what we’ve found. Or haven’t found.”
The next time I walked up to the nurses’ station, the curtain of room 2 was pulled open and the room was empty.
A week later, it was my turn.
“She’s back.” Amy slid the chart across the counter. “Same thing. Swole legs.”
I didn’t have to look at the record to know the name of the patient.
Adele was in room 2 again. I pulled the curtain closed behind me and walked over to the stretcher.
Her legs were indeed “swole.” From the knees down, they were both distended and tense. But there was no pain, no tenderness, and her pulses were completely normal.
“Dr. Lesslie, we need some help here.” Mrs. Hoskins was pleading, wringing her hands, and pacing the small room. “It’s just not getting any better.”
Her heart and lung exams were normal, and I told them we would check another urine specimen, just to be sure nothing had developed since her last visit. But there was no reason to repeat another lengthy workup.
Lori Davidson led Adele to a nearby bathroom and gave her instructions for collecting a urine specimen. After that, she walked her back to room 2, pulled the curtain closed behind her, and was in there for what I thought was a long time. When Lori finally came out, she looked at me, smiled, and shook her head as she walked over.
“What is it? What’s so funny?”
Lori put the full specimen cup on the counter. “We won’t need to be checking her urine. It’s going to be completely normal.”
“How can you be so sure? How can—”
“I’ve made the diagnosis, Dr. Lesslie. I know what’s causing the swelling in Adele’s legs.”
Mrs. Hoskins was standing beside Adele’s stretcher, gently stroking the girl’s long brown hair. She looked up as I walked into the room.
“Adele, let’s go over a couple of things.” I pulled a stool up and sat down, her clipboard in my lap. “Tell me about this knee pain you’ve been having.”
The teenager’s eyes widened and she looked over at her mother.
Mrs. Hoskins spoke. “She was having some pain in her knees—growing pains—that’s all. Didn’t fall or anything, and I told her to take some ibuprofen. That helped—didn’t it, honey?”
Adele was staring at her mother. She nodded, then looked at the floor and shook her head.
I cleared my throat and shifted a little on the stool. “What have you been doing for your knee pain?” Mrs. Hoskins stopped stroking the girl’s hair. She stood ramrod straight, tilted her head to one side, and stared at her daughter.
“I’ve been…” Adele looked up at her mother, then suddenly fell silent.
“Tell the doctor, child. What have you been doing?”
“I’ve been wrapping my knees up at night, right before I go to bed. I found some Ace bandages in the bathroom and I’ve been using those.” She sighed and slumped against the wall behind her.
“Have you been putting those bandages on tight?” I knew the answer, but needed to hear it.
“As tight as I could. And it helped. The pain was gone in the morning, but my legs were all swollen.”
Mrs. Hoskins stood with her hands on her hips, mouth gaping, shaking her head in silence.
“You’ve been doing this every night?” I placed a hand on one of her swollen ankles. The Ace bandages had acted like tourniquets. Causing fluid to collect in her legs overnight.
“Uh-huh.”
I glanced over at her mother and then back down at Adele.
“Okay, here’s what we’re going to do.”
I hadn’t seen Adele or her mother in the intervening eight years and never heard what happened with the girl’s “swole” legs.
“Like I said, Dr. Lesslie, Adele is fine now. Completely normal. No more swelling after that day. And it was all thanks to you. If you hadn’t have figured out about those Ace bandages, who knows what would have happened.”
She needed to know the truth here—that Lori Davidson had been the diagnostician. “Mrs. Hoskins, I—”
She shushed me with a waving index
The next time I walked up to the nurses’ station, the curtain of room 2 was pulled open and the room was empty.
A week later, it was my turn.
“She’s back.” Amy slid the chart across the counter. “Same thing. Swole legs.”
I didn’t have to look at the record to know the name of the patient.
Adele was in room 2 again. I pulled the curtain closed behind me and walked over to the stretcher.
Her legs were indeed “swole.” From the knees down, they were both distended and tense. But there was no pain, no tenderness, and her pulses were completely normal.
“Dr. Lesslie, we need some help here.” Mrs. Hoskins was pleading, wringing her hands, and pacing the small room. “It’s just not getting any better.”
Her heart and lung exams were normal, and I told them we would check another urine specimen, just to be sure nothing had developed since her last visit. But there was no reason to repeat another lengthy workup.
Lori Davidson led Adele to a nearby bathroom and gave her instructions for collecting a urine specimen. After that, she walked her back to room 2, pulled the curtain closed behind her, and was in there for what I thought was a long time. When Lori finally came out, she looked at me, smiled, and shook her head as she walked over.
“What is it? What’s so funny?”
Lori put the full specimen cup on the counter. “We won’t need to be checking her urine. It’s going to be completely normal.”
“How can you be so sure? How can—”
“I’ve made the diagnosis, Dr. Lesslie. I know what’s causing the swelling in Adele’s legs.”
Mrs. Hoskins was standing beside Adele’s stretcher, gently stroking the girl’s long brown hair. She looked up as I walked into the room.
“Adele, let’s go over a couple of things.” I pulled a stool up and sat down, her clipboard in my lap. “Tell me about this knee pain you’ve been having.”
The teenager’s eyes widened and she looked over at her mother.
Mrs. Hoskins spoke. “She was having some pain in her knees—growing pains—that’s all. Didn’t fall or anything, and I told her to take some ibuprofen. That helped—didn’t it, honey?”
Adele was staring at her mother. She nodded, then looked at the floor and shook her head.
I cleared my throat and shifted a little on the stool. “What have you been doing for your knee pain?” Mrs. Hoskins stopped stroking the girl’s hair. She stood ramrod straight, tilted her head to one side, and stared at her daughter.
“I’ve been…” Adele looked up at her mother, then suddenly fell silent.
“Tell the doctor, child. What have you been doing?”
“I’ve been wrapping my knees up at night, right before I go to bed. I found some Ace bandages in the bathroom and I’ve been using those.” She sighed and slumped against the wall behind her.
“Have you been putting those bandages on tight?” I knew the answer, but needed to hear it.
“As tight as I could. And it helped. The pain was gone in the morning, but my legs were all swollen.”
Mrs. Hoskins stood with her hands on her hips, mouth gaping, shaking her head in silence.
“You’ve been doing this every night?” I placed a hand on one of her swollen ankles. The Ace bandages had acted like tourniquets. Causing fluid to collect in her legs overnight.
“Uh-huh.”
I glanced over at her mother and then back down at Adele.
“Okay, here’s what we’re going to do.”
I hadn’t seen Adele or her mother in the intervening eight years and never heard what happened with the girl’s “swole” legs.
“Like I said, Dr. Lesslie, Adele is fine now. Completely normal. No more swelling after that day. And it was all thanks to you. If you hadn’t have figured out about those Ace bandages, who knows what would have happened.”
She needed to know the truth here—that Lori Davidson had been the diagnostician. “Mrs. Hoskins, I—”
She shushed me with a waving index
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