These days, in LA, doctors and RNPs no longer wore white coats. She was interested to see if she’d be given one here since studies had shown lab coats carried germs instead of protecting doctors and patients from them.
Trevor motioned her over. “Let me show you the charting system.”
Julie didn’t want to get too close, but he used a small laptop computer to sign in on for their first patient. Sure enough, she had to get close enough to catch the scent of his soap and masculine aftershave and the effect was far too heady for this time of the morning. Fortunately, the young man’s information popped up, distracting her, and Trevor explained the various windows to use and entries she’d be required to make.
“Don’t worry, I won’t make you do this until you feel ready.” He tossed her a friendly smile that put her on edge instead of comforting her. How would she handle the entire orientation at such close range? She needed to adjust her attitude and quick. If he could act detached and businesslike so could she.
Switching to all business, she armored herself with a professional disposition. Besides, Trevor seemed to have already forgotten yesterday’s news, and, even though it cut deep, Julie was grateful for the hiatus.
Trevor stood, laptop in hand, and headed for Exam Room One, where Donald Richardson, a twenty-seven-year-old type-1 diabetic ranch hand, waited. His chief complaint being nasal congestion for ten days and a headache for the past four to five.
After a friendly greeting and introduction of Julie to the patient, Trevor performed a quick examination of his nasal passages. Based on the examination, plus seeing a chart notation from Lotte, it seemed Donald’s temperature was elevated. Trevor told him it looked like he had a sinus infection.
“Take off your shirt so I can listen to your lungs,” Dr. Montgomery said.
Off came the shirt, and Trevor did not look pleased. “What’s this?” He pointed to a colorful shoulder tattoo.
Donald gave a sheepish glance. “My new tattoo.”
Trevor still didn’t look happy, and Julie assumed it was because of the possibility for complications that diabetics might face with body art.
“Did you bring your daily blood-sugar numbers?” Trevor wasn’t going to give the man a break just yet. He pushed some buttons on the laptop and brought up the most recent lab results, then took the small booklet Donald handed him. After glancing at the last couple weeks’ blood sugars, and sliding-scale insulin injections, he shared the info with Julie. She glanced at the computer screen and saw that Donald’s last A1C test was under 7 percent, which was a good thing.
“You know your kidney function has been borderline for a while now, and if you don’t keep your blood sugar under control, getting a tattoo can be dangerous.”
Donald hung his head, as if he was sick of hearing the diabetes story whenever he wanted to do or try something new. “I’ve been keeping it clean and there isn’t any sign of infection.”
“And that’s a good thing. But would you do me a favor, and next time you decide to get a tattoo, or body piercing or anything invasive, would you let me run some lab tests first? The last thing you need is to put your life in danger. If your blood sugar is high, a tattoo can be a playground for bacteria. That bacteria can invade your body and cause all kinds of trouble. Which is exactly what you don’t need.”
“I’ve been doing pretty good with the blood sugars.”
“I can see that. I’m just playing the devil’s advocate.”
From Julie’s assessment, Donald kept his weight under control and looked healthy. But the outside package didn’t always reflect the microscopic goings-on inside the body.
“I understand. You’re just looking out for me.”
“As long as we understand each other.”
“Okay. I promise. But, really, isn’t she a beaut?” Donald nodded at the tropical-inspired tattoo. “Whenever it’s colder than the North Pole up here, I’m going to look at this picture and dream about being in Hawaii.”
Trevor smiled. “That’s another place you’d have to work extra hard to keep your sugars balanced. Hot sticky weather is a playground—”
“—for bacteria. I get it, Doc.”
They exchanged a strained smile, and Julie fought to keep hers to herself.
“Well, the prescription I’m writing for the sinus infection should help, in case this tattoo springs an infection.” He wrote it out, tore it off, and handed it to the younger man. “If you notice any pain, swelling, redness, warmth, streaks or pus on or near that tattoo you let me know immediately.”
“I will, Dr. Montgomery, I promise,” Donald said as he buttoned up his shirt.
“And I gave you seven days of antibiotics for your sinuses. Take all of them. After that, if you aren’t completely cleared up, give me a call.”
“Will do.”
“Oh, and this is Julie Sterling, our new nurse practitioner.”
They gave a friendly greeting, and within seconds Julie nodded goodbye and followed Trevor out the door. Essentially, she agreed with his assessment and plan for Donald. But before she could say a word, Trevor was heading to the next patient’s exam room. He’d been adding all the pertinent data about Donald Richardson into the computer as he went along in the appointment. She wondered how long it would take her to become as proficient with the program.
He entered the next room and immediately washed his hands, as he’d done with the first patient, and made a friendly greeting while doing so. Julie would give Trevor an A for bedside manner—oh, wait, she’d already learned about his bedside manner … a long, long time ago. Man, she needed to erase that picture from her mind. And quick.
By lunchtime they’d hardly spoken ten non-medical-related words to each other, concentrating solely on the patient load and treatments. Their bodies being cramped together in small patient-exam rooms kept an unwanted heat simmering beneath Julie’s cool and calculated surface. Try as she might, she couldn’t ignore her reaction to being near Trevor.
At noon sharp, Lotte came waltzing into Trevor’s office, while he was explaining the required codes for specific ailments and treatments and labs. Julie’s head was spinning with intellectual overload and she was grateful when he handed her a printout of the codes. Until their fingers touched and some crazy tingly reaction nearly made her already-spinning head take flight.
“Come with me, Ms. Sterling,” Lotte said. “May I call you Julie?”
“Of course.” Thank heavens the woman was oblivious to anything beyond the clinic, because Julie was quite sure her cheeks had gone pink. She mentally crossed her fingers that Trevor hadn’t noticed.
“Let me show you the lunch room. Did you bring your lunch?”
“Oh.” Julie had been so nervous about facing Trevor again after the bombshell she’d laid on him yesterday that preparing her lunch had been the last thing on her mind. “I didn’t bring one.”
“Then let me give you a rundown of the local cafés.” Lotte pulled Julie by the arm out of Trevor’s office, and he barely glanced up, until Julie looked back and caught him taking a quick glance. Yipes, there went the head-spinning tingles again the instant their eyes connected. But just as quickly his interest shut down and he went back to the computer task at hand.
This all-business routine was wearing thin. Did it also mean he wouldn’t see her as a human being? “I’ll see you at one, then?”
He nodded, not bothering to look up again from his computer. “See you then.”
She