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He walks faster to keep up. Dr. Tolley is taller than him, and her long legs are used to walking at a faster pace.
“Two elderly patients are in radiology and being prepped for theater. The driver is also in radiology for query rib fractures. There was mention of a middle-aged woman with a possible ruptured spleen. She was driving to the hospital to receive adjuvant chemo post a double mastectomy.”
“Is she in radiology?”
Dr. Tolley hands Samuel the spare pager from her coat pocket. “The message wasn’t clear. She is being prepped for surgery.” She holds her card against the black box on the wall and the double doors swing open. Staff is passing before them like a busy intersection in downtown LA. They slide between bodies without colliding and head to the main desk. Three doctors who have not been introduced to Samuel are in a deep discussion.
“Morning, Dr. Tolley and Dr. McMahon,” the clinical nurse, Margaret, acknowledges their presence although she only gives a fleeting glance. Her head is down, and she’s moving patient files to create a clearing on her desk. Managing an emergency ward demands respect, and within minutes, she reminds him of a bear going about her duties. If antagonized, you know to back the hell away.
Margaret appears to be in her mid-forties with a gray regrowth around the crown of her head, and when she catches him staring at her, she grumbles, “This is no place to be just a pretty face.” She waggles her finger to her right. “Bed sixteen is waiting to be assessed.”
“We were expecting to see the oncology patient,” Dr. Tolley interrupts.
Margaret continues clicking on her computer as though we had disappeared. “Still in radiology. Dr. Tolley, can you please assess room seven? I’ll inform you both when the patient has returned.”
Dr. Tolley shrugs at Samuel, and they head to the assigned rooms. When he locates bed sixteen, he slides the curtain aside before closing it again. He picks up the notes at the end of the bed.
“Morning, Megan. I’m Dr. McMahon.”
“Morning, doctor.”
He flicks over her chart. “I believe you have difficulty in breathing and a cough on exertion.”
“Yes. I had x-rays, and now I’m back here awaiting the results.” She pulls the blue blanket up and over her shoulders. “It’s freezing in here.”
Megan is shaking under the blanket even though the room temperature is steady and not at all cool.
“What time were your x-rays?” He watches her breathing, noting the rise and fall of her chest is labored.
“Half-hour ago, but I was rushed out as there was another emergency.”
He takes the stethoscope from his neck and asks Megan to sit forward. Inserting the ear tips in his ears, he then places it on her back and listens. Crackles are evident along with a dead space void of sound.
“Can you take some deep breaths in and out?”
No change, and then she erupts into a coughing fit.
He rests a hand on her shoulder. “Can I get you some water?”
She points to her bag on the chair. Retrieving a water bottle, she takes a few mouthfuls and tries to catch her breath.
He then hands her the call button. “I’m going to see if they have sent your results. Press the button if you need anything.”
With the emergency demanding attention, Megan’s results may have been overlooked. He assumes the results to be double pneumonia. So he signs a form for the nurse to take blood cultures, arterial blood gases, and a sputum specimen. Then he arranges for her to be admitted for monitoring overnight, along with pulse oximetry and further blood tests to eliminate other diseases.
He accesses her results on the computer. Dark shadows indicate pneumonia, the right side more prevalent than the left.
He finishes his notes and calls the medical ward for Megan to be an inpatient and for an orderly to transport her to the ward.
“We’re not made of beds,” Margaret says from behind him.
“Then you better find one for my patient.” Samuel stands and returns to Megan to tell her she’ll be spending at least one night in the hospital.
He could have sent her home with standard antibiotic therapy for pneumonia and Ventolin if she needed it. With her breathing unstable, he’s not comfortable risking any more lives.
His hands have enough blood on them.
* * *
