“Yikes,” Andrea exclaimed. “I’m sorry to hear that. Did it upset you?”
“Not really, and you don’t have to be sorry. I assure you I didn’t take it personally. I found it more surprising than anything, provided it is true, because my family has always been so unquestionably proud of our Bellevue heritage. It’s even part of the reason I decided to go to medical school. Anyway, I’m definitely motivated to find out just how true her stories are.”
“Well, I’ll be interested to hear what you learn.”
“I’ll be sure to let you know,” Mitt said. “And about Dr. Harington: One more thing caught my attention, and that was how nonchalantly she dealt with the situation when the patient’s heart refused to restart. I mean, she had pulled out all the stops, I guess. But then when it was obvious it wasn’t going to happen she essentially just threw up her hands and said, ‘Okay, that’s it. Leave everything as is,’ and then she walked out.”
“What did you expect her to do?”
“I don’t know, to be truthful. But somehow more than what she did.”
Just then Andrea’s phone went off. She quickly answered. Mitt watched as she listened for a moment, nodded, and said: “Okay, I’ll be right there. Thank you.” After disconnecting she glanced at Mitt. “Well, the evening is starting. Someone’s fallen out of bed on Fifteen East.” She laughed.
Mitt laughed with her at the absurdity. “Welcome to the club. If you’ll wait for me to clear my dishes, I’ll come along with you. All of my admissions today are on fifteen as well.”
“Of course I’ll wait,” Andrea said as she put her empty coffee cup on Mitt’s tray before he hoisted it up and set off. At the exit, she held up, watching him slide his tray in at the soiled-dishes window. A moment later he caught up with her.
“I feel sorry for you,” Andrea said as they headed for the elevators. “It’s nearly eight o’clock on your night off, and you still have three workups to do.”
“No rest for the weary,” Mitt said, and meant it. Doing three more histories and physicals was the last thing he wanted to do. But it could have been worse. At least he’d already learned to slim down the process considerably and essentially just make sure there weren’t any contraindications for them having their surgery. Prior to Madison Baker’s advice, he would have spent an hour on each at a minimum.
They rode up in a packed elevator full of visitors and didn’t try to converse, remembering Dr. Van Dyke’s very specific warning to avoid talking in the elevators in front of nonmedical people because it invariably ended up being about patients. Once out on floor fifteen, they waited for the visitors who’d gotten off with them to disperse. At Andrea’s insistence before they parted, they went through yet another cheek-touching-air-kissing routine.
“Bonne chance,” Mitt said with an exaggerated French accent, playfully mocking Andrea’s insistence on the display of affection. “I hope you get more sleep than I did.”
“I hope so, too,” Andrea said as she set off with a wave over her head, heading east while Mitt turned to the west.
Entering the very busy nurses’ station on 15 West, Mitt felt lucky to be able to snare the last available monitor. As efficiently as possible, he read through the extensive electronic health records of his three admissions. There was Elena Aguilar, a forty-six-year-old recent emigrant from Venezuela. Mitt immediately called the translation department and was assured someone would be available in fifteen to twenty minutes. Elena was scheduled for a vein stripping. Mitt had read that the reason it had been decided to do the procedure as an inpatient rather than as an outpatient, which was typical, was because the woman weighed more than three hundred and seventy pounds.
The next patient, Latonya Walker, was a thirty-eight-year-old Black woman in for a breast biopsy and possible mastectomy. Unfortunately, she, too, was overweight, although not as dramatically as Elena. During medical school Mitt had learned that doing physical exams on such patients took longer than on thinner people for a variety of reasons.
The last patient was Diego Ortiz, age forty-four, in for a thyroidectomy for papillary thyroid cancer. He, too, was a recent emigrant, this time from El Salvador. Of mild interest to Mitt was that Mr. Ortiz’s rather small cancer had been found because a previous diagnosis of hypothyroidism required rather robust daily thyroxine treatment by mouth, drawing attention to the thyroid gland. Mitt found this interesting because he remembered from his internal medicine rotation during third year that being hyper or hypo didn’t increase the cancer risk. In Mr. Ortiz’s case, it was just that his being hypo had made his doctor examine his thyroid particularly closely, finding the small lump that was then diagnosed with a needle biopsy.
“Excuse me,” a voice said, interrupting Mitt’s thoughts. He looked up into the questioning face of one of the many nurses. “Are you Dr. Fuller?”
“I am,” Mitt said, momentarily surprised to be recognized and fearful he was about to be asked a question that he wouldn’t be able to answer.
“The translator is here,” the nurse said, pointing to a middle-aged woman in a short white coat similar to those the residents wore. She was standing outside of the nurses’ station counter.
“Great, thanks,” Mitt said with relief that a Spanish translator was available so quickly. He turned off the monitor he’d been using, gathered together his loose notes as well as the combination ophthalmoscope and otoscope he’d borrowed, and headed out of the nurses’ station.
Doing the physicals and briefs, what he now called “confirmation histories,” did take longer than Mitt had hoped. Once again, the translator was an indispensable help and thankfully very patient, but having to use her significantly lengthened the process. By the time Mitt had finished the three admissions and had returned to the nurses’ station to type up all his findings, it was well after 9:00 p.m. But at least there was one benefit to the late hour. At that time, it was far less busy in the nurses’ station, meaning there were plenty of monitors available. Earlier he’d been lucky. Now he had his choice.
As quickly as he could, he typed in all the information he’d gathered from interviewing and examining the three patients, emphasizing what he knew was the most significant, namely that all three had no signs or symptoms suggesting their scheduled surgeries needed to be postponed. He made it a point to emphasize for the anesthetist’s benefit that Mr. Ortiz was taking a sizable daily dose of thyroid hormone.
When he was finally completely done with the third case, he hit the Enter button and then rapidly stood with the intention of leaving. Instead, he had to wait for an intense but thankfully brief dizzy spell to subside. The moment it cleared, he noticed by coincidence that there was only one person besides himself in the nurses’ station, whom he assumed was the head nurse. Since he’d not yet met her, he was briefly tempted to make the effort to introduce himself, but then he changed his mind. Once again, he’d simply run out of gas. Although his dizziness had passed, its presence suggested to him that he desperately needed sleep.
After tossing his no-longer-needed notes into a wastebasket, he headed out of the nurses’ station on slightly wobbly legs, turning right to head down the long, now-empty corridor toward the elevators. But then he suddenly halted in bewildered awe. Ahead of him in the middle of the fully illuminated hallway was the selfsame hallucination he’d seen after the burst aorta incident. And at the instant he’d caught sight of the blond girl, he was also once again assaulted by the horrid cacosmia, making him gasp for air. It was as if the hallucination of the girl and the noxious smell were connected.