some tests to check you out.â He glanced at the chart again. Beverly had only had time to do the vitals, not a complete assessment.
âDo you take any medicines, Darlene?â
She shook her head. âSupposed to take theophylline and two inhalers, but I havenât lately. I ran out. Canât afford refills.â
Lukas nodded. âAny drug allergies?â
She shook her head.
âAny chance of pregnancy?â
This got her attention. She shot him a very startled look, blushed, shook her head. âNo.â
âSorry, I had to ask. Weâre doing an X-ray.â
She shot him another startled look. âDo you have to? I donât have insurance.â
He considered it a moment. Heâd like to see an X-ray, but with the other tests, it may not be necessary. âOkay, weâll put a hold on that for now, but we still may need it, depending on what the other tests show.â That could be what was bothering her.
She looked slightly relieved.
âHello.â There was a knock at the open door, and Kaye, the respiratory tech, walked in. âAre you Darlene Knight? Iâve got orders to make you start feeling better, or I lose my job. Got a few minutes?â
Lukas smiled at her. âThanks for coming so quickly, Kaye. Darlene, Iâll be back after your treatment.â He braced himself to face the man with the migraine.
âDo you make a habit of abandoning your patients in this emergency room?â Mr. Little demanded as Lukas walked back in and laid the clipboard down on the counter.
âNot if we can avoid it,â Lukas said calmly. âWould you mind stepping to the bed?â
âWhy?â
âIf Iâm going to treat you, Iâm going to check you out. Please move to the bed. If you need some help, I canââ
âI donât need help,â the man snapped, then grudgingly obeyed Lukas.
Lukas checked heart, lungs, reflexes. Normal. Then he lowered the lights and checked the eyes. Bingo. They were pinpoint, no dilation. In this dimly lit room, that didnât fit.
He picked up the chart. âMr. Little, it says here that youâre allergic to Imitrex and Reglan. Those are our drugs of choice for migraine. What medications have you taken before?â
âDemerol and morphine work best.â
âBut I canât in good conscience give you a narcotic without running some tests to make sure youâre not in danger. I need a CT and a urineââ
âWhat?â Little brought his hands down from his head and glared at Lukas. âWhatâre you trying to do to me? I just want some simple pain relief! No urine test.â
Lukas checked the time. Forty-five minutes until Camp took over. No problem with this patient; he was about to leave. Federal law had to be satisfied first, though. Lukas knew the regulations well. Unfortunately, Little probably did, too, if he was habitual.
Darlene was another problem. For some reason, Lukas wanted to finish her himself.
âOkay, Mr. Little, Iâll send the nurse in with a shot for you.â
The man visibly relaxed. âItâs about time.â
Lukas had Beverly take a dose of Toradol to Mr. Little in room three while Lukas looked for and found the young manâs old chart at the central desk. Very interestingâeleven E.R. visits in four months, all for pain shots and pills. How many other area hospitals had records on him?
âCarol, please call the area emergency departmentsand check to see if Mr. Dwayne Little has visited them recently for pain medication.â
Carol raised a brow at him. âYes, Doctor, but you know who he is, donât you?â
âYes. Thank you for your concern.â
Lukas returned to Darlene in room six.
She still wore her mask and the finger probe. Her O2 sat was still low, but better. Her arterial blood gas turned out to be better than Lukas had expected. He checked her breathing.
The wheezing was louder.
Rebecca Hamilton, Conner Kressley