"Excuse me," Kim said. "Are there any enteric viruses making the rounds these days in school-age kids?"
"Not that I'm aware of," John said. "We've been seeing a pretty nasty strain of the flu, but it's all respiratory. Why do you ask?"
"My daughter's got a GI upset," Kim said.
"What are the symptoms?" John asked.
"It started with cramps yesterday morning," Kim said. "Then diarrhea. I've treated her with some over-the-counter antidiarrheal agents."
"Has it helped?" John asked.
"I thought so at first," Kim said. "But then last night the symptoms returned."
"Any nausea and vomiting?"
"Some mild nausea but no vomiting. At least not yet, but she hasn't had much appetite either."
"Fever?"
"Nope, none at all,"
"Who's her pediatrician?"
"It was George Turner. After the merger, he was forced to leave town."
"I remember Dr. Turner," John said. "I rotated over to the Samaritan. He was a good man."
"For sure," Kim said. "He's now back in Boston at Children's Hospital."
"Our loss," John said. "Anyway, about your daughter. It would be my guess she's got a touch of food poisoning and not a virus."
"Really?" Kim questioned. "I thought food poisoning generally came on like gangbusters. You know, like the proverbial staph in the picnic potato salad."
"Not necessarily," John said. "Food poisoning can be present in countless ways. But whatever the symptom complex, if your daughter has had acute onset diarrhea, chances are it's food poisoning. Statistically it's the most likely cause. To give you an idea of its prevalence, the CDC estimates there are two to three hundred million cases a year.
The elevator stopped and John disembarked.
"I hope your daughter feels better," John said as the doors closed.
Kim shook his head. He turned to another resident. "Did you hear that? Two to three hundred million cases of food poisoning every year! That's crazy!"
"That would mean that just about everyone in the entire country gets it each year," the resident said.
"That can't be true," a nurse getting off duty said.
"I think it is," another resident said. "Most people take the symptoms in stride and attribute it to the 'stomach flu.' Of course, there isn't any such thing as the stomach flu."
"It seems astounding," Kim said. "It makes you think twice about eating out."
"People get food poisoning in their own homes just as easily," a woman from the back of the elevator said. "It comes from leftovers to a large degree, although inappropriate handling of raw chicken is another major source."
Kim nodded. He had the uncomfortable feeling that everyone else on the elevator knew more about the issue than he did.
When the elevator reached the ground floor, Kim got off and left the hospital. As he drove home, he couldn't help but ponder about food poisoning. He continued to marvel at the shocking idea of there being two to three hundred million cases a year in the United States. If such a statistic were true, it seemed incredible that he'd not come across it in any of his medical reading.
Kim was still mulling all this over as he came through his front door and tossed his keys on the console table in the foyer. He thought he'd get on the Internet and see if he could substantiate the food-poisoning statistic, when he heard the sound of the TV coming from the kitchen. He walked in.
Ginger was at the kitchen counter, struggling with the wall-mounted can opener. She was dressed in a spandex workout suit that left little to the imagination. Both Saturdays and Sundays she did aerobics religiously. Becky was sprawled on the couch in the family room, watching cartoons. She had a blanket drawn up around her neck. She looked slightly pale against the dark green wool.
They'd spent the previous evening at home because of Becky's condition. Ginger had made a chicken dinner, of which Becky had eaten very little. After Becky had gone to bed early, Ginger had stayed over. Kim hoped they'd gotten along okay while he was at the hospital. He'd expected them still to be in bed by the time he got back from rounds.
"Hello, everybody," Kim called out. "I'm home."
Neither Becky nor Ginger responded.
"Damn!" Ginger exclaimed. "This thing is a piece of trash."
"What's the trouble?" Kim asked as he stepped over to Ginger. Ginger had abandoned her efforts with the can opener and had her hands on her hips. She looked exasperated.
"I can't get this can open," she said petulantly.
"I'll do it," Kim said. He picked up the can, but before putting it under the opener, he looked at the label. "What is this?" he questioned.
"It's chicken broth just like it says," Ginger replied.
"What are you doing with chicken broth at nine o'clock in the morning?" Kim questioned.
"It's for Becky," Ginger said. "My mother always gave me chicken broth when I had the runs."
"I told her I wasn't hungry," Becky called from the couch.
"My mother knew what she was doing," Ginger said.
Kim put the can of broth back on the counter and walked around the central island and into the family room. When he got to the couch, he put his hand on Becky's forehead. Becky moved her head to try to keep the TV in view.
"Feeling any better?" Kim asked. She felt warm, but he thought it might have been because his hand was cold.
"About the same," Becky said. "And I don't want anything to eat. It makes my cramps worse.
"She's got to eat," Ginger said. "She didn't eat much dinner."
"If her body is telling her not to eat, she shouldn't eat," Kim said.
"But she threw up," Ginger added.
"Is that right, Becky?" Kim asked. Vomiting was a new symptom.
"Just a little," Becky admitted.
"Maybe she should be seen by a doctor," Ginger said.
"And what do you think I am?" Kim responded hotly.
"You know what I mean," Ginger said. "You're the best cardiac surgeon in the world, but you don't have much chance to deal with children's tummies."
"Why don't you go upstairs and get me a thermometer," Kim said to Ginger.
"Where would I find it?" Ginger asked agreeably.
"In the master bath," Kim said. "The top drawer on the right."
"How about your cramps?" Kim asked.
"I still get them," Becky admitted.
"Are they any worse?"
"About the same," Becky said. 'They come and go."
"What about your diarrhea?" Kim asked.
"Do we have to talk about this?" Becky asked. "I mean, it's like embarrassing."
"Okay, Pumpkin," Kim said. "I'm sure you'll be feeling your old self again in a few hours. But what about eating?"
"I'm not hungry," Becky said.
"Okay," Kim said. "Just let me know when you want something."
It was dark by the time Kim turned into Tracy 's street and pulled to the curb at the base of her lawn. He got out and went around to the passenger side to open Becky's door. Becky had herself wrapped up inside a blanket so that it formed a hood over the top of her head.
Kim helped his daughter out of the car and up the walkway to the front door. She'd spent the entire day on the family-room couch in front of the TV. Kim rang the bell and waited. Tracy opened it and started to say hello to her daughter. She stopped in mid-sentence and frowned.
"What's the blanket for?" she asked. Her eyes shot to Kim for an explanation and then back to Becky. "Come in!"
Becky stepped inside. Kim followed. Tracy closed the door.
"What's going on?" Tracy asked. She turned back the edge of the blanket from Becky's face. "You're pale. Are you sick?"
Single tears formed in the corners of Becky's eyes. Tracy saw them and immediately enveloped her daughter in a protective hug. As she did so, she locked eyes with Kim.
"She's feeling a little punk," Kim admitted defensively.
Tracy pushed Becky out to arm's length so she could again look at her face. Becky wiped her eyes. "You're very pale," Tracy said. "What's the matter?"