Doctors Make the Worst Patients
by VATERGrrl
Office Call
Jed Stevens snatched up a chart from the stack on the nurse's station counter on his way to the next exam, startled by how light the manila folder was. Most of his patients had been coming to him for years, and had charts to rival the phone book of a small town, or a college directory at the very least. That fact pointed either to his detailed note taking, or to the inexact science of immunology; he could not tell which, and liked to think it was due to the latter and not the former.
A thrum of excitement at meeting a new patient fizzed through his chest, but it was tempered with a mild but growing fatigue. His fatigue was paired with a slight, itchy pressure in his nose, the sort of feeling that made him want to grind the tip of his tongue against the roof of his mouth to drive it away. It seemed a better, more direct and subtle approach than dipping his head down to scrub at his nose with the slightly rough cotton of his lab coat sleeve, but the tongue grind would result in a distinct and unmistakable noise which his sharp-eared senior nurse, Mary, would recognize in an instant.
Instead, he settled for pulling a tissue from the box on the counter next to the stack of charts and coughed into it, hoping no one had either seen or heard as he crumpled up the used tissue and shoved it into his pants pocket. With another discreet clearing of his throat, he took a second to adjust his tie and make sure he had enough pens in his coat's breast pocket before he dutifully tapped on the door of exam room four.
"Oh, Lucy, I'm home!" It was a lame joke, but he liked to break the ice with new patients, or at least with their parents, who stood a better chance of recognizing the reference.
"Rick-eee!" The pleasantly rounded blond woman in the chair seemed to recognize Jed's tease, and, to his eternal gratitude, played along.
"Let me just wash my hands, then I'll be right with you." He set the chart down on his swiveling exam stool, then ran a stream of warm water from the high, curved faucet and drizzled bright red antibacterial liquid soap into one palm. The sink itself had been designed for maximum efficiency -- long, recurved handles which could be pushed on or off with an elbow, a paper towel dispenser just above the sink and within effortless reach. The only improvement that could have been made, Jed thought as he rinsed his hands, sending a cascade of tiny pink bubbles down the drain, would have been a stainless, wall-mounted tissue dispenser alongside the towel dispenser, so that he could have discretely plucked one out and scuffed it under his nose, any sniffling noises he made drowned out by the running water.
He had to settle for a quick, quiet-as-possible sniff before turning the faucet handles with his elbows and reaching for a paper towel to dry his hands. Then he drew in an equally quiet, centering breath before donning his best "Trust me, I'm a doctor" face and turning around to greet his new patient and his mother.
"Hi! You must be Brian, right?"
The four-year old sitting in the exam chair was reading a book, and didn't respond in any way to Jed's greeting.
"Must be a really good book, then. Can you tell me what it is, so I can read it later?"
Again, his question got no response, until Brian's mother leaned over and rapped her knuckles lightly on the arm of the exam chair. Instantly, the boy's head tipped up, and he looked in the direction of his mother, who gestured rapidly and then pointed at Jed.
"Hi, Brian. I'm Jed. It's nice to meet you." Jed tried again, and the child's gaze focused intently on his mouth, then skittered over in the direction of his mother. She gestured again, a series of rapid movements and finger shapes that Jed thought he'd seen before somewhere. Maybe on the news, or a Sunday morning show for Catholics, "The Eucharist," where the small image of a woman in a circle was superimposed on the screen, and she interpreted the lay for viewers.
"Haaaah-eeee." Brian's speech was distorted and drawn out, as if he was unused to speaking at all.
"Brian's deaf. I interpret for him." His mother, who had done such a dead-on imitation of Lucille Ball, finally spoke again. Jed noticed right off that she hadn't said, "I'm sorry, my son is deaf," just that he was deaf. Matter-of-fact, no shame and no regret. "We're working on lip-reading, but it's hard. Especially if you have a mustache -- it obscures your speech."
Jed rubbed a weary, embarrassed hand over the side of his cheek, his palm scraping over his beard with a quiet hiss. "I'm sorry. I didn't know." He chanced a look down at the chart, and in big letters, he noticed Mary had scribbled in, "Pt Deaf. Mother signs."
"It's been a long day," he apologized again, and Brian's mother gave another gentle, slightly bemused smile.
"I completely understand. And I guess it's my fault -- I should have said something right away." Jed noticed that she spoke and signed simultaneously, presumably to make Brian feel included and keep him up on the conversation. Her gestures were fluid, graceful and easy, and he found himself fascinated despite trying to maintain a safe professional distance.
"You're Mrs., uhm..." He looked down again at the chart, fanning it open and setting it on a rolling cart nearby. "Mrs. Senden?"
"Emily, please." She extended one of those graceful hands, and Jed shook it carefully, nearly reverently. He noticed then that her free, left hand, didn't have a wedding band on it, not even the shadow of one. "There's no Mr. Senden at home?" He blurted out the question without thinking, but again, Emily seemed to take it in good humor.
"No." The next part of her speech she didn't bother to sign. "My ex-husband filed for divorce just a few months after Brian was born. He sends child support, but that's about it. Obviously, he doesn't call Brian, even though we have a TDD and he could afford to get one."
Ouch. There was a decided chill to her voice, a hardness that hadn't been there even a moment earlier, and Jed decided to change the subject just as abruptly, veering back into what seemed safer territory.
"So, Brian, you're here for your asthma, right?" Jed understood that a four-year-old would be little help with describing symptoms, but he wanted to make all of his patients feel included in their own care plan. It seemed to help increase compliance if patient felt they had a stake in treatment.
Brian's small fist rocked up and down, like a nodding head. "Yes," Emily supplied.
"Do you feel bad right now? Is your chest tight?"
A shake of the head. "No."
"Well, that's good. So, I can just take a listen to your lungs, and get a history started?"
Jed waited as Emily signed, turning his own head toward his shoulder to try to conceal a quiet cough. The tickling sensation had come back into his nose, and now seemed to be building up steam. Although coughing wasn't the best strategy to chase away the itch, it worked to some degree, and seemed more acceptable than snatching up a tissue from the box on the cart and scrubbing furiously at his nose.
"O.K." Brian's hand shaped itself into an O, then a shape that Jed thought must be a K.
"Great. I'll make sure my stethoscope is all nice and warm." He rubbed the flat disc of the scope against his palm, settling the earpieces in his ears so that he could hear the hushed scraping noise his rubbing was creating.
"Now, just breathe in and out, normal breaths." He lifted up the hem of Brian's sweatshirt to slide the stethoscope up the child's rib cage, settling it first just below Brian's heart. He could detect only faint wheezing in the upper lobes, which was a good sign, and moved the stethoscope slowly downward to study the lower lobes. The left lower lobe seemed a bit crackly, a sign that there had been a fair number of serious past infections, but Jed wasn't terribly concerned.
"And, can I get you to cough?" He kept the stethoscope trained on the lower lobe, waiting until Brian had taken a deep breath and released it with a sharp sound into a hand cupped in front of his mouth.
"Good, very good." Part of his job as a pediatric allergist seemed to consist of constant reminders to his youngest patients to cover their coughs or sneezes with a hand, even though they weren't contagious, and Jed was relieved that he wouldn't have to trot out his tired old lecture for this new patient.
"I don't hear any significant wheezing or rattling in his lungs." Jed swiveled his stool around to face Emily Senden, who was jotting down notes on a small spiral-bound notepad. "Can you tell me a little bit about his history?"
Emily smiled grimly and pulled a larger spiral-bound pad from her large purse. "I'm still waiting for his medical records to be sent here -- we just moved to town a few weeks ago. But I've kept a set of my own notes, if that would help."
"That'd be great. But you can keep them until the end of the visit." Jed cleared his throat again and turned away abruptly, intent on the otoscope in its holder on the wall. Under the pretense of selecting the right size of plastic cone to fit onto the tool, he ducked his head toward his shoulder, pressing his bicep under his nose and sneezing quietly into his lab coat sleeve. "Hip-tchhh."
Emily was preoccupied with signing something to her son, and hadn't noticed, for which Jed was grateful. When he turned back toward her, hoping his nose wasn't turning pink already, he waggled the otoscope. "Ear check time."
Brian was used to that part of the examination, and tipped his head to the side even before Jed could ask. A cursory check of both sides revealed no otitis, no damage to the ear drums, and no evidence of increased pressure in the eustachian tubes.
"You ears look great, sport." Jed spoke directly to Brian after he'd popped the plastic cone into a metal dish destined for the autoclave. Brian's eyes followed the movement of his lips, obscured by a heavy mustache, then darted to his mother for translation. "All three of them are working great."
"No, I have two ears." Brian gave a laugh that sounded a little squeaky, but appropriately amused.
Jed waited for Emily's voice, then craned his head playfully around to inspect Brian's head. "Are you sure you only have two? I thought I saw three. Hmm, better get my eyes checked."
Brian's small fist pivoted up and down. "Yes."
"Your son misses nothing," Jed said privately to Emily, who understood and didn't sign it for Brian. "You'll have to worry later on about what you say now -- he'll remember it and hold it against you."
Emily appreciated the way Doctor Stevens used words like "say" and "hear" casually around both her and her son. She had known more than a few people who would grow nervous about using any words they thought were "inappropriate" or potentially hurtful, the same way that they might cringe after telling a blind person, "Did you see that story on the news last night?" or "See you tomorrow."
"I can only hope he has a good heart, and I won't have to resort to bribery."
"I think he's got a good heart in him, alright." Jed felt another, stronger tickle building up in his sinuses, and knew that it would culminate in the sort of harsh, violent sneeze that couldn't be easily disguised or ignored. "Let me just go get a peak flow meter -- I don't think we have one in here. I'd like to see what his lung capacity is when he's feeling normal."
The excuse seemed perfectly plausible, and his new patient's mother nodded and smiled as Jed got up from his stool and headed for the door. "Just give me three or four minutes, and I'll be right back." He rushed through his apology, figuring that two minutes in his office should suffice, and walked as briskly as he could without drawing attention to himself, placing the side of his left hand hard under his nose in what he hoped would be interpreted as a gesture of deep thought. In reality, his eyes were already watering, and he feared he wouldn't reach his office door before sneezing his fool head off.
Fortunately for him, none of the nurses he worked with noticed his level of distress or stopped to ask him any questions: the hallway between the exam room and his office was empty, as fact which he took as a mechiah or blessing/small miracle. Closing his heavy office door tightly behind him, Jed rested his back up against it and pulled a handkerchief from his pants pocket.
"Huuuh-arshmmmm! Huhh-arshhmmm! Arshmmm!" A triplet of sneezes tumbled out, and he muffled them as best he could in the dark blue cloth he held. Though he didn't suffer any nasal allergies himself, aside from an occasional reaction to cigarette, pipe and cigar smoke that was probably attributable to irritation and not true immune response, he made it a practice to carry at least one handkerchief with him to work each day, and kept three others in his desk drawer just in case he ended up giving one to a patient or parent. It happened rarely, usually only when a patient had a nosebleed or similar catastrophe in an exam room, or were especially sensitive to the lint on or chemicals used in facial tissues.
In this case, he was the one in need, even though he promptly pushed that thought to the back of his mind. He shoved the slightly damp handkerchief back in his pocket, grabbed a few tissues from the box on his desk, and blew his nose until it felt clear and much less itchy. Balling up the used tissues and tossing them into the trash, he made a point of washing his hands in the adjoining washroom -- only a sink and toilet, but adequate for his needs -- before taking a peak flow meter from his desktop and heading back toward the exam room where the Sendens were waiting.
"Sorry," he said, gliding back into the room. "The meter wasn't where I first looked for it, so I had to take one from my office." Well, the second part of his statement was accurate, but he felt uncomfortable with the dissembling job he was doing, and hoped like hell that his bravado and cheerfulness glossed over the lie. "I'll just put a tube in here, and then we'll see what Brian's p.f. is."
He dug into a small box of short, narrow cardboard tubes, fitting one onto the end the small instrument he held. "Now, I'm sure you've done this before, Brian, but let me give you my lecture first." He pointed to the cardboard tube, then to a set of miniscule plastic triangles which sat on either side of a slit in the plastic meter. "You blow into this end, as hard and as fast as you can, and these little arrows jump ahead and tell me how much air you can push out of your lungs in one breath."
Measuring peak flow was one of the best tools he had to indicate whether or not a patient was experiencing problems or approaching a danger point -- on the cusp of a cold, bronchitis or asthma attack, peak flows tended to fall lower than the patient's average. Once a baseline p.f. was established, both patients and their doctors could monitor daily or weekly readings to measure the effectiveness of a particular treatment regime or devise plans to switch to something new.
"Now, you hold this, and I'll count to three with my fingers. When I get to three, I'll point to you, and you blow as hard as you can, right?"
Brian nodded and reached for the meter, settling the cardboard tube into his mouth with practiced ease.
"Okay, then. One, two, and THREE!" He announced three loudly, in his usual style, but remembered to point at Brian to indicate it was time to give a big blast into the gauge. The blond boy took a deep breath, sat up as straight as he could, and puffed mightily into the meter, leaning forward as he did it.
"Great work!" Jed took the meter from his patient and looked at the reading. "Forty-five. That's really good. Can I get you to do that once more?"
Brian nodded, and they repeated the procedure. This time, it measured out at forty, which didn't surprise or worry Jed.
"Good stuff, Brian. You have an average peak flow of forty-two right now. That's great -- you've got nice, strong lungs." He stopped to scribble down both number in the new chart, then took the meter from Brian and pulled out the tube, which was slightly damp from where it had been in the boy's mouth.
Brian raised his hand up to his mouth again and coughed, a short burst of sound.
"Do your lungs feel full? Is anything coming up?" The cough had sounded dry and sharp, but Jed reached for the tissue box just to be safe.
"No, I'm O.K." Brian signed, then gave a thumbs-up and a smile.
"Good." Jed put the box back on the rolling cart, then picked up the chart beside it.
"Well, aside from a little coughing, you seem to be doing great. I guess this was kind of a getting to know you visit wasn't it?"
He waited for Brian to nod, then continued. "Do you think you'd like to come back sometime, or am I a really bad doctor?"
Brian thought for a moment, then signed rapidly. "No, you're good. You didn't give me a shot."
"So, if I have to give you a shot someday, then I'll be bad?"
Brian smiled. "Yes!"
"Ah, I see where I stand." Jed reached out to tousle Brian's hair, then scooted his stool back. "Ms. Senden, the next thing I'd like to have you do is to keep a symptom diary for a few weeks to track how Brian's asthma is. The diary is pre-printed and gives you some prompts, like noticing when the symptoms occur, how bad they are, and what environmental or emotional factors seem to accompany them."
Jed opened a low cabinet and ducked his head in, taking advantage of the darkness to rub briefly at his nose. "Here, I found it" He handed the thin booklet to her, making sure to use his left hand, not the right, which he'd just rubbed against his nose. "Do you need refills on any prescriptions? Albuterol? Theodur?"
"Brian had a nebulizer at home, so I think we need some more saline packs and some albuterol."
Jed nodded. "Easy enough." He scribbled down a prescription on his preprinted scrip pad, tore off the top page and handed it over to Emily, again with his left hand.
"If you could stop at the front desk on the way out, one of the receptionists will set you up with an appointment for two weeks from now." Then, impulsively, he drew his wallet out of his back pocket, opened it, and took out a business card, scribbling his home number on the back. "Just in case anything happens, I'm usually up until ten or eleven every night. I know you're both new in town, so I just wanted to make sure you had a fall-back, in case Brian has an attack or something. The closest emergency room is at Overlake Hospital, but if you haven't been there before, it can be difficult to find."
Emily tucked the business card away into her purse. "Thank you so much, Doctor Stevens. I appreciate the extra time you took to make Brian feel comfortable. His deafness sometimes gets in the way, even when it shouldn't -- people often make it into a big deal, and it isn't. American Sign Language is just that, a language. Just another way to communicate."
"I'll have to read up on the subject before your next visit," Jed promised, helping Brian get down from the exam chair and then escorting mother and son to the doorway of the room. "Stay well, and I'll see you soon."
It was his standard line, but he gave it a little extra as he watched Emily take her son's hand and sign to him with the other.
"Bye, Doctor Jed." Brian waved, then made the sign for doctor on his forehead, and then fingerspelled a swooping letter J with his pinky.
"Bye, Brian." Jed waved back and made a B over his heart. As they wandered out of earshot, he allowed himself to sigh and slump briefly against the hallway's long light blue wall. With the last appointment of the day -- it was already four twenty in the afternoon, - over and done, he could feel the fatigue that had assailed him just before the meeting sweep back over him, and he looked forward to spending a long, peaceful evening at home coddling himself with a good book, many cups of tea, and a small fire in the fireplace of his Craftsman bungalow living room. There, there would be no need to squelch the desire to sneeze, nor to muffle the noise so severely, only his son Tom to kid him about how loud he was while expressing real concern for his welfare.
Called to a Crisis
"Hey, Dad." Jed Stevens looked up from his medical journal to see his son, Tom Wyman, holding the receiver of their kitchen wall phone.
"Yes?" He placed a clean tissue in the crease of the magazine to mark his place and rubbed at his temples. The fatigue and stuffy-sneezy sensations that had plagued him during the afternoon were making their force felt, and he hoped that it was just a telemarketer on the other end of the line that he could tell to can it. Tonight, he wanted to finish one last article, make himself a cup of chamomile tea, and then go to bed as soon as he'd gulped it down.
"There's a lady on the phone who says she needs to talk to you." Tom covered the mouthpiece with one hand. "She sounds kind of freaked out."
Okay, certainly not a telemarketer, then. "Hmm. That doesn't sound good." He had given his name out occasionally to the parents of his patients, and made the rare house call in an emergency, but he couldn't think of any patients who seemed to be in that level of distress as of late. "I'll take the call here."
Tom handed over the phone, shrugged. He was used to his father's job seeping into the evening hours, either with extended office hours to accommodate two-parent working households or long conference calls with other immunology researchers to discuss new drug trials and protocols. Being an only parent wasn't easy on his father, Tom could tell, but he thought Jed had done an impressive job of it for years now.
"Hello? This is Doctor Stevens. Can I help you?" Jed always liked to start out calls in a calm, formal tone -- it seemed to keep everyone reassured.
The voice on the other end was only vaguely familiar, and he placed it only after she had revealed hr name. "Doctor Stevens? It's Emily Senden. I brought my son Brian in to see you this afternoon."
"Yes, Ms. Senden, I remember you. How is he doing?"
"Not very well. I don't know if he ate something he could be allergic to, or it's just the stress of adjusting to our new apartment, or ... Well, I gave him a nebulizer treatment fifteen minutes ago, and he's still coughing and wheezing. I'd take him to the emergency room, but I don't know where it is, and my insurance won't cover an ambulance unless it's a real emergency."
Jed snapped his fingers in his son's direction, pantomiming writing something down. "Get me a piece of paper and a pencil -- now."
To the frantic woman on the other end of the line, he began to ask preliminary questions to assess the situation. "Where is he right now? Is he awake?"
"Yes, uhm, I'm in my kitchen with him. The light's better here, and he's on the countertop."
"Okay, that's good, that's exactly the right thing to do, Ms. Senden." Jed paused to accept the pad of paper and pen from Tom, then doodled briefly to make sure the pen worked.
"Can you give me your address?"
She rattled off a location that was only a ten-minute drive from Jed's comfortable house in Medina, a fashionable and upscale suburb of Bellevue.
"Alright, you and Brian just sit tight. I'm going to get my status kit and hop in the car. I can be there in about ten minutes, okay?"
"Okay." Emily's voice had turned slightly breathy -- whether it was fear or relief, Jed couldn't tell.
"See you soon." Jed handed the receiver back off to Tom. "I'm going to have to go out for a while. A new asthma patient is having trouble breathing, and I think his mother is a single parent. She's in a bit of a state, as you can imagine."
"How old's the kid?" Tom walked the receiver back into the kitchen and hung it up, meeting his father near the front door. Jed was pulling an ivory colored aran wool fisherman's sweater over his oxford cloth button down shirt, not bothering with a windbreaker even though they could both hear occasional gusts rattling the trees.
"Four, I think." He grabbed a small black bag from a shelf in the hall closet, unzipping and looking inside to make sue he had what he needed. The kit was just large enough to hold a spare stethoscope, a few vials of epinephrine and Benadryl, and disposable syringes to administer the medications. He also kept a pocket watch in the bag, so he would have something to time respirations with in case he was called out without a wristwatch. There was a small tube of Benadryl cream, but that almost never got used -- the kit was usually strictly asthma territory, though he advised his parents to get to the nearest emergency room if they had any bad feelings about their child's condition.
"Shit. Okay, Dad, drive safe. I'll lock up after you, keep a light on."
Jed was too preoccupied and revved on adrenaline to fault Tom's use of obscenity. Indeed, he felt the same way -- he didn't like to think of Brian Senden struggling for air, his big blue eyes wide with fear.
"Thanks, Tom. I'll be home when I can -- don't wait up." Jed opened the door, jumped the three stairs off the porch, and ran to his car, fumbling with the key in his haste to unlock the door. Once he'd gotten into the car, started it, and fastened his seat belt, he gunned the engine, praying that the traffic would be light and that the cops would be merciful. By running a few yellow-verging-on-red traffic lights, and keeping a lookout for police cruisers or speed traps, he was able to screech up to the apartment complex entrance in a mere seven and a half minutes from the time he'd left the driveway of his own home.
He pounded his way up the outside stairwell, stopping at the third floor landing and looking left and right to determine which way to go. A small sign guided him to the left, and he passed four doors before finding the one he wanted. With his status kit securely under his left arm, he pounded on the door with his right fist, hoping he was being loud enough to be heard but not so loud as to be obnoxious.
"Yes?" A small, frightened voice called out from behind the door, and Jed made sure to position himself within view of the peephole.
"It's Doctor Stevens. You called me about ten minutes ago?"
He heard the slide and rattle of a chain lock, followed by the more muscular thunk of a deadbolt being thrown open. A second later, the door opened inward, revealing a rather frazzled-looking Emily Senden. Her neat braid was absent, her blond hair tumbled down to her waist in waves of bright gold.
"Oh, Doctor Stevens, I'm so glad you came. Brian's still on the counter in the kitchen, I left him there when I heard you knocking on the door."
"Sure." He stepped into the tiny foyer quickly, and noticed that Emily, in her haste to get back to her son, didn't bother to reset the deadbolt or the chain. Taking a moment, he set the deadbolt for her, noting how free and clear his own breathing was, feeling absolutely no compulsion to sneeze, not even the slightest tickle. It was amazing what a surge of adrenaline could do, and he understood why some of his medical- school friends had gotten swept up in the fast-paced world of emergency medicine.
But he'd had more than enough excitement before he chose his residency in allergy and immunology. He and Jinna had already had Tom, and she had fallen into a post-partum depression that couldn't be alleviated by the pharmaceuticals of the day. In some twisted effort to self-medicate, she'd gotten into alcohol, then heroin. He'd figured her for uppers, bennies rather than tranqs, but she couldn't resist the allure of downers, the escape they offered from her fears of being an inadequate mother to her son. Before Jed could get her into a residential treatment facility and a psychiatrist she would stick with, she had run away from their home to prowl the nighttime streets, hungry for a fix, and her last hit had been from an unscrupulous new dealer who liked to cut his smack with all sorts of crap. Jinna had no way of knowing what was in the tar, or how potent it was, had just drawn up her usual "safe and sane" portion, disappeared into the fog of opium, and never came back out.
Jed forced himself to blink a few times to rid himself of the images, and headed for the brightest light in the apartment, assuming it had to be the kitchen. Emily had already removed Brian's shirt, and Jed could see the boy's ribcage working, the skin just above his collar bones moving in and out with every breath.
"Hi, Brian, it's me, Doctor Stevens. We met this afternoon, remember?" He knew that Brian couldn't hear him, couldn't really focus on anything but breathing, but he kept up a monologue to make everything seem more normal.
"I hear you're having a little trouble breathing." His description of "a little trouble" was an understatement -- Jed could hear Brian wheezing and gulping for breath from ten feet away. "Let me take a listen and see what I can do to help you out, okay?" He tried to sign O.K. to Brian, but wasn't sure he was getting it right.
Over his shoulder, Emily was signing rapidly, interpreting the most important parts of what he was saying for Brian's benefit. While her fingers and hands flashed in his peripheral vision, Jed fixed the earpieces of his stethoscope into his ears and quickly rubbed the disk over his palm to warm it a little. No sense in startling the kid with a cold jolt of plastic and metal, after all, not if Jed could help it.
As he moved the stethoscope's disk slowly over Brian's ribcage, Jed could hear a combination of crackling and whistling, indicating that the small air passages in the lungs had constricted, possibly around a small amount of underlying congestion. Brian's lips were a faint blue, and Jed casually reached for Brian's clenched hand to check the nailbeds for cyanosis.
"How fast did this come on?" He couldn't recall if he'd asked Emily about food allergies earlier in the afternoon, but a rapid-onset attack might indicate a reaction to a newly-introduced food.
"He started having trouble just after dinner, around five."
"Ah. And did he eat anything unusual, anything he hasn't tried before?"
Emily shook her head. "No, I don't think so. I made chicken nuggets with the same coating I've always used, and forced him to eat some vegetables. He hates vegetables."
"I think we all did, at his age." Jed moved the stethoscope to Brian's back, and the child started coughing, a series of shallow, barking noises.
"I'm just going to give him some epinephrine -- he's had that before, correct?" Jed reached for his kit, taking out a small vial of clear liquid and a plastic-capped syringe. He tried as best he could to keep the syringe hidden from Brian's view, knowing it would upset the child and cause him to breathe even faster and more erratically, and stabbed the needle into the vial, drawing up a weight-appropriate dose of epinephrine, which would open the lung's passageways almost as soon as it was injected. It would also make the child nervous and jittery, but he planned to counteract that with a shot of Benadryl, which would help to calm any underlying allergic inflammation.
*
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This section of the story contains a few mentions of v-ing which might be objectionable to emetophobes
*
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*Jed was in the middle of flicking any remaining bubbles out of the syringe and readying Brian's arm for the injection when the boy threw up. Most of the mess splashed onto the floor, but Jed hadn't had enough warning to move back and let go of Brian's arm, and now the front of his off-white aran sweater was stained with vomitus.
"Oh, dear God!" Emily reached over with a damp paper towel, but Jed kept holding on to Brian, making it impossible for her to wipe at the stain. "I am so sorry!"
* objectionable passage ended *
"No harm," Jed answered distractedly, still concentrating on the syringe of epinephrine. With a swift motion, he stuck the needle into Brian's upper arm and pushed down the plunger, sending a dose of adrenaline into his patient.
Brian answered the jab with a subdued yelp, but Jed was glad to hear it. In his time in the ER, back in training, he learned that the pediatric cases you really had to worry about were the ones who weren't crying at all. The mere fact that Brian was able to complain at all was a sign that he was improving.
Only a few moments later, in fact, the child was wriggling impatiently on the kitchen counter, his lips a healthy shade of pink and his nail beds free of any tinge of blue. He signed something that Jed assumed was "I want to get down," a pulling of his hands toward his body, palms up and fingers curled inward, followed by emphatic pointing at the ground.
Jed shook his head in response. "No can do, sport. Not just yet. I need to give you another shot."
Brian's eyes were locked on Jed's lips, trying to determine what was being told to him, and looked beseechingly at his mother, who signed something quickly.
"You did tell him I need to give him another shot, correct?"
Emily crossed her arms over her chest. "No, I don't want to upset him."
"I can understand that, but I think he's smart enough to be told these things. And if you don't tell him, he's going to resent both of us when I have to jab his other am. Here," he added, letting go of Brian to grab another vial out of his stat kit. "You hold him while I make up a dose of Benadryl. He's not allergic to that, right? No past reactions?"
"No, none. I have a bottle of the liquid here, if that would be easier."
Jed paused, vial in hand but with a second syringe still tucked safely away in the kit and out of Brian's sight. "Yeah, I think that'd be ideal, actually. The epi is going to make him jittery as he-ck." He stopped himself before he could utter a half-curse. "Where do you keep it?"
Emily pointed to a high cabinet over her refrigerator.
"Good, safely out of his reach, even with a chair." Jed opened one of the double doors, finding the bottle of pink syrup immediately. He pried off the small plastic cup that had been jammed over the cap of the bottle, then prepared a dose using the conveniently marked lines.
Fortunately for Jed, Brian only made a small grimace of disgust before accepting the Benadryl syrup, swiping the back of his hand across his mouth after swallowing. "Yurrrgh!"
"Yup, `yurrrgh' is just what I say, Brian. I don't think the people who make this stuff really taste-test it. They just assume that you'll take it because you have to, right?"
The child's brows furrowed as he struggled to figure out what Jed was saying, and put out a hand to move aside some of the longer strands of Jed's mustache, though the hairs fell right back into place, bushy as the mustache was.
"Too long, huh?" Jed pantomimed a very long mustache, pointing his fingers down at the floor while holding them at his upper lip and wiggling them.
Brian laughed and repeated the gesture, nodding.
"You O.K.?" Jed repeated the hand shapes he'd seen Brian make in the exam room earlier that day, earning an enthusiastic nod and more rapid signing. Jed recognized the sign for "want" again, but not the sign after it.
Emily did, however, and shook her head no. "It's late -- no ice cream. Bath and bed."
Brian frowned, trying his best for a hurt-little-puppy look. "Cookie?"
"No, no cookie." Emily repeated the word for Jed's benefit as she signed to her son "Bath, then bed."
"O.K. B." Jed used Brian's name-sign, the letter B held over his heart. "Want down, bath?" He mimicked the signs he'd seen Emily use, hoping he'd interpreted them correctly and was using them in the right order. "I'll take my sweater off first, then help you down." He had to gesture the last part, pulling up his soiled sweater and placing it carefully on the counter beside Brian.
Emily felt her heart open up as Jed communicated in sign with her son, then swallowed hard when Brian locked his arms around Jed's neck and snuggled into the large man's oxford-cloth covered shoulder. Her son didn't trust people easily, and she wondered if perhaps he bore some scars from his father's abandonment, try as she had to insulate him from Alex's betrayal.
"Where's your bathtub?" Jed turned with Brian in his arms to ask her, carrying her son's weight easily, as casually as if he did this every day.
"It's down the hall. I'll show you." Emily hoped her voice sounded steady and controlled, neither overly hopeful and fawning or wavery and nearing tears. Watching how easy her son was with Jed, and how quick Jed had been to communicate in Brian's first language, made her want to capture the moment in a jar and keep it pristine forever. It was what she had hoped for with Alex, a father treasuring his son, but it hadn't been that way at all after Brian was diagnosed as "profoundly deaf." Instead, Alex had turned away, isolating himself and rejecting first Brian, then his wife. A few months and a tawdry fling later, he was filing for divorce, leaving Emily with a monthly child support check in exchange for his freedom.
"How about you strip him down and get him in the tub, and I'll go find a washcloth and a towel?" Jed placed Brian down gently on the tile of the bathroom floor, risking a covert scrub under his nose with the slightly scratchy cuff of his shirt. The adrenaline rush which had fueled his earlier work was wearing off, and as it subsided, the antihistamine effect it offered began to wane.
"The linen closet is just around the corner." Emily was too busy making sure the water was set to the right temperature -- warm but not scalding -- to have noticed Jed's discomfort.
"Be right back, then." Jed ducked out of the bathroom, relieved to be out of range just as the need to sneeze was escalating. He found the small linen closet easily and opened the door, using the solid panel as a welcome screen as he pulled a handkerchief from his pocket and pressed it to his nose.
"Huhh-ichhh! Ichhh!" Had he been alone, or even at home with Tom, he might have sneezed freely, making a noise his son called "like something on a deranged nature show," loud and fierce. Here, trying desperately to maintain a façade of health, he contained the noise as best he could, even though the sound of running water seemed to muffle everything fairly effectively.
Taking time to blow his nose and then carefully swipe at it before tucking the handkerchief back away, Jed picked up a washcloth and the largest, fluffiest towel he could find, then walked slowly back to the bathroom, where Brian was already splashing water about.
"Here's that washcloth I promised." He held it out to Emily, and then placed the towel carefully on the closed seat of the toilet before sitting down on top of it. "Brian seems pretty enthusiastic about taking a bath."
"I think he might have been a fish in a past life, actually." Emily laughed and ducked aside as Brian slapped his hands against the surface of the water, sending twin spurts of water up then sprinkling back into the tub. Five minutes later, his playfulness was turning into drooping eyelids and languid sweeps of his hands through the soapy water.
"The Benadryl must be having an effect." Jed stood up and unfolded the towel. "You want me to lift him out?" Thirty pounds of wet and sleepy little boy couldn't be easy for her to handle, and despite his growing fatigue, he wanted to spare Emily the effort.
"Oh, Jed -- Doctor Stevens," she corrected herself quickly. "You've done so much already. And he'll get you all wet -- you'll catch cold." She had already noticed the faint pink tinge of his nose and the occasional quiet sniff he gave when he thought she couldn't hear.
"If I get wet, I get wet. And all that talk about catching cold from getting wet or being out in the cold or the rain is just a lot of bull -- flapdoodle." Even though Brian wasn't looking at his mouth as he said it, he moderated his language once again to be polite. "The way you get sick is through a virus or a bacteria -- in the case of colds and flu, a virus."
*
*
*
This section of the story contains a few mentions of v-ing which might be objectionable to emetophobes
*
*
*"Even so, Brian already threw up on your sweater. I can't have you sacrificing your shirt, too!"
"Oh, what's a little fyook between friends, right, bud?" Jed scooped Brian up in the towel, using Tom's childhood word for "puke" as he wrapped Emily's son as completely as he could. "It kind of comes with the territory, really, working in pediatrics." He didn't bother to add that Tom had inadvertently "fyooked" on him a few times while undergoing chemotherapy. No sense in opening that closet, not when Emily obviously had enough worries of her own.
* objectionable passage ended *
"And besides," Jed added, following Emily into Brian's room. "That happens a lot in asthma cases, as I'm sure you've experienced with Brian. It's the body's way to try to circumvent a particularly intense coughing spell, and sometimes it even works."
"Still, I just feel awful. Are you sure I can't toss your sweater in my washing machine? It does wash, doesn't it?" Emily opened the top drawer of a dresser and pulled out a matching set of knit pajamas with a pattern of construction vehicles on it.
"Oh, yeah, nearly everything I own is wash-and-wear." Jed stepped back from the bed to allow Emily to help Brian into the pj's. The boy's arms were floppy from Benadryl-induced languor, and it took a fair amount of concentration to get him re-dressed.
"But, I should probably get going -- my son is waiting for me at home. If you could just put my sweater into a garbage bag, I promise I'll toss it in my own washing machine as soon as I get in the door."
"You have a son?" Emily helped Brian into bed, smoothed the covers down over him and bent down to kiss him on the forehead.
"Me? Oh, yeah." An insidious tickle distracted him for a moment, and Jed risked a less-secretive rub of his hand under his nose to try to force it back. "Uhm, how do you sign `good night'?"
Emily showed him, and he repeated the sign to Brian, who smiled sleepily and mirrored him. Once the child had closed his eyes and rolled over onto his side, Emily motioned Jed out of the room, leaving the door ajar as they left.
"In case he has a problem in the middle of the night," she explained. "How old is your son?"
"Seved-teed." Jed sniffed, reached back in his pocket for his handkerchief. "Sorry."
"So you are coming down with something." Emily watched as he unfolded the cloth and blew his nose, crossing her arms over her chest as he kept the handkerchief up against his face.
"Dough, I'b -- hishfff! Dot." He blew out a frustrated breath. "I'b allergic to dust, thad's all."
"If you're allergic to dust, you've done a damn good job of avoiding sneezing since you've been here. And besides, I keep this place as well-dusted as I can, so Brian's asthma doesn't flare up." She kept her arms crossed and her gaze steady on Jed as he blew his nose again, sniffed as if to see if he needed to blow a third time, then pocketed the `kerf.
"I certainly don't mean to impugn your housekeeping skills. I'm probably just reacting to something else -- that soap you used on Brian."
"Ivory Soap? 99.44 percent pure, no fragrance? That soap?"
"It g- huuh, got up my nhhh -nose?" He lifted a cupped hand to his face, sneezing into it with an unguarded "Hurr-eshhh-haaa!" Either fatigue was catching up with him, or his simmering cold was boiling over, but the result was one of the `deranged animal calls' that he dreaded coming out in mixed company.
"God bless you." Emily rummaged in her own pockets for a tissue to offer him, sounding for all the world like Carol Brady. "Oh, damn, hold on a second."
"Wha?" Jed was left to blink tears out of his eyes as Emily disappeared into the room across the hall from Brian's. She came out with a garishly printed box of blue tissues, holding the box by the bottom as she tilted the top toward Jed.
"Did I hear you say, `Dab'?" He pulled a few from the box and stacked them before giving a good blow. "Ms. Senden, I'm scandalized!"
"It's Emily, and don't be. I'm not exactly a saint. I'm no sinner, either, but far from sainthood."
"I hear you. And, please, call me Jed. All my friends do."
"Okay." Emily had to admit she somehow wanted to be more than his friend, in some indeterminate, longing way, but she said nothing. Instead, she peeled a garbage bag off of a roll kept under her kitchen sink, and jerked it hard and quick toward the floor, filling it with air so that the sides billowed out. Then she swept Jed's sweater into it, wrapping the sweater around itself so that he would not have to touch the stain before dumping it in his home washing machine.
"Are you certain I can't fix you a cup of coffee? Tea?" She asked as she tied a knot in the top of the garbage bag. "Here's your sweater," she added unnecessarily.
"Thanks." He gripped the bag just under the knot, swinging it over his shoulder. "I would like that cup of coffee, but I'm afraid I really do need to get home. It's just me and my son, and even though he's almost ready to graduate high school, I hate to leave him alone -- you never know when he'll throw a wild party."
"Well, some other time, then." She escorted him to the door, a short walk in the small apartment. "I hope you feel better soon -- take care of that cold."
Jed opened the door, looked back at her and smiled, pointing his index finger at her. "You've got my number."
When the Doctor Becomes the Patient...
Emily Senden stood uncertainly on the porch of what she assumed was the Stevens house. Jed -- Doctor Stevens, she reminded herself mentally -- hadn't given her the address, but a reverse telephone book at the local public library had made finding the place easy just by having the phone number at hand. She wasn't exactly proud of having used her specialized knowledge of information retrieval, but then again, delivering a plate of home-baked cookies could hardly be interpreted as a nefarious purpose.
On the other hand, however, she mused as she allowed herself to look over the immaculate if sparse landscaping around the Craftsman bungalow, there was no guarantee that anyone was home. Perhaps Doctor Stevens and his son -- he had mentioned a son, she recalled -- celebrated the Sabbath on Saturday, rather than Sunday, and were off at the synagogue. Or perhaps they were on an errand, or...
"Oh, for heaven's sake, Emmy girl," Emily muttered to herself, using her father's favorite nickname for her. He'd died years ago, before she'd met and married Alex Senden, and it was likely all for the best, considering how badly their marriage had turned out. Her mother, on the other hand, had been around to allow Emily to make her own mistakes, and now doted on her only grandson, quite willing to look after Brian for hours at a time if Emily had to run a special errand or if her work hours ran late.
Balancing the plate carefully in her right hand, she curled her left hand into a fist and rapped hard on the dark wooden door of the bungalow. There was no doorbell that she could find, though there were two arts and crafts lanterns set to either side of the door, and she wondered idly what they would look like at night, with the glow of the light bulbs filtering through the copper-colored mica shades.
The heavy door opened inward a moment later, and Emily found herself having to look up about a foot to make eye contact with the man who had appeared in the new space. He said nothing to her, initially, just looked down at the plate she held and then turned his head away from her.
"Hey, Dad, there's a lady at the door, trying to sell us cookies!" The tall, rather burly young man yelled back into the house, one of his hands high up on the door.
"Oh, no, I'm not selling them. I just stopped by to give Doctor Stevens these."
"Cool." He leaned back again, his face disappearing behind the door. "Dad! She says they're free!"
Emily shifted the plate from one hand to the other, bringing it close enough that the young man -- late high school or early college-age, she couldn't quite tell -- could smell them.
"Oh, man." He stared at the cookies with interest. "Did you make Oatmeal Scotchies? Those are just the best cookies in, like, forever." He sighed dramatically. "Dad tries to make them every once in a while, but he always burns them."
"Does your mother do any of the cooking?" Emily didn't recall seeing a wedding band on the good doctor's finger, but that didn't mean much -- a lot of men who worked with their hands didn't bother to wear a ring while on the job.
"My mom's been dead for years." He said it without inflection or emotion, frowned when he realized how it must have sounded to her. "She died when I was maybe a year old, I don't remember much about her," he offered in the way of an apology.
Emily was just about to offer her condolences when the door moved again and a haggard, red-nosed and clean-shaven face appeared.
"Yes?" Jed Stevens squinted to determine who was offering him cookies, trying to make out some discernible facial features against the glare of the afternoon sun which made a halo around his visitor. "Cad I helb you with subthig?" He dug a crumpled handkerchief from his pants pocket and pinched it to his nose, blowing into the cloth with vigor.
"You shaved off your beard!" Emily blurted out, watching as Jed pulled the handkerchief back down to reveal his mouth and chin. Gone was the heavy, walrus-like mustache that had made it so difficult for Brian to read the doctor's lips at their first meeting, and Emily admitted to herself that she liked his new look.
"Exgyuse be?" Jed squinted again and changed position in the doorway so that the sun was not directly behind his visitor. "Ebily? I bead, Miss Sehded?"
"Hi, Doctor Stevens. I just wanted to drop off some cookies for you and your son. Brian always wants me to make him cookies when he's not feeling well."
"Thad's so d --huuuh -- dice of you." Jed's eyes watered and pinched shut as he fought to hold back a sneeze. "Would you lige to cub ihh -- ishkewww! Ihd? I cad have Tob bage suh -- hishhhh! Sub coffee." He did his best to continue speaking as if he had not been interrupted by sneezes. "Coogies always go bedder with -- ishhh! Coffee."
"Bless you."
"Oh, thags." He smiled, and the effect it had on his face was undeniably appealing to Emily. "I'm so used to sayig thad all d --hishhh! -- day log. I'b lige sub kide of twisded flight attended: `Bless you, gesudheit, God bless, oy gevalt, blessigs, bless...' Id so rarely geds said to be."
"Bless you again, then."
Jed laughed. "Thags. Oy, gevalt, where are by badders? Is Briad id the car? Should you go ged hib? Wade, forged I said thad, I doad wad to give hib this cold." He fiddled with the cloth he held to try to find a dry portion, blew his nose again and then crumpled the `kerf and tucked it back into his pocket.
"No, Brian isn't with me. I asked my mother to watch him for a few hours while I delivered these." She rattled the plate again.
"Tob, cad you show Ebily -- er, Biss Sehded idoo the livig roob and stard sub coffee? I have to go fide adother shbattuh."
"You grew up speaking Yiddish?" Recognizing the word for "rag," Emily handed off the plate of cookies to Tom, allowed Jed to usher her inside the cozy Craftsman house.
"Oh, uhb, yeah. Id kide of cubs back whed I'b dod loogig."
Emily assumed he meant "when I'm tired," but she didn't want to start an argument, and she also didn't want to leave quite yet. It was apparent, both from Tom's earlier comment about Jed's cooking, and the disheveled state of the living room, that they could both use a bit of maternal attention, though she had no idea how either of them would take it.
"Addyway, Tob cad ged you sed ub with thad coffee, if you'd lige. I'll be ride back."
Both Emily and Tom watched silently as Jed shuffled slowly toward the back of the house and closed a door behind him. Even from that distance. Emily could hear a great, roaring sneeze, followed by another, and wondered if Jed had kept his previous outbursts quiet and polite for her benefit.
"You want regular, decaf, or instant? I think we might even have some Postum, for when Grandfather comes over." Tom didn't seem at all startled, just inclined his head toward the kitchen.
"Regular is fine by me." She followed in Tom's wake into the kitchen, peeling off the plastic wrap that covered the plate of cookies.
"So, you and your father live all alone here?" The kitchen, like the living room, emphasized hardwood -- she assumed oak -- and sent a clear message: masculinity.
"Yeah. We always have, for as long as I can recall. My folks lived out on Neah Bay when I was still in diapers, out on the rez, but Dad moved out here after Mom died."
"I'm sorry that that happened." Emily offered politely, to which Tom just shrugged and watched the coffee pot fill with strong brown brew.
"Eh, s'okay. Grandfather visits now and then, and I go out to stay with him for a little while every summer, sweat and purify and fish. It's fun."
Emily studied Tom's profile, his slightly-too-large nose, high cheekbones, and the pale copper color of his skin. His dark brown hair, almost black, hung to just below his ears, and would have looked almost feminine if not for his decidedly masculine face. "You're Native American, then?"
"Half Makah. Mom was full-blood, and Grandfather is one of the tribal healers out on the rez. Dad went out to help set up a more modern clinic out there during his internship, courtesy of the Bureau of Indian Affairs, and met Mom. A year later, I was born."
"Wow." Emily didn't know quite how to react to the amount of information Jed's son was divulging to her. Perhaps he was treating her visit like a stranger on a train -- just say whatever you wanted, because you'll never see them again.
Another roaring sneeze sounded from the hallway behind the kitchen, followed by a more sedate and muffled "chhhh!"
"Gesundheit!"
"I still thig thad's by job." Jed smiled ruefully as he came back, a blue- and white-checked handkerchief in his right hand. "Bud, thags." He sniffled, swiped under his nose. "I'b sorry about the codgestiod -- I dough id's udpleasad."
"No, no, it's nothing bothersome," she assured. "Would you like a cookie? I didn't know what you might like, so I made some chocolate chip walnut and some oatmeal scotchies."
"If you bade id frub scratch, I'd ead a brick, I thig. Tob probably told you, I'b dough Julia Child."
"My friend's mom tried to teach Dad how to cook, and we had to figure out how to use the fire extinguisher."
Jed sniffled again, trying to make it sound like a haughty, disinterested sniff. "Every house should have a fire extigwisher. The fagd th -- ishhh!" He ducked his head into the crook of his arm, trying to keep his germs contained. "The fagd thad we were able to -- hishhh! Tesd id was a bechiah."
"A blessing," Tom translated, taking three mugs down from a high cabinet. "Do you take milk in your coffee, Mrs. Senden?"
"Yes, please. And, please, call me Emily. Mrs. Senden is my ex-mother-in-law."
"Sorry." Tom pried open the refrigerator door and took out a small pint of half and half, followed by a larger carton of low-fat milk. "Dad, Emily, I've got this part. You can go into the living room and relax."
Jed looked at his son in wonderment. Normally, Tom was not the world's most eager host, preferring silence and occasional days of isolation, but now, for some reason, he seemed determined to play the role.
"If you idsisd. Bay I show your blaged to Ebily?"
"Yeah, I think she'd like it."
Emily was fully expecting to see a ragged and irreparably stained piece of wool or a tightly-loomed cotton blankie, maybe edged in satin. What she got was something quite different.
"My god, that's amazing!" She stared, open-mouthed, at the dark blue wool button blanket that hung from a carefully constructed quilt hanger in the living room. It was safely away from direct sunlight, but the pearlescent buttons which outlined a stylized raven figure glistened in the lowering rays of afternoon sunlight which crept in from an adjacent window. A tall cedar chest sat beneath the blanket, and someone had propped up a picture frame showing a slightly younger Tom, with a close-cropped crew cut, standing proudly with the same blanket wrapped around his shoulders.
"The audties ad gradbuthers of the clad bade id for Tob after he cobpleded his firsd visiod." Jed looked up at the button blanket for a moment, then concentrated on unfolding his handkerchief. Though he'd tried his best to sneeze out the irritation while he'd been sequestered in the bedroom, it didn't seem to have helped; if anything, it seemed to have thrown open the floodgates, and he felt a new wash of itching rising up in his nose, with nothing to be done for it but let it out.
"Would you ehhhh- hursh-hooo!" He aimed the sneeze as best he could away from Emily and into his handkerchief, praying he was doing an adequate job of protecting her from his germs. "Excuse be a biihhh --ih -- ishhooo! Kshhh-hooo!" He gulped in another breath, let it out on yet another sneeze. "Hishhh!" The force rocked his body forward, and he placed a hand on the top of the cedar chest to steady himself. "A bidud. I deed to sdeeze." The words were a lame afterthought, but they tumbled out anyway.
"Evidently." Emily's tone was light, the gentlest of mocking. "Perhaps you'd best sit on the couch, in case you need to sneeze again."
"Good poid." Jed pivoted on his heel and flopped down onto the couch, gripping one flat, hardwood arm with his left hand while pinching his nose closed with the fingers of his right. "Hnnnchhh!"
"Bless you. Tom?"
"Mmm-hmm?" He had just arrived with the three mugs of coffee: one with a splash of milk, one full and black, and one half-full and an ice cube rapidly meting in it. The café latte he handed to Emily, then cautiously set the cooled mug of coffee down on the arm of the couch, a safe distance from his father's hand. He held on to his own mug, waiting to hear what he assumed would be a request of some kind from his father's -- friend? Patient? Honestly, he had no idea what they were to each other, except that she seemed to know him in his capacity as "Doctor Stevens" and not simply "Jed."
"Could you bring your father some Sudafed? It sounds as if he could use it."
"Dough." Jed's voice was low, quiet, but forceful nonetheless.
"No?" Emily turned to look at him. "Are you serious?"
"Yub. Dough pills." He grimaced, pinched his nose again. "Hnnngchhh!"
"Bless you. And a box of tissues." She addressed her first comment to Jed, then her request to Tom, who stood with his arms crossed over his chest, trying his damnedest not to smile.
"Thag you. Ad, dough, thag you." Jed looked up at his son, who swung his coffee mug up and took a sip to conceal a grin. "Whud's so fuhh --hhh..." His breath began to hitch, quick hisses of air, and he scrambled to cover his face adequately. If the intensity of the itch was any indication, he would be very glad indeed to have a reasonably thick layer of cloth pushed up against and around his nose.
"Hhhh-ihhhghhh! --- huuuuh." The urge to sneeze banked itself, then crept back down, leaving Jed to sigh in relief. Moment later, he was tensed again, leaning forward to rest his elbows on the tops of his thighs. "Huhh-ihhh!"
Tom, for his part, took a large bite out of the cookie he'd snatched from the plate in the kitchen, trying to crunch it into bits small enough to gulp down without attracting any attention. He was used to his father's stubborn refusal to succumb to the need to sneeze, even though Jed himself had often lectured on the necessity of letting the rather amazing pressure force of a sneeze out into the open -- always hygienically covered, of course. Now he felt a bit like Willy Wonka waiting for Augustus Gloop to shoot up the pipe in which he'd been stuck by the bulk of his own gluttony, though he lacked Gene Wilder's curly red hair and ability to do pratfalls.
"Better in than out, Dad," he finally said, covering his mouth so Emily couldn't see him talk with his mouth partially full. "Really good cookies, Ms. Sen -- uh, Emily."
Jed looked over, with a glare that would have frightened concrete into peeling up and running for its life if not for the moisture pooling in his eyes. He sniffled and thumbed at tears, forcing himself to relax enough to coax the sneeze out. A few deep breaths later, the tickle built up to a breaking point, and he made certain to turn away from Emily, sitting less than three feet away from him at the opposite end of the couch, before he succumbed. "Hurr-AAAARSHHH! Hurr-shhhh!"
It was the same bellow Emily had heard while in the kitchen, and she had the distinct impression that he had been stifling or suppressing his sneezes ever since she'd shown up on his doorstep. The thought made her distinctly uncomfortable, but she didn't think it appropriate to say as much to Jed.
"Bless you," she said instead, her voice as calm as if nothing extraordinary had happened. "Tom, could you...?"
Tom grinned and gulped down the last of his coffee. "I'll go get `em." He headed back toward the kitchen, where Jed regularly stored at least one box of tissues in the cabinet below the sink. Placing his mug in the crowded sink, he squatted down to find the last box in the cabinet, and ripped the top open as he walked back to the living room, carefully pulling up a tissue so it was an easy grab from the box.
"Yo, Dad." He was ready to toss the box underhand to his father, but Emily took it from him and, much more sedately, pulled a few out to offer to Jed.
"Would you like one? Or two?"
Jed turned to look over at Emily, his handkerchief still pinched firmly around his nose. "Ah, how aboud ted?" He sniffled, pulling the `kerf down and tucking it into his pocket. "Thag you." He offered an additional smile of gratitude as Emily reached over, careful to grab the tissue she offered by the corner nearest him and avoid touching her fingers. Had the situation been different, he would have gladly touched her fingers, her hand, the length of her arm, but he confined himself to noting the faint warmth that remained as he folded the tissue in half and blew into it as heartily as he dared.
"Oh, dear, perhaps you'd like the whole box?" Emily kept her tone light and joking as Jed finished blowing and crumpled up the used tissue, but the congestion was heavier than she had expected. She pushed the box across the couch cushion between them at the same moment that he reached for another tissue, and when his fingers brushed the back of her hand, he pulled his hand back as if he'd touched an electric eel.
"Sorry, sorry," he said when he noticed her confused and faintly hurt expression. "I just, ah, by figgers are teebig with gerbs. Dough sedse id both of us beig sick."
Emily smiled at his gentlemanly concern for her, but also because of a little thought that popped into her mind: And if I did get sick, would you make a house call for me?
"I doubt I'll come down with anything. Working in an elementary school library, I come into contact with every germ on the planet, and if I don't bring germs home, then I get them from Brian and his pre-kindergarten class." It was a sedate, polite answer, and she hoped her more lascivious thought wasn't broadcast in some way.
The fact that Jed Stevens had literally saved her son's life Friday evening didn't seem to explain the feelings bubbling up from deep within her. Gratitude was one thing, but wanting to kiss this near-stranger, desiring the touch of his fingers on the back of her hand and up the back of her arm, was entirely another. She understood that his take-charge attitude, his magnificent competence in the face of a crisis and his easy way with Brian's deafness appealed to all the desires that her ex-husband Alex had failed miserably to meet.
"Germ factories." Tom agreed, ripping a bite out of a fresh cookie he'd paused to grab in the kitchen. "Not that I hate little kids or anything," he hastened to add, recalling that this was probably the same woman who'd called last night in a panic over her own child.
"Are there addy of those left, or did you eat theb all, already?" Jed pointed with the corner of a fresh tissue toward his son, who stuffed the last half of a cookie into his mouth. "You bide wad to offer Ebily wud, while you're add id."
"Yeah, sure, there's plenty of them. I'll just go get the plate."
While Tom was gone, Emily turned to face Jed, concerned with how distorted his voice sounded and how tired he appeared.
"You're absolutely certain you don't want to take something for your cold? If you don't mind my saying so, it sounds just awful."
"I doad dorbally believe id tagig pills." He pulled another tissue from the box, stacking on top of the one he already held, then tried with limited success to clear his nose into them.
"Why on earth not? You're a doctor! I thought you lived hand in glove with the pharmacy representatives!"
Jed coughed, tried to not look at his coffee mug, which was, indeed, branded with a pharmaceutical logo. "Well, uhb, I try to preserve sub degree of ibpartiality. The free sabples they give oud cad be wudderful, esbecially whed I'b tryig a patied oud od a bedicatiod. Bud for be, persodally, I jusd doad lige tagig subthig thad's goig to bage be groggy."
"So you'd rather just sit and suffer and be unintelligible?" Emily chanced an argument with him. "I can barely understand a word you're saying -- now I know what Brian feels like most of the time in the hearing world."
Her accusation made Jed wince, though he minimized his physical reaction of shame as best he could by hiding it behind another grab for tissues. "Sorry." He cupped the clean tissues under his nose and blew into them, trying to avoid touching the chapped and reddening sides of his nostrils.
"How about we do it this way: You take some sort of cold pill, and then you can have a cookie." Emily felt a bit as if she was negotiating with Brian, though the night before, she had rejected her son's request for a treat. With a fellow adult, however, she doubted she could apply the same sort of unilateral leverage. "If you're goig to blackbail be idtoo tagig subthig, I'll go with sub guiafedsid. I thig we have sub id the house, ad id's pretty harbless, as bedicide goes."
"Did I say `blackmail'?" Emily batted her eyelashes in an attempt to look innocent. "I was merely suggesting a trade: you take something for your cold, and I give you a cookie in return."
"Dough guiafedsid, dough cookie? You do drive a hard bargaid, Ebily."
"Well, I am a mother. Mothers just have ways of making you do thing you know are good for you."
"Like eatig brussel sprouts?" Jed coughed into his fist, sniffled.
"Exactly. So, guiafensin, then cookie?"
Jed pretended to consider, crossed his arms over his chest and pouted. "If I godda. But I wahd two cookies."
"Okay, two cookies. But you're going to finish the whole glass of water I give you, no arguments."
"Oh, alright." Jed sighed, but couldn't help smiling immediately after. "I guess I'b dot good at beig a bratty kid, eb I?"
"You did a fairly convincing job." Emily patted his shoulder and left for the kitchen, returning with a glass of water, two small white pills, and two cookies, one of each kind she'd baked. She gave him the pills and glass of water first, watching as he swallowed the pills then chased them down with three long swallows of water, draining the large tumbler she'd filled at the kitchen sink.
As she handed over the cookies, wrapped in a paper towel to prevent crumbs getting all over the couch, she told him, "You do know what they say: doctors make the worst patients."
While I didn't have the time or the attention span to participate in this spring's "Beginings and Endings" challenge, a part of Bunny 9, "doctors make the worst patients" kept nibbling at my ankles, following me around and making a nuisance of itself until I relented and started writing.
One incident in this trilogy is based, unfortunately, on a recent experience, since my husband caught a chest cold complicated by asthma and was coughing quite a lot and quite violently one evening. Part two therefore has some references to v-ing, so emetophobes might want to read that part with caution. I'll try to mark the act itself with a space and lots of asterisks, but there is some, uhm, aftermath, sorta kinda, in the form of a stained sweater. Yeah, 'nuff said, right?
Also, the reference to a sneeze which sounds like a wild animal is based on Garrison Keillor's article "God Bless the Sneeze", which I found reprinted in Reader's Digest in the 1980's (yes, I'm ancient...). I've been secretly dragging that article around for years, bringing it out occasionally for a smile and a memory of my first awakening to the sneeze fetish.