First Do No Harm Read online

  Pierce relaxed, and she pulled out the chair to sit across from Galen. “Is there anyone who hasn’t seen it? That shit is brilliant.”

  “Right?”

  “Honestly, I’m surprised you have time to watch TV, being a surgeon and all.” Pierce tried to control the disdain in her voice. She wasn’t being fair to Galen. This was her family. This was blood. Pierce needed to put aside whatever preconceived notions she’d come to. Galen was offering to help her. She was doing her a favor.

  “I didn’t when I was a resident. My life was the hospital and, if I got lucky, maybe a little eating and sleeping mixed in there. But you know what that’s like.”

  Pierce’s cheeks warmed with surprise at Galen’s camaraderie. She knew forgoing medical school to become a PA meant giving up the prestige of calling yourself doctor. Often, that meant Pierce just assumed everyone with an MD after their name looked down on her. But that usually wasn’t the case. They’d been sitting here for only five minutes, and Pierce had already been entirely wrong about Galen.

  “I do. And hey, thank you for meeting with me. I know this is kind of awkward, and it’s been like, a million years. But I really appreciate it. Sorry my mom put you in this position.”

  “I get it.” Galen laughed. “Moms, right?”

  “Totally.” Pierce found herself sinking into a comfort with Galen she wasn’t expecting, one that felt far more familiar than she’d anticipated. Maybe this wouldn’t be all bad?

  “So how do you like being a PA?”

  “I like it. I mean, it doesn’t give me the same autonomy as a doctor, but I do most of the same things they do in the ED—chest tubes, intubations, running codes. It’s not a bad gig.”

  “Yeah, and you didn’t have to go through a million years of residency like I did.” Galen took a sip of her espresso.

  “It has its perks, that’s true. But my skin still crawls every time a patient calls me nurse.” Pierce burned a little inside at the thought of the mislabeling. Just when she thought she’d gotten over the lack of status that came with being a PA, she realized she was still entirely too hung up on it.

  “I know what you guys do. I know your skills and how smart you are. You’re as good as any of us. And if it helps, most of my colleagues know that too. The general public just has to catch up.”

  Pierce smiled. Galen was proving to be much humbler than Pierce had ever imagined. “Thank you. That means a lot.”

  “I hear you’re looking for work?”

  “Actually, yes. I’ve been in Atlanta a few years now, and I think it’s time for a change. Boston seems like a good place to look.” Pierce had to wonder how much her mother had actually disclosed to Galen about her reasons for leaving Georgia.

  “You know it’s cold as hell here, right?”

  Pierce laughed. “I remember. I grew up in Fitchburg.”

  “That’s right. You used to come over for Thanksgiving when you were little.”

  Pierce hardly recalled visiting Galen’s family. She must have been only five or six years old. But Galen was old enough to. She hoped for a minute that her childhood angst hadn’t left any kind of lasting mark on Galen. Pierce wanted Galen to like her, and she found that longing very unsettling.

  “I guess I did. Besides, I like to ski. I know it’s asking a lot, but your mom figured with your connections in the ED at Boston City, you might be able to put a word in for me.”

  “I’ll be honest. I haven’t worked down there since I was a first-year resident. But I do know some of the attendings still, and I’m happy to do my best to talk to them about any openings. And hey, if not, I always need good PAs on my service!” Galen winked.

  “I appreciate that, but surgery isn’t my thing. Too sterile and slow. No offense.”

  Galen chuckled. “None taken. Listen. I’ll ask around this week and see what I can do, okay?”

  “Thanks. Anything to get the hell out of Atlanta is good by me.”

  Chapter Two

  The lonely one-bedroom apartment in downtown Atlanta was even lonelier with Pierce’s things parceled out into boxes and trash bags. She couldn’t wait to get the fuck out of that place. Katie’s ghost hung like the bad curtains she’d left up, and Pierce figured the only way to cleanse herself of her past was a fresh start. She’d certainly considered all the clichés about not being able to run from your problems. But she chose to ignore them anyway. A new life in Boston felt like exactly what she needed.

  Her flight was scheduled to leave at six a.m. the next morning. All of her things were packed, which was impressive considering how much Pierce actually owned. For one person, she had enough T-shirts for an entire Little League team. She didn’t have anything left to do except order a pizza and reflect on everything she was leaving behind. Pierce had a job she enjoyed but didn’t love. She had friends who were more like acquaintances. And she had an ex who haunted her even after so many months. Leaving was the right thing. Pierce’s family was in Massachusetts. She had a new job at one of the best teaching hospitals in the country. Now, she might even have a cousin to befriend her. The future wasn’t looking as bleak as she’d thought. Pierce smiled to herself, ready to put her old life behind her. A new start, a new Pierce Parker.

  * * *

  Pierce hated absolutely nothing more than a first day. From kindergarten through PA school, she’d dreaded the beginning of the year, tormented with anxiety about who she was going to talk to, whether anyone would like her, if she’d screw everything up. That fear only got worse the older she got. Her first day at Atlanta General she nearly threw up she was so nervous. It would take only a couple of hours to settle down and begin a new routine, but those few hours were always excruciating. Starting at Boston City was no different. Pierce was awake at three a.m., in her new apartment that was cold and unfamiliar. Nothing decorated the walls, and the small space still felt incredibly empty with just her bed in it. The walls were a dingy white, and the windows leaked the frigid January air. A clunky radiator occasionally roared to life, but Pierce wasn’t convinced it was giving off any heat. This place was squalor compared to her apartment in Atlanta. But she’d known to expect that before she moved to Boston.

  After an hour of tossing from side to side, followed by a podcast she’d hoped would lull her back to sleep, Pierce eventually gave up, made a cup of coffee, and turned on the TV. She’d been binging the original Twin Peaks for the second time. At least the show would be weird enough to distract her from the terror of her upcoming day.

  Finally, at five a.m., Pierce got in the shower, made a second cup of coffee, and put on a pair of clean scrubs. Not wanting to risk being late, she took the T to the hospital, arriving no less than ninety minutes early.

  * * *

  The Boston City emergency department was similar in size and structure to the one where Pierce had worked in Atlanta. When her shift started that day, she’d been briefly tutored in the electronic medical-record system, which, thankfully, she was vaguely familiar with, and then was left with Margot, one of the senior PAs.

  Margot was warm and energetic, like she’d always just had a little bit too much coffee. She let her tight ringlets with highlights of a bright purple loose in spite of what seemed inconsistent with the rigidity of the job. She had a couple of tattoos on her arms and a small stud in her nose. Pierce liked her immediately. Margot showed her around the department, the tour taking all of thirty seconds due to Margot’s lightning feet, then told her to start seeing patients. Pierce expected this. It was how medicine worked. “Orientation” consisted of “here’s the cafeteria and the bathroom” and a whiff of good luck.

  Her first patient was an older woman with leg swelling. Pierce walked into her room, legs shaking like she’d just graduated. She only hoped the panic would dissipate soon.

  “Mrs. Green, I’m Pierce, one of the PAs. Nice to meet you.” She greeted every single patient, every single time, this way. It felt comfortable, and practiced, and the words seemed to bring back some of her missing conf
idence.

  “You’re the what?” The obese, gray-haired woman lying in the bed scowled at her.

  “The physician assistant. I’ll be taking care of you.”

  Mrs. Green’s doughy face continued to look unimpressed. “You’re the assistant? When am I going to see a doctor? I’ve already been waiting here for three hours.”

  Pierce fought the urge to groan. She’d run into constant misunderstanding about her position back in Atlanta. But she’d forgotten just how rude Northerners could be. “I’m sorry to hear that. And you will see a doctor eventually. But right now, tell me what brings you in today.”

  Mrs. Green sighed and seemed to relax a little. Pierce had a way of instilling confidence in her patients. She could declare herself the PA a dozen times and still often get called “doctor.” She walked with her head high and her shoulders up, and she spoke with clarity and decisiveness. By the end of her time in a room, nearly all her patients seemed to be persuaded that whatever her title, Pierce could handle their issue.

  Emergency medicine doesn’t provide any breaks. It’s not the kind of office job or private practice where you can take thirty minutes to sit down and enjoy a sandwich. In fact, most of the time you’re lucky if you can pee every six hours. Pierce even had a rotation in PA school where not only did the clinicians have no designated break, but they had to eat whatever they could directly over a designated sink. It became known to Pierce and her classmates as “the eating sink.” Boston City wasn’t quite that extreme. But she still didn’t have time to sit and have a meal. At any given point, she was juggling seven or eight patients. That meant she was in charge of ordering their tests and medications, and following their lab results and imaging studies. When one of them was in pain and needed more morphine, Pierce would be called. She had no “break.” This routine left her exhausted by the end of the day, and she usually had to inhale a peanut-butter sandwich at her computer in between notes. But she didn’t mind. This fast-paced work was the only kind Pierce could see herself doing.

  “Thought I might find you down here.” Pierce was rocked out of her state of intense focus while charting on a patient with suspected sepsis. She recognized her cousin’s voice right away. Without thinking, she jumped from her chair and hugged Galen, an immense sense of relief washing over her. She hadn’t realized how tense and lonely she’d been since she arrived in Boston several days earlier.

  “Whoa.” Galen laughed but didn’t turn away from the embrace. “Rough day?”

  “It’s been good, actually. What are you doing down here?”

  “Came to check on you. And I figured you probably needed another coffee. Come on. I’ll show you where they keep the good stuff.”

  “I have, like, six patients right now. I don’t think I can—”

  “Sure you can.” Galen nudged Pierce’s shoulder. “Trust me. Those patients aren’t going anywhere. I bet five of them are waiting for CT scans, am I right?”

  Pierce grinned. “Four. One’s waiting for an ultrasound.”

  “Listen, Pierce. If there’s one thing I’ve learned in my old age, it’s that you have to take a minute to yourself every now and then. Otherwise, this place will kill you.”

  “Your old age, huh? You’re, like, the same age as me.”

  “I’m thirty-six now. And you’re, what, twenty-six?”

  “Twenty-eight,” Pierce said boastfully.

  “Still, I’ve got almost a decade on you, kid. Stick with me. You might learn a couple of things.”

  Pierce rolled her eyes. “Okay, Dad.”

  “Come on.” Galen laughed. “I’ll buy you a coffee.”

  * * *

  It was Rowan’s idea for Galen to go check on Pierce down in the emergency department. Of course it was. Rowan was like this perpetual saint, always giving money to the homeless guys holding signs on the parkway. It was so bad, actually, that she couldn’t walk past one of those Save the Children volunteers, or whatever they were, without making eye contact. And then, she was in. Rowan would be stuck talking to them for an hour, listening to their speech on why they needed her donation. Galen would rib her impatiently, but she also found Rowan’s empathetic, kind soul one of her best features. She was always going to be a Southern girl at heart, even once she’d left the ranches of Texas for the cold steel of Boston. Galen loved that about her.

  “Oh, there is no question you two are related.” Rowan had been waiting at one of the small tables inside the hospital Starbucks as Galen and Pierce walked in. Galen hadn’t noticed it before, but Pierce did bear a little resemblance to her. They both had the same strong, angular face and thick brow line. Pierce was a little taller but had the same stalky build as Galen. And it didn’t hurt that they wore their hair in the same short, swept-back cut.

  “Well, hello Dr. Duncan.” On seeing Rowan, Galen briefly forgot anyone else was in the room and moved closer to her, putting her hands on her hips.

  “Hello yourself, Dr. Burgess.” Rowan kissed her softly and gazed at Galen with the same flare in her eyes she’d had since they first kissed years earlier.

  The energy between them was rattled slightly by the sound of Pierce loudly clearing her throat.

  “Sorry. Ro, this is my cousin, Pierce.” Galen flushed just a little, but then decided she was still unapologetic about her often-disgusting display of love and devotion to Rowan.

  Rowan shook Pierce’s hand. “It’s so nice to finally meet you. Galen’s very excited you’re here.”

  Galen hadn’t exactly said that, but Rowan’s words seemed to put Pierce at ease nonetheless.

  “I’m excited to be here. I feel like I already know you. Instagram has a way of doing that.” Pierce laughed awkwardly. “That sounded stalkerish. Sorry.”

  “Hey, you better back off, Parker. She’s spoken for.” Galen punched Pierce playfully on the shoulder.

  “But I’m always looking for a newer model,” Rowan said, winking at Galen.

  “She doesn’t mean that. I just get better with age.” Galen grabbed Rowan around the waist and pulled her close.

  Rowan sighed. “She’s not wrong about that.”

  “You two are pretty gross, you know that?” Pierce said.

  “I know.” Rowan laughed. “Sorry about that. We’ve tried to tone it back a little, so you can imagine what we used to be like.”

  “Ro couldn’t keep her hands off me. It was really embarrassing.” Galen kissed Rowan’s cheek.

  “Sure. Let’s go with that, then,” Rowan said.

  “No, I think it’s really sweet, actually. I just went through a nasty breakup myself, and it’s nice to see that happily-ever-after is still a thing.” Pierce smiled and her gaze grew far away.

  Galen knew she’d have to address Pierce’s breakup sooner or later. After all, she had promised her mother she would mentor her professionally and personally. Besides, she was beginning to really like Pierce. Maybe it was DNA or something primal, or just two kindred spirits who were crossing paths, but Galen found herself wanting to help Pierce in whatever way she could.

  * * *

  Pierce hadn’t dated since her breakup with Katie. The prospect paralyzed her with fear of being hurt again, fear of being rejected, fear of having no goddamn clue how to date. For the entirety of her gay life, Pierce had been a serial monogamist. She rarely left one relationship without making sure she had another to fall back on. The habit had felt harmless enough at the time, but after Katie, she realized she needed a change. Pierce’s entire sense of self-worth seemed to have become tied up in whatever her current partner thought of her. Katie had only confirmed that fear by telling Pierce she was “exhausting” and “needed too much.” As emotionally unavailable as Katie was, maybe she had a point. Pierce was dependent on being part of a couple, and she was never going to fix that flaw without learning how to be alone.

  Several weeks had passed since she moved to Boston and started working in the Boston City ER. Her apartment was organized, she was beginning to feel settled in her job
, and she even saw Galen and Rowan at work for coffee or lunch every now and then. Her only real friend so far was her fellow PA, Margot. They occasionally went out for pizza after a late shift, and Pierce would text her about whatever patient of the day stuck some foreign object in an orifice they shouldn’t have. Pierce was grateful for Margot—and that her cousin was taking the time to show her the intricacies of the hospital system. All in all, things were going well. So well, in fact, that as Pierce lay on her bed, staring up at the ceiling fan, she thought it might be time to try her hand at love again, or something resembling it.

  Before she could think of a trillion reasons not to, she scooped her laptop up from under the bed and opened it. It had been nearly two years since she’d had to do this, and for the life of her she couldn’t even remember what dating sites people were using these days. They seemed to change so quickly. Pierce had met Katie on GayDate, but was that still a thing? Navigating the waters of online dating, between hookups and straight sites and Christian Mingle, felt daunting. But one by one, she went through each site she could think of—Tinder, Plenty of Fish, Her—crafting a profile she hoped would make her look not only desirable, but datable.

  28, gay, female. I’m an emergency medicine PA so I have tons of cool stories. Let’s go to yoga and eat tacos together.

  Yoga? Tacos? She couldn’t have sounded more basic if she tried.

  28, gay, female. I’m an emergency medicine PA. My workdays are spent suturing toddlers and trying to rein in the chaos of the ER. I like a good Netflix binge, particularly Making a Murderer or the likes, and in my spare time I play a little guitar. Looking for someone to take to Fenway Park this spring.

  Pierce sighed. She wouldn’t exactly say she played the guitar, but she could strum a few chords and knew how to sing well enough to fake it in order to impress a girl.

  “Nobody reads this shit anyway,” she mumbled to herself.