It's always been you, April Kepner

boards pt2

session 1

"Welcome to the American Medical Board of Surgery Certifying Examination. We'll give you four separate scenarios in 3 30-minute sessions, 10-minute breaks in between. To pass the test, you must pass two of the three sessions. Now you can fail a session and still pass. But examiners are not permitted to indicate whether you passed or failed each session. You'll be rated on your ability to diagnose, manage treatment, handle the unexpected ... Basically, the strength of your constitution in crisis. And when we move on to the, uh, next scenario, th-there's no doubling back" Madelyn's examiner explains

She nods her head "Understood"

"Perfect, let's get started. So then, a 65-year-old woman is being seen by her primary care physician for a workup of osteoporosis when she is found to have elevated calcium. Her P.T.H. level was well above normal. Her doctor sends her to you"

Malden takes a deep breath "Elevated calcium and P.T.H. would indicate primary hyperparathyroidism..."

....

"Next, I would resect it and explore the other glands"

"Aggressive choice" her examiner says

Without hesitation Madelyn says "Well, I suppose I could wait for the I.P.M. before taking further actions"

"Mm-hmm. Are you sure you're okay with that?"

"Yes, I'm okay with that"

session 2

"After that, I might mobilize the small intestine to create a roux limb, and open up the pancreatic duct longitudinally from the tail to the neck..."

"The patient has died. Moving on to the next scenario"

Madelyn smiles "Actually Sir, the patient has not died. The patient is the best hands possible, so if you'd let me finish you'd see the patient is on track to maintaining a full recovery "

Her examiners give each other a look of approval making Madelyn smile proudly to herself before continuing

-

After her second session Madelyn decides to take a quick walk to take her mind off of whatever the hell this is. As she walks down the hall she sees a group of men walk out of the men's restroom followed by the faint voice of April

Madelyn furrows her brows in confusion, walking closer to the men's room hearing Aprils voice becoming louder

"What? What? You're supposed to be doctors. I've seen your things. You've seen mine. It's all just flesh and cartilage. Get over it! Ugh!" April yells scaring all the men of

Madelyn walks in seeing April drying her shirt under the dryer "April, wh..."

"Oh, hey, Madelyn. How's it going?" April says quickly diverting Madelyn's attention away from whatever just happened

"Not as good as i'd like" Madelyn replies through gritted teeth "You?"

"I am dying in there. I am actually failing" April yells "They think I'm insane!"

"Oh, they're toying with me" Madelyn says

"I am self-destructing into a puddle of sweat" April says