Cowboy Up

July 4, 2016

"So much for your last-ever shift in the ER being a quiet one, Dr. Vincent. We've got an ambulance inbound."

The EMTs wheeled the gurney in and Dr. Jaclyn Vincent met them at the door. "Okay, what have we got?"

"White male, mid-to-late 20s, head trauma, possible thoracic trauma and internal bleeding, BP is 100 over 70."

"Cause?" the trauma surgeon asked as she saw the helmet and flak jacket. The helmet was virtually crushed in on one side. What told her who he was or at least where he'd been was everything else he was wearing. Jeans, chaps, boots, and spurs. She was pretty sure she knew the cause because she'd seen it twice before but still had to ask.

"Bull rider out in Mesquite. Got tangled up in the rope and ended up getting dragged around, stomped on and just as they got him untangled, he took a vicious kick to the head."

"Okay. Type and cross. I need x-rays head and chest. Let's move, people!"

As she turned around she almost ran into a girl who looked to be nine or ten.

"Is my daddy going to be okay?" she asked her face twisted with worry.

"Is that your father? The bull rider?"

"He's not a bull rider. Not really anyway. He used to be but now he's a chef at a restaurant. He was just doing this so he could quit drinking because my mom left and... Is he going to be okay?" she asked again, her hands shaking and tears streaming down her face.

"Let's hope so, sweetheart. Can you answer a few questions for me?"

"Yes," she said, her voice shaky with fear.

The doctor asked her for as much information as the child could provide when an older gentleman walked up beside her. "I'm her grandfather. Sorry, I was parking the car and she just ran inside when I stopped to see where they took my son. What can I do to help?"

Several hours later the doctor came back and asked them both to sit down.

"Okay, your father—and your son—is in serious but stable condition."

"What does that mean?" the girl asked.

"Just let the doctor talk, okay, honey?" her grandfather said.

"The blows to his abdomen ruptured his spleen and broke three ribs. There was a lot of internal bleeding, but we found the source, removed the spleen, and stopped it. The real concern is cranial." She looked at the girl and said, "His head. He suffered a massive blow that not only crushed the helmet, but caused a serious concussion and some swelling. These kinds of things can go either way and the next 24 hours are crucial. He's resting comfortably, breathing on his own, and he's not in any immediate life-threatening danger. At this point, that's all I can tell you."

"Thank you, doctor," the older man said.

"It's all her fault!" the girl said. "It's all her fault, Grandpa and I hate her!" The girl began crying and collapsed into her grandfather's arms.

"Audrey, she's still your mother. Please don't talk like that."

"I don't care! If she hadn't left, Daddy wouldn't have started drinking and he wouldn't have gone back to...this!"

Seeing there was nothing left to say or do, the doctor excused herself and walked away. Jaclyn Vincent's last day at Parkland Hospital in Dallas, Texas was tomorrow, and this was her last shift in the ER. She was calling it quits after five years as a surgeon, six years of surgical residency, medical school, and undergraduate studies. She'd go home at some point, get some sleep, then come back and clear out her desk and fill out some final paperwork and that would be that. The bull rider injuries were serious but nowhere near the horrors she'd seen during her years as a surgeon pulling shifts or being on call for the ER.

When she came back the following day, she started checking on her patients by force of habit. "Shouldn't you be clearing out your desk?" she heard Doctor Clifford Evans, the chief of surgery ask.

"I know, I know. I just want to check on our beat-up cowboy before I do," she said politely.

When she walked into his room she was very surprised to see him not only conscious but alert. "Well, good morning, Cowboy!" she said pleasantly. "I didn't expect to be able to talk to you yet. You took quite a beating."

"Yeah, I don't remember much after getting tangled up in the rope. I guess my spur got twisted up in it or something. Audrey, my daughter here, was telling me what happened and what you told her. Thank you, Doctor..." His eyes weren't focusing well enough to read yet so she helped him out.

"Vincent," she said supplying the needed information. "You can call me Jaclyn, if you like. Today is my last day."

"Oh, okay. New hospital? Private practice?"

"No, neither," she told him politely. "Let's take a look at you and see how you're doing. Are you in any pain?"

"No. Whatever's in that IV line is working like a charm."

"It's morphine. You cracked several ribs and came very close to having your left lung punctured. We had to remove your spleen, but if you've got a lose an organ, the spleen's your best choice." She shined a light in his eyes and said, "Any headache, double vision, blurriness?"

"I couldn't read your name tag, but I can see well enough to know you're a beautiful woman," he said with a smile.

Jaclyn laughed. "That's the morphine talking, but thank you."

"You are very pretty," Audrey said.

"Well thank you, young lady. You're a very pretty girl yourself."

"Just like her mother," he said.

"Don't talk about her, Daddy," she said angrily. "I hate her and this is all her fault!"

"Odd?" he said using her nickname to address her, "I'm sure the pretty doctor has no interest in our family business."

"Normally I'd agree," she said. "But since I have nowhere to go or nothing to do other than fill out some paperwork, I don't mind listening—if you want or maybe even need to talk."

She'd noticed the night before once they got his crushed-in helmet off, the cowboy named...she flipped through his chart and found it...Davis Martin, was a good-looking guy. Today she could see he was downright handsome. But the chart also told her he was just 28-years old and Jaclyn had never dated anyone more than a year or two younger than herself and had no interest in dating this total stranger, handsome or not. It was none of her business, but she couldn't help but notice that his daughter was somewhere around ten so by doing the math...

"It's not a very interesting story, Doc," he said. "But if it'll keep your pretty face around a while longer..."

She smiled at him as his daughter spoke. "I hate my mom."

"Honey, come on. Don't be like that, okay?" he father said weakly.

"I do!" She looked at Dr. Vincent and said, "She was sneaking around behind my dad's back with some guy from New York and right after Christmas she just left." The girl's eyes teared up again as she spoke and Jaclyn could she the anger in her face. "She came downstairs with two suitcases and told me she loved me—no matter what—but she couldn't stay with us any longer. Then she got in his car and left. And now...I hate her. I'm sorry, Daddy, but I do."

"Odd, Mom said she couldn't stay with ME any longer. Not you, honey. She doesn't hate you."

"No? Well what's the difference if she does or doesn't hate me? She moved to New York with this guy, she never calls, and..." The girl was crying again as she blurted out, "She broke your heart and mine and I...I hate her!"

Jaclyn's heart was breaking as she listened. She got up and pushed her chair next to the girl and sat beside her. Without speaking, she put her arms around her and pulled her head to her chest as the girl cried openly.

"I'm so sorry, sweetheart," she told her. "But this isn't your fault. You know that, right?"

The girl nodded as she sobbed. "I know that doesn't fix anything and it may not even make you feel any better, but you didn't do anything wrong." She lifted her head up with both hands and held her cheeks. "Okay?"

Audrey nodded again and tried to say, "Okay."

Dr. Vincent pulled some tissue from her pocket and dabbed her tears. She stood up and said, "Well, I'm afraid this is it. It looks like you're well on your way to recovery. I'll upgrade your condition from 'serious' to 'good' as my last official act." She turned to Audrey and said, "I'm really sorry, honey. I wish there was something I could do, but there are a lot of things doctors still can't fix and broken hearts is one of those things."

"Mr. Martin? Take care of yourself, and for the sake of your daughter and your own life, please consider giving up bull riding, okay?" She smiled and turned to leave.

"Doc? Hold on, okay? Hey, Odd. Grab my wallet out of my jeans over there, okay?"

His daughter did so and handed it to him. He opened it, dug around then said, "Hand that to the pretty doctor for me, okay?"

"What's this?" Jaclyn asked as Audrey handed it to her.

"It's my business card. I'm a chef at a restaurant here in town and I'd like to make dinner for you sometime—on the house. It's my way of thanking you." He smiled and knew it was mostly the morphine talking but still said, "And well...I'm kinda sweet on you, Doc."

Jaclyn couldn't help but laugh. She knew from Audrey that her father was an accomplished chef so that term wasn't something she expected from him even though he had ridden a bull at a rodeo the night before. Maybe he wasn't as sophisticated as she'd initially thought.

Davis kept talking. "If you're available...and interested...I'd be happy to sit and have dinner with you—unless you prefer eating alone."

Audrey was trying to smile as she said, "Please, Dr. Vincent? Please come to our restaurant and have dinner. My dad is an amazing cook. He's a chef."

"Yes, so I've heard," she said with a smile. She looked at the name and address and realized she'd eaten there before. "The French Room. This is one of the nicer places in Dallas. Do you own it?" she asked.

"No, ma'am," he said. "But that's my goal one day."

"Okay, I may just take you up on your very kind offer. I'll call ahead and let you know I'm coming, but not until you've had some time to recover. I certainly wouldn't pass up an opportunity like this."

"Opportunity?" Martin asked not quite sure what that meant.

She smiled at him and said, "Just a part of my new approach to life, Mr. Martin."

"Oh, okay," he replied smiling back at her. "And please call me Davis."

"Right! The man with two first-last names. Okay, Davis it is. I'll look forward to our dinner."

"Me too...Jaclyn. And good luck with whatever lies ahead."

"Thank you," she said.

Audrey stood up and came over to give her a hug. "Thank you for taking care of my daddy."

"My pleasure, sweetheart. Now you take care of him, okay?" she said with a smile.

"I will," she promised.

"Bye, Doc!" Martin said as she waved goodbye to him and his daughter.

As she was leaving, she saw Davis's father on his way in carrying a trophy and some other shiny thing. "Don't leave now, Doc!" Pete said.

"Oh, no way. At least not just yet," she said turning around. "I've gotta see this."

"Hey there, Cowboy," he said to his son. "Sweet pea," he said to Audrey.

"What's that all about, Dad?"

"You don't remember?"

"No, I don't remember much of anything," he said looking at the trophy.

"Well, does the number 8 mean anything to you?"

"I rode Swashbuckler for 8 seconds?" Davis asked with disbelief.

"Uh-huh. You sure did. And this is the first-place trophy. He set it on a chair next to Davis then showed him the buckle.

"Now that's nice," Davis said admiring the gaudy-looking thing.

Jaclyn leaned over and whispered to Audrey, "That is one ugly belt buckle." Audrey giggled and told her she agreed.

"Hey, I heard that!" Davis said. "This is a thing of beauty." He took it from his dad and tried to hold it up but pain shot through the morphine like a knife. "Maybe you better set that down, too, Dad."

"And this is for you too, Hotrod." His father handed him an envelope with something inside.

"How much?" Davis asked.

"Open it up."

"My eyes aren't focusing so well. Can you maybe help me out?"

He pulled the check out and said, the words getting louder toward the end, "Fifty-seven thousand dollars!"

"That's amazing, Davis," Jaclyn said. "Congratulations!"

"Hey, I can even afford to take you to a movie after dinner now," he said trying to smile.

"You just get better. We'll talk about a movie after we have that dinner." She said goodbye again and this time made it out all the way out.

"I really like her, Daddy," Audrey said. "She's nice. And she's really pretty."

"Yes, she is, honey. I like her, too. And she's...beautiful."

After clearing out her desk, Jaclyn dropped off the required paperwork with HR the stopped in to see Cliff on the way out. As he invited her in she recalled the conversation she'd had with him almost exactly one month ago.

June 6, 2016

"No, I don't understand. Jaclyn, you're one of the best surgeons I've ever met. Hell, you could take my place as chief of surgery in a few more years when I retire. This makes..."

"You'll never retire, Cliff. We both know that. You were born to be a surgeon and you'll probably die still practicing. You're not only the best I know, you love this. It's in your blood. It's who you are."

"True, but this isn't about me, Jaclyn. Think about the time you've invested and the experience you have. There are so few surgeons in the country and losing someone as good as you hurts everyone. Like me, you went through a six-year surgical residency after medical school and you've been here at Parkland for the last five years. Help me make sense of this, please!"

Jaclyn Vincent had just turned 38 and everything Clifford Evans, Parkland's chief of surgery, had just said was true. Medicine, and more specifically surgery, had been her entire life since she graduated from college, and until recently, she'd loved almost every minute of it.

There was just something so exhilarating about excising a tumor or repairing a gunshot wound or finding the source of internal bleeding then putting all of the damaged tissue back together again. The incredibly long hours, the unbelievably challenging demands of her chosen speciality, the need to be available at all times—none of that ever bothered her. It came with the territory and she'd been happy to carry the load.

But just over a year ago, things gradually began to change. She couldn't point to any one specific thing. It was rather a series of events or possibly missed events—or both—that had caused her to question the viability of her choices. Cliff was right. She was that good. She knew it and so did everyone who worked with her. And yet she had to face the truth. The words to a BB King song had played over and over in her head day in and day out for weeks: The thrill is gone.

Rather than see every procedure as an exciting life-or-death challenge, she now approached them like a well-programmed machine that knew exactly what to do and how to do it which is precisely what she did. And she still did it very, very well. But what had once been the only love of her life now felt like an ever-present weight; the proverbial albatross around her neck. Not only was the thrill gone, the thing that bothered her most was the inescapable feeling that life, and all of the things that made it worth living, were passing her by. For her, life was now little more than an endless grind of cutting tissue spent within the confines of the hospital made famous when President Kennedy was assassinated and brought there in order to try and save his life.

Jaclyn was grateful to Cliff who'd hired her and always supported her. She loved the other surgeons on staff as well as the many wonderful nurses, aides, and administrators who made Parkland hum. But like the people whose lives she routinely saved, she had one and only one of her own, and it now felt...hollow. She was 38, single, had no children, and no one to love; nothing but her life as a surgeon and that wasn't enough anymore. When she was honest with herself she was forced to admit that what that really meant was she had no one to love her. She was also forced to admit that the profession that once met her every need now left her empty and unfulfilled.

She'd told herself a year ago she'd find a way to work through this...phase she was obviously going through and kept telling herself 'this too, shall pass.' From the time she first became truly aware of it as something more than a fleeting mood, she told herself she'd spend the next year finding some way to deal with it or overcome it or... She couldn't even say the words to the third alternative, but it not only hadn't passed, it had gotten worse. And now, after a full twelve months of initially not enjoying her work to almost hating it, she'd finally said them out loud.

"I'm resigning, Cliff."

He'd offered her a month off and then a year sabbatical to teach surgery. When she told him 'no' to both offers, he asked her to consider going back into residency to try another specialty. This older, surgeon/doctor-for-life simply could not understand how anyone with her background and training could just throw it all away.

"Jaclyn, we're in a very dynamic, ever-changing field. If you take several years trying to 'find yourself' or whatever it is you're doing, it'll be extremely difficult if not impossible to come back. Have you really thought this through?"

She had. Over and over, day in and day out for the entire year with the last three months consuming her. Financially, she could likely retire and never work again were she even reasonably careful. As a surgeon, she'd made just over $350,000 her first year and paid off all her student loans, put 20% down on a new home, and paid cash for a new car. The second year she made just over $400,000 and paid off the mortgage and furnished the house with the nicest things she could find. The next two years she'd earned closer to $500,000 and virtually all of it had gone into investments which were doing modestly well. When it was all said and done, she'd put away close to a million dollars, owned a very nice home in an upscale Dallas suburb, and drove a brand new Acura MDX which she also owned outright, as well. Money wasn't a concern.

Besides, what good was any of that when she came home to an empty house night after night? How much money was enough when money was all she had? Yes, she had the respect of her colleagues, and she even occasionally had a patient come back and thank her for saving his or her life, but there wasn't one single thing she could hold at night to make the deep and endless loneliness go away.

Whatever it was she might be giving up, she knew she at least had to try. It wasn't just her biological clock ticking in her head so loudly it drove her crazy, it was laying in bed alone on the finest sheets money could buy in a beautiful home with trey ceilings, wainscoting, crown molding, hardwood floors in every room along with marble and granite and stainless steel. She had pretty much everything money could buy, but she didn't have love, and night after night she ached to be held. She dreamed of waking up next a man whose love was true; someone who'd love her more than life itself and whom she could love that way in return. The thought of a child coming in to crawl in bed with them because he or she had had a bad dream or just to tell her, "I'm thirsty, Mommy," filled her with warmth and happiness. Surgery did not.

Cliff even offered to let her cut back on her hours which she knew would allow her the time she'd need to try and find someone. The bigger problem was that work itself left her cold and alone so even if she...God forbid...never found someone, life as a surgeon no longer held any interest for her. She didn't expect Cliff to understand, so she didn't really even try to explain her motivations.

"Is there anything—anything at all I can offer you to get you to change your mind, Jaclyn?" he asked as she stood up to leave.