groaned.
âHello, Mr. Little, Iâm Dr. Bower.â Lukas placed the clipboard down on the counter and remained standing. âI hear you have a headache this morning.â
âYeah, Dr. Bower.â The man continued to rub his forehead. âItâs the worst Iâve ever had.â
âThen youâve had headaches like this before? Any nausea associated with them? Fever?â
âIâve had some before, but not as bad as this. Iâm puking my guts out.â
Lukas knew from checking the chart that the manâs temperature was normal. âHave you ever seen a doctorfor headaches before, Mr. Little? Ever had a CT head scan?â
âNot yet.â The man leaned forward and pulled a card out of his back pocket. âHere. Iâm supposed to go see a Dr. Pippin next week in Springfield. Heâs a neurologist.â
Lukas took the card and glanced at it. It was a blank appointment card, one anybody could pick up from a front desk of a busy office. Lukas was not impressed.
âWhat time is your appointment? Maybe I can call for an earlierââ
âI donât have an appointment yet, okay?â the man snapped. âLook, Iâve had this thing for two days, and itâs getting worse. Are you going to help me, orââ
Beverly rushed into the room. âDr. Bower, we just put an asthma patient in six who sounds really tight. Sheâs not panicky or anything, butââ
âIâll be there.â Lukas reached for the clipboard.
âHey, hold it a minute!â Little came halfway off his stool. âWhat about me? I want to know about my headache.â
âSorry, Mr. Little, Iâll be back,â Lukas soothed. âWe have an emergency.â He knew the irony of his words would be lost on this guy.
In exam room six, a woman in her forties sat forward on the bed with her legs dangling over the side. She wore a clear face mask attached by six feet of tubing to an oxygen regulator on the wall at the head of the bed. Lukas saw that her oxygen was running at 12 liters. Good. Beverly knew her stuff. The patient wore a pulse ox gauge on her right forefinger. It looked like a plastic clothespin with a thin cable attached to a small box on the bed.
Lukas glanced over Beverlyâs shoulder as she hurriedly took the womanâs vitals. The O2 sat had been 87 percent before the mask. Not good.
He stepped around to the other side of the exam table. âGood morning, Mrs. Knight.â
âMiss. Iâm Darlene,â she said between breaths.
âThank you, Darlene. Iâm Dr. Bower. Iâm going to listen to your lungs to get a better idea about whatâs going on.â He pressed his stethoscope against her back and heard a soft, musical wheeze, both inspiratory and expiratory. She was moving very little air.
He straightened. âBeverly, do you have the vitals yet?â
âYes, Doctor. BP 130 over 90, heart rate 120, respiration 36, temp 100.6.â
âOkay, thank you.â He gave orders for IV treatment and reassured Darlene. While Beverly carried out the orders, he went to the desk and ordered a stat respiratory therapy, blood tests and a chest X-ray.
Beverly had the IV established and was pushing the Solu-Medrol when he returned.
He glanced at the chart. âDarlene, weâll have someone here in a few minutes to give you a breathing treatment. Itâs going to help.â
She nodded, not looking at him, still fighting to breathe. âThanks.â
Lukas frowned at her for a moment. Interesting. Her eyes were bloodshot, and dark circles shadowed themânot the typical signs of an asthmatic. She avoided eye contact. She acted as if she had other things on her mind. Other asthmatics watched every move he and the nurse made, desperate for help, needing their reassurance and attention.
He sat down in front of her. âAfter we get your breathing improved, then weâll need to do
Rebecca Hamilton, Conner Kressley