Medical Error pft-2

by Richard L Mabry

  "Is she all right?" Mrs. Hernandez looked up at Anna, her anguish and pain reflected in her eyes.

  Mr. Hernandez sat grim-faced and stoic, obviously prepared to hear the worst and support his wife if the dread words were uttered.

  "Rosa is fine." Anna had more to say, but the words were cut offwhen Rosa's parents jumped to their feet and embraced, first each other and then her.

  "Thank you, Doctor." Mrs. Hernandez wrung Anna's hand."Thank you for saving our daughter."

  "Why don't you sit down and let me explain what we found?" Anna pulled up a chair so she'd be at eye level with Rosa's parents. "The force of the crash ruptured her spleen. We controlled the bleeding, then removed the spleen. It's a fairly common operation, sometimes done as an elective procedure for people with certain types of blood disorders. She'll function fine without it. We've replaced most of her blood loss, and she'll be able to build up the rest on her own."

  They both began to speak at once. Anna held up a hand. "I'll answer all your questions, but first let me get back in and look at Rosa. She'll be in the Recovery Room until she's awake and stable. Either I or one of my staffwill look in on her a couple of times a day, and the nurses will notify us immediately if there's any change in her condition. Why don't you wait here? The nurse will come and get you when it's okay for you to see her."

  Back in the recovery room, she found Matt writing in Rosa's chart. "How're you doing?"

  "I think I've got it covered," he said. "See what you think."

  She took the chart and scanned what Matt had written. It all looked good.

  "Do you agree with the morphine pump for pain?" Matt asked. "I can change it to IM Demerol if you want to." He lowered his voice. "Some of the older staffstill like that, but I figure you-"

  It felt so good to be back in action that Anna had almost forgotten her problems. Now one of them came roaring back at her. Whether it was the look on her face or the way she shoved the chart back toward him, Matt's voice trailed off. "Dr. McIntyre?"

  "Why don't you get Dr. Fowler to sign offon this?" Anna said.

  "Did I do something wrong?"

  "Matt, someone stole my DEA number and has been writing 'scripts for narcotics. I've had a hard time convincing the authorities to clear me, and even though they're supposed to have issued a new DEA number, I'm not sure the process is complete. Right now, I think it's best that someone else sign offon an order that involves narcotics."

  Anna couldn't read Matt's expression. Did he believe she was unjustly accused? Was he sympathetic or suspicious? Was she justifying herself in his eyes or feeding the rumor mill she knew existed in the medical center?

  "I'd heard a little about that," he said. "And I think you ought to know that none of us ever thought you did anything wrong."

  As though embarrassed by his statement, Matt looked down at the chart. "I'll get Dr. Fowler to sign offon this."

  "Thanks, Matt. I appreciate it."

  "Thank you for letting me help. I'm applying for a surgery residency here at the medical center. Would you mind if I listed you as a reference?"

  "I'd be honored," Anna said.

  "Look, Glenn. You need to come clean on this one." Ross Donovan watched a drop of his sweat hit his desk blotter. He loosened his tie and moved the phone to his other hand. "I saw your name on the label. I know you're involved in this some way. I can make sure you go down for it, or I can try to keep you out of it. But I can't help you unless you tell me everything."

  "Ross, you gotta believe me. I didn't think I was doing anything wrong. Honest." The last word came out like a strangled call for help.

  The lawyer waited for more, but all he heard was heavy breathing. Okay, now it got tricky. How far could he push the man? "Tell you what. When's your next meeting?"

  The answer came without hesitation. "Tonight at eight. The basement of St. Barnabas Church on McKinney."

  "Okay, I know where that is. I'll be parked around the corner at seven-thirty. Find me and get in the car."

  "You won't-?"

  "I won't tell your employer about this. At least not yet. But I want the whole story. And you'd better level with me. If I find out you're lying, all bets are off."

  After he hung up, Ross sat for a moment with his eyes closed. This was crunch time. If this meeting tonight worked out, he might be close to solving Anna's problems. Of course, if it didn't, he could be in big trouble, trouble that could have the police on him like fleas on a dog. It was times like this that had driven him to depend on courage in a bottle.

  Ross pulled out the bottom drawer of his desk and probed without looking, ignoring everything else in the drawer, until his fingers found what he wanted. He pulled out a bottle and put it on the desktop. "Your Honor," he said, in his best courtroom voice, "I call to the stand Mr. James Beam. Mr. Beam is an old friend, one who has been with me through many difficult times."

  Ross reached once more into the drawer and withdrew a glass. He held it up, and the rays of the noon sun passing through it cast a rainbow on the opposite wall. A bottle and a glass, companions he'd known for a long time. And oh, how he'd missed them.

  One drink-one drink wouldn't hurt, would it? He knew what it would be like, could almost taste the smooth liquor rolling across his tongue, feel the burn as it hit his stomach, anticipate the feeling that followed. He uncapped the bottle and filled the glass almost to the brim.

  Some ex-smokers carried a pack, testing their willpower and daring themselves to quit. Most didn't, though, because they knew that sometime, somewhere, they'd succumb to temptation. Stress, fatigue, even hunger were the enemies of the addict, whether their drug of choice was nicotine, alcohol, or narcotics.

  Ross had decided to keep his stash intact, to test his willpower. His AA sponsor tried to talk him out of it. "Don't be around alcohol. Don't be around people who drink. Don't go into bars. Avoid cocktail parties. All you need is the opportunity, because believe me-the craving will always be there. Always."

  If he ever needed some Dutch courage, though, now was the time. Ross was pleased to note that the surface of the amber liquid in the glass didn't move when he held it up. His hands hadn't always been this steady. He had things under control now. No problems.

  He wasn't sure how long he sat there glass in hand, staring at the half-full bottle of bourbon. Then he walked to the window and raised the glass in a toast. To sobriety… or to oblivion?

  Yesterday, he'd gone to an AA meeting and said, "I'm Ross. I'm an alcoholic, and I have ninety-nine days." If he went to a meeting tomorrow, would he be awarded a hundred-day chip? Or would he be saying, "I'm Ross. I'm an alcoholic. Yesterday I fell offthe wagon."

  He took a deep breath, then another. Finally, he turned away from the window. At the desk, he put the glass down next to the bottle and stared at them as though they were a magic crystal ball, holding all the answers to his questions. Would bourbon rule him for the rest of his life? In a single motion he swept both glass and bottle offthe desk into the wastebasket. He heard the tinkle, smelled the fumes.

  He shrugged. The cleaner would take care of the trash he'd created. Nothing could clean up the mess he had been about to make of his life.

  Ross grabbed his coat and briefcase and left the office, not totally sure where he was going but knowing that wherever it was, he'd get there sober.

  17

  Nick took his frustration out on his cell phone when Anna failed to show. She had promised to come by his office and have lunch with him after her appointment with Mike Simpson. Nick had planned his day carefully so he'd be free for lunch, had even picked out a place off- campus where they'd have a little privacy. He'd gotten up enough courage to say some serious things to her, but now it was as though the earth had opened up and swallowed her.

  When he hadn't seen or heard from her by one in the afternoon, Nick started calling. Her administrative assistant said Anna wasn't in and hadn't come into the office all day. Was there a message? Nick said he'd try elsewhere. No message.


  Anna's machine at home picked up on the first ring, so he figured there were already messages waiting for her. Nick hung up without adding one of his own. When a call to her cell phone came up dry, he swallowed hard and decided to leave a message. He hated that. Voicemail messages were so sterile and impersonal.

  He worked to keep his voice neutral-no urgency, no begging."Anna, this is Nick. I thought we had planned on lunch. Give me a call when you get this. I-" He bit back the rest of his message and hung up.

  Nick began to picture scenarios to explain why Anna was out of touch. Had Mike found a problem this morning? Maybe Anna had developed a late consequence of her head injury. What if she had a chronic subdural hematoma? At this moment, could she be suffering through the claustrophobic experience of an MRI? Was she once more lying in a hospital bed, or-oh, please, God, no-was she being prepped for surgery?

  Nick's temples throbbed. He pulled a bottle of Advil out of his desk drawer and washed two tablets down with cold coffee. Of course, there was another possible scenario. He'd shoved this one into the back of his mind, but it kept creeping forward to stick its tentacles into his consciousness and stir his thoughts into unease. Had those two Dallas police detectives, Green and Dowling, brought her in for more questioning? He could picture her, sitting in an interview room being buffeted by questions and looking to her attorney for help. That last thought made him cringe. He knew Anna had confidence in Donovan, but Nick wasn't sure she should depend on an alcoholic, even if he was dry, or sober, or whatever AA called it.

  "Dr. Valentine, call for you on line one." The voice on the intercom snapped Nick out of his thoughts before they could spiral downward any further.

  He lifted the receiver. "Dr. Valentine."

  "Doctor, this is Detective Green. You may remember-"

  "I know who you are. What do you want?" Nick regretted snapping at the detective, but it was too late. Anyway, the man knew he wasn't a big fan, so how much more harm could Nick's tone have done?

  Green went on, apparently unfazed. "We want you to come down here so we can get a formal statement from you."

  "What about? That parking ticket I got last week? I'm going to pay it. Honest."

  There was no humor in Green's voice. "You know what it's about, Doctor, so don't try to laugh it off. We need to get you on the record about Eric Hatley's death. Can you come down today?"

  Nick held the phone near the surface of his desk and shuf- fled some papers. He knew what his schedule was, but Green didn't. How long could he stall? "Just checking my calendar. Can't do it today. And tomorrow's out too. How about next week?"

  "How about we send a marshall down to your office with a subpoena? He can bring you back right now. Sound good to you?"

  "No, not really." Nick decided to give it one more try. "Look, today and tomorrow really are bad days for me. Give me fortyeight hours to rearrange my schedule and get someone to cover for me. I'll come down Friday afternoon. Will that work?"

  There was a murmur in the background, and Nick figured Green was conferring with Dowling. Good. Dowling had seemed like the more reasonable of the two. In a moment, Green said, "Friday at two p.m. Know where we are? On Harwood?"

  "Yeah, I know. See you then."

  Nick hung up, closed his eyes, and leaned back. The Advil hadn't touched his headache that bordered on a migraine. And now he had one more thing to add to his list of worries. "Lord, help me," he whispered.

  Anna met Neil Fowler at the door to the surgeon's lounge. She gave him a brief rundown on the surgery she'd performed, careful to mention how Matt Ryan had functioned extremely well as her first assistant. "He's applying for a surgery residency here, and I hope you'll remember this when you review his application."

  "Sure. Why don't you send me a memo-an e-mail will do-and mention this? I'll be sure that Peggy attaches it to his application when we get it." He moved toward the coffee urn."I signed offon the narcotics order for your case, by the way. I'll be glad when the DEA gets that straightened out, and I know you will too."

  He held up a cup and Anna nodded. When they were both seated with their coffee, Fowler told her about his own case, a bus driver whose face was so badly injured in the crash that it took more than two hours to repair the damage, realigning broken bones and meticulously sewing up lacerations. "Wouldn't you know it? Half our plastic surgeons have gone to a meeting in Chicago, so I got drafted. I haven't done a case like that in years."

  "You know you enjoyed the challenge."

  "Yeah, I guess you're right." Fowler tossed his empty cup into the wastebasket. "Do you feel okay? I know Mike told you to take another week off, but if you hadn't been here today, I'm afraid that little girl would have bled out. You saved her life."

  "I'm fine," she said. "Just a little wrung out, I guess."

  "Well, head home. I'll look in on your patient tonight. Call me tomorrow and let me know how you're feeling. I don't want to push you."

  "Thanks. I'll stop by the waiting room and talk with Rosa's parents before I go."

  At home, Anna dropped her backpack inside the front door and headed straight for the fridge. She pulled out a can of Diet Coke and trudged back to the living room, where she collapsed onto the couch and rubbed the cold container against her throbbing temples.

  She closed her eyes but couldn't rest. Her mind kept going in circles that had no end. She remembered something she'd seen in geometry-or was it algebra?-called a Mobius strip. It was a paper strip twisted a half-turn and fastened together so it had no beginning and no end. Start to draw a line down the middle of it, and eventually you'd end up back where you started, with a line on both sides of the paper. Well, her problems were a Mobius strip, with no end in sight. The detectives who seemed determined to charge her with murder; the person or persons who were using her DEA number to write bogus narcotics prescriptions; the identity theft that threatened her credit, cost Eric Hatley his life, and almost convinced Nick she was HIV-positive.

  That set her thoughts on another track-something she never thought would be a problem for her. Two weeks ago there were no men in her life. Now there were two. Each seemed fond of her and growing fonder, and that was nice. But they both had problems, and she wasn't sure she was strong enough to deal with her own difficulties, much less those of Nick and Ross.

  "Lord, I need help." Anna wasn't sure whether she'd spoken the words aloud or just framed them in her mind, but they were certainly an outpouring of what she felt in her heart.

  A loud banging at her door made her jump. What now? Her first thought sent a chill down her spine. Was it the police with a warrant for her arrest? They'd take her downtown and book her. Wasn't she supposed to get one phone call? What was Ross Donovan's number? She couldn't imagine they'd let her keep her cell phone in a jail cell. She scrambled through a pile of unopened correspondence on her desk until she found the slip with Ross's number on it. She started to stick it in her pocket, then changed her mind and wrote it on her palm with a Sharpie.

  The banging continued. What else? Her mind raced. She'd never prepared to go to jail before.

  "Anna, open up. I know you're home. I can see your car in the driveway."

  At the sound of Nick's voice, Anna felt a mixture of relief and irritation wash over her. What was he doing here? She wasn't ready for company. She wanted to shower and fall into bed.

  When she opened the door and saw the look on Nick's face, Anna's irritation melted.

  "Anna," Nick said. "I've been trying to reach you all day. When I couldn't get you, I pictured all kinds of terrible things. At first, I thought maybe Mike Simpson found a problem from your head injury. I could picture you back in ICU, or on your way to surgery. Then I had visions of those detectives arresting you. I know it's silly, but I just had this bad feeling about you. I had to see you and know you're okay."

  "Funny," she said. "I had that last vision myself when I heard you pounding on the door. So I guess we're both relieved."

  "May I come in?"

  "Of course. Wo
uld you like something to drink?"

  In a moment, they were seated side-by-side on the sofa."I'm sorry I wasn't around when you phoned," she said. "There was a huge pileup on the freeway, and I was scrubbed in on an emergency case. What was it you wanted?"

  Nick decided this wasn't the time for the serious talk he had in mind. When he spoke with Anna about his relationship, he wanted her in a better mood than this. But there was still something Anna needed to know. He sipped his soft drink, but his throat remained dry. "I had another call from our detective friends."

  "Which one? Green or Dowling?"

  "Does it matter? Dowling seems to be a little easier to deal with than Green, but I get the impression they've played 'good cop-bad cop' for so long, they've kind of settled into those roles. I'm not fond of either one." Nick finished his soft drink in one long gulp. "Anyway, I got a call from Green. He wants me at police headquarters for a statement. Says he needs me on record about the cause of death in the Hatley case."

  "But why? You've already told them it was nothing more than an adverse consequence of a medication we administered based on flawed information. They should worry less about going after me and more about catching the person responsible for that false information in Hatley's medical records."

  Nick sighed and leaned toward Anna, as though he could add urgency to his message through his body language. "Anna, I went through all this when I shot that man years ago. I know how the authorities can twist your words and tie you in knots. Don't you think the police and the District Attorney can do that with my statement? I don't want to go on record. I don't want to give them even one word under oath because I'm afraid of how they might use it against you."

  "Nick, I appreciate your concern. Don't think I'm not worried too. I'm supposed to talk with Ross Donovan tomorrow to plan our strategy. We're both afraid that Green and Dowling are about to arrest me."

  Anna saw something flash in Nick's eyes when she mentioned Ross Donovan's name. Was it jealousy? Probably. Well, she didn't have the time or energy to deal with it.