Chapter 54: A Battery of Tests

February 11, 1991, Chicago, Illinois

“I’m going to stay at the hospital when I walk Jess to work,” I said to Kara when we all got out of bed on Monday morning.

“I’m sorry I can’t be with you today, Snuggle Bear.”

“Al Barton and his rogues’ gallery of torturers are going to run every test they can think of on me. It’s going to be singularly boring!”

“I know, but you’ll be in the hospital!”

I pulled her to me and hugged her.

“Kara, I’ll be fine,” I soothed. “You can come to the hospital as soon as your classes are over.”

“I worry about you!” she protested.

“I know. But I’ll be fine, Honey.”

“Kara, it’s just tests,” Jessica said. “Please don’t worry.”

The three of us showered, then went downstairs to eat breakfast together. When we finished breakfast, I grabbed the overnight bag that I’d packed the night before, and the three of us headed to the hospital.

“What are you going to do until 8:00am?” Kara asked.

“Flirt with the nurses, of course!” I teased.

“I told you he was fine, Kara!” Jessica laughed.

When we arrived at the hospital, Kara kissed and hugged us both.

“I’ll see you this afternoon,” she said, then turned for home.

Jessica and I walked inside, and to the doctors’ lounge.

“She’s very concerned about you, Tiger.”

“I know. But right now, all we can do is wait for the results. I really don’t expect them to find anything.”

“You’re extremely confident for a man who suspects that he might have a mental illness.”

“I married you, didn’t I?” I grinned.

“Read your magazine, Tiger!” Jessica laughed.

I kissed her again, then sat down on the couch with The Economist. In my bag were also the latest issues of The Hockey News and of Winston Cup Scene, along with a couple of books. I expected to be bored out of my mind for the next thirty-six hours. I’d considered buying a Macintosh Portable computer, but at $7000, I simply couldn’t justify the expense. There were rumors of a much less expensive laptop to be released at some point in 1991, but no real details were forthcoming from Apple. Things weren’t better on the Microsoft side, because laptops running Windows were not to be found, and even those running DOS, like NEC’s ‘Ultralight’ had major shortcomings, such as no internal hard disk. And they were expensive as well.

Jessica ended up not being busy, so she came and sat with me for about an hour before she had to respond to a trauma. About forty minutes after that, I put away my magazine, and left the lounge. I saw Jessica working on a patient in one of the trauma rooms, so I asked the desk clerk to let her know I had gone up to Al’s office. He was waiting for me, and I walked into his office and started laughing.

“Welcome to the Jungle? Seriously?” I asked.

“I thought you might appreciate it,” he said with a grin. “I borrowed one of Gerry’s Guns N’ Roses CDs!”

“Why not Like a Surgeon by ‘Weird Al’ Yankovic?” I grinned.

“Nobody will be cutting you open. At least not today!”

“Gee, thanks!”

“I already have you registered. There are a few forms to sign, but they’re all filled out. Jessica filled out all the information for you on Friday.”

“So, now what?”

“We head up to Medicine and get you officially admitted. Did you eat as instructed?”

“Yes.”

“OK. Today we’ll do the metabolic panel, the glucose tolerance test, the stress test, and the cardiac workup. Tomorrow morning we’ll do the CT and neurological workup, and finish with the psych consult tomorrow afternoon. You’ll probably see a dozen different doctors over the next thirty-six hours.”

“All because I faint when I get bad news? And have mood swings.”

“And you have low blood pressure. And low blood sugar. Maybe those are all unrelated. Maybe they’re all innocuous and your fainting is just a reaction to adrenaline. But then again, maybe they’re all related. That’s what we’re aiming to find out.”

“But everything was clean last time,” I protested.

“That’s true. But we’re looking deeper now. It could all be metabolic. It could be some kind of chemical imbalance. It could be a tumor. It could be blood clots.”

“Wouldn’t the CT have detected those last time?”

“Not necessarily. As you like to point out, quite annoyingly, medicine is an art, not a science. Yes, there’s a lot of science, but there’s a lot we don’t know. And that’s where the difference between a good doctor and a great one makes a difference.”

“And the people I’m seeing today?”

“You don’t get to the positions we’re in at a major teaching hospital by being average,” he grinned. “Let’s go upstairs.”

I followed Al to the elevators and a few minutes later, I signed two forms at the nurses’ station, answered a few questions and was led to a room.

“Mr. Adams, please put on the gown. You can leave your undershorts on.”

“Steve, I’ll be back later to check on you. Jonas Nilson will be by in a few minutes to get started. I’m sure Jessica will come around as well.”

“Thanks, Al,” I said.

We shook hands and he left. I removed my shirt and pants, and hung them in the closet. I put my t-shirt, shoes, and socks on a shelf, put on the flimsy hospital gown, and got into the bed. Five minutes later, a very cute young nurse came into the room.

“Mr. Adams? I’m Angel Sanchez, your nurse.”

I smirked, “Well, Angel, obviously, I’ve died and gone to heaven!”

“If I had a dollar for every time I’ve heard THAT line, I could have retired already!”

“Sorry,” I said with a grin.

“It’s OK. I was warned about you! I need to get your vital signs, please.”

“Warned about me?”

“I just came to Medicine from OB about a month ago. Doctor Robertson had some very interesting things to say about you!”

“I’m sure she did! And all good, too!”

“There are also quite a few rumors circulating around the hospital!”

I laughed, “Oh, I’m sure. And I bet most of them are true!”

“What?”

“In my case, unlike the usual situation, the rumors are probably true!” I said with a sly grin. “Don’t you have some vitals to take?”

She smiled and hooked up a pulse oximeter, and then put the cuff of the sphygmomanometer on my arm. She took my blood pressure and recorded my pulse and blood oxygen level. Next she took my temperature.

“A phlebotomist will be here shortly to draw a blood sample. I need to record everything you’ve eaten since last night.”

“Breakfast this morning was four strips of bacon, two scrambled eggs, two slices of whole wheat toast with butter, and a twelve-ounce glass of grapefruit juice. And a cup of coffee.”

“Any snacks before bed?”

I was half tempted to answer ‘pussy’, because my wives and I had made love before falling asleep, but decided that would be pushing things a bit.

“No. Just sparkling water with a squeeze of lime juice.”

“How many hours did you sleep?”

“About six-and-a-half,” I answered.

“Exercise?”

“I usually run three to five miles every morning; I do it on a treadmill during the winter. I didn’t do that this morning because my normal routine is to do it after I walk Jess to work. This morning I stayed here.”

“That’s all I need at the moment.”

I decided to tease her a bit.

“Are you sure about that?” I said in as sexy a voice as I could manage. “There isn’t something else you need?”

“In your dreams!” she said with a small laugh. “As I said, they’ll be in to draw blood shortly.”

“Thanks, Angel! Anytime you want to visit heaven, you let me know!”

She laughed, “You weren’t kidding about the rumors being true, were you?”

“No! Go on; I’m sure you have work.”

She smiled and left the room. About two minutes later the phlebotomist arrived to draw blood. He introduced himself as John Black, and quickly filled two vials with my blood. As he was leaving, a doctor with what appeared to be two medical students in tow, came into the room.

“Mr. Adams, I’m Doctor Nilson, and these are two of my medical students, Mr. Atkins, and Miss Barnes.”

“Good morning, Doctor.”

“We’re going to get a complete family medical history, then we’ll start with the glucose tolerance test. Did anyone get a urine sample?”

“No,” I said.

“Let’s do that first, so we have a baseline. We’ll want to check your urine for any metabolic issues.”

“Do you mind if I ask specifically what you’re looking for?”

“There’s a host of things, but given the other symptoms Al told me about, the primary thing would by thyroid problems. Is there a family history?”

“You know, I have no idea. I can call my dad and ask any questions you have. Family health wasn’t something we talked about very much.”

“Let’s get the urine sample, take the basic history, and then you can call your dad and ask about any medical issues with your parents, grandparents, or siblings.”

I got out of bed and filled the specimen cup. The male medical student took it from me, capped it, wrote out my name and some other information on a label, and affixed it to the cup. I got back into bed and answered a long series of questions about my general health posed by the female medical student. At Doctor Nilson’s prompting, she took me through every ‘syncopal episode’ that I could remember, including one I’d completely forgotten to tell Al about - collapsing in the hospital when Wen had been shot.

“Have you had any shocking news that HASN’T caused an episode like that?” Doctor Nilson interjected.

“Not that I can recall,” I said. “I knew Stephie was going to die, so it wasn’t a shock, but at her funeral I nearly passed out. The same was true at Nick’s funeral.”

“Are those the only times you had that feeling that weren’t related to learning something that upset you?”

“When I was younger I would get dizzy if I stood up too quickly, but I’ve learned not to do that. I also used to get a bit of motion sickness from trying to read in a car, but I’ve never had a problem otherwise.”

“I think we’ll look at inner ear disorders, as well. I’ll get an ENT who specializes in neurotology to do a workup since you’ll be here long enough.”

“Neurotology?”

“A specialist who deals with inner-ear disorders. There are quite a few disorders that can cause bouts of dizziness.”

“But I don’t really have them except in certain situations.”

“But you told us that you have tinnitus, and have since you were young. That also leads me to ask for that workup. Whatever the issue is, it could be exacerbated by adrenaline. Maybe it’s mild and it’s only under stress that it affects you for now. But we’re just speculating until we get some concrete information from the battery of tests. I’m sure Al told you that once we complete all the tests, all of us will get together and figure this out. It’ll be a very good teaching case for our medical students. Your wife asked to be involved.”

“Of course she did,” I laughed. “Al told me in advance that wasn’t permitted.”

“It’s not. If you’re ready, we can call your dad and fill in some of these blanks.”

I nodded and reached for the phone. I used my Ameritech calling card and dialed the number of my parents’ house in Mason. Fortunately my dad was home and answered my call. I found out a few things I’d never known.

“When was THAT?” I asked when he revealed that he’d had skin cancer.

“1971,” he said. “I haven’t had a recurrence. The theory was that it was related to all the hours I spent in the sun in the Navy, Cuba, Las Vegas, and then in California. It was minor surgery to remove it, and there was no other treatment.”

I relayed that information to Miss Barnes, who wrote it on the form on her clipboard. There were a few other minor things that he’d had, but nothing particularly relevant. When it came to my mom, it was a completely different story.

“Your mother had rheumatic fever when she was thirteen, and two years ago had a thyroidectomy due to hyperthyroidism.”

“And nobody said anything about either of those things, why?” I asked, slightly annoyed.

“Your mom didn’t want anyone else to know. I’m telling you now because of the conversation I had with Doctor Barton after you told me about the tests he wanted to run.”

I relayed that information, and Doctor Nilson instructed me to ask why she’d had surgery instead of iodine treatment. My dad told me she had an allergic reaction to the iodine in the test before they started treatment, and I let Doctor Nilson know that. There wasn’t anything else, so I thanked my dad and hung up.

“You recall what I said earlier about thyroid problems being a distinct possibility? Right now I’d say that’s the thing we’ll look for. Not that we’ll exclude anything else just yet, but we have something close to a smoking gun.”

“I’m more than a little pissed that I didn’t know about any of this,” I said. “If I had, I could have told Al about it back when I was in here for tests a year ago.”

“Well, we know now. Let me have the nurse bring you the solution to drink and we’ll get the glucose tolerance test started. She’ll do a quick blood sugar level, then you’ll need to drink the solution within five minutes. We’ll get a blood sample every two hours for the next six hours. We’ll also get a urine sample at the same time. Once the test is over, we’ll get you something to eat. Until then, just hang out, read, watch TV, or sleep.”

“Thanks, Doctor,” I said.

He and the two medical students left the room, and Angel came in a few minutes later.

“My guardian angel,” I quipped.

“Like I haven’t heard THAT one before, either!” she laughed.

“I’ll try to come up with something new before you go off shift!” I grinned.

She did a blood glucose test, took my vital signs, and then had me drink a sickeningly-sweet glass of liquid. I downed it quickly, and she left the room. I pulled out my magazines and started reading.

“Hi, Tiger,” Jessica said, coming into the room about twenty minutes later.

“Hey, Babe. Not much going on here, though I did talk to my dad to get some medical history and discovered that my mom had hyperthyroidism a couple of years ago, and had her thyroid removed.”

“And nobody saw the need to tell you?” she asked, exasperated.

“You know my mom,” I said.

Jessica sighed, “Unfortunately, yes,” then she smiled. “I hear you kept your word!”

“About?”

“Flirting with nurses! I talked to Angel Sanchez before I came into the room!”

“She’s quite cute,” I said. “But it appears she’s heard all about me through the rumor mill!”

Jessica laughed, “There are some interesting stories floating about!”

“Maybe I shouldn’t have told her they were most likely true.”

“If she believed you, she’d be in for a serious disappointment!”

“And why is that?”

“You’re rumored to be a freak of nature in a certain department!”