Consult-Liaison Education Lessons Medicine Observations

Red Herring (VIII).

The urge was to glance at the roster on the wall and go directly to the patient’s room.

Instead, I said to the clerk, “Hi. I’m one of The Patient’s outpatient doctors. May I trouble you to page her doctor so I can talk with him?”

Five minutes later, a man wearing a bow tie and a stethoscope around his neck walked onto the unit. He pitched himself forward when he walked; his shoulders were ahead of his hips, which were ahead of his knees.

“So you’re her psychiatrist, huh? She’s a nice woman.”

Yes, she is.

“GI scoped her this morning to open the stricture,” he said, waving his hand to direct me to follow him. “No complications. She should’ve gotten a breakfast tray by now. You see her yet?”

Before I could answer, he continued, “Interesting case. Not sure why she developed the stricture. You want copies of her notes? I’ll give you copies of her notes.”

My eyes skimmed the papers as he handed them to me. Though several pages mentioned a significant narrowing of her esophagus, none mentioned cancer.


After thanking him, I went to go see my patient.

“Hellooooooo!” she squealed, waving her twiggy arms at me. “So nice to see yooooou!”

“Hello,” I laughed, noticing the sign marked “NPO”[1. NPO stands for “nil per os”, which means “nothing by mouth”, which means that the patient should not eat or drink anything for a certain amount of time. The sign should have been taken down since her procedure was done.] above her bed. “Do you mind if I sit down so we can chat?”

“No, no, sit, sit!”

“What did they bring you for breakfast?”

She gingerly lifted the plastic cover off of the breakfast tray. Pointing at each item, she said, “Eggs… toast… cereal… milk… juice… fruit?”

“There’s tea, too.”

“I don’t like tea.”

I smiled.

“Please, start eating.”

She peeled the wrapping off of the plastic utensils, plucked out the spoon and fork, and set them on the table. Her thin fingers opened the small milk carton and the single-serving of cereal.

“What happened this morning?

After pouring the milk into the cereal, she dunked the spoon into the mixture and fed the flakes into her mouth. She chewed, then swallowed, with ease.

“They put something down my throat.”

With the fork she scooped a blob of cold scrambled egg into her mouth.

“Why did they do that?”

“To open it up so I can swallow.”

She bit into a slice of toast. It looked soggy.

“Did it hurt?”

She shook her head. “I’m fine.”

I smiled again.

She ate it all: The eggs, toast, cereal, milk, juice, and fruit in heavy syrup. The tea continued to give off steam in the corner of the tray.

“That was good,” she said.

We sat in silence for a while. She looked out the window. I looked at the thin muscles hanging off of her bones.

Abruptly turning to look at me, she said, “Thank you. You knew there was something wrong and you got me help. I was really sick. Thank you.”

My cheeks suddenly felt warm. A smile blossomed on my face. No longer able to hold her gaze, I looked away and said, “You’re welcome.”

Finis! Epilogue to follow. The story begins here.