Chapter 23 #2
“Are you sure? You mentioned a surgery? I could call the authorities to do a welfare check. I just hate to pull them away from their work if he’s fine and watching television like a stubborn old coot.”
I’d have the rest of the year to observe procedures. Me watching wouldn’t change the outcome for that patient. They were in Dr. Rose’s and Foley’s very capable hands.
Maybe I was proving Foley right. I wasn’t sure. I just knew that Liliana was worried about Larry, and she didn’t worry without good reason.
“I can go. It’ll mean I’m late to the clinic, though.”
“That’s fine. We’ll manage.” She clicked a few buttons, then read off the address to me. It was a forty-minute drive. Not so far. And yet, with an unreliable vehicle, still too far away.
“Okay. I’m heading out now.”
“I’ll make a care package for him with some insulin samples for you to pick up.”
I put Larry’s address in my GPS and drove north from Riverton—the opposite direction from home—and then turned onto a tiny blacktop that took me west.
A dirt road led me between fields toward a small farmhouse that had seen better days.
Larry had lost his wife a couple of years ago, and he didn’t appear to have any close neighbors.
He was near the town of Starr, Nebraska—or what went for a town, at any rate, with only a few houses and one small gas station/market—but it would be a hoof to even get that far.
I was guessing Uber was out of the question out here, as were public bus lines.
I pulled up beside his pickup and got out of the car, nerves making my heart jumpy. There was a stillness to the place I didn’t like.
I shook off the sense of dread. I was just being paranoid. He was probably in his recliner like Liliana said, watching the old Westerns he liked. He’d tell me his truck needed work, but he’d get the next county shuttle over to Riverton, and we’d laugh about what worrywarts we were.
I went up the worn porch steps and banged on the door.
There was the barking of a small dog. Nothing else. I knocked again. “Mr. Schumacher! Are you here?”
Bark-bark-bark!
Was I imagining it or did those barks seem anxious? Could a dog really transmit that kind of emotion into their barks? I was losing it.
I knocked again. “It’s Dr. Donovan. Please come to the door so I know you’re okay! Larry?”
The barking went up in pitch. A few whines followed. Okay, I wasn’t imagining it. That dog was upset.
I tried the doorknob. It turned in my hand, unlocked, and I pushed the door open slowly. I wasn’t sure how this dog would react to me coming inside.
The little guy jumped at my legs, a small bundle of frizzy gray hair and floppy ears. He yipped, but showed no signs of aggression. He was hyper or frantic, but not dangerous.
“Okay, Lassie, lead me to the well.”
The dog whirled as if understanding me and ran for the hallway. I followed, casting a glance in the living room as I went. The recliner was empty. So much for that happy image.
I followed the dog to a darkened bedroom. I eased the door open. How embarrassing would it be if old Larry was just having a nap and I barged in?
“Mr. Schumacher?” I called out quietly.
There was a shape in the bed. He wasn’t moving. I rushed over and put two fingers to his carotid artery.
A weak pulse.
Shit. I lifted each of his eyelids. Sunken eyes from dehydration. Dilated pupils. Not fixed yet, so that was something.
I lowered my face to sniff his breath. A sickly sweet odor confirmed my suspicions.
I tugged out my phone and made the call.
“9-1-1. What is your emergency?”
“I’ve got a fifty-nine-year-old man presenting with DKA. He’s unconscious, most likely entering comatose state. We need an ambulance immediately.”
“Where are you located?”
My mind blanked for a minute and I had to check my phone GPS history to read it off to her.
“All right, we’ve got paramedics en route. If you’ll stay on the phone line—”
“I’m a doctor, and he needs my attention. Get here fast.”
I hung up and ran out to the car, cursing myself for leaving Liliana’s package of meds on the front passenger seat. The dog followed me, and it belatedly occurred to me that he could run away.
He was barking again, high-pitched and frantic while jumping against my legs. Guess he wasn’t going anywhere.
“I know, buddy. I’m coming back. Promise.”
I grabbed the plastic sack and jogged back inside. I dropped to my knees at Larry’s bedside, rechecking his pulse. Still there, thank god.
I dug through Liliana’s samples.
“Come on, Lil. Don’t let me down now. I need a fast-acting—aha. Here we go.”
I retrieved the injection pen of fast-acting insulin and lifted his shirt to administer it to his belly.
After that, there wasn’t much to do but monitor his vitals. He needed fluids, but he was unconscious and I didn’t have IV tubing or a bag. I found a blood-glucose test strip in the bag and checked his stats. His numbers were still too damn high.
The ambulance seemed to take an eternity. It was probably only six minutes. Still too long in an emergency.
I opened the door for the paramedics and gave them a quick rundown of Larry’s condition and the insulin I’d administered.
They got an IV set up, started more meds flowing, and loaded him onto a stretcher.
“Which hospital?” I asked.
“Elkhorn.”
“Okay, I’ll follow. What about his dog?”
They shrugged at me. Fair enough. They weren’t animal control. I looked at the little guy, still so worried for his owner. There wasn’t much more I could do for Larry. The ER docs would take care of him.
I’d check in and make sure he recovered. But something told me that Larry would want someone to take care of this little guy, too.
“Come on, buddy, let’s see if you have some dog food in the house. Then we’ll go for a nice car ride. That’ll be fun, won’t it?”
He whined.
“Yeah, I know. I’m worried too, but we’re doing the best we can.”
I crouched down to rub his head. He leaned into my touch, seeking comfort. My chest warmed.
“When your daddy wakes, you’re going to be so happy, huh? Good thing I decided to skip that surgery tonight.”
I’d made the right call. Maybe it meant something about my drive to be a surgeon. Maybe it didn’t.
All I knew was that if I hadn’t come, Larry would have died. And probably this little guy too.
Our health system was fucked. We all knew it. But the fact that a guy like Larry was so close to death when his condition could be easily managed by medication sent a hot rush of anger through me.
We should do better than this.
Larry shouldn’t have to drive so far to see a doctor or pick up medication. He shouldn’t be one bad battery or transmission away from death.
And he damn sure shouldn’t be surviving on only intermittent doses because he didn’t have health insurance and didn’t qualify for Medicaid.
Guys like Larry fell through the cracks in our system, and all the volunteer clinic shifts in the world wouldn’t change that.
But I wanted to.
Somehow.