That afternoon, when the rounds were finished, the new residents gathered in the small upstairs lounge. The room held eight tables, an ancient black-and-white television set, and two vending machines that dispensed stale sandwiches and bitter coffee.
The conversations at each table were almost identical.
One of the residents said, "Take a look at my throat, will you? Does it look raw to you?"
"I think I have a fever. I feel lousy."
"My abdomen is swollen and tender. I know I have appendicitis."
"I've got this crushing pain in my chest. I hope to God I'm not having a heart attack!"
Kat sat down at a table with Paige and Honey. "How did it go?" she asked.
Honey said, "I think it went all right."
They both looked at Paige. "I was tense, but I was relaxed. I was nervous, but I stayed calm." She sighed. "It's been a long day. I'll be glad to get out of here and have some fun tonight."
"Me, too," Kat agreed. "Why don't we have dinner and then go see a movie?"
"Sounds great."
An orderly approached their table. "Dr. Taylor?"
Paige looked up. "I'm Dr. Taylor."
"Dr. Wallace would like to see you in his office."
The hospital administrator! What have I done? Paige wondered.
The orderly was waiting. "Dr. Taylor ..."
"I'm coming." She took a deep breath and got to her feet. "I'll see you later."
"This way, doctor."
Paige followed the orderly into an elevator and rode up to the fifth floor, where Dr. Wallace's office was located.
Benjamin Wallace was seated behind his desk. He glanced up as Paige walked in. "Good afternoon, Dr. Taylor."
"Good afternoon."
Wallace cleared his throat. "Well! Your first day and you've already made quite an impression!"
Paige looked at him, puzzled. "I ...I don't understand."
"I hear you had a little problem in the doctors' dressing room this morning."
"Oh." So, that's what this is all about. Wallace looked at her and smiled. "I suppose I'll have to make some arrangements for you and the other girls."
"We're ..." We're not girls, Paige started to say. "We would appreciate that."
"Meanwhile, if you don't want to dress with the nurses ..."
"I'm not a nurse," Paige said firmly. "I'm a doctor."
"Of course, of course. Well, we'll do something about accommodations for you, doctor."
"Thank you."
He handed Paige a sheet of paper. "Meanwhile, this is your schedule. You'll be on call for the next twenty-four hours, starting at six o'clock." He looked at his watch. "That's thirty minutes from now."
Paige was looking at him in astonishment. Her day had started at five-thirty that morning. "Twenty-four hours?"
"Well, thirty-six, actually. Because you'll be starting rounds again in the morning."
Thirty-six hours! I wonder if I can handle this.
She was soon to find out.
Paige went to look for Kat and Honey.
"I'm going to have to forget about dinner and a movie," Paige said. "I'm on a thirty-six-hour call."
Kat nodded. "We just got our bad news. I go on it tomorrow, and Honey goes on Wednesday."
"It won't be so bad," Paige said cheerfully. "I understand there's an on-call room to sleep in. I'm going to enjoy this."
She was wrong.
An orderly was leading Paige down a long corridor. "Dr. Wallace told me that I'll be on call for thirty-six hours," Paige said. "Do all the residents work those hours?"
"Only for the first three years," the orderly assured her.
Great!
"But you'll have plenty of chance to rest, doctor."
"I will?"
"In here. This is the on-call room." He opened the door, and Paige stepped inside. The room resembled a monk's cell in some poverty-stricken monastery. It contained nothing but a cot with a lumpy mattress, a cracked wash basin, and a bedside stand with a telephone on it. "You can sleep here between calls."
"Thanks."
The calls began as Paige was in the coffee shop, just starting to have her dinner. "Dr. Taylor ... ER Three. ... Dr. Taylor ... ER Three."
"We have a patient with a fractured rib... ." "Mr. Henegan is complaining of chest pains. ..." "The patient in Ward Two has a headache. Is it all right to give him an acetaminophen ...?" At midnight, Paige had just managed to fall asleep
when she was awakened by the telephone. "Report to ER One." It was a knife wound, and by the time Paige had taken care of it, it was one-thirty in the morning. At two-fifteen she was awakened again. "Dr. Taylor ... Emergency Room Two. Stat." Paige said, groggily, "Right." What did he say it meant? Shake that ass, tootsie. She forced herself up and moved down the corridor to the emergency room.
A patient had been brought in with a broken leg. He was screaming with pain.
"Get an X-ray," Paige ordered. "And give him Demerol, fifty milligrams." She put her hand on the patient's arm. "You're going to be fine. Try to relax."
Over the PA system, a metallic disembodied voice said, "Dr. Taylor ... Ward Three. Stat."
Paige looked at the moaning patient, reluctant to leave him.
The voice came on again, "Dr. Taylor ... Ward Three. Stat."
"Coming," Paige mumbled. She hurried out the door and down the corridor to Ward Three. A patient had vomited, aspirated, and was choking.
"He can't breathe," the nurse said.
"Suction him," Paige ordered. As she watched the patient begin to catch his breath, she heard her name again on the PA system. "Dr. Taylor ... Ward Four. Ward Four." Paige shook her head and ran down to Ward Four, to a screaming patient with abdominal spasms. Paige gave him a quick examination. "It could be intestinal dysfunction. Get an ultrasound," Paige said.
By the time she returned to the patient with the broken leg, the pain reliever had taken effect. She had him moved to the operating room and set the leg. As she was finishing, she heard her name again. "Dr. Taylor, report to Emergency Room Two. Stat."
"The stomach ulcer in Ward Four is having a pain. ..."
At 3:30 A.M.: "Dr. Taylor, the patient in Room 310 is hemorrhaging. ..."
There was a heart attack in one of the wards, and Paige was nervously listening to the patient's heartbeat when she heard her name called over the PA system: "Dr. Taylor ... ER Two. Stat. ... Dr. Taylor ... ER Two. Stat."
I must not panic, Paige thought. I've got to remain calm and cool. She panicked. Who was more important, the patient she was examining, or the next patient? "You stay here," she said inanely. "I'll be right back."
As Paige hurried toward ER Two, she heard her name called again. "Dr. Taylor ... ER One. Stat. ... Dr. Taylor ... ER One. Stat."
Oh, my Godl Paige thought. She felt as though she were caught up in the middle of some endless terrifying nightmare.
During what was left of the night, Paige was awakened to attend to a case of food poisoning, a broken arm, a hiatal hernia, and a fractured rib. By the time she stumbled back into the on-call room, she was so exhausted that she could hardly move. She crawled onto the little cot and had just started to doze off when the telephone rang again.
She reached out for it with her eyes closed. "H'lo ..."
"Dr. Taylor, we're waiting for you."
"Wha'?" She lay there, trying to remember where she was.
"Your rounds are starting, doctor."
"My rounds?" This is some kind of bad joke, Paige thought. It's inhuman. They can't work anyone like thisl But they were waiting for her.
Ten minutes later, Paige was making the rounds again, half asleep. She stumbled against Dr. Radnor. "Excuse me," she mumbled, "but I haven't had any sleep ..."
He patted her on the shoulder sympathetically. "You'll get used to it."
When Paige finally got off duty, she slept for fourteen straight hours.
The intense pressure and punishing hours proved to be too much for some of the residents, and they simply disappeared from the hospital. That's not going to happen to me, Paige vowed.
The pressure was unrelenting. At the end of one of Paige's shifts, thirty-six grueling hours, she was so exhausted that she had no idea where she was. She stumbled to the elevator and stood there, her mind numb.
Tom Chang came up to her. "Are you all right?"
"Fine," Paige mumbled.
He grinned. "You look like hell."
"Thanks. Why do they do this to us?" Paige asked.
Chang shrugged. "The theory is that it keeps us in touch with our patients. If we go home and leave them, we don't know what's happening to them while we're gone."
Paige nodded. "That makes sense." It made no sense at all. "How can we take care of them if we're asleep on our feet?"
Chang shrugged again. "I don't make the rules. It's the way all hospitals operate." He looked at Paige more closely. "Are you going to be able to make it home?"
Paige looked at him and said haughtily, "Of course."
"Take care." Chang disappeared down the corridor. Paige waited for the elevator to arrive. When it finally came, she was standing there, sound asleep.
Two days later, Paige was having breakfast with Kat.
"Do you want to hear a terrible confession?" Paige asked. "Sometimes when they wake me up at four o'clock in the morning to give somebody an aspirin, and I'm stumbling down the hall, half conscious, and I pass the rooms where all the patients are tucked in and having a good night's sleep, I feel like banging on all the doors and yelling, 'Everybody wake up!' "
Kat held out her hand. "Join the club."
The patients came in all shapes, sizes, ages, and colors. They were frightened, brave, gentle, arrogant, demanding, considerate. They were human beings in pain.
Most of the doctors were dedicated people. As in any profession, there were good doctors and bad doctors. They were young and old, clumsy and adept, pleasant and nasty. A few of them, at one time or another, made sexual advances to Paige. Some were subtle and some were crude.
"Don't you ever feel lonely at night? I know that I do. I was wondering ..."
"These hours are murder, aren't they? Do you know what I find gives me energy? Good sex. Why don't we ...?"
"My wife is out of town for a few days. I have a cabin near Carmel. This weekend we could ..."
And the patients.
"So you're my doctor, eh? You know what would cure me ...?"
"Come closer to the bed, baby. I want to see if those are real. ..."
Paige gritted her teeth and ignored them all. When Alfred and I are married, this will stop. And just the thought of Alfred gave her a glow. He would be returning from Africa soon. Soon.
At breakfast one morning before rounds, Paige and Kat talked about the sexual harassment they were experiencing.
"Most of the doctors behave like perfect gentlemen, but a few of them seem to think we're perks that go with the territory, and that we're there to service them," Kat said. "I don't think a week goes by but what one of the doctors hits on me. 'Why don't you come over to my place for a drink? I've got some great CDs.' Or in the OR, when I'm assisting, the surgeon will brush his arm across my breast. One moron said to me, 'You know, whenever I order chicken, I like the dark meat."
Paige sighed. "They think they're flattering us by treating us as sex objects. I'd rather they treated us as doctors."
"A lot of them don't even want us around. They either want to fuck us or they want to fuck us. You know, it's not fair. Women are judged inferior until we prove ourselves, and men are judged superior until they prove what assholes they are."
"It's the old boys' network," Paige said. "If there were more of us, we could start a new girls' network."
* * *
Paige had heard of Arthur Kane. He was the subject of constant gossip around the hospital. His nickname was Dr. 007 - licensed to kill. His solution to every problem was to operate, and he had a higher rate of operations than any other doctor at the hospital. He also had a higher mortality rate.
He was bald, short, hawk-nosed, with tobacco-stained teeth, and was grossly overweight. Incredibly, he fancied himself a ladies' man. He liked to refer to the new nurses and female residents as "fresh meat."
Paige Taylor was fresh meat. He saw her in the upstairs lounge and sat down at her table, uninvited.
"I've been keeping an eye on you."
Paige looked up, startled. "I beg your pardon?"
"I'm Dr. Kane. My friends call me Arthur." There was a leer in his voice.
Paige wondered how many friends he had.
"How are you getting along here?"
The question caught Paige off-guard. "I...all right, I think."
He leaned forward. "This is a big hospital. It's easy to get lost here. Do you know what I mean?"
Paige said warily, "Not exactly."
"You're too pretty to be just another face in the crowd. If you want to get somewhere here, you need someone to help you. Someone who knows the ropes."
The conversation was getting more unpleasant by the minute.
"And you'd like to help me."
"Right." He bared his tobacco-stained teeth. "Why don't we discuss it at dinner?"
"There's nothing to discuss," Paige said. "I'm not interested."
Arthur Kane watched Paige get up and walk away, and there was a baleful expression on his face.
First-year surgical residents were on a two-month rotation schedule, alternating among obstetrics, orthopedics, urology, and surgery.
Paige learned that it was dangerous to go into a training hospital in the summer for any serious illness, because many of the staff doctors were on vacation and the patients were at the mercy of the inexperienced young residents.
Nearly all surgeons liked to have music in the operating room. One of the doctors was nicknamed Mozart and another Axl Rose because of their tastes in music.
For some reason, operations always seemed to make everyone hungry. They constantly discussed food. A surgeon would be in the middle of removing a gangrenous gall bladder from a patient and say, "I had a great dinner last night at Bardelli's. Best Italian food in all of San Francisco."
"Have you eaten the crab cakes at the Cypress Club ...?"
"If you like good beef, try the House of Prime Rib over on Van Ness."
And meanwhile, a nurse would be mopping up the patient's blood and guts.
When they weren't talking about food, the doctors talked about baseball or football scores.
"Did you see the 49ers play last Sunday? I bet they miss Joe Montana. He always came through for them in the last two minutes of a game."
And out would come a ruptured appendix.
Kafka, Paige thought. Kafka would have loved this.
At three in the morning, when Paige was asleep in the on-call room, she was awakened by the telephone.
A raspy voice said, "Dr. Taylor - Room 419 - a heart attack patient. You'll have to hurry!" The line went dead.
Paige sat on the edge of the bed, fighting sleep, and stumbled to her feet. You have to hurry. She went into the corridor, but there was no time to wait for an elevator. She rushed up the stairs and ran down the fourth-floor corridor to Room 419, her heart pounding. She flung open the door and stood there, staring.
Room 419 was a storage room.
Kat Hunter was making her rounds with Dr. Richard Hutton. He was in his forties, brusque and fast. He spent no more than two or three minutes with each patient, scanning their charts, then snapping out orders to the surgical residents in a machine-gun, staccato fashion.
"Check her hemoglobin and schedule surgery for tomorrow. ..."
"Keep a close eye on his temperature chart. ..."
"Cross-match four units of blood. ..."
"Remove these stitches. ..."
"Get some chest films. ..."
Kat and the other residents were busily making notes on everything, trying hard to keep up with him.
They approached a patient who had been in the hospital a week and had had a battery of tests for a high fever, with no results.
When they were out in the corridor, Kat asked, "What's the matter with him?"
"It's a GOK," a resident said. "A God only knows. We've done X-rays, CAT scans, MRIs, spinal taps, liver biopsy. Everything. We don't know what's wrong with him."
They moved into a ward where a young patient, his head bandaged after an operation, was sleeping. As Dr. Hutton started to unwrap the head dressing, the patient woke up, startled. "What ... what's going on?"
"Sit up," Dr. Hutton said curtly. The young man was trembling.
I'll never treat my patients that way, Kat vowed.
The next patient was a healthy-looking man in his seventies. As soon as Dr. Hutton approached the bed, the patient yelled, "Gonzo! I'm going to sue you, you dirty son of a bitch."
"Now, Mr. Sparolini ..."
"Don't Mr. Sparolini me! You turned me into a fucking eunuch."
That's an oxymoron, Kat thought.
"Mr. Sparolini, you agreed to have the vasectomy; and - "
"It was my wife's idea. Damn bitch! Just wait till I get home."
They left him muttering to himself.
"What's his problem?" one of the residents asked.
"His problem is that he's a horny old goat. His young wife has six kids and she doesn't want any more."
The next patient was a little girl, ten years old. Dr. Hutton looked at her chart. "We're going to give you a shot to make the bad bugs go away."
A nurse filled a syringe and moved toward the little girl.
"No!" she screamed. "You're going to hurt me!"
"This won't hurt, baby," the nurse assured her.
The words were a dark echo in Kat's mind.
This won't hurt, baby. ... It was the voice of her stepfather whispering to her in the scary dark.
"This will feel good. Spread your legs. Come on, you little bitch!" And he had pushed her legs apart and forced his male hardness into her and put his hand over her mouth to keep her from screaming with the pain. She was thirteen years old. After that night, his visits became a terrifying nightly ritual. "You're lucky you got a man like me to teach you how to fuck," he would tell her. "Do you know what a Kat is? A little pussy. And I want some." And he would fall on top of her and grab her, and no amount of crying or pleading would make him stop.
Kat had never known her father. Her mother was a cleaning woman who worked nights at an office building near their tiny apartment in Gary, Indiana. Kat's stepfather was a huge man who had been injured in an accident at a steel mill, and he stayed home most of the time, drinking. At night, when Kat's mother left for work, he would go into Kat's room. "You say anything to your mother or brother, and I'll kill him," he told Kat. / can't let him hurt Mike, Kat thought. Her brother was five years younger than she, and Kat adored him. She mothered him and protected him and fought his battles for him. He was the only bright spot in Kat's life.
One morning, terrified as Kat was by her stepfather's threats, she decided she had to tell her mother what was happening. Her mother would put a stop to it, would protect her.
"Mama, your husband comes to my bed at night when you're away, and forces himself on me."
Her mother stared at her a moment, then slapped Kat hard across the face.
"Don't you dare make up lies like that, you little slut!"
Kat never discussed it again. The only reason she stayed at home was because of Mike. He'd be lost without me, Kat thought. But the day she learned she was pregnant, she ran away to live with an aunt in Minneapolis.
The day Kat ran away from home, her life completely changed.
"You don't have to tell me what happened," her Aunt Sophie had said. "But from now on, you're going to stop running away. You know that song they sing on Sesame Street! 'It's Not Easy Being Green'? Well, honey, it's not easy being black, either. You have two choices. You can keep running and hiding and blaming the world for your problems, or you can stand up for yourself and decide to be somebody important."
"How do I do that?"
"By knowing that you're important. First, you get image in your mind of who you want to be, child, and what you want to be. And then you go to work, becoming that person."
I'm not going to have his baby, Kat decided. I want an abortion.
It was arranged quietly, during a weekend, and it was performed by a midwife who was a friend of Kat's aunt. When it was over, Kat thought fiercely, I'm never going to let a man touch me again. Never!
Minneapolis was a fairyland for Kat. Within a few blocks of almost every home were lakes and streams and rivers. And there were over eight thousand acres of landscaped parks. She went sailing on the city lakes and took boat rides on the Mississippi.
She visited the Great Zoo with Aunt Sophie and spent Sundays at the Valleyfair Amusement Park. She went on the hay rides at Cedar Creek Farm, and watched knights in armor jousting at the Shakopee Renaissance Festival.
Aunt Sophie watched Kat and thought, The girl has never had a childhood.
Kat was learning to enjoy herself, but Aunt Sophie sensed that deep inside her niece was a place that no one could reach, a barrier she had set up to keep her from being hurt again.
She made friends at school. But never with boys. Her girlfriends were all dating, but Kat was a loner, and too proud to tell anyone why. She looked up to her aunt, whom she loved very much.
Kat had taken little interest in school, or in reading books, but Aunt Sophie changed all that. Her home was filled with books, and Sophie's excitement about them was contagious.
"There are wonderful worlds in there," she told the young girl. "Read, and you'll learn where you came from and where you're going. I've got a feeling that you're going to be famous one day, baby. But you have to get an education first. This is America. You can become anybody you want to be. You may be black and poor, but so were some of our congresswomen, and movie stars, and scientists, and sports legends. One day we're going to have a black president. You can be anything you want to be. It's up to you."
It was the beginning.
Kat became the top student in her class. She was an avid reader. In the school library one day, she happened to pick up a copy of Sinclair Lewis's Arrowsmith, and she was fascinated by the story of the dedicated young doctor. She read Agnes Cooper's Promises to Keep, and Woman Surgeon by Dr. Else Roe, and it opened up a whole new world for Kat. She discovered that there were people on this earth who devoted themselves to helping others, to saving lives. When Kat came home from school one day, she said to Aunt Sophie, "I'm going to be a doctor. A famous one."