Life Sentences (4 page)

Emergencies there were more likely than car accidents. Pilar would also see her share of domestic violence victims, and gun and knife wounds, mostly the result of neighborhood street battles, and drug turf wars. Though ER at Receiving would be only one of Pilar’s rotations at the hospital during her first year, she had already chosen trauma medicine as her specialty. She hadn’t shared that with anyone, even Julie, because she didn’t want to spendhours defending her choice. ER at Receiving wouldn’t be anything like Father’s serene Mission-style office, nor would it be patronized by elite members of his club. She hoped she was a match for the challenges of this volatile environment. And anything would be better that a position in her father’s sterile milieu.

The stark gray stone and glass towers of the Renaissance Center, the Ren Cen, emerged from the shores of the Detroit River. She had only a few miles before she’d be in the parking lot at the hospital complex. She hoped the Center’s name was an omen for her own future. After all, the Ren Cen had its share of ups and downs and was on an upswing. She also heard about attempts to revive other city neighborhoods close to the hospital, so maybe Receiving’s ER wouldn’t be as bad as Pilar envisioned. Still, the queasiness she felt made her regret that second cup of coffee.

Pilar squeezed her shoulders to her ears and sighed. That exercise didn’t ease the tension. So, she massaged her neck. The pressure remained.

As she turned right onto Beaubien and away from the tidy line of condominiums edging the river, Pilar agreed with her father about one thing: she was a liberal do-gooder. “And I’m glad,” she said, and slapped the steering wheel. She smiled into the rearview mirror like the Cheshire cat in “Alice in Wonderland”, then had to slam on the brakes to avoid a collision with a sheriff’s car, red and blue lights circling and sirens blaring, that shot onto the street fromthe bowels of the Wayne County Jail. Once Pilar regained her composure, she resumed her journey with a more cautious concentration.

Soon the hospital complex came into view. As she circled the parking lot to find the employee area, humid air rose up from the asphalt like steam from a boiling pot. Pilar parked, exhaled loudly and got out of the car.

“Check out the new nurse,” one male doctor said to another when they passed by Pilar outside the employee entrance. She looked forward to their reactions when they discovered she was a peer. Perhaps not exactly a peer. Not until Pilar at least completed her first year of residency.

With fluttering stomach, Pilar practiced her new title to herself, Doctor Brookstone. She chuckled over the two doctors who undoubtedly only saw a good-looking one-night-stand. When the two Don Juans turned to check Pilar out one more time, an unappealing memory from med school surfaced: The dean telling her he doubted any woman could handle the burden of medical career and family. “So, it really is a waste of time, isn’t it?” he asked.

Often, the dreadful truth about careers and relationships were delivered to Pilar and similar women like a scalpel which cut into the brain. The comment made by the dean gave Pilar a sound shove into the feminist fight, where she was determined to come out a winner.

Pilar waited until the two doctors were out of sight before she approached the entrance. She stopped for a moment togloat over the sign that read, “Hospital Employees Only.” Then she drew in a long sustaining breath, pulled the door open, and crossed the threshold.

O
N
M
ONDAYS
, ER
WAS
considered quiet, especially after the carnage brought in on Friday and Saturday nights. So after Pilar’s initial orientation, meeting the patients assigned to her and making rounds was easy. As she left her supervising doctor after a scheduled lecture and headed to the lounge for lunch, Pilar met one of the doctors from the parking lot. His eyebrows shot up into surprised peaks. “Look who’s here”, his witching smile seemed to say. When he noticed Pilar’s lab coat and checked her name tag, a dropped jaw replaced his momentary seduction. Any pleasure Pilar had from that encounter with the thunderstruck doctor became history when he quickly gathered his poise, leaned his body toward her, and said, “You’re too pretty to be a doctor.”

Pilar glanced at his name tag — Jeremy Peters. “You sound like my father, Doctor Peters,” she told the brash young man. “And I don’t like him either.”

He backed away and grunted, “No need to get testy.”

“No need to be disrespectful,” Pilar retorted and held out her hand. “I’m Doctor Pilar Brookstone and you’re going to have to get used to me around here for a few years.”

Doctor Peters’ unenthusiastic hand shake reminded Pilar of those she detested, like a limp offering of dead fish. “You know what I discovered in med school?” Pilarasked as she dropped his hand and wiped hers against her lab coat.

He shrugged and looked uninterested.

“You don’t need a high testosterone level to be a doctor.”

“Yeah, well tell me that after a Saturday night of removing bullets and sewing up ten-inch gashes when you’ve been up twenty-four hours.” The two doctors walked through the doors to the physicians’ lounge and straight to a large, stainless steel coffee pot.

“I will, Doctor Peters,” Pilar stated, and handed him a steaming cup. “Coffee?” Pilar winked and noted she’d caught him off guard while she scoped his body as he had hers in the parking lot. Though he seemed ill at ease under Pilar’s scrutiny, he showed no other signs of timidness. Pilar noted that his rugged good looks were more like Indiana Jones than a doctor, who in her mind should fit the likeness of the white-haired, bespeckled pediatrician of her childhood. Now, Pilar sounded like the male colleagues she accused of stereotyping. Still, no one would question that Doctor Peters’ self-assured good looks would interfere with his ability to suture the wounded.

As he took the cup from Pilar, Doctor Peters reminded her, “Remember you’re only a resident. You have a lot to learn.”

Pilar grabbed her sandwich and coffee. Eating alone at the outdoor picnic table seemed more congenial than any further confrontation. Had her heated face revealedher true reaction to his admonishment? Pilar regained her composure and headed out the door, waving, “See you Saturday then?”

As Jeremy Peters stood motionless, mouth hinged open like a ventriloquist’s dummy, Pilar whispered to herself, “Round one is mine.” But was that a good way to start her first year?

The rest of the week didn’t go smoothly, but not because of the job. In fact, Pilar seemed to have impressed her supervising doctor by her no-nonsense manner and desire to help anyone in need of care. Everyone else, however, especially Doctor Peters, seemed put-off, Pilar guessed, by her looks. Any skills Pilar displayed intimidated, rather than engaged her co-workers. The two qualities, beauty and talent, seemed like oil and water. They just didn’t seem to mix. Disappointed, Pilar found that the work world was no different from her college experiences. Though there were women doctors on staff at Receiving, most female employees were nurses who clearly had learned their place in hospital hierarchy. Pilar believed she was treated more like the nurses. For instance, one time an orderly quickly retrieved the pen she dropped and returned it, commenting, “You’re too pretty to do the heavy work.” Had she noted sarcasm, or just disrespect in his tone?

Another time a male nurse asked Pilar out for “a friendly cup of coffee.” She declined, of course, only to be assaulted by unkind words. “Do you think you’re too goodfor me, Doc?” She told him no, that she was his supervisor and dating was against the hospital rules even though she had been well aware that male doctors broke that regulation regularly.

When Pilar and other doctors crowded around the coffee pot one morning she wanted to ask, “You can’t seem to make up your minds. Am I too bright or too pretty?” Instead, she held back her question and took her coffee to a corner table where she sat alone. The group seated at the table next to her laughed and chatted comfortably. Would she ever loosen up enough to join them? What held her back?

If Julie had been in the Detroit area, Pilar would have made arrangements to meet her for a drink after their shifts that day, just as they had done at the University of Wisconsin. While they sipped wine, they’d lean their heads together and recount the daily events, punctuated by poking fun at their colleagues whom they either felt superior to or feared. Often, they’d share an especially humorous moment in uproarious laughter and attract unwanted attention from the other patrons in the dimly lit cocktail lounge. Julie and Pilar also would listen to each other for as long as it took to air an annoyance or concern. Then they’d get down to more serious medical issues, family problems and relationships. The two friends would part from the session refreshed and ready to do battle again. “I miss Julie.” Pilar sighed.

S
ATURDAY NIGHT CAME WITH
the vengeance Peters promised. Pilar sat in the lounge after she had worked almost nineteen hours straight. She could hardly remember the first victim — a thirteen-year-old shot in the arm in a gang turf quarrel. Thinking back to him, Pilar fell asleep in a chair. She woke up after an hour’s nap, threw water on her face, and did a final check of the ER. When satisfied everything was in order, she drove home in a stupor and fell fully clothed into bed.

On the following afternoon, Pilar dragged her exhausted body back to the hospital expecting a worse evening than the one before. Halfway through her shift, an EMT found a teenage girl at the emergency entrance slouched on the ground and leaning against the wall. She was unresponsive and appeared to have been beaten. Once the girl had been placed on a gurney and wheeled into a vacant space in triage, Pilar saw that the bruises weren’t fresh, but the track marks on her arms were.

“Get an IV of Naloxone in her, one milligram to start,” Pilar barked to the nurse at her side. “And I’ll begin CPR. She’s fading fast. It looks like a heroin overdose.”

“Are you sure?” Peters asked as he hovered near Pilar’s right shoulder.

“Check her arms,” Pilar directed. “And since you seem not to know the signs,” she added, ignoring his seniority, “she’s hardly conscious. In fact, she’s in acute narcosis. She gurgles with each labored breath. Her pupils are constricted. There’s indication of depressed respiration. The bruises are not new. And she smells of alcohol.” When Pilar completed her diatribe, she wondered if Peters had been testing her. Surely, with his experience he would know an overdose.

The nurse inserted the IV and delivered the first milligram of Naloxone with little response. Pilar ordered another milligram.

“What does alcohol have to do with it?” Peters shouted over the loud, controlled confusion in the crowded area. “Oh, never mind. Dumb question. I know polydrug use like alcohol is common with heroin overdoses.”

“Did anyone see who brought her in?” Pilar asked without realizing how naive the question sounded. “We could use more information on what exactly she ingested.” The second milligram of Naloxone worked. The patient came out of unconsciousness.

“No one is going to stick around to be questioned by the police.” Peters rolled his eyes. “And if she dies, yadda, yadda, yadda.”

“Oh, right,” Pilar mumbled. “Her breathing and pulse are stable. I think she’ll make it.”

“This time,” one of the nurses snickered.

When Pilar chided her for that remark, the nurse snapped, “If she doesn’t kill herself, her boyfriend will.” She pointed to the fading black and blue mark over her eye.

“Yeah, well,” Pilar fumbled over her words and examined the bruise. “Maybe the police can talk some sense into her. Or better yet, find her parents.”

“You may know diagnostic systems and treatment, but you have a lot to learn about girls like her.” Peters shook his head as he answered. He tipped a finger to his forehead. “See you. Car accident victim.”

Exhausted and shaken by the pragmatic way everyone dismissed that poor girl, Pilar turned to the same nurse she reproached earlier and asked, “Do you think the police will get her counseling, maybe on Methadone?”

“Ha!” the nurse sneered. “She’ll be lucky if the police will keep her overnight. To them she’s just another Cass Corridor hooker with a drug problem. She’ll probably die of AIDS anyway.” The nurse shrugged. “Many of them do.”

“I need help in here,” Peters shouted.

Reluctantly leaving the teenager to be picked up by the police, Pilar raced to help Peters with a patient whose puncture wound spurted blood in rhythm, like one of those fountains that squirted water to music. Pilar secretly admired Peters’ unflustered composure and precise movements. It was obvious he’d been in that situation many times. As Pilar pressed a sterile cloth over the wound to slow the bleeding, she peered back over her shoulder to watch a policeman wheel the young girl away.

H
ALFWAY THROUGH HER SECOND
year of residency, Pilar decided what direction she wanted to go in medicine. One night during a rare dinner with her parents, Pilar mapped out her plans. “I’m applying to the Department of Corrections so I can work in a prison,” she announced.

Marcus carefully placed his knife and fork down and gestured the maid out of the dining room. He might have been waving a fly away. His eyes never veered from Pilar. When the door closed behind the servant, he exploded. “I have had enough of you and your arrogant confidence,” he said. “What makes you so sure you can save the world?” His mouth tensed into a thin line and hardly moved as the veins in his forehead pulsated with each angry word.

Pilar lowered her fork and smiled, pleased with the way the assured, controlled words flowed from her mouth. “First of all, Father, my future is not your decision.” His chin jutted out and he raised an eyebrow. Her calm response appeared to surprise him. “If you’re worried about yourinvestment, I’ll pay every dime back.”

“Pilar,” Celeste interrupted as she dabbed a white linen napkin at the corners of her mouth. Pilar had forgotten Celeste was in the room. She held up her hand to stop further comment. Her composure changed into contempt. “You have no idea about the real world, Mother, the one filled with the less fortunate who have no way to care for themselves. Well, Father dear, and Mother,” she nodded at them both, “I now know that world all too well.”