2
Alison
“Uh-oh, I think we have a problem here.”
Stepping into the exam room with my shadowing NP and closing the door behind us, I pretended to consult the tablet in my hand, frowning.
“I’m supposed to see Sadie Baxter in here, and I can’t find her.” Ignoring the woman sitting on the exam table with her arm around a small dark-haired girl, I squatted and peered beneath the desk, the chair, and the table itself.
“I’m righthere!” The little girl giggled, pulling her feet up and wrapping her arms around her bent legs.
“No, that can’t be right.” I shook my head. “Sadie Baxter is a baby who cries when I try to weigh and measure her. She’s not a big grown-up lady like you.”
“I am! I’m a big girl now. I’m not a baby.”
Feigning suspicion, I bent over and stared into the child’s gleeful face. “Hmmmm. You do seem to have the same beautiful brown eyes that Sadie has. And that smile. . . well, it looks awfully familiar, too.” I glanced at Jana Baxter. “And this is definitely Sadie’s mom, so I guess . . .” I tossed up my hands. “You must be Sadie!”
My expression sent Sadie into peals of laughter, putting her at ease as I went through the regular routine of listening to her heart and lungs, checking her belly, and examining her throat.
“Well, for a big-girl Sadie, you’re in perfect health.” I beamed at her. “Now I’d like you to meet a friend of mine. This is Ms. Cathy, and today’s her first day here. She’s going to be working with me for a few weeks. She’s in school to be a nurse practitioner, so she’s hanging out at my office for a while to see how we do all the things.”
Cathy grinned and extended her hand first to Sadie and then to Jana. “I’m so glad to meet you both. Miss Sadie, I think you’re the best patient Dr. Wakely and I have seen today. I’m told there’s a special treasure box just for girls and boys like you. Could you show me where it is? I think you’ve earned a treasure today.”
After a quick glance backwards at her mom, who nodded her assent, Sadie and Cathy opened the door and headed out to the hallway to find the Brave Patients Box of Treasures.
“Does she look okay?” Jana watched me carefully, and I knew she was looking for answers on my face now that her daughter had left the room.
“Not only does she look fabulous, she’s absolutely healthy.” I patted the mom’s hand. “Her last blood test showed her lead levels are completely normal. Not a thing to worry about.”
“Oh, my God, I’m so relieved.” Jana wilted backwards, resting her hand on the paper covered exam table. “I can’t even tell you how worried I was. And I didn’t want to let her see it, so I’ve been putting on a happy face.” She sighed. “Do you have any clue as to why her levels were high a few months back?”
I nodded. “Actually, I wasn’t sure, so I reached out to a friend of mine who’s a naturopath. She’s got great intuition about these things, plus she’s always researching something or another. It turns out she’d read a study about this very situation. She asked me if Sadie had had a vaccine in the months leading up to that test.”
“She did.” Jana’s eyes widened. “She had her chicken pox shot late, remember? Because she’d been sick when she was scheduled to be vaccinated, so we delayed it.”
“Yep, I saw that in her chart, and I remembered right away. So that’s likely what caused the lead levels to be elevated, since we’d ruled out food and environmental factors.”
Jana’s brows drew together. “Does that mean the vaccines are dangerous, Alison? You know, you hear so many things . . .”
I leaned my backside against the desk. “Well, I’ll tell you what, Jana. My policy has always been to offer my patients and their families all of the information that I have on hand and then to allow them to make the decision that’s right for them. For Sadie, we’ve had a relaxed vaccinations schedule, not loading her up on too many shots at one time, and that’s because you expressed that preference—and because Sadie is at home with you most of the time. She’s not in a daycare or preschool situation where she’s more likely to be exposed to illness more regularly. I respect each parent’s right to choose for their child. I would never advocate for anything that I believe puts my patients at risk. I try to give you as much trustworthy information as I can.” I crossed my arms over my chest. “That being said, to the best of my knowledge, the fact that the vaccine might have been the factor that raised Sadie’s lead levels doesn’t make me want to abandon all vaccines and call them dangerous. Most of the issues arise on a case-by-case basis, and for Sadie, I think she’s handling them well.”
“Okay.” Jana smiled. “Thanks, Alison. I appreciate you being candid about this. And thanks for seeing us today, for taking the time.”
“No problem. You know that I’m always happy to see that sunny smile.” I tousled Sadie’s hair as she and Cathy came back into the exam room. “Now, sadly, I need to go do some not-so-fun doctor stuff—paperwork. Ugh.”
I walked Jana and Sadie out of the room and down the hall, leaving them at the front desk to schedule Sadie’s next well-visit. With a final wave at the two, I turned to head back to my office with Cathy.
“You’re so great with kids,” she remarked as she perched on the chair in front of my desk. “Do you have your own?”
I ignored the brief, vague flash of hurt and shook my head. “Nope. I just take care of other people’s children, keeping them healthy as best I can.” Smiling slightly, I added, “Who has time to go to all the effort of finding a decent man, dating, maintaining a marriage and raising kids when you’re basically committed to your career? Between med school, all the training I had to undergo, and then actually practicing medicine . . . I can’t even keep a goldfish alive and well.”
“Guess it’s a good thing I got married and had my kids before I decided to become an NP,” Cathy observed. “My children still keep me busy, but my husband’s great about shouldering his share of the workload.”
“That’s wonderful.” I sank into my chair and leaned back. “And if you choose to go into an office practice, your hours will be reasonable.” I waved one hand in the air, indicating the room. “This is the first time I’ve worked outside of a hospital or medical center. Sometimes I feel guilty, like I’m slacking off since I took over this practice. I’m so used to getting by on a minimum amount of sleep, always worrying about the next thing I need to do, constantly behind . . .” I shook my head. “Keeping mostly regular hours here feels like a vacation.”
“From what I’ve seen today, you’re definitely not lazing around. You’ve seen more patients in your so-called half day than most doctors in my experience do on the days they work late. But you never make your patients feel rushed. You take your time, you listen . . . I have to say, I’m really impressed.”
“Thanks.” I pulled over a folder from the pile on the corner of my desk. “I hope you enjoy your time here, and if there’s anything the rest of us can do to make it better, let us know.” I tapped the file. “I’m just going to finish updating some charts and dictating a couple of letters, so you’re fine to leave. Not much exciting is going to happen for the rest of the day.”
