,” she said, “tell me about your girlfriend.”
“My girlfriend?”
Sandy held out a piece of the meatloaf to him and he dutifully swallowed it. “That woman who was sleeping in the waiting room. Kara?”
“Kyra,” he corrected her. “She’s not my girlfriend. She’s… it’s complicated.”
“Complicated, huh?” Sandy smiled and held out another bite for him to take. “Well, let me tell you, Dr. Dergan: that woman is crazy about you. She was crying her eyes out over you when you first came in here.”
“Really?” Joel couldn’t remember ever having seen Kyra cry before. He thought she wasn’t that sort of person.
“Well, you didn’t look so good,” Sandy said.
Joel just shook his head in disbelief. He couldn’t get over that Kyra would start crying over him. He realized that she had some feelings for him maybe, but this sounded much bigger than that.
Sandy fed him all the meat, but he was able to handle the mashed potatoes on his own. After he was done with the food, Sandy dug around in one of the drawers and pulled out another blue diaper. “Okay, time to get changed,” she announced.
“Can… can this wait?”
“No, you’ve been wearing that diaper all day,” she said. “Come on, Dr. Dergan, I do this a million times a day. There’s no need to be embarrassed.”
Sandy pulled the curtains and lifted up his gown, revealing the blue plastic. She efficiently removed the diaper, which he hadn’t realized was soiled. Sandy cleaned him off with wet wipes. “Do you usually wear protective undergarments, Dr. Dergan?” she asked.
“No, I don’t,” he said.
“Then what do you do? You don’t have control right?”
Joel watched as she slid the fresh diaper under his bottom. “I use a bowel program.”
Sandy closed the tape on the diaper and covered him up again. “All done. That wasn’t so bad, was it?”
“Uh…” Ask me next time I have to work with you on the floors.
As Sandy moved his legs back into position, he could see his left leg starting to twitch. He realized that he had probably missed several doses of the baclofen he took in order to keep his leg spasms under control. Although he wasn’t on a large dose, he knew from experience that the spasms would become much worse if he didn’t get his medication soon, and even more urgently, baclofen withdrawal could result in seizures. “Can you page Dr. Parker for me? I need to talk to him about my medications.”
“Of course, doctor,” Sandy said. He appreciated the respectful tone in her voice, despite the fact that she had just changed his diaper.
As she was turning to leave, Joel found that he couldn’t stop himself, “Sandy, wait.”
She stopped and looked up at him. “Yes, Dr. Dergan?”
Joel bit his lip. “She really cried?”
“Like she was your wife for forty years,” Sandy said.
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Ann received a page the next day from Dr. Doug Howard. She had a feeling that this was regarding her failing grade on the boards and she felt even more certain of this when Dr. Howard asked to see her in his office. She heard that sometimes when students failed the boards, they were asked to withdraw from a rotation. She hoped she’d be allowed to finish medicine, at least.
When Ann saw the stern look on Dr. Howard’s face, she wanted to go running in the opposite direction. He stood up when she entered the room, but didn’t smile at her. “Have a seat, Ann,” he said.
She sat down, pushing her hands between her knees to keep them from trembling.
“I was informed of your failure on the board exam last week,” Dr. Howard said. “I assume you already know your grade.”
Ann nodded.
“The dean let me know and he asked my opinion on whether or not he should ask you to withdraw,” Dr. Howard went on. “Usually I base this opinion on the mid-rotation evaluations of how the student is doing. You have one mid-rotation evaluation from Dr. Dergan, which he was kind enough to type for me. You, of course, know what his handwriting is like.”
Ann was too afraid to even crack a smile.
“Allow me to read it to you,” Dr. Howard picked up a white sheet of paper from his desk. “Ann Lowell’s strong desire to learn has acted as an inspiration to the entire team. In the two weeks that she’s been on our service, she’s demonstrated her high level of intelligence, her skills have improved rapidly, and she’s always eager to take on new challenges. One of most motivated students I’ve had the opportunity to work with.”
It was a glowing evaluation, but there wasn’t a trace of a smile on Dr. Howard’s face. “Of course,” Dr. Howard said, “this means nothing coming from Dr. Dergan, considering what inappropriate behavior went on between the two of you.”
Ann felt her heart sink into her stomach. He knew. Dr. Howard knew about her and Joel. Oh god.
“Initially, I didn’t believe it,” Dr. Howard went on, “but with that evaluation in conjunction with your failing grade… it’s more than a little bit suspicious. And it’s pretty obvious from the look on your face that you’re not going to deny it.”
Ann didn’t know what to say. She lowered her eyes. “I’m sorry.”
“Manipulating an attending who has a severe disability order to improve your grade is grounds for expulsion,” Dr. Howard said.
Ann’s eyes widened. “Manipulating? Wait… I didn’t…”
“Please, Ann,” Dr. Howard held up his hand. “Obviously, Dr. Dergan’s character is seriously in question as well, but between you and me, we know the truth. Do you know how this is going to look when you go in front of the dean? He’s a quadriplegic who just got off a ventilator and you’re a pretty young girl. Do you really expect me to believe you had pure intentions going into this? That you were in love with him?”
Ann felt her throat closing up. She wanted to try to explain to Dr. Howard how things had happened between her and Joel, how it was never about the grade, how much she had cared about him. But she could see in his eyes that he wasn’t going to believe a word she said. And he was right—the dean’s committee wasn’t going to believe her either.
“Honestly, I feel sorry for Dr. Dergan,” Dr. Howard continued. “I’m sure you seduced and then manipulated him, but his reputation is going to suffer thanks to you. I’ll do what I can for him because I respect the man, but I have no such obligation to you. I suggest you start making alternative plans for your career.”
Ann couldn’t believe this was happening. She watched Dr. Howard stand up and he appeared to be moving in slow motion. “As of now, you are suspended from the medicine rotation,” he said.
Ann barely managed to make it out of the office before she collapsed onto the floor, sobbing. Becoming a doctor had been her dream ever since she could remember and now it was over. She had too many strikes against her and now that Joel was no longer on her side, there was no way she’d be allowed to stay in the school. In five minutes, everything she had worked so hard for her entire life was suddenly yanked away from her.