A Degree in Murder

Chapter One: Call of Duty

The wailing of the ambulance siren grew louder and louder, temporarily distracting her from the task at hand. Although this was a sound she should be accustomed to, Eleanor could not help but wonder the cause of the emergency. Even though her job banked on the illness of others, she derived no pleasure from their suffering. All life was precious irrespective of race, religion, political views, social standing and sexual orientation.

Why does it feel like the only time I'm fully focused on my work is when a patient is right in front of me.

Eleanor focused herself and returned to her work: updating her curriculum vitae. As the head of the new anaesthesiology department at the Ridgeville Memorial Hospital, resting on her laurels was tantamount to career suicide. She was a career woman through and through, allowing nothing to get between her and the lofty goals she set for herself. This continued to be a bone of contention between her and her parents. However, the sense of pride Eleanor felt looking at her life's work served to only strengthen her stance. After several minutes of furious typing, her office phone started ringing. She picked up immediately upon seeing where the call was from: the emergency room.

"Good morning Dr Priest, we have a situation. An eight year old boy has presented in anaphylactic shock after he was stung by a bee. We administered oxygen and adrenaline but his oxygen saturation has continued to drop. The ER doctor failed to intubate him and we fear he might-."

"Say no more. I'm on my way," replied Eleanor, quickly placing the receiver down and rushing out the door of her office. She raced through the second floor corridor to the elevator and repeatedly pressed the G button. When the elevator doors opened at the ground floor, Eleanor resumed her short sprint to the ER. She passed a few doctors on the way, responding as tersely and politely as possible to their greetings.

"How long has he been on oxygen?" asked Eleanor, entering ER one.

"Four minutes and counting," replied a nurse, continuing the oxygen administration via the bag-valve-mask system.

"Great. We'll need to sedate him before the intubation. Please prepare midazolam and succinylcholine for the rapid sequence induction and intubation procedure," said Eleanor, performing the difficult airway assessment. When she was done, she understood why the young ER doctor struggled.

The midazolam was administered followed by the succinylcholine via the IV line in the boy's left forearm. When he started to lose consciousness, Eleanor grabbed a laryngoscope from the crash cart. She gently extended his neck with her left hand while using her right hand to position the laryngoscope in such a way that she could see his vocal cords. When they came into view, she quickly pushed the endotracheal tube (ET tube) through them. Satisfied with her technique, Eleanor secured the ET tube in place. She listened to his chest in five different positions and used an ultrasound scan to ensure the tube was in his trachea. Eleanor took a total of three minutes to complete the procedure, to the amazement of everyone watching.

"I'm sure you guys can take over from here," said Eleanor, breathing a sigh of relief when she saw that his oxygen saturations were rising.

"Yes we can. Thank you so much, Dr Priest," said Ogun Adebayo, the ER doctor.

"You're welcome. Please keep me posted on his progress," said Eleanor, walking out the door. She turned towards the direction of the elevator, moving at a steady pace before she was stopped by an all-too-familiar voice.

"Good morning EMP."

Shit.

"Good morning Sosuke," said Eleanor, gritting her teeth and forcing a smile. Sosuke Hirosaki was her fellow anaesthesiologist and the one person Eleanor could not stand. Bitter from losing the race to become the inaugural Head of the anaesthesiology department to a woman younger than himself, he shamelessly set out to undermine her at every turn.

"I'm sorry. I forgot that you hate that name. What are you doing so far from your office this early in the morning?" queried Sosuke, feigning interest.

"Well, if you must know, I was called to assist with an emergency. That's part of what we do here, remember? Speaking of early in the morning, you're thirty minutes late," said Eleanor, looking at her watch.

"I'm sorry, boss. Traffic was a BITCH today," replied Sosuke, staring at the ceiling for no apparent reason.

Eleanor took a deep breath, choosing her words carefully and said, "Look, I don't like this anymore than you do but we have to work together or else we'll lose what we fought for in the first place. Besides, it's not like I'll be HOD for life. You'll definitely have your chance."

"I guess you're right about that. We can't risk having the department dissolved before I've had my chance and I will have my chance," said Sosuke, finally turning to her.

"That's the spirit," said Eleanor, entering the elevator, "Anyway, I gotta run. I have to finish updating my CV. Loads of interesting stuff to add there."

Sosuke glared at her until the elevator doors slammed shut.