Rules Get Broken

by John Herbert

  I stood up and followed him out of the room and across the hall, closing the door behind me. As I waited for him to speak, he massaged his temples with his eyes closed. “Peggy went into toxic shock sometime early this morning,” he began finally. His voice was low, and he sounded exhausted.

  “Why?” I asked. “She seemed okay last night after her fever broke.”

  “Well, she was,” he explained. “And she wasn’t. As I’ve told you, we’ve destroyed Peggy’s cancerous bone marrow, but we’ve also destroyed her white blood cells and therefore her ability to fight infection. When her temperature started to climb yesterday morning, that meant some sort of infection was setting in. Some sort of infection she couldn’t fight. Dr. Porter ordered intravenous antibiotics, and by early last night, according to her chart, her temperature had returned to almost normal. Unfortunately, whatever bacteria started the fever stayed in her system after being killed by the antibiotics. Now, normally Peggy’s white blood cells would have destroyed these dead bacteria. Would have rendered them harmless and gotten them out of her system. But Peggy doesn’t have any white blood cells. So the dead bacteria stayed in her body and then broke down, releasing their toxins into her blood.

  “As a result, sometime early this morning, she went into what we call toxic shock. Her blood pressure plummeted, and she began to hemorrhage subcutaneously. Under the skin. That’s the reason for the bruises all over her body. At six forty-five this morning, one of the nurses went into her room to take her blood pressure, could barely get a pulse, saw that she was bleeding subcutaneously and assumed, rightly so, that she was in severe shock. She called the duty nurse, the duty nurse called me, and I called you.”

  Dr. Werner ended his dissertation like he always did, in a way that signaled he had, in his opinion, addressed all issues and answered all questions and that there was nothing left to be said.

  “When did Peg start to go into shock?” I asked.

  “As I said, one of the nurses went into her room at six forty-five and found her in shock.”

  “Great,” I said, suddenly impatient with his attitude and feeling anger rise. “That’s when one of the nurses found Peg in shock. That doesn’t tell me when she went into shock. That’s what I’m asking. When did she go into shock? At six forty-five this morning?” I started to wave my arms in exasperation. “Or at ten-thirty last night? In other words, how many times during the night did someone check on Peg? Or was the six forty-five visit the first time anyone went into her room all night? That’s what I’m asking, doctor.”

  More questions flooded into my mind as I tried to catch my breath.

  “And what about the private nurse we arranged for? The one who’s supposed to make up for the lack of staff over the weekend? What about her? Where was she? Why didn’t she realize Peg was going into shock?”

  “I don’t know,” Dr. Werner responded quietly.

  “Don’t know what, doctor? When Peg went into shock, or whether anyone checked on her until this morning?” I could feel tears welling up.

  “Mr. Herbert,” Dr. Werner replied with a sigh, “I understand that you’re upset and that you have questions you’d like answers to. I understand that. But right now the most important thing is Peggy and keeping her stabilized. So you’re going to have to excuse me. We’re getting ready to move her down to the intensive care unit on the fifth floor, and I want to be with her while we do that.”

  “One more question. Is she going to be all right? Will she live?”

  “I think she’ll be fine,” Dr. Werner answered. “She gave us a bit of a scare, but I think she’ll be fine.” He patted my arm reassuringly. “We’ll talk more later. As soon as we get Peggy settled in the ICU. Okay?”

  Before I could answer, the door to Peg’s room opened, and the foot of her bed appeared. Dr. Werner turned away from me and walked across the corridor to help the nurse negotiate the bed through the door. Our conference was over.

  As Peg’s bed came into view, I could see that it had been freshly made. The top sheet, crisp and wrinkle-free, was stretched taut over her body, leaving only her head and bare shoulders visible. Her hair was still flat and wet with perspiration, but her head now rested on a clean white pillow. The IV bottles swung from side to side over her head, the result of the turn into the corridor.

  Dr. Werner moved to the head of the bed, put a hand on Peg’s arm and looked down at her. Her eyes were closed. “We’re moving you to another part of the hospital, Peggy,” he said quietly, gently, “where we can keep a closer eye on you for the next few days.” He waited for a moment. “Your husband’s right here. Once we’ve got you settled, I’ll bring him in to see you. Would you like that?”

  Peg opened her eyes at these last words and turned her head first to the right and then, seeing only the nurse and Dr. Werner, to the left, where I was standing at the side of the bed.

  “Hi,” she whispered.

  “Hi again, sweetheart. I’ll see you in a little while. Okay?”

  “I’ll be waiting for you,” she answered tiredly, closing her eyes again as she spoke.

  “You should be able to see her in about thirty minutes,” said Dr. Werner after a quick glance at his watch. “Come down, and wait for me in the waiting room. The ICU’s on the fifth floor. Just follow the signs when you get out of the elevator.”

  “I’ll see you there,” I replied.

  The nurse began to push the bed down the hall, and I fell into step next to Peg, my hand on her shoulder.

  “I love you,” I said softly.

  “I love you too,” Peg whispered, her eyes still closed.

  I walked next to her for another seven or eight steps, and then I stopped and watched her bed move down the hallway towards the elevators. I watched Dr. Werner punch the elevator call button, and I watched him and the nurse stand there in silence, their faces raised as they tracked the progress of the illuminated floor lights over each set of elevator doors. I heard the ding signaling an elevator’s arrival, and I watched them maneuver Peg’s bed in the direction of the opening doors. And then the doors closed, and they were gone.

  I felt a hand on my shoulder. Startled, I turned around and found myself facing my father.

  “Where have you been?” I asked, surprised at his sudden appearance.

  “Down the hall,” he said, looking over his shoulder in the direction from which he had come. “On the bench, where you told me to wait.”

  “Right. I knew that. They’re moving Peg down to the fifth floor. To the intensive care unit.”

  “I know,” he replied. “I overheard one of the nurses who came out of her room. So now what?”

  “Dr. Werner said we should go down to the ICU and wait for him there. He said I’d be able to see Peg in about thirty minutes. So I guess we find the ICU, and then I guess we just wait.”

  “I’ve got a better idea,” my father said as we started to walk towards the elevators. “Neither of us has had anything to eat yet this morning. Why don’t you go down to the intensive care unit and wait for Dr. Werner while I try to scrounge up breakfast for us, and I’ll meet you there?”

  “You’ll be able to find the intensive care unit?” I asked.

  He seemed amused at my concern. “Don’t worry,” he assured me. “I’ll find it, and I’ll find you.”

  I pressed the down button, and the two of us stood staring at the bank of closed elevator doors in front of us, listening to the sounds coming from the elevator shafts behind them, the sounds of hissing cables and clunking doors opening and closing above and below us. It was five minutes after ten.

  Thirty-One

  I got off the elevator at the fifth floor and followed the signs directing me towards the intensive care unit. The waiting room was surprisingly small, but comfortably furnished with a large maroon leather sofa, two deep-cushioned matching leather armchairs, and gray tweed wall-to-wall carpeting. A wooden parson’s table covered with magazines stood against the wall at one end of the room, a small desk at the other
end. A door next to the desk, presumably leading to the intensive care unit itself, was marked “Positively No Admittance” and “Authorized Personnel Only.” Windows high above the sofa filled the room with natural light, but were too high to permit a visitor to look out.

  The waiting room was empty. I stood in the middle of the room for several seconds, trying to decide what to do, then went over to the table and picked up a magazine. But realizing I couldn’t possibly focus on reading, I threw the magazine back onto the table, walked over to the sofa, and sat down to wait. I listened for sounds coming from behind the door to the ICU, but all I could hear was the sound of rushing air from the ventilation system.

  Five minutes passed, then ten, then fifteen.

  Suddenly the door opened, and a man who appeared to be a physician entered the room. “Mr. Herbert?” he asked.

  “That’s me.”

  He was a young man in his late twenties. He was dressed in blue jeans and a blue-and-white checkered shirt, over which he wore the regulation mid-thigh white lab coat. His stethoscope was draped around his neck and hung down on either side of his chest. His black hair was rumpled, and he needed a shave. As he came through the door his expression was one of fatigue; but when he saw me get up from the sofa, his expression changed to one of discomfort, perhaps even one of pain.

  I walked across the room to meet him, searching his face for some inkling of what he was about to tell me. But as I got closer to him, I saw that he was searching my face, and I wondered why. We met more or less in the middle of the room, and I extended my hand.

  “Mr. Herbert, I’m Dr. Porter, one of the resident physicians assigned to your wife’s care.”

  He let go of my hand, jammed his hands into his pockets, lowered his head and stared at the floor between us. When he finally raised his head and allowed his eyes to meet mine, I could see he was a very uncomfortable young man. He hesitated, visibly, before continuing.

  “Mr. Herbert, I’m sorry to have to tell you this, but…Mrs. Herbert has passed away. She died about twenty minutes ago.”

  Book Two

  Thirty-Two

  The wind has picked up considerably since I first got here, and I pull the collar of my overcoat up and across my face in an attempt to protect my cheeks from the bitter cold. The predicted snow has arrived, and the first tiny flakes ride the wind down to the frozen ground.

  I stare at the bronze plaque in front of my feet. “Margaret Ellen Herbert,” the inscription reads. “June 1, 1946 ~ August 17, 1980,” and below that, “I love you ~ forever.”

  I look up and look around me to confirm that I’m still alone. I am.

  “I have so much to tell you, Peg,” I say out loud, directing my eyes once again to the grave marker in front of me. “A lot happened after you died that you don’t know about, and there’s so much you should know. So many things I’ve wanted to talk to you about for so long. Where to start?”

  I wait a moment to collect my thoughts, to let my mind go back to that terrible morning on the 17th of August, 1980. I remember that I felt as if I had been kicked in the stomach, my knees threatening to buckle under the weight of Dr. Porter’s words.

  I struggled to breathe. I squeezed the sides of my forehead with one hand, hard, as if I could purge my brain of what I had just heard if only I could squeeze hard enough. And then the tears started.

  “I knew it,” I said when I was able to speak. “I knew it. I just knew it. I knew this was going to happen the minute I walked into her room this morning. I knew they were playing catch-up ball up there. And I knew they were too late. I knew it, and they knew it, and now my wife is dead.”

  Dr. Porter continued. “She’d only been in the ICU a few minutes, and we had just finished moving her to one of the ICU beds when she stopped breathing. She didn’t give us any warning. She just stopped breathing. We did everything we could, Mr. Herbert, but she didn’t respond at all. Not at all. She was just too weak, I guess, and didn’t have any strength left after what she went through last night. Anyway, her heart stopped, and she died.”

  He paused for a second. “Mr. Herbert, I don’t know what else to say other than I’m sorry. Sorrier than you can ever imagine. She was doing so well. I really thought she was going to make it.”

  Again he paused, this time for several seconds, and he shook his head slowly. “They tell us never to get involved with our patients, and most of the time we don’t. But every once in a while someone special comes along, and whether you want to or not, you find yourself pulling for him or her. You find yourself getting involved. And Mrs. Herbert—Peggy—was one of those people. A really special lady.” His voice trailed off. “Again, Mr. Herbert, I’m very sorry.”

  He seemed to be searching for something else to say, something that would fill the deafening silence in the room. “Oh, I almost forgot. Dr. Werner asked me to apologize to you for his not being here, but he’s got another emergency on the eighth floor. He got the page just a few minutes ago and had to race up there. He wanted to tell you about Mrs. Herbert himself, but he couldn’t, and he hopes you understand.”

  I stood in front of him, my eyes closed. Crying. Unable to move. Unable to speak. Unable to think. I tried to swallow, but I couldn’t. I kept trying to take a full breath, but I couldn’t.

  “Are you okay, Mr. Herbert?” Dr. Porter asked. “Can I get you something?”

  I tried to answer him, to tell him I needed nothing. Nothing he could give me, anyway. But I couldn’t.

  “Mr. Herbert?” he called out, his voice louder now.

  I opened my eyes and looked at the young Dr. Porter and tried to clear my throat so I could speak.

  “What do I do now?” I asked.

  “We’ll keep Mrs. Herbert here until you’ve made the necessary funeral arrangements,” Dr. Porter responded, thinking he knew what my question meant. “Once you’ve made those arrangements, someone from the funeral home will contact us, and they’ll take care of everything. You won’t have to worry about anything.” He continued to look at me, oblivious to the irony of what he had said.

  Nothing to worry about? I thought as I stood there. Nothing for me to worry about? My God! I can’t begin to comprehend all I have to worry about. A nine-month-old son. A three-year-old daughter. Two families about to be shattered. Life without the best friend I ever had. No, nothing to worry about. Nothing at all! I thought bitterly, still staring at the young Dr. Porter.

  His voice broke into my thoughts. “Mr. Herbert, I need to get back into the ICU. I have another patient there I should be attending to. Are you sure you’re okay? Because if you’re not, I can get someone to stay with you for a while.”

  “No, I’m fine. Really. I just need a few minutes to pull myself together.”

  I took several deep breaths and felt myself starting to regain my composure. “There is one thing you can do for me,” I said. “I’d like to see my wife before I leave. Say good-bye. If that’s possible. Can you do that for me?”

  He hesitated before answering. “I can do that,” he replied after a few seconds of thought. “If you think you’re up to it.”

  “I’m up to it,” I assured him.

  “Just give me a few minutes to make sure everything’s in order back there, and then I’ll come back and bring you in to see her. All right?”

  I nodded.

  “Just wait right here,” he repeated nervously as he turned to go back into the ICU. “I’ll be right back.”

  I stood in the middle of the room, still unable to move. My mind was now strangely blank. I wasn’t thinking about anything, I realized. I was focused only on waiting for Dr. Porter to return and on seeing Peg. Nothing more. The news of Peg’s death had overwhelmed the circuitry of my brain, making it impossible for me to handle anything at that moment other than the most immediate tasks. So I just stood in the middle of the waiting room, right where Dr. Porter had left me, staring at the door to the ICU, waiting for him to return to take me to Peg.

  In less than five minutes,
the door to the ICU opened, and Dr. Porter once again stood in front of me. He seemed stronger now, more in control, more professional. “Ready?” he asked. “We’re all set if you are.”

  “I’m ready,” I answered, surprised at the weakness of my voice. “I only need a minute. Just enough time to see her and to say good-bye.”

  “Take all the time you need,” said Dr. Porter, holding the door to the ICU open for me. “We understand. Believe me, we do.”

  We walked down a short hallway past a nurse’s station and towards sliding glass doors that opened automatically as we approached. When we were inside the ICU, Dr. Porter guided me to a nearby bed almost completely surrounded by curtains. I walked up to it and stopped. I was vaguely aware of fifteen to twenty other beds in the dimly lit unit, most of them occupied and all without the encircling curtains. The large room was silent except for the periodic hiss of respirators and the asynchronous beeps of heart monitors.

  Dr. Porter reached past me and pulled back the curtain just enough to let me stand next to the bed. Peg was lying on her back, covered by a sheet drawn up to her neck, her arms at her sides outside the sheet. Her hair, which had been flat with perspiration when she left the ninth floor, was now dry and frizzy. Her lips were tightly compressed, unnaturally so, and a thin line of blood was visible between them. Dried caked blood lay in the recesses of her left ear. Her skin was much paler than it had been earlier in the morning, and the bruises on her arms from the subcutaneous bleeding were now a dark purple.

  I stood next to her bed, not moving, not feeling, not believing.

  I felt Dr. Porter’s hand on my arm and wondered if he were trying to comfort me or signal me that it was time to go. I ignored him and stared at Peg. His hand stayed on my arm, the grip a little tighter than it had been a few seconds ago, but I continued to stare at Peg’s face, trying to burn her image onto my brain so I would never, ever forget what she looked like. I didn’t want to remember her like this, but I knew the next time I would see her she would look even less like my Peg than she did at this moment.