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Chapter 4

Author: Greedy Pass
Margot held the X-ray up to the light, studied it, set it down, then turned back to the monitor to check the readings. She went through the morning’s test results one more time.

She stood at the bedside with her hands resting lightly on the rail, staring at the child for a long time.

She turned her head, her gaze passing over Caroline and landing on me.

"You are so talented, are you not?

"Here is your chance. Let us see if you can prove yourself again."

"Dr. Aldrich, that is not appropriate." The on-call doctor stood between us, looking from me to Margot and back, clutching a medication bottle with no idea who to hand it to.

Margot waved him off, her tone leisurely. "This resident from your hospital just single-handedly diagnosed an incarcerated hernia. I am sure a little problem like this will not be beyond him either."

She took a step forward until she faced me directly, her gaze bearing down. "You are the one who is so confident in his own judgment, right? The one who said I owed a child an acknowledgment? Then I am giving you the chance to prove it today."

I found myself wedged between the bassinet and the monitor, my back pressed against the cold metal casing of the equipment. My heart hammered so hard I felt it in my throat.

"Go ahead."

Margot pulled the medication bottle from the nurse’s hands and held it out to me, the base of the bottle nearly pressing into my chest.

I took it. My fingertips brushed over the label as I turned it in my hand.

The child still lay there, tubes in place. The numbers on the monitor kept ticking, and the oxygen saturation had already dropped to sixty-two.

I leaned down, brought my face close to his ear, and whispered, "Hey, buddy. Is this medicine making you feel bad?"

The beeping of the monitor filled the entire room. I held my breath and focused every ounce of attention on listening.

I waited, but there was nothing. It was only silence, emptier than before.

Margot folded her arms and drifted to my side, the corner of her mouth curling upward.

"What is wrong? Nothing to say? You had plenty to say a minute ago."

She took a half-step around the bassinet. "I have been doing this for thirty years. You think I have not seen your type before? Three months of treating patients, a handful of rare cases under your belt, and suddenly you think you are different from everyone else."

Her voice was not loud, yet the ICU was so quiet that every word seemed to crawl along the walls and into every ear in the room.

"How do you think I got to where I am today? By listening to patients a little more?"

She reached up and tapped the badge pinned to the left side of her white coat, her National Pediatric Specialist Committee pin.

"You are standing here, in front of a child who is on a ventilator and is unconscious, and you are talking to him. You think he is going to talk back? And then you will tell me what he said?

"Could you write that diagnosis in a medical chart and have it hold up to review? When the medical affairs office pulls the file tomorrow, are you going to write ‘per patient’s verbal report’?"

Her pace stayed unhurried, yet every word carried weight. Someone nearby let out a laugh, then immediately swallowed it.

"Let me tell you something. This field does not run on gut feelings. You think you are doing the right thing? You think you are speaking up for a child? You are writing your own career’s obituary.

"You got lucky and guessed right once or twice, and now you think you are some kind of chosen one? Do you have any idea what scares people the most in this line of work? People exactly like you.

"You barely finished your first rotation and are already trying to run, barely learned to read a chart and are already dreaming of running a department."

She leaned over the duty desk, pulled out a sheet of paper, and slapped it down on top of the monitor. "Write it down. Your name, department, and employee number. I will be having a conversation with Dr. Whitby tomorrow."

The child in the bed shifted, just barely, and the oxygen saturation on the monitor jumped from sixty-two to fifty-nine.

I heard it.

It was faint, like something floating up from deep underwater.

"It is... the tube...

"...something in the tube..."

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  • Little Voices   Chapter 13

    The on-call ER doctor froze for a second and opened his mouth to say something. I looked at him, and he swallowed it.There was no line at the CT room that late at night. The whole process, from wheeling the baby in to wheeling him back out, took about fifteen minutes.When the scan was printed, I stood in front of the lightbox. I did not need a magnifying glass to see it. There was a bright, high-density shadow on the image, an intracranial hemorrhage.The volume was small, yet the location was dangerous, close to the ventricles, and it could expand at any time.I turned to the parents. "He needs to be admitted. We are contacting neurosurgery right now for a drainage procedure. But do not panic. We caught it early, and it is treatable."The father’s hands would not stop shaking. The mother stared at me, her lips white."Doctor... how did you know it was his head? The other doctor said it was his stomach..."I glanced back at the scan on the lightbox. "The crying was different.

  • Little Voices   Chapter 12

    "But I need to fill in the gaps I had been missing."Caroline did not try to talk me out of it. All she said was, "Fine. Let me know once you have it sorted."The next morning, I posted a long message online. No images, no title, only a block of text."My name is Rowan Beckett, and I am a pediatrician."Over the past six months, a lot of people have been calling me the baby whisperer. Others have accused me of chasing publicity."But what I can tell you is this. Every diagnosis and every judgment call, I documented. I have waveform charts, palpation records, nursing logs, and rehabilitation assessment reports. All of it is on paper, and any of it can be verified."I have received invitations from several universities to continue my education. A lot of people have asked whether I am leaving clinical work. I am not."I just realized that what I can do on my own is too limited. When I come back, I want to be standing somewhere with a wider reach, so I can protect more people."I o

  • Little Voices   Chapter 11

    "The Health Commission’s documentation will arrive at the hospital this afternoon."I sat at my desk, staring at a crooked line I had written in a patient chart. I tore the page out and started over.Nobody in the department talked about it loudly.Gary’s belongings had been cleared out that same morning. His desk was near the back of the nurses’ station, where he used to keep a thermos and a potted plant.Someone had moved the plant to the windowsill. The thermos was gone, and the desk had been wiped spotless.During afternoon rounds that day, I passed by the desk. I did not stop walking, yet my eyes drifted over on their own. There was nothing left.The hospital issued an internal bulletin, and Caroline held a department-wide meeting. It was brief, and it covered everything that needed to be said.A week later, Caroline called me into her office again. She told me to sit down."Rowan, we are making some staffing changes in pediatrics. The neonatal intensive care unit needs a

  • Little Voices   Chapter 10

    By the fourth night, the presentation was down to forty-five pages. Every page had data, timestamps, and the signature of the person who recorded it. Not a single page contained the words I believe or I felt.The afternoon of the symposium, the auditorium was full. Hospital leadership sat in the front rows, doctors from every department filled the seats behind them, and more people stood lining the hallway. A camera was mounted at the back of the room.When I walked up to the podium, I caught something in my peripheral vision. There was a seat in the corner, against the wall, where the light barely reached.Margot was sitting there. She was not wearing her white coat. She had on a dark jacket, her hands resting on her knees, her face half hidden in shadow.I opened the presentation."Good afternoon. My name is Rowan Beckett. I am not here today to talk about theory or principles. I am here to walk you through two cases I handled personally."The first slide was the incarcerated h

  • Little Voices   Chapter 9

    "This is from the disciplinary board, delivered first thing this morning. It is Margot Aldrich’s suspension notice."I looked down at the paper. The letterhead was official, and the language was formal."Does she know?""She was notified at eight this morning," Caroline said. "She has not come into the hospital."A car horn sounded outside the window. I turned and looked out.A police cruiser was pulling slowly out of the parking lot. Through the glass, I could not make out who was sitting in the back seat. The car turned out of the entrance and merged into the morning rush. Within seconds, it was gone.I looked down at the suspension notice on my knees. The edges of the paper were creased where I had been gripping them."I am going to go check on the child."I stood, walked out of the office, crossed the hallway, and pushed open the ICU doors.He was still in bed. The tubes were still in place, and the numbers on the monitor flickered steadily.I walked to the bedside, leane

  • Little Voices   Chapter 8

    Gary had his head down, his hair falling over most of his face. A gray jacket was draped over his wrist, and he did not look at me.As he passed, his step faltered for a fraction of a second, so brief it was almost imperceptible. Then he kept walking, following the two plainclothes men around the corner and into the elevator.After the elevator doors closed, the hallway stayed silent for a few seconds.Caroline stood in the doorway of her office, staring in the direction of the elevator. She watched for a long moment before turning to face me."Come with me."I followed her inside. She closed the door and gestured for me to sit. She stood by the window with her back to me."Yesterday afternoon I brought the materials to the Health Commission. The disciplinary board received a separate anonymous submission at the same time, pointing in the same direction."Gary has been taken in for questioning."She turned around and leaned against the window ledge."He confessed. It has been

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