Deadly Errors (9 page)

Knowing no other effective way to broach the subject Tyler began with, “I’m afraid it’s not good news.” He paused for the full impact to register. “Larry’s not waking up. In fact, his condition is worse. He bled into the area I removed.”

Mrs. Childs sobbed, burying her face in both hands. Her husband reached an arm around her shoulders while his other index finger pushed up his bifocals to pinch the bridge of his nose, his head bowed.

“It’s that damned radiation, isn’t it!” Leslie Childs stood pillar straight, fists planted solidly against her narrow hips, flared elbows forming an imaginary barrier beyond which no family member dared to cross. Larry’s parents huddled behind this 5’7” alpha primate in worried silence.

Her outburst came as no surprise. Fully expecting her opening salvo he’d rehearsed a firm, but not too defensive reply. Meeting her eye to eye, he said, “Ms. Childs, I appreciate your concern for your brother, but we’d all be better served if we carry on this discussion on a less antagonistic basis.”

The mother looked up at her daughter. “He’s right, Dear.”

With acetylene torch eyes on Tyler, she forced a smile and dropped into a club chair next to her mother. Mrs. Childs reached over and grasped her hand. The priest began fingering Rosary beads.

Round two coming up, my friend, get ready, bell’s about to clang.

“Here’s what’s happened,” Tyler began. For the father’s benefit he rehashed the CT findings and the explanation given to Mrs. Childs earlier. Then, to all three family members he explained the findings at surgery, how biopsies were submitted to the pathologist, the time needed for a pathologist to make any sense of the tissue, and, finally, Larry’s failure to awaken long after the anesthesia should have worn off and finally the terminal hemorrhage.

When he finished Leslie asked, “All you’ve given us so far is a string of medical mumbo jumbo. What exactly does it mean?”

Fair enough question
, Tyler told himself. It was her sanctimonious tone and attitude that grated. Then again, her brother lay dying in the ICU. He took a moment to mentally rephrase his explanation before attempting another pass at it. “I’m afraid your brother’s brain is dead.”

“He’s dead?” Leslie asked without her prior defiance.

“Yes.”

Larry Childs Sr. hugged his wife more closely but she seemed to accept Tyler’s words as a grim anticlimax.

“But his heart is still beating, isn’t it?” Leslie asked.

Tyler slipped into words explained many times before. “True.” He paused. “But, the heart isn’t the essence of human life. The brain is. The heart is a symbol of love perhaps, but life can go on if it’s replaced. You can’t say the same for the brain. Once your brain stops working, your spiritual and personal essence stops too, leaving behind only a physical body carrying on a series of metabolic functions.” He braced for a theological rebuttal from the priest but none came.

Leslie nodded, accepting this explanation.

“I have to ask something,” Tyler continued, “that I know will be very difficult for any of you to answer, so if you wish, no answer will be sufficient for me to proceed.”

Leslie offered, “You want to turn off the respirator.”

Again, Leslie’s cooperative tone surprised him. “Yes.”

She thought about this a moment. Then, without conferring with her parents. “That’s what Larry would’ve wanted.”

“There is one more unpleasant issue I need to bring up.” Another pause. “I would think you’d want to know for certain that it was the radiation that caused his problems. I want you to allow me to order an autopsy.”

“H
E’S THE PRIEST who baptized and confirmed Larry,” Mrs. Childs whispered to Tyler as she walked into Larry’s ICU room. “I think it’s only right that he gives my son last rites.” Mr. Childs, Leslie, and the priest followed.

Tyler pulled the sliding glass door closed but didn’t approach the bedside so as to not intrude on the family’s private grief. For a long moment he heard only the heart monitor, the respirator, and sniffling. At the head of the bed, the three family members to either side, the priest pulled a long, embroidered sash from around his neck, kissed it, and began uttering words Tyler recognized as Latin.

S
ILENCE AGAIN ENCASED the room. Tyler cleared his throat softly and said, “I’ll show you where the waiting room is.”

A few minutes later when he returned to Larry a nurse was already turning down the IV drip. She glanced at him. “Time?”

Tyler nodded, wrapped his fingers around the corrugated plastic hose from the respirator, his other hand gripping the endotracheal tube. He paused to reflect once again on what he was about to do. Once disconnected, air could no longer be pumped into Larry’s lungs, causing his heart to stumble and die.
Is there a God? Is he watching? What would he do in my position?

He pulled apart the tubes and thumbed off the respirator power switch. Over the past hour he’d allowed Larry’s CO
₂
blood level to rise to a normal value, just on the off chance some brainstem functions were still there and he’d been wrong and Larry would resume breathing.

For three minutes Larry made no attempt to breath. Shortly after that Larry’s heartbeat began to slow until it finally stuttered, fought for a minute, then became silent.

T
HE MAN PICKED up the telephone on the third ring. “What!” His voice carried an alcohol slur and a hint of irritation that said he didn’t appreciate being disturbed at night.

The caller said, “We may have a problem.”

“At nine o’clock at night we may have a problem? Can’t it wait until morning? I’m busy.”

The caller wanted to tell the pompous egotistical sonofabitch to shut the fuck up and listen for once. “There’s been a complication. A patient received a radiation overdose.”

“So? That’s life, shit happens.”

“For Christ’s sake, listen up a second. This is different. We got us a doctor running around claiming hackers cracked our system.”

“Well in that case, there’s no problem. No way no how can we have a security breach. You should know that.”

The caller’s irritation rose. For a smart sonofabitch, the man wasn’t very smart. “That’s not the point. She’s got a wild hair up her ass about it, to the point she wants us to start an investigation. She says she’ll have to report this to JCAHO.”

He heard no flip reply this time, just a pause. Finally, “Who’s the doctor? We know anything about him?”

“It’s a her. I looked her up. She’s an anesthesiologist by the name of Michelle Lawrence.”

“Well? So what’s the problem? Just have to make sure nothing comes of it.”

T
YLER FLUFFED HIS pillow and settled back onto his left side, the cool cotton pillowcase refreshing against his facial stubble. He listened to rhythmic rap music thumps crescendo then fade as an unseen car passed four stories below. Even with his apartment windows closed, the vibrations easily reached his ears. Amazing. He wondered what those thundering decibels of sound energy must be doing to the delicate nerve endings in the driver’s cochlea?
Nothing good
, he decided, and imagined an entire generation of prematurely deaf—but hip—citizens. Any hearing aide stocks to invest in long-term? Assuming, of course, he ever got out of debt from the student loans his tough-love, pull-yourself-up-by-your bootstraps father forced him to accumulate. Which wasn’t completely fair, he admitted. Alimony from divorcing his first, alcoholic wife had been a killer on his financial resources.

He sucked a deep breath and tried to weigh what to do in the morning about Larry Childs’s death. Certainly report it to risk management and the clinical trial principal investigator, Nick Barber. But JCAHO was a different matter. Having been once burned, he couldn’t afford to get involved in something having any potential for severe blowback on his job. What if the root cause analysis pointed a finger at him? Would he be fired? His stomach turned sour. It reminded him of what happened in California.
Jesus, look how that turned out.

What would Dad do in this situation? More to the point, what was the right thing to do?

Another peek at the clock radio. 1:37
AM
. The alarm was set for 5:45. Four hours. Enough time to chew an Ambien into a bitter paste and rub it over his gums with the tip of his tongue to speed up absorption to a couple minutes rather than the twenty or so it’d take if swallowed.

No! He had to stop relying on sleepers. For all sorts of reasons, all of which he could recite as easily as the twelve cranial nerves. But the most important reason was the possibility of starting over with Nancy. For a PhD molecular biologist, she had a peculiarly strong prejudice against taking medication she didn’t believe was absolutely critical and life saving. She’d rather suffer through a cold than pop an antihistamine. On the other hand, she’d readily ingest any number of unscientifically proven herbs prescribed by a traditional Chinese naturopath. Got an ache? Chew a weed, but don’t take ibuprofen. A heritage that obviously migrated from Hong Kong to UCLA with her. In San Francisco she occasionally visited Chinese fortunetellers, claiming to not take their forecasts seriously. Tyler didn’t believe it for a second, suspecting she’d rescheduled her entire thesis defense because of one such prediction. Quirky, yes, but one of the little things he loved about her. Almost as much as he appreciated how she cheerfully set aside her studies when his unpredictable schedule allowed for a few unexpected hours together—only to get up an hour or so earlier than usual to make up the time.

Besides, her caution for Western medicine provided a healthy contrast to his willingness to pop medication at the first sign of a cold or an athletic-induced pain, which, now that he thought about it, had probably contributed to his present reliance on sleepers.

But he needed sleep. Besides, he could break the pill in half. That way …

Tyler focused on the clock radio again. 1:39
AM
.

Don’t do it.

But I need the sleep.

Sure you do, pal, but when will it stop? You know it has to stop. Especially now. You can’t let Nancy know you’ve developed this little problem.

It isn’t a problem.