Page 29 of Tacos & Toboggans
“That sounds like Ivy, at least what I know of her. She’s always sweet and loving to everyone who walks through her doors. You know she’ll do right by you.”
“If you can cast this and send me on my way, I can still work behind the counter or something.”
“Well, we will certainly cast it after we fix it.”
“Fix it? Like pop it back into place or something? There’s a jut to it that wasn’t there before.”
“You could say that,” I agreed. “But no, we won’t be popping anything back into place. The bone that’s fractured is below your thumb,” I explained, pointing to it on my wrist. “The one next to it, the lunate bone, may also be fractured, but they touch, so it can be hard on X-ray to know for sure, especially with swelling. The scaphoid bone will certainly need to be realigned and screwed together. The jury is out on the lunate.”
“Screwed together?” she asked, swallowing hard when she realized what that meant.
“Yes. To stabilize the fracture and properly align the bones, a pin will be needed to facilitate healing. Once the bone is back in place, I’ll inspect the lunate for fractures and instability. I’m confident the lunate won’t need any intervention, but I can’t be positive until I see what we’re dealing with in there.”
“You're talking about surgery?”
“That’s the only way,” I agreed gently. “Remember when we talked about a malunion?” I asked, and she nodded. “That’s what we want to avoid.”
“I can’t do surgery. That’s expensive. I mean, I have insurance, but…”
“But nothing,” Ivy said, pulling the curtain back. “This is my fault, so I’ll be covering the deductible. You don’t need to worry about money right now. There's no choice here; it needs to be fixed. Hello, Dr. Warren. It’s nice to see you. I hoped you’d be the doctor Loretta wanted to hunt down.”
I stood and hugged her. “It’s good to see you, too, Ivy. Remember when I told you to call me Major?”
“Sure, in the diner, but this is your place of work, and you deserve the respect of your title.”
I brushed my hand through the air. “I never stand on titles. If you’ll excuse me, it’s time to round up some helpers to get this sweet lady’s arm fixed so she can return to serving those delicious tacos.”
“I know they’re your favorite!” Ivy said with excitement. “Wait until you see what we have going on for the holidays!” She gasped and turned to Jaelyn. “I just had the best idea! We can talk about it later. For now, we do need to get your arm fixed.”
“I’ll send the anesthesiologist in to talk to you while I fire up the operating room,” I said, patting Jaelyn’s leg. “When was the last time you ate?”
“About eleven,” she answered, and I checked my watch again. “It’s five now, so that’s six hours. We may have to delay the surgery an hour, but I’ll let the anesthesiologist decide on that.”
“Wait, you mean like doing the surgery right now? Don’t we have to wait for the swelling to go down?”
“Normally, I would say yes, but it’s not so swollen that I can’t do this simple fixation immediately. I’d rather we get it done now, as I’m worried about the risk of losing blood flow to the bone if we don’t. Will you consent to that?”
She bit her lip for a moment before she spoke. “I don’t have a choice, do I?”
“Everyone has a choice,” I said, leaning against the edge of the bed. “But in your case, delaying care to the arm could cause permanent nerve damage.”
“I don’t want the surgery, but I want that even less, so I guess I’ll consent to it.”
I patted her leg, trying to ignore the zing of heat that zapped me when I did. She was a patient, nothing more. “We got this,” I assured her with a smile. “It’s a simple surgery and won’t take long, but it’s imperative we do it if you want to retain use of your hand.” I checked my watch. “It’s getting on in the evening, so I’ll keep you overnight in the hospital. That way, the nurses can do ice therapy and manage your pain for the night.”
“That’s going to cost even more,” she moaned, so I squeezed her leg gently until I had her attention again.
“Jaelyn, listen. Once we admit you for the surgery, you get twenty-four hours of care as an outpatient. That means there won't be additional room charges if you’re discharged in the morning.”
Jaelyn glanced at Ivy, who nodded. “Okay then,” she said, her tone dejected.
“We’ll have you back to work in no time. Meanwhile,” I turned to Ivy. “Everyone needs to stay off the toboggans.”
“Sir, yes, sir,” Ivy said, saluting me, which made me laugh. “It was dumb. I don’t know what we were thinking.”
“You were thinking you wanted to have some fun. I’m teasing you, mostly. While I’ve never heard of grass tobogganing, the idea of flying down a hill on a piece of wood, snow or no snow, is dangerous in and of itself. That doesn’t mean we can’t do it safely, but accidents happen.”
“You’re too gracious to my bonehead decisions, Major. I appreciate that you’ll be the one doing her surgery. I know she’s in good hands.”
