by Barbara Ebel
Annabel only smiled. All she wished for them was that Stephie zipped through the medical care and surgical removal of her neuroblastoma and got to enjoy life like a three-year-old should.
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Because of Dustin’s career so far, he had more insight than most laypeople into the dynamics of trauma cases that fled into the OR. Loved ones would accumulate in the waiting room and a waiting game would begin. Heads would turn whenever OR personnel came out to talk to someone and fingers would cross as visitors hoped no terrible news was headed their way.
And so it was for Dustin. More than two hours had elapsed since Sean vanished into the bowels of the OR with more physician and nurse manpower hanging on to his stretcher than he had ever witnessed. He tried to rationalize the amount of time his colleague was gone. He was hopeful because staff was back there still trying to remedy his colleague’s condition as best as possible. On the other hand, perhaps the situation was taking so long because the damage done was too extensive and they kept running into more and more trouble with his case.
Dustin sat and crossed one foot over his knee and eyeballed the sole of his shoe. He swore, in the last few hours, he caused measurable wear to both of them by pacing back and forth. Even the tile floor had dirty rubber sole marks. After some time, a janitor came by, emptied the trash cans, and mopped the floor. He swished the wet mop a second time over Dustin’s footprints.
He went over to the fake plants and leaned against the wall, thinking how much Sean meant to him. His friendship rated high on his list, along with his mother, and as much as Annabel had meant to him. With consolation, he thought about Solar. At least at home he had someone to talk to. It might be viewed as crazy, he thought, but yes, his bird mattered.
But no one could replace Sean. And, obviously, no matter what, his buddy would not be fit for work for quite some time. A bullet to the chest could have damaged his lungs or ribs, or worse than that, his heart. But no one could survive a bullet straight into heart muscle and right into the “chambers.” The shots must not have pierced Sean’s heart.
Whether his colleague stayed in the hospital in the near future, or at home, he must carve out lots of time to go visit him. Hopefully, Sean’s wife would understand and be supportive of him sitting by his bedside a good deal of the time.
Dustin spotted him coming out, his demeanor unmistakable. The head trauma surgeon in charge of Sean’s team swung through the doors and lowered his mask like a flag being lowered to half mast. It was all he had to see to know the terminal fact, as the man in blue scrubs with clues of blood on them, approached Sean’s wife. He said little to her and she broke down with pitiful crying. Immediately, she was surrounded in a circle by loved ones.
Dustin’s heartbeat slowed in mourning. He fought to be brave and not shed a tear when the surgeon came over.
“I’m sorry,” the surgeon said. “We did everything we could. Sean was hit in the chest, the bullet grazing major blood vessels. Give my condolences to the police force.” He lingered appropriately, waiting if Dustin had any questions.
Dustin extended his arm for a handshake. “Thank you.”
The surgeon left while the family moved to the “family room,” where they would have more privacy. He sank into the cold chair and took out his iPhone. Right away, Annabel’s message popped back up. Her communication was the last thing he wanted to see as he called the captain and reported the bad news.
As he headed back to his car, and the short drive back to the station, the day’s events echoed in his head like an exploding bomb. He passed the coffee shop and wished he had never stopped there earlier. But “what ifs” served no purpose, like his captain said.
He hated to think this way, but Sean was also his main confidant, who stuck by him through thick and thin. His partner doled out personal advice better than his own mother who, after all, he couldn’t tell everything. They would have had another “Annabel” discussion today had it not been for the mad man’s shooting.
That was it. He would try and bury his relationship and his memories of Annabel along with his best friend. Physically, they would be gone, but emotionally … that would take some time.
CHAPTER 19
It was mid-afternoon and the pace in the office had not let up. Since Stephie Miller and her father had left, kids with colds and allergies and skin infections had come and gone. Annabel ran cold water into a Styrofoam cup and drank the whole thing. She had a view of the hallway where a nine year-old girl stood on the scale and the nurse wrote down her weight.
Dr. Gillespie stopped outside the door. “Aren’t you beautiful!” he exclaimed to the girl. The nurse walked ahead and George tapped the girl’s ponytail. The youngster smiled and mother and daughter followed his staff straight into a room.
George waddled through the hallway and examined the girl’s chart outside the door. “New patient,” he said to Annabel. “Let’s introduce ourselves to Mrs. Klondike and her daughter, Tabitha.” He sprang into the room before she acknowledged him.
Tabitha sat sideways on the exam table. A sketchpad the size of an iPad was in her hands and one hand was busy moving about a pencil.
“Wow,” said her mother, Margaret. “We used to wait in Tabitha’s old pediatrician’s office at least a half hour.”
Tabitha glanced up and paused doing her artwork.
“I’m sorry to hear that,” Dr. Gillespie said. “Tabitha is too special to wait for a doctor.” He diverted his attention to the young girl. “You are a stunning nine-year-old. Are you drawing something?”
“Nothing great.” She shrugged.
George put his finger on the sketchpad and lowered it. The picture was a work-in-progress of a country field with cattle and bales of hay. Trees dotted the background and the girl so far had a decent start on perspective and depth.
“Wow!” George proclaimed. “You are more talented than the famous French artist, Claude Monet. His work was what they called impressionistic, but yours is what nature really looks like.” He put his hand on the side of her hair and patted.
Tabitha had vivid amber eyes and rosy cheeks. She gave the new doctor a half-smile while her mother reached over for the pencil and pad and the girl passed them to her.
“Anyway, I’m Dr. Gillespie and this is one of the University medical students, Annabel Tilson. What brought you in today?” He looked at Tabitha more than Mrs. Klondike, but she launched into the reason for the visit.
“We just moved to the Cincinnati area from up north. The timing was terrible because Tabitha was diagnosed and treated for asthma one month ago in the middle of our move. Her pediatrician insisted on our establishing a new doctor as soon as we were able to. He said she needed testing and possibly chronic medications.”
“Did you bring any prior medical records with you?”
“No, but I gave your nurse his name and information so our old doctor could electronically send it.”
“Perfect. So Tabitha did not take a test called spirometry to evaluate her pulmonary function?”
“No, but they did take a chest X-ray.”
“They said my heart looked okay,” Tabitha chimed in.
“Excellent,” Dr. Gillespie said, “because you’ll need that heart someday to break some young man’s heart.”
Margaret furrowed her brow. “Don’t get ahead of things.”
George stuck to the rest of the history and physical, which Annabel could relate to because of her older sister’s history. Since Tabitha was having no symptoms, he decided to wait for the records and the results of spirometry to prescribe her anything in the interim. He wrote orders in the chart and on the electronic medical record and went back to staring at Tabitha.
“Like you, that picture you are in the process of drawing is exquisite. Would you mind very much if I snapped a picture of it with my iPhone?”
Amused, Tabitha grinned and grabbed the pad on the empty chair next to her mother. She opened it to her black and white sketch.
George took his phone
from his pocket and stepped close. He clicked a photo and touched her ponytail again. “Thank you so much. I will treasure this, a landscape from a beautiful girl up north, now a resident of Ohio.”
Annabel and George peeled out of the room first and when the Klondikes passed them in the hallway, George stood at the front desk. Annabel held her breath, expecting him to rub his oily hands on Tabitha’s hair again. But he didn’t. He seemed to be transferring information from her chart into his private cell phone.
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Annabel monitored the head count in the waiting room and Becky concurred what she thought. Gillespie’s last patient for the day was a no-show. She crossed her fingers that he’d let her go early and not make her sit in the side room twiddling her thumbs or studying.
“He’s in his office,” Becky said. “I’ll rap on the door and tell him the news.” She lowered her voice. “And put in a word to let you go home.”
She came back quickly. “You’re out of here.”
“I owe you.”
“Students are already in debt. Don’t promise something that will take you twenty years to pay back.”
Annabel gathered her things and wished she could say good-night to Stuart, but he was with Dr. Clark and they still had one more patient to be seen. She left and had driven her own car that morning so she had no Uber driver to call. After scrambling into her car, she texted Bob.
“Hey, how’s your day? After all our studying about meningitis, any results back yet on Toby?”
She rapped her fingers on her steering wheel and waited. She’d had Oliver since late Sunday when she and Bob parted, but she didn’t feel the urge to race home. It was earlier than her usual pediatric days.
“Results weren’t ready earlier in the day .. I can recheck soon. Day’s been half-crazy.”
“I’ll pop over. I’m out already. I want to ask your opinion about something. Maybe visit Toby?! I’ll walk Oliver right away after leaving the hospital.”
“Text me when you’re here. I shouldn’t be too late either.”
Annabel closed with a thumbs-up emoji and went about her way. Soon she strolled through the revolving doors and into the hospital lobby and re-texted him.
After a five-minute message silence, Bob spoke up behind her. “You should earn a double grade for taking part in a pediatric office and a hospital rotation at the same time.”
Annabel swung around. “Ha, I’ll need two clinical grades because Dr. Gillespie is probably not too impressed with me. It works both ways, however. I’m not enthralled by his bedside manner.”
“What now?” The students stepped aside from the entrance and took cover behind an artificial tree.
“Since you began your hospital rotation, did you see any of the residents give a rectal exam on a kid?”
Bob glanced down for a second. “Not that I recall.”
“Or use a magnifying glass to examine genitals?”
“Annabel, that sounds quirky.”
“I find it as peculiar to be a spectator watching these things as it probably was for the youth who suffered a finger up his butt.”
“I see your point.”
Annabel sighed. “Just remember, you’ll follow in my footsteps and end up in Gillespie’s office next week.”
“Based on your discomfort, I’m hoping I get to work with Dr. Clark. I have a fifty-fifty chance, since I’ll be with Nell next week.”
“Linnell’s been assigned with you?”
“Yeah, I thought you knew.”
Annabel stared blankly at him. “Maybe you could say something up front that you’d like to shadow Dr. Clark.”
“I could try. However, they may automatically pair us up as a male student to a male doctor and the female with the female, as biased as that sounds.”
“Could be. Dr. Gillespie may, however, prefer a female student with him.” She thought a moment and then shook her head. “But maybe it doesn’t matter what a student’s sex is who’s beside him. It would take a shrink to figure him out.”
“What does Stuart think?”
“He said we only have a few more days in Gillespie’s office. We can’t like every attending or his or her ways of doing things, each and every time. We’ll be out of there before we know it, meaning I should grin and bear his behavior.”
Bob nodded his head slowly. “Good advice, Annabel. There are bigger burdens on our shoulders and you still have not figured out what you’re going to write down on your residency application.” He thought ahead and took a chance with adding one more point. “Not only what type of medicine you want to practice the rest of your life, but also what city you want to train in.”
“That’s a no-brainer. At least I know that, or at least what my first choice would be no matter what I apply for. Because all their programs are excellent.”
Bob kept his excitement to find out subdued. “Oh … your hometown.”
“It’s been productive going to medical school somewhere other than Nashville and home, but for my training, that’s another story. I can only hope that I match at Vanderbilt.”
“Smart. I envy you.”
“No you don’t. Good friends can’t envy each other.”
“I mean I envy you because you had it figured out already.”
“It would be heartwarming to have family around again. Since you’ve met them, you can understand where I’m coming from. My mom and dad, and uncle and aunt, even my stupid sister, are important to me. During the transition, I can even stay at their house … my original grandparents’ house. The one you visited.”
Bob started to sadden, and it showed on his face. She’d be gone and back to a life filled on a daily basis with love and support. There would be no room for him, perhaps not even enough room for Dustin.
“I’m sorry,” she said. “I guess all of us in medical school will be going our own ways.” Her expression also turned forlorn. “In a way, it will be sad to graduate next year and to fully realize that med school was a stepping stone to more training.
“But what am I saying? Don’t you realize we have another major exam to pass before we proceed? I better stop thinking about Gillespie because we still need to take the Step 2 two-day test of the United States Medical Licensing Exam board or we’re not going ahead with anything.”
“Yes, that test will be our major obstacle to date.” He stared past her to the elevators, to the here and now and Toby Owens. “I’d better get to the lab on the top floor.”
“I’m coming with you.”
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Upstairs, a slender woman with a buttoned-up lab coat and round glasses walked to the end of the laboratory counter loaded with machines and faced Bob.
“When med students come up here, they’re waiting for something more important than usual, and results that are hot off my machine. Who are you inquiring about?”
Bob told her with an imploring voice, “Toby Owens. We did a lumbar puncture on him.”
“Ahh. Vital lab work. I’m happy to assist.” She traced back her steps and took but a second. “Just in time. Here you go.” She waved a sheet in the air before handing it over. “Your resident and attending are going to want to know about this one.”
Bob read without watching where he walked and Annabel opened the door. “Says here the normal white blood cell count in cerebrospinal fluid is zero or no more than five WBCs per cubic millimeter of CSF. Toby’s count is two hundred and eighty-two!”
Annabel gasped. “We suspected as much. He has meningitis.”
“Those disease-fighting white blood cells are needed because they’re fighting off whatever the hell bacteria it is. I’ll tell Rick Mares.”
Bob stopped outside the elevator and texted his chief resident. “Toby has a high white blood cell count in his spinal tap results.”
“Meningitis,” Rick responded. “If you see him before me, you can confirm that to him. I need to evaluate the whole report before you leave.”
“Annabel is here. We’ll tell him.”
&
nbsp; “Do you still want to see Toby?” Bob asked her.
“Sure. We can both assure him that he’s going to be fine.”
They rode the elevator down to the orthopedics floor and hurried straight to Room 532.
“It was smart thinking that Dr. Mares isolated Toby already,” Bob said. “There may be a risk of spreading whatever infectious disease he may have.” They squirted sanitizer on their hands from the bottle on the cart outside the door and rubbed their hands. Annabel cracked the door open and frowned.
“Toby’s mom is in there and another boy.”
Bob followed Annabel in and first said hello to Toby. “It’s nice to see your mom here as well as another visitor.”
Toby lay still; his neck didn’t budge, and his casted leg lay like a brick on the bed. He grimaced and grasped Bob’s hand, but it was a feeble attempt. The youth was both bored with his hospitalization and very tired from his illness. “You two coming in makes four visitors. Lucky me.”
“This is Toby’s friend Jonathon,” Anne Owens said.
The dark-haired youth continued sitting in the bedside chair, his large sneakers pointed in. “Hi. I go to school with Toby too.”
“Nice to meet you, Jonathon,” Bob said. “Bet you two play basketball together as well.”
“Not lately,” Jonathon lamented.
“Is it all right if I talk freely about Toby’s medical condition?” Bob asked. He walked to the other side of the bed and rested a hand on Toby’s shoulder.
Mrs. Owen stepped between the bed and Jonathon. “Sure. We are all aware that the doctors believe that Toby has meningitis. Do you have an update?”
“The results of his spinal tap do confirm that diagnosis.”
“It figures,” Toby said.
“Why does he have such a headache?” Jonathon wondered aloud.
“Simply put,” Bob said, “with meningitis, there’s an inflammation of the membranes in a person’s brain, which causes swelling. That’s what triggers the symptoms in a patient’s head and neck.”