Mercy

by Rada Jones

  “She has trouble breathing. To help her, we’d have to put a plastic tube down her throat to connect her to a breathing machine. We’d have to place a large needle in her neck to give her medications. It will hurt.”

  “Will it save her?”

  “Save her? No. It may keep her alive a little longer. It may not. She will never be well. Most likely she’ll get worse. Alternatively, we could do all we can to keep her comfortable.”

  “Will she live?”

  “Not for long. But she’d be comfortable. She would die with dignity, and without pain. You could sit and talk to her.”

  “Will she answer?”

  “Probably not.”

  “I need her to talk to me. She must forgive me.”

  “She won’t do that,” George said. “She can’t speak.”

  “You must keep her alive. Do everything! I have the power of attorney. I’ll sign for it! Where do I sign?”

  “You think she would like that? To be kept alive by machines? Is that what she wanted?” George asked.

  Her eyes burning, her fists clenched, the woman turned to George.

  “I’ll tell you what you need to do. Everything. You’ll do everything to keep her alive!”

  George shrugged.

  “Is there anybody else we could talk to? Your siblings? Any other family?”

  “I’ll speak to them. I’ll speak to whoever I want to! And you, you’ll do your job. You’ll keep her alive! That’s all you need to worry about.”

  Emma sighed.

  “Let’s see how she responds to treatment.”

  She’s not ready. There’s no point in pushing it.

  38

  An hour later George went on break. Carlos covered for him. On his way to checking on Room 15, he stopped by the break room to grab a coffee. He had so much trouble sleeping lately that he could barely stay awake during the day.

  The note near the coffee maker read: “Fresh at 9:30.” He checked his watch. 12:15. He shrugged and poured himself a cup. He was almost done when the door opened and Brenda came in. She smiled.

  “How’re you doing, Carlos?”

  “Good. You?”

  “I heard you and Faith no longer…”

  “No.”

  “She’s seeing Ben, I heard.”

  “You’ve heard a lot of things.”

  “One can’t help it. Gossip travels in the ER like wildfire.”

  Carlos finished his coffee.

  “Carlos?”

  He stopped, his hand on the doorknob.

  “How about drinks after work?”

  “Sorry. I have errands to run.”

  “Tomorrow?”

  “I have a doctor’s appointment.”

  “Next week?”

  Carlos took a deep breath. He didn’t need this. He didn’t want to hurt her feelings, but he had no choice. He wasn’t interested in Brenda. He wasn’t interested in any woman. But Faith. And his interest in Faith was a disease.

  “Sorry, Brenda, I’m not ready to date. Not yet.”

  Brenda’s smile melted.

  “I’m not your type?”

  “You’re a very attractive woman,” Carlos said, looking at his shoes.

  “But not your type. You like them white, do you?”

  Carlos heard his blood boil in his brain He clenched his fists but spoke softly.

  “Sorry, Brenda. My personal life is personal.”

  “You’re brown too, you know. Even if you act like you’re white.”

  She slammed the door behind her.

  He saw red. Where the hell’s that coming from? What’s she talking about?

  By the time his pulse had slowed enough to let him go back, he heard: “Dr. Steele to Room 15, STAT.”

  That’s where I was going.

  He was too late.

  39

  After the conversation with Room 15’s daughter, Emma went to see the chest pain in Room 4. He looked OK. The dog bite in Room 11 was easy. No sutures. Just cleaning and antibiotics. And education: Don’t let your child pinch the dog while she’s eating. It’s not rocket science!

  She stopped by Room 15. The daughter wasn’t there. The patient looked much better. Good news all around. Her fingers were so cold that she couldn’t get the oxygen sats. She left a note asking George to get a forehead probe. She ordered a repeat blood gas and paged the hospitalist, then moved on to her next patient.

  Room 5. Three-year-old fall. The triage comment was “The family demands a head CT scan.”

  She went to Room 5. A crying woman sat on the stretcher holding a screaming toddler with a bruise on his forehead. A man in a white wife-beater paced the room.

  Emma smiled and introduced herself. Nobody smiled back.

  “Where did he fall from?”

  “The shopping cart,” the man said.

  They feel guilty. That’s why they’re angry.

  “Did he cry immediately?”

  “Yes,” the woman sobbed.

  “Any vomiting?”

  “No.”

  The kid looked great but for the frontal hematoma. Emma sang to him as she checked him out inch by inch.

  “Now we try the ankle—and the knee—and the hip.”

  The kid laughed.

  “And the belly—it doesn’t hurt—it doesn’t hurt—but it’s ticklish…”

  They all started laughing. That’s my singing voice. I’d better not quit my day job.

  They agreed to watch the kid. No CT. We’ll save a couple of grand on the workup, and save the kid a bunch of radiation.

  As she left the room, the speakers croaked: “Dr. Steele to Room 15.”

  She ran. George was performing CPR. The daughter got in Emma’s face, howling.

  “You killed her! You killed her!”

  Emma stepped around her to get to the patient. She checked for a pulse. None.

  “What happened?”

  George, still doing CPR, answered in spurts:

  “I don’t know… I gave the meds to Room 6… then I went on break…when I came back…she was unresponsive.”

  “You killed her, you motherfuckers! She’s dead!”

  She’s right on one account.

  “I’ll sue you! I’ll get you fired! I’ll put you in jail! You’ll never see the light of day! Murderers.”

  They needed security to escort her out.

  Epinephrine, CPR, intubation—nothing helped.

  She stayed dead.

  40

  Emma wished she had a chance to stop and think. To understand what happened. Another elderly patient dying unexpectedly. This was case #5. How? Why? She didn’t know. The one thing she knew was that she was toast. This was the fifth sudden death. The daughter’s anger and threats were likely to be the last straw. She was done as medical director. Fortunately, she didn’t have time to feel sorry for herself. She had an ER to run.

  She went to run the board, checking on the new patients.

  Room 14. Thirty-eight. Altered mental status.

  On her way to the room, she ran through the differential diagnosis. There has to be a reason. The elderly? Anything gets them altered. A touch of pneumonia, a urinary tract infection, forgetting their meds—or taking them twice. A 38-year-old is something else. Alcohol? Drugs? Seizure? Encephalitis? He’ll need a workup.

  He didn’t. She diagnosed him from the door. A textbook case for liver cirrhosis. Yellow, distended abdomen, spider veins. Metabolic encephalopathy.

  She smiled and introduced herself. They shook hands.

  “What happened?”

  “I’m getting confused. My ammonia must be up.”

  Emma laughed. “I wish all my confused patients told me what’s wrong with them. We’d save time and tons of money.”

  “I know. I’ve been here before. Your people scanned the bejesus out of me. They made me into a pincushion. They even wanted to do a spinal tap. I almost signed out against medical advice.”

  “You can’t sign out AMA if you’re altered.”
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  “I know.”

  “Have you been drinking?”

  “Not in six months. Ever since they told me I had cirrhosis.”

  “Good for you. But what makes you say you are confused?”

  “Not why. Who.” He nodded to the plump elderly lady coming through the door. “Dr. Steele, meet my aunt. She’s the one telling me I’m losing it.”

  “Hi. I’m Dr. Vera Tolpeghin.”

  “Glad to meet you. What specialty?”

  “Oh, I’m not your kind of doctor. I have a PhD in biology.”

  “Interesting,” Emma lied.

  “I can see you’re fascinated.”

  Emma laughed.

  “Never mind. He has trouble, especially in the evenings. Sundowning maybe? He gets distracted and has trouble finishing his sentences. He’s fine in the morning, but the evenings are no good. I hope it’s not another GI bleed.”

  “We’ll check.”

  She headed out. Dr. Tolpeghin stopped her.

  “We couldn’t help but hear what happened next door. That woman was awful.”

  “She was upset,” Emma said.

  “She was a bitch. A raging bitch.”

  Emma opened her mouth. She closed it. Her nephew laughed.

  “That’s Vera for you. No sugarcoating, no political correctness, no nothing. You can’t tell it by her accent, but she’s Russian. They’re not PC.”

  “Get over it, Boris. You’re just as Russian as I am. And just as politically incorrect.” She turned to Emma. “My being Russian is irrelevant. What’s relevant is that I’m on the hospital board of directors. Remember that, if you ever need help. Like maybe with this bitch.”

  That was a first for Emma. Whenever people told her who they were, they either wanted VIP care, or tried to threaten her. Nobody had ever offered to help.

  “Thank you, Dr. Tolpeghin. I appreciate it.”

  “Vera. And I mean it.” She handed Emma her card. “You, ER folks, work so hard. You deserve more appreciation.”

  “Thank you…Vera.”

  “Enough sweet talk. Am I getting checked or what?” Boris asked.

  She checked him.

  “Everything looks good,” Emma said, when she went to discharge him.

  “Thank you.”

  “My pleasure.”

  “Are you single?” he asked. With his yellow face split by a wide smile, he looked like a jack-o’-lantern.

  Emma laughed. “I don’t think that’s relevant.”

  “Why not?”

  “I don’t date patients.”

  “Once I leave the ER, I’m no longer your patient.”

  “I don’t think so.”

  “Too bad. I’ll be in touch. You never know. You may change your mind.”

  That was the best moment of her day. Even though it reminded her of the dangers of alcohol. Her diet was mostly wine-based these days. Even now, she was looking forward to her wine. Like he must have been, just months ago.

  It’s too late for him. His liver is gone, and his future with it.

  Am I next?

  41

  Angel

  This one’s for you, Emma. You wanted her dead. She wanted to be dead. Even her daughter wanted her dead.

  After she got absolution. No matter what it cost. What a bitch!

  I know you wanted to help her across the rainbow bridge.

  You can’t. They’d take your license. They’d shame you. They’d put you away.

  I can. I’m here for you.

  For my old friend Carlos, too. Like Hannibal Lecter, I’m having an old friend for dinner.

  He’s already cooking.

  He just doesn’t know it yet.

  42

  That evening something had changed. Emma knew it as soon as she set foot in the house. The place was clean. No dirty dishes. Nothing on the counter. The old kitchen sparkled. That hadn’t happened since Taylor came back. That hardly ever happened before that.

  It can’t be good. Last time I came home to a clean kitchen was when Victor left us. What the hell is it now?

  It had been another bad day. Another dead patient. One could hear the daughter’s screams across the lake. She threatened to sue them. Risk Management wasn’t pleased. Neither was Gus. Her time was running out.

  She needed wine. She grabbed a bottle. Heartland 2012. Australian Shiraz. Screw cap, like most New World wines. Good. I don’t need to look for the corkscrew.

  The bottle opened with a crack. Emma poured a good third into a long-stemmed glass. She looked through it. Dark red, opaque, earthy. She sniffed it. Dark fruit and pepper. Her mood lightened. She took a long sip, letting the smooth heat of the wine tickle her tongue, bathing her taste buds. She swallowed. She took a second sip. She refilled the glass. She was ready.

  No music, no typing, no sobbing. She’s either asleep or gone.

  Taylor’s door was cracked open. Emma knocked.

  “Hi Mom.” Taylor, beautiful and calm, sat up in bed.

  Careful not to spill her wine, Emma dropped in the orange rocking chair in the corner. Rocking soothed her. She loved it, even though it was a trap. Getting out of it was a job for Houdini.

  “How are you?” Emma asked.

  “I’ve been better.”

  “Me too.”

  “What happened?”

  “I lost a patient.”

  “Don’t you lose some every day?”

  “Not quite.”

  “You still care, after all these years?”

  “Of course I care. I couldn’t do my job otherwise. At least I shouldn’t. If you don’t care, you don’t belong there. People deserve better.”

  “Yep, but to get upset every time they die…”

  “Not every time. Sometimes it’s a blessing. When it’s their time to die.”

  “Today it wasn’t?”

  “I think it was.”

  “Then why are you upset?”

  “Her daughter took it badly. And I don’t understand why she died.”

  “Why does it matter? Who cares?”

  “The hospital cares. My malpractice insurance cares. I care. I need to understand what happens to my patients. It’s my job.”

  “Do you always worry about your job?”

  “I always worry about my responsibilities. My job is one. You’re another. How are you?”

  “I’m better now. I thought.”

  “That helps.” Emma sipped on the wine. She rocked. It felt good on her back.

  “I thought about myself.”

  How unusual.

  “And?”

  “I spoke to Eric. He didn’t take it well.”

  “What did he say?”

  “He left.”

  “He must have been surprised. He needs time.”

  “He ran away.”

  “I’m sorry, Taylor.”

  “You told me.”

  For once, Taylor wasn’t having a crisis, though she was due. She didn’t even blame Emma. Growing up, maybe?

  “I spoke to Dad.”

  “What did he say?”

  “He said that true love never dies. If Eric loves me, he’ll come back.”

  Emma swallowed her remark about Victor and true love with another sip of wine.

  “Would you take him back?”

  “Of course. If you love him. He needs time to get used to the idea.”

  “No. Not Eric. Would you take Dad back?”

  Shit.

  “Taylor, he left ten years ago. He’s married. He has kids. There’s nothing to take back.”

  “If he came and asked, would you take him back?”

  Not in a thousand years.

  “I don’t think that’s something to worry about.”

  “I’m not worried. I’m hopeful!”

  “Taylor, don’t you have enough to think about? You, the baby, Eric? Victor’s got Amber, the kids, and the dogs. He’s all set.”

  “How about you? Who do you have?”

  “I have you. And I have my work.�
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  “Your work has you. The ER owns you. You need to get a life. You need somebody. I have my own life. I’m going to be gone soon. As soon as I figure out what to do with myself.”

  “Thanks, Taylor, but don’t worry about me. Let’s think about you.”

  “I need a job. I need to make myself useful, instead of laying here, feeling sorry for myself.”

  Wow. “How about college?

  “In a year or two. Maybe. After the baby’s born. And I grow up a little.”

  “What job are you thinking about?”

  “I want to work in the hospital.”

  “Why?”

  “You’re a doctor. Dad’s a doctor. Eric is a nurse. Everybody close to me is into medicine, one way or another. I want to see if that’s my thing.”

  “That makes sense.” Emma said, hoping she’d change her mind. Taylor in the hospital? What a disaster! She didn’t like taking orders. And that’s what we all do there. Everyone, from the environmental workers to the CEO. We take stupid orders. Patients, consultants, insurance companies, lawyers, the government. They’re all riding us.

  “What are you going to do?” Taylor asked.

  “Me?”

  “Yes. What are you going to do about your life?” Taylor’s gaze bore into her.

  She’s taken me on as a project! God forbid she decides I need to take Victor back!

  “I’ll get a dog.”

  The thought came out of nowhere. Her heart sang. She smiled.

  I’ll get a dog. That’s exactly what I need. Better than men, healthier than wine.

  43

  Carlos couldn’t find a working IV pump. He tried Room 23, then 25. Nothing. He went to 26. He heard moans. Somebody in pain? He opened the door. The IV pump was there.

  So was Ben. Lying sideways across the stretcher, his scrub bottoms around his ankles. His coarse face was tight, his jaw clenched. Impaling herself on top of him, Faith smiled, her indigo eyes hazed with pleasure.

  Carlos felt sick.

  He bolted out, slamming the door. He barely made it to the bathroom across the hall. He retched again and again until he was empty. He felt weak. He splashed cold water over his face. His teeth chattering, he sat on the toilet to recover. He heard the door.