A Mother's Trial (7 page)

14

Steve Phillips knew an accusation when he heard one. And he had heard one here. All that pussyfooting around about “someone” doing “something” with that sodium, and changing all Mindy’s routines. It was horse manure, he thought.

“Look, Pris, don’t you see what they’re saying?” he said again in the van on their way home from the hospital.

“Steve, you’re crazy.” She looked at him in disbelief. He felt himself go red.

“Pris, you idiot. You’re so goddamn naive sometimes! They’re saying you put something into Mindy.”

“But they didn’t say that. They said there was more sodium going into her than they could account for. They’re worried about the high sodium, that’s all.”

“Right, Pris. They’re not saying it up front, but that’s what they mean. They practically accused you right out! Goddamn those idiots; they’ve got their head up their behinds.”

“Steve, I don’t think they’re saying anyone gave something to Mindy. How could they be saying that? Who would do that?” said Priscilla.

“That’s just what I was trying to get at in there. If someone did it, we gotta think who it might be. Because we know it wasn’t you and we know it wasn’t me. So maybe it was someone I sent up to C.Y.A. sometime, or someone you refused benefits to. I’ve gotta get a list of Kaiser employees out of those suckers, see if maybe there’s someone on there I recognize. You know how these kids are always threatening to do me in or come after my family. Well, maybe one of them did.”

“Oh, Steve!” She spoke through her hands.

“Well, you got a better idea?” He pulled the camper off Woodbine Drive in a vicious left turn into their driveway.

“No, but I still think you’re wrong.” She was crying again. “I wonder how Mindy is doing.”

“You want me to cancel the fishing?”

“No, no. The boys are counting on it. You’d better go pick them up.” She pushed herself off the high step of the van, landing heavily, and started for the front door.

“Okay. See you later.”

She didn’t answer. He watched her sturdy duck-footed walk as she passed under the bottle brush that sheltered the walk. She usually walked everywhere fast and head high, but she suddenly looked old and worn out.

Steve backed the camper out of the drive and headed for the neighbor where he had hastily dumped the boys after Pris had called him. Then he’d stop over at Skip’s and go out for some fishing along Point San Pedro Road. He wasn’t ready to tell Skip about it because he needed to pull his thoughts together.

He had no doubt the doctors were saying that someone had put something into Mindy, and that pretty damn soon they were going to be saying it was Priscilla. He was sure they were laying the railroad tracks right to her door. So he was going to have to work and head them off because he knew damn well that Pris hadn’t given anything to Mindy. They were probably trying to hide something, he thought. But Kaiser was a pretty damn big operation to be taking on as an adversary. There was just one vague glimmer of hope, and Steve clung to it now. Maybe when Sara came back, she’d straighten it all out. Maybe it was just one giant mistake.

15

Priscilla stood in the shower for a long time. She had lurched into the bathroom in time to throw up into the toilet. But now she couldn’t stop crying. She had been crying all afternoon in her bed, immobilized.

Lifting her swollen face to the jets of water, she let it all pour down her. A river of tears, she thought. They could not do this to her. They could not. The hot orange rug reflected back at her, mocking her with its cheerfulness. The water turned cold finally, and she shut it off.

She dressed in her room, choosing at random a dark corduroy dress to go over slip, nylons, and fresh underwear. She pulled a comb through her wet hair and fluffed at it with her fingers, wondering vaguely if she should set it. In the mirror her face was a ruin, her eyes red and sunken in their puffy lids. Her eyes seemed to weigh her whole face down.

She had decided to see Carte again to find out what he meant. She could not live like this, not knowing, shut out.

She couldn’t see Mindy again till four o’clock, when they would allow her five minutes, like some prisoner in jail. So at four, she was at the door to the ICU, ringing the bell to be admitted.

She couldn’t believe what she saw. The naso-gastric tube was gone. There was no IV. Priscilla looked over at the nurse who had come on shift while Priscilla had been at home. It was ridiculous, she thought. It was Lesley McCarcy, the same nurse who had been on Pediatrics with her the night before.

“So much for the change of staff Carte mentioned,” she muttered to herself. “Where are Mindy’s NG and IV?” Priscilla asked aloud.

The nurse shrugged. “She pulled the NG out right after I got here, about an hour ago. And the IV kept infiltrating, so Dr. Carte ordered Pedialyte. She’s taking it really well. She’s been just fine since she’s been here, Mrs. Phillips,” she added reassuringly.

“I knew it! I knew she’d do something like that if I wasn’t with her. She’s been trying to pull out the tube since she got it. But I don’t understand these changes. Do you know where I can find Dr. Carte?”

“Well, you could try the pediatric ward. I believe he’s on duty up there today.”

“Yes, I know.”

Priscilla finally tracked down Dr. Carte, who agreed to meet her again in the Quiet Room.

So, for the second time in that room, and for the third time that day, Priscilla and Dr. Carte confronted one another.

“Dr. Carte, I’ve just been in to see Mindy. She has no IV and no NG. If she’s so sick, why doesn’t she need these? I don’t understand.”

“Well, she pulled out the NG and the IV kept infiltrating. There’s only one site left for a cut-down and I don’t want to use it if I don’t have to. Her diarrhea is improved so I started her on Pedialyte. That’s just an oral solution of what’s in the IV—”

“I know. What I don’t understand is if she’s so sick that she needs to be in ICU, why doesn’t she need an IV? I mean, why keep her in ICU?”

“She’s doing all right on the Pedialyte, Mrs. Phillips. So far. I’ve already explained to you why the ICU is necessary. I really don’t have anything to add.”

He did not tell Priscilla, nor did she find out until much later, that although he’d ordered only a small amount of the solution be given to Mindy, the nurse, seeing how eagerly Mindy had taken it, how thirsty she seemed to be, had let her have the whole bottle of Pedialyte. He did not tell Priscilla how dangerous that could be. If a child with a high serum sodium level is rehydrated too quickly, it can cause the brain to swell with fluid. And when that happens, there is no place for the brain to expand, encased as it is in the hard shell of the skull. So brain damage can result, as can convulsions and even death. But they had been lucky with Mindy: she had tolerated the large amount of fluid well.

It was Priscilla who now brought up the topic she really wanted to explore. What had Carte really been driving at in the earlier meeting? And this time, he confronted the issue more squarely.

Mindy’s sodium level, he said, indicated that she was receiving an external source of sodium that was causing her diarrhea, and it was the sort of thing you could get over the counter at any drugstore.

“What do you mean?” Priscilla asked.

“Something with a laxative effect, that all of us are familiar with,” he answered.

“I’m not familiar with that,” she said. “There are no laxatives in our house.”

“Well, it’s common knowledge. You can buy it anywhere.”

“I don’t know anything about that,” she said again. And Carte did not answer her and did not look at her.

“It’s obvious to me that I can sit here and tell you over and over again, till I’m blue in the face, that I don’t know what you’re talking about,” she burst out. “But you’re obviously not going to believe me.”

And again, he looked away and didn’t answer.

Later, Priscilla swore she made the next suggestion. Carte would swear it was his own.

“The Child Protective Services has to be called.”

They would both agree, however, that Priscilla then said, “I’ve worked there and I know the procedure. You shouldn’t just call the social worker on duty. Call Annie Jameson. She’s the head. I’ve got her home number in my car. I’ll get it for you.”

Startled, Carte replied, “Yes. All right.”

Afterward, Priscilla claimed that at this point in the conversation, she demanded that there be a criminal investigation. Carte was to deny that she said it. Instead—and she always denied this in her turn—his recollection was that she made a very damaging admission.

“That makes me a prime suspect,” he swore that she said.

Priscilla half ran to her car in the parking lot behind the Medical Office Building. She found and opened her briefcase, dug in it briefly till she came upon Annie’s number. Then she hurried back to Carte and handed him the number she had written down.

“Thank you,” he said. Then he turned and without another word walked away from her. She stood, rigid and alone, and watched until he turned the corner and was gone. Later, returning home—and as though in preparation for coping with what was to come—she began a journal.

16

The Emergency Room had emptied out by five-thirty that afternoon. There were no more pediatric patients to be seen in the outpatient clinic. Evelyn could go home.

 She had never spent a harder day. She hadn’t had that kind of pressure since joining Kaiser. Most of her work here—for all the pediatricians—was outpatient clinic work, just like a private pediatrician’s practice. The only difference was that with Kaiser she had the advantage of constant consultation, any time she wanted it. It made the job less lonely, the atmosphere more relaxed, and the pressures easier to bear.

The drawback, Evelyn reflected, was that when something as nerve-wracking as this situation hit you, you weren't prepared. You weren’t used to living on the emotional edge. And you weren’t twenty-five years old, either. You were Chief of Pediatrics, dealing with parents who had hair-trigger emotions, and a very sick little girl with terrible veins and a bad case of dehydration. You were dealing with a potentially serious crisis.

Estol Carte had just left her office. He had spent a worse day than she had, but he had stayed on top of it in a way that would never cease to impress Evelyn.

He had sat by her desk and told her that the control sample on Mindy’s new formula contained precisely the right amount of sodium. So it appeared that the source of the sodium overload in Mindy’s original formula was not contaminated factory stock. And then he had described his most recent meeting with Priscilla Phillips. Apparently Mrs. Phillips had denied all knowledge of laxatives or cathartic salts.

“I told her I’d have to call the Child Protective Services, and she said I should call the head of it. She went down to her car and brought me back the number!” he’d told Evelyn, shaking his head.

“What did you do?”

“I called her. Also the San Rafael police. They’re meeting me here later.”

“God, it never occurred to me to do that, Estol. We re going to have to write up a child abuse report.”

“I know.”

“I’ll do it. I’ll work on it tonight. Have you been up to see Mindy?” said Evelyn.

“Yes, she’s doing fine. I ordered oral Cho-free for her. She hasn’t had either the IV or NG in all afternoon.”

“What about serum electrolytes?”

“I’ll leave an order for them to be drawn in the morning. That’ll give her body a chance to equilibrate whatever’s still in there. But I’m sure the sodium will be down.”

“Well, I’ll check first thing when I come on the ward in the morning,” said Evelyn. “I can’t believe we’ve got another whole day of this to go through.” She felt a sudden sense of comradeship—they could be two shipwrecked survivors on a lifeboat. She hoped they wouldn’t sink in the next storm.

Estol left, and Evelyn went back upstairs to collect her things. She shrugged out of her stiffly starched white doctor’s coat and into her warm one. She gathered up a handful of copies of the child abuse forms that Kaiser supplied in quadruplicate and stuffed them into her bulging bag, then walked back through the hospital to the parking lot. The fog had returned, she thought briefly, or perhaps it had never lifted at all.

17

Later Priscilla would not be able to remember how she arrived home that Saturday afternoon. She did notice that the camper was not there, so Steve and the boys had not returned yet. This was a good thing, for she did not want to be distracted now. She had to telephone Annie Jameson and warn her that Carte was going to call.

Annie Jameson was the head of the Child Protective Services in Marin County, a branch of Health and Human Services, and Priscilla knew her quite well. They had worked together on and off for the past ten years. Annie had been Priscilla’s manager when Priscilla had returned to work on a month-to-month basis in January 1975, and she had supervised Priscilla’s work as an on-call social worker in the Child Protective Services program when it started up in the fall of that same year. Annie’s grandniece was the same age as Erik, so that gave them something to talk about, and Annie had met Steve and the boys, but Priscilla considered the short, dumpy, sixtyish woman a professional rather than a social friend.

Annie’s line was busy, but after repeated attempts, Priscilla finally got through.

“You’re not going to believe this, Annie,” she began.

“I already know. The doctor just called; I’m on my way to meet him now. It will take a while. I understand he’s already called the police—you know that’s the procedure.”

“I know, Annie. Oh, Annie—I can’t believe this is happening to me. It’s totally unreal!” She broke into tears.

“Priscilla, I’m sure it’s a misunderstanding. We’ll straighten it all out in no time, I’m sure. The policeman and I will come over after we meet the doctor at Kaiser. Now don’t be upset—”

“Oh, Annie, I’ve been crying all day! I don’t know if I can bear it!”