It's Nothing Personal

by Gorman MD, Sherry

  Jenna smiled when she kissed Mia, careful to protect her daughter from her own mounting anxiety. Glancing at Tom, Jenna sensed his apprehension.

  Tom moved closer to Jenna and whispered in her ear, “Call me if you hear anything new.”

  Jenna nodded solemnly.

  “Have a good day at work and school,” Jenna said to Tom and Mia as she left the house. “I love you both.”

  On the drive in, Jenna listened to the story being recapped on the radio. After the third iteration, she had enough. She turned the radio off and drove the rest of the way in silence.

  Approaching the street in front of St. Augustine Hospital, Jenna was astonished by the amount of chaos. Every major local news affiliate had a van stationed directly in front of the hospital, and a sea of satellite dishes extended into the air. A number of police cars were present with officers standing outside the entrance.

  Jenna pulled into the parking lot. Before getting out of her car, she sighed heavily, hoping the release would prepare her for things to come. Hastily, she made her way through a side door into the lobby of the hospital.

  Inside, there was complete pandemonium. Tables, staffed by nurses and hospital administrators, had been set up across the entire length of the lobby. Hand-printed posters were taped to the walls that read “Hepatitis Testing/Information.” Hundreds of horrified people, presumably patients, descended upon the tables, searching for answers.

  Suddenly, Jenna felt conspicuous in her surgical scrubs. Afraid of being accosted by an angry or frightened patient, she quickened her pace and disappeared into the safety of a back stairwell that led up to the operating rooms.

  Jenna walked directly to the doctors’ lounge. The room was crowded with other anesthesiologists, all of whom were speaking at once. She moved toward the back of the room, catching portions of conversations along her way.

  “Do you leave your drugs sitting out?”

  “How could this have happened, right here, in our ORs?”

  “I wonder who she stole from.”

  Dr. Rob Wilson strode into the lounge looking deeply troubled. His already ruddy complexion took on a deeper hue of red, and his wrinkles were accentuated by his frown. Rob Wilson, standing at 6 feet, 4 inches and weighing over 250 pounds, was a man who, on physical stature alone, was difficult to ignore. His professional accomplishments also demanded respect. Dr. Wilson was both Chief of the Anesthesia Department at St. Augustine and President of Jenna’s group. Her colleagues took note of his presence, and their conversations began to die down. Eventually, the sound of multiple doctors shushing one another overpowered the last conversations, and the room became silent.

  “All right,” Rob said, “I know you all have a lot of questions. Let me just start by telling you what I know. There has been a cluster of patients testing positive for hepatitis C who lack the traditional risk factors. The common thread among these patients is that they all had surgery at our hospital between November of last year and April of this year.

  “Coincidentally, at the same time that these cases were being investigated by the State Health Department, one of the surgical scrub techs from the main OR was caught using Fentanyl. Her name, as many of you now probably know, is Hillary Martin, and she worked here during the time period in question. She was known to be positive for hepatitis C at the time she was hired.

  “About ten days ago, Ms. Martin turned herself in to authorities. Martin has admitted to stealing syringes of Fentanyl from our anesthesia carts. She would inject herself with the drug and replace the dirty syringe, refilled with saline, back on our carts before any of us noticed the theft. Unfortunately, if what she says is true, then at least some of us unknowingly injected hepatitis C virus directly into our patients’ bloodstream while they were under our care.”

  The doctors were speechless, and the collective body heat was causing the room to become stuffy.

  Rob caught his breath and continued, “At this point, ten patients have tested positive for hepatitis C. We have no idea how many more will turn up as we proceed with mass testing.

  “We will try to get more news to you as it becomes available. At this point, I must discourage all of you from discussing this matter with other members of the OR staff or other anesthesiologists who are not part of our group. The potential legal implications of this debacle are nothing short of epic. As such, I must also ask that all of you refrain from engaging in any discussions with the media. For now, that’s all I know. I suggest that the best thing we can do is get back to work and continue to take excellent care of our patients.”

  Once Dr. Wilson had concluded his speech, the noise in the room quickly escalated as Jenna’s colleagues pelted him with questions. Jenna, unable to tolerate the frenzy, quietly slipped away.

  Despite having been warned about discussing the scandal, it was the main topic of conversation throughout the operating rooms. By the end of the day, the speculations and rumors only made Jenna more upset and uncertain.

  Shortly after 3:30 p.m., Jenna’s cases were over, and she was mentally exhausted. Slipping out one of the back doors of the hospital, she made it to her car undetected, and drove home in silence.

  Pulling into her driveway, Jenna whispered to herself, “Please, God, don’t let this involve me.”

  CHAPTER 8

  June 15, 2010

  At 3 a.m. Jenna lay in bed, wide-awake with a pounding headache and a profound sense of dread. The racket from the chirping of crickets outside her open window sliced through her. Jenna had hoped that the Ambien she consumed the night before would have allowed her to sleep. Unfortunately, the sedative was unable to conquer her racing mind. Giving up on any hope of rest, Jenna grabbed her glasses, quietly rolled out of bed, and tiptoed down the hallway. Ginger’s paws clicked against the tile as the dog trailed behind her. When Jenna reached the kitchen, she could hear Tom snoring. In the early morning stillness, she swallowed four tablets of Advil and made a cup of tea.

  Jenna headed to her home office. Not wanting to wake the rest of her family, she left the lights off. Carefully, she felt her way behind her antique, cherry desk and sat in the leather chair. Alone in the darkness, Jenna wiggled the computer’s mouse. The light from the monitor was barely enough to illuminate the keyboard, but it was sufficient for Jenna’s purposes. She opened her email. Midway down the screen, her attention was drawn to an email from Dr. Rob Wilson.

  With a trembling finger, Jenna clicked on the mouse and opened the document. She was completely engrossed when Tom’s voice startled her.

  “Hey there! Can’t sleep?” he asked.

  Jenna nearly toppled over her tea. She could barely make out Tom’s frame. “Geez! You scared me to death! What are you doing up?”

  “I should ask you the same thing,” Tom muttered as he switched on the lights. “Everything okay?”

  Jenna squinted as the brightness hit her eyes. Tom walked behind her and massaged her neck. For a moment, Jenna closed her eyes, enjoying the warmth of Tom’s powerful hands against her bare skin.

  “Actually,” she groaned, “I didn’t sleep a wink last night. My world is upside down. Everything I’ve ever been taught to trust – the hospital, the staff – are all suspect. I just opened an email written by Keith Jones, Mr. Big Shot CEO himself. It’s addressed to all St. Augustine physicians. Rob Wilson forwarded it off late last night.”

  Tom peered over Jenna’s shoulders. “This ought to be interesting.”

  Jenna leaned closer to the screen and pushed her glasses up, “Yeah . . . interesting alright. It says the hospital is extremely remorseful regarding the unconscionable acts of their former employee. They intend to remain open and honest in their communications, and they want the physicians to know that most patients are not at risk.”

  Tom listened intently. “So far, it sounds like either they are the most honest, compassionate, for-profit corporation known to man, or the cover up has begun.”

  “I’d vote for the latter,” Jenna replied grimly.

&n
bsp; Jenna’s back stiffened as she continued reading the email.

  “Oh my God! You’re not going to believe this!” Jenna cupped her hand over her mouth. “Any patients who acquire hepatitis C as a result of Hillary Martin’s actions will be provided free medical care for life, including liver transplantation, if necessary.”

  Tom stood in silence for a few minutes while he digested what Jenna had said.

  “What’s your take on this memo?” he asked.

  Jenna swiveled the office chair around to face her husband and slowly shook her head.

  “I really don’t know. It feels . . . big . . . huge. It looks like the hospital has already lawyered up. I get the sense that they are trying to walk that fine line between appearing like they care yet, at the same time, aggressively covering their ass.”

  Tom nodded. “Yeah, I agree. This is something that could ultimately take St. Augustine down for good. It remains to be seen how many patients are infected, but it’s pretty much guaranteed that each and every one of them is going to sue, and probably for big bucks. The testing of thousands of patients alone is going to cost them a fortune, not to mention providing a lifetime of medical care for every infected patient.”

  Jenna was gripped by an alarming revelation. “I hope St. Augustine doesn’t throw anesthesia under the bus as a scapegoat.”

  Tom looked pale. Stroking Jenna’s cheek, he said, “You and me both.”

  Retreating into the kitchen to make some coffee, Tom left Jenna alone with her growing apprehension.

  Jenna turned back around to face the computer and called up the website for the local news affiliate. Not surprisingly, the lead story was the hepatitis scare at St. Augustine Hospital, but there was little more information than the day before.

  Thirsty for more details, Jenna typed Hillary Martin’s name into a Google search. The first hit was a Facebook page. Unsure if it was the Hillary Martin, Jenna rapidly clicked to the link.

  The photographs on the screen reignited memories of the scrub tech with whom Jenna had worked, but barely knew. With Hillary Martin’s crimes now revealed, the images on the screen were deeply disturbing.

  Jenna sat motionless, mesmerized by the photos. Her concentration was broken by the scent of fresh coffee, as Tom entered the office holding two steaming cups.

  “Thanks,” Jenna said, gratefully accepting the additional caffeine. She blew over the surface of the mug and cautiously took a sip.

  “Don’t mention it.” Tom walked around to Jenna’s side of the desk and pulled a chair up next to her. Right away, Tom took in the images on the computer screen and asked, “Who the hell is that? Please don’t tell me that’s our next nanny.”

  Jenna was too mortified to appreciate Tom’s humor. Instead, she responded with a barely audible whisper, “No Tom, it’s not our next nanny. Say hello to Hillary Martin.”

  Tom took a closer look at the pictures. He had not yet noticed the tears spilling down Jenna’s cheeks. When Tom finally glanced at his wife, Jenna was nearly catatonic. Her mouth was agape, her eyes wide, and her pupils dilated.

  “Jenna,” Tom said as he pulled his wife into his arms. “What’s wrong, baby?”

  Whispering shallowly, Jenna confessed, “I remember working with her! There was this patient I took care of a while back that had a clit ring. During the surgery, we were all commenting on it. Hillary Martin was the scrub tech for that case. She told us she had one, too. It stands out in my mind because who would admit to such a thing? Especially to people you don’t know very well.”

  Tom looked at his wife and asked, “Do you remember anything else?”

  Jenna tried to think back, but it had been many months ago. Like a bolt of electricity, a memory struck her. Jenna stood and started pacing, shaking her head as she muttered repeatedly, “Oh no! No, no, no.”

  The world crashed in upon Jenna. The lights in the room swirled around her. A tingly, buzzing sensation enveloped her body. Her heart raced, her mouth went dry, and she gasped for air. An immovable lump in her throat made it impossible to speak. She could hear Tom’s voice, but it sounded distant and distorted. Everything she had worked for seemed to be in jeopardy. Worse, what if her patient was infected? Jenna was drowning in guilt, grief, and fear.

  Tom shook Jenna by the shoulders and forced her to focus on him. “What? Jenna, what’s wrong?”

  Jenna’s heart sank. “I remember she disappeared before the start of the case. I went to see the patient, and when I came back, she was gone. They had to track her down. Tom, what if she stole my drugs?”

  Tom did not answer. He did not have the heart to tell Jenna what he was thinking.

  CHAPTER 9

  Later that morning, Jenna fought to clear her head as she prepared for her first case. However, as she drew up drugs for her patient, she was reminded of the devastation that Hillary Martin had left in her wake. For the past week, Jenna had been struggling to adapt to new hospital rules. Anesthesiologists were no longer allowed to draw up controlled substances until the patient physically entered the operating room. Serving as a constant reminder, a copy of the policy was taped prominently to the front of every Accudose machine. At first, before the story broke, Jenna thought the new policy was the result of some government regulation. Only now did she understand its significance.

  Jenna glanced at the memo, and it struck her that it was dated June 7, 2010. This was a week before she, or any of her colleagues, had any knowledge of Hillary Martin’s crimes. Coincidentally, it was also two days after Hillary Martin turned herself in to the authorities.

  The timing of the policy left Jenna feeling deceived. Her new reality consisted of a world where the operating room was no longer considered safe, and the staff could not be trusted. More troubling, it was not only the staff that Jenna could no longer count on. She strongly suspected that the hospital administration, including Rob Wilson, was controlling, withholding, and possibly covering up information.

  The nurse wheeled in Jenna’s first patient. Immediately, Jenna turned her back and logged into the Accudose machine. She resented being forced to neglect her patient while she drew up drugs. It placed her in the uncomfortable position of having to rely too heavily on the nurses. Too many things could go wrong, and Jenna was powerless to defend against it.

  With her drugs ready, Jenna was now able to focus. Everything the nurses did needed to be rechecked. EKG leads were in the wrong location, the oxygen saturation probe was on the wrong hand, and not one of the nurses had bothered to provide supplemental oxygen to the patient. Jenna silently went about the business of correcting their mistakes, trying to mask her frustration.

  Dr. Jon Miner, the surgeon, entered the room as Jenna was in the process of intubating.

  “Hey, Jenna,” Jon said as he watched her carefully tape the endotracheal tube in place.

  Jon and Jenna had a friendly relationship, but as Jenna glanced up, she noticed that the usual warmth in Jon’s brown eyes was missing.

  Jenna forced herself to paste on a convincing smile. “Hey, Jon. I see you must have survived the madness of the lobby. Congratulations.”

  The two doctors waited for the nurse to prep the patient for surgery. With the nurse preoccupied with her task, Jon moved in close to Jenna and said discreetly, “It’s crazy around here.”

  Jenna crinkled her forehead and frowned as she replied softly, “Yeah. It’s getting scarier by the minute. Personally, I worry about how we anesthesia doctors will be impacted.”

  Not one to mince words, Jon told Jenna, “Honestly, I think you guys could be in a lot of trouble. Aren’t you supposed to be responsible for your drugs? If that scrub tech was able to somehow steal narcotics because anesthesiologists weren’t securing them, I think that opens you guys up to lawsuits.”

  Jon’s words intensified Jenna’s premonition that she might end up with an infected patient.

  Jenna was defensive. “I guess it might all depend on how you did or didn’t secure your drugs. I mean, if you left them sitting
on the top of your cart in plain view, in an unoccupied room where anyone walking in could easily see them and take them, that would be one thing. But if you hid them somewhere, or took other measures to keep them out of sight, that seems to me to be a different story.”

  “Well, I’m not trying to scare you, but I had an interesting conversation with one of my neighbors last night, who just happens to be the father of Lyle Silverstein.” Jon’s words sounded foreboding, but the name meant nothing to Jenna.

  “Who is Lyle Silverstein?”

  “I can’t believe you don’t know,” Jon said, somewhat condescendingly. “Obviously, you haven’t faced a lawsuit yet in this town. Lyle Silverstein is one of the most aggressive, nasty, ruthless, and vindictive malpractice attorneys in the state. He also happens to be one of the most successful. So anyway, I ran into his father while grabbing my mail last night, and, naturally, this topic came up. His dad actually said with pride that Lyle is already representing several infected patients, and he expects to get more. According to Silverstein senior, Lyle is calling this his ‘retirement package,’ and he is gearing up for huge settlements. What probably matters most to you is that Lyle plans to go after both the hospital and the anesthesiologists. Like I said, if you end up with an infected patient, you could be in some serious trouble.”

  Jon sensed the nurse was eavesdropping. He shifted closer to Jenna and lowered his voice. “Jenna, do you think you could be at risk?”

  Jenna’s fear escalated. A headache started to sweep over her, along with a wave of nausea. She answered Jon in a secretive whisper, “I don’t know. I mean, I never left my drugs just sitting out. Anyway, I just don’t see how they could pin this on the anesthesiologist. The operating room is supposed to be a secure environment. It’s not our fault the hospital hired a criminal.”

  “Well Jenna, the anesthesia doctors may not have been the ones that pulled the trigger on the proverbial gun, but at least some of you left the gun loaded, cocked, and sitting out. Without the gun sitting there, none of this would be happening.”