Wheels In Motion Ch. 01

"I should be saluting you two. I sat at a desk most of the year," he said.

"Major, I'll be saluting you for the rest of my life after your help with GW," I said.

I'd been flown to Walter Reed from the hospital at Ramstein Airbase at the end of May. By the time I realized I was going to be free to start attending college in the fall, I'd missed all the application deadlines. I found out later that shortly after I'd mentioned that fact to my old command sergeant major in an email, he'd told the major, who had then called the admissions office at George Washington University, where he was an alumnus and where I'd wanted to apply. He'd informed them that the school would be worse off if I wasn't enrolled in classes that fall.

When that didn't work, they received a package with twenty letters of recommendation from various sergeants, lieutenants, and even a colonel who had been on the hospital staff at Bagram who'd taken a shine to me. When that didn't work, they'd gotten a call from the Major General in command of the Eighty-Second, who also happened to have gotten a master's degree there, recommending that GW get off the pot and make sure I was enrolled for the fall semester.

The day after that, I'd gotten a call from the admissions office telling me that I needed to get down there as soon as possible so they would have time to get a full schedule of classes set up for me for the fall semester. I didn't know about any of this until later, but the entire effort had been Major Seely's doing from an air base in Afghanistan. The major's good people.

"You don't have to thank me for that Liz," he said, then took a swig of his beer. "Just don't waste it."

"I won't, sir. After all the college work I've been doing while I've been in the Army, I'm only five semesters away from my bachelor's degree. Four, if I can test out of a few more courses."

"You're telling me you started college this fall and you're already a junior? Almost a senior? What's your major?"

"Biology/pre-med, sir."

"Dr. Charles, huh? I like the sound of that. Make sure you keep me up to speed on your career, Liz. You're going to make us all proud."

~~ FOUR YEARS LATER ~~

~~ George Washington Hospital, Washington DC, January ~~

The man in bed three gave a loud yelp of pain and started cursing as I rolled up to his bedside. "Can someone else please come do this?!" he snapped.

"Sir, please calm down. You being tense doesn't make this any easier for me," the young man wearing a white lab coat said. I'd heard the new first year resident had started this week, but this was my first time meeting him.

"Everything okay?" I asked.

"Hell no! This quack has stuck me four times now!" the man in the bed exclaimed.

"Nurse Hayden?" I said to the nurse on the other side of the bed.

She looked back at me and her eyes told me all I needed to know, but she covered by saying "Mr. Stevens is really dehydrated, so his veins are pretty flat. It's a tough stick."

"It's fine! I'll get it this time," Dr. Andrews said. I watched him prep a new site, line up the IV cannula, concentrate, then poke the needle into the back of the man's hand again. I winced as I watched his placement. There was no flash of blood in the collar, indicating he'd missed the vein again. Mr. Stevens started cursing once more, which turned into a hacking cough.

"Okay, Dr. Andrews, take a break." I said and rolled my chair up next to the bed. Nurse Hayden pressed the control to lower the bed to a better height for me, forcing him to step back with an exasperated look.

"Hey! What do you think you're doing? I'm the doctor here!" he exclaimed, obviously annoyed. I rolled my eyes as I pulled out a fresh line kit and started prepping the back of Mr. Stevens' hand again.

"Listen, maybe I don't need an IV. Can we please just not do this anymore right now?" Mr. Stevens asked Nurse Hayden.

"If you want to stop, we can Mr. Stevens, but she's already got your line in," Nurse Hayden said.

"What?" Mr. Stevens said, looking down at his hand.

"What?!" Dr. Andrews said, looking over my shoulder as I taped the line down to Mr. Stevens's wrist.

"I barely felt that!" my patient exclaimed.

"There you go Mr. Stevens, you're all set. Nurse Hayden, let's get a liter in him then recheck his vitals please. We'll be back to check on you in a bit Mr. Stevens." I smiled at him as I patted his knee then turned my chair to roll out into the hall as Dr. Andrews followed me.

"Hey, that was bullshit! Where does a nurse get off pushing me out of the way?!" he said, walking behind my chair. I guess it wasn't entirely his fault. I rarely wore a lab coat since they tended to hang over the side of my chair and get caught in my wheels. I could admit my scrubs and the long sleeved, waffle-patterned Henley that was my usual work attire looked like what most of the nurses in the E.R. wore.

"Is there a problem Dr. Andrews?" Dr. Jaya Chandra, the attending physician asked as she appeared, blocking our path. "I'm taking it you two just met?"

"This nurse elbowed me out of the way and performed an unauthorized needle stick!" Andrews said, with some satisfaction in his voice.

"Let me make introductions, then. Liz, this is Jimmy Andrews, first year, who started this week."

"Dr. Andrews!" he exclaimed, then stopped sheepishly at the look Dr. Chandra gave him.

She continued. "Dr. Andrews, this is Dr. Liz Charles, second year resident, who is going to be in charge of some of your training rotations, including tonight."

"Ah..." His face took on the color of a sickly tomato.

"Yes, 'Ah'. So, Dr. Andrews, I expect you to listen to everything she says and do everything she asks you to do. You won't find a better example to follow in the hospital if you want to succeed here." She walked off down the hall and I made a mental note to buy her one of her beloved chai soy lattes tomorrow.

"I, uh... I..." he stammered. He couldn't meet my eyes.

I turned my chair to face him. "It's okay, Jimmy, all first years have at least one big screw-up at some point. You just got one out of the way early, so now you have nowhere to go but up!"

"Right... I'm, uh, I'm really sorry. If I'd known you were a doctor--" he started but I cut him off.

"That's the wrong lesson, Jimmy. The lesson isn't to figure out who you have to treat with respect and who you don't. The lesson is to treat everyone in this hospital with respect. That goes for doctors, nurses, patients, custodial staff, the baristas at Starbucks, everyone. I have a hard candy shell, so I can let your little faux pas slide off me this time, but if I ever catch you speaking to the nursing staff or a patient the way you spoke to me you'll be emptying bedpans for a week. Are we clear?"

"Yes," he said gulping.

"Yes...?" I said with a raised eyebrow.

"Yes, Dr. Charles."

"Very good, Dr. Andrews. Now, go work up the gentleman in exam one, then recheck Mr. Stevens in about thirty minutes please."

I turned and rolled away from him down the hall. As I passed the nurses' station I saw Nurse Hayden and Nurse Navarro trying to hold in laughter. Nurse Hayden followed me into the doctor's lounge and closed the door before cracking up.

"That was classic, Liz! I wish I had a video of that to show to all first years when they arrive."

"Jesus, I hate entitled pricks. I hope it's not going to take too much work to beat that out of him," I said, pouring myself a cup of hot tea.

"The expression on his face when you started that line without the patient noticing was priceless! You really are the best stick in the hospital."

"When you learn how to do it while bouncing around in the back of a helicopter at night with only a head lamp for lighting, doing it in the E.R. should be pretty easy."

"Still, good job."

"Thanks, Kat. Let me know if he starts giving the nursing staff any shit, okay?"

"This is why you aren't popular with the other residents, you know. You're friends with too many nurses. Well, that and you keep making them look mediocre by comparison."

"I spent three years as a flight medic with doctors looking down their noses at me when I brought in guys I'd kept alive on the flight to the hospital. I'm not going to put up with that shit on my watch. I can't do anything about the attendings, yet, but I'll be damned if I stand by and watch the other residents pick up that bullshit habit."

Kat's phone buzzed, and she pulled it out of her pocket to look at it.

"It's the home office, one sec." She touched the screen and answered it. "Hey... Yeah, I should be home around eight. Right now? I'm hanging out with your favorite doctor. Sure, hang on..."

"You've been requested," she said. She hit the button for FaceTime and handed me the phone.

An adolescent girl, who looked like a younger version of Kat, appeared on the screen. Her hair color was hard to make out, as most of her head was covered in what looked like flour.

"Hey, Dr. Liz!"

"Hi, Caitlyn. What's up?"

"We're making pizza dough! Do you want to come and have pizza with us tonight?"

"I wish I could, sweetie. I'm on hour eleven of a twenty-four-hour shift."

"That's crazy! I can't believe they make you work so long!"

"Tell me about it. Uh, Cait, you've got a little something right there," I said, making a gesture to my own hair.

"Mom-Megs started it!"

I looked up at Kat, who was trying not to laugh.

A second face took Caitlyn's place on the screen "Vicious lies, Liz! It's all Cait's fault!" Mom-Megs was a pretty woman, in her early thirties like Kat, with a silver nose stud and shaggy black hair. Which was also mostly covered in flour.

"Hi, Megan. Looks more like some mutually-assured destruction going on to me."

"Is that some kind of army thing Liz? Make love, not war!" Megan said.

"War's more fun!" Caitlyn's voice said, off-screen, then another big poof of flour hit Megan in the face.

"Ack! Brat! Your pizza is going to have anchovies on it now!"

Kat took her phone back from me and looked at the screen. "If there's flour all over my kitchen again when I get home, my wife and daughter will both be lucky to not get anchovies the next five pizza nights."

I heard Caitlyn giggle, as Megan yelled, "Jeez, it's the cops! To the getaway car, Cait!" Then the call disconnected.

"Cait's growing like a weed. Isn't her birthday soon?" I asked.

"She'll be twelve next month. Her birthday party is the Friday after Valentine's Day, by the way. You'd better ask off for it. She'll never forgive you if you don't come."

"Text me the date, and I'll put it on my calendar. Honestly, I wish I could come over for pizza tonight. I'm starving."

"You need me to grab you something before I head out?"

"No, I want to get some air. I'm going to make a quick check on everyone, including the new baby doctor, then roll down the way to Eddie's and grab a sandwich." Eddie's Sandwich Shoppe was a block from the hospital, and had the best sandwiches I'd ever found.

"I don't know how you can eat those as often as you do and not weigh two hundred pounds," Kat marveled.

"Lucky genetics and thirty miles a week in my racing chair."

Kat snorted a laugh as I rolled away down the hall.

After checking on Dr. Andrews and the two new patients who'd arrived in the last hour, I just barely had time to get there before they closed. I grabbed my North Face jacket out of my locker and shrugged it on as I rolled towards the side entrance nearest to Twenty-Third street.

It had been sleeting when I arrived at work that morning, and conditions had only deteriorated since then. Frozen rain was coming down, and everything in sight was covered in ice. For a moment I thought about going back inside and hitting the cafeteria instead. One of my main problems with weather was I couldn't tell if my feet were getting too cold, since I couldn't feel them. I could easily get frostbite without even knowing it. I was wearing thermal underwear under my scrubs, but the wind was cutting through my winter jacket. My scrubs and sneakers had no chance of keeping my legs warm.

On the other hand, it was only a block away, and I really wanted a turkey and stuffing sandwich. Thinking of Eddie's cranberry sauce, I decided to go for it.

I immediately regretted my decision. As I rolled down the long wheelchair ramp that led from the side entrance down to the sidewalk, I started skidding, and grabbed my wheels to stop myself. My wheels themselves stopped rolling, but my chair kept sliding down the icy ramp. In a last-ditch effort, I locked the brakes then flailed my arms trying to grab one of the railings, but they were just as slick.

I looked ahead with alarm. If I didn't slow down, I was going to slide right across the sidewalk and out into traffic. Worse, I wasn't slowing; I was picking up speed.

"Little help!" I yelled as I approached the end of the ramp. There were a few passers-by on the sidewalk as I got near. Two of them looked up in alarm and jumped out of the way. Thanks a lot, assholes, I thought. I started to consider throwing myself out of my chair to try to stop.

The third person looked up, saw me coming and her eyes widened. She dropped her briefcase, took two steps towards me, and threw her arms around me and my chair. The momentum of her impact changed my course enough that instead of sliding out into the street, we both banged into one of the metal boxes found on every corner in DC that held stacks of the free Post Express and real estate magazines. We hit with a heavy thump just as a WMATA bus roared past on the street.

"Ow!" the woman said.

I hadn't felt too much of an impact, but I knew that didn't mean much. "Holy shit, are you okay?" I exclaimed, staring after the bus. My adrenaline was pumping and my heart was beating a hundred miles an hour. "I think you may have literally just saved my life!"

She straightened with a groan. "I think so. I whacked my elbow pretty good. How about you, are you alright?"

"I don't know yet. My feet were the only thing that hit. I won't know until I can have them checked out." I leaned down and ran my hands over my lower legs, not feeling any obvious injury. "I can't thank you enough, you really saved me."

"No worries, glad I could help." She stretched her arm and flexed her elbow painfully. She looked around, spotted her briefcase, and bent over to retrieve it.

She was tall, taller than I would have been standing, with green eyes and high cheekbones. Her hair was an incredibly pale blonde rolled into dreadlocks, gathered into a ponytail as thick as my forearm, and reaching down past her shoulder blades. Her eyebrows were almost white, hinting at a Norwegian or Swedish background maybe. She was well-dressed, wearing a suit under a knee-length camel hair coat, and was maybe a year or two older than I was. Obviously, a professional woman.

"I feel like I owe you dinner or coffee, or something for your heroics."

She smiled. "Thanks. I think I'd enjoy that, but I gotta run. I'm glad you're okay."

"Thanks again."

She turned and walked away down the street. Checked my watch. I still had enough time to make it to the sandwich shop, but I had a sinking feeling I needed to get back inside and get myself checked out. I looked and saw my savior turning the corner around the front of the hospital, dreadlocks swinging behind her back.

I made a move to start back up the ramp, then thought better of it and turned and followed in dreadlock woman's footsteps. The front entrance was at the ground floor, and I didn't need a ramp to get in there.

"Your diagnosis, Dr. Andrews?" I asked, a half-hour later.

"Um, are you sure you don't want the attending to look at this?"

"Dr. Andrews, this is your job now. No time like the present. Besides, your patient literally can't feel any pain at the injury site, and I guarantee there's going to be a second opinion. You can't mess this up. So, what's your diagnosis?"

He cleared his throat, looking at my X-Ray on the monitor. "Well, you have a non-displaced fracture of the left tibia. That will need a cast. You also broke your second and third toes on your left foot, and they'll need to be set too. They're pretty bad. I'd recommend splints instead of just tape." He looked at me for my reaction.

"Treatment instructions for the patient?"

"Uh, ice on the toes and ibuprofen every eight hours, follow-up with an orthopedist."

"Painkillers and ice for a lower limb injury in a paraplegic?" I asked skeptically.

"Yes, it'll help with the swelling even if you don't need pain management."

"Very good, Dr.!" I turned to the man standing in the doorway, watching. "Nurse Navarro, can you get Dr. Andrews the supplies for a cast and some splints so he can set my toes, please? And ask facilities to get some salt on the handicap ramp on Twenty-Third street if you wouldn't mind."

He nodded and left the room.

"Me?" Dr. Andrews yelped. "What about you getting a second opinion first?"

"My opinion is the second one. Your diagnosis was right on the money. So, let's follow through with the treatment. You and I have a lot more patients to get to tonight."

I rolled up to the nurse's station later that night, grumpy that I still hadn't gotten to eat anything other than one of the granola bars from the stash I kept in the backpack that hung from the back of my wheelchair.

Nurse Angel Navarro looked down at the bright pink fiberglass cast I now wore on my left foot in place of my usual Nike sneaker. The silver splints on my two toes wrapped in tape poking out of the end of the cast completed the look.

"Looks like he did a good job. I'm kind of surprised you let him do it," Angel said.

"Something I learned from my old crew chief. Show him I trust him to do a job he's supposed to be able to do after chewing him out for something else. Show a little trust, gain a lot of trust. He's been following me around for the last two hours trying to do everything he can to keep winning my approval. This was an opportunity, and it might have taken me a month to pound that into him otherwise."

"What if he'd messed up casting your leg or setting your toes?" he asked me.

"I was right there watching him. I mean obviously, it's my foot. What do I care if my toes heal crooked anyways? Not like I'd even notice. But he's got potential, for sure. What's next?" I held out my hand and Angel handed me a chart.

"Thirty-six-year-old female, blunt force injuries to the face in number six."

I made a face. "Domestic violence?" I asked.

He nodded. "Yeah, Doris brought her in. She's with her now."

"Okay, thanks." I rolled down the hall, chart in my lap, to exam room six. I hated these cases. Taking a deep breath to calm my stomach, I rolled into the room. I knew the police woman, which made this a little easier for me.

"Good evening, I'm Dr. Charles, how're we doing tonight?"

The woman sitting on the bed didn't look up. Her face was battered and bloody, one of her eyes blackened and swollen shut.

The police woman spoke up for her. "Hey Doc, this is Mrs. Gonzales. She's had a tough night."

"Thank you, Officer Green. Give us a minute, would you?"

I completed my exam quickly and cleaned up her injuries. The cut over her eye wasn't bad enough for a suture and I closed it with a butterfly bandage, and then called Doris back in. She came in with her notepad out.

"No sign of a concussion, but she's got a supraorbital fracture above her left eye. It might need surgery," I told her, as she made notes for her police report.

"Jaunita, you've got to get away from him," she said. "He's escalating and one of these times you're not going to the hospital, you're gonna be dead."

"Si... I know. I don't know how to, though. What do I do? Where do I go?" She had tears in her eyes.