Getting a quick history


“Can I ask you a bunch of questions, Bill?”

“Go for it.”

“Should I leave?” Father Brian asked.

“Nah. You can stay.” Bill shook his head. Father Brian leaned against the exam table and folded his arms.

“So Bill, do you have asthma or a lung problem?” I crossed my fingers that it would be a simple asthma attack. Ya. Asthma. We can do some puffs and be right as rain.

“Nope. Never have.” Bill shook his head. Dang it.

“And you never smoked or were around second hand smoke?”

“Nope. No smoking.” Shoot!

“So tell me about this chest tightness.” I said as I began to try to calmly pull open drawers to try to find a stinking blood pressure cuff. 

“I have been having it on and off for a week. I get this stabbing pain into my shoulder and back and then I can’t catch my breath. Then I break out into a sweat.” Oh dear sweet Jesus. I didn’t like the sound of this. Nope. Not one little bit.

“Do you have any sense of what causes the pain?” I located the stethoscope but now I had given up on the blood pressure. 

“No. Not really. But the coffee I just had in our meeting is coming back with a vengeance.” Bill held his hands over his sternum. Oh man! Now I was getting seriously nervous.

“Does anything make it better?” I asked. Oh please please please say something.

“Not that I have noticed. I just try to ignore it and it seems to go away eventually.”

“Let me just have a quick listen to your heart and lungs.” His heart rate was fast. I checked his pulse and counted 120. That wasn’t good. His breathing sounded clear although his respiratory rate was 24. He looked pale and pasty. A blood pressure at this point would have been uber helpful. And an oxygen saturation would be nice. And a chest x-ray maybe. And a 12 lead ECG. And some cardiac enzymes. Son of a Sasquatch! I needed him to get to the emergency room. Was it a myocardial infarction? A pulmonary embolism? A dissecting aneurysm?

“I’m thinking that we should probably have a doctor look at you, Bill.” I say with utmost calm. With that Bill pushed himself up from the chair and shook his head.

“Nah. I got so much to get done today. I have  six evaluations to do. I think I’m probably fine. Just some indigestion.” Oh good. Denial. That’s just great. 

“I really think you need to be seen. It would be nice to maybe see if it is your heart acting up since I am pretty limited here.” I said as I waved the stethoscope at him and grimaced. “I can’t even check your blood pressure.”

“We don’t have a blood pressure cuff here?” Father Brian asked.

“It’s on our list to get with the next pharmacy run.” Bill explained.

“I think Anne’s right, Bill, you need to be seen. Then, if it is nothing, you can come back to work with peace of mind. I can work on rescheduling your counselor evaluations.” Bill was quiet for a few moments. He looked at us both and realized that we were probably not going to take ‘no’ for an answer.

“Fine. I will have to walk back up to the cottage to get my car keys and my wallet then.” Bill said as he started to leave the office. 

“Oh, no worries, Bill. You can hop in my car and I will drive you up to the cottage and then on into town to the ER.”

“I was just going to go by myself. You are going to drive me?” He looked at me a little incredulously. 

“Sure.” I said trying to sound light and airy as I thought…“Cuz, dude, I can do CPR if needed!”

Staying alive!

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