Chapter 8
Chapter Eight
BARRETT
M onday mornings are always unpredictable.
It’s the easiest day of the week to book a last-minute appointment and the first chance for patients who’ve run into trouble over the weekend to be seen. I’ve come in to waiting rooms packed with pregnant women concerned about spotting or Braxton-Hicks contractions more times than I can count.
I’m accustomed to keeping a level head in the midst of a Monday stress fest and calming the fears of patients experiencing common, mostly benign symptoms that won’t put their babies at risk. Even when providing care for more serious issues, I’m rarely shaken. I’ve been working in a small, but busy private practice since the summer I finished my residency and am accustomed to the bustle.
At first, I was partners with Dr. Graham, an older doctor near retirement, who was eager for a protégé. But for the past three years, I’ve managed the caseload solo. Dr. Graham still delivers babies occasionally, as do the midwives in town, whose services have become more popular in recent years, but it’s largely a one -man show around here.
If you don’t elect to use a midwife or drive to the teaching hospital in Minneapolis for prenatal care, you come to Lake Drive Obstetrics and Gynecology.
I can’t afford to lose my cool or control of this ship.
There’s literally no one else to step in and take the wheel if I falter.
So, I never have.
But then, I’ve never encountered a patient like the one waiting for me when I arrive Monday morning…
“There’s a squirrel in there,” she screeches, pacing back and forth in front of the check-in window, her shoulders hunched, and her hands curled into claws. Her curly brown hair sticks up at least six inches in every direction in a fuzzy halo and the pale skin beneath her brown eyes looks bruised with fatigue. “I swear to God, that’s what it feels like. It feels like there’s a rabid squirrel in my uterus, trying to claw its way out.”
“I understand, ma’am,” Betsy, our front desk clerk says through the space in the sliding plastic partition. “But I?—”
“Do you?” the woman cuts in, pausing to brace both hands on the edge of the desk. “Do you really? You understand what it’s like to have a wild animal loose in your lady parts, tap dancing on your cervix with its sharp little squirrel claws?”
Betsy’s jaw drops. “Um. Well, no, but I?—”
“Then you don’t understand,” the woman says, her voice rising. “You don’t have a clue. So, I’d appreciate it if you’d stop patronizing me and get me in to see the doctor. I’ve read all his reviews. He’s not a quack like the one who did this to me. He’ll be able to fix it.” She drives her clawed hands into her hair, squeezing them into fists. “He has to fix it before the pain drives me fucking insane.”
“I’m sorry, ma’am,” Betsy says, her eyes widening as she spots me crossing the room to the door leading back to the offices and exam rooms. “But Dr. McGuire doesn’t have any open appointments this morning. And even if he did, we’re not taking new patients at this time.”
“He can work me in,” the woman demands. “He has to work me in. I can’t handle this anymore. Either he gets the squirrel out of me, or I’m getting it out myself.” She reaches into her purse and pulls out an eggbeater, one of the vintage ones that’s operated by a handle on one side.
As far as weapons go, it isn’t much, but the sight of it still sends a ripple of concern through the other patients in the waiting room, and Betsy looks like she’s about to cry as she says, “Please, ma’am. Put the eggbeater down. If I believe you’re a danger to yourself or others, I’ll have to call the police.”
“Good, call the police,” the woman says, her volume rising again as she thrusts the eggbeater into the air. “Call them, and I’ll tell them what doctors in this town are doing to innocent people who just want to be able to have sex without getting pregnant. I’m sure they’ll be interested to learn that last Thursday, I was a perfectly healthy woman. Now, I’m a mental case with a uterus full of angry squirrels.”
“I’ll handle this Betsy,” I say, detouring from my usual course to stop by the desk. I offer a small smile as the woman turns her wild eyes my way. “Hello, I’m Dr. McGuire. Is this about an IUD?”
Almost instantly, the tension in her features eases, her rage replaced by frazzled hope. “Yes! My girlfriend told me it was the best thing ever. She’s had hers for years without any problems and loves it, but it’s killing me. It feels like something’s physically attacking me from the inside.”
“Squirrels, she said,” Betsy pipes up. “Tap-dancing ones.”
The woman shoots her a glare before leaning my way and whispering, “I know there aren’t squirrels in there. I’m not a nutcase. I was just trying to make a point. And the point is that the pain is really bad and weird and bad. It’s seriously making me crazy. I haven’t slept in days.”
My brow furrowed, I say. “I’m so sorry about that. I’ll see what I can do.” Glancing Betsy’s way, I add, “Have her fill out the necessary paperwork and show her to exam room six. I’ll work her in between the other appointments.”
“Will do, Dr. M.,” Betsy says, reaching for a clipboard.
“Thank you so much, doctor,” the woman says, her entire body slumping with relief. “I appreciate it so much. You have no idea.”
“You’re welcome.” I back toward the door. “I hope we can help you.”
“Me, too.” Her eyes narrow on my face in a bit of a strange way, but I don’t have time to wonder what’s on her mind. If I’m going to squeeze another patient into an already crowded morning, I’ll have to work quickly and efficiently. Dropping my jacket, briefcase, and gym bag in my office, I head back out into the hall, rolling up my sleeves as I go.
Before I can call for Kinsey, Wren is already by my side, juggling an armful of charts as she says, “Mrs. Crabtree is just here for a pregnancy test, so I’ll handle that, and you can hold off on chatting with her until we have the results. Ms. Gibbons is having some spotting and seems pretty stressed out, so I’d suggest seeing her first, then working in Ms. Underwood, and then swinging back to Ms. Fritz, to go over the results of her biopsy last week before finishing up with Crabtree. This isn’t her first baby rodeo so she probably won’t want to chat for long and you can make up time there to get back on schedule.”
I nod. “Sounds good. The biopsy was all clear for Fritz, so that should be a fairly quick visit, as well.”
“That’s what I thought,” Wren agrees. “Assuming Ms. Underwood’s IUD retrieval isn’t complicated, and there aren’t actually any squirrels, you should be back on track by ten a.m.”
I fight the twitch at my lips. “You heard that?”
“The entire office and half the street outside heard it,” Wren says. “Poor woman. I feel for her, but hysteria rarely yields positive results in a medical setting. She’s lucky you were in a good mood this morning.”
“I’m known for my warm, even-keeled temperament,” I say, making Wren snort. Ridiculously pleased to have made her laugh, even a small, snort-laugh, I ask, “Where’s Kinsey? I thought she was going to stay on as head nurse until next week.”
“She is, but she’s not here yet. There’s a powerline down on the road leading out of her subdivision. It’s going to be another half hour or so before the power company can get it cleared. I said I’d hold down the fort until she gets here. I hope that’s okay.”
“It’s better than okay,” I say. “You’re my best head nurse in a crisis, and I’d like to have you in the room with me with Ms. Underwood. I need someone who can help her remain calm if we need to send her to the ER.”
Wren’s brows lift. “You think it could be a puncture?”
“I won’t know until I take a look, but that amount of pain doesn’t bode well.”
She nods. “As soon as she’s finished filling out her forms, I’ll take her temperature and ask about any abnormal bleeding.”
“Thank you.” I stop beside exam room one, squinting at the empty chart holder beside the door. I turn back to ask Wren for the file to find her already holding out the folder I need.
She sets it in my hand. “I’ve already updated the digital files for all this morning’s patients, too, so feel free to transition to the computer at any time. Though I know you like a good, old-fashioned folder.”
“I do,” I agree. “I also really like having you back.”
I already said it in a text last night, but I’m instantly glad I repeated myself. Wren blinks, clearly fighting a smile as her cheeks flush a faint pink. “Thanks, I’m glad to be back.”
She’s glad. I’m glad. Surely all this glad is a good sign.
I have to force the smile from my face as I knock on Ms. Gibbons’ room to announce my presence. I don’t want her to think I’m taking her spotting lightly, but I can’t help feeling hopeful.
Wren and I work so well together when it comes to managing patients and coordinating care. Maybe, with a little patience on her part and some hard work on mine, we could learn to work well together in a more…personal setting.
Sex obviously isn’t a problem—our chemistry was unlike anything I’ve ever experienced—but there’s a lot more to a good relationship than compatibility in the bedroom. Lane and I never had problems when we were in bed together, either, but she still left me for another man.
The same one she’s marrying in a few weeks.
Thinking about my ex-wife’s wedding, the one I RSVP-ed “yes” to in a moment of weakness, is enough to banish the last of my grin.
“Tell me about the spotting,” I say, as I step into the room, knowing Ms. Gibbons will want to dispense with the pleasantries and get down to business. This is her second baby, but her first time spotting, and I’m sure she’s anxious.
After a brief exam, I’m able to assure her that her baby is fine, explain that it was probably implantation bleeding she experienced, and encourage her to keep an eye on things and reach out if she experiences any further spotting in the future.
Then, I’m on my way to exam room six, and the strange noises emanating from within…
At first, it sounds like someone’s leading a yoga class. The deep, resonate moaning reminds me of the way one of the older instructors at the gym starts each practice, with long, droning chants of “Om,” that make my jawbone tickle when I try to emulate them.
When I get closer, however, I realize those are moans of pain, followed by Wren’s calm voice saying, “Let’s have you sit up until Dr. McGuire gets here, okay? It seems like you experience less distress when you’re upright.”
I jog the last few steps to the door and knock three times. “Ms. Underwood?”
“I’m ready, yes, please come in,” she says, her moan becoming a gargled whimper as I step inside. She’s already in a gown and drape and positioned on the exam table, making me bless Wren again for moving fast and getting everything prepared.
“It hurts so bad,” she continues. “I can’t stand it. This is why I can’t sleep. Every time I lay down, the pain gets so intense I just writhe around on the bed in agony.”
“And when did this start, Ms. Underwood?” I ask as I move to the sink in the corner, washing up.
“Call me Sylvia, Ms. Underwood is my mother,” she says. “And early Friday morning. About twelve hours after I had the IUD inserted at my primary care doctor’s office. And it’s just gotten worse and worse since then.”
“But there hasn’t been any spotting,” Wren supplies. “And no fever. So, if it’s an infection, it’s still in the early stages.”
Drying my hands, I turn back to nod at both women. “That’s a positive sign. Let’s take a look and see if I can figure out what’s going on with a manual exam. If not, we may have to order a scan to determine the exact location of the IUD and if it’s implanted itself somewhere it shouldn’t have. Lie back and scoot down for me, please. Feet in the stirrups.”
Ms. Underwood bites her lip, a strange expression crossing her face as I move to the rolling chair at the end of the exam table. She holds my gaze for a beat too long before lying down and shifting slowly into place, her moans now echoing off the low ceiling.
Ignoring the prickle at the back of my neck, I grab a pair of gloves from the box by the table and pull them on. Just a few minutes later, I see the problem. The IUD has lodged itself half in, half out of her cervix. “Okay, take a deep breath for me,” I say. “As you exhale, there’s going to be a little bit of pressure.”
Her exhalation ends in a sharp yip, but by the time she asks, “What was that?” I have the IUD in hand.
I lift it high enough for her to see it, before plunking it into the stainless-steel bowl Wren provides. I explain where I found it and follow up with, “Either the device wasn’t properly inserted, or your body decided to expel it. It’s fairly rare, but I have run into a few cases of women whose bodies won’t tolerate any kind of IUD, the copper or those with a hormonal component. But, if you’re still interested in this form of birth control, we could make an appointment to try?—”
“No, way.” She sits up fast, pressing her knees together. “I’m never putting anything up there ever again. Except for you know, things that I’ve put up there before that I know don’t cause rabid animal invasion feelings. That was torture. I’ll just go back on the pill. It was annoying to have to remember it every day, but nothing like that.”
“Sounds like a good alternative,” I say. “Do you need a prescription?” Sylvia indicates that she does and shares her preferred brand.
As I scribble the script, I’m already mentally moving on to my next patient, when Sylvia lets out a victorious “Ah ha!” sound.
I look up to see her beaming at me with a knowing gleam in her eyes.
“I remember now,” she says.
“Remember?” I sign my name to the script and tear it off. It’s another old-fashioned thing I enjoy—paper scripts—and Wren always makes sure I have several pads on hand. We’ve been running low, but now that she’s back, she’ll take care of it. That’s what Wren does. She takes care of things.
Too bad she can’t take care of Ms. Underwood…
Sylvia wags her finger my way. “You’re that guy from Middle-Aged Match, the dating app. You matched with me like…two weeks ago, but never replied to my message.”
My stomach dropping to the floor, I stammer, “Oh, w-well, that’s… I didn’t realize.” I clear my throat. “I apologize. If I’d realized, I would have referred you to another?—”
“Don’t worry about it,” Sylvia cuts in with a laugh and a wave of her hand. “I’ll delete the match when I get on my phone. And I’m not going to sue or anything, why would I? You’re a total professional. It was just driving me crazy, not knowing where I’d seen your face before.” She shrugs. “And lots of guys don’t respond to messages. That’s normal behavior for the douchebag half of the population.”
“I honestly forgot I opened the account,” I say, keenly aware of Wren’s attention, laser-focused on my no-doubt flushed face. “I didn’t mean to be inconsiderate. I’m just busy.”
“And good at your job,” Sylvia says. “I feel so much better already. You shouldn’t be on Middle-Aged Match anyway. No way you’re over forty.”
“I’m thirty-five,” I say. “But the average lifespan of men in my family is only sixty-five or seventy. History of heart disease. So, from that perspective I thought… Scientifically and statistically… Well, probability, I suppose is a better word…” Cursing myself for diving deep into my family health history in front of a woman I swiped on and one I’ve actually slept with, I stop blathering and surge to my feet. “In any event, I’m glad I could help. Have a good day.”
“Yeah, you, too,” Sylvia says, calling after me in a teasing voice, “And thanks for getting the squirrel out of my vagina.”
I exit the room, as uncomfortable as a resident doing a pelvic exam for the first time and start toward the next exam room on the list, wondering how I’m going to explain this to Wren. Or if she’ll even care. A part of me hopes she will, a little jealousy would show she isn’t as over what happened between us and ready to move on to my brother as she seemed yesterday in the park.
But the other part—the part that doesn’t want to hurt or disappoint her any more than I have already—hopes she’ll understand that it didn’t mean anything.
I hear the door open behind me and glance back to see my head nurse emerging into the hall. I pause, my brows lifting as I study her face, but she doesn’t so much as glance my way. She turns and heads down the hall toward the staff bathroom, closing the door a little too firmly behind her.
“Fuck,” I mutter, but there’s no time to talk things over with Wren now.
A nd there isn’t time for the rest of the day.
The patients keep coming and a few of the cases are more complicated than I expect from looking at their charts.
I work through most of lunch, grabbing a quick bowl of soup after the nurses have already finished their meals and gone back to work.
It isn’t until nearly five, as I’m heading for the breakroom for my customary end-of-day tea that I finally have the chance to breathe. The office is already clearing out, all the patients gone, and Betsy is turning off the lights in reception. I half expect Wren to have left without saying goodbye, but when I get to the breakroom, I find her waiting with two steaming mugs, just like old times.
But the expression on her face isn’t like old times.
She looks…hurt, and I curse myself all over again for being so fucking bad at this.
She deserves better. She deserves a man who knows how to woo her properly, with no missteps or mistakes. I should probably keep my mouth shut and let this be the thing that kills any chance of more-than-friendship between us. It would be the best for Wren, but the thought of her moving on makes me want to smash things, so instead, I say, “I needed a date for the wedding. That’s it.”
She frowns. “What?”
“That’s why I got on the dating app,” I add as I cross to the table for two where she’s placed the tea. “I wasn’t looking for a girlfriend or anything long-term. I just need a date to Lane’s wedding. I already RSVP-ed for myself and a plus one. If I show up without a date, Lane will notice. I don’t want to mar her big day with pity for her ex.”
Wren shakes her head, but before she can speak my cell rings.
“Sorry,” I say, pulling it from my pocket. “It might be Nora. I hired her to check on the dog today. Since she works from home.”
“Your neighbor Nora?” Wren asks, her eyes going wide with horror.
Dividing my attention between her and the phone, which is indeed displaying Nora’s name, I nod. “Yes. Why?”
“Nora’s terrified of animals. She has been since we were kids.”
“But she said—” I break off, knowing I have to answer the call before it’s sent to voicemail. “Just a second.” I tap the green button. “Hello, Nora. What’s up?” Hysterical crying explodes from the speaker, the sobs so loud I wince as I add, “Nora? What’s wrong? Are you at my place? Is something wrong with the dog?”
“I’m so sorry, Barrett,” she says, still crying so hard I can barely understand her.
Wren squeezes my forearm before hurrying from the room.
“I tried, but Keanu Reeves is going to kill me,” Nora continues. “I’ll probably be dead by the time you get home. I’m so sorry! Tell my brother I love him, okay? And that he can sell my vintage clothing collection to help pay for Gram to move into an assisted care facility?”
“Calm down, Nora,” I say, jogging out into the hall to find Wren waiting by the exit with my things. “I’ll be there in fifteen minutes. Lock yourself in the bathroom and I’ll be right there to help you out.”
“Oh, no, I can’t get there,” she says, her voice breaking. “It’s too far. I can’t get down off the counter. I’m going to die here. He’s going to finish eating any second and I’m done for. He’s really smart, Barrett, but I’m not sure he’s actually a dog. He might be something else. Something?—”
I think she says “unholy,” but the call cuts off before I can be sure.
“Come on,” Wren says, hurrying toward the staff corner of the parking lot. “I’ll follow you. Whatever’s wrong with poor Keanu and Nora, we’ll get it sorted.”
“Thank you,” I say, grateful for her backup.
Nora is a friend, and I’m pretty sure I can calm her down, but I don’t have a lot of experience with dogs.
Especially rat dogs, with a decided lack of manners.
This morning, Keanu seemed to think it was normal to circle the breakfast table like a land shark, growling and moaning and attempting to launch himself into a chair. From there, I assumed he would have made his way to the table and my breakfast, but I had the chairs pulled up too tight.
The suspicion is confirmed as I rush in my front door to find Nora on top of the kitchen counter, pointing a spatula at Keanu Reeves, who is currently eating burned scrambled eggs from a skillet on the stove.