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“Upset stomach and loss of appetite,” her mom replies. “She hasn’t been eating well.”
“Any vomiting?” I question.
The woman shakes her head. “She did have to the potty several times and was very uncomfortable when she did.”
“Does she eat a lot of greasy food?”
The parents exchange glances, their eyes wide. Her mom offers me a jerky nod.
“We own a fast-food restaurant.”
“Gotcha.”
“What’s wrong with her?” the dad questions sharply.
“I can’t say now, Mr. Kale. We’ll have to run some tests to get a proper diagnosis but is there anything else you can think of that can help?”
They shook their heads. “Ok. Let me get to work on those tests so we can see what’s going on. I’ll ask the nurses to give her some medicine for the pain in the meantime. “
“But you have your suspicions. You can guess what’s happening. You’ve seen something like this before, haven’t you?” he presses.
“I would hate to give you a diagnosis without a proper examination and tests to go by. Especially since you guys have already been to a clinic for this same issue. I know you’re concerned about your little girl, and I’ll do my best to provide you with some peace of mind but for now, all I can ask is for you guys to be patient until we get the test results.”
I can tell he wants to argue further but then he lets out a breath. He and his wife move to stand beside the hospital bed. One of the nurses approaches me.
“400 milligrams of acetaminophen and start up an IV,” I inform her.
“You got it, Doc. Should I call Doctor Shatt down here?”
“No, we can call him after we’ve taken a blood test.”
“Alright.”
I order a battery of tests, including blood work, imaging, and an ultrasound. Sarah is brave through it all, holding onto her parents’ hands as we proceed with the examinations.
While the team works on that, I head over to the front desk to fill in some paperwork. Thirty minutes later, I’ve got the results from the tests. I take one look at them and let out a soft breath. Instead of calling down my direct supervisor, I head to the fourth floor where his office is. After one quick knock, I step inside.
“Doctor Shatt?” I say, stepping toward his desk.
The middle-aged man raises his head to look at me. He nods once. “What do you need, Bianchi?”
I place the results in front of him. “A nine-year-old girl came in with a swollen abdomen.”
“Symptoms?” he asks, looking through the results.
I tell him everything the parents told me. A frown pulls across his face.
“It’s not what I think it is, is it?”
His expression is grim as he says, “If what you’re thinking is gastric cancer, then yes, I think it’s exactly that.”
My heart clenches. “Fuck.”
Dr. Shatt raises an eyebrow at my language. He’s the head of the pediatric department, which consists of me, a second-year resident, and an attending physician. Sometimes I wonder why he chose to go into pediatrics since he can be a little rough around the edges, but he’s a good man and I’ve seen how well he treats children. He’s also a great doctor, and if he’s confirming my diagnosis right now, then I can’t keep my promise to that little girl.
“You should inform her parents so we can get her started on treatments,” Shatt says to me, handing over the results.
I hesitate. “Could you please speak to them? You’re much more, um… experienced.”
