Silent Fear, a Medical Mystery

by Barbara Ebel

  The afternoon zoomed by and Danny hadn’t eaten lunch. He tossed his stethoscope on the couch under his Norman Rockwell fishing print and grinned. The picture stood for more than a pretty print. It represented some flow of continuity to his life – it had stayed right in his undisrupted office during most of the last year’s turmoil. His stomach started to grumble as his nurse, Cheryl, came through the open door.

  “Aren’t you going to eat what’s on your desk?” she asked.

  Danny strutted over to a vegetable assortment with dip, a piece of cake, and a cup of coffee.

  “Looks like left over party food,” Danny said.

  “You missed our late morning birthday break for Dr. Garner.”

  “I didn’t know Bruce grew older.”

  “He tried to keep this one quiet but that’s impossible around here.” Cheryl took the files in Danny’s outbox and put a telephone message on his desk. “Mark Cunningham called,” she said. “He asked for you to call him at the office.”

  Danny chewed a vegetable slice before answering. “I’ll get a hold of him right now.”

  “However, I know you didn’t eat lunch, so why don’t you take a little break while x-rays are being done on your patient?”

  “Thanks Cheryl. Appreciate the food.”

  “I think it’ll be closing time soon for most staff. How about rescheduling a few appointments?”

  “That’s fine, reschedule them for the first thing in the morning. I’ll let you know if I can get Harold to see my hospital patients while he’s making his own rounds.”

  “I’ll try, Dr. Tilson.”

  Danny called Harold as soon as he sat down. After giving Harold his patients’ names and information, Harold said, “No problem. I owe you.”

  Next, Danny called his attorney. “Mark, it’s Danny, did you get things ironed out with Rachel’s attorney?”

  “The paperwork from Phil Beckett confirmed the verbal agreement. When you want it, you’ve got two weekends a month for visitation with Julia.”

  “Thanks Mark. I’ll call Rachel and set it up for this weekend.”

  “Danny, what do you want to do about custody? I know you were going to give it some thought.”

  Danny stared at the birthday cake, which made him think of his baby girl who would have years of birthdays without him. That is, if things stayed the way Rachel wanted them. On the other hand, his own life could have more stability if he kept litigation out of his hair. He had more legalities in his life the last year than prominent TV judges. Mark cut into his thoughts and helped him out.

  “Even if we start proceedings, Danny, custody hearings, a trial, or even an agreement between two parties takes time. I’d advise you to go ahead in that direction. You can always back out later if you decide. Give it some thought and call me soon.”

  “Okay Mark. We’ll leave it at that.” Danny hung up and took a sip of cold coffee. He grimaced and masked it with cake as Bruce came in. “Happy birthday,” Danny said. “Sorry I missed the celebration.”

  Dr. Bruce Garner slid out the chair across from Danny. He needed the extra leg room. The founding partner of their group looked the same as he did for last year’s birthday. He was aging like a shiny dime.

  “Celebrations suit the staff,” Bruce said. “It breaks up office monotony and gives them festivity. I’m celebrating this weekend with my wife and we’re going out of town. You’re in charge but I’ll have my cell. Harold is on call.”

  Bruce lingered. The visit seemed to be Bruce’s way of giving him a vote of confidence. He felt more at ease with his senior partner than he had in a long time and believed Bruce considered him a better surgeon than Harold and Matthew.

  “By the way,” Bruce added, “the business books are looking good. We have a slightly higher percentage of unpaid statements that billing is working on, yet income is up.” Bruce got up and tapped the desk with approval.

  “We have excellent people here, Bruce.”

  “There’s always room for improvement.” Bruce’s long stride had him out of Danny’s sight as soon as Danny got up and grabbed his stethoscope.

  ----------

  One thing Rachel liked about a ten-hour week was the distance she maintained from operating room politics. The charge nurse left her alone, too, because she was “only a part-timer.” Again, she’d played her cards just right. The day passed effortlessly, preparing and assisting with instruments in three surgery cases from an elective appendectomy to a melanoma removal. She looked forward to seeing Julia when she got off, less so for Leo.

  After Rachel drove home, slipped her key into the front door, and entered, she caught Leo coming up from the basement steps in work-out clothes and a film of sweat. Other than the TV volume being low, she didn’t hear Julia.

  “Hey, babe,” Leo said. He walked straight over to her, wrapped his arms around her shoulders, and placed a kiss on her lips. “Hey, don’t look so glum. Bad day at the office?” He tilted his head and smiled.

  “It could always be better.”

  “I’ll cheer you up.” Leo ran his fingers through her hair. “If anyone gave you trouble today, tell me. They’ll have to answer to me. I could switch their medication when they come in with a script.” He laughed and leaned in again for a possible kiss. “I tell you what, I’ll give you a break tonight and diaper Julia all the way to bedtime.”

  “That’s considerate of you, Leo.” She immediately regretted her tone. After all, there were good things about him. “Is she taking a nap?” Rachel managed a smile and kissed him back.

  “That’s more like the Rachel I know,” Leo said letting her go. “I put Julia in her playpen when I went downstairs to the gym.”

  “Thanks, I’m lucky to have such a contented baby. I’ll go see her.”

  Rachel went into the bedroom where the playpen sat near the wall and adjacent crib. Colorful toys dotted the bottom. Julia was stomach down fast asleep. She still wore the body suit Rachel had dressed her in that morning. Leo must have done a good job with her. Julia was sleeping peacefully. However, Rachel knew it was best to wake her now so that she would sleep better throughout the night. She turned her over and picked her up.

  When Julia snapped out of her sleep, her little face registered alarm. “What?” Rachel said inquisitively.

  At the doorway, Leo had followed her. He stood against the frame like a sports clothes model, suited in a muscle shirt and gym shorts. The drawstrings dangled down the front of his lower abdomen and a lighted cigarette dangled at his lips. He exhaled into the bedroom.

  Rachel focused on Julia, who immediately started squirming in her arms.

  “I know you don’t like the baby around my smoking,” Leo said. “I won’t even come in. It’s kind of sexy seeing you two there.”

  Rachel cuddled the baby and patted her back but Julia wiggled even more and began to cry. By bedtime, Rachel realized that despite her best attempts, Julia was having a bad evening. She was grateful that Leo did the last diapering and slipped her into her one-piece sleeper for the night.

  ----------

  Sunday morning Rachel woke in a good mood, refreshed after an undisturbed night. Leo sat at the edge of the bed, turned and patted her hip. “Hey, babe,” he said. He rose and bounded to the bathroom. Rachel slipped into slipper socks and tiptoed into Julia’s room to spy on her playfulness, hoping to find her awake. She grabbed a diaper and approached the crib. Julia made baby gestures like swatting invisible bugs, but not as much as her usual animated self. She didn’t burst into excitement when Rachel came to the crib’s side.

  “Good morning, Julia. How’s my pretty girl today?” Rachel put the side rail down, leaned in, and gave her a kiss and a little upper arm squeeze. Julia’s neutral, yet wary expression changed to discomfort. Rachel placed her hand over the baby’s forehead. Maybe she had a fever. Rachel shook her head, probably not. She still had so much to learn about babies.

  Rachel unsnapped the bottom of Julia’s s
leeper, took the one-piece pajamas off, and put a top over her head. She pulled the sticky tabs from the dirty diaper and pulled the diaper straight out. Julia let out a painful sound, puzzling Rachel even more. “I’ll pick you up in a minute. I just don’t know what’s gotten into you.” Rachel put the diaper aside and picked up Julia’s legs to slide in a clean one. She put the new one down and began moving it under but stopped in horror.

  Rachel gasped. She stared at a red circular, painful-looking area on Julia’s bottom. More alarm gripped her. The lesion wasn’t there yesterday when she had left for work. She started to blurt out for Leo, but realized she needed to be cautious. This weekend with him had left her feeling uncomfortable with their relationship. She must approach talking to him with trepidation. She put the guard rail up and walked back into the bedroom. The bathroom door opened and Leo emerged. He pulled on a tee-shirt flung on his nightstand.

  “Leo, do you know what happened to Julia? She’s got a sore on her bottom.”

  For a moment, Leo’s bottom jaw tensed, and then he chose his words carefully. “Babe, I didn’t want to disturb you about it last night. It was an accident. I brought hot coffee in there while I changed her yesterday. A bit dribbled from the cup. I’m sorry. She forgave me, too.” He smiled and looked into Rachel’s eyes.

  Rachel didn’t know what to think. She wanted more details but it appeared as if he’d finished his explanation. “Leo, this is really bad timing. She has visitation with her father next weekend.”

  “Don’t worry, it’ll be gone by then.”

  Rachel turned and went back to Julia. She applied some salve to the sore, finished dressing her, and gave her a cautious hug so as to not touch her padded buttocks.

  ----------

  The next morning Harold mixed his own patient list with Danny’s. Most of their patients were on the same hospital floor which pleased Harold. This morning, his right knee bothered him walking along the corridors. Sometimes it acted up from the weather; sometimes from inactivity, and at other times it ached from too much activity. He originally insulted it by playing too much tennis during college. The more he played, the better he got, until one day he pulled a ligament.

  The last two patients to see for Danny were Michael Johnson and Troy Neal. He knew about their surgeries from the day before, so he glanced in their charts for any new notes since then. Troy Neal and Michael Johnson both ran a fever, which wasn’t new for Troy Neal. After surgery, in any case, post-op fevers were common and Harold knew most of them usually resolved spontaneously. Other than that, no problems had developed over night.

  With a slight falter in his walk, Harold entered Michael’s room.

  “Good morning, Dr. Jackowitz,” the day shift nurse, Peggy said. “Michael is the first patient I’ve checked on since getting here.” She held a plastic spirometer in her hands alongside Michael’s bedside. “I’m trying to get your partner’s young patient to use this as vibrantly as he probably plays on a basketball court.”

  “We’ll talk about that, then,” Harold said and introduced himself to Michael. “You were almost my patient so I’m glad to take care of you this morning for my partner.”

  The youngster’s head was still wrapped and his eyes still glazed, as if anesthesia still hung on to him. “Oh,” he said. “Where are my Mom and Dad?”

  “They’ll be in a little later,” Peggy said, putting down the spirometer.

  Michael fumbled for the wash cloth, brought it to his mouth, and expelled saliva which kept accumulating unnecessarily.

  “He’s a wet one, Dr. Jackowitz,” Peggy said.

  “If those secretions are coming from your throat,” Harold said, looking closer at Michael, “it’s best to keep practicing deep breathing with this plastic bedside breathing machine.”

  Michael blinked his eyes in acknowledgement. Harold leaned in with his stethoscope. “Take a good breath,” he said. Michael inhaled and slobbered more on his washcloth, Harold, and his stethoscope when he exhaled.

  Harold wiped his hands on what he hoped was the clean part of the cloth from Michael and then handed it carefully to Peggy. She brought another one from a fresh linen pile.

  “We’ll keep our eyes on your lungs,” Harold said. “They’re clear right now.” Harold examined the wrapping around his head; no blood stains, pus, or bulging. “Dr. Tilson will see you next time. You’ll be back on a boat or on a basketball court before you know it.”

  Michael scrunched his eyebrows. “I’m groggy, but I know I don’t play basketball.”

  Harold smiled at Peggy as Michael closed his eyes. “Let’s go see Mr. Neal,” he said.

  ----------

  Troy Neal had his bed inclined just enough so he could stare at the liquid breakfast that sat on the tray before him. “Good morning,” Harold said when they arrived. “I’m Dr. Jackowitz, we’ve met briefly before.”

  “You work with Dr. Tilson. I hope one of you will let me go home soon.” Troy scratched the unshaven stubble on his chin and looked pleadingly at the both of them.

  “Except that you’re still running a fever, Mr. Neal. Dr. Tilson thinks that cleaning out the abscess yesterday went fine and it won’t need to be done again. He’ll get you discharged one of these days, I promise.”

  “Actually, Dr. Jackowitz,” Peggy said, “Mr. Neal had a higher temp last night.”

  Troy gestured for the hand towel near Harold as he contorted his face and vomited a small amount of fluid. Harold slid his hand and the towel underneath his chin. “I’m sorry,” Troy said. “I didn’t know that upchuck was coming until it was too late.”

  Peggy grabbed the cloth, gave him a new one, and stepped to the sink to wash her hands with Harold.

  “Accidents happen,” Harold said, returning to Troy. He listened to Troy’s chest and wrapped his stethoscope back around his neck. “Dr. Tilson will see you the next time. For today, you’re not going anywhere.”

  ----------

  That evening, Danny’s ex-wife, Sara, felt ambivalent about going to the original Tilson’s family residence. The girls were also coming. Mary wanted to show Sara bridal magazines so they could pick out Sara’s maid of honor dress. Sara figured the chances of Danny being there were fifty-fifty. She had avoided any lengthy time with him except when it came to matters of their daughters, Annabel and Nancy, and legal matters were pretty much in the past as well. Danny’s affair had marred her femininity. She thought they had a solid marriage but the end of it signaled to her just how fickle life really was. His infidelity stung like a wound that had healed but the scar still remained.

  Since Danny appeared to be getting his integrity and professionalism back the last two months, he also seemed willing to help her more often with the girls. He had requested to spend time with her … to talk or go fishing. She was too fragile to accept. She thought Danny had suffered enough after his affair as well as from the gaggle of pursuing attorneys. His troubles had been potent but condensed into a compact time frame. Her blow wasn’t as sharp all at once - it lingered longer like a slow bleed. Her greatest comfort was her two teenagers. Though losing her oldest daughter, Melissa, had almost devastated her, at least Melissa hadn’t suffered through the upheaval of her parents separation and later divorce.

  Sara and the girls peeled out of their CRV in Mary Tilson’s driveway and headed to the front door. Annabel, the oldest girl, knocked and entered. She took off her baseball cap, laid it on the entry-way table, and crouched to greet Dakota who came bounding through the passageway. Sara and Nancy waited for Dakota to greet them, too.

  A jovial male voice sounded from the kitchen. “By Dakota’s response,” Casey shouted, “we know you aren’t a pack of burglars. Good timing because the master chef has kabobs on the grill.”

  Dakota swayed his tail back and forth and led them to the back where the big patio doors let the early evening light stream into the kitchen. Casey and Mary stood on opposite ends of the island but met Sara and the girls, giving them big
hugs.

  “Hey, what’s the long look for?” Casey asked Nancy.

  “She always has a long look,” Annabel chimed in, flashing her auburn eyes at Casey.

  “Better than what you look like,” Nancy said.

  “Enough, girls,” Sara said.

  “It smells good out there,” Annabel said.

  “He’s a good cook,” Nancy said, “but Grandpa’s restaurant was better.” She straightened her hair and hid her ears because she thought they were too big. She rubbed Dakota’s back end which pushed against her legs.

  “Nancy,” Sara said, “will you please be polite!”

  “What, like Annabel?”

  “Oh, pleeease,” Annabel chimed.

  “You two better watch it,” Casey said. “I’m going to become your uncle, which will give me the right to ground you both.”

  “Casey, you already have my permission,” Sara said. “And you probably had Danny’s a long time ago.”

  Casey winked at Annabel who ran her tongue over her braces.

  “Okay, muscle man,” Mary said, “why don’t you check on our dinner? I need to show Sara and the girls some dress options for the wedding.”

  “Yes, gorgeous.” Casey put his hand into her mid-shoulder length hair, found her neck, and gave it a quick massage. “And despite what Miss Sulky says,” he said looking at Nancy, “my grilled dinner gets five stars.”

  Mary showed Sara and the girls the dresses she had in mind. “I personally like the brownish-purple color for Fall and the knee length,” Mary said pointing at side-by-side magazine pages. “We can do the elbow length sleeve if you all would like.”

  “I think these look fine,” Sara said. “I like the gathered fabric at the waistline. What do you think, girls?”

  “Cool,” Annabel said. “I’ll be able to wear it for Senior Prom next Spring, too.”

  Nancy snickered. “If it still fits you by then.”