Collateral Circulation

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Collateral Circulation Page 10

by Barbara Ebel


  “This is Varg Dagmar,” Danny said.

  “Nice to meet you.”

  “Dr. Tilson is my neurosurgeon,” Varg said. Casey nodded his head, realizing why Danny didn’t introduce him as his patient; that he was adhering to privacy policies.

  “Actually, I was in the hospital last week and this amazing miracle worker did intracranial surgery on me. Yesterday, we met in his office and began discussing prime Tennessee real estate. Perhaps you may be interested and can tag team … your friend?”

  Casey pulled out a chair. “Danny and I are long- time friends.”

  “What Casey is saying,” Danny chuckled, “is that he’ll eventually be involved one way or another. However, I’d like to change the subject. You are going to follow my orders about workouts at the gym, aren’t you?”

  “Don’t worry, doc. I’ll do a bare minimum. I may even beat you out the door. I’m mostly here to pick up something.”

  “Okay. I don’t want to worry about you.”

  “I’ll leave you two alone, then,” Varg said. “I’ll do my real estate homework for you and call your office later this week.”

  “Look forward to it.”

  “And, by the way, I have an appointment with the psychologist, Marlene Bowen.”

  “Excellent.”

  Varg smiled, tipped his hand off his forehead and stepped away. He had a small bag and went over to the refrigerator case and pulled out a six-pack of a tall, canned drink. Danny and Casey grabbed their duffel bags and water as Varg went to the desk and put his purchase on his account.

  “Let’s get home,” Casey said. “I miss my wife.”

  “Ditto,” Danny said as Casey pushed open the glass door. “I miss my ex-wife, little girl and teenager, and Annabel who’s off at Vandy doing who knows what. And Dakota, too.”

  As they approached the car, Danny asked, “Are you driving since you’re ‘just’ an ambulance driver?”

  Casey patted Danny on the back. “I’m a highly trained EMT. You sure you don’t want to walk?”

  “No, thanks,” he said and laughed.

  Chapter 13

  Danny looked on the floor next to the bed to make sure he didn’t step on Dakota when he got up. But as soon as the dog realized his master was awake, he sprang up and banged Danny in the face.

  “Ouch!”

  Sara opened her eyes to find Danny rubbing his nose. “Are you okay?”

  “I’m sorry, I didn’t mean to wake you up,” he said, turning his head. “I’ll live. It’s a half hour before the alarm is going off. I must be wired up after that workout last night.”

  Sara inched closer to him. “No problem. Maybe we can make the most of it, especially since I’m just in a sling now. The orthopedic surgeon agreed that cast was a little too tight so he removed it yesterday. My skin was getting irritated.”

  “But did the x-rays show your bone is improving?”

  “Yes, not to worry.”

  Danny laid back down facing her, putting his hand on her hip. “And we never got to talk last night about the house repairs.”

  “They finished the porch yesterday; the front of the house looks great.”

  “That was fast.”

  “And the contractor will be over here this week to see what we want done with the downstairs.”

  “It’s going to be fun to restructure Mom and Dad’s place,” he said, rubbing her soft skin. He slithered in nearer to her even as Dakota bumped his muzzle into the small of his back.

  “How would you like to join me in the bathroom where we can squeeze toothpaste on each other’s brushes?” Danny whispered in her ear. “And eventually end up back here?”

  Sara pinched him on his arm and smiled.

  “Double ouch,” he said.

  “Even though I’m handicapped, I’ll beat you.”

  Danny laughed. “I have to herd Dakota in there, too, so we can trick him into staying there when we come back.”

  “He won’t disturb us,” she said, already on her way into the bathroom.

  “But I rarely get you alone,” Danny murmured.

  They did a cursory job in front of the mirror brushing their teeth and he was already kissing the back of her neck as she finished. Sara slid her good arm behind her where her fingers wrapped around him, feeling his warmth and growing erection. “What a way to start a day,” she gasped.

  Dakota laid his head flat on the bathroom rug and didn’t bother to follow their hasty departure back to bed. They wouldn’t be petting him anyway.

  -----

  The mid-morning, mid-week activity in the doctor’s OR lounge was busier than normal, especially since the surgery schedule couldn’t accommodate one more thing. The trauma room was handling an interstate highway emergency and there was a room running from a leftover middle-of-the-night shooting; Danny was between two cases and hoped to get to the office by 1 p.m.

  He yanked off his surgical mask as he headed quickly to the buffet of early lunch selections. He grabbed half a turkey sandwich and tomato bisque from the big soup pot and sat down.

  “Dr. Tilson, do I want to talk to you!” Danny looked up to see Steve Reaper, the ophthalmologist with an office in his building. “Let me grab lunch and I’ll be right back.”

  Danny savored his food and hoped Dr. Reaper had seen his referral, Paula Branson. When the doc came back, he planted his lunch on the table. “I just did a retinal detachment so that’s why I’m here. Most of my surgeries are in the outpatient center.”

  “I wish I could say the same thing. It’s a lot more laid back there.”

  Steve took off his white coat and draped it on the chair; he had a six-foot-two frame like Danny but was a lot more lanky, all arms and legs. Why he blinked so much, Danny didn’t know, but he figured he had something wrong with his eyes and perhaps that’s what caused his original fascination to become an ophthalmologist. Reaper was a little older than Danny and always wore soft leather Decker shoes like he was ready to jump on a boat.

  “I saw Mrs. Branson yesterday,” Steve said, reaching for the salt and pepper. “Thank you for the referral and, better yet, for the most interesting case I’ve seen in my career.” He took the top slice of bread off his sandwich and sprinkled the condiments until they dotted the table. “Or, more succinctly put, the most exceptionally healthy eyes I’ve ever seen.”

  Danny knew Steve had a busy practice and was a much sought-after surgeon. The only reason he had seen his patient so quickly was due to Danny’s request. Otherwise, unless it was an emergency, patients had to wait six months for an appointment.

  “I can’t wait to hear. I’m sure you saw the angiogram I sent you?”

  Steve rolled his eyes. “I looked at that and read your excellent history and physical. The radiologist’s findings were practically non-human but her eye exam? I will be writing an article about what I found on Paula Branson’s exam to “The Journal of The American Academy of Ophthalmology.”

  Danny put down his spoon, pushed the soup bowl aside, and rubbed his chin.

  “Of course, I won’t mention how difficult it was to zero in on the close exam with her chest in the way and that I had to keep dodging her flirtatious comments.”

  Danny laughed. “Sorry, but I’m happy to know it wasn’t only me.”

  Steve nodded and dumped the contents of a sugar packet into his coffee. “It’s a good thing I have an assistant in the room with me like obstetricians do.”

  “You can’t be too careful these days.”

  “Anyway, I’ll give you Mrs. Branson’s eye exam numbers …”

  “Whoa! It’s been years since I went to medical school or took an ophthalmology rotation. Talk to me like I’m half-dense,” he smiled and said.

  “Okay. Paula Branson has eagle vision. Visual acuity and pupil reactivity was stellar. All nine cardinal positions of her gaze could be used as the model for extraocular motility and alignment. Tonometry and visual fields are what you’d now expect. Her external exam and cranial nerves were one-hundred
percent. Mind you, Danny, this is a thirty-eight-year-old woman who shouldn’t be perfect.” He took a sip of coffee.

  “The slit-lamp exam and fundoscopy? The optic nerve, macula and vessels were gorgeous!” he squealed. “Leonardo da Vinci could have used the back of her eye for his anatomical drawings … human eyeball perfection.”

  Danny tried to finish his sandwich but it wasn’t easy swallowing; it was hard enough to digest what Mrs. Branson’s results meant to an ophthalmologist let alone a neurosurgeon.

  “And peripheral vision? And her perception of color?” Steve shook his head. “Phenomenal. I need to write to the Guinness world record people besides the Ophthalmology Society.”

  The two men stared at each other for a moment and Danny thought about a bigger picture. What caused Ms. Branson’s eyes to be different? What if those benefits enabled the failing eyesight of an elderly population or someone with diabetic retinopathy? Why couldn’t whatever she possessed enhance everyone else’s eyesight?

  He tapped his finger on the table. “What if we send her over to Vanderbilt’s ophthalmology department where she can be enrolled in current trials and research?”

  The preppy doc leaned closer. “I know of a current work in progress. I’m involved in the sidelines.” He grinned. “This may just get me on as an author and contributor.”

  Danny chuckled because there was nothing like notoriety in your specialty after co-authoring a major medical paper. “I’m seeing her in the office this afternoon. Write down the info and I’ll ask her to go see them.”

  -----

  When Danny exited the hospital after his next case, the predicted heat wave by the weather reporters had become a reality. He waited a second under the repaired ER awning and draped his lab coat over his arm. Casey’s ambulance wasn’t in its spot so he continued to his car. He wiped his brow while thinking about the morning conversation with Dr. Reaper. After making love with Sara that morning, that interesting medical case had made his day even brighter. What if Varg Dagmar’s psychology testing would also turn out as unprecedented?

  Danny stepped through the back door to his office and put his things down. Before checking his in-box or messages, he went into the kitchen to get something to drink.

  “Hi, Dr. Tilson,” Cheryl said, rounding the corner right after him. “The air conditioning is working overtime and everyone is in a grumpy mood.”

  “Not me. Maybe the powers that be will allow the heat, humidity, and clouds to build up so middle Tennessee is blessed with much-needed rain.”

  Dr. Foord also came in from the hallway; today his one earring was a thick, small silver hoop. Danny had to give him credit. He’d seen a lot of similar hoops in people’s noses and this looked a whole lot better.

  “Hey, Danny. I apologize. As Cheryl can attest, I’m running behind and patients are short-tempered. Plus, my nurse isn’t here so Cheryl’s helping me out.”

  “Jeffrey, don’t worry. It’s just the end of the summer doldrums. Matthew, you and I will get everyone seen by the end of the day.” He ran cold water into a plastic cup and laughed. “My dad used to have a quip for everything. He used to ask, ‘How hot is a Nashville summer?’”

  Cheryl and Jeffrey shrugged their shoulders.

  “So hot that I saw a fire hydrant chasing a pack of dogs!”

  Danny laughed along with the two of them, took his water with him, and said, “Come on, let’s get to work.”

  One hour and four patients later, Danny drank another ice cold glass of water. The blinds were half-closed as he looked out, people below walking at a snail’s pace. He stepped to his desk knowing Paula Branson’s chart was on top. This would be her lumbar laminectomy postop office visit; he was sure glad he’d met Steve over lunch.

  As Branson was a patient so fresh in Danny’s mind, he didn’t review her chart. Despite the heavier humidity in the office, Danny buttoned the entire row of buttons on his coat and signaled his nurse to follow him. Although Cheryl often went in and out of exam rooms to help him, he rarely requested that she stay with him during a patient’s visit. She gave him a questioning look and pushed a few stray hairs off her forehead.

  Paula Branson turned her head as soon as the door opened. She wore a flowered skirt and her one crossed leg swung up and down. A green top with a soft, gathered neckline plunged down into her cleavage.

  “Dr. Tilson! I wasn’t exactly sure if I would be seeing you or Dr. Garner today. At first, I heard my surgical doctor has retired but then I heard he still comes to the office. I wonder if you made sure I was to be seen by you?” She ignored Cheryl and, with a theatrical gesture, tilted her head back.

  Danny sat in the desk chair while Cheryl realized the best position for her would be somewhere between Danny and his patient. “Dr. Garner has very limited hours now. I followed your hospital postop care so it’s preferable that I see you…” He looked directly at her and emphasized, “for your neurosurgical care.”

  “Plus, I sent you for the ophthalmologist’s consult.” His tone was flat and factual; he hated not being himself and having to be on guard. He wished he’d been wary of Rachel’s advances in the OR a few years ago, but hindsight was golden.

  “Oh. Then actually, if I want to, I can see Dr. Garner in the future instead of you. I could schedule an appointment for one of the days that he comes in.”

  Cheryl glanced his way. “That is certainly your choice,” Danny said. “In any case, your surgical issues are probably taken care of and you won’t be needing us anymore.”

  She crossed her other leg and let her short-heeled shoe dangle from her foot. Danny fished around in his lab coat pocket for the paper from Dr. Reaper and flipped through the chart for his written consult. The report correlated with what Steve had told him.

  “Nurse, would you mind killing that?” Paula said. “I hate spiders.”

  Cheryl glanced at the tiled floor where Paula seemed to be looking. “I don’t see anything.”

  “It’s near the wall,” Paula said, rolling her eyes. “You know … it’s multi-legged and has a spot on its back.”

  Cheryl took two steps towards the corner, looking all the while. She shrugged her shoulders.

  Paula straightened her legs, then stepped down and pointed before she hurriedly got back on the table.

  “Is everything okay?” Danny asked.

  Cheryl pulled a paper towel from the dispenser. She didn’t even want to kill the thing, it was so insignificant. It was either a microscopic species or it was just born. She leaned over and pushed the bug behind the trash can. Paula didn’t pay any attention. She was looking out through the blinds … probably far off to outer space, Danny thought, where she was able to detect a single atom.

  With Cheryl still in the room, Danny examined Paula’s surgical site and gave her a lower body neurological exam. He was happy with her progress. “Any change with your headaches?” he asked.

  “They’re pretty much the same,” she said while laying her hand behind her head. “I’m not worried about them; they don’t interfere with anything.”

  Danny nodded and let it go at that. “I’ve received a stellar report from Dr. Reaper about your eyesight. He said he talked to you about it. The both of us would like you to report to Vanderbilt’s ophthalmology department. Your vision and eye tests would be extremely important information for them and your participation in their research might end up benefiting others.”

  Please, let her not be so self-centered that she won’t help out.

  Paula straightened her arms out behind her and leaned back to think about it. Danny leaned forward with the piece of paper and looked imploringly at her.

  She stopped swinging her leg. “Okay. I have nothing else better to do.”

  -----

  In the hallway after she left, Danny swept his hand over his forehead. “Yup, it sure is a hot day today.”

  “More so in there for you than for me,” Cheryl said.

  Danny laughed. “Exactly,” he said and continued to chuckl
e.

  Cheryl slowed. “Dr. Tilson?”

  “Yes?”

  “Don’t mind me saying so, but things have been a bit more breathable around here since you’ve filled Dr. Garner’s shoes. Even your two young partners appreciate it.”

  “Hmm,” he hummed, not knowing if he deserved the compliment.

  “You’ve changed a bit, too,” she tentatively added.

  “Maybe I’m mellowing out. Does that come with age?”

  “Not in Dr. Garner’s case.”

  He gave her a pat on the back before he went to his office and dictated the visit.

  Chapter 14

  On Friday, Casey’s hours rotated into the 11:00 p.m. to 7:00 a.m. shift and these nights always proved to be the most hectic. Downtown Nashville - especially Broadway - was crowded with pedestrians and cars, and the tawdry nightclubs and honky-tonk bars were jammed. The liberal use of alcohol helped make the amateur musicians’ heavy beat and lyrics of vice and misfortune sound as good as what was on stage at the Ryman Auditorium. The drinking also helped to increase the number of MVAs.

  The call for two ambulances was patched through from the police department after they received a call from a motorist who was behind a car that swerved off the road after veering away from another that was driving in the middle of the highway. While one passenger was ejected from the car as it went into the embankment, the driver at fault kept going and never stopped.

  Casey and Mark arrived quickly at the scene. Since it was after midnight - and on a less traveled road between Nashville and the suburbs - the police and medics didn’t have to worry about onlookers and rubberneckers.

  A silver sports sedan’s back end jutted onto the pavement and the front end was lodged below in some trees. A few beer cans and energy drinks were on the floor of the car as well as one outside the front passenger’s open door. Police officers talked amongst themselves as well as to the driver of the car who was able to respond to questioning but needed medical care for an apparent cardiac contusion from the steering wheel.

 

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