Page 19 of Broken Dreams

She ignored his biting sarcasm. “Yes. I’m here with Mr. Fisher and I believe he has extended his stroke. He’s aphasic, his pupils are unequal. His right hand grasp is weaker than the left. He can’t move his right leg at all. His blood pressure is 160/90, pulse is 104 and respirations are 16 per minute. He is not running a fever.”

“He doesn’t sound that much worse from when I accepted his transfer,” Roland said, and she thought maybe his speech was slightly slurred. Or maybe she was just angry.

He’d actually accepted this patient in his current condition? A flash of anger burned as she moved further outside Mr. Fisher’s room so he couldn’t overhear.

She spoke professionally with an effort. “Dr. Roland, this patient is not stable for rehab. His neuro status is such, that I don’t even think he should be on a regular unit. The stroke team is on their way. I believe he’ll need to be transferred to the ICU.”

“Fine. Let the stroke team decide where he should go. And watch your tone,” he added. “Or I’ll get you written up for insubordination.” Before she could say anything more, he disconnected from the call.

Insubordination? For informing him of his patient’s worsening condition? Unbelievable. She swallowed her anger, and turned to walk back into Mr. Fisher’s room, just as two staff members, a doctor and nurse, came running down the hall.

“Did you call the stroke team?” The nurse asked.

“Yes.” Grateful to have expert reinforcements, she reiterated Mr. Fisher’s assessment. The grave expressions on both of their faces, made her feel better. She had not over-reacted about the seriousness of Mr. Fisher’s condition.

The two members of the stoke team, quickly entered Mr. Fisher’s room. Less than a minute later, they asked her to call for the transport team.

“We’re taking him straight down to the CT scanner, then we’ll secure a room for him in the neuro intensive care unit,” the nurse said. “Depending on the result of his scan, he may go directly to the interventional radiology suite for another procedure.”

“Understood.” She quickly made the call, hoping Roland would show up as Mr. Fisher was being whisked away.

Then again, maybe it was better if Roland didn’t show his face after all. She might not be able to hold back her opinion of his apathetic approach to patient care.

“Amber? Is something wrong?”

She spun around to find Nick standing beside her, wearing dress slacks and plaid shirt covered by a white lab coat. He had a stethoscope around his neck, and eyeing his name tag, she realized he’d taken the temporary hospitalist position. She hadn’t seen him since the night he’d stayed for dinner at her parents’ house and was irrationally irked at how handsome he looked.

“One of my patients isn’t doing very well.” She gestured toward Mr. Fisher’s room, noticing the transport team had arrived. “Excuse me.” She stepped away to help get Mr. Fisher transferred from the wheelchair to the gurney.

To her surprise, Nick followed. He frowned when Mr. Fisher continued saying, “Purple shoe.” It wasn’t unusual to have some patients use non sensical words when suffering an acute stroke. They could hear and understand, but couldn’t pick the right words to say what they were feeling.

Amber had a bad feeling, purple shoe meant headache.

“When did this start?” Nick asked.

“He arrived from the inpatient nursing unit, like this.” She glanced at her watch. “Less than fifteen minutes ago.”

The scowl on Nick’s features was reassuring. He was getting a taste of Dr. Roland’s decision making right off the bat.

“Definitely acute stroke symptoms,” he said. The pretty dark haired neurologist nodded in agreement.

“What’s going on here?” Dr. Roland loomed in the doorway. She turned toward him. He was short, round, weighing at least three hundred pounds, and reeked of cigarette smoke, intermingled with another scent she couldn’t quite place. He looked like a walking heart attack waiting to happen. And she was secretly glad she had both Nick and the stroke team members here to witness this conversation.

She lifted her chin, meeting his gaze head on. She would not cower in the face of his anger. “As I mentioned, I called the stroke team. They’re here, now. And Dr. Tanner came over to see Mr. Fisher, too.”

Roland’s face flushed with anger, but after eyeing the other health care providers in the room, he didn’t let loose the way she sensed he’d wanted to. “This patient must have taken a turn for the worse during his transfer.”

It was all she could do not to throw the truth in his face. And from what she could tell, Nick felt the same way.

“In checking Mr. Fisher’s chart, it appears these symptoms started prior to you accepting him as a rehab patient,” Nick said in a curt voice. “This patient wasn’t a candidate for rehab at all. I think you owe Ms. Monroe an apology.”

Roland’s face turned an alarming shade of purple. “You have no right to speak to me like that. Do you know who I am? I’m the medical director of this unit!”

“I know exactly who you are.” Nick looked tall and imposing, even with his cane, as he stepped closer to the older man. “Do you know who I am? Nick Tanner, the new hospitalist. And I suggest you watch your tone, or we’ll continue this conversation down in Rick Johnson’s office.”

The threat of being reported to the chief of staff was enough to have Roland backing down. He shot her a furious glare, then turned and stalked off toward the nursing station.

It was on the tip of her tongue to ask Roland if he planned to make rounds, but she decided against it.

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