had been in the Detroit area, Pilar would have made arrangements to meet her for a drink after their shifts that day, just as they had done at the University of Wisconsin. While they sipped wine, they’d lean their heads together and recount the daily events, punctuated by poking fun at their colleagues whom they either felt superior to or feared. Often, they’d share an especially humorous moment in uproarious laughter and attract unwanted attention from the other patrons in the dimly lit cocktail lounge. Julie and Pilar also would listen to each other for as long as it took to air an annoyance or concern. Then they’d get down to more serious medical issues, family problems and relationships. The two friends would part from the session refreshed and ready to do battle again. “I miss Julie.” Pilar sighed.
S ATURDAY NIGHT CAME WITH the vengeance Peters promised. Pilar sat in the lounge after she had worked almost nineteen hours straight. She could hardly remember the first victim — a thirteen-year-old shot in the arm in a gang turf quarrel. Thinking back to him, Pilar fell asleep in a chair. She woke up after an hour’s nap, threw water on her face, and did a final check of the ER. When satisfied everything was in order, she drove home in a stupor and fell fully clothed into bed.
On the following afternoon, Pilar dragged her exhausted body back to the hospital expecting a worse evening than the one before. Halfway through her shift, an EMT found a teenage girl at the emergency entrance slouched on the ground and leaning against the wall. She was unresponsive and appeared to have been beaten. Once the girl had been placed on a gurney and wheeled into a vacant space in triage, Pilar saw that the bruises weren’t fresh, but the track marks on her arms were.
“Get an IV of Naloxone in her, one milligram to start,” Pilar barked to the nurse at her side. “And I’ll begin CPR. She’s fading fast. It looks like a heroin overdose.”
“Are you sure?” Peters asked as he hovered near Pilar’s right shoulder.
“Check her arms,” Pilar directed. “And since you seem not to know the signs,” she added, ignoring his seniority, “she’s hardly conscious. In fact, she’s in acute narcosis. She gurgles with each labored breath. Her pupils are constricted. There’s indication of depressed respiration. The bruises are not new. And she smells of alcohol.” When Pilar completed her diatribe, she wondered if Peters had been testing her. Surely, with his experience he would know an overdose.
The nurse inserted the IV and delivered the first milligram of Naloxone with little response. Pilar ordered another milligram.
“What does alcohol have to do with it?” Peters shouted over the loud, controlled confusion in the crowded area. “Oh, never mind. Dumb question. I know polydrug use like alcohol is common with heroin overdoses.”
“Did anyone see who brought her in?” Pilar asked without realizing how naive the question sounded. “We could use more information on what exactly she ingested.” The second milligram of Naloxone worked. The patient came out of unconsciousness.
“No one is going to stick around to be questioned by the police.” Peters rolled his eyes. “And if she dies, yadda, yadda, yadda.”
“Oh, right,” Pilar mumbled. “Her breathing and pulse are stable. I think she’ll make it.”
“This time,” one of the nurses snickered.
When Pilar chided her for that remark, the nurse snapped, “If she doesn’t kill herself, her boyfriend will.” She pointed to the fading black and blue mark over her eye.
“Yeah, well,” Pilar fumbled over her words and examined the bruise. “Maybe the police can talk some sense into her. Or better yet, find her parents.”
“You may know diagnostic systems and treatment, but you have a lot to learn about girls like her.” Peters shook his head as he answered. He tipped a finger to his forehead. “See you. Car accident victim.”
Exhausted and