Diagnosis Death

by Richard L Mabry

  "Your mother-in-law says they're praying for you. She's promised to bring you meals when you get home."

  Cathy smiled. "That's so typical of Dora. And it's not only because I married her son. She and Matthew are that caring about everyone."

  "I've noticed. That's why I'm sad that I need to look for an apartment. This arrangement was only supposed to be for as long as it took me to find a place of my own."

  "Think about it, Elena. How long have you been in town?"

  "A week."

  "Have you had a spare hour during those one hundred sixty-eight you've been here?"

  Elena shook her head. "Not really."

  "I know that Dora and Matthew are glad to have you living with them. Sure, go ahead and look for an apartment, even a house to rent if your budget runs to that. But don't be in a hurry."

  As Elena walked through the corridors of the hospital on her way to the ICU, she recognized the truth of what Cathy had said. Given how quickly things happened, Elena could be excused for not having found a permanent home. She'd look at apartments soon, but today she'd relax and enjoy her time with David.

  Charlie Lambert was still on the ventilator, but Elena was encouraged that he was now "overbreathing the vent"—breathing spontaneously before the ventilator fired. She squeezed his Achilles tendon between her thumb and fingers and smiled when she felt movement of the foot. Pressure with her knuckle on the patient's sternum resulted in a flinch. He was definitely responding to pain now. Another good sign.

  As usual, Mrs. Lambert was sitting at her husband's bedside, a magazine open on her lap. "What do you think, Doctor?"

  "I think he's stable, maybe a little better. We'll see what Dr. Shelmire says, though."

  "That nice young man from the ambulance came by this morning."

  Elena frowned. "Who was that?"

  "I believe his name was Eric. He drove the ambulance that brought Charlie here. He said he was checking to make sure the doctors hadn't fouled up or anything." She bit her lip. "I think he was joking. Don't you?"

  "Sure," Elena said. "But if he comes back, remember that now Charlie's under the care of the doctors here. Even though Eric's an EMT, don't let him fiddle with the IV or the respirator. Call for the nurse if that happens."

  Mrs. Lambert frowned, but apparently word from a doctor wasn't to be questioned. "Thank you for coming by. Will Dr. Sewell be here tomorrow?"

  Elena took a few moments to explain the situation. "So I'll be filling in for her for a while."

  "Tell her I'll be praying for her."

  So many people were praying for Cathy. Elena wondered why their prayers should be more effective than the ones she offered when her husband lay comatose in the ICU. How could she believe in prayer when her own didn't seem to go further than the ceiling? But obviously other people still had faith. She wished she did.

  Elena left the room and made straight for the nurse's station, where she found the nurse assigned to Mr. Lambert. "Did Eric Burson come by here this morning?"

  The nurse, an energetic young redhead, said, "Yes. Eric comes by here quite often to check on the patients he's brought to the hospital."

  "Does he ever . . ." How could she put this diplomatically? "Does he ever talk about the treatment the patients are getting? Study the charts? Have you ever seen him adjust an IV or change a respirator setting?"

  The nurse looked genuinely puzzled. "Sure. But he's an EMT. He's part of the team. Just the other day, he noticed that a patient's IV had almost run out. We were swamped, so he got a bag of D5RL and hung it himself, then charted it. He helps us any time he's here."

  "Thanks."

  The nurse returned to her charting, and Elena left the ICU wondering whether Eric Burson's motives were totally altruistic. She'd been told he carried a grudge against doctors. Would he ever take that to the extreme of setting up a medical misadventure of some sort? These patients were, by definition, critically ill. It wouldn't take much. A bit of medication slipped into an IV. A change in a respirator setting to deny the patient needed oxygen. And the logical thought would be doctor error—wrong diagnosis, improper treatment. One more complaint Eric could spread throughout the hospital.

  Far-fetched? Elena didn't think so. Because she was pretty sure she'd seen it before, in Dallas. She wasn't sure how the incidents could be connected, but she decided she'd have to be on her guard.

  What was the expression? "It's déjà vu all over again."

  When he saw Elena pull up in the motel's driveway, David wiped his palms on his chinos and took a deep breath. He'd missed her, missed her more than he ever thought he could miss anyone after Carol told him she was tired of playing second fiddle to his medical career. When she left, taking Brittany with her, a bit of David died. It had been two years since that stunning loss. But recently the hope that he could rebuild his life had started to glow like an ember in his heart.

  David climbed into the passenger seat and wondered if he should offer Elena a brotherly kiss. She solved his dilemma by shifting into "drive" and pulling away before he could buckle his seat belt. "Hey, it's so good to see you."

  "You too, David. Have you had enough coffee?"

  "There's always room for more, but I'm fine for now if you have something in mind."

  "What I have in mind is to drive around town while we talk. I need to get my bearings, and I suspect you'll find it helpful as well. Will that work for you?"

  "Sure. Do you have a city map?"

  Elena pointed to the glove compartment. "Cathy and Will gave that to me when I came here for an interview, but I haven't even unfolded it yet. Why don't you navigate? We can learn together."

  For an hour, David called out directions and comments while Elena guided them through the streets, both major and minor, of Dainger, Texas. Finally, he folded the map and stowed it again in the glove compartment. "I think that's it. There may be a few places we've missed, but I'm pretty sure I can find my way around now. How about you?"

  Elena didn't take her eyes from the road. "I think so."

  "You know, you said we'd drive and talk. To this point, I've done all the talking, and that's been confined to such significant remarks as 'Stratton Street runs into Highway 287 half a mile down that way.' Want to tell me what's bothering you?"

  "I don't know where to start. Everything's crazy."

  David gestured to a shopping center ahead on the left. "Pull in there. Let's see if we can make sense of it. You always said I understood you better than anyone except Mark."

  Elena dabbed at the corner of one eye. Was she crying? Maybe the mention of her dead husband had brought back a painful memory. David could identify with that. For months after his divorce, he'd found himself tearing up at odd times. He needed to assure Elena her reaction was normal. More important, he wanted her to know he was here for her. Not just until the wounds healed and the scars toughened. He was here for the long haul.

  Elena dabbed at her eyes, found that the tissue was sodden, and added it to the pile already building on the floorboard in front of her seat. She pulled another from the box David had retrieved from her glove compartment and blew her nose. "That's it—the totally fouled-up life of Elena Perez Gardner. What do you think?"

  "I think you've been handed some tough issues. It's always helped me to break things down so I can deal with them a little at a time. Sort of the way you eat an elephant?"

  The out-of-the-blue reference made Elena look up. "What about eating an elephant?"

  "It's an old joke. How do you eat an elephant? One bite at a time."

  Elena pulled down the sun visor and checked herself in the mirror. Her eye makeup had run, giving her the appearance of a raccoon. "Can you reach into the backseat and hand me my purse? I don't know how you can stand to look at me."

  She rummaged in her purse and began to repair the damage. "So tell me about eating this elephant."

  "Your midnight phone calls came in on your old home number and, most recently, your cell phone. Given those numbers, Will's in
vestigator should be able to track down the source. If he hasn't found anything by Tuesday midnight, maybe he can make some kind of arrangements to trace the call. I don't know how that stuff works, but he will."

  "Okay." The circles under her eyes yielded to cleansing with a Handi-Wipe and she began applying fresh makeup. "How about the suspicion that I'm some kind of mercy killer, starting with my husband?"

  "You don't remember taking Mark off the respirator, but you might have. I have an idea how we can get that answer. But you're sure you didn't terminate Pulliam's life. Is that right?"

  Could she tell David what she was afraid of? Would he understand?

  "Is that right?" David said again.

  "Have you ever heard of a fugue state?"

  "Sure. A dissociative reaction."

  "I'm afraid I had a dissociative reaction that allowed me to discontinue Mark's life support without remembering it. And what if that's how Chester Pulliam died too?"

  She watched David's face but saw no evidence of censure or disapproval. Instead, he thought for a few moments, then said, "You need to see a psychiatrist. Maybe he can regress you with hypnosis and put this to rest once and for all."

  "That's already been suggested, but I can't. I know it's crazy, but think about it. Suppose we find out that I did take Mark off the respirator while I was in a fugue state. That's understandable, a one-time thing. But what if I had a similar reaction when I saw Chester Pulliam's situation? Does that mean that every time I'm faced with a patient hanging between life and death there's a chance I'll terminate their existence? It would ruin my career." She clenched her fists. "No, I can't do it."

  "Let's talk about this later," David said. "Does that cover everything?"

  No, Elena thought. There was Mark's infidelity. But she still couldn't talk about that, not even with David. She'd mentioned it once, that evening when she'd melted into his arms and poured out her heart. Since then, she'd locked the knowledge deep inside her, where it burned like a glowing coal. Maybe if she worked hard enough, she could forget.

  She plastered a smile on her newly made-up face and said, "That's enough. Now, what would you like to do?"

  "I'm yours for as long as you want," David said. "Why don't we see if we can find you an apartment? Maybe one close to mine."

  "Where to?" David put his car in gear but kept his foot on the brake. "Have you scoped out the good places to eat? I mean, besides eating with the Kennedys. That was a great lunch, by the way."

  Elena half-turned in the seat. "So far, besides a couple of burgers, I've eaten at two restaurants, the hospital cafeteria, and in Dora Kennedy's kitchen. I agree that her food gets my vote, but that's not where we're going tonight. After all, it's Saturday night, so I've made some special arrangements." She pulled a sheet of directions from her purse. "Go down this street about a quarter mile to Elm and hang a left."

  David shrugged and let the car roll forward. Fifteen minutes later, he pulled to a stop in front of a modest two-story home on the north end of Dainger. "Are you sure this is the place? It doesn't look like a restaurant to me."

  "It's not," Elena said. "I haven't eaten the cooking here, but it comes highly recommended. Do you like jerk chicken?"

  David wasn't sure what Elena had arranged, but he decided to go with the flow. He helped her out of the car, walked her to the door, and rang the doorbell. Inside, he heard a muted version of the chimes of Big Ben. When the door opened, he saw a tall, strikingly beautiful woman with black hair and skin the color of dark chocolate. She wore a simple white dress, and looked like a million dollars.

  "You must be Dr. Gardner," she said to Elena. David thought he detected a slight island lilt to her speech. She turned to him. "And you must be her friend, Dr. Merritt. I'm Dominique Brown. Won't you come in?"

  Soon they were settled in a cozy living room. David wasn't much on décor, but he recognized that this one was done with taste.

  "Wonderful. Our guests have arrived." A tall black man appeared in the doorway. "I'm so sorry to be late. You know how phone calls for doctors seem to crop up at the most unexpected times." He extended his hand, first to Elena, then to David. "I'm Emmett Brown."

  Brown's close-cropped black hair displayed the faintest trace of gray at the temples, although his thin moustache had none. He wore slacks and a sport shirt of the type David associated with the Caribbean.

  Elena said, "Thank you for having us here this evening. David's an old friend from residency. He's going into practice with Dr. Gaines, and I thought this would be a good opportunity for him to meet you."

  Brown grinned. "David, I hope you like Jamaican food. I didn't when I first met this charming lady, but I found that it came with the package. Since I fell in love with her, I had to learn to eat things like jerk chicken. Now I love it, and I still love her."

  "You're kind to have us in your home," David said. "I'm sure the food will be fine."

  After Dominique excused herself to put the finishing touches on dinner, Elena asked, "Dr. Brown, how did you two meet?"

  "Please," Brown said. "Call me Emmett. And may I call you Elena and David?"

  "Of course," they answered in unison.

  "I'd finished medical school at Emory and was in New York to start my family practice residency at Montefiore Hospital. Dominique was working as a model in the city. We ended up at the same party, and like the song says, our eyes met 'across a crowded room.' We were married the next year."

  "So she gave up modeling in New York to move here with you?" Elena asked.

  "I wanted to practice in a town large enough to have good medical facilities, small enough to be family-friendly. Dominique says she gave up nothing and gained everything when we moved here. God hasn't blessed us with children, but we remain hopeful."

  "That's a great story," David said. "How do you like practicing here?"

  He thought he saw a hint of sadness in Brown's eyes. "There's enough variety to help me keep my clinical skills sharp. The medical facilities and opportunities for specialty consults are quite good for a city this size. Unfortunately . . ." He let the words trail off.

  Elena decided there was no reason to tiptoe around the subject. "What Dr. Brown . . . what Emmett is saying is that he's encountered a few patients who won't consider receiving care from a doctor of color." She turned to Brown. "Right?"

  "Unfortunately, that's true. And I've sensed a bit of prejudice on the part of one or two colleagues, as well. I hope that doesn't happen to you, Elena."

  David frowned. "I visited here a couple of times when I was negotiating with Dr. Gaines, and I didn't see any of that. Would you feel comfortable naming names?"

  Brown considered that for a moment. "Most of my colleagues, and that includes Doctors Sewell and Gaines, have been very accepting. I've probably encountered the most resentment from our hospital administrator, Dr. Godwin."

  Elena snorted. "Emmett, you're extremely well-trained—Emory for med school, residency at Montefiore—and you're getting grief from a nonpracticing doctor whose medical education was obtained in Grenada. How's that for the pot calling—? Sorry. Poor choice of words."

  Brown smiled. "That's okay, Elena. I'm not sensitive. Please don't think you have to run everything you say to me through the filter of political correctness. We're all friends and colleagues here. And I look forward to working with both of you."

  Dominique appeared in the doorway. "Dinner's ready. I hope you don't mind a bit of spice in your food. In Jamaica, we use Scotch bonnet peppers in our cooking."

  David rose. "Dominique, I'm a Texas boy. I'm sure your food isn't any hotter than what I grew up on."

  As they moved into the dining room, Emmett whispered in David's ear. "Don't be too sure of that."

  Elena sat with her eyes closed, deep in thought as David navigated the car back through the streets of town.

  "Earth to Elena."

  David's voice shook her from her reverie. "Sorry. What did you say?"

  "What was the stuff that Dominique served
? I don't know how long it'll take for my stomach lining to recover."

  Elena stifled a chuckle. "Jerk chicken. It's spicy, isn't it?"

  "Yeah, but you know, I think I could get to like it. And the other dishes?"

  Elena searched her memory. "Rice cooked with red beans and coconut milk. And fried plantain."

  She saw David glance in the rearview mirror, an action he'd performed perhaps a dozen times since they'd been in the car. "Is there something wrong?"

  "I'm trying to decide why that car has been following us since we pulled away from the Browns' home." He turned right at the next intersection. "You don't happen to have a jealous boyfriend, do you?"

  Elena turned to look over her shoulder at the headlights turning the corner and settling in behind them. "I'm not sure what I have. Whoever it is, why don't you see if you can shake them? Then we'll talk."

  15

  David rolled his car to a stop in the Kennedy driveway. "Good thing I paid attention during our get-acquainted-with-the-city tour today."

  "Me too. Between all the turns you made and the way you never touched the brake, I thought I was riding with Mario Andretti tonight," Elena unbuckled her seatbelt and stretched. "I'm glad you finally managed to shake that car. You do agree it was following us?"

  "Seemed that way to me."

  "That was some pretty awesome driving," Elena said.

  David shrugged off the compliment. "I probably watch way too many action movies. The main thing is you're home safely. Now tell me why someone would be following you."

  He closed his eyes and leaned back in the seat as Elena shared her story. When she finished, he opened his eyes and turned toward her. "Any idea who could be stalking you, or why?"

  "There are a couple of candidates, but I don't have any solid evidence. What would you suggest I do?"

  "The usual, I guess. Lock your car. Park in a well-lighted area. Don't—"

  "I mean, how do I find out who's following me?"

  "Sorry. If you need a baby delivered, I'm your man. But playing Sam Spade, that's not really my strong suit. What do the police say?"