Steve smiled to himself and felt a sense of comfort as he felt right at home. How he missed all the abuse and condescending remarks of a surgery resident’s life. He chuckled as the staff surgeon hadn’t even started harassing the poor resident. Yes, Erica could round up spies and fight bad guys, but surgery training was a whole different arena for battle.
“Carmichael, where the hell is your mind at this morning? You already said your hellos, but your stardom is over now, so let’s get back to reality if you can handle it. Can you please give us your full, undivided attention, kind sir?” shouted Sally.
Steve acknowledged passively with a head tilt that she sure had filled the shoes of Jake as chief resident. Rounds continued with the same energy and disrespect for the junior residents as they started. From patient to patient, order to order, and demand to demand, Sally kept the rounds moving with great swiftness toward the OR, which was waiting with her first operative case.
At the end of rounds, the chief resident would delegate the work to be done for the day. After the last patient was seen, Dr. Jensen motioned the team to surround her so she could give everyone their tasks for the day while she was in surgery. Everyone was taking notes as she rattled off the chore list. “And Dr. Carmichael, would you please stay focused today and try not to let all the celebrity shit steer you away from your priorities? Please go and see a Mr. Torklewood in room 320. He came in to the ER about an hour ago, and I told them to admit him to the floor for us to evaluate him. He came in with lower abdominal pain, so Steve, please do a full consult on him. Thanks.” She continued down the list, spreading duties amongst everyone staying out of the operating room that day. Steve knew he wouldn’t be invited to go to the OR for a while until he had earned his way back in.
After rounds and duty delegation, Sally took off to surgery, and the rest of the team went to the cafeteria for a cup of coffee and a quick breakfast. Steve debated just going to the consult or sitting with everyone on the team to bullshit for a while. He knew if he went to the cafeteria that he would be there for at least an hour with people asking about the last few weeks, the drama and the adventure, and he would never get out of there. Then he would see someone else and have to repeat the entire story all over again. He decided to bag the idea of breakfast and told his team that he’d just catch up with them at lunch. They quickly reviewed what needed to get done and went over a few labs, and then Steve was off to room 320.
The walk to Mr. Torklewood’s room was much like the entire morning: people saying hi, giving him high-fives and knuckles, wishing him well, and expressing joy that he was back at work and out of harms’ way. He would have spent more time chatting with people and answering their questions with dramatic details of the last few weeks, but then Sally’s comments rang in his ears about being a celebrity and not getting the work done. Plus, there was this uncomfortable man who needed to be evaluated for abdominal pain, lying in his hospital bed, waiting for Steve to determine if he needed pain control and surgery. With that in mind, Steve continued on his way to the patient’s room without pausing for any further
interviews along the way.
Mr. Torklewood was a pleasant, plump gentleman who appeared to be in his fifties. He had a distraught look on his face as Steve walked into the doorway of his room.
The doctor knocked on the doorframe. “Good morning, Mr. Torklewood. Dr. Carmichael here. I hear you have been having a little belly pain.”
As the man grabbed his lower abdomen and rolled toward Steve, he said, “Yeah, I had a pretty rough night. Never had pain like this before, doc. Went to bed feeling fine and then a few hours afterwards woke up with this excruciating pain in my gut.” He pointed to his lower abdomen to show Steve exactly where the pain was located.
Dr. Carmichael asked all the appropriate questions: length of time, duration, recurrent episodes, description of the pain, and so on. The pain was localized in the left lower quadrant after watching a football game a few days ago with some friends eating a lot of junk food and popcorn. While Steve was listening intently to the answers, he thought it sounded like a case of diverticulitis. Nonetheless, Steve let him finish his story and then asked more questions centered on his surgical history and medical issues. Then Steve took out his stethoscope from his lab coat to conduct his physical exam. He continued like he had never left the hospital. He started with the patient’s neck and continued to his heart and lungs and then the belly. There was exquisite tenderness in the left lower quadrant, and Steve was sure to be gentler to this area. As with all abdominal pain, especially lower abdominal pain, a rectal was warranted. No student, resident, or physician looked forward to this part of the exam, but it was not only required, it could also help pinpoint the reason for the pain and help with the diagnosis to determine need for surgery versus medical management.
Steve looked around the room in search for gloves. He found the box in the corner and began to explain to Mr. Torklewood what would happen next as he crossed the room. “Sir, I am going to have do a quick rectal exam on you just to make sure everything is ok down there in your rectum. It will just take a few seconds. You will feel a little pressure for a short bit and then it will be done.” Steve knew the pressure was quite an understatement because he and his fellow classmates in medical school had practiced that exam on each other. That was not the highlight of school.
Steve motioned for the gentleman to roll onto his side and then reached inside the bedside stand to grab a bottle of lube. The room became instantly quiet as Steve said, “Okay, Mr. Torklewood, there will be a slight pressure here in your bottom.” While Steve was conducting the rectal exam, Mr. Torklewood was very patient and cooperative.
As Steve made the finger sweep across the man’s prostate gland, he froze. Steve didn’t move, Mr. Torklewood didn’t move, and for the patient the pressure was becoming a bit uncomfortable.
“Hey, doc! Are we okay back there?” asked the patient.
But Steve was frozen, his eyes wide open and he could feel his heart race along as if it were busting out from his chest. Another fifteen seconds went by with absolutely no change on Steve’s part.
“Hey doc, are you okay?”
Steve quickly but gently removed his finger. His eyes were
fixed on the corner of the room. Nothing was there, but Steve was lost in extreme thought. He methodically took off his gloves, not even looking at his hands. His eyes were still focused on the corner of the room in a blank stare. He slowly walked backward from the patient’s bed.
Again, the man asked Steve if everything was okay.
Steve responded, “Huh? Sure, uh, sure. Everything is okay, Mr. Torklewood. I need to leave for just a moment. But don’t worry, sir. There was nothing wrong with your bottom. I think you have diverticulitis, but I will be back in a minute.” Steve quickly turned around and ran out the door toward the nurse’s station.
Steve ignored two residents who tried to say hello to him in the hall. He ran to the nurses’ station with fear written across his face. He frantically grabbed one of the phones on the desk and began dialing Erica’s office phone number. Sweat droplets formed on his forehead as if he were working out. He felt impatient when the phone was not answered immediately. After four or five rings, Steve finally heard a voice, but it was not a woman’s voice and definitely not Erica’s.
“Hello?”
“Where is Erica? This is Carmichael,” Steve demanded.
“I am sorry, but Erica stepped away from her desk. I can send you to her voicemail if that would be okay for you?”
“NO!” exclaimed Steve. “I need to speak with her immediately! Have her paged! I need to speak to her urgently! This is Dr. Carmichael, Steve Carmichael.” Steve could sense that person on the other side felt uncomfortable with his tone in his voice, so he quickly regrouped and tried again. “I am sorry, but I really need to speak to Agent Erica Miller now. I have some vital information that may affect national security if I don’t speak with her. NOW!” Steve raised his voice because he
heard what he was saying and it actually scared him.
After what seemed to be eternity, Erica got on the line. “Steve! What’s wrong?” Her voice sounded anxious. “What is the big deal? Why are you being so rude on the phone?”
“Erica, do you still have Thomas in custody?”
“Yes, Steve, but I am afraid they are just getting the paper work together for his release. We found nothing at his apartment, office, or car. There is nothing there. We looked everywhere, Steve, but we need to let him go.”
“Don’t let him go, Erica!” Steve yelled frantically. “He has it. Don’t let him out yet. You all couldn’t find it at his apartment, office, or car because he has it, Erica!”
“That’s impossible, Steve! They strip search each person who enters the jail. Then they go through all his belongings, shoes, underwear, belt, everything!”
Steve asked, “How much time do you have before he is released?”
“About ten minutes, I think.”
“Erica, he has that chip on him. Actually, it’s in him! He doesn’t have a prostate, Erica. He had prostate cancer. He told me they removed his prostate with surgery. He doesn’t have a damn prostate!”
“So who really cares, Steve?” Erica responded with annoyance. “A lot of men have their prostates out, Steve.
What’s the big deal?”
“Erica, the man had porn DVDs and a dildo at his bedside. The dildo was opened and freshly used. It was gross and disgusting, but the point is that he doesn’t have a reason to use it for pleasure. What do they do when they strip search him? I mean, how do they examine his butt?”
“They do a finger exam.”
“Right! He used the dildo to push the chip up his bottom way out of reach from any digital exam. No one would be able to feel that! And then he would just hold going the bathroom for a few days. And after he was released, he would be able to expel it! Erica, order an x-ray now! I will guarantee that you will see it on x-ray!”
“Steve, that is the most absurd, gross thought one could ever imagine! That is disgusting!”
“Erica, just do it!”
“Fine, Carmichael. I will do it, but this is totally against my principles. I have never heard of such-”
Steve interrupted, “I know it’s farfetched, and that’s why he did it. No one in their right mind would ever come up with such a disgusting idea, but that would explain why you couldn’t find the chip! Let me know what you find.”
Steve hung up the phone. His forehead was very sweaty, and his underarms were dripping wet. He looked up for the first time since he had gotten on the phone and didn’t even think about where he was having this most unusual conversation. The nurses, residents, and a few visitors were standing with their eyes and mouths wide open at the nurse’s station. Steve awkwardly smiled at them and pulled himself up from the chair to return to Mr. Torklewood’s room. As he was walking, he took a slight glance over his left shoulder to look back at the nurse’s station. The eyes were still wide, and the mouths had yet to shut.
Steve could only smile to himself. That conversation to an outsider must have been quite impressive, since even Erica couldn’t believe it. They must have had a difficult time following his end of the conversation. He quickly picked up his pace and went back into room 320.
Poor Mr. Torklewood had a few questions.
Steve, as if a huge weight had been lifted from his chest, sat on the bedside and began explaining the concerns that the doctor had for his patient and his probable diverticulitis. He explained the need for a CT and probable antibiotics for the infection and that surgery would be less likely to be needed at this point.
As he was discussing the information with the patient, Steve was paged overhead. He didn’t rush to get the page; Mr. Torklewood had a few more questions, and it was Steve’s job to make him feel more comfortable about his condition and the plan. Besides, he knew it was Erica, and he knew he was right.
After a few more minutes with the patient, Steve stepped up and off the bed, “Any more questions or concerns, Mr. Torklewood? Otherwise I am going to answer this page, and I will be back in a few hours to see how you are doing.”
The man nodded in agreement, and Steve was on his way back to the nurse’s station.
Just as he approached with all the eyes on him, he heard the page for a second time. “Dr. Carmichael, Dr. Steve Carmichael, please call star seven seven for an outside call.”
He sat down at the station, his pulse racing. He picked up the phone and dialed star seven seven. “Hello?”
“Steve?” asked Erica.
“Yes.”
“My boss wants you to come in to the local office downtown whenever you have a few minutes. He wants you to work for us, maybe as a consultant. You are amazing! You were right-on with your absurd idea, and only you could have come up with that!” she exclaimed.
Steve smiled. “And you didn’t believe me for a second!”
“I tried to, but it was a little out there for me. I am sorry I doubted you. When can we go out and celebrate? We need to plan our second date. I am ready when you are, Dr. Carmichael.”
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