Chapter 5
FIVE
LUKE
One of the best things about finishing residency is that my workday no longer starts at six-thirty A.M. As an attending surgeon, I have my own residents now, and I can roll in at the relatively civilized hour of seven-thirty.
I’ve never been a morning person, and the extra hour makes a big difference.
I never realized how much I missed a good night’s sleep until I was reacquainted with one.
But the day after I operate on Melissa’s daughter, I’m awake before dawn.
I know there’s no way I’ll get back to sleep, so I grab my laptop and log into the hospital’s electronic medical record.
The last nursing note in Claire’s chart reads simply: Child resting comfortably.
Mother at bedside. I bet Melissa spent the night there. I would, if it were my kid.
I click through the chart, but it’s far too early for the morning lab results to be up, and there’s nothing else of interest. I tell myself the lack of documentation is a good sign. If Claire was in pain or there was some other complication, surely the nurses would have charted something.
Since there’s nothing else to be learned from the computer, I throw on some workout clothes and head to the gym in the condo basement.
After forty minutes on the treadmill, I head back to my condo, take a long shower, and throw some Eggo waffles in the toaster.
I wonder if anyone’s bringing Melissa breakfast this morning, since she probably won’t want to leave Claire to go to the cafeteria.
Maybe her ex-husband will do it, if he hasn’t already gone back to his law firm in Toronto.
A glance at my phone tells me it’s still only six-fifty A.M., but I decide I’ve killed enough time. I’ll go to the hospital and join my residents for the end of rounds.
The junior resident is on vacation, so I have a small team this week: just a senior resident, Dr. Nick Decarie, and Kevin Talbot.
I find them at the nursing station on the surgical ward, sitting in front of a computer.
Nick’s simultaneously typing a note into the medical record and quizzing Kevin about the differential diagnosis for post-operative fever.
For all his faults (overconfidence in the OR and a tendency to flirt with the nurses), Nick’s good with the medical students.
I can tell Kevin’s a lot more comfortable with Nick than he was with me yesterday.
“Dr. Carlton,” Nick says, raising an eyebrow in surprise. It’s the first time I’ve joined them this early, and I’m sure he wonders if I’m watching more closely because he’s done something wrong.
“Hey,” I say, trying to sound nonchalant. “I got in early today, so I thought I’d join you guys for the end of rounds.”
“Great,” Nick says, but I can tell he isn’t thrilled. “We’re just finishing up here, actually.” He pulls a patient list from the pocket of his scrubs. “We just have the patient on the pediatric ward left. Claire Thompson, the appendectomy from yesterday.”
“Okay,” I nod. “Carry on, then. Pretend I’m not here.”
Nick leads the way to the pediatric ward and stops outside Claire’s room. “Kevin met this patient yesterday, so I was going to let him take the lead, if that’s okay?”
“Sure,” I agree, with an encouraging smile at Kevin. He looks terrified at the prospect of having to assess a patient while Nick and I watch.
Kevin knocks nervously on the door, and we file into the room. The first person I see is Melissa, sound asleep in the pullout armchair with Liam sprawled facedown on her chest. Next to them, Claire’s curled on her side in the hospital bed, also asleep.
It’s not even eight A.M., and I’m sure it wasn’t easy for them to get to sleep. Kevin hesitates, unsure if he should wake them up, and I open my mouth to tell him we’ll come back later.
But Nick’s too quick for me. “Good morning!” he says loudly. “How’s everyone doing today?”
Melissa’s eyes flutter open and latch onto me, and for a split second, she looks relieved.
She gives me a drowsy smile that lasts until she comes fully awake.
Then her expression shutters, and she tightens her grip on Liam and awkwardly stands.
By some miracle, Liam stays asleep in her arms, and she hitches him up on her hip.
Claire has woken up too, and is blinking at us in confusion.
“Hi, Claire,” Nick says cheerfully. He seems to have forgotten about his plan to let Kevin take the lead. “I’m Dr. Decarie, the senior resident. You met Dr. Carlton and Kevin yesterday.”
Claire nods, and Nick turns to Melissa. “And you must be Claire’s older sister,” he says with a charming smile.
“Actually, that’s Claire’s mother,” Kevin chimes in, interrupting Nick’s clumsy attempt at flirtation.
“You look much too young for that,” Nick says quickly.
“Uh huh,” Melissa replies. She doesn’t look impressed, and I have to smother a laugh.
“So how are you feeling, Claire?” Nick asks. “Any tummy pain?”
“No.”
“Do you mind if I have a look?” Nick asks, stepping closer to her bed.
Claire shakes her head shyly, and Nick pulls down the blanket so he can examine her. “Looks great!” he exclaims. “I can barely see the wounds. Are you sure you had your appendix out yesterday?”
As Claire giggles, Nick puts his hand on her abdomen to feel for tenderness. “Everything looks good,” he pronounces. “It’ll be breakfast time soon. Do you feel up to drinking some juice?”
“Yeah,” Claire says shyly.
“So the lab work from the morning looks great,” Nick explains. “It’ll be juice and jello for breakfast and lunch, but if that goes well, you can have regular food for dinner. You’ll probably be able to go home tomorrow.”
Melissa’s relief at this news is plain on her face. Even though she was asleep when we came in, she looks exhausted. I doubt she slept for more than a couple of hours last night.
“You’ll get another dose of antibiotics through the IV line later today,” Nick continues. “But we can change that to pills tomorrow, and give you a prescription.”
“Great,” Melissa says. Liam’s woken up, and he’s squirming in her arms. She sets him on the floor, but as soon as his feet touch the ground, he ducks under the bedside table and breaks for the door.
Melissa moves to chase after him, but she’s trapped by the table on one side and Nick on the other.
“I’ll get him, Melissa,” I say, sprinting for the door to intercept her son. He moves fast for a little kid, but I’m faster, and I position myself in the doorway to block the exit.
“Slow down, buddy,” I say, crouching down to Liam’s level.
But unfortunately, Liam doesn’t slow down, and he barrels into me. Somehow his head connects with my knee, and he falls back onto his butt.
For a moment, the room is dead silent. Liam’s staring at me in shock, and to my horror, I see blood trickling from his nose.
Far from saving the day, I’ve managed to tackle Melissa’s son and give him a nosebleed.
And then Liam starts to cry, loudly enough to be heard at the other end of the ward. Melissa rushes over and scoops him up.
“Shhh,” she whispers, as Liam buries his head in her shoulder. “You’re okay, Liam. It’s okay.”
“I’m sorry,” I say helplessly. “Uh, his nose is bleeding a little. I can call ENT to have a look at it.” I’m not keen to tell this story to an ENT surgeon, but for Melissa’s kid, I’ll do it.
Melissa turns to me, and there’s a glint of amusement in her eyes. “I don’t think we need ENT, but maybe you could find me a tissue?”
I rush to grab a tissue from Claire’s bedside table and narrowly avoid a collision with Nick, who had the same idea. Melissa definitely looks amused now. At least I’m supplying some comic relief.
Melissa wipes blood and snot from Liam’s face, and after he’s cleaned up, he doesn’t look too bad. “Liam’s nose bleeds really easily,” she explains. She sets him on a chair, tells him to look down, and gently pinches his nose.
“I’m really sorry,” I apologize again.
“It’s all right, Dr. Carlton,” Melissa assures me. “Liam’s nose is clearly no match for your abs of steel.”
Nick and Kevin both burst out laughing, and even Claire chuckles. I guess since I was crouching down, it must have looked like Liam ran into my stomach, not my knee. I don’t bother to correct them.
Melissa lets go of Liam’s nose and studies it for a minute. To everyone’s relief, the bleeding seems to have stopped.
“All right,” I say, trying to maintain some dignity. “Claire, everything looks great. Any problems, tell the nurse and she’ll get in touch with us.” I turn to Melissa. “Let me know if Liam’s nose starts bleeding again. I can ask ENT to look at it.”
“Thanks, Luke,” she says quietly. She meets my eye, and the amusement is gone from her gaze.
“Nice work, Dr. Carlton,” Nick jokes when we’re out in the hallway. “You and your abs of steel should round with us every morning.”
I roll my eyes and don’t answer.
“I think the mom likes you,” Nick continues. “Did you notice she called you Luke?”
Oh, I definitely noticed that, but I’m not about to discuss it with Nick. “Clinic starts in ten minutes, Nick,” I say crisply. “Go ahead with Kevin and I’ll meet you there.”
Nick and Kevin take off toward the elevators, and I head to the fridge in the nursing station, where they keep drinks and snacks for patients. I grab a ginger ale and apple juice and make my way back to Claire’s room. Claire greets me with a bright smile, but Melissa looks wary.
“It could be another hour before they bring the breakfast trays, so I brought you some drinks,” I explain, setting the ginger ale and apple juice on the table next to Claire’s bed.
“Thanks, Dr. Carlton,” Claire says.
“No problem,” I say, with a glance at Liam. “Has the nosebleed stopped, buddy?”
Liam nods solemnly.
“Good.” I notice Melissa’s still wearing the scrub top I gave her yesterday in the ER, and there’s a red stain over her left breast. Probably blood from Liam’s nosebleed.
“Dr. Carlton?” Melissa asks uncomfortably, and I realize I’m staring at her chest. I quickly lift my eyes to her face.
“You have blood on your shirt,” I explain stiffly. “From Liam’s nosebleed.”
Melissa looks down at her chest and then back up at me. “I’m sorry. I’d be happy to pay for the shirt.”
“What?” I’m definitely not worried about the stupid shirt. “No, don’t worry about it. The hospital won’t miss it. But I can find you another top if you want.”
“It’s fine,” she assures me.
“Okay. Have you had breakfast? I could grab you something from the cafeteria.”
Her eyebrows draw together in confusion. “Thank you, but I’m fine. Troy should be here soon, and I’ll probably grab something then.”
“All right.” I’ve run out of reasons to prolong the conversation and I’d rather not see Troy again, so I say goodbye to Claire and Liam and head to the clinic.