Godplayer (15 page)

Thomas bent over. “What did you say, Mr. Campbell?”

“I have to urinate,” said Mr. Campbell softly.

“You have a catheter in your bladder,” said Thomas.

“I still have to urinate,” said Mr. Campbell.

Thomas gave up. He’d let the nursing staff argue with Mr. Campbell.

As he turned to leave, he glanced at the sorry case in the bed next to Mr. Campbell. It was one of Ballantine’s disasters. The patient had embolized air to the brain during the operation and now was no more than a living vegetable totally dependent on a breathing machine, but with the quality of the nursing care at the Memorial, he could be expected to live indefinitely.

Thomas felt an arm on his shoulder. He turned and was surprised to find George Sherman.

“Thomas,” began George. “I think it is healthy that we have disagreements if only because it might force us to examine our own positions. But it upsets me to think there has to be animosity.”

“I was embarrassed at my own behavior,” said Thomas. That was as close as he could come to an apology.

“I got a bit hot under the collar myself,” admitted George. He let his eyes leave Thomas’s face, noticing which bed Thomas had stopped at. “Poor Mr. Harwick. Talk about a shortage of beds. Here’s another one we could use.”

Thomas smiled in spite of himself.

“Trouble is,” added George, “Mr. Harwick is going to be here for a long time unless .

“Unless what?” asked Thomas.

“Unless we pull the plug, as they say,” George smiled.

Thomas tried to leave, but George gently restrained him. Thomas wondered why the man felt obligated to touch him all the time.

“Tell me,” asked George. “Would you have the courage to pull the plug?”

“Not unless I talked with Rodney Stoddard first,” said Thomas sarcastically. “What about you, George? You seem willing to do most anything to get more beds.”

George laughed and withdrew his arm. “We all have our secrets, don’t we? I never expected you to say that you’d talk to Rodney. That’s a good one.” George gave Thomas another of his little taps and walked away, waving good-bye to the ICU nurses.

Thomas watched him, then glanced back at the patient, thinking over George’s comments. From time to time a brain-dead patient was taken off his life support system, but neither doctors nor nurses acknowledged the fact.

“Dr. Kingsley?”

Thomas turned to face one of the ICU clerks.

“Your service is on the line.”

Giving Ballantine’s patient one last glance, Thomas walked over to the central desk wondering how he could get Ballantine to refer his difficult cases. Thomas was confident these “unanticipated” and “unavoidable” tragedies would not happen if he did the surgery.

Thomas answered the phone with undisguised irritation. Invariably when the answering service looked for him it meant bad news. This time, however, the operator just said that he should call his mother as soon as he could.

Perplexed, Thomas made the call. His mother never called him during the day unless it was something important.

“Sorry to bother you, dear,” said Patricia.

“What is it?” asked Thomas.

“It’s about your wife.”

There was a pause. Thomas could feel his patience evaporating.

“Mother, I happen to be rather busy.”

“Your wife paid me a visit this morning.”

For a fleeting moment Thomas thought that Cassi might have mentioned his impotence. Then he realized that was absurd. But his mother’s next statement was even more alarming.

“She was suggesting you were some kind of addict. Dexedrine, I think she said.”

Thomas was so angry he could barely speak.

“Wha-what else did she say?” he finally stammered.

“I think that’s rather enough, don’t you? She said you were abusing drugs. I warned you about this girl, but you wouldn’t listen to me. Oh, no. You knew better ...”

“I’ll have to talk to you tonight,” said Thomas, disconnecting the line with his index finger.

Still gripping the receiver, Thomas struggled to control his rage. Of course he took a pill now and then. Everybody did. How dared Cassi betray him by making a big deal of the fact to his mother? Abusing drugs! My God, an occasional pill didn’t mean he was an addict.

Impulsively Thomas dialed Doris at home. She answered on the third ring out of breath.

“How about a little company?” asked Thomas.

“When?” asked Doris enthusiastically.

“In a few minutes. I’m at the hospital.”

“I’d love it,” said Doris. “I’m glad you caught me. I was just on my way upstairs.”

Thomas hung up. He felt a twinge of fear. What if the same thing happened with Doris as happened last night with Cassi? Knowing it was better not to think about it, Thomas hurried through the rest of his rounds.

Doris lived only a couple of blocks from the hospital on Bay State Road. As Thomas walked to her apartment, he could not stop thinking about what Cassi had done. Why would she want to provoke him like that? It didn’t make sense. Did she really think he wouldn’t find out? Maybe she was trying to get back at him in some illogical way. Thomas sighed. Being married to Cassi had not been the dream he’d envisioned. He’d thought she was going to be such an asset. So many people had swooned over her that he’d been convinced she was something special. Even George had been crazy for her, wanting to marry her after a handful of dates.

Doris’s voice mixed with static greeted him over the intercom when he pushed her bell. He started up the stairs and heard her door open.

“What a nice surprise,” she called as he rounded the first landing. She was dressed in a skimpy jogging outfit of shorts and a T-shirt that barely covered her navel. Her hair was loose and seemed incredibly thick and shiny.

As she led him inside and closed the door, Thomas glanced around the apartment. He hadn’t been there for months, but not much had changed. The living room was tiny, with a single couch facing a small fireplace. At the end of the room was a bay window that overlooked the street. On the coffee table were a decanter and two glasses. Doris walked up to Thomas and leaned against him. “Did you want to dictate a little?” she teased, running her hands down his back. Thomas’s fears about his potency quickly vanished.

“It’s not too early for a little fun, is it?” asked Doris, pressing herself against Thomas and sensing his arousal.

“God, no,” said Thomas, pulling her down onto the couch and yanking off her clothes in an ecstasy of excitement and relief at his own response. As he plunged into her he comforted himself that the problem that he’d experienced the night before was Cassi’s, not his. It never occurred to him that he had yet to take a Percodan that day.

The nurses in the surgical intensive care unit knew that problems, particularly serious problems, had an uncanny way of propagating themselves. The night had begun badly with the eleven-thirty arrest of an eleven-year-old girl who’d been operated on that day for a ruptured spleen. Luckily things had worked out well, and the child’s heart had begun beating again almost immediately. The nurses had been amazed at the number of doctors who had responded to the code. For a time there had been so many doctors that they’d been falling over each other.

“I wonder why there are so many attendings in the house?” asked Andrea Bryant, the night supervisor. “It’s the first time I’ve seen Dr. Sherman here on a Saturday night since he was a resident.”

“Must be a lot of emergency cases in the OR,” said the other RN, Trudy Bodanowitz.

“That can’t be it,” said Andrea. “I spoke to the night supervisor there and she said that there were only two: an emergency cardiac case and a fractured hip.”

“Beats me,” said Trudy, looking at her watch. It was just after midnight.

“Do you want to take first break tonight?”

The girls were sitting at the central desk finishing the paperwork engendered by the arrest. Neither was assigned to specific patients but rather manned the central station and performed the necessary administrative functions.

“I’m not sure either of us is going to get a break,” said Andrea, looking around the large U-shaped desk. “This place is a mess. There’s nothing like having an arrest right after shift change to spoil routine.” The nurses’ station in the ICU rivaled the flight deck of a Boeing 747 for complicated electronic equipment. Facing the women were banks of TV screens giving constant readouts on all the patients in the unit. Most were set within certain limits so that alarms would go off if the values strayed too far from normal. While the women were speaking, one of the EKG tracings was changing. As crucial minutes passed, the previously regular tracing began to look more and more erratic. Finally, the alarm went off.

“Oh shit,” said Trudy as she looked up at the beeping oscilloscope screen. She stood up and gave the unit a slap with her hand, hoping that an electrical malfunction was the cause of the alarm. She saw the abnormal EKG pattern and switched to another lead, still hoping the problem was mechanical.

“Who is it?” asked Andrea, checking for any evidence of frantic activities on the part of the nursing staff.

“Harwick,” said Trudy.

Andrea’s gaze quickly switched over to the bed of Dr. Ballantine’s OR disaster. There was no nurse in attendance, which was not unusual. Mr. Harwick had been exceptionally stable over the last weeks.

“Call the surgical resident,” said Trudy. Mr. Harwick’s EKG was deteriorating even as Trudy watched. “Look at this, he’s going to arrest.”

She pointed to the screen where Mr. Harwick’s EKG was showing typical changes before it either stopped or degenerated to ventricular fibrillation.

“Should I call a code?” asked Andrea.

The two women looked at each other.

“Dr. Ballantine specifically said ‘no code,’” said Trudy.

“I know,” said Andrea.

“It always gives me an awful feeling,” said Trudy, looking back at the EKG.

“I wish they wouldn’t put us in this position. It’s not fair.”

While Trudy watched, the EKG line flattened out with just an occasional blip. Mr. Harwick had died.

“Call the resident,” said Trudy angrily. She walked around the end of the ICU desk and approached Mr. Harwick’s bed. The respirator was still inflating and deflating his lungs, giving him the appearance of life. “Certainly doesn’t make you excited about having surgery,” said Andrea, hanging up the phone.

“I wonder what went wrong. He was so stable,” said Trudy.

Trudy reached out and flipped off the respirator. The hissing sound stopped. Mr. Harwick’s chest fell and was still.

Andrea reached over and turned off the IV. “It’s probably just as well. Now the family can adjust and then go on with their lives.”

CHAPTER 5

TWO WEEKS HAD PASSED since Thomas learned of Cassi’s visit to his mother. While they had only fought briefly, the tension had been unbearable. Even Thomas had noted his increased dependency on Percodan, but he had to take something to allay his anxiety.

As he ran down the hall late for the monthly death conference, he felt his pulse race.

The meeting had already begun, and the chief surgical resident was presenting the first case, a trauma victim who had expired shortly after admission to the ER. The resident and intern had failed to notice warning signs that the sac covering the heart had been damaged and was filling with blood. Since no attending had been involved, the doctors happily raked the house staff over the coals.

If the case had belonged to one of the private staff men, the discussion would have progressed very differently. The same points would have been made, but the physician would have been reassured that the diagnosis of hemopericardium was difficult and he’d done the best he could.

Thomas had realized early in the game that the monthly death conference served more to relieve guilt than to punish, unless the offender was a resident. Lay people might have thought the death conference served as a kind of watchdog, but unfortunately such was not the case, as Thomas cynically observed. And the next case proved his point.

Dr. Ballantine was mounting the podium to present Herbert Harwick. When he finished, an obese pathology resident quickly, ran down the results of the autopsy, including slides of the individual’s brain, of which little remained.

Mr. Harwick’s death was then discussed but with no mention that his trauma in the OR was the possible result of Dr. Ballantine’s inept surgery. The general feeling among the attendings was, “There but for the grace of God go I,” which was true to an extent. What made Thomas sick was that no one remembered that six months previously Ballantine had presented a similar case. Air embolism was a feared complication that at times occurred no matter what one did, but the fact that it occurred so often and at an increasing frequency to Ballantine was always ignored.

Equally amazing, as far as Thomas was concerned, was that nothing was said about Harwick’s actual death in the ICU. As far as Thomas knew, the patient had been stable for an extended period of time before the sudden arrest. Thomas looked at the members of the audience and puzzled why they remained silent. It reconfirmed for him that bureaucracy and its committee method of dealing with problems was no way to run an organization.