The Filly With the Red Bow
The Filly With the Red Bow
In medical school, the first thing they teach you is to never, ever, get attached to your patients. It isn't because you want to seem like a badass television doctor or anything. It's because, like it or not, some patients will die. Sometimes there will be nopony to blame but you. Other times, it's not something that could be helped. It was just their time.
They tell you that because, in the course of a doctor's career, one can expect to lose more patients than he could ever hope to keep track of. To have every loss mean something would break even the most emotionless pony in a matter of years. Those who are able to perform this emotional detachment, become doctors, and go on to lead successful lives while knowing what they do makes a difference in the lives of Celestia's citizens. Those who can't become dentists, I'd imagine.
I was one of those who could do it. I pulled myself away from the pain that was often times right in front of me. I know this sounds cold, but sometimes, it was easy. The family would be there, asking me with worry in their eyes, what I could do to prolong the life of their loved one. More often than I'd have liked, the answer was 'not much.'
That's the thing many ponies don't get about doctors; we aren't miracle workers. We aren't in the business of cures or full recoveries. That's not to say they don't happen, but only in the healthiest of cases do they ever seem to occur. Mostly, our job is to prolong the game of life, to keep a loved one in it for as long and as comfortably as we can. Sometimes we can help a sick pony live for another forty or fifty years, maybe even longer! Other times, we can only give them enough time to settle old accounts and make peace with their loved ones as they say their last goodbyes.
When I say I detach myself, I don't mean I feel nothing for the grieving families. I know their pain. I've lost relatives, just as they have. Perhaps once I'm off the clock, I'll shed a tear for a foal who's lost their grandpa too soon, or a widow forced to go on without the love of her life. It's hard to watch, trust me. But, at the end of the day, I know I can't let it get to me. To allow one case to stick with me while I'm trying to treat another would just cloud my judgement, and I can't afford to let it do that. Not with lives in my hooves. Sometimes, this job can be the most wonderful thing I'm sure anypony could ever experience. Other times, it can be the worst job in the world.
Out of all the cases I've treated in my sixteen years as a doctor in Ponyville, none of them have ever hit me as hard as the one I just ran from. Yes, I said ran. I'm sitting alone at a bar, finishing this bottle of whatever rotgut the bartender had closest to me. It's almost last call, but I don't care. My shift isn't even over yet, but it doesn't matter. Let them fire me. I can't go back to the hospital. I can't face that filly with the red bow.
The day I met her was unremarkable. She and her older sister had managed to force their eldest brother to come see me, even though I could see how reluctant he was to cooperate. It's something I run into a lot out here, honestly. For some reason, rural types think it's a sign of weakness to go see a doctor instead of simply 'walking off' a compound fracture.
He insisted he wasn't hurt, but his sister would have none of it. She practically dragged him into my office when nurse Redheart showed them to an exam room. I checked my records to reveal I had treated Macintosh Apple once before for a muscle strain or two.
After some coaxing, he said he had felt a tension in his chest and pain when he turned a certain direction, as well as shortness of breath. He also admitted may have twisted his torso a bit awkwardly while pulling one of the many carts needed to haul his harvest from point 'A' to point 'B'. This was not uncommon in the farmer set, and a quick palpation of the region did in fact reveal a few strained muscles near his ribs. I thought nothing more of it, and prescribed some light opiate pain medication and an order to stay off his hooves for at least two weeks.
Needless to say, he wasn't happy. It was about that time I took notice of a young, school-aged filly that had remained silent the entire visit. I'd have hardly noticed her at all if it weren't for that bright red ribbon in her mane. I kept candy in the exam rooms for the occasional immunization, but I also made it a habit to give them to foals when I had the chance. Rapport with families is just as important as bedside manner. After writing the prescription, she tugged on my coat.
"Doc, how'd ya get your cutie mark?" I hadn't noticed she was without one. Her sister quickly chastised her, assuring her I had more important things to do instead of letting fillies badger me, but I insisted I had time.
"Well, young mare, I was about your age when a friend of mine and I had been playing in the woods outside of town. While we were out, my pal tripped over a root and twisted his ankle. It looked pretty bad, but I knew I had to do something. I made a splint out of some sticks and broad leaves, stabilized the leg, and helped him out of the woods," I recounted fondly. "By the time we'd made it back to town and called a real doctor, I had my cutie mark."
I'll never forget the way her eyes lit up at the conclusion of my tale. "Really? Ya mean it was just that easy? And ya didn't even notice it?" I laughed.
"That's right. I hadn't even considered medicine before that point," I told her, grabbing the jar of hard candy from a top shelf and offering her any kind she desired. "It just goes to show you that you still have the whole world in front of you." She was beaming by that point, and I could tell her sister and brother appreciated my little story. I guessed they dealt with cutie mark related complaints more often than I dealt with colds in the winter.
They took their leave, and I went on about my rounds. After they'd left, something about that filly stuck with me. Even now, I don't know what it was. Maybe an unspoiled air of innocence that comes with knowing anything could be your special talent. Maybe just the way her eyes shined when she got excited. I couldn't tell you. When Macintosh showed up a few weeks later with only his older sister, I must admit I was a bit crestfallen. In a job where most of my time is spent around life that seems to be slipping away, fillies and colts offer a bit of a bright spot in my day. An assurance that no matter how many times the reaper wins, life is certain to continue on.
Upon their return visit, Macintosh's sore muscles seemed to have healed, though he still complained of shortness of breath. On top of that, his sister had added that he'd been more and more reluctant to get out of bed in the morning for his chores, and needed longer to rest after they had been done. I listened to his heartbeat, but it was normal. As a precaution, I decided to monitor him overnight. He was immediately opposed, but his sister once again proved to have the final say. After we'd gotten him assigned to a room, he seemed fine, if a little resistant.
The next day, I was ready to send him home until a nurse called me from my morning rounds and into his room. He was drenched in sweat, and unconscious. Vocal and physical stimuli did nothing to wake him as I checked his heart rate. Nearly three hundred beats per minute. He was in atrial fibrillation, and then... nothing.
"Nurse, get me the crash cart!" The blue light outside his room went on, gathering the other nurses from their stations as they began compressions while I charged the defibrillator. It was powered by magic, so it was ready to go fairly quickly. "Clear!" I shouted, ordering them to keep their hooves off of him while I placed the paddles on his bare chest. His back arched as the electricity ran through him. I put my stethoscope to his chest and sighed. We'd brought him back. His heart rate was returning to a normal rhythm, and within minutes, he began to wake up. Nurse Redheart took care of removing his sweat-soaked sheets while I sat with him, explaining what had happened.
He seemed unusually calm for somepony who had been dead for a few seconds. I told him it looked like I'd have to keep him for longer than one night after that little stunt. He smiled, a lot less resistant than before. "Ah don't mind, so long as ya get me well enough to keep up the farm." I'd practically raised him from the dead, and his mind was still on his family. Pretty admirable, I had to admit.
"I will, but we may need to keep you on some medicine for that heart of yours." He looked a bit confused.
"What's wrong with my heart?"
That was the million-bit question. "I don't know, but it's my job to find out. We'll let your sister know we'll be hanging on to you for a few more days."
He sighed reluctantly. "Well, if it'll help me get better, Ah suppose that's alright."
I resumed my rounds, but not before making sure he was hooked to a heart monitor to mitigate any repeat incidents. Heart disease was rare in ponies his age. In fact, I'd never had a patient go into atrial fibrillation younger than seventy! It was rare, but I figured it was just a fluke. After all, only a hoof-full of cases were even published in medical journals! It would have been irresponsible on my part to even assume his heart was a threat to his well-being.
Around an hour or so later, his sisters nearly knocked two nurses over getting to his room. I was at the nurses station, filling out paperwork when I overheard them talking. His eldest sister was composed, but his youngest sister was not. I could hear her choking back tears in the hallway.
"C'mon now, darlin', Ah'm okay," he assured her. I watched as he scooped her up into the bed with him. "Th' doctors are gonna take care of me, and Ah'll be back home ta help ya with your math homework before ya know it."
Once visiting hours were over, the two sisters came to me, the youngest having finally dried her tears, but still sporting the puffy cheeks of recent distress. "What's wrong with my brother?" she asked. I could tell her sister wanted the same answer, but was a bit more reserved.
"We don't know, but we'll find out. And when we do, we'll make him all better," I assured her. She looked down at her hooves, sniffed up one last tear, and brought her once bright eyes to mine.
"Do you promise?"
I didn't think twice. The words came out like I had anticipated her question. "I promise." Only a foolish doctor makes promises.
My reassurances didn't seem to help. From what I could tell, this filly had dealt with death before. That's when I realized I'd seen both her mother and father pass through these doors. I was still an intern, and the resident physician treated both of them. They weren't my patients, so I had no idea what they were in for, but they both passed within hours of each other. I remember the night it happened. Doctor Stratus was nearly speechless.
I was on call that night, and he came out of one of their rooms with a glazed look on his face. I hadn't really known him for very long, but I'll never forget what he said to me.
"Don't blame yourself. The moment you do, your career is over."
He quit the next day. I should have seen this coming. I should have realized what was going to happen.
It was like a tidal wave. You see the shoreline withdraw, and you know a wall of water won't be far behind. Unfortunately, you can't run from it; you'd never escape in time. So what do you do? Just stand on the beach and let it sweep you away? That's what he did. I'd be a liar if I said I didn't do the same.
So here I am, sitting at this bar because of the past few hours. I had placed Macintosh on a few medicines I thought would help regulate his heart and keep him out of A-fib. He would have gone home tomorrow. He would have been in his living room, helping his little sister with her homework while she happily thought about the joys of the coming day.
I was about to begin my evening rounds, when the code blue alarm went off. A weight dropped in my stomach. Somehow, I could feel this wasn't one of my elderly patients. I didn't even bother to check the heart monitors. I ran straight to Macintosh's room, where the nurses had already begun prepping him for the paddles. The monitor we'd placed on him indicated the worst.
From the moment I held the paddles in my magic, a sense of powerlessness washed over me, and all I could see was his sister's face, swollen with tears. I tried to detach myself, as I'd done so many times before, but I just couldn't. She wouldn't leave my mind. I bit my lip, and pressed the paddles to his chest.
"Clear!"
His back arched, much like it had before. The monitor recorded a beat or two, before returning to the dreaded flatline.
One more time, c'mon big guy! I thought.
The building hum of the charging machine drowned out the nurses in the room, starting compressions and trying desperately to restart his heart.
"Clear!"
Another arch, another blip. This couldn't be happening. Not now. Not after I'd promised.
"Clear!"
The smell of singed coat began to permeate the room. I was missing the marks. I couldn't give up now. I couldn't live with myself if I'd stopped one shock short of revival. If I could just get him back, I knew exactly what dosage and medication he would need to keep his A-fib under control. I just needed one more chance!
"Clear!"
The nurses had stopped compressions. I looked at them, and they stared back at me. "No... no! Celestia-damnit no!" I lifted the entire crash cart and hurled it into the hallway, the components shattering against the tile like a baseball through a window pane. The nurses fled the room, all except for Redheart. I never lost it like this. I was known for my rational demeanor. But I just couldn't take this loss.
Not after I'd promised.
I had to get out of that hospital. I strode right past her, the other shocked nurses, and out the front door. Which brings us to my current condition. Here, at a dive bar, drunk, in my doctors coat, no less. I did exactly what Stratus told me not to do. I just can't let go of the haunting thought that I should have started him out on stronger meds the moment he'd had his first incident.
Young stallions aren't supposed to die that way. Only old ponies who'd lived full lives, made peace with their families and rivals. Not young colts who didn't even get to say goodbye to the ones they loved most. Not colts who promised their little sisters the doctor knew what he was doing and would have them healthy and back to them in no time at all. Only doctors who made foolish promises.
So here we are, back to square one. I slid the bottle back to the bartender and threw some cash on the bar. The door opened, shining light from the street lamps into the hole-in-the-wall. I focused to see it was nurse Redheart, a coat brought tightly around her from the winter chill she was letting inside. She walked in. She was my oldest friend at the hospital. We'd known each other since I was just an intern, and had covered for me more than once when I screwed up. Without her, I would have never made it this far. She was as much a friend as she was a mentor in my earlier years, though I'd say the mentor role had somewhat reversed as time went on.
I was waiting for a lashing. Waiting for her to tell me what a disgrace I was for abandoning the rest of my shift, my other patients, all because I had a breakdown over one.
But, the harsh words I was expecting didn't come. Instead, I got a gentle hoof on my back.
"We're closin' up, ma'am," the bartender said as I got off the barstool. Maybe I wasn't as far gone as I thought. She nodded to him and led me outside, where we sat on a bench in silence. What was I supposed to say?
"I heard what you said to his sister," she spoke softly. I don't know if it was the cold, but I was numb. I stared at the other side of the street. "There's still one thing you have to do."
She was right. Damn bureaucrats. I had to call it. I was the only doctor on duty. It was my job. A job I was seriously reconsidering. We walked back to the hospital in silence. Thankfully, Redheart was the only nurse on call that night, sparing me the embarrassment of confronting the other nurses I'd no doubt rattled with my outburst.
We took the elevator, and before I knew it, my legs had absently carried me outside his room. He was right where I left him, blankets askew, defibrillator stickers still on his chest. Motionless, as though asleep. I couldn't even go into the room. I tried, but the best I could do was the doorframe. Redheart retrieved two chairs from the nurses station. I sat on one, while she took the other. As soon as my tail hit the seat, I wept. I couldn't hold back.
I'd seen traumatized foals witness their grandparents final moments, seen widows and widowers hold their loved ones hoof as they took their last breath, but this... this was nothing like those scenarios. His family fully expected him to be here tomorrow. They expected to be able to visit him bright and early at eight a.m. He hadn't even had a chance to tell them goodbye. There was no way he could have foreseen that to be necessary, but that fact did nothing to lessen the sting. First that poor filly had to lose her mother and father, and now her brother. How would she cope? How could one foal deal with such heartbreak before she even got her cutie mark?
Such cruelty. I couldn't imagine her suffering, and perhaps because of that, I wept. I felt Redheart's foreleg around me, pulling me toward her as she rested her head on my shoulder. I must have been a wreck. I don't know how long we sat there, but eventually, I knew I had one more thing I had to do for him.
Maybe sixteen years is all I'm meant to bear. Stratus' words rang in my ears as I realized I was doing the same thing he had warned me not to. It took him thirty years to finally fall. It only took me half that. Does that make me weaker? Perhaps. I gathered myself, letting the last stray tears fall from my eyes before I stood from the chair. I took careful steps into the darkened room, taking the blanket covering his torso and pulling it gently over his head.
I still couldn't shake the image of the filly with the red bow. How could I possibly tell her about this? How could I tell her one more pony she loved had left her? Without so much as a goodbye? The short answer was: I couldn't. I just couldn't do it.
I looked to Redheart as she stood in the doorway. The clock was just above her head. "Would you think less of me, if I told you I couldn't stand to do this anymore?"
She blinked, a line of tears running down both cheeks.
"No," she whispered.
I flushed more tears out of my eyes as I glanced at the clock.
"Time of death." I sucked my teeth as my words lodged in my throat. I looked back at the form beneath the blanket, placing my hoof atop the hoof of a beloved brother. It was as cold as the night air. I exhaled. "Twelve fifteen."
"Twelve fifteen."
