The Missing Link

015. Stay Away

15
❥๑━━━━━━━━━━━━━━━━━๑❥

THE NEXT DAY unfolded in a blur of events. By afternoon, Zane had landed a post at the hospital–his shift set to begin at six o’clock in the evening, stretching through to the quiet hours of two in the morning.

At St. Luke’s Hospital, time crept forward. Though the first and second floors thrived with the usual commotion of bustling wards, the third floor’s east wing exudes an air of calmness. Its rooms, sparsely occupied, provided a rare reprieve from the hospital’s otherwise relentless pace. It was in this quieter wing that Zane Nuñez had been assigned for his first shift.

In a modest office tucked near the nurse's station, Zane sat alongside Sarah Perez, a nurse with five years’ experience and a knack for no-nonsense efficiency. Across the desk, Dr. Jacob Dizon, a wiry man in his forties, briefed them on their first case of the night.

“Our patient is a twenty-eight-year-old male admitted for sepsis secondary to a urinary tract infection,” Dr. Dizon began, tapping the file in front of him. “He’s been started on piperacillin-tazobactam, 4.5 grams intravenously every eight hours. Initial cultures suggest Escherichia coli as the culprit.” He looked up, the faintest shadow of weariness crossing his face. “Let’s hope for a routine case—no unexpected complications.”

Sarah frowned slightly, her brow knitting as she scanned the patient’s chart. “Excuse me, Doctor,” she said, “but shouldn’t we consider switching to meropenem? His creatinine levels have been creeping up, and piperacillin-tazobactam can sometimes be nephrotoxic, especially in septic patients.”

Dr. Dizon raised an eyebrow, leaning back slightly. “Good observation, Sarah,” he replied after a pause. “We’ll monitor his renal function closely. If there’s any sign of worsening, we’ll escalate to carbapenems.” He handed the chart to Zane, his gaze softening for a moment. “This is the sort of teamwork you’ll need to master, Nuñez. Keep a close eye on the patient’s vitals and fluid balance, and let’s make sure we stay ahead of any surprises.”

Zane nodded, clutching the chart. "Understood, Doctor. We’ll keep you informed," he said.

“Good,” Dr. Dizon replied.

Sarah and Zane nodded in unison. “Understood, Doctor. We’ll make sure he’s comfortable and keep you updated,” Sarah assured him.

Sarah turned to Zane, a file already in her hand. “Shall we go over Mrs. Lasala’s case before checking on her? She’s in the room next door,” she suggested.

Zane tilted his head, recalling the name. “Wasn’t she admitted for respiratory distress?”

“Yes, she arrived late last night,” Sarah confirmed. “She’s on supplemental oxygen for now. Initial tests were inconclusive, but when I last checked her four hours ago, she was alert and stable.”

Dr. Dizon, pausing at the door, turned back to join the conversation. “Have you reviewed her medical history? Any prior conditions that might explain the respiratory symptoms?”

“She mentioned a history of asthma, dating back to childhood,” Sarah said. “But she hasn’t had any significant flare-ups in years. She also has type 2 diabetes, which could be a contributing factor.”

Dr. Dizon nodded thoughtfully. “Diabetes could complicate matters, especially if there’s underlying infection or inflammation. Let’s schedule a chest X-ray and possibly a CT scan to rule out anything more serious. And ask her about her daily habits—diet, activity level, even work environment. Patients often overlook details that might be crucial.”

“Agreed,” Sarah said. “I’ll recheck her vitals before we proceed. Anything else you’d like us to monitor?”

“For now, focus on oxygen saturation and her response to therapy,” Dr. Dizon instructed. “We’ll adjust the plan once we have the imaging results.”