Life Support (10 page)

"Which patients are you referring to?" asked Toby.

"I don't have the names in front of me now."

"Then you get the names. If you're going to question my judgment, I want specifics."

Corcoran sighed. "We're getting off the subject."

"No, this is the subject," said Carey. "The competence of Paul's ER staff. Do you know what was going on in the ER that night? They were having a goddamn birthday party! I went into the staff room for a cup of coffee and they had streamers hanging all over the place! A cake and a bunch of burned candles. That's probably what happened. They were so busy partying in the back room, they didn't bother to�" "That is a bunch of crap," said Toby.

"There was a party, wasn't there?" said Carey.

"Earlier in the shift, yes. But it didn't distract us from our jobs.

Once that tamponade case came in, we were up to our asses in alligators.

She required all our attention."

"And you lost her too," said Carey.

His comment felt like a slap, and heat flooded Toby's cheeks. The worst part of it was, he was right. She had lost the patient. Her shift had turned into a disaster�and a very public one. New patients had walked into the waiting room to hear an angry monologue by Harry Slotkin's son.

Then an ambulance had pulled up with a chest pain, and the police had arrived�two squad cars called in to help search for the missing patient.

The first law of physics had taken over as Toby's tightly regulated ER had devolved into a state of chaos.

She leaned forward, her hands pressed to the table, her gaze not on Carey, but on Paul. "We didn't have the backup to deal with a tamponade. That patient belonged in a trauma center. We kept her alive as long as we could. I doubt even the wonderful Dr. Carey could have saved her, either."

"You called me way too late in the game to do anything," said Carey.

"We called you as soon as we realized she had a tamponade."

"And how long did it take you to realize that?"

"Within minutes of her arrival."

"According to the ambulance record, the patient arrived at fivetwenty.

You didn't call me until five-forty-five."

"No, we called you earlier." She glanced at Maudeen and Val, who both nodded in agreement.

"It's not in the code record," said Carey.

"Who had time to take any notes? We were scrambling to save her life!"

Corcoran cut in, "Everybody, please! We're not here to get in a fistfight. We need to talk about how to handle this new crisis."

"What new crisis?" said Toby.

Everyone looked at her in surprise.

"I didn't get a chance to tell you," said Paul. "I just heard about it myself. Some newspaper's picked up the story. Something along the lines of Forgotten patient vanishes from ERA reporter called a little while ago, asking for details."

"What makes this newsworthy?"

"It's like that surgeon cutting off the wrong leg. People want to hear about things that go wrong in hospitals."

"But who told the newspapers?" She looked around the table, and just for an instant, her gaze met Carey's. He looked away.

"Maybe the Slotkin family told them," said Beckett. "Maybe they're laying the groundwork for a lawsuit. We really don't know how the newspaper got word of it."

Carey said, with a quiet note of venom, "Screwups do get noticed. "

"Yours usually manage to get buried," said Toby.

"Please," said Corcoran. "If the patient's found unharmed, then we'll be okay. But it's going on two days now, and as far as I know, there's been no sighting. We're just going to have to hope they find him alive and well."

"A reporter's already called the ER twice this morning," said Maudeen.

"No one talked to him, I hope?"

"No. In fact the nurses hung up on him."

Paul gave a rueful laugh. "Well, that's one way of handling the press.

" Corcoran said, "If they can just find the man, we might squeeze through this without any damages. Unfortunately, these Alzheimer's patients can wander for miles."

"He's not an Alzheimer's," said Toby. "The medical history wasn't consistent with that."

"But you said he was confused."

"I don't know why. I didn't find anything focal when I examined him.

All the blood work came back normal. Unfortunately, we never got the CT scan. I wish I could tell you his diagnosis, but I never finished the workup." She paused. "I did wonder, though, if he might be having seizures."

"Did you witness one?"

"I noticed his leg jerking. I couldn't tell if it was a voluntary movement or not."

"Oh, God." Paul sank back in his chair. "Let's hope he doesn't wander onto some highway, or near a body of water. He could be in trouble."

Corcoran nodded. "So could we."

After the meeting ended, Paul asked Toby to join him in the hospital cafeteria. It was three o'clock and the food line had closed down an hour ago, so they resorted to the vending machines, which were stocked with crackers and chips and a never-ending supply of coffee as strong as battery acid. The cafeteria was deserted, and they had the choice of any table in the room, but Paul crossed to the corner table, farthest from the doorway. Farthest from any listening ears.

He sat down without looking at her. "This isn't easy for me," he said.

She took one sip of coffee, then set the cup down with careful concentration. He was still focused not on her but on the tabletop.

Neutral territory. It was not like Paul to avoid her gaze. Over the years they'd seined into a comfortable, plainspoken friendship. As with all friendships between men and women, there were, of course, the small dishonesties between them. She would never admit how strongly attracted she was to him, because it served no purpose, and she liked his wife, Elizabeth, too well. But in almost every other way, she and Paul could be honest with each other. So it hurt her now, to see him staring down at the table, because it made her wonder when he had stopped being entirely truthful.

"I'm glad you were there," he said. "I wanted you to see what I'm up against."

"You mean Doug Carey?"

"It's not just Carey. Toby, I've been asked to attend the Springer board meeting next Thursday. I know this business is going to come up.

Carey has friends on that board. And he's out for blood."

"He has been for months, ever since the Freitas boy died."

"Well, this is the payback he's been waiting for. Now the Slotkin case is out in the open, and the hospital board's primed to hear all of Carey's complaints about you."

"Do you think his complaints are valid?"

"If I did, Toby, you wouldn't be on my staff. I mean that."

"The problem is," she sighed, "I'm afraid I did screw up this time. I don't see how Harry Slotkin could have escaped with his restraints tied down. Which means I must have left him untied. I just can't remember .

. ." Her eyes felt gritty from lack of sleep, and the coffee was churning in her stomach. Now I'm losing my memory, she thought. Is this the first sign of Alzheimer's disease? Is this the beginning of the end for me as well? "I keep thinking about my mother," she said. "About how I'd feel if she was lost somewhere on the streets. How angry I'd be at the people responsible. I got careless and I put a helpless old guy in danger. Harry Slotkin's family has every right to come after me with their lawyers. I'm just waiting for it to happen."

It was Paul's silence that made her look up.

He said, quietly, "I guess now's the time to tell you."

"What?"

"The family's asked for a copy of the ER record. The request came through their attorney's office this morning."

She said nothing. The churning in her stomach had turned to nausea.

"It doesn't mean they're going to sue," said Paul. "For one thing, the family hardly needs the money. And the circumstances may prove too embarrassing to air. A father wandering naked in the park� "If Harry's found dead, I'm sure they will sue." She dropped her head in her hands. "Oh, God. It's my second lawsuit in three years. " "The last suit was a crock, Toby. You beat it."

"I won't beat this one."

"Slotkin's seventy-two years old�not much of a life span left. That could lessen the monetary damages."

"Seventy-two is young He could still have years ahead of him."

"But he was obviously sick in the ER. If they find his body, if they can show he already had a terminal illness, it'll work to your advantage in court."

She rubbed her face. "That's the last place I want to end up. In court."

"Let's worry about that if and when it happens. Right now, we've got other political issues brewing. We know the news has already reached the media, and they love nightmare stories about doctors. If the hospital board starts to feel any pressure from the public, they'll be on my back to take action. I'll do everything I can to protect you.

But l'oby, I can be replaced, too." He paused. "Mike Esterhaus has already expressed interest in being ER chief."

"He'd be a disaster."

"He'd be a yes-man. He wouldn't fight them the way I do. Every time they try to cut another RN from our staff, I scream bloody murder.

Mike will politely bend right over."

For the first time it occurred to her, I'm taking Paul down with me.

"The one thing we have to hope for," he said, "is that they find the patient. That will defuse this crisis. No more media interest, no threat of a lawsuit. He has to be found�alive and well."

"Which gets less and less likely every hour."

They sat in silence, their coffee growing cold, their friendship strained to its weakest point. This is why doctors should never marry each other, she thought. Tonight, Paul will go home to Elizabeth, whose work has nothing to do with medicine. They'll have none of these tensions hanging between them, no shared worries about Doug Carey or lawsuits or hospital boards to ruin their supper. Elizabeth will help him escape this crisis, at least for an evening.

And whose help do I have?

N o rubber chicken tonight, observed Dr. Robbie Brace as a waitress set a plate before him. He looked down at the rack of spring lamb and new potatoes and glazed baby vegetables. Everything looked tender and so very young. As his knife sliced through the meat, he thought, The privileged prefer to dine on babies. But he did not feel particularly privileged tonight, despite the fact he sat at a candlelit table, a flute of champagne beside his plate. He glanced at his wife, Greta, sitting beside him and saw her pale forehead etched with a frown. He suspected that frown had nothing to do with the quality of her meal, her request for a vegetarian plate had been graciously filled, and the food was artistically presented. As she gazed around at the two dozen other tables in the banquet room, perhaps she was taking note of what her husband had already observed, They'd been seated at the table farthest from the dais. Banished to a corner where they'd be scarcely noticed.

Half the chairs at their table were vacant, and the other three chairs were occupied by nursing home administrators and an extremely deaf Brant Hill investor. Theirs was the Siberia of tables.

Scanning the room, he saw that all the other physicians were seated in better locations. Dr. Chris Olshank�who'd been hired the same week Robbie was�rated a table far closer to the dais. Maybe it means nothing.

Maybe it's just a screwup in the seating arrangements. But he could not help noting the essential difference between Chris Olshank and himself.

Olshank was white.

Man, you're just screwing around with your own head.

He took a swallow of champagne, drinking it down in a resentful gulp, the whole time intensely aware that he was the only black male guest at the banquet. There were two black women at another table, but he was the only black man. It was something he never failed to take stock of, something that was always in the forefront of his consciousness whenever he walked into a room full of people. How many were white, how many Asian, how many black? Too many, one way or the other, made him uneasy, as though it violated some privately acceptable racial quota. Even now, as a doctor, he couldn't get away from that painful awareness of his own skin color. The M.D. after his name had changed nothing.

Greta reached for him, her hand small and pale against his blackness.

"You're not eating."

"Sure I am." He looked at her plate of vegetables. "How's the rabbit food?"

"Very good, as a matter of fact. Have a taste." She slipped a forkful of garlicky potatoes into his mouth. "Nice, isn't it? And better for your arteries than that poor lamb is."

"Once a carnivore�"

"Yes, always a carnivore. But I keep hoping you'll see the light."

At last he smiled, reflecting on the beauty of his own wife. Greta had more than just eye-of-the-beholder beauty, one saw fire and intelligence in her face. Though she seemed oblivious to her effect on the opposite sex, Brace was painfully aware of how other men looked at her. Aware, too, of how they looked at him, a black man married to a redhead. Envy, resentment, puzzlement�he saw it in men's eyes as they glanced between husband and wife, between black and white.

A tap on the microphone drew their attention. Brace looked up and saw that Kenneth Foley, the CEO of Brant Hill, was standing behind the podium.

The lights dimmed and a slide appeared on the projector screen over Foley's head. It was the Brant Hill logo, a curly baroque B intertwined with an H, and beneath it the words, WHERE LIVING WELL IS THE BEST REWARD.

"That is a disgusting slogan," whispered Greta. "Why don't they just say, Where the rich folk live?"

Brace gave her knee a squeeze of warning. He agreed with her, of course, but one didn't spout off Socialist opinions in the presence of the mink and diamonds set.

At the podium, Foley began his presentation. "Six years ago, Brant Hill was only a concept. Not a unique concept, of course, across the country, as Americans grow older, retirement communities are springing up in every state. What makes Brant Hill unique isn't the concept. It's the execution. It's the degree to which we carry out the dream."