Chapter 3 - Team

Chapter 3: Team

         Janet walked into the classroom just ahead of Dr. Thompson, a cheerful middle-aged black woman who smiled at Janet, then went to the front of the class.

         "As you know," Dr. Thompson announced, "today is the day we announce your teams, and you decide on your internships.  The teams will be Debbie and Nadine, and Ann and Janet."

         No surprise there, Janet mused. Dr. Debbie Sanchez and her nurse, Nadine El-Tagiri were not only Paired, but in a timed-contract marriage. That left Janet, a nurse, teamed with Dr. Ann Nguyen.  The four of them were part of the Grissom Space Institute's first class of two hundred students, of whom forty would be chosen to crew mankind's first interstellar mission to Alpha Centauri.    Ann, judging from her class comments, was little short of brilliant, but in the three months they had been in class together, Ann had sat in the back and talked little with her classmates, especially Janet.  Some around the Institute referred to her as the Ice Queen for her aloofness in general. 

          Dr. Thompson pulled out her ecomm, the ubiquitous communication device that could be molded into any desired shape and used by all, and pressed her screen.  A chorus of chimes followed.  "I've just sent you the descriptions of those hospitals in the area which have agreed to host you.  Your job today is to decide which one to go to.  Let me know if you have any questions."

          Twenty minutes later, Janet noted that Debbie and Nadine were having a lively  discussion, while so far, Ann and Janet had read in complete silence.

         Ann looked up from her ecomm. "Washington General. That is where we should go."

         "Why?" Janet demanded, put off by Ann's tone and abruptness. 

         "They have an extremely high volume of patients, and their mortality and morbidity rates are the highest in Washington DC.  We would get a lot of experience there."

         Janet had only read about half the descriptions, but she wasn't going to simply acquiesce to Ann's suggestion.  "I think we should work at University Hospital in Baltimore.  It also has a high volume of patients, and the staff there is highly qualified."

         Ann frowned for a moment at her ecomm.  "Their volume of patients is only two-thirds of what Washington General has, and they have more staff. If we go there, we'd probably be considered like interns just out of medical school, and there would be more emphasis on teaching rather than actual experience.  We're both fully trained, and what we need to find out is if we can work as a team.  Washington General is more likely to give us the experience we need to find that out. Besides, they seem as if they can use some extra help."  Ann stared at Janet with her usual lack of expression, but her voice seemed to convey some impatience.

         Well, at least we had a discussion, if somewhat one-sided..  "Okay then," Janet smiled.  "Washington General it is."

                    #                                                  #

         "No!" Ann shouted, as Janet raised the automatic wound closer.

         Janet stared at Ann. It was only their second day in the Washington General emergency room, and that was the umpteenth time Ann had stopped her from doing a routine procedure.  This was worse than the practice sessions at the Institute.

         "What would you like me to do?" Janet demanded, patience nearly gone.

         "Put that thing away!" Ann snapped, pulling a synth-skin container and some tiny clamps from the table.

         "Why?"

         "Just do it."  Ann turned back to the patient.

         Janet turned her back on the patient, something she would ordinarily never do, and carefully put the wound closer back in its charger/disinfector on a side table.  Quick, easy technology to close wounds with synth-skin,, recently developed, with no problems I've ever heard of.    And Dr. No here vetoes it with no explanation.

         Ann's beeper went off.  "We need you in room six!" the disembodied voice of Dr. Malave, the head of the emergency room, echoed. 

         "On my way," Ann replied crisply.  "Join me when you finish up," she ordered Janet.

         Janet turned, played the disinfectant lamp over the patient's wounds, and pulled a blanket over him. 

         "I've got him, hon," came Suzie's voice behind her.  "You take a break."

         Janet turned.  Suzie, black, middle-aged, was the nurse's helper for that particular room.  "Thanks, Suzie," Janet nodded.  "I'll be right back."

         The bathroom was small and impersonal, but, in contrast to their first day, it was at least clean.  Janet stripped off her disposable gloves, stuck both hands under the sanitizer, then washed them, vigorously working the soap, before scrubbing her face. This was far above and beyond the usual requirements, but this was a routine Janet had developed in her last emergency room internship to calm herself.  Besides, Ann was a stickler for cleanliness.

          Janet smiled briefly as she recalled how Ann had ripped into the hospital staff on their first day after having seen the emergency room, even threatening to call in the hospital inspection board.  At least she is demanding of everyone, not just me. And, at least in that case, she was absolutely right. But what was wrong with the wound closer?  And why couldn't Ann just tell her? 

         Then Janet had a thought.  Let's find out if Dr. No is right on this one.

                   #                                        #

         "You want me to do what?"  George, her husband, best friend, and, in Janet's biased opinion, the best fix-it man in the universe, frowned over the vid. 

         Janet showed him the wound closer.  "Can you take this apart and see if there is something wrong with it?  I've got the instruction file and specifications.  By every test I can do here, it checks out as fine, and the other doctors use it, but Ann won't touch it.  And, given that it's a medical device, you probably want to take it apart in isolation."

         George gave a short laugh.  "You want to check up on Dr. No, do you?"

         "That's right."

         George leaned back.  "As it turns out, we're doing isolation and vacuum chamber work this week, and Professor Rodinovsky loves oddball projects.  Pete and I will scan this thing twenty ways from Sunday, then take it apart."  George thought for a moment.  "I'll be in a hovercab in front of the hospital at 6AM tomorrow to pick it up."

         Janet smiled.  "Have I told you recently how much I love you?"

         "Every day, my sweet," George smiled back. "See you at six."

                                       #                    #

         Janet walked into the emergency room at the beginning of her next shift in the middle of a raging argument between Ann and Dr. Malave.

         "I told you, she needed an immediate transfer to a burn unit!" Ann shouted.

         "And that's what I told the duty administrator!" Malave shouted back.  He was a big man, white, balding, somewhat overweight, whose face turned red when he was upset.  It was deep crimson now.  "It's not my fault my recommendation was not accepted!  I suggest," he added sarcastically, "that you go shout at the duty administrator, for whatever good that will do you or her now."

         "She did not need to die!" Ann insisted. "She could have been saved with a prompt transfer to a burn unit! You could have ordered that transfer, but you turned her over to the regular hospital staff!"

         "As I was told to do by my duty administrator!" Malave replied hotly.  "Take it up with him when you finish your shift, if you want, but you've got patients waiting for you right now!"  With that, he turned his back on her and strode from the room.

         For a moment Ann stared at his back, then turned to Janet, face now expressionless.  "Our first patient is waiting in room one," she announced, and led the way.

         "I'm sorry you got into that argument," Janet said to Ann's back as they walked briskly down the corridor.

         Ann whirled around.  "Are you?  I'm not!" she snarled, then calmed down just a bit. "At the point where I'm indifferent when people under my care die, I will stop being a doctor!"

          So much for those who call her the Ice Queen back at the Institute.  Ann clearly does care, at least about her patients. 

         "Do you realize, Ann," Janet caught her in the changing room at the end of an exhausting, twelve-hour shift, "that you treated eleven more patients than any other doctor today?"  Janet, curious because of an impression she received yesterday, had kept careful count.

         Ann waved that away.  "They were down a doctor and two nurses. It's natural that everyone would work harder."

         "You're not listening," Janet replied sharply, and Ann looked up.  "You treated eleven more than any other doctor here.  I'll bet that the other two doctors on duty treated about the same number of patients."

         Ann looked thoughtful for a moment.  "All of your patients were assigned by Dr. Malave," Janet continued. "This can't be accidental.  I wonder if he's trying to overwhelm you." Or drive you out. 

         Ann paused for a moment. "He won't succeed, but, while we're talking statistics, did you remember that this emergency room has the highest mortality and morbidity rates in the area?"

         "No, I didn't" Janet replied, "but, given what we found on the first day, that doesn't surprise me."

         "I doubt it's just the dirt," Ann contended.  "and I don't think it's Dr. Malave either, for all we don't get along."

         "So what is it?"

         Again the thoughtful look.  "I'm not sure, yet, but I intend to find out."

         "Well," Janet added, "while you're looking could you look into why we have no days off?"

         "That's actually my plan," Ann replied. "Our internship is short, and we need to find out quickly if we can work as a team."

         With or without killing ourselves or each other in the process?

                             *                                        *

         "So what's morbidity?" George asked in their daily phone call that night.

         "What percentage of your patients get sick after you treat them," Janet explained.  "Ann claims that, because she's a stickler for keeping things clean, that her morbidity rate will turn out less than that of the other doctors"

         "Could be a short-term statistical fluke," George retorted.  "Your doctor seems awfully sure of herself. Anyway,"  George held up the wound closer to the screen. " there is definitely something odd about this thing,  Ordinary scans check out fine, but  Pete and Dr. Rodinovsky figure that the cover blocks scans to some extent, maybe due to excessive lead content. They tried a more powerful scan, and it picked up some odd things, but was not conclusive.  I assume you want us to break into it?"

         "Be my guest," Janet, exhausted, held her head in her hands.  "Ann is still convinced something is wrong with them."

         "She might be right," George noted.  "If the cover partially blocks scans, they might appear clean but actually be contaminated, or so the prof says."

         Janet stood, and took a long pull at her coffee. "When do you think you can break into it?"

         "Might be some time before we can get in the lab again," George grimaced. "I'll do the best I can."

                             *                    *                              *

         

         George's call came in on the Wednesday of their final week, with only three more days to go before they were slated to leave.  "Sorry it took so long," he apologized, "but we couldn't get the isolation lab until yesterday.  Good thing we did; we found a real cesspool inside.  I'm sending you the file, but we ran it by Dr. Thompson, and she said there were some buggies in there that she's never seen."

         Janet gave the file a quick glance. "I'll tell Ann, but I've got to go now.  Thank you, and thank Pete and Dr. R for me."

         As Janet came out of the changing room, she met Suzie. "We've got a meeting," Suzie informed her, pointing to a doorway, which led into a conference room.

          "Overnight, in two other hospitals in our area," Dr. Mal explained, "patients in the ER have suddenly shown choking symptoms," He flashed a picture of a man with a purple head, clearly in distress.  "These patients sometimes die within minutes.  We're not at all sure what is causing this, but make sure you follow your sterilization routines to the letter.  I'd note," he muttered, "that Dr. Nguyen, has the lowest infection rate among her patients, and she follows cleaning and sterilization routines most carefully." He nodded to Ann, then turned to the rest.  "If any of you see these symptoms, please notify me immediately."

         Janet tried to catch Ann after the meeting, but Ann hustled them to their first patient, a victim of a vibro-knife fight, badly cut up.

          "Dr. Malave! I've got a choker!" announced one of the other doctors on the internal comm system a quarter hour later

         "Janet," Ann handed her the synth-skin applicator "do you think you might be able to close that wound in his leg and clean out the arm gash?"

           "No problem,"  It appears that Ann now trusts me enough to work as a real nurse.  As Janet worked, she could hear people frantically scrambling around, then the sound of one of the doctors cursing.  "I don't know!"  she heard.  "I just finished closing up his wounds, and he started exhibiting these symptoms."

         Did he use one of the automatic wound closers? A chill went down Janet's spine.

         As Suzie came in to wheel their patient out, Janet raced out to find Ann.

         Janet found Ann staring at a corpse, face nearly black.  "This happened in less than five minutes!" the attending doctor shouted, a note of panic in his voice. "I've never seen..."

         "Ann!" Janet interrupted.  "I need to talk to you right now!"  Without waiting for a response, Janet grabbed Ann's arm and pulled her to one side.  "I sent one of the automatic wound closers to be tested.  This is what they found inside," and Janet nearly shoved her ecomm, displaying George's report, in Ann's face.

         Ann scanned the results, and put her finger on a point in the screen.  "Probably that one," she said to herself. Turning to Dr. Malave, Ann shouted.  "At least some of your automatic wound closers are contaminated.  We need to stop using them at once.  Here the result of the one we had tested," and she showed the display.  "And, I'll bet that the other two hospitals got their closers from the same company."

         Dr. Mal stared at Ann for a moment, glanced at the corpse, took a brief look at the display, then thumbed his comm unit.  "Listen, everyone.  Stop using the wound closers, right now! We have a possible contamination issue!"  He turned to Ann.  "Are you ready to show how to close wounds the slower way?  We'll get a supply of synth-skin in immediately."

         "If you tell the other hospitals now," Ann noted, "you're sure to get credit for finding the cause of the choking plague."
         "What do I care about credit?" Dr. Mal demanded.

         "The publicity might be good for extra funding," Ann casually added.  "That might help solve some of the other problems you have."

         Dr. Mal stared at her for a moment. He then turned and ran for his office.

                             *                                        *

         Ann poked her head into the changing room at the end of the shift.  "We're wanted in Dr. Malave's office.  Now."

         Dr. Maleve closed the door behind them.

         ""We've traced the choking instances in all three hospitals to wound closers that came from one company," Dr. Mal announced. "Given our budget, they were probably the low bidder. The company used an unusual compound in their outer shell that blocked the disinfectant rays, just as you said.  The same compound blocked our ordinary scans of the interiors, but heavy-duty scans revealed the contamination which caused the choking, a mutant amoeba we hadn't seen before."

         Dr. Mal paused, then drew himself up stiffly. "On behalf of Washington General Hospital I would like to thank you for your work here, especially in detecting the cause of the choking plague.  I have written very positive recommendations for both of you, and those recommendations will also include personal thanks from the Head Administrator of our hospital.  I should also note," he added, "that the publicity generated will almost certainly generate the additional funding, needed to remedy the shortcomings noted by you, Dr. Nguyen.  As such, I would expect," and he paused dramatically, "that there will be no need to mention these shortcomings outside this hospital."

         "Of course," Ann agreed.

         Dr. Mal's head swiveled to Janet. "And you, Ms. Yablonsky?"

         Janet glanced at Ann, who gave a fractional nod. "No need at all," Janet assured him.

         Dr. Mal flashed a brief smile. "I also note that neither of you have taken a day off since you arrived," he continued, less stiffly, "I strongly suggest that you take the remaining days of your internship off, and your supervising doctor, Dr. Thompson, has agreed.  There should be no need for you to return to this emergency room."

         "None whatsoever," Ann nodded.  "Thank you, Dr. Malave, for hosting us in our internship."

         "You're welcome," Dr. Mal opened the door, a clear sign of dismissal.

         It was in the elevator that Ann finally spoke. "Could you join me for a moment?"

         Janet nodded, and followed Ann out to a hospital hallway with a few padded chairs.  They sat down, and Ann turned to Janet.

         "Who authorized you to send the wound closer for testing?"

         Janet lifted her head.  "No one.  I decided to do that on my own.  George and Pete were kind enough to help me."

         Ann pursed her lips.  "You might have told me."

         Janet smiled.  "You might have told me why you didn't want to use them." Or bothered to talk to me at any time in the last three weeks. "As it was, I tried to tell you when I found out, just before this shift began, but you were too busy."

         Ann stared at her, and Janet just sat back in her seat, staring back.  Two can play the silence game.

         After a few minutes, however, Janet added, "If we are going to be an effective team, we need to communicate.  I'm told, "and Janet smiled again, "that talking is a most efficient means of communication.  And, if we want to get on this mission, we have to do a better job of communicating than we did here."  There, lets see what she does with that.

         Ann's stare seemed to turn inward for a few moments, then she nodded briskly.  "You have a good point, Janet, and you've convinced me that you know your business.  I will do a better job of communicating in the future.  But for now," Ann stood, "I need to go."  She took a few steps down the hall, then turned.  "Thank you, Janet.  You did a good job here."  Then she turned again, striding down the hall.

         Three weeks working with her, and that's the first compliment I've gotten.

                   *                                                  *

          Janet came to the classroom early the following Monday, after a weekend in which George finally got her to calm down. But today, she had a mission.  It was the work of just a few moments to push all but four chairs to the back of the room in a jumble.  Janet arranged the four remaining chairs in a semi-circle. 

         Debbie and Nadine came in shortly, taking the two chairs together on one side of the semi-circle.  "How was your internship?" Janet asked.

         Debbie sighed. "Apparently they were under the impression we were just out of med school. It took them two weeks for us to convince them that we knew what we were doing, and even after that, we had a lighter load than their normal crew.  How about you?"

         Ann was right on that one.  "We were busy from the moment we walked in.  Did you hear about the choking plague we ran across on our last day?"

         Both Debbie and Nadine nodded. "That was a good catch," Nadine added in admiration.

         There was a motion by the door.  Ann came in and took a step towards her normal seat in the back, then stopped.

         Janet, a native of Charleston, South Carolina, put on what George called her 'Southern Belle' smile. "Ann, won't you sit here?  It will make it so much easier for us to communicate, don't you think?"

         Ann glanced at Janet, then at the chair, then back at Janet.  Something that might have been a smile flashed across her face before she sat down. "Thank you," she smiled back.  "I believe you might be right."