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At 10:48 on a weekday evening, a laboratory result appeared in a hospital record. The number was a D-dimer greater than 3,000. It did not explain itself, and no number could assign anyone to act. Richard was fifty-four. He had arrived with chest pain that began while he was lifting weights. An electrocardiogram had shown no abnormality. His chest X-ray and blood tests were still in progress. The advanced care practitioner who had been treating him considered a musculoskeletal explanation likely, but he could not reproduce the pain through movement or touch. Something more serious remained possible. His shift was over. The uncertainty was not.
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