RJ Nolan - L.A. Metro

"Dr. McKenna, will you be joining us?" Kim asked.

Jess momentarily lost her train of thought when her eyes met Kim's. Focus, McKenna. "No. You and Dr. Phan seem to have everything under control."

Kim nodded, then turned toward the resident with a smile. "Dr. Phan, lead the way."

Jess watched as the two women walked away. Her first impression of the new psychiatrist was a very positive one.

* * *

Jess stood outside the curtained bed. She was watching Kim coach Aimee Phan through the patient exam process. Jess was impressed by Kim's handling of the resident. She allowed a rare smile to cross her face. She's a good teacher.

Kim gently patted the elderly patient's arm before turning her attention to Aimee. "If you need anything else just let me know."

"Thanks, Dr. Donovan," Aimee said with a smile.

Kim stepped over to the closed curtain surrounding the patient's bed and turned to slip through the opening.

Jess stepped back just before Kim plowed into her. She grimaced when she heard Kim's gasp of surprise. "Sorry about that. Didn't mean to startle you. I didn't want to interrupt," Jess said.

"That's okay. Were you waiting for me or Dr. Phan?"

"I was waiting for you. I wanted to catch you before you headed back to psych." So far, Kim had managed to surprise her. Regardless of that, Jess's previous experience with psych led her to expect problems. Most of the psychiatrists couldn't wait to get out of the ER. If you didn't catch them before they left the floor, it could be quite some time before they returned. Even if you managed to catch them, it didn't mean they were going to offer their help graciously. She's been great so far. Give her a chance. "I've got a patient I'd like you to talk to and evaluate. I think he could benefit from some outpatient counseling."

Kim smiled. "Sure. I'm happy to help any way I can. What have you got?"

Jess's tension eased. Now this is more like it. She turned and led Kim out into the hall. They headed toward one of the private exam rooms. Jess stopped outside the door.

"Patient is a fourteen-year-old male. He presented with several infected cuts on the inside of his right forearm. He claimed a cat scratched him. While there are four parallel cuts, they are too deep and symmetrical to be animal scratches. I examined his other arm and he has quite a few similarly inflamed but healing cuts on that arm as well. I think we're dealing with self-inflicted wounds. From the look of the cuts I think he might be just starting out. I didn't find any scarring that suggested previous cutting."

"Are his parents here?" Kim asked.

"His mother is in the waiting room. He refused to have her present during the exam."

"Okay. I'll tackle him first, and then his mother."

"You need any backup?" Even as she asked, Jess knew it wasn't needed. It was just an excuse. She was curious to see more of Kim in action.

Kim smiled at the offer. "Thanks, but no. He shouldn't be a problem. You've already treated the infected cuts... Right?"

Jess was surprised by the feeling of disappointment Kim's refusal invoked. She handed over the chart in her hand. "Yes. He's good to go after you're done with him."

Kim gave a quick nod of acknowledgment and pushed open the exam room door.

Jess remained outside the door for several moments after Kim disappeared inside. She was trying to sort out the long dormant emotions coursing through her. As had previously been the case, she was aware of the strong attraction she felt toward Kim. It was now tinged with a growing respect for the psychiatrist. Jess pushed aside the unwelcome introspection. Now is not the time or place for exploring feelings .

Jess's attention turned firmly back to work when she spotted Karen Armstrong, one of the first-year residents coming down the hall. Might as well get this over with. "Dr. Armstrong," Jess called out. Jess frowned to herself when the resident visibly hesitated before making her way over. Yeah, you know what this is about. "I want to talk to you," she said when the resident reached her. "Let's go into the lounge."

* * *

Jess followed Karen into the staff lounge. She motioned for her to have a seat at the table. "You weren't at morning conference," Jess said. This was not the first conference the resident had missed.

"I had to take my daughter to daycare, and then drop off my husband at work. My husband's car is still in the shop."

"I'm not interested in excuses," Jess said, her tone calm but firm. "This is the fourth morning conference you've missed in two weeks. As we discussed before, attendance at morning conference is mandatory for first-year residents."

"I'm doing the best I can," Karen said, her stress apparent in her voice.

"You need to do better. You're only in the second month your residency and already falling behind."

"I can't make them repair the car any faster." Karen jerked her stethoscope from around her neck and slapped it onto the table.

Okay. Time to get serious. Jess had not wanted to turn this into a formal counseling session but Karen wasn't giving her any choice. "It's not just conferences. It's not fair to your fellow residents when you come in late or leave early. It doesn't get any easier as you go along. You need to get a handle on things now." Jess sighed to herself. Karen had a lot of potential, but she always seemed to have some problem that prevented her from fulfilling her responsibilities. "Do you want to stay in this residency program?"

Karen blanched and her hand clenched around her stethoscope. "What? Of course I do."

"Then I suggest you make some alternate arrangements so you arrive on time. I expect you to be at every conference for the rest of the month." Jess met Karen's gaze directly. "You should consider this a formal counseling session. If necessary, the next step will be to officially place you on probation. I will see you in conference tomorrow morning."

Jess knew she had been harsh, but hoped the resident would respond to the wake-up call. If she let Karen's behavior continue unabated now, it would carry throughout her residency. By the stunned look on Karen's face she had definitely made an impression on her. Without another word, Jess stood and made her way toward the door.

* * *

Kim made her way toward the staff lounge for a much needed cup of coffee. Unlike her colleagues, she had decided to remain in the ER as much as possible. It was only her first day and she already realized how bad things were between psych and the ER by the staff and residents reaction to her presence and help. The residents in particular had at first seemed shocked, then extremely grateful of her offer to work with them on the cases they presented. Philip had been right about the conflict between the two departments. If anything he had underestimated the depth of the problem. I definitely need to talk to Philip.

Kim pushed open the door to the lounge. She noticed Karen, one of the residents she had met earlier sitting at the table. Kim nodded to the resident and walked over and made herself a cup of coffee. Once she had her coffee, she approached the table where the resident sat.

Karen looked up, a sullen expression twisting her face. "Hey, Dr. Donovan."

"Hi," Kim said as she sat down at the table. She had been impressed with the resident earlier. Karen was bright and eager to learn. "How's it going?"

"Not so good," Karen said. Her scowl deepened.

Kim nodded sympathetically. "Want to talk about it?" Her first impulse was to try and help someone in turmoil.

Karen shook her head no.

Silence reigned for several minutes.

"It's not my fault she doesn't have a life and doesn't understand," Karen blurted out of the blue.

Confusion struck at the apparent non sequitur. "Who doesn't have a life or understand what?"