Page 42 of The Devil You Know
“Ben, I’m going to be late for work.”
He rubs his eyes again. “I don’t know what to tell you. Either give me five minutes to shower or shovel the snow yourself.” He raises his eyebrows at me. “You can shovel yourself, you know.”
“Great,” I say. “Thanks a bunch.”
“Jane…”
I storm out of the bedroom. Leah is at least waiting downstairs with her coat on, which is a bit of a miracle. I go to the garage door and press the button to open it, to check out the damage.
It’s worse than I thought. The plow cleared about three quarters of our driveway, but there’s still several feet of thick white snow between my car and freedom. It’s got to be shoveled.
I pick up the shovel and start in on the snow. Even before I’ve shoveled two loads of snow, I can feel the callouses forming on my palm. I should probably go put on some gloves, but I’m running late and I’m too pissed off to stop. Every time my shovel digs into the fresh white powder, I feel a new surge of resentment toward my husband.
After fifteen minutes, I’ve mostly cleared it all away. By this point, every muscle in my upper body is aching. Ifeel like I’ve just run a marathon entirely using my arms. This probably indicates that I’m not in very good shape.
I look back at the entrance to the garage. Ben never came to help me. Not that I’m even surprised.
_____
John Singer is sick. He’s really sick.
He’s only fifty-five years old, but he’s already got diabetes, heart failure, and atrial fibrillation. He’s had two heart attacks. His kidneys have failed and he’s been on dialysis for three years. And last year, he had his right leg amputated due to a diabetic foot ulcer that got infected.
Like I said—really sick.
I’ve never seen Mr. Singer before, but I’m going to be taking over his primary care from now on from another physician who left the VA. If you didn’t tell me that he was fifty-five, I would have guessed seventy-five. He limps into the examining room using a cane to support himself, with his wife at his side.
I wonder if she knows that the five-year mortality rate after an amputation due to diabetes is about fifty percent.
The only good news is that I see from his social history that three years ago, he quit smoking. So he’s got that going for him. Better late than never.
“There’s a mistake in your records, I think,” I tell Mr. Singer. “It says that you started smoking four years ago. I’m assuming that’sfortyyears ago, right?”
Mr. Singer shakes his heavily lined face. “No, four years is right.”
I frown. The fact that the blood vessels are obviously shot in Mr. Singer’s legs and kidneys means that the ones going to his brain probably aren’t looking too good either.
“That can’t be right,” I explain slowly. “That would mean you started smoking when you were in your fifties.”
“That’s right,” Mrs. Singer pipes up. “Smoking was just something that he always wanted to start doing. But he had to quit when he started dialysis.”
I guess at the point that he was being dialyzed three times a week, he realized that he wasn’t going to be able to live out his lifelong dream of being a smoker.
After I finish up with Mr. Singer, I emerge from the examining room to find Dr. Kirschstein waiting for me with a stern expression on his face. He has his hands shoved deep into the pockets of his white coat and all the lines on his face have deepened.
“Dr. McGill,” he says in a grave voice. “I must talk to you about your note on a patient named Richard Connor.” His frown deepens. “You left acriticalpiece of information off your note.”
My heart speeds up. Oh my God… what did I do? I search my brain, trying to remember this patient. Richard Connor… did he come in for… a diabetes check? Hypertension? Back pain? What the hell was he here for? The name sounds familiar but I genuinely can’t remember. “I… I did?”
He nods. “Richard Connor was aColonelin the army! A Colonel, Dr. McGill! That’s the highest rank before General. And you didn’t mention that in your note!”
“Oh.” My heart slows. “Sorry.”
“Colonels command abrigade, you know,” he says. “I had to addend your note with this information.”
“Sorry,” I say again. And because Dr. Kirschstein is still staring at me, I add, “I won’t do it again.”
He nods. “We’re having a staff meeting now. I’ve ordered deli sandwiches. Would you go downstairs to the cafeteria to get plates and napkins?”
