Diagnosis Death pft-3

by Richard L Mabry

  She'd never ridden in a police car before. Elena took note of the radio, the scanner, the radar unit. She flinched when she saw the shotgun mounted behind her, in front of a mesh screen that separated the driver's compartment from the back seat. She fastened her seatbelt, almost afraid to touch anything in the process.

  Frank laughed. "Pretty impressive, isn't it? I guess that's one reason little boys want to grow up to be policemen-so they can play with all these toys." He clipped his seatbelt. "Want me to turn on the lights and siren for the ride to the hospital?"

  Elena had her mouth open to reply when she realized he was kidding. "I appreciate your doing this."

  Frank waved it off. "No problem. Things are pretty quiet, and this gets me away from that desk for a while. Besides-"

  He nodded toward the microphone clipped to the shoulder loop of his immaculate tan uniform. "If they need me, they'll call."

  At the hospital, Frank wheeled into the Emergency Room parking area and left the unit in a slot marked "Police." He stopped at the ER admissions desk and was told that the emergency patient, whose name was John Daniels, was in room three with Dr. Baker.

  "I'll only be a minute," Elena said. "I want to see if the patient's going to be okay, and introduce myself to the doctor taking care of him."

  Frank pointed to a door. "I'll hang out in the break room there. See you soon."

  Elena tapped on the half-open door of room three and eased inside. Mr. Daniels lay on a gurney with a woman in hospital scrubs at his side, adjusting the flow of an IV. A middle-aged man in a white coat worn over slacks and a sport shirt stood to the side, scanning what Elena took to be an ER chart.

  She cleared her throat. "Dr. Baker?"

  The man looked up but said nothing.

  "I'm Dr. Elena Gardner. I'll be going into practice with Dr. Sewell. I'm the one who found Mr. Daniels right after he lost consciousness. I wanted to introduce myself and see how he's doing."

  Baker's smile was minimal but real. He offered his hand. "Evan Baker. Nice to meet you. The EMTs checked Mr. Daniels's blood sugar with a glucometer and started insulin. Even at that, his sugar was through the roof and his electrolytes were totally out of whack when he arrived in the ER. Typical diabetic ketoacidosis. We're bringing him under control, and I think he'll come out of it fine."

  "Good."

  "I understand you made the diagnosis on the spot, just from Kussmaul respiration and the smell of ketones on his breath."

  "I… Yes, that was my first impression."

  "Well, nice pick-up. I look forward to working with you."

  Elena left the treatment room feeling somewhat better. At least one doctor in town seemed to be on her side. Better than the reception she had received from Eric, the EMT. And, speak of the devil…

  "Doctor, come to make sure we didn't foul up with your patient?"

  "Eric, I don't know what I did to get off on the wrong foot with you, but whatever it was, I'm sorry. And, to answer your question, I dropped by to make sure I didn't miss something at the accident scene. As it turned out, my evaluation was correct, and your treatment was good. Mr. Daniels is going to be fine."

  Eric's reply was a sniff. He turned on his heel and headed out the door, where his MICU idled in the intake bay.

  Okay, I'm one for two. I'm not sure what Eric's problem is, but obviously he's got something against doctors. Or maybe it's just me.

  She found Frank in the break room, deep in conversation with one of the male nurses about the relative merits of the Dallas Cowboys and the Houston Texans. "Ready to go?" he said.

  "Yes, thanks."

  Elena climbed into the sheriff's SUV with a bit less apprehension this time. Actually, it felt kind of cool riding up here. And she had to admit she enjoyed having a handsome man beside her. It gave her a thrill-a guilty thrill, but nevertheless it was a sensation she hadn't felt in a long time. Part of her wondered what she was doing. Part of her said, "Relax. Enjoy."

  "Are you going to have enough room here?" Dora Kennedy reminded Elena of a bellman in a nice hotel, anxious that the guest would find the accommodations comfortable.

  Elena stood in the doorway and surveyed the room that would be her home for a while. It wasn't large, but the overall effect was cozy. A double bed was butted headfirst against the near wall to her right, with a double dresser and bookcase taking most of the wall opposite. The room's only window was at the far end of the left wall, with an easy chair, reading lamp, and end table nearer the hall on that side. The right-hand wall contained two doors, with a picture hanging between them. The door closest to the hallway was closed. The open door, nearest the outside wall, afforded a glimpse of a cozy bathroom.

  Elena wrestled a large suitcase onto the double bed. "I'm sure it'll be fine. Thanks so much for opening your home to me."

  "Not at all." Dora pointed to the open door. "You have your own private bath. Linens are in the cabinet."

  "Very nice."

  "This was Will's room. Since he left, we've used it for guests." She opened the closed door and shoved aside several hangers draped with coats. "Here's your closet. It doesn't get much use, so I'm afraid it's accumulated some things we don't want to throw away but don't use much, either."

  Elena took a handful of empty hangers and filled them with blouses, slacks, and dresses. "I'm sure there's still plenty of room. Besides, I hope to find a place of my own soon."

  She reached into the closet to deposit her clothes and bumped a long, khaki-colored canvas case on the top shelf. Elena started to move it, then jumped back as though she'd felt a snake. "Oh!"

  "What's the matter, dear?"

  "There's a gun up here. That's not exactly the kind of thing I expected to find in a preacher's home."

  "That's Will's shotgun," Dora said. "He and his friends used to go dove hunting in the fall. When he got married, Cathy told him he couldn't keep the gun in their house. Matthew's checked it, and I can assure you it's not loaded. Matter of fact, there aren't even any shells in the house. So it's perfectly safe." She reached out her hand toward the shelf. "Would you like me to move it?"

  "No, no. It'll be fine there."

  As Elena unpacked, Dora kept up a running commentary on the town. There was not a shred of what might be termed "gossip" in the whole conversation, but Elena got the impression Dora and Matthew Kennedy were tuned in on most of the comings and goings in the community.

  Elena moved to the bathroom and started to stow her makeup. "I had quite an introduction to Dainger," she called over her shoulder. "Even got to meet a sheriff." She sketched out the highway incident for Dora. "The lead EMT wasn't too pleasant, though."

  "That would be Eric. Poor man. Lost his wife, and he's blamed doctors for it ever since. But Cathy tells us he's good at what he does, so she ignores his jabs."

  "Well, there are always a few people like that around." Elena closed the last suitcase and shoved it into the back of the closet." The good news is that I sort of made friends with the sheriff and one of his deputies."

  "Oh, J. C. Dunaway's a fine Christian man. Our police force is good, mind you, but if I had a real problem, I'd trust it to J. C. in a heartbeat."

  "He was very nice. Even had one of his deputies drive me to the hospital so I wouldn't get lost. We had lunch afterward."

  "Which deputy?" Dora asked.

  "Frank Perrin. Do you know him?"

  In the short time she'd been around her, Elena had never heard Dora Kennedy say anything bad about anyone. The preacher's wife kept that record intact by saying, "Yes, I know Frank." But the expression on her face was what Elena imagined Dora would display if she found two-day-old roadkill in her driveway.

  Cathy laid down her book and reached for the phone. Who could be calling her at home on Saturday afternoon? She hoped it wasn't the hospital. Wasn't Dr. Brown on call? Then she saw the caller ID.

  "Elena. What's up?"

  "I just got into town and wanted to check in with you."

  "Glad you made it. Where are you
?"

  "I'm at the Kennedys' now, but I started out at the sheriff's office."

  A myriad of thoughts, all of them bad, flashed through Cathy's head. "Is there a problem? Do you need a lawyer? Will and I can be there in ten minutes. Let me call Sheriff Dunaway. He knows me. We-"

  "Take it easy. I saw the driver in front of me slump over the wheel of his car, and I called it in. The sheriff asked me to stop by his office for a formal statement. Then he had one of his deputies drive me to the hospital so I could check on the patient."

  "Whew. I had visions of something bad happening," Cathy said. "So you've been at the hospital all this time?"

  "Not really. After I finished looking in on the patient- he's a diabetic who went into a coma, and Dr. Baker's taking care of him-anyway, the deputy asked if he could buy me a hamburger. We sat at the Dairy Queen for half an hour. Then he took me back to get my car and led me to the Kennedy house."

  "I know most of the deputies here in town," Cathy said. "Which one were you with?"

  "Frank Perrin. Know him?"

  Cathy took her time answering. "Yes, I know him." She'd been wrong. Something bad had happened to Elena. Her new associate just didn't know it yet.

  Talk about embarrassing! It was Monday, Elena's first day in her new job, and she had to ask her landlady for directions to her office.

  Mrs. Kennedy waved it off. "No need to be embarrassed. You haven't had time to learn your way around." She topped off Elena's cup and refilled her own before sitting down at the breakfast table. "Tell you what. My husband has to go visit a couple of folks in the hospital. You can follow him, and he'll lead you right to Cathy's office building."

  Fortified with more breakfast than she'd eaten in years, Elena followed Pastor Matthew Kennedy's black Olds sedan as it wove its way through the streets of town. In about five minutes, he pulled over and pointed to his right. Sure enough, there was Cathy's office building. A bit further down the road, Elena saw the hospital.

  Elena waved her thanks and wheeled into the parking lot. Even though it was early, there were about a dozen cars scattered throughout the lot. Probably staff. Most of them were parked at the far end, but she recognized Cathy's auto in a space near the door. A stand-up sign showed the slot was reserved for "Dr. Sewell." Nothing was designated for "Dr. Gardner." Elena was halfway to the end of the lot when it dawned on her: she was a staff doctor now. No more thinking like a resident. She deserved to park next to Cathy. She did a quick K-turn and slid her little Ford in next to Cathy's Chevrolet Impala.

  Elena promised herself she'd have a new car someday. And not just a new car-she wanted a home of her own and freedom from the debt that hung heavy over her head. But if she intended to get any of those, it was time to go to work.

  She lifted her purse from the passenger seat. She'd brought a white coat with her, one with "Dr. Elena Gardner, Family Practice" embroidered over the breast pocket. She pulled it from the back seat, beeped the car locked, and started toward the office.

  When she was with Cathy, Elena had gone in and out through a back door, but for the life of her she couldn't remember how she got there. She took her cue from the glass-enclosed signboard in the lobby and made her way down the hall to the front door of Cathy's office. She took a deep breath, turned the knob, and walked into the waiting room.

  "May I help- Oh, it's you, Dr. Gardner." Cathy's nurse rose from behind the desk and hurried to the door to meet Elena. "I'm Jane. Jane Wilson. I know it's going to be hard to keep everyone's name straight for a while, but believe me, it won't be long before you know most of the folks in town."

  Cathy came out of her office to add her own greetings, and the next few minutes were controlled chaos. One woman, then the other, bombarded the newcomer with things they thought she should know. Finally Elena raised her hands in mock surrender. "I give up. How about I walk around and familiarize myself with the layout." She turned to Cathy. "Then, if it's okay, I'll watch as you see a few patients. If I have questions, I'll ask them later."

  "Of course," Cathy said. "We haven't made any appointments for you yet. I want to let you get your feet on the ground. However-"

  Elena didn't like the sound of that "however." But this was her boss, and she'd better get used to it. So much for being out on her own and independent. "Yes?"

  "I'm on emergency room call for the hospital this week. I thought it might be a good idea for you to take those patients. That should help you build a patient base."

  That didn't sound so bad. Elena had been to the hospital only two days ago, not to mention the brief tour with Cathy on her first visit. And she'd seen it from a distance just this morning. She was fairly certain she could find it again without getting lost-or calling Frank Perrin for help. At the thought of the deputy, she found herself wishing she could see him again.

  Elena tried to put her finger on why she felt attracted to Frank. Maybe it was his resemblance to Mark. After the not-so-subtle distaste her landlady showed, maybe Elena's feelings were the same ones that drive people to test a wet paint sign or to see if an iron's still hot. Anyway, it was nice to have a friend here, one who wasn't also a colleague. Maybe she'd call Frank and offer to buy lunch. Sort of return the favor from the other day.

  The morning passed uneventfully, and Elena picked up Cathy's routine quickly. The office was well organized. The diseases and problems presented by the patients were diverse but not particularly challenging. Cathy took the time to introduce each patient to Elena, following the same pattern each time. "This is Dr. Gardner. She'll be joining my practice. She's very well-trained, and I think you'll like her."

  While the two women waited in Cathy's office for Jane to prepare a female patient for an examination, Elena said, "Why did that last patient frown when you introduced me?"

  Cathy gnawed for a moment on her lower lip. "You won't see a lot of this, but there's a bit in every community. I introduce you as Dr. Gardner. They expect to see someone who looks like them. Instead, they see a woman with darker skin, long black hair, high cheekbones-a classic Latin appearance. Most patients are fine with this. But a few are thinking, This woman is a Mexican. Did she train in Guadalajara? Does she even speak English?"

  Elena's stomach knotted like the fists her hands were forming. "Did you expect this when you took me into the practice?"

  "Of course I did. And maybe I should have mentioned it to you ahead of time. But, frankly, the color of your skin doesn't matter to me. As I've said, you won't find a lot of this here, and once these folks get to know you, it won't make any difference to them, either. You speak clear, unaccented English. You trained at Southwestern, which in my opinion is second to none. You're an excellent doctor, whether your name is Gardner or Perez or whatever."

  Elena saw Cathy's dilemma. She couldn't very well introduce her new colleague by saying, "This is Dr. Elena Perez Gardner. She's a U.S. citizen. She was raised as an Anglo. She trained at UT Southwestern Medical Center. Don't let the color of her skin bother you."

  "Okay, I see where you're coming from," Elena said. "I guess it's up to me to overcome any prejudices these folks might have." She frowned. "What do you think is the best way to do that?"

  Cathy smiled and patted Elena's shoulder. "Be yourself. Let the real Elena come through. After that, things will take care of themselves."

  "That's the last patient," Jane said, and disappeared down the hall.

  Elena had been surprised at how busy the morning was. No wonder Cathy wanted help-pregnancy or no pregnancy. But it was a good experience for Elena. Now she had a decent working knowledge of the way the office ran. All but a couple of the patients warmed to her. And, as the morning wore on, she began to relax.

  Cathy stopped Elena in the hall. "How about letting me buy your lunch? We can go to RJ's. As I recall, our last meal there started out okay but ended up sort of intense. Maybe this one will be better."

  "I guess that-"

  Jane's voice carried clearly from the front desk. "Dr. Gardner, there's a call for you on
line one. Do you want to take it? It's Deputy Perrin."

  Elena could hardly miss the way Cathy's lips pinched at the mention of the name. She'd have to pursue that later. Right now, though, it seemed as though Frank had read her mind. Lunch with him was certainly appealing. She'd been with Cathy all morning, and the furthest thing from Elena's mind was a lunch where the sole topic of conversation was the practice of medicine in Dainger. She needed a break, and Frank Perrin promised to provide a lovely one.

  "Yes, I'll take it." Elena held her hands out palms up in a "what are you going to do?" gesture. "He probably wants to ask me more about the accident report I filed yesterday. Why don't you go ahead? I'll pick up a sandwich somewhere around here."

  "We start again at one," Cathy said, lowering the temperature in the office at least ten degrees with her attitude shift. She shucked out of her white coat, grabbed her purse from a desk drawer, and disappeared out the back door.

  Elena closed the door to the office before she picked up the phone and punched the blinking button. "Frank, this is a surprise."

  "Just keeping my promise to show you the town. Why don't I pick you up in about five minutes? We can grab a quick bite and still have time to drive around before you have to be back."

  "That sounds great. But I have two requests."

  "Name them."

  "Pick me up outside the back door of the office."

  "Secretive, but I'm game. What's the other?"

  "Let's go somewhere other than RJ's."

  Elena dawdled in Cathy's office for five minutes, then stuck her head out the door like a teenager trying to sneak off to a concert. No movement. No sound. She tiptoed down the hall and saw that the front desk was empty. Apparently Jane was at lunch. Good.

  She grabbed her purse and hurried out the back door. As he'd promised, Frank sat in his sheriff' s department SUV outside the rear entrance.