A/N: Hey everyone, sorry this addition is a week or two late. I've been swamped with work and school!
If you're enjoying this so far, I'd love to hear from you. Comments and feedback are welcomed on any chapter.
Caitlyn had decided she was not much of a fan of the County ER staff. It took several tries of asking for attention at the front desk before someone acknowledged her, and when she finally did get someone's attention, they immediately (and somewhat rudely, she felt) gave her a visitor sticker and sent her to the triage area to wait for Dr. Morris. If there was anything she inherited from her mother, it was a sense of impatience. Of course, she understood that there were other patients around and ambulances coming in but she didn't need the extra anxiety. All she wanted to know if her mother was OK. Since she had no choice but to wait, she observed the triage activity, watching another doctor talk to patients and a bored-looking nurse hand over paperwork to new arrivals.
"Caitlyn?" She looked up to see a red-headed doctor standing in the entrance to triage.
"Yes, that's me," she answered as she stood up.
"Caitlyn Coburn, right?"
"Yeah."
"Hi, I'm Dr. Morris; I spoke with your coworker on the phone. So sorry to have to call you at work. Why don't we head to the family room? It's a lot quieter."
As Dr. Morris led her down the hall, she couldn't help but feel anxious again. "Is everything OK?"
"Oh yeah, no worries. Triage can get chaotic since it's where our ambulance entrance is also located, so I didn't want us to get interrupted by any incoming traumas. Can I get you a drink or anything?"
"Um, no thanks. By the way, you probably figured this out because Mom told you where I work but I'm an RN. You can throw the book at me with medical terms. I'll understand."
"OK cool." He opened the door and gestured to a chair, and Caitlyn sat down, still seeming worried.
"OK Caitlyn. So...your mom collapsed in the ER this morning. I will tell you she thinks she had a bad fall and she hurt her head and possibly her ribs. She's fully oriented and her neuro exam went well, so I've just decided to keep an eye on her symptoms rather than order a CT right away. However, I did order a chest X-ray because she's having some pain while breathing and her side was a bit tender. We do know she's moderately dehydrated and she should be about finished with an IV of saline. She had most of the textbook symptoms."
"Any heart issues?"
Dr. Morris nodded. "She was in tachycardia when we were examining her, and it did show up on an EKG. She did say that's never happened to her before and she has no history of heart conditions...unless you know differently."
"No."
She looked straight ahead. "How about blood work?"
"I sent a CBC and a chem panel to the lab," Dr. Morris replied. "Unfortunately, the lab and radiology are backed up today. So it might be a bit of a wait for the results."
"But in the meantime, Caitlyn, I can assure you your mom will very likely be fine. The heart problem isn't life threatening; it's typical with dehydration for the heart to beat faster than normal, and I feel that anything her labs turn up is easily treatable. She just needs to rest, and I have her on a monitor so her vitals are being watched closely and we're making sure she doesn't develop any serious concussion symptoms."
"Do you have any other questions for me before I let her know you've arrived?"
"So you don't think she needs to go to med-surg or cardiology and be admitted, right?"
"As of right now I'm going to say no. She's doing fine in the ER. Let's worry about that if anything changes. I'm going to go let her know you're here, and if she's ready for visitors, I'll send a nurse to come and get you. Does that sound good?2"
She nodded. "Thank you."
Caitlyn was relieved as she sat in the family room after Dr. Morris had left. She had felt a lot of anxiety when the phone call came into work and found herself picturing the worst-case scenarios as she took the El to County. Now at least she could figure maybe her mother had just wanted company or something.
The door to the room opened, and Caitlyn looked up at a nurse with brown hair in a ponytail.
"Caitlyn? Hi, I'm Sam; I'm an ER nurse. I'll take you to your mom whenever you're ready."
Caitlyn started following Sam down the hall. "Are you a doctor?" Sam asked her, noticing her scrubs.
"Nope. I'm a nurse. Never was attracted to being a doctor. I see how hard the residents at Mercy have to work. I mean, us nurses do a lot too, but residents have way more training and pressure. I like the flexibility and life of a nurse better."
"Ah. Yeah. I'm actually training to be a CRNA."
"Really?" Caitlyn smiled. "My mom just keeps her fingers crossed I'll go to medical school someday. She's only joking with me about it but she really wanted another doctor in the family."
"Oh yeah. Dr. Morris and I were wondering if we were going to meet a younger Dr. Coburn before you got here. All your mom told us was that you worked at Mercy."
They got to Exam 2 and Sam opened the door, noticing Janet was sitting up and talking to one of her OB nurses.
"Hi Janet." Sam said. "I brought Caitlyn back with me. Let's see how you're doing." She took a look at the monitor and noted the chart. "Everything still looks good. Buzz if you need us." Sam exchanged pleasantries with the other nurse before heading out of the room.
The OB nurse looked at Janet and nodded hello to Caitlyn. "Looks like you have a visitor, so I'm going to get back upstairs. I'll let the girls know how you're doing. Everyone is asking, and don't worry, your practice is covered for the afternoon."
"Thanks Sandra."
Caitlyn sat on an empty bed. "Wow looks like you're popular today. Who was that?"
"Oh, that's Sandra. She's the nurse manager on OB."
Caitlyn nodded and sighed. "I'm just glad you're OK. I was really worried when Dr. Morris called and I got the message. I didn't know exactly 2what was wrong since I know we can't give details over the phone, but every scenario was in my head, including…"
"I know," Janet looked over at her. "Your first thought was probably the r word."
"Well yeah. That's kind of how my brain functions. What's going on today, though? Why did you go so long without eating or drinking?"
"Hmmm, I thought I was your mother." Janet made a face. "But fine; I'll entertain it. I've been on the go since I got up. I was up at 5 like usual and paged by 6. We're short-staffed upstairs and I had a busy day ahead of me. I'm exhausted already. I should have asked for help or eaten before I fainted, but it was impossible today. Besides Caitlyn, you know how hard it is sometimes to get meal breaks when you work in a hospital."
"I know. But Mom, you're already vulnerable. Did something else happen?"
"Nightmare last night. I woke up in a cold sweat at around 2:30. It made me a bit anxious, and I guess it followed me here. Dr. Morris doesn't think it's a panic attack, though; and it's really rare to pass out from those or need hospital treatment anyway."
"Oh, I'm sorry that happened."
"So let me ask you this," Caitlyn raised her eyebrows. "What kind of patient are you being? Be honest."
"I'm doing fine. I'm being perfectly good. Model behavior."
"Mom, I'm not buying it."
"I don't think I need all this fuss...the blood work, the X-rays. I'm tired. It's probably nothing. I tried explaining that to Dr. Morris and Samantha but..." She trailed off and shook her head.
Caitlyn frowned. "Yeah, I say the same thing when I pass out at work." Her voice had a touch of sarcasm in it. "And do you really think you should be delivering babies and seeing patients after fainting? Dr. Morris is just doing his job. He seems perfectly capable to me. You'd do the same thing if it were one of your patients-you'd want to order any test you thought would help-and you know it. I mean, I get it, you've never passed out before and it's probably embarrassing to have it happen here, but this is really just for the best. You'll likely have to go back to your own doctor too for follow-up and maybe some extra testing. Nobody wants anything serious to happen to you. Don't be so stubborn."
Janet looked over again. "So this is the game you're going to play? Turn the tables?"
"Sure am."
"OK, Cait. You win this round."
They sat in silence for a few minutes until Janet started talking again.
"Thank you for coming. Sorry you had to leave work."
"I may have to make up the hours, but it is what is," Caitlyn replied. "I came because I know you'd do the exact same thing for me if our roles were reversed right now. And you'd probably be nagging me." She couldn't help but laugh.
"I would come see you in a heartbeat."
Sam came back in the room. "Hey, I finally heard from radiology. We're ready to go."
"And you ARE going," Caitlyn said, looking in her mom's direction. "Sam, am I able to come upstairs? Sorry about the banter...Mom's being a pain." She rolled her eyes.
"Unfortunately, we don't allow visitors in the X-ray room," Sam replied. "But you can either come upstairs and we can take you to the radiology waiting area, or you can stay here in triage or the family room. The X-ray should only take about 15 minutes as long as it all goes smoothly and the tech doesn't have to reshoot."
"You can come if you want," Janet shrugged. "But I think I'll be fine."
"I'll stay down here," Caitlyn told Sam. "I'm kind of thirsty anyway."
"No problem. I'll have Dr. Morris get you when we bring her back down, and in the meantime, I'll have a nurse or a med student take you back to the family room. Security gets kind of nervous when visitors aren't accompanied by staff."
Caitlyn grabbed Janet's hand. "Behave up there. I'll see you soon."
Caitlyn may have only been told 15 minutes, but it felt like she was waiting for hours. She was just staring at the TV in the family room, but not really absorbing what the talking heads were saying as she sipped on a soda from the vending machine.
Finally, she saw Dr. Morris approach.
"Caitlyn, hi. We just brought your mom back to her room. She did a great job; no trouble at all. I should have the films back shortly and our radiologist will go over them with me. I'm also going to go look to see if we got her blood work back to review. If there are no major red flags, I'll give her discharge instructions and get her out of here. Do you have any questions for me?"
She breathed a sigh of relief. "Thank you, Dr. Morris. Only question I have is...can you take me back to my mom's room?"
"Of course. She's waiting for you. Come right this way."
"All right," Dr. Morris tapped on an X-ray board to get it on as Caitlyn and Janet stood in the hall with him. "Good news, Janet. Your heart and lungs are clear. We're not seeing any major breaks in the ribs or internal bleeding. It could just be a bruised rib or a hairline fracture, and those don't always show up on X-rays."
"Can I work with that?" Janet asked.
"With restrictions. I'd advise lighter duty for a few weeks. Use ice and take over-the-counter painkillers. You'll also have to do breathing exercises to keep air moving...it can be tempting not to breathe or cough when you hurt your ribs, but not breathing normally can lead to pneumonia or other infections. If you start running a fever or coughing up blood or you really can't breathe, you'll need to come back here so we can look into it more."
"I'm not good at light duty," she complained.
"It's not so bad," he grinned. "You get to spend some time sitting down ordering around your residents. I've heard you like that. No...seriously, I'd suggest trying to get extra assistance if you have any tricky deliveries or procedures. You should be over the concussion within the next 2-3 days, if that makes you feel better. As far as that goes, take it easy. No over-exertion. If you start to vomit, feel dizzy again, you have a headache that doesn't improve, or your balance starts to feel off, come back and we'll have to do a CT."
They went back into Exam 2 where he opened up another folder. "So, I have your blood work here too. Your cell counts are good, but it looks like you have low blood sugar. How often do you eat in a normal day?"
"I eat breakfast, then lunch and dinner seem to be whenever. Like I told you, I haven't had anything since about 5:30 this morning. Well, until Samantha got me the snacks and water."
"OK. Believe me, everyone in this room knows it's hard to eat when you work in a hospital. But I think you should start trying to make room for some extra smaller meals to keep your blood sugar up. Go home, take it easy for the rest of today and nourish yourself, and follow up with your regular doctor. I'll get Sam or another nurse to check your vitals one more time and I'll get your discharge papers ready. Any other questions?"
"Vasovagal syncope, huh?" Janet asked.
"Agreed," Dr. Morris replied. "There's no obvious underlying conditions in your labs. Based on what you told me, it sounds like you just got overwhelmed by the stress of the day and that, combined with the lower blood sugar, caused you to pass out. But that's why I suggest you follow up with your doctor in case they want to run more labs or find something in a checkup. Need anything else?"
"No, I think I'm good."
"Great. You know where to find me if you think of anything."
Caitlyn turned back to Janet. "See that wasn't so bad. Listen, I think I'm going to head back to triage and wait for you."
"Yeah, I'll be fine. You should go back to work anyway."
"Well…" Caitlyn smiled. "When you were upstairs, I called my boss to brief her. I offered to come back and/or work extra hours this week, but she told me don't worry and that family comes first, and I can just put down personal time. We haven't been able to have much time together in good graces lately. Let's give it a try."
Janet couldn't help but smile back. "I can't promise you I'll be much fun, but why don't you come on over? I have some fresh-squeezed juices in the fridge. I'll pour you a glass and we can talk about what to make for dinner."
"I'll help cook." Caitlyn picked up her bag and headed back out to the waiting room.
A short time later, they left County together and headed outside. Caitlyn was happy that at least for a few hours, she could put her differences aside to spend some time with her mother.
The next day, Janet was resting when she realized she'd missed Abby's call from yesterday evening. She had never even asked if Abby was OK and briefly felt guilty so even if she got voicemail, she at least wanted to acknowledge the call.
"Janet?" Abby asked when she picked up.
"Hi Abby. I'm really sorry about missing your call yesterday. Are you OK?"
"Oh yeah, everything's good. I'm not going in until 4 today and Luka's off and took Joe for a walk so I could get some quiet time. We're all getting over a stomach bug-it's been in the house for a week going around between us-and since Luka's finally feeling better, he told me I could relax while they got fresh air. Of course, all I'm doing is spraying Lysol everywhere. I figured you were just busy yesterday."
"Sort of." She paused. "I was actually in the ER yesterday for a lot of the day. Came down for one consult, passed out after it was over, and-"
"Oh my gosh," Abby interrupted. "Sorry, didn't mean to cut you off. Are you alright? What happened? Who treated you?"
"That's too many questions, Abby," Janet laughed. "I still have a headache. It was just a perfect storm of stress from being short-staffed, poor sleep the night before and not getting a lot to eat or drink. I went into the lounge to lie down and relax. One minute I was standing up and feeling crappy trying to have some tea, the next I was on the floor and Samantha was talking to me."
"Dr. Morris-Archie-treated me. He did a good job."
"Oh yeah, I'd feel comfortable with him too if I were in that position. He used to be immature, but he's really grown a lot. Did you have fun being the patient?"
"You know me. When Archie told me to go on light duty, I felt like he was speaking another language. I have a bruised rib and a mild concussion, both of which were from the fall. As tempting as it was to go back today, I figured it can't hurt to take an extra day or two to look after myself and rest up. Typical syncope episode. I have to go to my doctor in two weeks for a follow-up and make sure everything is good."
Abby grew serious. "Did your daughter come see you?"
"Oh yes. She bugged me a little bit but then she came back home with me, and we actually had a good few hours together. Well, for what I was awake for. We were making dinner and I had to rest in the middle of it, so she finished it off. I think we both wish things were like that more often."
"I get it," Abby said. "Well, I'm glad you guys had a good time and made it work. I relate to that whenever my mother visits, except your daughter's not bipolar so it's not quite the same. I just try to appreciate the good times and thank God she's stable."
"Hey, listen...do you want me or Luka to call you the next day or two and check on you with your concussion? Make sure everything's still OK? I can call you in two weeks after you see your doctor too."
Janet paused. "You certainly don't have to. You guys have jobs that keep you busy."
"Ah I'm sure I could find five minutes away from the ER. If I could at County, I can do it here."
"Thanks. I'd appreciate that but no pressure. I actually think I need to go lie down again. I missed my meeting last night too so I'm hoping to feel good enough later than I can get to one tonight, or tomorrow at the latest."
"I hope you make it. And hey, I know you're my sponsor and not vice versa, but if there's anything I can do for you, just let me know. But take care of yourself."
Janet smiled. "That's really sweet, Abby. I'll catch up with you again soon."
She hung up the phone and realized she wasn't going to make it to her bedroom for another nap. Instead, she turned off the TV (she knew she wasn't really supposed to be watching screens anyway with a headache) and dozed off. Janet didn't take a lot of time off work, but on a day like today—when she knew she needed to rest and had just enjoyed her daughter's company—it felt good.