Third Degree (2 page)

I’m dismissed with the wave of a hand, and then a nurse drops a stack of charts into my arms. I sigh and begin sifting through them, screening them for Rinehart to review later. An intern from another team breezes past me saying, “O’Reilly wants you in his office, stat.”

I straighten up. “Did he say why?” My heart is now drumming twenty extra beats per minute. There’s only one reason for the chief of surgery to call me into his office today.

My residency assignment
.

The girl shrugs and then gives me a patronizing look. “Come on, Isabel, you know you
got Johns Hopkins. There’s no way they’d let any other hospital snatch you up.”

A surge of confidence floods through me. I take the stairs two at a time up to the ninth floor, reciting the stats I’ve come up with to mathematically predict which residency program is most likely to accept me. It’s always been Johns Hopkins. That’s where my dad completed his cardiothoracic surgical residency. And that’s where I plan to be in a couple of weeks.

When I arrive at O’Reilly’s office, the door is open and my dad’s occupying one of the chairs across from the desk, his white lab coat hanging off the side. Why is he here? This must be good news, and the chief wants Dad to share the moment with me.

O’Reilly looks at me, his face unreadable. “Have a seat, Isabel.”

I toss my long brown hair over one shoulder and tuck my coat neatly under me as I sit.

O’Reilly’s forehead wrinkles and he tosses a manila folder onto his desk, opening it and revealing a stack of pink pages. “I’ll get right to the point, Isabel. You haven’t been accepted into a residency spot at this hospital—”

“I understand completely.”
Johns Hopkins, Johns Hopkins, Johns Hopkins
. It’s so close I can taste the Baltimore crime-capital air.

Dr. O’Reilly’s gaze zooms in on mine. “You’re not accepted into
any
residency program.”

I stare at him, my jaw slack, mouth hanging open. “Wait … 
what
?” From the corner of my eye, I can see that Dad hasn’t moved or reacted. He’s staring down at his hands. Did he already know?

“Your score on the emotional readiness portion of the exam wasn’t high enough to grant you a license to practice medicine without supervision,” O’Reilly explains, his voice flat.

Emotional readiness exam?
“You mean that psych evaluation you made me and Justin take?”

“Yes, that would be the one. And scoring in the adequate range is a condition you and Dr. Martin agreed on when I allowed you into this surgical program despite your age,” he says, even though he’s fully aware of my inability to forget facts and details like these.

What the hell was wrong with my answers?
I play back every bit of the hour-and-a-half-long session with the psychologist and find nothing I said that would make her deem me incapable of handling the job.

“The consensus among all the hospitals that considered you for residency programs is that you don’t have the ability to see consequences, to understand the impact your actions have on others, and though we have no incident to report of you making a poor medical decision in regard to a patient—”

“Exactly,” I interrupt.

“—it’s still a big risk none of the programs, including this hospital, are willing to take,”
O’Reilly finishes. “You would be in charge of interns, overseeing their education. You’re not ready for that, Isabel. You’re eighteen years old.”

“Eighteen and three-quarters.” My chest is tightening. I can’t breathe. No, I’m breathing. But struggling.

“Given your age and short trip through med school, there was always a chance you wouldn’t be ready for this next step.”

A chance, yeah. But I never thought it would happen. “That’s it? I’m done? I can’t be a doctor? Why the hell did you let me get this far if I couldn’t keep going?”

Dad wraps his arms around my shoulders. “It’s all right, honey. Take a breath.”

I inhale and exhale slowly before lifting my eyes to look at O’Reilly again. “Is this because of what happened today? The diabetes kid?”

“Just got that complaint in.” He points to a stack of pink papers. “That’s just one of many similar reports.”

“Does it say anywhere in that report that Justin wanted to diagnose him with food poisoning? Please tell me he didn’t get into any programs, either.” O’Reilly looks down at his hands.

“He did, didn’t he?” I shake my head. “God, that’s fucked up.”

“Isabel,” Dad warns, releasing me and turning his attention to his boss. “What are her options, then? Another year as an intern?”

“This hospital has already filled its intern quota for the fall,” he says. “You can apply to other programs, but I’m sure it would be the same situation. I can recommend her for a position in lab research. There are a number of facilities in the Chicago area—”

“I’m a surgeon. I’m not going to work in some lab, cutting up rodents.” I shake my head in protest. “I’m the best intern at this hospital and you know it.”

“You’re the most knowledgeable intern in the surgical program,” O’Reilly agrees. “But there’s a lot more to being a doctor than knowledge and diagnostic ability. Your practical surgical skills are above average, but not the best.” O’Reilly leans back in his chair, drumming his fingers together. “Perhaps this is simply an issue of lacking typical life experiences for someone your age. At least that’s one of the theories Dr. James presented in her evaluation. She pointed out that the majority of eighteen-year-olds are either just beginning college or starting out in the work world and have no real concept of their long-term plans. Dr. James believes your certainty may be a mask for avoidance of important age-related milestones.”

What a bunch of bullshit
. Even O’Reilly doesn’t sound like he believes any of that. I scowl at the memory of the pinched face, pressed pants suit, and perfectly in-place hair that came with Dr. Winifred James, Ph.D. She doesn’t even have a real medical degree.

“I’ve spoken to the AMA,” O’Reilly adds, obviously uncomfortable with the topic of
female adolescent milestones, “and they’ll allow you to retake the emotional readiness test, but not before at least six months have passed. That gives you a little downtime to do some thinking and experiencing.”

“What am I supposed to do for six months?” My whole life I’ve been on the fast track, never waiting for those age-related milestones. I’ve never had downtime. I’m not even sure I know what it means.

O’Reilly and Dad drone on about options for me and my destroyed future, but I can’t listen. All I can do is think about that stupid psych evaluation and getting my hands on it.
Dr. Winifred James, Ph.D., what else did you write about me?
I need to know where I went wrong. I need to know how to pass next time. But getting hold of it would be completely illegal and require a great deal of hacking—something I’m fortunately very capable of.

My devious and illegal planning is interrupted by O’Reilly’s secretary poking her head into the office. “Dr. Jenkins?”

“Yes?” Dad and I both say, twisting around in our chairs. I’m sure he’s replaying his patient list for today in his head like me, attempting to guess who might have taken a turn for the worse or be in need of further consultation.

“This Dr. Jenkins,” she says, pointing at me. “You have a speaking engagement in thirty minutes?”

I groan, remembering. “Fuck,” I mumble, but not low enough to avoid being heard. I stand up and wiggle my chair back into place. I’m only an intern for a few more weeks, so what will O’Reilly do if I skip out on this stupid task?

Dad looks like he wants to say something more, but I wave him off and bolt out of there. I don’t want to hear any patronizing speeches about everything turning out okay.

And to add an extra blow to my day, I have to face Justin and the smirk he’s wearing right now.
He knows. How the hell does he know already?

I squeeze my eyes shut for a moment and take a deep breath before approaching him. Justin holds out a wad of twenty-dollar bills.

“Who told you?” I say, staring down at the money.

He shrugs. “Word gets around. And no, I’m not going to say I’m sorry you flunked your test, if that’s what you’re thinking.”

“We both know you’re not sorry.” I glare at him. “Put your fucking money away. I don’t want it.”

He has to jog to keep up with my brisk pace. “What are you gonna do now? Where are you going to go?”

My fist pounds against the elevator button. “Somewhere you’re not.”

“Well, I’ll be
here
, so …” His grin broadens.

It’s hard to keep the shock from my face. As the elevator doors open, I reach over and snatch the money from his hand. “On second thought, I’ll take the cash.”

“You’re right.” He leans against the elevator wall. “I’m not sorry you failed, Izzy. And it’s quite possible I hope you fail in your next somewhere-that-isn’t-here location.”

I can’t freakin’ believe O’Reilly’s giving him a resident position in this hospital. My dad’s home base. My second home, practically. My stomach sinks, replaying every piece of the conversation I’ve just walked out on. My body has physical aches at the thought of this failure, of my lack of direction. What the hell am I supposed to do now?

I’ve been around this campus and university hospital since I was twelve years old. Leaving this and moving to Baltimore wouldn’t have been easy (though I’d gladly accept the challenge), especially not for someone like me, who places a lot of value on staying in the same spot for long periods of time. I’ve lived in Evanston with my parents since I was five, but there’s still that fear that something might happen and I might go back to not having a permanent home, like when I was with eight different foster families during the first five years of my life. It was so lonely it hurts to think about. In fact, I haven’t let myself think about this in years.

But right now I feel a hollow emptiness that comes with having my life thrown off track. It’s no different than when I was floating between foster homes—I wasn’t good enough for the last family, or the one before that. And now I’m not good enough to be allowed to practice medicine on my own.

Chapter 2

@IsabelJenkinsMD:
Will be MIA from the Chicago area until December. Taking some downtime to do something completely new …

A few years from now, when I look back at this moment, I think I’m gonna be asking myself how the hell I went from eighteen-hour shifts at a top hospital, scrubbing in on heart surgeries and brain tumor removals, to living in a college dormitory at a subpar university, taking classes that begin with course numbers like 101 and 102.

It’s good to step out of your comfort zone
. That’s what my mom said. She’s a high school biology teacher and therefore constantly using phrases like that, as well as others like
acting out
or
making bad choices
. When I told my dad my plan to have a normal college experience, he went on about his frat brothers and the parties they had. But he never really said whether he agrees with my choice or not. Oh well, too late now.

I’m Izzy Jenkins, regular freshman, on move-in day
. I repeat this several more times while navigating my way through this very corn-infested town. I’ve never been Izzy. Always Isabel. But I figured the new name might help shake off some of my old self.

And who knows? This could be fun and life-changing. I’ve spent the past month studying fashion trends and making sure I have a wardrobe that will help me blend in well with my peers. It wasn’t too difficult a task—it’s not like I’m a fashion failure to begin with. But being a medical intern for the previous school year meant I had clothing items that were more functional than cute.

I pull up to the circle drive of Lincoln Hall and take a deep breath, scanning for an open parking spot. Minivans and SUVs are jammed into every inch of available space, parents hustling around, carting boxes and things like underbed storage bins. It’s like ants flocking to a fallen french fry. Someone honks at me from behind and I’m forced to circle the building five times before a gray minivan finally pulls out and provides a space large enough for my compact car to slip into before anyone else can.

I put the car in park and grab my phone to call my mom. “I made it.”

“How is it? Have you met your roommate yet? Any cute boys?”

I glance out my window, taking in the chaotic atmosphere and the young people in matching T-shirts holding clipboards and attempting to direct students to the appropriate locations. “I’m sitting in my car in the circle drive. You told me to call you when I got here, so I did.”

Mom laughs. “You’re right, I did say that. You sound nervous. Are you nervous?”

My stomach is doing flip-flops, so I know the answer to this question is yes, but I’m afraid my parents will think I can’t handle this. I might have spent plenty of time in college already, but I’ve never lived in the dorms or done anything that fell into the “student life” category. I was still a kid then. But I’d rather have them worry about themselves than me and my weird plan to be normal.

“Yeah, Mom, I’m nervous.” I suck at lying. This whole normal-girl façade might be an epic fail. “I’m gonna go move in, okay?”

“Okay, hon, call me in a couple hours.”

After hanging up, I give one last glance at my phone like it’s my parents waving goodbye, which they did two hours ago before I drove from Evanston, Illinois, to DeKalb, Illinois.

I’m balancing two boxes I’ve just plucked from my trunk when a tall guy with dark wavy hair and bright orange flip-flops abandons the parents he was talking to and approaches me. “I’m not supposed to let you leave your car unattended. The circle drive is for loading and unloading only.”

Since he’s the epitome of physical attractiveness—impressive musculature, above-average height, good bone structure, attractive facial features—my defenses are already up. I drop the boxes onto the sidewalk with a loud thud. It’s noon, and the late August temperature is already causing sweat to pool between my boobs. I cross my arms and stare at the guy with the impractical footwear. “I’m here alone. What do you propose I do? Head back to Evanston and forget this whole college thing? Because we both know the assigned parking for students is a mile away and I can’t exactly make twenty trips back and forth before classes start tomorrow.”