Squinting at her name badge, I asked, “GN. What’s that?” Six months into my internship, I’d seen hundreds of students – medical, nursing, anesthesia – parade through 5L, the cramped labor and delivery ward at LA County Hospital.
She smiled. “Graduate Nurse,” she answered, her blue eyes locked on mine.
“That’s what, a graduate student or something?”
Fiddling with a tube, she drew blood into a thin glass rod, preparing to spin a hematocrit. Now glistening red on the inside, she paired it with another at the opposite end of the centrifuge, then closed the cover and hit the button. The familiar whir of the machine starting up softened the sounds in the cramped lab.
“No.” That smile again. “No, I’m waiting to pass my boards.”
“Boards?”
“Nursing. You can’t be an ‘RN’ until you pass them. Even if you’ve finished school.” The machine spun down, the blood cells now separated from the serum. Grabbing the capillary tubes, she placed first one, then the other, into the protractor-like crit reader. “Thirty-two,” she announced. “Pretty good. Your turn.”
I began the process on my blood tubes, expecting her to return to her patient.
“RN,” she said.
“Uhh?” I asked, snapping one of the little tubes before I could fill it with blood I’d drawn from the grand multip who’d arrived, “Red Blanket”, from the ER minutes before.
“We say it means ‘Real Nurse.’ They won’t let me work much on my own until I pass the boards.”
I looked over. She’d stopped mid-exit, half-turned back towards me, another smile building on her lips, her eyes steady at my gaze.
“Where?”
“What?”
“Where did you go to school?”
“St. Louis. St. Louis University. They had a special one year program if you already had a bachelor’s.” She hesitated, unsure if she should share. “I want to be a midwife. A Nurse Midwife.”
I finally got the machine spinning again. “So, is that where you’re from?” Stray wisps of golden hair tinged with California highlights dangled out from her blue surgical bonnet.
“No, Santa Barbara. I went to UC Santa Barbara. I grew up here in LA.” She looked out the window, then went on, “My sister was at nursing school, told me all about her OB rotation. ‘There’s midwives,’ she said. All at once, I knew.”
“Knew what?”
“Knew that’s what I wanted. To be. So I looked around, to see how long it took. First, nursing school then, midwifery, a master’s degree. Would take forever, I thought. So when I heard about this special program in St. Louis, I jumped. Took a few classes at Santa Monica College – I was an anthropology major at UCSB, didn’t have enough science – and they let me in!”
Fully facing me now, her excitement jetted out between us. Caught up in the wave, I smiled back.
“The other doctors around here, when I tell them, they almost laugh at me. Like my father – he’s a neurosurgeon – they say, ‘What for? Why don’t you just become a doctor, instead of taking work away from us.” Her eyes challenged me. “What do you think, about midwives? Would you want to work with one?”
At that moment, I’d do anything to spend more time with her. “Yeah, that’s a great idea, midwives. They can take care of the normal, the natural things for pregnant women, leave the problems for doctors. I’d work with a midwife.”
She dropped her head is if in thought. Noticing the hematocrit tube still in her hand, she twitched her lips, squinched her nose, and said, “I’ve got to get back to my patient. The junior resident wants to do a c-section, and told the intern to find out if she needs any blood set up.”
“Wait a minute. What’s your na…” Before I could say any more, she’d turned the corner, heading for 5M, the delivery and operating rooms.
My multip progressed quickly. Grayer, the no-nonsense Irish charge nurse, saw her stirring uncomfortably, and grabbed me, saying, “Dr. Truscott, you know these ladies progress half a centimeter with each contraction at this stage. That’s why they sent her up as a Red Blanket.”
“Red Blanket” meant an emergency of some sort – either the baby was in trouble or the mother about to deliver. I’d thought, after several months in the cauldron of LA County hospital’s labor and delivery unit, several hundred deliveries deep into my training, that I’d seen it all. But Miss Grayer was thirty years into her career, which began 7,000 miles away as a midwife, attending births after cycling to clients’ homes. Now she’d taken on the more demanding burden of turning brash young men (and a few women) into competent obstetricians. Using her harsh voice, greying bob-cut hair still covered by her nursing school cap, she ruled her domain without restraint, trusted by the senior residents and attending staff to keep us interns in line while they dealt with the actual medical problems continually flowing through the elevator doors.
My patient, typical of the population we saw on 5L, was a native of Mexico, arriving in advanced labor to prevent any chance of being sent back across the border to “el rancho”. Most of them had delivered several babies at home prior coming to the hospital, and probably knew more about childbirth then the newly-minted doctors ostensibly there to care for them. This lady – let’s call her “Maria Garcia”, as that’s the name 20 percent of them gave the admitting clerk – was quiet, silently hiding any indication of the pain she might be having from whatever uterine activity had dilated her cervix to seven centimeters. Knowing that, I should have realised that after six more contractions, maybe 15 to 20 minutes, she’d be ready to deliver. Grayer had observed that, instead of hovering near my patient where I should have been, I’d been flirting with that blue-eyed, headstrong nurse in the hematocrit room. She should have let me suffer the indignity of returning to find the baby lying in a pool of amniotic fluid between Maria’s legs, but her midwife’s antennae sensed something. Maybe the abdomen was a little bigger than usual, maybe Maria’s moans with each contraction came through on some hidden wavelength only Grayer was tuned in to, I don’t know. But the crusty charge nurse swiftly urged me to push the bed out of the four-patient labor room, across the central hall towards an open delivery “suite”.
“Nurse Myron!” she ordered as we swept by the GN I’d just spoken to in the hematocrit room several minutes earlier. “Follow us! We need a set-up STAT in room 2!”
Wide eyes full of either excitement or fear, she glanced once behind her at the doors swinging closed to the operating room she’d just exited, and then scurried ahead to open those of Room 2. She tore the cover sheet off the delivery pack while Grayer lowered the foot of the delivery table and I swung the bed parallel to it, urging Maria to slide over. She looked up at me as if I were crazy, but Grayer gave her no option, yanking on her arm while I pushed her hips, Meanwhile, Nurse Myron installed the stirrups and placed Maria’s legs in them, knees resting in the bare metal cups.
I turned to start washing my hands, but Grayer hollered, “Dr. Truscott! Don’t ever turn your back to the perineum when the patient is on the table!”
Pivoting around, I noticed that, yes, Maria’s perineum was indeed bulging, dark wavy hair wet with mucous peeking through her vulva.
Grayer persisted, “See, she’s already crowning a fifty-cent piece. No time!” As she spoke, Maria’s contraction ended, and the baby’s head shot back and up, no longer a force threatening to exit into our world.
I pulled on a mask, covering my mouth and nose, tying the slender paper straps across my head and neck. At the same time, I felt my gown being tied securely around my neck and waist. Soft, sure hands briefly touched mine above my shoulders, then gave me a quick double tap to indicate they’d finished, my gown secure. I turned around, and looked once again into those blue eyes, smiling with admiration, re-assurance, or amusement, I was not sure which.
Whipping drapes over her legs and abdomen, I looked up at Maria, who started to squint, hold her breath, and groan as the next wave hit her.
“Empuje con todas sus fuerzas!” I hollered, as she shook her head, grabbed nurse Myron’s arm, and grunted with the effort. The baby’s head seemed to pop out effortlessly, but immediately withdrew, facing sideways towards Grayer. I grabbed it, one hand at each ear, and started to push downward. Nothing. The baby was firmly wedged in place, not going back inside, but not coming out either. I pulled again, harder, this time aiming back and in as well as down.
“Shoulder dystocia…” Grayer murmured. She edged towards me, ready to intervene.
I’d been delivering babies since the third year of medical school, and had seen several of these emergencies. Usually with a fat infant, the upper shoulder gets stuck behind the mother’s pubic bone while the head remains trapped by the outer opening of the birth canal, the lower shoulder wedged against the mother’s spine. It’s a true emergency; the pressure is enough to stop the baby from taking its first breath, and prevent the blood from flowing through the neck out of the brain, but not enough to stop the arteries from pumping new blood in. Quickly, the baby went from pasty white to sickening purple as the blood backed up, threatening to squish the fragile contents inside the skull. I had at most 90 seconds to deliver the rest of the baby.
I’d already tried the first maneuver, changing the angle of birth, with no result. Next, Grayer jumped onto the delivery table next to Maria, and pushed with both hands and all her weight just above the pubis while I tried pulling once again. Nothing, the baby getting darker by the second. Nurse Myron was transfixed, a vacant stare hiding the terror she must have felt inside.
I sighed deeply, reached in under the baby’s lower shoulder, found the arm, and pulled on the elbow to sweep it across the face. At first, harsh resistance, then a sudden snap. I knew I’d broken the baby’s humerus. Immediately, a flaccid arm flopped out. The baby seemed to drop towards the floor, and fell into my hands. Nurse Myron woke up, and sucked the baby’s mouth out with a small blue bulb syringe. Grayer slowly sank back to the floor, brushed off her skirt saying, “You two have this under control now,” and left the room while the blond GN and I looked at each other over our masks and the now screaming infant.
“Ally.” She said.
“Huh?” In my panic, I’d forgotten all about her.
“Ally. My name’s Ally.”
ii
Vasser sat at the front desk, feeding another chart, sheet by sheet, onto the patient’s green plastic ID card in the beige stamping tool.
“Whoosh – clomp – ca-chunk. Whoosh – clomp – ca-chunk.” Vasser’s left hand melded with the handle she deployed to emboss each patient’s particulars into the lower right corner of every page. On one side of her desk sat a pile of blank charts all collated and ready for the ten or so patients expected to roll onto 5L during her 11 PM to 7 AM graveyard shift.
“That the Red Blanket?” I asked as I walked by, pausing to glance at the white board behind her, checking if I had another admission while I was delivering Maria, the shoulder dystocia.
Vasser paused mid-clomp, gave a little shake to her curly, unkempt dirty blond hair, and resumed her feverish chart creation. Grabbing another page, she turned away from me and looked at the stapled sheaf of papers, rumpled from the elevator ride on the bed with Maria, saying in her sing-song voice, “Maria Garcia.” She glanced at the whiteboard behind her. “Dr. Truscott.” She resumed the tedium of admitting another new mother to our hospital without further acknowledgement of my presence.
I sank into a rolling chair at a little desk built into the alcove across from her. A clock on the wall started to hum, clicked once, then again as the hour and minute hands lined straight up together. Midnight. Sixteen hours into my 24-hour shift on 5L, nearing the end of my third of six months on Labor and Delivery scattered throughout the first year of my Ob-Gyn residency.
Why hadn’t I seen this girl, this GN, Ally Myron, before? She knew her way around the delivery room, it clearly wasn’t her first night on the job. Had I been so wrapped up in the effort of becoming a doctor that I had dropped all awareness of anyone around me, seeing others merely for how they could help or hinder the eighty hours of work loaded on me each week?
As I waited for Vasser to finish my chart, a bed rumbled by on my right, followed by the nurse – my nurse – who’d helped in that shoulder dystocia. Turning the corner towards the post-partum room, she glanced back at me, subliminally acknowledging my presence. I began to fill out the forms from the chart Vasser brought over.
A minute later, a creamy arm, lightly tinged with tan, reached out, palm up, while a quiet, almost laughing voice asked, “Can I have my part, please?”
Looking up, once again a smiling face caught me, this time unencumbered by a mask. Blue eyes held mine, and I sensed a tug inside between stolid immobility and warm engagement. Maybe it was the late hour, lack of sleep, but instead of handing them over without a word – the standard interaction between me and any woman my age those days – I said, “So, why? Why do you want to be a midwife?”
I picked out the nursing sheets, tapped them on the desk to even the corners, and kept them close to my chest. Ally blinked twice, waiting. Grayer appeared from the hall leading to the labor rooms, officiously announcing, “Miss Myron! You’ve a new admit in C. And post-partum needs Garcia’s chart.” Her eyes flitted between the two of us who remained transfixed at the desk. I sighed, and handed the papers over to Ally.
I headed to the small break room adjacent to the lab where we’d first met, hoping the look on my face served as a beacon, a lighthouse warning of Grayer’s advance, yet showing the safe route around the shoals.
Opening the half-fridge, I yanked out a plastic cup of orange juice, meant for diabetic patients in hypo-glycemic crisis, ripped off the aluminum foil seal, and slurped the contents in one gulp. My forearms shivered while a cold electric pulse shot up my spine and down my legs. My hands shook a bit as I tossed the cup towards an open trash can, causing me to miss wide left. Obstetric emergencies no longer fazed me; I could rescue a fading baby in under ten minutes from the time I called an emergency C-Section. Something else, not the shoulder dystocia, had sapped my strength. The shot of orange juice revived my mind, but still I felt cold. I clenched my teeth, and sat down, steeling myself for the next crisis sure to come my way sometime in the next seven hours.
I breathed slowly, my thoughts drifting. I glanced at the bulletin board, and noticed something new amongst the baby pictures and tired cartoon strips: a of map Mexico. A swath of colored pins covered the area below the US border, in Baja California, Sonora, and Chihuahua. I walked over to the map, bent down and squinted, wondering what they all meant.
“I think the other nurses don’t like that,” I heard behind me. The inner shivers started up again.
“Huh?” I managed, turning round to the door, seeing Ally smiling once again at me.
“I ask all my patients where they’re from, then I put a pin there. I get the feeling the staff here, the ones who’ve been around forever, don’t like all these ladies coming over to have their babies.”
I raised one side of my mouth, a half-hearted returning smile. My eyes crinkled, and I shook my head several times. “Why? Who cares?”
“Well, I’m interested in finding out. They’ve all got a story, all these patients. Everybody else sees them as an imposition, not a person – the Eclamptic. The Footling Breech. You know? The other interns make fun of them, the residents ignore them as people. And the nurses – the nurses act like these women have stolen something.”
“Why’d you do that, stick those pins in?”
“I don’t know, I’m interested in that kind of stuff.” She paused, waiting. When I said nothing, she went on, “I was an Anthropology major.”
“Where? When?”
“UC Santa Barbara. I graduated four years ago.”
“1971?”
“Uh-huh.” Her smile turned dreamy as she nodded affirmation.
“So you’re what, 25?”
Another nod. “April 11.”
“No! My birthday’s April 9th! 1949, right?”
She checked at her watch. “I’m on break now, 15 minutes. Want to go down to the cafeteria, see if we can find something?”
“It’s closed at 10, you know.”
“Yeah, but sometimes they leave stuff out.”
“Or you can sneak into the coolers, get some pudding.”
The Women’s Hospital cafeteria occupied the first basement, along with the lab. We took the service elevator, sharing the car with bundle of soiled linens, headed for the sub-basement laundry. Ally wrinkled her nose at the foul cargo. At this late hour, we had an express trip covering six floors without a stop.
Florescent lights popped and flickered overhead, and our blue shoe covers added a scratchy refrain reflecting off the green concrete walls. The sliding gate protecting the cafeteria remained open wide enough to allow only one of us to slither in at a time. I headed straight for the cooler, and grabbed two bowls of wriggly chocolate pudding while Ally fiddled with the coffee urn.
Glancing my way, she raised a white ceramic cup, questioning with her eyes.
“Nope, never drink it. All it does is wake me up,” I said. She giggled, pouring herself some over two heaping spoonful’s of sugar.
“Any milk in there?” she asked. I grabbed a pint carton, the top already folded open. “So, an OB who doesn’t like coffee?”
“Yeah, never got into it. Everybody else needed it to stay awake at night to study. I wake up at 6 naturally, and did all my studying early, before classes. In the evenings, I’d go around to people’s rooms and bother them.”
“Where did you go to college?” We pulled out two round-bottomed chairs, the aluminum feet scraping a loud echo across the floor of the empty room.
“In Connecticut. Wesleyan.”
“How’d you get out here?”
“The only medical schools I got into were USC and University of Cincinnati. I grew up there, and didn’t want to go back, I guess. Besides, if I was going to spend eight hours a day in class, then study all night, I thought it would be a good deal if it were always nice when I did go outside.”
She nodded, stirring some milk into her coffee. I pulled the Saran Wrap off the bowls of pudding, and slid one over to her. The space between us narrowed, and I felt a warmth start to fill the cavernous room. “So did you always want to be a doctor?”
“Well, not always, of course. When I was a kid, I planned to be a baseball player in the summer and a mountain climber in the winter. But when I was fifteen, one day in the spring I was sitting on the diving board by our pool, and thought about what I should do ‘when I grow up.’ My mother’d always told me I could do, could be anything I wanted, and I was still young enough to believe her, so I ticked through a lot of things, and decided to be a doctor.”
Ally stayed quiet while I paused, so I went on. “I wanted to deal with people with no artificial barriers between us – just me and them, helping take care of the one thing they really have, their body.”
“But why OB?”
“I went to medical school thinking I wanted to be a psychiatrist. But during the first summer, I worked in a child psych clinic here, and realised I didn’t want to sit on my rear end eight hours a day listening to people tell me how bad the world is. In the fall of my third year, the first night on my OB rotation,” here I looked up, toward the now unseen melee in 5L, “I fell in love with it. Bam, just like that. Women came in, labor progressed, babies came out. It was exciting, and things mostly go well, not like other parts of medicine. I wanted to be around that more, I guess.”
Ally fixated on her coffee, so I added, “The more I do it, the more I learned, being born, it’s the one thing we all have in common, the most human thing there is.”
Ally raised her head, solemnly looked at me, and said, “Mothers. We all have a mother. That’s what I like about it, why I want to be a midwife. It’s where I can help change the world, getting mothers and their babies off to a good start in life. What could be more important?”
While she talked, I noticed a familiar feeling. The same one I felt that first night on OB. That I felt when my father took me on my first ride up a chair lift, and down a ski slope on Dollar Mountain at Sun Valley. Or whens I won my first ribbon in a swim meet, coming in second place. My face softened as I took in her sincerity.
“I’ve gotta go back,” she said, setting down her half-empty coffee cup. “Grayer’ll kill me if I’m not on time.”
I followed her to the elevator, waiting open for us. Once inside, she hit “5”, and I found myself asking, “Listen, maybe we should go out after work sometime? Did you ever see The Godfather? Part 2 came out last week…” I clenched my jaw, wondering where that had come from. Not me, at least not the cautious, introverted left side of my brain. Something, someone else had spoken.
As the doors slid open, she turned and said, “I’ll see you at 7:30, when I’m off? We can talk then?”
iii
Seven to eight in the morning, chaos rules in the County Hospital labor and delivery unit. Tension builds during the pre-dawn of six AM – the most common hour for women to deliver. Something to do with the evolutionary advantage of having a full day following birth in which to care for a vulnerable newborn? That traffic jam spills over into the next hour, when exhausted nurses, whose night ends at 7:30, are relieved by their counterparts coming in at seven. An intern would often start a delivery with one nurse, and, mid-maneuver, turn round to greet a new face, who knew next to nothing about the patient in their care. The doctors had no such relief, despite the next group appearing at eight AM. Whatever we started, we finished, sleep-deprived thought we might be.
Luckily, I found myself with no laboring patients after Maria Garcia, and hustled upstairs to finish my morning rounds. Without changing out of my scrubs, I shot down to the cafeteria, where I grabbed a tray and slid it onto the rails, bypassing the eggs, lumpy dried-out oatmeal, and coffee mugs, settling in front of the collection of cereal boxes. Disdaining the opportunity to simply slit open the Raisin Bran along the perforations dissecting the smiling sun-face on its cover, I grabbed a white ceramic bowl, adorned with a simple green line encircling the outward flowing rim. After a night on call, I needed a simulacrum of luxury, a cut above pouring milk into a cardboard box lined with wax paper. Onto my tray went an open carton of milk, a sealed cup of orange juice, and a glass to complete the illusion of being treated well.
Turning round, anticipating falling into a chair in an isolated corner behind one of the faded yellow concrete pillars, stained from decades of soup spills and gravy accidents, I caught a colorful flash to my right. At first glance, I couldn’t be sure, but a second look at the straight blond, sun-bleached hair spreading half-way down her back, and I knew that nurse from the shoulder dystocia sat there. My brain mis-fired, counter-manding its own orders to seek solitude. Twenty-four sleepless hours had decimated my defenses against that smile. Hoping to see it again, I found myself walking to her table.
“Thanks,” I said, still holding my tray.
She looked up, boggy-eyed, not smiling anymore. “Huh?” she said.
“That shoulder dystocia, helping me out.”
“Oh, yeah…” She appeared dispirited. I no longer felt like a hero. “They took it down,” she went on.
I waited, still standing, wondering if I should sit and talk, hear her out. The memory of her smile kept me rooted.
“My map, the one of Mexico, where I pinned the towns the patients come from. Someone tore it down, crumpled it into the trash.”
“Aw, that’s not fair,” I returned.
“No. Having babies, that’s supposed to be a good thing. When I was a little girl, like three or four, I played with dolls, tell them I loved them, imagined having one, a real baby, for myself.” She shook her head slightly, while I sat down. “Then, my mother was pregnant with my brother, when I was about six. I pretended I was pregnant, too, stuffed pillows under my shirt and waddled around like her.” Still watching her, I ripped the top off the Raisin Bran, poured it into the bowl, added a second box, and drowned the flakes with milk. “I always wanted babies, I guess, always fascinated by birth.”
“What do you mean?” I managed between slurps of soggy cereal.
“In middle school, my father helped me once with a science project. Chick embryos. We went to a store, got some fertilized eggs. They sold them by the day of fertilization. We bought about twenty, to cover the three weeks until they hatch. I broke them open, and my dad took pictures of the little baby chicks.”
“Wow, that must have been a big hit.”
“Well, no, this was Brentwood. There was another kid, Yasha. He was a little genius. He did his project with little windows in the eggs, so you could seem them inside, still growing.”
I mumbled understanding, hoping no milk dribbled from my mouth while I nodded.
“Later, in high school, I worked at my father’s hospital, Santa Monica. I had a job, ‘X-Ray tech assistant’ one summer.” I raised my eyebrows while she went on. “All sorts of stuff I did. Like aiming beams at lines doctors had drawn for cobalt therapy.” She started smiling with the memory. “There was this one time, I took a little old lady down. She was all wrinkled, with caked-on make-up and lipstick put on crooked. While I rolled her wheel chair into the elevator, she cackled, “I’m OK. Just give me some whiskey and I’ll be fine!’”
I almost snorted out some cereal as I laughed at the image. “Yeah,” I said.
“But the thing about it I liked, my favorite part, was taking someone down from labor and delivery. They’d order a fetogram, to look for a breech baby, you know.”
“Is that when you decided to be a mid-wife?”
“No, that came later, after college.” Her furrowed brow turned serious again. Sighing, she said, “After college…”
“Santa Barbara,” I said.
“Yeah, I got home from Isla Vista, and didn’t know what I wanted, what I should do…” Again she faded, her inner glow turned dark. “Um, I was in my parent’s house, listening to the radio and playing in my father’s darkroom. My sister was going to nursing school, one day we were talking. She told me about the new bio-psycho-social model. Incorporating a person’s family, life situation, culture. I was an Anthropology major at UCSB and that attracted me . I didn’t want to empty bed pans, like our mother did. Almost as an after thought, she said, ‘You know, there’s midwives.’ Nurse-midwives, she said. And instantly I knew, I knew that’s what I could, what I had to do.”
“Why?”
“I could see myself going to some island, maybe in the Caribbean, living on the beach, helping women have their babies there. Maybe have one of my own.” She arranged her tray, getting ready to leave.
“Wait,” I said. “Wait…we’re going to a movie remember?”
She cocked her head. “Oh yeah. What was it?”
“Godfather. Part 2. Supposed to be better than the first one.”
“I never saw it,” she said, fiddling with her silverware.
“When should we go?” Determination drove me forward. “How’s it gonna work, if you’re on nights?”
“I’m starting six weeks of days…”
“So we could go on Saturday, then?”
“Saturday, tomorrow?” She looked up. Her face carried a mixture of exhaustion and apprehension. Maybe this wasn’t going to work out. She’d seemed so friendly a minute ago, talking about midwifery, delivering babies on the beach.
“Sure.” I tried to make it sound natural, something we always did. “Where do you live? It’s playing all over. We can go somewhere to eat first. I’m in Alhambra, I have the day off, so I can drive anywhere…” I saw myself dancing around, an eager puppy begging for a treat.
“I don’t know, My place is out in Venice. At the beach. That’s a long way…”
“It’s no problem, come out on the Santa Monica, maybe see it in Westwood. All right? You’re off at, what, 3:30, I can get you at five?”
She looked at a little silver watch, loosely flapping on her wrist. Spinning it several times around, she clicked her thumb nail against her index fingertip. She glanced up at two other interns, down from 5L. One nodded briefly; she didn’t respond. Turning to me, she said, “43 Breeze. You know how to get there?”
“I’ve got a Thomas map book. I can figure it out.”
“No, it’s not a street. Venice has these walkways. You’ll have to…”
“Don’t worry,” I insisted. “give me your number.”
She pulled a pen from her shirt pocket, and scribbled the seven digits on the pant leg of her scrub suit, a habit we all had from taking notes on the fly. As she left, one of the flickering fluorescent tubes went dead, and the room grew darker.