Ahha, the plot is expanded here as the troubles multiply.

Chapter Eight

Wednesday 7:30 a.m.

            Across the street from Jackson Spring’s Medical Center sat the medical building, which housed the offices of most of the staff physicians.  Dr. Baker sat at his desk staring out the window.  His rooms were on the fourth floor and faced the medical center.  Gazing at it now, he had decided that over the last twenty-five years of his affiliation with the hospital, it had deteriorated.  Although he found that to be a normal phenomenon of aging, he was discouraged by the neighborhood he could see on the fringes of the hospital.

 The residential area had deteriorated at a more rapid rate, not having enjoyed the same amount of upkeep the hospital had.  The neighborhood in fact the entire north side of town was decaying.  It was sad.  Dr. Baker paralleled this to his once lucrative ob-gyn practice.  That’s not to say that he was not as busy.  He was just making less money than he had.  Even though he had raised his fees over the years as all his colleagues had, his increasing accumulation of more Medicaid and nonpaying patients had bit into his cash flow.  Those were the facts as stated by his accountant in the report he held in front of him.  He shook his head and set the letter aside not wanting it to upset him any further then it had so early in the day.

Turning his attention to his appointment book, he saw the day packed to the brim with patients.  He felt reassured that he must be doing a good job despite what his accountant had to say.  Again, he shook his head reflecting back to his financial report.  He considered letting one of his office girls go.  The others would have to do a little more work.

Barb, an RN, in his employ for the last twenty five years could see to it.  She was good at smoothing over ruffled feathers.  It would just have to be explained and made all right.  Stomach acid started to churn and began to burn as he contemplated the business side of running a private practice that his medical training had not prepared him for. 

His mind drifted back to yesterday morning in the operating room where he had performed a vaginal hysterectomy and a D and C before office hours started.  His first love was surgery.  With the monitors steadily beeping out the rate of the patient’s heart he had his own rhythm going of clamping, cutting, and tying off bleeders and probing ever deeper into the woman.  He was on a mission to rid the patient of her diseased organ and return her to perfect health.  He was omnipotent. 

Dr. Baker startled at the knock on the door recalling him to the present.  “Yes?”

“Dr. Baker, we’ve got them lined up already.”  Barb said as she leaned into the office trying to convey her need for him to hurry without actually saying the words.  Dr. Baker didn’t like to be told to put a rush on.  It irritated him.  He started toward the door to Barb’s satisfaction.

Barb stuffed her pencil in her gray hair and looked through her half moon glasses at the schedule.  She proceeded down the hall humming.  It was just another wonderful day at work.  She didn’t think of what she did as work because it was so second nature to her.   Barb thought of Dr. Baker’s office as a second home.  Sometimes she spent more time with her employer then she did her husband.  Taking care of Dr. Baker was so much like taking care of her husband.

Thirteen patients into his day later, he was interrupted in his flow of examinations by Barb regarding Mrs. Roark.  He had performed a vaginal hysterectomy on her yesterday morning.  The nursing unit had called to inform him that the woman was complaining, no crying about a pain in her left side.  The pain medication to remind him was Demerol 75 mg. IM.  Her vital signs were blood pressure 154/86, temperature 99, pulse 102, and respirations 24.  Did he want to increase her pain medication?  Or did he want to order her a medication pump? 

Dr. Baker digested the information for a minute.  Respirations were a little fast.  The blood pressure was up some probably due to the pain.  He didn’t like the patient controlled drug pumps because he wanted the nurse to have to see his patient such as when she needed a shot for pain.

“Yes, of course, increase the Demerol to 100 mg every three to four hours as needed for the pain.  No, she may not have a patient pump but they may give her an extra 25 mg. now and that should do it.”

“And doctor, while I have you your next patient is a new one and rather nervous.  She just recently moved into the area.  She came in for a routine exam and requested a pregnancy test.  It is positive but she has not been told.  She’s relying on us to take care of her and her next baby.”  Barb smiled.

“Well, I’ll just give her the exciting news.  Barb, which room is she in?”

“Number one and she’s all ready for you.”

“Thanks.”  Dr. Baker mumbled as he headed in the direction of the exam room and Barb went her own way.  Barb thought of Dr. Baker as she walked away.  She remembered the warm brown eyes below the now gray streaked brown hair.  His eyes were what drew you to him.  They were deep dark pools of warmth that had a calming effect on a woman in crisis.

Down the hall Dr. Baker knocked on the door of exam room one as a courtesy and entered when the woman answered yes.  He greeted Mrs. Phillips who was already undressed and on the table with his med tech, Jenny, standing by.  He introduced himself and explained his intent to examine her and then speak to her in his office.  The patient nodded her assent.  The only other words were spoken by Dr. Baker in order to fine tune her position in the stirrups.

Dr. Baker performed his exam.  The vagina was a purple-blue shade instead of its usual pink.  The ends of the cervical opening were turned up giving the appearance of a smile.  Mrs. Phillips’ uterus was happy and she was pregnant.  All the signs were there.

“You may get dressed and I will see you in my office.  After you are dressed open the door a crack.  My nurse, Barb, will know you ready and show you the way.”

Janet Phillips nodded her assent.  Dr. Baker left placing the chart in the receptacle by the door backward signifying to Barb he was done with his exam.

Dr. Baker picked up the chart outside room two and scanned the patient label on front.  Terri Shultz.  He had delivered Terri personally into this world.  To find her now fifteen, pregnant and an epileptic was dismaying. 

When Terri had shown up in the office two days ago pregnant, Dr. Baker had looked up her mother’s file.  Both the history of the pregnancy and the delivery had been normal.  Nothing out of the ordinary had occurred.   Birth trauma could cause epilepsy and Terri was epileptic.  He didn’t know how he could be blamed but he felt at fault.  The children he delivered got the best care and as a whole they had fewer birth problems.  

Terri Shultz.  She had felt strongly on her first visit that they spell her first name correctly.  Emphatic she wanted it spelled with an i at the end not the traditional y.  Dr. Baker sneered.  Here she was a fifteen-year-old unwed mother and the only thing she had been certain about was how she wanted her name spelled.

He tried to keep most of his judgments to himself when dealing with pregnant teenagers because he knew the last thing they needed was another adult telling them what they thought.  Dr. Baker tried to help the girls search through their options for the one that was right for them.  Then when the decision was made no matter what it was he continued to support them as much as he could.  Of course, he didn’t perform abortions and personally was against them but if that was the girl’s decision he made sure she was referred to the right agency.

Terri had not made a decision.  Denying her pregnancy, she was letting time make the decision for her.  That was two days ago with both her parents present.  Terri’s mom pushed for adoption.  The father was just pushy and wanted to blame everyone else in his anger.  Dr. Baker felt like it had been dumped in his lap, and he was not fond of the situation.

Dr. Baker opened the chart.  Terri had miscarried this morning.  Yes, he had given her the free vitamins and on top of that had given her the “booster,” also.  What more could be expected from him anyway?

Inside room two, Terri Schultz waited for Dr. Baker.  The waiting gave her time to think and she didn’t need that.  The tears streamed down her face again.  She had lost her baby.  Unhappy when she was pregnant she was even unhappier to have lost her child.  She had gotten used to the idea of having a baby and was beginning to enjoy the thought of being a mother no matter what others said.  At the thought of having lost her child, she bit back a fresh assault of tears.

Dr. Baker entered and recognized from the pinched expression on Terri’s face that she was drying off tears and trying not to continue to cry.  Dr. Baker put his hand on Terri’s shoulder. 

 “Now Terri, don’t cry.  Let’s see what’s going on first.”  Dr. Baker planted himself on the stool and rolled into the position to exam her.  He surmised that the baby was gone but she was still bleeding.  She would have to have a dilatation and curettage to clean up the uterus and stop the bleeding.  Finished, he addressed Terri.  “You may get dressed and I will be right back in.  Is your mother here today with you?”

Terri shook her head yes.

“I’ll have Barb get her and bring her back here.  I need to speak to both of you.”

Terri started to get into her clothes.  She wondered what the baby she had carried could have been.  Maybe it took losing this child to make her realize just how precious a life was?  She knew she didn’t want to go through this situation again for a long time.

Dr. Baker found Barb on his way back to his office and sent her to find Mrs. Shultz.  Having a few moments to himself he sat at his desk trying to sort out his feelings.

  He was relieved Terri had lost her baby and that disturbed him.  He had spent his adult life trying to preserve life at its highest quality.  To lose a life before it even had a chance was tragic.

He swung his chair to his right to face his bookshelves which covered the wall.  His eyes rested on the second shelf of the middle section which contained decorative samples of medicine capsules in clear glass containers of various shapes.  Actually the shelf held very little in the way of drugs except for the extreme corner which held three dark brown light resistant containers of prenatal vitamins and what he liked to think of as a “vitamin booster”.  These weren’t to be confused with the containers on the shelf above that held only prenatal vitamins without the additive.

Dr. Baker saved the vitamin boosters for his pregnant teenagers to help them with some of their extra nutritional demands.  He had very few answers to all the problems a pregnant teenager had, except these vitamin boosters.  These children faced with overwhelming difficulties when forced to deal with a child of their own.  It was ludicrous.  Of course, they needed an extra boost so to speak.

He got up from his desk and stood in front of the shelf.  He picked up one of the bottles and went back to his desk.  Sitting down he opened the container, eyeing the five light green tablets on top of the larger vitamins.

Dr. Baker thought back about seven months ago to the first time he had given the pills out.  Carol Turner, a nineteen-year-old teenage mother-to-be.  He hadn’t seen the result of his booster pills yet because she wasn’t due to deliver yet.  He had given the mother only three tablets because he was worried about the extreme potency of the drug.

With further use, his comfort level had gone up, and he gave 5 tablets out to a patient now.  It hadn’t seemed to have hurt Carol any nor had it seemed to Terri either even though she had lost her baby.  He had tried it on one other teenager, Karen McGuire, who had not delivered yet.  He hadn’t been able to resist trying it on Terri, only the best for one of his own giving her a chance to attain her happiness.

Dr. Baker returned the bottle of vitamins to the shelf away from the other unmixed containers of vitamins that sat on the first shelf.  He did the same with several other bottles.  Satisfied he left to return to room two to deal with the conclusion of Terri’s pregnancy.

Janet Phillip’s anxiety did not improve with getting dressed.  Opening the door a crack as instructed, she sat back down on the exam table.  She hoped she wouldn’t have to wait long, but in a doctor’s office that was futile thinking.  Taking deep breaths to calm herself, she recalled her other two pregnancies which had been so pleasant.  With this one, every little thing upset her.  It seemed so different from the other ones.  Maybe just her hoping it would be all right had put a hex on this baby.

Janet was surprised when in a few minutes the nurse returned and showed her into the doctor’s office.  Were they trying to rush her through?

Dr. Baker entered the office smiling.  “Well, hello again.”  He sat on the edge of the desk in front of Janet and picked up her chart.

“Mrs. Phillips from all appearances you are pregnant.  Congratulations.”

Janet burst into tears.  Dr. Baker was confused by Janet’s response figuring that this married woman with two children would be happy.  Evidently, he was wrong.  It made him pause in his thinking.

“Now, Mrs. Phillips, there’s no reason to be upset.  Everything looks fine and there is nothing to indicate that you won’t have a perfectly healthy baby just like your other two.”

“Oh…Dr. Baker, I’m sorry.  Janet sniffled and continued.  “I didn’t mean to cry.  It’s just that Ken, my husband, was just transferred here and money is so tight.  For a minute I could only think about the strain this is going to put on us.”

“Mrs. Phillips, may I call you Janet?”  She nodded her head affirmatively as Dr. Baker walked around his desk and sat down trying to put distance between himself and the distraught woman.  “As I was saying, I’m sure everything will be fine.  In fact I have some samples of prenatal vitamins I will give you so you won’t have that extra expense right now.”  Reaching with his right hand, he took a bottle of vitamins off the first shelf.  Glancing at them, he reassured himself that they were the right ones and handed them to Janet. 

“There you go.  And as for my fee don’t worry.  Stop at the desk and talk to the girls about it.  Arrangements can be made.  There’s just no reason to worry.  You just concentrate on having a healthy baby and we’ll take good care of you.”

Janet heard the dismissal in his voice and got up from her chair.  She was embarrassed and his patronizing tone deepened the feeling.  “Thank you, Dr. Baker,” Janet replied as she picked up the vitamins.  “You’ve been very kind and I’m sorry about the crying.”

Muttering more to herself than to Dr. Baker she said, “I just want a healthy baby.”  Janet thinking as she hurried out of the office eager to get away.  He must think I’m crazy with the way I acted.  She dismissed the thought as she got into the car and headed home in relief.