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page-doctor-bekker · 3 years

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Human Error (transfemme!sarah)

(A/N) this really doesn’t actually have anything to do with sarah being trans, it just takes place in the same universe. this is literally just an event that happened in this au written out so i can write about effects surrounding it without people being confused lol.

“Reese, we’re slammed, any chance you can take treatment four?” Maggie pointed at Sarah Reese, and then at the fourth treatment room. Sarah looked up from the computer, before grabbing her tablet and heading to the treatment room.

“Hi, Mr. Nearling? I’m Dr. Reese, what seems to be the issue today?” Sarah pushed for hand sanitizer, rubbing her already-dry hands together until the gel had absorbed.

“Trouble breathing…” The man took a few labored breaths, “Cold sweat… I’m shaking, I can’t breathe-”

“Okay, I see, when did this start? Does your chest hurt at all?”

“I… I had a big meeting today and it just happened suddenly. I guess it hurts a little bit.”

“Can I take a listen to your heart?” Sarah asked, already taking her stethoscope off of her neck. The man nodded, and she pressed the drum to his chest. His heart was racing.

He started talking fast, “Are you going to be able to give me a doctor’s note? I’m going to lose my job…” He started breathing faster.

“Has this ever happened before?” Sarah asked, lifting the stethoscope from the man’s chest, “Any history of anxiety or panic disorders?”

“Never like this,” He choked up and coughed a bit, “But, I had social anxiety as a kid.”

“Do you have any family history of cardiovascular disease, diabetes, or high blood pressure? Do you smoke, drink?”

“No, none of that,” The man waved his hands, “I’m a healthy guy. A vegetarian, everything- everything is fine! I’m perfect, I can’t-”

“Mr. Nearling-” He was hyperventilating, and Sarah grabbed one of his hands, “Mr. Nearling, I think you’re having an anxiety attack,” Dr. Reese let go of his hand, and hung her stethoscope back around her neck, and tapped on her iPad, “I’m going to give you something to calm you down, then we can talk about coping strategies and I will refer you to outpatient psychiatry to continue care. April, push 1.5 milligrams of Ativan.”

April pushed the medication through the patient’s IV line, and Dr. Reese pulled up a round, spinning stool to the bed and sat down. April nodded at the doctor, and left the room, pulling the curtain shut.

Mr. Nearling calmed down noticeably, which Dr. Reese took as a success - Panic attack subsided. Dr. Reese smiled, “It’s normal to have some residual physical symptoms, mild tightness, shortness of breath, but as the medication works you’ll calm down more and more. Have you ever had a panic attack before?”

Mr. Nearling shrugged, “Maybe? I’ve never gone to the hospital for it.”

“After a severe panic attack you may have more panic attacks in the coming days or weeks, so I’m going to call in a mild benzodiazepine in case you need a bit of help,” Dr. Reese typed that into the tablet, “When you feel the anxiety and panic start up, you definitely want to try coping mechanisms before you take medication for it. The medication is just for if those coping mechanisms don’t work, which sometimes happens and is to be expected every once in a while.”

Mr. Nearling nodded, taking a deep breath. It was shaky going out, but residual anxiety can do that.

“So, a good first step, whenever you’re having a panic attack, is to recognize that you’re having a panic attack. If it doesn’t work to say it in your head, say it out loud,” Dr. Reese tapped the tablet against her leg with each coming syllable for emphasis, “I am having a panic attack.”

“I am having a panic attack.”

And just like that, it was no longer a panic attack. Mr. Nearling went limp, and the monitors started going crazy. Dr. Reese held two fingers to the man’s neck, and yelled out, “I need a crash cart!”

Everything moved fast after that. Sarah was pushed out of the way by two ED doctors, who started barking out orders.

“He’s in cardiac arrest, page CT. Reese, get on his chest-”

Sarah could feel blood pounding in her ears, and she clasped one hand over the other and started humming. Ah, ha, ha, ha, stayin’ alive. Stayin’ alive. Ah, ha, ha, ha, stayin’ alive, stayin’ alive… No matter how much CPR she performed, she still needed the song to keep her on beat.

“-Milligram of Epi.”

Ah, ha, ha, ha…

“Hold compressions,” Dr. Choi barked, holding two fingers to the man’s neck, “Clear!”

The man’s chest lurched as he was shocked, and Sarah’s heart jumped into her throat. Dr. Choi held his fingers back to the man’s neck, “Another milligram of Epi. Charge to 200.”

Sarah resumed compressions. Ah, ha, ha, ha, stayin’...

“Clear!”

Sarah held her hands up, shaking. This never got easier.

“Asystole,” April sighed out, preparing another milligram of Epi. She knew exactly what Dr. Choi was going to ask for next.

“Another milligram of Epi.”

Sarah reached to resume compressions, but Dr. Choi swatted her hands out of the way and did CPR himself. Dr. Choi did it slightly faster than Sarah did. He knew the man was dead.

Sarah squeezed her clammy hands together, shaking like a leaf.

Dr. Bekker rushed in almost immediately after Dr. Choi stopped compressions, and was floored when Choi called time of death.

“Alright, why wasn’t this patient taken to the cath lab as soon as his heart attack was diagnosed?” Ava’s tone was stone cold.

Everyone looked at Sarah.

“He uh… He presented with…” She cleared her throat, “With shortness of breath, mild chest pain, cold sweat, shakiness, and extreme anxiety as well as a positive history for social anxiety. He did not-” She cracked her knuckles, “Um… He also displayed signs of work-related stress and no- Uh, no risk factors for heart attack. I determined he was having a panic attack and ordered 1.5 milligrams of Ativan and started talking about coping strategies with him.”

“Whenever a patient shows up with chest pains they should receive a FULL cardiac workup REGARDLESS of history and risk factors,” Dr. Bekker took a step towards Sarah, and grew louder, “If YOU were in the emergency room with CHEST PAIN, would you be anxious?!”

“I- uh-”

“You did NOTHING you should have. ANXIETY is NOT a contraindication for a heart attack, and now this man is dead. Leaving him to die in the waiting room would be more effective,” She spat out, her tone venomous, “Psych residents, I swear. God, isn’t anyone in this hospital competent?”

Sarah was out of the room before she even knew she was moving. Her feet dragged her away and her heart was practically leaping out of her chest. She felt tears welling up in her eyes and she started chewing on her tongue to avoid letting them go. She clenched her fists as Dr. Charles called her name.

“Dr. Reese! I was paged to the ED, something about you?”

“I need to use the bathroom,” She pushed past him, and he grabbed her arm.

“Sarah,” He whispered, “Go sit in my office when you’re done. I’m going to finish rounds. We’ll talk when I’m done,” He started to walk away, before turning around, “You’re not in trouble, Sarah, I just want to understand what happened.”

Sarah pushed open the swinging door to the women’s bathroom, bolted into the nearest stall and slammed the door shut. She sat down and started sobbing.

I’m in love with her.

She choked on her own snot, and ripped off a piece of toilet paper to blow her nose.

I’m in love with her, and she hates me.

She let out a wail.

i’m in love with her, she hates me, and I failed her.

The bathroom door opened.

“Sarah?”

Sarah held her breath, pulled her knees up to her chest to avoid making any noise.

“I don’t think she’s in here,” Sarah heard April, a gentle voice amongst the madness.

Sarah heard a pager beep.

“Ugh, I have a heart transplant. Whatever, send a note to Dr. Charles and let him know I was looking for her.”

She wants to yell at me some more. She wants to hurt me. She somehow knows about me and I’m going to get fired. I’m going to get fired and be all alone. She knows about me and she’s going to hurt me and I’m going to get fired.

They left, and Sarah let out her breath and let her feet fall to the floor. She blew her nose again, and took a deep, shaking breath. She stood up, and leaned her forehead against the stall door. She took her hair down from it’s low ponytail, and shook it out. She grabbed a piece of her hair and started absentmindedly braiding it - an old anxious habit.

A few minutes and three braids later, she opened the stall door and stared into the mirror in front of her. She wiped away her tears, approached the sink, and splashed water on her face, soaking one of her messy braids in the process. She dried with a thin paper towel, took another shaky, deep breath. She grabbed a helping of hand sanitizer on her way out of the bathroom. Force of habit. Even leaving her bedroom at home she sometimes tries to push the sanitizer button, even though it isn’t there.

Sarah practically ran to Dr. Charles’s office, hurriedly taking her braids out and running her hands through her tangled hair.

She unlocked Dr. Charles’s office door with her key, and closed the door behind her. She did not turn the lights on. Instead, she made a beeline for the couch. There was a throw blanket stored under one of the cushions, and she pulled it over her after grabbing it. She covered her face with a pillow, and screamed into it.

“Sarah?”

She forcefully uncovered her face, before relaxing once she saw it was just Daniel.

“Sarah,” He inquired, sitting down at his desk, “What happened today?”

Sarah sniffled, “I misdiagnosed a heart attack as a panic attack,” She choked out, “Mid-30s male presenting with shortness of breath, mild chest pain, cold sweat, anxiety, healthy weight, vegetarian, panicking with a history of social anxiety, currently experiencing work-related stress, no family history of heart disease, nothing.”

Dr. Charles sighed, “Common mistake. Hardly something to have a-”

“He died, Dr. Charles,” She cried, “He’s dead.”

Dr. Charles’s face hardened, “I see,” He faltered.

“And- And Ava, God, Ava…” She pressed her hand to her forehead, “She yelled at me in the middle of the ED, and she said I was incompetent and-” She choked out a sob, “She hates me.”

“She doesn’t hate you, Sarah,” Dr. Charles’s tone softened, “She’s just… She’s just angry. She won’t be angry forever.”

“I just really messed up today,” Sarah swiped her tears away with trembling hands.

“You did,” Dr. Charles agreed, “You did mess up today, but-”

“I’m going to get sued-”

“Sarah.”

“I’m going to lose my residency and I don’t have a fallback plan, I’m in so much debt and so much trouble-”

“Sarah, you’re not going to lose your residency,” Dr. Charles yelled, and Sarah fell silent. He took a deep breath, “I’m sorry for yelling at you, but you’re not going to lose your residency. Every single doctor has a misdiagnosis in their career, it’s just part of the job.”

“But he died. And it’s my fault.”

“Sarah, you are going to lose patients. And sometimes it’s going to be your fault,” He reasoned, “You’re a good doctor, Sarah, you’re a good doctor who made a mistake. You want to know what happened during my residency? I diagnosed a teenage girl experiencing vomiting and lack of appetite with bulimia,” He raised his eyebrows at Sarah, “She died of malnutrition. Autopsy showed she had ulcers all along her digestive tract,” He shrugged, “She was in too much pain to eat! But all I saw was a sickly thin teenage girl that was vomiting and couldn’t eat.”

Sarah stayed quiet.

“The point is, things happen. Death happens. Sometimes, conditions disguise as one another. Medicine is hardly ever an exact science,” Dr. Charles pointed out, “Human error is expected, you’re not going to get fired, and you’re probably not going to get sued. Mr. Nearling presented with no typical risk factors of a heart attack, and all the typical risk factors and symptoms of a panic attack. Did you purposefully ignore Mr. Nearling’s heart attack?”

Sarah shook her head.

“Boom,” Dr. Charles threw his hands up in front of him, “You had no malicious intent. You made a mistake, a common mistake, on a patient that didn’t present typically, and it had consequences.”

Sarah nodded.

Dr. Charles sighed, and looked at Sarah with a look of sympathy, “And now it will never happen again, right?”

She nodded.

“You’re going to take complaints with these symptoms more seriously?”

She nodded.

“You’re not a bad doctor, Sarah, you’re just a human,” He said, “In med school they always teach you what someone who has a heart attack looks like, just like they taught me what someone who has an eating disorder looks like. You just have to learn to get past that phenotype and look deeper.”

Sarah stayed quiet.

“Look... This is hard. I get it,” Dr. Charles sighed, “Just... go home, Sarah. Take a breather.”

“What?”

“Go home. Come back in a few days. Take a break.”

“Yes sir,” She said, quietly, before standing up to leave.

(A/N) thanks for reading :) i’m going to build on this at some point and write a follow-up to this one shot. hope you enjoyed! this is a foundation for the parts i want to write, so it doesn’t have too much about sarah’s actual transition. i am so sorry for making ava be mean :(( EDIT: If you liked this, check this out bc I am continuing it!

#chicago med #one shot #chicago med one shot #sarah reese #writing #also my favorite sarah headcanon is that she still has to hum or sing stayin alive to do cpr #she has no natural rhythm without a guide lol #thats okay #transfemme!sarah #my au #angst #mild angst #dr charles #dr charles comforting sarah reese #dr charles is a good father figure #crockettstiddies

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