Chapter 7 – Like Father Like Son?
"I'm sorry Cosmo we are seriously under staffed today so you will have to deal with cases on your own, but come to me for authorisation and when in doubt, ok?" Abby yawned handing over a chart, sitting on a stool at the admit desk.
Cosmo nodded as he took the chart and walked to curtain 3. He drew back the curtain and looked at his patient, a burly male who appeared to be creeping up to 60 years of age. He is laid, sat up on the gurney with his arm out having an IV inserted by Jade the nurse. He is breathing erratically, his complexion is pale and clammy.
"Charles Martin?" Cosmo asked with a smile, looking at the chart. The patient nodded in response. "Good morning I'm Dr Martin" He had to laugh at the namesake. Cosmo felt good calling himself "Dr Martin" though he is not yet qualified.
"Likewise" The patient chuckled "Yeah Martin is a fairly common name" He frowned at Cosmo as he reminded him of someone he knew, who's a look-alike but couldn't think where.
"Yep" Cosmo nodded and looked at the chart "So from this triage assessment you tell us you have chest pains?"
He nodded in reply.
"BP?" Cosmo asked, looking at the nurse.
"160/100"
"A bit of on the high side, should be below 140/90" He muttered to himself trying not to think of the textbook. "You generally suffer from high blood pressure?"
"Yes, but I have it under control with my meds"
"Do you have tightness to your chest?" He asked tilting his head to one side.
"Yes I do and I have pains all down one side"
"Ok… Can you unbutton your shirt please?" He asked putting the stethoscope in his ears. He then placed it on his chest when he exposed his skin. "Hmm rapid heartbeat" Taking the stethoscope out of his ears. He quickly glanced at the nurse and asked "CBC and a chest film"
Jade nodded as she noted Cosmo's requests, "Is that it?" She asked, raising her brows, which got the med student worried as if he has missed something out.
"I will have to do an Echocardiography on you," The young doctor demanded. "And I will back with you in a short moment"
Cosmo spotted Abby as he walked out, through the curtains, she is still sat at the admit desk, evaluating a pile of charts. He headed towards her and called out her name. "Dr Lockhart?"
"Yes?" Abby's wavy hair bounced as she looked up, took off her reading glasses to focus better.
"I need authorisation to order an EKG"
"Your diagnosis?"
"Atrial Fibrillation"
"What's his history?"
"He's 58 years old, high BP 160/100, ordered chest films, CBC and he's a truck driver"
"Tell him to stop snacking out at truck stops" She grinned.
"Really… Do I say that to him?" Cosmo curled his top lip up shaking his head, acting naïve.
Abby laughed "Well yes you could say that on his discharge if your final diagnosis matches up your expectations"
"Is that it?"
She shook her head, "No! Are you telling me that you want to order EKG and you haven't got the test result back from the lab?"
"Well erm… the nurse just doing it now"
Abby sighed rubbing her forehead, her teething problem is starting now with Cosmo's lack of organization.
He slapped his forehead as he remembered something else. "Oh yes he says that he has pain all down one side"
"Where? His arm or his body?"
"I didn't ask specifically"
Abby closed her eyes gently in disbelief "I think need to check him over as I suspect it maybe something else"
Abby took the chart from Cosmo and looked at it. She blinked hard as she forgets that her eyes are not as good as they used to be, she puts her glasses on again. She quickly scanned the details from his assessment.
"I need to see if there's DVT underlying his problem… and Cosmo, next time can you please pay a special attention when you are with a resident who orders tests, I can't believe you've forgot the Chem-7!"
"Huh? No wonder the nurse looked at me funny…" He shook his head as he followed Abby to curtain 3.
"Hello Mr Martin I'm…" Abby stuttered as she drew back the curtain to introduced herself. She blinked hard as she instantly recognized the face, its Chuck. The shock from seeing him, who coincidently happens to be in the same time and place as Cosmo where he is working caused Abby to cut up her words. "Dr… Lock…hart"
"Hey Abby… Long time no see!" Chuck grinned.
Cosmo frowned and looked at his boss wondering if they already know each other.
"Will you excuse me for a moment?" Abby cocked her head to one side, forcing a smile. She ushered Cosmo out through the curtain and headed to the admit desk.
"Cosmo I'll deal with this one myself," She demanded.
"Why?"
She shrugged her shoulders "It's complicated"
"What? But he's my patient and I'll never learn this way if you do this"
"Yes this is different"
"How different?"
"Anyway you are only a med student and do you always question your superiors Mr Martin?" Abby scolded glaring her eyes into his. Cosmo's emerald eyes glared back at her and snatched a chart from the rack on the counter. Abby lets out a sigh with relief watch him walk to the waiting room. She feels bad having to turf her intern away from his patient, but she doesn't want to face any repercussions for him.
"So do you see any of the old gang then?" Chuck asked rubbing his chin.
"Not really, people move on" Abby replied looking down scribbling on the chart.
"I've only been back in Chicago a year"
Abby nodded, she is staying calm as she could lash out at him for what he put Susan through.
"Can you undo your buttons, I would like to listen to your heart" Abby glanced at Chuck over her reading glasses and then noticed a wedding band on his left hand as he is unbuttoning his shirt.
"I've been working all over the place like Alaska, Texas and just got back from Denver"
"Oh good for you" Abby sighed as she is really not bother about his life story and then puts her stethoscope in her ears and places it on his chest.
"I don't know if you heard that Susan and I split up, she went off with another guy and never saw my son again"
Abby blinked hard looking at Chuck when she listens to his heart and thought to herself… You liar!
"Your heart is beating rapidly and irregularly," She said, pulling away the stethoscope from her ears.
"Well I do have angina"
"You suffer from palpitations?"
"Not really"
"Your heart sounds a little different from angina attack," She said placing her stethoscope round her shoulders "You might have DVT – Deep Vein thrombosis, I need to look at your legs"
"I thought so… that stupid kid doctor wouldn't listen, full of self importance"
"Do you mind not talking about my member staff like that please," Abby scolded.
"He knew sweet fuck all ok?"
"Hasn't it occurred to you that he's only a med student and has a lot to learn and adapt in this place?"
"Whatever…" He snapped "I'll have to take my trousers off cos I can't roll the damn thing up"
"Ok, I'll come back in a minute when you get them off" Abby drew back the curtain to leave.
"Hey Abby"
"What?" She poked her head through the curtains
"You're still a little sexpot aren't you?" Chuck laughed as he unzips his trousers.
Abby closed the curtains in disgust. She shuddered as she heads to the admit desk.
"Where's the med student who ordered Mr Martin in curtain 3, a EKG before getting results back from the lab?" Kerry asked, browsing at the board then screeched, "For god sake we don't have money for this kind of thing!"
"It's ok Kerry, it hasn't been ordered" Abby replied entering the desk placing a file in a tray.
"So why hasn't it been wiped off?"
Abby walked around Kerry's electric wheelchair, picked up a board wiper and erased Cosmo's name and the EKG. Wrote her name in place, smiling forcefully back her.
"Abby I've come in to help cover the staff shortage, if that's ok with you?"
"Oh thank you Kerry that's good of you, as long as you remember that I'M the boss ok?"
"If you say so Lockhart," She replied dryly. She shifted the gear in reverse and Abby quickly jumped back to prevent getting her toes crushed. "You know I like to keep active. Oh by the way you remember that letter about someone who wanted the ER to be refurbished? We still haven't a clue who it is"
"Maybe he or she wants to remain anonymous"
The ambulance bays doors crashed open and two EMT's rushing in with a patient.
Weaver whizzed round the admit desk to catch up with the EMT's pushing the gurney.
"What we got?" Kerry asked as her hair flickered from wind rushing from the speed of her chair. Abby joins in the rush.
"Female 21, head injury, blunt trauma to tib/fib, hit by a car, 120/80, O neg and she's shocky" said EMT Reilly.
"Ok put him trauma 1"
"Are you gonna treat him?" A friend of the patient asked worriedly if Kerry is capable of doing her job.
"Yes I am and who are you?"
"How are you gonna reach?" Shaking his head. "I'm her boyfriend"
The EMT stopped the gurney in the middle of the trauma room. Kerry parked herself beside the gurney and the nurse gathered rounding up the equipments.
"Pulse 140 and BP is now 140/100" Abby said standing opposite checking the vitals.
Everybody looked to see where the mechanical whirring was coming from. It was Kerry pressing the button on the control panel to elevate the wheelchair up then stopped when she reached her desired level. Abby had to laugh, not at Kerry because she has seen her do it many times, she laughed at the patient's boyfriend, who's jaw dropped to the floor watching her rise up in the air. He couldn't believe his eyes.
"CBC, Chem-7 UA and can someone get me the portable from radiology please and call the OR?" Kerry demanded.
"I'll do that," Said the white haired Hispanic nurse, hanging up the IV bags on the stand.
"Thanks Chuny"
"Abby, I can take care of this one ok? You can go back to your patient"
"Are you sure? Page me if you have any problems"
"Thanks" Kerry nodded as she watched Abby snapping off her gloves as she leaves the room.
"O-neg are up"
"Good bilateral breath sounds" said Kerry listening through her stethoscope "Abdomen fine and just deep laceration on the scalp where she hit her head"
"Portable's here, it was in trauma yellow" Chuny said pushing the equipment through the door.
"That's great" Kerry smiled putting on blue shield bib over her. "Someone shut the door, going take some x-ray"
A craggy looking surgeon with white curly hair and glasses pushed the door open with both hands; his surgical Sub-I intern, a young blonde female, followed him in the trauma room.
"What have we got here?" Dubenko asked, flicking his curls back away from his eyes looking up at Kerry. He still has the same hairstyle after all these years.
"Blunt trauma to tib/fib, were waiting for the x-ray results" Kerry informed him.
"X-ray results here!"
Dubenko took the films from Chuny and raised them up in the air against the bright light with Weaver tilting her head to one side to glance at them.
"Hmm her right leg is shattered, she be lucky if she doesn't lose that leg, ok lets get her to the OR" He ordered. They wheeled the patient out of the room.
Abby headed back to the curtain three reading through her chart.
"Abby" Luka said, coming up from behind "Can I have a word in the lounge please?"
"Sure" She followed him into the lounge, Luka closed the door after her.
"I see you took Cosmo on and off a case?" He asked
"Did he tell you this?" Abby whipped off her glasses.
"Yep"
"Oh great!" She said and then sarcastically mimics a cry "Boo hoo I must go to the Chief of Staff cos Abby wont let me play doctor"
"Don't be so sarcastic Abby!"
Abby raised her brows at Luka; a little smile crept on her face as she finds him a turn on when he is angry.
"Why?" He barked in his thick accent.
"He's a relative, you know the rules Luka," She pouted at him.
"He didn't tell me that"
"He wouldn't know" Abby gently folded her arms and whispered, "Because it's his father. Chuck"
"What?" His head jerked up in surprised and bit his bottom lip "Now he's has a good opportunity for a good pasting what he did to Susie"
"Just drop it Luka" Abby sighed "That doesn't sound good coming from the Chief of Staff"
Luka pursed his lips "I just get angry with men who mistreat women"
"I know hun… at the end of the day he is a patient, he has to be treated the same as the others even though I have the desire to give him a lethal dose" She puts on an evil grin then starts to play with his tie and then Luka leaned forward to kiss her.
"Have a word with Cosmo and explain the reason," Luka mumbled in their kiss.
Abby broke the kiss and pushed herself away from him "Luka, I erm we need to talk"
"What about?" He moved his eyes to look out of the window and spotted Cosmo coming towards the lounge, he quickly broke away from the kiss and nodded at the direction of the door "He's coming"
"Ok" Abby rolled her eyes and rubbed her forehead.
"So why I couldn't treat him then?" Cosmo interrupted with a frown, walking into the lounge.
"I leave you both to it" Luka leaves the room.
"Because he's a relative, ok?" She answered.
"A relative? I don't know him from Adam, oh I get it because the guy has got the same surname as me" He scoffed and said "Oh I'll remember that every patient that comes in here called Martin, I shall not bother treating them"
"No need to be sarcastic" Abby frowned at him
"Don't forget that I am not my mother you know, sweet and sincere" Cosmo shook his head, towering over his boss's petite frame.
"I damn well know you're not like your mom!" She growled, "You have your father's attitude, you've have his drive for determination"
"Oh so you knew my father that well"
"I don't want to have this conversation ok? Cut the shitty attitude you've only been here a few days" She then pointed her finger up at him "So don't push it"
"Yeah I will push it" Cosmo walked to the door to leave the room "because I've heard that you were the one with an attitude when you first came here!"
Abby jaw dropped to the floor and scoffed in disbelief. Is this Abby Lockhart the next generation, the male version?
"Get it sorted then?" Luka asked as he walked back in to the lounge with one hand in his pocket.
"Yes" Abby seethed in her acknowledgment.
"So what is you wanted to talk about?"
"It doesn't matter, I'll talk to you about it later" She heads to the door.
"I want to talk about it now" Luka reached his hand out to grab hold of her arm.
"This isn't the time and place Luka" She snatched her arm out of his hand.
"I'm not letting you go out there until you tell me what's bothering you"
"Ok you want to know what's bothering me?" Abby snapped, "Us"
"What about us?"
"I don't think it's going anywhere"
"What you mean not going anywhere"
"For god sake Luka will you stop repeating what I'm saying!"
"But I don't understand" He moaned in his thick accent shrugging his shoulders "I thought everything was going ok and the sex is great, I must be blind if I'm missing something what you can see"
"It's not about the sex Luka! It's the connection between you and me, we don't talk. Well no… you don't talk. In fact you have never changed since when we first dated 25 years ago!"
"What is it with you women?"
Abby clutched her head "I've made a mistake by going out with you, look I am very fond of you, it's just I haven't got over John yet. I can't seem to move on as I am still hurting"
Luka looked at Abby pursing his lips "I do understand what you are going through"
"Yes of course Danijela, Marko and Jasna…" Abby bit her bottom lip "I'm sorry Luka, I can't do it now"
"Guess there's no us?"
"I don't know Luka" Abby said, looking down staring at the empty space on the floor. "I just don't know what I want…"
"Let's look at your legs" Abby said forcing a smile as she drew back the curtain. She leaned over the gurney to examine his legs by tracing her hand over them. She noticed a huge swelling on his left leg around the calf.
"Mmm you have a nice touch," He muttered in his smile.
Abby grimaced when she paused to bite her tongue, keeping herself from saying something that would get her in to trouble. She looked up at the Nurse and asked "Jade, can you get 5000 U EV bolus dose of heparin?" then swung her head to look at Chuck "You have DVT, I will give you a heparin jab to stop the clotting, we will get you something to elevate the leg and we should keep you in for observation"
"I can't believe I've got DVT"
"They can but anyone you can get them from sitting down for periods of time, like on a long haul flight and according to your notes you are now a truck driver, which means you don't stop for breaks as often as you should"
"I know and yes I'm a truck driver" He lowered his head, shamefully. "I can't have many stops, we have a deadline to meet"
"So you didn't like nursing in the end?"
"I lost my licence through wrongful accusation"
"Oh?" Abby nodded "I won't ask you why…"
"What you mean?"
"Here you are Dr Lockhart," said Jade as she walked in, interrupting their conversation, handing over the heparin jab.
Abby rubbed the alcohol wipe on to his left thigh then injects the heparin. "Ok, you will get another dose in…
"6 hours… Maintain aPTT 2 times the control" Chuck interrupted, nodding his head. "Yeah yeah I haven't forgotten my medical knowledge"
"Well you if know it all, I wont bother wasting my breath" She raised her brows as she noted in the chart "You can relax while I go and input your assessment on to the PC"
"Can someone call my wife and tell her I'm here please?"
"We can do that"
Abby headed to the admit desk, cataloguing in her thoughts in her head what he said and putting two and two together like She left me for another man and lost my licence through wrongful accusation. Then again he was a little flirtatious with her… There are always two sides to every story; Susan wouldn't ever lie to Abby… would she?
Chuck shuffled off the bed to open the curtains a little to watch the ER world go by, as he felt shut out from it all. He glanced at the young nurse who was assisting Abby and Cosmo earlier. He heard her called Cosmo by his first name and waved at him in a flirtatious way. Chuck amused himself at the nurse who has a crush on the med student until it had dawned on him that the 'Dr Martin' who saw him could possibly be his long lost son, the son he hasn't seen since he was three years of age. Now he can see Susan in him… He jerked up from the bed, dragging the IV stand along with him out in the ER.
"Erm Mr Martin can you go back to your bed? You need to keep that leg of yours elevated!" Abby shouted as she looked up with the phone to her ear.
Chuck glared at Abby and pointed at her "I have a bone to pick with you Lockhart! How dare you keep him away from me you bitch!" He shouted clutching his chest and collapsed on to the floor…