“I’ll try,” he said. After removing his trousers while keeping his modesty, Gina assisted him into a reclining position.
Mr Jones was sweating and breathing hard after getting onto the gurney. As a precaution she gave him oxygen. “Sometimes oxygen can help with the pain,” she said, and connected the cardiac monitor and automatic blood-pressure cuff as well. One glance at the heart monitor, and she was certain that he was as stable as she could make him for the moment.
“I’ll take anything at this point,” he said, breathed deeply and then closed his eyes. The wrinkle between his brows deepened.
“Let me see who I can find for you.” Hurrying toward the nurses’station, she almost collided with Dr Ferguson in the hallway. “Doctor? I’ve got a situation I could use your help with.”
“Sure. What’s the trouble?” Thomas asked, putting aside the chart he was reading and focusing on Gina.
“I’ve got a patient who’s requesting a male physician. He’s apparently very private and wouldn’t allow me to examine him properly, but he says his groin is swollen, red and painful. He’s also feverish, tachycardic, and in extreme pain. He can’t sit very well.” Gina hesitated as she watched him digest that information. “I think there’s something seriously wrong with him.”
“Anything else?” His blue eyes searched hers, his expression unreadable.
Gina swallowed, uncomfortable with his piercing regard. “At this point, no. That’s all I’ve got.” She knew she should have had more information to give him, but right now the patient needed the doctor’s input.
“Lead the way. Any family with him?”
“No, but he is married.” Gina led Thomas to the patient.
They entered the cubicle. “Mr Jones? This is Dr Ferguson. He’s going to do a more thorough exam.” Gina backed out of the way and pulled the curtain around them. “I’ll wait outside to give you a bit more privacy. Call me if you need something.” Gina tugged the curtain closed.
“So, what seems to be the trouble, Mr Jones? The nurse seemed to think it was of a…delicate nature.” Thomas observed the man’s flushed cheeks and glanced at the monitor, confirming Gina’s assessment of stability.
“It is,” Mr Jones said. “I have a…um…condition. It’s too painful. I held out as long as I could, but I just don’t know what to do about it anymore.”
“Oh, I see. Well, how about I take a look?”
Thomas gloved up, preparing to examine the patient. When he eased the gown away, he cringed and tried to keep all expression from his face. Good God. He took a deep breath as he assessed the man’s affected areas. The groin and upper thigh were red, the skin inflamed and hard as a rock. The left testicle was the size of a grapefruit. “What happened here?”
“I fell and a few days later this is what showed up.” Mr Jones shook his head in disgust, but even that small movement seemed to give him pain.
There had to be more to the story than that. “You fell?” That wasn’t what his gut was telling him had happened to Mr Jones. Thomas’s suspicions were more along the lines of malignancy. The man might have a trauma as well, but that wasn’t the only thing wrong with him. Thomas sighed, knowing this wasn’t going to be an easy case. But then, easy cases rarely interested him. He liked the intricacies of complicated cases. He knew he should go into hematology or infectious diseases, but his heart was in emergency medicine and the excitement it brought.
“Tripped over the damned cat. Guess I need to get my eyeglass prescription changed, too. Didn’t even see her.” He winced as Thomas continued the exam.
This was no injury from a fall. Instinct and years of experience told Thomas it was much more than that. The lymph nodes in the left groin and tissue in the upper thigh were swollen, firm, red and painful to the touch. With a sigh, he stood upright. “I’d like to run some tests to figure out what’s going on and see if we can’t make you more comfortable with a little medication.” This wasn’t going to be a simple fix or an easy diagnosis. He was certain of it.
Thomas stepped outside the curtain, but he didn’t have to look far for Gina.
“So, did you figure out what’s going on with him?” she asked, and walked along beside him to the nurses’station.
“Unfortunately, I left my X-ray glasses at home today.” He picked up the chart and started writing. “Give him some morphine.” Thomas shuddered, sympathetic to Mr Jones’s plight. “Then complete lab work-up, X-rays, CT scan, urine culture and blood cultures. We’ll also probably have to set up a referral to the hematology- oncology team as well. Have the secretary find out if they can see him today. This looks pretty urgent.” Thomas scribbled quickly in the chart as he rattled the orders off to Gina.
“You think he’s got cancer, don’t you?” she asked, her eyes wide.
“I think he has advanced cancer, and doesn’t have a clue. Tripped over his cat and believes that brought on this condition,” Thomas said, and shook his head.
“Denial is a very powerful coping mechanism,” Gina said, thinking about her own situation with her parents. “It gets people through a lot of tough situations they couldn’t deal with otherwise.”
Thomas didn’t respond for a moment, but studied her wide, expressive eyes clouded with concern for her patient. The woman was gorgeous. Tall, slender, with curly red hair pulled back into a clip that somehow managed to almost contain the mass. Yeah, he’d seen that before. Not going near that again, no matter how attractive the package. Once was enough for him. Keeping things professional was his best strategy with the budding attraction he was starting to feel for Gina. “Are you asking me not to be judgmental?”
“Yes. For just a moment.” She bit her lip, hoping she wasn’t leaping off a cliff here.
“Well, you’re right,” he said, and scribbled some more on the chart, then handed it to her. “But I still think he has cancer.”
“Thank you, Doctor.” She nodded, sending the mass of curling ringlets bobbing.
“Thomas, please.”
She gave a quick smile. “Thomas, then.” She took the chart from him. “I’ll get started on these right away.”
Travel nurses. He just didn’t get that. Uprooting their lives every three months to go somewhere else and do it all over again. Having come from a family firmly entrenched in Virginia, wanderlust wasn’t in his genes. Travelers fulfilled staffing needs, and they certainly had one now. Returning to his charting, he forced himself not to watch Gina walk away, though looking at the back of her was just as attractive as looking at the front. With a sigh of disgust at the surge of hormones racing through his system, he reached for the phone and jerked it off the hook. Now was not the time for him to be falling for a coworker, especially one he’d just met.
Gina approached Mr Jones’s cubicle. “Knock, knock. Can I come in?” She peeked through the curtain.
“Yes, ma’am,” Mr Jones responded. He lay with his eyes closed, his fingers laced and resting on his abdomen.
“The doctor’s ordered some bloodwork and other tests,” she said, and took his arm to look for a vein. “As soon as I get an IV started, I’ll give you some pain medicine, too. You look like you could use a touch of it right now.” In minutes she had the IV fluids going and injected the pain medicine. “Here comes the morphine. Just breathe slowly and let it go to work.” Easing a patient’s pain was the most important thing to her as a nurse. Sometimes the pain was physical, sometimes it was emotional. But she did whatever she could to help those in need. That’s why she’d become a nurse. She focused on helping others and found a place where she fit in.
Within minutes Mr Jones started to relax and his heart rate decreased by twenty points. “That’s better, isn’t it?” Gina asked, and patted his arm in a soothing manner. “Now that you’re a little more comfortable, I’m going to get you to Radiology for those other tests. Why don’t you tell me a little about yourself while I take you over there?”
Several hours later, after all the tests were over, Gina brought Mr Jones back to the cubicle and searched for Thomas. She knocked on his office door. “Dr Ferguson? Um, Thomas? Mr Jones’s tests are complete and ready for you to review.”
Thomas set down the chart he had been reading. “I’m sure they’re not good, but I’ll be happy to look at them.” He stood with a sigh, disturbed by the task ahead, knowing already what the results would be. Gina hesitated by the door, looking up at him, chewing on her lower lip as worry crept into her eyes. He wanted to put her at ease. He knew he could be demanding sometimes, but he just wanted what was in the patient’s best interests. Not that she knew that, being so new to working here. “Something else on your mind?” he asked, and approached her, wanting to see if his reaction to her was any different than it had been this morning.
“I know it’s not my place to tell you how to do your job, but…” Some doctors didn’t appreciate interference, especially from someone they didn’t know. But she wouldn’t be acting in her patient’s best interests if she didn’t say something.
“But what?” Thomas raised a brow and nodded, realizing he was standing very close to her. He took a step back, adding just a little distance between them. “If you have something to say, say it. I appreciate the honesty.” Especially after the games his ex had played. Honesty was a refreshing change.
“You have doom and gloom written all over you even before you go in there. He deserves your best face, even if it’s not how you feel.” Gina tensed, watching Thomas, waiting for him to tear into her. A moment passed, and he said nothing. Surprised that he didn’t, Gina waited for him to answer.
“I’m not going to give him false hope if that’s what you’re asking,” Thomas said, and met her gaze squarely. “That’s not appropriate.”
“If there’s any hope at all, it’s not false,” she said, as they moved away from his office toward the cubicle. “Sometimes people need to have something to believe in, even if they know it’s only temporary.” Thomas walked along with her, contemplating her words.
“You sound pretty certain of that,” he said, and stopped outside the cubicle.
“Unfortunately, I am. Comes from personal experience.” Without elaborating further, she pushed aside the curtain. “We’re back, Mr Jones.”
“What’s the word, Doctor?” he asked.
“Mr Jones, I believe it would be prudent to have you stay in the hospital for a day or two to undergo further evaluation.” He leaned against the counter in the room and gave a mental sigh. “After the exam and looking at your preliminary test results, I’m thinking that you have cancer in your groin. It wasn’t the fall that caused your injuries, but it certainly may have aggravated them.”
“Cancer, eh?” Mr Jones said, and blinked several times as he digested the information. “That’s a tough one.” He rubbed his jaw with his work-callused hand.
“It certainly is. So if there are any treatment options, the oncologist will be able to give you a better prognosis than I can right now.” Thomas hated bearing bad news, but it was part of the job. And Gina was right. If there was any hope at all, it wasn’t false. He’d do well to remember that.
“OK. If you say so.” Mr Jones closed his eyes. “I don’t know what I’m going to tell Elizabeth. She’s always leaned on me.” The long sigh he emitted said it all.