“DON’T MOVE!”
A resident shrieked, hands in the air.
“Don’t… move,” Dan said, lowering his voice as he leaned under the table. “Carlos, look by your right foot. See it?”
“Got it, Dan.”
“Good boy.”
The junior residents glanced at one another.
“Rule you never forget,” Dan said, straightening with a glass slide pinched between two fingers. “Drop a slide? Don’t stand up. Don’t roll your chair. Don’t breathe. One person hunts. Everyone else freezes. Otherwise you’ll grind twenty years of history into the carpet.”
He wiped dust from the slide with his sleeve. “This one’s from my med school mentor. He charged residents a hundred bucks for the first broken slide, five hundred for the second, and if you cracked a third—he fired you. Said clumsy hands don’t belong in pathology.”
Two mandatory conferences shaped the week: frozen section review on Mondays; unknowns on Wednesdays. Residents were expected to preview every case and, when called, describe the histology and walk a differential. Five weeks in, James felt the rhythm, if not always the answers.
Dan ran both sessions from the driver’s seat of the multi-headed scope like a bandleader at a jam. Voice dipping, hands sketching broad arcs, he punctuated take-home points like cymbal crashes. Most residents sat two seats back to avoid being whacked—or sprayed.
“Deanna,” he said, moving a slide into view, “what did you think?”
“Incisional skin biopsy,” she said. “Proliferation of spindle cells and histiocytes, rare giant cells, ill-defined granulomas. Differential: dermatofibroma versus xanthogranuloma. But since these are your slides… I’ll add mycobacterial spindle cell pseudotumor. Are you about to flex with an AFB?”
Dan’s mouth twitched. “Dr. Berkowitz—eagle eyes.”
He swapped in a stain. Bright red rods swarmed the field.
“Armadillos in Texas,” Dan said. “Nodules on distal extremities. Originally called benign. Re-biopsied when it grew, sent to my professor. Leprosy. Animal reservoirs aren’t just trivia.”
He turned to James. “Okay, Dr. Deetan. You’ve been unusually quiet. What about this one?”
James leaned in. “Pigmented skin lesion. Asymmetric proliferation of melanocytes at the dermal-epidermal junction in expansile, discohesive nests. Upward intraepithelial spread, downward extension along adnexal epithelium. Pleomorphism, prominent nucleoli, atypical mitoses. Scant melanin.”
“So?”
“Melanoma. Vertical growth phase.”
Dan lifted his brows. “Did you rehearse that all night?” His glance slid toward Deanna.
Before James could answer, the overhead speaker crackled: “Frozen section to surgical pathology.”
Conference broke like a school bell. Deanna shot James a quick wink as she stood. James fumbled his notes, and their laughter overlapped.
“Good thing those weren’t slides,” she said. “You’d owe Dan a small fortune.”
“Thanks for the preview help,” James said. “You saved me.”
“Anytime,” she said. “Dan doesn’t make it easy, but we’ve all sat in that seat.” Jasmine, faint as a memory, trailed as she moved beside him. “Ever hear about Jerry the Barbarian and frozen section conferences?”
“Sounds like a sitcom.”
“More documentary.” Her grin went wicked. “Jerry Taylor. Finished two years ago. He and Dan turned every conference into a cage match. Dan had better eyes—don’t tell him I said that. Jerry knew it. One night Dan caught him reading the frozen section log before review—cheating.”
“No.”
“Oh yes. So Dan changed the log—every diagnosis, wrong.”
James’s laugh startled even himself. “Please tell me—”
“Next day? Jerry called them all. Loud. And wrong.” She shook her head, delighted. “Priceless.”
“So why ‘the Barbarian’?”
“Imagine Dan, but louder. On espresso. With cymbals.”
“Terrifying. Where is he now?”
“Last I heard? St. Charles. Then Alaska.”
“Alaska?”
“Burnout,” she said, laughing. “Had to cool off. See you at lunch.” She tucked her hair behind one ear, lab coat flaring as she turned the corner. The scent of jasmine lingered.
“Well,” a voice said behind James, “someone’s making the right connections.”
“Carlos.” James hadn’t realized he’d been watched. “It’s not like that.”
“Like what?” Carlos smirked. “Deanna doesn’t help just anyone.”
“She offered.”
“I know. We’re the same year, one behind Dan. Dan will teach anyone who breathes—whether you want it or not.” Carlos grinned. “Deanna’s different. She’s a step ahead of all of us, Dan included. She helps, but not to score points.”
“What do you mean?”
“First year, I was on call. A maintenance guy came in—daughter at Children’s with cancer—looking for answers. Deanna was headed out the door. She sat with him two hours. Explained the diagnosis. Prayed with him. Gave her home number.”
“Wow.”
“She doesn’t tell stories like that. She just does them.” Carlos’ smile softened. “She likes you, Deetan.”
“It’s these fluorescent lights,” James said, already hot. “Bad wavelengths.”
“Uh-huh. Funny how every angle still reads red. See you at lunch.”
She likes me? No. Put it away. Too much else to learn.
Next Chapter: Chapter 5-The Doctor’s Doctor
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