Chapter 120: Room Three
Thursday the sixteenth of October 2031. My eleventh week in that office.
The last patient of the afternoon was booked at two.
I take the histories, the vitals and the timed observations. I do not diagnose. That is a different license and I am not confused about which one I hold.
The chart came out of the rack at one fifty.
It is a paper chart. Moreno keeps paper, and I have never asked him why, because I know why.
Blackwood, Ethan. Date of birth 12 July 2025.
Six years and three months old. Twenty-one point eight kilograms.
Nine days of cough after a cold, and a father who had heard something at night on Tuesday and Wednesday and had written down what time.
He had written down what time. I want that in the record and I am not going to say anything else about it.
Clipped inside the front cover of the file is an authorization for the release of protected health information, renewed on the fourteenth of March 2031, and my name is in the blank.
It is renewed every March. It has been renewed three times.
There is nothing sentimental about it. It is a form and it expires.
They came in at two minutes past two.
He came ahead of his father because he always does and because he knows where room three is.
He is tall for six. He has his mother’s face, which I have only seen in photographs and once in a coroner’s file, and which nobody in that family has ever mentioned to him.
He got onto the table without being asked and put both hands flat on the paper.
He asked me whether it was going to be the cold thing.
I said the stethoscope is always cold and I was sorry about it and I had never once managed to fix that.
He said that was fine and to get on with it.
Then the door opened behind us, because the medical assistant needed a room key, and his head went round.
He is six years old and his head still goes round.
Temperature 37.1. Pulse ninety-six.
Oxygen saturation ninety-seven percent on room air.
No retraction. No nasal flare. He can say a whole sentence without stopping to take a breath in the middle of it.
Moreno wanted a timed respiratory observation before he came in, and a second one at the end of the visit, and the two of them written up side by side in the note.
Fifteen minutes, seated, at rest.
That is not a difficult thing to do. It is only a thing somebody has to actually do.
You cannot count and write at the same time. You never could.
The office dictation handset is tethered to the desk in room one, and room one had a four-year-old in it with a bead in his ear.
So I use my own, which I bought in August for thirty-four dollars at a shop on Lincoln that also sells batteries.
It is not the same one. The other one is in a drawer in a kitchen with the spare keys, and I have never put a battery in it again.
I took it out of the pocket of my scrub top.
I put it on the paper of the exam table where he could see it, because he is six and he asks about things.
He asked what it was.
I told him it was for writing things down when your hands are busy.
He accepted that entirely and went back to swinging his feet.
His father sat in the chair by the window with his coat still on.
He did not say anything. He has not said very much in five years, and I have stopped waiting for him to, and that is the whole of what there is between us.
I looked at the clock over the door.
I set my watch to the sweep hand at the top of the minute.
Then I put my thumb on the switch on the side of the casing.
The light came on in the corner, small and red, the way it does.
“Sixteen October 2031. Fourteen twenty-two.”
“Blackwood, Ethan. Date of birth twelve July 2025. Timed respiratory observation, room air, seated, at rest. Baseline, prior to examination.”
“Respiratory rate twenty-four over sixty seconds.”
“Equal chest rise. No retraction. No nasal flare. No stridor.”
“Scattered expiratory wheeze, both bases, on forced expiration only.”
“Saturation ninety-seven percent. Pulse ninety-six, regular.”
“Child is comfortable, speaking in full sentences, in no distress.”
“Observation continuing. Fifteen minutes.”
“Entered by Carter, L. Registered nurse. Licence 041-529814.”
I put the recorder down on the paper beside his knee.
He looked at it for a moment and then went back to his feet.
I sat down on the stool with my hand flat on the table and I watched him breathe.
Six years and three months. Twenty-four over sixty seconds.
The second hand came round to the top of the minute again.
The red light was still on.