Page 14 of Deprived No More

“Thanks, Ava. I’m pretty lucky.” I need to remember this conversation the next time I’m cockblocked by one of the kids.

“Your first patient of the day is an add-on. I’m happy to see him around my scheduled patients, but from what I can gather, you’ll probably need to be involved at some point.”

“Why? What’s their story?”

He was referred by the ER for a fracture of his hand. “The details are a little sketchy. I pulled up the pictures, and it looks like it’ll probably need surgical repair.”

“Where’s the sketchy part come in?”

“He injured it several weeks ago but only went to the emergency room yesterday. From reading that note, it sounds a little off. I’d review it before you meet him to see if the story changes. I guess ultimately it doesn’t matter how it happened, just that it needs to be repaired.”

“You’re right. We don’t have to deal with as much of that drama as the ER does. But I’ll take a peek at it.”

As Ava walks away, I open my computer to pull up the patient in question and review his films and his recent ER visit. I have to admit my curiosity is piqued. Thomas Browning is a thirty-one-year-old male who claims to have been in a car accident two weeks ago, injuring his right hand. It doesn’t appear he has insurance, so perhaps this was what delayed his seeking out care. The office will usually set up a payment plan with uninsured patients, but based on these x-rays, he’ll likely need this fracture set with a pin to keep the bones from moving as it heals. While it can often be performed without general anesthesia, the procedure is still costly.

“Nick, your first patient is in exam room three,” our receptionist, Joanie, greets from the doorway.

“Thanks. I’ll be right there.”

“Oh, good morning, Holden. I heard you had to start your day at the crack of dawn in the OR.” I overhear as Joanie walks away from my office. “Can I get you a cup of coffee?” I have to stop my eye roll. When’s the last time anyone offered me a cup of coffee?

“I’m good, Joanie. Thank you. I grabbed one downstairs.”

“Well, your first patient of the day should be here in about thirty minutes. You finished up this morning faster than I expected.”

’Cause he’s super surgeon. Just ask him.

“I’ll be in my office trying to catch up on notes if you need me.”

I step into the hallway just as I see him close his door. Shaking my head in irritation at the newest addition to our staff, I rap on the door of exam room three and step inside.

“Hi, Mr. Browning. I’m Nick Barnes. It’s nice to meet you,” I greet with an outstretched arm. Realizing it’s probably his dominant hand he has injured when he doesn’t attempt to return the salutation, I drop my hand by my side and proceed. “What brings you in today?”

“I was in a car accident a few weeks ago, and my hand has gotten worse.”

Looking down, I find his hand resembles a baseball mitt. It’s swollen and looks terribly painful. “Could you tell me a little more about the accident? What do you think you struck with your hand? The dash?”

“I think so. It all happened so fast. Their car was going about fifty miles per hour when they hit us. All the airbags went off. They plowed right into the front of the car.”

“Wow. It sounds like things could’ve been a lot worse than just your hand. Were you evaluated on scene by EMS after such a serious accident?”

“Nah. I had to jump and run. People were shooting at me and shit.”

There’s no point trying to mask my expression. Ava was on the money that this sounded sketchy, but I wasn’t expecting this sharp turn. “Were you hurt anywhere else?”

“No. My back is sore, but this hand just hasn’t gotten better. I can barely move it.”

Reaching over, he winces as I assess him. He has good blood flow and sensation. There are no wounds noted on the hand. “Can you make a fist?” I ask.

“Not really.”

“Well, as you know, this bone here is broken and really needs to be fixed in the OR,” I say pointing to the base of his second finger. “Do you mind my asking why you waited so long to come to the emergency room to have it evaluated?” This has to have hurt more than a bruise. I can’t fathom he didn’t consider it could’ve been broken. However, it dawns on me that with people shooting at him, there may have been illegal activity surrounding this. He may not have wanted to risk checking in to an ER and being caught.

“I guess I just hoped it’d get better on its own. I don’t have any insurance. Someone told me the driver’s insurance might cover it, but I don’t know the guy.”

“The police can usually give you information on the other vehicle to try and get their insurance details.”

“No, I meant the guy driving the car I was in.” Again, I stand with a blank expression. How does he not know who was driving the car he was in? “Doesn’t matter. I can barely afford the pain pills the ER gave me, much less surgery.”

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