Page 41 of A Hidden Hope

From the confused look on her face, he almost wondered if he had spoken in Penn Dutch. He had a habit of doing that—slipping into the dialect at times. He was just about to explain himself when she sprang from the rocking chair and made a quick exit out of the store.

David stared after her in dismay. He was wrong. Wren was nothing like his sister.

Wren Baker was in a mood.

All day, Annie, Evie, and Charlie sensed something was going on with her and they stayed clear.

Even Dok. But then Dok sent Evie and Charlie off in her car to deliver insulin to Dan Hostetler, who had a broken leg and couldn’t come into the office for supplies, and Dok was busy in her office, so that left Annie to deal with Wren.

She was at her desk, reading through the dispatcher information in the file Dok had given to her, when she happened to look outside the window and see Silas Eicher, an Amish farmer, shuffling up the path into the clinic. He looked unwell, his face pale and his movements sluggish.

“Silas, please have a seat,” Annie said, motioning to a chair in the waiting area. “I’ll get you in as soon as Dok is free.”

Silas nodded weakly, sinking into the chair with a sigh. Annie’s eyes darted back to Wren, who was now heading their way from the exam room. She’d been hoping Dok would’ve been the one to come in, but she was on a phone consult with another doctor.

“Silas Eicher should be seen before the next patient,” Annie said.

Wren frowned. “Does he have an appointment?”

“No, he’s a walk-in. Dok makes allowances for emergencies.”

Wren looked up, her expression sour, like she’d just taken a bite of a lemon. “Because they’re never real emergencies.”

Annie hesitated. “Silas doesn’t look too good. Maybe—”

Wren cut her off with a curt nod. “I’ll handle it, Annie. Get him settled in the exam room and I’ll be right in.”

Annie bit her lip, feeling the familiar rush of intimidation. She helped Silas into the exam room, her concern growing with each step.

Wren came into the room. “So what seems to be the problem today?” Annie noticed that she didn’t introduce herself and barely glanced at Silas but spent most of her time looking at his file on the computer monitor.

“Dizzy ... can’t catch my breath,” Silas mumbled.

“Probably just too much hard work in the hot sun.” Wren’s voice was brisk. “I’ll need to take your blood pressure and listen to your heart.”

Annie’s worry grew. She knew Silas well enough to sense something was off.

“Your blood pressure is high,” Wren said. “Higher than last time you were in. I’ll prescribe you something to manage it. And you need to listen to your body. Pace yourself when the weather is this hot.”

“But ... my chest...” Silas’s voice was faint.

Annie’s heart raced. “I’ll go get Dok.” This wasn’t just sunstroke.

“No need to bother her.” Wren didn’t even glance up as she wrote on the prescription pad. “Annie, the pharm rep left some samples of lisinopril. If you’ll get them for me, we can get Silas feeling better right now.”

Annie darted out of the room and went straight to Dok’s office, bursting right in. “We need you.”

Dok’s face tightened with concern. “I’ll call you back.” She hung up the phone.

Annie followed as Dok entered the exam room. Wren was writing a prescription, her back to Mr. Eicher.

“Wren, what’s the situation?” Dok said, her voice calm but firm. She moved closer to Silas, her eyes scanning him quickly.

“It’s just a case of high blood pressure. I’m prescribing him medication.”

“Chest ... feels tight ... can’t breathe,” Silas gasped. He was grasping his left arm.

“This is more than high blood pressure. He’s showing signs of a heart attack.” Dok acted swiftly, her voice taking on an authoritative edge. “Annie, call 911. Now. Then bring me aspirin.”

Wren froze, her pen hovering over the prescription pad. “But he ... but I ... I didn’t realize...”

In a flash, Annie was in Dok’s office to call 911, then to the medicine cabinet and back to the exam room.

But in that brief time, Silas had gone into full cardiac arrest. He was flat on his back on the exam table and Dok hovered over him, doing CPR.

“Annie,” she said, somehow knowing she’d come back into the room, “get the defib.”

Annie ran to the hallway and brought back the defibrillator. She set it up in record time and handed the paddles to Dok.

Dok checked the defib monitor. “Stand back.”

Annie took a step back, watching for a sign of life returning to Silas. His face was losing color. Three quick shocks, one right after the other, and then Dok was back to CPR.

Annie held her breath, silently praying for him. Ten seconds, thirty seconds, fifty seconds—

“I got it!” Wren’s fingers were on Silas’s wrist. “I feel a pulse!”

The sound of approaching sirens filled the air and in walked Gus and his paramedic partner.

He was all business, hardly acknowledging Annie other than a slight wiggling of his eyebrows.

Gus prepared the gurney as Dok provided some staccato-style information about Silas’s condition, making sure they knew everything.

They whisked Silas on the gurney through the office, past the waiting room full of wide-eyed patients, and out the door into the ambulance.

Dok and Annie followed until the doors closed and the ambulance left for the hospital.

The waiting room full of patients was completely silent, watching the scene.

“DOK! Is SILAS gonna MAKE it?” Hank Lapp said. Annie didn’t even know when Hank had come in.

Dok turned and pointed at Hank. “Say a prayer for him.” She headed back to the exam room but stopped for a quick second. “Annie, come with me.” They went into the exam room, where Wren sat ashen faced in a chair. Dok closed the door.

“He had a pulse,” Wren said, as if that fixed everything.

Dok nodded. “A weak one. Why did you miss the signs of a heart attack, Wren? Annie spotted them. I saw them as soon I walked into the room.”

“Because...” Wren sounded flustered. “Silas Eicher has a history of high blood pressure. That was the most logical assumption. Go first to the chart and see a patient’s history. That’s what I’ve been taught—”

Dok lifted a hand in the air to stop Wren. She turned to Annie. “Why do you think Wren missed Silas Eicher’s heart attack?”

Annie swallowed. Suddenly, she was five years old again, with a doctor asking her to contradict her mother’s imagined symptoms. She didn’t like being put in that spot then and she didn’t like it now.

Dok knew that. “Annie,” she said, her voice softening a bit. “This is about helping Wren to be a better doctor.”

Annie cleared her throat but kept her eyes fixed on the tops of her shoes. “Wren doesn’t really...”

When her pause went on too long, Dok said, “Doesn’t really what, Annie?”

“She doesn’t really look at the patients.”

“I do too!”

Dok let out a sigh. “Wren, you have to see the patient. Really see them. That’s why I believe so strongly in making house calls. I learn more from going into someone’s house than I ever could in a twenty-minute appointment in the office.”

Wren’s eyebrows knit together. “House calls are an incredibly inefficient use of time. Not to mention that half of your patients don’t have access to the internet. There’s no data on them. Data is what you need to make an accurate diagnosis.”

“Medicine is more than data. More than statistics.”

“That’s not what I’ve been taught in med school.”

Annie’s head went from one to the other, like she was watch ing a tennis match. The tension in the room might have been invisible, but it was thick.

Dok lifted her eyebrows. “And that’s the whole reason why medical students are required to have residencies. This is the time to gain experience and learn to rely on more than numbers to tell you what you need to accurately diagnose a patient.”

Wren’s face was a mixture of determination, defiance, and just a hint of guilt. “Then maybe I need a bona fide residency.” She rose and left the room.

Dok exchanged an exasperated look with Annie. “I’ll go call Silas’s son and let him know what’s happened.”

Annie cleaned up the exam room to prepare it for the next patient. By the time she returned to her desk, she noticed the door had been left open.

“If you’re LOOKING for that lady doctor with the BIRD name,” Hank Lapp said, “she’s GONE.”

Before Annie closed the door, she swept a gaze over the parking lot.

Had Wren left the office? Or the practice?