Sacred Trust (27 page)

“Sure, Rita,” Mercy said. “Sounds like you're busy. If you need help I'll come down. Just give me ten minutes.”

“Dr. Mercy, you don't understand. It's Tedi.”

Mercy went cold. “The code? I heard a code.”

“Doctor, it's Tedi.”

 

Tedi had stopped breathing. She lay unconscious on the exam table.

“Claudia, bag her.” Lukas prepped her neck with an alcohol swab, then turned and pulled on sterile gloves as the code team assembled in the room.

Rachel Simmons, the team leader, came bustling in last, scowling. “What's going on?”

Lukas ignored her. “Randy, get another IV line for us. Rachel, get me some vitals. Millie, get her on a monitor.”

Rachel hesitated, staring at the patient. “You mean you haven't even gotten her vitals yet?' She placed her stethoscope over Tedi's chest. “Who called the code? This patient is not coding.”

“She's not breathing and she's unconscious,” Claudia snapped, still bagging Tedi. “Dr. Bower told you to get vitals.” Her voice grew louder and sharper. “That was an order!”

Lukas extended Tedi's neck and identified his landmarks, palpating the throat. There. The cricothyroid membrane. He reached for the scalpel and prepared to incise.

“BP's 50 by palp,” Rachel said. “I can't get the diastolic.”

Lukas nodded, hoping no one noticed the sheen of perspiration on his upper lip, his quickened breathing. He never liked invasive procedures, but it went with the job, and he knew his strengths and limitations. He also knew who was in control.
Lord! Help! I can't do this alone.

He lowered the scalpel and placed the point of the blade against the tender flesh of Tedi's neck. He drew a fine line of red, an initial surface cut. The body jerked in reaction to the pain. She gasped. Aha! She was still unconscious, but the drug was working to reverse the anaphylactic shock.

Lukas pulled the scalpel back and checked her throat with the stethoscope.

“We have some promising air movement here,” he said with relief. “Claudia, assist her breathing.” He listened to the lungs. Good. He checked her heart. It sounded stronger and not as fast as before. The cyanosis was disappearing.
Thank You, Lord! Thank You!
“What's her BP now, Rachel?” Tedi may still need dopamine.

He turned to find Rita standing at the threshold. “Let's make sure we have a bed open in ICU,” he told the secretary. “Have you called her family yet?”

“Yes. Dr. Mercy is on her way. She should be here any minute.”

“Good. Tell that nice couple in the waiting room that she's doing better.” He turned to Rachel. “Do you have her pressure yet?”

“Yes, it's 82 over 53.”

Okay, it was slowly coming up. The child's color looked better. If she kept improving she would be okay.
For the first time he had opportunity for a more thorough assessment, and he frowned at some bruising on her shoulders. He checked it more closely. The marks were faded, slightly yellow in color, so they were fairly old. They couldn't have anything to do with her present condition. He would ask her about them later.

M
ercy raced down the hospital hallway and into the emergency room without slowing down. “Where's Tedi?” she called as she continued past Rita.

“In here, Mercy,” Lukas called from the open doorway of trauma room one. “It's okay. She's doing better.”

The code team stepped away from the bed as Mercy rushed into the room and to Tedi's side. “I heard you call a code over the phone, Lukas. What's going on?”

“Anaphylactic shock,” Lukas said. “Apparently from a bee sting. The beekeepers brought her in. She's getting air much better now.”

Mercy bent over her still-unconscious daughter. “May I use your stethoscope?”

Lukas handed it to her.

“What happened?” Mercy asked as she listened to Tedi's chest. She glimpsed the tiny line of drying blood on her daughter's throat. “You started a cric?”

“She stopped breathing. I couldn't intubate her.”

“Is that why you called the code?”

Rachel Simmons stepped up to the bed. “Funny you
should ask, Dr. Richmond. I wondered the same thing, since your daughter's heart never stopped. You're on the QA team; maybe you can explain to Dr. Bower what constitutes a code and what constitutes a violation of protocol.”

Mercy straightened slowly and stared at Rachel in amazement. This nurse had always shown a decided lack of compassion for patients on the floor, but Mercy wasn't sure, at first, that she'd heard the woman correctly.

“Am I to understand that you're complaining because my daughter wasn't actually dead when Dr. Bower called the code?” Mercy's voice froze the air around them.

“Of course not. That's not what I mean.”

For another moment Mercy didn't trust herself to speak. She continued to hold Rachel's gaze until Rachel looked away. She knew the woman had some grave personal problems and that it affected her work and her interpersonal relationships. No one wanted to work her shift. Mercy had often been irritated by her attitude, and sometimes she felt sorry for her. But this was inexcusable.

Claudia stepped up to the bed, glaring at Rachel. “Excuse me, Nurse, but weren't you the one who refused to send anyone down for us when we called upstairs for help?”

“We were busy. You're not the only department in this hospital.”

“When it comes to little girls fighting for breath, we are!” Claudia snapped.

“I don't know if Dr. George will feel the same way,” Rachel said, backing out of the room. She turned to leave.

“Come back here, Nurse,” Lukas called before she could step out the door.

Her back stiffened. She stopped, but did not turn to look at Lukas.

“As Claudia has stated,” he said, “were you not the one who refused my stat order to come to the trauma room tonight?”

She turned around and glanced at him with narrowed eyes, but didn't reply.

“In fact, I requested help twice and you refused twice,” Lukas continued. “Your insubordination endangered this child's life. I had no choice but to call a code. If you have reason to doubt my professional opinion or skills, tell it to administration, and they can take whatever actions they feel are warranted. In the meantime you are to obey my orders when I am on duty. Is that understood?”

Rachel raised an eyebrow and stared at him coldly.

“If it is not,” Lukas insisted, “I will request your immediate termination. Is that clear?”

She held his gaze for a moment longer, then looked away. “Very.”

“Thank you. I am going to write you up for this, and if it happens again, I will request your dismissal from this hospital.”

Rachel's face flushed bright red. “Dr. George may not agree to that, either.”

Mercy stepped over to stand beside Lukas. “Rachel, the cessation of breathing constitutes a respiratory code. It is a protocol not subject to interpretation. You may go back to the floor…for the time being. I haven't decided yet what I'm going to do about this, but I, too, can request your termination.”

They waited until the nurse had left the room.

“Wow.” Claudia breathed at last, looking at Lukas with awe and respect. “I didn't know you had it in you.”

Lukas grimaced. “Unfortunately, my temper surfaces
from time to time.” He turned to Mercy. “I'm impressed. You really can keep your cool when you want.”

“Really? I hadn't noticed. Thank you for your support, Dr. Bower. It's very comforting.” She bent back over her daughter, whose eyes had begun to open.

The rest of the code team left the room, except for Claudia, who took Tedi's blood pressure once more.

“I'd've fired her on the spot,” Claudia muttered as she smoothed Tedi's hair back and swiped at a smudge of dirt on the child's cheek. “She shouldn't have a license to nurse. She's rough on everyone. There's a bad morale problem on the floor because of her.”

Mercy looked in dismay at the dirt covering her daughter's body. “Claudia, would you hand me some of those moist towelettes behind you? Where has this child been, a barn lot?”

“Exactly,” Lukas said. “Don't ask me what she was doing there.”

Tedi blinked and squinted. “Mom?” Her raspy voice barely reached them.

Mercy leaned closer. “Yes, honey?”

Tedi's eyes opened wider. “You're here?”

Mercy kissed her daughter's cheek. “Yes, Tedi, I'm right here. How do you feel?”

“Mom, I was so scared.” Tears formed in Tedi's eyes and dripped down the sides of her face, forming dirty streaks that disappeared into her hairline. “I thought I was going to die. It was dark in the barn, and this big dog kept trying to get in.” Her hoarse voice cracked.

“Try not to talk right now,” Mercy soothed.

“But I have to, Mom. It was so awful. First Julie came and gave Dad some wine, then they started talking about marriage, then she told him I said you supported us, and
I had to leave because I…because I was scared. But I didn't want—”

“Tedi, honey, slow down.” Mercy cleared some of the grime from her daughter's face.

“Mom, I swelled all up, and my lips got thick, and I couldn't breathe, and at first I couldn't find my way out of the barn. I thought that dog was going to eat me when I fell out of the doorway, but he didn't, and then some people came.”

“She must mean the beekeepers,” Lukas explained. “They're in the waiting room. They were the ones who found her and brought her in.”

“Good.” Mercy tossed away a soiled towelette. “I want to talk to them and thank them personally.” She frowned and leaned closer to inspect Tedi's shoulders. Both looked as though they'd been bruised. She straightened and caught Lukas's attention, then jerked her head toward the bruises.

“Yes,” he said softly. “I noticed those just a few moments ago.”

“What do you think?” she asked.

“I don't dare make a guess.”

“Mom?”

Mercy bent back down. “Yes, honey?”

“Grandma always said to pray when I got scared, and I did. Don't you think Jesus answered my prayer?”

Mercy hesitated.

“He sure answered ours,” came a female voice from the doorway.

They turned to find the senior citizen beekeepers standing in the entrance, smiling.

“You don't look the same as when we brought you in,” the man said, holding his work-stained bill cap in his hands.

The woman's iron-gray hair matched her friendly eyes. She stepped in ahead of her husband and approached the side of the exam table. “Looks like you've been cleaning out the barn, kiddo.”

“Are you the ones who found me?” Tedi asked.

“Sampson's the one who found you,” the woman said. She reached out and touched Tedi's arm, as if to assure herself the child was really okay. “He's our dog,” she explained to Mercy. “He just wouldn't leave us alone tonight, growled and whined all during dinner.”

“He barely ate his own food.” The man stepped farther into the room. “That's when Goldy got worried.” He gestured to his wife. “She insisted we follow Sampson and see what he wanted. I told her she'd been watching too many Lassie reruns, but she insisted.” He shook his head and sighed. “I'm sure glad I listened to her.”

“Now, Carl, you know you were worried, too.” Goldy patted her husband's arm.

“I'm thankful to both of you,” Mercy said. Tears welled up in her eyes, and she forced them back. “You saved my daughter's life.” She took Goldy's hands and squeezed them gently. Her own hands trembled. “Thank you.”

“And don't forget Sampson, Mom,” Tedi said. “He didn't eat me. He saved me.”

“We were just the tools, child,” Goldy said. “The Lord was watching over you. He was taking care of you all along. We've been in the waiting room, praying, and we called some friends to pray, too. I want to go call them back and tell them our prayers have been answered.”

“Yeah, just like Grandma says.” Tedi smiled at the couple. “Thank you for saving me and for praying. Thank your friends, too.”

Goldy bent forward and kissed Tedi on the temple. “You're so welcome, honey.”

As the beekeepers left, Rita stepped into the exam room. “The bed is ready in ICU. We had to get parental consent to admit Tedi.” She glanced at Mercy. “I'm sorry, but I had to call the legal guardian. Tedi's father is on his way down to sign the forms.”

Mercy stared at Rita for a long moment. No, she wasn't a traitor. She was doing what she had to do. It was the law. Stay in control. “Of course you had to call him, Rita,” she said at last. “We have to follow the rules.”

“Dad's coming here?” Tedi asked softly.

“Yes, honey,” Mercy said.

“But can't you just stay with me?”

“Don't worry, I'm not leaving this hospital.” Mercy glanced down at her denim cut offs and stained T-shirt. Her hair hung around her shoulders in a tangled mess, and she hadn't even brought a comb. Too bad. The staff would handle it. Tonight she was a mother, not a doctor.

Lukas placed a hand on Mercy's shoulder. “Your mother's still in Colorado, isn't she?”

Mercy nodded.

“Is there someone I can call for you?”

Mercy looked down at her daughter. As Tedi's condition improved, Mercy's was deteriorating in direct proportion. She was letting down, but she couldn't let down too much. She shook her head. There was no one to call.

“Why don't I get in touch with your secretary so she can cancel your appointments tomorrow,” Lukas suggested. “You'll be tired.”

Mercy looked at Lukas and forced a smile. “I'm a part-time E.R. doc, remember? I'm used to doing without sleep. Besides, I'm off tomorrow morning.”

“Good.” Lukas leaned over Tedi to check her breathing once more.

Mercy gently touched Tedi's left shoulder. “Honey, what are these bruises?”

Tedi stiffened, and her eyes grew fractionally wider.

Lukas raised his stethoscope, then lowered it again. “Keep breathing for me, Tedi.”

Tedi obeyed as she held her mother's gaze. Mercy saw fear there, and the fear she saw shook her badly. She waited until Lukas was done. “Tedi, do you remember how you got them?”

Tedi continued to hold her gaze and shook her head. “I…I guess tonight. I fell.”

At the edge of her vision, Mercy saw Lukas shaking his head. She broke eye contact with her daughter and looked up at Lukas.

He mouthed the word
wait.

As she stood there struggling for control, Theo's voice reached them from the central desk. “I'm here to see Theadra Zimmerman. I'm her father.”

Mercy watched Tedi's expression grow even more fearful. “It's okay, honey, I'm here.”

They heard quick footsteps, and both of them looked toward the doorway.

Theo came rushing in. “Tedi!” He stopped and glanced at Mercy, then Lukas.

For some reason, Mercy couldn't help noticing that every blond hair on Theo's head was in place. He was impeccably dressed in a blue silk shirt and black Levis. It was as if he'd taken time to groom himself before coming down.

“What happened?” His voice was surprisingly subdued for Theodore Zimmerman. “They wouldn't tell me anything when they called,” he continued. “They just told
me to come to the emergency room because my daughter was here.” His eyes sought and found Tedi. “What happened?” He stepped to the other side of the exam table and laid a hand on Tedi's shoulder.

Tedi recoiled. Theo withdrew his hand. He shot Mercy a quick look of annoyance. His eyes were bloodshot.

Lukas stepped forward. “Mr. Zimmerman, I'm Dr. Bower. I'm the E.R. physician on duty. Your daughter was injured this evening. She's better now, but her condition is still serious. We want to watch her in ICU overnight, and we need your signature on the admittance forms.”