Julio – The Growing Years

 by: Miguel Sanchez

© 2006-2008 by the author

The author retains all rights. No reproductions are allowed without the author's consent. Comments are appreciated at...

I saw Billy’s demeanor change to one of outrage. He was about to speak when another voice was heard. “Dr. McFadden, don’t you have patients to see?”

The young doctor turned to look where the voice came from. “Yes Dr. Belote but I’m trying to tell this old man here that this area is for Duke University Medical Staff only.”

While the young doctor’s back was turned, Bill hung his ID from his jacket pocket. “What old man Doctor?” 

Chapter 59

He turned around and looked at Billy. “Uh,”

“You were saying Doctor?”

The young doctor seemed to have lost his tongue because he just started stammering. “Uh, well I uh.”

Billy stepped forward. “Young man, is this how you talk to everyone you come into contact with?”

The young doctor hung his head. “No sir.”

Billy lifted Dr. McFadden’s head up with his finger so he could look him in the eyes. “So what possessed you to speak to me and my guests like that?”

The doctor shook his head. “I don’t know.”

Billy didn’t accept that answer. “That’s crap and you know it. You thought you’d act like a bad ass.”

I’d never seen Billy this mad before but he had a right to be. Dr. McFadden looked at Dr. Belote but he just shook his head. “No sir it wasn’t like that at all.”

“It wasn’t?” Billy asked, raising his voice. “You were rude and I won’t have any staff member act like that. I see you’re a 1^st year resident.”

“Yeah I am,” Dr, McFadden said quietly.

Billy got into his face. “Yeah, did I just hear you say yeah to me?”

I thought the young doctor was going to pass out. “I, I, I no sir. I mean, yes sir, I’m a 1^st year resident.”

Billy nodded his head. “What’s your specialty?”

“I’m looking to go into Internal Medicine.”

Billy started wagging his finger. “I’m putting you on notice Dr. McFadden, if you EVER talk to anyone like you did to me, you’ll be suspended. Do I make myself clear?”

Dr. McFadden swallowed hard. “Yes sir, it won’t happen again.”

“Good,” Billy said as a nurse came back up.

“Dr. Shields, the woman and her son are in a pediatric room and I’ve paged the on call pediatrician but he’s not called back yet. She’s also raising hell about no one seeing her sick child.”

Billy looked at me. “Miguel, can you do me a favor?”

I smiled. “Sure Billy but I don’t have privileges here.”

He nodded his head. “That’s not a problem; we’ll get that taken care of. Will you see him?”

I nodded my head. “Sure Billy, but let me make a phone call first.”

Billy nodded his head. “Sure Miguel, you can use that phone over there; dial 9 to get an outside line.

I called the boys and told them Jay and I were going to be a little later than we anticipated. They didn’t seem too upset by the news. “Nurse will you show me what room he’s in?”

The nurse started to lead me down a short hall. “I’m Francis Kramer Dr. Sanchez.”

Just then Billy got my attention. “Take Jay with you, this could be a learning experience for him.”

We waited while Jay caught up with us. “Are you sure about this Dad?”

I smiled as I nodded my head. “Why not son, you should never pass up any chance at learning.”

We stopped outside the door and I took the chart out and started reading it. I went to look at the vital signs and there was nothing. I looked up at the nurse. “Was the child seen in triage?”

The nurse shook her head. “I tried to get her to being him into the cubicle but she kept running her mouth.”

I nodded my head then opened the door. As soon as the nurse stepped in the barrage started. “Well it’s about damn time and what the hell are you doing back here. I’s said I’s wants to see a Doctor.”

I could see the exasperation on the nurse’s face. “This is Dr. Sanchez.”

I extended my hand out to her. “Why was I…?”

I interrupted her. “Ma’am this is an Emergency Room.”

She started running off at the mouth again. “I know damn well what this place is and my son is sick yet I’s was made to wait.”

I set the file down and went over to the child. “People are taken back on the nature of their illness or injury. The most severe cases come first and others just have to wait.”

I started to remove the boy’s shirt and put my hand against his chest. As he breathed I felt what seemed to be congestion. “Well my child is sick mister.”

I stopped what I was doing then picked the boy up and handed his to the nurse. “Take him over to triage and get me his vitals then get me a PA and Lateral chest x-ray.”

The woman started yelling again as I wrote my orders. “What the hell are you doing? My child is sick and I want him seen now.”

I could see Jay itching to say something but my looks kept him calm. “Ma’am, I need some information and had you done what the nurse had asked, I’d have it. Now, how long has he been sick?”

She just stood there not saying a word now. Jay slammed his hand on the exam table. “Lady what’s with you? You come in here raising hell about your son then when my Dad tries to help you, you run off at the mouth or say nothing to help him.”

She started spouting off again. “Who the hell do you think you are?

I was about to step in when I heard, “Dr. Sanchez, triage STAT.”

I looked at the woman. “Stay here, I’ll be right back.”

I hurried back up to the ER and I saw Francis. “What’s going on?”

She handed me the chart and I looked at it. His temperature was 103 and respirations were labored. I walked with her to the triage room and the child was definitely having trouble breathing. I borrowed the nurse’s stethoscope and listened to his lungs. I shook my head as I handed it back to her. “How bad is it Dr. Sanchez?”

“I want a CBC along with that chest x-ray. Has the attending answered the page?”

She shook her head as she picked the child up. “Not yet doctor.”

She took the chart and child and headed to X-Ray. I saw Jay and the woman talking to Billy. I walked over and tapped Billy on the shoulder. “Have you got a minute so you can get my credentials?”

Billy turned around. “Miguel, I think you should listen to this.”

I looked at Jay and the woman. She stepped forward and hung her head. “Dr. Sanchez, I want to apologize for the way I acted. I just thought you were like that other doctor I called at the clinic.”

Jay stepped up. “Yeah Dad, she said she called several days ago and a nurse said it was probably a virus and to give him Tylenol and give him plenty to drink.”

The woman took over. “The next day I called again because Kareem wasn’t any better and I demanded to talk to a doctor. After waiting for I don’t know how long a doctor finally answered. I tried to tell him what was wrong but he said there was a bad virus going around and that was what my boy probably had.”

I stopped her at that point. “Did you try to get him in to see a doctor?”

She nodded her head. “Yeah I did, I begged and begged but the doctor said it was a virus and they didn’t have any medicine to treat it. It just had to run its course.”

He was right about a virus but he really should have seen him. “Did you get his name?”

She shook her head. “He said it very fast and I didn’t catch it, Dr. Pole or something like that.”

Billy interrupted. “That would be Dr. Simon Dole. He’s a very competent physician.”

I remembered the boy’s last name when I looked at the chart. “Ms. Douglas I know this is all hindsight but you should have taken him there.”

She nodded her head. “I guess you’re right Dr. Sanchez, looking back on things.

I smiled at her then patted her hand. “I’ve ordered some tests and a chest x-ray; we’ll get to the bottom of this for you.”

Francis was on her way to x-ray when she was stopped. “Nurse, where are you going with that child?”

She stopped and looked at the voice. “He’s going to x-ray.”

The doctor snatched the chart out of her hands and started reading it. “Like hell you are. Who’s this Dr. Sanchez?”

“He’s on…,” she started saying when the doctor interrupted her.

“I’ll not have some wet back spick writing orders for some damn nigger kid.”

Francis was shocked at the doctor’s comments but didn’t say anything. “He is on staff Dr. Dole.”

He looked up at the nurse. “I don’t give a shit if he’s the Administrator. I’m the on-call Pediatrician and my orders will be followed, is that understood?”

She couldn’t believe what she was hearing. “But Doctor, he’s.”

Dr. Dole stared at her. “Do you have a problem carrying out my orders nurse?”

She took the chart back. “No Doctor. What should I tell the mother?”

He shook his head. “Not a damn thing. Put him back in what ever room you found him and tell that nigger bitch I’ll be in there when I get time.”

“Yes Doctor,” she said softly as she turned to head back to the ER.”

The 4 of us were still talking when I saw Francis walking back into the department. She came over to our little group and I could tell she was visibly upset. “What’s wrong nurse; did he get the chest x-ray I ordered?”

She shook her head handing the boy back to his mother. “Can I see you in the staff lounge please?”

I looked at her trying to figure out what was wrong but couldn’t. “Ms. Douglas, why don’t you take Kareem back to the exam room and I’ll be right with you.”

Francis led us to the Physician’s Lounge then waited for everyone to enter. Billy looked at her and she was still upset. “Nurse Kramer, what has you so upset?”

She locked the door so we wouldn’t be interrupted then took a deep breath. “Dr. Shields, I know you like Dr. Dole so this is going to be very hard for you to believe but trust me sir, it’s the truth.”

I had a feeling I wasn’t going to like what I was about to hear. “Francis, I know you’d have no reason to lie about something this serious so just spit it out.”

She nodded her head then took another deep breath. “I was taking Kareem Douglas over to x-ray when Dr. Dole stopped me and asked where I was taking him. I told him then he grabbed the boy’s chart out from under my arm. He started reading it then made some very disparaging remarks about you Dr. Sanchez and Kareem and his mother.”

“What did he say,” Billy asked, looking a little steamed.

She closed her eyes trying to fight back tears. “He referred to Kareem and his mother as niggers and he called you a spick.”

Billy shook his head. “I’ve known Dr. Dole for a very long time. Are you sure you heard correctly?”

Francis nodded her head. “Yes sir, he used those terms several times so I’m quite sure.”

Jay was appalled. “Doctors are supposed to treat people who are ill, not based on the color of their skin.”

I nodded my head. “You’re right son and I don’t ever treat someone based on their ability to pay. That’s why I set up the free clinic at the Children’s Hospital. Where’s Kareem’s chart?”

She still had it under her arm. “Here it is Dr. Sanchez.”

I took a quick look at it and Dr. Dole had not written an order over ruling mine. I also knew that he’d never admit to making those kinds of statements at a hearing so it would end up being his word against that of a nurse. “Does someone have a small tape recorder?”

Billy smiled. “I have one in my office, why?”

I handed Francis Kareem’s chart. “I don’t think he’d admit to making racist comments at a hearing so they only way to hear them is going to be for Nurse Kramer here to get him to make them again.”

“You’re right Miguel,” Billy said unlocking the door. “Where is Dr. Dole?”

Francis shook her head. “I don’t know Dr. Shields. He said he’d see Kareem when he had time.”

Billy opened the door. “Alright, that will give us some time. Miguel, come with me and we’ll get your credentials made. You still have your North Carolina license don’t you?”

I reached into my pants pocket and took out my wallet then looked for it. I removed the card and handed it to Billy. “Yeah and I just had it renewed.”

We went outside then Billy grabbed a chit and wrote an order for a stat portable x-ray and for the CBC. “Nurse Kramer, I want you to find an x-ray tech and get the chest films done STAT. Do not page one. Once that’s done, I want you to personally draw the blood for the CBC. Jay, can you help her?”

I saw my son swallow hard. “Uh sure, I guess so.”

Billy patted Jay on the back. “You’ll be fine son. Come on Miguel; let’s get your credentials done. Nurse Kramer, We’ll be only be a few minutes.”

As we stepped out of the lounge, we saw a tech with a portable x-ray machine. Francis hurried over and talked with the man while I followed Billy to his office. On the way, we stopped in at security and Billy had them take my photograph. After that was done, our next stop was to Billy’s office. He sat down at his computer and turned it on then handed me a form to fill out. “Fill this form out Miguel.”

I quickly filled the form out then Billy entered some of the information into the computer. A couple minutes later he printed out my ID card. After attaching the photo to it, he laminated it then punched a hole in it and put a thing on it so I could hang it off my pocket. He opened his top drawer and took out his micro recorder. “Let’s go Miguel; I want to hear what Dr. Dole has to say.”

We went back to the ER and Francis was holding the lab reports. She shook her head as she handed me the paper. “His white count is elevated and the chest films show he’s full of fluid.”

I read the lab report then handed it to Billy. “It looks like the boy has pneumonia. I’ll make arrangements for him to be admitted. Nurse Kramer, I want you to have Dr. Dole paged to the ER. He didn’t write orders cancelling the chest films and lab work. Here’s my tape recorder. Put it in your pocket and see if you can get him to shoot his mouth off again.”

She went over to the phone then punched in a few numbers. “Dr. Dole, report to the ER STAT; Dr. Dole, report to the ER STAT.”

“I think Ms. Douglass and her son might be better off waiting in another room where there won’t be any chances of him seeing her. In the mean time give him some Tylenol, get Respiratory Therapy to start a breathing treatment to see if we can’t loosen up some of that congestion and get him on some humidified Oxygen.”

“Right away, Dr.” replied Francis.

I could see Billy thinking about my suggestion. “Good idea Miguel. Can you go and escort her to an empty room at the other end of the hall please then hurry back to the department. Oh, take your ID off your coat and put it in your pocket. I don’t want him knowing who you are right away.”

I did like Billy asked, and then joined him in the lounge.

Francis was looking at a chart when Dr. Dole came in. “What’s so important nurse?”

She found Kareem’s chart and handed it to him. She reached into her pocket and turned the little recorder on hoping he’d open his mouth. “You need to write an order countermanding the order Dr. Sanchez wrote on Kareem Douglas.”

He took the file and reached into his pocket for his pen. He drew lines on the order then scribbled something on the chart. “You seem like a bright nurse who knows the proper order of things don’t you?”

Francis had an idea what he was talking about so she decided to play along. “Yes Doctor, I do.”

He smiled. “Good then you know we can’t have wet backs and niggers here telling us how to run OUR business. There used to be a time when niggers knew their place but now, they think they’re just as good as us but WE know better, don’t we Nurse Kramer?”

She didn’t like where this was heading so she tried to say as little as possible. “Yes Dr. Dole, I understand completely what you’re saying.”

Billy and I left the lounge and took the long way around so we could come up from behind Dr. Dole. “I don’t know who this Dr. Sanchez thinks he is but he’ll not come in upsetting the good order of things. No sirreebob, it just won’t happen. He probably went to some third rate school down in Mexico or where ever. I’ll bet you he didn’t even go to Medical School. I’ve heard there are places where you can have someone forge diplomas. I’ll bet you that’s just what he did. What do you say Nurse Kramer?”

She didn’t want to say anything. “I don’t know Dr. Dole.”

He finished writing then handed her back the chart. “There you go nurse. No damn spick phony doctor will come in here telling me how to run MY clinic. I know them niggers get free Medicaid because they’re too busy spitting out babies at the drop of a hat. When they come in, I’ll listen to them whine and complain then tell them their kid has a virus and send them on their merry way. When they call the clinic, I bill Medicaid for an office visit.”

I looked at Billy and he was seething. “I’ll not have a doctor like that here at this hospital. He’d have us closed with the fraud he’s pulling. I’m going to have to get our legal department in and do a full audit on the clinic. Come on; let’s see what this guy has to say.”

We eased up and he was still spitting out his trash. “If that nigger comes back, just keep putting her chart at the bottom of the pile.”

“Is that how you treat all your clinic patients, Dr. Dole?” Billy asked.

Dr. Dole turned around and was obviously surprised to see Billy. “Well uh no Dr. Shields, I don’t treat all my patients like that.”

We walked around the counter and Francis handed Billy the tape recorder. “I know you just treat the black patients like that, huh?

He shook his head. “No, I don’t treat any patient like that.”

Billy held up the tape recorder and I thought Dole was going to faint. “Now I wonder what’s on this tape.”

I looked at Kareem’s chart that was lying on the desk. “Did you scribble out my orders?”

He smirked at me. “I’m the Pediatrician on call and that boy is my patient.”

Billy looked up. “This doctor saw him at my request doctor so I’d like to know what gives you the right to countermand another physician’s orders.”

Dr. Dole puffed his chest out. “I know that boy and there isn’t a damn thing wrong with him. I’ve seen him more times than you can shake a stick at.”

I looked over to Francis. “Do me a favor Nurse Kramer, call up to medical records and have them send down everything they have on Kareem Douglas. Just so you know doctor, I’m Dr. Sanchez.”

I took the tape player out of Billy’s hand and started rewinding it while he glared at Dr. Dole. “It just so happens I’ve seen the CBC on Kareem Douglas and his white count is through the roof. So, would you like to say there’s nothing wrong with him?”

Dr. Dole started getting irate. “Just who in the hell ordered that?”

Billy wasn’t going to have this discussion in the department. “I did and I’ll not have this discussion in the ER. I want you in my office now. Miguel, can you make arrangements for him to be admitted to pediatrics?”

“Now just wait a damn minute,” Dole shouted as he slammed his fist on the counter. “He’s my patient and I’m on call.”

“Not for long,” Billy said. “Now get your ass down to my office NOW. Nurse Kramer, contact the next pediatric attending and ask him to come in please while I deal with this person.”

Francis contacted another pediatric attending and she was having a hard time trying to deal with him. She covered the mouth piece. “Can you talk to Dr. Miles please? He’s not happy about giving his weekend up.”

I nodded my head as she handed me the phone. “Dr. Miles, this is Dr. Miguel Sanchez.”

“What can I do for you doctor?”

I took a deep breath and put on my best salesman’s voice. “I’m sorry to have to disturb you on your weekend off but a situation as arisen here at the hospital and we really need your assistance.”

“What’s the problem?”

‘So far so good,’ I thought.

“Well Dr. Miles,” I started but he interrupted me.

“We’re both colleagues here so call me Kevin.”

At least he didn’t hang up on me. “Kevin, we have a bit of the problem here and as I said, we really need your help. You’re the next in line on call. We have an 18 month old male with pneumonia.”

“I don’t mean to sound rude Miguel but what’s the matter with Dr. Dole or is he being righteous again?”

I had to stifle my laughter. “That’s an understatement my friend but I’m not really at liberty to go into that. The boy needs to be admitted right away. Would you take him?”

“I guess Dole’s mouth has overloaded his ass again and it’s caught up to him. Sure Miguel, I’ll take him.”

I breathed a sigh of relief. “I’ll write the admission orders and get him started on antibiotics. Thank you for taking him Kevin.”

“Glad to help Miguel. Good bye.”

I hung up the phone then wrote the admission orders on Kareem Douglas. I slid the chart over to Francis. “I can’t believe it Dr. Sanchez; you managed to talk Dr. Miles into taking a patient on his day off and get him to come in to see him.”

I just smiled then headed down to Billy’s office.

To be continued...

Posted: 07/18/08