by Barbara Ebel
“Pretty good. Can we buy them?”
“You betcha.”
Relief swept over him. He wasn’t fond of shopping and at least it didn’t take too long to find something he liked. Sitting back down, he switched shoes and peered at the price tag. Expensive enough, but nothing like the name brand sneakers. He rose, which caused his nausea to ramp up. Stagnant food in his GI tract churned upward instead of downward.
Mrs. Owens walked away, but not in the direction he wanted. She went further to the back of the store and disappeared around the corner. In slow pursuit, he followed to find her stepping into the women’s shoe section, where aisles were full of shoes of various heights, colors, and styles. His mother remained oblivious to him and intently stood in one spot looking high and low on the racks.
This would be purgatory, he thought. When she shopped, it was insane. She took forever and, plus, she could be damn picky. He glanced in the mirror as he headed past her. He had to admit that he looked pasty; even his freckles looked pale.
Toby kept walking to the bench to sit. He needed to be more comfortable to endure however long she would take. She was only two shoes further along in her quest than when he turned into the aisle, but she hesitated, holding one pair. With a nudge to a shoe she was wearing, it fell on the carpet, and she slipped on a low-heeled tan shoe.
He put his head lower towards his knees, but that didn’t suppress the bile-like acid taste in his mouth. Looking around, he figured the rest rooms were located in the back corner of the store, so he went around another aisle and barely made it to the men’s room. Without a soul inside, he flew to a stall and spewed forth his breakfast. His stomach felt like a washing machine spinning everything around and, after a second time, there was little left to heave up. He grabbed some toilet paper, wiped his mouth, and stood straight. Actually, now he felt a tad bit better. He headed to the sink and thought it over … whether or not to tell his mother. No sense in her making a big deal about it, he thought, so better not to say anything.
When he went back to the aisle, Mrs. Owens was at the end of the same aisle and she still didn’t have a pair that she liked. He sat next to his box of sneakers and waited it out.
-----
Annabel and Stuart peeled out of the pediatrician’s office at lunch time, grateful that they didn’t have to stay with their attendings for the next patients. Families had been heavy with questions during the morning visits and Dr. Gillespie and Dr. Clark were both behind.
“So how’d it go last night?” Stuart asked.
Annabel laughed to herself. He couldn’t be referring to her sex with Dustin, but that was what she thought of first.
“Dustin’s mom was really nice. I think we hit it off with no problems. And thanks to you, she enjoyed the blueberry cheesecake I bought her. Nice touch.” They stepped off a curb and she added, “You’re already a practiced psychologist, soon-to-be future psychiatrist.”
Stuart glanced up and nodded. “Glad to help.”
“So Bob survived his first night on pediatric call last night. They were pretty busy.”
“Is he getting any studying done?”
“Less than we are.”
“Did you have any interesting cases this morning?”
“Mostly well-baby checks,” she said, frowning. “But later today, a three-year-old and her father who came in yesterday should return with a twenty-four-hour urine sample. I don’t know what tree Dr. Gillespie is barking up with that one.”
“Our attendings both seem knowledgeable and dedicated.”
“I would have preferred working with Dr. Clark if I had a choice.”
“Why?”
“I don’t know. Maybe being in a room with a same sex doctor makes more sense for doing physical exams in such a private setting.”
“But all exams are ‘quote’ private, and that shouldn’t make a difference. Didn’t mean anything, even when we did our OB hospital rotation, and think how intimate that was.”
“Yeah, you’re right.”
They stopped in front of the restaurant and Stuart peered at the chalkboard on the sidewalk listing their lunch special. “What are you getting today?”
“Beats me. Let’s get back quick, though. I’d like to study.”
-----
At 4 p.m., the buzz of sick children coughing and sneezing and the clatter of toys from the kids in for school physicals was down to a quiet calm. Annabel was bent over a book while Dr. Gillespie was in his office talking to a family.
Becky came and hung out in the doorway. The bun in the back of her head was starting to unravel, so she un-speared a bobby pin and pierced it back through a clump of hair. “Mr. Miller is here from yesterday,” she said, “and Dr. Gillespie asked if you could go get the urine sample he should’ve brought in. It goes to the lab.”
“I’d be happy to.” Annabel left her study materials and went to the front desk, where Stuart was leaning against the exit counter. “Let’s go check out the toys,” she said and laughed.
The students entered the kids’ space. Legos were strewn on the carpet, a brown bear was face down, and a plastic doll was stuck in a dollhouse chimney. The children’s books in a wire rack were mostly stacked neatly in a row. Next to them, little Stephanie sat on a yellow plastic chair and her legs swung back and forth.
“Hi, Mr. Miller,” Annabel said and glanced at Stephie. “How are you today?”
“I’m okay. Daddy said I have to sit like a nice girl because we won’t be here long.”
“You are doing a fine job. This is my friend Stuart.”
“Hi, Stephie,” Stuart said. “You are wearing the prettiest shoes in here all day.”
Annabel turned to Mr. Miller. “Were you successful obtaining Stephanie’s urine for twenty-four hours?”
“My wife and I managed. Stephie’s cooperation was easier to get than getting her to clean up her toys every night. We told her it was for the doctor. He would test her pee, which might help him understand the bump in her belly.” He rolled his eyes at the mention of “pee.”
Mr. Miller’s muscular arms reached under his chair and he handed Annabel a bag with the container in it.
“Dr. Gillespie said we’ll see you and Stephie on Friday after all the test results are back.”
Mr. Miller rose. “Thanks, doc; see you then.”
Stephie and Stuart had a “Chester the Chesapeake” paperback from the book stand; she pointed to a picture of the dog wearing sun glasses and giggled.
“Do you have a dog at home?” Stuart asked.
“Our dog is old, but we love him.”
“He’s young at heart, I’m sure.”
“Bye,” Mr. Miller said as they left. Stephie looked back and waved.
Stuart held the door while Annabel carried the urine sample. “I was close to her,” Stuart said, “I couldn’t help but notice the pallor of her conjunctivae. Does that have anything to do with her sickness?”
“I don’t know. That and the lump in her belly. How do you tie those two signs and symptoms into one entity?”
“Or maybe they are two separate issues.”
“Precisely. Medicine is like an investigative police work field.”
“That explains it. There’s so much in common with that field of work, that’s why you get along with, and you’re dating, a police officer.”
CHAPTER 10
Toby sat on the front step of his house waiting for his friend Jonathon to show up with his mother. He admired the new sneakers his own mother had bought him earlier in the day. The urge to wear them had been too great and he had sprung them out of the box. That shopping excursion had cost him dearly, however, because his mother took no less than another hour to decide on not one pair of shoes for herself, but two. Then she dragged him to a coffee shop, where she lingered over a strong cup of caffeine. The smell of it practically made him puke again.
He didn’t want to do much, but when Jonathon called after dinner wanting him to go to the movies, and didn’t ask him
to go play basketball, he decided it was better than hanging out in his room. His mother, however, had warned, “You’re still having those muscle aches, so head home right after the show.”
Two SUVs went down his narrow dead-end street. Next, Jonathon’s mother came to a halt in a sedan wearing minor door damage. Toby pranced down the path past two Crepe Myrtles on either side and made sure to go around the back of the vehicle so he didn’t sit on the side of the previous accident. He didn’t trust the driving of his friend’s mother anyway.
Lucy Harmon and Jonathon greeted Toby as he settled in the back seat. She turned around in the cul-de-sac and focused again on the public radio discussion about a local political race.
“Nice sneakers,” Jonathon said. “When did you get them?”
“Today.” Toby rolled his eyes. “A shopping excursion,” he said softly.
“Still, you got something to show for it.”
Toby nodded. “I don’t feel like going this week, but I’ll have to try them out on the basketball court.”
“What do you mean? You don’t want to play this whole week?”
“Don’t tell my mom, but I threw up today. And my mom and dad didn’t see it before, but I scraped most of my dinner into the trash. After all, it’d be better to sit through a superhero movie tonight than have them confine me to my room.”
“I hear ya. I won’t say anything. I’ll eat popcorn for both of us.”
Toby stuck out his tongue with disgust and Jonathon giggled.
Lucy Harmon pulled into the multi-screen cinema complex and followed a line of cars with drivers looking for the best parking spaces. She glanced into the back mirror as she headed towards the front doors to let the boys out. “I’ll be back outside here at nine thirty sharp to pick you both up …”
The sound of loud pop music grew louder and drowned out Mrs. Harmon’s words as a four-by-four vehicle raced from the side street into the front lane of the entrance to the theatre. A loud metallic sound ensued as the Harmon’s sedan careened from the impact of the high-set vehicle. As movie-goers jumped out of the way, their vehicle pitched and vibrated until it came to a stop halfway up the curb.
As the side of her car still seemed to moan, Lucy Harmon caught her breath and recovered from the surprise and shock of what happened. She realized she was probably not injured and immediately turned around to the boys.
Toby still had his right foot up on the console, where he’d been showing off his sneakers to Jonathon. But the crush to the right side of the car had shoved the front passenger seat. Toby held his leg, his face grimacing with pain. Her own son held his eyes wide open, and with a squeaky voice, said, “Mom?”
“You okay?” she asked.
“I think.”
They both looked at Toby, knowing his leg was not unscathed.
-----
The entrance of the movie theatre became an accident scene as two officers wrote up a report. Two EMS personnel deposited Toby on a stretcher and loaded him in the back of their ambulance.
“The cause of the accident is a twofer,” one cop said to the other while putting his pen back on the clipboard. “Between that driver’s reckless speeding in a crawl zone and that lady’s lack of attention, we got ourselves real live action outside the theatre instead of on the broad screen.”
They silenced as Mrs. Harmon walked over to say one last thing. “I called Toby’s parents and they’ll go straight to the ER, and a tow truck driver said it’ll be twenty minutes before someone gets here.”
“Another one is on the way for the other vehicle,” the clipboard officer said. “Do either of you want to hop into that ambulance and get checked out in the ER?”
“We’re good.” Lucy walked over to the ambulance with Jonathon and said good-bye to Toby.
-----
Toby had never been in an ambulance or an accident before, nor had he ever broken a bone. He guessed he was lucky to make it to eleven years without any significant medical problems. All these years, all his mother or father did was to bring him to Dr. Gillespie’s for physicals and stupid stuff like a sore throat or spring allergies. Now it seemed like bad luck was crushing on top of his whole life. In one day, some kind of GI bug was making him sick and his leg just took the brunt of an accident and it screamed out in pain.
With the beginning of sixth grade imminent, he couldn’t bear to consider what this all meant. He stared with a blank expression while a paramedic took his vital signs and the other one started the vehicle and pulled away from the scene. He disliked the bright lights inside, which spotlighted the medic as he began putting an IV in his forearm. After a substantial gulp, he held his breath as the catheter slid in.
The paramedic asked him more questions about his health history and made a big deal whether he was allergic to any medications. Soon the ambulance stopped and the two men wheeled him out and into more bright lights. Faces peered down at him as the stretcher stopped in a curtained cubicle.
The drapes flung open and Anne Owens burst in. She ripped her glasses off, rubbed tears away, and then stuck her glasses back on. “Oh my God!” she exclaimed. Toby’s father, Jack Owens, ended up at the end of the stretcher while personnel hooked Toby up to monitors.
Toby’s heart pounded in his chest with all the commotion. He heard the paramedics tell the doctors what happened and then his mother echoed his health history all over again. Someone stuck a needle into the IV port, and a few seconds later, the pain in his leg eased away like a calm after a storm. Next thing he knew, he was in a different, dark room, where an X-ray tech manipulated him on a table to snap the leg images that a doctor ordered.
Toby dozed off and woke in another quiet room near a large machine. “Toby, go back to sleep,” a young woman said. “We’re going to give you a ride into the CT scanner.”
-----
An orderly wheeled Toby back into his cubicle and Mr. and Mrs. Owens jumped out of their seats. A middle-aged man wearing a surgical hat and white coat followed close behind. “In all the commotion before, I’m not sure if I properly introduced myself. I’m Dr. Castle, the orthopedic surgeon on call tonight.”
With enthusiasm for his job, he pushed the X-ray he carried up on the view box. “With Toby’s accident, and pain, tenderness, and bruising in that right leg,” he said, “you both have probably assumed correctly that your son has suffered a broken leg.” He pointed to the film. “His fibula, which is the outer, smaller bone of the lower leg, has a shaft fracture - a break right in the middle of the leg.”
As her pupils dilated, Anne Owens rushed her hand up to her mouth. Toby vaguely listened but grasped the important points and formulated questions. No more basketball and would he be able to walk? What about school?
“Your son is very lucky that the larger bone next to it, the tibia, is not broken and that he does not have an open fracture.” He glanced at both adults.
Jack Owens grimaced at the film. “Can you fix his break?”
“Yes, with a closed reduction. I can set the bone without surgery so that it will grow back together. However, the procedure is painful and I don’t want to expose him to that, especially at his age. Better for all concerned if we take him to the OR for IV sedation or a general anesthetic. The anesthesiologists are experts at taking care of airways and sedation while I do my job.”
Anne and Jack glanced at each other and nodded. “Whatever’s best for our son,” Anne said.
“Then I’ll put him on the OR schedule. After a bone breaks, it is best to realign the ends as soon as possible, which will also lower the risk of infection in the bone.” He nodded with encouragement. “We’re admitting him to a room. It may be a few hours, so you all may be more comfortable waiting upstairs. After surgery, he’ll go back to the same room until I decide about discharging him.”
-----
Thursday morning, Bob Palmer strolled into his pediatric hospital team’s office in fine spirits. After a day of rest after call, more studying under his belt, and time with Oliver, he wa
s energized for a new day.
Linnell and his chief resident, Rick Mares, were slipping into their white jackets. Rick was an effective team leader and teacher and overly zealous about tackling his last year in residency. He had a pinched nose and a small chin and his long strides in the pediatric hallways were difficult to keep up with. He put his index finger on a piece of paper on the table and glanced at both students.
“We’ve been asked to do a consult this morning. Why don’t one of you get started with it and report back to me while I start rounds with the other students?”
Bob guessed Nell would deliberately pretend to be thinking about it; she was skilled at deflecting work when she wanted.
“I’ll do it,” he said.
Rick handed him the piece of paper. “Patient’s name is Toby Owens and he’s eleven years old. Consult says he was in a car accident last evening and suffered a broken fibula. Dr. Castle did a closed reduction under anesthesia in the middle of the night and the kid just got back to his room an hour or two ago.”
“So why does the ortho team want pediatrics involved?”
“Apparently, the kid already had a fever in the OR. Dr. Castle is being cautious and not sending him home today. There’s always a chance for infection in a bone break and he would rather have us overseeing any medical concerns.”
Bob stuck the paper in his pocket. “I’ll go see him and talk to the family if they’re there.”
“The basics, Bob. An H&P and anything pertinent.”
Bob slipped through the office door while Nell pretended to be studying the team’s list of patients on the board. He left the pediatric floor and headed to the orthopedic wing, where there were no cartoon character pictures hanging in the hallways and no rooms designated for play therapy.
At the nurses’ station, he stood aside and went through Toby’s chart, which was up-to-date with his admission information and the surgeon’s operative procedure note. He strolled into Room 532 where the youth was semi-inclined in the bed and focused on the drip, drip, drip of the IV fluids hanging from the nearby pole.