"Look on the bright side," Julia said at one point with a fake smile, "you'll probably never have to help out in surgery again."
We both knew that Julia would've killed for the opportunity to help in surgery, knowing how ambitious she was, but I chose not to point out that fact. Instead, I took comfort from the knowledge that she was obviously threatened by me.
"We both know I had nothing to do with what happened," I replied with a smile, channeling confidence I didn't actually feel. "Dr. Taylor actually commended me on my performance."
With that, I turned and walked away, pretending like Julia and Kyle's attitudes didn't bother me. I watched them later, chatting casually with each other, and couldn't help the pang of loneliness I felt.
This has nothing to do with me personally, I kept repeating to myself. It's not that I wanted to be included in their snarky little group, but having a friend would be nice. I couldn't help but wish that Lori had been a member of my intern group - how different things could have turned out if she had been. I made a mental note to ask her out for coffee soon.
Things were getting back to normal by the end of the week - as normal as they could be in any Emergency Room, that is. The gossip had died down and, though I still wasn't getting along great with the other interns, they were no longer being outright snarky to me.
I'd also begun to accept the death I'd witnessed in the operating room as a learning experience - just part of the job. Theoretically, I had always known that patients sometimes died during surgeries, but now that knowledge was a little more first-hand. I decided to stop thinking about it and move on.
That all changed, however, when I was called into the Department Chair's office on Friday afternoon.
"Michelle, welcome," Dr. Viola Grimes said as she ushered me into her office and motioned for me to sit.
Dr. Grimes was in her mid-forties, with short greying hair and wire-rimmed glasses. She had always been nice to me, yet I couldn't help but find her intimidating. As the only African American female physician on staff of the Emergency Room, she kind of took me under her wing from the start. She'd been at Miami General for decades and was one of the most respected doctors in the hospital-and in the field. Being able to work under her guidance was one of the other reason I chose this hospital for my internship. Hesitantly, I took a seat across from her.
"So, Michelle, why don't you tell me about your experience helping out in surgery the other day," Dr. Grimes said once I was comfortable.
I opened my mouth, but nothing came out. I wasn't sure what to say. Surely, I wasn't in trouble, right?
"I … I was there just to help. There isn't much I can tell you, the other doctors would probably have more details. I was just holding the retractors. Then, when the patient began to crash, I switched positions with another attending, who helped attempt to get the situation under control."
"That's what it says in the file here," Dr. Grimes pushed the folder across her desk towards me.
I wasn't sure what to do, so I remained quiet.
"The reason I've asked you here," Dr. Grimes continued, "is because this case has been chosen for presentation at the next month's Morbidity and Mortality conference. Are you familiar with what that is?"
"Yes," I replied, relieved to finally discuss something I was comfortable with. "An M&M conference is a regular review of complications and errors made during the patient's hospital stay. Cases are reviewed, system errors are identified, and ways of improving patient care are discussed."
"Well," Dr. Grimes said with a smile, "you sure have the textbook definition down. But that's basically it." She paused. "And you have been chosen to present this case at the next month's conference."
"What?" I sat forward, confused. "Surely, there are people with far more experience than I have that could present the case."
"Yes," Dr. Grimes replied with a knowing smile. "Unfortunately, none of them want the added chore. This is the kind of thing that often gets pushed off to the lowest person on the totem pole. And for this particular case, that person is you."
Dr. Grimes motioned for me to take the file sitting in front of me on her desk. Tentatively, I picked it up.
"Don't look so mortified," she said with a chuckle. "It really isn't that bad. No one is going to blame you for anything that happened. You are just there to present the facts and answer the questions. M&M presentation experience is great for any intern. It's a good skill to have."
I perked up a little at that. I always leapt at the chance to learn new things. Which, I reminded myself, is what got me into this in the first place.
"Okay," I said, nodding, finally able to offer her a real smile. "I can do this!"
"Sure you can. All you need to do is familiarize yourself with the details of the case and be prepared to answer questions. There may be a little more scrutiny than normal for this case in particular, as the man who died, Charles McDaniel, was our senator's brother-in-law. We want to make sure all of our bases are covered in the event of any litigation."
My eyebrows went up at the word litigation, but I didn't want to ask. Instead I just nodded some more. Dr. Grimes rose and slowly walked towards the door, signifying the end of our meeting.
"If you need help or have questions," Dr. Grimes said as I exited her office, "there are a few residents who have presented cases in the past and can give you pointers. I'm sure you can find someone willing to help."
Nodding, I made my way back to the Emergency Room.
"What was that about?" Julia asked, obviously alerted to my meeting with Dr. Grimes. I couldn't help but wonder how her and Kyle were always so well informed. "Did you get in trouble?"
"No," I replied with a smile, trying not to let her see how nervous I was. "I was asked to present the case of that operating room fatality at the next month's M&M conference."
I could see the jealousy in Julia's eyes, so I turned and left before she could start badgering me about it. Instead, I headed up to surgery to see if I could find Lori again.
As luck would have it, Lori was in the surgeons' lounge, reviewing a file with a few other people.
"Michelle, right?" she asked with a smile when she noticed me. I nodded."How are you doing?"
"Much better," I replied with a smile of my own. "I was wondering … and it's okay if you don't have time to help, but … have you ever had to present a case at an M&M conference?"
"Oh yeah," Lori replied with a laugh. "We all have." Lori motioned to the other two people sitting with her. They nodded in agreement. "Those are usually pushed off on an intern or resident. None of the doctors ever want to do them."
"Glad I'm not alone," I said. "I really don't know where to start. Is there any way I could pick your brain at some point?"
"Sure," Lori replied, looking at her watch. "My shift is about to end and I'll have a few minutes before I have to get home to relieve my babysitter. Have a seat."
Feeling much more encouraged than I had been only moments earlier, I sat down next to Lori and her friends and began reviewing the case.
Chapter 3
"Don't stress yourself out," Lori cautioned as she stood behind me, peering into the full-length mirror in which I was scrutinizing my appearance. "You'll only psych yourself out."
"Easy for you to say," I replied, "You're not the one who has to present this case in front of the who's-who of this hospital."
I straightened my dark pink shirt and buttoned my blazer. I'd opted for a black skirt suit instead of dress pants and, with my curly hair pulled up in a tight bun, I hoped my overall ensemble implied competence and respectability.
"I've done it before," Lori reminded me.
I nodded, taking a deep breath. I knew I shouldn't take my anxiety out on Lori. She'd been nothing but helpful to me during the entire process and had even procured a babysitter to be here, supporting me on her day off. I knew that as a working mother, Lori relished what little time she had with her daughter - and yet she had sacrificed that time for me today.
"You're right," I said, turning from the mirror to face her. "Thank you. For everything."
"Not a problem," she reassured me. "Now go kick some ass!"
We found seats in the back of the conference room and I flipped through the file one more time as I waited for my turn to present. I didn't really need to review my notes; I was very well versed in the fine details of the case by now. I had interviewed every doctor, nurse, and technician that had been in the room during the procedure. I knew everything that had happened as well as how each person had responded and why. I had this. I was going to be fine.
"Dr. Carter," someone finally called. Lori, who was sitting next to me, nudged my arm.
"Michelle," she whispered. "That's you."
I blanched. I don't know why, but I somehow managed to space out. Filling a little silly, I nodded and stood, straightening my outfit as I headed to the podium. The room was filled with doctors, administration, and the board of trustees. All I had to do was present the details of the case; they would discuss whether there had been any errors, as well as ways in which the system could be improved in the future. And then it'll be all over.