Sacred Trust (30 page)

“No one around here could afford it. I love these out-of-staters. I'm going home. Lock up, will you?”

“Zimmerman, no booze tonight. You've got to be fresh in the morning.”

Theo ignored him and walked out the door.

A
t five-thirty Thursday morning Lukas walked out of his call room, still groggy from too little sleep, but glad of the three uninterrupted hours he'd received. Claudia met him at the desk.

“Sorry to wake you, Dr. Bower. The patient I just called about hasn't come in yet. He has a laceration from an accident at the shoe factory.”

Lukas nodded. Graveyard special.

“Just to keep things interesting, though,” Claudia continued, “we have a sixty-four-year-old Caucasian female on her way here by BLS ambulance complaining of chest pain and shortness of breath.”

“BLS? For chest?” That surprised him. A BLS unit—Basic Life Support—could not administer nitroglycerin, could not start an IV and didn't even have a cardiac monitor on board.

“Yes, the ALS unit went on a transfer trip to Springfield. I have a room ready for each patient, and both are stable. They should be here in a few minutes. I have some good news for you.”

“I could use some.”

“Looks like we're going to be working together a lot more. Beverly traded some days for my nights, and they just happen to be on your shifts. I'm looking forward to it.”

Lukas felt his shoulders slump. Beverly didn't like working nights. There went another nurse who didn't want to pull a shift with him. Either he was getting more difficult to work with, or Jarvis was causing more trouble.

“Do you want me to call a nurse down from the floor to help out down here?” Claudia asked.

“Let me see the patients first, since they're both stable.”

Claudia grinned. “You just don't want to risk dealing with Rachel Simmons again on this shift.”

He nodded. “I don't want to risk losing you to the police on assault and battery charges.”

“You're right. All you'd have to do is request her termination. I'd have to kill her.” Claudia turned toward the desk, then turned back. “I checked on Tedi Zimmerman just a few moments ago. She's sleeping peacefully, and so is her mother.”

Lukas nodded. “Thanks.”

Claudia held out a container of breath mints. “Want one?”

He took the hint. “Should I comb my hair, too, Mother?”

“Wouldn't hurt.”

About three minutes later Lukas and Claudia heard a woman's voice before the emergency medical technicians wheeled her through the E.R. door. “Watch those turns! I don't want to go flying off this thing.”

“You're perfectly safe, Mrs. Baker,” the female tech assured her. “Just relax.”

“Are you sure this oxygen tank is working? I'm not breathing any better.”

“Yes, Mrs. Baker, I've check it three times.”

Lukas recognized Mrs. Dondi Baker as they wheeled her past the desk and into exam room five, where he directed them. She had been a chronic complainer the last time she was in. Lukas had seen her chart in the stack on Estelle Pinkley's desk as one of the patient complaints. She'd been furious when Lukas gave her an inexpensive script for antibiotics and told her all she had was bronchitis after a chest X-ray and blood test ruled out pneumonia. She'd come in by ambulance that time, too.

“Did you get my overnight case from the ambu—” Mrs. Baker recognized Lukas in midsentence. “You again!”

“Hello, Mrs. Baker.”

She tapped the male tech on the arm. “Excuse me, but I distinctly remember telling you to call Dr. George. He's my family doctor, and he's the one I want to see.”

“I'm sorry, Mrs. Baker, but as we explained to you before we brought you in, Dr. George is not on duty here in the emergency room. Dr. Bower is, and he'll take good care of you.”

“You didn't tell me Dr. Bower was on duty, or I would have waited to see Dr. George. I have an appointment to see him later this morning, but I just started feeling so bad…” She patted her chest.

Lukas braced himself and preceded Claudia into the exam room to help with the patient transfer. “What seems to be the problem this morning, Mrs. Baker?”

The gray-haired woman glared at him mutinously while they moved her from the cot to the bed. “I want to see Dr. George.”

“How about we check you out and get you feeling better. Then I'll call and let him know you're here,” Lukas suggested.

“He'll come for me.”

Claudia put a blood pressure cuff on her arm. “Now, Mrs. Baker, do you really want to drag poor, hardworking Dr. George out of bed at five-thirty in the morning unless this is something serious this time?”

“I don't want all those tests again. Dr. George says they were completely unnecessary, and you know my insurance doesn't cover all this expensive stuff. I'm not a rich woman, and these bills are more than I can pay.”

“Why did you call the ambulance if you're worried about expense?” Claudia asked. “That costs more than an entire E.R. workup.”

Mrs. Baker patted her chest. “I couldn't breathe, and my daughter called for me.”

“Where is she now?”

“With her children. She can't get a sitter this early.”

Lukas stepped out while Claudia attached the monitor leads to Mrs. Baker's chest. For someone with breathing trouble, she sure talked a lot. He still heard her muttering to Claudia when the next patient came through the doors with his arm wrapped in gauze from a knife wound.

Lukas took the new patient's vitals and charted them instead of calling another nurse to help out. He started the patient on a Betadine soak, then stepped back into exam room five.

He glanced at the monitor and nodded. No irregularity. The vitals didn't look too bad, with normal blood pressure and heart rate. She did have a temperature of 100.6, tympanic. “How are you feeling now, Mrs. Baker?”

She took a deep breath. “Nothing's changed.”

“Have you noticed if you've had a fever the past few days?”

“I don't think so. I haven't felt very well, but I didn't take my temperature. I'm not a hypochondriac.”

“On a scale of one to ten, how would you rate the pain in your chest?” If he could get an idea about the pain, he could do a nitro challenge and see if it helped.

“I wouldn't call it pain, exactly, just kind of a tightness with a dull ache. Can't you do something to help my breathing? That's what bothers me most. I've been coughing a lot.”

“Productive?”

“What?”

“Is it a dry, hacking cough, or—”

“No, I think I'm having a lot of drainage.”

He looked at her chart and noted that she had no history of heart problems, but with her complaints he didn't want to take any chances. “Okay, Mrs. Baker, I'd like to do a chest X-ray and EKG to rule out any heart problems. Then I want to do a blood—”

“Just hold it right there.” She paused to cough. “Didn't you hear what I said a while ago? I don't want you running any of those tests on me. Those X-rays are expensive, and some of that comes out of my pocket.”

Lukas caught himself gritting his teeth and forced himself to relax and smile. “Mrs. Baker, I need to be able to find out what's wrong with your chest. The tests I want to do are routine for this kind of problem.”

“Dr. George is right. You do run too many expensive tests.” She turned to Claudia. “Call Dr. George. He'll know what to do.”

Claudia shook her head. “Dr. George will want the same thing, Dondi.”

“Why don't we get the blood test for now,” Lukas suggested. “It won't cost too much, and it can tell us if there's
infection. We can decide on the rest after the results of that come back. Meanwhile, we'll give you a breathing treatment and see if that helps. Then we'll put you on some oxygen.”

“That's more like it,” Mrs. Baker said.

While Claudia did the orders, Lukas went back in to see the laceration patient. It wasn't as bad as it had looked at first, but the stitching required some time. Claudia helped Lukas while lab took a specimen of Mrs. Baker's blood and respiratory therapy gave her a breathing treatment and put her on oxygen. Lukas heard the woman muttering about a doctor and a nurse who abandoned their patients. Sounded like Mrs. Pinkley was about to receive another patient complaint.

Lukas left Claudia to finish with the laceration while he washed and went in to check on Mrs. Baker. He picked up the lab report on the way.

“Sorry to keep you waiting, Mrs. Baker,” he said as he walked into the exam room where the woman sat, still attached to oxygen. “We had another patient.”

She grunted and nodded, still scowling.

“We have the results of your blood test,” he continued. “You have a white count of 17,900 and 11 bands, which means you definitely have an infection. Without a chest X-ray I can't tell if it's pneumonia, and without that or an EKG, I can't tell if it might be your heart. How are you feeling now that you've had the breathing treatment?”

She nodded. “Better.”

“Do you feel as if the oxygen has helped you, as well?”

Again, she nodded, but said nothing, as if she hated to admit he might have helped her.

He took a deep breath. “Mrs. Baker, I strongly recom
mend further tests, but since you have an appointment with Dr. George later this morning, I'll get you started on some antibiotics and let you go. That is, of course, with the understanding that someone will be with you to help in case you begin to feel worse.”

“My daughter can come over, although the kids get on my nerves when I don't feel well.”

“And you'll keep your appointment with Dr. George?”

“Yes, of course,” she said irritably.

“Then we'll leave you on oxygen for a little longer, and you'll be free to go.” Lukas turned and breathed a sigh of relief. In less than an hour his shift was over. No more of this until Monday.

 

Mercy awakened to the sound of Theo's voice, and at first she thought she was in the middle of an old nightmare. She opened her eyes, glanced over beside her, and saw Tedi still sleeping in the hospital bed.

Theo stood over in front of the ICU desk, arguing with the nurse on duty. “I made it clear to Dr. Bower last night that I would be picking my daughter up first thing this morning. He made no indication that this would be a problem.”

Mercy stretched and pulled herself out of the cot. That was a barefaced lie, but she knew this nurse could handle him.

“I'm sorry, Mr. Zimmerman, but Dr. Simeon is Tedi's admitting physician, and he hasn't been in to see her yet.”

Theo glanced impatiently at his watch. “How long is he going to be? I can't wait around here all day. I've got an important meeting in less than an hour, and I already missed one meeting because of this.”

Mercy strolled toward the desk, attempting to paste a pleasant expression onto her face. “It's okay, Theo. I'll take care of her today.”

Theodore turned around, eyebrows raised in surprise. “I thought you were a busy doctor,” he said.

“I'm off this morning. They'll want you to sign the paperwork, of course, but I'll take her home, or to school, depending on how she feels.” She kept her voice light and unchallenging. She had a quality assurance meeting this morning, but Tedi was infinitely more important.

Mercy could read the confusion in Theo's face at her sudden capitulation after last night. But he was too concerned with his own interests to realize she was doing this because of last night and all the other nights her daughter may have been frightened of him—too afraid even to tell her own mother.

He glanced at his watch again. “What if the doctor doesn't release her today?”

“I'll call you and let you know.” She took pride in the evenness of her voice, even though she wanted to sock him in the mouth again, like last night. “You'll be at the office?” she asked.

“Probably not until later. I'm showing a place this morning.”

Mercy nodded. If she played him right, she might be able to keep Tedi for the rest of the day, maybe even overnight. But her eyes flicked to the small bruise by his mouth, and she knew he wouldn't forget that right away. If Theo knew how badly she wanted to keep Tedi, he'd never let her do it. Play it cool.

“Okay, Mercy. Where are those papers?” He glanced again at his watch, and Mercy suppressed a smile of satisfaction.

 

Jarvis George felt better, thanks to the Demerol he'd finally decided to take. But that wasn't why he was grinning this morning. He leaned back in his leather chair and clasped his hands behind his neck. The papers on his desk told it all.

The fax from Ivy had arrived a few moments ago—a sincere, heartfelt letter questioning Bower's ethics. Jarvis felt a momentary pang at the way he had snapped at Ivy before she left on her trip, but it got the desired results, didn't it?

Mrs. Dondi Baker had been shipped out a few moments ago with an MI—something Bower had failed to pick up on in the wee hours this morning. The idiot hadn't even done an EKG or an X-ray. That oversight alone had sealed his fate, and Ivy's letter was just icing on the cake. The quality assurance committee meeting this morning would be a breeze.