Code Blue | Grey's Anatomy // Book 2 // COMPLETED

40 | Cuts

Patients who undergo an amputation often feel sensation where the missing limb was, as if it's still there. The syndrome is called "Phantom limb." It's as if the body can't accept that a terrible trauma has occurred. The mind is trying to make the body complete again. Patients who experience phantom limb report many different sensations. But by far, the most common is pain.

Walking up to the main desk that morning was like walking into a concert for some boy band. Everyone was gathered around for a quick announcement that Owen had to make. Sighing, I moved next to my friends as Owen stepped up onto the staircase.

"Okay, Folks. Let's just start." Owen sighed, "As many of you know, Seattle Grace Mercy West has suffered a financial setback. The administration is working hard to keep the impact of that setback as small as possible. To that end, we're gonna have to initiate some cost-cutting measures. The board has hired a physician advisor to help."

"What's a physician advisor?" Meredith asked.

"Well, she consults on maximizing efficiency, streamlining processes, accessing where we can trim our budget," Owen replied.

Bailey huffed, "Who to fire and when to fire them?"

Owen cleared his throat, "She's here to advise and to help. I was hoping to introduce her in person, but she seems to be late."

"Oh, on her first day?" Cristina mocked, "Not very efficient."

Everyone chuckled as Owen continued, "You can expect to see her in the halls, in your labs, in the O.R."

"So we're gonna have an accountant following us around in the O.R.s?" Derek spoke up.

"She's not an accountant. She is a trained surgeon." Owen corrected, "Frankly, she is here to try and help us. Thank you for your cooperation."

As Owen finished up, I headed down to the E.R. to grab a patient before they were all gone. "Dr. Kepner, Dr. Forrest, um, we're swamped, and I have a shortness of breath lady who needs a consult, and you probably have better things to do, but I need help, please. I'm drowning here." Stephanie walked over to April and I at the E.R. desk.

April took the chart, "What bed?"

Stephanie looked around, "One, two, three-"

"What are you...stop it." April told her, "Edwards, if you're covering the pit, it is your job to know every bed in the pit. Okay. Put on your big girl pants. You're about to learn how to run the pit. Let's go."

As April and Stephanie took off, I got paged to a room upstairs. I didn't have any current patients, but the page wasn't specific. "April, I got paged to a room. I'll be back as soon as possible. You and Edwards good here?" I asked as I walked by.

"Yeah, fine." she waved for me to go.

Making my way upstairs, I walked into a room and smiled when I saw the patient. "Skylar!" I smiled and hugged her, "Why are you here? Is something wrong?"

She shook her head, "No, no. I'm just experiencing a little bit of late set phantom limb pain. I'm just here to talk about solutions for it. I just got a nurse to page you up so I could let you know I was here."

I sighed in relief, "Good. Good. Well, I'll see if Dr. Hunt could come up and talk to you. He used to be a medic in the army so he might know something. Also, maybe Dr. Robbins."

"That's the woman who lost her leg in the crash, right?" Skylar asked.

I nodded, "Yeah, that's her. Did you come alone or is dad here too?"

"Dad's here since I can't exactly drive again yet. I think he went off to get some food. We only got here a few minutes ago but he's already hungry."

"Of course he is." I chuckled, "Well, I do have to get back to work, but I'll drop by again later."

"Sounds good." Skylar smiled.

Heading up to the Peds floor, I found Arizona in a room with one of Alex's African exchange children. Walking in, I passed Alex and Cristina as they walked out. "Hello." I greeted the mother and her daughter before turning to Arizona, "Hey, um, my sister is here and I was wondering if you could maybe talk to her about phantom limb pain. That is, if you've ever experienced it."

Arizona stared at me for a few seconds, "Oh, uh, sure. I'll see what I can do later."

"Awesome. Thank you." I told her before heading back down to the E.R.

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"Brian Turner, age fifty-five." the paramedic said as he and his partner pulled the patient out of the ambulance, "Minor head injury. Vital signs stable."

"Fell off the damn ladder cleaning the damn gutter." the patient, Brian, told us.

The paramedic nodded as he handed April the chart, "I was gonna say all that. Fewer damns."

"You'll need to know if he lost consciousness in the field," April told Stephanie, teaching her as we rushed the gurney inside.

Stephanie turned to the patient, "Sir, did you lose consciousness in the field?"

"I didn't fall in the damn field. I fell in my damn yard." Brian told her.

"Ask the paramedic, not the patient," I told Stephanie.

The paramedic smiled, "Oh, he was conscious the whole damn time."

"Um, could we just start over?" Stephanie asked.

April handed her the chart, "Uh, no time. Get him triaged. Go."

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Later on in the day, the same paramedic had brought in another patient. "And on three." one of the other doctors said as we lifted the patient from the gurney to a trauma bed, "One, two, three."

"Last B.P. was one-ten over seventy, but there was significant dashboard damage." the paramedic said.

"Stop." April told him, "Dr. Edwards, what injuries are we most concerned with in this patient?"

Stephanie looked up, "We always start with the ABCs."

"If you'd been listening to the paramedic, you'd have your answer." April turned to the paramedic, "Can you start over?"

"There was significant damage to the dashboard-" he repeated.

"What's the basic law of motion, Edwards?" April asked.

Stephanie looked to her, "The basic-"

"Energy cannot be created or destroyed, but can change in form or be absorbed," April told her.

"Uh, which means the impact to the dashboard was absorbed by the patient." Stephanie finished.

I nodded, "So the injuries we're most concerned with are?"

"Are knee injury, possible pelvis, c-spine," Stephanie answered.

"Correct." April nodded before looking to the paramedic again, "Matthew here stabilized the pelvis in the field."

Matthew, the paramedic, paused, "Uh, it really wasn't that big of a-"

"So now you can start your exam," April told Stephanie as we began.

"So I'll just...see myself out then," Matthew muttered as he handed April the last of the paperwork.

As he walked out, I caught him staring at April. It was cute, like a little middle school crush. April, however, didn't notice in the slightest. She had been running around all day, non-stop.

I decided to stay with my sister that night as she was going to have a few more tests done the next day, so I was up early the next morning and back in the pit. April, Stephanie, and I worked all day doing the same stuff as the day before. I visited my sister a few times, but no news yet about what was going on.

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"Edwards, status report." April walked over to Stephanie at the desk.

Stephanie looked up, a little startled, "Uh, uh...your M.V.C. is in bed one waiting on an angio. I paged an Ortho consult for bed two, and drunk guy in bed three."

"And what's in bed four?" I tested.

"New patient. Pateller dislocation." she answered.

April nodded, "And bed thirteen?"

"There is no bed thirteen."

April smiled, "Good job, Edwards. You passed. And your waiting room is clear. Nicely done."

"Ah, sorry to interrupt." Matthew, the paramedic, walked over to April on his way out for the night.

April looked to him as Stephanie and I smiled, "Do you need something?"

"Kinda." he replied, "I've been watching you for two days. You don't seem to slow down. I thought you might need a break. Maybe grab a cup of coffee? Probably shouldn't have started with the whole 'watching you' thing, huh? Now you think I'm some sort of creeper. I'm not. Unless you're inclined to have coffee with creepers, in which case, I totally creep, like, all the time."

April smiled wide before accepting and sending him on his way. "Aww." I gushed, "Well, we have a quick meeting in the board room, so I'm off. See you there."

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"All right, welcome." the advisor, Alana, which I had yet to meet, greeted us as the attendings and other important people gathered into the board room, "Welcome, everyone. Thank you so much for coming. It has been a privilege to watch you work, and I am so impressed with what I've seen. Dr. Karev's Pediatric African exchange program-"

"You cannot cut that program." Cristina interrupted, "I'm sorry, but these children, these...little orphans...we are the only hope they have. Many of them have rare disorders that most Western doctors rarely have the opportunity to treat. And if you stop the program, I will never get that chance again. They...they will never get that chance, the precious children."

"I have no intention of cutting it." Alana assured her, "It's a no-brainer from a P.R. standpoint. That kind of positive visibility is gold. However, there will have to be some cuts. And I'm going to suggest one that is going to seem surprising at first, but that addresses fiduciary concerns with nominal impact on the core facility and the human and physical resources."

"Oh, I'm sorry. What?" Jackson asked.

"Uh, yeah. I'm out." Bailey was confused as well.

"I am proposing that we close your E.R." Alana said.

"What?" everyone asked.

My jaw hung open, "I'm a Trauma surgeon! The E.R. is where is spend most of my day!"

"We're a level one trauma center," Owen told her.

"We're a hospital," Webber added.

"In the last three days, your E.R. went from being in shambles to peak efficiency." Alana continued.

"Well, then why would you propose cutting it?" April asked.

Alana sighed, "This allows me to see that in either case, it's not bringing in the money."

"It's bringing in the patients," Owen argued.

"Over half of whom or non-emergent, under-insured, and belong in a primary care physician's office." she explained, "You have surgical interns in there doing chest exams. It's hemorrhaging resources. Look, I know these cuts are going to be painful. But understand that I am trying to keep your hospital doors open."

"This is ridiculous." Derek cut in, "You can't close the E.R. You went to Med school. You have to ask yourself-"

"Do you have a better idea?" Bailey countered, "Because the way I see it, this woman is trying to keep the hospital from closing, in-in which case there'd be no patients, we'd have no jobs, and some of us don't have a few million to fall back on. So unless you have a better idea, why don't you just sit there and listen to what she has to say?"

"Damn," I muttered under my breath.

Alana cleared her throat, "All right. So...the other proposals include a review of I.C.U., step-down closures with a reorganization of post-op care..."

As soon as the meeting was over, I grabbed something to drink before heading up to my sister's room where I was surprised to see her and Alex talking and laughing. "What's going on in here?" I asked.

"Alex came looking for you." Skylar smiled.

I raised an eyebrow as I handed Skylar a bottle of water I got her, "Really?"

Alex stood up, "Yes, I was wondering if you wanted to grab some drinks. You know, since the E.R. is closing and you're going to be fired soon."

Skylar gasped, "You're losing your job?"

"No." I laughed and pushed Alex gently, "Alex is just being stupid. If anyone is getting fired, it's him because no one can stand him."

"Harsh." he laughed, "So, drinks. Yes or no?"

"I guess." I sighed.

He headed for the door, "Meet you at Joe's in ten?"

"Yeah." I waved.

Skylar whistled, "Ohh, you got a hot date?"

"It's not a hot date if I've been here for two days straight and I'm going to get drunk with a friend." I laughed.

"Didn't you sleep with him though?" she asked.

"Shh!" I hushed her, "We do not speak of that moment."

After making sure Skylar was good, I said goodbye to her before heading off to Joe's to get hammered and remember how good it was to have an E.R. were my skills actually went to good use.