The Fifth Horseman

Some days are good

'Ahhhhh!' a young woman kept screaming from the top of her lungs. She violently tossed and turned on her bed. The commotion had alerted everyone. 'YOU! YOU! I WILL KILL YOU!' she yelled, her eyes transfixed to Sheila, the doctor retracted standing back horror-stricken.

'And what are you doing?' asked Dr Julie, shaking Sheila's shoulder. She noted the needle in her hand, uncapped, sharp dripping blood from the tip pointing away from her. 'Sheila, put the needle down.'

Sheila shook her head and collected herself. 'Oh sorry Dr,' she quickly disposed of the syringe needle in the sharps bin right next to her.

The nurses called in for back up, and immediately 2 broadly built Medical Assistants came rushing in, exactly what you needed for a situation like this. They held the patient down, tying her wrists to the side of the bed. She kept kicking, screaming, and even spat on one the nurses' faces. Sheila winced, pitying the young nurse, her dear friend. Sheila was the one who called her in to accompany her while she took the patient's blood for thyroid levels. So, naturally Sheila felt somewhat responsible.

'Tranquilise with a dose of midazolam 5mg stat,' commanded Dr Julie. One of the nurses nodded and proceeded to prepare the drug. The syringe was handed to the Medical Assistant or MA in short. The patient kept screaming at him, her eyes wide open, her neck moving away from the needle that came closer to her. Just as timing was right, the MA pulled up her sleeve and punctured it through her shoulder. The patient threw an even larger tantrum but enough hands were on her to keep her down while the medicine coursed its way through her muscles and into her bloodstream.

Sheila wrote in her documentation, still playing the events in her head. 'KILL ME?' she asked herself. 'Poor Nabila,' she thought thinking of the nurse who had only been the sweetest to her since she started working here. As soon as Sheila was done with the ward tasks, she crosschecked her to-do list once more just to be certain. In precisely 5 minutes, the specialist would come back from her lunch and expect all things be as immaculate as the way she left it, with all orders carried out systematically and without delay.

'OK, get the CT request, the bloods from Bed 2,5,17,28, 37, and 42, call up pathology to trace cultures of Bed 3,4, and 8, and what else...' she seemed to have a sneaking suspicion that she had forgotten something. 'AHHH!' she heard screaming again from the very same cubicle. Dr Julie exited with a group of nurses right behind her. 'Sheila, come here!' said Dr Julie. Sheila immediately ran to her Medical Officer's call.

'Here,' she delivered a tube of the patient's blood sample to her. 'Run it to the lab,'

Sheila was grateful. 'Thank y-'. Before she could finish her sentence, she had Dr Julie's hand in her gaze. 'and I need an explanation letter. For how you handled yourself. That was not professional and certainly not safe. What if she had like HIV or Hepatitis or something? Did you read her file? Let's just say she has made some questionable decisions in the past. You don't want any accidents.'

Sheila nodded humbled. Dr Julie was a good doctor, in fact one of the best around. She was her unofficial mentor, unlike the bloke they had initially assigned to her in which the most exchange they ever had was 'Hi'. Dr Julie had good skills, immense knowledge and great ideas but she was a judgemental prick. Still, flaws aside, Sheila admired her work etiquette.

Sheila crossed another task from her check-list. Her stomach growled but lunch break was now over and the Dr Lily, the specialist was back for afternoon rounds. Dr Julie recounted the events that took place while she was gone. Dr Lily didn't seem at all surprised at what happened, in fact her first retort was quite sound, 'why didn't you just call in Psychiatry and ask them to take the bloods? It's their patient anyways, we are just helping to hold their patients for them. This will only create panic among our other patients.' Dr Julie heeded the counter-point and nodded at Sheila. That only meant that it was Sheila's responsibility to call Psychiatry the next time that happened. If there was one thing Sheila learned, it was the pecking order of the hospital. Sheila couldn't turn around and nod at anyone else and that was what people meant when they told her that she was going to be at the bottom of the food chain.