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“Good morning, Dr. Ashworth.”

“Good morning, Dr…” I could never remember her name. I tried to play the game in my head where I made something about her physical features trigger an association. Oh yeah, she had pointy elf ears. “Peers.” I smiled, glad I had only mildly stumbled.

“Are you headed home?” I asked

She slammed her locker. “Yes, just ended my twelve, really it was thirteen. But who’s counting?”

“Right.” I laughed. “Have a good day.” I knew she was going home to sleep off what was a long night.

I was glad this week I was on days. Night shifts were always the hardest to bounce back from.

I grabbed my stethoscope from my locker and looped it around my neck. I clipped my hospital ID badge to my pocket. It wasn’t my best picture. I had pulled my blond hair back in a ponytail that day, and my eyes looked glazed over from lack of sleep.

I locked my small cabinet to see my first patient of the day. I liked to check in with my existing patients before taking on anyone new. Arriving as early as I did, I had plenty of time to peek in on everyone and say hello.

The nurses were swapping muffins and bagels as I walked past the station. One of the pharmacy reps had dropped off breakfast this morning.

“Oh, Dr. Ashworth, do you have a minute?”

I stopped and spun on my heels. “What’s up?” I quickly looked at her nametag. “Joanna.”

“It’s the patient in 405. He was complaining all night about his knee pain.”

“Did you up his pain meds?” I asked.

“No. We thought we’d ask you when you came in.”

“You could have paged me or called my on-call number. He just came out of surgery.” I was irritated. I had given strict instructions that if his pain level rose, I was to be contacted.

I rushed off to check on him before scolding the nurse any further.

I pushed open the door. “Mr. Hamlin, I heard you had a rough night.”

He winced before I even made it to the bed. “I didn’t sleep at all. And those nurses wouldn’t give me anything other than the original prescription.”

I carefully examined his knee and pulled the bandages away from his skin. The incision was a small one. It was amazing what we could do with surgery, but it didn’t mean it wasn’t going to hurt like a bitch.

“Well, I was hoping the swelling would have gone down a little more.” I looked at the man, clearly uncomfortable, even with icepacks and pillows cushioning his leg. “How about we up the pain killers today just a bit, and then we’ll back off them slowly tomorrow to get you to a manageable dose? I don’t want you to be too loopy, but it’s not worth not getting any sleep either. Agreed?”

He nodded enthusiastically. “I’ll take anything at this point.”

I squeezed his shoulder. “I’ll have the nurses bring it in right away.” I smiled. “Get some rest.”

I walked out, closing the door behind me, and sought out the nurse to administer the higher level of medication. This was exactly the type of situation that irritated me. The man needed sleep to heal, and for whatever reason, no one thought to call me or consult Dr. Peers last night. Now he was miserable and sleep-deprived. The last thing he needed after having knee replacement surgery. I marched toward the nurses’ station ready to tear off some heads.

“Bagel, Dr. Ashworth?” One of the assistants held up a box of pastries in my direction.

“No,” I barked. “I want to know why Mr. Hamlin didn’t get the medication he needed last night.” I slammed my patient files on the desk. “He hasn’t been out of surgery twenty-four hours.”

Everyone stopped eating and looked at me. “I-I wasn’t here last night,” the girl stammered.

“Well, find someone who was,” I snapped at her. “I’ll wait.” I eyed her as she scurried away from the baked goods and started asking nurses who was responsible for Mr. Hamlin.

I tapped my pen on the counter, waiting for an excuse. I wrote up the changes for his medication and handed them to the nurse administrator to update his patient information while I waited.

I pointed at her. “And make sure that says urgent.”

She nodded. “I will.”

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