AN: so much time has passed since I began writing this. I'm sorry for the delay. 2016 was a crazy year for me. I felt uninspired. Writing in English is hellish. I started out because I love to write, loved FF and met some nice ladies around here. You know what? Writing in a language that isn't your own is awfully frustrating! As I said before, I tried my hand at it mostly to practice my English. But these characters could be so much more. In my mind, there are so many edges and facets on each of them, that I fail to get through to you. But I'll finish this. Now that I finished my Residency I have no excuses left. I need to do this for myself.
Thank you to all of you who are still in there. I love you.
As soon as I disconnected the call, I went crazy with all the possibilities. My first instinct was to call Edward and let him know Alice was okay but my beep gained a life of its own, and all my personal issues came second to my patient's needs. There was only the physician, the person who lived to make sure everyone else lived as well, or in the impossibility of preserving life, someone who ensured a dignified and painless death. That night I lost a patient.
"Dr. Swan, we have an 81-year-old male with acute onset of dyspnea, he was admitted yesterday with hematuria that improved over the last 24 hours… He's been living with his daughter since he was discharged from hospital three months ago. He had an MI and spent over a month in the ICU." The nurse was said as I quickly scanned the patient's chart. Atrial fibrillation… recently stopped warfarin because of previous bleeding… left kidney mass… severe intensive care myopathy… cognitive impairment after prolonger ICU stay... Great.
"How're his vitals?" I asked already sensing the worse.
"BP 100/40, heart rate 110, O2 sat 90%," the nurse answered.
The patient was tachypneic, sudoretic and had distended neck veins. His heart and lung auscultation was unremarkable.
"Could you please ask someone to bring me the portable echographer?" I asked. "Sir, I'm Dr. Swan, and I'm here to help you," I said as soothingly as possible. I couldn't force myself to tell him everything was going to be okay because I knew it was a lie. Pulmonary embolism. He couldn't form coherent sentences.
"Are you in pain?" I asked after giving the first quick instructions.
"No…" But he was restless and scared, trying to get out of bed. "Sir, please, you have to lie down…"
ECG had a T-wave inversion of the anterior precordial leads, and the ultrasound helped to support my initial assessment, PE with a PESI of over 200… Very high risk. Low platelet count, drop in hemoglobin of 3 grams because of the recent bleeding. I called the intensivist for consultation and transfer. Thrombolysis was too risky.
"I'm going to be sued it I give him alteplase, but he's going to die if I don't…" The chart had a do not resuscitate note. It was a smart choice.
"He's not in shock yet," the nurse noted.
"Yes, he is. His normal BP is 150/80. He's in shock. Let's start him on heparin and hope for the best."
"I can't! He's going to bleed out!" She disapproved.
"We don't have much time, let's do this. Prepare everything for transportation," I asked politely, but I was beginning to feel a little irked. The patient didn't have time to bleed out, as the nurse had been so quick to preview. Instead, he became suddenly irresponsive, hypotensive and collapsed.
"Cardiac arrest!" The nursed yelled. Those were the words that got everyone running in any ward. I idly took the chart and scribbled the details of the situation, annexed the ultrasound prints, and wrote the time of death.
Everyone stared at me like I was some crazy person, as I calmly finished my notes. "DNR," as in do not resuscitate, I felt inclined to answer to the nurse.
"Nurse Anders, after you finish here, I'd like a word with you. In private." As I glanced around, I noticed everyone was expecting me to say more. "Thank you all for your help. Sometimes there isn't much we can do."
Half an hour later, there was a soft knock on the door and the young nurse came in. Her expression was hard to read, somewhere between frightened, angry and disappointed.
"I'll be very direct," I said evenly, "our work is very stressful. This case's circumstances were particularly difficult and decided what's best this patient was hard. We can have a very long argument of what approach could be better, and there is much to be said. I respect your work, and I usually take into consideration opinions aside of my own. That doesn't mean that you can be disrespectful or that you can delay administrating any treatment I see fit to prescribe." She flushed knowing that I noticed she took her time preparing the medication. "Also, shouting isn't protocoled either. Next time, instead of refusing so vehemently, you can ask 'isn't he at risk of bleeding?', for instance."
"I'm sorry," but I didn't think she was. "Are you going to report this?" She asked bitterly.
"No, I just wanted to clear the air. Like I said I respect your work, what I'm asking you is the same courtesy."
She was dumbfounded. That wasn't really what she expected. It wasn't her hesitation that made everything go wrong; the whole situation was doomed from the start. I just needed her to understand that working as a team involved a great deal of respect and trust.
"Sure," she hesitated. "I'm sorry," and this time she sounded contrite.
"It's fine. No hard feelings, eh?"
Next time Nurse Anders called it was 3 a.m., and it was a 72-year-old man admitted with pneumonia. He got up to go to the bathroom and started feeling dizzy. BP 50/30, anterolateral ST elevation.
"Nurse Anders, he's in cardiogenic shock. Let's start him on our protocol of heparin, aspirin, and ticagrelor. We're going to need a CVC to give him noradrenalin, and I'm going to call the cardiologist for PCI." This time, everything went smoothly and in 30 minutes the patient was stabilized and transferred.
It was 6 a.m. by the time I stopped for some coffee from the vending machine. I almost kicked myself because I hadn't called Edward. Realizing how much I was amiss, I must have grunted something as I grabbed my cellphone from my lab coat pocket because of nurse Anders, who somehow was standing right behind me without my notice, asked me if everything was alright.
"I just remembered I forgot to call my boyfriend," I answered truthfully. Sleep deprival has always been like truth serum for me: all my natural barriers were inactivated. It makes you feel like you just had two or three glasses of wine before dinner.
"Tell him it was my fault," she teased.
"Maybe I will." And I knew that even though it'd been a crappy night, somehow I found myself a new ally and maybe even a friend.
Ambivalent feelings were still bothering me after my shift was over. I walked to the cafeteria, where a very smiling Angela was waiting for me with my breakfast already waiting on the table, trying to figure out a way to fix things between Alice and Edward. I was happy and relieved that she decided to return from her exile, but I was aware that nothing could ever be the same. Her coping mechanisms were inexistent, and her family was devastated.
"You're an angel, Angela. Your parents were spot on with the naming." I told her as I dropped unceremoniously in a chair next to her.
"You have no idea. God, I always have the crappiest night shifts!" I exhaled soundly and shifted my attention back to my phone where I scanned my emails. Greta confirmed that all the arrangements for picking up Alice in the company's private jet were made. I still had to tell Edward about it, but since he decided to pick me up from work, I thought it might be best to talk to him personally. I assumed he was probably still asleep, resting for the first time in weeks.
"The Greek God's here!" Angela teased and smiled with mischief. I was startled by her cheerfulness and turned my head instinctively to see who's coming. Not even she was completely immune to his charms.
"Good morning, ladies!" Edward greeted us good-naturedly, like someone who routinely came to the hospital. "You look exhausted, Bella. Weren't you able to get some rest?" He softly enquired while tracing the dark circles under my eyes, assessing, all lightness disappearing in an instant.
Angela shifted in her seat, clearly uncomfortable with his intensity. He swallowed hard and something must give crossed his mind, I could see a flicker behind his eyes, a decision perhaps, before he suddenly turned on his bedazzling smile once again and pulled a chair from a nearby empty table.
"So, Angela, it's a pleasant surprise to meet you here," he said as he was taking a seat dragging his chair as close to mine as possible and leaning towards me, placing his arm casually on the back of my chair.
"Very inconspicuous, Edward," I admonished him as I looked around and noticed some people in the room were looking in our direction.
After the "Mike Newton" episode no one saw me dating, and everyone assumed I was still mending a broken heart, especially after Jessica and Mike's wedding announcement. There hadn't been many intrusive questions recently, but the leaning act he was pulling would stir people's curiosity, especially when the boyfriend looked like Edward.
"Your face was on the cover of every tabloid in England only a few weeks ago, so I think the cat is out of the bag."
"Not here. No one cares about British aristocracy on this side of the Atlantic," I argued back.
"Well then, it seems like this is the safest place to be," he responded with irony. "You think that's why she doesn't want to transfer to London?" He turned to Angela. "Maybe it's the NHS's quality that's putting you off."
"Why are we discussing this now?"
"Is it open to discussion, then? Because I was under the impression that you're not amenable to negotiation, Dr. Swan. Angela, can you help me out with this one?" He demanded, tilting up his face in challenge.
"Don't get me into trouble, Edward." She flushed. "Besides, you're asking the wrong person since I like to have my best friend around. I'd be lonely without her." Her eyes were bright with tears as she squeezed my hand with reassurance.
"The feeling is mutual, Angie."
"That settles it then, I'll just have to kidnap you both and puff, problem solved." He added teasingly.
"Why don't you move to Seattle? It's an equally reasonable option to solve your problem." Angela asked. I had considered it might be an option while I finished my residency. In the long run, I had to move to London permanently. I didn't ask him myself to move because there was a part of me that wasn't ready to ask and another that wasn't ready to hear the answer.
"It's very hard for me to take care of business based in Seattle. It'd take a lot of planning and massive relocation." He answered as he'd already given it some thought. "I'd always assumed that my kids would be British because of tradition and all that, but I have to admit that I´m already resigned to the fact that they'll only be half British."
"Oh!" Angela gasped and as soon as she recovered her wits she winked at me. I was paralyzed.
"Too soon?" He teased. "Is she always this skittish about commitment?" He turned to Angela again.
"It's something new in her, I think." My friend answered truthfully. Edward's smile stayed in place, but his eyes were shadowed.
What the hell are you doing, Edward?
"She was engaged before so maybe it's just me?"
I gave him an I won't even bother answering look that seemed to fulfil its purpose. "I need an ally in this part of the world." He stated defensively.
"Believe me, she is that and some, aren't you Angie?"
"I just want you to be happy, and for now it seems that this man is trying, so I'd give him some leverage." She smiled as she stood up. "Good chat, I'll be seeing you. Enjoy your day off, Bella." And she waved goodbye, hurrying away.
"You're a piece of work. Everyone is staring at us. My privacy will be a distant memory as soon as someone googles you! Can you imagine the gossip?" I whispered.
"Bella, it's only a matter of time. This transition period should be over by now. I know it's important for you to keep your privacy but you won't be able to keep your anonymity forever. People will want to know more about you - it's inevitable. You said you wanted more. I'll give you more: I'll give you everything if you want me to; I'll give you things I didn't know I had in me to give. I want everyone to know that you're with me, that you're mine. I know you're afraid, I get that, but keeping me at arm's length isn't working for me. I need you, and I'm ready to commit. I won't hide away in your apartment anymore waiting for you. If I want to pick up my girlfriend from work, I will. Do you have any objections?"
"Edward, you're unconsciously shifting your attention towards a different matter from what's really bothering you." I focused on his striking green eyes and saw understanding. "This is not the place for us to speak but I have some good news that I'd like to share with you. In private."
"You're transferring to London?" He interrupted, happier than I'd seen him recently. How did he jump to that conclusion?
"Transferring? Where?" Asked a familiar voice coming from behind me.
"Chief?" I almost fell out of my chair as I suddenly turned around and stood up, nearly hitting him in the process.
"I thought I heard something about a transfer?" He eyed me with suspicion.
"No, I don't think you did."
"You think?" He pressed.
Edward thought that was a good point to introduce himself and stood up to shake hands with the Director. Of course, he introduced himself as Edward More Cullen, ticking a hidden box of knowledge inside the man until then. My Director had been commissioned to talk about some of the MorePrm drugs in a few congresses, so it was a miracle to keep my anonymity in the hospital for such a long period. Edward wanted it gone, but my life would be a lot harder if anyone figured out I was the heiress of Lord Henry More.
"More Cullen? I think I recognize that name," he said.
"Only if you'd ever been to England. My family is somewhat notorious back home," he smirked. Notorious was the understatement of the year.
"Something to do with the MorePharm company perhaps?" His eyes widened with the realization. And just like that, the connection was made, and I knew my life was about to change.
"Well, that's not an easy question to answer, but I do have a special interest in that company."
My Chief's demeanor changed completely. It never ceased to amaze me how money and influence could get you anything you wanted.
"And what can we do for you? Are you interested in enrolling our Hospital in a new study? Using Dr. Swan as a communication channel is very unusual." He was fishing for information and Edward knew it. Of course, MorePharm wouldn't go to a Resident about anything related to a clinical trial. Especially in the hospital's cafeteria.
"Not at all. My interest in Dr. Swan is very personal. I stopped by to drive Bella home. I think it's very dangerous to drive when you're sleep deprived."
"Of course, that's thoughtful. Well, I understand now the talk I overheard about transferring." He pressed, his tone deceptively soft.
"She's very adamant that she doesn't want to leave, so I guess I'll have to bring out the big guns to convince her."
"It's a big change to ask from anyone," he added with assessing eyes.
"I know, I postponed the kidnapping plan," Edward's eyes were filled with mischief as he added, "so far."
"Well, I can't say that I hope you succeed in your endeavor. I'll see you tomorrow at eight, Dr. Swan."
I stood up sometime during the awkward exchange. As soon as my Director walked away so did I.
"You're in a hurry today." Edward accused as he closed the distance between us.
"I have something to tell you, and we'd better talk in the car. Let John drive; we'll get your car later."
"You're not in a cooperative mood."
"I know what you were doing back there, stop manipulating things. You can't always get what you want; I'll transfer when I please. It's not your decision to make." I had had a very rough night, it made me cranky, and to top that I was in a relationship with the most manipulative man, who happened to be related to the family from hell.
"It's when now, not if? I can live with that." And then he smiled the brightest of smiles, the kind one reserved for winning a gold medal in the Olympics.
I rushed out of the busy cafeteria, trying not to notice the extra attention created by Edward's rock-hard arm around my waist. I was anxious to be alone with him, yet as soon as we entered the car I had no idea how to breach the subject. I knew that as soon as I told him that Alice called me he'd want to take over and she didn't want to be pushed around. So, how to share the news with tact?
"I was lonely yesterday without you." He said mindlessly caressing my hand.
It still surprised me how tender he could be. It started to rain as we approached our destination, the sky turning dark suddenly. If I were superstitious, I'd have seen it as an augury.
I was edgy and feeling like a coward for postponing telling him about Alice, and not knowing the right words. He wasn't behaving naturally either. He was acting possessive, clinging to me lovingly but somewhat desperate. Was I projecting my feelings or was he just picking up my mood? We walked hand in hand to the elevator, not saying much.
As soon as we entered my apartment, I closed the door behind me and vomited the words that were fighting to come out. "Edward, I have no idea how to prepare you for this, so please keep calm." That was the worst phrasing possible because asking someone to keep calm usually had the opposite effect.
I filled my lungs with as much air as I could to say everything in one sentence before he started his inquisition. "Alice called, she's okay and coming home today. Greta made all the arrangements; you don't need to worry. The company's jet is on its way to get her in New York and fly her back here. Mathew will be picking her up at the airport and drive her straight home later today." I managed to say everything without taking another breath. During my tirade, his face took a fishy expression that would be funny in different circumstances.
"When did she call? Why didn't you tell me? I'd fly there myself! Why didn't you call me?" He repeated himself bewildered. I leaned against the entrance door for leverage,
"Because I knew you'd be like this! And before you say anything else, I decided to put her and her needs first, okay? I didn't want to scare her off. It'll be a lot less conspicuous if we stay at home and wait for her other than actively going for some awkward reunion in the airport or any other public place."
"How did you find her?"
"I didn't, she was the one who took the initiative to call. I merely made the necessary arrangements to bring her safely home." I told him about our brief conversation over the phone, and he kept pushing me to recall everything to the smallest detail.
"And she decided to come back home? Simple as that?" He asked eventually and insisted for Alice's number. He wanted to call her, to make sure she was coming.
As I walked away from the lobby, probably the weirdest place to have that conversation, I felt a faint and delicate scent coming from the kitchen and listened to the kitchen service door closing and turned to Edward. "I thought we were alone."
He looked terrified and tried to bar my entrance in the kitchen. It was silly to pursuit a burglar, I know, but I reacted on instinct and acted quicker than Edward.
Oh God, nothing could have prepared me for the sight in front of me. Over the kitchen island rested a breakfast tray, with a crystal vase with a single, perfect red rose, a neatly piled plate of chocolate pancakes decorated with strawberries and a red heart on top with SAY YES written in bold white letters.
I froze, my mouth hanging open. I don't know how long I stared at Edward before he finally broke the silence.
"Say something, please." His voice was tremulous, a first for him.
"What's the meaning of this?" I asked coarsely.
"I think the ring is quite self-explanatory." He answered unamused. "Poor timing…"
"I'd say, it's probably the worst." I hadn't even noticed the blue velvet box. There was a beautiful diamond at the center surrounded by what it seemed to be a ribbon of smaller diamonds. Edward's choice was a lot less flashy and unconventional than expected. And it was perfect for me. I burst out crying, knowing that I couldn't say yes. Not that day. Afterward, desperation took over me because I realized that it might never happen. Henry More would find a way back from the dead to order me not to. Madeline's voice whispered schizophrenically in my head "he has 12 billion reasons". "Edward, I can't. Not now."
"I know it's the worst timing possible," his eyes watered as I stepped back and away from him. "But I love you, and I miss you every day. You're the one who kept me well-balanced through this last few weeks. I need you by my side. I want to help you. I want to take care of you. I want you to sleep more than 20 hours a week, and I want you to do it in my arms where you're safe. I'll move here while you finish your residency. I know how much that's important to you. I know how much it means to you accomplishing something for yourself. You're so strong; I know that. But sometimes you almost kill yourself in the process of showing it to yourself. And I love you for it. Against my better judgment, in spite of it, I love you."
"Edward, we can´t get engaged today of all days. How do you think Alice will feel?" I was in panic mode.
"We don't need to tell her."
"Great, that's just what she needs – again not being told something important."
"Are you saying you don't want to marry me?" He was angry now, grabbing the marble stone forcefully for support. His fingers turned as white as the stone.
"That's not what I said!" My voice was faltering, and an edge of hysteria was giving it a rougher timbre.
"That's a lot of wording, and I got lost in translation. A simple yes would suffice."
"I didn't say yes. I said, not today." I emphasized the not today part. But there was a part of me that was more inclined to a maybe not ever. He probably sensed that too.
"Was that the answer you gave Mike Newton? I can see now how he might have gotten confused and thought it was okay to fuck your friend behind your back." He was in full rage now, and I couldn't be more hurt if he slapped me.
"Get out," I demanded.
"Bella, I'm sorry. I stepped out of line."
"Get out of my sight Edward Cullen."
"I'm sorry." He stood motionless in front of me. His eyes were regretful, and his hands were cast together pleading.
"Get out!" I screamed at him, but he only took the hint when I threw the offensive tray against the wall.
He calmly picked up the ring from the floor, stepping on the shattered glass without a care, and stopped right in front of me. My vision was blurry from the tears, but I still looked straight into his eyes, defiantly.
"I'll keep this for now and save it for you. It'll be with me at all times. Whenever you change your mind, it'll be here," he touched his inside breast pocket. "I think we both need some space now." Understatement of the year. "I'll come back later before Alice arrives."