My next case was a twelve-year-old complaining of stomach ailments. My heartbeat quickened, as I started my differential diagnosis. Unlike the cut and broken limb, internal ailments could be any sort of problem something benign like a stomach ache to something serious, like a bowel obstruction.
“He’s not so bad right now,” his mother said to me. “But the ride over, he was in agony.”
I looked up at her. “In the car?”
She nodded.
“Was it worse when you went over bumps?” I asked.
“Uh … maybe.”
I turned to Peggy. “Let’s do blood and urine, and order an ultrasound.”
“What is it?” the boy looked at me in a panic.
“I suspect it’s your appendix. We’ll do a few tests to confirm that,” I said trying to be reassuring.
He gripped his mother’s arm. “How do you fix it?”
“We’ll arrange for you to have surgery.”
His panicked eyes looked to his mother. “Will it hurt?”
“They’ll give you some happy juice so you’ll sleep. You won’t feel it.” Peggy smiled at the boy.
I wanted to reassure him, and at the same time, as routine as appendectomies were, that didn’t mean there was no risk. For one, I wasn’t sure how severe the issue was now. It could burst, and we’d have a whole new set of life-threatening problems. Surgery alone had its risks.
Tension built in my shoulders and a drip of sweat ran down my back.
“It’s a common surgery,” Peggy said. “Nothing to worry about.”
I shot her look and then turned to the mother. “There are always risks, but the risk of letting an appendix fester and burst outweighs the risks from surgery.”
Peggy cocked her head and looked at me funny, but continued to pull together the items to take blood and get a urine sample.
I needed some water. “I’ve ordered the ultrasound and put in for the blood and urine tests. Can you stay on it? Make sure they’re done?”
Peggy studied me but said. “Yes, Dr. Foster.”
I exited the area and went to the staff lounge to get a bottle of water. I drank it down, willing the cool water to wash away the tension and anxiety. What the fuck was wrong with me?
I returned to the emergency area. Since we were waiting on tests for the boy, I met with the next patient. I entered the area the middle-aged man waited for me in.
“Hello, I’m Dr. Foster.” I shook his hand and then pulled up the notes on the computer. “You’re having back pain?”
The man studied me, focusing on my face. “That’s right. You’re sort of young, aren’t you?”
It had been a while since anyone had commented on my age. “I assure you I have gone through medical school.”
“Is that what you told Ms. Mason?”
His question was like a hot lance straight into my gut. “Where is the pain located?” I said, ignoring his question and starting my assessment.
“Around the middle.” He reached his hand behind his back to show me.
“Both sides?” I asked as I moved behind him on the exam table.
“No, just this side.”
That suggested a possible kidney issue. “Are you having any trouble urinating? Pain or maybe frequency?”
“It’s my back, not my dick, doc.” He shook his head. “Are you sure you know what you’re doing? Rumor is you messed up and that’s why Ms. Mason is dead. She was my teacher and my kids’ teacher. An icon in the community, and you let her die.”
My heart rate shot up and I had to put my hands on the examining table to catch my breath.
The nurse looked at me. “Would you like me to order urine tests?”
I nodded. “Yes.”
“Urine? I’ve got pee in my back?”
“What you’re indicating could be your kidney, not your back,” the nurse said.
I tried to pull in a breath to calm my nerves, but it was like there was a tourniquet on my lungs and I couldn’t suck in air. My hands began to shake. I was fucking losing it.
“Order the test.” I said moving to exit. “And see if Dr. Balding can follow up. I’ve got a kid with an appendicitis.”
The nurse’s eyes narrowed and I knew what she was thinking. Doctors didn’t leave patients in the middle of an exam. But if I didn’t get out of there, I was going to fucking lose my mind.
I rushed from the room and back to the staff room. I’d known that something had seemed to go terribly wrong with Ms. Mason. And I knew the word around town was that I’d fucked up. But something about hearing it in person, of having someone question my ability, affected me. It was like everything I knew about medicine went out the window. My confidence, already a little shaken, was now demolished. Realizing that make me feel weak. I was supposed to be a kickass doctor, and here I was being tortured and beaten down by my own self.
I decided to go outside in the clean mountain air, hoping it would clear away the tension and self-doubt. It wasn’t like I hadn’t lost a patient before. I had. All of them were difficult, but I’d been able to suck it up and move on. So, what was it about Ms. Mason that had me unraveling? I did everything right. I ordered the tests. I asked the nurse to keep me apprised of her condition. So, what the fuck had gone wrong?
“Nick?”
I whipped around to see Mia. When she saw me, her brow arched up, as if she was surprised at what she saw. I must have looked as unhinged as I felt. “Are you all right?”
“What do you need?” I asked wincing at the terseness of my voice.
Her eyes narrowed. “I need to know you’re all right before you go back and work on anyone.”
I ran my hand through my hair. “You and ole bubba seem to think I killed Ms. Mason.”
“I never said that.” She moved toward me, with concern on her face.
She reached out to touch my arm but I pulled back. “You
