"As an Emergency Doctor, there are seven things you should know.
"Number one—you'll kill someone one day. It's going to happen. You'll often need to make critical decisions with no patient history to guide you. You'll make the right call most times. But a few times, you won't and you'll lose the patient. When that happens, learn what you can from the situation, forgive yourself and move on. You
will
kill someone. Accept it now and you'll handle it better when the time comes.
"Number two—half of what comes through the door aren't legitimate emergencies. What'll make you efficient is being unapologetic about priorities. If some idiot limps in with a sprained ankle and whines that he hasn't been treated while cardiac arrest cases are pouring in at the same time, tell that limping bastard to shut up, sit the hell down and wait.
"Number three—people are weird. They perform acts you'd never dream of, and insert unthinkable objects into orifices where such objects should never be inserted. After a week in this ER, nothing will ever surprise you again.
"Number four—spring is suicide season. The assumption is that suicide peaks in winter, because of holidays and the weather. That's bull. Suicide rates are lowest in winter. People kill themselves in April and May, with the sun shining and flowers blooming.
"Number five—burnout is real. If it hits you hard enough to affect your mental health, don't try to power through. That's a great way to endanger your patients. If you're about to crash, let me know. I'll see that you get a break as soon as scheduling allows.
"Number six—you'll be sued at least once before you're 50.
"And number seven—you'll save lives on every shift. That's why you'll enjoy this job as much as you'll detest it. Questions?"
This was the opening speech of Dr Elizabeth Elgar, an ER Attending physician, to the 8 new residents under her supervision.
The residents were between ages 27 and 29. All had done pre-med courses, attended medical school, gotten their M.D.s, completed their internships and a year's residency in Internal Medicine.
Although it was their first day of Emergency Medicine, it was their second year of residency overall. The first year in Internal Medicine was mandatory for their program. They were in for three years of Emergency Medicine residency before they'd be full-fledged Attendings.
Nathan Bellamy, 27 years old, was among this crop of residents who stood listening to Dr Elizabeth Elgar's speech.
Nathan had no illusions. He had a damn good idea what this job involved—he'd already been a doctor for 2 years. Yet with a streak of the hope that had always sprung eternal in him, he let himself believe Dr Elgar was exaggerating. Just slightly, to drive her points home.
As the weeks of his residency passed, Nathan found she hadn't exaggerated at all.
But it wasn't until April 1982, two-and-a-half years later, that her speech hit home for him.
*****
Author's Disclaimers: Suicide is a major theme in this story. If you find this theme distressing, please don't read further.
There are Emergency Room scenes and I haven't shied from details. If you're easily queasy, beware.
If you enjoy reading about brutal punishments heaped on women who stray, this story isn't for you. Any comment glorifying violence or containing hateful slurs will be deleted.
This story is long. The pace is unhurried. The writing is descriptive. These are features, not bugs. If you prefer wham-bam stories, you're not the target audience here.
*****
PART ONE: THE KID
"I sometimes lie awake in the sawdust, dreaming I'm in a suit of light." Buddy Mondlock,
The Kid
.
New York, April 1982
*
Delta Lake was to one side of him. To his other side were trees on an elevated ridge.
Dr Nathan Bellamy was at the wheel of his AMC Eagle, driving to the place he'd worked at for the last 4 years; Delta Lake Hospital. It was a Level I trauma center in upstate New York. In the city of Rome at the foothills of the Adirondacks. The hospital was a convenient 3 miles from the Lake Delta Fire Department, and a bearable 10 miles from his apartment.
He worked 12-hour shifts; morning, afternoon or night. Whenever his shift began in the morning, he always stopped at a certain inn for breakfast. It wasn't much of a detour from his route. He turned left before the dam and followed the road for a mile until he reached Rossini's Inn.
He'd done that this morning.
Giorgio Rossini owned the inn. His wife had handled the running of things, but chronic kidney failure had claimed her two years ago. When Giorgio became widowed, his daughter from a first marriage had moved from Buffalo to help him. Emma Rossini, with a recent degree in Business Admin, had been in the position to seamlessly pick up where her stepmother had left off.
Giorgio ruled the kitchen. Emma ruled everything else.
That morning, Nathan drove to Rossini's Inn, walked into the breakfast parlor and parked himself at an empty table. A waiter had come, poured him coffee, and taken his order.
As he'd sat drinking it and waiting for his breakfast, Emma had come in from the garden, crossing the breakfast parlor towards the kitchen; probably going to speak with her father about something. When she'd spotted Nathan, she'd walked over to his table. "Good day to you, Dr Bellamy."
Nathan had given her a ceremonial nod. Overly formal greetings were their personal joke. "And a good day to you, Miss Rossini. I trust you're in good health."
"I am indeed in good health, thank you Doctor. And yourself?"
"I too am in good health."
Emma laughed. She cut a slender, long-legged figure as she leaned her hip against his table. Her black hair was sheared to her angular chin, but her lace dress lent her a feminine air. "The waiter's taken your order?"
