Chapter Twenty-Seven
DOC HADN’T BEEN able to shake the uneasy feeling he’d had since seeing Lucas lying lifeless on the ground. Lucas had tried to tough it out, proudly accepting his awards and congratulatory embraces, but then he’d told them his head hurt, and they’d come directly to the emergency room. It was nearly eight o’clock, and Lucas was sitting on the exam table, his long legs dangling off the side, his arms crossed and his fingers drumming while they waited for the doctor to come in. The triage nurse had taken his vitals and put a cervical collar on him, which made him look even younger and more vulnerable than he was.
“How’s your head, buddy?” Doc asked.
Lucas shrugged. “Still hurts. Can I take this thing off? My neck doesn’t hurt.”
“No, honey. They said not to,” Juliette said.
“Let me see how much longer it’s going to be.” Doc got up and opened the curtain.
Mandy, the nurse he’d dated, was walking by and stopped when she saw him. “Doc? Hi. What’re you doing here? You okay?”
Shit . “Hi, yeah. My son fell off a bull.” Son came out without any thought, and he realized his mistake. He prayed Mandy wouldn’t make a scene.
“Your son ?” she whispered. “Are you married ?”
“No. My girlfriend, Juliette, and I just reconnected after sixteen years. I didn’t know about him.” He didn’t know what the right thing to do in this moment was, but he knew Juliette could hear him talking to a woman, and he didn’t want her to worry. He stepped aside, allowing Juliette to see who he was talking to, and prayed this wouldn’t go south. “Juliette, this is Mandy. We went out a while back. Mandy, this is Juliette and our son, Lucas.”
“ Oh ,” Juliette said a little awkwardly. “Hi.”
“It’s nice to meet you.” Mandy looked between Doc and Juliette, and a small smile appeared. “You’re a lucky lady. Doc’s a great guy. I wondered why his heart was never up for grabs, but now I understand. I’m glad you’ve reconnected. I hope you’re not hurt too badly, Lucas.”
“Thanks,” Lucas said.
Relief swept through Doc. “Thanks, Mandy.”
She nodded. “Take care.”
As she walked away, Doc pulled the curtain closed instead of going to look for the doctor and took Juliette’s hand, addressing her and Lucas. “Sorry about that.”
“It’s okay,” Juliette said. “We know you had a life before we got here, and she was nice about it.”
“Yeah, who cares?” Lucas said.
The curtains parted before Doc could say anything more, and in walked Dr. Chen, a tall thin woman in her early fifties with straight black hair and wire-framed glasses whom Doc knew from the many years they’d been working with the hospital for their fundraisers. “Doc,” she said with surprise. “I wasn’t expecting to see you in here.”
“Hi, Dr. Chen. This is my girlfriend, Juliette Chambers, and our son, Lucas.”
Surprise flickered in her eyes for only a second before she caught it and schooled her expression. “Well, it’s a pleasure to meet you both, although better circumstances would have been nice.” She smiled at Lucas. “Lucas, Nurse Jacob told me you are a heck of a bull rider, but a bull got the better of you on your dismount, and you landed on your back. Is that right?”
“Yeah, but I won the competition,” he said proudly.
“Congratulations. Did you hit your head when you fell?”
“I’m not sure, but I don’t think so. I hit the ground, and the next thing I knew, Doc and another guy were looking down at me asking if I could hear them.”
“He landed on his back,” Doc said.
“Okay,” she said. “Lucas, do you remember everything that’s happened since your fall?”
“Yeah. I argued with them about coming here. Then I got something to eat, and I accepted my awards, but my head hurt, so we came here.”
Dr. Chen looked at Doc and Juliette. “Mom? Dad? Does that sound about right?”
“Yes,” they both said.
“Good. Lucas, are you in any pain?”
He pointed at his head. “My head hurts.”
“On a scale of one to ten, one being no pain and ten being the worst pain imaginable, how would you rate your pain?”
“Five, maybe.”
“And do you hurt anywhere else? Your arms, legs, back, neck?”
“Not really. My upper back is a little sore, but it doesn’t really hurt.”
“Can you rank it on a scale of one to ten for me?”
Lucas’s brows furrowed. “Three, I think.”
“So, bad enough to be annoying, or worse?”
“It’s not annoying. It’s just sore.”
“Okay. That’s not unusual after an incident like yours. I’m going to do a quick exam, and we’ll see what’s going on.” She put on gloves and did a neurological exam, and then she checked his reflexes and had him scrunch his shoulders and wiggle his fingers and toes. She moved behind him and palpated his back, asking if it hurt when she touched certain areas.
Lucas didn’t seem bothered by any of it.
She loosened the cervical collar and began examining his neck. “Does this hurt?”
“No,” Lucas said.
She repositioned her fingers. “How about this?”
Lucas shook his head. “No.”
She continued feeling around. “Tell me if anything hurts. Even a little.” Her brows knitted. “How long have you had this lump on your neck?”
“I didn’t know I had a lump,” Lucas said.
“Have you been sick recently or had a cold or a toothache?” she asked.
“No,” Lucas said.
“Then it could be from the fall,” she said. “Does it hurt when I apply pressure?”
“No.”
Doc thought back to Lucas’s practice last week. He’d taken a hard fall, and Doc had checked him out, but he didn’t remember anything unusual on Lucas’s neck at that time.
Dr. Chen refastened the cervical collar and had him lie down so she could complete her exam. When she was done, she took off her gloves and addressed Doc and Juliette. “I don’t feel any broken bones, but I’d like to get some blood work and a CAT scan of Lucas’s head and neck and X-rays of his back, so we can make sure there’s nothing going on that we should be concerned about. Nurse Jacob will bring in the orders, and then you can go up to radiology.”
“They’re going to do them now?” Lucas asked.
“It might take them a while to get to you, depending on how many other patients there are, but yes, they’ll do them tonight. Then you’ll come back to see me for the results.”
“Are you concerned?” Doc asked. He’d watched closely as she’d examined Lucas, and he didn’t see any neurological or motor deficits. Whatever she felt in his neck didn’t seem to bother him, either, so he wasn’t overly concerned, but he wanted to hear it from her.
“He had a traumatic fall. I’d be remiss if I wasn’t,” she said. “Let’s get the tests done so we can see if we have cause for concern, and we’ll go from there.”
Doc should have known better than to ask. Of course she couldn’t give the all clear without seeing the test results. “Right. Of course.”
“Thank you, Dr. Chen,” Juliette said.
“Can I take off the collar now?” Lucas asked hopefully.
“I know it’s uncomfortable,” Dr. Chen said. “But to be on the safe side, I’d rather you kept it on until after we have the results.”
Lucas groaned.
NEARLY THREE HOURS later, they were back in the emergency room waiting for Dr. Chen to give them the results. It had been a long night, and they were all on edge. Lucas had been texting all evening and complaining about having to sit around. He was bored, tired, and irritated with the cervical collar. On the upside, his headache had subsided. Doc’s family had been texting him and Juliette to check on Lucas, so he’d started a group thread that included his family and Juliette to keep everyone up to date. He’d asked Cowboy to take care of Juliette’s horses, and Dare and Billie were checking on his dogs.
Lucas looked up from his phone. “Can I go on a trail ride tomorrow with Layla and her cousin?”
“We’re sitting in the emergency room waiting to see if you have a head injury,” Juliette said. “Don’t you think we should wait to get the results before making plans to go horseback riding?”
“I don’t have a head injury,” Lucas snapped. “My headache is gone . I’m not even dizzy. Please?”
“Why don’t we ask Dr. Chen after we get the results?” Doc suggested.
“Whatever.” Lucas thumbed out another text.
Doc took Juliette’s hand. “You okay? Do you need anything? A drink? Something to eat?”
She shook her head. “I’m just ready to get the results and go home.”
“Me too,” Lucas said without looking up from his phone.
Doc wished they were all going to the same home. “What about you, Lucas? Are you hungry? Thirsty?”
“No. I’m good. Thanks.”
When Dr. Chen came in, she smiled warmly and said, “Good news, Lucas. We can take off that uncomfortable collar.”
“ Yes . Thank you,” Lucas said, and they all breathed a sigh of relief.
Dr. Chen removed the collar and set it down. “The CT scan of Lucas’s head was clear, as were the X-rays, so there’s nothing to worry about there.”
“See?” Lucas said. “I told you I didn’t have a head injury. Can I go on the trail ride tomorrow?”
“Sure,” Juliette said.
“We did find an enlarged lymph node on the right side of Lucas’s neck that I think you should get checked out,” Dr. Chen said.
“Lucas, if you have mono, I’m going to kill you,” Juliette said. “Does that still mean weeks off school?”
“I don’t have mono. I’m not sick,” he snapped.
“I ran a monospot with the blood work and have ruled out mono,” Dr. Chen said. “The rest of the labs were normal, and I didn’t feel any other swollen nodes. I’m not sure what’s causing this, which is why I’m recommending you get it checked out. I’ve provided names of a couple specialists on your discharge paperwork.” She handed Doc the paperwork.
A specialist? Doc mentally ran through the possible causes of swollen painless lymph nodes.
“Another doctor? Just for that?” Lucas asked.
“Don’t worry. It’s not happening tonight,” Dr. Chen reassured him.
“They can be caused by lots of things, like viral infections and sore throats,” Juliette said. “Maybe you’re coming down with something.”
“It’s probably nothing,” Doc said to reassure them. “But we’ll get it checked out. Thank you, Dr. Chen.”
“Let me feel it.” Juliette got up and felt Lucas’s neck. Concentration lines deepened across her brow. Doc could tell she didn’t like what she felt, but she managed a small smile. “Yeah, it’s probably nothing. We’ll follow up and get it looked at.”
“Can I still go horseback riding tomorrow, Dr. Chen?” Lucas asked.
“Absolutely,” she said. “Try to land on your feet when you dismount.”
He smiled. “I will.”
“You might be sore tomorrow from your fall. Tylenol or Motrin should help,” Dr. Chen said.
“Thank you, Dr. Chen,” Juliette said, her voice heavier than before. “Ready, Lucas?”
“Yeah. Can I get a Dr Pepper from the vending machine on the way out?” Lucas asked as he and Juliette walked out.
Doc hung back and touched Dr. Chen’s arm, stopping her from walking away. “Robin, between you and me, should we be worried?”
Her expression turned apologetic. “If he were my child, I’d get him in right away.”
Doc managed a nod, and as she walked away, he quickly scanned the paperwork for the referrals. Dr. Michael Santowski, Pediatric Oncologist and Dr. Bethany Rodgers, Pediatric Oncologist .
His stomach plummeted. He looked down the hall at Juliette and Lucas pushing through the doors to the lobby, and a million thoughts hit him at once, his gut twisting. Emotions swamped him, making it hard to breathe. Pull your shit together.
He forced himself to focus, mentally batting the painful thoughts away. He needed to figure out how to break the news to Juliette and how they’d get Lucas to an oncologist without scaring the ever-living-fuck out of him.