Jama stretched in her chair, arching her back and rubbing her eyes. She was tired, and the words on the computer screen blurred more and more often. The later the afternoon grew, the less able she was to keep Doriann from her thoughts. And Tyrell. And Monty.
She heard a car door closing and looked outside to see a young woman pushing a wheelchair up the ramp to the front porch.
In the wheelchair was Jama’s beloved old friend and the retired school coach, Ted Claybaugh.
The woman paused outside the door, looking at the sign Ruth had placed there. She said something to Ted, who replied gruffly. The woman shrugged, opened the door and backed inside with the wheelchair.
“I’m sorry, Dr. Keith,” she called over her shoulder. “Mr. Claybaugh insisted on being brought here.”
Jama stepped into the waiting room and greeted her grizzled old friend with a hug. “Ted, I knew you’d be in charge of that nursing home by now.”
The longtime widower grunted and shook his head, but there was the light of humor in his gray eyes. “I had to get my bluff in on them soon as I walked in the door.” Gone was the former deep bass boom of his voice.
“You’re not walking today? What’s the deal?” Jama knew it was the nursing-home rules that anyone taken to a medical facility must be safely transported, but she also knew Ted would have walked, anyway, had he felt able.
“I thought I’d fake chest pain so I could come see my favorite student.”
“Are you really faking?” She glanced at the aide.
The woman shook her head.
“Tell you what, Ted,” Jama said. “Why don’t you let me get some vitals since you’re here?”
“Guess you could. I should have the right to observe your skills, bedside manner, all that, while you work me up.”
“It won’t be much of a workup,” she warned.
After falling for the third time on the front steps of his home a few months ago, Ted had checked himself into the nursing home, despite the protest of his son and daughter. He’d told them he’d never been a burden to anyone, and he wasn’t about to start now.
“He’s been complaining of chest pains since this morning,” the aide said. “They’ve been getting worse, according to the pain scale.”
“Since this morning?” Jama exclaimed. “Why wasn’t his physician called?”
“I thought it was indigestion,” Ted said. “We had chili last night for dinner, and Shirley Watts always puts too many beans and onions in it.”
Jama led the way to a treatment room. “Most recent vitals?” She avoided glancing into her director’s office. She could expect Ruth’s displeasure to radiate into the hallway.
“I have them charted here.” The aide handed Jama a sheet. Ted’s temperature was elevated by a degree, his pulse a little fast and his respiratory rate a bit too rapid.
“So, Ted, what does the pain feel like?” Jama asked, pulling the blood pressure cuff around his arm.
He peered over his glasses at her. “It hurts.”
Jama rolled her eyes at him. “Describe the pain to me. Is it dull, or throbbing, or sharp and piercing?”
He suddenly winced, bending forward. Beads of sweat formed on his forehead as his skin paled. “I’d say sharp.”
“Where is it?”
He pointed toward his left lower chest.
Her concern increased a notch. This could be several conditions. Indigestion did not explain the fever, neither would simple pleurisy. If he had a left lower lobe pneumonia, it could hurt like the dickens. She should have sent him on to the nearest medical facility as soon as he’d been rolled in the door, but she hadn’t expected his problem to be so serious.
“Takes your breath away?” she asked.
“Not for long.” His grimace relaxed, and color returned to his face. “They never last long.”
Jama tugged the stethoscope from her neck, pumped the pressure cuff, then released it. Not much change in his blood pressure. She pressed the bell of her stethoscope over his chest and watched his face as she listened to his heart. With the elevated temperature and sharp pains, it could be a simple respiratory chest pain due to his fever, but the fever wasn’t that high. Still, she’d like to know where it originated.
“So tell me what you’re thinking,” he said before she could remove the bell of her scope from his chest, the boom of his voice returning via her earpieces.
“I’m not thinking yet.”
“Sure you are, you’re just not ready to tell anybody about it.”
She straightened, then listened to his back. “Breathe for me.”
“I haven’t stopped breathing all day.”
“Deeper.”
He did as she said.
She couldn’t tell much by the sound.
“Will I live?”
“That depends.” She wrapped the stethoscope back around her neck.
“On what?”
“If you’re talking about another ninety years, maybe not. I’d feel better if I could do more thorough testing, but we don’t have the personnel for it right now, and as much as I learned in med school, I wasn’t taught how to operate a lab or take X-rays. I’d like to send you to another facility—”
“When will this place be up and running?”
“Next week.”
“I’ll be back when you’re up to speed,” he told her.
“I don’t think you should wait,” Jama warned. “You could have a serious problem, and if it isn’t caught in time—”
“I know, I know, it could kill me.” Ted’s weathered face broke into a smile that shot Jama’s mind back to a time in the classroom, when she’d answered a question especially well. “Something’s going to get me sooner or later, Jama Sue. Who wants to live forever?”
“Depends on the alternative.”
“I’ve got a good one. It comes with a street of gold.”
“Well, I’m going to do all I can to make sure you don’t hit the pearly gates prematurely. They might not have your mansion ready.”
“Do what you need to, but just remember you’re not God.”
“I bet you’re really popular with your regular doctor.”
“I’m having my records transferred here next week. You’re my doctor now.”
Again, Jama was struck by the enormity of what she was doing. Physicians were discouraged from treating family members, and Ted felt like family to her, as had so many people in this town when she was growing up.
“I made that decision when you entered medical school.” He grimaced. Obviously, the pain had returned.
Jama gave in and hooked him up to an EKG machine. In fifteen seconds, she saw the display on the monitor, which didn’t show any significant problem for someone his age. Still, with anything less than a perfect EKG, she could not totally dismiss the possibility that the pain was coming from his heart.
She was wishing for a good phlebotomist and lab tech when Ruth stepped to the doorway of the exam room.
“Dr. Keith, would you mind introducing me to our patient?” Ruth asked.
“Ted Claybaugh,” Jama said, “meet Dr. Ruth Lawrence. She’s the director of the clinic.”
Ted nodded.
“Mr. Claybaugh,” Ruth said, “you need to go elsewhere for treatment.”
Jama bit down on her tongue to keep from saying something she would regret.
Ted looked at Jama. “I don’t care if she’s the President of the United States, Jama Sue, if you’ve been away long enough to forget about the stubbornness of the Claybaughs, then you’ve been gone too long.” He sounded as if he was addressing a football team after a fumble.
Ruth crossed her arms over her chest and took a step closer to Ted. It appeared to Jama that in Tanzania, bedside manner had not been high on the list of priorities.
Jama gestured to Ted. “Dr. Lawrence, meet our former teacher and football coach, who controls this town and everyone in it.”
“He can call me Ruth.” She approached Ted’s side. “Very pleased to meet you, Doctor Claybaugh,” she said dryly.
Jama was surprised to detect a glint of gentle humor in her director’s eyes, though she couldn’t be sure.
Their patient raised his thinning gray eyebrows. “You can call me Ted.” He didn’t break Ruth’s stare.
“Ted.” The gentleness of Ruth’s expression expanded into her voice. “As Jama has already explained, it is unfortunate that we don’t have the personnel we need to give you a proper medical workup today. The few tests we can do would not qualify as standard of care.”
“And as I have already told Jama, I’m not too concerned about—” He winced again.
Ruth looked at the chart the aide had brought in. “Ted, you have every right to go to whomever you please for your medical care, and we would be thrilled to have you as our patient as soon as we’re open for business.”
“Thank you. That’s what I intend to do.”
“I understand that you mean to wait until Jama is able to take your case, but that wouldn’t be wise.”
“I’ll take responsibility for that.”
“Consider our position here,” Ruth said. “The future of this clinic depends on a strong flow of new patients. For that to happen, we need to keep a flawless reputation. How do you think our clinic’s reputation would fare if we tried to treat you today, and something went wrong? Or if we sent you away without treatment, and you grew worse?”
“I would never blame this clinic for anything.”
“If there is truly something wrong with you—and it appears that there may be—then that may no longer be up to you.”
He studied her for a moment. “Nobody in my family would dream of suing this clinic.”
“Symptoms suggest you could have a blood clot in a lung,” Ruth stated flatly. “Left untreated, that could be fatal.”
Jama bit her tongue. Those symptoms could mean anything at this point. These were scare tactics, pure and simple.
Ruth continued. “Word would get out about it. People don’t want to go to a clinic where the patients die because the doctors misdiagnose.”
Ted frowned and looked down at his hands for a moment, then looked at Jama. “Your director’s been around the block a few times, hasn’t she? Handled a few crotchety old men.”
Jama grinned at him. She had worked with other arrogant doctors during her residencies. From what the mayor had said earlier in the day, and from Ruth’s response to her husband’s call today, it sounded as if she might be going through a divorce. Jama might be hard to get along with, herself, under the same circumstances.
Of course, she was dealing with comparable circumstances—actually, even worse circumstances. So maybe she was overly sensitive today, as well.
Give it a better try, Jama.
“I’ve got a lot of pride in this town,” Ted said. “And we can’t have something going wrong for this clinic before it even gets up and running. So I guess I’d better do what the doctor orders,” Ted said.
Jama felt a rush of relief, though she wasn’t ready to thank Ruth for bursting in and commandeering the patient. “Your family doctor is Stewart in Fulton, isn’t he?”
Ted nodded.
“I’ll call him and let him know you’re on your way to the E.R.”
Jama walked beside Ted’s wheelchair out the door, hugged him goodbye and returned to her own office. She would call Ted’s physician, and give her erratic emotions time to settle before facing Ruth.
How she missed her old relationship with Tyrell at times like these. In the past few months, she’d become accustomed to calling him to talk about whatever was on her mind. He’d always listened.
Why had he gone and blown it all by asking her to marry him?