Stress Test (32 page)

Matt made a palms down gesture. “No, just gathering information to help me decide what kind of antibiotic would work best.” He glanced down at the ER record. “She’s not allergic to any medicine?”

The mother tossed her head and blew to reposition a strand of hair, apparently no longer willing to take even one hand off her crying child. “She’s never had much. She has had all her shots, though.”

Matt looked at the birth date and did a rapid calculation. The child would be almost two years of age. “But no shots recently?”

“No. Is that wrong?”

“Not at all. But I need to make sure there’s nothing else that might contribute to the fever.” He unclipped a pen from his pocket and wrote on the ER form. “I’m going to start her on an antibiotic. She should get better within a day or two. Ruth will talk with you about things you can do and medicines you can give Kaylee to keep her fever down. If she’s not better in three days, she needs to be seen again. Ruth will give you the names of two pediatricians you can call.”

“I . . . I can’t afford . . .”

Matt could almost feel the cold stares of the bean counters who hated the way uninsured patients used the ER as their family doctor.
But what can I do?
“Or you can bring her back here. We’ll be happy to look at her again.”

Matt went on to assure the mother that the odds of Kaylee having another seizure were small, and there was no need to start anticonvulsants at this point. As he spoke, Matt thought through his treatment decisions to make sure he hadn’t missed anything along the way.

“Do you have any questions?” Matt asked.

When the mother shook her head, Ruth said, “Wait here. We’ll give Kaylee the first dose of her antibiotic, and something to help bring her fever down.” Matt’s last vision of the scene was a far cry from what had greeted him when he first parted the curtains. The mother seemed calmer, and Kaylee now rested quietly in her arms.

As they walked away, Randy, in a short white coat over hospital scrubs, turned to Matt. “You handled that really smoothly.”

“Thanks. I haven’t taken care of a child with a febrile seizure in years, but this crash course as an ER doc brings it all back. With the right training, you could do the same.” Matt studied the face of the medical student. “Think that might be what you want to do?”

“I thought so. But my ‘almost father-in-law’ is a plastic surgeon in town. He has pretty much a high-end practice, and he and my girlfriend are pressing me to go into that specialty, maybe even join his practice. They think I’m crazy to even consider emergency medicine.”

Matt could see the scenario as clearly as though someone had diagrammed it for him. A prospective father-in-law wanted to be sure his daughter enjoyed the prestige of a doctor husband, along with the comforts provided by a good income. He guessed that wasn’t unlike what Jennifer had pushed for—a comfortable life. She wanted Matt to be successful and make a lot of money, yet always be available for her. Matt had been unable to convince her that she couldn’t have it both ways. He hoped Randy would be smart enough to make his own decision.

“What antibiotic did you choose?” Randy asked. “And why did you give an antibiotic anyway? Aren’t a lot of those infections viral? Why didn’t you wait to see if the child got better on her own?”

Matt was ready for that one. He’d heard it before, usually from physicians in academia. “Yes, I chose to give her an antibiotic: amoxicillin,” he said. “And in case you’re wondering, I read the journals and attend the lectures. I know about the argument you have in mind, but I don’t practice in an ivory tower. To my mind, the studies are inconclusive.”

“But—” Randy said.

Matt plunged on. “Even though there’s a school of thought that antibiotics aren’t needed for otitis media, I defy those doctors to defend their position while standing in an ER late at night with a crying child and a distraught mother who’s just seen her baby convulse.”

Ruth stopped beside them. “Got her settled.” She turned to Randy. “I almost forgot you were there, you were so quiet.”

Randy grinned. “I remember what I was told on my first night in the ER—keep my eyes open and my mouth shut.”

Ruth handed Matt a chart but addressed Randy with a matching smile. “You’ll never get in trouble that way.”

Matt glanced up at the clock on the wall. He’d stopped wearing a watch because it continually snagged on the exam gloves he pulled on and off dozens of times a night. “Ruth, how’s it look out there?”

“About average. It’ll quiet down later, though.” She turned to Randy. “Here’s something you may not know. There’s nothing in the books about this, but you can mark it down. Four a.m. will be when things hit bottom. The ER is slower. The staff is sagging. But the patients that come in are either really sick—heart attacks, traffic accidents, that kind of thing—or suicides.” She grimaced.

“And I’ll bet the docs love it when they get awakened at that time,” Randy said.

“Absolutely right,” Matt said. “I’ve been on both sides of those phone calls. Even if the doctor can handle the problem over the phone, most of the time they can’t get back to sleep, but it’s too early to get up.”

Randy shrugged. “Leslie’s dad says that’s another reason to go into plastic surgery. He keeps telling me that for a while I may have to take care of the drunks who come in with lacerations, but pretty soon I can slough those off to a general surgeon or an ER doctor and plan on sleeping through the night.”

“What do you think about that?” Matt said.

“I don’t really know. Dr. Stokes thinks he’s got my life planned out for me . . . Maybe I should be grateful for it.”

“Or maybe you should make your own decisions instead of letting someone else make them for you,” Ruth said in a quiet voice.

Matt wondered if he hadn’t been guilty of the same thing, giving in to Jennifer’s subtle pressure. He surprised himself with the next words out of his mouth. “Just pray about it, Randy. Turn the decision over to God.”
I wish I’ d learned that lesson a little earlier myself
.

TWENTY-THREE

“I’ve got a lunch appointment with Matt Newman.” Sandra put Elaine’s morning coffee on her desk. “Remind me about a quarter to twelve.”

Elaine waved her boss to a chair. “I had dinner last night with Charlie Greaver.”

Sandra didn’t expect a long conversation. She ignored the chair. Instead she leaned a hip on Elaine’s desk and sipped her coffee. “And what did you find out?”

“About Dr. Newman? Not really anything. But it was an interesting evening.”

“Are you going to tell me about it or just sit there and keep me guessing?” Sandra asked.

“Charlie and I have had occasional dates for the past couple of years. You know—lonely widower, eligible widow. It was mainly a case of having someone to talk to, a companion for the theater or a party. I probably went out with him once for every two or three times he asked me. But since I’ve begun accepting all his invitations, I think he’s getting more serious.”

“I’m sorry if I’ve put you in a bad position.”

Elaine toyed with her coffee cup. “Actually, you haven’t. I’ve always enjoyed Charlie in an offhand sort of way, but since we’re seeing each other more often, I’ve gotten to know him better, and I have to say, I like what I see.”

“That’s great,” Sandra said.

“Um, sort of. You see, because both Charlie and I are getting more serious, I worry about trying to pump him for information about your client.”

Sandra noticed the subtle shift. Previously, Matt had been “our client.” Now he was Sandra’s. “So what I hear you saying is that you don’t want me using you as a pipeline into the DA’s office.”

Elaine suddenly seemed to find the top of her desk terribly interesting. Without looking up, she said, “If there’s a bombshell, I’d probably pass it on to you. But otherwise, I’d like to concentrate on my relationship with Charlie. I don’t want to be a spy, and that’s what I feel like now.” She met Sandra’s gaze. “I hope that’s okay with you.”

Okay? Sandra wasn’t sure. She’d counted on information from Charlie Greaver via Elaine as sort of an early warning system. On the other hand, she had to admit that the ethics of the situation had bothered her a bit. She made up her mind. “Elaine, I’m happy for you. You’ve been alone long enough.”

Matt looked around the coffee shop. If any of the eating places along Elm Street downtown deserved the title “hole in the wall,” this one did. But Sandra said the sandwiches they served were delicious, and it was conveniently near her office, so Matt had agreed to meet her here at noon.

The clock on the wall behind the lunch counter said five minutes
to twelve. The place was full already, but as Matt was about to give up he spotted a couple vacating a small table in the back corner. He hurried over and hovered while a sweating busboy dumped the dirty dishes into a plastic tub and took a few pro forma swipes at the tabletop with a moist rag.

Matt plopped into the chair that faced the door and placed the folder he was carrying in the seat opposite it. A waitress hurried over, spotted the folder, and asked, “You meeting someone?”

“She’ll be here in a moment,” Matt said. “One Coke and one Diet Coke. And leave the menus. We’ll be ready to order in a minute.”

She huffed away, obviously aware that the quicker patrons ordered, the quicker they were served, paid, and vacated the table, leaving tips in their wake. Matt decided to make sure his tip reflected the waitress’s patience—or lack thereof.

He was staring at the front door for what seemed like the hundredth time when Sandra breezed through it. Matt felt a strange sensation in his chest when Sandra eased into the chair opposite him, and wondered for a second if he’d developed a heart murmur. But he knew what it really represented: a heart problem, just not one that demanded an electrocardiogram or stress test.

Sandra placed Matt’s folder on the edge of the table and covered it with her purse. “Sorry. I think I’m a few minutes late.”

Matt took a long drink of his Coke. “No problem. Just glad we could get together.”

“Before I forget, your neurosurgeon, Dr. Gordon, called me. He said you’d missed a post-op appointment. He wants you to be certain to reschedule.”

Matt looked at his cell phone and punched a couple of buttons. “No record that he called me or sent a text. Why did he call you about it?”

Sandra twisted in her chair. “I guess because . . .” She took a deep breath and started again. “Ken and I used to go out—were pretty close, in fact. I think he used that call as an excuse to talk with me.”

Somehow, in his struggle to understand his feelings for her and cope with the drama in his life, Matt had managed to ignore the possibility that Sandra could be in a relationship. Should he try to find out if she still had an interest in Ken Gordon? It was none of Matt’s business, but picturing her dating another man was hard to take—which told him his own feelings were probably genuine, not just rebound or transference. He wanted to ask questions—a lot of them—but decided to keep silent. Right now Sandra was his attorney, and that’s all she could be until the shadow hanging over him was gone.

Matt had a couple of hours to kill before going on shift. He decided to go back home and sneak in a short nap. Things had been busier in the ER recently, and he had a hunch he’d need the rest.

It seemed he’d no more than stretched out on the couch and closed his eyes than his cell phone buzzed in his pocket. He checked his watch and discovered he’d been asleep for a half hour—just long enough to get into sound sleep. That was the life of a doctor.
Sleep
when you can, and expect to be awakened before you’re ready
.

“Hello?”

“Matt, this is Rick. Do you have a minute?”

Matt stretched and yawned. “Sure. What’s up?”

“I appreciate the time you spent with me yesterday.”

“No problem. Have you talked with your wife?”

“Yeah, I called her after I left your place. She says she’s happy I’ve taken that step of faith, but I want to show her I’m serious. I figured that getting involved in a church would be a good way to do that.”

Matt rubbed his hand over his head, noting that the stubble was now turning into longer hair. “That’s a good idea, Rick. But you’ve already taken the only step that’s necessary. Attending church is definitely a way we can grow in the faith, but it’s not a requirement for being a Christian.”