seconds more, and then nodded, snapping out of his deep thought. âHayes is ready when you are.â
I grabbed a lead apron, slid my arms through the armholes, and then fastened the tie behind my back as I walked to the reading room to fetch Dr. Hayes.
As expected, he was sitting in his chair in front of his monitor in the dark, speaking quietly into his dictation mic. I waited patiently just outside the doorway for him to finish, and then he looked up at me.
âDana Marks, twenty-three years old, presenting with abdominal pain and significant weight loss since Wednesday. Some hair loss. No history of abdominal disease or heart problems, no previous abdominal surgeries, no previous abdominal exams.â
Dr. Hayes pulled up the image Iâd just taken, and squinted his eyes for a moment. âHow significant?â
âNineteen pounds.â
He looked only slightly impressed until the image appeared on the screen. He blanched. âOh my God.â
âI know.â
âWhere has she been?â
âShe hasnât traveled recently, if thatâs what you mean. She did mention being attacked by a drunk after a party Tuesday night.â
âThis is profound. Do you see the ring of gas here?â he asked, pointing to the screen. His eyes brightened with recognition. âPortal venous gas. Look at the biliary tree outline. Remarkable.â Dr. Hayes went from animated to somber in less than a second. âYou donât see this very often, Scarlet. This patient isnât going to do well.â
I swallowed back my heartbreak for Dana. She either had a severe infection or something else blocking or restricting the veins in her bowel. Her insides were basically dead and withering away. She might have four more days. They would probably attempt to take her to emergency surgery, but would likely just close her back up. âI know.â
âWhoâs her doctor?â
âVance.â
âIâll call him. Cancel the UGI. Sheâll need a CT.â
I nodded and then stood in the hall while Dr. Hayes spoke in a low voice, explaining his findings to Dr. Vance.
âAll right. Letâs get to it,â the doctor said, standing from his chair. We both took a moment to separate ourselves from the grim future of the patient. Dr. Hayes followed me down the hall toward the exam room where Dana waited. âThe girls doing okay?â
I nodded. âTheyâre at their dadâs this weekend. Theyâre going to meet the governor.â
âOh,â the doctor said, pretending to be impressed. Heâd met the governor several times. âMy girls are coming home this weekend, too.â
I smiled, glad to hear it. Since Dr. Hayesâs divorce, Miranda and Ashley didnât come home to visit nearly as much as he would have liked. They were both in college, both in serious relationships, and both mamaâs girls. Much to the doctorâs dismay, any free time they had away from boyfriends and studying was usually spent with their mother.
He stopped, took a breath, held the exam-room door open, and then followed me inside. He hadnât given me time to set up the room before he came back, so I was glad the upper GI was cancelled.
David was shaking the bottles of barium.
âThanks, David. We wonât be needing those.â
David nodded. Having seen the images before, he already knew why.
I helped Dana to a sitting position, and she stared at both of us, clearly wondering what was going on.
âDana,â Dr. Hayes began, âyou say your problem began early Wednesday morning?â
âYes,â she said, her voice strained with increasing discomfort.
Dr. Hayes abruptly stopped, and then smiled at Dana, putting his hand on hers. âWeâre not going to do the upper GI today. Dr. Vance is going to schedule you a CT instead. Weâre going to have you get dressed and go back to the waiting room. They should be calling you before