The Fifth Horseman

Some days are good

‘Ahhhhh!’ a young woman kept screaming from the top of her lungs. She violently tossed and turned on her bed. The commotion had alerted everyone. ‘YOU! YOU! I WILL KILL YOU!’ she yelled, her eyes transfixed to Sheila, the doctor retracted standing back horror-stricken.

‘And what are you doing?’ asked Dr Julie, shaking Sheila’s shoulder. She noted the needle in her hand, uncapped, sharp dripping blood from the tip pointing away from her. ‘Sheila, put the needle down.’

Sheila shook her head and collected herself. ‘Oh sorry Dr,’ she quickly disposed of the syringe needle in the sharps bin right next to her.

The nurses called in for back up, and immediately 2 broadly built Medical Assistants came rushing in, exactly what you needed for a situation like this. They held the patient down, tying her wrists to the side of the bed. She kept kicking, screaming, and even spat on one the nurses’ faces. Sheila winced, pitying the young nurse, her dear friend. Sheila was the one who called her in to accompany her while she took the patient’s blood for thyroid levels. So, naturally Sheila felt somewhat responsible.

‘Tranquilise with a dose of midazolam 5mg stat,’ commanded Dr Julie. One of the nurses nodded and proceeded to prepare the drug. The syringe was handed to the Medical Assistant or MA in short. The patient kept screaming at him, her eyes wide open, her neck moving away from the needle that came closer to her. Just as timing was right, the MA pulled up her sleeve and punctured it through her shoulder. The patient threw an even larger tantrum but enough hands were on her to keep her down while the medicine coursed its way through her muscles and into her bloodstream.

Sheila wrote in her documentation, still playing the events in her head. ‘KILL ME?’ she asked herself. ‘Poor Nabila,’ she thought thinking of the nurse who had only been the sweetest to her since she started working here. As soon as Sheila was done with the ward tasks, she crosschecked her to-do list once more just to be certain. In precisely 5 minutes, the specialist would come back from her lunch and expect all things be as immaculate as the way she left it, with all orders carried out systematically and without delay.

‘OK, get the CT request, the bloods from Bed 2,5,17,28, 37, and 42, call up pathology to trace cultures of Bed 3,4, and 8, and what else…’ she seemed to have a sneaking suspicion that she had forgotten something. ‘AHHH!’ she heard screaming again from the very same cubicle. Dr Julie exited with a group of nurses right behind her. ‘Sheila, come here!’ said Dr Julie. Sheila immediately ran to her Medical Officer’s call.

‘Here,’ she delivered a tube of the patient’s blood sample to her. ‘Run it to the lab,’

Sheila was grateful. ‘Thank y-‘. Before she could finish her sentence, she had Dr Julie’s hand in her gaze. ‘and I need an explanation letter. For how you handled yourself. That was not professional and certainly not safe. What if she had like HIV or Hepatitis or something? Did you read her file? Let’s just say she has made some questionable decisions in the past. You don’t want any accidents.’

Sheila nodded humbled. Dr Julie was a good doctor, in fact one of the best around. She was her unofficial mentor, unlike the bloke they had initially assigned to her in which the most exchange they ever had was ‘Hi’. Dr Julie had good skills, immense knowledge and great ideas but she was a judgemental prick. Still, flaws aside, Sheila admired her work etiquette.

Sheila crossed another task from her check-list. Her stomach growled but lunch break was now over and the Dr Lily, the specialist was back for afternoon rounds. Dr Julie recounted the events that took place while she was gone. Dr Lily didn’t seem at all surprised at what happened, in fact her first retort was quite sound, ‘why didn’t you just call in Psychiatry and ask them to take the bloods? It’s their patient anyways, we are just helping to hold their patients for them. This will only create panic among our other patients.’ Dr Julie heeded the counter-point and nodded at Sheila. That only meant that it was Sheila’s responsibility to call Psychiatry the next time that happened. If there was one thing Sheila learned, it was the pecking order of the hospital. Sheila couldn’t turn around and nod at anyone else and that was what people meant when they told her that she was going to be at the bottom of the food chain.

As rounds continued, Sheila confidently updated her specialist stressing the parts that she personally crossed out on her checklist. Still she felt strange and anxious that she missed something. ‘And when is the CT planned?’ asked Dr Lily sternly. Sheila flipped through her notes. ‘Shit did I forget this?’

‘23rd this month,’ a voice sounded from behind. Sheila turned to see that it was Ram. He smiled. ‘Good,’ Dr Lily replied.

‘Really? 23rd?’ Sheila asked softly at Ram’s ear. ‘No! I saw the appointment book earlier, and it was a clear date. If you go now, you might still get to book it.’

‘You lied?’

Ram turned a smug look toward her. Sheila was impressed and deeply grateful. Ram had helped her many times this month. She knew she couldn’t ask for a better friend and partner in crime.

As soon as afternoon rounds were done, Dr Julie gathered all her interns around her. Like children in preschool, they ran toward her, nodding and smiling, relieved the day was over. Some had plans for the night, a movie, hitting the clubs, dinner with family, or just plainly sitting in front of a TV. Sheila had one final task before the 5 pm clock-out and that was the handover. She gave her colleague notes on the cases and the instructions that came with them.

‘So? How will you be spending your Saturday night?’ asked Remy, the aforementioned colleague, excited to make small talk. ‘I’m gonna head back. Jenny said she cooked pasta. Gonna try it out,’

‘That’s it? Pasta with Jenny? No PLANS?’ Remy winked.

‘Aren’t we a little old for PLANS?’

‘Nonsense. We’re exactly the right age. This is the point of time we still get to keep our youthful bodies and have disposable income. So we should be doing things with them, both our bodies and our income,’ she nudged Sheila’s shoulder, in case the euphemism wasn’t clear.

Remy was right, but Sheila couldn’t see things that way, not anymore. The moment she steps foot into the hospital, everything stops being about her, and becomes about the people in the beds. And the problem is that doesn’t stop when she leaves the hospital either. As she recalled, most nights, she and Jenny just sat and talked about patients, their Medical Officers, their specialists; day in and day out, always the same thing. This endless circle was what her life was now and ‘PLANS’ was just something the past Sheila would be obsessed about, now the more mature, wiser Sheila with the budding grey hairs.

‘OH SHIT!’ she smacked her forehead. ‘Sorry Remy, gotta run.’ She cursed her way down the stairwell and dashed for Radiology. ‘Oh good, still open,’ relieved. She asked the guy at the counter for the appointment register and quickly booked in the 23rd for the Mr Richard’s Abdominal CT. It was imperative that she had the date. He had a slowly growing abdominal aneurysm, and she had promised him earlier that they would see the results together.

She walked out of Radiology with a huge sigh of relief. Ram patted her on the back while he walked pass. ‘Going home?’

‘Yeah, what else?’ she snarkily replied. She couldn’t see Ram’s embarrassed face walking out. He was not the best at small talk.

There was already a long line eagerly waiting to clock-out holding their punch cards in their hands making small talk with fellow staff. Sheila slowly approached and stood with the rest as more followed behind her.

She felt a towering presence behind her. A large figure loomed over her. She turned behind to notice Mr Jamal, the General Surgeon. He immediately noticed her. ‘You are a house officer here?’

‘Yes,’ inclined to respond.

‘So many of you,’ he sighed.

Sheila nodded tightening her lips. ‘When will this line end?’ she mumbled to herself.

‘Tell me girl, how old are you?’

‘Erm, 28.’

‘Really? You look easily 16 I tell you.’

Sheila smiled again. Her stomach kept growling and her pores kept sweating, drenching her already filthy white-coat. The awkwardness of the whole situation was unbearable to her.

‘Hey!’ someone called out, another specialist but not someone she recognized approached them and shook Mr Jamal’s hand. They started to chatter while Sheila tried to increase the distance between them. ‘Come on, come on, come on,’ she mumbled and as soon as the two nurses were done ahead of her, she placed her card in the machine and heard that glorious sound of freedom. She hurried slotted her card back in the holder and dashed for the exit.

‘Don’t be a stranger girl,’ Mr Jamal called out waving his hand at her while she sped. Reluctantly she turned to smile and nod and then continued back to her car in the parking lot.

As her routine, she would remove her white coat and throw it on the floor rug in the back of the car. Though she once judged people for treating in insides of their cars like laundry baskets, she was now one of them but ‘only till the internship was over’ she always told herself. She straightened her back and massaged her sore neck. Her eyes caught a glimpse of a crow and she trailed it until it reached the balcony of a roof. It was four storeys above A&E. The bird’s eyes wondered, scavenging. ‘Must be a good view,’ Sheila mumbled under her breath before she climbed into her car gently smiling

**

‘Really?’ Jenny didn’t know which story astounded her more; the physical harassment by the schizophrenic, or the attempted flirting by the creepy specialist twice Sheila’s age.

‘I know right?’ Sheila covered her mouth, ‘it was just too awkward. What do I tell him?’

‘And 16?’ Jenny thought, ‘that just screams pedophile.’ They laughed about it, reducing it to a dinner joke, something women did to diffuse such situations so they can go on about their daily lives.

‘What about you?’ asked Sheila.

‘Well, Daniel is still trying to ask me out,’

‘Are you kidding me?’

‘I’m not,’ she smiled, ‘he keeps saying I owe him dinner for some help I asked him once,’

‘The central line,’

‘Yes, and he is good at those things, so I asked him to help because I want the patient to feel better you know. Why poke the patient so many times when you can just get an expert to do it?’

‘So?’ When is the dinner?’

‘Shut up!’ Jenny’s face was no poker face. The blushing, the folding of hair at the back of her ears, the awkward and random smiling were all tell-tale signs just too obvious and familiar, juvenile even. But Jenny couldn’t even realize that they had not spoken to each other for about 15 minutes easily. She just smiled to herself twirling her pasta in deep thought.

‘Well I’m happy if you’re happy,’ said Sheila. ‘And the pasta is amazing,’

‘No! it’s bad!’ Jenny retorted, pouting her lips in disappointed.

‘Yeah, it’s bad,’ Sheila confessed, ‘I didn’t want to hurt your feelings,’ she laughed.

‘It’s OK, I’ll give it another go next time,’

‘Does Daniel like pasta by any chance?’

‘Shut up, Sheila,’ Jenny stormed out to the kitchen. Sheila smiled, ‘you’re adorable.’

All things considered, Sheila had interesting day, and when her parents called her that night, she made sure she only told them the good parts.

Sheila took things a day at a time, because that was the best advice everyone gave her. Some days were good and some days were not so good. Even though her bosses were indifferent to her coming and going, her colleagues loved her and her nurses too. Who wouldn’t if you bought them food apologizing for letting a patient spit at you? Who wouldn’t if you did your job well enough and did perfect handovers? Who wouldn’t if you knew their stories and made them feel more than just sick vulnerable bodies to be poked and prodded?

It was a random day after work. As per her routine, she threw her coat in the back of her car. She looked up and there it was, that same bird again. Something told her to go back in, and find the stairwell. Something told her to go up and open that roof door. She didn’t know until she got there. It was the view, and the peace it brought. She reached the end of balcony and stood next the crow on the ledge. Far away the city lights coming alive in the distance, the lake waters shimmering, and beneath her, all the way down, like ants, a charade of endless sirens and casualty victims begging for help; the kind of help that she was proud to be a part of. She smiled as the wind kissed her cheek, and smiled at the crow next to her. ‘Thanks’ she muttered.

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