Chapter 3
Jonah pulled his Mercedes Benz into his assigned parking space outside of the three story building where he spent his day. Christian Brothers Family Health was the incorporated collaboration of fifteen doctors who provided a wide array of medical services, with the hope that the center would be one stop shopping for patients. All of the doctors in the practice were Christians, hence the name Christian Brothers. Jonah added the specialty of pediatric cardiology to the ranks and was notably the highest paid and most in demand of the group. He had advanced training to perform complex interventional tests and procedures like biopsies and catheterizations necessary for diagnosis and treatment. Pediatric heart problems were more common than most people knew. He saw kids all day who suffered from slight heart murmurs and genetic heart disorders to severe and irreversible congestive heart failure.
He stopped at the reception desk. Mia, a bubbly young woman with an infectious smile greeted him.
“How are you doing this morning, Mia?”
“I’m good.” She reached into a slot and handed him a message slip. “I’ve already sent someone upstairs—a new patient—so they’re probably still filling out forms. And your mother called.”
Jonah sighed inwardly, but nodded thanks. He took the two flights of stairs that led to his office, walked in, and fell into his chair. He’d been ignoring his mother. The anniversary of his brother’s death was looming. Her annual ritual of grieving for Joshua included Jonah’s participation whether he wanted to be a part or not. He wasn’t ready for it. Not this year. And definitely not this morning.
There was a tap on the door, and then it creaked open.
Tom Cooper, one of the other doctors, peeked in. “Good morning. I don’t mean to bother you again, but I really need your numbers.”
Jonah groaned against Cooper’s annoyance. “You don’t have to keep reminding me every day. I’ll make my deadline.” Jonah crumpled the message slip and tossed it in the trash basket.
Cooper took a few steps into the office. “Are you going to see the Lazarus kid I referred to you last week?”
“Lazarus is my first patient this morning. They’re in the waiting room. You just walked past them.”
Cooper scratched the side of his face. “Good. Glad you fit him in so fast.”
Christian Brothers treated a set number of charity cases on a monthly basis. Each doctor was assigned a minimum of four patients to treat, with the exception of Jonah. His tight schedule didn’t permit it because the follow-up on cardiac cases was often extensive. He simply didn’t have time to take on so many free patients. He generated his income from billing, and his lifestyle required a lot of billing.
Cooper and several of the doctors in the practice were furious when he announced he couldn’t do as many pro-bono cases. Three of them actually wanted him out of the practice if he weren’t going to govern his work by the guiding principle of the organization; in this case, “Service before profit,” but he knew they wouldn’t be successful in ousting him. Pediatric cardiologists were few in number. Christian Brothers needed him.
Jonah made a pretense of reading something in a medical chart. After a moment, he lifted his head and shot Cooper a hostile glare. “Something else?”
“No, just keep me updated,” he said. “On Lazarus and the report.” He left the office.
What was that about? Cooper was probably hatching some type of plan to get Jonah’s patient load on the meeting agenda again. He didn’t know what was wrong with that man. He was seeing the Lazarus child as he requested, but he wasn’t satisfied. Cooper wouldn’t be happy until Jonah was seeing as many pro-bono cases as he was. He always wanted more. Everyone seemed to these days. At work and at home.
Jonah could hear the voices of his team in the corridor, greeting Cooper just before April Thomas appeared in the doorway.
April, his cardiovascular technologist, was a pretty young woman about twenty-six years of age. She performed all the ultrasound tests on his patients. Accredited in EKG, echocardiology, and even trained to assist with more invasive procedures like cardiac catheterization, April was his right hand.
“Good morning, Dr. Morgan.” She approached his desk with a medical record in one hand and a coffee mug in the other.
“Any luck that’s for me?”
April seemed to be dragging a little this morning, but she smiled anyway as she placed the cup in front of him. “I felt like being extra sweet this morning. We’re studying servanthood in my Bible Study class.”
Jonah reached for the mug, which bore his Alma Mata, Morehouse College of Medicine. “Thanks. I rushed out of the house without my second cup.” He took a sip. “So how was your date last night?”
April rolled her eyes. “He was a snoozer. All he did was talk about himself and how great a lawyer he is . . . blah, blah, blah,” she replied, waving her hand back and forth. “But you don’t have time to hear about that. You’re double booked all day, and Lazarus is ready in room one.” She handed him the chart. “He’s a real cutie. His mother is very nice, but worried to death.”
“Hmmm, what else is new? Isn’t everyone worried by the time they get to see me?” He opened the thin file, glancing at Dr. Cooper’s referral and the nurses’ notes. “That’s who I am; The Grim Reaper.” He looked at her, a chuckle at the end of his words.
“You don’t always have bad news.” April clutched both elbows across her chest. “I think finding out you have a slight heart murmur is much better than complete heart failure.”
“True,” he said, standing. “But our patients don’t even know the range of conditions the heart can have. Anything irregular is bad news to them.” He came around the desk, placed a hand on April’s shoulder, and squeezed gently.
“You’re the best, and you make the best coffee. Time to get to work.”
Amadi Lazarus was a slightly underweight nine-year-old boy with coal black skin that was telling of his African heritage and the darkest eyes Jonah had ever seen. He remembered learning in high school science that no human being actually ever had black eyes. But if ever anyone was close, it was Amadi.
“That’s it.” Samaria Jacobs, Jonah’s registered nurse placed a band aid on the site where she’d drawn blood. “We’ll make sure to get you that sticker before you leave, okay?”
Amadi nodded, his hands trembling, and Samaria left the room, closing the door behind her. Amadi’s mother stepped closer to the examination table where Amadi sat and reached for her son’s hand.
“Tell me why you think you’re here today, Amadi.” Jonah moved the stethoscope across his chest.
“Something’s wr-r-r-rong with my heart,” Amadi replied, stuttering. “F-f-f-fat Tommy told me I’m going to have a heart attack and die.”
“Who’s Fat Tommy?”
“A mean boy who lives in our apartment complex.” Amadi’s mother, Monifa Lazarus frowned. “With a big mouth.”
“Well, Fat Tommy is probably wrong. Kids your age have a very small chance of having a heart attack,” Jonah replied.
“But th-th-th-th-they can, if they already have a bad heart, right?”
“They can, but it’s rare.” Jonah spoke in between listening to heart sounds. “Tell me, Amadi, have you ever been sick before, like sicker than having a cold?”
“I was in the hospital once, in T-T-T-T-Togo. Right, Mama? When I was five.”
Monifa Lazarus wrung her hands. “He had an infection. I would know the word if I heard it.” Her thick accent broke her speech. “A lot of the kids were sick from the school, and he had to be in the hospital for a few days to get medicine.”
“We’ll request the medical records. Any preliminary tests we need can be done here today following my examination.”
Mrs. Lazarus’s face relaxed some, and for a few seconds, her hands were still.
There was a light tap on the door, and as if she read his mind, April walked in.
“Amadi, this is Miss April. She’s going to do a few tests on you. One of them is called an electrocardiogram.”
“I had that before.” Amadi bobbed his head up and down as he spoke.
“Good, then you know it doesn’t hurt.” Jonah stepped back a few feet, allowing April space to work.
While her son seemed to be more relaxed than he had been before the exam began, Mrs. Lazarus had gone back to wringing her hands, and the wrinkles in her forehead looked like they were permanently etched there. “What can you tell from this test?” she asked.
“Any irregularity in the heart rhythm can change the heart’s electrical activity. We’ll get a printout that will show us the rhythm. I’m looking for a certain wave pattern.” Jonah placed a hand on Amadi’s shoulder. “I’m going to let Miss April do the test, and I’ll be back.”
Jonah left the exam room, taking the scanty medical record Monifa Lazarus had bought with her. Once in his office, he went directly to his desk and reached into the top drawer for a bottle of Tylenol. He was getting a headache. He swallowed two pills and chased them with the coffee that had gotten cold on the desk. Then he opened Amadi’s medical file and began reading.
Not much had been done in the way of diagnosis, but Jonah knew something was there. His heart sounds had murmurs that he suspected would show him an irregular rhythm. After a few minutes, April entered with the EKG tape. Jonah looked at it, noting the gallop pattern he suspected. “Let’s do an echo and a chest x-ray.”
“Anything in the record?”
“Nothing conclusive. Treating of symptoms. But he’s got a bad rhythm—slow too. We’ll get to the bottom of it.”
“Amadi, go to the waiting room,” Mrs. Lazarus instructed, turning his shoulders and pointing him to the door. Although reluctant to leave his mother’s side, the boy did as he was told. “Dr. Morgan, I don’t know how to thank you for seeing Amadi. I don’t have any money or insurance, and you people have been so kind to us.”
“Amadi is a great kid. I’m glad to be his doctor,” Jonah replied.
“You are a good man,” she said. Jonah could tell she still struggled with her English. “Amadi has had a lot of doctors. They don’t talk to him sometimes when they see him. They just work like they’re handling a piece of meat.” She hesitated for a moment. “You’ll forgive me if I presume something?”
Jonah acknowledged her with a nod.
“You are a Christian, right? But you aren’t like some of the other Christians I know. Saying they love God, but not really loving people.”
It occurred to Jonah that this was some big witnessing opportunity, but he was at a loss for words.
“I’m sorry, Doctor, if I’m wrong. I assumed you were a Christian, because of the paperwork I read about the office.”
“No, Mrs. Lazarus, I am.” He hesitated again, but still didn’t respond to her statement. He didn’t know what to say.
“I have taken enough of your time. I will talk to you when you have the results.” She seemed to sense his discomfort, and Jonah couldn’t help but notice she looked a little disappointed. He saw her to the door.
“We’ll see you back by the end of the week. By then I should have all the test results.”
Mrs. Lazarus nodded and left.
Within seconds, Samaria stuck her head in the door that he had left half open. “Your next patient is ready.”
Jonah was still feeling uneasy. You aren’t like all the other Christians. That troubled him, but it troubled him even more that he hadn’t thought to tell her some of the things Pastor Kent talked about, like explaining that all Christians are not at the same maturity level or how some people hadn’t been fully changed yet. What was that he’d preached . . . putting on the new man . . . renewing your mind? Heck, he didn’t know. He was a doctor, not a preacher.
“Dr. Morgan, did you hear me?” Samaria was still standing in the door. “Dr. Gunter asked that you call the National Heart Society back.”
Jonah hadn’t heard her. He’d received a couple of messages from NHS, but hadn’t taken the time to return the calls. Now he was wondering why Gunter was insisting. Although he strongly encouraged continuing education, conferences, and research opportunities, Gunter, the senior partner in the Christian Brothers, didn’t often request the doctors do anything outside of patient care. Maybe it was important.
“Their annual benefit is in Atlanta on Friday night,” Samaria said. “I heard about it at school.”
Jonah nodded absently, thinking he’d try to stop in later and see what was on Gunter’s mind. “Did you have a chance to get the blood work ready on the Lazarus kid?”
“It’s ready,” Samaria replied.
Jonah was thoughtful for a moment, and then made a notation in the chart. “Expedite it, okay? I’d like the results first thing tomorrow.”
He noted the confusion on her face. In pro-bono cases, expenses were kept to a minimum. Some of the other doctors had expedited lab work in the past to make diagnosis, but he never had. He’d always followed protocol.
“Okay.” Her voice indicated she was looking for a plausible explanation. When he didn’t give her one, she put the chart she was holding on his desk and left the office.
Right behind her, April entered, holding the disc of the echogram.
Jonah stood and stuck the pen he’d been writing with in the pocket of his lab coat. He came around the desk just as April stuck the tape in the player.
“How’d it look?” She nodded at the chart on his desk.
“Not much in the record.” Silence fell as they watched the film. Jonah used a hand to wipe the frown from his face and stopped the tape. “I’m rushing the blood work. I’m seeing something that may be pretty serious.”
They walked out of the office, and Jonah fell into step with April as they walked down the corridor. “Rushed blood work means the Q Labs guy will have to come twice today. That’s two times the looking for you ladies.”
“What do you know about the Q Labs guy?” April’s voice didn’t carry the light tone he’d been expecting.
“I hear the break room talk.” He leaned closer to her ear, putting a hand on her shoulder. “I know who’s being naughty and who’s being nice around here.”
He heard her intake of breath right before her shoulders stiffened.
“I didn’t mean you’ve been naughty,” Jonah attempted to clean up the inference that she’d obviously taken personally.
“No. It’s okay, Dr. Morgan. I just have a headache.”
“That seems to be going around today, but you’ve had a lot of those lately. Getting enough sleep?”
She nodded agreeably, but he could still tell he’d jarred her. April had been moody lately. High one minute, low the next.
He returned his hand to her shoulder and began to squeeze gently, hoping to massage tension. “Don’t ignore those headaches too long. If they don’t get better, let somebody do a CT scan—find out what’s going on.”
“I will,” she said, but her voice was noncommittal.
Jonah knocked on the exam room door, announced himself, and walked into the room, but not before he saw raw hurt glittering in her eyes.