Chapter 6
SIX
HOLLY
“You’re late.”
I look up from my phone, startled by Dr. Klinkhart’s clipped voice. He stands in the clinic hallway, arms crossed over his chest, radiating disapproval like heat from a furnace.
“I’m not late,” I respond automatically, checking my watch. “I took forty-five minutes for lunch. My schedule clearly states I get a full hour.”
His jaw tightens. “I paged you. Multiple times.”
“Paged me?” My eyebrows shoot up. “I never got a pager.”
“If you had bothered to respond to the page,” Dr. Klinkhart continues as if I hadn’t spoken, “you would know we had an emergency come in. Serious crush injury to the hand. I had to handle it alone.”
Heat flushes my cheeks. “I’m telling you, I never received a pager. At all. Not yesterday during orientation, not this morning. No one gave me one.”
“Don’t make excuses.” His blue eyes bore into mine. “Just admit when you’re wrong, Dr. Chang. It’s a quality good doctors typically possess.”
The accusation stings, unfair and unwarranted.
My pulse quickens with anger. I open my mouth to tell him exactly what I think of his leadership style, but the words stick in my throat.
He’s my attending. My supervisor. Someone who will ultimately evaluate my performance and determine whether I get that wilderness medicine certification.
And until Dr. Mercer returns, I have no choice but to make the attempt to stay on his good side.
“I apologize for the miscommunication,” I say through gritted teeth. “But I can’t admit to misplacing something I never had in the first place.”
“Dr. Klinkhart! Dr. Chang!” Greta’s voice carries down the hallway as she rushes toward us, her face flushed with embarrassment. She clutches a small black device that emits an intermittent vibration. “I’m so sorry! I completely forgot to give Holly her pager during orientation!”
His expression freezes, jaw so stiff I practically hear his molars cracking.
“It’s been going off like crazy,” Greta continues, pressing the vibrating box into my hand. “I had it in my desk drawer and just remembered when I heard you two talking. This is completely my fault.”
Vindication tastes sweet, but only long enough for him to open his mouth again.
Because Dr. Klinkhart doesn’t apologize. Instead, his lips press into a thin line, the muscle in his jaw working.
“Now that we’ve cleared that up,” he says stiffly, “you can follow me. We have another emergency coming in—downhill skier who wrapped himself around a tree. ETA five minutes.”
He turns on his heel and strides away, expecting me to follow.
I clip the pager to my waistband, exchanging a quick glance with Greta, who mouths “sorry” with an exaggerated grimace. I give her a tight smile and hurry after Dr. Klinkhart.
Part of me wants to demand an apology, to call him out on his unfair assumptions. But a louder part—the part that’s worked too hard to get here—reminds me to choose my battles.
“What are the details on the incoming case?” I ask instead, falling into step beside him while maintaining as much distance in the hallway as possible.
Professional. Clinical. Focused on the patient. That’s how I’ll prove myself to Dr. Noah Klinkhart. Not by winning arguments, but by demonstrating that I’m more than capable of keeping up with him.
Even if he makes me want to scream with frustration.
Dr. Klinkhart spends the rest of the afternoon throwing rapid-fire clinical questions at me and giving me no more acknowledgement than another query when I answer them correctly.
I’m not exactly a slut for praise, but the complete lack of it starts to chafe after a few hours.
The only indication he gives of satisfaction with my clinical skill is when he jerks his head toward a treatment room and tells me to take the last clinic patient of the day on my own.
I push open the examination room door with my most reassuring smile firmly in place. It immediately falters when I’m greeted by the sight of two nearly identical children with unnaturally pale complexions and a frantic woman hovering between them.
“Are you the doctor,” the woman says, practically trembling with relief at my friendly nod. The scent of distressed omega fills the small room, making my head swim for a moment. “Thank goodness. The receptionist said Dr. Klinkhart was busy and—“
“Don’t worry, I’m here to help. I’m Dr. Chang.” I say, keeping my voice steady as I close the door behind me, already reviewed chart under my arm. “You’re Mrs. Frost, correct?”
She nods rapidly. “Lila Frost. These are my twins, Emma and Evan.”
The children sit side by side on the examination table, their white-blonde hair making them look almost ethereal against the fluorescent lights. Despite their pallor, they offer me matching shy smiles that don’t quite reach their eyes.
“What seems to be the problem today?” I ask, pulling up a stool and sitting at their level.
“They’ve been sick for nearly a week,” Lila explains, wringing her hands. “It started with chills and night sweats. Then the vomiting began, practically every day, and now they’re both complaining about joint pain and headaches.”
I frown, studying the twins more carefully. “Any rashes? Changes in vision? Sensitivity to light?”
“Emma developed a strange rash on her back yesterday,” Lila says, helping her daughter lift her shirt to reveal splotchy red patches. “Evan doesn’t have it yet, but they always get sick in sequence, a day apart.”
I pull on gloves and examine their flushed skin, noting its unusual pattern—not quite like typical viral rash I’d expect. “Have they been exposed to anyone else who’s sick? Any recent travel or changes in routine?”
“No, nothing unusual. Just school and home, like always. I assumed it was just a seasonal infection, but they’re both getting worse.”
“But they haven’t had a fever?”
“Nope, not at all.”
I check their charts for the vitals already obtained by the nurse. Not only do neither of the twins have a fever, but both their temperatures are a little lower than I’d expect, which is strange.
“Emma, can you follow my finger with your eyes?” I ask, moving my index finger slowly across her field of vision. She complies, but I notice a slight lag in her tracking. I repeat the test with Evan and observe the same delay.
“I’m going to draw some blood for cultures,” I tell Lila, keeping my voice calm despite my growing concern. “And I’d like to get urine samples from both children as well.”
“Is it serious?” Lila’s scent spikes with anxiety.
“It’s difficult to say without test results,” I answer honestly. “The symptoms could be from an infection, but we need to determine exactly what we’re dealing with.”
As I prepare the equipment for blood draws, I notice Evan’s hands trembling slightly. “How long has the tremor been present?”
Lila’s eyes widen. “I... I didn’t notice that before.”
“That’s okay. I’ll just make a note of it.”
I work efficiently, collecting blood samples and throat cultures from both children while keeping up a stream of light conversation to distract them. They’re remarkably stoic patients for eight-year-olds, barely flinching when the needles pierce their skin.
“Dr. Chang,” Emma says suddenly as I label her blood vials, “my mouth tastes like pennies all the time. Is that because I’m sick?”
I pause, adding this new symptom to my mental checklist. Metallic taste isn’t typical of most common childhood infections, though it isn’t impossible.
“Maybe,” I tell her, though my mind is racing through possibilities. “But I’m going to find out for sure just as soon as I can.”
Once I’ve collected all the samples and completed a thorough examination, I sit down across from Lila, choosing my words carefully.
“I’m ordering blood cultures to check for bacterial infection, plus a comprehensive metabolic panel and complete blood count,” I explain. “The results won’t be back for a few days, but they’ll help us determine what’s causing their symptoms.”
“What do we do until then?” Lila’s voice breaks slightly.
“I don’t want to start antibiotics unless we know what we’re dealing with.
Keep them hydrated, use acetaminophen for fever and pain, and monitor for any new symptoms.” I write down my instructions.
“If they develop any difficulty breathing, severe headache, confusion, or if the tremors worsen, bring them back immediately.”
I pause, looking directly at the twins. “And I want to see you again in seventy-two hours no matter what, or sooner if symptoms don’t begin improving.”
“What do you think it is?” Lila asks, unable to hide her fear.
“It’s hard to say, but an infection isn’t off the table,” I say, maintaining professional detachment despite my concerns. “The testing will help. For now, I just want you to keep paying attention for any new symptoms, and I’ll call you when we get the test results.”
I help the children down from the examination table, noticing how they both wince when their feet hit the floor, another indication of joint pain.
“Thank you, Dr. Chang,” Lila says, gathering her children close. The genuine gratitude in her voice makes my chest tighten.
“You’re welcome. Please don’t hesitate to call if anything changes before your next appointment.”
After they leave, I stand alone in the examination room, reviewing my notes. Something about this case feels wrong. The constellation of symptoms doesn’t neatly fit any common childhood illness.
I’m also not a family medicine or pediatric specialist, by deliberate choice. Maybe I’m looking for zebras because I haven’t seen enough plain old horses in person.
Though something tells me that pawning off what is probably a bad case of the flu on me wasn’t an accident.
Maybe if I do enough of Dr. Klinkhart’s grunt work, he’ll eventually let me go solo on the types of cases that I actually came here to see.