V.I. Warshawski 04 - Bitter Medicine (2 page)

She hit a buzzer next to her desk, releasing the grill covering the door, pointed at a phone, and returned to her mounds of paper.

Carol Alvarado responded with the unnatural calm crisis produces in some people. Lotty was in surgery at Beth Israel; Carol would call the obstetrics department there and find out what hospital I should take her sister to. She knew where I was-she had been there several times visiting Hector. She put me on hold.

I stood, the phone damp in my hand, my armpits wet, legs trembling, fighting back the impulse to scream with impatience. My flabby-chinned companion watched me covertly while shuffling her paper. I took diaphragm breaths to steady myself and concentrated on a mental run-through of “Un bel di.” By the time Carol returned to the line I was breathing more or less normally and could focus on what she was saying.

“There’s a hospital somewhere close to you called Friend-ship Five. Dr. Hatcher at Beth Israel said it’s supposed to have a Level Three neonatal center. Get her there. We’re sending out Malcolm Tregiere to help. I’ll try to get Mama, try to close the clinic and get out as soon as I can.”

Malcolm Tregiere was Lotty’s associate. Last year Lotty ad reluctantly agreed to resume part time the perinatal practice at Beth Israel that had made her famous. If you’re going in for obstetrics, even half time, someone has to cover for you. For the first time since opening the clinic, Lotty had taken on an associate. Malcolm Tregiere, board-certified in obstetrics, was completing a fellowship in perinatology. He shared her views on medicine and had her quick intuitive way with people.

I felt a measure of relief as I hung up and turned to flabby-chins. She was agog watching me. Yes, she knew where Friendship was-Canary and Bidwell sent all their accident cases there. Two miles up the road, a couple of turns, you couldn’t miss it.

“Can you call ahead and tell them we’re coming? Tell them it’s a young girl-diabetes-labor.”

Now that the crisis had penetrated, she was eager to help, glad to call.

I sprinted back to Consuelo, who lay on the grass under a sapling, breathing shallowly. I knelt beside her and touched her face. The skin was cold and heavy with sweat. She didn’t open her eyes, but mumbled in Spanish. I couldn’t hear what she said, except she thought she was talking to her mother.

“Yeah, I’m here, baby. You’re not alone. We’ll do this together. Come on, sweetheart, come on, hold on, hold on.‘

I felt as though I were suffocating, my breasts bending inward and pushing against my heart. “Hang on, Consuelo. Don’t die out here.”

Somehow I got her to her feet. Half carrying her, half guiding her, I staggered the hundred yards or so to the car. I was terrified she might faint. Once in the car I think she did lose consciousness, but I put all my energy into following the dispatcher’s hasty directions. On up the road we’d come by, second left, next right. The hospital, slung low to the ground like a giant starfish, lay in front of me. I slammed the car against a curb by the emergency entrance. Flabby-chins had done her part. By the time I had my door open, practiced hands had pulled Consuelo easily from the car onto a wheeled stretcher.

“She’s got diabetes,” I told an attendant. “She just finished her twenty-eighth week. That’s about all I can tell you. Her doctor in Chicago is sending out someone who knows her case.”

Steel doors hissed open on pneumatic slides; the attendants raced the gurney through. I followed slowly, watching until the long hallway swallowed the cart. If Consuelo could hold on to the tubes and pumps until Malcolm got there, it would be all right.

I kept repeating that to myself as I wandered in the direction taken by Consuelo’s gurney. I came to a nurse’s station a mile or so down the hall. Two starch-capped young white women were carrying on an intense, low-pitched conversation. Judging from a smothered burst of laughter, I didn’t think it had anything to do with patient treatment. “Excuse me. I’m V. I. Warshawski-I came in with the obstetrical emergency a few minutes ago. Who can I talk to about her?”

One of the women said she was going to check on “number 108.” The other felt her cap to make sure her identity was still intact and put on her medical smile-blank yet patronizing.

‘I’m afraid we don’t have any information about her yet. Are you her mother?“

Mother? I thought, momentarily outraged. But to these young women I probably looked old enough to be a grand-mother. “No-family friend. Her doctor will be here in about an hour. Malcolm Tregiere-he’s part of Lotty Herschel’s team-you want to let the emergency room staff know?” I wondered if Lotty, world-famous, would be known in Schaumburg. “I’ll get someone to tell them as soon as we have a nurse free.” A perfect Ipana smile flashed meaninglessly at me. “In the meantime, why don’t you go to the waiting room at the end of the hall? We prefer people off the floor until visiting hours start.”

I blinked a few times-what relevance did that have to getting information about Consuelo? But it was probably better to save my fighting energy for a real battle. I retraced my steps and found the waiting room.

The room had that sterility hospitals seem to choose for maximizing the helplessness of people waiting for bad news. Cheap vinyl chairs in bright orange stood primly against muted salmon-colored walls; a collection of old Better Homes and Gardens, Sports Illustrated, and McCall’s were strewn about on chairs and a kidney-shaped metal table. My only companion was a middle-aged, well-made-up woman who smoked endlessly. She showed no emotion, did not move except to take another cigarette from her case and light it with a gold lighter. Not being a smoker, I didn’t even have that for amusement.

I had conscientiously read every word about the controversial sixth game of the 1985 World Series when the woman I’d spoken to at the nurse’s station appeared.

“Did you say you came in with the pregnant girl?” she asked me.

My blood stopped. “She-is there some news?”

She shook her head and gave a little giggle. “We just discovered no one had filled out any forms for her. Do you want to come with me and do that?”

She took me through a long series of interlocking corridors to the admissions office at the front of the hospital. A flat-chested woman with a faded blond rinse greeted me angrily.

“You should have come here as soon as you arrived,‘’ she snapped.

I peered at the name badge that doubled the size of her left breast. “You should hand out little leaflets at the emergency entrance telling people your policies. I’m not a mind reader, Mrs. Kirkland.”

“I don’t know anything about that girl-her age, her history, who to contact in case of any problems-”

“Stop the soundtrack. I’m here. I’ve contacted her physician and her family, but in the meantime, I’ll answer any questions that I can.”

The nurse’s duties weren’t pressing enough to keep her from a promising daytime soap. She leaned against the doorframe, blatantly eavesdropping. Mrs. Kirkland gave her a triumphant glance. She played better to an audience.

“We assumed here that she was with Canary and Bidwell-we have a preferred-provider arrangement with them and Carol Esterhazy phoned in the emergency. But when I called her back to get this girl’s Social Security number, I learned she doesn’t work for the plant. She’s some Mexican girl who got sick on the premises. We do not run a charity ward here. We’re going to have to move this girl to a public hospital.”

I could feel my head vibrating with rage. “Do you know anything about Illinois public-health law? I do-and it says you cannot deny emergency treatment because you think the person can’t pay. Not only that-every hospital in this state is required by law to look after a woman giving birth. I’m an attorney and I’ll be glad to send you the exact text with your subpoena for malpractice if anything happens to Mrs. Hernandez because you denied treatment.”

They’re waiting to find out if we want to move her,“ she said, her mouth set in a thin line.

“You mean they’re not treating her?” I thought the top of my head would come off and it was all I could do to keep from seizing her and smashing her face. “You get me to the head of this place. Now.”

The level of my fury shook her. Or the threat of legal action. “No, no-they’re working on her. They are. But if they don’t have to move her they’ll put her in a more permanent bed. That’s all.”

“Well, you give them a little phone call and tell them she’ll be moved if Dr. Tregiere thinks it advisable. And not until then.”

The thin line of her lips disappeared completely. “You’re going to have to talk to Mr. Humphries.” She stood with a sharp gesture meant to be intimidating, but it only made her look like a malevolent sparrow attacking a bread crumb. She hopped down a short corridor to my right and disappeared behind a heavy door.

My nurse-guide chose this moment to leave. Whoever Mr. Humphries was, she didn’t want him to catch her lounging during working hours.

I picked up the data-entry form Mrs. Kirkland had been completing for Consuelo. Name, age, height, weight all unknown. The only items completed were sex-they’d hazarded a guess there-and source of payment, which a second guess had led them to list as “Indigent”-euphemism for the dirty four-letter word poor. Americans have never been very understanding of poverty, but since Reagan was elected it’s become a crime almost as bad as child-molesting.

I was inking out the “Unknowns” and filling in real data on Consuelo when Mrs. Kirkland returned with a man about my age. His brown hair was blown dry, each hair lined up with a precision as neat as the stripe in his seersucker suit. I realized how disheveled I looked in blue jeans and a Cubs T-shirt.

He held out a hand whose nails had been varnished a faint rose. “I’m Alan Humphries-executive director out here. Mrs. Kirkland tells me you’re having a problem.”

My hand was grimy from sweat. I rubbed some into his palm. “I’m V. I. Warshawski-a friend of the Alvarado family, as well as their attorney. Mrs. Kirkland here says you aren’t sure you can treat Mrs. Hernandez because you assumed that as a Mexican she couldn’t afford to pay a bill here.”

Humphries held up both hands and gave a little chuckle. “Whoa, there! We do have a concern, of course, about not taking too many indigent patients. But we understand our obligation under Illinois law to treat obstetrical emergencies.”

“Why did Mrs. Kirkland say you were going to move Mrs. Hernandez to a public hospital?”

“I’m sure you and she may have misunderstood each other-I hear you both got a little heated. Perfectly understandable-you’ve had a great deal of strain today.”

“Just what are you doing for Mrs. Hernandez?”

Humphries gave a boyish laugh. “I’m an administrator, not a medicine man. So I can’t tell you the details of the treatment. But if you want to talk to Dr. Burgoyne I’ll make sure he stops in the waiting room to see you when he leaves the intensive-care unit… Mrs. Kirkland said the girl’s own doctor is coming out. What’s his name?”

“Malcolm Tregiere. He’s in Dr. Charlotte Herschel’s practice. Your Dr. Burgoyne may have heard of her-I guess she’s considered quite an authority in obstetrics circles.”

“I’ll make sure he knows Dr. Tregiere’s corning. Now why don’t you and Mrs. Kirkland complete this form. We do try to keep our records in good order.”

The meaningless smile, the well-groomed hand, and he returned to his office.

Mrs. Kirkland and I complied with a certain amount of hostility on both sides.