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“I am not supposed to be checking lab results.”
Dr. Coyle had insisted Shaun help examine medical charts with him. Shaun did not know who they were for, or why they were doing it, but Coyle had left him with little time to refuse.
“...I am supposed to be in the clinic… helping my patient.”
Dr. Coyle gave no response, seemingly absorbed in the data results before him. It both confused and frustrated Shaun.
“...I don’t know why I need to be here”, he said, probing further.
Dr. Coyle drew out a hush. Shaun knew that hushing was reserved for small children or infants and was designed to have a calming effect, but neither of those rang true. Shaun was not an infant nor a child, and being hushed did not answer his question.
Finally conceding to confront Dr. Coyle directly, Shaun timidly pressed on, “Why did you bring me in here if you do not want to talk to me and aren't asking for my help?”
This got Dr. Coyle's attention. His eyes finally latched onto Shaun’s, if only briefly, before the other looked swiftly away.
“I just thought, since we’re coworkers, we should get to know each other.”
Dr. Coyle shrugged diminutively, like it was the most obvious thing in the world. Like Shaun should have known why the man had coerced him into a room he wasn’t assigned to, for no apparent reason.
It’s possible Shaun was missing something, but that was unlikely, considering nobody had notified him that he would be working with Dr. Coyle today, and surgical residents were not meant to converse outside of their designations.
“You are my coworker and superior, but we do not work in the same unit and I am not assigned to you. I need to go back to work. Goodbye-” Shaun turned to leave.
Dr. Coyle’s hand shot out to grab at the junction between Shaun's elbow and forearm. The sudden contact caused him to startle and Shaun felt his shoulders tense up to his ears.
“Hey, I can make some calls. It’s no big deal. Just sit down and, sure, analyze some data with me.”
“But-”
“-I heard you have a gift.”
Shaun trailed off. The praise was unexpected, and he couldn’t help but feel faintly pleased.
Dr Coyle caught on almost immediately, “You’re sharp, I could use that.”
Shaun wasn’t quite sure what to do anymore. If Dr. Coyle said he wouldn’t get in trouble, then there was no other reason to leave. Dr. Coyle wanted him and Dr. Coyle was a senior at the hospital.
“...Ok”.
It was uncertain whether the proud look on Coyle’s face was meant for Shaun, or for himself, but the moment didn’t last long before the man was dragging up a chair beside him. Shaun sat quietly, and turned his attention to the charts ahead where Coyle was dragging his finger along his data tables. It didn’t take long to figure out what they were studying. A few clicks, and a brain CT popped up on screen.
Shaun didn’t ask who the imaging was for; he had identified the problem and knowing the name would not change that.
“There is severe ICP near the optic nerve, which could cause papilledema or even permanent blindness. You should consult with your patient immediately…if they have not already lost their vision”. Shaun was sure of his diagnosis, but the chances of Coyle not having recognized it before him were inscrutable.
The swelling was much too obvious, and the location couldn’t be mistaken, not even by an orderly.
Dr. Coyle’s face remained mostly impassive, eyebrows barely raising in mock surprise.
“...You already know,” Shaun stated simply.
“Can’t say that I missed it” Coyle admitted.
“What should I be looking for?” Coyle’s lack of transparency was entirely inefficient and Shaun saw no reason to keep valuable information private.
“Well, the chicks’ got a major pill problem, so edema was a no-brainer. But it doesn’t explain the seizures.” Dr Coyle appeared genuinely perplexed. It didn’t stop him from leaning against the back of his chair, arms crossed lackadaisically above his head. Coyle was right. A pill addiction could attribute to excess fluid retainment in the brain, but edema in the optic nerve could not cause seizures. They were unrelated complications.
That being said, Shaun did not understand the lack of urgency in the matter. Possible blindness and seizures were still extremely significant issues, if not deadly. They should be consulting the patient as soon as possible.
“You should still talk to the patient about the edema. A seizure could cause further inflammation of their brain tissue.”
Nothing.
“It could kill them," Shaun emphasized.
Dr. Coyle exhaled laboriously, not moved by Shaun's advice. “That’s not why I’m here.”
“...Ok, would you like me to do it for you?”
Coyle looked affronted by his offer but quickly shook the look away. “No. I’ll talk to her. Didn’t you hear me say I wanted to get to know you?”
Nodding cautiously, Shaun responded, “Yes… get to know me and analyze data. I analyzed the data. Your patient might-”
Shaun felt Coyle’s fingers on his scalp, abruptly brushing against the locks in his hair. Lurching back, the wheels in his rolling chair took him at least three feet away.
“Woah”
Shaun shuddered. Coyle had touched him. Coworkers were not allowed any physical interaction without explicit consent.
However, Coyle had made it clear that he was attempting to engage in some form of bonding. Demonstrably, bonding might involve touching, and Shaun had not disagreed with letting Coyle ‘get to know him’.
…It was his fault. He should have been clearer, or understood that being touched could be related to building interpersonal connections.
“S-sorry. I did not like that”.
“Do you always get like that?” Coyle interjected, unperturbed by Shaun’s reaction.
“In most cases, yes. I do not like to be touched without warning.”
Coyle was visibly intrigued, and without missing a beat, persisted “So…every time a patient tries to hug you, thank you, you flinch away like that?”
“...Very frequently,” Shaun voiced, wary of the sudden interrogation. “I try not to but I cannot help it. Aversion to touch is a symptom of autism. I have autism.”
Coyle studies him for a moment, “They must feel pretty upset – when you turn them away”.
Shaun is slightly disconcerted.
The man scoffs, but it doesn’t sound remotely humorous. “To just reject a patient like that… Don’t you feel a little guilty?”
“I… I do not owe them my autonomy. I owe them the right to excellent healthcare…and maybe a few fun facts.”
Coyle seems displeased with the answer, but remains composed in a way that can only be described as artificial. Then, deliberately slow, he begins to reach out his arm, stretching the limb toward Shaun's back.
“But I bet it would make them happy,” Coyle utters, as he moves his hand. “Just try it. You could make me happy.”
Shaun eyes Coyle’s hand with vehement concentration, but forces himself not to move as the man’s palm settles against his coat.
Only moments later, Coyle softly pats his back.
Shaun doesn’t understand why it causes the hairs on the back of his neck to stand up or why he can’t stop thinking of the amount of steps it is from the monitors to the door. He doesn’t understand why he wants Coyle to stop. There had been definite warning and Shaun was given incentive to stay still, yet it was remarkably hard to keep from moving.
Coyle lets his hand linger, and the contact feels more warm than rough, though Shaun had subconsciously expected it to be the other way around.
When his Dad would hit him, it used to be rough. It typically sent his younger body tumbling to the ground. Even when Steve would ruffle his hair, it wasn’t soft, like Coyle’s touch.
Coyle was just being mindful. Something of which his patients and coworkers seldom did, at least not out of their own volition.
Shaun silently wished being mindful did not involve Coyle touching him.
The warmth on his back was removed, and a tenseness Shaun didn’t know he had left his body.
“You did good” Coyle smiled, the faintest hint of smugness tracing his features. Shaun didn’t say anything back.
For the second time that evening, Coyle sighed, only marginally satisfied with Shaun’s placidity.
Without further ado, he turned back to the screen and furrowed his brows in contrived focus. The blue glow cast itself vividly on his skin and the brights of his eyes became even brighter in the light. The data had not changed, and Shaun hadn’t progressed to any additional scans, but Coyle was set on pretending the test results were what concerned him most.
Shaun felt forced to follow Coyle’s lead and stiffly faced himself toward the CT scans. Silence enveloped the room like a weighted blanket. Only Coyle’s occasional palatal clicks broke the quiet, and contrary to habit, Shaun didn’t find himself telling the man to stop. Instead, he opted back into analyzing the images. If he was going to stay with Coyle, Shaun wanted to understand what for.
“This patient of mine, total cunt,” Coyle suddenly relays, breaking the little concentration he had gathered.
Shaun doesn’t give comment. “I mean, the case is interesting, but the girl isn’t,” It doesn’t deter Coyle in the slightest. “She’s already got herself knocked up, and you wouldn’t believe the odor”
“Digusting” Coyle’s nose is scrunched in blatant distaste.
Shaun was going to say something, he was going to provide a fairly extensive list of reasons for why pregnancy and unpleasant odors may coexist, but the tangent came to a halt. Suspended before him, appeared a diagrammatic map of the optic disc, then the nerve head, and finally the surrounding vessels. He tracked the blood flow, words blending into the corners of his vision, and series after series of visual-spatial processes flitted past in his mind. In the ophthalmic artery, a clot formed, swelling into a microscopic lump that sat in between the optic nerve and bone ridden canal.
“Is anybody home?” Shaun flinched at the sharp sting on his face. Coyle had flicked his cheekbone, ending the stupor.
“What is your patient's name?” Shaun inquired, effectively moving past the action.
“Carly.” Coyle was tapping his fingers impatiently against the desktop. “You’ve got something?”
“...Yes, Carly has CVT, cerebral venous sinus thrombosis. A blood clot in her venous sinuses is preventing fluid drainage, elevating pressure in the brain and causing both her seizures and edema in the optic disc”
Coyle slapped the table enthusiastically, face erupting into a smile.
“CVT can stem from both pregnancy and menopause, a factor of the foul odor. Carly could experience brain herniation at anything from a few days to a couple months, but seizures are a sign that the edema is beginning to slowly kill her from the inside. You should-”
“Right,” Coyle concludes, already grabbing his lab coat from his chair. “I’ll go inform my team of my verdict.”
Shaun raises his finger hesitantly, “It was actually mine”.
“You’d like to be a better surgeon wouldn’t you?” Coyle hastily adds.
Coyle is leaning against the exit door, staring ambitiously at Shaun’s hunched form.
“...Yes”
“Then loosen up a little. If someone wants to touch you a little, be a good sport, and hold still,”
Shaun doesn’t understand why Coyle is telling him any of this, or leaving so quickly.
Coyle goes on. “...When we see each other again, I’ll teach you a thing or two”.
Winking charmlessly, the man is out the door.