Lower right quadrant pain. Nausea. Vomiting. Fever. The words arranged themselves in my mind with terrifying clinical efficiency. After thirty-one years in medicine—twenty-three years as a general surgeon and eight as chief of surgery at St. Catherine’s Hospital—you do not hear that cluster of symptoms without seeing a differential diagnosis assemble itself immediately. Appendicitis. Acute appendicitis until proven otherwise. And if an emergency room physician had allowed two hours to pass without proper assessment and treatment, the situation could already be moving from urgent to catastrophic. An inflamed appendix could perforate. Perforation could lead to peritonitis, sepsis, shock, death. There are moments in medicine when time feels abstract, like something you measure in schedules and wait times and OR blocks. Then there are moments when you understand with perfect clarity that thirty minutes can be the difference between a routine laparoscopic procedure and a child-sized coffin.
“Who’s the attending physician?” I asked.
“Dr. Vance. Dr. Leonard Vance.” Ethan swallowed audibly. “He barely examined me. He did this quick palpation, barely touched my stomach, then told the nurse to give me Tylenol and discharge me. Dad, I’m not making this up. Something is wrong.”
I backed out of the driveway so fast the gravel sprayed under the tires. “Listen to me carefully. Do not let them discharge you. Tell them your father is Dr. Garrison Mills, chief of surgery at St. Catherine’s Hospital, and I am on my way. Do not leave that ER, Ethan. Do you understand me?”
A pause. Then, smaller: “Yeah.”
“If your appendix ruptures because they delayed treatment,” I said, hearing the controlled fury in my own voice, “people are going to lose their medical licenses.”