Null Pointer

Variations on a CWE28 Theme

The Award

“Doctor Belden, please report to trauma three,” echoed over the intercom just before Brian was able to give his order to the hospital barista. So, it’d be another cup of lukewarm hours-old coffee from a breakroom pot, several hours after he wanted it.

Why did I want to be a doctor, again? Brian asked himself, heading straight for trauma three (do not pass caffeination).

“What do we have, other than a lack of coffee?” He asked those already attending the patient.

“If we knew, we’d’ve waited until you had coffee to page you,” the nurse practitioner answered.

“I appreciate getting even that much consideration.”

“Paramedics got the call to that new bike path along the Hudson, man down. Witnesses said he just went down. Didn’t skid out or lose control or anything. One minute he’s biking along; the next he’s falling off his bicycle. He was alert and responsive when the paramedics arrived; told them he just ‘sort of blacked out for a minute’. He’s been going in and out since. Vitals are stable, though.”

“So, that’s practically textbook for a seizure disorder. What’s neurology have to say?” They paged him for the weird stuff, not the obvious stuff.

“Neurology says the EEG is normal, even as he’s going in and out of these ‘black outs.’”

“That’s a fun one,” Brian murmured. The symptoms really were textbook for a seizure, so why wasn’t the test showing it? What else could present like a seizure with normal brain activity?

The patient was coming around again. Brian introduced himself, promised to do his best to figure out what was going on.

“Appreciate that, Doc. There any water around? It’s getting hot in here….”

Brian nodded to the nurse who looked to him for confirmation before filling a cup with water, but added that to his pile of symptoms. The hospital was always at least two degrees colder than Brian wanted to be. It never got “hot in here.” Never.

“We have a temperature on our patient?” He asked.

“Paramedics had him at 98.2 on the bus. Intake has 97 flat.”

That was a significant drop for readings that were almost certainly less than fifteen minutes apart, but there were dozens of ways to explain that. “How long ago was the last read? And can we get a fresh one?”

“About an hour and a half,” the nurse answered.

“And I’ve got 99.9.”

“So, he’s fighting something. Let’s keep an eye on the temperature until we get this figured out. Hey, you haven’t been on a cycling vacation recently, have you?” Brian asked their patient.

“Earlier this month, yeah. Finally did the Mediterranean Double K. Just under 2,000 kilometers, along the coastline from Barcelona to Lisbon.”

“Must have been quite the experience,” Brian said. He loved the idea of a bucket list trip like that when he heard about them. He thought he’d enjoy the experience of doing a trip like that or a pilgrimage or hiking the Appalachian Trail or whatever. In theory. In practice, it sounded exhausting.

“Jess, you sent blood down to the lab straight off, of course?” The nurse practitioner who had called him into this case confirmed she had. “Would you call down and ask them to test for IPDD?”

The patient blacked out again. “IPDD? I don’t think I’ve heard of that one?” The nurse asked.

“Parasitic infection. Disrupts the receptors on the neurons – brain’s functioning normally; body’s just not getting the direction consistently. There’s never been a confirmed case that originated outside of the Iberian Peninsula, so you’re absolutely forgiven for not having it on your weird case bingo card in New York.”

“It was on yours.”

“La Guardia still hopes I’ll cover the odd shift, so they haven’t kicked me off their internal mailing list. CDC put out a treatment plan reminder this week, because there’s been an uptick in cases in Spain, and they figured some of them were likely to get on planes and land in places like New York City before they were symptomatic, since it has a long incubation.”

The nurse practitioner came back in. “Lab confirms, Doc. I pulled up the latest guidance, because this isn’t a disease I have the protocol memorized for.” She handed him the tablet.

Brian skimmed it, making sure it meshed with his memory of the CDC bulletin – just to be sure the CDC hadn’t been putting out updated guidance that might not have made its way to a small hospital’s internal systems yet – and then handed the tablet back. “Go ahead and start the protocol. I’m going to get that coffee now.”

“As always, we appreciate the assist, and you somehow always just happening into the right information to make all our weirdest diagnoses.”

“Glad I could help.”

“But you’d be gladder if we timed these things for after your morning coffee,” one of them teased.

“You say that like your coffee mug doesn’t say nothing can be held against you until you’ve finished it,” Jess teased back. “We’re all fully dependent on our morning fix. We can’t give Doctor Belden too much of a hard time for that.”

“I’ll be back to check in on the patient. You can give me a hard time about my coffee dependency then.”

“I’ll hold you to that, Dr. B.”

Honey gave her husband a kiss when he arrived home from the hospital that evening. “How was your day?” She asked.

“Mm. Diagnosed a guy with a rare parasitic infection from Europe before my first coffee,” he answered casually.

Honey giggled. “You know you say that so casually, it’s no wonder your siblings tease you about being boring.”

Brian raised an eyebrow. “You want me to tell my dramatic brother and too-curious-for-her-own-safety sister that I have a reputation for being able to diagnose all the weird cases, so I get called to them. You want me to tell those two that if we ever had a horror movie pandemic, I’ll probably be the one diagnosing patient zero? I thought it was better for everyone that they think I’m boring.”

“They’re not so bad,” Honey admonished.

“So, you don’t think Trixie would hear a story like this and dive headlong into the mystery of how a parasite that’s never been found outside of the Iberian Peninsula infected a New Yorker, before I get to the part where I already know how that happened and there’s no mystery at all?”

“I mean, she might. But I don’t think she would suggest actually going to Spain or Portugal to find the parasite and bring it to justice. And if she did suggest it, I think I could talk her out of it,” Honey said.

“And Mart? Mart wouldn’t freak out that I was going to bring one of these weird cases home with me, like we don’t have protocols to make absolutely certain that never happens?”

“He would, but then he’d get over it,” Honey acknowledged. “It’s Bobby who would decide that his brother is going to start the zombie apocalypse, which of course he’d find terribly exciting.” She considered. “Actually, I kind of want to tell him, because he’d write a whole Cosmo fanfiction about it on the Appleton board, and I want to read it.”

“Bobby writes fanfiction?” Brian asked.

“Very well, actually,” Honey said. “He has Mart’s sense for words without Mart’s tendency to overreach. I mean, don’t tell him I know which username is his. I think he likes the anonymity of it.”

“Honey,” Brian complained as she tried to tell him he couldn’t refuse the award the mayor wanted to bestow upon him. “I read my email and asked a guy if he went on vacation. I do not deserve a dinner in my honor and a medal or whatever for it.”

“You saved a man’s life,” Honey reminded him.

“That’s the job. I do that every day.”

“It’s heroic every day,” Honey replied. “Just because you’re used to it after all this time doesn’t mean it doesn’t matter.”

“But if you want to make that argument, then the paramedics who brought him, and the ER team that treated him and had the good idea to page me, and the lab that ran the bloodwork that actually confirmed it, they’re all heroes, too. As much as me. More than me.”

“That’s an argument you can make to the mayor. You can say that it was a joint endeavor and all parties involved in the case should be honored equally.”

Brian sighed after reading the Sleepyside Sun’s account of “Local Hero Receives White Plains Mayoral Award”. The byline wasn’t Mart’s, but Brian could hear his brother’s voice loud in between the words. “Tell me Bobby was less dramatic about it?” He said with resignation.

“TBD,” Honey answered. “He’s only posted the first chapter so far. You’ve successfully started the zombie apocalypse, but it’s too soon – especially with Bobby’s flare for unexpected plot twists – to tell whether you’re the hero or the villain and how dramatic he’s going to be about getting there. I can send you the link, if you want to read that, too.”

Brian shook his head. “Only if I can request to have my brains eaten by zombies before I have to suffer through being famous. I like being Boring Brian.”

“Clark Kent,” Honey teased. “Go to work. They’re used to you saving lives there.”

“And the nurses and lab techs are so thrilled to get the little scrap of recognition, they’ve been effusive in their thanks.”

Honey laughed at him. “You’ve become the most reluctant best Bob-White in your old age. You and Jim should go hiking. He’s the only one who will commiserate with you about how terrible it is for people to notice you’re a good person doing good things in the world.”

“So,” Jim said once they’d settled into the pace of the trail, “you only ask to go hiking when something’s on your mind.”

“Honey says you’re the only one who will commiserate with me about how terrible it is for people to notice you’re a good person doing good things in the world.”

Jim burst out laughing. “The White Plains award?”

Brian nodded. “I didn’t want it. Honey said I couldn’t refuse it, but I could share the love with the other people who, like me, were just doing their job when we – collectively – saved that man’s life. And now they’re so thrilled by the rare recognition that I get even more attention from the people who should know I didn’t even do anything out of the ordinary than I do from the people who think I did something special.”

“So maybe that’s what you do. You become the guy who lets other people get recognized for the nothing out of the ordinary they do every day that is something special for the people they do it for. You’re still going to be famous, and probably famous for not wanting to be famous, but at least the other folks who want it, who deserve it, and never get it, will get a little, too.”