(2018-09-20) A Boy Named Mike
Abby follows up with the Smith family while on rounds at the PB Med Center

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The Powell-Braxton Medical Center has seen better days. The flash flooding that submerged lower parts of the hospital sees that the whole place is still in upheaval. But the staff is braving on and there's a teams of different repair people milling around, fixing water damage and double checking the electric. After two days off, Abby finds herself working an early morning shift. She's just now stopping the reception desk, going over someone's chart, her glasses pushed up her forehead.

The storm is most likely subsuding, less injuries coming in. Until yesterday evening, a young boy was brought in from deep in the foothills of the San Juan Mountains. Firefighters running water planes to other lake where roads were washed out brought in Michael Smith. This is perhaps in the caseload for Dr. Thatcher. When brought in, he presented with a broken leg and infection, the infection subsequent to the broken leg which caused an open wound on the leg. Presently in ICU until the fever is under control, further examination revealed multiple contusions about the boys arms and back that was not consistent with the explination of the leg. The leg was injured as the boy fell into a ravine going after his father who had left the family residence when power had been out for a couple of days, he planned to walk to town to get supplies. The mother followed the stubborn boy and got him back to the house for care. The infection most likely started in the interim between the fall and waiting for supplies. Boy and mother are currently in their room, perhaps waiting on rounds for information.

As the caseload from one shift was passed along to the next, Abby found herself in possession of Michael Smith's chart. She spends significant amount of time going over it, something that's especially important with pediatric patients. Due vigilance. She frowns at the inconsistency between the injuries and the explanation for them. These are the sort of things that won't be figured out just by pouring over paperwork however. So after clipping his chart to her clipboard she heads off to talk to the pair. Arriving at the door she waits outside briefly to listen before knocking and walking in.
Its clean, ICU clean, with more regular duties being done to keep the room organized. Its just the mother, Elizabeth Smith, and the patient, Michael Smith. Michael is in the bed hooked up to a drip to help with antibodies and meds for the infection and recover of the leg. It is set now, in a less-permanent lite-cast so it can be monitored and reset if needed. He's half awake half a sleep, which is more cognizant than when he presented according to the chart. He's 12 years of age, and appears healthy other than the leg, the contusions and the current fever which is mildly controlled. Elizabeth looks up, "You the doctor? How's my boy?" She doesn't seem to waste time with raising concern. "How much longer do we need to stay here?" The crux of it, ready to go it seems on the part of Elizabeth.

"Yes, I'm Doctor Thatcher. How are you feeling today, Ms. Smith?" Abby asks politely, casting a quick look over in her direction. Then she heads to Michael's bed and checks over his vitals, examines his cast and makes it a point to get a quick look at the contusions as well. "Hello Michael, can you hear me?" she asks quietly, waiting to hear his answer before she turns back to Elizabeth, "He's stable. Other than that, I can't say exactly. He won't be discharged today."

After her diluge of concerns, Elizabeth does nod, "Well enough, all things considered." She was sitting in a chair near the wall, but does stand as Abby beings to examine Michael.
Michael turns his head, he can hear. He furthers his comprehension, "Yes doctor." His voice is wobbly, a hint of shake at most, maybe a little dry. He does have a drink on a stand not too far away. "I can get out of bed soon." As if he's judging his own level of being fit in the moment. Its more unlikely he'll walk too much until the fever fully breaks, but a little walking wouldn't hurt to help circulation most likely.
"A day or two hopefully, can't affort staying to long." That is another crux, the amount that might have to be paid for the leg now.

"We'll see. Why don't we wait and see until after lunch once you've woken up a bit more?" Abby is watching his face carefully before the straightens and turns her focus onto her more fully. "He can't be released until we know that infection is under control. Doing it before than could result in a much longer stay later." The corners of her lips pitch downward and she moves to sit in an extra chair, "Do you think you can go over what happened that night again?"

"Okay," agrees the boy, with a nod about waiting to be released, he turns towards the nearest window and settles back into relaxing. That fever has him more knocked down than the leg for the now it seems. Meanwhile, Elizabeth shrugs, "Yeah, don't want it worse on Mikey." Or the pocket book. She moves along with Abby, taking a seat as well. "Well, Henry had gone out earlier that day. Said we had supplies but a couple days and we'd need more. Was gonna walk down to town to get water and food." He glances to the side as if recalling what happened from time to time. "Mikey .. Michael, later that night, he thought his dad might need help. He was going to storm down the mountain too. This is the night of the second storm." The worse part, "I couldn't stop him, but I followed. He fell in a Ravine, maybe a wash from the storm, that snapped his leg. So I did my best to get him back to a bed to care for him until we could get the practitioner up there again." A general practitioner/family doc, when the roads cleared.

"You couldn't stop your son from exiting the house during the storm?" Abby asks, not sounding judgemental. Just curious. Her eyes jump from the papers to the boy and then back to her again. She's writing something down in her notes when she moves on to ask, "He had some other bruises and contusions that don't seem consistent with a fall. Do you think you could tell me about that? And where is your husband?"

"I tried to grab him, he's stubborn," returns Elizabeth, who may be just a bit taller than the youth, but he's coming into his frame as a boy who does a lot of manual chores out where the Smith family lives. Elizabeth follows Abby's gaze towards Micheal, but not for long, returning to watch Abby's features instead. As with most charting, the mother does look down as if she could read it despite it being tipped away, then eyes right back up again. "He and his father, doing work," she begins, there is some hesitancy as she explains the contusions. As if putting pieces together. "On Sunday, after the first .. storm and the one Monday night. I think he got it then, they .. cleared some trees from around the cabin."

Abby is slow while writing and is cursed with the same terrible penmanship that all doctors seem to be. "Will he be visiting later? I'd like to speak with him. I'll be be here until late tonight." She clicks her pen and tucks it into her jacket. "I'm going to see about having a nurse come in here after lunch. They'll get him set up with crutches and make sure they're properly adjusted to his height and weight."

"If they find him, they said they'd bring him here first," she explains to Abby about the boy's father. "He was walking for supplies, no ones seen him since. The fire fighter mentioned something about a search?" Or she's hopeful, but clearly doesn't know the location of the father at the moment. "That would be good, the nurse can let us know how the fever is going. We'll get him walking about just yet." She tries to use that same spiriit of preserverence from earlier, they'll walk out the moment they can.

"He's been missing since the storm then?" Abby looks concerned. "Why don't you give me the name of the firefighter and I'll follow up for you. So you can concentrate on your boy." Her smile is gentle, an attempt at being reassuring. "We'll get you out as soon as we can."

There is a nod from Elizabeth, "Hamilton was on his pocket, D. Hamilton." She didn't get a name otherwise, but most likely in her mindset on arrival, she didn't think to get the full name of the firefighter person that helped get her to the hospital. "Thank you, the sooner the better, doctor." A look around the room as if feeling confined even, one reason the Smith's probably live remotely to begin with, maybe.

Abby rises to her feet again, "I'll track down this D. Hamilton person. Please try to get some rest, everything is going to be alright." Maybe. But it's probably not bedside manner to day that outloud. She gives Michael another quick over before heading to the door, "I'll be back later Ms. Smith."

Ms. Smith gives a nod, looking from doctor to the boy as Abby heads for the door. "Thank you doctor." She offers the gratuity of the medical assistence even if things don't all add up. There is concern for the boy at least, despite other factors. She even moves to stand nearby and brush some hair over an ear while the boy lies and the doctor departs.

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