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Authors: Sarah Bilston

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BOOK: Sleepless Nights
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“Have you ever heard of it before?” Kent pressed. Emmie shook her head; her lips formed the shape of a “no.”

“From what we’ve been able to find out,” Kent went on, more gently, “it’s a—real bad illness that makes you sick, and gives you a fever, and—ah—do you want to explain?” he asked hopefully, turning to Tom.

Tom came and sat beside Emmie. “Reye’s syndrome is a very serious disease. No one knows exactly what causes it,” he explained, “but it’s got something to do with disturbances in the chemical levels in a child’s blood. It leads to swelling of the organs—liver, kidneys, even the brain. Symptoms include fever, vomiting, drowsiness, and even seizures.”

“Emmie, was Angela ill in the weeks before she died? Did she have any of those symptoms?”

Emmie stared at us all, one after the other. She looked a little bit wild. “I—I—” She gulped. “Angela had a cold, a real bad cold, starting a few weeks before she died; then it sort of got better, the cold part I mean, although she seemed—not herself, you know? I had the doctor up here almost every day, I kept telling him she wasn’t right, he kept telling me I was being silly…was it my fault, then?
Was it my fault?”

Kent caught our eye; he had seen the thing we saw, I knew it immediately. His body had stiffened, just as mine had, just as Tom’s had, at something in Emmie’s words. “You had the
doctor
out here? Which doctor was that?”

Emmie brushed his words aside. “Dr. Reid. He’s our family doctor. Was it
my fault?”

“Emmie, listen to me,” Kent said urgently. “How often did you
have your doctor out here? What did you tell him when he came? What did he say to you about Angela?
Think.”

But Emmie had her head down on the table now, her forehead cradled in her fingers. “It was my fault, they were right, I should have explained better. I should have made him understand,” she groaned. “It’s just like they said, just like they said…”

I went and put my arms around her. “That’s not what we’re saying at all,” I told her. “Emmie, we need to know exactly what happened.” Kent got out a notepad and a leaky blue pen.

Angela, as Emmie explained slowly, painfully, had caught a cold from a neighbor’s kid, and was for a week a very miserable two-and-a-half-month-old baby. The family doctor, who lived nearby, came out to see her on several occasions and, when she seemed to be in real discomfort, “he told me to give her some aspirin, just a bit of aspirin to take the edge off the pain, and then a few other things—some kind of lotion in a bowl of water, and this plastic thing to squeeze out her nose.”

However, as the symptoms of the cold got better, Angela seemed, oddly, to get
worse.
She became, in Emmie’s memory, lethargic, lying still in her bed, staring blankly ahead, slipping in and out of sleep. Emmie eventually suggested taking her daughter to the hospital, but the doctor insisted she was overreacting.

“Dr. Reid said I should just learn to ‘enjoy’ my baby, he said I was being silly, an overanxious mom,” she told us, fingers white, knuckles blenched. “He said young moms “can’t read their kids.” He said most women are happy if their babies lie quiet, he said I didn’t appreciate what I had. Then the day before Angela died she was real sick, she threw up everything I fed her in the afternoon. I was frightened. So I called him out again; that time he said my milk must have been bad. I believed him,” she went on, turning to face us, “I believed him. That’s why I bottle-fed Paulie, you know; I was so frightened my milk poisoned Angela. Was he wrong, do you think?”

I could see Kent carefully writing this down in his book, heavily underscoring some words, his pen spluttering with the force—
“Angela vomits day before death; Reid blames milk; Reid dismisses Emmie’s concerns.”

“Emmie, who told you that Angela died of crib death?” Tom asked.

“Dr. Reid,” she replied, eyes half-closed. “Of course it was Dr. Reid. He called me a few days after the death, said he had the results of the autopsy, wanted to tell me as soon as possible so we could get on with the funeral. I was crazy the whole time, thinking of my baby in that cold place. Dr. Reid said he wanted to put an end to it all, get her decently buried. That was when he said it was crib death.”

“Are you sure about that? He definitely used the phrase ‘crib death’?”

“I wrote it down. He said there was nothing anybody could have done. Said I shouldn’t blame myself. And I asked him—I said, what about the cold and the sickness, and he said, ‘Babies don’t die of colds or an upset stomach, it was just a coincidence.’ So I learned the words ‘crib death,’ so I could say it to the folks in town. And Dr. Reid was so kind: he helped me with the funeral. Dad was crazy, Gramps locked himself in the shed, it was the doctor who helped me arrange everything. He even gave me money for a dinner in the church hall afterward.”

“Reid gives Emmie money for funeral expenses,”
Kent wrote in his looping script; and then, discreetly, “??” by the side. “Emmie,” he said, looking up briefly, “did you see the death certificate? Did you get a copy?”

Emmie shook her head. “Dr. Reid picked up the certificate and gave it to the funeral director,” she explained. “He said he wanted to save me the trip.” We sat in silence, listening to the slow sound of Kent’s pen moving across the paper.

“Did you never hear from the medical examiner’s office? Did no
body call you to explain what had happened, to offer to help you?” I asked. “That would be typical state practice.”

Emmie thought. “I—you know, maybe someone
did
call,” she said finally. “It was all such a mess, I didn’t really know what was going on, I was half out of my mind, you know? But I—I think Gramps took a phone call from someone, said she wanted to get me some counseling—counseling!” She laughed shortly. “Why would I talk to some stranger about my Angel? What could they possibly tell me? So I never called her back,” she finished fiercely. “I don’t need people poking their noses into my life, I had my family to take care of me, my neighbors, Dr. Reid…” her voice trailed off.

“You’re saying it was
his
fault.” She half-stood, her hands strangling the table.

“Yes, dear, that’s exactly what we’re saying, but for God’s sake don’t go after him with that meat tenderizer,” said Kent firmly, closing his notebook and stuffing it into his pocket. “Do you understand me, young lady? We’ll follow this up, we’ll go talk to Reid, find out what the hell he has to say for himself. But if you start threatening him, you’ll get yourself into trouble and you’ll lose Paulie for good. It’s one thing to menace an abusive ex, it’s another to go waving a gun at the local doctor. You do that and McColley will have your head for sure. You stay out of this like a good girl, and we may be able to get you compensation from Reid
and
keep Paulie safe at home. No promises, but I’m feeling better about this than I have in a while.”

He nodded at her curtly, then gestured to us to stand up. “What’re you doing these next few days?” he asked, a grin creasing his face. “Something tells me we’ve got a house call of our own to make. Boy, I’m glad we won’t have to go to Wyoming to sort this one out after all…”

47

Jeanie

I
was walking past Mrs. Forrest’s office at Quiet Lanes, cheerily swinging a bag of new knitting wool for Sue-Ellen and a magazine about airplanes for Ken, when the unmistakable sound of a sob brought me up short. I stopped for a second in the hallway, irresolute, hoping I’d imagined it—but there it came again: a deep, snuffly, miserable sob. Bright, chirpy Mrs. Forrest was crying.

I knocked gently on the office door, and walked in; Mrs. Forrest was sitting by the window, holding a letter. “Oh, Jeanie, it’s you. I mean, hiya!” she said, in a ghastly imitation of her usual cheer. Her fuchsia scarf was trailing forlornly over the back of her chair; without it she looked unexpectedly drab. A large cup of tea sat beside her on the windowsill, a filmy skin of cooled milk floating horribly on the top. “How lovely, gee, everyone’s going to be thrilled you’re here,” she went on, struggling to manage a toothy smile, but her hands remained dropped in her lap, motionless. Something was seriously wrong.

“Mrs. Forrest, is there anything I can—er—do?” I asked hesitantly, hovering awkwardly on the edge of the room, and then, in response to something in her face, I walked in, closing the door carefully behind me. “Have you had bad news?”

“Oh, my heavens, Jeanie, how did you guess?” Mrs. Forrest looked genuinely astounded.

“I—um—you’ve had a letter,” I pointed out tactfully.

She looked down at the document, then up at me again, tragically. “You are quite right, Jeanie. It seems I may not be able to keep Quiet Lanes,” she added, now dropping the pretense, the sentence ending in an open wail. “Oh, Jeanie, I don’t think I can bear it. This is my life, Jeanie. My life!”

Mrs. Forrest was not the cleverest woman I’d ever met, but the place ran with the peaceful hum of organized inevitability. And the more time I’d spent there, the more I’d come to recognize the little home manager’s affection for her patients. “Why on earth will you have to leave?” I asked her, surprised.

Mrs. Forrest adjusted her wire glasses with trembling fingers, glanced at the letter again with an expression of utter hopelessness, then permitted herself another small sob. “I’ve known for a while, Jeanie, that I’m not up to the job of care manager, not—well, not in these days. Once upon a time it was just a question of—of caring, you see. Caring for old people. But now there’s all this technology. And—
management.
” Her voice, as she uttered the dread word, dropped to a spectral whisper. “
Efficiency
—it’s all about efficiency, especially in these difficult economic times. I can’t do it, and they know I can’t—the managers of the SeniorOne group of care homes, that is, who own this place. The letter—it says I have six weeks to—to implement—something or other, but really it’s just a way for them to get rid of me. I know it!” She ended with a howl; tears began to stream down her face and plop onto her shirt. Wordlessly, I handed her a pink tissue from a pink floral box on the desk. She blew her nose, loudly.

“But Jeanie, this isn’t your problem!” The wobbly smile appeared again, a flash of brilliant white. “You go join the residents. I know Sue-Ellen and Joel and Ken are just
longing
to see you,” she added. “If I have to go—
when
I have to go away from Quiet Lanes, the one thing I’ll always be pleased about is hiring
you,”
she remarked tragically. “You have just shaken us all up in the most wunnerful way, and I—”

“Mrs. Forrest, may I read the letter?” I interrupted briskly, cutting through her tremulous praise, and when she nervously held out the paper, I plucked it from her hands, sat down on the edge of the desk, and read the epistle through carefully from beginning to end.

It was from someone called Andrew, a vice-president of the SeniorOne Elder Care Group. (A great deal of money had clearly been spent producing a spangly logo that adorned the top third of the cream-colored page.) Andrew’s first paragraph was fairly straightforward (hello, how are you, the once-yearly inspection of the cooking facilities will be at such-and-such a time). The part that clearly had the little home manager in a tizzy was a section entitled “New Mandates” in the middle of paragraph two:

We have become persuaded, after several focus groups, that collaborative enterprise is the most effective tool to promote elder care excellence in recession-era America. We are therefore enclosing a leaflet which encourages health-care providers to learn to work together through active problem solving and decision making. Our goals in response to this new initiative are three-fold:

  1. socializing health-care providers in collaborative work, in mutual experiences of shared problem solving and focused decision making, thereby enabling greater patient benefits;
  2. creating and enabling mutual understanding of, and respect for, multi-disciplinary contributions; and
  3. producing, enhancing, and developing the necessary abilities for successful and institution-changing collaborative practice.

We expect that all care home managers will implement this new strategy, and plan an inspection in three weeks to
evaluate its progress. All managers must construct a detailed twenty-page report (FAO Lina Shwartz) on their implementation strategy by next Wednesday, and a further 20 pages in advance of the inspection to indicate goal achievement success rates (numbered one, two, three).

Mrs. Forrest watched me read this nonsense with eyes like deep pools. “You see,” she said at last, miserably, when I put down the letter, one more tear spilling over, “I can’t do that. They
know
I can’t do that. Jeanie, I don’t even know—” again, that low, horrified whisper—
“what it means!”

I started to laugh—I just couldn’t help it. But it was a mistake, of course; looking deeply offended, the little care home manager drew herself up to her fullest height. “I cannot see why you think this is funny, Jeanie,” she said, sounding deeply hurt. “I may not be the best manager in the world, but I try my best, and—”

“No, no,” I interrupted, putting out my hand apologetically, “it’s not funny, I mean, it
is
, but
you
are not. Look, Mrs. Forrest, I’ve just finished a master’s degree in social work. I’ve plowed through whole textbooks full of government initiatives and strategies for geriatric excellence, and all the rest of it.
I understand this
.” I waggled the letter at her.

Mrs. Forrest looked at me as if I had just plopped down in her garden in a spaceship, fully equipped with antennae and three arms.
“You do?”

I grinned at her. “How much responsibility are you willing to give me, Mrs. Forrest?” I asked, and she gasped.

“Responsibility? Do you mean—?”

“If you want, I will” (tapping the letter) “‘construct a detailed twenty-page report on our implementation strategy.’ It’ll take me about fifteen minutes, I reckon. I’ve got some essays on my computer, I’ll just cut and paste stuff into a new document, add a few more syllables and bullet points, and you can sign the thing.”

BOOK: Sleepless Nights
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