Doctored Vows - Chapter 2

“Dr. Hoffman?”

Behind my locker door, I hide my grimace before removing it entirely.

Once I’m confident my expression represents a third-year surgical intern instead of the whiny brat it wants to portray, I answer, “Yes.”

I know who’s accosting me before I pop my head out of my locker. The head of the residency program at Myasnikov Private has the same burly tone as Dr. Abdulov, but since they pay him too much to socialize with the interns as often as his less-revered counterparts, I don’t hear it as frequently.

I skipped the dressing down Dr. Abdulov no doubt planned to unleash earlier this morning. It wasn’t by choice. When my grandmother called to say my grandfather was having a medical episode, I raced out of the hospital minus a lecture and my personal possessions—although I did gain another reason for my minimal sleep schedule.

The mystery stranger hasn’t left my head since our eyes collided. His handsome face was pulled in a frown, but that didn’t detract from his appeal. His first impression exuded downright sexiness, and his smirk alone conjured up hundreds of wicked thoughts when I finally crawled into bed a little after six.

If I had an iota of energy left after helping my grandfather through a severe bout of respiratory insufficiency, I would have tried to put the visual to good use.

Alas, my nether regions remain as unbasted as my grandmother’s overcooked Christmas turkeys.

Although I had planned to arrive for my shift earlier than the assigned time, the alarm I swore I set didn’t sound until minutes before my next double shift.

I nod like I have no clue what Dr. Sidorov could want to discuss when he asks, “Can I speak with you?” before I follow him into the hub of Myasnikov Private.

Top-of-the-line desks and bulky leather chairs are nothing out of the ordinary for private hospitals run with profits in mind more than integrity, but it still frustrates me.

Dr. Sidorov’s desk cost far more than the B12 deficiency test they tried to deny Mrs. Ivanov.

When did possessions become more important than ethics?

My heart sinks when Dr. Sidorov gestures for me to sit across from him before he slides a multipage document across his desk. I put on a brave front when my grandmother planted her hands on each of my cheeks before she told me how proud she was of me, but I can no longer hold back my fear that I am about to lose my ability to practice medicine.

It’s so prominent my vision is too blurred to read the thick black ink in front of me.

“I shouldn’t have said what I said. It was a long, tiring week, and I acted like a brat. But I promise that the patient’s best interest was always at the forefront of my mind. That’s what we’re about, isn’t it? The patients?”

I wave my hand at his door like the wards filled with sick people are outside, my heart sinking when my hand drifts past priceless paintings and collectible antiques on the way.

Defeated, I slump low before vying for another semi-paid position. “Will you at least consider deferring my residency to the general hospital? Their surgical roster won’t be as demanding as Myasnikov Private, but I’m sure I will get an occasional sit-in when the time comes to defer my studies to a specialist position.”

My eyes snap up from my hands when Dr. Sidorov replies, “And lose an upcoming neurosurgeon prodigy? Don’t be absurd.”

I couldn’t be more shocked if he had slapped me.

“I… He…” I whisper my next set of words. “I called Dr. Abdulov a pig.”

He checks a document before correcting, “An uncaring, arrogant, chauvinistic pig.”

Since I have no defense, I remain quiet.

It is for the best. I may have missed his praise if I had tried to plead innocent.

“And you were right.” Shock zips through me when he grins. “He is a pig.” I haven’t gotten over my first lot of disbelief when I’m hit with another dose. “Your diagnosis was also correct. Tests proved Mrs. Ivanov has a severe B12 deficiency. She was given her first dose of serum hours ago, and her prognosis has already drastically improved. We removed the ventilator and lowered the sedatives keeping her under. She woke two hours ago.”

My mouth falls open, but other than that, it refuses to adhere to any other prompts my brain is giving. I knew her diagnosis could be unearthed without a scalpel. I’m just a novice at being told I was right by anyone, much less a supervisor.

Even when they’re proven wrong, they rarely admit it.

“Her surgery?”

That’s it. That is all I can get out—two measly words.

“Was canceled this morning. Her B12 levels were so low she will be rostered for bi-weekly serum injections…” His words trail off when an emotion I didn’t mean to show leaps onto my face. “Do you disagree with my medical plan?”

“Umm…” Please excuse my idiocy. The genuine interest in his tone has left me a little dumbfounded. “I don’t disagree with it. I just want to make sure the dosage level isn’t too excessive. An overdose of B12 can be as dangerous as a deficiency. What was the level identified in her MMA test?”

“We conducted the homocysteine test. It was…”—again, he checks a document in front of him—“thirty-eight.”

“Thirty-eight picomoles per liter?”

I sound shocked. Rightfully so. Those levels are dangerously low and are most likely the cause of Mrs. Ivanov’s numerous neurological episodes. It would have made it seem as if she were having a stroke, or worse, it could have caused a stroke.

When you’re deficient in B12, it causes an increase in homocysteine. Too much homocysteine causes inflammation of the blood vessels and oxidative stress—both significant contributors to strokes.

“Was an MRI conducted?”

When Dr. Sidorov nods, I hold my breath, waiting for him to elaborate. “It showed increased blood flow, but no dangerous clots were sighted.”

I exhale deeply, relieved. “That’s wonderful. I’m so grateful.”

“As was Mr. Ivanov.”

His words pique my attention as my heart rate soars. I don’t know if it is a good or bad surge. It may be a bit of both. The “Mister” part of his comment instantly conjured up murky brown eyes and a devastatingly cut jaw, but it also proves a relationship between the patient I assessed and the man who kept me awake half the night.

I can only hope it is a blood relation and not one founded by law, or my limbs will be weighed down with guilt instead of untapped sexual exhaustion.

My focus shifts back to Dr. Sidorov when he says, “You were mentioned multiple times while he endorsed a check to fund the new wing slated for completion by the end of the year. The praise was so inspiring that it felt right to offer you this now instead of waiting for your residency to end.”

When he nudges his head to the multipage document, I lift it from the desk. My eyes aren’t as misted now, so the font is legible.

“You’re offering me a promotion?” Before he can answer, my eyes bulge out of my head. The wages cited must be annually instead of monthly like my residency contract because the digits are excessive. “I think someone made an error. This amount can’t be right.”

Dr. Sidorov laughs when I twist the contract around to face him. “It is as stated and will be backdated to the day you began your third year.”

I do a quick calculation and almost squeal when the figure means I can pay off my grandfather’s latest medical insurance excess bill and some of my credit card debt. There isn’t enough to put toward my student loans, but it far exceeds the internship hourly wage I was earning only hours ago.

“Are you sure this is allowed?” I ask, confident I’m dreaming. “I’m not yet a qualified surgeon.”

Again, he nods. “Things are different in the private sector.” His eyes gleam with excitement. “And if you continue to encourage endorsements like the one you secured this morning, this is just the beginning of an illustrious medical career with Myasnikov Private.”

I almost fall over backward when the check Mr. Ivanov donated is exposed. Even with my new salary giving me indigestion, it would still take me working two jobs for over three decades to earn the figure cited on the handwritten check.

Doubt creeps in when Dr. Sidorov hands me his favorite pen out of the breast pocket of his jacket. He’s been behind the scenes at this hospital for so long that he no longer wears a doctor’s coat or scrubs.

“Would you mind if I take the contract home and read it before signing it? My mother always said you should never sign anything without reading it twice.” My wet eyes are back, but more from fond memories than fear of unemployment. I loved my mother dearly, and I miss her every day.

Dr. Sidorov seems put off by my request, but he still obliges. “I guess that won’t be a problem.” He removes the document from his desk and places it into an envelope. “If you have any questions, you know where to reach me.”

I nod until the possible inconvenience of his offer smacks into me. “Is there someone else I should call if I have any questions? I won’t have time to review the offer until after my shifts tonight.” I overexert the “s” at the end of shifts to ensure he knows I won’t be heading home anytime within the next seventeen hours.

I’m tempted to pinch myself when he replies, “Why don’t you take the day off so you can look over it… twice.”

The humor at the end of his statement doesn’t match his pinched expression.

He looks as uneasy as I feel.

“And draft your resignation to the sterilization contractor you’ve been working for the past four months while you’re there.”

His lips raise at the bewilderment on my face.

I wasn’t aware he knew about my secondary employment.

“I’ve known for some time but figured you’d give it up when awarded a full-pay contract.” He sees something I didn’t mean to express. “Was I wrong?”

“No. I… ah…” I roll my shoulders before saying with more certainty, “No. You are correct. I just don’t want to leave them short.”

“They’ll be fine.” He sits in his big, bulky chair before raising his eyes to mine. “I’m sure you won’t be hard to replace.”

Ouch. There’s a sting my ego never anticipated after being praised so highly.

“Still, I would like to finish my assigned shifts.” When anger hardens his features, I add, “If that’s okay with you?”

He breathes out his nose before finally giving in with the faintest head bob.

“Thank you.” I gesture to the envelope in my hand. “For both. It is nice to have the belief of someone who doesn’t share your blood.”

He smiles at my praise before shifting his focus to a pile of documents in front of him. They’re not patient records, more the calculated-to-the-penny reports of the mammoth debt most patients leave with once they’re discharged.

With his focus elsewhere, I show myself out before immediately starting what I hope will be one of my last sixteen-hour-plus workdays.

With the ER overrun with another foodborne illness outbreak, this is the first five minutes I’ve had to myself in ages, and I use it by scrolling through patient records. I prefer a one-on-one approach, but there are too many overflowing vomit buckets to sneak a visit to the surgical ward, so I log into HIS (Myasnikov’s health information system) and type my patients’ names into the search bar.

Every name on my rounds roster shows a result except for Mrs. Ivanov.

“Is there an issue with HIS?” I ask a colleague, conscious it could be a software issue and not solely user error. I’m great with bedside manner, but I hate the computer side of my profession. Technology and I aren’t friends.

A nurse whose name is skipping my mind joins me at the nurses’ station. “I don’t think so. Who are you looking for?”

“Irina Ivanov.”

“Ivanov?” she asks, her tone as peaked as her manicured brow.

I nod. “She’s a patient on the surgical ward. I wanted to check her current blood workup.”

“Oh… umm…” She sounds more worried than daft. “Perhaps the report hasn’t been added to her file yet.” She clicks me out of the patient screen and logs me into the pathology mainframe we use when we’re too impatient to wait for the pathology department to upload the results to the patient’s record. “There you go.”

“Thanks.” My gratitude is short because she helped me find Mrs. Ivanov’s latest blood workup, and the results are miraculous, but she completely overlooked the fact we have a patient in a ward who hasn’t been admitted.

Mrs. Ivanov was brought in by an ambulance five days ago. That means the ER department should have handled her admission. If her time here was missed, and the department is not assigned the funds for her consultation and subsequent admission, they could lose even more medical officers than they lost the prior year.

“Who should I call to ensure Mrs. Ivanov’s admission was done correctly?”

“You could ask the admissions clerk,” answers the nurse, “but last I heard, she was off sick.” When I huff in frustration, she promises to look into it if I assist her in administrating Ondansetron to a child in bay three. “She hasn’t kept anything down in over twenty-four hours and has severe abdominal distension.”

The worry on her face has me leaping up from my seat and following her into a curtained-off cubicle without further consultation.