Chapter 9
AIDEN
I entered the exam room at the free clinic to find a woman in her mid-forties. She straightened and smiled when she saw me, but I could see the effort it took her. She was worn down around the edges.
“Hey there, I’m Dr. Donovan. I’m a volunteer resident working under Dr. Meadows’ supervision today.”
“Hi, Doctor. Thanks for seeing me.”
Warmth spread through my chest. Today in the clinic had been the first time I got to use my title as a doctor working with patients. Back in med school rotation, we always had to announce ourselves as student doctors.
With me going into research instead of a more hands-on residency, my change in status hadn’t felt real before. Suddenly, it did. This woman, and the few people I’d seen this morning, were counting on me for their medical care.
It was a big responsibility, one that I took seriously.
I skimmed the electronic chart the nurse had updated. “So, Sandra, we’re not feeling so hot today, huh?”
“No,” she said, voice rasping. “Can’t seem to get rid of this cough.”
She broke into a series of barking coughs as if to demonstrate. Just from the sound of it, I was leaning toward bronchitis.
“All right, let’s take a look at you.”
I shined a penlight into her nose, ears, and throat.
“We’ve got some redness and swelling. Let’s listen to your lungs.” I hooked the stethoscope into my ears and pressed the metal diaphragm against her upper back. “Take a big breath for me.”
She inhaled a shaky breath, then released it.
I shifted the stethoscope’s diaphragm lower. “Again.”
She started to inhale and broke into another coughing fit. I waited it out.
“Sorry,” she wheezed.
“That’s all right.” I’d heard the low-pitched gurgles, the whistles, and crackles to make my diagnosis.
I reached into my pocket and fished out a butterscotch candy for her. “This should soothe your throat until we get you the good stuff.”
She laughed a little and took it with a grateful smile, unwrapping the yellow candy and popped it into her mouth.
I always carried a few around, a habit I’d picked up from one of the attending doctors in Maple Grove. It was for me, more than the patients. With long, unpredictable hours between meals as a student doctor, I’d sometimes needed a boost in blood sugar.
“We’ll get you a script for antibiotics,” I told Sandra. “You’ll need some steroids, too, to open the bronchial tubes and make your coughs more productive.”
She flushed and looked down. “I, uh, don’t have insurance. Do you know how much…”
Liliana had given me the rundown on resources we could offer to patients who couldn’t afford medication.
“That’s okay. We have some insurance match cards that will get you a discount. I’ll send in the nurse with some for you. Do you have a preferred pharmacy?”
“The hospital is fine.”
I nodded. “Okay, get plenty of rest and fluids. Stay on the meds for the full prescription. You should start to feel better in a day or two, but it’s important you finish the entire dose.”
“I will. Thank you.”
I patted her arm. “All right, get dressed and I’ll send the nurse back.”
I exited the exam room and went into our joint office. Dr. Meadows was in with a patient, so I had to wait for his okay on the prescriptions.
I took a seat at the desk and updated the digital chart on my tablet with the details of my examination. Liliana entered behind me, muttering something about impatient old coots. She knelt to retrieve a few samples of insulin, her movements jerky with annoyance.
“You okay over there?” I asked.
She huffed. “This man just infuriates me! He won’t keep up with his prescriptions. He comes in every few weeks in rough shape. One day, he’s going to push it too far, and I just…” She made a frustrated growly noise. “I wish I could do more.”
“You’re doing a lot,” I said. “You care more than most people do.”
“It’s never enough,” she said with a sigh. “This stubborn man is gonna give me gray hair before my time.”
I laughed. Liliana was in her early thirties. She had plenty of time before she went gray. “But think of how great you’ll look with red highlights.”
“You think?” She patted her hair. “I might have to try that.”
“Hey, Lil, I know you’re busy, but my patient will need an insurance match card. Can you go talk to her about how it works when you’re done with Mr. Stubborn?”
“Sure.” She opened a drawer to withdraw the cards. “How many prescriptions?”
“Two, assuming Dr. Meadows signs off on it.”
I couldn’t work independently as a doctor until I was formally licensed, and that couldn’t happen until I finished residency.
Dr. Meadows had observed me with my first three patients, then declared it was time to take off the training wheels.
He still had to review my charts and authorize prescriptions, though.
“He’ll sign off,” Liliana said without hesitation. “This is pretty standard care. Dr. Meadows doesn’t really get fussed over red tape.”
“What’s this?” Dr. Meadows walked in. He was mid-sixties, with salt-and-pepper hair. “Are you telling tales on me, Nurse Garcia?”
She chuckled. “Only the good ones.”
“I knew I liked you.” He turned to me. “Have something for me to review?”
I handed him my tablet. “Case of bronchitis.”
“Mm-hmm. Yes. This all looks good. What would you recommend prescribing?”
I rattled off the generic antibiotic and steroid combination I thought would be most affordable and get the job done. He nodded.
“Good, good. Let’s give her a sample of the Prednisone, so she can start breathing easier immediately.”
Liliana opened a different cabinet and withdrew the packet and slipped it into her pocket. “I got you covered, Dr. Donovan. Your next patient is in Exam 4.”
“Thanks, Lil.”
I saw patients for the next two hours—until the clinic closed at seven. Dr. Meadows walked out with me while Liliana stayed behind to finish some paperwork and lock up.
“Good work today,” he said. “I’d never know you hadn’t done a residency yet.”
“I did a rotation in primary care up at Maple Grove Medical,” I said. “Got plenty of practice before deciding to specialize in surgery.”
“You’re a natural with people. Great bedside manner. When Liliana told me you came from the surgical department, I had my doubts. Not the most personable doctors sometimes.”
I thought of Dr. Foley’s attitude around me. He’d dismissed or insulted me in every interaction. “Yeah, I guess there are some egotistical assholes. Dr. Rose is lovely though.”
Dr. Meadows nodded. “Ah, yes, our celebrity doctor. She’s impressive. Is that what brought you here?”
I hesitated. Did I want to share that I’d come here to rectify mistakes that never should have been made?
“She’s part of the reason,” I said. “My brother lives in town, and I…wanted to strengthen my application for residency in Baltimore or Cleveland.”
“Ah, an overachiever.”
“I wouldn’t say that.” After all, I’d underachieved or else I could have landed one of those residencies already.
“You could have easily matched with dozens of other residencies, I’d wager. You’ve got a confidence that many new doctors lack. But that wasn’t good enough for you, was it? You wanted the best.”
“Does that make me seem entitled or spoiled?”
“No, son. It makes you seem passionate. Ambitious. Good traits in a surgeon. But you’ve got a lot of compassion, too. Surgery isn’t the only path you could take.”
“I considered primary care,” I admitted. “But…”
“It’s not the rockstar of the medical world?”
“Something like that. I want to make a real difference.”
“Well, you did that today. Make no mistake. I hope we’ll see you back here tomorrow.”
“Every weekend,” I promised. “I’ve got to keep up with my research hours, but I’ll try to fit in at least one more evening shift during the week.”
“See?” He grinned. “Total overachiever.”
I laughed as I unlocked my car and got behind the wheel. Dr. Meadows’ praise meant a lot to me. Dr. Rose was always so preoccupied with her surgeries and Dr. Foley was so full of himself that I didn’t get a lot of feedback on my work.
I’d observed two surgeries—both basic procedures Foley was handling on his own. Unlike larger hospitals, Elkhorn didn’t have a dedicated observation room, so the only way to watch was to be in the OR with the surgeon’s blessing. So far, the timing hadn’t been right for me to see Dr. Rose in action.
Foley was good, but I was impatiently waiting for a chance to see Rose handle a complex surgery.
It wasn’t going to happen tonight, though, and I was already running late for dinner with Flynn and Bailey and all those brothers.
I drove across town and pulled off the highway onto a bumpy drive that passed by the auto shop. I’d been out here for Thanksgiving—and again to get my car serviced my first weekend in town—so I knew the way.
I parked next to Bailey’s red Camaro, a sleek GTO, and a couple of motorcycles. I recognized the dented tailpipe on Knight’s bike. Shit. I forgot he was going to be here.
Bailey came around the corner of the house, grinning when he saw me. Two dogs trailed him, a German shepherd and a black-and-white border collie, tongues lolling out as they panted.
“Hey!” he said as I lowered a hand to indulge the doggos’ sniffs and licks. “We weren’t sure you were going to make it. Knight said you’ve been working a lot?”
Guilt niggled at me. I was working a lot by choice. The less time I spent around Knight, the better. I didn’t trust my self-restraint. Not when that night in Omaha continued to live rent-free in my head.
The way Knight had made me lose control was incredibly freeing—and incredibly scary. I really couldn’t let that happen again.
“Yeah, I picked up some hours at the free clinic today. Sorry I’m late.”
“No worries. I hope you brought your appetite. Flynn went a little overboard on the meat. We’ve got enough hamburgers and brats to feed twenty men.”
I laughed. “More leftovers for everyone, right?”