The Doctor's Courageous Bride. Dianne Drake

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СКАЧАТЬ style="font-size:15px;">      “She’s here to demand one more hour a day from you,” Paul teased, faking a frown.

      “Stop that!” Solange laughed, hitting playfully at Paul. “It should only take half an hour of Allain’s time. You’ll have the good doctor thinking I’m quite the mercenary.”

      “And just when I finally quit believing all those rumors about the pirates on the Caribbean seas,” Allain quipped.

      “It’s not quite a pirate’s ransom that I want,” Solange explained. “Just a few routine tests for my patients whenever the need arises. I have a little medical infirmary up in the mountains, and I don’t have the facilities for X-rays and lab work. I came to make arrangements here.”

      Actually, Frère Léon had insisted she make the arrangements and had practically shoved her off the side of the mountain to get her to do it. Now she was here, she was glad she’d come. This was a wonderful facility. Neat, tidy. Clean. Paul was terrific. Allain was, too. And it was nice getting herself back into the medical community, around doctors, after being away from it this past year. Even if this was just a cordial acquaintance since she would rarely, if ever, have the need to come here again in person, she was enjoying the camaraderie. The working dynamics here were good, and the chumminess fun. Nothing like her last months at her clinic in Miami.

      “Well, for your patients, Solange, I always have an extra half-hour. But in the meantime, I need to get back to that possible case of Pott’s because, to me, it’s just not quacking like Pott’s.”

      “Quacking?” Solange asked.

      “Quacking,” Allain repeated. “You know the old saying, ‘If it looks like a duck, and it quacks like a duck…’”

      “Then it must be a duck,” Solange supplied. “And your Pott’s disease isn’t quacking like Pott’s disease.” Pott’s disease, a form of tuberculosis, occurred when the TB bacillus escaped the lung and traveled throughout the body and lodged in the spine. It was a common occurrence, and in the Caribbean the leading cause of paralysis in young men.

      “Something like that. He has the right symptoms, especially the paralysis below the waist. But he’s latent.” Latent TB, meaning he tested positive for exposure to the disease but didn’t have the actual disease. “And I couldn’t find any significant case history of Pott’s in latent TB.”

      “Well, you’re right about that. You don’t normally see Pott’s in latent,” Solange replied. Then she deferred to Paul. “Sorry. I shouldn’t be stepping in here. I’m just the visitor.”

      “The visitor who’s welcome to step in any place, any time she wishes,” Paul said, gesturing for Allain and Solange to follow him to the small, two-bed room where the patient, Agwe Bourg, was snoozing quietly in bed. “We don’t really have any kind of a medical hierarchy here so, by all means, step in, comment, offer opinion, order tests. It’s all welcome.”

      “Why do I get the feeling that I’m working?” Solange asked, laughing.

      “Because Paul’s like that. He just sneaks it in on you. And watch your pockets, Doctor. He’s been known to pick a few of those on occasion.”

      “You left out the part where I make you think it was your idea to have your pockets picked,” Paul added, opening the door and walking straight to the bedside of Agwe Bourg, a man, probably in his mid-thirties, who had a wife and seven children depending on this diagnosis. “So in spite of Mr Bourg’s being latent, why would you suspect Pott’s, Dr Sebastian?” Paul asked, keeping his voice low so not to disturb his patient.

      “Like I said, he has the latent diagnosis, which puts him close to the disease. Maybe not right on it, but definitely close. And he does have the other symptoms—paralysis, general malaise.” He drew in a deep breath, then let it out slowly through his mask. “But it’s not Pott’s. At least, that’s my gut instinct.”

      Paul nodded, but said nothing, so Allain continued. “He’s in the right age category, though, so that’s not a rule-out.” Often, diseases that were difficult to diagnose were given a final diagnosis by ruling out other conditions and symptoms. Rule out enough factors, then take a good hard look at what was left.

      Paul nodded again, looking down at Agwe Bourg. “Fever?”

      “Yes,” Allain said.

      “Weight loss?”

      Allain nodded. “He says he has no appetite, and we haven’t been able to get him to eat a thing.”

      “Cold abscess?” Solange asked, pulling up a chair to sit next to Agwe. An abscess, cold to the touch, was almost always present in Pott’s.

      “No. I’ve checked him twice, and so far he’s negative for a cold abscess. That doesn’t mean it won’t develop, but Mr Bourg has been ill for a couple of weeks now, according to his wife, so it’s not likely to appear at this point.”

      “That’s good,” Solange said, taking hold of Agwe Bourg’s hand. “Standing over a patient, looking down at him, is so impersonal. I like being on their level. It makes for a better rapport.” Gently, she gave the man’s hand a squeeze, then watched as he squeezed back. “Good muscle tone. Good reflexes. Do either of you have a stethoscope?”

      Paul pulled one from his pocket and handed it to her. She listened to Agwe’s breath sounds for a moment, then handed the stethoscope back. “Clear lungs.” She looked at Agwe. “Do you have a cough?”

      He shrugged to indicate he didn’t understand. So Solange repeated the question in Creole—the language spoken by most of the rurals. On Kijé, the languages were a mixed bag. Broken English, Creole, and, among the uppercrust, French.

      “OK, no,” Agwe said.

      “Do you think the TB might be going active?” Allain asked, totally captivated by Solange’s gentle bedside manner.

      Paul noticed that the younger doctor had barely taken a breath as he watched Solange check Mr Bourg. It was such a subtle lesson she was teaching. One about eliminating the impersonal tone in medical practice and making the patient feel cared for. A chair at the side of the bed, a squeeze of the hand…these were such simple little things that mattered so much. With all the haste and hurry around his hospital, Paul thought about how often the simple things were overlooked, and he admired Solange for remembering. Somehow, she would always manage them no matter how rushed she was, and he admired that even more.

      “His TB going active is a possibility,” Solange said. “It can do that, depending upon certain factors—more exposure to the active disease, other physical illnesses or weaknesses. But I think Mr Bourg is doing fine. Probably suffering from some kind of secondary infection outside Pott’s, if I’m not mistaken. Because when I took his hand, he shifted in the bed and moved his legs. Just a little, mind you, but I saw movement.” Her eyes crinkled a smile at Paul over the top of her mask. “You did, too, didn’t you?”

      Paul nodded, his eyes smiling back. “So I think we’re all in agreement now that’s it’s probably not Pott’s disease, and Mr Bourg is one lucky man because of it. But we’ll still need some blood tests to rule it out.”

      Solaina bent forward to speak to Agwe, to which he responded by pulling down his mask and giving her a great big grin, revealing a mouth full of rotten brown teeth. Friendly, but infected. And there it was. An uncomplicated thing now. “There, Doctors, СКАЧАТЬ