Page 61 of No Greater Love
We moved through a few more cases when the man with back pain approached the desk, looking slightly annoyed.
"Hey, I didn't know I'd have to wait this long," he said. "I'm just gonna go and make an appointment with my family doc."
Nate looked up with the same deadpan expression. "That's probably a good idea, sir."
By the next patient, something had shifted. I found myself anticipating Nate's questions, reaching for supplies before he asked. When an elderly woman came in complaining of chest pain, I was already pulling up the EKG machine while he took her history. We moved around each other like dancers who'd been practicing the same routine for years.
From the corner of my eye, I caught Sophia watching us from the charge desk, a small smile on her face.
Then came the moment that surprised us both. A young mother arrived with her toddler, both of them in tears. The child had been crying inconsolably for hours, and the mother was convinced something was terribly wrong.
"He won't eat, he won't sleep, he just screams," she sobbed. "I know something's wrong. I know it."
Nate started his assessment, but the toddler only screamed louder at his approach. I stepped forward without thinking.
"Hey there, little guy," I said softly, crouching down to the child's eye level. Something about my voice seemed to catch his attention. "That's some impressive lung capacity you've got there."
The crying reduced to hiccups. I pulled out my stethoscope and made it into a pretend telephone.
"Hello? Yes, this is Dr. Tasha calling about a very important patient," I said into the stethoscope. "Really? He's the strongest crier you've ever heard? Wow."
The toddler giggled, reaching for the stethoscope. In the sudden quiet, I could hear it—the telltale wheeze of a reactive airway.
"Mild asthma exacerbation," I said quietly to Nate. "Probably triggered by crying, which made him cry more."
Nate nodded, already reaching for the nebulizer. Twenty minutes later, the little boy was breathing easily and playing with toys in his mother's lap.
"That was sharp, picking up on the wheeze with all that screaming. Good instincts," Nate said as they left.
Before I could respond, chaos erupted in the waiting room.
"Excuse me! EXCUSE ME!" A man's voice, loud and increasingly frantic. "I need to be seen RIGHT NOW!"
Through the glass, I saw a middle-aged man in a business suit pushing past other patients, his face flushed with panic. He practically ran to our desk, leaning over it with wild eyes.
"I'm bleeding to death," he gasped. "I'm going to die. You have to help me now!"
Nate remained calm, but I could see him shift into high-alert mode. "Sir, I need you to take a deep breath and tell me what's happening."
"I'm bleeding internally! There's blood everywhere! I've been bleeding for hours!" The man—Mr. Hendricks, apparently—was practically hyperventilating.
"Okay, sir. Can you tell me about any changes to your diet recently? What have you had to eat or drink today?"
Mr. Hendricks waved his hand dismissively. "You're not taking me seriously! I'm BLEEDING TO DEATH! I don't have time for twenty questions!"
Nate's jaw tightened almost imperceptibly. "Sir, I understand you're scared. We're going to take good care of you. But I need you to work with me here."
"I need a doctor! Now! Not a nurse asking me about my lunch!"
I felt my own temper flare at the dismissive tone, but Nate just nodded calmly. "Let's get you back to a room and figure out what's going on."
Because of his dramatic presentation, Mr. Hendricks got bumped ahead of several other patients who had been waiting longer. As one of our ER techs wheeled him to the main treatment area, Nate leaned over and whispered in my ear.
"He's loud, which is usually a good sign. It's the quiet ones who tell you they're dying, matter-of-fact, that youreallyworry about. That 'sense of impending doom' is no joke. We take this guy seriously because of what he's saying, but the way he's saying it... usually means we have a little more time to figure it out. Still, never get complacent."
In Room 6, Mr. Hendricks was still agitated, pacing back and forth despite our attempts to get him on the gurney. His vital signs were completely normal—blood pressure, heart rate, oxygen saturation all within normal limits.
"I need a stool sample," Nate said. "If you're having GI bleeding, we need to confirm it."
