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Chapter 1: Just a stomach ache

“It’s answering,” whispered Henry Hinkel to the curled-up form of his wife huddled under their bed covers. Hearing a reassuring click he blurted into the telephone, “Hello, hello, this is Henry Hinkel, it’s my wife, Eleanore. She needs…”

But the automated greeting choked off his plea, ignoring him with programmed indifference:

“You have reached the offices of Doctors Marlburg and Jefferson. If this is an emergency, hang up immediately and dial 9-1-1. Again, if this is an emergency, hang up immediately and dial 9-1-1…”

“Sonofabitch!” he murmured through clenched teeth. “How long have we been seeing Marlburg? What the hell is this now?”

Eleanore stirred at the anger in his voice. “Henry,” she said, struggling for the strength to lift her head and speak, “what’s wrong? What…what did they say? When will he see me?” The words came slowly, her voice deep and hoarse.

…He felt trapped, desperate to get help for Eleanore but uncertain how to circumvent the blind loop of their doctor’s answering machine. His hands tightened into fists, digging the manicured nails at the end of his small, thick fingers into his soft palms. He could feel his teeth grinding, his normally pale cheeks glowing, his face tightening.

“I got the goddamn answering machine.”

“Oh…oh, I’m so…so sorry.”

Henry caught himself, realizing that his angry words had increased Eleanore’s distress. He strained to bring his voice under control, pursing his lips as he said, “Not you, Honey, I’m not mad at you, I’m the one who should be sorry. It’s the damn answering machine, just ‘Dial 9-1-1, or go to the ER’ The ER! … We’re his patients, he’s my client, they’re our friends, we play golf together – this is the way he treats us?”

Eleanore’s response came slowly through shallow breaths. “Please, Henry, don’t. It’s…it’s only a stomach ache, I’ll be OK.” But the agony in her voice belied her pained assurances.

… The woman he loved, the woman he had been with for more than half his life, lay on her left side in a fetal position, clutching an oversized pillow with both arms, her right knee all but drawn up to her chest. The silhouette of her face, barely visible above the top of the bedcovers, looked far older than her sixty-eight years, her eyes sunken into the creases of pale skin, her long auburn hair splayed in matted clumps across her head and onto the pillow. She lay so still that the reflection might have been a photo of a crime scene with a murder victim sprawled across a bed...

“It isn’t OK, and you’re not OK.” …

“It might just be cramps. It…” Her attempt to speak was cut off by several short, reflexive gasps. “Ah-ah-ah,” she moaned as her right hand grasped her lower belly.

… “It’s not cramps, not any cramps like you ever had, anyway. I think we should go to the ER.”

“No…please Henry, no. I don’t…want to move. I…”

Her words were cut short by a wave of nausea. Covering her mouth with one hand she gurgled, “towel….”

… Her body wrenched into spasm but produced only a small puddle of drool and greenish puke that pooled harmlessly on the little cloth. …

“Sweetheart, you really should get to a doctor. Northeast Suburban isn’t that far, we can get there in twenty minutes.”

“Please, no, no, Henry. Let me be, please.”

Henry was torn between aggravating his wife’s agony by forcing her to go the hospital or agreeing to wait out her misery to an uncertain end. Having watched her bear up through three deliveries, one time in labor for over twenty-four hours, he had admired her high tolerance for pain. And he could see that moving her would not be easy. …

But what was he waiting for? For her to die? To scream out in unbearable pain? She didn’t want to move, that much he could appreciate, but how much longer could he let her suffer? Henry Hinkel resolved that if she didn’t get better soon he would carry her to the ER whether she consented or not.

The hours dragged on. At 10PM she had a bad spell, her body tensing in spasms of pain for several long minutes. He slipped his arms under her to lift her out of the bed, intending to carry her to the ER, but she gasped in pain from the first slight movement.

“Stop, Honey, please stop, don’t…don’t touch. It’s…not that bad, please.”

… Getting busy signal after busy signal, he punched the redial button on the phone repeatedly until a voice finally answered… “Dr. Marlburg says he can squeeze Mrs. Hinkel in between patients. There might be a lull about 10AM if a couple of follow-up visits go quickly. Can you be here by then?”

… But it was nearly another half-hour later, fifteen minutes after noon, when Dr. Anthony Marlburg stepped into the examining room. A bit shorter and paunchier than Henry Hinkel but about the same age, he wore a long white coat and had his professional game face on, firmly establishing a partition between physician and patient. This was business, not a meeting between old friends, not a time to chat about golf or exchange pleasantries. Not even a handshake, just a quick nod of greeting as he walked to the small office sink and began scrubbing his hands. Turning his head in their direction as he washed up, he said, “Hi Eleanore, Henry. Sorry to keep you waiting. Busy morning.”

Turning so that he could address both Eleanore and Henry he said, “You have what we call an acute abdomen – there is a blockage in the intestines that requires surgery. I believe the most likely diagnosis is appendicitis, but there are many other possibilities. And, with women, we always must consider a tubal or ovarian problem.”

“What now?” intervened Henry, his voice breaking as the seriousness of his wife’s illness began to set in.

“I will order some lab work: a complete blood count to check for signs of infection or bleeding, and an abdominal sonogram and X-rays to see if there’s anything that shows up. Mostly, we need to get her to a surgeon. This is clearly something that requires a surgeon to decide on the course of action.”

“How do we find a surgeon?”

“I’ll take care of that. I have good relationships with several surgeons that I refer patients to. I’ll call and see if the one I have in mind is free today.”

“Who is that?”

“Dr. McDonald, Dr. Matthew McDonald. I’ve been sending patients to him ever since I went into practice. If he’s available, you’ll see why – he’s very good with patients, which unfortunately I can’t say for all my surgery colleagues. You’ll like Dr. McDonald.”

Good with patients – we’ll see what that means, Henry thought. But all he said was “Thank you so much, Tony.”

Almost simultaneously Eleanore said, “Thank you, Dr. Marlburg, thank you.”

“You’re welcome, that’s what I’m here for, after all. Now, let’s get going. I’ll call Dr. McDonald right away.”