A White Coat Is My Closet (45 page)

Her door was already open, but I still rapped on it with my knuckles as I entered the room, smiling. Her mother sat wearily in a chair next to her bed, flipping disinterestedly through a magazine. Emily was curled up under her bedspread with an array of dolls and stuffed animals spread out in front of her. She had a little plastic comb and was dragging it through one of the doll’s matted hair. It appeared she was more likely to pull the poor doll’s hair out than she was to loosen any of the tangles.

“Hey, Miss Em. I’m glad I caught you in your room. I was wondering if you could do me a favor?”

She looked at me skeptically but gave the impression that any diversion would be a welcome distraction. “What do you want?” Her voice was heavily layered with suspicion. Anytime someone from the medical team walked in, it usually meant either an exam or a painful blood draw.

“There’s a seven-year-old boy down the hall,” I lied. “His name is Michael. He gave me this puzzle to put together but bet me I couldn’t do it.” I studied the box with confused intensity. “It looks pretty hard, and I’m not too good with puzzles.” I shifted my gaze to her and pasted on as helpless and as sincere expression on my face as I could. “I don’t want to lose the bet, so I was hoping you could help me put it together.”

She sat up in bed enthusiastically. She was too cute. Her long brown hair was pulled back from her face and secured with a Hello Kitty clip. It fell down to her shoulders in soft curls and framed a creamy white complexion accented by ocean-green eyes. “I’m good with puzzles!” she volunteered confidently.

“You are?” I beamed triumphantly. “Do you think you could help me?” Then I let the box drop to my side and tried to look dejected. “That is, if you’re not too busy.”

With a sweep of her hands, she knocked most of the dolls to the side of the bed. “No, I’m good with puzzles. I don’t mind helping you.”

I looked over at her mom and winked. Her mom’s face brightened with an appreciative smile. “Great,” I said, “Let me put some of these dolls onto the chair, and you scoot over so I can sit down next to you.” I grabbed an armful of dolls and deposited them onto the chair. Then I dropped down on the bed next to Emily and adjusted her pillow so we could share it. When we were comfortable, I pulled her bedside table across our laps and spilled the contents of the puzzle box out in front of us.

“It’s been a long time since I’ve done a puzzle. I don’t even know where to start.” I confessed.

Without hesitation, Emily shot her hands out and began manipulating the puzzle pieces. As if giving essential directions, she patiently explained, “First you have to turn all the pieces over so that you can see the pictures.”

“Oh, that’s a good idea. I suppose I should have thought of that. Lucky thing you’re here to help me. I don’t think I would ever have been able to put the puzzle together correctly if some of the pieces stayed upside down.” She smiled up at me, and together we corrected the orientation of each of the pieces.

“How do you know which pieces to begin with?” I asked her, as if I were completely confused.

She accepted my ignorance as if it was to be expected and began to gently impart her strategy. “It’s best to try to put together the pieces that have flat edges first, because you know those are the sides. Try to find two flat pieces that have matching colors.”

When assembled, the puzzle would be a picture of a princess castle under a rainbow, and Emily reached for two pieces that were both a deep purple and snapped them together. “See, these are the purple part of the rainbow. See how they fit together?” She picked up the top of the puzzle box and directed my attention to the picture. “And see how the purple part of the rainbow is the top part of the puzzle? That’s how you know they go together.” She beamed at me as if she had just explained the paradigm of creating world peace.

“Wow!” I expelled an impressive sigh. “You really are an expert puzzle person. Let’s see if we can put the whole thing together, and I won’t tell Michael you helped me. That way, I’ll win the bet for sure.” I smiled warmly at Emily. “Then I’ll get both of us an ice cream cone to celebrate. What do you say? Can we do it?”

Emily’s eyes widened in delight. “It will be easy.”

Twenty minutes later I walked out of Emily’s room. The puzzle had been assembled and now covered her bedside table with an expansive rainbow. I left with the promise of returning shortly with ice cream. I laughed to myself as I headed back to the nurses’ station.
That half hour might very well end up having been the most productive part of my day.

I had no sooner gotten to within twenty feet of the nurses’ station when Susan, the charge nurse, caught my eye. “I was just going to page you. Dr. Bargus called. He’s sending a six-year-old boy over to be admitted with the diagnosis of painful limp.”

I just rolled my eyes. We had taken to calling him “Dr. Bogus” because 90 percent of his admissions were bogus or completely unnecessary. The guy was either stupid, lazy, scared, or a combination of all three. “Painful limp? Does the kid have a fever? Has he gotten an X-ray?” I began to enumerate the steps that should have been taken to try to establish a diagnosis prior to admitting the child. Chances were, the little boy had something as simple as a sprained ankle, and rather than having to come into the hospital, he could be sent home with an Ace bandage and a bag of ice. I was about to escalate my protest when I remembered who we were talking about. With Dr. Bargus, the whole dialogue would have been pointless. He would just whine and sound increasingly concerned and helpless. I could hear it now:
I know it’s unlikely, Zack, but it’s better to be careful. We wouldn’t want to miss a bone tumor or a septic hip.

At that point, I’d just have to bite my tongue. I was always tempted to respond that most doctors could tell the difference between a stubbed toe and a bone tumor, but it was no use. Dr. Bargus had been on staff for the better part of a century, and he was loved by his patients. As residents, we just had to resign ourselves to the fact that his patients would be well taken care of, because if they even looked cross-eyed at him, Dr. Bargus would admit them to us to ensure any potential dangers were attended to adequately.

“Tell you what. Call him back and tell him to just send the boy to the ER. I’ll see the kid down there. I suspect that, perhaps with the benefit of an X-ray, we’ll establish an accurate diagnosis and be able to send him home. If the boy really needs to be admitted, I’ll call you. We have a lot of empty beds, so we’re safe.” I smiled. “No risk of him losing his reservation.”

Susan returned my smile. “I’m thinking about applying for a job in his office. Do you think he’d pay me better than I’m paid here if I just do all his work?”

I laughed. “From what I’ve seen lately, you’re overqualified. A Boy Scout with a first-aid kit could do a better job than Dr. Bargus.” We let our laughter fade. We knew we were exaggerating and were now being a little mean-spirited. The guy wasn’t malicious, he was just clueless.

As I walked away, I distractedly said over my shoulder, “I’m going to check on the morning labs. I’ll head down there in about thirty minutes. That should give the little boy adequate time to get checked in.”

When I walked into the residents’ office, I found Diane poring over a chart. She looked up at me, smiled vaguely, but kept her attention focused on the pages in front of her. “Hey, Zack, how’s the Italian love life? Spicy? Or are you going a little too heavy on the garlic?” She looked up at me briefly, seeming to get great satisfaction from listening to her own witty repartee, and then directed her concentration back down.

I felt a quiver of anxiety creep down my spine. After our many recent conversations, Diane knew all about Sergio, and it wasn’t as if I had anything I was trying to hide from her. I just still felt uncomfortable casually discussing my relationship while at work. Diane respected my privacy, and I knew she wouldn’t broadcast her knowledge about me to anyone else, but I remained nonetheless guarded in the hospital. I couldn’t help but feel it was a slippery slope. Once one person learned the personal details of my life, it could be only a matter of time before it became common knowledge. One would think I had matured beyond viewing that prospect as being so frightening, but mental evolution was slow. In many respects I hadn’t grown beyond being a nervous adolescent, certain I would be the object of ridicule if everyone were to learn I was gay. I swallowed and chastised myself silently. No wonder there was so much homophobia in the world; I was a poster child for perpetuating it.

Seeming to sense my anxiety, Diane again looked up at me. “Come on, Zack, don’t get your panties in a bunch. Your secret remains safe with me, but honestly, you make way too big a deal of it. No one really cares.”

She might have been psychic, or, having had this discussion with me before, she could easily read my worries. “I know,” I said. I relaxed just from acknowledging my discomfort to her. I went to the water cooler and filled a cup with cold water. “I feel a little silly. Old habits die hard. Little by little, I’m beginning to get less freaked out about it. In fact,” I said, pasting on my most confident smile, “I’m sure in the very near future, I will think so highly of myself I won’t give a shit what anyone thinks about me!”

She rolled her eyes. “Let’s not go overboard. My opinion of you will always matter, and if I think you’re being a shit, you’d better damn well pay attention.” She laughed.

“Point taken. Let’s just say I’m making progress at my own pace. Slow as a glacier, but progress.” Eager to change the subject, I said, “Now, speaking of panties, what has yours in a twist? You’ve been glaring at that chart since I walked in. What bugs?”

“Oh.” She opened the chart so that I could look over her shoulder. “I was just reviewing Baby Lash’s chart. She’s a three-week-old admitted a couple days ago with an elevated bilirubin. Initially, we suspected that her yellow skin was just the result of her bilirubin being only slightly above a normal range and that she’d improve with therapy. In fact, on rounds this morning, my intern said she was doing fine. But look at these values.” She circled sequential numbers with her pen. “Though the baby has already been getting treatment for two days, some of these values are actually getting worse. It kind of worries me.”

I evaluated the numbers she had circled and began to shake my head. “You have good cause for worry. The levels aren’t skyrocketing, but they imply that the baby is at risk for having biliary atresia.” Biliary atresia was when the bile ducts inside or outside the liver didn’t develop normally. In babies with biliary atresia, bile flow from the liver to the gallbladder was blocked. The condition led to liver damage, which could be deadly if corrective surgery wasn’t performed. I clapped Diane on the back. “Better draw some more comprehensive labs to check her liver. If they’re abnormal, you’ll have to put a call into the surgeon.”

She looked at me with mock surprise. “Gee, you’re pretty smart.” Then, seeming to take pleasure in goading me, she included under her breath, “For a gay guy.”

I had pretty much finished drinking my water, so I poured the rest down her back. “Bastard,” she yelled as she sprang to her feet. “I was just emphasizing my point. You’re a good doctor. Who cares if you’re gay?”

“Hey! No one cares. And,” I said, smiling, “if you believe no one cares, you’ll also believe I spilled the water down your back by accident. Now, I have to get down to the ER to see one of Bogus’s patients. I’m sure Bogus has already done an exhaustive workup and is depending on me only to confirm his clinical impression.” I winked at her as I turned to leave. “Don’t kill anyone while I’m gone.”

The cup I had been drinking from bounced off the back of my head. Lucky thing it was thin plastic. I heard Diane laughing as the door closed behind me.

In an attempt to oxygenate my brain, I jogged down the four flights of stairs to the first floor of the hospital. When I was on call, the stairs were the only exercise I got.
It’s too bad
, I thought.
A hospital of this size should have a staff gym. It would be great for productivity and morale.

I walked through the ER and approached the central desk. Patty, one of my favorite nurses, was standing behind it with one phone pressed to her ear and another held against her stomach. As charge nurse, most of her job was traffic control: keep the well patients moving, keep the sick patients from dying, and keep a lid on the chaos. Not an easy job.

When she had hung up both phones, I smiled at her and asked as nonchalantly as I could, “What are you doing just kicking back? If you have nothing to do, could you at least grab me a quick cup of coffee? I take it with cream and a couple of Splendas, not sugar.”

Her face read totally compliant. “Sure, it will be a pleasure to get you some coffee. You want me to mix anything else with your high colonic? Because….” She paused for emphasis. “If you expect me to get you a cup of coffee, that’s how you’re going to take it.” She smiled at me expectantly. “I hear using lavender makes your farts smell like a French meadow.”

“On second thought, maybe I’ll skip the coffee. Too much caffeine makes me jittery.” I held my hand out in front of me and made it shake. “Yep, thanks for your gracious offer, but I’ve probably had too much already.” We both laughed. No doubt her humor prevented her from losing it completely.

“Listen,” I said, “Dr. Bargus was sending over a six-year-old with a painful limp. Has he shown up yet?”

The question was barely out of my mouth before her phone began ringing and her beeper went off. She consulted the main triage board and whispered a response before she began speaking into the phone. “Room five, bed three.” She brought the phone to her lips. “ER, Patty.”

I walked into the room and found a little boy sitting on the bed. He had dark curly hair and brown eyes. His little Levi’s were cuffed at the ankle, and he wore a Spider-Man T-shirt. I obviously had an affinity for attracting patients guised as superheroes. “Hey, champ.” I pulled the chart out of the bedside rack and reviewed his vitals. He had no fever. “Dr. Bargus called me and told me that you were having trouble walking.” I looked at him intently. “That must be a big problem for Spider-Man. Can you still swing from a web?