Day 16

My on-call phone rings at 9:07 on a Saturday morning.
“My husband woke up with lip swelling…he has an enzyme deficiency and needs his injection.” There’s a group of people in the community who have this deficiency, and we have standing orders and a stock of their medications in the fridge for these flare-ups. They’re good at recognizing their symptoms, and their reactions are usually fairly quick, but not imminent throat closures. But we still have to treat them as potential airway emergencies.

“Is he talking? Is he breathing?” I make sure he’s okay. “Can I meet him at the health centre at 9:30?” I’m still in my PJs.
“Well,” she says hesitantly, “he swells up pretty quickly.”
I’m 95% sure that twenty minutes is a safe time gap before I see him, but if she thinks that’s too late, then I have to trust her. “Okay I’ll head there right now.”

I glance out my front window to check if the person on-call yesterday dropped off the truck for us. Nothing. Shit. I call her, and it’s a few rings before she picks up, her voice muddled from sleep.
“Hey, sorry to wake you, but I need the truck right now. Can you drop it off?” She promises to be at my place as soon as she can, but I’m watching the time and doing the math of how long it will take her. If 9:30 really is too late, I can’t wait for the truck.
Screw it. I’m going to run there.
Can you stay and wait for the truck? I text to Claire, my preceptor. I’ll meet you there.

The –35 degree air is harsh against my lungs. I arrive sputtering and totally out of breath, and only beat my preceptor by five minutes in the truck. The patient shows up at 9:40, walking, talking, and chipper. I can’t help but laugh to myself. My first instinct about this patient had been right, but I’m not exactly in a line of work where I can afford to gamble.

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My phone rings again while I’m in with a patient. I excuse myself out of the room to hear a man, angry on the phone.
“Someone there diagnosed me with pneumonia last week and gave me some antibiotics. I’m not feeling any better, and now I’ve infected my baby granddaughter, who had to be medevac’d out. When a person has pneumonia, you’re not supposed to just send them home, you’re supposed to isolate them!”

I press my fingers against my temple. I remember seeing him and treating him for an early pneumonia. I also explicitly remember telling him not to visit his baby granddaughter or other family while he was sick, but I guess this isn’t a good time to argue about that. My preceptor and I were also the ones who saw his granddaughter two nights ago, staying until the wee hours of the morning until the medevac team arrived.

“Come to the health centre,” I tell him. “We’ll see what we can do for you. Maybe we need to try you on a different antibiotic.” He hangs up.

I pull his chart for Claire. “Do you mind seeing him for a second opinion? I treated his pneumonia, but he doesn’t feel any better…maybe he needs something else, or I missed something? He’s a bit angry, though.”
“Of course,” she agrees kindly.

She brings him into her room, and a minute later, I hear him yell, “Well, my wife won’t stop giving me shit, and everyone is blaming me for making the baby sick!” He storms out of the room and jams his boots on.
“Would you like me to do anything for your pneumonia?” she asks. He doesn’t answer her and slams the door on his way out.
She and I look at each other, sigh, and shrug.
“Guess he just needed someone to yell at to offset his guilt,” I say. “Sorry you had to take that.”
She doesn’t seem too bothered. Anger, she writes under Reason for Visit. I laugh. At least there’s fruit salad in the fridge today.

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I come back in the afternoon to see a young lady who called me saying she was having “itchiness down there.” She sits shyly in my office chair as I ask about her sexual history and get her consent to do swabs for STI testing. After we do the swabs, I give her some cream for a yeast infection.
“If the swab results are negative, we won’t call you. If we find anything, we’ll call you back for treatment,” I explain.

She shuffles in her seat, then peers at me anxiously. “If you find anything on the swabs, does that mean my partner is seeing someone else?”
It suddenly hits me: the piles of lab reports I’ve sifted through during my career, holding no significance to me except for being sorted into positive or negative results – that single word may have been the moment the world shifts on its axis for someone else.

“I wouldn’t jump to any conclusions yet,” I say gently. “Based on your symptoms, I think you might just have a yeast infection. We always test for everything to be safe. But we’ll let you know if there’s anything else to be concerned about.”

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We’re trying to head home in the truck when my phone rings yet again.
“Nurse-on-call phone, Genevieve speaking.”
A woman howls through the speaker. “I’m cooooooolllllddd! Help meeeeeeee!”
“Who is this? Are you outside?” She’s apparently inside her house, but won’t answer any of my other questions as I try to triage her. She starts to alternate between crying and laughing hysterically. I look helplessly at my preceptor in the driver’s seat.

Sean, one of the full-time nurses here, is sitting in the back seat. “What’s her name?” he mouths to me. I tell him, and he gestures for me to pass him the phone.
“Hello dear, it’s Sean. What’s wrong?” He listens for a minute. “Have you been drinking tonight? Yeah? No more drinks tonight, okay? I just want you to drink lots of water. And eat something. Stay inside, get some rest.” He listens again. “Okay, okay. Yes, thank you. Good night.”
“Lifesaver!” I thank him.
He chuckles. “Good thing about always being here…I know all of them and what they’re up to.”

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We’re driving home from the clinic for the third time today. I glance at the clock – 8:27PM. Just three more minutes until I can switch my phone off and pass on the on-call duties. Someone told us that the Northern Lights had been beautiful last night, so we drive out in search of them “past the airport”, as we were told. We’re squinting to see the road in the dark.

“Do you think they meant we had to cut through the tarmac?” Claire, at the wheel, wonders aloud. Our airport consists of a tiny building with a single guy on duty, no fence, no security.
“There’s a stop sign there,” I point out. “But just a regular stop sign…not No trespassing.”
The arm of the security gate is raised. She shrugs and drives through. The sky is pitch black around us, and then, the little blue lights on the ground along the runway start to light up as we pass by. We start to giggle.
“Oops, okay, maybe we’re not supposed to drive on the airport tarmac?”

We turn around and wave sheepishly at the guy on duty, who has run to his window to see what was going on. He probably can’t see our faces, but we’d just met him last night at a friend’s get-together. I’m sure he’ll let this slide. We head home, still laughing at the absurdity of it all.

All in all, it’s been a good on-call day.

Comments

  1. Your 6 weeks in the Great White North needs to be made into a TV drama!

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