Not only as Sally had said, ‘you look like hell,” Moe also felt like hell. The week was a blur, like watching a movie with the VCR on fast-forward. He was vaguely disoriented and had no sense of balance or proportion. No time to assimilate the week’s events. With his father’s illness, his subsequent death and the murder of the colt, it was no wonder he felt like hell.
For the past week, in lieu of sleeping, he stared at the murky black ceiling of his motel, imagining it was a black hole. Everything he loved and had worked for these last forty-one years was being sucked through that hole and scattered somewhere off in space. Since his divorce, Moe had been spending a lot of time, too much time, on personal introspection. His life seemed empty and meaningless. At times he wondered why, and for whom, he worked so hard. Then he remembered, he worked this hard to pay his alimony and taxes. Now it all makes sense, Moe had thought bitterly, his life did have a purpose. Yes, right now he felt like hell and even worse, he suspected that things were not going to get any better, at least not in the foreseeable future.
After leaving the business office, Moe navigated the short distance to the back office. His office nurse was in the lab, peering at a urine sample through the microscope.
“Morning Diane.”
Diane glanced up. “Sorry about your father,” she said stiffly.
“Thanks.” Moe changed the subject immediately. He was tired of talking about his father and the funeral. “Who’s urine you looking at?”
“Julie McAllister. Room number two. Bed wetter.”
“See anything?”
“It’s clear, Dr. Mathis, just a few epithelial cells and some oxalate crystals,” Diane said coldly.
For twelve years Diane had assisted Moe. Five years ago she had dropped the formality of calling him Doctor in favor of the more intimate, Moe. That was, of course, until just the last few months, when he again became Dr.Mathis. Diane again calling him Doctor, reminded Moe of his mother. As a child he was Moe, except when she was displeased with him, then he instantly became Moses. Moe knew exactly what the problem was with Diane and why he was now again Dr. Mathis, but had no idea how to deal with it. Diane was hurt, offended and angry.
“What contestants do we have today? Any surprises behind any of the three doors this morning?” Moe bantered, gesturing at the patient exam rooms.
He was trying hard with this line. It used to be an inside joke but today, it only managed to scour a pinched smile from Diane. Though certainly not in the same league as Diane Parkinson of The Price Is Right, when she smiled, Diane instantly changed from a plain to an engaging, if not an overtly attractive, woman. However, there had been a paucity of smiles lately.
“Behind door number one,” she hissed. “We have Howard H. Swensen, here for a mildly elevated PSA of 8.7, referred by Dr. Holman. He’s an okay guy. He’s in my ward at church.”
“What’s got into Holman?” Moe asked. “He never sends me anything.”
“You know why, don’t you?” Diane asked.
“No. Why?”
“It’s simple. Dr. Holman is religious, a stake president. You’re not.”
“You really think that makes a difference?” Moe asked. “To men that have over twenty years of education.”
Diane shrugged indifferently. “What do you think?”
“I don’t,” Moe replied. “Maybe. What else you got?”
“Behind door number two, there is Julie McCallister, an eight-year-old referred by Dr. Greenfeldt for enuresis, your favorite non-disease. This is her urine. Big surprise, it’s normal. And finally, behind door number three, is another elevated PSA. Mr. Robert E. Robinson, referred by, believe it or not, Dr. Butras.
“Not from Dr. Butras,” Moe joked. “I hate calling him back about his referrals.”
“Fortunately, he writes more clearly than he speaks. The referral form is on the chart. You won’t have to call him, just send back the form.”
“Whatever you say.” Moe smiled.
Diane pushed past him. “I’ve got to post this urinalysis slip in Julie’s chart.” Then almost immediately she turned back and sneered, “Oh, I almost forgot, in your office, there is a pretty drug detail woman from Merck.”
“What’s eating you, Diane?” Moe asked, though he already knew the answer.
“Could you just drop the references to “The Price Is Right” and Diane Parkinson. And I don’t care who you see first, but Mr. Swensen has the first appointment.”
“Who did you say was in my office?”
“A Merck rep. She’s been here before. She’s just your type, blonde and big boobs.” Diane glared at Moe for a moment, then she was gone.
Moe bent over to turn off the light switch to the microscope. Impulsively, he slid open the cabinet drawer just below the scope, the one Diane used for personal items. At the back of the drawer, Moe spotted a brown plastic medicine vial. Feeling a little guilty, he grabbed the vial and read the label. Dan Henrie—Coumadin-5mg—Sig, one po qd.
Coumadin! He’d completely forgotten Diane’s husband was on Coumadin. For atrial fibrillation, or something. What was that vial doing in Diane’s drawer? Better not jump to conclusions, Moe thought. Probably, she was just getting Dan’s prescription filled at the hospital pharmacy. But—but Casey had been murdered with Coumadin! With his mind grappling with the possible implications, Moe replaced the vial and closed the drawer.
“Dr. Mathis!”
Moe jumped. He hadn’t heard Diane return.
“Don’t you think you had better start seeing patients? We’re already backed up.”
Slightly unnerved, he waved at Diane and quickly retreated from the lab. Had she seen him rifling through her drawer? So what if she had. After all, it was still his office. But was it just a coincidence that Diane had Coumadin in her drawer? Probably so. A lot of people had access to Coumadin; it was a pretty common drug. Even so, it made one think.
Standing before the first exam room, Moe reviewed the chart of Howard H. Swensen. Mr. Swensen was sixty-seven years old and still an active land developer and real estate broker. He had a medical history of gout, high cholesterol, hypertension and bladder tumors. Mr. Swensen had no known allergies, and his medications included Allopurinol, Lipitor, Lopressor and Cardura. I’ve been in the business too long, Moe mused. I can pretty much fill in the blanks on Mr. Swensen right now. As he often did, Moe began a game of patient sleuthing. Undoubtedly, because of his surname and the gout, he has a fair, florid complexion with blond hair and probably some graying due to age. Also the gout, high cholesterol and the hypertension all indicate he’s probably overweight. He has to be a smoker, or at least had been a smoker, because of the history of bladder tumors. And, he probably has some prostatic enlargement due to his age and because Dr. Holman has chosen Cardura along with Lopressor as the drugs to treat his hypertension. Moe sighed, then entered the exam room; no surprises here, Mr. Howard H. Swensen was exactly as Moe had imagined.
“Morning Mr. Swensen, I’m Dr. Mathis. How are you today?”
Howard Swensen fidgeted in his chair and tugged at the loose skin hanging from his neck. “I don’t know, Doc, that’s what I’m here to find out. That’s why they pay you all the big bucks.”
Moe always found that answer irritating, particularly on a day like today, but he maintained his composure and sat on a stool facing Mr. Swensen. He glanced through Mr. Swensen’s brand new chart. “Dr. Holman sent you to see me because a blood test, the one that checks on the prostate, came back a little high. Do you know much about the PSA blood test?”
“I’ve read a little about it in the Mayo Clinic Newsletter,