Doctor and His Nurse

Dr. Maxwell Straus finally warms up to his new nurse

Eric Hollis, a 30-year-old personal aide to Dr. Maxwell Straus, knocked on his boss's door before entering, "Cabot has you by the balls on this one."

"Goddammit. For the last time, No! How much more paperwork am I going to have to fill out now to make them go away," Maxwell Straus replied.

"There may be no away out of this one. The budget for all our supplies and medications now go through his office. The governor signed a new order giving the Oregon Department of Health more control," Eric said.

"But I've already told them we just need the medical goodies, no undertrained nurses walking around wreaking havoc," Maxwell said, "Maybe I'll call up my old friend Dr. Ellery to see if we can get out of it."

"Dr. Ellery won't be able to do anything, his hands are tied by Cabot. That guy is like a czar in the department. Listen, I know you like running everything one way but perhaps having another nurse here won't be so bad," Eric said.

"I like to run my office my way. The right way! You know, that way we actually save lives instead of destroy them."

"I should have told you this first, but there's a nurse coming Monday. Her name is Katie and she just graduated from University of Oregon's nursing program."

"Just let me call Dr. Ellery. He has friends in high places."

Dr. Straus knew he was fighting a losing battle. He was of the opinion that there was a right way to do things and to compromise, just one bit, was a loss of moral character. In the last 7 years he had become more adamant about his personal code of ethics. He grew up in North Falls, Oregon but attended UCLA on a football scholarship and later went to medical school there as well. As soon as he became a doctor, he married his high school sweetheart Paula.

They promised each other they'd move back to North Falls as soon as he paid off the remaining medical school loans. Maxwell took a job in a doctor's office in Beverly Hills. He hated it. All he had wanted to do was save lives but here he was, in the most over-medicated zip code in the country, getting paid to subscribe skin creams to young models who would throw a panic attack over one blemish.

The money was fantastic. Within a few years he had pocketed a million dollars and his wife was pregnant. They would have their child, a son, and move back to North Falls.

But as her due date approached everything kept going wrong. Paula became sick and tired. After a week in the hospital labor came, but Maxwell's son was stillborn. Maxwell was heartbroken and Paula's sickness was worsened. She got infected during labor and within a week she was dead. It was a freak accident. In America, only one-fourth of one-percent of all pregnancies result in the mother dying. And even of those, most are women with some type of pre-existing condition such as diabetes or hypertension. Paula was fine.

Maxwell blamed the nurses that surrounded her up to labor. Infections were preventable. He couldn't pinpoint it, and maybe it was just random chance, but it was the nurses who killed his wife. Maxwell had been the one fixing errors of those nurses when he was just there to support his wife emotionally.

He quit his job immediately, took his million, and returned to North Falls. After six-months of doing nothing but staring at the stars he took over the private practice of a retiring doctor. That was seven and a half years ago. He threw himself completely into his work. He had no interest in finding a woman he was with Paula, eternally. North Falls was small, a few thousand people in the remote eastern-Oregon. Maxwell's clinic was the only medical office the people of North Falls could get to without driving for almost an hour. His neighbors relied on him.

"So, how's it going Fred?" Maxwell spoke with a feigned excitement. It was Fred Ellery, a former professor of Maxwell in medical school. Now Dr. Ellery worked for the state of Oregon and was Maxwell's one contact when dealing with bureaucracy. But as Maxwell begged Dr. Ellery to help him out, it was clear there was nothing they could do. Oregon's Department of Health was adamant that smaller communities start taking in new nurses to help deal with the excess of young nurses. Maxwell had one nurse in his clinic, a 50 year old, named Hannah, whom he trusted implicitly. He just didn't want a 22-year old.

"Alright, well, thanks Fred. I appreciate you taking my call."

Maxwell's stubbornness had not gotten him what he wanted and it only made him leave work even more frustrated. It was a Saturday night and he was not working the next day. It had nothing to do with the fact it was a Sunday. Maxwell had worked every Sunday for the last three months. There were only a few days Maxwell took off every year, and they weren't even Thanksgiving or Christmas. He never worked on May 14, the day he and his wife got married, and July 2, the day she died. Tomorrow was July 2.

***

To say Katie Grays was nervous was an understatement. Six months ago she had no idea she would end up in Eastern Oregon. Who wanted to live in such a small and backward place? Katie grew up in Portland before going to the University of Oregon. Her plan was to move in with her boyfriend back in Portland and find a job at a hospital there.

When she made a surprise visit to his apartment, and found him having sex on the couch with a girl he later claimed he had met the night before, she was crushed. Despite a heated argument in which her boyfriend threw every excuse he could think of at her, she drove away blocking his number and e-mail. She hadn't heard from him since that day and didn't want to.

Any man would argue that her boyfriend made a mistake. She was gorgeous with natural dark blonde hair that went to her shoulders and the most unforgettable hazel eyes. While she was often insecure whenever she looked in a mirror, Katie kept her trim figure. She was blessed with breasts similar to her mothers, round C cups. After the break-up she had only been to the gym more often, hoping it would be a way to get her mind off her boyfriend. Her waist had slimmed down and the squats made her butt even more eye-catching.

As she made the drive east to North Falls trying to appear attractive was the last thing on her mind. When she realized she didn't want to live in the same city as her ex-boyfriend, she signed up for a state program for new nurses. It would be a good entry point into the medical system but she didn't get to pick where she ended up. As it turned out, the state picked North Falls for her.

***

Maxwell Straus sat at his desk at 6:00 AM on Monday morning looking over the medical records of the patients he would be seeing later that day. He heard a knock on his door but it wasn't his aide Eric or his trusted nurse Hannah. It was Katie.

"Dr. Straus? Hi. I'm Katie Collins, the new nurse," she said as she reached out her hand for a professional handshake.

"You can sit down," Maxwell said. He had taken a day off, but his anger didn't lessen at all. He spent it flipping through old photo-books filled with he and his wife. A picture of them on his graduation day, and another one of them at their wedding. His favorite photo of the two of them was taken at DisneyLand. He had asked a stranger to take a picture of them together as they posed with all their ridiculous Disney loot, Mickey Mouse ears and a Goofy stuffed animal. As the stranger was about to take the picture, Paula let go of her Mickey balloon by accident and they both laughed as they reached out unsuccessfully trying to grab it. The stranger had pressed click just as the two extended one arm to snag the balloon, with the other still wrapped around each other in embrace. The laughter bursting out of the photo was undeniable, and it still brought a smile to Maxwell today.

"So. You want to be a nurse here for six months? You've never worked anywhere else before this?" Maxwell said.

"Well, I've shadowed and I've assisted nurses. But yes, this is my first real nursing job."

"Listen, I don't do surgeries around here. It's mostly check-ups and diagnosis, but I still take things seriously. If you mess things up people will be hurt. So, just because you're new doesn't mean you get any get out of jail free cards," Maxwell said.

Katie was instantly taken aback. Her new boss did not sound fun at all. He was a hard-ass. At the same time, she was compelled by his seriousness. She got into nursing to save lives. It wasn't fun hanging around the sick and old all day. Maxwell was in his mid 30s, Katie guessed, but carried himself as if he was much older. He was tall, 6'2, and well-built. He was wearing a shirt, but it was clear he had a build much more similar to a lumberjack than a typical doctor.

"Well, I'm here to do my best. I can't wait," Katie said with a smile. She knew she sounded naive and overly-friendly to Dr. Straus but she could not help herself.

"Good," Maxwell said. There was a lingering pause between them two. Maxwell took in the entire aura of Katie. Maxwell couldn't help but notice her beauty. He had not been with a woman since Paula. Women were not usually on his mind, even if he saw movie with a blonde-bombshell running around in a bikini. But as he looked at Katie he thought of how cute she was, and how her eyes looked a bit like his wife's. "How are you enjoying North Falls?"

"It's ok. It's quiet. Like...real quiet," Katie said.

"It is. I grew up here. That's what I like about it. There's no phonies here, just nice people. Are you from near at all?"

"Not at all. I'm from Portland and went to school in Eugene. I've never even been this far east in Oregon."

"Why'd you pick it then?" Maxwell asked.

"Well, I didn't. I just signed up for the program and they chose for me. I can't say I was jumping up and down when I found out I would be working out here," Katie said.

"I guess that makes two of us."

***

The first week of work for Katie was a bore. A part of her took that as a good thing. She didn't have too many stressful moments that her nursing textbooks had prepared her for. Maxwell had given her the duty of weighing patients and asking them some preliminary questions before he could see them himself. She sometimes got to conduct a blood test. But for all the more intense duties Maxwell stuck with his older nurse, Hannah. Katie was delegated to a second-tier position. She was the youngest, but she wondered how soon she would go crazy in North Falls.

"Here's the results from the morning tests," Katie said as she walked into Maxwell's office.

"Great. Thanks. That was my last patient of the day if you need to head home now."

"Are you sure you don't want me to stick around a bit longer? I can help you enter those tests and start to setup up follow-ups with the patients that need one."

"That's ok. Thanks though," Maxwell said.

"When I worked as a nursing assistant before, I got good at filling out the Medicaid forms. Are you sure you don't want me to do that?" Katie offered. If she had been in a city she might be willing to take off for home sooner. But given there was not much awaiting her in the small empty house she was renting she wanted to be as productive as possible at work.

"I'll fill it out myself. I have ever since I took over this practice. It's worked well," Maxwell said, pausing before speaking the last sentence in clear and loud language. It was clear he wanted Katie to leave the office by his tight body language. His thick forearms forced on his desk, with pen in hand, as his eyes remained glanced up at Katie.

"Ok. Well, I guess I'll see you Monday."

***

The weekend for Katie was dull. She explored North Falls as much as one could. There were a couple antique stores she had fun walking around, examining every old handmade chair and picture frame built 100 years ago, but there was little she had any interest in buying. At home she called some friends from back home and chatted, but most of them were off to eat at restaurants and having cookouts at night. They were too busy to spend too much time on the phone with Katie and she began to wonder if she could last six months.

The house Katie was renting sat at the bottom of the hill, near a stream, and during the day she went on a few walks. It was quiet and beautiful, but the isolation only made it scarier at night. As she laid in bed alone she wondered if anyone was within 100 yards of her. What was she doing in North Falls?

She knew that Dr. Straus was working over the weekend. Maybe she'd stop in and see if he needed help? No, that was not a good idea. He was the type of man who did not enjoy being undermined or even surprised. There was just nothing else for Katie to do except watch television and read her book on Eleanor Roosevelt her mom had bought her.

On Monday morning she showed up to the office at 6:00 AM.

"Hello Dr. Straus. How was your weekend?"

"It was good. Why are you here so early? You know my first patient doesn't get here until 8:00 AM," Maxwell said.

"Well, I just figured I'd come in a bit ahead of schedule to see if you needed help with anything."

"I don't," Maxwell said, realizing he was being overly harsh on his new nurse, "but thanks."

Maxwell reflected on Katie. She was eager and had a flawless first week. Things were smoother in his office with an extra pair of hands and though Katie was young, she was at least good at the limited tasks he had assigned her. She would get to keep doing them, he decided, since she was so good at them. There was no chance of her getting in the middle of the flow that he had with Hannah, his trusted nurse.

"Oh ok. Well, I guess I''ll just wait in my office until eight then," Katie said.

She turned around and began to walk out the door. Maxwell noticed her butt looking nice in her tight jeans. Katie hadn't put on her nursing uniform yet.

"Wait," Maxwell said, "Here! You don't have to if you'd rather wait until 8:00 AM to start the day, but here's some of the files from today's patients. If you really want to help out how about you go through them and figure out what tests we'll likely need to order."

"Of course," Katie said, "I'll get right on it."

Maxwell handed her some files and she began to flip through them examine their contents.

"Check to make sure you have all my AM patients in there," Maxwell said.

Katie began to peer at the papers making sure she had seen this type of record before. She had, and was relieved she wouldn't have to come back to Dr. Straus for clarification.

She looked at him and caught him staring at a picture on his desk. It was tilted away from Katie, so she could only get a glance at it, but it was a picture of a young Dr. Straus and a woman with arms wrapped around each other. Was it his girlfriend? Katie wondered. The other nurse, Hannah, had mentioned in passing to Katie that Maxwell wasn't married and didn't have kids but perhaps he still had a companion.

"Got it all?" Maxwell asked as he tilted his head up.

"Yes. I'll have these ready in no time."

***

Katie was in her "office", a small room about the size of a closet, that was barely big enough for her desk. She began reading over the medical records. All she had to do was figure out which patients were due for immunizations, or a certain test, or anything else that the doctor would need to know before meeting with each person. It wouldn't take long. Usually these checklists were just gone over right before the patient arrives. Doing them early might save Dr. Straus some time, and more importantly it would help Katie prove to him she could handle more responsibility.

By 7:40 AM she was back in Dr. Straus' office.

"Here you go," Katie said, "It looks like your 9:30 will need a mammogram - the guidelines have changed in recent years so it was missing from there. Everything else looks good but I marked down all the blood tests that needs to go."

"Hmm. Great. Well, thanks Katie," Maxwell said. He was starting to warm up to having her around. Hannah was invaluable during the day, and cared about all the patients, but didn't have quite the same hustle that Katie had been showing.

"No problem Dr. Straus," Katie said.

"You can just call me Maxwell."

***

Once the day started, Katie was back into her more routine work and didn't get too much time with the patients during examination. But, when Maxwell passed her in the hallway, he gave a smile instead of the more intimidating stare down he had giving for lots of last week. It's not like he wasn't still intimidating to Katie in many ways. He was a full 8 inches taller than her and his sturdy frame compared to her petite one made for a physical mismatch that translated to a psychological level. Even though he was now smiling, he was still so serious. His practice was his life.

At the end of the day, Katie offered to go over the files for the patients for the next morning. That way neither she nor Maxwell would have to get in early. He agreed. In a way, his compulsion to do everything in his office and have total control was not just about maintaining good medical standards. It was about filling time. He had nothing to do outside of work. Even though he felt at home in North Falls, he had no one to explore it with and no one outside of his office. Both his parents had passed away.

Katie was looking over the files, mostly just going through a checklist of standard tests, when she opened up the notes that the doctor had taken that day. One of the patients, a 51 year old man, had blood in his urine. Maxwell had ordered tests for kidney infection but Katie was unsure. He didn't have fever or the chills which accompany most kidney infections. And when she looked at the records from his standard physical six months ago, he had constipation and dribbling urine. Those were symptoms that sounded common, but taken altogether sounded like the possibility of prostate cancer to Katie.

"Uh. Dr. Straus, can I talk you for a minute about this patient. The four o'clock," Katie said, sitting down in his office.

"I thought I told you to call me Maxwell," he said.

"Oh. Sorry. It's just...do you think you should order some tests for him to check to see if he has prostate cancer."

"What? Why? He had blood in his urine. I think it's probably a kidney infection by the way he was talking about his pain."

"Well, you know he's over 50. Look at his last physical. He said he was waking up in the middle of the night to pee and was dribbling urine. I don't know," Katie said.

"I don't think so," Maxwell said. He sat straight up in his chair, now towering over Katie from afar. His hands motioned in the air and he shook slightly his head as he spoke, "No pain in the thighs, no problems otherwise with his manhood. There's no reason for the test."

"It's just that-"

"You handle the paperwork Katie. I'll handle the tests."

***

After Katie left, Maxwell began to go through the paperwork he had in front of him. This weekend he was working at a clinic about 50 minutes north of North Falls. It was for a Native American reservation that didn't have access to medical care. They didn't have extensive medical files, but he was reviewing notes from his last visit so he could be prepared.

He glanced at the folder Katie had left on his desk. She had some nerve coming in and suggesting a test that he hadn't ordered. Hannah had never done that in the more than seven years she had worked with him. Maxwell had ordered tests for prostate cancer hundreds of times. If he thought the symptoms had matched to today, he would have ordered test for prostate cancer himself.

Without thinking he pushed the notes from the Native American visit aside and picked up his patients files. He began to pour through all the notes and his tests on the man from the last several years.