Page 18 of Rules of the Heart

Valerie must have been up all night creating it, because when Ella got to HR, she was greeted with a thick booklet of questions and answers, as well as the equally thick booklet of hospital rules that she had been given when she joined the hospital.

Ella had read it, of course, but she hadn’t memorized it verbatim.

“Hi, Ella, please sit down. Dr. Bush has requested that you read through the rules booklet again and then answer these questions. They will be sent to her for evaluation and once you get them all correct, you will go back to your normal schedule without these sessions.”

“Valerie said this was for a month,” Ella grouched.

“It’s a month minimum, but Valerie says that if it takes longer, then it takes longer.”

Great. That was just great.

Ella sighed as she opened the booklet. She was fairly sure she could get through this fast, and the questions couldn’t be that difficult. After all, how hard could regurgitating a bunch of rules be?

Unfortunately, it seemed that things wouldn’t be that simple.

There were questions on the rules, for sure, but there were also multiple example questions. Valerie gave detailed scenarios of surgeries and required Ella to list how she would react according to the hospital rules.

Ella gnashed her teeth as she read the different questions Valerie had written. Valerie knew her too well. She had deliberately chosen situations in which she knew Ella’s first instinct would be to break the rules in order to save her patient.

Ella knew the correct answers to the questions—at least, the answers Valerie wanted. She could lie and say that she would react according to the rules, but that didn’t sit right with her.

So, she stubbornly wrote out what she would honestly do in each situation, giving reasons as to why the rules were obsolete in those cases. She didn’t expect her reasons would sway Valerie and suspected she would have to redo this assignment multiple times, but while Valerie was stubborn, so was Ella, and she wasn’t giving in on this point.

There were some scenarios in which following the rules was the only sensible thing to do, but Ella didn’t do it because those were the rules; she did it because that was what was in the best interest of her patients.

Once her hour was up—she had only done a few pages of the very thick booklet—Ella went to the locker rooms to get changed, trying to quell her bad mood. If she was going to be doing this every morning for the foreseeable future, she would need to learn not to let it ruin her day. She loved her job and she wasn’t going to let Valerie sour it for her.

The next day, she got to HR to find that Valerie had marked her answers, in red pen, no less. Unsurprisingly, Ella had gotten a number of questions “wrong.” Valerie had even written snarky responses as to why they were wrong.

As much as she was giving Ella extra work, she was giving herself extra work, too. Surely, she would get tired of this eventually.

Ella wished that she and Valerie could talk, truly talk, without arguing, for once. She felt sure that if they could just get past this rules thing, they had the potential to be good friends. However, every time Ella saw Valerie, Valerie resolutely ignored her, and Ella wasn’t going to be the one to go running to her, not given how unreasonable Valerie was being.

“This is so stupid!” Ella sighed in frustration on the fourth day of her HR assignment. “I’m never going to give the answers Valerie wants. Why won’t she just accept that?”

Penelope, the unfortunate HR representative who had been assigned to ensure Ella turned up for her morning sessions, looked at Ella from over her glasses. “Valerie isn’t going to budge on this. You may as well just give her what she wants. Trust me, this is not a fight you’re going to win.”

“Butwhy?I know she cares about her patients! Why can’t she see that this stance is compromising patient care?”

“Trauma does funny things to the brain,” Penelope said cryptically.

“What do you mean?”

Penelope sighed. “I’ve been at this hospital a long time, you know, ever since Valerie was an intern. There was… an incident. Do you remember the first patient you killed?”

“Of course. I think all doctors do. It’s still something that haunts me.”

“Well, the first patient Valerie killed died because Valerie broke the rules. She did it with the best of intentions, trying tohelp her patient, but the patient died because of it. Valerie was young and had thought the rule unimportant, but it turned out that the rule was put in place for everyone’s protection and going against it brought about the death of a patient who otherwise could have been saved.”

Ella’s hand paused on the page. “What happened?”

“She overdosed a patient on morphine. The patient was in excruciating pain and Valerie couldn’t take it anymore. Unfortunately, the patient’s heart was weaker than Valerie had realized, and she died a few minutes later.”

Ella felt her insides squeeze with sympathy. As much as she hated Valerie’s rigid insistence on sticking to the rules, given what she had just heard, she could understand it a little better.

Ella’s stance on the rules was for a similar reason, after all. She had seen too many patients who could have been saved die just because of stupid policies.

For Valerie to have been responsible for a woman’s death when she was so young because she disregarded the rules… Well, Ella could see why Valerie would make the assumption that breaking the rules killed people.

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