Do No Harm

They banged through the swinging doors. A scramble of faces, and then Don standing overhead, the stifling smell of his aftershave permeating the hall. A nurse tried to pry David's stethoscope from his hand, but he didn't let her.

Don's face registering concern. "Dave-Jesus!"

Carson ran through the CWA as the gurney swept into the procedure room, his disheveled hair bouncing with his steps. He fought through the sea of nurses and interns, taking David's hand.

David squeezed his hand reassuringly. "What do we do first, Dr. Donalds?" he said weakly.

Carson took a step back. "I don't… "

Don pushed Carson aside with a glare. "Carson, get out of here. This is a serious trauma. We can't have you mucking around like before."

Through the arms of two nurses, David saw Carson's face wilt. Someone hit the brakes and the gurney slid to a halt.

"Dr. Donalds will be treating me," David said.

"Bullshit," Don said. "I'm not having that kid in here. Not after what happened last time."

"He will be my physician." David's voice was uneven from the pain, but firm.

"We don't have time for this right now, Dave," Don said, readying a syringe. "He's a medical student."

"And I'm the chief," David said sternly. "At least for now. Get out of Dr. Donalds's way."

Don lowered his hands, irritation flickering across his handsome face. "And who's going to be the attending on this case?"

David managed a smile. "I am."

Carson's voice cracked when he spoke. "Look, I don't think this is such a-"

A nurse leaned over David, then an IV needle dug into his arm. "I am not presenting either of you with a choice," David said.

"Fuck this," Don said. "Let him kill you. What the hell do I care?" Storming from the room, he shot a latex glove at the rolling trash bin, but it flew wide and landed on a counter.

"Dr. Donalds," David said. "Dr. Donalds."

Carson's eyes slowly found focus. "Yeah?"

"What do we do first?"

"Check vitals?"

"How are we looking?"

"We're looking good." Carson slid his cold stethoscope along David's side, checking his lungs. David inhaled without being prompted.

"What do you want to ask me?"

"Do you have pain anywhere else aside from the entry site?"

"No," David said.

A note of confidence crept into Carson's voice. "I want a Foley in, let's see if it nicked a kidney."

"Exactly." David clenched his teeth to fight down the next wave of pain as the nurse reached for a urine catheter. "But you may want to think about giving me something for the pain first."

"Shit. Morphine." Carson turned to the nurse. "Five mgs."

"Let's start with two," David managed. "We can always step it up."

"Two mgs. And someone get that Foley in."

A flurry of hands at David's pants, and then his penis laid bare in a gloved hand.

"Listen for bowel sounds," David said. He sensed the nurse readying the catheter to shove up his urethra and wished the morphine had kicked in. Carson took his hand. The nurse's arm tensed, and the pain set David's body ramrod straight in the gurney. Pat appeared from nowhere and wiped the sweat from his forehead with a moist roll of gauze.

Carson set the bell of his stethoscope on David's stomach.

"Lower," David said. When he released Carson's hand, the white imprints of his fingers were visible. "Lower."

"Good bowel sounds," Carson announced.

"No blood in the urine," Pat said. "I'll send it for a UA."

"Dr. Donalds, why do we send urine for a UA?" David asked.

"To check for microscopic blood."

"That's right. Next step, next step," David said. "Where are we going next?"

"We're getting you a CT to see if the shard penetrated the abdomen wall?"

"Is it a question, Dr. Donalds?"

"We're getting you a CT to see if it penetrated the abdomen wall," Carson said with more conviction. His head snapped up. "Let's move him."

Nurses scrambled around David's body like industrious rats. The gurney started moving again, heading over to radiology. Someone's arm brushed the protruding shard and David cried out in pain. His face felt as if it were on fire. Sweat ran into his eyes. He tried to slow his breathing.

They slid David onto the large white scanner and the room was cleared. He began the slow, lonely journey through the quietly whirring machine. He felt peaceful and drowsy, either from the morphine or the calm, hypnotic movement of the scanner.

When he emerged, he saw Carson through the window, peering into the computer monitor, looking relieved. The machine printed out a few sheets of CT cuts, which Carson picked up and snapped into an X-ray box. He stepped back into the scanner room with the sheet of CT cuts, finally allowing himself to smile. "Missed your large bowel by a few centimeters," he said. "No perforation, no free air. You're looking at a deep flesh wound. Why don't you take a look?"

Still lying on his back, David raised the sheet above his head so he could view it through the overhead lights. Carson's read was accurate, but before David could agree out loud, Carson had already turned to the others and said, "Let's get him back to Procedure Two."