"Sage, I don't know why you look tired, you've only been on call for twenty-six hours," Mo said while her fingers tapped against her hips. Sage could only tell it was a joke by the small upturn of Mo's mouth.
She loved Mo teaching her the stuff she hadn't learned about during medical school. Each shift she worked with the woman, she grew to love her even more.
"I've had more coffee than sleep lately, so please don't remind me."
"Well, you should have been a nurse then, because after twelve hours at this place I go home and sleep without another thought in my head except for which episode of True Blood I need to watch next." Mo was in midsentence when Sage saw her favorite nurse's eyes narrow.
Before Sage could even blink, Mo was already en route to discuss why a second-year medical resident was attempting to put an IV in a patient in the wrong direction.
As Mo reamed the med student, Sage couldn't help but feel sorry for him. Then the thought dissipated as she downed her tenth cup of coffee for the night. They all had to learn, and part of that process was getting schooled by the nursing staff who knew what to do better than many of the doctors.
Since the heat was temporarily off her, Sage took a moment to sit down, resting her throbbing feet momentarily. The doctors' lounge was probably the cleanest room in the hospital since it was the least used. Closing her eyes for a blissful moment, the world felt right.
Not even five minutes passed when she heard chatter coming over the ER radio. Sitting up, she leaned in to listen and could hear bits and pieces of ". . . bus versus train, mass-casualty incident, en route code three."
Instantly she found herself on alert. Every cup of coffee she drank that night came back in full force and the sand in her eyes disappeared. Although her time in the emergency department had proven to be educational, nothing could prepare her for the unknown tragedies that had been unfolding before her since she'd begun her residency.
"This doesn't sound good." Turning, Sage spotted another resident throwing on a trauma gown as he rushed from one of the on-call rooms.
"No, it doesn't." Fear slithered through her, though she hoped it wasn't showing.
She scanned the ER, making a mental note of available rooms and resources as she locked eyes with Mo and they exchanged a look that spoke volumes. The previously quiet emergency room became a bustling hive of activity as everyone took their places like actors in a play.
As sirens sounded, and the first of the injured from the bus versus train came rolling through the emergency room doors, Sage began to doubt herself for the first time in a while. Nerves unsettled her stomach and she found herself clenching her hands into fists as she stuffed them into her pockets.
"Get him to bay three!"
"He's gone. I'll tell the family when they arrive."
"Put pressure on that wound now!"
Noise. Commands. Movement. It was synchronized chaos. Sage felt like she was watching from the outside and she began to panic, feeling as if she couldn't breathe.
And then she felt the warmth of strong hands on her back. "You've got this, Sage. Take a breath and close your eyes for two seconds and then dive in there," Spence whispered in her ear.
"I . . . I'm . . . I don't know what to do." The weakness in her voice frustrated her. Spence turned her toward him and looked into her eyes.
"Look, I've been watching you since the first day you walked into this place, and I have no doubt that you will make a fine doctor. Don't think for one minute that not every single person in the medical field has felt at one point or another that they can't do it. It's tough work and we hold people's lives in our hands. But you will make it. You are strong and smart, and you know what you're doing. Have faith in yourself and your abilities."
"How can you be so sure?"
"Because I'm the best and I only work with the best." His confident smile empowered her. The knots in her stomach loosened and her shoulders straightened with determination. The ER doors burst open again with a whole new set of patients, and suddenly Sage knew what to do.
Within a half hour, every trauma room was filled with critically injured patients, as was the ER hallway. The noise of paramedics shouting out quick reports, doctors issuing orders, and family members sobbing was almost deafening.
Staff was using supplies faster than they could be restocked and the entire environment was looking more like a war zone than a hospital. Sage had little time as she moved from patient to patient, doing whatever she could.
"Sage, we need help over here!" Mo shouted as a young man was wheeled into a room that had barely been cleared out.
"He's spiraling quick," Sage said as she looked at the stats, her hands never stopping.
"Blood pressure seventy-two over forty-five and dropping, heart rate one fifty-two." Mo's voice was calm and sure.
"We need to get another IV in him right away. Open up that fluid and let's get two units of O-negative blood in here now. He's going into shock."
"I can't find a pulse," Mo said, looking at Sage as if she already knew the conclusion. Sage wasn't ready to give up on the man. He was too young.
"Start chest compressions, get the epinephrine ready." Sage directed the staff but was very aware that his bleeding was uncontrollable. After another fifteen minutes of resuscitation, Sage had to say out loud what everyone already knew. "Time of death, 10:40 p.m."
The fact that none of them had the time to mourn the loss of a young man's life was almost as disturbing as actually losing him. Before Sage and Mo could put on a new set of gloves, another patient was being wheeled in by paramedics who looked pale and exhausted.
"Twenty-three-year-old female, approximately eight months pregnant and in active labor. She's fully dilated. Vital signs stable, but she does have two superficial glass wounds to her right arm. Bleeding is controlled, but the baby is crowning and ready to come into this world."
The young woman was alternating between sobbing and screaming out in pain.
"Are you ready for this, Mo?" Sage said as she moved her onto the ER gurney.
Mo was prepared in less than a minute, with towels and tools needed to deliver a baby.
"I know you're scared right now"-Sage glanced at the chart-"Stacy, but your baby is ready to come out and meet you."
"It's too soon," Stacy wailed.
"You're eight months along. Your baby can make a healthy entrance, but you have to work with me, okay?" Sage looked the woman in the eye, knowing she had to calm her down or she would never be able to push, which would mean an emergency C-section.
"I can't do it. I hurt so much."
"Listen, Stacy, you either push this baby out, or you're going into surgery," Sage said forcefully, which startled the woman enough to quiet her as she stared at Sage in shock. "What are you having?" Sage asked.
"A girl." Stacy's lip trembled.
"Then let's bring your daughter into this world." Stacy nodded as she leaned back.
"We need a push now," Mo said, giving Sage a look that said it was getting more critical by the second. Sage barely had time to glance at the monitors before she felt another tightening of her own stomach.
"Push, Stacy!" Sage yelled, and much to her relief, the woman bore down and gave it all she could. After a few tense moments and some strong pushes, Sage found herself delivering the too-still infant.
Before panic could set in, Mo was there, cleaning the baby's mouth out, and then a loud cry rent the air and could be heard above all of the chaos in the ER.
"Stacy, she's beautiful," Sage said in awe, amazed that in the midst of all this tragedy, a miracle had been placed in her arms. Sage looked at the messy, beautiful baby girl and gently laid her on her mother's chest.
"Thank you," Stacy quietly whispered as she took hold of her daughter while Mo and Sage then went to work on her other wounds.
Patient after patient came and went, and somehow the staff kept on going until finally the ER slowly calmed. When there were no new patients, Sage looked at the clock and realized she had just put in a thirty-six-hour day with a few short naps in between.
"It was a pleasure working next to you tonight, Sage."
Turning, Sage felt tears in her eyes. "Mo, there's no one I would rather work with," she said, knowing she was more emotional from pure exhaustion.
"I don't know about that. There's a certain doctor here I think you don't mind working with too much," Mo said with a taunting smile.