The Dr Annabel Tilson Novels Box Set

by Barbara Ebel

  “Oh,” Jonathon said.

  “This is quite insane,” Anne said, pushing her glasses up on her nose. “Where on earth could my son pick up this infection? All he does is stay home, play basketball, and hang out with Jonathon. We rarely do anything.”

  Bob and Annabel couldn’t interrupt as Anne Owens spilled out the thoughts that had been troubling her.

  “And why does he have it and none of us do? Toby is a good kid. He never does anything crazy.”

  While shaking her head, Mrs. Owens aborted her rant. Jonathon made a little laugh from the sideline and leaned over closer to Toby.

  “Except while we were in Florida and you ate that disgusting slug.”

  “What?” Anne asked.

  Jonathan realized he said something in front of her that he shouldn’t have.

  “Toby, what is Jonathan talking about?”

  Toby gritted his teeth and shot Jonathon a dirty look. His mother put her hands on her hips and waited. It appeared he had no choice but to divulge what happened.

  “We were waiting outside that lunch restaurant on the boardwalk while you and Jonathon’s mom were still shopping. Two local boys, older than us, tried to gross us out by telling us about mudbugs, and then they dared me to eat a slug that was right there on the steps. Mom, it doesn’t matter. It didn’t taste that bad.”

  Mrs. Owens eyes grew big and Jonathan added, “But they had to pay Toby six dollars because they lost the bet.”

  Anne Owens couldn’t restrain herself. She turned to Toby, as sick as he was, and clunked him on the side of his head. “What the hell’s the matter with you!”

  “Ouch. You’re not going to tell Dad, are you?”

  “Probably not. He’ll wonder what kind of mothers Mrs. Harmon and I were on vacation … letting you eat slugs!”

  CHAPTER 20

  George Gillespie stuffed papers into his old-fashioned briefcase and closed the door to his office. He strutted down the hallway, ready to go home.

  Becky was the only person left at the front desk, and he made a point of stopping. “Enjoy your evening, Becky.”

  “You too, sir.”

  After unlocking his car door, he dug his hand in his pocket one more time to make sure he remembered his cell phone. Rest assured, he drove the twenty-minute drive home, looking forward to his wife’s cooking. She always conjured up something decent on Monday night because she counted on the leftovers for him on Tuesday when she always had a meeting.

  George’s wife, Marlene, was a busy physician’s wife. George often heard hospital gossip from her because she worked part-time in the administrative offices. The rest of the time, she donated her time heavily to charitable children’s organizations, where most of the money went to the medical care of children at their very hospital for families that couldn’t afford it.

  Marlene, in her late forties, was aging very well. She kept a shapely figure and actually stood an inch higher than her shorter husband. Her rosy lipstick was her trademark, which accentuated her full lips and bleached white smile.

  In Marlene’s mind, it was a strange marriage, which she had finally come to terms with and had decided to go about with her own life. Which, of course, was comfortable. It was not as if George made a ton of money, but she lived as cozy as other spouses of thriving physicians, and she did enjoy her philanthropic endeavors of helping children.

  She often admitted to herself that, when she married him, the writing was on the wall and she had a clear premonition that their sexual relationship did not seem normal. It was one thing to get a sense of how other relationships worked, but she also had her own past history as a foundation. Each and every past relationship she had had with a man was a pleasant, if not awesome sexual experience. It was not only intercourse itself, but the desire for sex had percolated in her male partners. They would make physical advances that were appropriate and she would do the same. Sometimes it turned out to be hot and wild.

  Sex was important to her and, yet, she had married someone with a scant libido. At least for her. And it hurt her feelings.

  For years, in the beginning, she egged her husband on to engage in sex because he showed no initiative. Then, in the middle years, she stopped practicing her neediness because he was down to no initiative whatsoever. They attended one session with a marriage counselor, during which George proclaimed, “It’s just not enjoyable for me.”

  On top of this, he kept handy tubes of lubricant on his nightstand as well as next to his toiletries in the bathroom. The contents would slowly disappear and then the tubes would be replaced. That spoke for itself.

  All of this really hurt her feelings, yet she knew enough to not take it personally. He must be gay, she figured, and he was either aware of that fact or he was the last one to realize it. At that point, she thought about throwing in the towel, but her wedding vows were for life and divorce was a terrible concept she didn’t want to try.

  Marlene heard the garage door open and her husband came in with his usual restrained personality. She followed him to his front room office. “How was your day?”

  George put down his briefcase. “Just like the other three hundred and sixty-four. Parents and kids come and go and I help solve some of their problems. Medical ones.”

  George placed his iPhone on the edge of the desk, took off his sport coat, and slipped into the bathroom. Marlene hesitated and decided to go for it … pick up his phone and glance at his recent pictures. Over recent months, she happened to stumble on a dozen pictures of his patients, which she found odd. Interestingly enough, they were sweet photos of kids, and they, or their parents, must have allowed him to snap them. Maybe he was compiling a bulletin board of his happy patients for the waiting room or something like that.

  She tapped on “photos” and, since last week, the only picture that showed up appeared to be a half-finished black-and-white sketch. She shook her head at why he bothered to take a picture of it, but it was none of her business.

  Marlene went to the kitchen and doled out a stir-fry chicken dish for dinner.

  “I liked that,” George said when he finished. “New recipe?”

  “Yes, and I made extra.” Although she had nowhere to go the rest of the evening, she reapplied her lipstick when she got up to do the dishes. George helped her bus the plates to the sink and then went straight back to his office.

  He had brought home no medical paperwork that needed attention. After reaching for his phone, he opened up the pictures and stared at Tabitha Klondike’s sketch. More importantly, he went to his list of contacts and scrolled to the Klondikes … the entry he had discreetly entered as they left the office.

  He stared off into space and formulated what he would say on the phone and placed a call.

  Margaret Klondike answered. “Hello?”

  “Mrs. Klondike, this is Dr. Gillespie. Every once in a while, I call a patient and the family in the evening to make sure there were no problems with their appointment in my office during the day. Like a post-medical call survey. Were the girls at the front desk friendly, etc., etc.?”

  Margaret took a few seconds to process the reason for his call. “The visit went smoothly, thank you.”

  “I picked your visit specifically tonight because your family is brand new to the area. I want to make sure you are satisfied with your beautiful daughter’s new medical care.”

  “Yes, like I said, everything was fine.”

  “I wish I could thank your daughter for letting me snap a picture of her lovely sketch.”

  “She’s around here somewhere.”

  George waited. He heard noise and voices in the background and then the sweet voice of Tabitha Klondike sounded in his ears.

  “Hello? Dr. Gillespie?”

  “Tabitha, honey, I wanted to personally thank you. Your sketch on my phone is your personal present to me. It’s the most glorious photo in my whole collection. On your next visit, please do show me the finished project.”

  Tabitha beamed with delight. No one h
ad ever made a big deal about her artwork like him before. “I will finish it before my mom brings me again.”

  George’s free hand went to his crotch. His hardened crotch.

  “I look forward to it.”

  He couldn’t keep talking and taking care of his crotch at the same time. “Bye, then,” he said, and hurried into the bathroom.

  -----

  Annabel and Bob left Toby with his mother and friend Jonathon, and went to the nurses’ station. Bob first made a copy of his patient’s LP results and then stuck the original in the lab results section of his chart. Both students huddled at the side of the counter.

  “I’m pretty sure I would not have taken that Florida kid up on his dare,” Annabel said. “Kids do crazy things to avoid humiliation.”

  “At his age, I might’ve,” Bob said. “It is possible to chuck something small down your throat really fast, like a slug or a snail, and avoid tasting it.”

  “Not only are they disgusting, but think where they’ve been.”

  “What’s disgusting?” Rick Mares asked, stepping up behind them.

  “Eating a slug or a snail,” Bob answered.

  “Surely neither of you lost your mind and did such a thing. Mollusks are distasteful, I’m sure, and gross. Slugs secrete a film of mucus for their own protection … to keep stupid human beings from eating them.”

  Annabel cocked her head at him and he said, “I graduated from college with honors in biology. My studies included terrestrial mollusks. Come on, let’s sit somewhere. Bring Toby’s lab sheet.”

  “It’s dinnertime,” Bob said. “Any objection to going to the doctors’ lounge? I rarely make it in there to eat scrumptious free food.”

  “Excellent idea. However, did you tell Toby about his confirmed diagnosis?”

  “We did, along with his mom and friend.”

  Rick nodded and peeled down the hallway in front of them with his long stride and opened the door. “This is a great time of day to go in here. It will be half as busy as lunchtime.”

  A round center table inside was stocked with cheese and crackers and fruit, but two tables against the wall had hot food and soup. They fixed a plate, grabbed drinks, and gathered around their own table. Only a handful of doctors remained, some watching the news. Nell was hidden from view on the couch and popped up.

  “Hey,” she said. “Can I join you? And are we otherwise done for the day, Dr. Mares?” She half sneered at Annabel while she placed two cookies on the empty spot on her plate.

  “Yes, you can go,” Rick said. “We’re finished, except for my discussion with Bob regarding his consult.”

  “Then I’d love to stay. Toby Owens is the only possible pediatric case of meningitis I’ve seen.”

  “For all of you,” Rick said, “now a confirmed case.” He tapped his finger on the table and Bob immediately produced his copy of Toby’s results.

  “Miss Linnell, Bob’s patient’s CSF white count is two hundred and eighty-two.”

  “Did we prescribe the correct antibiotic?” Bob wondered. “One that we can keep using on Toby?”

  Wide-eyed, Rick stared at the sheet and dropped his fork.

  “What’s wrong, Dr. Mares?” Annabel asked.

  He raised his head slowly and turned solely to Bob. “You neglected to tell me the breakdown percentages of the type of white blood cells in Toby’s fluid. I have never seen this before.”

  Bob ducked his head and tapped his forehead in disapproval of himself. Obviously, he goofed up.

  “No harm done,” Rick said. “I am simply flabbergasted and this is an opportunity for the three of you to review the basics. So what are the five types of white blood cells?”

  Bob was still making amends with himself and Nell had stuffed half a cookie in her mouth, so Annabel took the gamble. “Basophils, lymphocytes, monocytes, eosinophils, and neutrophils.”

  “Correct. Now, which cells are disproportionately increased above normal values during a bacterial infection?”

  “Neutrophils,” Bob said.

  “And which cells are increased during a viral infection?”

  “Lymphocytes.”

  “Toby does not have higher numbers of either in his cerebrospinal fluid, flat out eliminating a bacterial meningitis or a viral meningitis. So, in answer to your question, Bob, the IV antibiotic Toby is receiving is incorrect because it is meant to stampede out a bacterial infection.”

  “So which other type of white blood cell is increased?” Annabel asked. “What on earth strange infection does he have?”

  “The differential shows thirty-two percent eosinophils. He has an eosinophilic meningitis! Even I am going to need to investigate this further, because high eosinophils point to one thing. And one thing only – parasites!”

  -----

  Rick suddenly got up. “I must go write an order to discontinue the antibiotic and leave a note on Toby’s chart. Have a good night.”

  “I’m leaving,” Nell said. “Bob, are you coming?”

  “Annabel isn’t finished with her chicken sandwich. I’ll catch you tomorrow.”

  Linnell stopped at the center table, wrapped up some snacks to-go, and flashed a final smile at Bob.

  Annabel grinned. “We’ll be like Rick one of these days. Residents pull longer hours than we do. It’s like their work never ends.”

  “Are you saying that we better enjoy medical school while we still can?”

  “Something like that. I better get going too. Poor Oliver must be waiting patiently.” She chewed the last bite while Bob contemplated.

  “Rick seems stumped by Toby Owens. We should have talked about calling in an infectious disease specialist.”

  “You’re right. And you and I don’t have the resources to figure out rare medical conditions. I wish we were close by to the campus medical library.”

  Bob turned around. “Doctors and foundations do lend books in here.”

  “I forgot about that. I’m rarely in this lounge.” She also turned to take note of the book shelves on half the wall on the other side of the room.

  “Wonder how old some of them are.”

  “Let’s check.” The students bused their trash and studied the spines of the textbooks. Annabel opened a few. “The publishing dates are relatively new and the older ones are recently edited.”

  “Here’s an option.” Bob pulled out a navy blue text. “Modern Infectious Diseases.”

  “Perfect,” Annabel said. “Another option is checking with the government disease control site.”

  “I’ll do one and you do the other and we can compare notes.”

  “I’ll snuggle with Oliver and the book later tonight after I walk him and do some other pediatric reading.”

  “I can come over and snuggle with the two of you too,” he chanced saying.

  “My bed isn’t big enough for three.”

  “Actually, Oliver can stretch out and hoard an entire bed just by himself!

  -----

  Annabel bounded up the two flights of stairs and inserted her key in the door. It was a normal occurrence when Oliver stayed with her. Before she even cracked open the door, the biggest smile of her day would spread across her mouth.

  She pushed straight in with her bag and textbook from the doctors’ lounge. “Oliver, look at you! You are an impeccable young watch dog.” After giving him an exuberant petting and taking a walk, they went back to the apartment.

  Annabel changed and settled by the headboard of her bed and was grateful not to cook or to heat up leftovers for dinner. “Come on up, Oliver. Curl up next to me and watch for our Mr. Squirrel outside the window. I must research a nasty disease.” Oliver had no problem heeding her request and he turned belly up with his snout nuzzling her.

  It took time, but Annabel finally weeded out a pertinent eosinophilic disease from the book and then remembered it from medical school. Called “cysticercosis,” it was an infection caused by the adult tapeworm, Taenia solium, acquired through poor hygiene and eating raw po
rk. What she had forgotten was that it could affect the central nervous system and then it was called neurocysticercosis.

  However, she thought, there was a slim chance that Toby had this one. The disease was most prevalent in Africa, China, India, and Latin America and seventy to ninety percent of the patients presented with seizures. Toby had no history of seizures since his illness began.

  Annabel’s hand rested on Oliver’s fur as she indexed another eosinophilic meningitis. The diseases were rare and she had never heard of the next one. Maybe because it reared its ugly head in Asia, Central America, and South America, and particular spots in Africa, and not the United States. Called “gnathostomiasis, the disease was caused by parasitic worms acquired by eating undercooked or raw reptiles, birds, frogs, eels, and freshwater fish.

  She pondered over the food sources and wondered if a slug would count. However, on further reading, she eliminated it as Toby’s disease. The most common symptoms were migratory swellings under the skin and Toby had no dermatologic manifestations. One other awful symptom was when the nematode entered a patient’s eyes, causing blindness. She shook her head. At least, thankfully, Toby did not have gnathostomiasis meningitis.

  The sun had long set and only a street light illuminated her favorite tree outside. She slinked off the bed without disturbing Oliver and closed the blinds, but her true intent was to check her phone. She left it in place on the kitchen counter and pressed messages. The last ones were between her and Bob. There was still no return message from Dustin after she had texted him during lunchtime.

  CHAPTER 21

  Dustin Lowe’s night couldn’t be worse. Death and violence was part of his job, but he was always the objective observer to other peoples’ losses. His partner’s death, however, made him just like everybody else he consoled, especially when folks had told him late in the day, “I’m sorry for your loss.”

  He felt especially alone. Not in the mood to eat any dinner, he grabbed a container of milk, measured two scoops of protein powder, and mixed the drink in the blender. He sipped it over a half hour on his most comfortable chair and, for the time being, didn’t even feel like talking to Solar.