“Not yet.”
Since Fern was stable, the doctor would probably wait to show up during early rounds, or so James hoped.
“James?” Fern’s eyes fluttered open, her voice thready. “Is that you?”
He sat down in the chair Marilee had just vacated and took Fern’s hand. “I’m here, sweetheart.”
“I’m sorry.”
“Nothing to be sorry for.”
“Your one night out.”
“Shh, we’re here now. Nelson too.”
“Hey, Mom.” Standing on the opposite side of the bed, the boy leaned forward and kissed his mother’s forehead.
She lifted her hand, her fingers trembling, to touch Nelson’s cheek. “Oh, you shouldn’t have left the—”
“Yeah, we should have,” Nelson said. “That tent was so cold, it was like we were at the North Pole. I’d rather be here with you where it’s warm.”
She managed a weak smile.
“Go back to sleep now, sweetheart.” James stood and bent over to kiss her, smoothing a few strands of her wavy brown hair away from her face. “I’ll be nearby if you need me.” He hadn’t been there for her tonight though, not when she fell. Not when she’d needed him.
The realization that he’d failed her twisted in his gut.
Fern didn’t fight the need for sleep, and she drifted off quickly.
James joined Marilee and the boys in the waiting room. Strange to be on this side of a medical emergency instead of being the one to help resolve the crisis.
Marilee handed James a brown paper sack. “I picked up all of Fern’s meds I could find. I thought maybe the doctor would want to check them.”
“Good idea. Thanks.”
“I put a nightgown for her in one of the drawers and some makeup for when she feels ready for that.”
Frank came awake slowly and stretched. “How is she, son?”
“Sleeping. Thanks for stepping in for me,” James said.
“Not a problem. She’s our little girl, you know.”
“Yeah. I know.”
Gideon struggled to sit up and knuckled the sleep from his eyes.
“Hey, Dad.”
“Hi, son. Thanks for taking care of your mom.”
Barely awake, he yawned and nodded.
Marilee said, “We’ll take the boys back to our place. They can catch up on their sleep. Tomorrow, or rather later today, you can let us know what Dr. Chopra says.”
James agreed that was a good idea. He gave both of his boys a hug and thanked Marilee and Frank again.
When they’d left, he returned to Fern’s room. He placed the sack of Fern’s meds on the bed table, settled into the chair and simply watched his wife sleep until his own eyes closed with fatigue.
Chapter Twenty-Two
WHILE IT WAS STILL DARK OUTSIDE, THE NIGHT nurse came in to check Fern’s vitals.
James woke up with a start.
“She’s doing fine,” the nurse said quietly. “Someone just made a fresh pot of coffee in the staff lounge. You should go up and get a cup.”
“Thanks.” He checked his watch. A little after six. The lines on Fern’s monitor moved steadily across the screen. “I think I’ll do that.”
The nurse left, and James stretched, rotating his head to loosen the taut muscles of his neck. He hadn’t started the weekend meaning to camp out in a hospital room half the night. At least his feet were warmer here than they’d been in the tent.
With Fern still sleeping, he slipped upstairs to get a cup of coffee and brought it back with him. The taste was far better than the vending machine dregs that visitors were forced to consume when the cafeteria was closed.
When he returned, he found Dr. Chopra talking with Fern. The monitor had been turned off as no longer necessary.
“Good morning, doctor,” James said. “You’re here early for rounds.”
Wearing a white lab coat, she turned to greet him. A petite woman with dark hair pulled back from her face, she had large, luminous brown eyes and a retiring manner. She was also a leading expert on multiple sclerosis and other diseases affecting the nerves.
“I am having trouble understanding why Fern did not respond better to the latest medication,” she said, her slight accent a leftover from her childhood growing up in India. “It has been quite effective with my other MS patients.”
“It’s probably ’cause I’m ornerier than most,” Fern quipped, though her speech was still slurred.
“I suspect the cause is something a little different than that, but we will see.”
Noting the doctor was carrying Fern’s chart, James said, “Last night Fern’s mother brought all of Fern’s meds from home. Would you like me to check them against your records? Maybe there’s some sort of discrepancy.” He picked up the brown paper sack from the bed table and showed the doctor the stash of pill bottles.
Normally James wouldn’t suggest a member of the patient’s family check medications, nor would it be medically acceptable. But as an RN, he was qualified to handle the task.
Dr. Chopra’s forehead furrowed as she considered the idea. Before she reached a decision, her pager interrupted. She checked the caller’s number.
“I have to take this,” she said and handed James the chart. “I will be right back.” She stepped into the hallway.
James bent to kiss his wife. “Good morning, Sleeping Beauty. Feeling any better?” Her color seemed better than last night and she wasn’t feverish, which meant no virus had invaded her weakened immune system.
“A little better. Did you stay here all night?”
“Since about two o’clock when I got here from the Scout camp.” He sat down in the chair with Fern’s chart and the bag of pill bottles. “I didn’t see much point in going home. I’d only have to come right back.”
“Where are the boys?”
He flipped open the chart. “Your mother took them home. She’ll let them sleep late this morning.”
“And then spoil them with waffles and all the bacon they can eat.”
“Probably.” He chuckled and started checking off the medications one at a time as they were listed on the chart, then setting the bottle aside. Some of the meds Fern took once a day, others were “as needed.” A couple weren’t familiar to James, and he noted one prescription had expired.
He held the bottle up for Fern to see and asked her if she was still taking the expired medication. If the old med had lost its efficacy, that could be the problem.
She squinted at the bottle. “No, Dr. Chopra had me switch to a different formula. It should be there somewhere.”
“Okay, I’ll throw this one out then.”
He finished checking all the pill bottles against the chart. Everything seemed to be in order. Still, Fern’s MS had taken an unexpected turn for the worse.
Why? Just as important, when had the plunging downturn started?
He thought back over the past few weeks. The doctor had ordered a new medication. James had picked up the new prescription at HHH Pharmacy across the street just like he always did. But Harold, the owner and regular pharmacist, hadn’t been there that day. There’d been a death in the family.
A new pharmacist had filled the prescription. A new, young pharmacist overwhelmed by too many customers waiting in line.
And James had been distracted by the news of the upcoming pay cut. He hadn’t checked—
Spurred into action, James quickly found the new prescription bottle among the others. He examined the medication and the dosage and checked that against the chart.
“That’s it!” he shouted, his eureka moment propelling him to his feet. Why hadn’t he checked this before? Confirmed the dosage with the doctor when Fern started having more problems and not improving? He was a medical professional. He should have known better. In the past, he’d caught errors just like this here in the hospital.
Why hadn’t he caught the mistake in Fern’s case?
Fern looked at him as if he had lost his mind. “What’s it
?”
“The pharmacist filled the prescription with the right medication but the wrong dosage. Instead of a hundred milligrams the doctor had ordered, she gave you ten-milligram pills.”
Shaking her head, Fern said, “Harold wouldn’t make a mistake like that.”
“He didn’t. He had a young woman filling in for him that day. Maybe she read the prescription wrong. Dr. Chopra’s handwriting isn’t the best. Or if she called it in, there could have been a misunderstanding.” A weak link in the system from James’s perspective. It was too easy to misread handwritten notes on a chart or a prescription or misinterpret verbal instructions.
Fern’s puzzled expression suggested she wasn’t convinced. “Would the milligrams make that much difference? I was in a downward cycle when the doctor gave me the new medicine. Maybe it’s the same cycle just getting worse.”
“That’s possible, but I suspect stopping the old medication and taking only ten milligrams of the new was like no medication at all.” He glanced toward the hallway. “I’m going to find the doctor. We’ll see what she thinks.”
He found Dr. Chopra standing near the nurses’ station, still on the phone.
James waited impatiently to speak to her.
As the morning had progressed, activity on the floor had steadily picked up. The meal service cart arrived, rattling down the hallway. The wheels on a laundry cart squeaked as it rolled by, a high-pitched sound that put James’s teeth on edge. Somebody ought to oil those wheels instead of letting them inflict pain and suffering on people who were already sick.
Finally the doctor ended her phone conversation.
“I think I’ve found the problem,” he told her, guilt burrowing into his conscience for not checking Fern’s meds at the very beginning. “Here’s the latest medicine you prescribed.” He pointed to the chart and handed her the pill bottle. “That’s what she’s been taking. In the past day or two, you told her to double up on the meds.” Which might have accounted for her slight, and all too temporary, improvement.
Dr. Chopra scanned the chart and checked the label on the bottle. “Oh no, that is not correct. Ten milligrams is not enough to offset Fern’s MS symptoms. This is very bad.” She completed a prescription form and looked up at James. “Would you please order the correct medication from the hospital pharmacy immediately. We will start Fern on the proper regimen this morning and see if she will improve.”
“I’m not on duty this morning. If I’m not logged in, the computer won’t allow me to order meds.”
“Oh yes, of course.” She turned to the day-shift nurse on duty. “Order this stat, please. Administer a dose as soon as it arrives.”
“Yes, doctor.” The nurse gave James an encouraging smile. “I’ll make sure they get on this right away.”
“Thanks.” James exhaled in relief. His inattention to Fern’s meds had cost her dearly. He wouldn’t let that happen again. Ever.
The doctor tucked her pen back in the pocket of her lab coat. “I would like to keep Fern overnight to see how she responds to the medication in the proper dosage. If she does well, you may take her home tomorrow.”
After the morning service at Holy Trinity Church, Elena went to retrieve Isabel from her Sunday school classroom.
“I didn’t spill any juice on my dress, Buela.” The five-year-old made the announcement while twirling around in the red velvet Christmas dress she’d insisted on wearing again this morning. Elena had plaited her dark hair, and it whipped around the child as she spun.
“What a good girl not to spill.” Elena helped the child into her coat and then took her small hand and they walked toward the parking lot. “What did you learn today?”
“About a big, big whale that ate up nobody and then spit him out.”
Elena suppressed a smile. “Do you mean Jonah?”
“I dunno.” Using both feet, she hopped over a crack in the sidewalk. “Can I wear my new dress to my school tomorrow?”
“Oh no, sweetie. That dress is too nice to wear to school. You’d get it all dirty.” Not to mention the damage she might do to the dress while crawling around in the sand box or painting at an easel.
“But I want my friends to see my new dress.”
“They’ll see it some other time.”
Isabel pulled her hand free of Elena’s, dug in her heels and planted her fists on her narrow hips. “But I want to wear it tomorrow, Buela.”
Elena wondered where Izzy had gotten her stubborn streak. From Elena’s own son, Rafael? Or from the child’s mother?
“Izzy, sweetie, we’ll find you something else to wear tomorrow.”
“No!” She stomped her foot. “I want to wear this one.”
A passing couple eyed both Elena and Isabel with disapproval.
“We’ll talk about it later, Izzy.” Hoping her granddaughter wouldn’t make an even bigger scene, Elena kept on walking. “We have to get home now to feed your Tito and your daddy their Sunday dinner.”
“My daddy will let me wear my dress to school.”
Unlikely, but Elena wasn’t in the mood for an argument. “Do you know where we parked?” she asked as a diversion. “I don’t see my car.”
“I do! I do!” She pointed, then ran across the parking lot in the direction of Elena’s small, green SUV.
“Izzy!” Fearing a car might strike the child, Elena raced after her. “Wait for me!”
Isabel beat her to the car. “I found it! I found Buela’s car.”
Breathing hard—and saying a quick prayer of thanks that Izzy was safe—Elena knelt in front of the child and took her firmly by the shoulders. “You know better than to run off from me when there are cars around. You could’ve been hurt.”
The child’s gray eyes widened. “I didn’t do anything wrong.”
Elena eased her grip. “Yes, you did, sweetie. You ran off without watching for cars and you nearly scared your Buela to death.”
Suddenly, Isabel threw herself into Elena’s arms.
“I don’t want you to die, Buela. Please don’t die.”
Please, Lord, give me the patience I sorely lack. “I’m not going to die for a long, long time, little one. But you must learn to be more careful.”
If only Cesar or Rafael had been here, they could have been holding Isabel’s hand more tightly than she. Isabel wouldn’t have run off on her own.
But the two men in Elena’s life, whom she loved more than any others, generally refused to attend church, with the rare exception of the times Isabel performed with her Sunday school class. And then only Rafael would attend with her.
That thought created a lump of regret in her throat that was hard to swallow.
James arranged to take Monday off as a personal day to bring Fern home. He didn’t want her to be alone. Not yet. Not when she was fresh out of the hospital.
Sunday afternoon he’d gotten a call from Ron Beckwith that the Scouts were home safely with no traumas to report. James had been relieved his sudden departure hadn’t created any problems.
After Ron’s call, he’d picked up his rested and well-fed boys from the Driscolls. This morning he’d gotten them off to school, then headed to Hope Haven anxious to learn if the meds in the proper dosage had improved Fern’s condition. Although asking for a huge improvement overnight was like praying for a miracle.
He took the stairs two at a time to the second floor. Instead of scrubs, he was dressed in jeans, flannel shirt and his warm jacket. He’d brought a comfortable velour lounging outfit and a jacket for Fern to wear on the way home.
Taking off her reading glasses, Anabelle greeted James at the nurses’ station. “Why didn’t you let us know Fern was in the hospital? We would have come to visit her yesterday.”
“I spent most of the day with her.” In truth, he hadn’t thought to call his colleagues. He’d been solely focused on his wife and her needs. “By afternoon she was pretty worn out. More than anything, she needed rest. And you know how hard that is to get in a hospital.”
A
nabelle nodded her agreement. “Too true, I’m afraid.”
Candace popped her head out from the storeroom. “I was shocked to see Fern’s name on the admissions list. I haven’t had a chance to drop in to see her yet.”
“We hope she’s feeling better today,” Anabelle said. “Is she being discharged this morning?”
“That’s the plan if she’s responded well to her new meds. Has Dr. Chopra been in yet?”
“Not that I’ve seen.” Candace shook her head.
Anabelle asked, “Are you still planning to speak at city council tomorrow night?”
He winced. Between the scouting trip and Fern’s crisis, he’d all but forgotten he had agreed to provide a public statement about the hospital’s plan to reduce expenses on the backs of the employees.
“Yeah, I’ll give them a written statement, but I haven’t a clue yet what it’s going to say.”
“You’ll think of something,” Candace assured him.
“Some of the employees are planning to come to the council meeting to support you,” Anabelle said.
“Great. Then I especially hope I don’t make a fool of myself.”
Lorraine Wilder, James’s day-shift supervisor, approached the nurses’ station and smiled. “I just checked on your wife. She’s alert and ate a good breakfast. I imagine she’ll be going home this morning.”
“That’s good to hear. Thanks.”
He left his co-workers and went down the hall to Fern’s room. She was sitting up in bed watching a talk show on television. She’d combed her hair, put on a trace of makeup and changed into her own nightgown.
“Hey, there, Sleeping Beauty. You’re looking good this morning.” He crossed the room to give her a kiss.
“So are you, handsome. No work today?” She punched the button to turn off the TV.
“Nope. I hope I’m going to spend the day with you at home.”
A tiny frown pinched her brows together. “You don’t have to do that. Mother could come over if I need her.”
“I think she spent most of yesterday cooking for the boys and then sent home a casserole with me. She could use a rest too.”
“I’m certainly a bother, aren’t I?”
Strength in Numbers Page 19
