Hot Docs On Call: His Christmas Wish. Susan Carlisle
for the CT of her abdomen. They would have taken her by wheelchair, so why the bedside X-ray rather than doing it in Radiology?
There might be a perfectly logical reason why they’d done a portable chest X-ray instead of just doing it while she’d been there for her CT scan, McKenzie told herself.
“Is there something wrong?” Edith asked.
“You’re in the hospital, so obviously everything’s not right,” McKenzie began. “It concerns me that you saw blood when you spat up earlier. I need to figure out where that blood came from. Your esophagus? Your stomach? Your lungs? Then there’s your pain. How would you rate it currently?”
“My stomach? Maybe a two or three out of ten,” Edith answered, making McKenzie question if she should have sent the woman home and just seen her back in clinic in the morning.
Maybe she’d overreacted when Edith had mentioned seeing the blood. No, that was a new complaint for the woman and McKenzie’s gut instinct said more was going on here than met the eye. Edith didn’t look herself. She was paler, weaker.
“Does anywhere else hurt?”
“Not really.”
“Explain,” she prompted, knowing how Edith could be vague.
“Nothing that’s worth mentioning.”
Which could mean anything with the elderly woman.
“Edith, if there’s anything hurting or bothering you, I need to know so I can have everything checked out before I release you from the hospital. I want to make sure that we don’t miss anything.”
McKenzie listened to Edith’s abdomen, then palpated it, making sure nothing was grossly abnormal that hadn’t shown on Edith’s CT scan.
“I’m fine.” The woman patted McKenzie’s hand and any moment McKenzie expected to be called dearie. She finished her examination and was beginning to decide she’d truly jumped the gun on the admission when Lance stepped into the room.
“Hey, beautiful. What’s a classy lady like you doing in a joint like this?”
McKenzie shook her head at Lance’s entrance. The man was a nut. One who had just put a big smile on Edith’s pale face.
“What’s a hunky dude like you doing wearing pajamas to work?”
McKenzie blinked. Never had she heard Edith talk in such a manner.
Lance laughed. “They’re scrubs, not pajamas, and you and I have had this conversation in the past. Good to note your memory is intact.”
“That your fancy way of saying I haven’t lost my marbles?”
“Something like that.” He turned to McKenzie. “I’m a little confused about why they did a portable chest X-ray rather than do that while she was in Radiology for her CT.”
“I wondered that myself. I’ll talk to her nurse before we leave the hospital.”
“We?” Edith piped up.
Before Lance could say or reveal anything that McKenzie wasn’t sure she wanted to share with the elderly woman, McKenzie cleared her throat. “I suspect Dr. Spencer will be going home at some point this evening, and I certainly plan to go home too.”
After real food and frozen yogurt.
And mouth-to-mouth.
Her cheeks caught fire and she prayed Edith didn’t notice because the woman wouldn’t bother filtering her comments and obviously she had no qualms about teasing Lance.
“After looking over everything, I’m thinking you just needed a vacation,” Lance suggested.
To McKenzie’s surprise, Edith sighed. “You know it’s bad when your husband’s doctor says you need a vacation.”
Edith’s husband had been gone for a few years. He’d died about the time McKenzie had returned to Coopersville and started practicing at the clinic. Edith and her husband must have been patients of Lance’s prior to his death. Had the woman changed doctors at the clinic because McKenzie hadn’t known her husband and therefore she’d make no associations when seeing her?
No wonder he’d been so familiar with Edith.
“What do you think is going on, Edith?” Lance asked, removing his stethoscope from his lab coat pocket.
“I think you and my doctor are up to monkey business.”
McKenzie’s jaw dropped.
Lance grinned. “Monkey business, eh? Is that what practicing medicine is called these days?”
“Practicing medicine isn’t the business I was talking about. You know what I meant,” the older woman accused, wagging her finger at him.
“As did you when I asked what you thought was going on,” Lance countered, not fazed by her good-natured fussing.
The woman sighed and seemed to lose some of her gusto. “I’m not sure. My stomach has been hurting, but I just figured it was my constipation. Then today I saw that blood when I spit up, so I wasn’t sure what was going on and thought I’d better let Dr. Sanders check me.”
“I’m glad you did.”
“Me, too,” the woman admitted, looking every one of her eighty years and then a few. “I definitely feel better now than I did earlier. I think the oxygen is helping.”
“Were you having a hard time breathing, Edith?”
“Not really. I just felt like air was having trouble getting into my body.”
More symptoms Edith had failed to mention.
“Any weight gain?”
“She was two pounds heavier than at her last office visit a couple of weeks ago,” McKenzie answered, knowing where his mind was going. “Her feet and ankles have one plus nonpitting edema and she says her wedding band,” which Edith had never stopped wearing after her husband’s death, “isn’t tighter than normal.”
While Lance checked her over from head to toe, McKenzie logged in to the computer system and began charting her notes.
“Chest is noisy.” Lance had obviously heard the extra sounds in Edith’s lungs, too. They were difficult to miss. “Let’s get a CT of her chest and maybe a D-dimer, too.”
She’d already planned to order both.
“I’ve added the chest CT and a BNP to her labs, and recommended proceeding with the D-dimer if her BNP is elevated.” McKenzie agreed with his suggestions. “Anything else you can think of?”
He shook his head. “Maybe a sputum culture, just in case, but otherwise I think you’ve covered everything.”
Not everything. With the human body there were so many little intricate things that could go wrong that it was impossible to cover every contingency. Especially in someone Edith’s age when things were already not working as efficiently.
They stayed in Edith’s room for a few more minutes, talking to her and trying to ascertain more clues about what was going on with her, then spoke with Edith’s nurse to check on the reason for doing the portable chest X-ray rather than having it done in the radiology department. Apparently, the machine had been having issues. Edith’s nurse was going to check with the radiologist and text McKenzie as soon as results were available.
“Anyone else you need to see before we go?” she asked Lance.
He shook his head. “I went by to check on the mayor prior to going to Edith’s room.”
“Oh,” McKenzie acknowledged, glancing his way as they crossed the hospital parking lot. The wind nipped at her and she wished she’d changed from her lab coat into her jacket. “How is he doing?”
“He’s recovering from