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I followed the advice of two people, Henry for one, who suggested that I not continue to edit old stuff, but instead, write something new. I did that, following this prompt from my instructor: ì The assignment for the class to be held on November 13th: In whatever you hand in for feedback, please try to include one or more descriptive passages.î

Here is the work in progress, which I have to send off by Wednesday. I’d appreciate editing comments.

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TURN THE PAGE

ìIf you get a chance, Iíd like you to read my book.î

His book, John thought. The guy is a resident, moonlighting in the emergency room, and heís training to be an ophthalmologist – how could he have time to write a book?

ìWhatís the title?î John shouted to Dr. Benton, as he walked up the first flight of stairs, moving away from John, who had stopped at the bottom. Information had to be passed quickly.

ìThe life of an Intern.î The lanky physician reached into his black shoulder bag and retrieved a dog-eared copy with the price clipped from the inside of the dust jacket. He was near the top of the stairs when he tossed the book, underhanded, over the railing. It landed with back cover, Dr. Robert Bentonís face up, in Johnís hands. From a distance John heard, ëYou can read my copy, but you have to give it back.î

Ambling to the cafeteria, he flipped the book over, opened the hard cover and read the introductory blurb: ìDr. Walker, in his first weeks of internship, is tired and a little afraid. He has forgotten when he last slept, but knows in the coming hours heíll have to make life and death decisions, deal with nurses who often know more than he, cope with worried relatives, and pretend to be what he has yet to become – a qualified doctor.î

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Diane, sixteen years and a few hours old, ran to keep up with her friends as they squeezed through the silver chain-link fence cut from the tarnished metal post. This fence was built to keep everyone from taking shortcuts to shops and restaurants on Somerville Ave, but enterprising teenagers had long ago cut through the diamond shaped links, creating this path across the high speed rails to the street on the other side.

Diane followed, always, but not because she was slower than her classmates. She was a track and field star with promise of State records in the quarter mile, but as the oldest in her family of five, she looked out for others. This time, though, she snagged her letter jacket on the fence and worked to free herself. She heard the clack, clack, clack of the train, the shrill of the whistle, and saw the backs of her friends as they sprinted across the tracks. She pulled away from the last link, ran down the embankment, but lost the race, the first of her sophomore year, to the west bound commuter rail.

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John was sitting at his desk in the Respiratory Therapy office, chin on one palm, gazing out the window when the ambulance arrived. It bounced off the asphalt at the bottom of the ramp, sparks flying, and screeched up the short hill to the emergency roomís automatic, buffed steel and glass, doors. Not waiting for the Stat call to his office, John hurried to the trauma room and winced when he saw a deliberate pattern of red drops crossing the black and white scrubbed linoleum. Blood, he thought, is usually confined: to the stretcher, to the trauma room. It almost never leads to the patient like bread crumbs.

He pushed through the single swinging door, walked to Dianeís side and slipped his left hand under her unblemished chin, replacing the ambulance driverís right hand with his, on the Ambu bag.

ìWhat happened?î John turned to Mel, the nurse dressed in pleated white pants and blue top, struggling to find a vein for the IV.

ìHit by a train.î

Dr. Benton stood at the foot of the stretcher, stethoscope around his neck, but without his proper, dust jacket pose. He was flustered and trying hard not to show it.

ìWe better call an Orthopod for that foot,î Mel urged.

ìOkay, okay, letís do that now,î Dr Benton responded.

ìAnd her BP is falling, may have a flail chest, how about the Thoracic Team? I think Phillips is on callî

John has the observing position in these situations. He maintains the airway, but besides relieving whomever might be doing chest compressions, he stands, and watches. It upset him to see the physician in charge, not in charge. He had been to many failed resuscitations but this one he was desperate not to lose. Diane was so young, so pretty and other than her foot dangling off the stretcher, she didnít look like sheíd been hit by a train. But, she needed skillful care to survive and Dr. Benton, the ophthalmologist to be, knew it.

ìWhat about blood gases?î John asked. The test was as basic as monitoring heart rate, why wasnít Dr Benton shouting these orders?

With the exception of a piercing scream when the orthopedic surgeon snapped her foot back on her ankle, Diane was mostly unresponsive. Nothing to needle sticks, and only moans when the chest tube was inserted. Soon after her scream, her blood pressure began to fall, her pulse rate slowed and it was evident that her internal injuries might take her life.

John compressed the Ambu bag, and continued to hope Diane would recover. When Dr Phillips, the chest surgeon moved close to his side, John turned and asked.

ìWhat do we do now?î

ìPray,î Dr. Phillips responded without hesitation, as though he knew the question in advance.

ìPray,î John looked backed quizzically.

ìPray that she doesnít live.î

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The waiting room, long and narrow, with one wall of windows had uncomfortable, rigid chairs with metal frames. If you followed the black and white linoleum tiles that covered the trauma room you would find yourself in this room. Far in the back, huddled in a group, some holding hands, others crying, were Dianeís friends; those who made it across the tracks in front of the train, and others summoned after the ambulance whisked her away.

Bill, his full name William Jennings Brown, labored in the emergency room for almost three years, ever since his tour of duty in Vietnam ended. He stood ramrod straight, his reddish brown hair a trifle longer than heíd worn it as a medic. His training was thorough,his battlefield experiences brutal, his bedside manner, unflinching. He shouldnít be standing here, bearer of news, this wasnít his role. But Dr Benton was nowhere to be found.

Bill looked down at all the faces in the waiting room and asked in loud, firm voice, ìWho is here for Diane Reed?î

Heads raised, hands clenched tightly, young, unlined faces turned: expectantly, hopefully, tearfully.

ìSheís dead.î

And Mel walked away.