The Fellowship

Chapter 3

The trauma hallway and room were bursting with activity. The critical nature of the incoming patient was evident. Every level of medical professional on the team realized that it would be a race against the clock to save the young man’s life. There would be no time to discuss methods of treatment or to consult with the Attending Physician. It literally was down to do or let the young man die. And by the gods, if Trivoli had anything to say about it, this young man was going to get another chance at life. ‘The ball is in my court now! This is what I have been training for my entire career,’ raced through the surgeon’s mind.

A feral smile came to the Fellow’s face as the overhead loudspeaker squawked, "Trauma patient is in the department. Trauma patient is in the department."

Seeing the blood drenched, limp body of the young man on the ambulance stretcher, Garrett began firing off orders letting instinct take control. "I want a quick chest x-ray and abdomen x-ray. Check for pulses. Get me a pressure. Hang all four units of blood and notify the Operating Room that we’re coming up now. Tell them to have Thoracic Surgery meet us up there. Call the Blood Bank and have them send a ten pack of O positive blood to the O.R. to start, and a four pack every fifteen minutes for the next hour."

Trivoli watched as the team worked to meet all of the demands. The monitor showed tachycardia with multiple PVC’s, the pulse was weak and thready; the blood pressure was 70 over 40.

‘Not good, not good at all,’ Trivoli thought. "Time to move, NOW, to the O.R.," the low contralto voice decreed.

The directive caused the hallway to clear almost immediately creating an unobstructed path to the elevators. Every hand and foot was in motion to expedite the young lad’s way to the operating room, giving him a desperate chance for life. Once inside, the doors closed and the ascent was speedy.

The elevator came to a stop, the doors opening on the Operating Room level.

With the look of a well-rehearsed team, the forward momentum towards the area of bright lights and cold steel resumed instantly. The driven group easily negotiated the sixty feet of hallway and the two left-handed turns needed to bring them to the main entrance of the O.R. where they were met by the surgical personnel. The exchange of one team with the other was flawless with not an ounce of momentum lost.

The E.R. trauma team now watched their patient being maneuvered swiftly down the hall and into the surgical theater. The concern on their faces could have been construed as a silent prayer offered for the safekeeping of their patient’s life, teetering precariously on death’s doorstep.

A second or two passed before they were able to register what had taken place. They could feel the adrenaline surging through their bodies, their lungs in need of more oxygen. Slowly, each one began to look to the other, searching for reassurance. It felt as though they had been part of some surreal dream sequence of the perfect trauma delivery system. It felt good, damn good! Now, if only the patient would survive.

"Paper work," the stern looking woman at the desk demanded with an outstretched hand. "Do you have any paper work on the trauma patient?"

The dream atmosphere was now broken by the harshness of reality. John turned his gaze to her and slowly shook his head; "There was no time, no paper work generated. Hell, we didn’t even give him a name." He looked down at his watch noticing that only twelve minutes had elapsed since the trauma pager warned them of the almost immediate one-minute ETA.

She looked over the top of her glasses at him and mockingly said, "What am I supposed to call him?"

The other E.R. nurse cleared his throat and softly spoke, "Lucky…call him Lucky Doe." Steve truly believed that, deep in his heart. The ex-paramedic had seen many gunshot victims bleed to death, either enroute to the hospital or upon arrival in the trauma rooms. But this had been different; it had almost a magical feel to it. "I’ll let Admissions know." The nurse ran his hand through his thinning, light brown hair in a sort of calming gesture.

"What trauma surgeon is in charge of that patient?" The woman asked the E.R. nurses in front of her. She saw the puzzled look on their faces. "Why am I asking you," she muttered to herself, "first day of…hell, first hour of a new staff year." Her finger slammed down onto the intercom switch connecting her to the surgical arena for that particular patient. "Room One. Do you have the patient with multiple gunshot wounds?"

"Yes!" was the reply heard over the low hum of static noise.

"Your patient will be called Lucky Doe." The woman paused. "I need the name of the operating trauma surgeon please."

There was silence. A moment later the intercom crackled to life. "Trivoli,

Trauma Fellow Garrett Trivoli."

The patient had been quickly transferred to the operating table, prepped and draped while the anesthesiologist hurriedly applied his monitoring devices to the young man’s body. Trivoli’s eyes never leaving the monitor, donned the customary protective clothing of the operating arena.

"Place him in trendelenburg position and keep the temperature in this room at 50 degrees," the Fellow directed. "I’ll need size 8 gloves, please." She glared at the scrub nurse as she held out her hands. "I suspect that this will be the first and last time I have to tell you my glove size."

The nurse was shocked at the display of arrogance in the new Fellow. ‘Jeez, not even an hour into the new training year and already an attitude.’

She readied the sterile gloves for the surgeon to wear. "I’ll make sure the word gets around, Doctor," she nodded politely. ‘Yeah, that you’re one demanding bitch.’

Garrett now stepped up to the table, extending the gloved hand, "Bovie, please."

The surgeons were at the forefront of the battle to save the young life now. There was no time to waste, as Trivoli and Chief Surgical Resident, Rob Kreger would have to quickly find the major bleeders and stop them if at all possible. It was sure to be a team effort and one that would not be over anytime soon.

**********

John and Steve returned to find the E.R. aide, Marianna, starting to clean up the trauma room. They were startled to see the amount of mess that had happened in such a short time.

"I can’t believe what a mess you guys make," she teased them.

"Well, be glad that trauma was only in this room ten minutes," John said, "or it would be a lot worse."

"Oh my, guess I’m a little late," Dr. McCormick poked his head into the room.

"Sorry, doc, the patient is already in the O.R.," Steve apologized to the E.R. Attending Physician.

"Alright then, ah…what was his name, do we even know?"

Steve looked straight at the stout, balding physician; "We’re calling him, Lucky Doe."

The doctor let a smile slowly crack across his face, "Let’s hope so."

"Say, you wouldn’t happen to know who the trauma surgeon was?" Dr. McCormick asked stepping back into the room.

"Trivoli, Trauma Fellow Garrett Trivoli." A large grin appeared on John’s face. ‘Yeah, this Trivoli rush came as close to having sex as one could get at work,’ the tall blonde nurse thought to himself. ‘This might even put a whole new outlook on the time that I spend in trauma.’

The Physician was surprised by the expression on John’s face. "Thanks, I’ll get the information I need when they’re done in surgery," McCormick said as he started to leave.

The nurse’s facial expression would not erase itself from Ian McCormick’s mind. He knew of John’s fanaticism with sports, his appetite for lewd comments and sexual escapades. ‘Trivoli, hmm…could have been a collegiate sports figure, or maybe someone who cracks comments like John.’ Then it hit him. That look! It was the one that most teenage boys have after their first sexual encounter or men when deep in lustful thoughts. The physician looked over his shoulder at John. ‘Oh, God, he’s getting off on men now! Jeez…I hope it’s only Garrett Trivoli,’ he thought and began to quicken his pace away from the Trauma hall, a feeling of homophobia coming over him.

************

In a combined group effort, the three co-workers and Housekeeping brought the trauma room back to a state of readiness. Now, the nurses would have to try to put together some sort of paper work on Lucky Doe. Everything had happened so fast and simultaneously that it was going to be hard to chronologically come up with the chain of events that took place.

Finally, Steve and John were satisfied with their Trauma Assessment paper work. It was sparse but told the entire eleven-minute story of Lucky Doe while he was in their care. They both knew that once Nan reviewed it, their manager would be asking why certain things had not transpired in the way of patient care.

Steve hung his head; "Nan’s going to be on the war path over this one."

"The patient’s still alive," John snapped. "At least I hope he is. If she has questions, let her take it up with the physicians."

"I say, why don’t we just let her watch the tape. That should answer any of her damn questions."

John’s face lit up; he had forgotten that all traumas were video taped for critical review. ‘Maybe I should review it, myself. I wonder…will it be as arousing the second time around?’ The thought was now evident on his face.

"Jeez, John, I wish you could keep your mind on work instead of last night’s conquests," Steve was now visibly agitated.

‘Oh, but I am!’ was the younger nurse’s mental reply.

***********

The operating room was quiet except for the rhythmic bleeps of the heart monitor, a constant reminder of the life they were trying to preserve. Surgeons had their own peculiar style of conduct that surrounded them in the operating arena and Garrett Trivoli was one for intense concentration, solely focusing on the patient. Spoken words being kept to a minimum. Perhaps this is why everyone paid attention when the voice of the Surgeon was heard.

"Vitals, please." The words seemed to be spoken as a directive and not polite etiquette.

The anesthesiologist surveyed his electronic equipment. "Heart rate, 90. BP 108 over 66. Respiration’s 14. Color appears to be good," he reported, looking directly at the patient’s face.

Garrett breathed a sigh of relief. The biggest part of the battle was over. Now only the small skirmishes remained. A fight is still a fight no matter how big or small. The surgeon had learned the hard way many years ago. Some of the most deadly battles were those that could possibly be mistaken as insignificant annoyances. Over the years, Trivoli had learned to let instinct guide the swiftness of response, but to take care that her quest for perfection was not marred by some insignificant oversight that would conquer in any altercation.

"Now comes the tedious part, Dr. Kreger. We run the intestines looking for any sign of perforation or nick," the surgeon looked over at the Chief Resident.

"Doesn’t appear to be any injury to it." Dr. Kreger challenged. "I don’t think we’ll find a thing to worry about."

An eyebrow arched high on the forehead and icy blue eyes shot like daggers. Garrett’s voice dropped to a low tone. "This, Dr. Kreger, is my patient. I will do whatever I feel is necessary to assure the success of this operation now and for the future. If you don’t agree, then I suggest you assign yourself to a different trauma fellow after today."

Beads of perspiration gathered across the Chief’s forehead. ‘No!’ his heart screamed ‘You are the one, I want to learn from you.’ He let his eyes drop in submission and nodded his head. "I’m sorry," was all he could verbalize.

He knew that out of the three Fellows, Trivoli had the skills and surgical expertise that he wanted, but her overall manner with the staff left much to be desired. She seemed to pit herself against them at every turn. He’d have to remember not to pick up those habits.

"Good! Then you won’t make that mistake again." Her voice was calloused and cold, rivaling the room’s temperature for sending a chill straight to the bone.

His eyes shot up to meet hers and he wondered if he would be able to withstand her condescending attitude for the year to come. He had been told that he could learn many things from this Fellow but no one had mentioned her brash and arrogant ways.

Painstakingly slow but ever so diligently the two surgeons examined the loops of intestines for damage. They could find no defects but something kept the Fellow on guard, instinct was taking over again.

"Vitals, Please."

The O.R. staff was beginning to hate the sound of the word ‘please’ coming from the tall surgeon’s mouth. It was evident that she had no idea of the courtesy she was extending in the polite mannerism. It came off sounding more like a suffix to the word before it.

"Heart rate 98, BP 100 over 64, respiration’s 16," the anesthesiologist reported.

Garrett could not shake the feeling. "Raise the pressure to 120."

The anesthesiologist pulled a syringe off the tray at his workstation. He uncapped the needle and proceeded to inject one milligram of the drug into the port of I.V. line. "Should take just a few minutes," he reassured the surgeon, "before we can see some results."

"While we are waiting for that to take effect, let’s mop up this abdominal cavity of any free fluid."

The circulating nurse silently kept watch of each sponge that entered the young man’s abdomen and patiently retrieved them as they were discarded.

"Seventeen used inside," she announced, "seventeen out."

"Pressure is now 122 over 70."

"Ok, let us do this one last time." The surgeons inspected each loop of bowel thoroughly, slowly checking for any sign of injury.

"There!" The Chief Resident pointed out. "I see a drop."

Trivoli’s eye was caught by the glistening appearance. There, upon wiping the site, one could see another droplet forming within a few seconds. It had paid off. The skilled hands of the Fellow manipulated the area of bowel to reveal a small one-millimeter perforation in the wall.

"1-0 Silk on a curved needle."

Garrett took the needle and put a stitch or two in to hold the area closed. Kreger clipped the silk and proceeded to dab the area; both surgeons waited to see if the stitch would hold.

Rob Kreger silently studied the surgeon across from him and waited for the "I told you so." But it never came. He would have closed without ever checking and risked numerous complications that could have killed the young man that they worked so hard to save. ‘This one is the best,’ he silently thought. ‘I’m going to learn a lot this year.’

Several minutes passed and the evidence was conclusive, the stitch would hold. The surgeons continued their final inspection. Both were satisfied when no other warning signs of injury could be found.

"Is the sponge count correct?" The tall Surgeon waited for an answer.

All eyes were on the circulating nurse as she made her final count.

"I don’t have all day here, nurse, and neither does my patient." Garrett’s voice was antagonistic in nature.

"Yes, Doctor Trivoli, eighteen in and eighteen out." The nurse looked over with eyes turning from shock to that of shooting darts at the brash surgeon. She was an experienced O.R. nurse and didn’t appreciate being treated in this manner.

"Great! Now let’s close and see how he does in recovery." Trivoli motioned for the Chief Resident to do the honors.

Rob Kreger felt a sense of acceptance by the gesture. Here was a surgeon who strived at perfection and the task of closing was offered to him. It was something that was usually given to first year residents as a practice procedure; but right now it felt very much an honor coming from Garrett Trivoli. No matter how small or monotonous the task, the Chief Resident was sure the Fellow would be meticulous down to the last detail. It was that frame of mind Dr. Kreger kept as he sewed the layers of surgically severed muscle and flesh together.

The operation over now, Garrett addressed the other participants in the young man’s fight to stay alive. "I want to say thank you for the expertise that each of you brought to this arena today, and I will expect nothing less from you in the future. I’m looking forward to working with you again." She turned away from the group of people huddled around the dramatically illuminated form on the surgical table.

"I’ll be opting out of her cases for the next year." The circulating nurse spoke softly under her breath to the scrub nurse who nodded in agreement.

"Rob, page me if anything changes, I’m going to see if any family members are here for Lucky."

Kreger nodded his head in affirmation as he began to take off his gloves and gown. "I’ll stay with him in recovery for a while."

Stripping her mask off with one hand, Trivoli gave a small wave with the other hand and proceeded through the door. Above the O.R. desk the large wall mounted clock read 1458. ‘Seven and a half-hours of surgery, not bad for my first day. It will be even better once I have them all broken in the right way.’ Garrett thought about her empty stomach and remembered that food and drink would be necessary soon. A bathroom break and quick shower might be nice, too.

The family came first, that is if one was found. It was Trivoli’s customary ritual to meet and inform the family immediately after any surgery. It was one way that the surgeon could help to put them at ease during their traumatic experience.

Garrett approached the O.R. desk and waited for the Supervisor’s attention.

"Hello, I’m Dr. Trivoli. Can you tell me if Lucky Doe has been identified yet?"

"Sorry, doc." The older woman shook her head. "But there is a message for you from Dr. McCormick in the E.R. to call him when you are done."

"Thanks," Garrett motioned to use the phone at the desk.

"Go ahead, it’s extension 2744."

The surgeon punched in the numbers and waited for someone to answer.

"Dr. Trivoli returning a call to Dr. McCormick."

A pause, then, "Have him page me at 1048 when he has a moment to talk then." The surgeon replaced the phone, acknowledging the woman at the desk with a slight nod of the head. "I can trust that after today you won’t have to call in to my Operating Theater to ask my name, now will you?"

"But doc, it’s the first day of a new year. How am I supposed to know everyone’s name?" She looked annoyed at the tall surgeon opposite her.

"Then I can assume that nobody will have a problem knowing me or my name then the rest of the year, since I’ve already told it to you." She challenged the nurse.

The nurse drew in a long breath, her eyes turning into beady little black dots. "Trust me Dr. Trivoli, I’ll make sure everyone knows all about you." She let the residual air in her lungs come out of her nose in a snort as she watched the surgeon walk away, muttering to herself, "Damn arrogant Bitch!"

************

The warm water of the shower felt good cascading down the tensed muscles of the surgeon. It was a feeling that Garrett had come to expect at the end of a surgery case, when the focus had been on the needs of the patient, every muscle, every fiber of being standing at attention ready to meet any demand. It seemed such a small price to pay in her quest for perfection. When one knew first hand of the agonizing pain that the patient was experiencing or the torment of their loved ones, perfection was all that matter. It was never going to be Garrett Trivoli that dropped the ball. The water temperature slowly increased. The soothing rhythm and heat began to loosen her sore shoulders and back. This was indeed a luxury. How many cold or tepid showers had been taken on board ship during the last three years? That never changed the reason Trivoli was here in the shower after surgery. It was more than to clean the body. The streams of water diluted the tears that were still felt inside, tears of anguish and loss over past situations and loved ones.

Beep-beep…Beep-beep…Beep-beep!

The reflective ritual dissolving with the pager’s cry egged the surgeon to finish. Garrett quickly toweled off and stepped outside of the shower stall.

The pager beeped again. The swift skilled hand of the surgeon picked it up and brought it within range of the clear blue eyes. Trivoli, recognizing the number, hastily dressed in a fresh set of scrubs and found the nearest phone.

"Dr. Trivoli here, I was paged." The surgeon waited for the person to come to the phone.

"Dr. Trivoli, this is Dr. Ian McCormick, E.R. Attending," the deep voice said. "How is Lucky Doe coming along?"

"We just finished surgery about 30 minutes ago. Lucky is doing a lot better than initially expected. He sustained several bullet wounds in the abdomen and one in the right upper lobe of the lung. The thoracic team placed a right side chest tube and cleaned the wound. The two bullets found in the abdomen shattered the left kidney beyond repair and penetrated the colon near the hepatic flexure. A nephrectomy and resection of four centimeters of transverse colon with therapeutic colostomy was preformed. A one-millimeter perforation was found in the small intestinal tract on close inspection and was repaired as well. Lucky Doe is now in recovery and holding his own at this time." Garrett was proud of the work that was done and it showed. After all, it was near perfect for not having people trained to her level of expectation.

Ian was impressed with the concise but thorough report. "I had heard that it was an awesome sight in the trauma room, the team…altogether that is. I wouldn’t know first hand, I wasn’t fast enough to even see the patient come through my E.R."

Garrett was unsure as to the exact nature of the statement. "Well, sir, I…"

"I guess I’ll just have to be a little faster than normal when I know you are on trauma call," McCormick chuckled. "Never saw a first day trauma team move so fast. I understand that there are rumors that you have been secretly rehearsing for the last few years."

"Every day is a rehearsal for the day after it. So, yes, in that respect I have been working up to it."

"Well, Trivoli, it sounds like you did exactly the right things except let me see that patient. You know that it is my E.R. that you get to work out of on those traumas." The E.R. Physician stated in a serious tone of voice, "Next time you’re down in my E.R. make sure you introduce yourself to the staff. It seems that they don’t enjoy being ordered around by the voice of a higher being. You have a fan club with the two trauma nurses, but then again it was only a meager ten minutes of fame."

That last statement shocked the surgeon. "But sir, I wasn’t down there… What do you mean by a fan club?"

Ian had found a source of contention in her armor. She absolutely hated to be liked, perhaps seeing it as a weakness in one’s character. He thought about that for a moment before goading her. "Doc, don’t let it worry you. You did well in their eyes; today you’re the hero. Next time you could be the thorn in their side. It’s a day to day kind of thing," Ian forewarned the surgeon. "I’ll see you around."

"Humph!" Garrett said with disgust as the line went dead. She wasn’t here to cater to the whims of the nursing staff. If anything, it would be the nurses who catered to her.

‘Well, I can’t wait to see what a big hit I’m gonna be with the night crew,’ Garrett mused staring at the phone. The nursing staff had always been a puzzle to Trivoli, whether in the Navy or in the civilian sector. One nurse could accept you as a person and the next would merely look on you as an intruder in their domain. Funny how you never quite knew which way it would be until you were thick in the middle of some crisis. Hopefully, things will go just as well tonight as it had this morning. After all, they were all there for the same reason. The number one priority in the surgeon’s mind was always how successful her skills had been on her patient. Garrett could not see it any other way.

*************

Always put the patient before one’s self was the surgeon’s motto. Today was no exception to the rule as Dr. Trivoli stopped in the recovery area to check on Lucky Doe before she found the cafeteria. The patient now had a much better color than the bloodstained pallor of earlier. Checking the chart, one could see that the Chief Resident had only signed out several minutes before.

Garrett was pleased to see that the warning about how a patient was cared for had been heeded. Perhaps this would be a very enlightening year after all. Satisfied, the surgeon continued in the quest for nourishment.

‘Perhaps a meal might make me a bit more mellow for the next shift of nurses,’ pondered Trivoli. ‘I at least owe them that or they’ll think of me as some kind of dark ages warlord.’ It was going to be a long time until this night would be over and a hungry surgeon was not always the most tolerant of new surroundings or people.

The time was well after 1800 hours when Garrett was making her way to the cafeteria. The sight of her department head took her by surprise as he came down the hall toward her, still dressed in his lab coat. She would have thought him gone by now. His eyes lifted to settle on her striking figure and a spark of recognition came to his face. He quickly maneuvered the hallway, darting between its human obstacles until he was face to face with the tall surgeon.

"Ah, there you are Dr. Trivoli. I need to talk to you." His voice was calm and unwavering as he motioned toward his office down the hall. "Let’s go into my office, shall we?"

Nodding, the woman followed him into the office. The surgeon’s mind was racing with thoughts. She was sure that it had something to do with the trauma patient she had operated on all day. Had she done anything wrong? She reviewed her earlier actions, flying through them as she settled herself into the brisk pace of her superior. ‘Shit rolls down hill, well I guess I get it straight from the top now.’ She thought about the Navy and its ways, the chain of command and how the orders and discipline came down through the ranks. ‘Well, let’s see, the ball will start rolling with the Chief of the Service/Attending who will question the Fellow then pass it down to the Chief Resident who will ream out the Resident who in turn will yell at the Intern who will blame the Medical Student. Yeah, that seems right.’ It was all coming back to her, the civilian hospital chain of command.

"Dr. McMurray, I…" she started only to be interrupted.

"Have a seat, Dr. Trivoli," the older man pointed to a chair on the other side of his large desk as they entered the room.

The office was large, a symbol of his importance in the hospital setting. It was modestly furnished with several photos of the good doctor in his travels fashionably displayed among the bookcases and on the desk. Garrett’s eyes studied them as she sat down in the appointed chair. There was a common person in each of the photos next to the distinguished surgeon; it was a woman who always appeared at his right side, a gentle smile gracing her face.

Noticing her interest in the photo on his desk, he picked it up and began to reminisce. "This one was taken when I was in New Guinea," a smile crossed his face. "We spent two weeks there, my wife and I."

"She’s a beautiful woman, Sir." The tall surgeon leaned forward to get a better look. "You must have had some wonderful times traveling with your wife."

"Yes, we did. Heck! We still do." His index finger gently glided over her image under the glass. "Best thing I ever did," he grunted, "I’d do it again." He regretfully put the frame back on his desk, allowing his eyes to linger on it for a brief moment longer. "Well, enough about me. I want to talk about you." His voice was now all business as his brown eyes stared directly at her.

The surgeon felt like she was being dissected right there in his office, his piercing gaze trying its best to cut deep into her soul. Her back stiffened and her shoulders squared in a mock attempt to ward off his insight into her being. She had a thick shell, one that had hardened over the years and she was sure that no one would be able to penetrate through it. It had been her survival tactic and allowed her to move from one station in life to another, never fearing the hurt that life brought with it. After all, it couldn’t hurt if it never got close enough to her to leave any impression.

Steel colored eyes locked onto brown as she asked, "What about me?" She leaned slightly forward as if to challenge the man.

They stayed there for what seemed to be an eternity, until McMurray blinked as he sucked on his teeth making a sharp noise. He sat down in his high-backed leather chair and swiveled it away from her, his mind gauging her boldness. ‘She may be a woman, but she’s got balls bigger than a lot of men I’ve known.’ His mind recounted his first day as a Fellow many years ago. He saw so much of himself in her that it was scary to think about. Right then and there he made his mind up. She was going to learn in the next year what had taken him so many years to realize. Her skills as a surgeon were by far more superior to the other two Fellows. He would teach her what she needed to know to enhance those skills and her life, not to mention the lives of all those around her.

He decided to take a hard line with her and his tone of voice showed it as he began speaking. "Every year I saddle one Fellow and make it their duty to establish a good working relationship with the E.R. staff." He swung the chair around to face her. "This year that person is you." His eyes squinted as he looked at her.

Her mouth opened abruptly. "What?" The puzzlement was written all over her face.

"You heard me. I want you to be the liaison between this department and the E.R., and that means starting immediately."

"Why me? Why not one of the other two?" She paused. "If it’s because I’m a woman…" shades of discrimination and sexual harassment ebbing at the edges of her mind.

He looked out of the corner of his eye and pointed directly at her with his right hand as he fished for something out of the drawer to his left. "I don’t ever want to hear that in my office again." He pulled three folders out of the drawer and threw them on the desk. "It’s all in here," he pointed to them. "Check for yourself if you’d like."

She looked down to see the name listed on each of the folders, Dr. Rene Chabot, Dr. Nathaniel Hostetler, and her own, Dr. Garrett Trivoli, was written on the outside. Her eyes looked up to his, pleading for some kind of answer.

"Dr. Chabot won’t have the time to invest with a family due to deliver in the next few months and Dr. Hostetler, although unmarried, will need to devote all of his time to honing his surgical skills. That leaves only you, Dr. Trivoli. You have no family, your surgical skills are refined and beyond reproach. I’ve got to teach you something in this program and this is what I have chosen for you. I suggest that you make it your business to be a part of the overall picture in that E.R. and that means spending time with the staff both inside these walls and outside in their private lives, too. I don’t care how you do it. Just do it."

The look on his face was one of no nonsense and she knew it. "But…" she grasped at thin air for words.

"No buts, Trivoli. I want to see you be a leader here, not just another blade in the system. I believe that you have a lot of untapped potential. You just haven’t figured it out yet." He shook his head as he thought of his recent discussion with several very irate O.R. staff members. "As a surgeon, your main goal is to heal through surgical intervention for the well-being of your patient." He glared at her, his face showing his anger. "Not through the use of confrontation and a demeaning attitude toward your staff. You keep this up, Trivoli, and no one will want to work with you. Then we’ll see just how perfect your little world will be when you’re all by yourself in that surgical theater."

His face softened and his voice mellowed as he reached out and touched the photo on his desk again. "Besides, you’re going to learn real fast that those nurses aren’t the enemy. One day that nurse that you threw your weight at today could very well save your butt and the patient’s, too." He glanced at the photo, then back to her. "Now go and think about what I’ve said."

She immediately jumped to her own defense. "But I’m a damn good surgeon. Why should I…"

"Because YOU," his forefinger shot out aimed right at her face. "You are a mere cog in this piece of machinery that we call a hospital. The last time I looked, Dr. Trivoli, I was the one writing your ticket in this program. Now, unless you are willing to give up this Trauma Fellowship, I must demand that you learn to become a part of the whole and not cause a hole in any part." He paused long enough for her to digest that last statement. "Did I make myself clear enough?"

Garrett rose from the seat and turned to leave. Reaching for the doorknob she paused and turned to face her new mentor. Before she could speak, she saw McMurray thumbing through her folder. "I’ll try not to let you down, Sir, but don’t expect me to change overnight. I’ve had a lot of practice at being as demanding of those that work with me as I have of myself."

"Good! Then you’ll learn to accept your own shortcomings at the same time as you do everybody else’s. Garrett, learn to get off of the high horse you’ve imagined yourself on and people may just start looking up to you for who you are, not what you are." His head never came up from out of its absorption in the folder.

"I’ll see what I can do." She exited the office and stopped dead just a few steps down the hall. This was going to be harder than she had anticipated. She shook her head and wondered what freight train had just run through and left a large gaping hole in her plan for the rest of her life. Seething to herself, she named it the "McMurray Special," vowing to never be caught in its path again. She would live with it this time, she had to, and nobody bailed out on the first day of a Fellowship Program. Besides, it was against her nature to give up.