Code Blue

by Richard MD Mabry

  She read through the chart, blessing Dr. Gladstone's old-fashioned, copperplate penmanship. Milton Nix, age fifty, occupation banker. You have to give him high marks for modesty, she thought. Most people would have put down "President of the First State Bank of Dainger."

  "How've you been feeling, Mr. Nix? Any problems?" She glanced up and decided the man looked pretty much the same as when she sat across from him three months ago and virtually begged him for a loan to start her practice.At that time, the other banks in town had already turned her down, using a variety of excuses—no room in town for another family doctor; she had too much debt already in student loans; a woman doctor would never be successful in this town. Nix, unlike his counterparts at the First National and the Continental Banks, had finally decided to take a chance on her.

  "I'm feeling fine, Dr. Sewell," Nix said. "But I've got a busy day. Can we get this thing moving?"

  Okay, enough small talk. Back to the chart. Nix was five feet ten, one hundred fifty pounds. On the thin side, but his weight had been stable for years, so put aside thoughts of a cancer somewhere. Usual visits for coughs and colds. A couple of prostate infections. Congestive heart failure, controlled with Lanoxin and a beta-blocker.

  "Mr. Nix, I don't find any electrocardiograms in here," Cathy said. "When was your last one?"

  "Any what?"

  Cathy regretted her error. Never drop into doctor-speak.She'd been taught that early in her training. "Did Dr.Gladstone do any heart tracings?"

  Nix shook his head. "Don't remember. I think Doc probably did one or two at first, but on my last few visits he took my blood pressure, listened to my chest, poked and prodded a little, and wrote me a prescription. Can't you do the same thing?"

  "Since this is your first visit here, I think it's best to get a little more information. Let me listen to your heart and lungs, and check your blood pressure. Then I'll have my nurse run a cardiogram. She'll draw some blood for a few lab tests.Nothing to worry about, but I think it's safer that way."

  Mr. Nix grumbled his way out of the exam room and down the hall after Jane, who was already at work charming him. Cathy finished reading through the chart and decided that "Doc" Gladstone hadn't really done a bad job with Mr.Nix. She did see one minor change she wanted to make, though.

  Cathy left the exam room and found Karen Pearson sitting in her office. She recalled Karen's first visit a month ago when the office still smelled of fresh paint.

  "Dr. Sewell, I'm pregnant," Karen had said. "I've been seeing Dr. Harshman, but I've changed my mind. This is my first baby, and I want you to do the delivery."

  Cathy had tried to be circumspect. The ethics of the matter aside, even to give the appearance of stealing the patient of an established physician was guaranteed to cause friction with the other doctors in the community. And she had a hard enough time in that area already.

  Karen was insistent, though. She said that her current obstetrician lacked the bare minimum of consideration. "Every woman that Dr. Harshman's taken care of says they'd go to a veterinarian before they'd go back to him," was how she'd put it.

  Finally, Cathy had put in a call to the administrator's office at Summers County General Hospital to ask if her request for obstetric privileges had been approved.

  "Sorry, Doctor," the secretary said. "It's still in committee."

  After that, Cathy's repeated calls were always met with an excuse. The paperwork got misplaced. One of the board members was out of town. They were checking precedents.Cathy knew why Karen was in her office today, and she dreaded giving her the answer.

  "Karen, how are you doing?"

  "I'm less than a month from my due date," Karen said. "Dr. Sewell, I'm still hoping you can take over my care. Do you have obstetrics privileges yet?"

  Cathy felt her heart drop. She was sure Karen would know the answer just from the look on her face. "I'm sorry, Karen. I'm still trying. You know, we've been through this already. Why can't you stay with Dr. Harshman?"

  "Oh, please, Dr. Sewell. You know very well what that man's reputation is. And now, he says I might need a Caesarean section. I was worried enough about him doing a regular delivery. I can't stand the thought of him doing a C-section. Can you do it, Dr. Sewell? Please?"

  "I'm sorry, Karen. I wish I could help. But I'm having trouble getting privileges to do normal deliveries, and there's no way they'll let me do a C-section. Have you considered switching to Dr. Gaines?" Cathy said, naming the other obstetrician in Dainger.

  "His practice is full. His nurse told me that I have a perfectly competent doctor and suggested I stick with him."

  Cathy extended her hand to Karen, partly to help her from the chair and partly as a gesture of compassion. "I'll keep trying. Don't give up."

  "I won't. I've been praying that you'd be the one to deliver my baby. God will take care of this."

  Cathy bit offthe reply that was on the tip of her tongue.With words of assurance that sounded hollow in her ears, she left Karen and turned her attention to Milton Nix.

  Jane met her in the hall and held out an EKG tracing."Mr. Nix is in exam room one."

  Nix looked up when Cathy walked in. "Did that fancy test help you find anything that Doc Gladstone didn't figure out with his stethoscope?"

  Cathy studied the tracing, looked at the chart once more, and made a decision. "I'll want to see what the blood chemistries show us, but at this point I think you're doing well.Your beta-blocker is okay, but I want to make a slight change in your other heart medicine. I see that your prescription has been for the brand-name drug, Lanoxin. I suspect that Dr. Gladstone wrote it that way years ago and just never changed it. If I write the prescription a bit differently, the pharmacist can give you a generic form and save you a little money."

  Cathy could see Nix's lips open, then shut. If he had any complaints, he kept them to himself. He probably wasn't anxious to have anything changed in the regimen he'd been following for years, but this wasn't really much of a change.Besides, she figured the "saving money" part would win him over.

  She reached for her prescription pad and dug into the pocket of her white coat. Where did that pen go? "Excuse me. I can't find my pen. I'll be right back."

  Nix reached into his shirt pocket and pulled out two ballpoints."Here. They've got the bank's name on them. When you're through, leave 'em in the waiting room. Maybe I'll get some return on my investment for this trip after all." She might have been mistaken, but there seemed to be the ghost of a grin on his thin-lipped face as he handed the pens to her. Two in one day. That must be some kind of a record for Milton Nix.

  She wrote the prescriptions exactly the way she'd been taught: carefully, with attention to legibility, calculating the number of pills that should be dispensed, double-checking the directions. She added refill instructions and signed the prescriptions before tearing them offthe pad and handing them to Nix.

  "Just follow the directions on both of these, and call me if you have any questions."

  As she passed the prescriptions to Nix, she noticed that the ink in the pen she'd been using was blue. She'd need to make sure she didn't use Milton's pens in the office anymore.That was another thing her mentors had emphasized. Use black ink. It photocopies better and gives a neater appearance.She could hear the voice of Dr. Seldin, the chief of internal medicine, saying, "If you're sloppy in little things, you'll be sloppy in the big ones too. Take the time to do it right."

  Cathy sat staring into space, the phone receiver in her hand. When a strident stutter tone shattered the silence of her office, she replaced the handset. Idly, she noted that her hand was steady when she did so. Her surgery instructors had always said she had good hands, even under pressure.She wished her mind were as steady right now.

  Two phone message slips. Two calls. And, just when she thought the situation couldn't get worse, she sank further into the pit of anxiety and depression that had held her for these past several months. Josh would have a field day with this.

  "What's wrong?" Jane pau
sed in the door, a chart in her hand. Cathy shook her head. Uninvited, Jane eased into the chair across the desk. "You want to talk about it?"

  Cathy reached for the soft drink sitting on her desk."Those message slips you gave me? The first was from a sheriff' s deputy. About my accident." She lifted the can to her lips, found it empty, and tossed it into the wastebasket under her desk.

  "Did he find the other driver?"

  "He said that since there's no evidence of a collision and no witnesses, he's writing it offas driver error on my part."Cathy sighed. "Actually, he reached that conclusion right after he arrived on the scene, but Will pointed out the skid marks and pressured the deputy to at least look into it."

  Jane leaned forward. "Will that affect how your insurance company handles the claim?"

  "No longer an issue. If my insurance had been in force, this might have raised my rates. But the second call was from my agent. The company just notified him that my last premium check bounced, so apparently, my policy wasn't in force at the time of the accident." Cathy squeezed her eyes closed for a moment. She wouldn't allow herself to cry in front of Jane. "The agent was nice. He said he'll make calls to some people higher up in the company. He'll try to get them to reinstate the policy. He even said he'd talk with the owner of the dealership that's renting me a car and see if he'll discount the bill since I may be paying it out of my own pocket."

  "So you're driving without liability coverage?" Jane's voice was calm, but Cathy saw the concern in her eyes.

  "The agent's given me temporary coverage. But this is something else I've got to straighten out." Cathy shrugged."I need to make one more call."

  Jane took the hint and tiptoed out, closing the door softly behind her.

  Cathy fanned out the three message slips like a bridge player studying a critical hand. Sheriff. Insurance Agent. The last call from Dr. Marcus Bell was marked "Urgent." She punched in his number.

  "Thanks for calling back," Dr. Bell said.

  "I hope it's good news, Marcus. I could use some."

  "Actually, it is," he said. "The credentials committee will consider your request for hospital privileges tomorrow night."

  "Finally." Cathy saw a glimmer of hope through the gloom that had surrounded her for so long. If she could expand her practice, the extra income might help solve her rapidly multiplying financial worries.

  "Would you like to attend the meeting? If you want me to, I'll arrange it."

  Cathy turned that thought over for a few seconds. Would her presence improve her chances of a positive response? It couldn't hurt. "Yes, please."

  "Great. They meet at six in the conference room," Marcus said. "Would you like to have dinner with me afterward?"

  Cathy experienced a return of the guilt she'd felt after turning down Marcus's previous dinner invitation. He'd tried not to show it, but she'd seen the hurt in his eyes. And he seemed like a nice guy, one who might turn out to be a friend—maybe more than a friend. Her lips formed a "Yes," before she stopped herself. Hard on the heels of the tiny flutter she'd felt at the prospect of dating Marcus came memories of her past relationships. No, she wasn't ready to take a chance.

  "I'm sorry, Marcus. I want to meet with the committee, but can I take a raincheck on dinner?"

  Jane took the chart Cathy handed her, filed it with a flourish, and said, "That's it. You're through for the day."

  Automatically, Cathy looked at her watch. Three o'clock.Another light day spent doing insurance physicals, caring for emergencies other doctors couldn't see, refilling the prescriptions of some of Dr. Gladstone's patients who'd decided to give Dr. Sewell's daughter a chance since their faithful old GP was retiring. She knew her bank balance—knew it to the penny—and if her practice didn't pick up soon, Milton Nix's bank would bring in an auctioneer and sell offthe office furniture and equipment she'd gone so deeply in debt to buy.

  Not only that, today another patient had told her, "Dr.Sewell, I don't believe those rumors I've been hearing. You're a good doctor." There was no longer any question in Cathy's mind. Someone in town wanted her gone.

  Should she make the call? See if the job offer at the medical school in Dallas was still open? No, she couldn't. Going back to Dallas would mean leaving the refuge she hoped to find here in her hometown. Going back to Dallas would mean taking a chance on seeing Robert, having to interact with him. Going back to Dallas would mean returning to the scene of her greatest humiliation. No, Dallas held too many memories. She'd stay here.

  A chilling thought struck her. Could Robert be behind all this? His father had both wealth and influence, and Robert was already on his way to achieving that status. It wouldn't be beyond either of them to call in some favors, spread a little cash around, and make her life miserable.

  She tried to be logical about it. Why would Robert try to force her out of Dainger? Out of spite? Maybe. He didn't want her back. The newspaper clipping was proof enough of that. But if she returned to Dallas, he could "arrange" to bump into her from time to time, just to rub it in. But surely even Robert wouldn't go that far. Would he?

  She shucked offher white coat and tossed it into the laundry hamper, grabbed her purse and briefcase, and headed for the door. She paused at Jane's desk. "I'll be on my cell phone if you need me. See you tomorrow."

  "Are you going . . . ?" Jane left the question dangling.Cathy chose to ignore it. "Remember, I have an appointment in Fort Worth tomorrow morning. I'll be in about ten."

  She'd have to make arrangements about a car, but for now the rental was still hers. Cathy sat in it with the motor idling, uncertain about her next step. Emotions and thoughts tumbled about in her head. She didn't want to think about her folks. Didn't want to relive those events. But Josh kept telling her that she had to face it. She had an appointment with him tomorrow, and she knew he'd probably mention it again. Maybe today was the day.

  Cathy backed out of her parking spot and set a course that she knew she could never forget, no matter how long she was gone from Dainger. Away from the professional building that Jacob Collins had built to house his pharmacy and a few doctors' offices. Jacob, her high school classmate, now her landlord. She wondered how he'd react if she was unable to pay the rent this month or next.

  She drove carefully—her mind consumed with thoughts of the past—up the short hill to the Y intersection, where a right turn would take her to Fort Worth. She turned left, then right, then left again. Soon she was on the edge of town, passing the homes of Dainger's more affluent families.

  Milton Nix lived there. The open doors of the double garage revealed a midsize gray sedan and a dark SUV. Cathy replayed Nix's visit in her mind. Had she missed anything? She wanted all her patients to do well, but she especially needed the goodwill of the banker.

  That rambling ranch house belonged to Judge Sam Lawton. The garage doors were closed. A Ford pickup, its original dark blue faded in spots, stood in the drive. In the yard, two young Hispanics wielded a leaf-blower and string trimmer. Given Sam's age, she guessed he'd stopped doing his own lawn work. Apparently, he could afford it. Cathy had heard rumors that Sam put away a good bit of money before the voters turned him out of office, money that didn't come from his salary as a county judge. Apparently, small towns had their share of under-the-table deals and influence peddling.

  The next house stood out from its plainer neighbors, its magnificent architecture set offby a striking landscape.A small red Cadillac stood in the driveway in front of the closed doors of a three-car garage. Whoever lived there certainly had money. When she saw "Collins" on the mailbox, Cathy decided that either Jacob was more successful than she thought, or his wife had pressured him into that expensive showplace. Cathy wondered idly who Jacob had married.She'd have to ask around.

  The sunny day and mild temperatures combined to relax the muscles in Cathy's shoulders as she rolled slowly along the narrow road. She let her mind wander, putting faces with most of the homes, remembering happier times growing up here. She'd wanted for nothing. Ran with a
clique of girls from upper-class families. She grimaced when she realized what a spoiled brat she must have been.

  There it was around the next corner: a modest one-story house built of white Austin stone, surrounded by two acres of green grass and spreading oaks, bordered by a white-rail fence. There had been a time when she knew every inch of the property, knew the best trees to climb and the hiding places where no one could find her. She couldn't read the faded letters on the mailbox, but Cathy remembered when it said "Sewell" in shiny black letters. There was no sign of activity at the end of the gravel driveway. The doors to a detached, two-car garage were closed.

  Cathy stopped at the entrance to the drive, her car's right wheels on the gravel shoulder of the road. She sat in silence for several minutes, her mind flitting back and forth like a hummingbird. Then, movement in the rearview mirror caught her eye as a black SUV raced over the hill. Cathy watched in horror. The vehicle veered to the right on a collision course with the rear of her little rental. She rammed the car into gear and screeched into the driveway, scattering crushed gravel in her wake. The SUV sped by with no signs of slowing, and she felt her car rock with the force of its passing. Was this the same SUV that had driven her offthe road once already? Was it more evidence of a plot against her, or was this another sign of paranoia?

  Cathy shivered. It took her a moment to gather her thoughts. Finally, she looked up the driveway at the house.This was no longer home. She knew where she had to go.It was time. Her decision made, she took a deep breath and eased her car out onto the road.

  A half-mile later, Cathy pulled in under a metal arch and navigated down a patched and pothole-scarred narrow lane. She let the car creep along as she searched for familiar landmarks. The names were hard to read, but finally she saw it ahead. Cathy parked, locked the car, and followed a dirt path, beaten down by the tread of many generations of feet.

  When she found the large granite slab, she dropped to her knees on the green grass in front of it. Despite the sun she felt on her back, the stone felt cold as she let her fingers trace the letters carved deep into it: SEWELL. Her shoulders shook. Finally, she sobbed, "Daddy, I miss you so much.And I'm so very sorry."