Lillie came in smiling.
Not the careful, watchful smile from her second visit. This was something warmer, more deliberate — the smile of a woman who had decided to make an investment. She settled onto the exam table and folded her hands over her stomach and said, 'I have to tell you, Dr. Price, you're honestly the best OB I've ever had. I feel so safe here.'
'I'm glad,' I said.
I kept my eyes on the chart. I noted the week, the fundal height, the blood pressure reading Caroline had taken at intake. Twenty-seven weeks. Everything measuring on schedule. I asked the standard questions and wrote down the standard answers and I did not look at Lillie's face when she answered them, because I didn't need to. I had learned, a long time ago, that what people say with their mouths is the least interesting thing about them.
Lachlan wasn't here today. Business trip, Lillie had mentioned to the front desk when she checked in. Just her.
I noted that too.
Halfway through the appointment, I asked Lillie to give a urine sample. She nodded, gathered herself up from the table with the particular careful movement of a woman in her third trimester, and took the labeled cup from Caroline. The restroom was down the hall. She left her bag on the chair by the window.
I was writing in the chart. I wasn't looking at the bag.
But I was.
The bag was open at the top — a wide-mouthed tote, the expensive kind with the soft leather handles. Inside, among the usual architecture of a woman's daily life, was a prescription bottle. The label was mine. My name, my clinic, the correct dosage, the correct fill date. Everything exactly right.
Except the capsules.
I had prescribed a prenatal with a pale yellow capsule. Standard formulation, the same brand I'd been using for two years. What was visible through the amber plastic of that bottle was white. Not off-white. Not a different manufacturer's shade of yellow. White.
I finished writing my note. I capped my pen. I did not touch the bottle.
Lillie came back. I completed the exam. I measured, I listened, I noted. The baby's heartbeat was steady and strong — one hundred and forty-four beats per minute, a good number, a number that had nothing to do with its mother's choices. I scheduled the follow-up. I told Lillie what to watch for in the coming weeks. I held the door.
'Same time in two weeks?' she asked, at the threshold.
'We'll confirm by text,' I said.
She smiled again. That warm, invested smile. Then she was gone.
I stood at the window of the empty exam room for a moment. The chair where her bag had been was just a chair now. The morning light came in flat and gray off the overcast, same as always.
I picked up my phone and called the lab.
---
The bloodwork came back the next afternoon.
I reviewed it at my desk, door closed, coffee going cold beside me. The folate levels were low. Not critically — not yet — but measurably below where a patient at twenty-seven weeks on a consistent prenatal regimen should be. The B12 was borderline. The iron was fine, which was interesting, because iron was present in the substitute capsules too. Someone had been careful. Not careful enough, but careful.
I sat with it for a moment. Then I picked up the phone and called Angela.
She came by my office twenty minutes later. I laid it out clean and simple. A patient presenting with supplement levels inconsistent with her prescribed regimen. A possible discrepancy in what she was actually taking versus what had been prescribed. I cited the lab values. I cited the prescription record. I did not speculate out loud about how the discrepancy had occurred.
Angela looked at the numbers. She looked at me. She has a way of looking at people that feels like being accurately measured.
'I'll authorize a pharmacy audit,' she said. 'Full chain of custody on the prescription.'
'Thank you,' I said.
'You want to tell me what you think happened?'
'I want the audit to tell us what happened,' I said.
She held my gaze for another second. Then she nodded and left.
I waited until she was gone. Then I opened my bottom desk drawer and removed the small wireless camera I had signed out from clinic administration two days ago, under the general safety initiative that had been approved building-wide after a patient reported a missing wallet in October. I walked down the hall to the bank of exam rooms. The hallway outside rooms four and five had a narrow alcove — a place where patients sometimes set their bags while waiting for the restroom.
I positioned the camera. Angle, coverage, timestamp activation. I had done this before, in a different context, in a different life. My hands were steady.
I walked back to my office and pulled up my afternoon chart.
Lillie thought she was being careful.
She had no idea what careful looked like.
