Flatlining

010

"Dr Ellis, present," Dr Devine instructed but Evelyn was stuck partly in her shock. When she started rounds that morning, she wasn't expecting Dr Fender's mother to be patient number one of the day.

"Oh, uh, Sh-Shirley Fender, sixty-two, history of aortic valve replacement following an episode of infective endocarditis six weeks ago," she read aloud, the dots beginning to connect in her head. Six weeks ago, right around the time Dr Fender went AWOL for almost a month, which made sense if his mother was seriously unwell. No wonder he was so fussy over the woman when she came to visit him at the hospital. "Has opted for elective surgery to replace the mechanical valve with a bovine xenograft."

"Pros and cons of a xenograft?" she asked sharply.

"Xenografts don't last as long as mechanical valves but eliminate the requirement of anticoagulants," she answered as the door swung open, Dr Curtis strolling in with a tablet beneath his arm.

"And why isn't the patient a good candidate for anticoagulants?" he questioned casually with one hand tucked into his lab coat.

"Anticoagulants increase the risk of haemorrhage but the patient also suffers from chronic kidney disease due to hypertension, which increases the chance of anticoagulant-related nephropathy," she explained. "She's also taking regular ACE inhibitors to treat the hypertension, which are contraindicated by anticoagulants for risk of angioedema."

"Well, Shirl, she knows her stuff," Dr Curtis grinned as he joined her bedside, bringing the older woman into a hug that left Evelyn and the group of interns feeling slightly confused.

"Hello, Thomas," Shirley beamed.

The door once again opened, this time revealing Heidi, who clearly wasn't expecting the attention of the whole room to befall her. Her eyes widened, pink dusting her cheeks as she muttered an apology for her tardiness but when she noticed Shirley, she frowned, "Shirl?"

"You two know each other?" Evelyn questioned in shock.

"Of course, Tom's been friends with Sam since they started med school," the older woman explained with a fond smile.

"I don't follow," she murmured, eyebrows scrunching in confusion as her eyes flicked between Heidi and Shirley.

"Heidi's Tom's sister," she continued, not sensing the hesitation from the girl in question, who wore a conflicting expression. Evelyn's eyes widened in shock as the information was revealed to the room, a mixture of reactions flooding the faces of the group of interns. "Known Heidi since she was about twelve-years-old."

"That's—"

"Not a word, Dr Crawford," Dr Devine drawled sternly, causing the intern's mouth to snap shut although his nostrils flared with annoyance. Evelyn wasn't sure if their resident was aware of the relationship — not that she gave any indication that the information had shocked her.

"Dr Ellis, you're with me today," Dr Curtis instructed, quickly changing the subject to save his sister from the unwanted attention.

"O-oh, I'm actually on Dr Fender's service until further notice," she explained, her cheeks heating as she recalled the reason for her being stuck with him in the first place. It wasn't something she wanted circulated, especially not in a room with the attending's mother.

"Not today you're not," he told her, scrolling through the tablet as Dr Devine ushered the rest of her interns out of the room to finish their rounds. "I want a full pre-op panel, prothrombin, chem seven, blood cultures and an echo."

"Right away, sir," she agreed.

"I'll leave you in the capable hands of Dr Ellis, Shirl," he grinned.