Going into short call, Connie has won the game.
“Winning the game” means she managed to discharge all her patients. I don’t know how she does it. Maybe she has some magic tonic she feeds to everyone to get them well. Maybe if Mrs. Jefferson were her patient, she’d have grown her leg back by now.
Although I do end up getting some amazing news on arrival to the hospital. The social worker Robyn greets me on the floor and says to me, “Jane! I got visiting nursing services covered for Mrs. Jefferson!”
I can hardly believe my ears. “You didn’t!”
“I did!” Robyn cries. I’ve worked with Robyn many times in the past month and she always seems a little jaded and dejected. But now her lined eyes are lit up. “It’s all arranged!”
I stand there, savoring this information. I may actually get to discharge my rock star. Wow.
“That’s wonderful,” I say. “You’re amazing, Robyn.”
Robyn buffs her fingernails on her shirt. “Just in a day’s work,” she laughs. Then she adds, “The only snag is that she still needs IV antibiotics for her infection, right?”
I nod. “Three more weeks.” “Does she have a PICC line?”
A PICC line is a central line that is usually inserted for long term antibiotics, because it can stay in place longer than other kinds of lines. Mrs. Jefferson has been getting her antibiotics through an IV in her arm, but she definitely can’t keep that at home.
“I’ll arrange it,” I promise.
County Hospital has a special nurse who inserts PICC lines. I’ve heard you have to sell your soul to get her to come insert one, but at this point, I’m willing to make the trade.
Mrs. Jefferson is even happier about her discharge than I am, which is probably appropriate since she’s the one who’s actually going home. When I walk into her room, she bursts into tears.
“I can’t wait, Dr. Jane,” she sniffles. “I just want to play with my grandkids again.”
Each of her grandchildren has drawn her a card, and they’re plastered on the walls around her room. By the backwards writing on the card, I’d guess none of them is much older than kindergarten age.
“I’m really happy for you,” I tell her.
“Thank you so much, Dr. Jane,” she says. “Thank you for everything you done for me. I’ll never forget it.”
“You’re welcome,” I say, even though I didn’t actually do anything.
Robyn is the real hero. I’ve just been a glorified babysitter.
It might make sense to give Connie more patients on short call to even out our discrepancy, but Connie’s already made it very clear how she feels about that. So the first patient of the morning goes to me.
The patient’s name is Jean Rogers. She came to us from a nursing home with altered mental status, meaning she’s tired and confused as hell. She was diagnosed in the ER with a urinary tract infection but she hasn’t perked up yet despite a few doses of antibiotics. So it’s up to us to figure out the mystery.
When I get to the hallway where Mrs. Rogers’s room is located, I smell something terrible. I lift my head, sniffing just hard enough to identify the smell. I have no idea what it is.
That’s when I see a nurse emerge from Mrs. Rogers’s room wearing a facemask. I raise my eyebrows at the nurse.
“Is she on droplet precautions?” I ask. Droplet precautions are used when a patient has an infection colonizing the mucous membranes of their nose or mouth, which thereby spreads into the air. It basically means everyone who enters the room has to wear a mask.
The nurse shakes her head at me. “No, it just smells really bad in there. I couldn’t take it. I thought I was going to throw up.”
Well, that’s just great.
I brace myself as I enter the room. The stench hits me like a punch in the nose.
There are a lot of really bad smells in the hospital. If I had to rate the worst of them, I would do so accordingly:
- Clostridium difficile colitis, which causes a really smelly diarrhea
- Rectal gangrene
- Vomit
- Gastrointestinal bleed
- Rectal abscess
But I literally have never smelled anything this awful before in my life. I look at Mrs. Rogers, a withered, wrinkled body lying in the hospital bed. There’s no way she weighs more than a hundred pounds soaking wet. How is it possible such a powerful smell could come from her?
All I know is that nearly all the really bad smells come from the rectal area, so Alyssa will have my head if I don’t check her down there.
Dallas, I’m going in. At least this time I’ve got my guaiac cards.
I have literally checked every orifice of Mrs. Rogers’s body and I can’t identify where that smell is coming from. And it’s not going away. If anything, the smell is growing in intensity. It seems like a distinct possibility that in another 24 hours, the whole hospital will smell like Mrs. Rogers. In 48 hours, the entire city. In 72 hours, the entire world.
And only I, Jane McGill, slightly incompetent medicine intern, have the power to stop it.
The first thing I do is call the nursing home to get Mrs. Rogers’s old records (I know, Medicine is so glamorous). We need to get a little more history. For all I know, she’s smelled like this her whole life.
“We’ll send you the records right away,” the woman at the nursing home promises me.
“Thanks, I really appreciate it,” I say.
I run to the bathroom to scrub my hands really well. I keep an eye out for Ryan, because I don’t want to run into him right now. I feel certain the stench of Mrs. Rogers is clinging to my clothes and hair. I’m going to have to douse myself in Julia’s organic bleach to get rid of it.
When I return from the bathroom, the records have not yet been faxed. I start writing up my note on Mrs. Rogers, keeping an eye on the fax machine, but still nothing. Finally, I decide to give them another call. “Hello,” I say. “This is Dr. McGill at County Hospital. I’m waiting
for the records on Jean Rogers.”
A bored female voice says into the phone, “Who?” “Jean Rogers. She’s a resident at your facility.” “Who did you talk to before?” the woman asks.
I stare at the phone. “I have no idea.”
“When you talk to someone on the phone, you need to ask them for their name,” the woman says accusingly.
“Well, how many of you are there over there?” I retort.
The woman seems none too pleased with me right now. “I’ll see if we can send those records to you again.”
“And what’s your name?” I start to ask, but she’s already hung up on me. Damn. How am I supposed to get peoples’ names if they just hang up on me?
An hour later, I still have not received any faxes from the nursing home. And the nurses are spraying air freshener all over the hallway where Mrs. Rogers’s room is located. This is getting serious.
I call the nursing home again and this time I get another unfamiliar voice answering. I wish I had the names of any of the people I’d spoken to so far.
“This is Dr. McGill,” I say in a voice that, I have to admit, is not loaded with patience. “This is the third time I’m calling to get the medical records faxed over on Jean Rogers.”
What the woman on the other line says to me manages to completely shock me: “Oh, we don’t have a fax machine.”
I stare at the phone. “What?”
How is it possible in this day and age to not have a fax machine? Do they also treat patients with leeches? Am I calling them on their telegraph?
“We don’t have a fax machine,” the woman repeats cheerfully. “But…” I sputter. “The last two people I talked to said they were
faxing the records over!”
“Faxing or sending?” she asks me. “We generally mail out medical records.”
Holy crap. Are they serious? They really expect me to wait like five to seven days to get the records on Mrs. Rogers? This is the most ridiculous thing I’ve ever heard. The smell will surely have killed her by then.
“Do you want me to mail those out to you?” she asks. “No, don’t bother,” I say.
I go find Alyssa to report on the situation to her. One thing I know is that at least this isn’t my fault. I did my best to get those records. I called three times. They don’t have a fax machine—surely she can’t blame me for that.
I locate Alyssa in the resident lounge and explain the situation with Mrs. Rogers. I watch her rolling her eyes and I have a really bad feeling.
“There’s nothing I can do,” I insist. “They don’t even own a fax machine. Can you believe that?”
“Nothing you can do,” Alyssa repeats. “Is that really true, Jane? Is there absolutely nothing you can do to get those records?”
“Uh…” I really wrack my brain, trying to think of a possible way to get the records. It mostly involves some sort of telepathy. “I don’t… think so…”
“Think harder,” Alyssa says. “How could you get those records rather than just throwing up your hands and giving up?”
When it becomes clear that I have no idea how to answer the question, Alyssa finally takes pity on me and clues me in: “You can go to the nursing home and pick up the records yourself.”
I can?
“I’m allowed to leave the hospital?” I ask her. “You said I can never
leave the hospital while on call.”
Alyssa shakes her head. “Well, I’m here to cover you. And the nursing home is only five blocks away.”
So it is.
It’s actually a huge relief to get to leave the hospital. I toss my white coat in the lounge, rescuing only my badge, my pager, and the release of information for Jean Rogers. I figure I’ll look like an idiot walking around the streets of Manhattan in a long white coat. Plus, it’s about a million degrees out and super muggy.
I take my time walking over to the nursing home. I never ever get to leave the hospital while on duty, so now I’m really milking it. I know the first thing Alyssa will ask when I get back will be, “What took you so long?” But it’s worth it.
Maybe I’ll get a hot dog.
The nursing home is a dreary place with the dirtiest front steps I’ve ever seen. It looks like at least one animal and/or person has peed on them. The awning of the building is covered with bird poop, and has long rips in it. The lettering in the sign “Nursing Home” is worn away at the edge, so that it just says “Nursing Ho.”
Nursing Ho. Heh.
I march through the entrance, clutching the information release form in my sweaty hand. I’d been hoping for a burst of air conditioning to greet me inside, but instead I realize it’s even hotter inside than outside. I wipe away a few strands of sweaty hair that are stuck to the back of my neck.
I scan the corridor of the dreary building, hoping to locate someone who could help me. I see there’s a front desk, so I move in that direction, my clogs squeaking loudly on the floor. There’s a middle-aged woman sitting there, fanning herself as she talks animatedly to a youngish guy wearing blue scrubs. The guy in scrubs is carrying a giant cake with the lettering: “Happy Birthday Dad!”
That’s kind of sweet, coming to surprise your dad with a big cake like that. What a nice guy.
“Jane?”
I look up from the cake, and surprise surprise!, I’m face to face with none other than S*xy Surgeon. I stare at him, unsure what to say. What the hell is he doing here? I can’t imagine he was sent here to retrieve records on a patient. And what’s the deal with that cake he’s holding?
“Hi,” I say.
We’re still just staring at each other. He isn’t volunteering the reason why he’s here, and I’m too stunned to say anything to him.
It’s pretty awkward until the woman at the desk barks, “Can I help you, Miss?”
“Oh,” I say. “Um, I’m trying to get the medical records on a patient of mine.”
The woman gives me a dirty look, which is a stark contrast from the googly eyes she was making at Ryan a minute ago. Sometimes I’d love to be a hot surgeon guy.
“We can’t just give you patient records,” she says, folding her arms across her chest. “You need a release to be filled out.”
Triumphantly, I hold the signed release in the air. Jean Rogers is pretty demented, but not so much that she can’t sign her name, thank God.
“Fine,” the woman grumbles and gives me a set of hasty and confusing directions to get me to medical records.
“Thank you,” I say.
