The Follow-Up

November 17, 2010

An ER doc checks the status of a memorable patient.

"This is Dr. DiNardo."
"Donna. It’s Gerry O."
"Gerry! What are you doing up at this time?"
“Couldn’t sleep. How’s the graveyard shift?"
"Could be worse. Right after you went home, Center City took a huge crap on us but we are digging out. Think I’ll get a chance to take a pee in a little while."
"Yeah. Sorry to hear that. Hey, what happened to my girl?"
"Uh…"
"You know, the girl with that weird thing on the pelvic exam? GYN thinks it’s cancer. Did the attending come down? What did the CT scan show?"
"Yeah, Jennie Franklin saw her. She agreed with you - she thinks its cervical cancer."
"Yeah? Did she say anything about why it looked so bizarre? I’ve never seen anything like that; her cervix was black and necrotic…"
"Yeah."
"It was as big as a tennis ball."
"Yeah, GYN biopsied it and cultured it."
"They’re going to admit her, aren’t they?"
"Uh…"
"Donna, what -"
"They wanted to wait for the results of the CT scan."
"Jesus Christ. She’s 22 years old! What the hell?"
"I know, I know."
"Why do they need the CT scan to decide whether or not to admit? Damn it! The only reason I ordered the CT was to see if she had an abscess. I had no explanation for her fever…"
"I know. Why are you yelling?"
"I’m sorry, I’m sorry. Is it back?"
"The CT scan?"
"Yeah."
"Yeah, it’s back."
"So?"
"It’s not good. It’s everywhere. She has metastatic disease to the liver, lung, everywhere. This CT is a death sentence."
"Jesus. Does she know?"
"I haven’t told her yet, but I think she knows something is wrong."
"God, Donna, don’t let them send her home. Some of the things she said…I think she is being abused or something at home…she told me that she works at a Starbuck’s on South Street but I’m in there all the time and I’ve never seen her there…she’s hiding something and if they don’t admit her then she is going to disappear and she’s gonna die… Jesus she’s almost dead already…"
"I know, I know…Hey Gerry - "
"Christ, Donna she is only 22 years old."
"Gerry, have you been drinking?... Ger?"
"I’m OK."
"You’re OK?"
"Yeah. What about oncology? Will oncology admit her?"
"Gerry. I’ll get her admitted. If GYN won’t admit her, I’ll have oncology or internal medicine or even family medicine do it. I’ll get someone to admit her. She spiked another fever a little while ago. If worse gets to worse I’ll admit her to internal medicine and consult infectious disease."
"OK."
"Infectious disease can run a culture on her farts."
"Hah."
"Are you OK?"
"Yeah. Just tired."
"Is Rika home?"
"She’s working the overnight uptown."
"Are you guys still coming over on Saturday? Mike says he will make empanadas."
"Yeah, yeah…just need to find a sitter."
"Go to bed. It’s almost dawn."
"Uh-huh…can’t sleep."