Richard Mabry: Diagnosis Death

Cathy chimed in. "What if she asks, 'Who's this we?' "

Will grinned. "I suspect he'd give her a knowing look. 'You know. And don't forget it.' How's that?"

Elena pondered that for a moment. "We could try it. I'd like to think this was a one-time thing, a way of hurting me because Mark dumped her to stay with me."

Cathy tilted her glass and crunched a piece of ice. "That's settled. Now what about the person who murdered Charlie Lambert? We're not talking about withdrawing life support from a patient who's dependent on it. This was a man on the road to recovery. He might not be the same person as before his stroke, but he'd be alive."

"I've been waiting for the police to come knocking on my door," Elena said. "If Nathan Godwin gives them that bottle of Anectine with my fingerprints on it, I don't see how I can avoid being arrested."

"Either he hasn't called the police yet, or they're taking their time with their preliminary investigation. In either case, we still have some time. We'll try to come up with a solution before they get to you." Will pushed back his chair. "Right now, I'm due back at the office. We'll talk about this later."

"Jane, this is Dr. Gardner." Elena snugged her cell phone against her ear with her shoulder and used both hands to wheel her car into the hospital parking lot. "I have one more stop to make before I come back to the office. Anything going on?"

"Nothing that can't wait until you get here. Your first patient of the afternoon cancelled, so you've got a little time."

"I'm at the hospital. Given the cell phone reception here, you'd better have the operator page me if you need me."

Elena wasn't sure where the office she wanted was located, so she took a moment to consult the directory in the main lobby. She envied David the opportunity to get to know the place he'd practice, instead of being thrown into the middle of it with almost no warning. But she was proud she'd been able to adapt so well to her role in Cathy's practice. If only everything else was going smoothly.

She found the office number, determined its location using the map alongside the directory, and set out in that direction. As she walked, Elena rehearsed her speech. The Jefferson family had come to the office that morning with their mother. A review of Cathy's previous notes confirmed Elena's impression that this was a woman slipping further into the heartbreaking world of senile dementia. Mrs. Jefferson was totally out of touch with reality now, and there was no way her family could care for her at home. Elena hoped that the hospital's social worker might be able to help find an answer.

Here it was, room 1003. She read the name on the door: N. Cook, Social Worker. Elena tapped on the door, and a pleasant female voice replied, "Come in."

File cabinets occupied the space along every wall except for the door through which Elena entered. A scarred metal desk sat in the center of the room, and the woman behind it was almost hidden by a stack of papers. She motioned Elena to one of the two mismatched client chairs across from her and beamed a thousand-watt smile at her visitor. "Have a seat. I'm Natalie Cook. How can I help you?"

Elena offered her hand. "I'm Dr. Elena Gardner. I-"

The social worker's expression was one of pure shock. "How in the world did you ever find me?"

"I beg your pardon?"

"You're Mark's wife, aren't you?"

"Do I know you?"

"No, my mother made sure of that long ago." She leaned across the desk and Elena saw the resemblance before the next words confirmed it. "I'm Natalie, Mark's sister."

Elena felt as though she were inside a huge snow globe that some giant hand had given a shake. Her world had just turned upside down. "Natalie? But your name is Cook, not Gardner."

"Cook is my married name. After my mother threw me out of her house, calling me a hippie who'd never make anything of her life, I migrated to Santa Fe. I was scratching out a living selling trinkets in the town square when I met Clark. He was the youth pastor at a church there. We started dating and were married six months later."

"Your mother never mentioned you."

"No, when I didn't live up to the image she had in mind for her daughter, it was as though she'd taken white-out and erased my name from the family Bible. She wouldn't take my calls, returned my letters unopened. The only reason I know that you and my little brother were married is that one of my high school friends had my address and sent me the clipping from the paper."

Elena tried to assimilate what she was hearing. "How do you go from selling jewelry on the square in Santa Fe to practicing social work in Texas?"

"Clark was called to be associate pastor of the First Methodist Church here in town, and we found out the hospital was looking to add a social worker. I didn't have any training, just a couple of years of college, but I bluffed my way through the interview and got the position. I've been learning on the job ever since."

"Do you and Clark have any children?"

Natalie bit her lip. "Last year, Clark decided he wasn't cut out for ministry-or for marriage. I'm alone now."

Elena hitched her chair closer. "Natalie, you're not alone anymore. I'm glad I found you. But I have some news about your family."

"Sorry I'm late." Elena tossed her purse into her desk drawer. She snatched her white coat from the hook behind the door and shrugged into it, then scanned the hall. The plastic bins outside every exam room door held a chart. She was starting behind, and to catch up she had to put aside the events of the past hour. There'd be time enough to think about them this evening when she had dinner with David.

Elena tapped on the door of the first exam room and entered to find an elderly woman fidgeting on the edge of the exam table. Her right shoe lay on the floor, and she was flexing the toes of that foot.

"Mrs. Musgrove, I'm Dr. Gardner. I'm terribly sorry to keep you waiting. I was held up at the hospital." Elena perched on the rolling stool and studied the chart. This was the woman's first visit to the practice. She listed a chief complaint of foot trouble. "Tell me about the problem with your feet."

The woman kept her eyes fixed on her foot, as though her gaze alone might make it well again. "I've got this place on it that won't heal."

"How long has it been there?"

"Maybe six months, might be a bit longer."

"Does it hurt?"

"No. But I told my daughter about it. She took one look at it and made this appointment. I don't think it's much, do you?"

Elena had no trouble finding the ulcer on the bottom of the woman's foot. It was about an inch in diameter, fairly shallow, with a clean central crater. She placed her fingertips lightly on the top of the foot. The pulse was weak, and the skin was cool. Elena pulled a hatpin from the lapel of her white coat and lightly jabbed the woman's foot. "Feel that?"

"Not really. But I don't have much feeling in my feet, anyway."

Elena thought she knew what the woman's problem was, but she wanted to be certain. "How's your weight?"

"I don't see what that has to do with my feet, but now that you mention it, I've been losing weight, even though I eat quite a bit."

Elena went through several more questions. She made a couple of notes on the chart, then set it aside. "Mrs. Musgrove, I think you have diabetes. I'm not sure how long you've had it, but it's affected the nerves and the circulation in your feet. I'm going to have my nurse set up an appointment for some lab work to confirm that diagnosis. Meanwhile, here's what you need to do to keep that ulcer from getting worse."

She gave the woman comprehensive directions, all the while trying to ignore the clock in her head that was saying, "You're behind. Hurry up." This patient deserved her best, and if it took a bit of time, so be it.