Code 15

by Gary Birken

  Absently, he spun his Rubik’s Cube in one hand. Normally, he’d be engrossed in aligning the multicolored squares—a feat he could now do in just under four minutes. His skill level didn’t make him tournament ready, but it was, nevertheless, an impressive achievement that had taken him a year of steady practice to attain.

  With each passing day, his fear that Morgan Connolly had figured out how Alison Greene died grew stronger. He was well aware that trying to confirm his suspicions could place him at considerable risk. But after spending many hours contemplating his limited options, he decided an attempt was worth the risk. His plan was well conceived and well rehearsed. Setting the cube down on a small wooden table, he stopped rocking, reached for his cell phone, and tapped in the number of the Cardiac Care Center.

  “CCC. This is Jean. May I help you?”

  “This is Mr. Tillinghouse in Patient Relations. May I speak with Dana McGinley please?” he asked.

  “Please hold.”

  Dana, who had been called in at five a.m. on her day off to take care of a young woman suffering from a postpartum blood clot to her lungs, was just finishing up her morning charting when she saw the unit secretary motion for her to pick up the phone. With a puff of exasperation, she put down her laptop and reached for the phone.

  “This is Dana.”

  “Miss McGinley. My name’s Hugh Tillinghouse. I work in Patient Relations. We’ve recently been asked to look into the Alison Greene case and I was hoping you might be—”

  “I was expecting to hear from you.”

  “I beg your pardon.”

  “I assume you’re calling me because her parents have made a formal complaint about the cross.”

  “They expressed some concerns. I’m not sure I’d call it a complaint,” Gideon answered, hoping Dana would take him where he wanted to go. “I’ve spoken to them a couple of times. I told them I would get back to them after speaking with you.”

  “I’m a conscientious nurse, Mr. Tillinghouse, but I generally don’t check to see what religion my patient happens to be. I feel terribly about what happened, but I think the parents’ gripe is a little misdirected. They should be talking to Mr. Ogden. He’s the one who placed it around her neck.”

  “I can assure you that nobody in administration feels you did anything wrong. However, the hospital does feel it would go a long way to soothe the parents’ pain if we could offer them an explanation of what happened. Being a Code Fifteen, I know it’s a sensitive case. Because of her role on the Patient Safety Committee, I spoke with Dr. Connolly. I told her I’d be calling you. She mentioned to me that you two have already discussed the case in some detail.”

  “We met last week. That’s when I assured her that it was Mr. Ogden who put the cross around Alison’s neck.”

  “Did you mention that to the parents?”

  “I did, but they didn’t know him.”

  “You’re quite certain Miss Greene wasn’t wearing the cross when she came from the recovery room?”

  “I’m positive. I didn’t have any idea it was magnetized until I met with Dr. Connolly. She was the one who discovered it.”

  Gideon felt the hollow of his stomach suddenly wince in spasm. His worst fear realized, he asked, “Do you know how we might be able to contact Mr. Ogden? I was hoping I could convince him to call the Greenes.”

  “I’m sorry. I don’t.”

  Gideon deliberately sighed loud enough for Dana to hear him.

  “You might be able to find him by contacting Broward College. He said he was a professor there.”

  “Did he mention what department he was in?”

  “Not that I recall.”

  “I’ll try to check it out,” he said.

  “If I see him again, I’ll tell him to give you a call.”

  Taken back by her comment, Gideon asked, “See him again?”

  “It doesn’t happen very often, but every now and then one of our visitors will come back to visit somebody else or they just want to talk to one of us about something.”

  Trying to keep the pretense going, Gideon said, “But you only saw Mr. Ogden once. You probably wouldn’t even recognize him.”

  “I think I would,” she said immediately. “He had a very distinctive look about him. He also had a big gap between his front teeth.”

  Gideon resisted the sudden impulse to smash the phone against the nearest rock. Summoning every drop of restraint he had, and taking caution to speak in a normal voice, he said, “I know how busy you must be so I won’t take up any more of your time. Thank you for your help. By the way, please remember that Mr. Allenby considers this case to be of an extremely sensitive nature. I’m sure you understand.”

  “Patient confidentiality,” she said. “I know the drill.”

  Dana hung up the phone and started back toward her patient’s room. Being an ICU nurse, she had been involved in many situations involving unhappy family members where patient relations had intervened. Mr. Tillinghouse’s call was one of many similar calls she had received since coming to work at Dade Presbyterian. It wasn’t one she was likely to give any further thought to.

  GIDEON went inside and made his way upstairs to his bedroom. He set his cell phone down on an exquisitely crafted baroque dresser. Gazing at his image in an antique gold-framed mirror, he parted his lips and studied his front teeth. He thought about all the times he had considered having the space closed. He had even seen a highly touted dentist who specialized in cosmetic problems but had never made the follow-up appointment to have the bonding procedure done.

  Still staring into the mirror, Gideon used his index finger to explore the gap between his teeth. With an ever-growing appreciation of Morgan Connolly’s intelligence and compulsive nature, he reached for his cell phone. There was no doubt in his mind that she had gotten an excellent description of him from both Dana McGinley and her father’s physician assistant.

  With a half smile, he scrolled through his phone book. When he reached Dr. David Areca, the dentist whom he had seen in consultation, he dialed the number.

  CHAPTER 41

  DAY FIFTEEN

  Sitting at the nursing station, Morgan finished writing an antibiotic prescription for a teenager with a sinus infection.

  It was still early in the day and the patients hadn’t started flooding the emergency room as yet. She was studying a chest X-ray when her pager went off. It was her office. She picked up the nearest phone.

  “Mr. Allenby would like to see you,” Kendra told her in an uncharacteristically formal voice.

  “Is he standing right in front of you?” Morgan asked.

  “Yes, I believe so.”

  “Great,” she muttered. “Put him on.”

  “Good morning, Morgan. I was hoping we could have a chat.”

  “I’m in the ER, but things are pretty quiet. Can we talk over here?” she asked, wondering how he had acquired such an uncanny sense of bad timing.

  “That would be fine. I’ll be right over.”

  Morgan replaced the phone and looked over at the chart rack. Fortunately, there were no new patients to be seen.

  “I’ll be back in a few minutes,” she told the charge nurse.

  As soon as Morgan walked out of the department, she saw Bob approaching. From the somber look on his face, there was little doubt in her mind regarding the purpose of his call.

  “I’m sorry to interrupt but it’s rather important.” He pointed across the hall. “Why don’t we talk in the library?”

  “Fine,” she answered, thinking to herself that calling the small converted office with one recycled table and one hand-me-down bookcase a library was the euphemism of the month.

  Morgan unlocked the door, waited for Bob to walk in, and then followed him inside. They sat down at the table. He pressed his palms together and then lightly tapped his fingertips.

  “We have a problem, Morgan. I received a call from AHCA about an hour ago. As I feared they might, they’re sending a team down from Tallahassee to do an
on-site investigation of our recent Code Fifteens. Not only do they want to look at the Tony Wallace and Alison Greene cases, they also want to see everything we have on Faith Russo.”

  “That doesn’t make any sense. It hasn’t even been two weeks since Miss Russo’s death. I spoke with Blair Clarke in risk management a couple of days ago. Our formal reports to AHCA haven’t even been sent out yet.”

  “I understand that.”

  “So why are they sending an investigating team down?” she asked.

  “Because they can.”

  “I beg your pardon?”

  “AHCA is under no obligation to wait for the hospital’s final report prior to pursuing an investigation.” He paused briefly. “Look, Morgan. You’re focusing on the wrong thing. AHCA’s coming. Trying to understand the method to their madness isn’t important. At the moment, we have a tough but manageable problem on our hands. My fear is that if we don’t handle this thing just right, it could snowball into a major catastrophe.”

  “What do you suggest?” she asked, already beginning to silently cringe in anticipation of his answer.

  “We have to show the state that Dade Presbyterian Hospital delivers excellent and consistent health care, and that these patient errors were nothing more than unfortunate aberrations.”

  “Unfortunate aberrations?”

  “Exactly. We have to persuade them that we fully understand what went wrong and that we’re actively revising our patient care protocols and instituting measures to avoid a repeat occurrence.” Bob fiddled with the Windsor knot of his tie. “We’ve got one swing at the green here and we’d better not shank it.”

  Hardly surprised by Bob’s action plan, Morgan asked, “When are they coming down?”

  “They said they’d let us know in a few days, but I suspect it will be sooner rather than later.” Bob stopped talking just long enough to clear his throat. “There’s one other matter we should discuss. You were the treating physician in the Faith Russo case. You’re also the chairperson of our Patient Safety Committee. I think AHCA would view that as a clear conflict of interest.”

  “I agree. In fact, the same thing occurred to me and I decided to limit my involvement to the Tony Wallace and Alison Greene cases.”

  The relief Morgan expected to see in Bob’s face was conspicuously absent.

  “That may not be enough,” he said with an obvious note of reluctance. “I think the smart move is for you to step down as the committee chair.”

  “Step down? Why in the world would I—?”

  “It would be temporary, Morgan—just until we get past this mess.”

  Morgan pushed back in her chair. She then interlaced her fingers and said, “I hope this doesn’t have anything to do with our talk the other day about my level of stress, because if that’s the case, I think you’re—”

  “Morgan, this is a time for putting our personal agendas aside for the good of the hospital.”

  “But you’re not giving me the—”

  He raised his hand. “I’ve already discussed the matter with the board and they agree with me. I assured them you would understand and do the right thing.”

  With Bob having made up his mind, and with the backing of the hospital board, Morgan knew it was pointless to pursue the discussion. To borrow from his endless supply of corny sports metaphors, she was being expected to take one for the team.

  “It appears I have no choice.”

  “I think in time you’ll see this is the most sensible approach to our problem. I’ll give Sal Hutchinson a call. He’s been vice chair for a year. He should be able to handle things for a while. I’ll tell him to get in touch with you so that you can bring him up to speed on things.”

  Morgan pushed her chair back and stood up. Allenby didn’t follow.

  “That only leaves the matter of how we handle the Faith Russo case,” he said.

  Morgan’s entire body rattled with frustration. “I thought we just decided that I was stepping down until the investigation was complete.”

  “I’m afraid it’s not that simple. In view of Dr. Canfield’s autopsy findings, we obviously have a problem.”

  Morgan retook her seat. “What kind of a problem?” she asked, growing weary of his tap dance.

  “I’ve asked Eileen Hale to go over the specifics with you.”

  “Eileen’s our director of Medical Affairs. Why would you like me to speak with her?”

  “Because your involvement is a medical staff issue, I think it’s more appropriate if you two hashed things out. Just give her a call sometime today.”

  “With all due respect, Bob, this is absurd.”

  “You’ve been going through a lot lately. It’s hard to lose somebody who—”

  “Bob, I loved my father dearly and I think about him every day. But that doesn’t make me a nonfunctional physician or human being. Losing a parent is something we all face. I’m fine.”

  “I understand you’re pregnant and that you’re also having significant marital problems.”

  “Which are hardly original occurrences around here. My personal life in no way impacts on my ability to do my job.”

  Bob’s kindly smile was devoid of any sincerity.

  “You’re an important member of our medical staff. We’re trying to help. Once all this unpleasant business with AHCA’s behind us, we can get back to business as usual.” He stood up and started for the door. “We’ll talk again in a few days.”

  Bob’s quick departure left Morgan staring across the room. If there had been anything made of glass within arm’s reach, she would have smashed it against the wall.

  “What a joke,” she whispered, fighting to control her exasperation at Bob’s phony Dutch uncle approach.

  Feeling she was nearing the end of her rope, Morgan reminded herself she had most of her shift to complete. Doing everything in her power to temporarily stick her conversation with Bob in some far recess of her mind, she stood up and headed back to the emergency room.

  CHAPTER 42

  At four p.m., Morgan signed out her patients to the oncoming physician and went straight to her office.

  She sat down at her desk and reached for the tall stack of phone messages that always awaited her at the end of the day. Leafing through them absently, her mind switched to the phone call she was about to make to Eileen Hale. It was one of those moments when she needed her father’s perceptive advice. Ever since she declared her intention to study medicine, his compassionate and incisive guidance had always played an important role in her professional decision-making. Morgan found herself smiling as she thought about his unique way of sorting through the irrelevancies of a difficult problem to focus on its salient parts. Perhaps more than anything, she missed their special friendship.

  Morgan tossed the messages back on her desk. After another few minutes, she picked up the phone and dialed Eileen’s extension. Eileen and Morgan had attended medical school together at the University of Florida. Following graduation, Eileen went to California for her residency while Morgan headed south to Tampa. They became reacquainted when they began working at Dade Presbyterian. Having a similar work ethic and approach to the practice of medicine, they had always gotten along well.

  “Office of the director of Medical Affairs.”

  “This is Dr. Connolly for Dr. Hale. I believe she’s expecting my call.”

  “She’s on another call but she told me to interrupt her if you called. Hold on, please.” After a minute, Eileen’s secretary came back on. “I’ll connect you now.”

  “Hi, Morgan. Is it true about you being pregnant?”

  Morgan had to smile. “It’s true.”

  “When are you due?”

  “The beginning of October.”

  “Congrats.”

  “Thanks.”

  “So how are you?”

  “I guess that depends on how this conversation goes.”

  After a deafening silence, Eileen said, “Bob asked me to get in touch with you. He has some concerns
about these recent Code Fifteens.”

  “I gathered as much when I spoke to him.”

  “I’m not going to sugarcoat it. Canfield called Bob right after the autopsy. He insisted you blew it. He said you missed a diagnosis any third-year medical student could have made. I don’t have to tell you that Bob puts a lot of faith in Canfield’s opinions.”

  “That may be part of the problem.”

  “Bob feels as if the recent stress in your life may be clouding your professional judgment.”

  Promising herself she wouldn’t become unhinged, she said, “I wasn’t aware Bob was a trained psychiatrist.”

  “When you’re the CEO of a huge hospital, you don’t need to be. He told me that he had had a long talk with you about the Code Fifteens and that instead of conducting a rational investigation, you had gone off on some absurd witch hunt.”

  “I’m not sure I would agree with his assessment. Bob’s looking for easy explanations. Unfortunately, they’re not there. I informed him of certain possibilities I felt he should be aware of. I wouldn’t call it a witch hunt; I would call it doing my job. Unfortunately, Bob felt these alternative explanations could damage the hospital’s reputation and instructed me not to pursue them. What’s worse, he’s using my involvement in the Faith Russo case to make sure I have no contact with AHCA regarding the other Code Fifteens.”

  “You may be a hundred percent correct. But the problem is that your disagreement with Bob could lead to major problems for you. As I’m sure you know, he has certain discretionary powers regarding patient safety; especially how it applies to physician competency and behavior. He doesn’t need me or anybody else to advise and consent.”

  “I thought I had certain rights as a member of this medical staff.”

  “You do. And you’re more than welcome to exercise them. That’s assuming you want to get into a full-blown battle with the hospital over this thing.”

  “What are you suggesting?” Morgan asked.

  “Sometimes it’s smarter just to choose a less complicated path.”