Brainstorm. Sheldon J.D. Cohen

or it might have already passed into your bladder. I’ll come back soon to check on you, and if everything’s okay you can go home.”

      “Okay, I’ll wait,” he said, “but I’ve got too much work to stay in a hospital.”

      Pollard conceded that it was better to let this patient have his way, since he was agitated and his symptoms might be letting up.

      Patient volume was already picking up. In the next room was a frightened ten-year-old boy with a lacerated hand. Pollard placed four sutures, administered a tetanus injection, dressed the wound and gave the mother verbal and written instructions before sending him home.

      When he returned to check on George, he knew his patient’s pain had probably passed. He was pacing back and forth.

      “Feeling better?”

      “Yeah.”

      “What about the pain?”

      “It’s gone. I can go home now.”

      “Your pain was five. What about now?”

      “It’s ZERO.”

      Pollard sighed knowing that George’s emphasis on the score was his way of insisting on going home. He told his anxious patient, “Look I’m ninety five percent sure it’s a kidney stone. Everything points to it. An X-ray could clinch the diagnosis. Sometimes the pain leaves and that could be temporary or permanent, but we can never be certain what will happen.”

      “Can I take some medicine and take my chances at home?”

      Pollard sensed his question inferred an ultimatum.

      “Do you have a family doctor?”

      “No, said George, forgetting or failing to mention Dr. Crowell.”

      “All right, Mr. Gilmer. We can let you go since you are feeling better. Understand, this means you might have passed the stone into your bladder or are just having some temporary relief. If the pain returns, come right back. In the meantime I’ll give you the names of the doctor on call to follow up with.”

      “Sure thing, doc.”

      “Take these pieces of gauze,” offered Pollard. “Urinate through it like before so if you pass the stone out of your body you will catch it on the gauze. If that happens, take it to the doctor so that so that he or she can have it analyzed. Now, before you leave I would like to get an X-ray and some blood tests. The X-ray may help us pinpoint the stone’s location, and the blood tests may help us determine why you developed the stones in the first place. People develop stones for many reasons, including rare ones, and if you do have a stone, you have to find out why, and that takes tests.”

      “Thanks, but I’ll see the doctor you give me and get them then.”

      George’s response came as no surprise. He never stopped pacing the examination room, nor did he stop staring at the wall long enough to make eye contact with Pollard. He left as soon as he received written instructions, test requisition slips, and the name and phone number of the on-call doctor

      Pollard watched as the patient walked away. Moments later, he heard his name called by one of the nurses.

      “Dr. Pollard, we’re receiving a telemetry strip from the field. It looks like the paramedics are bringing in a sixty-one-year-old man with a possible acute myocardial infarction. Also there is a very serious ventricular arrhythmia.”

      The pace was picking up. Things were getting back to normal in the Emergency Department.

      CHAPTER 12

      George rushed out of the Emergency Department. He felt uncomfortable in a medical environment and wanted to end the experience as fast as possible. No doubt, he probably had a kidney stone. That first episode at Fred’s house was all too similar. Two kidney stones were double bad luck. How could anyone tolerate such pain if the stone was stuck for days? Maybe, thought George, he should get those damn tests done.

      Gail was waiting at the kitchen table when he got home. She glanced up from her coffee and felt reassured. By his calm expression, she was certain he was pain free.

      “What happened?” she asked.

      “The doctor said I had a kidney stone. Lucky for me, though, they didn’t have to do anything. The pain is gone.”

      “A kidney stone? What the heck…”

      “Yeah.”

      “Hmm. I can tell that you feel better. I called your work today and spoke to the foreman. It’s Andy Simpson, right?” He nodded. “I told him that you went to the hospital because of the pain.”

      He looked relieved. “Yeah, good idea.”

      “It wasn’t my idea. You told me to do it.”

      “I did?” he said, looking startled.

      “Don’t you remember?”

      For several uncomfortable moments, he stared back at her with a blank expression.

      “Must have forgotten,” he mumbled. “That pain was all I could think about.”

      “You’ve been forgetting a lot. When are you going to realize you’re not yourself? I don’t know who you are anymore. Look at what’s happening to you. Stomach pains, kidney stones, forgetfulness, you’re angry all the time; you’re even fighting with people. Please! Take those tests that Dr. Crowell ordered. I can’t understand why you don’t do it.”

      He felt backed into a corner. “You’re right. I’ll go, but now I’m going to work.”

      “Work? When I spoke to Andy, he figured you wouldn’t be back today.”

      “I got lots of work. Gotta go now.” He brushed her cheek with a quick kiss and dashed out the door. She watched him leave, thinking he appeared calmer than earlier. She considered speaking with Dr. Crowell since George did not get angry when she approached the subject of his following through with the prescribed tests.

      Andy looked up with surprise when George walked in. “Your wife called and said you went to the hospital. We didn’t expect you today. Everything okay?”

      “Yeah. I’m okay. The doctor thinks I passed a kidney stone.”

      “Man, that hurts.” Having had a kidney stone himself, Andy knew.

      “Worse pain I ever had.”

      “Sure you’re okay?” said Andy.

      “Sure. I’m fine.”

      “Why not work on the lighter stuff today?” suggested Andy. “Take care of the trim, and let the other guys do the rest.”

      “No, no. I don’t have any more pain and can do my regular work. In fact, when I finish today’s work, I’ll start the trim.”

      Andy eyed him with suspicion, but kept quiet. George knew Andy was watching him and he went to great lengths to avoid Andy and his coworkers. Not only had his relationship with coworkers changed, but also everyone was on guard not to provoke him.

      He felt anxious even though he was not suffering recurrent pain. He would be involved with some task and then suddenly forget what he was doing and how he got there. Such confusion compounded his anxiety. During periods of clarity, he recognized his faulty thinking, but at other times, he reverted to paranoia.

      CHAPTER 13

      Meanwhile, Gail was busy researching the subject of brain tumors. She got good news and bad news. The good news was that George did not complain of headaches, a major symptom. Yet he did have an episode of vomiting, which could also be symptomatic of a brain tumor. Still, she suspected his ulcer might have triggered the vomiting. Her paramount concern was his mental change, an initial symptom in twenty five percent of all brain tumor cases. The findings included personality changes, confusion, disorientation, behavior changes,