by Barbara Ebel
Roosevelt Harvey nervously glanced at his watch and practically galloped into Bonnie Barker’s room. “Congratulations on the birth of your baby,” he said, shoving the bedside clipboard into Annabel’s hands. He looked between Bonnie walking out of the bathroom and Tony, who sat on the windowsill. “I’m Dr. Harvey, the senior doctor in charge.”
Bonnie bounced her head up and down and lowered herself into the recliner like she had hemorrhoids. “It hurts to have a baby,” she squealed. “Since you’re in charge, remind me not to do it again any time soon.”
“You are a sturdy young woman; it took a lot to get through such a complicated delivery.” He shook her hand, which surprised her, and she began to smile.
“Dr. Tilson, what are Ms. Barker’s vital signs since yesterday?”
Annabel grabbed the bedside clipboard. “Her blood pressures have been less than 130 or 120 and diastolics are all normal. No problems with her respiratory rate or pulse, and she’s afebrile.”
“I can go home today, can’t I?” Bonnie asked.
Roosevelt peeked in the chart. He sat on the edge of the bed and read the latest notes in each section. “Hemoglobin and hematocrit have stabilized. Other labs are fine. No signs of infection. Let’s plan on releasing you tomorrow if you continue on this path.”
Tony sprang up from the ledge, more excited than Bonnie.
“I can’t wait,” she said. “But I hate to go without my baby, Sam. Maybe they’ll tell me more today.”
Dr. Harvey looked straight at Tony. “Are you a visitor or a significant other?”
Tony winced. “Half and half.”
Roosevelt didn’t want to touch that one. “Be sure and holler if you think of any questions today. Dr. Watson and her team will be here if you need them.”
“Yes, but can I have something more for pain?” Bonnie asked. “I still hurt down there.”
He glanced at the pain order she already had in place. An extra pill on top of what she was receiving was reasonable.
Ling Watson sighed and shifted her weight from one foot to the other. It was time to move on.
“Yes, that’s not a problem,” he said. He leaned into Ling’s left ear and softly told her, “Another 200 mg Motrin.”
Ling stepped close to Tony and perched herself on the windowsill. She opened up the chart to an order page, took a pen, and scribbled. She ended by rolling her eyes.
“One more thing,” Dr. Harvey said, looking at Annabel. “Mrs. Barker is breastfeeding, so we must take that into account. Motrin is the preferred pain medication for nursing women. Unlike narcotic pain pills, ibuprofen-like meds will not make her or her baby sleepy.”
Annabel nodded, grateful that despite his hurried schedule, he was taking time to teach.
Outside the door, Dr. Harvey absentmindedly patted the top of his head, making sure his toupee was still in place. “When Kathleen Chandler’s husband arrives, and if he would like to speak to the senior doctor, then give me a call.”
He disappeared off the labor and delivery ward to his own office where the waiting room was full of waddling pregnant women and women anxious to put their pap smears, exams, and requests for birth control behind them for the day.
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Ling dropped the brown binders on the round table in the lounge. “There are no orders in these charts that can’t wait,” she said to the unit secretary, who poked her head in and then went back to the desk.
“I sense a break in the action,” Caleb said. “Who’s joining me for a late breakfast or early lunch or whatever you want to call it?”
“Isn’t the earlier drive-through breakfast biscuit holding you for a while?” Ling asked.
“Up until this minute.”
Dr. Watson threw him a glare and fumbled in her locker.
“You coming, Annabel?” He started for the door.
Wondering, Annabel followed his springy and energetic gait to the cafeteria. When he arrived earlier, she didn’t notice him with a take-out breakfast and he didn’t sit down to eat. How did Ling know he stopped at McDonalds? Were they together before they arrived on the wards?
Annabel picked her lunch out a lot quicker than Caleb, so she already was seated at a table by the time he arrived.
“It’s nice to get away,” he said, placing his tray across from hers. “We had a hell of a morning. I don’t want to see any more OB deaths during residency. And after residency, I don’t want to think about it. CPR and resuscitation skills for obstetricians out of training end up being rusty; between you and me, I think they depend on anesthesiologists being around and backing them up.”
“You all pulled your weight this morning as residents, though,” Annabel said, complimenting him.
Nearby, there were four people sitting at a table and a female wearing a college sweatshirt diverted her gaze to Dr. Gash. He kept a beard, short on the sides and fuller on his chin, which took advantage of his square jawline. Annabel wasn’t surprised when he stole a sideways glance at her in return.
Annabel lowered her voice. “You’ve seen other OB fatalities?”
“Oh yeah, and they aren’t pretty. In this specialty, you’ll overhear docs talk about cleaning up after midwives. Don’t get me wrong … they are not one-hundred-percent bad, but there are those that don’t meet the minimum state licensing requirements and standards as well as those that are flat-out negligent. Midwives are more common and more needed in areas where there’s a shortage of OB/GYNs. Unfortunately, those are regions where hospitals are often a hell of a ways away in an emergency.”
He shook salt and pepper on a bowl of chili as Annabel hung on every word. So far, she had never heard anything good or bad about midwives.
“There are pregnant women,” Caleb continued, “that view hospitals, modern technology, medications, and having their babies in sterile-like environments as anti-natural. Like a mother not vaccinating their children against diseases. I mean, vaccines work and they are the biggest success story of modern medicine. Anyway, these pregnant women think that childbirth should be totally natural. If you ask me … subconsciously they want to give birth like women did in the Stone Ages.”
Annabel grimaced and speared a cherry tomato from her salad.
“Well, not that bad,” Caleb admitted. “Anyway, for the last ten years or so, home births are on the rise. Women choose to give birth in their own home. But in the event of an emergency, do these midwives have a backup plan?” Caleb paused. “No,” he said with emphasis.
“Then how did you happen to stumble upon a fatality where a midwife was involved?”
“EMS rushed in a dead baby after a botched at-home breech delivery by a midwife. The ER and OB docs then tried their damnedest to save the mother, who was also ambulanced in. That case was doubly negligent because, apparently, the midwife never talked to the parental couple about the dangers of vaginal birth after cesarean section or VBAC, which the mother had a history of.”
“Jeez,” Annabel said.
“That father or husband? In a couple of years, he won’t need to work another day in his life … if that’s what he wants. A jury will find it inhumane to not award him a multi-million-dollar lawsuit against the midwife.”
Annabel shook her head. “I bet he’d trade back that windfall if he could have his wife and newborn back.”
“No doubt. I later stumbled upon him downtown after one of his attorney appointments. He told me something I’ll never forget. He said that if he ever bought a Lamborghini later on, he was going to put an infant car seat in the passenger side … to remind him how he came to acquire the vehicle and to always remember his wife and child.”
“I’ll peek in the next, or only, parked Lamborghini I spot to see if there is an infant seat.”
Caleb gave her a quick nod. “Since there aren’t too many of them cruising around, one of us will discover it.”
CHAPTER 11
As the elevator door began snapping shut, Caleb thrust his hand in and paused it. He sprang in and held the d
oor for Annabel.
“Thanks for suggesting lunch,” Annabel said. “I don’t rank as high as you with Dr. Watson. I wouldn’t have suggested it in front of her.”
They stood on one side of the elevator. A neatly dressed man stood against the other back wall, his hand gripping a shiny aluminum cane. He tapped its rubber gripper on the floor several times. When they didn’t ride up immediately, he pushed the button for the OB/GYN floor several times.
“It worked out,” Caleb said softly. “Grabbing meals while monitoring and taking care of obstetric patients can be a luxury. Like today. You never know what’s going to happen. And with Ling, sometimes you have to ignore her shortcomings. Between me and you, I think she’s getting worse lately. She needs a vacation or something.”
The man between them took one step when they resumed moving, ready to spring out as soon as the door opened. When they arrived, he pulled ahead with a tilted gait.
“He’s three-legged and burning rubber,” Caleb said as they walked past the waiting room.
“He’s anxious, here to see a family member in labor, or he’s mad-as-hell about something.”
“Hey, you.” A woman’s voice they recognized approached from behind. “Doctor?”
Annabel and Caleb whirled around. It was Kathleen Chandler and the man from the elevator behind her.
“You two were in the room,” Kathleen said. “This is my husband, Mike Chandler. Mary’s father.”
“You were afforded a lunch hour?” he said sarcastically with a British accent. “My wife and I surely won’t be eating anytime soon. Our daughter passed away,” he continued. “We aren’t doctors, and my wife isn’t a midwife, so we don’t even know what questions to ask. But if there is no absolute understandable reason why Mary died, a lawyer is going to be asking our questions for us.”
Annabel gulped for air and her heart pounded while they all suffered an uncomfortable silence.
“I’m Annabel Tilson, a medical student. Our attending doctor can help you. We can call him.”
“And where is our daughter?” Mark barked.
Annabel glanced at Caleb, who peeked down at his shoes. Surely Dr. Harvey and Dr. Watson had told her that a legal autopsy would be performed.
“You can inquire downstairs in the basement where they’ve taken her.” Hopefully, Annabel thought, no one had started the autopsy yet and Mike Chandler would still be able to see his daughter.
“We’ll be back,” he said.
Annabel and Caleb made sure they were out of range. “I’m sorry,” he said. “I have more to lose than you if they end up being pissed off at me. I’m in an OB residency and you’re not.”
“Thanks a lot, Caleb.”
“You handled them perfectly.” He rubbed his fingers in his beard and then used his iPhone to alert Dr. Harvey that the Chandlers wanted to talk to him.
-----
Caleb pulled ahead as Annabel walked past each labor room. A few of the doors were closed and she wondered if any new patients had been admitted. Then she realized she hadn’t given Bob and their potentially nonsensical plan a thought all day. She pulled her iPhone from her pocket and found no email or text messages from him. Maybe he aborted their dog plan but she doubted it.
Bob could be at a Petco or PetSmart right now shopping for a sturdy dog collar and a nylon leash. Or he was in the process of making other decisions: what type of food would he start their puppy or dog on and which bowl should he buy? Those were fun items to shop for and they might belong to the dog and the two of them for the entire life of their pet. Yet, although she was missing the shopping trip with him, it was handy that he was available to do it. More important was their decision of which dog to adopt. She was part of that no matter what and, now that the time drew near, she couldn’t wait. Maybe tomorrow at this time, she’d be a dog mom.
One of the day shift RNs rolled the red medicine cart ahead of her. The woman pulled the twelve-hour shift on the days when Sherry had off. She stopped, parked herself outside Bonnie Barker’s room, and stared down at an open chart.
“Dr. Tilson,” she said as Annabel began passing. She gestured at an order page, her bracelets clanking together at the bottom of her lanky arm. “This looks like chicken scratch. What did Dr. Watson write? It’s for Bonnie Barker.”
Annabel stopped. The nurse’s name tag said “Melba Fox, RN.” She peered down. “Looks like morphine 200 mgs, but that can’t be right because that’s too high.”
“Not necessarily. Ms. Barker is already on a nonsteroidal, which isn’t holding her pain in check, so she needs something in addition to that. And you’re a medical student. You haven’t been around long enough to understand that some of these patients are previous or presently drug addicts. That means that they have an accumulated tolerance to opioids and need and take far more than anyone else. I see it all the time.” She flicked her hand in the air. “After all, look at her. Eighteen years old with a baby already. And a newborn with some kind of a problem, which is what I heard. In all fairness, she’s a druggie and her baby is suffering the consequences.”
Annabel narrowed her eyes and studied the woman with thick-penciled eyebrows.
“Really,” Melba said. “I don’t mean to sound cynical like your chief resident. I’m not that bad. I am just reporting what I see around here.”
“I hope the opioid addiction problem isn’t that bad.” Talking about Bonnie Barker’s baby made Annabel turn around and walk over to the nursery. Maybe baby Samantha could use a visitor.
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Bob Palmer’s common occurrence these days was to sleep late for two reasons. Ehrlichiosis was the medical reason; besides other significant signs and symptoms, the tick-borne disease made him especially tired. His energy level returned only somewhat faster than a snail slinking across the street and he hoped that by next Monday, his return to the last week of internal medicine would be almost normal.
The second reason for sleeping in late was simply because he could. Since starting medical school, he couldn’t remember a few days in a row like this when he woke with the sunrise peeking through his window treatments and then he would fall back asleep several times until it was midmorning. It was glorious. However, deep down he knew it only qualified as a treat, like a present that would befall a kid on a major holiday, so he better not get used to it.
Today, however, he not only didn’t sleep in, he was more vibrant and snappy. The thought of finally getting a dog with Annabel made him spunkier, both because of a new pet, but also because he’d be working with her in a separate collaborative manner. Different from the way they had been working together on medical rotations. Now they would have an outside interest all to themselves, a healthy way to step aside from the wards, sickness, and studying, as well as to take a break from following orders and the attentiveness and empathy they needed when dealing with patients.
Annabel Tilson had caught his attention the first two years of medical school when everyone was getting their feet wet and becoming accustomed to the crazy education and training they had signed up for. But he never had the opportunity to get to know her better. That changed when he landed on the same rotation as her in surgery. However, a friendship grew rather than a love interest because Annabel became enamored at that time with their chief resident.
Because they intensified their friendship, that hurt him rather than helped him. She went on to meet and later date the policeman, Dustin Lowe. Putting the situation into perspective, he realized that the only way she “saw” him was as a true friend, even when he had accompanied her to Nashville when her family dog died. Meeting her family in Tennessee also brought him closer to her and he enjoyed the whole household, but it made him more certain. Romantic notions about him did not fill her head like the way he thought of her.
Bob weighed his options quite often and always came up with the same result. If he stated his feelings to her or if he made a romantic gesture, he stood the chance that would make her uncomfortable; he could even lose her as hi
s very best friend. He innately sensed this and his feelings usually didn’t lie.
It had been a tough situation to deal with on a regular basis on their shared rotations. But now their schedules were unhitched … which was why he had to drum up a more permanent method of seeing her. Dustin Lowe might be sharing his bed with her, but Bob could share a dog with her and continue their strong-bonded friendship.
For now, it was the best plan he could come up with and it better work. He not only loved her, he practically adored her. She was a knockout, but she was so much more than that; personable, agreeable, and thoughtful to just about everyone. And she always dove to the bottom of a situation with more streetwise smarts than he ever possessed, which always struck him as ironic since she came from a more well-to-do family than he did.
So, he thought, as they were about to embark on a new journey together, he’d be sure to keep a tight rein on his emotions and not display his feelings and jeopardize what they had.
Bob dragged himself out of bed, showered, and dressed in cotton sweatpants and a t-shirt. He savored a flavored coffee at a coffee shop and then drove to the back of the shopping strip to the pet store. He realized most customers probably shopped online because there were only a handful of customers in the spacious store. This was a new experience for him, however, and he preferred picking out the items in person.
One whole side of an aisle displayed leashes and collars for dogs of every size, which posed to be a problem. How could he buy anything if he didn’t know how big the dog would be? Yet how would they bring home a dog if they didn’t have the proper gear?
He spotted one collar of its kind … a red collar with five solid bells attached. Labelled for a “large” dog, he figured he could tighten it for a medium dog as well because of so many punched holes. Not only Christmassy, but it was also unique, fun, and frivolous. Their dog would clatter with tinkling bells every time he or she would make a move or run. He clutched it in his hand and then moved on to leashes, where he found a perfect matching off-white nylon leash with two red stripes.
