Every Fifteen Minutes

by Lisa Scottoline

  “I don’t see how that’s relevant.”

  Eric let it go. He had made his point, and he could see heads nodding around the table. He would be damned if they’d get steamrolled into approving an unsafe drug and he loathed the corruption in the drug-approval process. Physicians at HGH ordered only those drugs stocked in the hospital pharmacy, and patients preferred to continue whatever medication they were on, after discharge. HGH was only one of the hospitals being lobbied to carry Rostatin, as the first wave of the drug’s rollout across the country, and hospital approval could make or break a drug in the marketplace.

  Dr. Sharon McGregor, Chief of Orthopedic Surgery, looked over. Her eyes were grayish behind wire-rimmed glasses, which set off her silvery hair, clipped in chic layers around her ears. “Morris, I agree with Eric. I feel as if we’re rushing to trend on this drug. I don’t want to approve it merely because it’s the latest and greatest. It’s not a Chanel jacket. It’s okay if it’s last season’s.”

  Eric smiled. “What she said. Something about Chanel.”

  Everybody but Morris laughed again, even the three committee members who never said anything.

  Sharon continued, growing serious. “Morris, do you need me to remind you that we did the right thing when we voted no on Calcix, that new osteoporosis drug? You see now, reports are coming out that it encourages excessive bone growth. Women are showing up with tumors in their jawbones. It’s unconscionable. This committee is the last line of defense for HGH.”

  Otto Vinki, the diminutive Russian-born Chief of Internal Medicine, closed his laptop, which was what he did when he reached a decision. Otto was the oldest member of the committee, close to seventy-something, but his eyes retained their acutely brilliant blueness, though his bald head was covered by a network of fine white strands that looked more like bacterial spores than hair. “I also share Eric’s doubts,” Otto said, in a Slavic accent that would’ve sounded authoritative even ordering take-out pizza. “I believe that we’re jumping the gun and I have an issue with the underlying theory. Statins don’t treat a disease, they treat a risk factor for a disease. We can convince people that if they lower cholesterol, they have fewer heart attacks, but I quarrel with that treatment goal, too. I have my vote.”

  Everyone at the table turned, as, at the far end, the hospital pharmacist motioned for attention, raising an elegant hand with slender fingers. Mohammed Ibir was one of the most talked-about pharmacists in the system; African-American, hard-working, and only in his thirties, he was already developing ways to save HGH money. “The merits of Rostatin aside, I can tell you that it is much more expensive than Rosuvastatin and Atorvastatin. It’s a third more costly, and I might add, that’s typical for Wacher Labs. For example, the prices for their chemo agents are completely out of sight, and they have a new hep C drug in the pipeline that is projected to cost $84,000 per treatment cycle for one year.”

  “For one patient?” Eric recoiled, appalled.

  “Yep.” Mohammed lifted his dark eyebrows comically.

  Sharon chuckled. “They have no shame!”

  Morris pursed his lips, unhappy. “We’re not discussing the hep C drug today, Mohammed. We have an agenda for a reason. Let’s follow it.”

  Otto started shaking his head. “I’ve heard enough, and my patients await me. Shall we put this to a vote?”

  “Yes,” Eric answered.

  Morris shook his head. “No, this is an important decision, and we allotted three meetings to discuss it before we vote.”

  Otto scoffed. “We don’t need three meetings, Morris. We should vote.”

  Morris caught Mike’s eye. “Mike, legally, we can’t put it to a vote yet, can we? Donna’s not here.” He gestured to an empty chair, and Eric realized for the first time that the Chief of Pediatrics was missing.

  Mike shook his head. “You’re right, Morris. We can’t vote without a full committee. People, we have to table discussion until next week.”

  Otto rolled his eyes.

  Sharon groaned.

  Eric sighed inwardly, then Morris turned to him.

  “Eric, I hope you keep an open mind and review the studies in the meantime.”

  “Fine,” Eric answered, wondering about that house in Myrtle Beach.

  Chapter Twenty-one

  Eric had just returned to the unit and tossed his messenger bag on his office chair when Amaka came to his door, with a frown. “Good morning, is something up?”

  “Yes. Trouble. Perino’s wife is here and she wants to take him home.”

  “Oh boy.” Eric had been concerned there would be fallout with Perino after yesterday’s incident. He headed with her down the hall toward Perino’s room. “Where’s Sam?”

  “With Perino and the wife.” Amaka fell into step beside him.

  “Good. Did he call the wife after yesterday?”

  “I don’t know.”

  “Did he call Mike in Legal?”

  “Yes, and they’re standing by.”

  “Okay.”

  “I called security just in case, and they promise they’ll be quicker this time.”

  “Security, really?”

  Amaka shot him a confident smile. “No more instant replays of yesterday, not on my watch.”

  “Thanks.” Eric arrived at Perino’s room, immediately taking in the scene. Sam stood on the near side of the bed, looking relieved to see him, and Mr. Perino sat on the edge of the bed in his hospital gown, leaning forward slightly, staring down at the floor. His wife Linda was a short, round woman whose bleached-blonde hair was pulled back into a bristly ponytail, and she had on wide jeans and a pink sweatshirt with an iron-on dreamcatcher. She whirled around when Eric entered the room.

  “Oh, here comes the big muckety-muck,” Linda said, her brown eyes flashing with anger. Her forehead furrowed, and wrinkles lined her thin lips like a lifetime smoker. Her features were somewhat coarse, and she frowned in anger, stepping forward, holding Perino’s streetclothes and sneakers.

  “Good morning, Mrs. Perino.” Eric extended his hand, but Mrs. Perino scoffed.

  “You want me to shake your hand? I don’t think so. You’re the one who attacked my husband. I’m getting him out of here. He’s not staying another minute.”

  Eric remained calm. He wanted to set the record straight, but he also understood how she could be upset. “Mrs. Perino, I didn’t attack your husband. Here is what happened—”

  “You did, too! He’s got a big bump on his head because you tackled him. You’re supposed to be taking care of him. We came here because we thought you would take care of him.”

  “We are taking care of him and we will continue to do so.”

  “He’s only been here three days, and this happens? I’m taking him out of here.”

  “It would be against my medical advice for you to try and leave with him—”

  “What do you know? You’re not even his doctor. He is.” Mrs. Perino pointed at Sam, who came forward, holding up a calming hand.

  “Mrs. Perino, Dr. Parrish is my boss and he’s fully up to speed on your husband’s case.”

  “Oh yeah?” Mrs. Perino spun on her sneakers to face Eric again. “What were you doing when he hurt himself on the table? How did that happen?”

  “I’m sorry, Mrs. Perino,” Eric said, though Legal had told him that he should never apologize, because it could be construed as an admission of liability. “You’re right, that shouldn’t have happened—”

  “How do you explain it then? Everybody here’s asleep at the switch. Nobody’s paying any attention to him. You just stick him in the room and ignore him.”

  Sam interjected, “Mrs. Perino, I explained it to you on the phone last night. You said you understood how this came about. It was your husband’s reaction to an unfamiliar nurse.”

  Eric joined in, “Mrs. Perino, I assure you that we are giving him the treatment he needs. He wasn’t being ignored, and he never would be. We work in teams and his team is absolutely dedicated.” He turned to Perin
o, who slumped on the edge of the bed and still hadn’t looked up. “Mr. Perino, how are you feeling?”

  “I want … to go home,” Perino answered, still staring at the floor. “You’re not … helping me. Nobody here is helping me. I want to go home.”

  “Mr. Perino.” Eric touched Perino’s shoulder gently. “I’m sorry about what happened yesterday, but I can’t let you go home, not until—”

  “My wife wants to take me home … and she’ll take good care of me, like before we started all this, in and out of hospitals, and I can go back to work—”

  “Donnie, you don’t have to talk to him.” Mrs. Perino stepped closer, backing Eric away with a steady glare. “Doc, don’t you dare speak to him. You’re the one who could’ve broken his neck. He could have split his skull!”

  “Mrs. Perino, please, listen to me.” Eric faced her, undaunted. He could see that she was angry but underneath that, concerned for her husband’s welfare. “As I’ve explained to your husband, his abrupt withdrawal from his meds can cause adverse and even violent reactions. That’s why he hit his head on the tray, and we had to subdue him before he could hurt himself any further. That’s why he needs to stay here—”

  “No way,” Mrs. Perino shot back, waving the streetclothes at him. “Now get out of this room so I can get him dressed and out of here.”

  “I can’t do that, Mrs. Perino. Neither can you—”

  “You can’t tell me what I can and can’t do! Who the hell do you think you are? God?”

  “No, not at all.” Eric kept his cool.

  “I brought him to the hospital. I can take him out of here anytime I want. You can’t stop me.”

  “Mrs. Perino, your husband was admitted under Section 201, after we evaluated him in the emergency room and decided to admit him. That’s considered a voluntary admission, but that doesn’t mean that the discharge is voluntary, as well.” Eric had been unhappily surprised to learn that as a doctor, he spent too much time acting like a lawyer. The admissions and discharges of mental health patients were governed by a myriad of state laws, on top of the rules and regulations that the hospital imposed.

  “What are you talking about? How could it not be? If I got him in, I should be able to get him out.”

  Eric knew it was counter-intuitive and Mrs. Perino wasn’t in a listening mood. “If you recall, you were asked to sign a form agreeing to give seventy-two hours’ written notice before leaving the hospital, if you are leaving against medical advice—”

  “I don’t have to follow your rules!”

  “It’s not our rules, it’s state law. It says you can’t take him out of the hospital today, and it’s designed for your husband’s well-being. You signed the form and—”

  “I don’t remember that! It musta been in the fine print! I didn’t think I wasn’t gonna be able to get him out again!”

  Mr. Perino began rubbing his face, still hanging his head. “I want to go home. You can’t keep me here against my will. I’m not a prisoner.”

  Eric addressed them both. “You have to think about what’s best for him.” He gestured to Perino, who by now was eyeing them both unhappily. “Please, think about what happened yesterday. Without warning, he started slamming his head into his bedside table—”

  “So you say! Did you see it with your own eyes? Who knows what happened! I want him out!”

  “I have no reason to disbelieve my nurse.” Eric heard the sound of talking in the hallway, which told him that security was arriving. “But legalities aside, how would you feel if you took him home and he got out of control? You wouldn’t be able to help him. As you say, he could split his skull. You would never forgive yourself if something happened to him.”

  “Dr. Parrish?” called the security guard, as he entered the room with two other uniformed security guards. “Can we be of any assistance?”

  “Not yet, thank you,” Eric answered, holding up an open palm like a stop sign. “I think we will be able to figure this out together—”

  Mrs. Perino gasped, then laughed derisively. “What the hell is this? Are you guys gonna arrest me? You gonna handcuff me? All I’m trying to do is take care of my husband!”

  Eric turned to her, trying to defuse the situation. He wasn’t about to have Mrs. Perino thrown out, even though it was within his power. “Security is here only in case we need them, but we’re not going to need them.”

  “Doc, you might! I used to play women’s softball, fast-pitch. I have a hell of an arm.”

  “Good to know.” Eric managed a smile. He sensed the dynamic change as soon as security arrived, if only because Mrs. Perino probably felt embarrassed in front of them.

  “Listen, I want to take him home, right now. He’ll be fine at home with me. My sister’s husband could help if I need it. They live around the corner. He works construction.”

  “In an emergency, you might not have time to call him. Your husband could hurt you without meaning to.” Eric remembered the family history from Perino’s file. “Your nieces and nephews come over a lot, don’t they? What if he hurt one of the kids? Think about that.”

  “He would never do that,” Mrs. Perino shot back, but less strident. “He never raised a hand to me or the babies. He loves those babies.”

  From the bed, Perino stared down at the floor, shaking his head. “I would never do that. Those kids, they’re the world to me.”

  Eric put a hand on Perino’s shoulder. “Mr. Perino, I know you wouldn’t mean to, but that’s not the point.” Then he turned to Mrs. Perino. “I agree with you, he would never do that when he’s acting like himself, but he’s still under the influence of these medications. He’s a threat to himself and his family until they’re corrected and balanced in his system.”

  Mrs. Perino threw up her hands, her frustration plain. “That’s just what Dr. Rockwell said. You guys keep telling me he’s crazy because of his medication. Klonopin. Where do you think he got the medication? Valley Forge Memorial, that’s where. A doctor just like you, he came in and told me my husband needed to be on those drugs. And now you’re telling me that that’s what made him crazy. What is it with you guys? Why should I trust you?”

  “Because we care,” Eric answered, simply. “We’ve been treating him and giving him the best medical care possible, and I know we can continue to help him through this transition—”

  “Why can’t I take him to another hospital? Can’t I do that? Can’t I get him transferred?”

  “I think Dr. Ward has been making good progress with your husband, but that is your right, absolutely. You are free to go ahead and try to get him transferred; in that event, we would need the other hospital’s confirmation that he has been admitted.”

  Sam looked from Eric to Mrs. Perino. “Mrs. Perino, we really have been making progress. We’re following a treatment plan. It would be best for your husband if we could stay the course—”

  “No, I’m leaving, I’m going to see a lawyer.” Mrs. Perino glowered at Eric as she stormed to the door. “I’ll have your license, I swear I will.”

  “Linda?” Perino asked, bewildered, and she stopped, putting her hand on his shoulder.

  “I’ll get them for this, I promise.”

  Chapter Twenty-two

  Eric finally had a chance to sit down at the end of the day, stealing a few minutes to deal with the incident with Mrs. Perino, which he’d have to document, per hospital procedures. He was searching his system’s vast internal website for the proper e-form when he heard a knock on his doorjamb.

  “Eric?” Laurie appeared, dressed to go running in a white singlet and gray shorts, her long brown hair up in a clip. She grinned crookedly. “You forgot, right?”

  “Right. Sorry. I can’t go, I’m busy. Go without me.”

  “The hell I will. We’re going. You need the exercise.”

  “I’m behind on my paperwork.”

  “There’s not a doc in this hospital that’s up-to-date on paperwork, and it’s never about patient care, just insurance,
and more regs, and more updates to regs to put in our binders, then a notice to throw out all the binders because we’re going paperless.”

  “This is important. I want to log in this incident—”

  “Oh, what happened? A crazy person did something crazy?” Laurie came around his desk, palmed Eric’s computer mouse, and glanced at his monitor. “Bye, work.”

  “No, leave it.” Eric reached for the mouse, just as Laurie closed out the website. “Arg.”

  “Get up and let’s go.”

  “Go without me.” Eric didn’t feel like running. He felt like logging in Perino, answering his email, and worrying about Max, Renée, Perino, Hannah, and Caitlin.

  “What’s up? You look bummed.”

  “Remember Max Jakubowski, with the grandmother?”

  “Oh, yes. How are they?” Laurie’s face fell into grave lines. “I called her to follow up yesterday, but there was no answer.”

  “She’s in hospice, and I’m worried about Max.”

  “The poor kid.” Laurie clucked. “He was sweet.”

  “She appears to be hanging in there, but I know it’s going to crush that kid.”

  “Let’s get going, it will give us a chance to catch up and talk about it. Come on, you need cheering up.” Laurie gave him a gentle shove on the shoulder. “You’re too big a deal to run with me, now that you’re number two?”

  Eric smiled, leaning away from the computer keyboard. “Is this your way of saying congratulations?”

  “Yes, how charming am I, on a scale of one to ten? Twenty-two?”

  “I don’t know, what’s your ranking? Forty-something? Oh, wait. That’s your age.”

  “Whoa, that’s harsh.” Laurie wrinkled her nose, comically. “We dropped to eleven.”

  “Ruh-roh, somebody needs to work harder.”