CHAPTER 11 NEW NORMAL #2
They were ringing not because I believed the patient was actively or intensely suicidal, but due to her symptoms.
I kept asking questions, making sure she was cleared psychologically and then left the room.
Air was hard to suck in. I needed to find Bowie.
My throat tightened, fear deep in my body.
“Aife, did you clear her?” It was like he knew.
Bowie took me in, seeing something in my eyes. “What’s going on?” Concern laced his voice. I guess the doctor had a soft spot for me.
“She’s cleared from an SI perspective. Two things,
though.” I tried to keep myself calm. The patient wasn’t me, and I had to keep thinking that.
“Sure.” He motioned for me to keep talking. “Did her MRI come back?”
Bowie walked off, headed toward a computer.
I followed after him. After a few clicks, he pulled up her completed MRI and began to read the radiology report and click through the images.
We both looked at it, though I had no idea how to read it.
The images just looked like any other brain to me.
I was hoping something would just leap out at him, but it seemingly didn’t.
“What am I looking for here, Aife?” The imaging must have just looked normal to him.
“Is there a cyst or tumor or growth of some kind on her pineal gland?” I couldn’t believe I was voicing this. This was supposed to stay in Texas; none of this was supposed to follow me here. Chicago was supposed to be my safe zone away from the trauma I had dealt with.
Bowie poured over the MRI, clicking through the images much slower now. “Yes, there is, actually. It’s a small one, about seven millimeters. Those are benign though, Aife.”
“Can you do me a favor?” Again, I couldn’t believe I was doing this.
My mouth dried. “Just call it intuition. We probably don’t even do it here.”
I was rambling, and I knew it. This was an ongoing problem when I got overwhelmed.
My palms were sweaty, my pulse had quickened, and everything felt like I was in a tunnel.
“I suppose so, but only because you’re my best social worker. What exactly are you recommending?”
“Technically, I am not recommending anything.
However, I am simply proposing that you check her prolactin levels. If they come back high, give me a call.” I quickly scribbled my cell phone down and handed it to him.
Bowie quirked a brow. “I expect an explanation either way, Aife.”
“Yeah, that’s fair. She’s clear from a psych point though.”
I needed to sit down. Things were hitting a little too close to home.
I had to remind myself that the patient wasn’t me.
That this was most likely coincidental. Heaving a breath in, I collapsed in a chair to put a note in.
My vision was still tunneled as my memories plagued me.
There were so many questions I still had for the patient.
I wasn’t a 173 medical professional, but I needed to know. What if she was like me?
Ignoring the urge to burst into her room, I decided to write down all my questions instead.
Maybe I could convince Bowie or her nurse to ask them.
Taking out some paper, I wrote down all the symptoms I could remember.
Did she have any skin issues like an unexplainable rash?
Did she have trouble regulating her body temperature?
Was she getting hot flashes or did she feel unreasonably cold?
Was she having difficulty sleeping? How long was she able to sleep for?
Did she have trouble staying asleep or going to sleep?
Had she lost her peripheral vision at all?
Did she have any other visual issues? Did she have memory problems?
How frequent were her migraines? When did they start and where were they located?
Did anything treat them? Could she sweat?
My hands flew across the page as I wrote more and more questions.
“Aife, what are you doing?” Dr. Bowie asked,
peeking at my frantic note taking. “I requested the labs you asked for even if we don’t normally test for those. I mean, they are typically more outpatient.”
“Well, thank you, Dr. Bowie.” I scribbled a few more questions down. “How soon do we think those will be back?”
“I ordered them stat, so hopefully soon. There’s clearly something you aren’t telling me.” Bowie was a smart man, that much was obvious to everyone. The question was: did I feel ready to open up?
I blinked after briefly thinking of what I was willing to admit. “What do you know about the pineal gland?”
“There’s still plenty of research that needs to be done around it. So far, research reveals it regulates melatonin and possibly other hormones. We also know pineal cysts are typically benign.”
“Right, most research would show that. What do you know about prolactin?” Typically, the clinical aspect of case management was not my forte. I left that to my partner. There were some things I knew about, but most of it was gibberish to me. This, however, I knew.
Bowie analyzed me for a moment. I’d only been at this hospital for about a year, but he knew what my strengths were.
He knew that it did not include the clinical/medical side.
“Well, it’s the hormone that produces breast milk. Usually, high levels are in pregnant and nursing women. Any reason you are giving me a pop quiz on random medical facts?”
Nodding, I flicked my tongue against my bottom lip.
I was still trying not to panic. A huge trauma response was trying to happen to my brain and body.
My muscles bunched, all of them prepped to run.
“I have a point to all this, I promise. What does it mean when a non-pregnant individual has high prolactin levels?”
“You look for underlying causes that would lead to elevated prolactin.” He shrugged, like it was an obvious answer.
“Well, that’s what we would hope for, at least. I know I seem crazy, but please ask her these questions.” I handed him my notes. “When her labs come back, page me. I’ll tell you my theory.”
“Aife.” His voice was slightly stern. It was obvious to me that Dr. Bowie was not used to being ordered around without some sort of explanation. I didn’t want to color his interpretation though. There was also a good possibility that I was entirely wrong.
“Dr. Bowie, I’m just asking for a little leeway. In all likelihood, I’m completely wrong. But if there’s even a .1 percent chance that I’m right, I want the evidence to back me up.”
“She’ll likely need to follow up outpatient once we treat the migraine.”
I nodded. It wouldn’t be treated if my theory was right. Nothing fixed those migraines. I would know; I had first-hand experience.