by Barbara Ebel
Table of Contents
DANGEROUS DOCTOR
Copyright © 2019 by Barbara Ebel, M.D.
CHAPTER 1
CHAPTER 2
CHAPTER 3
CHAPTER 4
CHAPTER 5
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
CHAPTER 10
CHAPTER 11
CHAPTER 12
CHAPTER 13
CHAPTER 14
CHAPTER 15
CHAPTER 16
CHAPTER 17
CHAPTER 18
CHAPTER 19
CHAPTER 20
CHAPTER 21
CHAPTER 22
CHAPTER 23
CHAPTER 24
CHAPTER 25
CHAPTER 26
CHAPTER 27
CHAPTER 28
CHAPTER 29
EPILOGUE
FROM THE AUTHOR
DANGEROUS DOCTOR
by Barbara Ebel, M.D.
Book Six of the Dr. Annabel Tilson Novels
Book One: Dead Still
Book Two: Deadly Delusions
Book Three: Desperate to Die
Book Four: Death Grip
Book Five: Downright Dead
Book Six: Dangerous Doctor
Copyright © 2019 by Barbara Ebel, M.D.
All rights reserved. No part of this book may be reproduced, stored, or transmitted by any means – whether auditory, graphic, mechanical, or electronic – without written permission of both publisher and author, except in the case of brief excerpts used in critical articles and reviews. Unauthorized reproduction of any part of this work is illegal and is punishable by law.
Paperback ISBN-13: 978-1-7324466-4-9
eBook ISBN-13: 978-1-7324466-3-2
This book is a work of fiction. Names, characters, places and events are the product of the author’s imagination or are used fictitiously. Any resemblance to actual events, persons, or locations is coincidental.
Acknowledgements
A very special thank you to Sheriff Patrick Ray in middle Tennessee for his input on particular police matters in my novel.
CHAPTER 1
The thickset man stood with a girth as solid as a tree trunk, his eyes peering at a patient’s chart from underneath bushy eyebrows. He stood barely at five-foot-six inches and his firm abdomen protruded from the middle of his white coat, enough to mimic a woman’s early pregnancy. His name was George Gillespie, or more formerly noted on his desk placard as “Dr. George Gillespie, Pediatrician.”
Medical student Annabel Tilson had no clue what the attending doctor was reading from inside the folder he held in his stubby fingers. It was not yet noon and she had tailgated him all morning in his private practice, which he shared with one other physician. Now, as well as earlier, the man’s facial expression was full of prim self-restraint.
He wore a thin black mustache; one so inconspicuous that she wondered why he bothered to let it grow at all. Below it, his lips failed to crack a smile. Nor did he verbally share an observation with her about what he surmised from the preliminary information noted in the chart about the patient’s visit. He closed the file, gave a knuckle tap on the door, and turned the doorknob. With a slight nod of his head, he motioned for her to follow him into the room.
Sitting in a chair, a woman straightened her shoulders and squared her glasses on her nose. Her son, Toby, swung his legs from the examination table and flinched as Dr. Gillespie took two steps forward. The eleven-year-old extended his arms behind him and leaned back like he was giving himself space to evaluate George’s approach.
Annabel remembered being the young boy’s age and a pediatrician’s office was the last place the red-headed youngster would want to be. In the height of the summer, before school started back, there were plenty of activities he could be engaged in outside.
“Hi, Dr. Gillespie,” the woman said. “You previously told me that Toby is old enough to be seen without me, but I want to address two issues with one visit.” She stayed put, appearing comfortable in shorts and a loose white blouse, and darted her eyes to Annabel.
“Mrs. Owens,” Dr. Gillespie said, “Annabel is the newest medical student shadowing me on her pediatric rotation.”
“No problem.” She shrugged while reaching down to a single folded piece of paper lying on top of her pocketbook. Toby and Annabel cracked a smile at each other.
Dr. Gillespie took the form she handed him: “Ohio Department of Health • School and Adolescent Health • Physical Examination.” He rotated his arm to the side and handed it off to Annabel. “A back-to-school form for the nurse’s office.”
Annabel scanned the sheet, which included boxes for a physical exam, health history, screening for vision, hearing, and posture, as well as questions related to speech and ability to participate in academics and sports.
“Let’s get going, then,” George said. He asked Toby to lean forward while he peered into his ears with an otoscope.
“Dr. Gillespie always says not to wait until the last minute to bring your kid in before school starts,” Anne explained to Annabel. “Otherwise, the waiting room is so jam-packed, you’d think he and his partner were giving away free tickets to a Reds baseball game.”
Dr. Gillespie tapped his finger on Toby’s chest. The youth grasped the Florida tourist T-shirt he was wearing and swiped it over his head as if on cue. The pediatrician listened to his heart and lungs and soon asked Toby to walk back and forth in the room. He paid strict attention to his patient and then sat on a stool with the entire medical folder. Annabel handed him back the sheet.
“Does Toby wear glasses that I’m not aware of?”
“No,” Anne said.
George checked off multiple boxes for “yes” or “no” responses and collaborated with Mrs. Owens that Toby had no new physical or academic limitations.
“Tell Dr. Gillespie what you’ve been complaining about,” Mrs. Owens said to her son as she handed him back his shirt.
George glanced over at her and grinned. He hated twofers; when a patient’s office visit ended up with two chief complaints and diagnostic problems because he could only bill for one. A robust yearly salary was not what he was in the specialty for, however, it was becoming more difficult these days to make a reasonable living despite all the hours he put in.
Toby popped his head through his top and grimaced. “Mom, it’s not a problem and I’ve hardly been complaining.”
“I know you better. You don’t want to miss swimming or soccer when school starts, but you did complain twice since we came back from our Florida vacation.”
Toby rolled his eyes with emphasis. “I guess my legs are getting some muscle pain. And yesterday, it started in my back and arms.”
“On physical exam,” George said, “you’re a healthy young eleven-year-old and you’re walking fine. If you have that symptom tonight, one aspirin may chase it away.” He closed Toby’s record and stood. “I’m giving the school form to the front desk so they can make a copy. You two can pick it up on the way out.”
Annabel, Anne, and Toby followed Dr. Gillespie out the door. At the front desk, he added with a sour face, “You know where to find us, but chances are, Toby’s muscles are starting to go through a growth spurt. Before you know it, he’ll be too old to visit a pediatrician anymore.”
“Thanks, Dr. Gillespie,” Anne said, taking the original school form.
“Bye,” Annabel said. “Enjoy the remaining time you have off, Toby, before school starts.”
“Thanks. Nice meeting you.”
Mother and son disappeared out the door. For Annabel’s benefit, Dr. Gillespie muttered out loud as he wrote cursive at the bottom of Toby’s office note. “Last-minut
e comment after school physical: myalgias for several days.”
Annabel sighed. For her, gone were the summers spent with her family enjoying the great outdoors in Tennessee. Amazingly enough, however, this was her last real summer in medical school because this time next year, she’d be starting residency. Pediatrics was her last major subject specialty rotation and maybe it was going to be easier than she thought. She would appreciate a more relaxed atmosphere after her experiences so far.
Another medical student friend, Stuart Schneider, was shadowing the other doctor practicing in the pediatrician’s two-physician practice. She would be glad for Stuart’s comradery, she thought. Then, after the next two weeks with Dr. Gillespie, she and Stuart would finish pediatrics with a team at the University Hospital’s children’s ward.
Annabel realized the two pediatricians were very accommodating to allow medical students to learn, yet clutter up, their office, and also knew that doctors affiliated with teaching through the medical school or residency were skilled physicians on top of their specialties. In her educational experience, most of them had big hearts to pass on their knowledge and instruct the upcoming new generation of physicians, and the ones not working full time for the University did so for little pay or secondary gain.
She eyed George Gillespie. Annabel had no opinion yet; she couldn’t discern what to make of the little sturdy physician who didn’t talk a lot.
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Behind the spacious front desk area, a thin wall separated one room into two. An economical kitchenette was to the right. The room adjacent to it functioned as a supply room with a compact old-fashioned Xerox machine, a stuffed bookshelf, and a card table. Stuart dawdled in there, his hands jammed in his student white jacket. The pediatrician he was following, Heather Clark, had her head posed over a pediatric manual.
Annabel and Stuart nodded at each other like some secret code to express their feeling of ineptness. At least on the internal medicine rotation they had shared, they felt needed, if not abused with “busy” work when more significant events were not keeping them occupied. They recently did OB/GYN at the same time too, but they were on opposite daily time slots.
“Annabel,” Dr. Gillespie said, “come see one more patient with me and then you two can go to lunch.”
She marched after him and he pulled another folder from the inbox outside an exam room. Inside, a young girl stood next to her mother, who sat on the chair. The six-year-old first exchanged a weary glance at Dr. Gillespie and then rested her hand on her mother’s shoulder.
“Good morning,” Dr. Gillespie said. “Jump up on the exam table, Kellie.”
“She’s not jumping anywhere lately,” Mrs. Hill said. “She gets tuckered out quicker these days compared to her friends. We need a refill of her albuterol inhaler.”
Kellie withdrew her hand and did as she was asked. The paper on the exam table rustled as she shimmied up and got comfortable. She had thin, dry hair neatly pulled back in a ponytail and her fingernails were painted a bold pink.
George licked his finger and flipped a few pages to check the patient’s medication and prescription history. “Appears like you’re going through your inhaler quickly. Tell me in your own words, Kellie, what’s going on with your asthma.”
Dr. Gillespie slid the chart on the counter and rubbed his right thumb along the tips of his fingers. Annabel kept a low profile behind him, especially since no one had mentioned her presence.
Kellie shrugged her shoulders. “I use the inhaler almost every other day because I’m coughing. Sometimes I wake up in the middle of the night too.”
“I heard her coughing last night and made her use it,” her mother interjected.
“I bet you’re a pro at this,” the pediatrician said, standing squarely in front of Kellie, “but are you using it correctly?”
The young girl nodded. “I breathe deep and spray with my mouth around it tight. I count to ten holding my breath, take it away, and breathe out slowly.”
“She is a pro,” Mrs. Hill added and George bobbed his head in agreement.
Annabel shifted her weight from one foot to another as an overwhelming sense of déjà vu came over her. The discomfort continued as Dr. Gillespie asked his patient more questions and then examined her. When he was almost finished, Kellie had a coughing spell and took the almost-empty inhaler from her mother. She held it steady in her hand, ready to use it.
Annabel pursed her lips. She closed her eyes for a moment as a wave of emotion crept over her. She fought back tearing up. This little girl’s chief complaint, her sitting there with symptoms of asthma, affected her personally.
Annabel’s older sister, Melissa, had battled with asthma, and now the memory and what happened to her came to the forefront of her thoughts. She had not zeroed in thinking about her sister’s death for a long time, the way she died, the travesty of it. Like Kellie, her sister lived with asthma as she grew up. She was fragile, pale, and sweet and was the “trailblazer” for her and her other sister. It was Melissa that first started calling their grandfather “Pop-Pop” and the granddaughter that adored biology based on his love of the natural world.
It was impossible to not consider what her sister would have become and where she’d be right now. No doubt a physician, a veterinarian, or a biologist. She was sure the both of them would have been thick as thieves, as opposed to her younger sister, Nancy, whom she hadn’t talked to in months.
Annabel wished she could go off and privately sob the held-back tears that she was harboring, but it wasn’t the time or the place. Dr. Gillespie had put all his examining tools away and was standing to the side of the black table.
“It appears Kellie’s mild asthma has become more persistent,” he said. “What she needs to be on now is a daily controller medication. I’m going to prescribe another inhaler for chronic therapy, but this one is an inhaled corticosteroid. It will reduce Kellie’s hyperresponsive airway and it works differently than the short-acting beta-adrenergic agonist, or albuterol, which rapidly reverses bronchoconstriction.”
“Whatever you say, Doctor,” Mrs. Hill said.
“My nurse will come back in to answer any questions you two may have about using it. Make a follow-up appointment if she doesn’t improve. In any case, I can see how she’s doing when you schedule her school physical.”
Behind the front desk, Stuart waited for Annabel.
“By the way,” Dr. Gillespie said to both of them, “corticosteroids are super anti-inflammatory drugs and can be given by different routes. In Annabel’s last patient’s case, the inhaler will deliver a decent dosage to her lungs and not deliver as many side effects as the oral route. We want to prevent adverse effects on our young patient’s bone mineral density, immune function, and growth.”
“Thanks,” Annabel said without much enthusiasm. “I didn’t know steroids could be inhaled.”
A stout middle-aged woman handed paperwork to a parent through the window and faced the students. “By the way, I’m Becky. Despite what the doctors or their two nurses think, I keep this place afloat.”
“That means you have to listen to her,” Dr. Gillespie said and walked away.
“Since you’re going to lunch, there are basically two selections within a short distance: one trendy with great coffee and the other with melt-in-your mouth pizza and pasta. Usually, we tell students to be back within forty-five minutes.”
Stuart nodded for the both of them. They took off their jackets, went through the waiting room, and out the front door. But Annabel’s heart felt heavy. She was fifteen when her sister Melissa died at seventeen years old and now, years later, she realized that she never adequately mourned the passing of her older sister and best friend.
CHAPTER 2
Annabel was grateful she walked the few short urban blocks with Stuart, who was dependably introverted, quiet, and yet extremely bright. He was quite thin, his weight not budging up or down during medical school, and his head usually hung down as if he absorbed his smartness from
something emanating up from the floor. They waited for a utility vehicle to pass and then crossed a street.
It was early summer, Annabel remembered, one of the days that were always special to each member of the family. Their grandfather and parents would break away from their suburban Nashville homes and bring the girls to middle Tennessee. Their destination was the Caney Fork River.
The three sisters were playing, poking sticks between the rocks along the riverbed, around the first bend below the massive Center Hill Dam. Clad in flip-flops, their feet and hands were wet, and occasionally, they’d stare forward at their Pop-Pop. He waded in the river with his fishing pole dangling in front of him. Behind them, both of their parents sat in folding chairs flanked by coolers. A bit of flirting occurred between them and then her father, Danny, leaned over and gave her mother, Sara, a quick kiss.
That summer, Annabel began transitioning to the eventual tomboy she became during her teenage years. She wore a baseball cap while her sisters wore sunhats with wide brims. One of her front teeth had also grown crooked; it would be several more years before braces would become fixtures during her formative teenage years.
The river they played at changed its height, shape, and course depending on the rainfall and the Tennessee Valley Authority’s manipulation of the dam’s gates. That day, a few vultures soared over the forested area, a barely perceptible current passed, and time and again, a rainbow trout splashed at the surface. There was no minimum length to catch and keep those trout, only a maximum daily limit to catch seven. Their Pop-Pop had three in his bucket near the girls and smiled every time another fish jumped up, letting him know its whereabouts.
Melissa, Annabel, and Nancy all squatted around a snail, which made no attempt to move except for its tentacles perched on the top of its head, which quivered back and forth. From the corner of her eye, Annabel noticed a turtle lumbering out of the water. She jumped up and rushed straight over. How she loved turtles and frogs, and most living things, for that matter. The large aquatic reptile had a rough, dark shell mostly covered with mud and algae, but that didn’t hinder her in the least. She reached down to pick him up.
