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7
GRAYSON
Wanda sits on the exam table in her tailored pants and matching sweater set, pearls around her neck and her hands clasped in her lap.
“Now, Dr. Mercer, I don’t want you to worry,” she says. Her voice shakes a little more than it used to, but I don’t know if that’s simply a result of aging. I hate to admit it, but she sounds a bit scared.
“I won’t worry,” I tell her, but of course, that’s an impossible promise to keep. I worry all the time. Or at least, I’m experiencing concern all the time. One of the skills that I’ve tried to develop is to feel the emotion without the connection, which sounds terrible now that I say it. To keep my brain unplugged from my heart, I guess. Understanding without grief. Concern without worry. Acceptance of diagnosis without sorrow. Pinpointing without blame. It’s a weird skill, honestly, and right this minute, I’m stretching it.
Because Wanda Chamberlain has a tear in her eye.
“Why don’t you tell me what’s going on?” I say, sitting on the stool and rolling close to her. I hold my tablet in both my hands to avoid reaching out to pat her knee. Keep it totally professional.
“I have an appointment with my heart doctor in a month,” she says, and I swallow away a lump of concern. Of course she has a heart doctor. She’s an older woman who runs nonstop to oversee every aspect of Chamberlain Academy. Wanda’s heart is what keeps this school running, and if there’s a weakness there . . .
“But something’s slowing down,” she says, making a circling gesture that includes pretty much all of her from the waist up.
My brain fills with possible translations of “slowing down,” and I force my attention to her words. Giving all my effort, I replace thoughts ofWandawith attention tothe patient. This is no easy task, but it’s how I have to do things. How I keep everything professional.
“Breathing isn’t what it used to be,” she says. Then she grins. “Many, many things aren’t what they used to be, but breathing is a pretty crucial part of my daily routine.”
“Mind if I take a listen?” I swear, I’ve never said those words before. I sound like a TV doctor from the 1960s.
I place the stethoscope against her back, listening to hear breathe. There’s a crackle I don’t like the sound of, but I don’t say anything until I listen again, the scope against her heart. I feel her eyes on mine, watching for any reaction. I give her nothing, keeping my gaze determinedly away. Doesn’t matter what I’m looking at, as long as it’s not Wanda’s eyes.
Elder care is a specialty, and not mine. But there are things everyone learned in school, residency, and rounds. And the sounds of COPD are right there, moving from her lungs to my ears.
I roll back a few feet, needing a bit of space. “Have you had pneumonia recently?” I ask.
She shakes her head. “Not that I know of,” she said.
Do I tell her she would have noticed? But knowing Wanda’s strength, she might have muscled through it.
“I’m hearing a bit of a rattle,” I tell her. Again, words I’ve never said. “Have you ever been a smoker?”
She gives me a look somewhere in the neighborhood of mild disdain. “Dr. Mercer, now really.”
“Did you spend a lot of time in rooms with smokers?” I ask again.
“Do you think I’ve got lung cancer?” she asks. I’m surprised by how quickly she asks.
I shake my head. “I have a lot of talents, but cancer is not something I can hear,” I tell her.
She smiles. “Right.”
I wait, and she answers my question. “I’ve been on the board here for many years, but I didn’t run the trust until I was in my thirties. Before then, my father and my uncle ran things, and there were many meetings held under a fog of cigarette and cigar smoke. You can bet that as soon as I took over, that nasty smoking habit was eradicated.” She shakes her head and waves a hand in front of her face, as if blowing away both the smoke and the memory.
“Sounds like you were ahead of the indoor clean air acts,” I say.
She nods. “Of course, I was in my thirties about ten years ago,” she says with a grin.
I hold up my tablet. “I might be the only person around here who wouldn’t believe that,” I say. “Your chart doesn’t lie.”
She leans close. “But you’ll never tell.”
“Of course not,” I say, smiling at her mock-serious expression.
She shakes her head. “I’m not joking, Grayson. I mean, you wouldn’t tell anyone if I was slowing down.” She means it. No more playing.
