“My wife,” he mumbles, fighting against us as he tries to sit up. “She was in the passenger seat…”
“Mr. Monroe, I need you to lie down,” I say, gently but firmly pressing his shoulders back. Looking toward the EMTs for answers, I ask, “Was there a second patient?”
“No, he was alone in the vehicle,” the EMT responds, a look of pity on his face.
I exchange glances with Dr. Reyes. This isn’t uncommon in head injuries—confusion, sometimes even full-blown confabulation.
“Mr. Monroe, you were alone in the car,” I explain, keeping my voice calm and clear as I cut away the rest of his shirt to assess his injuries. The bruising across his right side is already developing, a violent palette of reds and purples. “Can you tell me what day it is?”
His brow furrows. “Tuesday? No, Wednesday. It’s Wednesday.”
“You were so close.” I smile. “But today is actually Thursday. And can you tell me who the president is?”
He gives me an incorrect answer as I continue the immediate neurological check, while Dr. Reyes listens to his chest through her stethoscope.
The way she and I move in sync sparks an unexpected reminder of Cole. How effortlessly we worked side by side, thriving off each other’s energy. And then my mind drifts further, to how intensely his hazel eyes watched me before we parted ways.
A chill runs down my spine, and I shake my head, forcing myself back into the present. I don’t have time to think about him right now, especially when it’s so unlikely I’ll ever see him again.
“Definite decreased breath sounds on the right,” she confirms. “Let’s get a chest tube prepped and rush that X-ray.”
The next forty-five minutes blur into a familiar cascade of procedures, assessments, and interventions. The chest tube releases trapped air with a satisfying whoosh, improving Mr. Monroe’s oxygen levels almost immediately. The head CT comes back remarkably clean—no obvious bleeds or fractures. By the time we transfer him to the surgical floor for observation, the patient is stable, oriented, and apologizing for the confusion about his nonexistent wife.
“Nice work in there,” Dr. Reyes says as we’re updating our charts later on. “You were good with him.”
“Thanks,” I reply, feeling the post-adrenaline crash beginning to work its way into my muscles. “He was lucky. One more rotation on that rollover and we’d be having an entirely different conversation.”
“That’s the job,” she says with a nonchalant shrug. “Sometimes all we can do is hope like hell we can pull them back.”
Her pager beeps. She checks it, grimacing when she sees the code. “Speaking of disaster, your favorite patient is back.”
I don’t need to ask who she’s referring to. “Third time this week?”
“Fourth. Apparently the new security protocols didn’t stick.” She gives me a sympathetic grimace. “I’d take it myself, but—”
“No, I’ve got it,” I say, straightening my scrubs. “It’s fine.”
It isn’t fine, but it’s my job.
I find Lars Winters in bed three, already shouting at a young nursing assistant who’s trying to take his vital signs. He’s a frequent flyer on the hunt for pain meds, and he’s quick to get aggressive—verbally and physically.
And he only wants me to take care of him.
“I told you I don’t need that shit! Where’s the blonde? The one who understands my condition!”
Zoe, a new nursing assistant still learning the ropes, gives me a desperate look as I approach. There’s a slight tremble in her hands.
“I’ve got this,” I tell her quietly. “Go help Marco with an intake in six.”
She nods gratefully and retreats without a word. I straighten myself and step up to the bedside, making sure to stay just out of grabbing distance. I learned my lesson after his second visit.
“Mr. Winters,” I say, keeping my voice neutral but polite. “I understand you’re in pain again.”
Lars Winters is fifty-two, ashen-faced, and reed-thin, with the hollow-eyed look of someone who’s been riding the opioid carousel for a while. His file lists a back injury from three years ago, but every scan we’ve done shows nothing that would cause the level of pain he claims to experience.
“Dr. Brigham,” he says, voice instantly switching to what I easily recognize as false relief. “Thank God you’re here. These other idiots don’t understand. My pain is at a ten—no, an eleven. I can barely breathe through it. You’ve got to give me something.”
He’s predictably dramatic as he speaks, his movements showing none of the body language I’d expect from someone in even the slightest bit of pain.