Special Tutoring (2)
I wanted nothing more than to collapse into bed and sleep like a stone. But before I could, there was still one thing left to do.
I staggered over, threw myself onto the sofa, and opened the Dead Medical Scholars Gallery once more.
That was it. Farewell to these insufferable ghosts. Please, I begged, just don't come looking for me until tomorrow morning.
I was about to close my eyes and pray for peace when the comment notifications started chiming, stubborn and relentless.
The vibe was off.
Fuck. What the hell. Were these bastards lying in ambush as a pack this whole time?
My excuse of a comment was utterly ignored. Not long after it went up, the first question dropped.
My head went fuzzy. Xanthopsia, bradycardia, hyperkalemia. I'd seen this in a textbook. Cardiac glycosides.
I didn't hesitate. I posted the answer.
Nailed it. A classic case — miss it and you'd kill the patient.
The second question came flying in immediately.
This one was easy too. Altered consciousness from hyponatremia. She was symptomatic, so you had to correct it fast.
The instant my reply went up, the Gallery fell into a cold silence. Then the comment bombs started dropping.
What—what was even the problem? I scrambled, panicking, turning it over in my head. Rapid correction was right, wasn't it? Or was it...
Ah. Fuck.
Central Pontine Myelinolysis. CPM. Correct the sodium too fast and the center of the brain melts down, leaving the patient in a permanent vegetative state. I'd drilled that into my skull. And I'd almost done something insane, locked onto the idea that I had to correct it fast.
I could get this one. Thiamine. Vitamin B1.
Thank god. But there was no time to rest. The fourth question came leaping out of a territory I had never even imagined.
A butterfly rash? Pancytopenia? Proteinuria?
Fuck, what even is this. Lupus? Systemic lupus erythematosus? It kind of sounds like it... Three specific antibody tests? anti-dsDNA? anti-Sm? And what else was it?
My mind went blank white. This wasn't my field. How was a first-year emergency medicine resident supposed to know this?
I'm not an internist, okay. I don't need to know this much...
In the end, I posted nothing at all.
Common knowledge, she says. Yeah, common knowledge for that damn old hag, maybe.
I just shut my eyes. And a moment later, the fifth question went up.
T-wave inversions... myocardial ischemia? But the enzymes are normal and he's not in pain right now? So just observe?
The moment my answer went up, the Gallery threw the biggest roast festival I had ever seen.
And just like that, it all came crashing down. That day I got two right and three wrong. Two of those wrong answers would have been fatal.
Right. I was emergency medicine. EKGs, fine, I'd give them that — but I wasn't obligated to know internal medicine this deep, this granular. This was too much.
What?
Silence.
I realized the ghost's words fit together with perfect, airtight logic. The ER was the front line of every disease. You couldn't cherry-pick your patients. Which meant you had to know more — broader and deeper — than anyone else.
Ah. I was tired. Really, truly tired.
I collapsed right there, leaving behind the wrecked kitchen table, the shredded pigskin, and the miserable wreckage of my exam score.
My head felt like it was going to split open.
"Ugh..."
I groaned and pushed my upper body off the floor. Shoulders, lower back, wrists — every joint in my body creaked. The aftershock of last night's suture practice, plus the price of catching a nap on the floor.
Fuck. My life. What a piece of shit.
I stared at the table with hollow eyes. Pigskin massacred beyond recognition, empty drink cans, and surgical instruments scattered in a chaotic sprawl.
...Still.
Yesterday's sense of defeat was gone. In its place, a strange stubbornness I couldn't explain was burning in a corner of my chest. A vicious little resolve: if it was going to be like this anyway, I was going to squeeze those crazy ghost bastards for everything they were worth.
I staggered up and splashed cold water on my face. In the mirror stood a hospital slave, dark circles hanging to his cheekbones, no mistake about it. I flashed a grin at that pathetic mug.
Alright. Let's play again today.
I sat on the sofa and opened the Dead Medical Scholars Gallery with the easy familiarity of an office worker clocking in. Then, as brightly and energetically as I could manage — as if yesterday's massacre had never happened — I put up a new post.
I kept the greeting light. But my hopes were brutally shattered by the very first comment.
Yeah. That's more like you.