《Mending Broken Hearts》15. The Next Day
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5:00 am...shut up stupid phone...hit snooze
5:05 am...why won't this stupid thing shut up?...hit snooze
5: 10 am...two more minutes, then I'll get up...hit snooze
5:40 am...oh shit, I am late!! Damn it!! Stupid phone...why didn't my alarm go off?
6:15 am in the ICU residents room: "Madi...I am so sorry I am late...my alarm didn't go off this morning"
"Don't worry about it, I just got here a couple of minutes ago", a sleepy Madi said to me, "Kylie and her intern are still signing out to the other team, I am going to run and get some coffee. Do you want something from the food court?"
"You know what...let this be the first day ever of me drinking coffee. I'll walk with you"
Last night, I had reached home after 11 pm and had gone to bed right after that. But so much had happened on that one day in the ICU, I lay in bed for several hours trying to process all of it. I had started the day with almost punching a resident, then arguing with Noor's husband, then telling her that he loved her, then escorting their baby to her new home for the next few days...and then of course rescuing Madi from in front of the ice cream section in the pharmacy, and being dumb enough to hug her, even though she was completely safe at that time.
So was I over Noor now? Was this it? After years of obsessing over her, had it really taken me less than 12 hours to realize that she and I were probably never meant for each other? And how did I actually end up getting along with her husband?
By 1 am, I thought I had all the answers to that part of my day. Maybe I never loved Noor the way I thought I had. I had dreamt of a life with her, but maybe I just wanted to be with someone I could call my own, who would care about me as much as I cared about her. I had lived on my own for almost 11 years, with med school and then PhD, life got lonely. And she was a good friend who always seemed to be there for me, but clearly it wasn't in a romantic way and I had misread the whole situation. Seeing Salman with Noor, had made me realize that what I had with Noor wasn't even a fraction of what he had with her.
I also tried to unpack the rollercoaster of feelings that I had gone through when I thought Madi was in trouble. But I was very, very uneasy about having any thoughts related to Madi. She was engaged, she was my senior resident, she was way out of my league, and most importantly I told myself...I was not looking for any relationships. The last one I was in, had stalled my life by almost a year. I needed to get back on track if I was ever going to achieve my ambitious professional goal of becoming a physician and a scientist. And thinking of Madi as anything more than a friendly colleague would open up a pandora's box that I could not afford.
So last night, just before I had dosed off, Madi was on my mind. But only because I had made a resolution that I would strictly adhere to our friendly professional boundaries. I got along with her very well, there was no doubt it. And it really was nice to have someone smart and intelligent like her, as a sounding board for career advice.
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I had a feeling that anything more than that would put me on a slippery slope leading to a place that I could not afford to be in...and where I may find myself alone, again.
"Are you trying to put milk in your coffee, or coffee in your milk?", I heard Madi say, as she looked at my large cup that at the moment was half filled with 2% milk.
"The latter...", I grinned at her, as I filled the remainder of the cup with coffee and then put two sachets of sugar in it to cover up any remaining coffee taste.
She feigned anger and replied to me, "Omar, you are a disgrace to coffee drinkers...next time just have a Mountain Dew or an energy drink, and don't you dare stand next to me making that abominable concoction!"
Then we both laughed and made our way back to the ICU, ready for another day of insanity.
See...we get along very well, as friendly colleagues. Only a fool would mess this up!
Rounds that morning went by relatively fast. No one needed to be put on a ventilator or rushed off to surgery. When we went by Noor's room, Salman was fast asleep on a chair with his head on her bed and his hand clasping hers. Our entire team looked at each other and nodded in agreement that we should skip her room for the moment and let him sleep, so we moved on to the next room.
"Poor guy...we should check up on his daughter once rounds finish", Madi whispered to me.
"Absolutely!", I whispered back.
The overnight team had reported that Noor had a relatively stable night. They were able to take her off epinephrine, the medicine that was helping her heart pump, and her blood pressures had remained stable. They were also able to decrease the ventilator settings, which meant that her lungs were starting to recover.
An hour later when we came back to Noor's room, Salman was awake and so we included him in our discussion on Noor's care.
"I am glad she had a good night...but her road to recovery is still long", the attending told Salman, "You know that better than anyone else, so Salman, please pace yourself. Between your daughter and your wife, you're going to need help managing everything"
"Yes Dr Muller, after the last 24 hours that has become very evident. My sister is coming from Kentucky for a few days and then my mother-in-law is trying to get a US visa to come from Pakistan. We hadn't planned on her coming for at least another 6 weeks so just trying to rush things now...", Salman replied.
"Good...well let us know if anyone of us can help at all", Dr Muller told him with a sincere smile.
Salman looked at Madi and I and gave us a small, tired smile as well. He was holding himself together remarkably well, given everything that had happened. I was a little surprised at the speed at which I was developing respect for that man, but I guess that was life...unpredictable, yet miraculous, as long as you kept an open mind.
While the attending listened to Noor's lungs, Salman said to us, "Do you want to see my daughter's pictures?"
Madi and I nodded, as he whipped out his phone and proudly scrolled through pictures of his tiny daughter in her incubator. As tired as he was, and as stressful as his family's situation was, his fatherly glow was shining through bright and clear.
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"She is adorable!!", Madi exclaimed, "Omar and I were just thinking of paying her a visit. Would that be ok with you?"
"Yes, of course. I'll come too. Grab me when you're done with rounds"
And that is exactly what we did after we finished putting in all the orders for our patients and making sure than none of them would need us urgently.
To get to the children's hospital we had to go through the food court that connected the two buildings on the 3rd floor. Yes, the same food court I had diligently avoided over the last 2.5 months that I had been in that institution, so I wouldn't have to think about Noor.
Ironically, now as I crossed it, all I could think of was Noor and her daughter.
'Life is what happens when you're busy making other plans' - John Lennon
That quote could not have been truer for the what had happened in the last day or so.
The children's hospital was like a different world altogether. The walls had colorful murals on them, humans of all sizes roamed the corridors and there were little play areas randomly situated in the hallways.
"Every time I come here, I wonder why our adult hospitals have to be in shades of white and grey only. Who said adults don't like color?", Madi said, shaking her head.
"Adults are boring...", Salman laughed.
"Its funny...that's exactly what Noor said when I asked her why she had chosen pediatrics", I chimed in, remembering a conversation I had with her.
But perhaps I shouldn't have said that because Salman's expression instantly changed, even though he kept quiet. If I had to guess, I would say for a moment he had forgotten who I was and the history I had with his wife. But there is nothing I could do to erase that, he would just have to come to terms with it...like I had.
Not wanting to make things more awkward I hung back as we entered the neonatal ICU and let Madi and Salman lead the way.
"Oh hello there...look little one, look whose daddy is here", a woman in pink scrubs said to a tiny infant in her arms. I had seen the baby yesterday, but then she was covered in blankets and I hadn't really been able to appreciate how small she really was.
While I was still standing there mesmerized by baby girl Noor, I saw Salman start to take his t-shirt and then stood there is just a sleeveless undershirt, right in the middle of the neonatal ICU.
What the hell is he doing?
I looked at Madi, who was deliberately trying to act natural, as if she was used to non-patient men taking off their shirts in the middle of the hospital for no reason...but when she looked at me with wide eyes and shrugged, I knew even she had no idea what was going on.
Salman must have realized that the two of us were flabbergasted at what he was doing, because he laughed as he sat down on a chair next to his daughter's incubator and the nurse handed the baby to him in just a diaper and he put her face down on his almost chest, covering her back with a baby blanket.
"Oh for God's sake guys...don't tell me you've never seen this happen before..."
A reasonable physician take off his shirt in the middle of an ICU...no I had never seen that happen before. But he did have an explanation, thankfully!
"Its called kangaroo care. Studies have shown that putting premature babies on to their parent's skin, so that they have direct skin-to-skin contact, helps them calm down, feed and sleep better and even improve their breathing pattern. This is literally why kangaroos have that little pouch where baby kangaroos stay"
"Ohhh, that makes sense...I was thinking your brain was just confused where you were because of the lack of sleep", I said, with relief, "I can safely say that if you tried to do this with an adult patient you would get sued for inappropriate behavior"
Salman laughed again, "You adult medicine physicians have no idea what you're missing out on by not taking care of kids..."
I was kind of starting to agree...should have paid more attention in my pediatrics rotation in medical school
The nurse then hooked up a little syringe to a gastric tube that went in to baby girl Noor's nose and into her stomach. She was too small to feed with a bottle, so the gastric tube was the next best thing to get nutrition into her.
"Is that formula milk?", Madi asked, clearly the pediatric world was very different from ours.
"No actually its donor breastmilk...", the nurse told us.
Salman looked at us smugly, "And before you ask...yes breastmilk is donated to the neonatal ICU by mothers who have excess milk, for infants of moms who can't produce breastmilk themselves. Its a lot better for the premature gut than regular formula, that's why we pasteurize the donor breastmilk and give it babies like my daughter"
That sounded like a scientifically sound concept, except for one thing...in Islam, if a woman breastfeeds multiple children, they are considered siblings, through milk kinship, and are therefore prohibited from getting married.
"Wait...so do you know who the milk comes from?", I asked.
"It most cases it comes from an anonymous donor...but I actually looked into this for another Muslim family. Apparently, donor milk when used for a medical indication is permissible according to many scholars, though I guess others would argue that its a grey area. In premature infants, donor breastmilk saves lives...so, it makes sense to me that it should be allowed just like a medicine", Salman explained, then he grinned and added, "Besides, most donor milk is from white women...so she'll just have to marry a desi..."
"Or she'll have to just avoid getting married to someone who was born in Chicago! I am assuming the milk comes from local moms?", I replied, contemplating on the issue.
"Yes, it does...we could also just ask his mom if she ever donated milk", Salman replied.
"Yup...though that would be a very awkward conversation with a future mother-in-law"
I had more opinions on baby girl Noor's marriage but then heard Madi snicker in the background. Salman and I both turned to look at her, and saw her holding her hand over her mouth as she physically tried to stop herself from laughing.
"Do you guys realize that she is less than a day old...and you're planning her marriage! She doesn't even have a name yet. Maybe start there...", Madi said, looking at Salman and then me.
Now that she had said it out loud, it was kind of funny that Salman was discussing the future of his daughter with me of all people, while he sat there shirtless, cradling her. He probably had similar thoughts because he chuckled and nodded as well.
"You're right maybe she should have a name first...", then he became more solemn, "But that is not something I am willing to do without Noor"
I looked at Madi, she wasn't smiling either now, but she did try to comfort him.
"Salman, I know she is still critically ill, but she is heading in the right direction. Just take it one day at a time"
He gave her a small smile, and said, "Thanks Madi...I don't know what I would have done without you..."
I nodded, agreeing that Madi had a played a huge role in everything that happened yesterday. But then Salman turned towards me.
"You too, Omar. I...uh...apologize, we got off on the wrong foot yesterday. But really, I appreciate everything you've done for Noor, and this baby", he said, placing a gentle kiss on the tiny forehead that was protruding from under the blankets on his chest.
"Don't mention it...I'm just glad I could be there", I told him. And I meant it. I would do anything for his family.
We stayed for a few more minutes marveling at how baby girl Noor, tried to raise her tiny head and turn towards her father's voice every time he spoke. She knew who he was, even if she was less than a day old.
Finally, Madi and I said goodbye to him but as were about to leave, he spoke up again, "Has anyone ever told you, the two of you are great together..."
What the heck? We are not together...
I could feel the heat rise in my face, and heard Madi stutter, "We...uh...are not...".
"...as an ICU team", he smiled coyly, as he looked at Madi and then me, "what did you think I was saying?"
Is he for he real?
Needless, to say Madi and I walked back to our ICU in an awkward silence, and for the rest of the day she pretty much ignored me other than sending a few work related texts.
This is exactly why professional boundaries exist...idiot Salman, no more respect for him!
Madiha
I know I had told myself last night that Omar was just a colleague, and that my emotional wires were messed up because I was tired. But this morning when I saw him stumble into the resident room, wearing the same plain gray shirt from last night over his scrub pants, his hair still tousled from laying in bed, and the slight scruff on his face since he obviously did not have time to shave, I knew my resolve to keep him out of my messy life wasn't going to last long.
Our eyes met as soon as he entered the room, and he gave me a drowsy smile before putting his backpack down. I was still sleepy from the late night we had, but when he came closer to me and I caught a hint of his cologne I could literally feel the cogwheels in my brain start to move faster.
I had offered to get him something on my coffee run that morning because I was really just hoping to take a walk to the food court on my own, to clear my head. He had been pretty vocal about not drinking coffee and so it had seemed like a perfect excuse to get away from him. Instead, he decided to make this day 1 of his coffee endeavors!
So, as we walked together to the food court I focused the conversation on our patients and tried to plan for the the transfer of those to who were getting better out to the regular wards. And that worked for a while, but then we needed to take the elevator from the 15th floor ICU to the 3rd floor food court. When the elevator door opened I was thankful that it was empty. That way I could stand in the corner opposite him and not have to be scrunched up next to him, breathing in his cologne and going to dreamy places I should not be going to.
Omar was standing in front of me, but instead of just stepping into the elevator when it arrived he held his arm out to hold the elevator door for me, and said, "After you..."
That was not the first time, he had held doors open. He always did that, for everyone. And it was not the fact that he was holding the door open that had my heart racing and my skin tingling, it was the way that act had exposed his biceps and and made me remember the warmth and security of his arms when he had hurriedly hugged me last night and whispered, "Oh...thank God!"
Jeez louise...Madi, what the hell have you gotten yourself into? My 7th grade science teacher's voice came into my head and I could picture her standing there aghast, looking at me as I was covered in foam from an experiment gone wrong.
Sorry Mrs Parker...I should not be experimenting with hot objects...
Wait...did I just call Omar a 'hot object'?
Oh my God...someone just kill me, please.
Thankfully, Omar was scrolling through his phone oblivious to the conversation going on in my head between me and my alter ego...and I guess the ghost of Mrs Parker.
The elevator started to fill up as we descended. I stubbornly stuck to my side of the elevator, but Omar was being the gentleman he always was and kept moving with every new person in the elevator till he was standing right next to me.
I couldn't smell his cologne, though I wish I had because it may have covered the mouth stench coming from the person standing on the other side of me, but I did realize that we were both taller than the ordinary desi, and our heights were quite compatible...
Compatible for what Madi? Doing chest compressions during CPR?
Of course...what else?
"CPR for 20 mins...", Omar said, without looking up from his phone.
"What?"
Crap...was I speaking out loud again?
Now Omar did look up at me, "The 45 year old man we had successfully resuscitated on our last call, apparently they had to do CPR on him again this morning...Jake just messaged on our intern group chat"
Oh I am so glad...wait, not about the patient coding, I meant that Omar had not heard my inner voice.
I AM your inner voice...yours truly, alter ego.
Oh shut up! I need some caffeine...
I really needed to stop having conversations with myself, even though research did recently show that people who speak to themselves are more intelligent.
Or they could be psychopaths...
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