Omar

"Noor's blood pressure and heart rate have been stable for a couple of days now, she has not required much support from the ventilator and her blood tests have been negative for any signs of infection for the last several days. In my opinion, we should be able to take her off the ventilator successfully", I declared at rounds that morning.

"I agree Omar, she'll need oxygen through a face mask likely but it doesn't seem like she needs the support of a ventilator", then turning towards the nurse he said, "Let's start to decrease her IV sedation, and as soon as she wakes up, we will pull the breathing tube"

Noor's nurse for the day was Amber, the same nurse who had taken care of her for most days over the last week. So she had built a good rapport with Salman.

"Noor's husband is with their baby right now, can we wait for him to come? She'll want to see him when she wakes up", Amber advocated for her patient and her family.

"As a rule we don't wait for family because we never know when the ICU will become busy, and then we won't have time to take her off the ventilator. I am sure it would be a nice surprise for her husband to see his wife awake, but I would prefer we just do it now", our attending reiterated.

In principle, I agreed with Dr Muller. We all knew that the ICU can be a ticking timebomb, and when things get rough simpler procedures like taking someone off the ventilator and monitoring them to make sure they do ok, never take precedence.

But Noor was a unique patient. And not just because many of us had personal ties to her, but because when she became unconscious she was pregnant. When she would wake up, she would no longer be pregnant.

I remembered meeting her in the food court. I was overcome with emotions then, but I had still noticed how she had tenderly placed her hand over her pregnant abdomen. Being a mother had obviously meant everything to her, and waking up without her baby would devastate her.

But maybe that devastation would be slightly less if her husband was there with her. The man had been so devoted to her and their daughter over the last week. He would know exactly what to do to calm her.

"Dr Muller, with all due respect, I agree with nurse Amber. Proceeding without Noor's husband is not the right approach", it wasn't often that I stood up to my attending, but at that moment I needed to advocate for my friend, and frankly her husband. I had gotten to know Salman over the course of last week, and I knew he would want to be there for her.

I explained my objection and to my surprise, heads were nodding by the time I finished talking.

"Ok Omar, good point. Let Salman know to come as soon as possible and we'll break rounds to come back and take her off the ventilator when he is here", Dr Muller told me.

So I texted him, and we went on to the next patient.

Twenty minutes later Salman had arrived and the rest of the team reached Noor's room. Amber shut off the sedative and then we all waited with bated breath. The time it takes for patients to wake up enough to breathe completely on their own is very variable. But about 20% of the patients also end up needing to go back on the ventilator for various reasons. So Madi and I got the supplies ready to put the tube back in, just in case Noor fell into that 20% category.

"Come on Noor, you can do this...", I heard Madi whisper to herself as she looked over to her friend and her husband.

I looked at Salman, who had not left his wife's side since we had entered the room. I don't think he had blinked either, as his eyes were focused on Noor and her breathing, and he held her hand tightly.

Soon, we could hear Noor make a soft choking sound, an indication that she was starting to wake up enough to realize that there was a tube in her throat. Madi and the ICU fellow sprung into action then, as one gently pulled the tube out while the other held her head steady.

Finally, she opened her eyes too and I heard Salman say her name softly. She immediately looked at him, still dazed and confused because the sedation had not yet completely worn off, but she did not take her eyes off him. It was as if in that moment there was no one else in that room other than she and her husband.

To my surprise, I felt myself smiling and tearing up just looking at them. In a room full of people, all they needed was each other.

I am so happy for you, Noor

I took my eyes off the couple and looked at the monitors that she was still hooked on to. Every monitor was silent...which in an ICU is an excellent sign.

Dr Muller moved in to listen to Noor's lungs, as she seemed to get more oriented to where she was. Madi greeted her and then Noor seemed to have noticed me in the room, because she gave me a small smile. Her throat was probably still hurting, because of the tube being in there for a week, but she was able to whisper and ask for some water.

Things seemed to be going as well as they could, so the ICU attending and fellow eventually left, leaving just Madi and I in the room, along with Salman and Noor.

Till then we had all focused on making sure that Noor was able to breathe off the ventilator, and hadn't really broached the subject of her baby, or go into details of her illness. I was still trying to figure out how to start that conversation when I heard Noor let out a muffled but agonizing scream.

Oh no...she knows

She had just realized that she wasn't pregnant anymore, and was staring at her abdomen, her face completely drained of any color.

"Where is my baby?", she looked at Salman then at Madi and I.

Salman immediately put his arms around her, but turned to us to say, "Could you go over everything that happened. I can't be her husband and a physician right now"

So Madi and I jumped in, going over everything that had happened to her. It took us a while to explain things, because she was still groggy from the sedation. But all the while Salman had held her and she had clasped his hand tightly. When she would start to panic, he would whisper something to her which immediately calmed her. And when she didn't understand something, he gently repeated it as she looked at him with an intensity that could only come from a love so strong that no adversity could ever come in its way.

If I had any doubts that the two of them were meant for each other, they had completely vanished now.

Finally, Madi and I stepped out of the ICU room, after making sure Noor had no more questions and that her breathing remained satisfactory without the ventilator.

"I don't think we could have done that without Salman", Madi said, without looking at me.

"I agree"

Their room was across the nurses station so we decided to work on the computers there for a little while so that we could keep an eye on Noor through the glass doors, but also give her and Salman some privacy.

Madi and I sat side-by-side, me typing away my patient progress notes and she putting in the list of orders for the various medications and tests for all our other patients. Then, out of the blue Madi asked, "Are you ever jealous of Salman?"

I looked at her, but she was looking straight at Noor's room, with a blank expression on her face.

What kind of a question is that?

"No...not of Salman, but I am jealous of them. They sure seem to have figured out this whole falling in love and marriage business"

Madi finally turned to look at me, she still had a glazed look in her eyes, but managed to say, "You'll figure it out too, with someone"

But then she got up and left without a word, leaving me sitting alone, wondering what in the world was going on with her. She had even left her pager and all her patient notes as well as the list of orders that needed to be put in for our patients, some of which were time-sensitive.

"Wait, Madi. Where are you going?", I called out after her.

But there was no reply from her as she kept walking and then was out of my sight. I would have gone after her, but technically we were supposed to observe patients for at least a couple of hours after taking them off the ventilator.

For Noor, it had only been an hour, and it wasn't fair to leave Salman to do that observing. Plus someone had to put all these orders in. So I grabbed her patient notes and stayed put, vowing to go find Madi if she didn't come back soon.

Why is she acting so weird all of a sudden?

Madiha

The cold late October air hit my face as I stepped out of the hospital buildings' side entrance. Not many people used this entrance so it afforded the solitude that I needed. I had forgotten to grab my jacket, but that was ok, because I needed the cold to numb me. I needed this fire inside me to die off, quickly.

I am fine, I told myself. This was just stupid hormones, and lack of sleep, mixed in with a temporary crack in the cool, calm and collected exterior I had made for myself.

I could not possibly be falling for him

He was wrong for me. In every sense of the word.

He was my junior. I was his senior resident.

He was doing internal medicine only because he messed up the timing of his surgery residency application. Soon, he may not even be in Chicago.

He was from an exceedingly rich family. And he would inherit some of it even if he was the 'black sheep' of the family. I was a from a middle class, ordinary family.

He was so good-looking, I had seen the way Kylie looked at him sometimes. She was my co-resident who had placed 'dibs' on him when we were joking around and looking at the pictures of the new intern class. She may not be his senior resident on this rotation, but she still ended up spending a fair amount of time with him. And she was the brunette, with greenish eyes, and full pink lips that every man desired.

He had been desperately in love with the only real friend I had. And even if things had changed between them now, it had taken her being seriously sick for that to happen. What would happen when she gets better again, and he remembers all the feelings he had for her? Even if he was truly over her, is she the standard that he is looking for? Because, I would never be able to reach that standard.

He had grown-up in a life of luxuries. I carried so much baggage, I felt broken.

We could never work, even if he was interested in us working.

I knew all of this. I had known this from the first day of this rotation. Yet, all I could think of when I was in Noor's room and saw the way her husband was with her, is that I wanted that too. That sincere love and longing for someone who reciprocates those feelings, is what I desperately craved.

And I wanted it with the man who was standing next to me, in that room. The man who never once looked at me, his eyes focused only on his ex-fiancé.

For a moment I thought he was just looking at her intently because she was his patient. At some point all of us were looking at her intently. But then I noticed the adoring smile on his face, and the tears in his eyes, and I felt something that I had never felt before: an ugly mix of envy and resentment, envy towards my friend, and resentment towards the man standing next to me for making me feel this way.

Madi, what the hell is wrong with you...she is married, and in love with her husband, she and Omar will never happen.

I had never doubted that, but that didn't mean that he wouldn't long for her. Or that he wouldn't replace her with someone just like her. That someone could never be me, because she and I were worlds apart.

I sat down on the bench along the wall, and rubbed my arms. I would have to go in soon, but for now I needed the cold air to help me forget everything so I could function.

Instead, a little voice reminded me of how he made me feel sometimes. The comfort I felt looking into his warm eyes, the sudden feeling of relief I had felt when I heard his voice on the phone as the drunken man had inched closer to me. Or how his words had repeated themselves in my brain over the last week, and given me some hope when the rest of me felt dark.

"I can see you Madi"

"You don't have to pretend you're not scared, not with me, ok?

"Madi...I got you...ok?"

But he had also made it abundantly clear that those words had been said out of pure friendship, nothing more.

Even this morning before rounds, when he had offered to go with me to get coffee, I had really thought that there was something more between us, there had to be with the way he had crouched next to me and asked me if I was really ok.

But again he had called himself just a colleague and friend.

I didn't want friends. I had lived my life with few friends if any, and I could keep doing that. From him, I wanted more.

Madi...what the hell, have you gotten yourself into? You're supposed to be smart, and strong. Right now, you're being neither.

I realized then that I had left my pager inside the building, and I was on-call in the ICU.

Five more minutes...and then I'll go back.

If I was going to get into trouble for not answering pages, I would have gotten into trouble already. So I closed my eyes and leaned against the wall. I was shivering, but I didn't care. It kept my mind away from the mess that was my heart and mind. And maybe this was also a way to punish myself for being envious of a friend who had gone through so much. I thought I was a good person at heart, even if I made mistakes sometimes. But right now I was seriously doubting myself.

Another 5 minutes would not make a difference.

But they did in a way that I had never thought they would.

*****

"Madi, Madi...wake up...you're freezing", a panicked voice penetrated the darkness around me.

Someone shook me vigorously and then I felt a jacket draping over me. My head was throbbing with pain, and I couldn't feel my fingers or toes. When I opened my eyes, everything was a blur but then Omar's face came into focus.

"What are you doing out here, Madi? Get up...your lips are blue", his voice was less panicked now but the intensity did not change.

Did I fall asleep out here in the cold?

I felt arms wrap around my shoulders, lifting me up to my feet effortlessly.

"Can you walk? We need to get you inside"

I nodded. My head was still hurting and lips shivering enough that words were difficult to pronounce, but I let him keep a hand on my upper back as he guided me back into the building, and then helped me wear the jacket properly, zipping it from the front. The jacket was a few sizes too big and smelled like him, but it felt so good on my cold body.

I could barely feel my fingertips, but the rest of me had started to warm up. I wanted to believe that it was just the jacket, but I knew it wasn't. It was also Omar's presence, and the warmth in his brown eyes that were looking at me, probably trying to figure out why his senior resident was so broken.

Or maybe it was his soft but deep voice, that asked me, "Madi, what is going on with you? This is not you"

I think I am falling for you...and I don't know how to stop it.

But I could never say those words out loud, because if I did, I could never take them back, no matter how much the consequences of those words hurt me.

"I am fine...I was just tired, I must have dozed off", I told him, but kept my gaze lowered. He had this uncanny ability to see through me, and I didn't want to be questioned anymore.

He didn't say anything for a few seconds, but I could feel him looking at me, studying me, maybe even judging me. When I did look up, he had a frown on his face, and was shaking his head.

"Stop lying to me...I know you, you are not fine...you haven't been fine for days. And if I don't mean anything to you, talk to someone who does, but Madi, figure out what the hell is going on with you", his voice was no longer soft, or comforting. It was as if something had snapped inside him, something that told him that he didn't have to put up with me, that he had reached the end of his patience with me.

What I should have done in that moment is told him that he did mean a lot to me. But hindsight is 20/20, and in that moment all I could think of was how dare he think that he knew me. If he did, he would know why I was acting the way I was.

I never asked him to be patient with me! He is free to do and feel as he pleases...I'll get over him.

"You don't know me, Omar. You've been assuming things about me, just like you did on the very first day of your residency. Like I said, nothing is going on with me...and even if there was it's none of your business!", I started to walk away from him towards the elevators.

But footsteps followed me, and Omar's voice rang out in that empty foyer, "Madi...do you know that I have been covering your pager for the last hour?"

I didn't. I didn't even realize how long I had slept, I thought it was only a few minutes, but I had left my phone in the residents room.

I disappeared for an hour, in the middle of my ICU shift? Have I really lost it?

I turned to look at him, maybe I was being unfair with him, "Omar..."

But he cut me off, and in a stern voice said, "The attending, the ICU fellow, nurses...everyone has been asking about you. And I've tried to cover for you...while trying to find you, and being scared shit for you...so yes! it is my business. I can't keep lying to everyone on your behalf"

Of course, this is all about him

"I didn't ask you to lie for me", I heard myself raise my voice, "If it's your reputation you're worried about I'll tell everyone what just happened"

"It's not my reputation I am worried about...I am just a lowly intern, no one cares about me. Besides I won't even be at this institution for long"

Omar said more words after that, but they all seemed to blur away into oblivion. All I could hear ringing in my ears was, 'I won't even be at this institution for long'.

I knew this would happen, yet I let myself develop feelings for him. Of course, he wouldn't stay here. There was nothing keeping him here. In fact, October/November was when the surgery residency spots opened. He had probably already started to apply for those spots.

I need to get away from him, and stay away...2 more days in the ICU, and then I am done with him and these stupid feelings.

I unzipped his jacket and took it off, "I don't need this..."

"Keep it", he snapped, "You're not..."

Before he could complete that sentence, the loud sound of two pagers going off at the same time startled both of us.

"Why are we both getting paged?", I asked him, as he handed my pager to me.

It didn't take long for us to realize why.

Noor was having trouble breathing. The nurse had asked us to come by her bedside asap. Omar and I got on to the elevator as soon as the doors opened and then hit the blue code button, followed by the button labelled 15. That way the elevator would go straight to 15th floor ICU without stopping.

"I should have stayed in the ICU...", Omar muttered to himself.

And he would be up there is it wasn't for me.

I prayed silently that this was just a false alarm, and some extra oxygen and better positioning would help Noor breathe better quickly. Otherwise, I could never forgive myself.