Because this was the third time that week Mr. Fluckinger had checked himself into Mercy Hospital's emergency room with a suspicion that he had one fatal disease or another, Jeannie was inclined not to bother running any tests, but that would be unethical. With time, she'd grown used to treating Mr. Fluckinger, then, had become annoyed with him, and now found him so frustrating that she couldn't even walk into his favorite check-up room without rolling her eyes in advance.
She'd met him on her very first day at Mercy Hospital, a few hours into her very first shift as a nurse. A coworker, Hannah Hoffman, had made the rounds with her, helping Jeannie find her way around the sprawling complex of a hospital and showing her the basic ropes inherent to nursing. Jeannie had been surprised to discover that most of what she'd learned in college was ignored. Of course, the staff was careful to ensure the hospital's cleanliness and their patients' safety, but sometimes some of the more extraneous procedure was tossed aside in the name of speed. Like most hospitals, Mercy had more patients than they could realistically treat in a timely manner, and sometimes a nurse would make a diagnosis without a doctor in order to help speed the process along, or a routine blood pressure would be skipped in order to jump right to the more important examination.
Just as Jeannie had started to feel as if she understood which procedures could be bypassed and which still needed followed, she'd reached Examination Room 35B, Hannah still guiding her and describing different hospital policies and equipment as she walked. They'd walked into the room, and Jeannie had seen Mr. Fluckinger for the first time. He'd looked very fit; his muscular arms rested on his chest as he lay in bed. A balding head lay flat on the gurney without even a pillow to support it, and he'd stared at the ceiling, his lips moving in some silent conversation.
Jeannie would later learn that Mr. Fluckinger would count the seconds that passed from the time he was admitted to the waiting room until the first nurse came to treat him. He kept track of the time lags; maybe he had a chart at home; and he'd make sure the staff knew if they were a little bit slow in treating him one day. He was very concerned about receiving proper treatment at all times.
Hannah had stood stiffly, as if she was afraid at getting caught doing something she wasn't supposed to, and had said, "Well, Mr. Fluckinger, what seems to be the trouble today?" She'd pronounced his name Floot-I-ger.
"It's a lump I found on my arm," Mr. Fluckinger had announced, holding up his left arm. It had quivered, as if he barely had the strength to hold it up, and Jeannie had felt immense pity for the man.
To Jeannie's surprise, Hannah barely glanced at the offending limb. "There's no lump there, Mr. Fluckinger," she'd announced.
"Well, you're not looking at the right place," Mr. Fluckinger had protested, turning his arm around so that his wrist faced down. "Look at my elbow. There's a giant lump right on it. I think that it's probably cancerous."
Finally, Hannah bothered to bend over and peer at the "lump," then argued, "That's just part of your elbow, Mr. Fluckinger. It's always there. It's part of the bone that holds your arm together."
"No, it's not," the man had protested. "It's not my elbow. I know what my elbow looks like, and the lump from my bone got bigger. Maybe twice as big. I'm not leaving until you take a biopsy or run a cat-scan or something to find the cancer."
'You're fine," Hannah had growled in response. "I'm going to release you now."
Hannah had struggled to convince Mr. Fluckinger that she was right, and after he'd finally left, grumbling about the lack of care she'd received, Hannah told Jeannie the truth about Mr. Fluckinger's condition.
"You'll see him here a couple of times a week," Hannah announced as they continued their rounds. "He's a hypochondriac. I think he subscribes to medical magazines or reads text-books or something, because sometimes he comes in convinced that he has some disease even I've never heard of. Other times, he'll think he has whatever's been on the news lately, or something really common. It's always different."
"There's not anything we can do for him?" Jeannie had asked, still too naive about the patient to realize how little anyone at the hospital really cared about what they could do for him any more. "We couldn't even just give him placebos and tell him they'll cure everything? Or something like that?"
"Didn't you hear what I just said?" Hannah demanded. "He reads medical books. He knows enough about diseases to always look for what's wrong with him or what's wrong with however we're treating him. He'd see right through any placebo treatment."
At first, Jeannie had thought Hannah was being cynical, but after her own fair share of experience with the hypochondriac, she too thought him a hopeless case. At first, she'd tried to be accommodating. When he'd complained of a constant headache that he feared might lead to an aneurism, Jeannie had prescribed him a pain-killer. When he'd said that his left arm had fallen asleep that morning and he thought he might be at risk for a heart-attack, Jeannie had thrown together a diet and exercise regiment guaranteed to ease even the harshest cardiovascular system.
These measures had proven unsatisfactory for Mr. Fluckinger, however. "I don't want Tylenol, I have that at home," he'd complained. "It's not about the headache, it's what it signifies." The other time, he'd announced, "I work out every day. Clearly, it's not a problem of not working out enough. Why are you afraid to run a test on my heart? Is it because I'm not some millionaire donor who gets wings of the hospital named after me?"
The most aggravating aspect of Mr. Fluckinger's complaints, however, wasn't his mistaken assumption that he wasn't receiving proper treatment due to some imaginary class-system. It was his constant presence at the hospital. Once, when they'd both had a rare moment of relaxation, Jeannie had asked Hannah, "Doesn't he have a job, or something?"
Recognizing the subject of conversation after several minutes' worth of complaint, Hannah had responded, "He must. That man has some exceptional health insurance, to be able to afford so many visits out here. Even without the tests and the medication and whatnot, weekly emergency room visits don't come cheap."
"Maybe he's a millionaire," Jeannie had breathed. "It would explain why he doesn't get in trouble for always missing work. And maybe, that's why he always complains about us not treating him well. This is all some screwed-up test to see if he can live like the poor folks or something."
Mocking Mr. Fluckinger had become a sport unto itself at Mercy Hospital, as he'd become an almost legendary figure amongst the nursing staff due to his constant presence. The interesting thing about legends, however, was that they were most interesting to those who had never seen them, and who only knew their legendary aspects because of the stories they'd heard. After a matter of weeks, Jeannie was already sick of him, and the way he always wasted her time.
The last time Mr. Fluckinger ever checked into the emergency room, he thought he had some rare African flu that Jeannie didn't recognize. She was sure it was something real; he always thought he had something real, but she would have had to look it up to know what it was Mr. Fluckinger thought he had. Jeannie didn't feel like doing at that work, and merely asked, "Have you been to Africa lately?"
"No, but I don't have to," Mr. Fluckinger assured her. "You get it from eating African beef."
"I see," Jeannie breathed. "And tell me, Mr. Fluckinger, do you buy a lot of African beef? Where do you even find African beef?"
"Well, I don't buy it for myself," Fluckinger had announced. "I'm not stupid, and I don't completely ignore my own health. I don't know where restaurants get their meat from, though."
"I see," Jeannie sighed, trying to resist the impulse to roll her eyes. "And tell me, why is it that you think you have this African whatsit-called?"
"I have all the symptoms," Fluckinger answered. "I have a fever, chills, sore throat, and it hurts to swallow."
"Sounds like your normal cold," Jeannie complained.
"Well, it's not," Fluckinger assured her. "Trust me, I can feel it, this is something serious. I don't think I'll leave this hospital alive."
Already bored with his dramatics, Jeannie lay her hand on Fluckinger's forehead, and was surprised to feel its warmth. She then did what she should have done right off the bat, and stuck a thermometer in his mouth. Jeannie smiled at Mr. Fluckinger as she waited for the device to display his temperature. When it was ready, she read it to find that it read 101 degrees.
"Looks like you have a fever," Jeannie told him. "Honestly, I don't think you've got the African beef thing. I'm going to prescribe an anti-inflammatory, and if you don't feel better by the end of the week, come back and see me." No need to give him that advice; even without it, he'd be back by the end of the week anyway.
"Can you even prescribe medicine?" Mr. Fluckinger demanded. "You're just a nurse. I want to see a real doctor." He had a point, and seeing as he actually had real symptoms, Jeannie supposed that it would be all right in this case to let the doctor actually see the whiner.
When Doctor Peterman arrived, Jeannie continued her rounds. When she came back to the room, Doctor Peterman had made his diagnosis and was finished with Mr. Fluckinger. Curious, she asked, "What's the deal?"
"Common flu," Doctor Peterman sighed, and even though the nurses made a great effort to keep Mr. Fluckinger from wasting the doctors' time, he knew the full story, too. "I didn't prescribe him anything, but recommended some over-the-counter remedies."
"Great," Jeannie chirped, entering the room to go through the motions of making sure Mr. Fluckinger understood the treatment.
When she entered the room, however, Jeannie found her patient panting and sweating. His face was bright red, as if he'd just finished running a mile, and Jeannie immediately knew something was wrong with him. "Mr. Fluckinger, are you all right?" she called as per her training, and when he didn't respond, she called for Doctor Peterman to come back immediately.
The doctors rushed back into the room, ready to deal with whatever mysterious medical malady had suddenly manifested itself, and Jeannie continued her work again, having done all that she could in the emergency situation. She took an elderly man's blood-pressure while his wife complained that he was having a heart attack and when would the doctor be in? She helped a woman in premature labor transfer to the proper ward, and held down a man who writhed while a doctor tried to treat his stab wound.
When Jeannie returned to Mr. Fluckinger's room again, he was asleep, but his sheets were sweat-soaked and even while dreaming, the patient's breath rasped. She checked his recently updated chart, saw that the doctors had simply written "Hypochondria" where they were supposed to indicate a diagnosis.
Jeannie questioned Hannah about it over her break.
"How should I know what the deal is?" Hannah responded in the overly-intent way she always did when she was lying to keep a secret, but really wanted to tell the secret and would if she were only asked. "I'm not his doctor," she continued.
"No, but I know that you're good friends with Doctor Peterman," responded Jeannie, using the phrase "good friends," which was code around Mercy Hospital for dating. "In fact, I think you and he grabbed coffee together about an hour ago when you took breaks at the same time."
"OK, maybe we did," confirmed Hannah with her aggravatingly knowing smile. "You really think we waste that time talking about work and patients?"
"Yes," Jeannie replied. "I do."
With a dissatisfied shoulder slump to show her frustration at Jeanie's refusal to play along, Hannah confessed, "All right, he did mention Mr. Fluckinger to me, but only because he was complaining about how much the case annoyed him."
"Yeah?" pressed Jeannie. "And what did he say?"
"He said that there's no reason that Mr. Fluckinger should be dying," Hannah replied. "Absolutely none. In fact, apparently Doctor Peterman tried to get Mr. Fluckinger released, but he was outvoted because the patient still has symptoms, and they think he's in real physical danger."
"So, if nothings wrong with him, what's with the symptoms?" Jeannie asked.
Hannah shrugged, then offered, "I have my own personal opinion, but you know it doesn't mean anything, seeing as I'm not a real doctor. . ."
"All right," Jeannie sighed. "What do you think?"
"I think he's doing it to himself," Hannah announced. "The human mind can do intense things. I've heard of people who can quit smoking just because they're hypnotized to do it, you know. I think his hypochondria became so intense that he actually convinced himself that he's sick, and then he got sick."
"I've never heard of anything like that," Jeannie protested.
"It happens all the time, but on a smaller scope," Hannah assured Jeannie. "It's the same idea that when one person in a crowded room yawns, everyone else around them yawns, too."
Jeannie still felt her doubts about the theory, but when she returned to Mr. Fluckinger's room, he looked even worse than before. He wheezed with each breath, and every blanket on the bed was now soaked from sweat.
Jeannie gathered clean sheets and moved to change Mr. Fluckinger's bedding. When she removed his wet blankets, Mr. Fluckinger began to shake violently, as if he were freezing to death, even though Jeannie could tell that the room was warm, almost hot. "You'll be all right," Jeannie assured him, even though she didn't know that he would.
She supposed that these sheets would need changed in a matter of hours, maybe less, considering the rate at which Mr. Fluckinger was sweating. When she moved up toward his head to tuck the top of the blanket around his shaking shoulders, Mr. Fluckinger looked at her with pained, pleading eyes and mouthed "I told you so."
A moment later, he began to seize. Jeannie called for the doctors, taking no action as she hadn't been trained for this sort of emergency procedure. Endlessly long seconds passed, and finally doctors flowed into the room, pressing Jeannie out in their hurry to save the man.
When they were finished, Jeannie could tell by the expressions on the doctor's faces that they'd been unsuccessful. "What was it?" she asked Doctor Peterman, the last to exit. "Did he have the virus after all?"
Peterman gave her a frustrated shake no, and answered, "The symptoms were right, for the most part, but he didn't respond to the medicine. It was like those practice diagnoses you do your first year. The patient knows the basics of how he's supposed to feel, but something about it's not real. Like he was faking or something."
"I didn't say it makes sense," Doctor Peterman assured her before he continued on his walk. Jeannie held her ground for several seconds, and peered into the examination room, where Mr. Fluckinger lay still under a sheet. She wondered if she could have done more initially to save him. As befuddling as the case had been, she wished she could have done more.