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was good that he had a day off yesterday, but I wondered if getting back to work would be like getting on the proverbial horse after falling off. Would he be hesitant? I shook my head. Dealing with death was something doctors, especially emergency room doctors, had to accept and move on from.

Instead, I opened up the files to the contracts I was working on and got to work.

11

Nick

I parked out back and entered the hospital through a side door, not wanting to be noticed. I didn’t want the looks of pity or blame from anyone who might be lurking around the hospital or in the waiting area. I went to the locker room mostly to get my head in the game. I splashed water on my face from the sink and stared at myself in the mirror.

“You got this, Foster,” I said to my reflection. My reflection didn’t look so sure. I left the locker room and headed toward the emergency department. As I reached the triage area, my chest cramped and I felt like I couldn’t take in a breath. My heart started racing, and I had to stop. What the fuck? I resisted putting my hand over my chest, as I didn’t want anyone around me think I was having a heart attack, but holy fuck, that’s what it felt like.

“Dr. Foster? Are you okay?” one of the nurses asked. She was heading past me but had stopped and looked at me with concern.

I took a deep breath. “Yeah, sure. Indigestion.”

“You ate hospital food?”

I smiled, hoping I looked jovial. “That must have been it.” I pushed down the anxiety and forced myself forward.

“We’ve got a full waiting area this morning,” Peggy said as she walked with me to my first patient. “First up, a six-year-old who sliced his arm falling at an old construction site.” I plastered on my smile as I introduced myself, and then gave my usual spiel to the child about gluing him back together as I used liquid stitching to treat the gash in his arm.

Next up, I set the arm of a hiker who fell while venturing off the trail. I began to note that often people ended up in the emergency room for breaking the rules, such as going into restricted areas.

My next case was a twelve-year-old complaining of stomach ailments. My heartbeat quickened, as I started my differential diagnosis. Unlike the cut and broken limb, internal ailments could be any sort of problem something benign like a stomach ache to something serious, like a bowel obstruction.

“He’s not so bad right now,” his mother said to me. “But the ride over, he was in agony.”

I looked up at her. “In the car?”

She nodded.

“Was it worse when you went over bumps?” I asked.

“Uh … maybe.”

I turned to Peggy. “Let’s do blood and urine, and order an ultrasound.”

“What is it?” the boy looked at me in a panic.

“I suspect it’s your appendix. We’ll do a few tests to confirm that,” I said trying to be reassuring.

He gripped his mother’s arm. “How do you fix it?”

“We’ll arrange for you to have surgery.”

His panicked eyes looked to his mother. “Will it hurt?”

“They’ll give you some happy juice so you’ll sleep. You won’t feel it.” Peggy smiled at the boy.

I wanted to reassure him, and at the same time, as routine as appendectomies were, that didn’t mean there was no risk. For one, I wasn’t sure how severe the issue was now. It could burst, and we’d have a whole new set of life-threatening problems. Surgery alone had its risks.

Tension built in my shoulders and a drip of sweat ran down my back.

“It’s a common surgery,” Peggy said. “Nothing to worry about.”

I shot her look and then turned to the mother. “There are always risks, but the risk of letting an appendix fester and burst outweighs the risks from surgery.”

Peggy cocked her head and looked at me funny, but continued to pull together the items to take blood and get a urine sample.


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