All Aboard Andi's Dream Ch. 07

All night long they plowed parking lots and driveways in Springville. The big Ford scraped the lots right down to the pavement even after cars had been in and out all day. They talked about their past. Gus was passionate to hear about Lucy's races, all of them, on foot, swimming, and biking, and Lucy wanted to hear about Gus's daughters. Finally, Lucy said, "Paul told me you like to race, too."

"Yeah, it's nothing heroic like you out there riding your bike across the entire country, my races are much shorter."

"How much shorter?"

"They go a..." he looked embarrassed to say it. He finally let out, "quarter mile."

"You drag race?" Her eyes got huge. "What class?"

He started another plowing pass. "Super Stock." He looked over at Lucy, who was almost drooling. "You like cars?"

"Oh God yes! My dad and my brothers raced. I worked on dad's pit crew, he had a powder blue 1940 Willys gasser, my brother had a 1964 Mustang."

Gus finished that pass and turned around to make a pass in the opposite direction. Here at the Bee Quik, he could push snow in both directions and get out of there quickly. "My super stock is a 67 Camaro SS, I have a 1962 Ford Econoline pickup for show, and my street cruiser is a 69 Olds 442 and I'm working on rebuilding a 1962 Ford Falcon Ranchero. Paul and I occasionally cruise main street in our cruisers."

"Can I drive the Ranchero?" she asked, hoping to hide the excitement in her voice.

"If you help me get her on the road."

"When can we start?"

They talked about cars and biking. As much as Lucy was excited about Gus's cars, Gus was excited about helping Lucy with her bike races. The Olympics trials are only two years away and he's been egging her on to try out for the team.

"I can't put time like that into the team again," said Lucy.

"Then try out, beat everyone, then announce to the press, 'I want to concentrate on working at the VA, we owe it to our veterans.' The VA will make you employee of the year."

Lucy laughed at his comical suggestion at first, then she sighed. It would send a powerful message, but she wasn't sure if she still had it in her to beat those kids. "Let's see what spring brings when I break out the bikes."

Archie's feed store lot was quick, just a strip that took two passes and a driveway around back to the storage building. As they left, Gus hit the button for the salt spreader that was sitting in the dump bed of his big ford. "Springville Feed, plow and salt..." muttered Lucy as she wrote that down on the clipboard.

"No. This is pro bono, like the Humane Society thrift store."

"It's a business," insisted Lucy.

"It's a friend. If I didn't drop my plow on occasion, Kenny would be out here shoveling by hand. Thanks to Wehrle Holloway bumping up their rent constantly they can't afford a plow on occasion. The farmers count on this business, so if there's no cars stalled in the parking lot, I'll move his snow and if he says anything I'll say I took a short cut through his parking lot."

Tears filled Lucy's eyes as Gus talked about treating his friends and fellow Springville businessmen right. Why couldn't she have met him years ago?

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Kenny followed Paul's lead as they headed to the cabin. They took Zoar Valley Road out of Springville, then cut over US 219, which was empty due to the storm, then followed the road past some incredibly old farms. The farmhouses looked like they were built well before 1850, and the barns looked older.

Paul's sled, the Yamaha VK 540, was a workhorse. It was built for working in the backwoods in northern Ontario. It even has reverse gear, so you can back the sled up to whatever you plan to haul. Kenny had a workhorse also, his Ski-Doo Skandic had a super wide track meaning that he had incredible traction and pulling power. He and Yi purred along behind Paul and Andi, traveling in trail until Paul pulled to a stop. He got off of his sled and went to his trailer and checked on the twins. They had stuffed lobsters and were having a lobster fight. "Are we there?" asked Sandy.

"Nope, I just need to pull this lever, so you don't get there first." And Paul pulled a lever that set a drag brake. Back on the sled, Paul started ahead, and the treelined road started going downhill. They turned a corner, and it started going downhill steeply. "This is why I set the drag brake on the girl's trailer," said Paul to Andi. "I was worried that the snow coach would push us down the hill, and we'd jack knife." Pulling the trailer with the brake set, they headed down an incredibly steep hill. The twins were hanging in their seat straps, pretending to be falling out as they went down the steep hill. The rock wall of the valley was on their right, and on their left was a sheer drop with occasional metal traffic guide rails.

"This is a road?" shrieked Andi. "It's a cliff!"

"Yeah, when you drive a car up the hill it feels like you're going to flip over backwards," said Paul. Andi couldn't see his grin, but she knew it was there.

"I never saw anything like this in Colorado!"

"This is a back road," said Paul. "Tertiary roads are engineered differently."

As they came down the steep road, Kenny pointed out the stream at the bottom of the steep road to Yi. "That's Cattaraugus Creek, that's where the trout are waiting for us."

Yi immediately forgot about her fear as she looked at the creek as it curved its way down the length of the deep valley. "Is this the Sore Valley?" she shouted.

"Yeah, close enough," said Kenny. "I grew up swimming and fishing in that creek. On those hot and muggy nights when we couldn't sleep, mom and dad brought me and my sisters down here and we'd just sit in the creek and cool off. Three naked little kids with mom and dad." He clearly missed those days.

Yi's bright beautiful eyes tried to follow the track of the creek as it wove its way under the snow, only to be exposed occasionally when it tumbled over ice-covered rocks. Yes, that's a trout haven, thought Yi. Dreams of trout almondine filled her head. From creek to pan to plate... only things that are easier to complete that journey are eggs. "The chickens!" she cried.

"What?"

"The girl's chickens! They're probably all dead," Yi gasped. "We haven't been to the cabin in days."

"They're ok," said Kenny. "We checked them yesterday, I made sure Doc had plenty of automatic feeders. They only need heat and water. There may be some extra eggs, you never know."

They reached the bottom of Zoar Valley, and the valley sides rose above them. Snowmobile tracks showed where the road was and showed how the people who lived in Zoar Valley were getting about. They stopped so Paul could release the trailer's drag brake, then moving again, they crossed a bridge over Cattaraugus Creek and turned on to Trevett road. "We're almost there," said Paul. "Wait until late September, this valley is a riot of colors!" Andi couldn't wait. Autumn in Colorado is brightly colored, but it's all yellow and green. She always was jealous of Vermont with their brightly colored maples.

"Let's take the hill!" shouted Kenny as he goosed the throttle.

"We just took a hill," said Yi as they turned on to Trevett Road and charged at the valley wall. It appeared like there was a seam in the valley wall and Trevett Road went straight into it, then started climbing. The road wove side to side as it clawed its way out of the depths of Zoar Valley. The climb was just as steep as Zoar Valley road and Andi and Yi felt like they were going to fall off the sleds so they clung to Paul and Kenny tightly.

Soon the climb eased, and they passed two large houses, one on the left, one on the right, and they waved to the folks that were shoveling their driveways. Trevett Road was only visible by the mailboxes poking out of the snow and the piles of snow from previous plowing. Then the road made a wide sweeping turn to the left.

"PIG FARM!" shouted the twins in unison and yes, they were passing Brad and Dianna Clemmon's hog farm. They turned up Brad's driveway, then cut out across the fields and were soon at their cabin. They parked behind the cabin, and everyone went straight to the big barn.

"We have to give the chickens a new bed," said Sandy with an air of knowledge and she pulled handfuls of straw from the small bale of straw that was in the henhouse. The ammonia stench of chicken shit was overpowering, and Yi gagged as she hit the exhaust fan to clear the air. They checked every coop and found dozens of eggs buried in the straw and chicken shit. As they cleaned up the henhouse, below them, engines roared to life. Kenny was first out of the barn with the snowblower, and he started clearing around the barn where the attachments for the tractors were sitting, next was Paul on the old Ford 8N tractor and he quickly coupled to the drag plow, followed by Andi on the Kubota with the plow already coupled to the front lift arms.

Andi never considered the turns her life has taken. Six months ago, she was a successful but overworked doctor at Colorado University, living alone with her babies. To her, a farm was a distant concept that provided her with food and a tractor was a toy that she would give a co-worker's son. Now she's on a tractor, and along with her husband, she was plowing out a buried driveway while her girls were showing their governess how to care for chickens. All Andi considered was that she's never been happier.

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Andi spent much of her time during her second and third months of marriage preparing for her new job with the VA. The VA was a sprawling governmental monolith with sprawling governmental regulations and requirements, and she had to learn how to deal with medical issues 'The VA Way.'

Now it was her first day, and she stood in the parking lot with Paul and Lucy, looking at her new clinic. "Relax," said Paul, as he massaged her shoulders from behind. "You know how to treat you patients. Concentrate on that, let the VA worry about VA rules."

"Are you sure?"

"Honey, it's your clinic. What are they going to do, penalize you for saving a war hero's life? Not even the VA is that pathetic."

Paul kissed Andi goodbye, then she and Lucy entered her clinic. She said hello to several patients, then she and Lucy got in line at the front desk. It was a storefront operation built in a closed clothing store in a nearly empty strip mall. Some of the walk-ins were not there for pulmonary issues, they were there because the nearest outpatient VA clinic was 30 miles away. Most of the people in the waiting room were men, but there was a female veteran among them, waiting for her turn. Lucy turned to Andi and said, "We got this, boss."

"Right now, I'd rather be in the Your Host diner with Paul." Paul had been in and out of this clinic for months as it was being built, so he was known by the staff and Andi wanted to do this on her own. There were three people in line waiting to sign in, and the waiting room was filled with men waiting. There were no amenities of any kind.

Andi finally reached the woman at the check-in desk and asked, "is the line always this long?"

The woman at the desk didn't even look up and said, "It's still early, give it time."

"Buzz me in please," said Andi.

"Where ya headed honey?"

"Doctor Robert's office."

"She ain't in till later."

"She's here now," said Andi, her 'mom voice' creeping into the conversation.

The woman at the computer looked up and said, "Let's see your ID." After reviewing Andi's and Lucy's identification, she buzzed them in, and Andi found herself in a long hall with doors on either side. To her right was a large physical therapy gym with treadmills, exercise bikes, and exercise beds for the patient to lie on and perform exercises. Next was a pulmonology lab where test were administered. "I want to check this out boss," and Lucy ducked into the lab.

Andi kept exploring. There were several examination rooms that had a rear door. In an empty examination room, Andi peeked through the rear door to find that it opened to an open area where there were desks and cubicles for the office staff and the nursing staff.

At the end of the hall, there was an exit and also a hall to the right. She turned right, and the hall had offices on her left and it ended and a hall that went back to the waiting room. She noticed a technician following a patient who was walking toward her. The patient had an oxygen tank hanging on a strap from his shoulder and was using a nasal canula. When he got to Andi's end of the hall, he turned around and went back to the other end of the hall and turned around. "Six minute walk?" Andi asked the technician, but she just glared at Andi.

"Don't interrupt," said the technician as she followed the patient. Andi had gotten the technician's name from her badge, Agnes Trenton. Agnes' attitude with her patient was brusk. She was harsh and ungracious when she spoke to him, and nasty to people who stepped out into the hall and almost bumped into her.

Andi watched as they came all the way back up the hall and when they got near her, she said, "Ms. Trenton. When you are done with your patient, please come see me in my office. Office one twelve." She didn't answer Andi. Agnes turned around and headed back up the hallway.

"Fat chance," muttered Agnes.

"I was not kidding Miss Trenton," said Andi, who was walking immediately behind Agnes, still investigating her clinic.

Andi then stepped into the administration area between the examination rooms and asked for everyone's attention quickly. "Hi, I'm Doctor Adrianna Roberts. I'm new to Western New York and my daughters and I are excited to be here. I want us to work together to show the VA what a caring clinic is all about. As a gold star daughter and the wife of a veteran, I want you to know that if you are not here one hundred and fifty percent for those men and women out there in the waiting room, then this clinic is not the place for you. I'll write glowing reviews for you and help you with your future placement, but from this moment forward, this clinic is dedicated to being the best at serving our veterans."

Andi saw Lucy peeking in a door and grinning as Andi briefed her troops. "If you have any complaints, you know my email address. If you have suggestions on how to serve our men and women my door is wide open. Thank you," and she left. She wanted to speak with Ms. Trenton.

Andi finally got to see her office. It was clearly apparent that Paul decorated it for her. There were photos of their wedding, especially the picture of her, Macy, the twins and Wonka taken the moment that Andi realized she had a sister, and they could go sledding. There was a picture of Paul at the helm of Miss Arcadia, Judge Atherton's thirty-six foot sloop and photos of Andi at the helm of Andi's Dream, and the big photo of the whole team when Yi and the Judge caught that beautiful sail fish. Prominent were photos of the twins collecting seashells and catching mullets on the stern of Andi's Dream.

Ms. Trenton finally arrived, and she appeared reluctant to speak to Andi, and Andi had to ask some very direct questions. "Is that how six minute walks are normally conducted?"

"Yes, that's how I was trained to conduct them," Ms. Trenton said evasively.

Andi got very serious. "We have men and women coming back from the desert with serious respiratory issues. Until the equipment I ordered from the Mayo clinic arrives, our best tool in diagnosing the condition and progress of our patients is with the six-minute walk."

"I am well aware of that," said Ms. Trenton.

"Then why were you using a twenty dollar finger clip pulse-ox to check his O2 saturation? Where is the Wellue O2ring?" the O2 ring is a ring the patient wears that saves his oxygen data for the duration of the test and the technician can download the data. It's not the best solution, but until the new equipment comes in, it's better than the cheap pulse-ox.

"It wasn't charged..."

"And why was the patient carrying his oxygen on his shoulder? Carrying anything will skew test results for someone with respiratory conditions." Ms. Trenton looked at Andi in silence, then Andi said, "I asked you a question."

Finally, Ms. Trenton said, "the large oxygen tanks on wheels are locked up."

"Before I go I will make sure you have access to the large tanks. Unfortunately, the damage has been done..."

"What damage?" demanded Ms. Trenton.

"Forcing the patient to carry the oxygen tank, using the incorrect Pulse/Ox meter, failure to accurately measure the distance the patient traveled in six minutes, all of the tests you administered are invalid. We have no clear starting point for measuring their progress, so we have to start over again. I want a MOP, a Method of Procedure written up describing how the six minute walk will be conducted for every patient, how you're going to measure his oxygen saturation and how you're going to accurately measure the distance the patient walked. Also, I want a circular track, I don't want them walking up and down a hallway."

Ms. Trenton looked shocked. She couldn't believe what was piled on her. "I don't know..." she sputtered.

"I have a change of command ceremony to attend in North Dakota in two days then I have to go to Denver and close out my apartment before I'm here full time. I'm expecting to be dazzled when I get back.

"Yes, ma'am."

Ms. Trenton left the office and Lucy stepped in. "What did you do to her? She looks like she just saw bigfoot, or a ghost, or something like that."

"I told her that her six minute walks suck, and I wanted them fixed by the time I got back."

"How do you suck at six minute walks?"

"The patient was carrying his oxygen on a shoulder sling," said Andi.

"That'll do it." Lucy began poking through the papers on Andi's desk.

"I have to get these all taken care of before I leave today," groaned Andi. Just then, a knock came at the door. "Come in."

A large woman with graying hair came in and said, "What's wrong with the six minute walks?"

"That depends. Who are you?" asked Andi.

"I'm Estelle Gibbons, I'm in charge of the lab, what is wrong with the six minute walk tests?"

"Besides everything?" asked Andi. She wasn't falling in love with Estelle Gibbons, either.

"I have veteran Kyle's six minute results right here, look at them yourself."

"I don't need to. Just tell me a couple of things, at the four minute mark what was veteran Kyle's blood oxygen saturation?"

Estelle looked at her document. "Ninety One Percent."

"And how was that data obtained? Did he stop, show her the oxygen level and start again?"

"Yeah,"

Andi leaned back in her chair. "So, every minute he gets a break to recover. How far had he gone by minute four?"

"About five hundred meters."

"And how is that measured?" said Andi.

"The hall is fifteen meters long, simple math, you count the number of lengths he walked, multiply by fifteen."

"No, I want no math, simple or otherwise. I want raw data that we can analyze and quantify. Until we get the new equipment, this is our number one diagnostic tool."

"What about RHC?" asked Estelle. "Do you intend to start requesting RHCs?" The RHC is the Right Heart Catheter, a probe is run to the heart and data is collected from the heart itself. In the hands of a good thoracic surgeon or cardiologist, the RHC collects tons of great data, and is the number one method of determining pulmonary hypertension, a condition that is becoming a 'veteran killer.'

"Lucy, can you do a few RHC's for us?" asked Andi.

"Two or three a day," said Lucy, without looking up from the magazine she was reading.