He stopped pacing, his gaze going from Sara to his wife and back again. “Where’s the other doctor?”
“He got called away on an emergency.” She walked to the sink and washed her hands, saying, “I’m Dr. Linton. Can you catch me up to speed here? What happened?”
“She passed out,” the man said, nervously twisting his wedding ring around his finger. He seemed to realize he was coming off as a bit frantic, and moderated his tone. “She’s never passed out before.”
Faith Mitchell seemed aggravated by his concern. “I’m fine,” she insisted, then told Sara, “It’s the same thing I said to the other doctor. I feel like I’ve been coming down with a cold. That’s all.”
Sara pressed her fingers to Faith’s wrist, checking her pulse. “How are you feeling now?”
She glanced at her husband. “Annoyed.”
Sara smiled, shining her penlight into Faith’s eyes, checking her throat, running through the usual physical exam and finding nothing alarming. She agreed with Krakauer’s initial evaluation: Faith was probably a little dehydrated. Her heart sounded good, though, and it didn’t seem like she’d suffered from a seizure. “Did you hit your head when you fell?”
She started to answer, but the man interjected, “It was in the parking lot. Her head hit the pavement.”
Sara asked the woman, “Any other problems?”
Faith answered, “Just a few headaches.” She seemed to be holding something back, even as she revealed, “I haven’t really eaten today. I was feeling a little sick to my stomach this morning. And yesterday morning.”
Sara opened one of the drawers for a neuro-hammer to check reflexes, only to find nothing there. “Have you had any recent weight loss or gain?”
Faith said “No” just as her husband said “Yes.”
The man looked contrite, but tried, “I think it looks good on you.”
Faith took a deep breath and let it out slowly. Sara studied the man again, thinking he was probably an accountant or lawyer. His head was turned toward his wife, and Sara noticed another, lighter scar lining his upper lip—obviously not a surgical incision. The skin had been sewn together crookedly, so that the scar running vertically between his lip and nose was slightly uneven. He had probably boxed in college, or maybe just been hit in the head one too many times, because he obviously didn’t seem to know that the only way out of a hole was to stop digging. “Faith, I think the extra weight looks great on you. You could stand to gain—”
She shut him up with a look.
“All right.” Sara flipped open the chart, writing down some orders. “We’ll need to do an X-ray of your skull and I’d like to do a few more tests. Don’t worry, we can use the blood samples from earlier, so there won’t be any more needles for now.” She scribbled a notation and checked some boxes before looking up at Faith. “I promise we’ll rush this as much as we can, but you can see we’ve got a pretty full house today. X-ray’s backed up at least an hour. I’ll do what I can to push it through, but you might want to get a book or magazine while you wait.”
Faith didn’t respond, but something in her demeanor changed. She glanced at her husband, then back at Sara. “Do you need me to sign that?” She indicated the chart.
There was nothing to sign, but Sara handed her the chart anyway. Faith wrote something on the bottom of the page and gave it back. Sara read the words I’m pregnant.
Sara nodded as she crossed through the X-ray order. Obviously, Faith hadn’t yet told her husband, but there was a different set of questions Sara needed to ask now, and she couldn’t do so without giving away the news. “When’s the last time you had a pap smear?”
Faith seemed to understand. “Last year.”
“Let’s take care of that while you’re here.” Sara told the man, “You can wait outside.”
“Oh.” He seemed surprised, even as he nodded. “All right.” He told his wife, “I’ll be in the waiting room if you need me.”
“Okay.” Faith watched him leave, her shoulders visibly slumping in relief as the door closed. She asked Sara, “Do you mind if I lie down?”
“Of course not.” Sara helped her get comfortable on the bed, thinking Faith looked younger than her thirty-three years. She still had the bearing of a cop, though—that no-nonsense, don’t-bullshit-me squareness to her shoulders. Her lawyer husband seemed like an odd match, but Sara had seen stranger combinations.
She asked the woman, “How far along are you?”
“About nine weeks.”
Sara put this in her notes as she asked, “Is that a guess or have you seen a doctor?”
“I took an over-the-counter test.” She changed that. “Actually, I took three over-the-counter tests. I’m never late.”
Sara added a pregnancy test to the orders. “What about this weight gain?”
“Ten pounds,” Faith admitted. “I’ve kind of gone a little crazy with the eating since I found out.”
In Sara’s experience, ten pounds usually meant fifteen. “Do you have any other children?”
“One—Jeremy—eighteen.”
Sara made the notation in the chart, mumbling, “Lucky you. Heading into the terrible twos.”
“More like terrible twenties. My son is eighteen years old.”
Sara did a double take, flipping back through Faith’s history.
“Let me do the math for you,” Faith offered. “I got pregnant when I was fourteen. I had Jeremy when I was fifteen.”
Not much surprised Sara anymore, but Faith Mitchell had managed to do it. “Were there any complications with your first pregnancy?”
“Other than being fodder for a Lifetime movie?” She shook her head. “No problems at all.”
“Okay,” Sara answered, putting down the chart, giving Faith her full attention. “Let’s talk about what happened tonight.”
“I was walking to the car, I felt a little dizzy, and the next thing I know, Will’s driving me here.”
“Dizzy like the room spinning or dizzy as in light-headed?”
She thought about the question before replying. “Light-headed.”
“Any flashes of light or unusual tastes in your mouth?”
“No.”
“Will’s your husband?”
She actually guffawed. “God, no.” She choked on an incredulous laugh. “Will’s my partner—Will Trent.”
“Is Detective Trent here so I can talk to him?”
“Special Agent. You already did. He just left.”
Sara was sure she was missing something. “The man who was just in here is a cop?”
She laughed. “It’s the suit. You’re not the first person to think he’s an undertaker.”
“I thought lawyer,” Sara admitted, thinking she had never met anyone who looked less like a police officer in her life.
“I’ll have to tell him you thought he was a lawyer. He’ll be pleased you took him for an educated man.”
For the first time, Sara noticed the woman was not wearing a wedding ring. “So, the father is …”
“In and out of the picture.” Faith didn’t seem embarrassed by the information, though Sara supposed that there wasn’t much that could embarrass you after having a child at fifteen. “I’d prefer Will didn’t know,” Faith said. “He’s very—” She stopped mid-sentence. She closed her eyes, pressed her lips together. A sheen of sweat had broken out on her forehead.
Sara pressed her fingers to Faith’s wrist again. “What’s happening here?”
Faith clenched her jaw, not answering.
Sara had been vomited on enough to know the warning signs. She went to the sink to wet a paper towel, telling Faith, “Take a deep breath and let it out slowly.”
Faith did as she was told, her lips trembling.
“Have you been irritable lately?”
Despite her condition, Faith tried for levity. “More than usual?” She put her hand to her stomach, suddenly serious. “Yes. Nervous. Annoyed.” She swallowed. “I get a buzzing in my head, like ther
e are bees in my brain.”
Sara pressed the cold paper towel to the woman’s forehead. “Any nausea?”
“In the mornings,” Faith managed. “I thought it was morning sickness, but …”
“What about the headaches?”
“They’re pretty bad, mostly in the afternoon.”
“Have you been unusually thirsty? Urinating a lot?”
“Yes. No. I don’t know.” She managed to open her eyes, asking, “So, what is it—the flu or brain cancer or what?”
Sara sat on the edge of the bed and took the woman’s hand.
“Oh, God, is it that bad?” Before Sara could answer, she said, “Doctors and cops only sit down when it’s bad news.”
Sara wondered how she had missed this revelation. In all her years with Jeffrey Tolliver, she’d thought she had figured out every one of his tics, but this one had passed her by. She told Faith, “I was married to a cop for fifteen years. I never noticed, but you’re right—my husband always sat down when there was bad news.”
“I’ve been a cop for fifteen years,” Faith responded. “Did he cheat on you or turn into an alcoholic?”
Sara felt a lump in her throat. “He was killed three and a half years ago.”
“Oh, no,” Faith gasped, putting her hand to her chest. “I’m so sorry.”
“It’s all right,” Sara answered, wondering why she’d even told the woman such a personal detail. Her life over the last few years had been dedicated to not talking about Jeffrey, and here she was sharing him with a stranger. She tried to ease the tension by adding, “You’re right. He cheated on me, too.” At least he had the first time Sara married him.
“I’m so sorry,” Faith repeated. “Was he on duty?”
Sara didn’t want to answer her. She felt nauseated and overwhelmed, probably a lot like Faith had felt before she’d passed out in the parking lot.
Faith picked up on this. “You don’t have to—”
“Thanks.”
“I hope they got the bastard.”
Sara put her hand into her pocket, her fingers wrapping around the edge of the letter. That was the question everyone wanted answered: Did they get him? Did they catch the bastard who killed your husband? As if it mattered. As if the disposition of Jeffrey’s killer would somehow alleviate the pain of his death.
Mercifully, Mary came into the room. “Sorry,” the nurse apologized. “The old lady’s kids just dropped her here. I had to call social services.” She handed Sara a piece of paper. “CMP’s back.”
Sara frowned as she read the numbers on the metabolic profile. “Do you have your monitor?”
Mary reached into her pocket and handed over her blood glucose monitor.
Sara swabbed some alcohol on the tip of Faith’s finger. The CMP was incredibly accurate, but Grady was a large hospital and it wasn’t unheard-of for the lab to get samples mixed up. “When was the last time you had a meal?” she asked Faith.
“We were in court all day.” Faith hissed “Shit” as the lancet pierced her finger, then continued, “Around noon, I ate part of a sticky bun Will got out of the vending machine.”
Sara tried again. “The last real meal.”
“Around eight o’clock last night.”
Sara guessed from the guilty look on Faith’s face that it had probably come out of a takeout bag. “Did you have coffee this morning?”
“Maybe half a cup. The smell was a bit too much.”
“Cream and sugar?”
“Black. I usually eat a good breakfast—yogurt, fruit. Right after my run.” Faith asked, “Is something wrong with my blood sugar?”
“We’ll see,” Sara told her, squeezing some blood onto the test strip. Mary raised an eyebrow, as if to ask if Sara wanted to place a wager on the number. Sara shook her head: no bet. Mary persisted, using her fingers to indicate one-five-zero.
“I thought the test came later,” Faith said, sounding unsure of herself. “When they make you drink the sugary stuff.”
“Have you ever had any problems with your blood sugar? Is there a history in your family?”
“No. None.”
The monitor beeped and the number 152 flashed on the screen.
Mary gave a low whistle, impressed by her own guess. Sara had once asked the woman why she didn’t go to medical school, only to be told that nurses were the ones who practiced the real medicine.
Sara told Faith, “You have diabetes.”
Faith’s mouth worked before she managed a faint, “What?”
“My guess is that you’ve been pre-diabetic for a while. Your cholesterol and triglycerides are extremely elevated. Your blood pressure is a little high. The pregnancy and the rapid weight gain—ten pounds is a lot for nine weeks—plus your bad eating habits, pushed you over the edge.”
“My first pregnancy was fine.”
“You’re older now.” Sara gave her some tissue to press against her finger so the bleeding would stop. “I want you to follow up with your regular doctor first thing in the morning. We need to make sure there’s not something else going on here. Meanwhile, you have to keep your blood sugar under control. If you don’t, passing out in the parking lot will be the least of your worries.”
“Maybe it’s just—I haven’t been eating right, and—”
Sara cut her off mid-denial. “Anything over one-forty is a positive diagnosis for diabetes. Your number has actually inched up since the first blood test was taken.”
Faith took her time absorbing this. “Will it last?”
The question was one for an endocrinologist to answer. “You’ll need to talk to your doctor and have him run some more tests,” Sara advised, though, if she had to make an educated guess, she would say that Faith was in a precarious situation. Except for the pregnancy, she would be presenting as a full-blown diabetic.
Sara glanced at her watch. “I would admit you tonight for observation, but by the time we processed you and found you a room, your doctor’s office would be open, and something tells me you wouldn’t stay here anyway.” She had spent enough time around police officers to know that Faith would bolt the minute she got the chance.
She continued, “You have to promise me that you’ll call your doctor first thing—and I mean that, first thing. We’ll get a nurse educator in here to teach you how to test your blood and how and when to inject yourself, but you’ve got to follow up with him immediately.”
“I have to give myself shots?” Faith’s voice went up in alarm.
“Oral meds aren’t approved for use in pregnant women. This is why you need to talk to your doctor. There’s a lot of trial and error here. Your weight and hormone levels will change as the pregnancy progresses. Your doctor’s going to be your best friend for the next eight months, at least.”
Faith seemed embarrassed. “I don’t have a regular doctor.”
Sara took out her prescription pad and wrote down the name of a woman she’d interned with years ago. “Delia Wallace works out of Emory. She has a dual specialty in gynecology and endocrinology. I’ll call her tonight so her office knows to work you in.”
Faith still seemed unconvinced. “How can I suddenly have this? I know I’ve put on weight, but I’m not fat.”
“You don’t have to be fat,” Sara told her. “You’re older now. The baby affects your hormones, your ability to produce insulin. You haven’t been eating well. The stars lined up and it triggered you.”
“It’s Will’s fault,” Faith mumbled. “He eats like a twelve-year-old. Doughnuts, pizza, hamburgers. He can’t go into a gas station without buying nachos and a hot dog.”
Sara sat down on the edge of the bed again. “Faith, this isn’t the end of the world. You’re in good shape. You’ve got great insurance. You can manage this.”
“What if I …” She blanched, breaking eye contact with Sara. “What if I wasn’t pregnant?”
“We’re not talking about gestational diabetes here. This is full-blown, type two. A termination won’t suddenly make the pro
blem go away,” Sara answered. “Look, this is probably something you’ve been building up to for a while. Being pregnant brought it on faster. It will make things more complicated in the beginning, but not impossible.”
“I just …” She didn’t seem capable of finishing a sentence.
Sara patted her hand, standing. “Dr. Wallace is an excellent diagnostician. I know for a fact that she takes the city insurance plan.”
“State,” Faith corrected. “I’m with the GBI.”
Sara assumed the Georgia Bureau of Investigation’s plan was similar, but she didn’t quibble. Faith was obviously having difficulty absorbing the news, and Sara had not exactly eased her into it. You couldn’t unring a bell, though. Sara patted her arm. “Mary will give you an injection. You’ll be feeling better in no time.” She started to leave. “I mean it about calling Dr. Wallace,” she added firmly. “I want you on the phone with her office first thing in the morning, and you need to be eating more than sticky buns. Low-carb, low-fat, regular healthy meals and snacks, okay?”
Faith nodded, still dumbstruck, and Sara left the room feeling like an absolute heel. Her bedside manner had certainly deteriorated over the years, but this represented a new low. Wasn’t that anonymity why she had come to Grady in the first place? But for a handful of homeless men and some prostitutes, she seldom saw a patient more than once. That had been the real pull for Sara—the absolute detachment. She wasn’t at a stage in her life where she wanted to make connections with people. Every new chart was an opportunity to start all over. If Sara was lucky—and if Faith Mitchell was careful—they would probably never see each other again.
Instead of going back into the doctors’ lounge to finish her charts, Sara walked past the nurses’ station, through the double doors, into the overfilled waiting room and finally found herself outside. There were a couple of respiratory therapists by the exit smoking cigarettes, so Sara kept walking toward the back of the building. Guilt about Faith Mitchell still hung heavy on her shoulders, and she looked up Delia Wallace’s number in her cell phone before she forgot to follow up. The service took her message about Faith, and Sara felt slightly better as she ended the call.
She had run into Delia Wallace a couple of months ago, when the woman had come in to see one of her wealthy patients who had been airlifted to Grady after a bad car accident. Delia and Sara had been the only women in the top five percent of their graduating class at Emory University Medical School. At the time, it was an unwritten rule that there were two options for female doctors: gynecology or pediatrics. Delia had chosen the first, Sara the latter. They would both turn forty next year. Delia seemed to have everything. Sara felt like she had nothing.
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