"It needed doing."
"What did you say exactly?"
"That a dozen or so members of his department were dinosaurs who sucked at managing pain, and then I suggested an audit on the subject might be in order. I waited until today, of course, figuring it safer to express my opinion in a crowd, where he'd be forced to behave."
"You've got to be kidding."
Jimmy, now looking more defiant than sad, shook his head.
Earl's stomach did a pirouette at the thought of how Peter Wyatt would react, crowd or no crowd, to such a frontal assault, especially since the charge hit home. No greater hot-button issue existed in palliative care than proper pain management. The dilemma was, the more potent an analgesic and the bigger the dose, the more likely the medication would stop a person's breathing as well as the pain. Though some enlightened doctors advocated sufficient amounts to make a patient comfortable, even if they inadvertently hastened the person's inevitable death, some didn't. They administered instead rote, inadequate quantities rather than risk an accusation that they'd committed active euthanasia.
Then he thought Jimmy had to be ribbing him. He wouldn't be so crazy as to pull such a stunt with Wyatt. "Come on. This is a joke, right?"
Jimmy's gaze shifted to a point behind Earl and his eyes widened. "Oh, sweet Jesus, I see the man himself headed this way."
"Quit kidding me, Jimmy, not about this."
"Oh, but I'm not. And he's flushed purple as an eggplant."
Of course Peter Wyatt wouldn't be behind him. Maybe Jimmy had never said anything to him at all, the story being just a way of making a point about a problem that he thought deserved attention from the new VP, medical. Earl loved how the priest could quick-shift from the serious to quirky, off-the-wall teasing. Delivered at the right moment, his jokes could lift the spirits of an entire ER staff and keep the craziness of what came in the door from eating at their minds. What's more, fun could be had in playing along with the man, calling his bluff, throwing out even nuttier nonsense, the game being to top him. Earl relaxed. "Yeah, right, Jimmy. And were I to turn around, there'd be the Pope as well, the pair of them coming to admonish you for sticking your nose where it had no business."
"Dr. Garnet!" rattled the gravelly voice of Dr. Peter Wyatt, the sound running down Earl's spine like knuckles on a washtub.
Jimmy winced. "Want me to stay? I will, but my presence might inflame things."
"Jesus Christ, you really did tell him off!" Earl still couldn't believe it.
Jimmy's gaze hardened, completely devoid of the sadness from minutes ago. "As I said, it needed doing. Do you want me to stay or not?"
"Garnet, I want a word with you!" Wyatt's bellow sounded twice as close as before.
"Jimmy, I swear I'll get you for this. But right now, just get out of here."
"See ya." He flashed that magic grin, gave his hamstrings a quick stretch, and jogged off.
Earl, fuming, turned to confront the chief of oncology, and had to stifle a nervous laugh at the sight of the man descending on him. Bushy eyebrows and a furrowed forehead always endowed Wyatt's grim face with more horizontal lines than the mug of an onrushing bulldog. Normally he stuffed his stocky frame into a three-piece suit, giving himself the formidable air of a Winston Churchill. Today, however, wearing a Hawaiian shirt and Bermuda shorts, he looked more like a knobby-kneed drug dealer. "Peter, good to see you." Earl force-marched his mouth into a genteel smile and held out a hand in greeting. "Fine day for a race, isn't it?"
Wyatt huffed up to where he stood and ignored the gesture. "I see that priest's already gotten to you."
Oh, brother. "Jimmy? He just promised to leave me in his dust during today's race, as usual."
"He didn't tell you what he said to me?"
At close range, Earl could see droplets of perspiration appear across Wyatt's beefy forehead despite the cool breeze. He almost suggested the man sit down somewhere but figured Wyatt would take it as an insult, he being a staunch practitioner of middle-age macho. "He never mentioned you at all, Peter. And why would he? Today's a time for fun, not business."
"Fun, my ass. That comedian in a collar had the nerve to tell me and my physicians how to treat dying patients. Even suggested that there ought to be an audit of how we practice. I never liked these modern types of chaplains, always going on about 'interfacing' and 'holistic care,' as if that's going to shrink a tumor. But Fitzpatrick crossed the line today, and I don't want him in my department anymore. You make sure he stays away."
"Now, wait a minute. I can't do that."
"No?" Wyatt drew in a sharp breath, the kind meant to show indignation, except the wheeze in his nose ruined the effect. "If you won't, then I'll go to the CEO, the board of directors, whoever it takes to get rid of him."
The man's angry voice had started to attract passersby. "Peter, this isn't the time or place."
Wyatt looked uneasily around and broke into a professional smile. "I want him to leave oncology patients alone." His voice had dropped to a whisper but had the sibilance of an angry snake.
Earl maintained the show grin he'd started with, but his cheek muscles had started to burn. "I won't do that, Peter. Jimmy's the only person some patients have to talk with, especially the terminal ones. They'd die alone if it weren't for him."
Wyatt's smile congealed a little, like cold grease. "Garnet, I didn't want you as
VP, medical in the first place, and you sure as hell aren't changing my opinion any-"
"Well, I'm sure I can work with you, Peter," Earl interrupted. Despite the pain, he attempted to widen his grin, determined to take control of the situation. It felt more like a show of teeth than a smile. "How about I issue a formal reminder to him and all other Pastoral Service personnel? Something to make it clear that while their insights into patient needs are always valued, final decisions on issues of pain control and medication have forever been and forever will be the exclusive domain of doctors? A kind of 'render unto God what is God's and unto Caesar what is Caesar's' memo."
Wyatt turned a deeper shade of purple. "You're making fun of me."
Earl imagined him in a toga and sporting a crown of leaves around his head. If anyone had an emperor's complex and fantasized about possessing the power to make all of St. Paul's do his bidding with a thumbs-up or thumbs-down, it had to be Peter Wyatt. "Not at all, Peter," Earl quickly reassured him. He knew that Wyatt also held considerable sway over the other dinosaurs who'd led the anybody-but-Garnet lobby and opposed his appointment of Earl Garnet to his current post. They couldn't wait to engineer his downfall. The best defense against this bunch would be copious stroking and keeping them busy. "The truth is, Peter, you just gave me a brilliant idea."
Wyatt's heavy jaw slowly opened, as if about to swallow something whole. "Me? What kind of idea?"
"Who better to lead a hospital-wide audit on pain management than yourself? You've always showed the way in making sure St. Paul's was on the cutting edge of such protocols." And he had. The protocols gathered dust on shelves at every nursing station. "But do we really know if all of us are using them properly? It's a flaming-hot topic right now, as you're well aware, and I can't think of a better person to guide us through the minefield it's become than yourself."
"Conduct a hospital-wide audit? Why, that's a huge undertaking-"
"As far as I'm concerned, you inspired the idea, and the job's rightly yours. The Wyatt Inquiry, we could call it. You'd have the power to appoint anyone you wanted to help you, and I'd order the full cooperation of all the other chiefs. It would be your show, start to finish."
"But I'm so busy-"
"With or without you, it goes ahead, Peter. And that could be a hell of an ordeal if you have to live under somebody else making a mess of a matter you're naturally passionate about. A lot harder than doing it right yourself. Isn't that why any of us take these crazy jobs in the first place?"
Wyatt hesitated, a look of alarm pushing its way onto his thick features. "Yes, that would be hard…
"
Earl watched the fight go out of him.
During the man's early days in the late sixties, Wyatt had possessed the courage to take on malignant diseases at a time when they had 80 percent mortality rates. His research had even helped develop the treatments that stood the statistic on its head for lymphomas. In that category, now it was survival rates that stood at 80 percent.
How sad it was to see this tiger so diminished, his once heroic passions for epic cancer work diverted to such puny issues as perceived turf incursions by an overzealous chaplain. "So what do you say, Peter? Will you think about it?"
No answer. He looked overwhelmed.
Earl moved in with the clincher, knowing the one sweetener Wyatt wouldn't be able to resist. "There might even be a paper in it for you, Peter. After all, if you were to develop a road map that would help other hospitals actually implement current protocols in pain management, leading journals would fight to publish it."
Wyatt hadn't had anything accepted for publication for over a decade. What's more, he'd been a victim of one of the crueler spectacles in academic research. Five years ago, still chafing under his dry spell, he'd finally received an invitation to present a paper at a national conference. He'd attended, proudly presented his latest work, and then sat down, ready for questions from the audience. But the moderator, legend had it, instead of inviting inquiries, had stood, pointed at Wyatt, and declared, "This man has demonstrated exactly the type of research we don't want."
Earl had anticipated that the chance of a comeback would kindle a glow in Wyatt's eye.
It didn't.
Instead he remained stone-faced and said, "If you insist, I've no choice."
Wyatt's attitude puzzled Earl. The man he knew had an ego the size of Antarctica, and the lure of any stage generally lit him up so brightly he could be his own spotlight. "Does that mean you accept?"
"I suppose I'll have to." He might have consented to have a leg amputated, for all the enthusiasm he showed.
Weird. But what the hell, as long as the situation with Jimmy seemed defused.
"Good! Then let's join the rest and enjoy the race."
"Wait! There's something else you need to hear."
Oh, God. Earl glanced at his watch, hoping Wyatt would get the message to keep this short. "I'm listening."
"The nurses tell me we've had patients complaining about near-death experiences."
"What?"
"You know. That out-of-body phenomenon, the thing Deloram wrote a paper about."
Now Earl felt really puzzled. "Peter, I don't understand the reason you're telling me this." His tone, he realized, sounded more cross than he intended, but patience had limits.
"We never got reports like that before, at least not so many. The first few months the nurses thought nothing of them. Then more patients continued to describe similar ordeals. Some, I'm told, were quite terrified. I swear it's that priest's fault. He's probably talking too much about God, heaven, and the afterlife, making his charges have nightmares about it."
Earl groaned inwardly, incredulous that Wyatt could remain so fixated on Jimmy. "Probably they're just vocalizing that kind of thing more, Peter," he said, trying to hide his exasperation, and started to walk back toward the crowd.
Wyatt followed behind. "Damn it, Garnet, it's not that simple-"
"Similar accounts have been in the media lately, thanks largely to Stewart's research," Earl cut in. If he could somehow trivialize the matter, Wyatt might drop it. "Could be that the phenomenon's been occurring with greater frequency than we knew, and patients, having seen the publicity, realize it's not just them. As a result, they feel open to talk about it now." In the distance he saw Michael wave impatiently, beckoning him to rejoin the ER crew. They were already pushing their bed into the coveted inside post position. Definitely time to ditch Wyatt. He walked faster. "Anyway, it's race time."
"But something's funny," Wyatt went on, easily picking up the pace. "Most of the people it's happened to weren't that near death yet. Oh, they're terminal, in pain, and not in good shape, but their vitals were still stable, not at all what I'd expect for a person who's seeing angels, tunnels, and bright lights."
So much for diplomacy. "Jesus, Peter. They're dying. Many of them will want to talk about that stuff. Patients always have, even atheists. It's human nature. But here isn't the place to discuss it."
"Hey!" Michael Popovitch shouted from the middle of the street thirty yards away. "We're ready to begin." He wore an industrial-strength scowl and sounded pissed.
Sheesh, what's eating him? Earl wondered. The rest of the team settled on give-it-a-break glances and tapped their watches, a far more gentle and appropriate rebuke. Michael should lighten up. "Relax! I'm coming," he shouted, and started to jog toward them.
Wyatt matched him stride for stride, clearly determined to continue their conversation.
Earl didn't intend to let him. "Look, Peter, obviously we'll have to talk about this another time. But I don't think you should make much out of it." He accelerated, pulling a few yards in front, and called over his shoulder, "Why not ask Stewart what he thinks? After all, he's the specialist in that kind of thing."
At the starting line Thomas, Susanne, and J.S. were starting to jostle good-naturedly with members of the Baby Bucket team, who'd tried to steal their spot.
"Earl Garnet," Janet yelled, eyeing him from her perch on the bed, "I'm pregnant with your baby. Chivalry demands you yield the post." She placed a hand to her forehead, adopting the melodramatic pose of a damsel in distress.
Earl laughed. He and Janet always lent their talents to the campy theatrics that were a highlight of these fund-raisers. "All's fair in love and war," he called back. "That's been my plan all along. You pregnant, us on the inside track."
"You're a scoundrel, Earl Garnet," she cried, to the delight of all.
He gave an appropriately wicked leer as he shouldered through a last-minute rush of other competitors who were late to take their positions.
Wyatt caught up to him. "The nurses already did that, a few days ago."
Piss off, damn it! Earl nearly screamed. But they were jammed together, and rather than risk angering him again, he tried to be civil through clenched teeth. "Already did what?"
"Asked Stewart Deloram to check out the accounts that our patients have been giving. I'm told he suggested the same explanations as you did, but agreed to interview the people who were still alive."
Overhead loudspeakers crackled to life. "Ladies and gentlemen, take your marks."
Cheers broke out around them.
Teams scrambled into position.
"Let's go, Dr. G.," J.S. hollered.
Susanne and Thomas joined in.
Someone blew charge on a trumpet.
But Wyatt remained so wrapped up in his crazy story, he didn't even react to the excitement swirling around them. He just leaned in toward Earl to make himself heard. "I don't know what happened. He burst into my office yesterday, mad as hell, and accused me of trying to set him up as a fraud, then stormed out."
Oh, brother, Earl thought. Not another feud. "Peter, I'm sick as hell of being asked to sort out these kind of kindergarten spats, especially the ones involving Stewart. Now both of you act like adults and sort it out yourselves." He'd ended up shouting far more loudly than necessary to be heard above the din around him.
The rolls of flesh in Wyatt's face shifted as he assumed an injured look. "But the man refuses to even talk with me now."
Earl waved him off in exasperation and joined the welcoming arms of his ER team- all except Michael's; he still seemed upset about something as well- and mounted the bed they would push to victory. At least that's how he lustily predicted the outcome during a crude exchange of triumphant gestures with Janet, and beyond her, the surgeons in Sean Carrington's Cutting Edge mob.
God, it felt delightful- the sanest moment of his morning, when he was responsible for nothing more than the safe passage of a bedpan filled with apple juice.
Chapter 4
That same Saturday, 5:30 p.m.
The roof of Eight West, St. Paul's Hospital,
Buffalo, New York
Jane Simmons sat at the picnic table, sipping a beer as she chatted with the other ER nurses. A silver medal for the ER team's closer-than-usual second-place finish behind Father Jimmy clinked against the neck of the bottle.
The so-called wind-up party, well into its fifth hour, had lasted six times longer than the race itself, and a hundred or so others still hadn't gone home. Everyone seemed glad to hang out where they could see one another's faces again. But the reason she'd stuck around stood on the other side of the dance floor among a group of residents, too many of them women.
Thomas Biggs leaned against a picnic table, his arms folded across his chest, laughing easily and listening more than talking.
She felt jealous, and hated herself for it. When he eventually came to the makeshift bar, a long cafeteria table laden with drinks in buckets of ice, she walked over to greet him.
"Hi, Thomas. Want to share a beer?"
"Hey, J.S. Sorry, I said I'd go into ER early, starting a few hours from now. Split a juice with you?"
"Cute!"
"Would you like to dance?"
"Sure."
He swung her out onto the platform, where a dozen other couples snaked around to the strains of "Lady in Red." It blared from speakers suspended in a pair of potted trees, all part of the loaned decor that turned the gravel surface on top of the hospital's west wing into what the program described as the "Roof Garden." Mauve velvet ropes strung between chrome posts to demarcate an area well away from the edge looked as if they'd been borrowed from a movie theater lobby. Behind them stood a veritable jungle of more borrowed large plants. These concealed the ten-foot chain-link fence that, according to hospital lore, had been erected around the perimeter six years earlier after the then chief of psychiatry jumped to his death. Without the greenery as camouflage, the place resembled a prison yard.
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