to this.” The strength had left her voice. She unfolded the papers and held them out with shaking hands. “I have the power of attorney. Are you satisfied?”
Beverly caught up with Lukas as he reentered the E.R. proper. “That Mustang’s mine!”
Lukas struggled to work up some enthusiasm. “Don’t tell me you cajoled Dr. Wong—”
“Nope.” She jingled Cowboy’s keys. “Sweet-talked one of the new EMTs to help me. Buck likes animals.”
“Yes, but did you tell him this wasn’t a gerbil?”
She grimaced. “He knows it’s a big animal.”
“Horses are big animals. How will you feel if your helper comes back in here on a stretcher?”
“Awful.” She shrugged. “Dr. Wong’s finished with Cowboy. Got any patients for me?”
“Have I ever.” He gestured toward the charts at the desk. “Enjoy.”
He left her staring at the sudden overload and stepped back into exam room one to check on Mr. Verris. Shelly still sat there beside his bed, and Lauren entered behind Lukas, as if geared to his location by radar.
“Any change?” Lukas asked Lauren.
“Test results are in.”
Lukas checked the printouts. Nothing. Everything was normal. Even the drug screen was not helpful, because all it showed were benzodiazepines, and that was to be expected for someone who occasionally took them to sleep. Lukas could have done a quantitative drug screen, but that would have taken too long.
“BP’s gone up just a little, but not much,” Lauren continued. “Pulse and respiration are the same. They’ve called from upstairs to let us know they’re coming to take him to ICU.”
“Let’s make sure they know he still needs a CT scan.” Lukas did his own assessment. Was it his imagination, or was the man breathing more deeply? As he watched, Frankie’s head moved a fraction of an inch.
Lukas looked up to see if Lauren had noticed. “Has he moved like that before?”
“I don’t think so.”
He watched a moment longer. It was probably just a stimulation of the limbic system, a common event in a coma patient.
Lukas did an auscultation of Frankie’s chest one more time, then shook his head. With a nod at Shelly, he left the room. He was feeling more and more frustrated as the day progressed.
Lauren stepped out of the room behind him. “Dr. Bower? Some of the staff are getting together after this shift over at the cantina across the street. Want to join us?”
“Uh…sure. Yes, I’ll be there. Thank you for asking.” Lukas nodded and continued down the hall, knowing he would be kicking himself tonight when it came time to show up at the cantina. He would be starving when he got off, as usual, and since he always ate out anyway, this would be a good way to get better acquainted with the people who worked here. Unfortunately, he knew that by the time he arrived at the restaurant, he would be feeling so awkward about meeting with a group of near strangers, he would have lost his appetite. Almost.
Moving to a new place was lonely business, especially for him. Funny, he could face patients and coworkers all day long with no problem, but when his time was not regimented, he had trouble forcing himself to reach out to others. It wasn’t that he didn’t like people, because he did. The youngest of three boys in a loving Christian family, Lukas was the only shy one in the bunch, and he had often been teased about it. The teasing had only made him more self-conscious, turning him inward, and now his family despaired of ever seeing him married. But this was a new place, and no one here knew about his shyness. It was time to dig himself out of the rut—or pray that God would move him out.
He took Mrs. Richmond’s papers to the secretary. “We’ll need copies of these, Carol. Please call Dr. Richmond back and tell her that she needs to be on standby. Her grandmother is holding her own at the moment, but she could deteriorate fast, and she’s now a full code.”
“Yes, sir.” Carol grabbed the papers from him, dark eyes glowering as she spun around to the copier. She muttered something under her breath.
Lukas watched the characteristically cheerful secretary in surprise. “Carol, are you okay?”
She put the first sheet into the copier and pressed the button. “Fine, just fine,” she mumbled. “We’re swamped, we’ve got patients dying back there, and all I hear are complaints that we’re not seeing people fast enough.” She indicated the waiting room. “Griping because you haven’t looked at their scalps yet. They’d be in here right now, except one of them had to step outside for a smoke. I get so tired—”
“Have they been signed in?”
“No, I’ve been too busy with these other—”
“I’ll take care of them.” Lukas glanced out the door, where one of the women he’d seen earlier stood smoking, talking to the other. He strolled out to join them.
“Hello, ladies, I’m Dr. Bower. I hear you’re unhappy about our service. What’s the emergency?”
The smoker quickly shoved her half-smoked cigarette into the receptacle like a school kid caught by the teacher.
“We need to be treated for head lice,” the nonsmoker said.
The patio was deserted, Lukas noticed. He took another step forward, carefully looked at first one over-permed head of hair, then at the smoker’s long, stringy brown hair.
He took out a notepad and a pen and wrote the name of a shampoo. He held it out toward the smoker. “Wash with it once, then wait a week and wash again. You can buy this at your local pharmacy.”
She stared at the note in his hand. “No prescription?”
“You don’t need a prescription for this. The two of you can share a bottle.”
“But we’ll have to pay for it.”
Lukas felt his skin tingle with growing irritation. He inhaled slowly, counting to ten as he placed the note on the top of a trash can nearby. It had suddenly become a stressful day, the worst he’d had in a long time. He couldn’t blame it all on these two misguided souls.
He turned and opened the heavy glass door. “Ladies, the shampoo costs less than a pack or two of your favorite brand of cigarettes.”
“But we have Medicaid cards,” the smoker called after him. “We can report you for refusing to treat us!”
He stopped midstride and slowly turned back toward them. “Feel free,” he said, keeping his voice calm. “I feel I should warn you, however, that when a card carrier tries to use the card in the E.R. for nonemergency care, she can lose her card. It’s called Medicaid abuse. I think you’ll find that shampoo works very well as long as you follow the directions.” He stepped inside and let the door close silently behind him.
There were other Medicaid cardholders—for instance, the little baby in exam room three—who needed treatment today, not next week, and Lukas saw to it that
