think lupus could explain this?”
She leaned toward me, turning one side of her face for me to examine.
I hadn’t noticed it before in the less than optimal lighting of the exam room, but as she came closer, I could see that her cheeks and forehead were obviously a little more flushed than the rest of her face. It was the classic “butterfly” distribution of the facial rash of lupus—the “red wolf.” She had really done her reading.
But how had she managed to do this? The rash was in the typically described form and was the appropriate color. I looked closer. It was all I could do not to say something, but there was the answer. It was clear that Lucinda had applied a faint dusting of makeup to her cheeks and forehead. It was very subtle, but it was definitely makeup.
That was enough. Now I knew what I had to do.
“Lucinda, this is very concerning,” I told her truthfully. “I’m going to make a few phone calls and we’re going to get you some help.”
Relieved at last, she leaned back on the stretcher and said, “Thank you, Dr. Lesslie. Thank you so much.”
When I got to the nurses’ station, I slumped into one of the chairs. Susan looked over at me, puzzled.
“Do we need to do anything for the woman in 4?” she asked.
“Would you call up to the behavioral med unit and see if one of the psych doctors is up there?” It was a long shot at this time of the morning, but we might get lucky.
A few minutes later, I was talking with Martin Childress, the on-call psychiatrist. He had happened to be upstairs handling a problem patient when Susan had called.
I told him about Lucinda Banks, hoping desperately that he might be willing to take a look at her.
When I finished describing her case, there was a long pause on the other end of the phone. I was trying to think of my next step, when Martin said, “Robert, that sounds fascinating. Let me finish up here with this patient, and I’ll be down and talk with Ms. Banks. Thirty minutes okay?”
“That would be great,” I said gratefully. “She’ll be right here in room 4.”
I hung up the phone, relieved and thankful for the help. And I was thankful that Lucinda Banks was going to get some help. She didn’t have lupus, or heart disease, or a blood clot in her lungs. She needed psychiatric help and not another lengthy and futile workup.
When Martin Childress came down the hallway a little while later, I picked up the chart for room 4 and handed it to him.
“Thanks again for seeing her,” I told him.
“No problem,” he responded, studying the front sheet of her record. “I’ll let you know what I find.”
He walked over to room 4, stepped in, and pulled the curtain closed behind him. I sat there, watching and listening for some explosion, some outburst from Lucinda. But the room remained quiet.
“Here,” Jeff said, sliding the chart of room 3 over to me. “Bobby Craddock. Eight-year-old with a sore throat and temp of 102.”
I picked up the chart, read his name, noted the complaint and the boy’s temp, and thought— A sore throat. Thank you, Bobby Craddock.
8
Out of Death Comes Life
Friday, 7:45 a.m. Virginia Granger had been in her office with the door closed for the past half hour. That wasn’t anything unusual. What was unusual was that she had been meeting all this time with Walter Stevens, one of the hospital’s VP’s. I couldn’t remember what he was VP of, but I knew he was young and hadn’t been on the job for very long.
They must be discussing the department’s missing medication . Nothing had turned up to explain the inconsistent narcotics count, and now the administration was involved. That certainly didn’t thrill Virginia.
Her door opened and she stepped partway out.
“Dr. Lesslie,” she called, getting my attention as I stepped out of the medication room. I had been washing my hands, looking out the window into the parking lot. I’d been watching a young mother herd her four young children toward the ER
She leaned toward me, turning one side of her face for me to examine.
I hadn’t noticed it before in the less than optimal lighting of the exam room, but as she came closer, I could see that her cheeks and forehead were obviously a little more flushed than the rest of her face. It was the classic “butterfly” distribution of the facial rash of lupus—the “red wolf.” She had really done her reading.
But how had she managed to do this? The rash was in the typically described form and was the appropriate color. I looked closer. It was all I could do not to say something, but there was the answer. It was clear that Lucinda had applied a faint dusting of makeup to her cheeks and forehead. It was very subtle, but it was definitely makeup.
That was enough. Now I knew what I had to do.
“Lucinda, this is very concerning,” I told her truthfully. “I’m going to make a few phone calls and we’re going to get you some help.”
Relieved at last, she leaned back on the stretcher and said, “Thank you, Dr. Lesslie. Thank you so much.”
When I got to the nurses’ station, I slumped into one of the chairs. Susan looked over at me, puzzled.
“Do we need to do anything for the woman in 4?” she asked.
“Would you call up to the behavioral med unit and see if one of the psych doctors is up there?” It was a long shot at this time of the morning, but we might get lucky.
A few minutes later, I was talking with Martin Childress, the on-call psychiatrist. He had happened to be upstairs handling a problem patient when Susan had called.
I told him about Lucinda Banks, hoping desperately that he might be willing to take a look at her.
When I finished describing her case, there was a long pause on the other end of the phone. I was trying to think of my next step, when Martin said, “Robert, that sounds fascinating. Let me finish up here with this patient, and I’ll be down and talk with Ms. Banks. Thirty minutes okay?”
“That would be great,” I said gratefully. “She’ll be right here in room 4.”
I hung up the phone, relieved and thankful for the help. And I was thankful that Lucinda Banks was going to get some help. She didn’t have lupus, or heart disease, or a blood clot in her lungs. She needed psychiatric help and not another lengthy and futile workup.
When Martin Childress came down the hallway a little while later, I picked up the chart for room 4 and handed it to him.
“Thanks again for seeing her,” I told him.
“No problem,” he responded, studying the front sheet of her record. “I’ll let you know what I find.”
He walked over to room 4, stepped in, and pulled the curtain closed behind him. I sat there, watching and listening for some explosion, some outburst from Lucinda. But the room remained quiet.
“Here,” Jeff said, sliding the chart of room 3 over to me. “Bobby Craddock. Eight-year-old with a sore throat and temp of 102.”
I picked up the chart, read his name, noted the complaint and the boy’s temp, and thought— A sore throat. Thank you, Bobby Craddock.
8
Out of Death Comes Life
Friday, 7:45 a.m. Virginia Granger had been in her office with the door closed for the past half hour. That wasn’t anything unusual. What was unusual was that she had been meeting all this time with Walter Stevens, one of the hospital’s VP’s. I couldn’t remember what he was VP of, but I knew he was young and hadn’t been on the job for very long.
They must be discussing the department’s missing medication . Nothing had turned up to explain the inconsistent narcotics count, and now the administration was involved. That certainly didn’t thrill Virginia.
Her door opened and she stepped partway out.
“Dr. Lesslie,” she called, getting my attention as I stepped out of the medication room. I had been washing my hands, looking out the window into the parking lot. I’d been watching a young mother herd her four young children toward the ER
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