“I’m waiting.”
Pam studied the man she’d always loved. He stood there, his feet planted firmly on the floor, but with a frozen expression, as if he was holding his breath, anxious for her response.
“I think you should end this thing with Susan.”
“Sure,” he answered quickly, seeming relieved. “I agree. I’m doing everything I can think of. What do you suggest?”
Dear Lord, she prayed silently. Please help us. Here goes. “You could sell her the property she wants.”
Stunned, Tom stopped in his tracks. “Are you out of your mind? That’s the only leverage I have against her. I’ve given in to everything that woman wanted, and she still wants more.” He released a cruel laugh. “Do you honestly think she’ll go away if I just hand it over to her? Come on, Pam. You can’t be that naïve. She’s never going to go away. And she’s never going to be satisfied. She’s like a chronic illness. She keeps coming back, time after time!”
“I agree.” Pam insisted, trying to keep her voice calm. “But we’re never going to have a normal life if you can’t resolve this. Sell her the property. You can build a rehab center somewhere else.”
Tom pounded his fist on the wall. “If I thought it would end her garbage for good, I’d do it. But it won’t work. She’ll just want something else later.”
“And what about your sons?”
The same pained expression she’d seen in the past flashed over his face. “What about them?”
She struggled to keep her tone even. “Susan told me she realized the boys were getting caught in the middle of your problems. She wanted to put a stop to it. Reconciling seemed to make the most sense.”
Vehement, Tom shook his head. “Absolutely not. I already told you. She’s just using that to try to drive a wedge between you and me, and to make me feel guilty about the kids.”
Pam wanted to feel a sense of relief. Instead, only doom prevailed. Her head pounded. Her throat burned. Frantically, she forced herself to push aside the confusion and heartbreak swelling in her soul. She must remain objective. And detached. Like when assessing a patient’s medical condition. There was no room for emotion, fear, or second guessing. This was the rest of their lives they were talking about.
“Susan has a valid point, Tom.”
“Which is?” he challenged.
“Your battle with her is hurting your children. It’s all over the newspapers. People read this and then they talk about it. Kids overhear things. They don’t understand the context. They just see or hear the words.”
Tom stared at her. Then, seeming subdued, he took a seat on the couch. “I understand what you’re saying. Unfortunately, the simple truth is that my relationship with the boys has been crap from the beginning. Susan and I made rotten parents together. I let her take the lead role because it was easier than fighting. But it didn’t matter. We still found reasons to disagree.”
He turned away, but not before Pam saw the tears rimming his eyes. They ripped the holes in her heart even deeper.
Please God, Pam prayed. Please give me the right words. She swallowed, hoping to take the strain out of her voice.
“You could be right, Tom. Or wrong. This time could be different. Maybe it felt hopeless before, but now you’ve made contact again. Susan realizes this. I’m sure she also realizes that the boys are older now. Soon, they can make their own decisions. They’ll make their own assessments of their parents. Don’t you see? It’s got to end somewhere. Why not right here?”
One of the lawyers returned with a pile of documents. “Am I interrupting?”
Pam looked to Tom.
“These need your signature now if we’re going to file them in court today.”
“What are they?” Tom asked evenly.
“The libel and slander suit against Susan. And the request to attach all her assets.”
“I’d like to ask a question,” Pam interjected quietly.
“Sure,” the lawyer nodded.
“How long do you think it will take to resolve all this...mess?”
The lawyer scratched the top of his balding head. “Nothing in court happens fast. It will take at least a year.”
“Minimum?” she inquired.
Clearly uncomfortable, he loosened his tie.
“Like I told Tom, I’m certain that even if we win, Susan’s lawyers will file appeals.”
Pam looked to Tom. His expression told her he’d made up his mind.
“Thank you.” Slowly, she walked to the door. She didn’t want either man to see her tears.
“Pam!” Tom shouted. He stepped in front of her. “Where are you going?”
“The hospital,” she managed, avoiding his eyes. She got past him and through the door.
She heard his footsteps trailing her but she did not stop. He grabbed her arm just before she reached the street and swung her around to face him. “What are you doing?”
She found she still could not face him. Couldn’t he see? They couldn’t start their new life together with all this turmoil. It was a recipe for disaster.
“Pam! Look at me!”
“I can’t,” she cried.
He tried to pull her close but she resisted.
“Tell me what’s wrong!” he demanded.
She could hear the desperation in his voice. It tore at her soul. But better now, she tried to reason, than later. Clearing her throat of the tears, she found her voice.
“Susan needs to keep you in her life. If not as her husband, then as the boys’ father. And if that doesn’t work, she’ll come after you personally and professionally. Like she’s doing now. Trying to humiliate you in public.”
“Okay,” Tom replied.
“Don’t you see?” Reluctantly, she met his gaze. “One way or another, if you continue to fight her, she’s got you, Tom. She wins. Even if she loses.”
“And you think I should just walk away?”
“I know it sounds hard, but yes,” she answered. “And then each of you could sign a contract saying that this will be a final settlement of all matters involving real estate. So she can’t come back later.”
He dropped his hands to his sides. “I can’t. It won’t stop her.”
The stone cold glint in his eye pierced Pam’s heart. She felt like someone had just picked her up and slammed her against a stone wall. It took all the strength she could muster to remove her engagement ring and hold it out to him.
“No!” Tom shouted. His face turned red.
“We have no choice.”
“You can’t do this!”
“I don’t want to,” she sobbed. “But it’s not going to work. I can’t bear the thought of us being married and miserable. Please,” she implored. “Just take the ring!”
“I will not!”
“Then…” She could hardly get the words out. “I’ll…I’ll send it back to you.” With that, she turned and ran out of the building.
Truths Unveiled
Truths Unveiled
Chapter Forty-Four
“Triage to the waiting room, stat,” a voice projected over the intercom system. Pam heard the page while finishing a patient’s discharge papers. The door between the waiting room and ED kicked open. She saw a nurse come rushing through with a limp, swollen-faced child cradled in her arms. Two teary-eyed parents followed her in.
“I need a doctor!” She ran past Pam, taking the child into one of the critical patient rooms.
Pam followed. “What’s the story, Pat?” Quickly, she and the nurse undressed the small child to begin their assessment.
“We were at the park,” the child’s mother started. “She was playing in the grass. I heard her cry so I ran over. She was holding her arm. It started to turn red. That’s when I saw a bee stinger sticking out. I tried to get it out.” The woman began crying uncontrollably.
Her husband continued. “Ashley’s face and arms started blowing up. We got her in the car and came right here.”
“Has she ever been stung before?”
Pam asked.
The mother nodded. “Once, but she was fine afterward.”
“Anaphylaxis,” Pam diagnosed aloud. She shot Pat a warning glance. To the mother, she explained, “Children who are allergic to bees do not experience a reaction until the second time they are stung.”
“Her respirations are poor,” the nurse reported.
Pam agreed. “We need to tube her. Get me the Benadryl and some Epi. And an IV.” Pam noted the child’s face turning a bluish shade. The reaction was causing her throat to constrict. She placed an oxygen mask over the child’s mouth and nose to help her breathe.
“Anaph… what? What does that mean?” the father questioned.
Pam heard him but did not respond. Anaphylaxis was a deadly form of the allergic reaction. She didn’t have much time. Working feverishly, she noted the nurse breaking out the intubation kit.
The examination room, quiet and empty minutes before, filled with a dozen staff members. Everyone had a job. Orders were shouted and complied with, keeping one goal in mind: to save this child.
“What’s that tube for?” the father demanded.
“Sir,” another nurse began. “You need to let the doctor and staff work.”
“Fine, but that’s my kid. I want to know what’s going on!”
Pam tuned out the man’s demands. Instead she focused on her job, going through the protocol in her mind. She injected the Benadryl and epinephrine into an IV to help the child’s body fight the toxic intrusions from the bee that now raced through her system. She then placed the intubation tube down the child’s small throat. That should help.
“Her blood pressure is dropping,” a nurse reported.
Pam glanced at the monitors. “Let’s repeat the Epi dose.” She tried to remain calm, but knew the child was not responding.
“What does that mean?” the mother cried out. She rushed toward the child.
Her husband joined her, demanding attention. “I want to know what’s going on! Why isn’t she getting better? Do something!”
“Sir, please calm down,” a nurse requested. “Your child is experiencing a severe allergic reaction. We’re doing everything we can to help.”
The child’s mother gasped. She broke into a flood of tears and ran out of the room.
“You better listen to me!” the father warned, getting in Pam’s face.
“Move, sir!” She pushed past him and continued working.
“You better save my kid or you and this hospital are going to be…”
“Need a hand, Pam?” As if on cue, Tom walked into the room.
She quickly glanced in his direction. “Where have you been?” her eyes asked, grateful for his intervention. Obviously, he’d been walking by and overheard the ruckus. Then she turned away. She had no right to expect anything from him on a personal level. He would have done the same for anyone standing in her shoes.
“Let’s go out in the waiting room,” she overheard him tell the man. There was something in his tone that made the suggestion non-negotiable.
Pam sighed with relief. At the same time, she felt for the child’s parents. Their grief ripped right through her. She blocked it out, keeping her attention on the child. The small face had now turned ashen, causing Pam’s fear to become a reality. Anaphylaxis had two phases. First, it closed the airway until the victim couldn’t breathe. Then it dilated all the blood vessels, causing the blood pressure to drop to dangerously low levels. Pam secured the airway with the tube but she still couldn’t get the child’s blood pressure back up.
“Try the Epi again.” Pam instructed, fighting to keep calm. “Someone hang me a dopamine drip.”
“I’ll get that!” Tom interjected, returning to the room. He helped a nurse set it up. “What’s the status?”
“Airway secure. Oxygen saturation is fair, but I can’t get her BP up. The heart rate is racing too fast.” Pam knew giving too much Epi could worsen the condition, but she had no alternative. She needed the drug’s blood pressure-increasing effects.
“Doctor!” the nurse exclaimed. “She’s in fibrillation!”
Working feverishly, Pam refused to give up. It was so hard to imagine how a simple bee sting could have such a terrible result. “Charge the paddles! Let’s defibrillate!” she directed. At the same time, she prayed. For the child, her family, and for herself. Please let me help her, God. Don’t take her.
The combination of low blood pressure and a rapid heart rate caused the child’s heart to stop beating. Instead, it just quivered like a Jell-O mold. The only way to get it started again was to shock it.
Pam applied the paddles to the small chest three times, in succession. It didn’t work. “Start CPR!” her voice cracked.
Everyone focused on the heart monitor, willing it to show a normal beat. Drugs, shocks, CPR. They repeated the routine over and over again.
The heart monitor went from a flurry of activity to a straight, flat line. Beads of perspiration soaked Pam’s head. She knew it was time. The nurses knew it was time. Tom knew it, too. “Does anybody have any ideas?”
Silence screamed through the four corners of the room. They had done everything they could. It just didn’t work.
“Stop CPR,” Pam relented, fighting to keep her voice steady. She looked at her watch. “Time of death… 11:45 a.m.”
For a moment, the room stilled. Then everyone switched into cleanup mode. Nurses and aides started bustling around picking up the mess they’d created. They unplugged IVs and shut off the heart monitor. Only an occasional whisper could be heard.
Pam had lost patients before. Many of them. That was the nature of emergency medicine. Not everyone could be saved. Still, she replayed the steps she’d taken in her mind over and over again.
Pam found textbook cases, like this one, the worst. Most medical procedures have a chronological list of steps. If the doctor follows those steps, everything should work out fine. But it doesn’t always happen that way. Sometimes, no matter what she did, it just didn’t work.
She’d also learned early on that the end result left scars that lasted forever. While she repeatedly second-guessed herself, the patient’s family mourned their loss. Eventually, in many cases, that mourning turned into blaming her.
“Do you want me to go with you?”
Pam knew what Tom was referring to. She had to break the news to the deceased child’s parents. They would want to hear it from the doctor in charge. Tom’s offer to share that horrible burden made her remember again why she loved him. And always would. It took everything in her being to turn him down.
Avoiding his eyes, she shook her head. “Thanks, but its okay.” Quickly, she walked past him, determined not to let him see her tears. But inside, her heart cried out: “This is why people marry, you idiot! To share the bad, along with the good. To strengthen each other. To bask in the successes and provide a safe haven when life pulls the rug out from under you. Tom just offered that to you. Be thankful. And stop being so selfish. He needs that same understanding from you!”
Pam tuned out the voice and went to meet the child’s parents. The conversation did not go well. The only thing she could offer them was prayer, which they were not ready to accept. Now numb and yet overflowing with anguish for them and herself, she sought the refuge of her new office.
Seated at her desk, only Pam’s eyes moved. Occasionally she swallowed, to force down the lump in her throat. She sat with her hands in her lap, both her arms and her legs trembling slightly. Thank God she had her work. It would sustain her. It always did. Except now, after losing that little girl, her self-esteem wavered. She also found herself in the exact position she’d tried so desperately to avoid: here, in Middleton. Not Boston, Chicago, or some other large city where she could lose herself with a broken heart. She felt so exposed. Raw. Foolish.
She and Tom had spoken briefly, earlier that morning, before this latest emergency. They’d agreed to remain friends. Best friends. And intellectually, she wanted that. No matter what the circumstances, he
held a part of her heart. And, she believed, she held a part of his. But at this very instant, every nerve in her body screamed in anguish. Without meaning to, he’d touched her soul. He’d left his print upon her, and she would never be the same again.
Truths Unveiled
Truths Unveiled
Chapter Forty-Five
“Are you heading over to MMC, Chief? We’ve got some reports they requested.”
Truths Unveiled Page 21
