“It must have been an emergency,” Noah said out loud in a vain attempt to buoy his sagging emotions. “Surely she must have been in a rush, and I’ll be hearing from her with all the details.” But the attempt to make himself feel better didn’t work. It would have been so easy for her to express some emotion; even just a few words would have made a complete difference.
He tried to rally his injured self-esteem by coming up with another potential explanation. With all the time she devoted to social media, maybe it didn’t even cross her mind that he might be sensitive about not being told in advance. Her constant communicating in a virtual world without all the rich, nonverbal aspects of real-time, face-to-face interaction had probably made her less sensitive to nuances of other peoples’ feelings. By her own admission, she spent most of her free time in a world where everything could be handled by a mere click of the mouse, and whatever interaction was in progress was gone without consequence. Considering all the wonderful intimacy they had enjoyed together that week, there was no way she would have wanted to upset him. It had to be more oversight than purposeful.
Feeling a strong need to be proactive rather than just sitting there feeling sorry for himself, Noah leaped to his feet. He quickly changed out of his scrubs and into his normal hospital clothes. He even decided to stop by the laundry and get a freshly cleaned and pressed white jacket to look his best. For Noah, work had always been his fallback. It had been the way he’d handled Leslie’s departure.
Fifteen minutes later, Noah was on the surgical floor, rallying the troops by calling for afternoon work rounds to begin earlier than usual. With a burst of energy, he goaded all the residents to the max, demanding particularly thorough and up-to-date presentations on all the patients as they went room to room. He quizzed everyone on the latest journal articles apropos of each case, turning afternoon work rounds into teaching rounds.
When rounds were done, Noah visited each of his own inpatients and had lengthy conversations about their progress and what they should expect over the next few days, discharging three of them. Noah then visited two patients who were scheduled for surgery the next morning. Both had been transferred from hospitals in the western part of the state, where their surgery had been botched and needed to be redone.
With no more work to be done on the surgical floor, Noah retreated down to his desk in the surgical residency program office. Since it was now well after 5:00 P.M., he happily found the place empty. His intent was to read the journal articles for the following day’s Journal Club, but instead of calling them up on the monitor as planned, he had a different idea. Although his initial intention was to visit the Annals of Surgery, he googled Brazos University instead.
The website was impressive. There were more than two hundred photos of modern buildings of red brick, concrete, and glass. He was surprised to see as much grass as he did, since he thought of West Texas as being desertlike. He could see the flat terrain surrounding the city and the horizon with a sky that seemed larger than life. He had never been to Texas, and there was nothing about the pictures that beckoned him. He wasn’t much of a traveler. The farthest south he’d ever been was South Carolina, but that was when he was a teenager.
Next Noah looked at the Brazos University Medical Center website. The hospital appeared even more modern than the rest of the university, suggesting that it was a relatively late addition. Within the website, the WestonSim Center had its own section, advertising itself as one of the world’s premier robotic-simulation centers for medical teaching after its opening in 2013. When Noah clicked on it and looked at the exterior photos of the extremely modern glass-sheathed building and read the description of the 30,000-square-foot behemoth, he had to agree. It was a sweet setup, a quantum leap better than what was available at BMH, which had to fight for space in the Wilson Building’s basement. Looking at the many photos of the WestonSim Center interior, Noah was even more impressed by the mock-up sets that looked amazingly realistic, including two fully functioning operating rooms, a delivery room, an intensive-care unit with multiple beds, and three ER trauma spaces. Noah could easily imagine Ava in all of them, taking advantage of their potential for teaching anesthesia technique and how to handle such emergencies as malignant hyperthermia.
Next Noah checked if the hospital and the medical school had all the appropriate certifications from the various accreditation organizations. It did, including the ACGME, or Accreditation Council for Graduate Medical Education. That was the key one, meaning the medical school and the residency training program were entirely qualified.
After several hours of frantic activity since leaving the OR but with nothing but busy work left to keep him occupied, Noah glanced at the time. It was now almost seven-thirty in the evening, and still there had been no additional text from Ava. With painful resignation, Noah began to accept that he wasn’t going to hear any more from her like he had hoped. It seemed that the curt, original text might be all he was going to get until she returned.
Feeling exceptionally weary, depressed, and confused, Noah stood up from his desk. He hadn’t felt this bad since Leslie Brooks had bailed out and left him with a denuded apartment. He struggled with the question of what he should do, whether he should go back to his bleak apartment or stay in the on-call facilities in the hospital. Technically, Noah wasn’t on call, but he knew there was plenty of room if he wanted to stay. Since he was in no condition to make a rational decision, he ended up staying in the hospital by default.
23
SATURDAY, JULY 29, 4:50 P.M.
After spending Wednesday, Thursday, and Friday nights in the on-call facility in the Stanhope Pavilion, Noah finally felt the need to go back to his apartment Saturday afternoon when he finished everything he could think of doing in the hospital. By then he was entirely caught up in all aspects of his wide-ranging responsibilities as the super chief surgical resident. Even the basic science lecture and the Journal Club agendas for the following two weeks were already done, as was the resident on-call schedule for the months of August and September.