The Queen of Hearts(78)

“Excellent!” roared Dr. Elsdon, his wild hair electrified. “Now give me the causes of elevated gap acidosis.”

I let my mind drift as Emma dutifully began reciting the mnemonic MUDPILES, resolving the next chance I got, I’d confront her to get some help. Nobody could endure such a loss without support.

Dr. Elsdon was winding down with no noticeable dimming of his fervor, despite his having given this particular lecture dozens of times before. Well, obviously some things just stir the human heart. The students might have been slow to realize the inherent beauty of acid-base disorders in the beginning, but now everyone was swept away with passion. Toxic alcohols! Respiratory alkalosis! This was exciting stuff!

At eight o’clock, Emma nodded at me and headed home to sleep for the day. I waited until she was gone and waylaid Dr. Elsdon as he packed up his lecture materials.

“Zadie,” I began, pointing at myself in case he didn’t remember my name.

“Bernard,” he said, pointing at himself. “Glad we got that straightened out.”

“Sorry to bother you, ah, Dr. Elsdon, but I was wondering something.” I collected my thoughts. “If you thought a person might need medicine for, ah, sadness, would you bring them to the ER?”

His expression changed. “Do we think this person might be having a reaction to a recent tragedy?”

“Yes! A grief reaction.”

“Are you— Does this person have any thoughts of harming themselves?”

“Oh! It’s not me,” I said. “I’m asking for a friend.”

He waited, his face kind. Then he nodded, extracting a small piece of paper from his pocket. He scribbled something on it. “Okay,” he said. “Take her to Dr. Butler today. She’s our best staff psychiatrist, and she sees students through the clinic. She’ll help your friend.”

—

I trotted out to the ED main desk and signed myself in, then grabbed the first chart in my section. Today I was paired with a third-year resident I didn’t know named Dr. Alanna Tamara, who went by the nickname Sensei. Apparently she was really good at martial arts of some kind. I looked around but didn’t see anyone who could possibly be Dr. Tamara, so I scooted toward room 35, reading the triage sheet as I went.

The patient’s name was Jack Dmitriy-Rau and he had ankle pain. This sounded boring, but easy enough. Today I was going to be a model of efficiency; I was not going to allow myself to be bogged down in inane conversation. Starting right now, with Mr. Dmitriy-Rau.

I tapped on the door and entered. Mr. Dmitriy-Rau, a portly gentleman sporting a relaxed expression, was sitting fully dressed in a business suit. The patients were all given a gown and asked to disrobe when they were brought back to the exam rooms, but many of them misunderstood or ignored these instructions, leading to a bottleneck as the day progressed. In Mr. Dmitriy-Rau’s case, however, fully undressing in the chilly exam room did seem superfluous for an ankle injury.

After introductions, he stood and extended a lavish hand to me, launching unbidden into a thorough account of his day.

“. . . And then after the breakfast, which was a bit heavy, to be true—I am the early riser, yes, but I do not often care for the full breakfast. But my wife, she like to cook, so sometimes I have quite more than I mean. So. I must be more careful in future with my figure, you can see”—here he rubbed his ample belly—“but is done with love, so how can I refuse?”

I politely attempted to bring the train back to the station. “It sounds delicious. How did you hurt your ankle?”

“Well. I take my time with the breakfast, proper compliment to the chef, so, and then we have the full tea. Also I watch the early-morning newscast. To see the weather, the traffic, you know. But this often lead to the argument. My wife, she does not like news, until Today Show. She like the man newscaster there.” He chuckled. “Maybe she like him little too much.”

“Is that when you sprained your—”

“No, no. That come later. First, she make me stay until the Today Show start. So. Also have more of the tea.” He gestured expansively. “Why not? By now is too late for the moderation, so may as well enjoy. Right?”

“Right, but—”

“Yes, so, and then dog start to bark. We have little dog, ‘yap, yap, yap’ all the time, yap-yap, is enough to drive you crazy. Yap, yap. I say if you are going to have the dog, why not have the more man dog? This dog, it sound like the little bird.”

“Did you—”

“Yap-yap-yap-yap. I cannot stand it. Finally, I say I must go to work. And my wife say, ‘Wait. You must walk dog.’ I do not wish to walk dog. I do not even like dog, now the yap-yap is going to make me late for work? Intolerable. But she is very strong personality, my wife.”

I abandoned politeness. “Mr. Dmitriy-Rau, where are you hurt?”

“This I am getting to. Yap, yap. The leash we have misplaced. Everywhere we look; all the while, yap, yap. Enough to make you tear out the hair. Or maybe you give the very small nudge.”

“Nudge?”

“With the foot. Certainly not a . . . injury nudge.”

“You have no injury?”

“Certainly I have the injury. I am telling you it now.”

Desperately: “Yes, but what is the injury?”

“Well, so. The dog, he is fine. I do not harm him. Smallest nudge only, with little bit of the foot.” Mr. Dmitriy-Rau nodded in agreement with himself.