Before Kim had even read the name, Ginger appeared at the end of the corridor. She had to move out of the way for Mr. Amendola to pass.
"I just got a call from the ward clerk on Becky's floor," she reported. "I'm supposed to tell you that the gastro something-or-other doctor is seeing Becky at this very moment."
"Then I'm out of here," Kim said quickly. He replaced the chart into its rack and stepped into his private office. While he was getting his suit jacket from the closet, Ginger came in.
"Where are you going?" she asked.
"Back to the hospital," Kim said.
"When will you be back?" Ginger asked.
"I don't know," Kim said. He pulled on his winter coat. "Let Cheryl know, so that the patient doesn't sit and wait in the examining room."
"What about the other patients?" Ginger said.
"Tell them there's been an emergency," Kim said. "I'll be back but probably not for an hour and a half or so."
Kim picked up his car keys and went to his rear door.
Ginger shook her head. She was the one who would have to face the patients. From past experience she knew how upset they were going to be, especially the ones coming from out of town.
"Just do the best you can," Kim said as if reading her mind.
Kim dashed to his car. He jumped in, started it, and drove out into the congested street. Leaning on his horn, he weaved in and out of the traffic. He felt desperate. Particularly after Tracy 's comments, he did not want to miss talking directly to the GI consult.
In the hospital lobby, Kim repeatedly hit the elevator button as if such action would bring a car sooner. Several visitors eyed him suspiciously.
Once on Becky's floor, Kim literally ran down the hall. When he entered Becky's room, he was panting. He saw Tracy standing off to the side, talking with a woman in a long, professorial white coat. Even a quick glance told him that Tracy was distraught.
Becky was in her bed on her back with her head propped up against the pillow. Her dark eyes stared ahead. At the moment, the only apparent motion was the relentless drip of fluid in the millipore chamber of the IV line.
Kim stepped over to the side of the bed. "How are you doing, Pumpkin?" he asked. He grasped her hand and lifted it. There was little resistance.
"I'm tired," Becky offered.
"I'm sure you are, dear," Kim said. Instinctively he felt her pulse. Her heart rate was on the high side of normal. By gently pulling down one of her eyelids, he checked her conjunctiva. It was pale but not significantly paler than it had been. He felt her skin. It was not particularly hot or moist, and her level of hydration seemed better than it had been the night before.
Kim's own pulse began to race. He could tell what Tracy had meant. There had been a change in Becky, and Tracy 's description of glassy-eyed and listless was accurate. It was as if part of Becky's incredible life force was in abeyance. She'd become lethargic.
"I'm going to talk to Mom," Kim said.
"All right," Becky answered.
Kim stepped over to Tracy. He could see she was subtly trembling.
"This is Dr. Kathleen Morgan," Tracy said.
"Are you the GI specialist?" Kim asked.
"I am indeed," Kathleen said.
Kim eyed the woman. In many ways she was the physical antithesis of Claire Stevens, although they were about the same age. Kim estimated that she couldn't have been much over five feet in height. Her face was round and her features were quite soft. She wore wire-rimmed glasses that gave her the aura of a schoolmarm. Her dark hair was prematurely streaked with silver.
"Dr. Morgan has told me she thinks Becky's case is serious," Tracy managed.
"Oh, that's a great comment," Kim remarked with obvious derision. "Serious, huh? I don't need someone to tell me it's serious. She wouldn't be in the goddamn hospital if it weren't serious. I need someone to say what it is that she has and how to treat and cure it."
"The lab will call me the moment they have a positive," Kathleen said warily. She was taken aback by Kim's response. "Until then our hands are tied."
"Have you examined her yet?" Kim demanded.
"Yes, I have," Kathleen said. "And I've gone over the laboratory results that are available."
"And…?" Kim remarked impatiently.
"So far I agree with Dr. Faraday," Kathleen said. "-Food-borne bacterial illness."
"She looks worse to me," Kim said.
"To me too." Tracy added. "She's changed just since last night. She's not herself; she's not as alert."
Kathleen cast an uncomfortable glance over at Becky. She was relieved to see the child was not paying attention to their conversation. Nonetheless she suggested they move out into the hallway.
"Having just seen her. I can't comment on any change," Kathleen said. "And there wasn't anything in the nurses' notes to that effect."
"I want her more closely monitored," Kim said. "How about moving her into one of the isolation rooms in the ICU?"
"I'm only a consult," Kathleen said. "Becky is officially under the care of Dr. Claire Stevens, the pediatrician gatekeeper."
"Then how about you convincing her?" Kim said. "Last night I suggested as much on admission, but I got the feeling she's on AmeriCare's side and worried about costs."
"That doesn't sound like Claire to me," Kathleen said.
"But, to be truthful, I don't think your daughter needs the ICU. At least not yet."
"That's an encouraging statement," Kim snapped. "In other words, you expect her to get worse while the lot of you sit around and do nothing."
"That's unfair, Dr. Reggis," Kathleen said, taking offense.
"The hell it is, Dr. Morgan," Kim spat. He pronounced her name with more scorn than he felt. "Not from my point of view. As a surgeon I make a diagnosis, then I go in and I fix it. In other words, I do something, whereas now I have this sickening sense my daughter is slipping downhill in front of my eyes and no one is doing anything."
"Stop it, Kim!" Tracy said, fighting tears. As anxious as she was about Becky, she didn't want to have to deal with Kim's contentiousness.
"Stop what?" Kim challenged.
"Your bickering!" Tracy managed. "This constant fighting with the doctors and the nurses is not helping. It's driving me to distraction."
Kim glared at Tracy. He couldn't believe that she could turn on him so quickly, especially since the issue involved Becky's care.
"Dr. Reggis, come with me!" Kathleen said suddenly. She made a motion with her hand as she started toward the nurses' station.
"Go!" Tracy encouraged. "Get a grasp on yourself."
As Tracy went back into Becky's room, Kim caught up with the striding Kathleen. She had her mouth set and was moving at a surprising clip with her relatively short legs.
"Where are you taking me?" Kim questioned.
"To the chart room behind the nurses' station," Kathleen said. "I want to show you something, and I think we should talk, just you and me, doctor to doctor."
The nurses' station was a beehive of activity. The day shift was preparing to leave and the evening shift was just coming on duty. Kathleen walked through the congestion with practiced ease. She held open the chart-room door and motioned for Kim to step inside.
Once the door closed against the hubbub, relative quiet ensued. The chart room was a windowless nook with built-in desks and X-ray view box. The communal coffeemaker stood on the countertop in the corner.
Without speaking, Kathleen slipped some X-rays from their folder and snapped them up onto the light box. She turned the unit on. The films were of a child's abdomen.
"Are these Becky's?" Kim asked.
Kathleen nodded.
Kim leaned forward to study the details as he allowed his trained eye to scan the X-rays. He was more adept at reading chest films, but he knew the basics.
"The bowel looks uniformly edematous," he said after a moment.