Small Town Doctor

by Robert James Allison

  Doc perched his glasses on the end of his nose, deftly scanned the chart, and flipped through the lab results.

  “Looks good to me,” he said absently and continued, “this Nelles seems to know his business, but I would appreciate it if you could have your supervisor contact him at home or wherever and get his authorization to stop the sedative. I’ll sleep just fine without it.

  “I would like some solid food and I note that the chart allows that, as soon as I ask and I’m asking. Please. I’m starved,” he finished and handed the chart back to the nurse with a smile and very polite. “Thank you very much.”

  The nurse took the chart back and with half a smile said, “I’ll see what I can do about both.” She was pleasantly surprised to find that this doctor seemed to be readily accepting his treatment. Most doctors made the very worst patients, she had heard. This was the first time she had ever really nursed a doctor and his cooperative attitude was a surprise.

  ~*~

  The nurse walked quickly from the room with the chart and headed for the supervisor’s desk. Ten minutes later she was back disconnecting the IV with the sedative and then she disconnected the other IV that was feeding him nutrients with a saline solution. Now that he was asking for solid food, the nutrients were no longer going to be needed. “Okay, Doctor. Your food is on the way and I’ll bring it in when it gets here.” She tossed over her shoulder as stepped out the door.

  Hospital kitchens never totally shut down, so even though it was late at night, Doc was soon enjoying a passable ham sandwich and glass of cold tea. Hospital food was good for you, he knew, which was why it always tasted so bland. Right now, he would have rather had an unhealthy hamburger, but this was certainly better than the needle.

  He decided that in the future, should the situation arise, he would be more sympathetic to his patient’s complaints about hospital stays. With that decision made, he quickly finished off his sandwich.

  Eating the sandwich made him realize how hungry he was and the accompanying salad disappeared seconds after the sandwich. Finishing off his tea with the same speed, he placed the glass on his bed stand, pushed the tray back from his bed and settled down to a deep restful sleep, just as he had promised the nurse he would.

  At 6:00 a.m. he was awakened gently by the sunlight filtering through the curtains in his room. Shortly, the day nurse came in and dawdled over him, taking his temperature, straightening his covers and in general, making a nuisance of herself. Breakfast arrived shortly after the nurse left and it didn’t take him long to eat it.

  Not long after breakfast, a tall man of medium build with a thin dark moustache came strolling into the room and said, “Good morning, Doctor Collins, I’m Doctor Nelles. How are you feeling this morning?”

  “Much better thank you. Pretty bad break on that leg wasn’t it?”

  “I’ve seen worse, but not for a while. You lost a lot of blood and we had to take some time to stabilize you before we could operate. You have two permanent pins and one permanent screw in that leg now. You’ll know when it is going to rain before the weatherman,” the doctor said lightly and continued, “it’s a pleasure to talk to a patient who understands exactly what I’m saying without explanations.”

  “Doctor at my age I already know when it is going to rain before the weatherman. My joints aren’t what they used to be.”

  “Please, call me Fred.”

  “Okay, Fred, my first name is Bill.”

  “Nice to meet you, Bill.” Fred said and stuck out his hand.

  “A pleasure to make your acquaintance, Fred,” Doc said with a smile as they shook hands. “Now, tell me how the little girl is that I came in with.”

  “She will be just fine. You did a ‘Four-O’ job on her. You definitely saved her life. That blood transfusion was just what she needed. The ambulance drivers told us all about it. In fact, the donor rode along with them and gave another pint of blood before they made him stop for fear it would weaken him too much.”

  “But I….” he started to respond that Jesse had saved her life, but then stopped. He was remembering his promise to him not to reveal who he was or that he was a doctor. But why did they think I was the treating doctor anyway? He wondered. There were four people in that room who saw Jesse do the doctoring. They also saw that I was unable to move off of the couch. Better keep my mouth shut until I know what is going on, he decided.

  “I know.” Nelles said, holding up his hand in a staying motion, and continued, “you were just doing what you were trained to do and it was second nature, but I’m telling you I’ve never heard of a better job of doctoring under the circumstances. Anyway she is going to be just fine. She had a very serious concussion and a nasty cut on the left temple, but there was no neurological damage, so far as we can tell. The CAT scan was negative so I expect a full recovery. She will probably get out of here before you.”

  “You figure about two weeks on me, don’t you?”

  “Just about right, Bill. If you are lucky and the leg heals properly so that we don’t have to re-break it and set it again. That isn’t likely, but frankly at your age the bones don’t heal like they should. You know that as well as I do. An infection from the wound concerns me more than that though. So, as you will notice from your chart, which the nurse tells me you check quite regularly,” he said with a broad smile and continued, “you will be on an antibiotic for your stay here and probably a couple of weeks after that.”

  “I approve,” Doc stated with a feigned seriousness.

  “Nothing is too good for the local hero,” Nelles replied and continued, “you know, of course, that all the nurses on this floor drew straws to see who would get to attend to you. We don’t get too many heroes around here. Now I’ll leave so that you can get some rest.”

  “One more thing before you leave, Doctor Nelles. Who described all of these heroics for you and the nurses?”

  “Why, the mother and father and the blood donor.”

  “Did they happen to mention anyone named Dan or a man with a beard?”

  “The family didn’t, but the ambulance drivers noticed a bum with long hair and a beard over in the far corner of the room. Said he looked scared to death and was white as a sheet. Must have been the sight of all the blood, I guess. Some people just can’t take that. Why do you ask?”

  “Oh, no particular reason. It’s just that I noticed him once fleetingly and was curious as to who he was.”

  “No one seemed to know who he was and the family said they didn’t even notice him.”

  “Thanks again, Fred.”

  “Anytime, Bill. I’ll look in on you again tomorrow,” he finished, as he turned for the door.

  ~*~

  It was the middle of December before Doc got out of the hospital and then he could barely get around on his walking cast and crutches. A cab was the only form of public transportation he could take back to his Bed and Breakfast and it was a real effort to get in it, let alone ride the five hours back to town.

  When the cab dropped him off he was met by several of the town’s people who helped him into the Bed and Breakfast. Jim Shrock had moved his things downstairs to a front bedroom so he would not have to try to negotiate the stairs. Just the few up to the Bed and Breakfast and into the front room was enough to wear him completely out, but the town’s people lingered, treating him as if he were the returning conquering hero. He was very uncomfortable at being treated like a hero when he knew he hadn’t done a thing. But he couldn’t let on that he hadn’t been the hero, because to do so would break his promise to Jesse.

  Jesse, he thought, I wonder if he stayed around or if he has fled to yet another dismal shack in some other nameless town where he can again be just the local bum? Avoiding always his past, lest it catch up with him and cause him more untold misery and revive memories he has tried so hard to bury with the little girl in Massachusetts?

  Finally, the town’s people left him to his bed and rest. Every one of them though, vowed to do whatever they could for
him, if he but just ask. He thanked them all for their kindness and made as though what had been done was all in a day’s work and nothing to make a big scene over. That seemed to have the opposite effect and he decided to say as little as possible about the event from then on.

  ~*~

  The next morning he clumped out of his room and down the front steps heading for the park bench at the four-way stop. What was just a pleasant stroll not three weeks ago was a long and agonizing journey this morning. The air was quite cold at this elevation, but he only knew that he had to try to see if Jesse was still in town.

  From the bench he could see that the shack was still up, but there was no sign of life and no sign that anyone had been near it for days or even weeks. He sat on the bench, braving the cold, gazing about the town hoping to catch a glimpse of Jesse. In his present condition it was impossible to walk around the town. Many of the town’s people stopped and lingered though as he sat on the bench.

  ~*~

  Day after day, he trudged down to the bench seeking some sign of Jesse, but none was to be found. He quizzed each person who stopped to greet him about Dirty Dan and his shack, but no one had seen him and no one had looked for him. After all, Dirty Dan was just the local bum. Who cared where he was or what he was doing?

  Two days before Christmas he was still at his post on the bench. His leg was much better now and he had discarded his crutches. He was still in a cast, but it was a walking cast and he had definitely decided to start walking. Walking was still not easy, but it was much easier than before and he was confident that in a week or two he could have the cast removed, and then probably walk fairly well with a cane.

  As he was thinking of getting the cast off, a voice from behind him said, “Well, I see you are still kicking, Doc, but not too high. You ought to know better than to spend so much time out in the cold in your condition.”

  Mike Maltby! He thought, as his head spun around and he saw Mike standing behind and off to his side. He had completely forgotten about Mike. “Michael! Where in the world have you been?” he exclaimed.

  “Might ask you the same thing, Doc, except that I know the answer. I asked you to come out here and I’m sorry it caused you so much pain and trouble,” Mike said, with a tinge of sadness in his voice.

  “It’s okay, Mike. Not your fault I can’t run up a flight of stairs in the middle of the night anymore. I came of my own free will.”

  “Yes, but at my urging. Had I known this was going to happen I would have found someone else.”

  “Who?”

  “You got me there, but still, I feel responsible.”

  “Well, it would have been worth it if it had worked.”

  “Doctor Blockman is gone then?” Mike asked.

  “I guess so. At least, no one has seen him and I can’t look for him. I haven’t been able to up to now anyway, but now I might be able to look around a little. Doubt it will do much good though,” he finished with sadness.

  “You probably don’t need this stuff then,” Mike stated as he handed him a big manila envelope, which Doc somehow knew contained about everything that could be found on Jesse Blockman.

  He took the envelope and said, “Won’t hurt to have a look, but why wait so long to give it to me?”

  “Those records weren’t easy to get and I had to go pick them up in person, Doc. Eyes only stuff there. You as much as said so yourself. Plus, the sources I used to get that information don’t want to be known and they want it back as soon as possible.”

  “What sources, Mike?”

  “Can’t say and I don’t think you want to know anyway,” Mike answered flatly.

  “Oh, I see. I guess,” Doc responded as he hefted the envelope.

  “Did you look at the file, Mike?”

  “Yes and I have to say that from what I can understand it looks like just what it is supposed to. Doctor. Blockman dropped the ball and a little girl died.”

  Doc responded, “That’s what he says happened and from what I saw last month he knows what he is doing when it comes to medicine. My biggest problem right now is that this whole town is still treating me like a hero and I can’t tell them the truth without hurting Jesse. Even if he is gone from this town, he isn’t gone from the world, as much as he would like to be. He’s punished himself more than any court or family member ever could.”

  Mike walked around the bench and took a seat next to Doc saying, “We all pay for our mistakes, Doc. One way or another, but when you doctors make a mistake, others pay, too. That’s the problem with being a professional. People rely on you so heavily.”

  “I know. Every prescription and every diagnosis is a judgment call and doctors carry that burden around all of their lives. Some carry it better than others, but we all carry it. Those that can’t, drop out, but this man isn’t a dropout and from what I saw last month I don’t believe he is a bad doctor. I don’t believe he has ever made a bad call.”

  “Now, Doc. You should know as well as I that the world is not black and white. A doctor who makes a mistake is not necessarily a bad doctor. Doctor Blockman could have been one of the best, but he made a fatal mistake. That doesn’t make him bad, just human and he’ll pay for that humanity the rest of his life.”

  While Mike was talking Doc was starting to leaf through the documents. Then he said, “These court documents are originals.”

  “Yeah, my sources figured the originals are always the best. Copies tend to hide things and they are used to looking for hidden things,” Mike answered frankly.

  “But the medical charts on the little girl are copies. How come?” Doc queried.

  “The originals were lost so the judge allowed the copies into evidence under what they call the ‘best evidence rule’ according to the transcripts. That’s Greek to me.”

  “How in the world could the originals have been lost, Mike? Hospital charts are closely guarded. Especially, if an error is suspected. The medical review board goes over them with a fine-toothed comb. They must have put the originals somewhere.”

  “The medical review board only had copies, too, Doc. The originals apparently were misplaced shortly after the girl died.”

  Doc was adamant now, “That doesn’t wash. No hospital is that careless and these copies aren’t even very good. Look here, there is a smudge right where the dosage of medicine that Doctor Blockman ordered is noted….”

  Mike looked at the sheet and then at Doc whose face was actually turning white. “What’s the matter? You feel okay?” Mike asked with concern for his friend. Perhaps his only friend.

  “That smudge there. Look at it real close.”

  “Okay, so what? I saw it earlier. It’s a little hard to read, but it is an ‘8’.”

  “Yes, it’s an ‘8’ now, but what was it before?”

  Mike was confused now. “What do you mean before? Before what?”

  “Before it was erased or whited out and the number written over. Medical notations on hospital charts are never erased or whited out. We always draw though the incorrect entry and write a new entry on the next line. Even the new all-digital charts aren’t written over, the old entry is lined with red and the new entry follows. Nothing is ever deleted or written over. Any first-year medical student knows that, but why didn’t someone notice this at the trial?”

  “Those aren’t the copies used at trial, Doc.”

  “But you said these were from the court file,” Doc shot back.

  “Not the medical records. The hospital asked for them back since they were all they had and the court allowed it. They were copied again for storage in the court file. These are those copies. They are actually copied twice from the originals.

  “Now, I know something about copy machines and for some reason if you copy something twice, it will sometimes show up better than the first time. Sometimes a correction will bleed through. Something to do with the contrast being different on the second copy and plus these copies were undoubtedly made with a different machine.

  “Copy m
achines vary in quality. One will bring out minor flaws in originals and others will not. Probably the erasure, or whatever you think happened there, was not visible on the first copy, but a second, higher resolution copier, brought it out, or at least enough to make it look blurry. We could find out for sure if we looked at the copies the hospital has. It could be that the blur is there, too, but in the heat of the trial and preparation for trial it wasn’t noticed.

  “Plus, you have to remember that Doctor Blockman was already convinced that the girl’s death was his fault. The notation was probably not looked at that closely. The court was more interested in Blockman’s state of mind than in the note that he admitted to having made. He did admit it at trial, too. Just read the transcript of his testimony.”

  “Mike, can your sources get a look at those other copies? Can they do some lab work on them to see if the blur is more than just a blur?”

  “I suppose, but what are you thinking?”

  “Something smells here, Mike. Hospital records don’t disappear like that without a good reason. Might not hurt to check on the nurse who administered the medication per Doctor Blockman’s instructions. Who was she and who did she know on the staff, if anyone?

  “I tell you, Mike, I don’t like the smell of this. I’ve spent too many years around hospitals and hospital staff. They have strict rules about keeping records and making records. Maybe I’m just being wishful, but something here doesn’t feel right. Can you have some more checking done? Discretely, of course.”

  “Doc these people are nothing but discreet. They have to be. Their lives depend on it. I’ll see what I can do. Do you need these records anymore? If not, I’ll take them back and make some more requests.”

  “No, I’ve seen enough. The more I think about it the more I think something is not right here.”

  “Okay, I got to run. Got a flight out in five hours and the drive is three and a half to four on that serpentine road,” he said lightly, as he gathered up the envelope and headed for a car which he had rented for use in ferrying these documents. “See you, Doc. Don’t sit out here too long.”