“I can’t believe little Nicky is a doctor. Well, I can believe it. You were always smart as a whip. Of course, it was equally possible you’d end up in jail. I’m glad you stayed in school.”
I laughed. “Me too.” I studied her for outward signs of problems, and took her hand to check her pulse. Her skin felt clammy and her heart rate was a little high. I checked the computer for her blood pressure which was also high. “Are you in any pain?”
“Oh, I ache everywhere all the time,” she said with a wave of her hand.
“How about in your chest?” I noted the scent of cigarette smoke on her.
“Do you remember when you and little Eli Parker put frogs in my desk?”
“You made us stand in the front of the class holding them for the rest of the day,” I said. I looked down at her lower legs, noting they were swollen. “Any chest pain or difficulty breathing?”
“Everything is difficult at my age,” she said with a sigh.
I went back to the computer. “Are you smoking?”
“Oh, just a few cigarettes a day. They haven’t killed me yet.”
I hid my reaction to that statement behind my next question. “Are you on any medications?” I scanned her medical history, but it appeared that she hadn’t been to the doctor in years.
“No. I’m as healthy as a horse. Well, except for today.”
“What happened today?” I turned my attention back to her.
“I woke up feeling off. You know how you do sometimes. I decided to take it easy, but as the day wore on, I just felt like I was slowing down. Like my batteries were running out.”
“Have you had this before?”
She shrugged. “I don’t think so. I heard you won an award for all your doctoring, is that true?”
“I did last year. Have you taken anything today? Pain reliever?”
“I took a couple of acetaminophen this morning. I wanted to come in sooner, but my son said I probably just have the flu. Oh, he’s probably right. I am feeling nauseous.”
“Peggy, can we get her something in case she needs to be sick?” I turned my attention back to Ms. Mason. “What made you decide to come in?” I was having a difficult time pinpointing the problem out of so many it could be including the flu.
“Well, I was on the phone with Poppy Litner this morning, do you remember her? She taught middle school.”
I nodded. “Yes.”
“I was telling her how I was feeling like my batteries were running out and she said I should see a doctor. Well, of course I didn’t think so. Why would I go to the doctor for a little cold or flu? But then she said people my age can die of that, and well, I’m not ready to go yet, Nicky.”
“You’re not going anywhere, Ms. Mason,” I said. “If you were on the phone this morning, why are you just here now? Did you see your regular physician?” The notes in the EMR didn’t indicate she’d seen anyone, but that didn’t mean it hadn’t happened. Some doctors took longer to put their notes in the system.
“Well, my son couldn’t come get me and so he sent my grandson, but of course he had to finish his video game first. Did you know they can play a game with people around the world all from their living room?” She shook her head like she couldn’t believe the advances in modern technology. “Then when he came, we had to run a few errands first. He got into a fight with his girlfriend, so he wanted to pick up some flowers for her.”
“Dr. Foster?” Another nurse came into the area. “We’ve got a pregnant woman in labor.”
“Where’s Dr. Balding?” I asked, entering more notes into the computer.
“He’s in the middle of inserting a chest tube.”
“Where’s her OBGYN?” I asked.
“Forty-five minutes out. She’s starting to push.”
Shit.
“A baby, how wonderful,” Ms. Mason said. “You go take care of that Nicky. I’ll be fine here. Peggy will take care of me, won’t you dear?”
“Yes ma’am,” Peggy said.
“I’m ordering some blood work and a chest x-ray,” I said to Peggy as I entered the orders on the computer.
“I’m sure it’s just the flu,” Ms. Mason said.
I finished entering the order and pressed the send button. Then I went to Ms. Mason’s side. “Never hurts to be thorough,” I said, repeating something she used to say when were kids.
She laughed. “You always were a good student. Now go deliver that baby. I want to know all about it when you get back.”
I pulled Peggy aside. “Watch her and let me know if anything changes, okay?”
“Of course.”
“I’ll be back soon, Ms. Mason.” I headed toward the area that the mother in labor was in. I could hear her through the emergency room. Some moms were vocal in their labor, yelling, screaming, grunting, and others seemed to pull inward, making very little noise while in labor. This one was letting everyone in the ER know she was having a baby.
“This is Mrs. Pierce,” the nurse said as I arrived.
“Mrs. Pierce, I’m Dr. Foster. It looks like your child is ready to arrive.”
The young woman panted out a few breaths. “The sooner the better.”
“Has labor and delivery been notified?” I asked, going to the computer to read as much as I could about the patient as possible.
“Yes. They’re sending down a nurse.”
“This is full term?” I said as I noted the due date a week away.
“Yes.” Mrs. Pierce moaned, and then bore down like she was pushing.
I rushed to her.
