Although the name on the chart was oddly familiar I couldn't place her. I was covering for a partner who was on vacation. It felt like my day would never end.
When she bopped into the office I knew immediately. We went to school together. Years ago. She sat down quietly on the exam table typing away on her mobile phone. I approached cautiously my mind musing on occupational hazards. I wondered if she would recognize me.
As I introduced myself I searched her countenance for signs of familiarity. I quickly realized that she was too busy talking to even notice. She was a classic example of today's connected youth. She grew up in the email/text message generation. Conversations were more a one way soliloquy then a rational bidirectional exchange of information.
I found myself only half listening as she continued to harangue me with unimportant non sequiturs. Please be a cold...be a cold...be low back pain.
I awoke from my reverie horrified by the one phrase that struck terror down to the core of my being.... I'm having a little itch and discharge....by the way do we know each other?.
I brushed off her question and entered doctor mode. This is what I trained for. If I could run a code and make life changing decisions I certainly could pretend I didn't know a young woman I was doing a pelvic on. (Wow...did I really just write that!)
I handed her a gown and left the room to collect an assistant. This was one exam I wouldn't be doing solo.
When I returned the technician had placed her on the exam table. Her legs were up in stirrups and her gown was folded over. Smack dab in the center of the commotion was the chair of honor reserved for yours truly. I donned a pair of gloves and inspected the speculum. As I sat down my medical assistant stood above me...ready.
And their laid our patient. Fingers tapping away at her cell phone as she continued to talk at random. She urgently chewed a piece of gum that appeared in her mouth as quickly as her clothes came off.
While placing the speculum and collecting samples I froze. Oh...I know! We went to high school together!
All of the sudden the room became unbearably hot. My face burned a shade of crimson. The medical assistant bit her lip and squeezed my shoulder tightly in order to stem the tide of laughter. Yes....yes...maybe.
I quickly finished the pelvic and left the room to send the specimens to the lab. Upon returning my patient had fully dressed. As I explained my findings I could barely look her in the eyes. With great embarrassment I gave her a script to treat a yeast infection and rushed out the door.
As she left I could hear her chatting away with the receptionist without a care in the world. I fled to my office and closed the door. I took a few deep breaths. A drop of sweat raced down the side of my face.
And then I had a moment of clarity.
It was like she was the doctor.
and I...befuddled, afraid, and powerless...
was the patient.
Wednesday, September 7, 2011
Tuesday, September 6, 2011
This Is Not One Of Those
My dream is always the same...
It’s just another day in hell. I stand on the Bone Marrow Transplant unit. There are no windows. Suddenly the building starts to shake. The ceiling cracks letting in rays of sunlight. The ground rumbles below.
Sadness, grief, and despair spew from the floor. They rise as black lava erupting from the innards of the building and drag me to the street. I am swept forward as black death encompasses the earth and moves to envelop the sun. It carries me to the east…..always to the east.
*
I've never thrown a punch. Never been in a fight or carried a gun. So if you ask me what it is like to do battle…I only have a limited set of experiences to draw from.
I did, however, catch a glimpse of the desperation of war during residency when I spent a month in the Bone Marrow Transplant unit. I felt continuously under fire, attacked from all sides, desperate. I experienced death every day.
It wasn't just the elderly...it was also the young. Mothers, fathers, children…no one was spared!
*
The Bone Marrow Transplant program during residency was large. There were fifty patients on the unit and then twenty to thirty scattered amongst the oncology floors.
We had ten admissions a day and the same number of discharges. On average one patient died every 24 hours.
The job of taking care of these patients fell on two fellows, two residents, one attending physician, and countless dedicated nurses.
There are many beautiful life affirming stories that occur on a Bone Marrow Transplant floor.
This is not one of those.
*
I remember my last day on the unit. I spent the morning avoiding ambush. There were no codes. All our patients survived the night.
I stepped into Mrs. P’s room gingerly. Mrs. P had been in the hospital for over 6 months. She had a stubborn lymphoma that persisted despite treatment. She knew that she would never return home.
She knitted every morning as she watched the news. As with so many patients, our conversation moved from cordial greetings to a discussion of world events. I went through the motions of my examination as she recounted the most recent atrocities. They were particularly horrible today.
We did this every morning. She telling me who recently died, or was killed, or robbed. And I feigning interest although in reality I had lost touch with life outside the unit. The world could fall apart around me but I was too busy…scurrying after labs, running codes, talking to family members. Secretly trying to protect myself from the death and destruction that surrounded me.
If you listened closely to the discussions that we had every morning the essence of what was said would sound something like this…
“Doctor, I watch TV and see that in the world things are happening, and I am still here”. And dutifully I would respond, “yes, yes, bad things are happening in the world and yet, thankfully, you are still here!”
Mrs. P’s days were limited. And my days on the unit were almost over. I worked 12 hours a day, every day, for a month. My time at home, in-between shifts, was surreal. I would sleep, eat, have conversations. Mostly exhausted bridges to my next stint on the unit.
I had become a robot, a zombie.
I was withdrawing.
*
It was just another day in hell.
I sat down for rounds that morning. Mrs. P was right...things were happening in the world and strangely I couldn't’t relate. The TV above us was blaring the latest news. My attending was sitting down with his daily Tab and being prepped by the other residents.
The hum of the nursing station had reached a fevered pitch. I glanced at my progress notes and realized that I forgot to add the date and time. I looked at the clock on my pager:
10:45 AM
09/11/01
The world had instantly changed.
And it would take a good deal of time and spiritual healing to realize that it wasn’t just another day..
of death and destruction on the unit.
It’s just another day in hell. I stand on the Bone Marrow Transplant unit. There are no windows. Suddenly the building starts to shake. The ceiling cracks letting in rays of sunlight. The ground rumbles below.
Sadness, grief, and despair spew from the floor. They rise as black lava erupting from the innards of the building and drag me to the street. I am swept forward as black death encompasses the earth and moves to envelop the sun. It carries me to the east…..always to the east.
*
I've never thrown a punch. Never been in a fight or carried a gun. So if you ask me what it is like to do battle…I only have a limited set of experiences to draw from.
I did, however, catch a glimpse of the desperation of war during residency when I spent a month in the Bone Marrow Transplant unit. I felt continuously under fire, attacked from all sides, desperate. I experienced death every day.
It wasn't just the elderly...it was also the young. Mothers, fathers, children…no one was spared!
*
The Bone Marrow Transplant program during residency was large. There were fifty patients on the unit and then twenty to thirty scattered amongst the oncology floors.
We had ten admissions a day and the same number of discharges. On average one patient died every 24 hours.
The job of taking care of these patients fell on two fellows, two residents, one attending physician, and countless dedicated nurses.
There are many beautiful life affirming stories that occur on a Bone Marrow Transplant floor.
This is not one of those.
*
I remember my last day on the unit. I spent the morning avoiding ambush. There were no codes. All our patients survived the night.
I stepped into Mrs. P’s room gingerly. Mrs. P had been in the hospital for over 6 months. She had a stubborn lymphoma that persisted despite treatment. She knew that she would never return home.
She knitted every morning as she watched the news. As with so many patients, our conversation moved from cordial greetings to a discussion of world events. I went through the motions of my examination as she recounted the most recent atrocities. They were particularly horrible today.
We did this every morning. She telling me who recently died, or was killed, or robbed. And I feigning interest although in reality I had lost touch with life outside the unit. The world could fall apart around me but I was too busy…scurrying after labs, running codes, talking to family members. Secretly trying to protect myself from the death and destruction that surrounded me.
If you listened closely to the discussions that we had every morning the essence of what was said would sound something like this…
“Doctor, I watch TV and see that in the world things are happening, and I am still here”. And dutifully I would respond, “yes, yes, bad things are happening in the world and yet, thankfully, you are still here!”
Mrs. P’s days were limited. And my days on the unit were almost over. I worked 12 hours a day, every day, for a month. My time at home, in-between shifts, was surreal. I would sleep, eat, have conversations. Mostly exhausted bridges to my next stint on the unit.
I had become a robot, a zombie.
I was withdrawing.
*
It was just another day in hell.
I sat down for rounds that morning. Mrs. P was right...things were happening in the world and strangely I couldn't’t relate. The TV above us was blaring the latest news. My attending was sitting down with his daily Tab and being prepped by the other residents.
The hum of the nursing station had reached a fevered pitch. I glanced at my progress notes and realized that I forgot to add the date and time. I looked at the clock on my pager:
10:45 AM
09/11/01
The world had instantly changed.
And it would take a good deal of time and spiritual healing to realize that it wasn’t just another day..
of death and destruction on the unit.
Sunday, September 4, 2011
Mary's Disease Was Not Measured In CT Scans
You killed my patient.
His words were like venom. He spit them in the direction of the phone held by his left hand which bobbed in front of his face.
You mean the one with the metastatic lung cancer? The one whose finger like tumor strangled her esophagus making the act of swallowing similar to trying to fit a hamburger through a closed vice grip?
I could feel the heat emanate through the line as his temperature rose. I could sense the amplitude of his body shaking as his words came out an uneven staccato.
Yes the one whose disease burden had noticeably shrunk on last nights cat scan.
I felt calm. I had watched from the periphery as Mary's physical and mental condition declined dramatically. Although she was my partner's patient, I grew fond of her during a recent hospitalization.
She struggled to comprehend the changes overtaking her. She was lost in a whirlwind of chemotherapy and radiation, medication and complications. Her oncologist spoke of the future as if it was already written. Full of hope...he never mentioned prognosis. Never talked of life expectancy.
He managed her disease on a cellular level. He thought in terms of tumor growing...tumor shrinking. But Mary's disease was not measured in ct scans or labs tests. One look revealed life's harshest reality. She could no longer walk. She could no longer eat. She was dying.
Two weeks ago Mary developed a fever. She became confused. And she refused to get out of bed. Her family brought her to the oncologist who prescribed antibiotics. Her physical state improved initially but was now receding. Mary's family, overwhelmed and afraid, brought her to the emergency room.
The ICU nurse woke me form a sound sleep. There was no DNR order and Mary needed to be intubated. The oncologist had already given the order to ventilate but the nursing staff was reticent. Lack of familiarity added clarity to their perspective. There was no history or personal involvement to falsely color the obvious.
I quietly spoke to Mary's husband.
What would she say if she could see what is happening?
She'd be horrified!
Would she want to be on a ventilator?
No!
Should we just make her comfortable?
Please!
I asked for the nurse and ordered a morphine drip and ativan. When I arrived the next morning I found a crowd huddled at the bedside. Mary was peacefully unconscious. Her husband was somber yet relieved.
She died and hour later.
The oncologist lit into me mercilessly. She had pneumonia. We could have treated her. You let her die.
I took a deep breath and paused.
All of our patients die. We have no control over that.
If we are lucky we can allow for a little dignity. Perhaps help them control how and when.
Upon finishing I realized that the oncologist missed my last sentence. The sound of the dial tone on the other end confirmed..
he had already hung up.
His words were like venom. He spit them in the direction of the phone held by his left hand which bobbed in front of his face.
You mean the one with the metastatic lung cancer? The one whose finger like tumor strangled her esophagus making the act of swallowing similar to trying to fit a hamburger through a closed vice grip?
I could feel the heat emanate through the line as his temperature rose. I could sense the amplitude of his body shaking as his words came out an uneven staccato.
Yes the one whose disease burden had noticeably shrunk on last nights cat scan.
I felt calm. I had watched from the periphery as Mary's physical and mental condition declined dramatically. Although she was my partner's patient, I grew fond of her during a recent hospitalization.
She struggled to comprehend the changes overtaking her. She was lost in a whirlwind of chemotherapy and radiation, medication and complications. Her oncologist spoke of the future as if it was already written. Full of hope...he never mentioned prognosis. Never talked of life expectancy.
He managed her disease on a cellular level. He thought in terms of tumor growing...tumor shrinking. But Mary's disease was not measured in ct scans or labs tests. One look revealed life's harshest reality. She could no longer walk. She could no longer eat. She was dying.
Two weeks ago Mary developed a fever. She became confused. And she refused to get out of bed. Her family brought her to the oncologist who prescribed antibiotics. Her physical state improved initially but was now receding. Mary's family, overwhelmed and afraid, brought her to the emergency room.
The ICU nurse woke me form a sound sleep. There was no DNR order and Mary needed to be intubated. The oncologist had already given the order to ventilate but the nursing staff was reticent. Lack of familiarity added clarity to their perspective. There was no history or personal involvement to falsely color the obvious.
I quietly spoke to Mary's husband.
What would she say if she could see what is happening?
She'd be horrified!
Would she want to be on a ventilator?
No!
Should we just make her comfortable?
Please!
I asked for the nurse and ordered a morphine drip and ativan. When I arrived the next morning I found a crowd huddled at the bedside. Mary was peacefully unconscious. Her husband was somber yet relieved.
She died and hour later.
The oncologist lit into me mercilessly. She had pneumonia. We could have treated her. You let her die.
I took a deep breath and paused.
All of our patients die. We have no control over that.
If we are lucky we can allow for a little dignity. Perhaps help them control how and when.
Upon finishing I realized that the oncologist missed my last sentence. The sound of the dial tone on the other end confirmed..
he had already hung up.
Friday, September 2, 2011
It's Complicated
My son glances up at me with those stunning brown eyes as his fingers pull at the sides of my pant leg. His head plunges downward and he clasps his hands behind his back. He is working up the courage to ask. His feet sway side to side. I know what's next....daddy, can I come with you to the hospital?
My heart sinks and then bounces back into my throat hampering my voice. How do I explain to a seven year old and keep him from becoming enamored? Should I tell him being a doctor is not just about pagers and fancy phones? Blue tooths, reflex hammers, and pens with shiny pharmaceutical logos?
*
He is shimmying back and forth in his booster as I turn down the car radio to answer a page. How do I explain my life's work? The all consuming task that has swallowed my youth. Ground me into pieces and spit me out...ragged and torn.
What do I tell a little boy about uncertainty? About the irrational complexity of the human body and the self inflicted torture of those who willfully try to master it. Or of consequences. Could I explain how it feels to be responsible for the loss of anther's life?
*
As we enter the hospital he marvels at the balloons in the gift shop. For him, the wards are a carnival of grandparents with kind words and smiling nurses offering sweet treats. But does he see the beaten and haggard bent over their rosary beads in the ICU waiting room? Or hear the mindless hum of the ventilator? Or notice the fetid smell of sterility that permeates the hallways?
Can I explain to him that a doctors career is series of battles which are all inevitably lost. And that victory occurs in crowded exam rooms were quiet desperation is met not with miracles but humanity and humility. A kind smile, a generous hand, and a partnership built on difficult decisions.
How...I ask you...do I protect him from a profession fraught with such difficulty?
How do I elevate him to a life that offers so much?
Wednesday, August 31, 2011
Sometimes We Are Doctors
If death was the end zone, George had been on the one yard line twice in the last five years. And I, as part of his team of doctors, watched as he stubbornly maintained his goal line stand. Miracles rarely happen in medicine. They certainly don't happen to the same person more then once.
Yesterday as George glided into my office you would have never known that eternity's grip had been so close. He was the picture of health. Strong and confident. He walked with a lightness found only in those who have escaped the ICU's tenacious grasp.
His complaints were minor. An ache hear...a pain there. Nothing extraordinary. Our conversation eventually turned social. After leaving the office he was going to his rental property to mow the lawn. It was a house. He owned it for years.
His current tenet, Jim, had moved in shortly after George's first hospital adventure. A young man with two children. Originally his wife had lived with them but she left Jim and the children one quiet morning.
Jim, overtaken by depression, eventually lost his job.
There he was. Two children. No wife. No income. Living in a rental property with no hope of having money to pay the next months rent.
George clearly remembers the day sitting in his kitchen with his hand on Jim's shoulder as the kids slept quietly in their bedrooms. Don't worry about the rent. You'll pay it when you're able.
After all that George had been through...compassion was more a privilege than a burden. He would wait. Two years to be exact. Until Jim could cover the monthly costs. Another year before he would pay the past dues. But Jim's children would grow up healthy and happy.
Looking across the exam table into George's warm kind eyes I felt great pride at being one of his doctors. One of the team of people who helped him stave off the inevitable. Because George would then help Jim. And Jim would bring up two wonderful children. And Jim's children would go on to touch other lives. Like dominoes my good intentions had helped start a reaction.
I believe George sensed what I was thinking. As left the office he turned and looked at me squarely.
We are all patients sometimes...
and sometimes we are doctors.
Yesterday as George glided into my office you would have never known that eternity's grip had been so close. He was the picture of health. Strong and confident. He walked with a lightness found only in those who have escaped the ICU's tenacious grasp.
His complaints were minor. An ache hear...a pain there. Nothing extraordinary. Our conversation eventually turned social. After leaving the office he was going to his rental property to mow the lawn. It was a house. He owned it for years.
His current tenet, Jim, had moved in shortly after George's first hospital adventure. A young man with two children. Originally his wife had lived with them but she left Jim and the children one quiet morning.
Jim, overtaken by depression, eventually lost his job.
There he was. Two children. No wife. No income. Living in a rental property with no hope of having money to pay the next months rent.
George clearly remembers the day sitting in his kitchen with his hand on Jim's shoulder as the kids slept quietly in their bedrooms. Don't worry about the rent. You'll pay it when you're able.
After all that George had been through...compassion was more a privilege than a burden. He would wait. Two years to be exact. Until Jim could cover the monthly costs. Another year before he would pay the past dues. But Jim's children would grow up healthy and happy.
Looking across the exam table into George's warm kind eyes I felt great pride at being one of his doctors. One of the team of people who helped him stave off the inevitable. Because George would then help Jim. And Jim would bring up two wonderful children. And Jim's children would go on to touch other lives. Like dominoes my good intentions had helped start a reaction.
I believe George sensed what I was thinking. As left the office he turned and looked at me squarely.
We are all patients sometimes...
and sometimes we are doctors.
Sunday, August 28, 2011
I Am All Of These
The edges of Cameron's lips rise undeniably toward the clear blue sky. His legs move methodically. One motionless on the scooter and the other periodically kicking to propel himself forward. He weaves in and out dodging my shadow as I jog beside him.
I struggle to keep pace. My breathing unsteady and labored. My joints aching. And my brain foggy from lack of sleep and replaying the events of the day.
*
The hospital was uncharacteristically quiet. Even for 5 am. My eyes fluttered with fatigue as I willed my mind to focus after two nights of countless interruptions. I felt no joy in this early morning excursion.
The room was lit by a small lamp. A woman in her forties sat with a young child curled on her lap. A boy...Cameron's age. My eyes adjusted to the absence of light.
The middle aged man lying on the bed looked far older then reality. He took deep irregular breaths. Each pause a question. His wife held his hand gingerly. I inhaled the seen cautiously. I couldn't help but think of my dad. Were his last moments like this?
The woman dabbed her eyes with a tissue. She tried to move slowly to avoid waking up the child perched on her waist. I placed my hand on her shoulder. It won't be long now. She replied softly. I know.
I sat for a few moments and waited. The breaths became less and less frequent. Then suddenly they stopped. The woman shuddered. Mutely shaking she sobbed. Visceral, uncontrollable movements made more powerful by there silence.
From the distance I could here a kitschy lullaby on the PA system. Somewhere in the obstetrics ward a baby had just been born. I remembered a poem by John Donne:
Each man's death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.
*
Cameron has fallen behind. He stops to tie his shoes. My thoughts sprint forward without the distraction of companionship.
Father and son. Doctor and grieving family member. Above the fray and yet bruised and broken below the surface.
I am all of these.
Cameron clanks ahead and the sun catches the tail of his scooter and blinds me momentarily. I stop and bend forward my arms resting on my knees. My calfs exploding. My heart flubbing. And my brain longing for the sweet reconciliation and abandon of sleep.
He pauses a few feet ahead and cranes his neck backward. Dad...dad...you can't stop now!
His words are like daggers filleting open my torso and exposing a deep, primal need....to be told what to do.
My legs respond despite the minds abrasive litany of curses.
Despite all that has happened today.
I will continue running.
I struggle to keep pace. My breathing unsteady and labored. My joints aching. And my brain foggy from lack of sleep and replaying the events of the day.
*
The hospital was uncharacteristically quiet. Even for 5 am. My eyes fluttered with fatigue as I willed my mind to focus after two nights of countless interruptions. I felt no joy in this early morning excursion.
The room was lit by a small lamp. A woman in her forties sat with a young child curled on her lap. A boy...Cameron's age. My eyes adjusted to the absence of light.
The middle aged man lying on the bed looked far older then reality. He took deep irregular breaths. Each pause a question. His wife held his hand gingerly. I inhaled the seen cautiously. I couldn't help but think of my dad. Were his last moments like this?
The woman dabbed her eyes with a tissue. She tried to move slowly to avoid waking up the child perched on her waist. I placed my hand on her shoulder. It won't be long now. She replied softly. I know.
I sat for a few moments and waited. The breaths became less and less frequent. Then suddenly they stopped. The woman shuddered. Mutely shaking she sobbed. Visceral, uncontrollable movements made more powerful by there silence.
From the distance I could here a kitschy lullaby on the PA system. Somewhere in the obstetrics ward a baby had just been born. I remembered a poem by John Donne:
Each man's death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.
*
Cameron has fallen behind. He stops to tie his shoes. My thoughts sprint forward without the distraction of companionship.
Father and son. Doctor and grieving family member. Above the fray and yet bruised and broken below the surface.
I am all of these.
Cameron clanks ahead and the sun catches the tail of his scooter and blinds me momentarily. I stop and bend forward my arms resting on my knees. My calfs exploding. My heart flubbing. And my brain longing for the sweet reconciliation and abandon of sleep.
He pauses a few feet ahead and cranes his neck backward. Dad...dad...you can't stop now!
His words are like daggers filleting open my torso and exposing a deep, primal need....to be told what to do.
My legs respond despite the minds abrasive litany of curses.
Despite all that has happened today.
I will continue running.
Thursday, August 25, 2011
Sometimes Our Healthcare System Is Like This
Sometimes our healthcare system is like this:
I'm sitting outside a restaurant eating lunch with my brother and cousin. Out of the corner of my eye I see a woman fall.
Her wrinkles and unsteady gait betray her youthful facade. A cane bounces against the building and lands next to her. She is disoriented. Confused.
We jump out of our chairs and turn around. A flash of blazing cell phones connected to shaky hands greets our arrival. Multiple bystanders cry out in unison...we're calling 911.
The lady sits up and leans against the side of the building. Her eyes regain clarity...No...don't...I'm OK!
The cell phones recede but the crowd is restless. They form a circle around their prey ready to pounce. Are you OK? Did you hit your head? Does your hip hurt? With each question the anxiety level rises. I try to clear a path. To give her space.
We hoist her into a chair. She is beginning to recover. The owner of the restaurant hands her a glass of water.
A young athletic women bursts through the crowd. She grasps her cell phone like her hands are the jaws of life pulling an accident victim out of a car crash. She is almost yelling....I just want you to know an ambulance is on the way! She speaks into the air. To no one in particular.
As the fire truck and ambulance arrive the poor women quietly shakes her head. No...no...I didn't want this.
She slouches nonchalantly and listens as the EMT tries to convince her to go to the hospital. But...I'm okay...really.. I'm okay. I just slipped while trying to get up.
They force her to sign a medical release and then the ambulance and fire truck slink away quietly.
With little hesitation. The women leans over the cain and propels herself out of the chair. She hobbles across the alley...her hips swing comfortably side to side. She walks fifty more feet and then enters a medical complex.
Even with the twenty minute delay at the restaurant...
She will be right on time
for her orthopaedic appointment.
I'm sitting outside a restaurant eating lunch with my brother and cousin. Out of the corner of my eye I see a woman fall.
Her wrinkles and unsteady gait betray her youthful facade. A cane bounces against the building and lands next to her. She is disoriented. Confused.
We jump out of our chairs and turn around. A flash of blazing cell phones connected to shaky hands greets our arrival. Multiple bystanders cry out in unison...we're calling 911.
The lady sits up and leans against the side of the building. Her eyes regain clarity...No...don't...I'm OK!
The cell phones recede but the crowd is restless. They form a circle around their prey ready to pounce. Are you OK? Did you hit your head? Does your hip hurt? With each question the anxiety level rises. I try to clear a path. To give her space.
We hoist her into a chair. She is beginning to recover. The owner of the restaurant hands her a glass of water.
A young athletic women bursts through the crowd. She grasps her cell phone like her hands are the jaws of life pulling an accident victim out of a car crash. She is almost yelling....I just want you to know an ambulance is on the way! She speaks into the air. To no one in particular.
As the fire truck and ambulance arrive the poor women quietly shakes her head. No...no...I didn't want this.
She slouches nonchalantly and listens as the EMT tries to convince her to go to the hospital. But...I'm okay...really.. I'm okay. I just slipped while trying to get up.
They force her to sign a medical release and then the ambulance and fire truck slink away quietly.
With little hesitation. The women leans over the cain and propels herself out of the chair. She hobbles across the alley...her hips swing comfortably side to side. She walks fifty more feet and then enters a medical complex.
Even with the twenty minute delay at the restaurant...
She will be right on time
for her orthopaedic appointment.
Subscribe to:
Posts (Atom)