“Sure.”
“Really?”
“Sure, Steph. Why not?”
“I don’t know. The position’s kind of. . . inherently
authoritarian.”
“To some extent,” I said. “But I’d imagine the position can adapt to
different styles of leadership.”
“Well,” she said, “I’m not sure I’d make a good leader. I don’t really
like telling people what to do. . . . Anyway, enough about that. I’m
getting off track. There were two more passing-out episodes before I
brought up the psych thing again.
“Two more,” I said, looking at my notes. “I’ve got a total of five.”
“Correct.”
“How old’s the baby by now?”
“Just under a year. And a hospital veteran. Two more admits, negative
for everything. At that point I sat mom down and strongly recommended
a psych consult. To which she reacted with. . . here let me give you
the exact quote.”
She opened the chart and read softly:” I know that makes sense, Dr.
Eves, but I just knoii’ Cassie’s sick. If you’d only seen her-lying
there, cyanotic.” End of quote.”
“She phrased it that way? Cyanotic’?”
“Yup. She has a medical background. Studied to be a respiratory
tech.”
And both her kids stop breathing. Interesting.”
“Yes.” Hard smile. At the time I didn’t realize how interesting. I
was still caught up in the puzzle-trying to arrive at a diagnosis,
worrying when the next crisis was going to be and if I’d be able to do
anything about it. To my surprise it didn’t happen for awhile.”
She looked at the chart again. A month passes, two, three, still no
sign of them. I’m happy the baby’s okay but I’m also starting to
wonder if maybe they’ve just found themselves another doc. So I called
the home, talked to mom. Everything’s fine. Then I realized that in
the heat of everything, the baby had never had her one-year exam. I
schedule it, find everything intact, with the exception that she’s a
little slow vocally and verbally.”
“How slow?”
“No retardation or anything like that. She just made very few
sounds-in fact I didn’t hear anything from her at all, and mom said she
was pretty quiet at home, too. I tried to do a Bailey test, but
couldn’t because the baby wouldn’t cooperate. My guesstimate was about
a two-month lag, but you know at that age it doesn’t take much to tip
the scales, and given all the stress the poor thing’s been through, no
big deal. But brilliant me. Bringing up language development got mom
worried about that. So I sent them over to ENT and Speech and Hearing,
who found her ears and laryngeal structure one hundred percent normal
and concurred with my assessment: possible mild delay in reaction to
medical trauma. I gave the mom suggestions about stimulating speech
and didn’t hear from them for another two months.”
“Baby’s fourteen months old,” I said, writing.
And back in the E.R four days later. But not with breathing probs.
This time she’s spiking a temp a hundred and five. Flushed and dry,
and breathing fast. To be honest, Alex, I was almost happy to see the
fever-at least I had something organic to work with. Then the white
count came back normal, nothing viral or bacterial. So I ran a
toxicology. Clean. Still, lab tests aren’t perfect-even our error
rates are running ten to twenty percent. And that spike was real-I
took the temp myself. We bathed her and Tylenoled her down to a
hundred and two, admitted her with a fever-of-unknown-origin diagnosis,
pushed fluids, put her through some real hell: spinal tap to rule out
meningitis, even though her ears were clear and her neck was supple,
because for all we knew she had one heck of a headache she couldn’t
tell us about. Plus twice-daily bloodwork-she went bananas, had to be
held down. Even with that, she managed to dislodge the needle a couple
of times.”
She exhaled and pushed the grapefruit farther away. Her forehead had
moistened. Swabbing it with a napkin, she said, “First time I’ve told
it like this from the beginning.”
“You haven’t had any case conferences?”
“No, we don’t do much of that anymore. Rita’s basically useless.”
I said, “How did the mother react to all the procedures?”
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