Angels on the Night Shift

by Robert D. Lesslie, M. D.

  John and Fay Sessions followed their daughter out of cardiac and down the hallway, leaving Jeff and me alone in the room.

  He was trying to clean up the mess created by more than two hours of frantic activity, while I stood at the counter and tried to document what had just happened.

  “I’m worried about the girl’s father,” Jeff quietly observed while reeling in dozens of feet of cardiac monitor paper strewn haphazardly on the floor. “He’s still in a daze. I’m not sure he knows what’s going on.”

  “He knows,” I told him. “He just doesn’t know how to handle it. That was his daughter lying there, and in his mind, he caused this. Of course it was an accident, but I don’t think he sees it that way.”

  “That’s what I mean,” he agreed, standing up straight and looking over at me. “I’m worried about how he’s gonna deal with it. I remember when I was teaching my daughter to ride a bike and she fell and broke her wrist. It was a simple greenstick fracture and did fine, but it killed me. I beat myself up about that for a long time. Still bothers me when I think about it. But this…this is a whole different thing. And I don’t know how I would…” his voice trailed off and he was silent.

  I nodded my head in understanding. “Let’s just hope she recovers,” I sighed, turning once again to my charting.

  The next morning, Ted Nivens was telling me about the elderly woman he was leaving me in ortho. She had tripped and fallen while getting up to go to the bathroom and had broken her right hip. We were waiting on her labs and for the orthopedist to come down and admit her.

  “That’s all I’ve got for you,” he told me, and then headed toward the ambulance doors. He only took a few steps before he stopped and turned around.

  “Oh, and you might be hearing something from the folks upstairs,” he added, moving closer and lowering his voice.

  “The folks upstairs?” I asked.

  “Yeah, the nurses in the CCU,” he began to explain. “Jane Plexico, specifically. The new charge nurse.”

  “Why? What happened?” I was curious now.

  “Darren was the nurse working with me last night, and we had two patients that needed to be admitted to the CCU. We were just waiting on beds, and as usual, it was taking a long time. But for some reason, it was really long last night, and Darren went upstairs to see what was going on. Apparently he found the staff sitting in their lounge, talking, and not getting either of the rooms ready. It had been more than four hours, and he exploded.”

  Knowing Darren Adler, I could easily imagine that happening, and I probably wouldn’t have blamed him.

  “What happened after that?” I asked Ted.

  “Well, both of our patients were upstairs in the unit in less than twenty minutes,” he told me, chuckling. “But there will probably be some fallout. Just wanted to give you the heads-up.”

  He turned around, and this time he made it through the doors.

  They had just closed behind him when—“Code Blue! Pediatric ICU! Code Blue! Pediatric ICU!”

  It was the hospital intercom, and there was an arrest upstairs in the unit. I looked down at Amy Connors and said, “Here—hold this!”

  I dropped my briefcase on the countertop and hurried down the hallway toward the staff elevators in the back of the building. The pediatric ICU was on the fourth floor, and when I got to the elevator, one of the respiratory therapy techs was standing there holding the door open for me.

  “Thought I heard somebody running this way,” he said. “Peds ICU?”

  “Yeah,” I responded. “Thanks.”

  The doors closed and I stood there, impatiently watching the panel of floor buttons as they lit up one by one.

  “Must be that insecticide kid, the one poisoned by her father,” the tech said from behind me. I didn’t turn around, knowing he was probably right and not wanting to respond.

  “Not many other children in the unit right now, and they’re all doing okay,” he added.

  The elevator doors opened and we both hurried off to our right and to the nearby back door of the peds ICU.

  There was a flurry of activity over in room 4, and one of the nurses there looked over, saw me, and motioned for me to hurry.

  I made my way to the side of the bed and looked down. It was Trish Sessions. One of the unit nurses had her hands around the girl’s chest and was doing CPR, while another was pushing some IV medication through the tubing in her arm. Two of the staff pediatricians were standing at the foot of her bed, nervously looking at the various monitors on the wall and quietly conferring with each other.

  “Is there anything I can do?” I asked them.

  Trish had remained stable during the night, then had suddenly crashed a little over an hour ago. She lost her blood pressure and then her cardiac activity became very irregular. Her heart had been fibrillating for the past five minutes.

  She was gone.

  I didn’t speak to John or Fay Sessions that morning. Their family doctor had come in and talked with them about Trish and about how it was an accident and no one’s fault. And the doctor had stressed the importance of their supporting each other during this time and in the weeks and years to come.

  Within six months they were divorced. It wasn’t long after that I saw John in the ER. He had come in with some multiple and vague complaints. He told me about the divorce and that Fay had moved back to Georgia to be near her family.

  John Sessions was only a shell of the man I had seen that terrible morning in the ER. He had the same vacant, troubled eyes, but now he was lost. I wanted desperately to help him, but this kind of pain was beyond my healing. He needed to find forgiveness. And then he needed to forgive himself.

  11

  Get Off My Bus

  Robert, if it’s under control when the 10 a.m. doctor comes in, Walter Stevens would like to meet with us in his office.”

  Virginia had walked up beside me at the nurses’ station and spoke quietly, making sure no one heard what she said.

  I looked up at the clock. That was a little less than an hour from now, and the morning hadn’t been too bad.

  “Okay, Virginia,” I told her, signing the bottom of the chart in front of me and tossing it into the discharge basket. “I’ll do what I can.”

  She turned without saying anything more and walked back to her office.

  Great, I thought. That’s just what I need—another meeting with Walter Stevens.

  Darren walked up and put the chart of the patient in ENT on the countertop.

  “This is a good one,” he said, smiling.

  Just then, I heard a loud holler from down the hallway in the direction of our ENT room.

  “OH, LORDY!”

  I looked down at the chart and asked him, “What’s the problem? Why the—”

  “OH, LORDY! DO SOMETHING!”

  “She’s got a bug in her ear,” Darren explained. “Looks like a candle fly, and it’s moving around. I thought I could grab it with some tweezers but it went in deeper. She thinks it’s going to lay eggs in there, and that’s really got her freaked out.”

  “Come on,” I told him. “Let’s go rescue this gal.”

  When Ted Nivens came in at ten, the bug lady was gone and there were only two other patients in the department. Virginia Granger was standing behind the counter. Her arms were folded across her chest and she was looking at me over the tops of her glasses.

  “Looks like we can go now,” she told me, stepping around Amy Connors and heading down the hallway. I told Ted where we would be and tried to catch up with her.

  When we turned the corner and passed the entrance to X-ray, I asked her, “What do you think this is about, Virginia? More of Stevens’s investigation?”

  “I’m sure that’s it,” she said flatly. “He told me he had some definitive information and he wanted to share it with us.”

  “Definitive,” I repeated, slowly stressing each syllable. “I wonder what that means.”

  She looked over at me and said, “Robert, let’s just
let him do the talking. We’re only there to get information and see what he’s thinking.”

  “Why do we have to deal with this guy? Why don’t we just go directly to Bill Chalmers?”

  Chalmers had been the hospital administrator for the past ten years, and I had always found him to be reasonable and focused on patient care. That always made things easier for us.

  “I wanted to do that too,” she answered. “But Bill made it clear we needed to deal with Stevens. Don’t ask me why, but that’s where we are.”

  We turned another corner and stood in front of the door to the administrative offices.

  “Remember,” Virginia said, looking me straight in my eyes. “Let him do the talking. And keep your temper. We both know how you can get sometimes.”

  “Virginia, I—” But she had already opened the door and walked into the administrative waiting area.

  Walter Stevens was expecting us. He didn’t stand up when we entered his office.

  “Have a seat, Ms. Granger,” he said to her, pointing to one of the chairs in front of his desk.

  Then he pointed to the other chair. “Robert.”

  I quickly glanced around the room, noting the prominent display of diplomas on the wall behind him and the copy of the Wall Street Journal neatly folded on his large mahogany desk.

  Something seemed odd however, and I looked over to Virginia to see if I was imagining this. I wasn’t. She was sitting low to the floor like I was, and much lower than Stevens was behind his desk. This was textbook first-year business negotiation, or maybe Machiavelli 101. He was in an elevated position, and we were forced to look up at him. It was meant to intimidate the people you were meeting with, without their even knowing it. I glanced over again at Virginia. She cut her eyes at me, looked down briefly at her chair, and gave me a slight nod. I cleared my throat and shifted in my seat.

  “Dr. Lesslie, Ms. Granger,” Stevens began. “I’m glad you could meet with me this morning. I believe I have some interesting news for you, and something that should greatly relieve you.”

  He paused and put his palms flat on the top of his desk, surveying the two of us with apparent satisfaction. I wanted to say something but remembered Virginia’s admonition. Between the two of them, I was much more afraid of our head nurse.

  “Go on,” she said to him.

  He reached behind him to a small credenza and picked up a manila folder. I immediately recognized it as an employee file, but when he tossed it on his desk, there was no name on the outside.

  Stevens began drumming on the chart with his fingers as he continued. “We’ve done some extensive research into your ER staff and have found some interesting evidence. In fact, I now know beyond the shadow of a doubt who has been stealing the drugs from your department. And while I don’t know yet where they have been selling them, I know what they have been doing with the money.”

  “What in the—” I uttered, cut off by a sharp glance from Virginia.

  As if he hadn’t noticed my remark, Stevens went on. “You have a criminal in your department, Virginia, and it’s time for them to be exposed and terminated. Well…” he paused, chuckling at himself. “Not really terminated, in the strictest sense. But they will lose their job immediately. And I intend to see that they are prosecuted to the fullest extent of the law. We will make an example of them so that this sort of thing never happens again.”

  He cleared his throat and settled back in his chair.

  “You may have heard my theory of ‘the bus,’ ” he continued. My ears perked up when he said this, and I thought I noticed Virginia shake her head, just a little.

  “You see, the hospital is like a big bus, and it is the administration’s responsibility to be sure we have the right people on board. We want Rock Hill General to be the best bus—the best hospital—it can be. And we know clearly that someone on our bus doesn’t need to be here. It’s my job to determine that and to collect the evidence needed to prove it.”

  He stopped and looked first at the head nurse and then at me. He was enjoying this and was waiting for our response. I stared at him and then at Virginia. She was amazingly calm, and just sat there quietly. Then slowly she brought her right hand up, adjusted her glasses, and put her index finger over her lips. I knew that look, and I knew she was getting angry.

  “And just how have you collected this evidence, Walter?” she asked him quietly.

  He leaned back in his chair and put his hands on the armrests.

  “I’m afraid that is confidential,” he told her gravely. “But ironclad, you can be sure of that. And Bill Chalmers is aware of my findings and is in full agreement with my plan of action.”

  Out of the corner of my eye I could see Virginia’s shoulders slump a little. Her hand went back to her lap. For the first time, I was becoming discouraged.

  We sat there, the three of us, and just looked at each other. It was clear to me that Walter Stevens was willing, if not eager, to sacrifice someone for his own gain. There was a malevolent streak in this man that made my skin crawl.

  Finally, Stevens couldn’t wait any longer.

  “Don’t you want to know who this is?” he asked, jabbing the file in front of him with his finger. “Don’t you want to solve this matter and be done with it?”

  Virginia just stared at him, and I didn’t say a word.

  “Well, you need to know,” he declared, leaning forward in his chair and picking up the file. “Because tomorrow, we will be taking action.”

  He opened the folder, spun it around, and slid it across the desk in front of the two of us. I couldn’t read anything in the record—it was still too far away. But attached to the left side of the chart, stapled to the upper left corner, was a black-and-white picture of the employee.

  I felt as if someone had punched me in the gut. It was Amy Connors.

  12

  Ambushed

  Virginia and I retraced our steps back to the ER, silent and shaken by what we had just learned. Stevens hadn’t offered any further explanation, and after making it clear that the meeting was over, he instructed us not to tell anyone about his plans. He was going to meet with Amy Connors the next day and “handle things then.”

  Finally I looked over at Virginia and asked, “Well, what do you think of that?”

  She abruptly stopped in the hallway and turned to face me.

  “I think he’s crazy,” she said flatly. “He doesn’t have any idea what he’s talking about. You and I have both known Amy for more than ten years, and if there’s anyone in the department I would trust with my life, it would be her. Stealing drugs and selling them? Preposterous! Or stealing the drugs and using them herself? That’s insane! I wanted to reach over and grab him by his neck and shake him for everything he’s worth…which wouldn’t be much!”

  Suddenly, I had of vision of her doing this, and I couldn’t keep myself from smiling.

  “Don’t you laugh at me!” she huffed, then turned and started off again for the ER.

  I caught up with her long strides and said, “After hearing all that, don’t you think we need to go to Bill Chalmers? I mean, this is so off the wall, I think he ought to know about it.”

  “I’m going to do just that, this afternoon,” she told me with determination. “But I’m a little concerned. Bill made it clear how he wanted to handle this, and he may not be willing to listen. But he’s got to know what Stevens is up to, and I know he doesn’t want to lose one of the best secretaries in the whole hospital.”

  We had turned the corner into the department and stopped outside the empty ortho room.

  “This business about us not telling anybody,” I said quietly. “I’m not sure if that’s—”

  “What business are you talking about?” she asked with a straight face.

  “You know, the—”

  “I didn’t hear anything like that,” she interrupted. “In fact, I’m going to sit down with Amy right now. She needs to know what’s going on, and she needs to know where I stand on this be
fore Stevens gets hold of her.”

  She was about to walk up the hall, when she added, “You can sit down with us too, if you want. In fact, that might be a good idea.”

  Things were happening quickly and I was still trying to get my head around what Stevens had told us. But of course I would sit down with the two of them. I didn’t want Amy to think I had any part in this.

  I followed Virginia up the hallway to the nurses’ station, where she stopped, leaned over the counter, and said something to Amy.

  Ted came out of room 1 and walked over to me.

  “Well, how did that go?” he asked me, knowing only that we had met with one of the administrators. “Anything serious going on?”

  He put his chart down on the counter and started making some notes, obviously not too concerned.

  “Just some of the usual,” I told him. Once things were out in the open, I would make sure he knew everything that was going on.

  “Yeah, I know how that goes,” he replied, not looking up from his work. Then speaking to Lori Davidson, he said, “Lori, the guy in 1 needs a urine and a CBC.” He handed her the chart and added, “Thanks, and let me know when it’s back.”

  The countertop was empty, with no patient charts to be picked up.

  “I’m going back to the lounge for some coffee,” he told me. “Want a cup?”

  “No, I’m fine,” I answered, watching Virginia and Amy step into the head nurse’s office. “I’ll be with Virginia if you need me.”

  “Okay. I’ll be right back. There’s not much cookin’ right now.” He headed down the hallway, and I walked over to Virginia’s office.

  Amy glanced over at me as the door closed. She was sitting in one of the chairs across from Virginia, and I walked over and sat down beside her. She looked first at the head nurse, then at me, and then back to Virginia.

  “What’s up?” she asked, smiling. “Did I win the lottery? Or am I in some kind of trouble?”

  Virginia glanced over at me and then quickly back at Amy.

  “We need to talk about something,” she began, taking off her glasses and carefully placing them on the desk. “And this is awkward for me, Amy. In fact, I can’t believe we have to have this conversation. But there are a few things you need to know.”