Code Blue (15 page)

Emma Gladstone settled carefully into the patient chair. The patent leather purse she held in her lap looked big enough to accommodate supplies for a three-day trip.Cathy wondered how the elderly lady could manage carrying around that load just ten days after major surgery.

Cathy leaned across her desk. "Mrs. Gladstone, can I get you anything? Are you comfortable?"

The woman smiled serenely. "I'm fine, Doctor. I just wanted to come by and tell you how much Ernest and I appreciate everything you've done."

Cathy tried to act as though compliments came her way every day, instead of with the frequency of snow in July."Think nothing of it. All I did was assist Dr. Harshman. And at that, I had to scrub out before the case was finished."

"Oh, I don't mean just the surgery, although Arthur told Ernest that you were a lot of help. I wanted you to know how much we appreciate your coming by to check on me in the hospital and calling me after I went home."

Harshman actually complimented her? Despite her best efforts to appear cool, Cathy felt her jaw drop when Mrs.Gladstone unloaded this bit of information. Would wonders never cease? "I try to show all my patients how much I care for them."

"And it's appreciated."

"I'm afraid there are some folks who don't share your opinion of me."

Mrs. Gladstone wrinkled her nose. "Oh, that suit Gail Nix had her husband file? I was sorry to hear that."

"Mrs. Nix is behind the suit? Not Mr. Nix?"

"Dear, I have a good idea of pretty much everything that goes on in this town. I heard from a reliable source that Milton was grateful that you saved his life. He didn't care about the prescription error. It was Gail who badgered him into filing the suit. Apparently, she has something against you."

Cathy thought back to the contact she'd had with Gail Nix since returning to Dainger. She'd pegged the banker's wife as a vapid airhead, more interested in her social position than anything else. Why would she have a grudge against Cathy?

After Mrs. Gladstone left, Cathy plunged into her afternoon's appointments and soon was too busy to think further about Gail Nix. With one thing and another, it was late that night before Cathy's thoughts returned to her conversation with Mrs. Gladstone.

During her training Cathy developed the habit of mentally walking the halls of the hospital each night before she dropped offto sleep. She'd review the patients in every room, patients whose lives had been given over to her care. With her switch to private practice, Cathy made only one small adjustment. Now each night she reviewed the patients she'd seen in the office that day. Only when she was satisfied she'd done all she could for each of them was she able to turn over and fall asleep. Not tonight.

Lying in the dark, Cathy wracked her brain to figure out what she'd done to anger Gail Nix. Why had the woman badgered her husband into filing a malpractice suit?

"You've done it now. You're awake." Cathy was surprised to hear that she'd spoken aloud. Maybe she wasn't handling the stress as well as she'd implied to Josh. She slipped out of bed, turned on the bedside lamp, and padded to the medicine cabinet. How about a couple of Tylenol? It might help the headache that had become a frequent companion. Her self-diagnosis was tension headache. Should she go back to Josh and ask him for something to calm her nerves? She'd avoided sleeping pills and tranquilizers all her life, probably because she'd seen her mother take too many of them. That thought cemented her decision. No, she'd gut it out.

She slid back beneath the covers and turned out the light.She was still awake when she heard a commotion outside.What—?

Quickly, she wrapped her robe around her and groped under the bed for her slippers. She was halfway to the window when she heard someone shouting.

"Cathy! Cathy! Get out. The garage is on fire!"

It took a moment for the words to register. Fire in the garage below her! Cathy snatched the little framed photo of her parents from her bedside table and slid it into the pocket of her robe. At the door, she reached for the knob, then pulled her hand back with a shriek, bringing it to her lips to soothe the burn. Now what? These stairs were the only real way out. Get out a window? Knot bed sheets together and shinny down them? Would they hold? What if she fell and broke an arm or a leg? There seemed to be no other choice.

She pulled the top sheet offher bed, but before she could make use of it, the floor shook beneath her and a thunderous blast assaulted her eardrums. Something hard struck the back of her head, and she descended into silent darkness.

"I think she's coming around."

Cathy had been under general anesthesia only once in her life: a tonsillectomy when she was six years old. She recalled the sensations as she woke up. The strangeness of moving slowly from a dark tunnel into the light. Her confusion as she tried to make sense of the images hitting her retina. She had that same feeling now. Blurred forms hovered over her, their voices reverberating like sound at a rock concert. Only this time, like a velvet curtain, the smell of smoke permeated the air.

"Doctor, can you talk?" She squinted her eyes and made out the face of Joe Elam, concern lining his already wrinkled face. His wife, Bess, stood beside him.

"I—" Cathy shook her head, trying to clear it as she'd seen athletes do after "having their bell rung." The motion set offa pounding in her head like men with hammers holding a convention inside her skull.

"Just lay back." Bess Elam's voice was calm. No panic there. This was a mother and grandmother, used to taking care of bumps, bruises, and any other catastrophe that came along.

Cathy relaxed back onto the grass and tried to remember how she'd gotten here. Then it came to her. A fire. Then an explosion. Her apartment! Everything she'd accumulated in the past ten years was in there. Granted, most of it was still in boxes, but it was precious to her. Insurance couldn't replace the memories some of those boxes held.

"Doc, open your eyes." She forced her lids to respond and looked into the face of Mark, the emergency medical technician.

"Mark—" She choked and gagged. Someone held a bottle to her lips, and she sipped water. "We've got to stop meeting this way."

"Yeah." His laugh was forced. "Doc, let me check you over. You got knocked on the head pretty good."

"How long was I out?"

"They tell me it was only a few minutes. But I still need to go through the routine."

She lay still as he took her blood pressure and pulse, then shined a light into her eyes. His fingers probed the back of her skull, setting offan encore by the men with hammers.

After he'd finished his examination, she asked, "So, do I get a clean bill of health?"

Mark sat back on his heels. "You ought to go to the ER and let a real doctor check you. Maybe get a CT scan. But best guess? You'll be okay except for a headache."

"Nothing new for me. Thanks, Mark. Can you help me sit up?"

Willing hands helped her to a sitting position. "Now let me try to stand."

Mark and Joe Elam steadied her so that her legs scarcely bore any weight. She swayed for a few seconds, then said, "Okay, let me try it without your support."

"Doc, we really need to take you to the ER," Mark said.

She knew she was being stubborn—a doctor trying to treat herself—but she asserted her independence anyway."I promise I'll let Joe drive me there, but I've had enough ambulance rides this month."

She gritted her teeth against the pain that bored into the back of her head when she turned to look around her. A fire engine idled at the curb, its red and white strobes alternately painting the leaves of a nearby live oak. Two firemen coiled and stowed lengths of hose that looked like huge, puttycolored snakes. In addition to the Elams, she recognized several neighbors.

Cathy turned with dread toward the little garage apartment that had been her home the past two months. She expected to see nothing but a mound of rubble and ashes. Instead, although the steps were badly charred and one side of the garage and her apartment above it were covered with smoke and soot, the framework seemed intact. The garage door stood open, and the Elam's car sat in the driveway.Shadows obscured the interior of the garage, but she could make out puddles of water on the floor.

"What happened?" Cathy asked.

Bess Elam answered. "I was in the kitchen for a snack when I saw somebody moving around over here near the foot of the stairs. I knew you were in for the night, so I was suspicious. Then I saw a flicker— like a match or a lighter— and then some flames. I yelled to Joe and he called 911. By the time we got outside, whoever I'd seen was gone and the corner of the garage was on fire."

Cathy rubbed the back of her head. "I remember an explosion. Did your car blow up?"

"We were afraid the car's gas tank would go, so I had Joe run in and back it out. I started uncoiling our garden hose to fight the fire when, I guess, the fire reached some cans of paint we had stored in the garage. Anyway, they exploded.As best we can figure, the force of that blast rocked the floor of your apartment, making you fall back and hit your head.The firemen were here by then. One of them fought his way up the stairs through the flames and carried you down here.End of story."

Cathy knew better. She was pretty sure that this wasn't the end of the story. It was just another chapter. And she hoped it didn't get any worse before she could bring it to an end.

S
INCE THE FIRE CHIEF PRONOUNCED THE STAIRWAY TO HER APARTMENT unsafe, Joe Elam used a tall ladder to climb up and pack a suitcase with Cathy's list of things she needed for the next day or so. Cathy stood at the foot of the ruined stairway and wondered what else could possibly happen? If this was an attempt to kill her, how much worse could it get? The obvious answer was that they could succeed.

Cathy spent the rest of the night curled up on the Elam's couch, waking at every sound. The next morning, she stepped out of the front door, thankful that her car had been parked at the curb, safely out of danger. She paused at the end of the sidewalk, her keys in hand, and took stock of her situation.The smell of smoke permeated the blouse, slacks, and jacket she wore. Nothing she could do about that today, but as soon as she could, she needed to have all her clothes cleaned.Would insurance pay for that? She made a mental note to call her agent when she got to the office. More paperwork, more hassles, more problems.

Before Cathy could open the door of her car, Will Kennedy's pickup screeched to a stop behind her and he jumped out. He covered the ground between them in a few quick strides, and the hug he gave her threatened to crack her ribs. "Cathy, are you all right? I just heard this morning about the fire."

"I'm okay, I guess. Just a few bumps and bruises." She went on to explain what had happened. "The Fire Chief agrees with the Elams that the fire was deliberately set. He thinks someone soaked the corner of the garage and the stairs leading to my apartment with gasoline, then lit it and ran. I'm lucky Bess saw him and got help as quickly as she did."

"Do you plan to stay with the Elams for now?"

She'd wrestled with that one all night. "Joe and Bess made that offer, but their house is so small we'd be tripping over each other. Besides, it will be at least a couple of days before my back unkinks from one night on their couch. I don't know if insurance will cover the cost of a hotel."

"I have a better idea. Why don't you move in with my folks? They have a spare bedroom—my old room, matter of fact—and I know they'd love to have you."

The idea of staying with Pastor and Mrs. Kennedy appealed to her. Truthfully, Cathy had been deeply touched by their kindness. It was like having a family again. On the other hand, she wondered if by moving in she'd open herself up to a "hard sell" about coming back to the church.

It was as though Will read her mind. "In case you're wondering, Dad and Mom won't pressure you about where you are with God. They'll pray for you, that's all. Right now we all want you to be comfortable . . . and safe."

Cathy looked at her watch. "Will, I need to talk with you about something I learned yesterday, but right now I have to get to the office. I have patients to see right up to the close of the day, which, considering the shape of my bank account, is a good thing. But having all this to deal with will keep me tied up all day. I hoped we could get together this evening."She looked toward the smoke-stained walls of her little apartment where Joe and two of his friends were already at work building a new stairway. "I can't cook for you, but can we still have dinner?"

"I've got a suggestion. I'll pick you up at your office about—what? Five thirty?"

"Make it six."

"Okay, I'll come by at six. We'll go to my parents' house for dinner. Then we can talk in Dad's study. If you agree to stay with them, I can come back here for your stuff. Deal?"

Cathy wanted so badly to give up control and let someone else take over her complicated life. So far, Will hadn't disappointed her. She hoped that wouldn't change. With more conviction in her voice than in her heart, she said, "Deal."

Cathy opened the back door of her office suite to find Jane waiting for her. "Are you all right?"

"I'm fine, Jane. Mainly I have a little headache, and I smell like the inside of a wood stove. Other than that, nothing that a good night's sleep won't fix."

"Do you want me to cancel some of today's appointments?"

"No need. I'm fine."
And besides that, if my practice grows a bit, maybe I can start drawing a full salary.
"Give me ten minutes in my office. Then I'll be ready to go."

Cathy had been pinching pennies when she moved to Dainger. Now she was glad she'd let her insurance agent talk her into the added expense of renter's insurance. Her call to him took a bit longer than ten minutes, and Cathy sensed that he wondered whether her business was worth all the trouble she had caused him, but when she hung up she'd extracted a promise to have an adjustor contact her within twenty-four hours. The Elam's insurance would cover the damage to their garage and her apartment, but she would be looking to her own insurance for expenses like cleaning, and replacing personal effects. Idly, she wondered about the effect of the heat and smoke on her laptop, her small collection of CDs, her little portable TV.

Cathy emerged from her office and found Jane waiting in the hall. "Mr. Greiner is in treatment room one. He has a wart on his thumb."

There was no doubt in Cathy's mind that Jane's diagnosis would be correct. In all her years as an office nurse, Jane had probably seen ten times as many cases of
verruca vulgaris,
or common wart, as Cathy had treated in her brief exposure to dermatology.

Cathy put down the magnifying glass she'd used to examine the skin lesion. "Mr. Greiner, I can refer you to a dermatologist who can freeze that with liquid nitrogen.Or, if you want me to, I can use my Hyfrecator. The end result is the same. Your choice."

"What's the difference?"

"A dermatologist would probably use a spray of liquid nitrogen to freeze that wart. You'll get a little blister in the area. When that comes off, the skin underneath it is pink and tender. But pretty soon it will look and feel completely normal."

"Does it hurt?" he asked.

Cathy remembered her own experience when she'd had a wart removed from her finger while in med school. "My treatment felt like a burn, and it took a while for the pain to go away. After that, though, it was fine."

"What about the high-ver-natum or whatever you said?" Greiner asked.

"This is the Hyfrecator." She pointed to a rectangular off- white plastic box sitting on the waist-high treatment cabinet behind her. A thin black cord connected the box to a pencil-like probe with an angled needle on the tip. "It's an electrocautery unit. Probably the most common one in the world."

"So how does it work?"

"I usually inject a little local anesthetic. Then I put the tip of the needle in contact with the wart and deliver a low-voltage electric current that makes it shrivel up. A scab forms, and when it comes off, the tissue underneath it is all healed. Same end result as freezing."

Greiner seemed to think about the options. "I don't see any need to go somewhere else for this. What you're suggesting sounds fine to me." He shrugged. "Let's do it."

Fifteen minutes later, while Jane made Greiner's follow-up appointment, Cathy thought back to her reasons for going into family practice. One of the main ones was the ability to offer her patients a broad range of services. She had no intention of taking patients away from the specialists. She referred more complex cases to them and was glad to have their expertise to lean on. No, it all boiled down to what she thought of as her "business model." Give the patient the best care with as little inconvenience to them as possible. Now if the credentials committee would give her all the privileges she needed to do that, maybe she could get on with her life.

Cathy looked up from the forms strewn across her desk.Was that a knock at the door? She looked at her watch. Was it after six already? She hurried to the office's front door, unlocked it, and beckoned Will inside before relocking it.

"Sorry I didn't hear you at first. I've been doing paperwork for about three-quarters of an hour, and I guess I got lost in it." She motioned him to the chair across from her desk. "Give me five more minutes and we can leave."

"No problem." He gestured toward the stack of papers. "If you have that many insurance claims to file, business must be picking up."

"I wish. Most of these are claims we have to re-file because the insurance company either paid incorrectly or denied improperly. Sometimes I think they do that to hang on to their money a bit longer. I wonder how many doctors' offices take the denials at face value, bill the patient for the balance, and let it go at that."

Will leaned back and crossed his legs at the ankles. "That's what makes you special, Cathy. You're not 'most doctors.' You take the time to care. The folks in Dainger are lucky to have you practicing here."

She signed the last form and tossed it on top of all the others. "I hope more of them recognize that. Until some of these insurance claim checks come in, it's pretty slim pickings around here."

She emptied the pockets of her white coat before rolling it into a ball. "Be right back. I need to toss this into the laundry hamper." That accomplished, she pulled her purse from her bottom desk drawer and grabbed her jacket from the hanger on the back of the door. "Let's get out of here.I'm starved, and if what your mother serves on a weekday is anything like what she cooks on Sunday, I'm ready for it."

In the parking lot, she pulled her keys out of her purse and pressed the remote to unlock her car. "Shall I follow you?"

"You can, or you can ride with me and I'll come by in the morning to pick you up and take you to work. That way I get to see you even more."

Cathy thought about it for a moment. Why not? She locked her car and allowed Will to open the door of his pickup for her. When they were both belted in, she said, "What makes you so sure I'll end up staying with your folks?"

He backed out of the parking space and steered into the street before he answered. A big grin spread across his face. "Ladies and gentlemen of the jury, I'd like to call your attention to the following points. Dr. Sewell's back is probably still sore from the Elam's couch. She likes my parents almost as much as I do. And . . ." He paused for emphasis."My mother's cooking would lure an escaped convict back to prison."

Cathy gave him a playful punch on the arm. "Wait until I'm back in my apartment. I'll cook for you again. But, in the meantime, I'd be happy to enjoy your folks' hospitality—and your mother's cooking."

Cathy opened one of the boxes Will and his father had just carried to the Kennedy's spare room. Because Joe and his impromptu work detail hadn't yet finished the new stairs, and Will adamantly refused to let Cathy climb up the ladder, she'd had to give him a detailed list of what to pack for her. This had proved sort of embarrassing to Cathy, but he assured her that attorneys, like physicians, were hard to shock.

Dora Kennedy stood in the doorway after the Kennedy men withdrew to give Cathy a degree of privacy as she unpacked. "Dear, can I help you?"

Cathy shook her head. "I think I'll be fine. Again, I really appreciate your letting me stay here. I hope it won't be too long."

"Stay as long as you need to. There are clean sheets on the bed and clean towels in your bathroom. And you just make yourself at home anywhere in the house."