“Were you down?”
Abby considered the question. “Not really. I just wasn’t seeing the miracles of Christmas clearly.”
“Christmas is the best time of year, isn’t it?” Her patient’s gaze fell on her immobilized arm. “Only this year someone else will have to do the cooking because I suspect I’m not going to be doing much of anything.”
Helping reposition her pillow, Abby nodded her agreement. “I suspect you’re right. I hope you have your shopping finished.”
“Mercifully, yes. I’m one of those crazy women who gets up before dawn and does all my shopping on the day after Thanksgiving.” The woman chuckled self-derisively. “Fighting the crowds is a bit rough at times, but the bargain buys are worth the effort.”
“Aren’t they just the best? I do the same thing.”
Dirk stepped into the area, his face going pale.
Abby bit back a sigh. Did he really dislike Christmas so much that just hearing a discussion about shopping bothered him? How would she explain to her child that his or her father didn’t like Christmas?
Avoiding looking at him, Abby entered her nurse’s notes while Dirk went over the X-ray results with Mrs. Clifton, explaining that she needed to schedule an appointment with her primary care provider in addition to seeing the orthopedic surgeon the following day.
He left the room long enough to grab some patient education materials, flipped the pamphlet open to a page with a photo of magnified images of a normal bone and an osteoporotic one.
“Your arm broke more easily than it should have because your bones are thinning due to a condition called osteoporosis,” Dirk explained, pointing out the difference in the bones in the pictures. “This happens when the bones lose mass, weakening, leaving them in a state where it takes much less force to cause a fracture. Sometimes even something as simple as taking a step can cause the bones to crush in on themselves when the bones have weakened.”
“Crush in on themselves? The bones can break without me even falling?”
“Yes, it’s possible in osteoporosis, but falling or taking a hit is much more likely to be the culprit of a break.”
“I have this?”
“You do.” He nodded. “Have you ever been told you have osteoporosis?”
“At my last physical, my nurse practitioner mentioned that I should be taking calcium.” The woman gave a guilty shrug. “She tried to get me to go onto a medication to make my bones stronger.”
Dirk’s brow lifted. “Tried?”
The woman sighed, shrugged her good shoulder. “The medicine gave me bad indigestion so I only took a couple of doses.”
Dirk frowned. “Did you let her know you’d stopped taking the medication?”
She shook her head, careful not to disturb her arm. “No, I figured I’d discuss it with her at my next visit.” She gave him a thoughtful look. “If I’d been taking the medicine, would my bone have broken from falling tonight?”
“It’s impossible to know for sure,” Dirk replied. “Medications can add around ten percent back to the bone strength, which is a significant amount and can mean the difference between a break and no break.” He pointed to the X-rays again. “The medicine rebuilds those tiny connections, adding strength. With bones as thin as yours are, you do need to be on some type of bisphosphonate.”
“Putting up with a little heartburn would have been better than this.” She gestured to her immobilized arm.
“You should discuss your options with your nurse practitioner. There are a wide range of treatments for osteoporosis, including a once-a-year intravenous infusion of medication. With the IV method, you wouldn’t have to worry about taking a pill or having indigestion as that alternative would bypass that system and the side
effects of pills.”
The woman asked a few more questions which Dirk patiently answered. Watching him, watching his seemingly infinite patience when the woman became repetitious in her efforts to understand, gave Abby insight to Dirk. She’d witnessed his patience, his kindness, his caring time and again in the emergency room while he dealt with patients from all walks of life. Not once had he lost his temper or behaved unprofessionally.
She didn’t have to wonder if he’d been a good father. He had. Although, no doubt, with completing his residency, he’d probably been so busy that he’d missed out on more of his daughter’s short life than he’d have liked. Sandra Kelley had been a lucky woman to have Dirk’s love, to have had his baby, and experience the joys of pregnancy and motherhood with Dirk by her side, loving her.
Despite his aversion to Christmas, Dirk was a good man. The best Abby had ever met, really.
Honest, honorable, giving, strong in character.
Why didn’t he like Christmas? Did the holidays remind him of all he’d lost? Of Christmases he’d shared with his wife and young daughter?
Would she and their child forever live in the shadow of his former life? God, she prayed not, but deep down she wondered if that wouldn’t be the case.