**REMEMBER THAT YOUR UP AND DOWN ARROW
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on fire. The patient held his left hand to his neck,
his unshaven face contorting as Lauren McCaffrey angled
him onto the exam bed.
Laurens eyes smarted from the aroma
that permeated the air around him. Mr. Proctor,
Im going to set you up with something to help you
breathe, but I need to check your oxygen saturation level.
Lauren did so gladly. This was ridiculous.
A nurse worked with bad smells all the time. This man,
however, didnt just smell dirty or sick. There was
another odor she couldnt define and didnt
have the time to analyze. She raised the head of the bed
so he could lean back and still be seated upright, then
she laid a hand on his shoulder to help ease him back.
She reached for the package of plastic
tubing and ripped it open. Did you say this is a
flare-up of your asthma, Mr. Proctor?
Gil Proctor nodded. Sweat lay thick across
his forehead, and tears dripped down his face from obviously
irritated eyes. He didnt behave like an asthmatic.
Someone who was experiencing an asthma attack sat up straight
and still to concentrate on getting the highest airflow
they could manage.
She attached the probe to his finger
to check his oxygen.
Whatre you doing that for?
he demanded. His voice grated, probably from some kind
of physical irritation.
Lauren explained what she was doing while
she connected him to the automatic blood pressure cuff,
all the while trying not to gag. She chided herself for
her squeamishness. This guy was in trouble. She needed
to forget about her own dropping oxygen level and be as
compassionate as possiblehe needed help.
Wheres the doctor?
he snapped. I want a doctor. My lungs
Dr. Sheldon will be here in a moment,
Mr. Proctor. This oxygen should help a lot, and our respiratory
therapist is on her way to give you a breathing treatment.
She adjusted the tubing, careful to avoid dislodging it
when he coughed again. Dont worry, she
soothed. Were going to help you. Just try
to breathe through your nose, and relax if you can. Do
you want me to call your wife from the waiting
Aint my wife!
Your friend, then.
Yeah, get her back here. Tell her
to get me a drink.
Ill bring you some water
as soon as the doctor has checked you.
He grunted and tugged at the tubing.
She stepped to the entryway and peered
out to find Grant and Gina talking with the secretary
at the central workstation. She waved at them and caught
their attention, then gestured for them to come. They
nodded. Gina carried a nebulizer unit.
From the time Grant Sheldon had come
to work here in May, he seemed to move with an aura of
calm. His presence soothed overstressed staff and patients
alike. As he stepped into the exam room, a barely discernible
frown around his eyes revealed that he noticed the smell.
On the other hand, Gina Drakes
pretty, copper-colored eyes widened, and she looked hard
at Lauren. Lauren gave her friend a short nod of acknowledgment,
then turned to give Grant the chart.
He studied the information for a moment,
then introduced himself to the patient. I understand
youre having trouble with your asthma today?
He looked again at the chart, eyes narrowed, as if seeking
something that wasnt there.
Gil nodded and coughed again.
Grant looked at the blood pressure reading
on the monitor, then looked at Lauren. Hed picked
up on the readings right away. When did your breathing
start getting bad?
The patient frowned. I dont
know. Couple hours ago.
Have you ever been admitted to
a hospital for your asthma, or have you ever been placed
on a ventilator to help you breathe?
Gil gave an irritated shake of his head.