by C. J. Miller
“Is it realistic? I’ve been sitting here and thinking about Annabelle and Tom. What will they do without me?” Jessica’s tears started over again. Gemma felt her own eyes well with tears and she couldn’t hide them or wipe at them from inside her suit.
“They won’t have to answer that question. They won’t have to live without you. We have the CDC expert and the doctors and nurses are working on a cure,” Gemma said.
Jessica shook her head. “I’ve been trapped in this trailer for too long. I want to walk around outside. I picture just opening the door and leaving. I want to see my husband and daughter. Other people are sick in town. Why aren’t they in isolation? Why am I forced to stay here?”
Gemma could hear the hysteria in her friend’s voice. “We don’t have enough room at the clinic to keep everyone in isolation. Those who are ill are staying in their homes and trying not to spread the virus. The entire town is under quarantine. If you leave here, you won’t be able to stay away from Annabelle and Tom and they could get sick too.”
Jessica lay back against her pillows. “Tell me some good news. All I can think about is missing Christmas with Annabelle. I already missed Halloween and Thanksgiving with her.”
“Tom and I already talked about that. When you’re cured, we’re having a holiday do-over.”
“What’s a do-over?” Jessica asked.
“We’ll put Annabelle in her princess costume and make a turkey dinner and Santa will have to visit again,” Gemma said.
Jessica coughed, which turned into a fit of coughs. Her eyes watered. Gemma waited until it passed and then handed Jessica a cup of water.
“Please drink if you can,” Gemma said.
Though she hadn’t weighed Jessica, her friend looked more gaunt. It was difficult to tell if the dark shadows under her eyes were malnourishment or exhaustion.
“What can I bring you for dinner? Tonight, the diner is bringing the meals and I have an in with the owner.” The diner’s owner, Nina, was her brother’s girlfriend.
“Nina and Flint are still doing well?” Jessica asked, sounding tired.
“They are. I’ve never seen my brother so happy.”
“What about you? Are you happy?”
“I worry about you and Gram Dottie and my patients. I know it’s hard on you to be here,” Gemma said.
“What about Dr. Granger? What’s new with him?”
A lot was new with Rafe. New levels of sexual experiences and uncharted territory, at least for her. “We had a few moments of passion.”
“Define moments of passion and do not leave off the details.”
“We slept together,” Gemma said. Multiple times, in the doctor-and-nurse lounge and then all night long at Rafe’s house.
Jessica’s eyes widened. “Finally. How was it?”
“Great, except after the first time, I got clingy and told him to stay in Dead River, which is absolutely the last thing he wants to hear.”
“After the first time? You had sex with him more than one time?” Jessica asked.
“Yes. Several times,” Gemma said. She wanted to tell her friend about the black box in his bedside table, but wasn’t sure if that was crossing the line between gossiping with a friend and divulging intimate secrets about her lover.
“Are you falling for him?” Jessica asked.
No. Never. She knew that would lead to her heart being broken. “We’re not in love. We’re two colleagues who have been spending an inordinate amount of time together and there’s always been a connection between us,” Gemma said.
“How did you leave it with him?”
They hadn’t defined their relationship. Why did it matter how they thought of it? The only word she needed to describe it and keep it clear in her mind was fleeting. “We’ve formed a quasi-friendship,” Gemma said.
“Next time Dr. Granger comes in here, I will ask him about it,” Jessica said.
“You cannot! This is not high school. And we were planning to keep it a secret. You can’t mention anything to him,” Gemma said.
Jessica frowned. “Too bad. I think I could make him squirm and I could use the entertainment.”
“I don’t want him to squirm. I want him to admit that Dead River isn’t so bad. With a virus and murderer loose it’s not on anyone’s top ten travel destinations, but it’s a great place to live.”
“The smallness isn’t for everyone,” Jessica said.
“What some may see as small, I see as close-knit,” Gemma said.
Jessica closed her eyes and Gemma knew she was drained.
“Let me finish up in here and then you need to sleep.” She grabbed the trash from the can, placed in a new bag and tidied up. By the time she was finished, Jessica was asleep.
Gemma visited her grandmother last. Before stepping into her room, Gemma looked through the window. The lights were dimmed and her grandmother was sleeping. She looked frail and pale beneath the white linens on her bed. Under other circumstances, Gemma would not be providing direct care to the people she loved since it was hard to be objective in those cases, but the clinic didn’t have anyone else. No one had heard from Felicia, which left only Gemma and Anand.
Gemma entered her grandmother’s room quietly, not wanting to wake her.
She stood at the foot of the bed. Her eyes darted to the cross that Gemma had brought from her grandmother’s home. It had belonged to Gram Dottie’s husband and Gemma hoped it brought her comfort.
She recorded the results of her examination in the computer, concerned about the spike in her grandmother’s temperature. One hundred and two point seven wasn’t alarm worthy, but she’d ask Dr. Rand about it.
She didn’t note any other changes in her health. “We’ll find a cure, Gram. I promise.” Then she slipped out of the room.
After completing the procedures to safely exit the virus wing, she went straight to Dr. Rand’s office, thinking of her grandmother’s high temperature. He was working at his computer.
“I finished my rounds,” Gemma said. “I put a couple of notations on the patients who had marked changes. My grandmother’s temperature was high and I’m concerned about that.”
Dr. Rand nodded sympathetically. “I’ll check on her. I know you’ve been worried about her.”
Dr. Rand was behaving warmer toward her than he had since learning his ex-wife had slept with Theo. Had Dr. Rand finally come to terms with what had happened with Mimi, both the end of their marriage and her death? “Thank you, Dr. Rand. And thank you for picking up the extra shift for Rafe.”
“It’s frightening what’s been happening around here. We’re trying to bring this to a speedy conclusion and put it behind us,” Dr. Rand said.
Gemma held onto the idea of the quarantine being lifted and normalcy returning to the town. “I’m going to take care of a few patient requests.”
Dr. Rand nodded. “I’ll review your notes and then I’ll suit up and follow up on these cases.”
He returned to his computer and Gemma hurried to call Nina at the diner.
Fifteen minutes later, Gemma was chatting with Nina, who promised to bring over the specially prepared dishes for the patients as soon as they were ready. The line to the phone in the virus wing lit up. It was their policy to answer immediately. “Nina, I’ve got to go. Talk soon.” She pressed the button to connect to the line in the virus wing.
“Dr. Rand? Everything okay?” Gemma could hear machines beeping uncharacteristically loudly.
“Not okay. Get in here. Your friend Jessica is in distress.”
Chapter 8
Gemma dropped the phone and raced to the virus wing. With quaking fingers she dressed in her protective suit, hating she was losing precious seconds. Her patients had been stable when she checked them a few minutes ago. Had she been distracted and missed a c
ritical symptom? Too tired to be sharp? She had spoken with Jessica and hadn’t noticed anything.
She had promised Jessica she would be okay and Gemma could not break a promise to a friend.
Finally in her gear, she entered the virus wing through the double door enclosure. Dr. Rand was in Jessica’s room.
“Patient has low oxygen levels. Her lips were blue when I came in,” Dr. Rand said.
“Did the oxygen sensor alarm?” Gemma asked, wondering how long Jessica had been lacking oxygen.
“Her pulse ox wasn’t on her toe. It was on the floor,” Dr. Rand said. “It’s lucky I was here. I decided to look in on every patient, otherwise...”
He didn’t need to finish his statement.
He was holding an oxygen mask over Jessica’s face and Gemma took it from him. Had she knocked her friend’s sensor off her foot? That wasn’t like her. Had she made a mistake that would cost her friend her life?
* * *
Gemma was raw and shaken when she exited the virus wing. Dr. Rand had stabilized Jessica and Jessica had woken for a time. Her vitals were stable and she didn’t appear to have suffered any severe neurological impacts from her oxygen deprivation, but time would tell.
They would keep Jessica under close watch for the next forty-eight hours. Gemma had to call Tom and let him know what had happened, but she needed someone to talk to first. She had gone over and over the time she had spent with her friend and she remembered checking the monitors. Had she bumped one on her way out? Pulled a cord free? Missed an alarm? Had the ventilation system misfired?
Rafe’s office door was unlocked and his office was vacant. She sat at his desk and lifted the phone receiver. She could call her brothers. She could call Anand. But she wanted to talk to Rafe. He answered his cell on the first ring.
“Strange receiving a call from my office,” Rafe said.
At the sound of his voice, she felt tears spill down her cheeks. “Everyone is okay now, but something bad happened to Jessica.”
“Tell me,” Rafe said.
She explained about her rounds and what Dr. Rand had found when he’d gone in for his follow-ups. “Thankfully, Dr. Rand was there. What if I had reported no issues? Would Jessica have suffocated in her room?”
“You are a good nurse. I am glad Dr. Rand was there too, but this is not your fault. Jessica could have kicked the sensor off. She could have had a seizure and the sensor disengaged.”
“That doesn’t make me feel better,” Gemma said. Could the Dead River virus have caused the oxygen deprivation? They hadn’t seen the symptom in any of their other patients yet.
“It’s hard caring for friends and family. It’s impossible to be detached. But I can say with confidence that you did not do anything to cause your friend harm. We are dealing with a dangerous, unknown virus. Some of the symptoms are manageable, others are terrifying. We’ve been lucky to keep as many people alive as we have.”
A depressing thought. “Again, not making me feel better.”
“I’m sorry. I don’t think lying to you will make this easier,” Rafe said.
She didn’t want lies, but she wanted to know that they would find a cure. “Can you tell me more about the sequences?”
Though he wouldn’t have been conducting experiments at home, Gemma wanted to think about anything except her friend’s near death. “The initial sequences I found haven’t matched to every sample.” As Rafe reviewed what they knew about the virus, Gemma focused on his words.
“I still have hours left on my shift, but I feel sick,” Gemma said. She didn’t know how to get through them.
“Take a break. Walk away for a few minutes. Go to the lounge and lie down.”
At the mention of the lounge, the steamy memory of being there with Rafe sprang to mind and heat flamed up Gemma’s neck. “Maybe that’s wise.” She wished Rafe was with her. She wouldn’t ask him to come to the clinic when he needed rest, but being near him had a relaxing effect on her. She wished he was in the lounge and she could lie next to him.
“Don’t let it shake you. We need you, Gemma. You’re smart and good at what you do. You’ve got to hang in even though I know this is hard.”
Gemma thought of Felicia Martin, the nurse who had quit. To Gemma’s surprise, the woman hadn’t returned to ask for her job. Gemma had been sure her quitting was a stress reaction. But it looked like they’d be down one nurse for the duration.
She said good-bye to Rafe and hung up the phone.
Gemma wouldn’t leave the main clinic in case she was needed, but she would take a break and clean up the patient files that were still out of order behind the reception area. As hard as Cathleen was working to sort them, they had a decade of lab notes, doctors’ notes and test results to file with the proper patients.
The phone rang at the reception desk and Gemma answered.
“Hey Gemma, it’s Levi Colton. Katie and I have been following the problems in Dead River on the news, but I wanted to call and find out how you were doing. We’ve been worried.”
Her cousin Levi was a doctor and he and his wife, Katie, had moved from Dead River six months ago to a town in dire need of a doctor.
“We’re doing everything we can. I wish you were here. We could use an extra set of capable medical hands.”
“I wish I could help. I’ve been told no one in and no one out.”
“That’s been hard,” Gemma admitted. She gave him an update on the virus and their research. Unfortunately, he didn’t have much that could help them.
“If there’s anything I can do, please don’t hesitate to call,” Levi said.
“Thanks for calling. If I think of anything, I’ll be in touch.” She wrote Levi and Katie’s home number on a slip of paper. A phone consult with another doctor might come in handy down the road.
After she hung up with her cousin, she returned to her filing. Gemma sat on the floor and started with the top piece of paper. Lab results with the patient name across the top. It was easy to file. Same with the next dozen sheets of paper. The next sheet was notes from a case several years ago where the patient had died. She thought of Jessica and how close she had come to death. Gemma shuddered.
The patient’s name wasn’t typed across the top of the sheet. Gemma flipped the page over. Dr. Rand had been the physician of record and Gemma remembered the case. The clinic had their share of deaths and the staff took each one hard.
Finding the patient’s name, Gemma filed the paper and returned to the stack. Though she shouldn’t read a patient’s file without a legitimate medical reason, some pages weren’t labeled as well as others and she had to scan for a patient name. An hour later, Gemma had worked through a number of papers and felt more depressed than before she had begun.
In the hectic day-to-day life in the clinic, she felt they helped most of their patients. Looking at the results on file, it seemed like they had too many to help and in some cases, the patients were worse upon receiving treatment than before entering the clinic.
The practice of medicine wasn’t an exact science. Patients didn’t all react to the same medications in the same way. Some patients lied about their symptoms or if and how they’d taken their medications, which could prove a nasty surprise to the clinician. But Gemma was seeing cases that had turned on a dime.
A patient had entered the clinic needing a tetanus shot because he’d been cut by a rusty nail while installing a roof. He had developed hand tremors and sweating, which had led to Dr. Rand administering antibiotics and a sedative. The patient had gone into respiratory arrest and had died. Though Gemma hadn’t known the man, she was bewildered by someone dying of tetanus. She remembered hearing about the case. Dr. Rand had been inconsolable after it had happened.
In another case, a patient with type 2 diabetes had come into the clinic with hypoglycemia. She had been in the area
shopping and had felt shaky, sweaty and nauseated. Concerned, her friend had brought her to clinic to be examined. Soda, a glucose tablet or a handful of raisins and then monitoring her sugar levels should have helped. It hadn’t. The woman had suffered a seizure, slipped into unconsciousness and died. Gemma had been working that day, although she’d been assisting Dr. Moore with another patient at the time of death. Dr. Rand had been distraught. He’d followed procedures and something had gone wrong.
Gemma set aside the papers. The clinic couldn’t help everyone, but some of the more straightforward cases should have been resolved with the proper treatment. It boggled Gemma’s mind that it hadn’t worked out that way.
Before Rafe had arrived, Dr. Rand had been the star of the clinic, performing life-saving procedures. A perceived mistake or an unintentional oversight were hazards of the job. In some cases, a doctor had to choose treatment from a variety of acceptable options and they sometimes chose wrong.
A dark thought crossed her mind. What if Dr. Rand had done wrong and then had tried to cover it up? He couldn’t prove he had provided treatment or that he’d provided the right treatment. Gemma returned to the patient records and looked at the list of signatures on the pages. For legal reasons, in situations that resulted in a patient death, the clinic kept detailed notes on which staff members had treated the patient.
In both cases, the nurse of record was Felicia Martin.
An even darker thought crossed Gemma’s mind. Had Felicia known about a mistake that Dr. Rand had made and had covered it up? Had that played a part in her stress and reasons for quitting her job?
Gemma couldn’t imagine a doctor intentionally harming a patient, but she knew gray areas in patient care existed. A doctor who’d been up all night on call, a doctor who had worked thirty hours straight without sleep or a doctor who had misunderstood a patient’s symptoms could result in tragedy.
Doctors couldn’t be held to an impossible standard, but they could be held liable for recurring mistakes or gross negligence.
Gemma was running on fumes after the incident with Jessica. Was she looking for problems and someone to blame or was Dr. Rand not the superstar doctor everyone believed him to be?
