Diagnosis Death by Richard L. Mabry Read Free Book Online Page B

Reflexes diminished, no doubt about it.
    "Mrs.—" She checked the chart. "Mrs. Gunderson, I'm going to order a couple of blood tests. If they confirm what I'm thinking, we should be able to get you back to your old self pretty quickly."
    For the first time since the exam began, there seemed to be a spark in the woman's eyes. She leaned forward, apparently eager to catch Elena's words. "Did you say what I think you did? You can do something about this?"
    "I think you've had an episode of what we call thyroiditis—an inflammation of the thyroid gland. It left part of the gland unable to make thyroid hormone, which is why the rest of your thyroid enlarged to compensate." Elena ran her fingers over the area to demonstrate. "But it still isn't making enough thyroid hormone. That makes you tired. It causes you to ache all over. Does cold bother you? Do you have trouble in an air conditioned building?"
    The woman looked at Elena like she'd pulled a rabbit out of a hat. "How did you know?"
    "It's my job to know that, Mrs. Gunderson. No trick to it." Elena ticked a few boxes on the lab request sheet clipped to the front of the chart. "The nurse will draw some blood for tests. I want to see you back in a week. If I'm right, we'll start you on a medication called levothyroxine. It may take a bit of dosage adjustment, but I think you'll soon feel like your old self."
    "No surgery?"
    "No, did someone suggest that?"
    Mrs. Gunderson ducked her head. "Well, I saw another doctor last month about this. He said I probably needed surgery. I guess now he meant surgery on my thyroid. But when he found out I didn't have insurance, he sent me here to the charity clinic."
    Elena fought to keep her voice level. The surgeon might have made a diagnostic mistake. Then again, he could have decided that, in the absence of insurance, a referral would be a good idea. "If you'll tell me the name of that doctor, I'll call him. I'm sure he'll be pleased that no surgery is necessary." And if he punted this poor woman because there was no fee in sight for him, he's going to get an earful.

    Elena struggled upward from sleep like a diver returning from the depths. She opened one eye and frowned at the strident tones that assaulted her eardrums. Phone? She lifted the receiver and was rewarded with a dial tone. Pager? Her frontal cortex slowly ground into gear and returned the message: nope, different sound, not the same cadence as her pager. She reached across her body, pushed down the pillow in which her head was nestled, and saw the flashing red numerals on the bedside clock: 6:01.
    She slammed her palm down on the bar to silence the alarm and tried to recall why she had to get up. Did she have early morning rounds at the hospital? Was there a conference at the medical school? No and no. What is today? It had to be . . . Saturday. Then it all came tumbling back.
    Today she was driving to Dainger to meet Cathy Sewell. Driving to Dainger? No, if anything, she hoped she was driving away from danger. Away from the midnight phone calls, leaving behind the notes with the threatening messages, trying to flee the guilt that enveloped her every time she came near the ICU at Zale Hospital. Surely no danger awaited her in Dainger—only the hope of a better tomorrow.
    Elena rolled out of bed, scuffed her feet into slippers, and hurried to the kitchen. She needed coffee, lots of it. She flicked the switch to set the already-prepared pot brewing and padded off to the bathroom, thankful she'd stopped at the store and bought yet more coffee last night.
    Back in her bedroom, she chose and rejected three outfits before settling on a blouse and slacks that seemed casual yet professional. Wasn't that coffee ready yet? Elena walked through the kitchen door in time to hear the coffeemaker give one last gurgle and fall silent. She poured a cup and burned her tongue with the first sip.
    She stumbled to the bathroom and risked a glance at herself in the mirror. She recoiled when she