Episode 7:

 

Forgot About J

 

 

“Good morning, Justin,” Dr. Elizabeth O’Brien said quickly as she passed med student Justin Timberlake on his way into the hospital.

 

“Morning, Dr. O’Brien,” Justin replied tiredly.  It was a Saturday morning in mid-September, and after a late night with Britney, Justin was exhausted, having gotten only a few hours of sleep.  He was glad he at least had Sunday off so that he could catch up on sleep.

 

Justin made his way into the lounge, where his temporary supervisor, Dr. Jack Palmer, was also getting ready to start his shift.

 

“Hey, Dr. Palmer,” Justin said, opening up his locker.

 

“Hey, Justin,” Jack greeted.  He waited until Justin was ready, and then the two men walked out into the hall together.  They went first to the nurses station, where nurse Natalie Spade was sorting through charts.

 

“Hey, Natalie,” Jack greeted her.

 

Natalie looked up and smiled.  “Oh, hi, Jack. I’m glad you’re here.  I have a patient for you.  Seventy-five-year-old man complaining of fatigue and dizziness.  Exam 3.”  She handed him a chart.

 

“Should I come with you or take somebody else?” Justin asked.  Now that he had been working at the hospital for almost a month, Jack had been letting Justin exam patients himself, rather than tag around with him all the time.

 

“Nat, you got another patient Justin can have?” Jack asked.

 

“Yeah… here you go,” she said, giving a chart to Justin.  “Thirteen-year-old girl, complains of abdominal pain.  Exam 4.”

 

“Thanks,” Justin replied, glancing at the chart as he walked down the hall to the exam room.  Kristine Miller, age thirteen, abdominal pain.  Justin tossed the information around in his mind.  He reached Exam 4 and walked in to find a girl sitting on the gurney.  She looked small for thirteen and had wavy brown hair that was pulled back into a ponytail.  In a chair beside the gurney sat a woman, probably Kristine’s mother.

 

“Hi, Kristine,” Justin addressed the girl, offering a slight smile.

 

“Hi,” Kristine replied softly, gazing at him with pale blue eyes.

 

“And are you Kristine’s mother?” he asked the woman.

 

“Yes,” she said.  “I’m Ellen Miller.”  Studying him for a minute, she asked, “Are you a doctor?  You look awfully young.”

 

“I’m a med student,” Justin replied.  “My name’s Justin Timberlake.”

 

“I see,” said Ellen, continuing to scrutinize him.  Her gaze made him uncomfortable.  After a pause, Ellen added, “Kristine will be examined by a real doctor, won’t she?”

 

“Don’t worry, ma’am, I’m required to show all my patients’ charts to a resident before I can treat or discharge them,” Justin said, trying to hold back his anger.  She obviously thought of him as some incompetent kid.  Well, he would show her.

 

“So, Kristine,” Justin started in, ignoring Ellen’s stare, “I hear you’ve been having some stomach pain.”

 

Kristine nodded.

 

“Okay.  Well, I’m going to ask you some questions first, and then I’ll examine you, and we’ll get to the bottom of this, okay?”

 

“Okay,” Kristine said.

 

“Okay, first of all, what other kinds of symptoms have you had?  Any fever, nausea, vomiting?”

 

“Yeah, everything except the fever part,” Kristine replied.

 

“Okay,” Justin said, writing it down on her chart.  “Have you eaten anything out of the ordinary lately?”

 

Kristine frowned, thinking.  Then she shook her head.  “Not that I can think of.”

 

“How about allergies?  Do you have any allergies?”

 

“No,” Kristine said, glancing at her mother.

 

“No, no allergies,” Ellen confirmed.

 

“Okay…” Justin noted it on the chart.  To her mother, he said, “Well, it’s probably just a stomach bug, but I’ll examine Kristine to make sure it’s not anything serious.  I’ll send someone in to get a gown for Kristine, and I’ll be back in a little bit to do the examination.”

 

With that, he went back into the hall, where he met up with nurse Lance Bass.

”Lance, could you get a gown for the patient in Exam 4?”

 

“Sure,” Lance replied.

 

“Oh, and do you know where Dr. Palmer is?” Justin asked.

 

“Uh… last time I saw him, he was with a patient in Exam 3,” said Lance.

 

“Thanks,” Justin replied and went next door to Exam 3 to find Dr. Palmer.  Sure enough, there he was, examining an elderly man.  Justin stepped into the room and asked tentatively, “Dr. Palmer?”

 

Jack glanced away from his patient.  “Yeah, Justin?”

 

“Um, can I talk to you in the hall when you get a chance?”

 

“Sure,” Jack said.  Turning back to his patient, he said, “Excuse me for a minute, Mr. Franklin.”  He stood up and followed Justin out into the hall.  “What is it?”

 

Justin handed him Kristine’s chart.  “Thirteen-year-old complaining of abdominal pain, nausea, and vomiting.  No allergies, and she hasn’t eaten anything weird lately.”

 

Jack nodded, skimming over the chart.  “Okay.  So, what do you think it could be?”

 

“Gastroenteritis or appendicitis,” Justin replied.

 

“Good,” Jack said.  “Check her belly, and if anything feels strange, come get me, and we’ll do an ultrasound.”

 

“Okay,” Justin replied.  “Thanks, Dr. Palmer.”  With that, he turned and went back next door to examine Kristine.

 

+++

 

Psychiatrist Dr. Lynn Michaels looked up from her desk as she heard someone knock on her closed office door.

 

“Come in!” she called.  The door opened to reveal the tall, thin frame of a teenage boy.  Lynn smiled.  “Good morning, Oliver,” she greeted.  “Come on in and have a seat.”

 

The boy walked slowly into Lynn’s office and sat down in one of the two chairs in front of her desk.  He clasped his hands tightly together in his lap and fidgeted, looking nervously around the room.

 

“Relax, Oliver,” Lynn said gently.  Oliver glanced at her and stopped fidgeting.  But he continued to sit stiffly on the edge of the chair and look anywhere but into her eyes.  “So, Oliver… how are you doing?” Lynn asked.

 

“Fine,” came Oliver’s quick reply.

 

“Are you really?  You look much better physically, but what about emotionally?”

 

Oliver raised his head sharply and glared at her with his deep brown eyes.  “I’m not crazy,” he hissed.

 

“I know you’re not.  You know, psychiatrists help more than just insane people,” Lynn said.

 

“I don’t need a shrink,” Oliver muttered, glancing down at his hands.

 

“I’m not a ‘shrink’,” Lynn replied.  “I’m a psychiatrist, a doctor.  I help people.  I’d like to help you, if you’ll let me.”

 

“I don’t need any help.  I’m better now.”  But Lynn could clearly see that he was not.

 

On the outside, sixteen-year-old Oliver Williams seemed like the kind of boy who had everything he could ever want.  He was good-looking, with light brown hair and chocolate brown eyes.  He was popular at school, especially with the girls.  He was a good student who had always tried hard and made A’s and B’s in all his subjects.  But the thing he prided himself most upon was soccer.  Oliver loved soccer.  He had played the sport ever since he was a little boy and had always excelled at it.  He had been playing on his school’s varsity team ever since he was a freshman, and now, as a junior, he was the captain and star of the team.  Oliver had everything going for him.  At least, that’s what people thought.

 

In reality, Oliver had been suffering from depression for two years, ever since the death of his younger brother, Johnny.  No one in his family had ever really recovered from Johnny’s death; each of them were suffering in their own ways and making others suffer as well.  Since Oliver was now his family’s only child, he had been put under an incredible amount of stress and pressure to succeed.  His father, without meaning to, always pushed Oliver beyond his limit.  The one who had gotten Oliver interested in soccer as a child, James Williams wanted his son be the best.  He demanded Oliver devote all his free time to soccer, and Oliver feared that if he messed up, he would be letting his father down.  Oliver’s mother, Caroline, was not much better, for she refused to let go of her dead youngest son.  For two years, she had lived her life in a daze, thinking of nothing but Johnny.  Her marriage had suffered from this, and so had her son.

 

By the start of his junior year, Oliver was desperate.  His life was a living hell.  He and his friends were drifting apart, for after so many months of Oliver avoiding doing things with them, they had stopped trying to include him.  His grades, which had once been good, had slipped and were now mere D’s and C’s at best.  The only thing he could concentrate on anymore was soccer.  It was the one thing that was still going right for him, the one thing that still mattered.  The problem was, it mattered too much.

 

Thirty seconds left in the game.  The score was all tied up.  The other team had the ball.  Oliver stood in the goal, his eyes focused on the black and white soccer ball, as it came steadily towards him from the opposite end of the field.  He knew the other team was going to try to score a goal in the last few seconds.  All he had to do was block it, and the game would go into overtime, giving his team another chance to win.  But if he missed it, the game would be over.  His team would lose one of the most important games of their season, the game against their biggest rivals.  He couldn’t let that ball get by him.  He couldn’t let them score. 

 

The ball came nearer. Oliver saw the kicker’s foot go back and come forward swiftly to connect with the ball.  The ball soared through the air, coming towards the goal, just to the left of him.  His arms outstretched, Oliver dove to the left, trying to stop that ball from reaching the goal.  But he failed.  He went too far left; the ball sailed past his right side and hit the net with a light swishing sound. 

 

Immediately, the field erupted in cheers.  But they were not coming from his teammates.  The other team leaped up and down, hitting each other on the back and hugging.  With that final goal, they had won the game by a single point.  And it was all Oliver’s fault.

 

That night, nearly a month ago, was utterly miserable for Oliver.  His coach and teammates tried to console him, to tell him that it wasn’t his fault.  But he knew it was, and he knew he had let everyone down – his coach, his team, his school, and most of all, his father.  Later that night, Oliver was brought into the ER.  He had overdosed on his father’s sleeping pills in a suicide attempt. 

 

Miraculously, Oliver survived the overdose and had been discharged the previous week.  While he recovered in the hospital, Lynn had been called in on a psychiatric consult and had spoken with him several times.  This was her first appointment with him as an outpatient.  Oliver obviously hadn’t wanted to come, but his parents had forced him to.  Lynn was glad they had, for Oliver needed help, and she hoped she could give him that help.

 

+++

 

Jack was just leaving a patient’s room, when his med student, Justin, approached him.

 

“Dr. Palmer?” asked Justin.

 

“Yes, Justin?”

 

“I examined the girl in Exam 4, and her belly felt normal,” said Justin.  “She said the pain is mostly on her right side, but her belly was soft, not rigid, and it didn’t hurt her any worse when I touched her.”

 

“Did you get some bloodwork done to check for infection?” Jack asked.

 

“Yeah, but the results aren’t back yet,” Justin replied.

 

“Okay.  Well, I don’t think it’s appendicitis, but wait for the bloodwork to come back just to make sure.”

 

“What if the bloodwork comes back fine?  Do we just send her home?  She seems to be in a lot of pain, more than stomach flu or something.”

 

Jack thought for a moment.  “Well, we could do an ultrasound, just to be sure.”

 

Justin nodded.  “Okay.  I’ll come get you when her bloodwork gets back.”

 

“Okay, thanks, Justin.”

 

Jack glanced at his watch as Justin walked away.  It was almost nine-thirty in the morning.  Time for a coffee break.

 

+++

 

Justin strode into Exam 4, the results of Kristine’s bloodwork in his hand.

 

“Mrs. Miller, these are the results of Kristine’s blood test,” he said, holding up the packet he held in his hand.  “They showed no sign of infection, which pretty much rules out appendicitis.  However, I’m concerned about the amount of pain Kristine is in, and I’d like to do an ultrasound to make sure it’s nothing serious.”

 

“What’s that?” Kristine asked.

 

“Oh, don’t worry, it doesn’t hurt at all,” Justin said.  “It’s just a way to see inside your stomach, to make sure nothing is wrong.”

 

“Okay,” Kristine said nervously.

 

Justin smiled slightly at her.  “Don’t worry,” he said again.  “We’re just being cautious.  You probably just have the flu.”

 

+++

 

“Hi, Nurse Bass,” said a tentative male voice, surprising Lance, who nearly dropped the suture kit he was holding.

 

“Oliver!” he exclaimed, turning around to find the lanky teen standing behind him, shifting awkwardly from foot to foot.  “What are you doing here?  Can I help you with anything?  Or do you just want-“

 

“I just came from my first counseling session,” Oliver interrupted.  “Thought I’d drop in and say hey.”

 

“Oh.”  Lance smiled.  “Well, hey yourself.  How did your appointment go?”

 

The boy shrugged.  “Okay, I guess.”

”Are you seeing Dr. Michaels?”

 

“Yeah.”

 

“She’s good.  You like her?”

 

“She’s okay.”

 

“That’s good.  How are things going at home?”

 

Oliver shrugged again.  “My mom rarely lets me out of her sight, and my dad took the damn door off my bedroom and locked up all the meds.  What do you think?”

 

“Sorry,” Lance said with a sympathetic smile.  “But you know they’re just doing that because they love you.”

 

“Yeah,” Oliver said hollowly, “I know.  Well, I guess I should be going now.  You’re probably busy.”

 

Lance nodded slowly.  “Well, listen, you take care of yourself, and if you ever need to talk to someone other than Dr. Michaels, stop by.  I can always make some time to talk to you.”

 

Oliver smiled slightly.  “Thanks, Nurse Bass.”

 

“Lance,” Lance corrected.  “Just call me Lance, Oliver.”

 

“Okay.  See you later… Lance.”

 

Lance watched as Oliver schlepped away down the hall, a strange feeling gnawing at his stomach.  Though he didn’t know the teenager very well at all, Lance felt a strong connection with him. 

 

There was a rule about getting too involved with patients, and Lance had broken it with this particular one.  He had spoken with Oliver while he was in the ER.  At the time, he was sullen and angry, angry at himself for failing at his suicide attempt, angry at his parents for finding him and calling the paramedics before the drugs he had ingested could finish him off, angry at the hospital staff for saving his life.  Basically angry at the world.  Going against policy, Lance had told the boy about his own demons, about his sister’s suicide and his own battle with clinical depression.  He thought that if only Oliver knew that other people could empathize with what he was going through, it would help him deal.  And it had seemed to thus far.  Oliver had opened up to him that day, sharing his feelings, telling him what sent him over the edge that night.

 

When Oliver had been moved from the ER to another room, Lance had come to visit him a couple times.  And now that Oliver was discharged, he was coming back to visit Lance.  It seemed to be the beginning of a friendship.  An unconventional friendship, maybe, for there was a ten-year age difference between them, and other than depression, they had little in common.  But that was enough.  The thing that brought them together was the very thing that alienated Oliver from his family and friends.  And a sufferer of depression himself, Lance knew Oliver needed someone he could relate to, a sort of confidant.  And Lance was willing to be that for him.

 

Shaking his head, Lance delivered the suture kit he was holding to one of the exam rooms, hoping all the while that Oliver was going to be okay.

 

+++

 

“So, Kristine, what kind of stuff are you interested in?” Justin asked casually, as Dr. Palmer performed the ultrasound on his patient.  He watched the screen the ultrasound showed up on with interest.

 

“I play volleyball,” Kristine said softly.

 

“Volleyball. That’s cool,” replied Justin.  “So, are you on your school’s team?”

 

“Uh-huh.”

 

“Cool.  What grade are you in?”

 

“Eighth.”

 

“So, do you like school?”

 

“It’s okay.”

 

“You get good grades?”

 

“Sometimes.”

 

“Cool.  So… uh… you gotta boyfriend?”

 

Kristine gave her mother a quick sidelong glance, then said quickly, “No.”

 

Justin smiled and nodded, trying to think of something else to ask her.  His thoughts were interrupted by Dr. Palmer.

 

“Justin, take a look at this.”

 

Justin glanced back at the ultrasound monitor and squinted. He couldn’t make out anything abnormal.

 

“Do you see anything?” Dr. Palmer asked.

 

“Uh… no?”

 

“Neither do I,” Dr. Palmer replied, and Justin nodded, relieved.  To Kristine’s mother, Dr. Palmer said, “Mrs. Miller, everything looks fine.  It’s probably just a stomach virus or something she ate.  Have her take some ibuprofen or antacid tablets for the pain, and if it’s not better in a few days, bring her back in, or call your family doctor.”

 

“Okay,” said Ellen Miller.  “Thank you, doctor.”

 

“Kristine, go ahead and get changed, and then you can go home,” said Justin.

 

“Okay,” said Kristine in relief.

 

Dr. Palmer and Justin left the room.

 

+++

 

“Hey, Siara, if Elizabeth asks where I am, tell her I went on lunch break,” Jack announced to his fellow ER doctor, Siara Reily, right at noon.

 

“Sure, Jack,” Siara replied, as Jack pulled a jacket on over his green scrubs and left the lounge.  He made his way out of the ER and walked the two blocks to Sully’s, the little café where many of the Memorial staff members ate lunch and dinner.

 

Inside the restaurant, he found several of his good friends from the hospital – Josh McCartney, AJ McLean, Kevin Richardson, Brian Littrell, and Brian’s girlfriend, Ivory Harnett.

 

“Hey, Jack!” they all called to him, waving him over to the two tables they had pulled together.

 

“Hey, guys,” said Jack, taking a seat next to Josh.  “What’s up?”  He got a mumble of the usual, “not much” and “nothing”. 

 

Jenny, one of the waitresses at Sully’s, who was always there at lunchtime, came up to their table right away to take Jack’s order.  He ordered his usual double cheeseburger, fries, and Mountain Dew, and sat back to wait for his food to come. The others had already ordered, but were still waiting for their food as well.

 

“So, Aje, how’s Bianca doing?” Jack asked.

 

“Really good,” AJ replied.  “She was thinking about coming back to work on Monday, but I told her to wait another week.  She doesn’t realize how much it’s going to take out of her, going back to work.”

 

Jack nodded.  “Yeah, tell her to take her time.  She’s only been gone three weeks; she should take at least another week off.”

 

“So, is Howie off today, AJ?” Brian asked.

 

“Yeah, he’s got Dani for the weekend, so he’s off,” AJ replied.

 

“How is Dani, anyway?” asked Jack.

 

“She’s doing pretty good.  She’s not back at school yet, but Howie said she’s recovering just fine from her surgery,” AJ replied.

 

“That’s a relief,” said Jack.  “God, I couldn’t imagine going through something like that.  If it was my daughter…”  He shuddered at the thought.  The others nodded in agreement, falling into a solemn silence.

 

“So…” AJ said, to break the pause, “you guys all ready for tonight?”

 

The five men of the group exchanged grins, while Ivory just looked confused.

 

“Guys night out tonight, honey,” Brian informed her.

 

“Oh really?  And you were going to tell me when?” Ivory asked, miffed.

 

Brian smirked.  “Right now.”

 

“Yeah.”  Ivory rolled her eyes.

 

“What’s the big deal?  You and your chick friends are always going out together.”

”So where are you guys going then?” Ivory asked, ignoring her boyfriend.

 

“Just J’s house,” Jack chimed in.  “The remodeling in the basement’s finally done; we gotta celebrate!”

 

“Oh.”  Ivory smiled.  “Well, have fun then.”

 

At the moment, Jenny came back, carrying a large tray of food for them.  As everyone began to eat, the conversation died, and they fell into silence again.

 

+++

 

Around four o’clock that afternoon, Justin sat in the lounge on his break, playing a video game on the hospital’s Nintendo Gamecube with nurse Lance Bass, who was also taking a break.  The Gamecube was supposed to be there to entertain patients, but for some reason, it always ended up in the staff lounge.

 

Justin’s concentration on the game was interrupted when Addie Burke burst into the lounge.  “Justin!”

 

“Just a minute; I’m almost done with this level,” Justin murmured, his tongue sticking out of his mouth in concentration, his body jerking back and forth as he steered his sports car on the screen.

 

“Justin, now!” Addie demanded, causing Justin’s car to veer off the road.

 

Slamming his controller down, he stood up.  “I’m on break; what is it?” he asked, none too kindly.

 

“Did you treat a Kristine Miller earlier today?” Addie asked.

 

“Yeah; she went home hours ago,” Justin replied.

 

“Well, she’s back now, and she’s in bad shape. Jack’s working on her in Trauma 1.  You better get in there,” said Addie with a grim expression, turning and hurrying out of the lounge before Justin could utter a word.

 

“Shit,” Justin whispered, his eyes wide.  What could have happened to her?  Worried, Justin ran out of the lounge and down to Trauma 1 as fast as he could.

 

+++

 

“She was complaining of a stabbing pain in her stomach, and then she just collapsed!” cried Ellen Miller, Kristine’s mother, her eyes filled with frantic tears as she looked down on her daughter, who lay unconscious on the gurney.

 

“We’re going to do everything we can for her, Mrs. Miller,” Jack promised.

 

“But what happened?  You said it was just a stomach virus!  You said she’d be fine!” Ellen shouted, her voice rising shrilly.

 

“We don’t know yet; we’re trying to find out what’s wrong with her now,” Jack said.  “Addie, could you show Mrs. Miller to chairs now?”

 

“Sure,” replied Addie, who had just come back into the room.  “Come with me, Mrs. Miller.  You can’t be in here while the doctors are trying to work.”  Putting her hand on Ellen’s back, she led the hysterical mother out of the room.

 

“What happened?” Justin cried, bursting into the room just after Addie and Ellen had left.

 

“I don’t know yet,” Jack told him gravely.  “She was just brought in by the paramedics a few minutes ago.  Her pulse is weak, and her blood pressure is extremely low.  Her mother said she was complaining of a stabbing pain in her abdomen, and then she collapsed.”

 

“Let’s get an ultrasound,” said Siara Reily.

 

“But we did one this morning!” Justin exclaimed.  “Everything looked fine, right Jack?”

 

Jack didn’t reply.  Instead, he helped Siara get the ultrasound equipment ready.  While Siara rubbed the transducer across Kristine’s stomach, Jack watched the monitor.  Suddenly, he gasped.  “She’s bleeding internally!  Belly’s full of blood!’

 

“What happened??” Justin asked again.  “It was fine just a few hours ago!”

 

Jack shook his head.  “I have no idea. Addie, page the OR and have them get a room ready.  This girl’s going to need surgery right away.”

 

Addie, who had just come back into the room, immediately got on the phone in the room, while the other doctors and nurses bustled around Kristine, inserting drugs into her IV lines and checking her monitors.

 

To one of the other nurses, Jack said, “Go get Dr. O’Brien.  We need to find out what’s wrong with this girl.”

 

The nurse ran out of the room and returned minutes later with Dr. Elizabeth O’Brien, who was head of the ER.

 

“What do we have here?” she asked, and Jack explained everything, starting with when he and Justin had examined Kristine that morning.

 

“Someone get me a copy of her ultrasound from this morning,” Elizabeth said.

 

One of the nurses got the ultrasound films from Kristine’s chart and handed them to Elizabeth, who took them out in the hall to study them.  She came back in a few minutes later.

 

“Could you make out anything?” Jack asked.

 

“It’s hard to tell,” Elizabeth said.  “Her chart doesn’t mention it, but could she be pregnant?  It looks like it could be an eptopic.”

 

“Pregnant?” Justin asked in disbelief.  “But… but she’s only thirteen!”

Elizabeth shrugged.  “Believe me, thirteen-year-olds these days do more than we think they do.”

 

“So you think she’s got an eptopic pregnancy?” Jack asked in surprise.  Eptopic pregnancies, which occurred when the fetus was growing inside one of the fallopian tubes instead the uterus, were rare, and in a thirteen-year-old girl, it was something he would have never suspected.

 

“I’m not positive; the ultrasounds don’t reveal anything.  But her symptoms all add up to it – sharp pain on one side of her abdomen, vomiting from morning sickness, and now internal bleeding.  Her fallopian tube has burst.  She needs to get to surgery right away.”

 

“We already paged surgery,” said Siara

 

“Good.  Someone page OB too and get someone to come look at the ultrasound.”

 

Suddenly, all at once, it seemed, all the machines Kristine was hooked up to went haywire.

 

“She’s dropped her pressure!” cried one nurse.

 

“We’re losing her pulse!” shouted another.

 

“She’s in V-fib,” said Siara.  “Get the crash cart; charge the paddles to 200!”

 

Addie wheeled the crash cart up to the gurney.  “Charging paddles.” 

 

“Here, let Justin shock her,” said Jack, when the paddles were charged.  Addie handed the paddles to Justin, who took them in awe, having never used them before.  “Just say clear and then press them to the pads on her chest,” Jack instructed.

 

“Okay. Clear!” Justin said nervously and pressed the paddles to Kristine’s chest.  Her body jumped with the jolt, and so did Justin, in surprise.

 

“Still in V-fib.  Charge again,” Siara said.  Justin handed the paddles back to Addie, who charged them up and gave them to Justin again.

 

“Clear!”

 

The process repeated again and again.  The paddles were charged to a higher voltage each time, but Kristine’s heart did not respond.  Finally, the line on the heart monitor went completely flat.

 

“She’s in asystole,” said Siara.

 

“Start CPR,” said Jack, nodding at Justin.

 

Justin nodded in reply and cupped his hands together to start doing chest compressions on Kristine, as he had been taught in med school.  For nearly half an hour, he pushed down on her chest repeatedly, praying with each compression that her heart would beat.  But each time, he was disappointed.

 

Finally, Siara said, “Hold compressions.”

 

Justin pulled away, exhausted.  The heart monitor continued to wail, the line running flatly across the screen. 

 

“That’s it,” said Siara.  “She’s gone.”

 

Justin was tired, and his arms ached from doing the CPR for so long, but the thought of giving up was too much to bear.  “No!” he cried.  “No, she’s not gone!  Just a few more minutes.  Give me a few more minutes.  I can get her back!”  Gasping for breath, he bent over her body again and started chest compressions once more.  “1 and 2 and 3 and…”

 

“Justin,” Jack said.  “Justin, stop.”

 

But Justin ignored him and kept going.  “4 and 5…”

 

“Justin, she’s already dead,” Siara said gently.  “You’re not going to get her back.  It’s too late.”

 

“No!” Justin cried, shaking his head furiously.  “No, I…”  He let out a breath of air and stopped, his body sagging in defeat. 

 

Siara watched him in sympathy.  Jack looked at his watch.  “Time of death – 17:10.”

 

Addie turned off the beeping monitors, and the other nurses disconnected Kristine from them and removed the IV’s from her arms until her body lay alone on the gurney, a sheet covering her lower half.  Slowly, Addie pulled the sheet up to her chin.

 

Just then, a woman appeared in the doorway.  “Is this where they needed the OB consult?” she asked in surprise. Jack turned to see that it was Dr. Melanie Reyes, one of Memorial’s obstetricians.

 

“Yeah,” he said.  “We think this girl might have had an eptopic pregnancy.  She came in this morning with abdominal pain on her right side and complained of vomiting.  We ruled out appendicitis and sent her home, thinking it was just the flu or a virus.  She came back in about an hour ago with internal bleeding and arrested half an hour ago.”

 

Melanie nodded.  “Sounds like an eptopic,” she said.  “Did she know she was pregnant?”

 

“No,” Jack said.  “No one thought to do a pregnancy test on her.  She’s only thirteen.”

 

“Did you do an ultrasound?” asked Melanie.

 

“Yeah. Come on; I’ll show you the films.  My student and I both looked at them, and so did Elizabeth O’Brien, and none of us could see anything wrong,” Jack said, as he led her out of the room.

 

“Yeah, they can be tricky to read sometimes,” Melanie replied.

 

“Hey, Jack, do you want me to talk to the mother?” Addie called, as Jack started down the hall.

 

Jack stopped and turned around.  “No, I’ll do it,” he replied.  Then he continued on down the hall with Melanie.

 

+++

 

Justin sat in the lounge, his chin in his hands.  He stared out the window without really seeing anything.  He felt so empty, so depressed, so devastated.  He now knew what it was like to lose a patient.  Kristine had been his first.  The feeling was horrible.  He wasn’t grieving for Kristine as a person; he hadn’t really known her as a person, just as a patient.  But it was awful knowing that he had had a chance to save her life, and he had failed.  Like Jack had said, maybe there really was nothing he could do for her.  But he couldn’t help but feel that if he had just tried harder, she might still be alive.

 

“Justin?”

 

Justin slowly looked up to see Jack standing in the doorway.  He did not reply.

 

Jack walked into the room and sat down beside him.  “You win some; you lose some,” he said, glancing over at Justin.  “I know that’s hard to accept, but that’s the reality of being in the medical field.  You can’t fix everyone.”

 

Justin hung his head.  “I know,” he murmured softly.  “But I feel like we should’ve caught this earlier.  If we had known this morning what was really wrong with her, this wouldn’t have happened.”

 

“I know, Justin, but there’s really no way we could have known.  Even Elizabeth said that.  Dr. Reyes, the OB, looked at her ultrasound, and sure enough, she had an eptopic pregnancy.  But how were we supposed to guess that?  She was only thirteen; most people don’t get pregnant at thirteen.  She was only a couple months along, so it was impossible to tell that by looking at her.  She had morning sickness and had probably missed her period, but at thirteen, the menstrual cycle isn’t always regular anyway, so I’m sure she never suspected she was pregnant.”

”But what about the ultrasound?” Justin asked.  “Shouldn’t it have showed that?”

 

“If it was a normal pregnancy, we would have been able to see it. Sometimes you can detect an eptopic on an ultrasound film too, but not always.  I couldn’t make it out either.  If we had known this girl was pregnant, we would have gotten an OB consult this morning, and it could have been discovered.  But we didn’t know she was pregnant, so no one thought that was necessary.”

 

Justin nodded.  He understood that it wasn’t really his or Jack’s fault.  It wasn’t anyone’s fault.  It was just a horrible tragedy.  But he still blamed himself.  “So did you talk to her mother?” he asked Jack.

 

Jack nodded.  “Yeah.  It was one of the harder ones.  Not only did she find out her daughter was dead, but she also discovered that her thirteen-year-old had been having sex behind her back with a boyfriend her mom had forbidden her to see.”

 

Justin remembered Kristine’s expression when he had asked her if she had a boyfriend, the look she had shot at her mother, and her quick no.  He understood now.

 

“Was she mad?” Justin asked.  “That we didn’t know what was wrong this morning?”

 

“Yeah, she was,” Jack said, sighing.  “A lot of people get that way.  Some try to sue the hospital for malpractice.”

 

Justin’s head shot up in alarm.  “Do you think she’ll do that??”

 

“She might.  But I already asked Elizabeth about it, and she said she doesn’t think the mother would win if she tried.  She’s an experienced doctor, and she couldn’t even see anything on the ultrasound.  Probably only an OB or maybe a surgeon would be able to tell it was an eptopic pregnancy, and under the circumstances, we didn’t see the need for a consult.  That would be our defense if we needed it in court.  But it probably won’t get that far, even if the mother does threaten to sue.”

 

“That’s good,” Justin said, sighing with relief.  The last thing he needed was to be accused of killing a girl one month into his third year of med school.

 

Jack glanced at his watch.  “Well, we’re off at six, and it’s quarter till now.”

 

“Good,” Justin said.  He sighed and buried his face in his hands again.  “I just want this day to be over with,” he moaned, his voice muffled.

 

Jack studied him for a moment, then got an idea.  “Hey, Justin,” he said.

 

Justin looked up.  “What?” he asked wearily.

 

“Some of the guys and I are having sort of a ‘guys’ night in’  at AJ McLean’s house – he’s one of the paramedics.  Why don’t you come?  You need something to get your mind off this.”

 

“Really?” Justin asked, surprised at being included in something Jack and the other staff members were doing.

 

“Sure,” Jack replied, smiling.  “You did a good job today, Justin, even if you did lose someone.”

 

Justin broke into a slight smile, touched by Jack’s compliment.  “Well… okay,” he said finally.  “I’ll come.  Where is it and what time?”

 

Jack gave him the directions to AJ’s house and told Justin to be there at eight.  “Well,” he said, standing up.  “I’m gonna go now.  I’ll see you tonight, okay?”

 

“Okay,” Justin said.  “See you tonight.”

 

+++

 

“But, Justy, I thought we were going to spend tonight together!” Britney protested.

 

“I know, Brit, but I already told Dr. Palmer I was coming.  Besides, I want to go.  It’ll be fun.”

 

“Yeah, for you.  But what do you expect me to do?  Just sit around here and wait for you to get home?”  Britney glared at him.

 

“Well… I dunno.  But I won’t be there the whole night.  I’ll come home, and we can have sex then,” Justin said brightly.

 

“Ha, we’ll see about that,” said Britney with a smirk.

 

Justin rolled his eyes.  “Oh, come on, Britney, you want me, and you know it,” he said smugly.

 

“I can have any guy I want,” Britney continued, tossing her hair.  “Why should I stay tied down to some arrogant doctor wannabe who’s never around?”

 

“Because this arrogant doctor wannabe is gonna be rich someday, that’s why,” Justin said.  “You’re going to need someone to support you and pay for all your boob jobs, you know.”  Seeing Britney’s look of rage, he quickly added, “Besides, this arrogant doctor wannabe loves you.”  He kissed her lips, and when he pulled back, there was a smile on her face.

 

“I love you too, Justy,” Britney cooed, and the couple kissed again.

 

+++

 

Hours later, the party was in full swing, with AJ and his friends from both the hospital and outside of work gathered around his newly-remodeled basement.

 

Having already downed several beers, Justin was having a great time.  He had already forgotten the depression he had suffered from earlier that evening.  Now he just wanted to get drunk and have fun.

 

“Hey, Dr. Palmer,” he said, waving, as he headed for the bar.

 

“It’s Jack, Justin,” Jack replied.  “You can call me Jack.”

 

“Jack,” Justin said, nodding.  “This is a great time, eh?”

 

“Sure is,” Jack replied.  “I can tell you’re having fun,” he added under his breath, snickering as he saw Justin weave his way to the bar.  He couldn’t poke too much fun at Justin though; he was already pretty loaded himself.  Normally, he tried to watch himself with the alcohol because Addie didn’t like it when he was drunk off his ass.  But tonight, there was no Addie to reprimand him, and he planned to take full advantage of that fact.

 

“Hey, Jack,” said Kevin, coming up to Jack.  “How’s it going?”

 

“Great,” Jack replied.  “I’m having fun.  How ‘bout you?”

 

“Yup,” Kevin said.

 

In the background, Jack heard the music blaring from the stereo change, and Dr. Dre and Eminem’s “Forgot About Dre” came on.  He paid no attention until he heard a familiar, whiny voice attempting to rap along at the top of his lungs.  Both he and Kevin turned and stared in disbelief as they watched Justin climb on top of the counter of the bar and rap right along.  Well, try to rap anyway.

 

“Oh my God, who the hell is that?” snickered Kevin, his green eyes dancing with amusement at the curly-haired white guy trying to be Dr. Dre.

 

“That would be Bianca’s med student, Justin Timberlake,” replied Jack, never taking his eyes off Justin, who was making a complete ass of himself in front of the rest of the crowd, who had stopped what they were doing to stare at him.

 

“Nowadays, everybody wanna talk like they got somethin’ ta say, but nothin’ comes out when they move their lips, just a buncha gibberish, and muthah’-f*ck that ‘cause they forgot about Dre,” rapped Justin, waving his arms around in an attempt to be “ghetto”. 

 

Before they knew it, Chris Kirkpatrick had leapt onto the counter as well.  “Whoo!  Go Justin!  Go Justin!  It’s your birthday!  Go Justin!”  he shouted, mocking Justin.

 

The crowd began to chant along, and poor Justin, who didn’t realize he was being made fun of, continued to act like a big rap star and make a complete idiot of himself.

 

“Oh my God,” Jack gasped, out of breath from laughing so hard.  “I hope he doesn’t remember this once he’s sober.  He’s never gonna live it down at the hospital.”

 

Kevin grinned.  “That’s for sure.”

 

+++

 

“Hey, that was one tight act you put on there, Justin,” commented AJ teasingly as he passed by Justin an hour after his “performance”.

 

“Yo, you can jus’ call me J-Dawg from now on, g,” slurred Justin in ebonics, staggering towards the bar once again.  He helped himself to a beer and nearly missed the bar stool when he tried to sit down.  He just laughed idiotically at himself, popped the top on his beer, and finished off the can in three gulps.

 

“Your med student’s completely smashed over there, dude,” AJ said to Jack, pointing at Justin.

 

Jack rolled his eyes.  “Not my problem.  I’m not in charge of him here.  He’ll regret it when he wakes up tomorrow with the world’s worst hangover.”  He took a sip of his own beer and sidled over to where AJ’s hired strippers were dancing for Josh and the rest of the men crowded eagerly around him.

 

+++

 

By midnight, most of the guys had left.  Only a few of them remained, some stumbling drunkenly around AJ’s basement, helping him pick up, while others sat at the bar or in front of the TV, still drinking.  Justin, who had spent much of the latter portion of the night in the bathroom, was passed out on one of the couches.

 

“Somebody should probably go wake him up now,” Josh said casually to Jack, nodding to Justin.

 

Jack snickered, remembering Justin’s rapping.  “He’d probably rather sleep forever than face going back to work on Monday.  I have a feeling by the time Chris gets to work, the whole ER will know.”

 

Josh laughed.  “True.”

 

Jack opened his mouth to say something else, but was cut off by Doug, one of AJ’s friends from college, who called out, “Hey, could one of you doctor people come over here?”  He was leaning over the unconscious form of Justin.

 

Jack and Josh exchanged worried glances.  “Shit, I forgot all about him,” Jack muttered, as the two hurried over to the couch where Justin was passed out.

 

“I don’t think he’s doin’ so good,” Doug said, motioning down at Justin.  “His breathing sounds really weird.”  Sure enough, Justin’s breathing was very slow and shallow.

”Check his pulse,” Josh said, and Jack knelt down and felt Justin’s wrist.

 

“Shit, his pulse is weak,” Jack said.  “He’s had way too much to drink.”

 

“Alcohol poisoning?” Josh asked.

 

“I think so,” Jack said grimly.  Raising his voice, he shouted, “Somebody call 911!”

 

+++

 

 

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