Fic: All I Want For Christmas Is ... Inappropriate (NC-17, 1b/6)
Back to Part 1a
The patient in room twelve had been admitted to the Cardiac ICU, and Mr. Swanson and his stitches were on their way home. Len sat at the desk for another minute, wondering why he was putting off going to check up on Jim Kirk.
For some reason, he was finding it harder to go see him than it was to look in on Swanson, or, on his last shift, a homeless guy who’d ODed on heroin, or, on the shift before that, the skinhead who’d gotten the swastika tattoo on his scalp sliced open with a broken beer bottle and was tweaked out on meth to boot.
There was nothing for it, though. Jim Kirk was currently the sickest patient in the ED, and needed his attention. So Len rubbed his eyes-was it really only ten o’clock?-and returned to room two. He tapped on the wall, and then slid the curtain open as quietly as he could.
Jim appeared to be dozing lightly. A clean emesis basin rested on his lap, and his mouth was slightly open. His lips were dry and cracked, and there was a fleck of dried vomit on his chin. The nasal cannula had gone slightly askew. He looked like hell.
But Leonard just couldn’t stop looking.
The buzz of the automatic blood pressure cuff pumping up startled Len out of his inappropriate reverie, and roused Jim as well. His eyes drifted open, and Len had to tear his gaze away to glance at the monitor.
“Blood pressure eighty-four over sixty, pulse one-fifteen, respirations eighteen. Nice progress, Mr. Kirk,” Len said, hoping he sounded at least somewhat professional. He examined both the IV sites, and found them to be in fine shape.
“Hafta take your word for it,” Jim said, “since I don’t know what any of those numbers really mean. And if you keep calling me Mr. Kirk, I’m gonna think you’re talking to a ghost, ‘cause my father’s been dead for twenty-six years. But that’s a story for another time. So, can I go home now?”
Len just barely bit back a bark of laughter that he knew would’ve have been both unattractive and, yes, inappropriate. The word of the evening, Len thought.
“Ah, that’s a resounding ‘no,’ I’m afraid,” he said.
“But why not? I’m feeling much … oh, fu-”
Len winced as the kid’s own abdominal muscles wrenched his torso forward. He helped steady the basin, and Jim’s head, as Jim puked and retched. The monitor bleeped, complaining about another string of arrhythmias, and Jim’s pulse shot back up into the 130s. The smell in the room strongly indicated that vomit was not the only bodily effluvium that had just been produced.
Leonard wet another washcloth, and sponged Jim’s face down again. He handed him a cup of water.
“Rinse and spit-don’t try to drink any,” he cautioned.
“Not on your life,” Jim said, now that he was able to speak again. “Fuck. Fucking fuckity fuck. Can I please just die now? This is so fucking embarrassing.”
“No, you may not die.” Len replied sternly. “I won’t allow it. I’ll have someone help you clean up, and then I’m admitting you upstairs.”
“Admitting?” Jim said, physically recoiling in horror despite his weakened physical condition. “As in, putting me in the hospital?”
“As in, yes.”
“But at home I can sit on the toilet with a bucket in front of me! I’ll be much more comfortable!” Jim protested.
“You need to be in the hospital,” Len said. “You’re doing a little better, but you’re still severely dehydrated. You need IV rehydration, and you need monitoring.”
“But-”
“What’s your living situation?” Len interrupted.
“I live in the farmhouse with my mom,” Jim said sullenly. “No laughing. We work the farm together. It works.”
“All right-well, think of it this way,” Len said. “Your mother is sick, too. Not nearly as sick as you’ve managed to get, but plenty sick enough that she doesn’t need to be worrying about you.”
“But-”
“Do you not remember, that just ninety minutes ago you were unconscious? That you were so sick you didn’t even notice when the nurse and the orderly stripped you naked and cleaned you up? That you were terrified because you felt your heart skipping beats?”
“Um, kind of? But-”
“But nothing, Mr. Kirk,” Leonard said sternly.
“Jim,” Jim insisted again.
“All right, Jim-look at this, then.” Leonard turned the monitor towards Jim so he could look at it. “The thing where you feel like your heart is skipping a beat? You’re only actually feeling a small percentage of them.” He pushed a button on the monitor to show Jim’s heartbeat. “Watch. When it looks like this-” Len pointed to the squiggly wave- “it’s called a normal sinus rhythm. Well, not actually totally normal, because I’m betting that 120 is about twice as fast as your pulse usually is. And-look, there it was. Did you feel that?” Len pushed a button to freeze the display, and pointed to a spot where the wavy line shot way up, and then dipped down farther than usual.
“That was one of those thingies?” Jim said.
“Yep. They’re happening a couple times every minute, probably because your blood is sludgy and thick from dehydration, and because your electrolytes-chemicals in your blood that can affect heart rhythm-are totally out of whack, also from the dehydration.”
Jim raised his eyebrows. “You really are a doctor, aren’t you?” he said in an impressed tone.
Len put his hands on his hips and rolled his eyes. “Well of course I’m a doctor! What do I look like, with this white coat, and a stethoscope crammed in my pocket-a trapeze artist? A fireman? A pilot?”
“Well, it’s just that you look too-”
Jim got that pre-puking look again, and as he vomited, Len once again supported him and smoothed the hair off his forehead, with a gentleness that completely contradicted the crankiness in his voice. They repeated the face-wiping and mouth rinsing routine.
Jim sat silently for a moment as he regained some composure. “Fine,” he croaked. “Okay. You win, Dr. Sawbones. I’ll submit to shitting myself and having my ass wiped by strangers, for the sake of my mother. And because you’re a doctor, not a trapeze artist.”
“Good.” Len allowed one corner of his mouth to quirk up in a fraction of a smile. “Now, the rest of your family should be getting discharged in not too long, and they’ve all asked if they could come see you. Is that all right?”
“Sure. As long as I’m not stewing in my own shit, that is.” He pulled the sheet up around him more tightly, as if he could hide.
“I’ll send someone in to help you get cleaned up right away,” Len said. “After that, one of the nurses will do the admitting paperwork with you. I should warn you, it might take a while to get you a bed upstairs. We’re running a little slow tonight, what with the holiday and all. I’ll be back to check in on you after I look in on the other patients again.”
“Thanks, Dr. Sawbones.” Jim cleared his throat. “I appreciate it. I really do. Sorry I’m such a pain.”
The sapphire blue eyes gazed at him intently, and Len couldn’t help gazing back. Inappropriately.
“You’re not a pain. You’re just really sick. Now, you rest, and I’ll see you in a while.”
“Thanks.”
Len sent an aide in to help Jim clean up, and checked in on the rest of the Kirks, who were in the process of being discharged home.
“Are you sure it’s salmonella?” Mrs. Kirk asked.
“Well, the lab test takes three to five days, but it’s pretty certain you all have a food-borne illness. And I think your theory about it being the eggnog is probably right on the money.”
Mrs. Kirk sighed. “Salmonella has to get reported to the health department, right?”
“It does. I’ll report four suspected cases tonight, and the lab will follow up with me and the health department when the results come back.”
“Oh-and I reached the neighbors on Sam’s cell phone. They’re sick too-but just the adults, the same as us. Does … is … will the health department … do anything to them?”
Len frowned. “To be honest, Mrs. Kirk, I don’t know what exactly they’ll do. I’ve only been in Iowa for a few months, and this is my first reportable food-borne illness since I’ve been working here.”
“Oh. I suppose we’ll all learn, then. Uh-excuse me.” Mrs. Kirk dashed out of the room again, across the hall to the bathroom.
Leonard checked on the other two Kirks, who had finished their paperwork and were keeping each other company in one of their rooms.
“The nurse said we could wait here until Mom was discharged,” Sam said. “How’s Jim doing?”
“Better,” Len said, “but I’m admitting him overnight. He’s still working on IV rehydration, which I suspect is just keeping up with the fluid loss at this point.”
“It was really scary to see how sick he got,” Sam said. “I mean, we were all feeling pretty awful, but he just really crashed.”
“You were smart to call 9-1-1,” Len said.
“We had to,” Sam’s wife Aurelan said. “I mean, there was this crashing sound in the bathroom, and then he wouldn’t open the door when we knocked. The EMTs had a hell of a time getting him out of there-it’s so small, and the door opens in, and he was on the floor in front of the door.”
“EMTs are used to hauling people out of bathrooms,” Len said. “It happens all the time. Though usually it’s elderly people, or people who’ve had heart attacks. I almost think building codes should require that bathroom doors open outwards.”
“So, can we look in on Jim?” Sam asked.
“Why don’t all three of you look in on him briefly on your way out? He’s in room two. Check with a nurse before you go in, though,” Len said, not wanting Jim to suffer any more embarrassment than he already had.
“We will. Thanks,” Sam said.
Len sat at his computer terminal and updated Jim’s chart.
“Dr. McCoy?”
The charge nurse was standing in front of him.
“What’s up?”
“Iowa City PD just called-they’re riding in with IC Ambulance, bringing a male, 54, highly intoxicated, with a head laceration, and extremely noncompliant. Oh-he’s wearing a Santa suit, and insists he’s the real Santa.”
“Terrific,” Len said. “At least there’s no kids in here right now.”
It was shaping up to be a long, long night.
The police and EMTs brought in the raving, bleeding Santa in restraints, but the treatment of the wound needed to wait until he could be more cooperative.
Another potential cardiac patient was brought in; Len stabilized him and determined he wasn’t having a heart attack, but transferred his care to Cardiology as soon as he could.
During a lull, Len thought about his last conversation with Jim Kirk. What was it the kid had said right after he’d finally decided maybe Len really was a doctor, and not some kind of impostor?
“It’s just that you look too …”
And then the barf.
Too what?
Too stupid? He’d never been told he looked stupid before.
Too young? Fat chance-the gray hair seemed to be creeping in more and more every day.
Too what?
Another patient rolled in; a toddler who’d just had a seizure. Working out that it had probably been a febrile seizure, and reassuring the parents, took his mind off the question for half an hour.
But as he did the paperwork for the toddler, the question seeped into his mind again.
Too what, though?
In Len’s fantasy world, it would be something like “too hot,” or “too good looking.”
Hah.
“Bah, humbug. You old fool,” Len muttered to himself. “What the hell are you thinking, anyhow?”
Len’s self-castigation was interrupted by the arrival of a new patient, a woman in her forties who was sure she was having a heart attack. The monitor showed nothing but an elevated heart rate, blood pressure, and respiratory rate. On further inquiry, it turned out the woman had a history of panic attacks and anxiety, and had just had an unpleasant encounter with her passive-aggressive mother-in-law. She hadn’t taken her medication, because she’d been drinking, and knew she shouldn’t mix alcohol with Xanax. Len was sure this wouldn’t be the last ER visit related to family dynamics on one of the most stressful holidays of the year.
By the time Len was able to go check on Jim Kirk again, it was nearly midnight. Half of him was peeved that the admission process was so slow, but the other half of him was perversely glad he’d be able to see him again without it being odd.
Once again, Len tapped on the wall next to the curtain that was the door to room two.
“Yep?”
Leonard ducked into the room, feeling guilty about it even though he was supposed to be there. It was his job to be there.
Did Jim actually brighten up a bit when Len entered the room?
“Look!” Jim said, pointing to the monitor. “My pulse is lower, and my blood pressure is higher-that’s good, right? And I haven’t puked in like half an hour!”
“That is good. And before you even ask, yes, you do still have to stay in the hospital tonight.”
“Oh, I know. My mom made me promise I wouldn’t give you a hard time. Except there is this one thing.”
“What is it?”
“Can I please, please, pretty please, get up to use the bathroom? Please? With sugar and a cherry on top?”
Len rolled his eyes. “What are you, six? But sure. I can unhook your IVs for a minute. And the monitor.”
“Wait-hang on-will that mean I have to get stuck with new IVs?” Jim asked.
“Nope-the catheters stay in; I can just unhook the fluids from the tubing, just like this. See? No new needles required.” Len finished unhooking the IVs, and then pushed a button on the monitor to pause it while he removed the wires from the electrodes and took the BP cuff off Jim’s arm.
“Whew, you didn’t have to yank those stickers off me either. I mean, I wasn’t worried about putting new ones on, but it’s gonna smart, ripping those off. All zillion of them,” Jim said. He started to swing his legs over the edge of the bed, but McCoy stopped him in a hurry.
“Now, hold on there for a second, champ. Take it slow and easy-I don’t want you to pass out.”
Leonard helped Jim sit up slowly.
“Okay?”
Jim nodded. He looked down at himself, and frowned.
“Holy crap, I’m not wearing anything!”
Len opened a cabinet, and tossed him a gown.
“Oh, great-this is one of those hospital gowns, right? The kind that’s real breezy in the back?”
“Function over fashion, pal,” Len said, smirking at him.
“But … but …”
“Exactly,” Leonard said, the smirk intensifying.
Jim met Len’s smirk with an even gaze, and then a genuine smile.
“I thought I liked you, Dr. Sawbones, but now I’m sure. And don’t take that lightly-I’m a life-long iatrophobe, and I’m not kidding.”
They stared at each other for a few seconds, and a sudden wave of propriety came over Len. He helped Jim get his arms through the front of the gown without snagging the hardware.
“All right-let’s get you standing up. No-slowly, you idiot!”
Jim stood wobbling on his feet, as Len held him up by one elbow.
“I’m fine. Okay. You can let go now.”
Len let go slowly (and, when he was honest with himself, reluctantly).
“I’ll let you get yourself collected. Do you want someone to help you to the bathroom?”
“I think I can handle it. Thanks, Dr. Bones.”
Len left before he had a chance to wrestle with himself about offering to help Jim fasten the ties of the gown, and sat back down at his station to look over some lab results that had just come in. He was interrupted by a snicker from a nearby desk, and looked up to see what had caused the normally staid nurse to lose her cool.
Jim Kirk was strutting back from the bathroom, gown dangling every which way, ties unfastened, leaving absolutely nothing to the imagination.
“Looks like your patient in two forgot something,” the nurse said.
Len planted his face into his open palm. “Good grief.” And he didn’t, absolutely didn’t, open his fingers ever so slightly so he could have a peek at what was going by. Which was shapely, and firm, and-
Inappropriate.
He stood up and returned to room two, since, after all, the IVs and the monitor needed to be reconnected. Urgently.
He didn’t bother to knock, since his patient obviously didn’t care about his privacy.
“You know, those gowns do have ties on them,” he said.
“Isn’t this the part where you’re supposed to say ‘don’t worry, it’s nothing everyone here hasn’t seen before,’ instead of complaining?” Jim said, as he settled himself back into the bed.
Len silently reconnected the monitor, and plugged the IV fluids back into the line in Jim’s left arm, then his right hand. He couldn’t come up with anything witty to say, but he trusted that Jim would have some choice phrase come to mind shortly. He looked back up at Jim, expecting to see a mighty smirk or grin, but instead saw a sheen of sweat on his upper lip, and a greenish tone to his suddenly pale face.
Len grabbed the basin from the table, and thrust it in front of Jim, just in time for Jim to make a deposit.
When that moment of Jim’s ordeal was over, he lay back, eyes closed, apparently concentrating on breathing. Len watched the monitor, concerned that perhaps he shouldn’t have let Jim get up after all, and was relieved to see the numbers returning to close to where they’d been before Jim’s trip down the hallway. He silently went to the sink and wet yet another cloth with warm water, and gently wiped Jim’s face for him again.
“You’re gonna be okay,” he said quietly. “I know it feels like this is gonna go on forever, and that you’ll never feel better again, but I promise, this won’t last forever.”
Jim’s eyes stayed closed, as he settled his breathing down to a more normal rate. He opened them again, and squinted at the doctor.
“Thanks,” Jim said.
They looked at each other again, bloodshot blue eyes meeting hazel ones, but neither one of them could think of anything to say.
There was a tap on the wall outside the curtain, interrupting the moment.
“Mr. Kirk?” said a woman’s voice.
“That’s me,” Jim said.
The woman entered. Len recognized her as a nurse from the medical unit upstairs.
“I’m Mrs. Greene; I’m a nurse on the medical floor. We’ve got a bed ready for you up there. Sorry it took so long to get you admitted, but we’re a little short-staffed at the moment.”
“It’s okay,” Jim said.
“Well: let’s get you out of here, and someplace a little more comfortable than the ER,” the nurse said. “You ready to go?”
Jim looked at Len again. “I guess,” he said, not breaking his gaze, as the nurse began unhooking him from the monitor.
“Dr. McCoy!” called a voice from the ER floor.
Len didn’t look away, and neither did Jim.
“Dr. McCoy! There’s been a multi-car MVA on the I-80! At least five patients!”
Len unlocked his gaze from Jim’s. “Take care, Jim,” he said quietly, as he left the room.
“Thanks, Doc,” Jim said.
Len didn’t have time to sort out what had just happened. After the first report from the officer at the scene, he switched straight into overdrive. He called in all the people who were on call for such emergencies, and helped the nursing staff get ready for several major trauma patients. By the time the first ambulance rolled into the bay, the well-oiled machine of the University of Iowa Emergency Department was ready to uphold its reputation as a first-class Level 1 Trauma Center.
Eight hours later, everyone who came to the ER alive was still alive. Leonard heard there were two people who didn’t make it to the ER, but he knew there was nothing he could do to fix that. Three patients had already been through surgery and been admitted to the Surgical ICU. Two more were awaiting surgery to repair fractures. Four had been treated and released. One of those four was released to the custody of law enforcement, as he had caused the accident, and had blown a .16 on the Breathalyzer.
It was nearly nine in the morning before Len had his paperwork wrapped up. It seemed to him that the second he logged out of the medical records system, the incomplete question reappeared in his mind:
Too what?
He sighed heavily as he opened the program again. It wasn’t unethical to check on the disposition of a patient he’d admitted to the hospital, he told himself.
He called up Jim Kirk’s chart. He paged through the nurses’ notes, and was appalled to see that Jim had had an anaphylactic allergic reaction to the first antibiotic they’d given him, which had set his progress back considerably. Len paled at the idea of a patient who was already that ill having anaphylaxis on top of everything else. It could easily have killed him.
He wanted to go upstairs, on his way out, and check on Jim. But he couldn’t sort out whether his interest was professional, or something else.
Len chewed on his fingernail, and wrestled with his conscience. Something had clearly passed between him and this patient. Sure, he’d been attracted to patients before, and had empathized with patients before. But he’d never felt such an intense draw to a patient before.
He’d had enough experiences with patients falling in love with him to know that such occurrences were commonplace. When a person takes care of someone else, especially in a crisis situation that’s emotionally charged for the patient, it’s common for the vulnerable patient to develop feelings of closeness to their caregiver.
And that, Leonard realized, was the problem. No matter what he felt, it would be inappropriate to act on it, even if Jim Kirk were willing, because of that dynamic.
With the weightiest sigh he’d produced during his entire shift, Len closed Jim Kirk’s records again, and went to the staff locker room. He tossed his coat and scrubs in the laundry, and changed back into his civvies. He left the hospital, squinting in the bright sunlight, got in his car, and drove home.
Part 2
The patient in room twelve had been admitted to the Cardiac ICU, and Mr. Swanson and his stitches were on their way home. Len sat at the desk for another minute, wondering why he was putting off going to check up on Jim Kirk.
For some reason, he was finding it harder to go see him than it was to look in on Swanson, or, on his last shift, a homeless guy who’d ODed on heroin, or, on the shift before that, the skinhead who’d gotten the swastika tattoo on his scalp sliced open with a broken beer bottle and was tweaked out on meth to boot.
There was nothing for it, though. Jim Kirk was currently the sickest patient in the ED, and needed his attention. So Len rubbed his eyes-was it really only ten o’clock?-and returned to room two. He tapped on the wall, and then slid the curtain open as quietly as he could.
Jim appeared to be dozing lightly. A clean emesis basin rested on his lap, and his mouth was slightly open. His lips were dry and cracked, and there was a fleck of dried vomit on his chin. The nasal cannula had gone slightly askew. He looked like hell.
But Leonard just couldn’t stop looking.
The buzz of the automatic blood pressure cuff pumping up startled Len out of his inappropriate reverie, and roused Jim as well. His eyes drifted open, and Len had to tear his gaze away to glance at the monitor.
“Blood pressure eighty-four over sixty, pulse one-fifteen, respirations eighteen. Nice progress, Mr. Kirk,” Len said, hoping he sounded at least somewhat professional. He examined both the IV sites, and found them to be in fine shape.
“Hafta take your word for it,” Jim said, “since I don’t know what any of those numbers really mean. And if you keep calling me Mr. Kirk, I’m gonna think you’re talking to a ghost, ‘cause my father’s been dead for twenty-six years. But that’s a story for another time. So, can I go home now?”
Len just barely bit back a bark of laughter that he knew would’ve have been both unattractive and, yes, inappropriate. The word of the evening, Len thought.
“Ah, that’s a resounding ‘no,’ I’m afraid,” he said.
“But why not? I’m feeling much … oh, fu-”
Len winced as the kid’s own abdominal muscles wrenched his torso forward. He helped steady the basin, and Jim’s head, as Jim puked and retched. The monitor bleeped, complaining about another string of arrhythmias, and Jim’s pulse shot back up into the 130s. The smell in the room strongly indicated that vomit was not the only bodily effluvium that had just been produced.
Leonard wet another washcloth, and sponged Jim’s face down again. He handed him a cup of water.
“Rinse and spit-don’t try to drink any,” he cautioned.
“Not on your life,” Jim said, now that he was able to speak again. “Fuck. Fucking fuckity fuck. Can I please just die now? This is so fucking embarrassing.”
“No, you may not die.” Len replied sternly. “I won’t allow it. I’ll have someone help you clean up, and then I’m admitting you upstairs.”
“Admitting?” Jim said, physically recoiling in horror despite his weakened physical condition. “As in, putting me in the hospital?”
“As in, yes.”
“But at home I can sit on the toilet with a bucket in front of me! I’ll be much more comfortable!” Jim protested.
“You need to be in the hospital,” Len said. “You’re doing a little better, but you’re still severely dehydrated. You need IV rehydration, and you need monitoring.”
“But-”
“What’s your living situation?” Len interrupted.
“I live in the farmhouse with my mom,” Jim said sullenly. “No laughing. We work the farm together. It works.”
“All right-well, think of it this way,” Len said. “Your mother is sick, too. Not nearly as sick as you’ve managed to get, but plenty sick enough that she doesn’t need to be worrying about you.”
“But-”
“Do you not remember, that just ninety minutes ago you were unconscious? That you were so sick you didn’t even notice when the nurse and the orderly stripped you naked and cleaned you up? That you were terrified because you felt your heart skipping beats?”
“Um, kind of? But-”
“But nothing, Mr. Kirk,” Leonard said sternly.
“Jim,” Jim insisted again.
“All right, Jim-look at this, then.” Leonard turned the monitor towards Jim so he could look at it. “The thing where you feel like your heart is skipping a beat? You’re only actually feeling a small percentage of them.” He pushed a button on the monitor to show Jim’s heartbeat. “Watch. When it looks like this-” Len pointed to the squiggly wave- “it’s called a normal sinus rhythm. Well, not actually totally normal, because I’m betting that 120 is about twice as fast as your pulse usually is. And-look, there it was. Did you feel that?” Len pushed a button to freeze the display, and pointed to a spot where the wavy line shot way up, and then dipped down farther than usual.
“That was one of those thingies?” Jim said.
“Yep. They’re happening a couple times every minute, probably because your blood is sludgy and thick from dehydration, and because your electrolytes-chemicals in your blood that can affect heart rhythm-are totally out of whack, also from the dehydration.”
Jim raised his eyebrows. “You really are a doctor, aren’t you?” he said in an impressed tone.
Len put his hands on his hips and rolled his eyes. “Well of course I’m a doctor! What do I look like, with this white coat, and a stethoscope crammed in my pocket-a trapeze artist? A fireman? A pilot?”
“Well, it’s just that you look too-”
Jim got that pre-puking look again, and as he vomited, Len once again supported him and smoothed the hair off his forehead, with a gentleness that completely contradicted the crankiness in his voice. They repeated the face-wiping and mouth rinsing routine.
Jim sat silently for a moment as he regained some composure. “Fine,” he croaked. “Okay. You win, Dr. Sawbones. I’ll submit to shitting myself and having my ass wiped by strangers, for the sake of my mother. And because you’re a doctor, not a trapeze artist.”
“Good.” Len allowed one corner of his mouth to quirk up in a fraction of a smile. “Now, the rest of your family should be getting discharged in not too long, and they’ve all asked if they could come see you. Is that all right?”
“Sure. As long as I’m not stewing in my own shit, that is.” He pulled the sheet up around him more tightly, as if he could hide.
“I’ll send someone in to help you get cleaned up right away,” Len said. “After that, one of the nurses will do the admitting paperwork with you. I should warn you, it might take a while to get you a bed upstairs. We’re running a little slow tonight, what with the holiday and all. I’ll be back to check in on you after I look in on the other patients again.”
“Thanks, Dr. Sawbones.” Jim cleared his throat. “I appreciate it. I really do. Sorry I’m such a pain.”
The sapphire blue eyes gazed at him intently, and Len couldn’t help gazing back. Inappropriately.
“You’re not a pain. You’re just really sick. Now, you rest, and I’ll see you in a while.”
“Thanks.”
Len sent an aide in to help Jim clean up, and checked in on the rest of the Kirks, who were in the process of being discharged home.
“Are you sure it’s salmonella?” Mrs. Kirk asked.
“Well, the lab test takes three to five days, but it’s pretty certain you all have a food-borne illness. And I think your theory about it being the eggnog is probably right on the money.”
Mrs. Kirk sighed. “Salmonella has to get reported to the health department, right?”
“It does. I’ll report four suspected cases tonight, and the lab will follow up with me and the health department when the results come back.”
“Oh-and I reached the neighbors on Sam’s cell phone. They’re sick too-but just the adults, the same as us. Does … is … will the health department … do anything to them?”
Len frowned. “To be honest, Mrs. Kirk, I don’t know what exactly they’ll do. I’ve only been in Iowa for a few months, and this is my first reportable food-borne illness since I’ve been working here.”
“Oh. I suppose we’ll all learn, then. Uh-excuse me.” Mrs. Kirk dashed out of the room again, across the hall to the bathroom.
Leonard checked on the other two Kirks, who had finished their paperwork and were keeping each other company in one of their rooms.
“The nurse said we could wait here until Mom was discharged,” Sam said. “How’s Jim doing?”
“Better,” Len said, “but I’m admitting him overnight. He’s still working on IV rehydration, which I suspect is just keeping up with the fluid loss at this point.”
“It was really scary to see how sick he got,” Sam said. “I mean, we were all feeling pretty awful, but he just really crashed.”
“You were smart to call 9-1-1,” Len said.
“We had to,” Sam’s wife Aurelan said. “I mean, there was this crashing sound in the bathroom, and then he wouldn’t open the door when we knocked. The EMTs had a hell of a time getting him out of there-it’s so small, and the door opens in, and he was on the floor in front of the door.”
“EMTs are used to hauling people out of bathrooms,” Len said. “It happens all the time. Though usually it’s elderly people, or people who’ve had heart attacks. I almost think building codes should require that bathroom doors open outwards.”
“So, can we look in on Jim?” Sam asked.
“Why don’t all three of you look in on him briefly on your way out? He’s in room two. Check with a nurse before you go in, though,” Len said, not wanting Jim to suffer any more embarrassment than he already had.
“We will. Thanks,” Sam said.
Len sat at his computer terminal and updated Jim’s chart.
“Dr. McCoy?”
The charge nurse was standing in front of him.
“What’s up?”
“Iowa City PD just called-they’re riding in with IC Ambulance, bringing a male, 54, highly intoxicated, with a head laceration, and extremely noncompliant. Oh-he’s wearing a Santa suit, and insists he’s the real Santa.”
“Terrific,” Len said. “At least there’s no kids in here right now.”
It was shaping up to be a long, long night.
The police and EMTs brought in the raving, bleeding Santa in restraints, but the treatment of the wound needed to wait until he could be more cooperative.
Another potential cardiac patient was brought in; Len stabilized him and determined he wasn’t having a heart attack, but transferred his care to Cardiology as soon as he could.
During a lull, Len thought about his last conversation with Jim Kirk. What was it the kid had said right after he’d finally decided maybe Len really was a doctor, and not some kind of impostor?
“It’s just that you look too …”
And then the barf.
Too what?
Too stupid? He’d never been told he looked stupid before.
Too young? Fat chance-the gray hair seemed to be creeping in more and more every day.
Too what?
Another patient rolled in; a toddler who’d just had a seizure. Working out that it had probably been a febrile seizure, and reassuring the parents, took his mind off the question for half an hour.
But as he did the paperwork for the toddler, the question seeped into his mind again.
Too what, though?
In Len’s fantasy world, it would be something like “too hot,” or “too good looking.”
Hah.
“Bah, humbug. You old fool,” Len muttered to himself. “What the hell are you thinking, anyhow?”
Len’s self-castigation was interrupted by the arrival of a new patient, a woman in her forties who was sure she was having a heart attack. The monitor showed nothing but an elevated heart rate, blood pressure, and respiratory rate. On further inquiry, it turned out the woman had a history of panic attacks and anxiety, and had just had an unpleasant encounter with her passive-aggressive mother-in-law. She hadn’t taken her medication, because she’d been drinking, and knew she shouldn’t mix alcohol with Xanax. Len was sure this wouldn’t be the last ER visit related to family dynamics on one of the most stressful holidays of the year.
By the time Len was able to go check on Jim Kirk again, it was nearly midnight. Half of him was peeved that the admission process was so slow, but the other half of him was perversely glad he’d be able to see him again without it being odd.
Once again, Len tapped on the wall next to the curtain that was the door to room two.
“Yep?”
Leonard ducked into the room, feeling guilty about it even though he was supposed to be there. It was his job to be there.
Did Jim actually brighten up a bit when Len entered the room?
“Look!” Jim said, pointing to the monitor. “My pulse is lower, and my blood pressure is higher-that’s good, right? And I haven’t puked in like half an hour!”
“That is good. And before you even ask, yes, you do still have to stay in the hospital tonight.”
“Oh, I know. My mom made me promise I wouldn’t give you a hard time. Except there is this one thing.”
“What is it?”
“Can I please, please, pretty please, get up to use the bathroom? Please? With sugar and a cherry on top?”
Len rolled his eyes. “What are you, six? But sure. I can unhook your IVs for a minute. And the monitor.”
“Wait-hang on-will that mean I have to get stuck with new IVs?” Jim asked.
“Nope-the catheters stay in; I can just unhook the fluids from the tubing, just like this. See? No new needles required.” Len finished unhooking the IVs, and then pushed a button on the monitor to pause it while he removed the wires from the electrodes and took the BP cuff off Jim’s arm.
“Whew, you didn’t have to yank those stickers off me either. I mean, I wasn’t worried about putting new ones on, but it’s gonna smart, ripping those off. All zillion of them,” Jim said. He started to swing his legs over the edge of the bed, but McCoy stopped him in a hurry.
“Now, hold on there for a second, champ. Take it slow and easy-I don’t want you to pass out.”
Leonard helped Jim sit up slowly.
“Okay?”
Jim nodded. He looked down at himself, and frowned.
“Holy crap, I’m not wearing anything!”
Len opened a cabinet, and tossed him a gown.
“Oh, great-this is one of those hospital gowns, right? The kind that’s real breezy in the back?”
“Function over fashion, pal,” Len said, smirking at him.
“But … but …”
“Exactly,” Leonard said, the smirk intensifying.
Jim met Len’s smirk with an even gaze, and then a genuine smile.
“I thought I liked you, Dr. Sawbones, but now I’m sure. And don’t take that lightly-I’m a life-long iatrophobe, and I’m not kidding.”
They stared at each other for a few seconds, and a sudden wave of propriety came over Len. He helped Jim get his arms through the front of the gown without snagging the hardware.
“All right-let’s get you standing up. No-slowly, you idiot!”
Jim stood wobbling on his feet, as Len held him up by one elbow.
“I’m fine. Okay. You can let go now.”
Len let go slowly (and, when he was honest with himself, reluctantly).
“I’ll let you get yourself collected. Do you want someone to help you to the bathroom?”
“I think I can handle it. Thanks, Dr. Bones.”
Len left before he had a chance to wrestle with himself about offering to help Jim fasten the ties of the gown, and sat back down at his station to look over some lab results that had just come in. He was interrupted by a snicker from a nearby desk, and looked up to see what had caused the normally staid nurse to lose her cool.
Jim Kirk was strutting back from the bathroom, gown dangling every which way, ties unfastened, leaving absolutely nothing to the imagination.
“Looks like your patient in two forgot something,” the nurse said.
Len planted his face into his open palm. “Good grief.” And he didn’t, absolutely didn’t, open his fingers ever so slightly so he could have a peek at what was going by. Which was shapely, and firm, and-
Inappropriate.
He stood up and returned to room two, since, after all, the IVs and the monitor needed to be reconnected. Urgently.
He didn’t bother to knock, since his patient obviously didn’t care about his privacy.
“You know, those gowns do have ties on them,” he said.
“Isn’t this the part where you’re supposed to say ‘don’t worry, it’s nothing everyone here hasn’t seen before,’ instead of complaining?” Jim said, as he settled himself back into the bed.
Len silently reconnected the monitor, and plugged the IV fluids back into the line in Jim’s left arm, then his right hand. He couldn’t come up with anything witty to say, but he trusted that Jim would have some choice phrase come to mind shortly. He looked back up at Jim, expecting to see a mighty smirk or grin, but instead saw a sheen of sweat on his upper lip, and a greenish tone to his suddenly pale face.
Len grabbed the basin from the table, and thrust it in front of Jim, just in time for Jim to make a deposit.
When that moment of Jim’s ordeal was over, he lay back, eyes closed, apparently concentrating on breathing. Len watched the monitor, concerned that perhaps he shouldn’t have let Jim get up after all, and was relieved to see the numbers returning to close to where they’d been before Jim’s trip down the hallway. He silently went to the sink and wet yet another cloth with warm water, and gently wiped Jim’s face for him again.
“You’re gonna be okay,” he said quietly. “I know it feels like this is gonna go on forever, and that you’ll never feel better again, but I promise, this won’t last forever.”
Jim’s eyes stayed closed, as he settled his breathing down to a more normal rate. He opened them again, and squinted at the doctor.
“Thanks,” Jim said.
They looked at each other again, bloodshot blue eyes meeting hazel ones, but neither one of them could think of anything to say.
There was a tap on the wall outside the curtain, interrupting the moment.
“Mr. Kirk?” said a woman’s voice.
“That’s me,” Jim said.
The woman entered. Len recognized her as a nurse from the medical unit upstairs.
“I’m Mrs. Greene; I’m a nurse on the medical floor. We’ve got a bed ready for you up there. Sorry it took so long to get you admitted, but we’re a little short-staffed at the moment.”
“It’s okay,” Jim said.
“Well: let’s get you out of here, and someplace a little more comfortable than the ER,” the nurse said. “You ready to go?”
Jim looked at Len again. “I guess,” he said, not breaking his gaze, as the nurse began unhooking him from the monitor.
“Dr. McCoy!” called a voice from the ER floor.
Len didn’t look away, and neither did Jim.
“Dr. McCoy! There’s been a multi-car MVA on the I-80! At least five patients!”
Len unlocked his gaze from Jim’s. “Take care, Jim,” he said quietly, as he left the room.
“Thanks, Doc,” Jim said.
Len didn’t have time to sort out what had just happened. After the first report from the officer at the scene, he switched straight into overdrive. He called in all the people who were on call for such emergencies, and helped the nursing staff get ready for several major trauma patients. By the time the first ambulance rolled into the bay, the well-oiled machine of the University of Iowa Emergency Department was ready to uphold its reputation as a first-class Level 1 Trauma Center.
Eight hours later, everyone who came to the ER alive was still alive. Leonard heard there were two people who didn’t make it to the ER, but he knew there was nothing he could do to fix that. Three patients had already been through surgery and been admitted to the Surgical ICU. Two more were awaiting surgery to repair fractures. Four had been treated and released. One of those four was released to the custody of law enforcement, as he had caused the accident, and had blown a .16 on the Breathalyzer.
It was nearly nine in the morning before Len had his paperwork wrapped up. It seemed to him that the second he logged out of the medical records system, the incomplete question reappeared in his mind:
Too what?
He sighed heavily as he opened the program again. It wasn’t unethical to check on the disposition of a patient he’d admitted to the hospital, he told himself.
He called up Jim Kirk’s chart. He paged through the nurses’ notes, and was appalled to see that Jim had had an anaphylactic allergic reaction to the first antibiotic they’d given him, which had set his progress back considerably. Len paled at the idea of a patient who was already that ill having anaphylaxis on top of everything else. It could easily have killed him.
He wanted to go upstairs, on his way out, and check on Jim. But he couldn’t sort out whether his interest was professional, or something else.
Len chewed on his fingernail, and wrestled with his conscience. Something had clearly passed between him and this patient. Sure, he’d been attracted to patients before, and had empathized with patients before. But he’d never felt such an intense draw to a patient before.
He’d had enough experiences with patients falling in love with him to know that such occurrences were commonplace. When a person takes care of someone else, especially in a crisis situation that’s emotionally charged for the patient, it’s common for the vulnerable patient to develop feelings of closeness to their caregiver.
And that, Leonard realized, was the problem. No matter what he felt, it would be inappropriate to act on it, even if Jim Kirk were willing, because of that dynamic.
With the weightiest sigh he’d produced during his entire shift, Len closed Jim Kirk’s records again, and went to the staff locker room. He tossed his coat and scrubs in the laundry, and changed back into his civvies. He left the hospital, squinting in the bright sunlight, got in his car, and drove home.
Part 2