Mervyn let himself back in, shut the door, and sat at my bedside. “Status conference?” he asked.

I nodded immediately, curious over so much overheard information.

“Sandrine, I touched base with Dr. Alan on your case. For safety, we’d like to draw some blood to check on how your liver and kidneys are doing, your infection-fighting cells, and your electrolytes. Probably everything is fine, but we’d feel better knowing. If it’s okay with you, I can do the draw here. We’ll also get more saline in case you need it tomorrow, and some Tylenol to take the edge off if your liver function looks OK.”

I shrugged. That was OK with me.

Mervyn made deeper eye contact. “Despite your history, which I’ve described, Dr. Alan finds your abdominal pain concerning. He wants you to know it would be his preference to get an abdominal CT, which we could do at the hospital without admitting you.”

I shook my head. “I react to oral contrast, and prior CTs have revealed nothing.”

“I know, and we agreed to hold off because of your history, but those were his thoughts he wanted me to communicate. He’s concerned enough about you that he directed me to perform a full abdominal examination daily until things resolve.”

“What does he think is happening?”

Mervyn shrugged. “It’s more clinical caution. Your symptoms could suggest IBS with or without inflammation of abdominal nodes, or surgical conditions, and with you appearing unwell his caution is increased. Without CT results, he can’t fully rule out an inflamed appendix or partial obstruction of your bowel.”

I searched Mervyn’s face for his opinion, which he didn’t offer.

“If things change or your pain becomes more of a concern, we could obtain a CT without oral contrast, without spending much time in the emergency department at all. We could arrange it so you go straight back and stay only until the results are read. If they were negative, we’d bring you straight home. Dr. Alan wanted to be sure you knew.”

“Okay. Would you tell me if you thought that was needed?”

“Of course. I’ll always tell you when I think it makes sense to do something differently. You have my word. But I did consult Dr. Alan not just to arrange bloods and fluids; I wanted his view on your case, and this is his view.”

“He was okay with your following me closely but no CT?”

“Yes, in his view that’s an acceptable minimum with your current presentation.”

“He wants us to continue with your lung PT and suggested we add percussion to our breathing exercises. Ever had your chest percussed?”

I told him yes, once, years ago during a mild pneumonia. I remembered it feeling strange.

“Let’s work on that until the courier arrives with the phlebotomy kit.”

He drew out his stethoscope and asked me to sit up. “We’ll listen to your chest before and after to see if it helps. Deep breath in? Again? Keep going. Okay, say ‘99,’ please?”

“And again?”

“Again?” The stethoscope was cool but Mervyn kept one comforting hand on my shoulder as he listened.

“Your chest is about the same, no better, no worse. I’m going to percuss your lungs now from the back. We can do that through your nightgown. This might feel a little strange but shouldn’t hurt. At times I’m going to say ‘breathe,’ and when I say that please do the clearing exhale we worked on earlier, okay?”

Mervyn hit me lightly on the back, starting from the bases of my lungs and working upward. I felt like a human bongo drum.

“Breathe!”

I exhaled hard as he continued to pound on my back.

“Good! Breathe!”

I began to cough; while I coughed, Mervyn kept pounding my lungs. Thick phlegm leapt into my mouth and I yanked up my mask and grabbed a tissue.

Mervyn stopped banging. “Productive? That’s good!”

I nodded, teary-eyed, spitting phlegm.

“May I see?”

I rolled my eyes, embarrassed, and handed over the tissue.

“No embarrassment needed! Nurses see far worse. The color and consistency are medically valuable information.”

Here he peered in. “It’s yellow, which is typical when you’re fighting an infection, but there’s no red, no blood, so that’s good. It’s very thick, which again suggests we need more fluids in you. But it’s great that we’re able to help you get that out of your chest.”

Mervyn held up his stethoscope. “Okay for a second listen?”

I breathed and ninety-nined, and Mervyn seemed pleased.

“We’re starting to shift the consolidation in your right lung. We’ll keep this up until your lungs sound clear.”

There was a knock at the door, and I heard Chella’s voice as she handed over the bag from the courier. I strained to hear as Chella and Mervyn whispered in the hallway.

“How’s she doing? This morning she asked me to set up Dr. Alan as her primary care and put him on a retainer. I have that underway as a rush with his office and her contracts attorney. I’m just worried about her. She goes down with these things so hard, and it’s been more than a week. I’m so glad she hired you.”

“I’m glad, too. I hope Dr. Alan and I can start to get to the roots of all this. She’s tough, which is good. We’re seeing progress with the pneumonia, but she’s still quite ill overall and might need another day of IV fluids. We’re pulling these bloods as a precaution. Please keep clearing her schedule? And can you ask Ryan to bring a large mug and a few bottles of cocktail bitters? Dr. Alan has some good ideas to get her drinking more water.”

“Of course. I really hope she feels better soon. Have her let me know if there’s anything else I can do.”

“Will do. Please wait here? The draw will be fast and you can get the tubes back out to the courier.”

Mervyn returned, laid out the tubes, put a towel under my non-IV arm, tightened a tourniquet on my upper arm, and alcohol-swabbed the inside of my elbow.

“Small prick now, good.”

Mervyn was a good phlebotomist, with an accurate stick that barely hurt. He filled the first tube rapidly and switched to the second. “Your staff is wonderful, and they all care about you and have offered anything they can do to help.”

“I’m very lucky.”

“They’re all worried. Everyone I talk with says this is a pattern, you getting very sick out of nowhere.” He traded tubes. “We’re going to get you better and then work on root causes, for your recurrent infections and your IBS.”

The last two tubes filled and he had me press a cotton ball to my arm while he packed up the tubes and handed them off to Chella for the courier. He returned juggling my favorite blue-and-white cappuccino mug and three bottles of bitters.

I raised an eyebrow. “Is Dr. Alan prescribing patent medicines?”

“No, but he will be on me like white on rice if we can’t get you drinking more fluids. His suggestion was warm water; it’s more soothing, with just a drop of bitters to keep the taste interesting.” Mervyn poured the water he’d been recycling for steam baths back into the mixing bowl and filled the electric kettle with fresh water.

“Regular, orange, or lemon bitters?”

“Regular?”

Mervyn added a drop to the mug and poured the water before it boiled.

I tried a sip. It tasted faintly, exotically herbal and the warmth didn’t feel as bad going down. I tried a second sip.

“Was Dr. Alan right?”

“This is better. I guess you can tell him he was right.”

“I hope that’s the first of many times,“ said Mervyn. “Cheers!”