The Promise (Thunder Point #5)(23)

Peyton enjoyed the pace of the Thunder Point clinic, especially once Devon was back managing the schedule and paperwork. It ran very smoothly. A three-person clinic with appointments spaced to give the practitioners the opportunity to handle the walk-ins, to take time for lunch and breaks, even to arrive late or leave early, was so easy on the nerves. Scott was able to spend some time at the ER or Bandon clinic, which supplemented his income. Now that Peyton was on board, that moonlighting didn’t rob him of time with his kids. They had it worked out so that the bulk of their appointments fell when both Peyton and Scott were available to see patients, and with Devon’s expertise in scheduling, they were at the clinic together at least twenty hours a week.

A couple of very low-stress weeks zipped by. Peyton even took a long Fourth of July weekend with her family at the farm.

Peyton happened to be standing at Devon’s desk one weekday afternoon when Al Michel brought in one of his foster sons. The boy was pale as a ghost, slightly bent at the waist, and he was holding a bowl. “Oh, boy,” Peyton said. “Who is this, Al?”

“This is Kevin, and he’s feeling really terrible.”

“That bowl was a dead giveaway. Come on back. Let’s figure it out.”

“I heard there was a bug going around,” Al said, following them to the exam room. “I had to pry him off the bed to bring him in to see you.”

“Can you make it up on the exam table, Kevin?” she asked him.

He took his time, but he made it.

“Ordinarily I’d put you in a gown, but if you’ll just loosen your jeans, that should be enough. Lay down for me. And tell me where the pain is.”

“Right about here,” he said, indicating his lower abdomen just south of his belly button. “But I been throwing up, and I think it’s just sore.”

She pressed down, and when she let up, he winced.

“Al, can you take Kevin’s shoes off, please? Socks can stay on.” While Al was doing that, Peyton took the boy’s temperature. Then she swatted the bottom of his feet, and again, he winced. “When did this start?”

“Early this morning, but it’s getting worse,” Kevin said.

“Did it come on suddenly?”

“Sort of, yeah. Like food poisoning—I had that once. It’s like one minute you’re fine, and all of a sudden you’re dying....”

She smiled at him and ran a hand over his sweaty brow. “Stay down for me, Kevin. I’ll be right back.”

She stuck her head in Scott’s office. “I’ve got a hot appy. Hundred and one temp, extreme tenderness, vomiting. Want to weigh in and decide where to send him?”

Scott was on his feet instantly. When a practitioner made that call so fast, it could be real hot. He already knew after just a couple of weeks of working with Peyton that she wasn’t indecisive—when she was sure, she was right. She certainly didn’t lack confidence. He walked in to the exam room. “Hey, Kev,” he said, right before starting to torture him, pressing, poking. Kevin winced and moaned. Scott felt his hot, damp brow. “So, Al, we think this is appendicitis. I want you to take Kevin up to Pacific Hospital in North Bend. I’ll call ahead and make sure there’s a surgeon available.”

“Is this an emergency?” Al asked.

“It certainly could be. That’s not my call, that’s the surgeon’s call, but we don’t mess around with appendicitis. That’s why I want him to see Kevin right away. I have a feeling this is going straight to the operating room.”

“I should go scoop up the boys,” Al said. “They don’t like to be separated, especially when something big is going down. You can understand.”

“I’ll go see to the boys. I’ll tell them what’s going on and make sure they get up to North Bend if there’s going to be an operation. There could be some waiting around while someone decides. They’re going to want some blood work to confirm. Or, it could move fast. Want me to explain to Eric you’re not going in to work?”

“Well, when it rains, it pours. Eric and Laine left town for a few days, and I’m in charge. I have the station and the tow business. Norm is my backup—could you let him know he’ll have to stay late? He can call Manny if necessary. We’ll just hope no one needs a tow. Justin is at the station, and Danny’s at home right now. I told them I wanted to make a quick trip to your office to make sure Kevin just had a bug.”

“Al, I don’t want an operation,” Kevin said, a little tremor in the twelve-year-old’s voice.

“Don’t be nervous,” Peyton said. “It’s an easy operation, as long as they get to it quickly. Once they get that appendix out, you’re going to feel so much better. But you have to get to the ER right away. No time to waste.”

“Everything is going to be fine, Al,” Scott said. “I’ll make a couple of calls, all right? I’ll make sure they’re expecting you. No screwing around, no stopping for any reason. Get going.”

“Thanks, Doc. Tell Justin I’ll call him as soon as I get to the hospital, as soon as I know something.” Al worked Kevin’s shoes back on while Kevin fastened his jeans. Then Al pulled the boy to a sitting position, and rather than helping him down from the exam table, he lifted him in his arms. “Let’s not jiggle it around,” he said with a nervous smile. “Hang on to that bowl.”