The Dr Annabel Tilson Novels Box Set

by Barbara Ebel

  “I’m simply overtired and having a bad day,” she stated, gripping the armrest. “Sometimes my best work comes when I’m a bit drained. The cases energize me. But not today.”

  “Dr. Watson, fatigue is not a badge of honor. It’s a sign of danger. Do you really want Dr. Harvey to reiterate all the reasons why you should be taken out of your residency for, hopefully, only a short time?”

  Ling held her breath. Damn it, she thought. She couldn’t think straight; couldn’t make up her mind to hear him out or not. It might be too painful to listen to him echo what she couldn’t admit to herself.

  “I didn’t think so,” he said. “Fortunately, an excellent chairman of Psychiatry is employed at the University. She runs a program for the health and well-being of medical staff and they address these very issues of what you’re going through. You possess all the signs and symptoms of physician burnout.”

  The two attendings were in this together, she thought. She stood on trial and didn’t stand a chance of changing their mind.

  -----

  “That was easy,” Caleb said in the ER. “An antibiotic for a urinary tract infection, and the pregnant lady we just saw can be sent home. She was a smart one to come in with the initial symptoms of burning and frequency instead of letting the infection fester unchecked.”

  “However, couldn’t she have scheduled an appointment at the clinic?” Annabel asked.

  “True. Trips to emergency rooms are becoming more commonplace for problems which can easily be taken care of in a doctor’s office or clinic.” He put the patient’s chart in the rack. “And everyone wonders why the cost of healthcare keeps going up. That’s a small additional reason.

  “Come on; let’s get a cup of coffee out in the lobby on our way upstairs.”

  The barista noticed Annabel coming across the lobby. “What’ll it be?” she asked. “Cappuccino, an Americano, chocolate-covered blueberries, or espresso beans covered in chocolate?”

  “Sounds like you earned a history here,” Caleb said.

  Annabel laughed. “Guilty as charged. I’ll take a French vanilla cappuccino and grab a box of blueberries.”

  “I’ll take an unflavored milk coffee,” Caleb said. “A latte for short.”

  The barista whipped up their drinks. “One vanilla cap and one regular latte,” she said and rang up their items.

  “I can’t wait to see Amy Wagner’s third stage of labor,” Annabel said as they left. “You better not let me miss it. I have yet to see a ‘from beginning to end’ normal delivery.”

  “But here’s the thing. You never know what’s going to happen. It’s a crapshoot. The more I do OB, the more grateful I am that I’m a guy.”

  Upstairs, Dr. Gash steered them into the lounge to finish their hot beverages. They both studied the wall board from the table as Dr. Harvey walked in. He closed the door behind him, looked at them, and raised his eyebrows.

  “Honestly, Dr. Harvey, we just walked in,” Caleb said with a guilty expression on his face. “The ER patient was not an admission, just an early UTI.”

  “In that case, you should have bought one for me.” He nodded at their paper cups.

  Annabel and Caleb glanced at each other with a grin.

  “I have two things to talk to Dr. Tilson about, but you stay too, Dr. Gash.” He dragged out a chair. “Annabel, would you mind attending the gathering at the funeral home tomorrow morning for Mary Chandler? It would be respectful and a kind-hearted gesture if someone from our medical team attended. This is not under your job description, so feel free to say no. You would not need to show up here tomorrow morning. We’d expect you around noon.”

  Annabel didn’t give it a second thought. “I’d be honored.”

  “I’ll let the chairman know and his secretary can text you the location.” He put both elbows on the table and rubbed his hands together. “I have another request, which is more complicated. How would you like to become a very rare student? Would you be willing to present grand rounds next week? We’ll discuss the topics, we’ll give you lots of slack with your other work, and I will give you guidance. We’ll make sure you are still allotted study time.”

  The request came as a shock. She couldn’t fathom standing up to lecture those with more experience than her. Which was practically everyone who would be in the lecture hall. However, she trusted Dr. Harvey. He would not throw her to the wolves; she was sure of it. But why was he asking her? Then she realized the department had taken Dr. Watson out of the picture and they were in a pinch for a speaker. They were willing to try her out and give her the opportunity. She gulped.

  “I want to say yes, Dr. Harvey, but using me may be a mistake. I can’t pull off personally and professionally what someone with more experience can.”

  “I have faith in you.”

  Annabel glanced at Caleb. He seemed as surprised as she was and kept quiet.

  “Okay, Dr. Harvey. Please don’t be disappointed in me, however.”

  “That’s the least of my worries.”

  -----

  Annabel finished her drink, savoring every last bit of foam at the bottom of the cup. Roosevelt and Caleb had gone off for patient care and left her with a list of scut work to do. She went to the computer in the corner of the room, hunted down lab values on laboring patients, and wrote them on her index cards. She checked the board again, where a nurse had updated Amy Wagner’s labor progress. Her husband and nurse were rallying her along. She was bravely or stupidly going “natural” and refusing any type of anesthesia. Annabel couldn’t decide which behavior was more accurate … brave or stupid.

  Her phone dinged and she pulled it from her pocket.

  “Oliver had no accidents overnight,” Bob wrote. “He is housetrained like a Westminster ribbon winner! You going to pop by tonight?”

  She was glad for the timing of the text, since she had a few minutes.

  “They don’t give ribbons out to those dogs just because they don’t pee in the house! I would love to come over. but I’d better study. The attending also gave me a ‘project.’ I’ll explain later. She hit the arrow to send and then had an idea and began writing again. He gave me tomorrow morning off – to attend a patient’s funeral home function. Why don’t you come if you’re up to it? Oliver too. (He can stay in the car and I can see him!)”

  “Would that be appropriate for me to be there?” he wrote back.

  “Department wants representation. Another student would be wonderful.”

  “Sure. I’ll plan on it.”

  “However, how are you feeling?”

  “Amazingly enough, I slept ten hours. Repeat … Ten hours. With a dog at the bottom of my bed … a first. It was scrumptious.”

  Annabel laughed out loud. “You’re crazy. And you’re spoiling him already.”

  “So what’s your point?”

  She tried to hold back from laughing again and smiled. “All right, then, see you both tomorrow. I’ll give you the details later.”

  Bob texted her a “thumbs up” emoji. She pocketed her phone as Emmett tilted his head around the door.

  “Come on in,” she said. “How are you today?”

  Emmett opened his mouth wide with a smile, displaying a chipped tooth she had not seen before. “Better than I deserve. I notice Dr. Harvey is here today more than usual and Dr. Watson isn’t.”

  “How perceptive of you, Emmett. Appears to be the way they want it for a while.”

  “I figured. That will make your rotation easier.”

  “Like I said,” she whispered, “that’s perceptive of you.”

  “Nicer for me too. The twelve-hour days I pull are long. They will be more tolerable if the personalities around here are more balanced.”

  “I agree.”

  “Dr. Gash said you’re welcome to come into Mrs. Wagner’s room any time. She’s getting closer to pushing that baby out.”

  “I can’t wait.” She moved away from the computer. “Thanks, Emmett.”

  “If I can help you
with anything, you just let me know.” The man pointed at her for emphasis, his arm flashing his muscles like logs and the pigmented figures on his skin.

  She walked beside him down to Amy’s room. “Don’t faint in there,” he said with a wink when she turned in to observe her first full delivery.

  -----

  Amy Wagner breathed deeply and rhythmically between a contraction and glanced over at Annabel and managed to chuckle. “I should start charging an admission fee.”

  “Especially for medical students,” Annabel replied. “We’re as useless as an un-baited fishing hook.”

  Caleb sat on the stool at the bottom of the bed and Dr. Harvey stood off to the side. The nurse was ready to help in any way possible. The fetal heart rate monitor raced along with its tracing. Harry, for the moment, stared with a mixture of fright and amazement at the action going on between her legs.

  “More,” Amy said, looking to her husband. He snapped out of his trance and popped open a tiny plastic container of Vaseline. He dabbed a bit on his index finger and applied it to Amy’s lips.

  “My lips and me are so dry,” she said. “I could drink a pond.”

  Harry put the petroleum jelly on the nightstand and sat back down on his own stool. “Come on, hon, concentrate. You can do this.”

  “Easy for you to say.” The next contraction clamped down and waves of movement rippled across her abdomen. Amy leaned forward and grimaced with all her might. The baby’s head bulged, pushing against her vagina like it was desperate to get out.

  Harry’s face went a shade whiter. “Are you still sure you don’t want any anesthesia?”

  Her pain eased. “Too late for that!” she exclaimed. “You’re the one who could use some. What I need is to get baby Bobby out of me and food and water into me. Damn! I haven’t had anything to eat in a gazillion hours!”

  Annabel glanced at the nurse. They both tried to suppress a smile.

  The next wave of pain started. “A Big Mac and French fries,” she blurted out, and then concentrated on her breathing. Now she absolutely didn’t care what was going on down there and who was doing what. Certainly, all modesty and attempts at dignity were thrown out the window.

  Dr. Harvey stepped right behind Caleb, who was gowned, gloved, and masked. “You’re almost there,” Dr. Gash said to Amy as the infant’s head protruded.

  A tray table with the needed medical supplies were next to Caleb. His attending gestured toward the episiotomy scissors.

  “No anus is tearing under my watch,” Dr. Harvey said.

  Annabel at least understood what he was talking about, but had to laugh at his remark. At least when things were going as they should, she thought, there was room for humor in the delivery room.

  Caleb picked up the blunt-tipped episiotomy scissors. He used them to make an incision to the perineum to widen the vaginal canal for delivery. By cutting the muscle between the vagina and rectum, he would prevent the vagina from tearing.

  Amy concentrated deeper than before. She pushed with all her might. The bottom of her was on fire. What felt like a basketball popped out as everyone in the room saw a giant head pop out. But her temporary relief was fleeting as the second round of pain finished her off. The baby’s shoulders followed.

  Under the mask, Caleb was as proud as the father. He didn’t mind that he held a slimy newborn with a big cone head. Everything had gone well, and when that happened, it was the best thing about OB.

  Wearing a huge smile, Amy grasped her husband’s hand to the side. She lost track of time as the doctors continued with their afterbirth chores. But after all the “awwws” about baby Bobby, Caleb picked up suture material and began sewing her vagina back up.

  “I never realized how much easier a C-section is,” Amy lamented. She winced with pain.

  “Now Susan and your dog Blue will have Bobby to play with,” Annabel said, trying to distract her. “My friend and I bit the bullet and adopted the dog we were thinking about.”

  Amy nodded and managed to smile. “What did you name him and is he adapting to his new situation?”

  “We named him Oliver. He has two new homes and he’ll have so much love in his life, he’s going to blossom like a rose.”

  -----

  With excellent Apgar scores, newborn baby Bobby was taken over to the nursery. Caleb wrote the notes that were needed in Amy’s chart and the electronic medical record, and then Roosevelt congregated his resident and student in the hallway.

  “Nice job,” Dr. Harvey said. “And we can pat ourselves on the back. With Mrs. Wagner’s help and cooperation, we pulled off a successful TOLAC.”

  Dr. Harvey looked at his wristwatch. “The hours are flying by. What do we need to put next on the top of our list?” He pushed his coat to the side, shoved his shirt in, and looked at Annabel. Caleb was still wearing a silly grin from his flawless delivery.

  “I have all the pending labwork on patients,” Annabel said. “Nothing was abnormal. May I suggest we visit Bonnie Barker and discharge her if nothing has changed after her transfer?”

  “Excellent idea.”

  They headed towards Bonnie Barker’s old room before her ICU experience. If Annabel was any judge of character, she could swear Dr. Harvey was enjoying himself a lot more than usual … maybe with the sense of vigor like the old days when he was a resident.

  CHAPTER 21

  Bonnie Barker, nestled deep into the chair, held Sam with a baby blanket wrapped around her. After allowing her to nurse to her heart’s content, she lowered the baby to her lap and adjusted her top. Tony enjoyed watching them and was ready to help her out in any way he could. Bonnie glanced at him.

  “It’s your turn,” Bonnie said. “Would you like to hold Samantha?”

  “More than anything.” He crouched over and tenderly picked up his infant. He rocked the baby in his arms while Bonnie grinned.

  “You’re amazing,” Tony said.

  “She is, isn’t she?”

  Tony shot Bonnie a glance. “Sam is amazing, but I was talking about you.”

  “Oh. So are you.”

  He disregarded her remark. “I don’t know any medical stuff, or the junk that goes on in hospitals, but seems to me you have had a horrid time of it since you got here and you’re brushing it off with a smile.”

  “What else am I supposed to do? Cry? Look at the result. I’m okay and, despite Samantha having this fragile bone problem, she’s going to be okay too. She has two parents who are going to see to it.”

  Tony half-closed his eyes and his lips trembled. That may be the case, he thought, but they’d be better off married. He sighed and continued to sway the bundle in his arms.

  Bonnie scooted forward and turned to the side, facing him fully. “Did you really mean it when you alluded to us getting married in the past?”

  “I did. I still think it would be best for us all, but I’m not going to belabor the point; otherwise, I would never find out if you really cared about me if I pressure you into it.”

  “Tony, I’m sorry. The best guy in the world has been right in front of me and I was too stupid to see it. In and out of my narcotic slump, all I did was think about you. All I did was want to reach out and tell you that I love you. Does the offer still stand? For us to tie the knot?”

  He stared at her, a warm feeling growing in his heart.

  “For us to get married,” Bonnie added. She thought she was clear, but he sat there with his lips clamped like an oyster.

  “Hallelujah! There is a God. Absolutely. I love you too.” He held Samantha with his right arm, rose from the bed, and put his hand behind Bonnie’s shoulder. They kissed and he crouched down next to the chair. They both peered down at their baby, Samantha’s eyes glued on Tony.

  “Maybe her bones will be sturdy enough,” Bonnie said, “and you can teach her how to play soccer.”

  -----

  With the obstetric medical team down to three, they slipped into Bonnie Barker’s room. Maintaining his balance on his sneakers, Ton
y was hunched down next to Bonnie’s arm chair with Samantha in his arms. Annabel’s heart warmed at the sight. They were wrapped up in their own world and didn’t notice the team’s entrance until they were practically on top of them.

  Dr. Harvey cleared his throat and Bonnie looked over. “I made it back to where I started,” she said, “thanks to all of you, and Dr. Watson.”

  Annabel didn’t mention that she would not have gone to the ICU in the first place if Dr. Watson had practiced careful penmanship. She was only in training, but it amazed her the things that patients did not know … like what went on behind the scenes.

  “And we have an announcement to make.” The sparkle in Bonnie’s eyes became brighter. “Tony and I are getting married.”

  “Congratulations,” Dr. Harvey said.

  “When’s the big day?” Caleb asked.

  Bonnie and Tony shrugged. “We haven’t gotten that far yet,” Tony said.

  “Hopefully, as soon as possible,” Bonnie said.

  “This is terrific news,” Annabel said. “Congratulations.”

  Dr. Harvey scanned Bonnie’s bedside chart, which had a new set of vital signs. “How are you feeling?”

  “I’ll live, despite a little sore throat and being tired.”

  “You had a breathing tube in your windpipe, so that is understandable. Your irritated throat will get better. And your blood count is improving after that hemorrhage, so in the coming weeks, you will feel perkier.”

  Roosevelt turned to Annabel. “What are her lab values?”

  Annabel rattled them off from her card.

  “All are within normal limits.”

  “Dr. Harvey,” Bonnie said, “the pediatrician said we can take Samantha home when you discharge me, if we closely follow her up in the clinic within a week. Can’t you send me home? I’m ready. I’m sure of it.”

  Roosevelt laughed and raised his sagging shoulders. “I couldn’t deny that request if my life depended on it.”