Author's note: this is an inserted/altered scene which takes place during the episode, "Ruby Redoux." Basically, I wasn't getting enough Dubenko, so I wrote in some more!
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Outside Mr. Rubadoux's room, Dr. Anspaugh's stern voice rose as he chastised Abby Lockhart: "If you have concerns, you ask the consulting doctor to step outside to discuss them. You do not, in front of a patient, attempt to subtly disagree with a senior cardiologist and the Chief of Surgery! That kind of behavior is helpful to no one. Do you understand?"
Thrown back into the role of guilty schoolgirl, it took a second for Abby to regain the ability to speak. Then she answered, "Yes, I understand." As Anspaugh began to brush past her, she added belatedly, "I have concerns."
Anspaugh didn't even reply. He just fixed her with a steely glare and walked away.
"That went well," Abby berated herself, rolling her eyes upward and exhaling. She knew that Anspaugh was right about her behavior – it was inappropriate for her to challenge his opinion in front of the patient. But still, she felt that he was wrong on the more urgent issue of Mr. Rubadoux's surgery.
Lowering her gaze, Abby realized that she was being watched. Dr. Dubenko stood observing her from a couple of yards down the hall, a bemused expression on his face. 'Oh God, like I need this now,' Abby thought. She regarded the surgeon with her best 'go away' look.
Dubenko either didn't pick up on the repulsing vibe, or he was undeterred by it. He closed the gap between them and addressed Abby, smirking slightly, "You know, Lockhart, when I told you to be more assertive, I wasn't really suggesting that you take on Dr. Anspaugh."
Despite her frustration, the comment made her grin at the absurdity of the situation. Here she was, an intern, going up against two senior attendings, one of whom was arguably the most powerful man in the hospital. What the hell was she thinking?
"Am I crazy?" Abby sighed, "The patient is an 85 year-old male, aortic stenosis, history of heart disease including chronic CHF, weak kidneys, reduced lung capacity, and did I mention that he's 85 years old? . . . Would you operate on him?"
Dubenko paused thoughtfully, then replied, "I might . . ."
Abby's shoulders slumped.
". . . but only after I had done everything in my power to convince him and his family that it was a bad idea."
"I've done everything I can think of to do," Abby retorted, "Kayson and Anspaugh, in Mr. Rubadoux's mind they're what doctors are supposed to look like. I'm just some overgrown nurse. I bring up risk factors and he completely ignores me."
"It's your job to make him see you as a doctor."
"Well, I can't. And I don't think he should get inappropriate care because of that."
Dubenko stared at a point above Abby's left shoulder. She fancied that she could see the wheels turning as he computed probabilities for various outcomes of the surgery and estimated the likelihood that Abby would be able to shake an octogenarian out of his ageist/sexist world-view.
Darting back into eye contact, Dubenko asked, "Who's your attending?"
"Carter. But Mr. Rubadoux is convinced that Carter killed his wife 10 years ago and doesn't even want to be in the same room with him."
"Ah." There really wasn't much to say to that. A long pause ensued. Abby and Dubenko just looked at each other. Then Dubenko shrugged and said, "OK. I'll give it a try."
Until he said it, Abby hadn't realized that that was what she'd been hoping for – to have somebody on her side. She smiled, relieved, but asked, "Won't Dr. Anspaugh be mad at you?"
"Not as mad as his is at you," Dubenko tossed back with a crooked grin, as he opened the door and entered Mr. Rubadoux's room. He closed the door behind him, not so subtly indicating that Abby should stay outside. She agreed that it was better that way. Dubenko might as well have a fresh start with the patient.
As Abby waited in the hallway, someone grabbed her from behind, large hands covering her eyes. She panicked for a moment, flashing back to her abductors' van, staring helplessly out the window as they drove to what she assumed would be her death. Jake's voice broke the spell. While she wasn't thrilled that he continued to keep his hands over her eyes as he chatted about how much she must hate this, the delay in releasing her let her complete the transition from terror to irritation.
When she could see again, Abby glanced back toward Ruby's room. Following her gaze, Jake asked, "What's up?"
"Dubenko's trying to convince my patient not to have open heart surgery."
Watching through the glass door, Abby could see Dubenko's mop of curly brown hair from behind as he sat facing Mr. Rubadoux, and could make out snatches of their conversation. At first, things seemed to be going reasonably well. Dubenko didn't have the personal gravity of an Anspaugh, but he projected confidence when it came to medicine. And, while his social skills could never be described as smooth, Abby had seen him deal kindly with patients in the ER. For several minutes, the surgeon spoke in a low voice. Mr. Rubadoux appeared to be listening.
Then Ruby's indignant bark broke through Dubenko's more subdued tones, "I should've known better than to expect decent care in this dump! You're trying to get rid of me – to pawn me off on somebody else, just like they did with my Sylvie."
Dubenko's quiet, measured response was met with, "That's not what the other doctors said. Are you saying they're wrong? Why can't you people get your stories straight?"
After several angry rebuffs in which Mr. Rubadoux accused Dubenko of trying to trick him out of the treatment to which he was entitled, the surgeon seemed to lose focus. He didn't return any of Ruby's aggression; instead, the more irrational Ruby was, the more hyper-rational Dubenko became. He got up and walked around, drifting into analyses of morbidity statistics and ejection coefficients.
"Please don't draw a graph, please don't draw a graph," Abby murmured.
Sure enough, out came the marker and Dubenko made an impromptu visual aid showing multiple vectors and data points. On the Dubenko oddness scale, this was actually pretty mild – the graph stayed within the confines of a large x-ray envelope rather than sprawling across the wall. But it was enough to drive the nails into the coffin of an already dying conversation; Ruby looked at the surgeon like he had two heads.
A few minutes later Dubenko came out of the room. In a deadpan voice he reported, "Mr. Rubadoux says I'm 'too shifty'."
Abby bit her lip to keep from laughing. She couldn't tell whether Dubenko's eyes held puzzlement or self-depreciating humor. 'He's got to know that he weirds people out, right?'
Still, he had tried. Abby regarded him warmly, saying, "Thanks anyway." At the same time, Dubenko addressed her companion, "Hi Jake."
While Jake returned the greeting, Abby found herself checking her body language and proximity to the younger man. As a general rule, she didn't like to appear too "couple-y" around the hospital. Especially around Dubenko. Especially since that painfully awkward let's-write-an-article-over-burgers encounter.
Actually, part of her wanted Dubenko to know that she was seeing someone, so that, hopefully, he would stop making a fool of himself on her behalf. Although she didn't like to admit it, Abby knew that she rarely felt protective of the men she was involved with – she was too busy protecting herself from them. So, it struck her as odd that she felt a sort of empathy toward this guy in whom she wasn't romantically interested. Of course, that was how she felt at moments like this, when Dubenko came off as a nice harmless eccentric. There were other times when she wouldn't be at all surprised to learn that he kept human heads in his freezer.
Abby snapped out of her reverie when Dubenko asked Jake, "So, how was San Francisco?"
'San Francisco? Crap! I completely forgot to ask him about his trip.' Aloud, she tacked on, "Oh, yeah, how was it?"
Jake enthused a bit about the residency program, but ended by calling it "a long shot." Then, glancing over at Abby, he added, "Of course, I could match right here at County."
Abby could feel Jake scanning her features, gauging her reaction. She smiled back noncommittally. He should know better than to expect more than that in public.
Dubenko went on about how UCSF's surgical program compared with County's: ". . . so for right now, they're stronger, but hopefully that will change in the near future as we hire more surgeons – preferably some who have an interest in teaching . . ." He trailed off, distracted by the buzz of his pager.
Abby and Jake shared a look as Dubenko read his pager. Briefly returning at least some of his attention to them, Dubenko nodded and began to take his leave, heading toward the elevators. But after a couple of steps he turned back to Jake and offered, "Let me know if you want to talk strategy."
Abby surmised that "strategy" had something to do with preparing for interviews and such. When she went through the match last year, Susan had briefly worked with her on shaping up her CV. Abby got the impression that Dubenko was a bit more intense about the whole process. And, perhaps, about every process, she thought, smiling wryly.
Glancing over at Abby, Dubenko continued, "Speaking of strategy, Mr. Rubadoux mentioned a Dr. Obelmeyer . . ."
"Yeah, that's his regular doctor. We've been trying to contact him."
"Keep trying. He's your best shot at getting through to him." Although the surgeon was facing Abby, he appeared to be listening for something behind him. The ding of the elevator arriving at the floor sent him off briskly. Abby and Jake walked in the same direction, at a more relaxed pace.
Stepping inside the elevator, Dubenko's lips quirked into an enigmatic smile as he added, "Some minor alterations in the surgical schedule might bump Mr. Rubadoux's procedure back a few hours." Then the doors closed and he was gone.
Now that they were alone, Jake turned to Abby and asked flirtatiously, "So, what would happen if I matched right here?"
"Well, Jake, then you would be working at County . . ." came the coy reply.
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Like it? Hate it? Suggestions? For now, this is a stand-alone fic, though I may do additional chapters, each of which would be a relatively self-contained vignette.