Heart of Hope: Books 1-4

by Williams, Ajme

  “What? It’s on her record that it was ordered.”

  He turned the screen toward me. “It’s not here.”

  I frowned. “Where would it have gone?”

  He shrugged. “Computer glitch? Sent to different department? The order button wasn’t pushed? Could be any number of things.” He said it matter of factly, almost dismissively. As if this sort of thing wasn’t uncommon.

  “A woman died who could have been saved by this test.”

  He jerked his attention to me, as if he’d realized the seriousness of the situation. “We can’t test for what we don’t receive. I’m sorry.”

  I inhaled a breath to steady my nerves and my fear that Ms. Mason was the victim of a computer software glitch. I needed an IT person to help me. I went back to my office to find out who was in charge of IT issues. I knew the hospital outsourced that job, but wasn’t sure with whom. After a little research, I learned it was a company in Reno.

  I called the tech support line asked for one of the people assigned to us.

  “I’d have to come over to examine the system to know for sure what happened,” the woman on the other end of the line said when I explained the issue.

  “It is possible the software is at fault?”

  “Maybe, but more likely it’s a user error. Someone entered the wrong code or in the wrong place or didn’t push some button. EMR software isn’t the most user friendly. I don’t know that any of these software companies had doctors in mind when it was created.”

  “Can you come out and see what you can find out?” I’d hate to learn that Nick had made an error, but if he had, I didn’t see it.

  “Sure. Hold on while I get my calendar.” A few minutes later, we’d made an appointment for next week. I wished I could get her there now, but I was sure the hospital would balk at my authorizing the extra fees for an emergency IT visit. Yes, they’d want the information for the lawsuit, but that wasn't the top of the list, especially if it was possible the software was in error. The contract put the responsibility of that fully on the hospital, not the software creator.

  I sat back in my chair, feeling more unsettled than I had before walking in my office. I’d been sure that Ms. Mason’s death was due to her failure to give Nick a full rundown of her symptoms, and showing up too late. But now I had to consider that a lag in having the blood work and a missing chest x-ray order were to blame. That would put the responsibility of her death on the hospital, whether it was a software glitch or not. And if Nick made some sort of error, on him as well. I hated myself for thinking the next thought; had Nick been having PTSD-symptoms in the ER before Ms. Mason’s death?

  I needed to talk to Dick about this, but was reluctant to do so. He wouldn’t like this information, and chances were he’d look at ways to take the blame off the hospital. While the hospital employed Nick, to blame him and then fire him would fix their PR problem if this got out. A computer problem that potentially put all patients at risk, would be harder to overcome. Chances were everyone who lost a family member or friend here would wonder if their death was due to a computer error. I thought of Eli who’d certainly add that to his list of grievances against Nick.

  When I’d returned home to Goldrush Lake, the one thing I considered a positive, aside from being with my father and brother, was the slow pace at work. While smaller hospitals often had fewer resources, they also had fewer patients and potential legal issues over large city ones. Since returning to town, my stress level was high, not just from this, but also from my inability to stop myself from getting naked with Nick. That was one thing that I could do better at. What I couldn’t control was Nick’s mental health or computer glitches, and I was afraid one or the other was going to create big problems for the hospital.

  17

  Nick

  Waking up next to Mia was lovely and sad at the same time. It had been one of my favorite things back when we dated four years ago. We hadn’t lived together, but we’d spent many nights together. I remembered feeling her lush warm body against mine as my first awareness in the morning. With a smile, and my eyes still closed, I’d touch her, slowly wake her with soft kisses until I’d slip inside her.

  I didn’t do that this morning, although I’d wanted to. Today, we weren’t a couple. We weren’t in love, although each time I told myself that, my heart would clench like it was calling me a liar. She didn’t love me. I suspected she thought I was mentally unstable and possibly to blame for Ms. Mason’s death. She was in a position to ruin my career. My heart, no matter how it felt, had to accept that what Mia and I had four years ago was gone and couldn’t be recreated, even if we wanted to. Which she didn’t. Once again, her job was more important than me.

  Not liking that my thoughts made me seem like I was having a pity party, I’d slipped from bed, showered and got ready for my shift at the hospital. When the coffee was brewed, she’d joined me in the kitchen. She’d taken a shower, but I was sure she’d go home to change so she didn’t show up to work in the same clothes she’d worn yesterday.

  “Sleep okay?” I asked handing her a cup of coffee.

  “Really well actually.”

  “Me too.” I wanted her to know I wasn’t nuts.

  Yet when I approached my first patient that morning, I felt agitated. Like every nervous neuron was firing. It wasn’t a good start to a long shift and it just got worse as I began to investigate the ailments my patients were presenting. I was second guessing my assessments and what tests to run. I ended up ordering a pregnancy test for a sixty-year-old woman well-past menopause. That made me look inept, but what really rocked my confidence was the constant feeling of stress. Not in a good way. In the past, the challenge of diagnosing and treating people led to adrenaline that was exciting. Today the stress was fear. I was scared shitless that I was going to mess up. No amount of deep breathing or stretching seemed to calm me down or loosen my tight agitated muscles.

  Fuck, maybe Mia was right. Maybe I was nuts. Maybe I shouldn’t be working like this. I hadn’t missed anything, the pregnancy test notwithstanding. But I was being sued for malpractice, and my head wasn’t in the game like it should be. I was operating from constant fear I was going to fuck up instead of a competent physician looking to treat and help people.

  “Your girlfriend is here,” Peggy said with a nod toward a curtained off exam area.

  For a minute, I thought of Mia. Of course, she wasn’t my girlfriend. Peggy’s smirk told me it was Joyce. Jesus, just what I needed. Then again, chances were Joyce wasn’t sick. She was just here for her monthly Dr. Foster fix. On the other hand, what if she was sick and I missed it? It was wrong of me to dismiss her. Yes, she was the girl that cried wolf, but that didn’t mean she was lying every time. Fucking A I was a mess.

  “You all right, Dr. Foster? I can see if someone else will see her,” Peggy said.

  “I’ll see her.” Get a grip, Foster, I told myself. I went to the curtain and entered. “Ms. Maynard. What seems to be the problem today.”

  “Oh Dr. Foster, I’m so glad you’re here. I was afraid you’d be on administrative leave or something.” She sat on the exam table in a tight-fitting tennis dress. The hem barely reached mid-thigh. The top buttons were undone, showing off her ample cleavage.

  I quirked a brow. “Why?”

  She looked at me for a moment and then shook her head. “Nothing. I think I sprained my ankle.”

  “Let’s take a look,” I said, reaching down to her ankle. She’d already taken off her shoe and sock.

  “You have such warm strong hands,” she cooed as I held her leg at the calf and did a visual exam.

  For once she did seem to have signs of injury as the ankle was swollen and bruised. “Can you move your toes?”

  She waggled her toes painted with bubble gum pink polish. “I guess it’s good I had a pedicure,” she said.

  “Does it hurt when I do this?” I touched various parts of her foot and ankle, noting when she winced or told me it was sore.

  W
hen I was done, my instinct said sprained ankle. Before Ms. Mason’s death, I’d have said sprained ankle, wrapped it, and prescribed pain reliever, elevation, and ice. Today, I looked at the swelling and bruising and wondered if I should get an x-ray.

  “Are you able to put any weight on it at all?” I asked.

  “It hurts when I do,” she said, lifting her foot to my groin level. I put my hand under it before she got any ideas.

  “On a scale from one to ten, how painful?” I asked, lowering her foot and going to the computer to enter the information.

  “Eleven. I should probably stay for observation.” She leaned forward, and I wondered if she had a sports bra on because it looked like her tits were about to come out of her top. “You know, Dr. Foster, I don’t believe what people are saying about you making a mistake and causing Ms. Mason’s death. She was so old.”

  I gritted my teeth. How fucked up was the world that one person who supported me was the one I didn’t want on my side.

  “It must be so hard to have the whole town talking about you like that,” she finished.

  Fuck. The whole town? “I’m going to order an x-ray just to make sure there isn’t a fracture.”

  “So, I needed to stay a little bit?”

  “Yes. I don’t think there’s a fracture. If not, we’ll have your ankle wrapped and send you home with some pain reliever. But no tennis for a while.”

  “How will I get my exercise?” Her foot reached out and touched my shoulder.

  I closed my eyes, willing God to give me strength. I typed in the order for the x-ray and then stood, moving away from her.

  “I’m going to call up to make sure they’ve received the order and find out how long it will be.”

  “I’ll be here,” she smiled seductively.

  I left the area, reminding myself to keep the curtain open when I returned after the x-ray. I called up and verified the test would be done within the next thirty minutes or so. I wished I’d called up the day Ms. Mason was in.

  My next patient was a man with the flu, and after that, I stitched a hiker’s calf, cut on a fall while venturing off the trail path.

  “Joyce’s x-rays are done,” Peggy said after I gave the hiker his discharge information.

  I blew out a breath. “Any chance you can come with me?”

  Peggy laughed. “You’re not afraid of her, are you?”

  “Yes. Yes I am.”

  “I believe in you, Dr. Foster,” she said with a wink as she carried a syringe to a woman in another area.

  “Ms. Maynard,” I said, leaving the curtain open. “I’m sorry for the wait.”

  “I don’t mind, although it would have been more fun with you here.”

  I sat at the computer, trying to angle myself away from her limbs. I pulled up the x-ray, read the radiologists notes, and examined it myself.

  “Good news. No fracture. It’s just a sprain.” I found the treatment notes for a sprained ankle, copied and pasted it into the EMR, with a few tweaks for her care. Then I stood. “We’ll wrap it up, and you’ll want to stay off it as much as possible.” I gave her the rest of the treatment prescription. “A nurse will be in to wrap—”

  “Can’t you, Dr. Foster? I trust you more than a nurse.”

  I looked at the treatment area and most nurses were busy. The faster she was wrapped and discharged, the sooner I’d be away from her.

  “Sure.” I got the bandage and other items, and wrapped her ankle, doing the best I could to avoid her touching me, which wasn’t easy.

  “You’re strong, Dr. Foster. Do you work out?” she squeezed my bicep.

  “I run.”

  “Outside? Without your shirt? I’d like to see that.”

  Inwardly I rolled my eyes. “When you get home, elevate your ankle. Can you do that?”

  “In bed?”

  Jesus. “Is there someone here who can drive you?” It was her right foot, a needed limb for driving.

  “No. Can you drive me?”

  “I’ll arrange for a ride.” We were a small town, but we had a lot of tourists that had to get places, so we had taxis, shuttles, and ridesharing.

  “I’ll make you dinner,” she ran her finger over my chest.

  I stepped back. “It’s still morning.”

  “Lunch then. Come on, you have to eat.”

  “Dr. Foster,” Mia’s voice called me.

  I turned, noting her narrow eyes and curt done. “Yes.”

  “I need to talk with you when you’re done.”

  “I’ll be right there.” I lowered Joyce’s leg. “Here is a crutch.” I motioned for the nurse who was bringing it to us. “Can you show Ms. Maynard how to use this and then call someone for a ride home?”

  “Yes, Dr. Foster.”

  I turned back to Joyce. “Elevate and ice.”

  She saluted me. “Yes, doctor. The dinner date stands. Clearly I’m not going anywhere.” She handed me a paper. “I know you can get my address from my file, but here it is.”

  I shoved the paper in my pocket. “Good day, Ms. Maynard.”

  “Later, Dr. Foster.”

  I shook my head as I turned to meet with Mia. Her expression suggested I wasn’t going to like what she had to say.

  18

  Mia

  After what I’d learned that morning, I couldn’t put off talking to Dick about the possible EMR problem and my appointment with the IT person to check the program. I wasn’t looking forward to it. The last thing he’d want to hear was that the EMR system failed. That would put the fault squarely on the hospital.

  “The EMR isn’t the issue,” he said sitting back in his chair. “More likely, Nick didn’t hit the send button.”

  “Why would the blood work order make it and not the chest x-ray?” I asked.

  He shrugged. “Doctor error. That’s what we need to focus on.”

  I leaned forward. “I know that you don’t want an EMR issue for liability reasons, but if there is a glitch, blaming and firing Nick won’t protect you. It will happen again, and then what? Especially if it gets out that that you knew there could be a problem in the system?”

  He leaned forward too, his eyes narrowing. “You represent the hospital, Ms. Parker.”

  “I do,” I said, not caring that he didn’t like what I was saying. It was my job. “And as your lawyer, I’m recommending you have the system checked. I’m a lawyer, not a miracle worker. If you have a problem in the system, you have potential patients at risk. I recommend that you have a backup protocol to ensure tests, especially from the ER, are being received.”

  “Fine. But I guarantee the problem happened in the ER, not with the system. Stay on that.”

  I wanted to reach across and slap him for being so willing to blame Nick. “You know, it’s also possible that Ms Mason was just too late, but you seem focused on an error. Do you have something against Dr. Foster?”

  He sat back again. “I like Nick. But I can’t let this hospital suffer if he’s to blame.”

  Dick wanted a scapegoat, and since it was insensitive to blame the victim, Nick was his. Because I represented the hospital, I couldn’t do much to protect Nick if the hospital was prepared to let him take the blame. That thought made me sick to my stomach. It felt like a betrayal to Nick, even though legally, my duty was to the hospital.

  After meeting with Dick, I headed down to the ER, hoping for a chance to talk to Nick again and suggest he get his own lawyer.

  “He’s with Joyce,” Peggy said with a smirk and a nod toward where Nick was meeting with a patient.

  I moved closer to catch a moment with him before he moved on to his next patient.

  “You’re strong, Dr. Foster. Do you work out?” the alluring woman squeezed his bicep, and I had the urge to poke her eyes out.

  “I run,” he said, wrapping her ankle. Why wasn’t a nurse doing that?

  “Outside? Without your shirt? I’d like to see that.”

  Gag.

  “When you get home, elevate your ankle
. Can you do that?”

  “In bed?”

  Double gag.

  “Is there someone here who can drive you?” he asked. At least he was trying to keep things professional.

  “No. Can you drive me?”

  “I’ll arrange for a ride.”

  “I’ll make you dinner.” She smiled seductively, and ran a manicured finger over his chest.

  He stepped back. “It’s still morning.”

  “Lunch then. Come on, you have to eat.”

  I’d had enough. “Dr. Foster.”

  He turned to me. “Yes.”

  “I need to talk with you when you’re done.”

  “I’ll be right there.” He lowered Joyce’s leg. “Here is a crutch.” He motioned for a nurse. “Can you show Ms. Maynard how to use this and then call someone for a ride home?”

  “Yes, Dr. Foster.”

  He turned back to Joyce. “Elevate and ice.”

  She saluted him. “Yes, doctor. The dinner date stands. Clearly I’m not going anywhere.” She handed him a piece of paper. “I know you can get my address from my file, but here it is.”

  He shoved the paper in his pocket and I felt red hot rage burst through me. Why wasn’t he throwing that away? Not that I cared, of course. But as a professional, he needed to toss her number in the trash.

  “Good day, Ms. Maynard.”

  “Later, Dr. Foster.”

  He strode toward me, looking more annoyed than turned on, but still. “What’s up?” he asked.

  I motioned for him to follow me to one of the unused patient rooms. “You need to get a lawyer.”

  His entire body tensed. “Why?”

  “Because you do.” I started to leave the room, but he reached out and took my arm.

  “What the fuck, Mia? You going to blame this all on me? I told you to look into the EMR.”

  “I represent the hospital and the hospital says it’s not the EMR.” Those words felt like sandpaper in my mouth.

  He stepped back.

  “Fortunately, it looks like you have a soft place to fall. Someone to comfort you.” I wished I’d been able to hold that back, but seeing Joyce openly proposition Nick made my blood boil.