Angels on the Night Shift (25 page)

With a broad smile on his face he turned to Susan and said, “We need a doggie-gram in ENT, stat!”

12:45 p.m.
It turned out that Princess had indeed ingested Grand Ma-ma’s diamond ring, and I informed Elva and Barney that they would have to wait a day or two to retrieve it. Elva seemed happy with that plan, but Princess seemed a little disconcerted when she heard talk of Milk of Magnesia and castor oil. I would leave that part up to them.

I was standing at the nurses’ station when Virginia Granger appeared in the doorway of her office, motioning for me to join her there. I had just finished treating a child in room 3 with an ear infection and was tossing his chart in the discharge basket.

“I’ll be in Ms. Granger’s office,” I told Susan. “If you need me, just holler.” I walked around the nurses’ station and passed the door of the medicine room just as Lori was coming out.

“Lori,” Virginia called to her, still standing in the doorway. “I need you in here for a few minutes.”

The two of us walked into her office, and I closed the door behind us. Virginia was already sitting behind her desk, and without a word she pointed to the two chairs in front of her. We obediently followed her silent instructions and took our seats.

“Now
that
was a lot of fun,” Virginia said, shuffling some papers on her desk. “Three hours in a management meeting. It’s like having your fingernails pulled out one at a time.” She sighed and added, “I guess it’s important, but we could have handled the significant stuff in about fifteen minutes. Oh well.” She pushed the papers to the side of her desk and looked up at us.

“So, Dr. Lesslie, I assume Lori has told you about what she discovered this morning in the medicine room.”

“She did, and I—”

She raised her hand, interrupting me. I knew better than to continue, and I waited, knowing she had a plan, and knowing she would unfold it when she was ready. Lori and I looked at each other and then back at Virginia.

She reached across her desk and pulled her telephone over in front of her. Then she dialed some numbers, pushed the speakerphone function button, and hung up the receiver.

We sat there, all of us silently looking at each other, while the phone began to ring. Virginia adjusted her glasses, then peered at me over the top of their heavy black rims.
What is going on?
I wondered.

“Hello.”

It was Amy Connors. My head jerked over toward Lori, whose mouth was now hanging open. She was staring down at the phone.

“Hello,” Amy repeated.

I looked over at Virginia for some understanding. Still looking over her glasses, she raised her hand and with a ramrod-straight index finger pointed directly at me.

Out of the corner of my eye I could see Lori’s head turning toward me.

I was afraid Amy might hang up so I quickly said, “Amy, this is Dr. Lesslie.”

There was silence on the other end, and I sat there, waiting.

Finally I repeated myself. “Amy, this is Dr. Lesslie.”

“I heard you.” The voice was quiet, subdued—and my heart sank a little. “What is it, Dr. Lesslie?”

I looked over again at Virginia, seeking some kind of guidance here.
What could I tell her? How much should I share?

Virginia nodded her head, and I thought I saw a flicker of a smile at the corners of her mouth.

“Amy, I’m in Ms. Granger’s office with Lori, and the three of us are on speakerphone.”

Silence again.

“Amy?” I spoke.

“I’m here,” she answered, still quiet and restrained. “What do you want?”

I took a deep breath and began telling her about what Lori had found this morning. She didn’t say a word as I explained how more narcotics were being stolen, and that the problem was continuing.

“It’s what we’ve known all along,” I told her. “You couldn’t have had anything to do with this. And pretty soon it will be obvious to everyone else. The administration has made a big mistake and we’re going to be sure they make this right.”

“And just how are you going to do that?” she asked, with an edge of sarcasm in her voice. “I’ve been fired, remember?”

“That was a mistake,” I persisted. “We all knew that, and we’re sorry that happened.
I’m
sorry that it happened. It never should—”

“Amy, this is Virginia Granger,” the head nurse interjected, moving the phone closer to her and nodding at me. I gladly let her take over.

“This has all been a terrible mistake, and handled very poorly,” Virginia continued. “No one in this department has ever doubted your innocence, and I hope you know that. Our hands were tied once the administration made their decision. But now, with this new evidence, we’re going back to Mr. Chalmers and clearing this up. We still have to find the person responsible for this, so I’m asking you not to say anything to anybody about what we’ve talked about. You are the first person, other than the three of us, to know anything about it.”

She paused, waiting for some acknowledgment from the other end.

“Amy?” Virginia gently prodded.

“I’m here,” she answered. “And I’m not going to say anything.” Her voice was still quiet, and I sensed some suspicion in it. Or maybe it was a lingering hurt.

“This is all going to move pretty fast now,” Virginia continued. “And it should all be out in the open soon. In the meantime, though, I want you to be thinking about something.”

I looked up at our head nurse, my eyes questioning this last statement.
Where was she going with this?

Virginia met my eyes, but there was no clue there.

“Amy, we want to have you back in the ER,” she said.

There was silence again, and I added, “That goes for all of us. I want you to come back too.”

Lori leaned over the desk, close to the phone.

“Amy, this is Lori. I miss you, and I love you.”

I glanced over at Virginia and this time there was no mistaking it. She was smiling. When she saw me looking at her, smiling myself, she pretended to scowl at me and turned her head away. But there was that smile again.

Then she once more faced the telephone.

“Amy, this is a lot to be giving you, we know. But just take some time and think about it. And know that when this is all over, we want you back here in the ER.”

The three of us sat there, staring down at the telephone, waiting.

“Thanks for calling,” Amy finally said. “I’ve got to go now.”

And she hung up.

I leaned back in my chair and let out a long sigh.

Lori looked over at Virginia and asked, “Well, what do you think?”

Virginia had taken off her glasses and was cleaning them, intently studying the bifocals.

“Well, it’s about what I expected,” she began. “At least she didn’t hang up right off the bat. She could have done that, and I wouldn’t have blamed her. She’s been put through a lot, and for us to call her out of the clear blue like that—well, I think she handled it pretty well.”

“But do you think she’ll ever come back to the ER?” Lori persisted.

Virginia put her glasses back on and looked at her.

“Only time will tell. Only time will tell.”

I was about to say something, when Virginia stood up and said, “Lori, I need to speak with Dr. Lesslie for moment. Would you mind?”

She got up, and with a look of relief on her face said, “I’ve got plenty to do.” As she stepped toward the door she turned and faced her head nurse.

“Ms. Granger, thanks for letting me be here for that.” Then she turned and headed out into the department, closing the door behind her.

“We’re lucky to have her,” Virginia said. “She’s a good nurse, and a good woman.”

Then she settled back down in her chair and started drumming her fingers on the desktop.

“Now, what are we going to do?” she asked thoughtfully. I knew she wasn’t expecting an answer, so I just waited for her to collect her thoughts.

“At some point, we need to let the administration know about this,” she mused. “Probably sooner rather than later. But considering how they’ve handled this so far, I would rather it be later.”

“Did you get a chance to look at the narcotics log?” I asked her.

“No, but Lori told me Darren was the last to sign the morphine count. I know how you feel about him, but it’s time we sit him down and have a talk. I would rather resolve this without getting Stevens involved again, if we can.”

“Are you convinced it’s Darren?” I asked, thinking I knew her answer.

“Who else could it be?” she asked. There was sincere concern in her voice, and I knew she wanted there to be some alternative. But there didn’t seem to be one. Everything seemed to be pointing to Darren Adler. Maybe I had been wrong all along.

When I didn’t answer, Virginia said, “We need to bring him in this afternoon and confront him with all of this. He’s your friend, and you know he needs help. This needs to stop before something really bad happens.”

She was right, and I knew it.

“When does he work again?” I asked.

She had already taken a copy of the schedule out of the top drawer of her desk and was studying it.

“He’s working the three to eleven shift this evening. Why don’t we meet with him as soon as he gets here?”

“Okay,” I told her. “If I’m busy, just grab me.”

There were a couple of patient charts in the
To Be Seen
rack, and I picked up the first one, room 4.

Kim Carlton—26 yr old F—fever.
Good. Maybe this would be straightforward. The triage nurse had recorded her temperature as 99.9, and her blood pressure was normal. I checked her heart rate—it was high at 118. Then I noticed that this was Kim Carlton’s third visit in as many days. That was always a red flag. So much for being straightforward. Any time a patient came back to the ER, you had to check things a little deeper, pay a little more attention, and look for something serious going on. A third return visit just compounded all of that.

I glanced over the two previous charts. Both times she had come in with a complaint of fever, both times nothing had turned up, and both times she had been sent home. Liz Kennick had seen her initially, and Ted Nivens had seen her just last night. I would be surprised if they had missed something significant.

Kim Carlton was waiting for me in room 4, sitting comfortably on the stretcher. Her husband, Elliott, was sitting on a stool in the corner of the room and got up as I entered.

“Hello, Doctor,” he greeted me, shaking my hand. “I’m Elliott Carlton and this is my wife, Kim.”

“I’m Dr. Lesslie,” I introduced myself. “Kim, tell me about this fever you’ve been having.” I leaned back against the counter, while Elliott sat back down on his stool.

“When did it start, and what other symptoms are you having?”

Kim proceeded to tell me her story. She had been doing well up until three weeks ago. She started having some mild headaches and a low-grade fever, and occasional knee and shoulder pains, but nothing else. No cough or vomiting, and no weight loss.

“I’ve lost my energy,” she told me, “and don’t seem to be able to do the things I’m used to doing. I tried to run about a week ago and almost collapsed.”

“Just so you know, Doc,” her husband interjected. “This is a woman who runs half-marathons. So something must be going on.”

I nodded my head, impressed by this piece of information, but a little surprised because of the now-frail appearance of the young woman sitting before me. Elliott was right—something must be going on.

I continued questioning her. After my examination I told the couple we would be checking on some labs and getting a chest X-ray.

“We’re going to try to get to the bottom of this today,” I told them, determined to do just that.

“Thanks, Dr. Lesslie,” Elliott said, getting up and sitting by his wife on the stretcher.

At the nurses’ station, I studied the record in front of me and the labs that Liz and Ted had done on her first two visits. Clara Adams had room 4 today, and I asked her to get a urine specimen and draw some blood from Kim.

“They’re nice people, aren’t they?” she said, picking up some lab slips and making some notations on them.

“Yeah, they are,” I agreed, not looking up from the clipboard. “We just need to figure out what’s going on with her.

“Now this is odd,” I murmured, thumbing through the pages of the record.

“What’s odd?” Lori Davidson asked, standing on the other side of the counter.

“Just these labs on the woman in 4,” I answered. “Liz got a CBC two days ago, and her hemoglobin was 14. Last night, when Ted checked one, it was 12. That might just be lab variation, but if her hemoglobin is falling, I don’t have a clue why. We’ll see what today’s looks like.”

Clara walked back over to where I stood, carrying several vials of blood and a cup of Kim’s urine.

“Take a look at this,” she said, holding the cup where I could see it.

The urine was dark, almost muddy.

“Did you check it for blood?” I asked her.

“Not yet,” she answered. “I thought you would want to see it first.”

If that was blood in her urine, it opened up a lot of possibilities. But the fact that it was dark and murky made me wonder if she was breaking down muscle from all of her running. She might be in kidney failure and on the verge of getting into real trouble.

“Nurse!”

Elliott Carlton was standing in the opening of room 4 and calling for help.

“Nurse, can somebody help us?”

Lori immediately headed to their room and disappeared behind the curtain. I finished making some notes on Kim’s chart and then quickly followed her.

Kim was sitting on the stretcher, wrapped in a blanket and shivering. But it was more than shivering—she was shaking, and her teeth were chattering. I had never seen anything quite like it, and the contrast between this and her condition just a few minutes ago was startling.

“What’s the matter?” I heard Lori ask her.

“I….I…can’t get warm,” Kim stuttered, her head shaking uncontrollably.

Lori was reaching for another blanket, when Clara walked into the room. She stopped at the foot of the bed and stared wide-eyed at our patient.