The Call Room

FROM THE AUTHOR

"After countless sleepless nights in the call room during residency thinking about my patients, colleagues, and the emotional chaos of hospital life, I wanted to write a story that captured all of it—the exhaustion, the stress, the intimacy, and the unexpected love that can grow in the middle of it all. This book is a tribute to the humanity that fills the hospital, and my hope that all of our lives may have a few more happy endings."

—Jaqueline Rose

Chapter one

Angela sat unmoving in the passenger seat, staring at the small yellow sign on the gray cement wall that read Physician Parking. Displayed proudly, like a poorly made lifetime achievement award finally earned after seemingly endless years of hard work. As she looked around at the sea of old and reliable cars filling the hospital parking garage, a halogen light flickered from the low ceiling. She smiled to herself, imagining it as the flashing lights of paparazzi greeting her for the far-from-glamorous first day as a physician.

In the driver’s seat next to her, Victoria shut off the engine. The two remained motionless in the now silent car, seat belts still pulled tight across their chests, and Angela wondered what she’d expected. The other cars had likely been there for hours, driven unassumingly in the early-morning darkness through quiet streets to care for sick people whose lives depended on the physician behind the wheel. And today, she would become that physician.

Twenty-six years of rigorous studies and focus to get to this exact moment, and Angela felt completely unprepared. In college, when others had gone to parties on Friday nights, she called her organic chemistry textbook her boyfriend and went out with him. Their long nights spent cuddled together in the library stacks or snuggled tightly in her dorm room were not the wild college years portrayed in movies, but they were her dream. In medical school, she would bike home from overnight shifts at the hospital, the early-morning quiet of the city broken by the occasional raucous shouts of drunken strangers making their way home from very different nights than hers. While they’d partied, she’d held pressure on trauma wounds and learned to properly seal a bag mask. The slow and steady breaths she administered saved a life. She wouldn’t trade those nights for anything. The years of studying had brought her to this moment. Today, she would finally walk into the hospital as a doctor.

There would be no red carpet to usher in the occasion. Nothing bigger than this simple yellow sign to celebrate her arrival. Just sick people who needed help, and she hoped she could actually help them. And she was terrified of what it would mean if she couldn’t.

Angela fiddled with the strap of her messenger bag clutched between the knees of the new black slacks she’d recently purchased on her small resident budget. The sudden leap from student to physician wardrobe felt like playing dress-up in her parents’ closet.

Victoria flipped down the visor over the steering wheel and ran her fingers through her blond pixie cut.

“Are you trying to tame it or make it wilder?” Angela asked. “’Cause I think the point of a pixie cut is that those are the same thing.”

“This is clearly my professional coiffing,” Victoria said as she continued to tousle the wild locks.

“Maybe if you would have gone with the collared shirt I suggested, you wouldn’t have to worry about your hair?” Angela said.

“We can’t all be quite as professional as you,” Victoria said, turning over and giving Angela a wink as she ran her hand innocently over the low-cut collar that Angela had cautioned her against wearing. Suddenly feeling self-conscious about her own outfit, Angela flipped down her visor. Big blue eyes stared back at her. The dark-brown curls that she’d woken up early to tame for once seemed devoid of frizz. Despite her pale skin, the few days off between the end of school and the start of residency meant that, for once, there were no bags under her eyes. Certainly, that would change soon.

“Ready to save some lives?” Victoria finally said.

“Can we save that for day two?” Angela said, turning her head to shoot a small glare at her roommate. They’d spent hours in this old, boxy Subaru, traveling to the women’s clinic where they volunteered throughout college. Those days, as they’d blasted music with the windows down, they celebrated each step on the journey to become physicians together. While this moment felt like it should be the biggest celebration to date, she hadn’t anticipated its unsettling reality.

“I mean, we did successfully graduate from medical school last week. I bet we are ready to order some Tylenol,” Victoria said.

“I don’t know. How much has the patient already had? Are they a two-gram max per day or three type of person? Are these six hundred and fifty milligram or five hundred milligram tablets?”

“Maybe they’ll let us order an enema. Sometimes that can feel like a lifesaver to a patient.”

“It’s our first day of intern year,” Angela said. “The only thing we are ordering is a latte from the coffee cart by the main entrance—and that’s if we’re lucky enough to have a break from boring orientation lectures.” They laughed, easing the tension of their first-day jitters, but Victoria’s hands still gripped the steering wheel. “This many years of education has definitely prepared us to sit through hours of boring lectures. It’s just orientation. How bad can it be?”

“Don’t tempt fate,” Victoria said, shooting Angela her most serious glare.

“All right.” Angela took one last deep breath. “Let’s see if we can find the call room.”

* * *

Over twenty minutes later, and completely disoriented from following multiple people’s misleading directions all over the hospital, Angela and Victoria finally found themselves in front of a nondescript gray door on the second floor in a remote wing of the building. Were it not for the placard with almost unreadably small print just to the left of the door declaring it the Resident Call Room, they would never have believed this was the right place.

“Looks like a janitor’s closet,” Victoria said.

Angela knocked. They would have twenty-four-hour access to this and every other room in the hospital as soon as they got their badges, but for another few minutes they were still outsiders.

The door flew open.

“How many ATP are produced in the Krebs cycle?” a gangly redhead shouted at them, his lanky body stretched out in a giant X between the doorframe and the door itself, blocking their entrance.

“One in the actual cycle, the rest come from oxidative phosphorylation,” Angela replied instinctively, trying to see past the guy blocking the door.

Overlapping voices came from just behind the door.

“Oooooh, she got it. Let her in, Boz!”

“No pimping the interns until tomorrow,” said another bodyless voice from somewhere deep in the room.

“Only pimp with relevant stuff. Real medicine. Not medical school crap,” added another.

A commanding voice came from the back of the room and silenced the din.

“Second-years, back to work. Let the doctors in.”

The redhead—Boz, from the sound of the shouts—stepped backward into the room. He held the door open with his right hand and made a grand sweeping motion with his left, indicating that they should enter. Angela stepped into the call room for the first time, Victoria right behind her. She’d imagined this moment for years. The faint smell of stale coffee replaced the antiseptic hospital hallway aroma. The low buzz of electricity from the computers was audible over the quiet whispers of the other residents who all seemed to instantly refocus on their work. This magical room, filled with people who knew how to apply all their years of studying to save lives, was exactly where Angela wanted to be.

Outdated computers lined the walls to her right. A few of the old monitors flashed the hospital logo, while the rest of the computers were actively in use. To the left, a small kitchen area contained a microwave, coffeepot, watercooler, and fridge. The coffeepot was half filled with the darkest coffee Angela had ever seen. The rest of the appliances had a yellowed color that reminded Angela of antiques at a consignment shop. Straight ahead, in the back of the room, was a lounge area with a few mismatched couches and an awkwardly mounted old television that probably weighed a metric ton. Angela couldn’t remember the last time she’d seen a non-flat-screen TV. There were a few doors off the back lounge area, all closed. Four other people whom Angela assumed were the other new interns sat awkwardly on the couches in the back of the room. Each had the posture of a person trying to take up as little space as possible.

“Welcome,” said the same authoritative voice that had put an end to the hazing at the door. Angela took in the woman who had her arms crossed, leaning back slightly against a table that separated the front work area from the back lounge space. She was tall, or at least taller than Angela, with a lopsided haircut shaved close on the left and pushed back behind her ear on the right. Her modern look was captivating, like an advertisement for young Portland culture, yet her demeanor clearly indicated that she was in charge. She personified the evolution of medicine, where knowledge trumped historically stodgy appearances. Just standing there silently, she embodied exactly the kind of doctor that Angela wanted to be. “Come and sit with the rest of your class while we wait for the last intern to find us.”

Taking her seat on the couch, Angela expected small talk, but after a few head nods and lifted hands that almost counted as waves, the group sat in awkward silence. She was tempted to engage the powerful resident still standing in front of them, but every conversation topic that went through her mind felt wrong. Eventually one last, frazzled individual arrived, an obvious first-year who was stupefied by Boz’s question about reversible causes of cardiac arrest.

“I’m Charlie McAdams,” said the captivating doctor leaning against the table. “I’m one of the third-year residents. This is our resident room. We’re starting off orientation here because it’s the most important place in the hospital for us. The chief resident, program director, and other attendings will run the rest of your orientation. But they’re not welcome in this space.” Angela had a vision of Charlie, with her powerful voice, telling the program director and chief that they were not allowed in the room. She couldn’t imagine anyone questioning Charlie, no matter the institutional hierarchy.

“This is our safe space. I assume several of you had a hard time finding it, because no one else knows where it is.” Angela and Victoria looked at each other. They’d asked over a dozen people where the room was and received progressively less helpful answers. “It’s not hidden, but it’s not well known.

“Look around. We are your peers, your colleagues, and your support system when you need it. Residency is hard—long hours in high-stress, life-or-death situations. The people who understand best what you are going through are sitting next to you right now.” Several people looked around the group and nodded. Angela realized her leg was bouncing as her mind wandered back to several deaths she’d seen as a medical student. She tried to still her body. She’d watched as her senior residents had worked late, trying everything they could to save their patient. Then staying much later with the families after their best efforts had failed. Talking. Listening. Sitting in silence. Anything to survive under the incredible pressure of what they tried so hard to do. She’d watched young doctors near collapse under the weight of failing to save a life and realized she was now stepping into that role and responsibility. Looking at the strangers around her claiming to be her new support system, she wondered if there was anything in the world that could really ease this impending burden. Then again, something about the calm and confidence in the way Charlie spoke eased her fear just a little.

“For the first few weeks, you will be paired with a third-year, your senior resident,” Charlie continued.

“When you kill someone, it’s on them!” Boz shouted out without looking away from the computer where he now appeared to be working.

“Not helpful, Boz,” Charlie said. “But not totally wrong. It’s our job to teach you as much as possible but to do it safely. You’re not alone here.

“This is our space. To your right are the two call rooms. Think of them as the smallest hotel rooms you’ve ever seen, where you may or may not be so lucky as to someday get the worst interrupted sleep of your life. To your left is the silent workroom. If you don’t like the chatter in the main room, you can go work there.”

“And if you talk in there, apparently you’re an asshole!” Boz chimed from the far side of the room to a smattering of chuckles from the other residents at the computers next to him.

“And there’s the bathroom.” Charlie concluded the tour by pointing at the final door and ignoring Boz’s commentary. “Welcome to your home away from home and your family that isn’t your family. Any questions?”

The taciturn group remained silent.

A piercing screech broke the silence, and Boz leapt out of his seat, pulling the bright-red code pager off his waistband and juggling it like it was hot to the touch. It hit Angela how close she was to being in this very position. Yesterday, Boz had been an intern, and today he was expected to respond alone to the emergency.

“Boz.” The calm in Charlie’s voice contrasted sharply with Boz’s frantic reaction. He coughed, and the pager finally stopped bouncing between his two hands. Unable to take her eyes off Charlie, Angela watched as she commanded the room.

Standing up straight with her arms loose at her sides, Charlie’s gaze locked on Boz. His panic remained palpable even from across the room. After a brief pause, Charlie continued, “Why don’t I bring the interns so they can see how a good code is run? We can all help with this one. It’ll still be your code, as the senior, but we’ll be there as backup.”

Angela watched as Boz looked at Charlie. The fear in his eyes was so different from the impish glee that had been there just a few minutes ago. “Yeah, uh, that’s a good idea,” Boz said. “For their learning.” His eyes flitted from the pager to Charlie and back again.

“All right, Doctor, where are we headed?” Charlie asked, and the steadiness emanating off her seemed to ease Boz’s panic.

“Room 406 South,” Boz said, grabbing the white coat off the back of his chair. He threw it over his shoulders as he hurried toward the door. “Cardiac arrest. Let’s go.” Charlie nodded to the interns and motioned for them to follow him.

“We don’t need to run, though,” Charlie said. “There’s already a team there and we don’t want to show up more out of breath than the patient.”

Down the long hallway, they walked at a pace faster than most people run. Victoria nudged Angela with her elbow. “So much for waiting to save lives until day two,” Victoria whispered.

They were at the tail end of the group, and Angela strained to hear what Charlie was saying to Boz. Charlie’s long strides set the pace, and it sounded like she was coaching Boz through advanced cardiac life support steps as they made their way up the two flights of stairs.

Immediately after exiting the stairwell, Angela could see the controlled chaos of the code erupting into the hallway. Two people stood next to a red metal cart with the top drawers open. Syringe and gauze wrappers littered the ground. Boz and Charlie entered the room, but the line of interns lagged, uncertain of their role.

Angela was not going to miss this opportunity. Grabbing Victoria’s hand, she pulled her into the patient’s room, sliding along the back wall.

Boz stood at the foot of the bed with his hands gripping the plastic footboard. Charlie stood behind him, giving him space to lead.

“What do we know?” Boz asked.

“Eighty-six-year-old woman with diabetes and chronic kidney disease. Came in today, diagnosed with sepsis in the ED. Just made it to the floor and was one liter into her resuscitation when we lost IV access and then she lost consciousness. We called a rapid response, then lost her pulse altogether about four minutes ago and switched it to a code,” said the nurse with a name tag that read Kelsey.

Angela gaped. Fluid resuscitation and medications were critical in a code, and they either needed to get another IV in quickly or find some other kind of access.

Boz nodded, processing the situation. Angela wondered if he was thinking what she was. After confirming that the respiratory therapist at the head of the bed had the airway, Boz assigned a nurse named James to keep time and record the medications, and Kelsey stood near the door coordinating with the pharmacist who waited in the hallway with his cart due to limited space in the room.

Angela watched Charlie standing behind Boz. Her demeanor seemingly calmed everyone in the room and turned chaos into medicine.

Gently placing her hand on Boz’s shoulder, Charlie whispered something in his ear, quietly and subtly enough that were Angela not completely enthralled by her presence, she probably would have missed the assistance she gave him. Angela followed Boz’s gaze as it moved to Jack, the nurse doing compressions. Exhausted, with sweat on his brow and compressions that weren’t as deep as they should be, Jack looked like he needed to swap positions.

“Doctor, take over compressions,” Boz said, pointing at Victoria. With a twinge of jealousy, Angela watched Victoria begin her first code as a physician. Jack stepped back, and Victoria seamlessly assumed her new role. Fingers entwined, elbows locked out, she leaned over and began strong, deep chest compressions.

Angela’s gaze returned to the foot of the bed, where Charlie subtly redirected Boz. While no one else in the room seemed to notice Charlie, Angela couldn’t take her eyes off her. Not only was she perfectly orchestrating the complex dance of a code, but she was doing it while making it look for everyone else like Boz was leading the team. Charlie whispered again, and Boz’s eyes went to the patient’s hand, where a small mountain of adhesive tape held a tiny IV in place, as if whoever inserted it knew that losing it would mean losing the patient’s life.

“What vascular access do we have?” Boz asked Kelsey.

“Just a 22-gauge IV in the hand. Between dehydration and her kidneys, we haven’t been able to get anything bigger anywhere,” Kelsey replied. A 22-gauge in the hand was barely big enough to draw labs, let alone sufficient to give medication and fluids to resuscitate this woman. Angela’s pulse quickened as she realized how dire the situation was.

“Better than nothing. James, have we given any meds yet?” Boz said.

“Not yet, Doc.”

“When the doctor finishes two minutes of compressions, we’ll pause for a pulse check. Draw up a milligram of epi. If we can’t get a bigger IV, let’s get an intraosseous line going. Do we have an IO kit here to do that?”

“Check,” Kelsey said. “We’ll draw up one milligram of epinephrine, and I’ve got the IO kit here.”

Charlie took the IO drill from Kelsey and moved behind Angela. Excitement swelled in Angela’s chest as she realized the warmth of Charlie’s body behind her meant she was going from observer to doctor.

“You ever done one of these before?” Charlie whispered to Angela, holding out the IO kit.

Shaking her head, Angela was unable to speak with Charlie so close to her. She could feel her heart pounding in her chest, but it remained steady, matching Charlie’s demeanor. Was Charlie really going to trust a day-one intern with this critical task?

“Have you seen one done before?” Charlie asked with the same calm authority that was always present in her voice.

Angela nodded. In medical school she’d seen a few codes where they drilled into the bone to get access quickly. As a medical student, she had hovered near the back of the room and observed. That felt a world away from where she stood currently.

“All right, see one, do one,” Charlie said, handing her the kit. Looking up into Charlie’s hazel eyes, the code and everyone else in the room disappeared. The confidence Charlie had in her was all she needed to believe in herself. A small dimple popped out on Charlie’s right cheek as she smiled reassuringly at Angela. “I’m right here if you need me.” The words were like a calming spell, and Angela’s chest relaxed enough for her to take a full breath. She knew she could do this with Charlie’s help.

Breaking free from Charlie’s eye contact, Angela took the IO kit and turned back toward the bed. She cleared off a small workspace near the patient’s legs and opened the kit. Checking her hands to make sure they were not shaking, she felt her body steady. Inside the kit she saw a small drill, a needle, and cleaning supplies under a sterile drape and gloves. Quickly grabbing the sterile drape from the top of the kit, she placed it over the patient’s leg to expose only a few inches of skin just below the patella. She slipped on the gloves, then grabbed the chlorhexidine brush and pinched the handle to activate the cleaning liquid. The skin turned a mustard yellow as the sanitizing liquid cleaned the exposed area. Angela attached the needle to the drill. Positioning the tip exactly where she wanted it, she squeezed the trigger. The drill buzzed in her hand but the needle didn’t advance into the bone. Biting her lip, she pushed harder, knowing the urgency of the situation required all her mental and physical strength.

“Good.” Angela felt as much as she heard Charlie’s voice in her ear, breaking her focus as the needle still failed to advance. “You’ve got this,” Charlie said, placing her hand gently on Angela’s shoulder. “Try a little more pressure.” Charlie’s voice was steady and soothing. Every muscle in her body eased into Charlie’s gentle touch, and she pushed down on the drill with a newfound strength. There was a pop, and suddenly the warmth of Charlie’s body was gone. Angela almost dropped the drill. She let out a deep breath and wondered how long she’d been holding it.

“Well done, Doctor,” Charlie said with a nod. Her praise, so rare in the hospital, filled Angela with pride. “Let’s hang a bag of normal saline and run it open into the IO.” The cold of the room hit Angela as Charlie stepped away and returned to her spot behind Boz. Looking up to see Victoria was no longer doing compressions, Angela realized that at least two minutes had passed for her to get the IO in place. Time is tissue. Angela heard the old mantra in her mind. The longer the patient didn’t have a pulse, the less likely she was to get one back and the more likely she was to have damage to her organs even if she did come back to life.

Calling for a pause, Boz instructed Angela to check for a femoral pulse. A thready but unmistakable rhythm beat under her fingers.

“There’s a pulse,” Angela said.

“All right,” Boz said, placing his hands near the patient’s groin to confirm. His face lit up with a huge grin. “We’ve got return of spontaneous circulation!” Looking over his shoulder at Charlie, she gave him a subtle congratulatory nod. Angela looked at him. She’d never heard ROSC spelled out during a code. Was he nervous? Was that him trying to teach her? Impress Charlie? Angela couldn’t quite figure out Boz just yet, but she was very impressed with how Charlie had clearly run the code while making it appear that Boz was in charge.

“Well done, Doctor. You’ve got ROSC. What next?” Charlie said.

“Oh, yeah.” Boz seemed to suddenly remember that getting a faint pulse back in the patient did not mean the job was complete. “Kelsey, can you call over to the ICU and get us a bed? James, can you draw a rainbow? Are you good to maintain that airway until we get to the unit?”

One by one, the team responded to Boz’s instructions, echoing back to confirm their next steps. Looking over at Angela and Victoria, Charlie tipped her head toward the door, indicating that their roles were done and it was time to leave.

Charlie led the interns through the maze of the hospital hallways and across the street to the clinic building. She dropped them off in the program director’s office.

“A little later than expected, Dr. McAdams,” the program director chided while looking down at his watch and then back at Charlie.

“There was a code. We needed additional support, plus it was an outstanding learning opportunity,” Charlie said, looking the program director squarely in the eye. Angela noted the lack of an apology in Charlie’s response. Despite seeming displeased with the answer, the program director simply nodded. “I have to head back to finish up patient care,” Charlie said, and she turned around, walking back toward the hospital. An unexpected wave of disappointment crashed over Angela as she watched Charlie leave. Time for the boring lectures part of the day, she presumed.

* * *

The rest of the day continued much more as Angela had originally predicted it would go. They took pictures for ID cards in the basement that would hang on lanyards around their necks identifying them as physicians. They picked up their pagers with a promise that it would not go off for the next few hours, and that it would absolutely go off every day after. They sat through a long lecture on social media and appropriate posts for medical professionals, a presentation on the electronic medical record, and a sexual harassment talk. As they were talked at and shuffled along, Angela found her mind wandering back to the code and how Charlie’s mere presence behind her infused her with warmth, strength, and confidence.

At the end of the day, the class of interns stood outside on the sidewalk between the clinic and the hospital, all wearing their new long white coats with pockets overflowing with orientation materials.

“Anyone else feel like they’ve been drinking from a fire hose all day? Want something less overwhelming and more alcoholic to drink?” one of the interns said. Angela looked at his white coat and the name tag declaring him Dr. Jonathan Schwartz. There was a smattering of head nods, then the quiet group became a little more animated as they made a plan to meet at the neighborhood bar later that evening.

“We’ll be there,” Victoria said as she looped her arm through Angela’s and redirected them toward the parking garage.

“Well, that’s basically what we predicted for day one,” Angela joked as they walked away.

“And if that’s just day one, it’s going to be one hell of a year,” Victoria said with a smile.

Angela couldn’t agree more.

Tempe M.
This book was a fun, addictive read with both light, humorous moments as well as some serious moments, and not to be left out, some very steamy passionate scenes, sometimes in the most surprising places!

Fiona S.
The Call Room is a delightful medical romance with just a little bit of drama and was an easy read that I didn't want to put down.