Code Blue (3 page)

She forced herself to sit quietly and breathe deeply until the knot in her throat loosened. Then she wadded the clippings and note into a tight ball, which she consigned to the wastebasket with as much force as she could muster.

No use rethinking the past. Time to get on with her life."Jane," she called, "may I have the charts for today's patients? I want to go over them."

Jane returned and deposited a pitifully small stack of thin charts on Cathy's desk. The look in Jane's eyes said it all.
Sorry there aren't more. Sorry you're hurting. Sorry.

Cathy picked up the top chart but didn't open it. "Do you think I made a mistake coming here to practice?"

Jane eased into one of the patient chairs across the desk from Cathy. "Why would you ask that?"

"I applied at three banks before I got a loan. When I mention to other doctors that I'm taking new patients, they get this embarrassed look and mumble something about keeping that in mind, but they never make any referrals.Several of my patients tell me they've heard stories around town that make them wonder about my capabilities. And my privileges at the hospital have been stuck in committee for over a month now." Cathy pointed to the stitches in her scalp. "Now the situation seems to be escalating."

"You mean the accident on Saturday?"

"It was no accident. I'm convinced that someone ran me offthe road and intended to kill me."

"Did you report it?" Jane asked.

"Yes, but fat lot of good it did. If Will Kennedy hadn't insisted, I think the deputy who came out to investigate the accident would have written the whole thing offas careless driving on my part." Cathy grimaced. "Of course, he may do that anyway."

"What was Will Kennedy doing there?"

"He came along right after the wreck. When I couldn't manage under my own power, Will carried me up the embankment. Then he insisted I go to the emergency room, and when they were loading me into the ambulance he slipped his card into my hand and whispered, 'Please call me. I want to make sure you're okay.' " Cathy pulled a business card from the pocket of her skirt, smoothed the wrinkles from it, and put it under the corner of her blotter.

"Did you phone him?"

Cathy shook her head. "I started to, but I couldn't. I'm not ready to get close to any man. Not Will Kennedy.Not Marcus Bell. Not Robert Newell." She took in a deep breath through her nose and let it out through pursed lips.

"Especially not Robert Newell."

"Who is—?"

Before Jane could finish, Cathy spun around in her chair and pulled a book at random from the shelf behind her."Not now. Please. I need to look up something before I see my first patient." She paged the book, but none of the words registered.

Jane's voice from behind her made Cathy close the book."Dr. Sewell, you asked me a question. Let me answer it before I go. I don't know if someone's really making an effort to run you off. I've heard some of those rumors. They're always anonymous, like 'Somebody told me that Dr. Sewell's not a good doctor.' Or 'I heard Dr. Sewell came back to Dainger because she couldn't make it in Dallas.' You have to ignore the gossip and rumors. They're part of living here."

Cathy swiveled back to face Jane. "I thought it would be easier to get my practice started in my hometown."

"It might be, except that people here will compare you to your daddy, who was the best surgeon Dainger ever saw. In that situation a young, female doctor will come up short, no matter how qualified she is."

Cathy tossed the book on her desk and held her hands up, palms forward. "If someone wants to get rid of me, they're close to succeeding. I don't know how much longer I can go on."

"You're a fighter, and I'm right here with you. Just stick with it." Jane turned and walked toward the doorway.

"Thanks. I appreciate it."

Jane stopped and faced Cathy once more. "Have you been out to visit your folks?"

"It won't do any good. There's nothing for me there. I don't have anything to say."

Jane shook her head. "Sometimes you don't have to say anything. Sometimes you simply have to make the effort and go. It's the only way you'll ever put all that behind you."

M
R. NIX, HOW CAN I HELP YOU?" CATHY SQUIRMED A BIT, HOPING TO achieve a more comfortable position. When she purchased equipment for her examination rooms, she hadn't figured she'd ever be this sore. Next time, she'd think about a rolling stool with a bit more padding.

Cathy thought the man sitting on the edge of the treatment table might have shown the briefest of smiles. Or was it a smirk?

"My family doctor's retiring, Dr. Sewell, and I need my heart medicines renewed. Since my bank has a vested interest in your making a go of it here, I thought maybe I'd try to help you out a little by giving you some of my business."

Cathy bristled at the word "business" and the condescending attitude that went with it, but she did her best not to show her displeasure. She couldn't afford to alienate this man over something as minor as his choice of words. Besides, each day she saw medicine changing from a profession to a business. What used to be "patients" were now called "consumers" and "physicians" had become "providers."

Let it go.
She plastered a smile on her face. "Let me look at the records Dr. Gladstone's office sent. Then I'll check you over. After that, we can talk about continuing your medications.I'm sure Dr. Gladstone did a good job, although I may suggest we tweak your medications a little bit."

She read through the chart, blessing Dr. Gladstone's old-fashioned, copperplate penmanship. Milton Nix, age fifty, occupation banker.
You have to give him high marks for modesty,
she thought. Most people would have put down "President of the First State Bank of Dainger."

"How've you been feeling, Mr. Nix? Any problems?" She glanced up and decided the man looked pretty much the same as when she sat across from him three months ago and virtually begged him for a loan to start her practice.At that time, the other banks in town had already turned her down, using a variety of excuses—no room in town for another family doctor; she had too much debt already in student loans; a woman doctor would never be successful in this town. Nix, unlike his counterparts at the First National and the Continental Banks, had finally decided to take a chance on her.

"I'm feeling fine, Dr. Sewell," Nix said. "But I've got a busy day. Can we get this thing moving?"

Okay, enough small talk. Back to the chart. Nix was five feet ten, one hundred fifty pounds. On the thin side, but his weight had been stable for years, so put aside thoughts of a cancer somewhere. Usual visits for coughs and colds. A couple of prostate infections. Congestive heart failure, controlled with Lanoxin and a beta-blocker.

"Mr. Nix, I don't find any electrocardiograms in here," Cathy said. "When was your last one?"

"Any what?"

Cathy regretted her error. Never drop into doctor-speak.She'd been taught that early in her training. "Did Dr.Gladstone do any heart tracings?"

Nix shook his head. "Don't remember. I think Doc probably did one or two at first, but on my last few visits he took my blood pressure, listened to my chest, poked and prodded a little, and wrote me a prescription. Can't you do the same thing?"

"Since this is your first visit here, I think it's best to get a little more information. Let me listen to your heart and lungs, and check your blood pressure. Then I'll have my nurse run a cardiogram. She'll draw some blood for a few lab tests.Nothing to worry about, but I think it's safer that way."

Mr. Nix grumbled his way out of the exam room and down the hall after Jane, who was already at work charming him. Cathy finished reading through the chart and decided that "Doc" Gladstone hadn't really done a bad job with Mr.Nix. She did see one minor change she wanted to make, though.

Cathy left the exam room and found Karen Pearson sitting in her office. She recalled Karen's first visit a month ago when the office still smelled of fresh paint.

"Dr. Sewell, I'm pregnant," Karen had said. "I've been seeing Dr. Harshman, but I've changed my mind. This is my first baby, and I want you to do the delivery."

Cathy had tried to be circumspect. The ethics of the matter aside, even to give the appearance of stealing the patient of an established physician was guaranteed to cause friction with the other doctors in the community. And she had a hard enough time in that area already.

Karen was insistent, though. She said that her current obstetrician lacked the bare minimum of consideration. "Every woman that Dr. Harshman's taken care of says they'd go to a veterinarian before they'd go back to him," was how she'd put it.

Finally, Cathy had put in a call to the administrator's office at Summers County General Hospital to ask if her request for obstetric privileges had been approved.

"Sorry, Doctor," the secretary said. "It's still in committee."

After that, Cathy's repeated calls were always met with an excuse. The paperwork got misplaced. One of the board members was out of town. They were checking precedents.Cathy knew why Karen was in her office today, and she dreaded giving her the answer.

"Karen, how are you doing?"

"I'm less than a month from my due date," Karen said. "Dr. Sewell, I'm still hoping you can take over my care. Do you have obstetrics privileges yet?"

Cathy felt her heart drop. She was sure Karen would know the answer just from the look on her face. "I'm sorry, Karen. I'm still trying. You know, we've been through this already. Why can't you stay with Dr. Harshman?"

"Oh, please, Dr. Sewell. You know very well what that man's reputation is. And now, he says I might need a Caesarean section. I was worried enough about him doing a regular delivery. I can't stand the thought of him doing a C-section. Can you do it, Dr. Sewell? Please?"

"I'm sorry, Karen. I wish I could help. But I'm having trouble getting privileges to do normal deliveries, and there's no way they'll let me do a C-section. Have you considered switching to Dr. Gaines?" Cathy said, naming the other obstetrician in Dainger.

"His practice is full. His nurse told me that I have a perfectly competent doctor and suggested I stick with him."

Cathy extended her hand to Karen, partly to help her from the chair and partly as a gesture of compassion. "I'll keep trying. Don't give up."

"I won't. I've been praying that you'd be the one to deliver my baby. God will take care of this."

Cathy bit offthe reply that was on the tip of her tongue.With words of assurance that sounded hollow in her ears, she left Karen and turned her attention to Milton Nix.

Jane met her in the hall and held out an EKG tracing."Mr. Nix is in exam room one."

Nix looked up when Cathy walked in. "Did that fancy test help you find anything that Doc Gladstone didn't figure out with his stethoscope?"

Cathy studied the tracing, looked at the chart once more, and made a decision. "I'll want to see what the blood chemistries show us, but at this point I think you're doing well.Your beta-blocker is okay, but I want to make a slight change in your other heart medicine. I see that your prescription has been for the brand-name drug, Lanoxin. I suspect that Dr. Gladstone wrote it that way years ago and just never changed it. If I write the prescription a bit differently, the pharmacist can give you a generic form and save you a little money."

Cathy could see Nix's lips open, then shut. If he had any complaints, he kept them to himself. He probably wasn't anxious to have anything changed in the regimen he'd been following for years, but this wasn't really much of a change.Besides, she figured the "saving money" part would win him over.

She reached for her prescription pad and dug into the pocket of her white coat. Where did that pen go? "Excuse me. I can't find my pen. I'll be right back."

Nix reached into his shirt pocket and pulled out two ballpoints."Here. They've got the bank's name on them. When you're through, leave 'em in the waiting room. Maybe I'll get some return on my investment for this trip after all." She might have been mistaken, but there seemed to be the ghost of a grin on his thin-lipped face as he handed the pens to her. Two in one day. That must be some kind of a record for Milton Nix.

She wrote the prescriptions exactly the way she'd been taught: carefully, with attention to legibility, calculating the number of pills that should be dispensed, double-checking the directions. She added refill instructions and signed the prescriptions before tearing them offthe pad and handing them to Nix.

"Just follow the directions on both of these, and call me if you have any questions."

As she passed the prescriptions to Nix, she noticed that the ink in the pen she'd been using was blue. She'd need to make sure she didn't use Milton's pens in the office anymore.That was another thing her mentors had emphasized. Use black ink. It photocopies better and gives a neater appearance.She could hear the voice of Dr. Seldin, the chief of internal medicine, saying, "If you're sloppy in little things, you'll be sloppy in the big ones too. Take the time to do it right."

Cathy sat staring into space, the phone receiver in her hand. When a strident stutter tone shattered the silence of her office, she replaced the handset. Idly, she noted that her hand was steady when she did so. Her surgery instructors had always said she had good hands, even under pressure.She wished her mind were as steady right now.

Two phone message slips. Two calls. And, just when she thought the situation couldn't get worse, she sank further into the pit of anxiety and depression that had held her for these past several months. Josh would have a field day with this.

"What's wrong?" Jane paused in the door, a chart in her hand. Cathy shook her head. Uninvited, Jane eased into the chair across the desk. "You want to talk about it?"

Cathy reached for the soft drink sitting on her desk."Those message slips you gave me? The first was from a sheriff' s deputy. About my accident." She lifted the can to her lips, found it empty, and tossed it into the wastebasket under her desk.

"Did he find the other driver?"

"He said that since there's no evidence of a collision and no witnesses, he's writing it offas driver error on my part."Cathy sighed. "Actually, he reached that conclusion right after he arrived on the scene, but Will pointed out the skid marks and pressured the deputy to at least look into it."

Jane leaned forward. "Will that affect how your insurance company handles the claim?"

"No longer an issue. If my insurance had been in force, this might have raised my rates. But the second call was from my agent. The company just notified him that my last premium check bounced, so apparently, my policy wasn't in force at the time of the accident." Cathy squeezed her eyes closed for a moment. She wouldn't allow herself to cry in front of Jane. "The agent was nice. He said he'll make calls to some people higher up in the company. He'll try to get them to reinstate the policy. He even said he'd talk with the owner of the dealership that's renting me a car and see if he'll discount the bill since I may be paying it out of my own pocket."

"So you're driving without liability coverage?" Jane's voice was calm, but Cathy saw the concern in her eyes.

"The agent's given me temporary coverage. But this is something else I've got to straighten out." Cathy shrugged."I need to make one more call."

Jane took the hint and tiptoed out, closing the door softly behind her.

Cathy fanned out the three message slips like a bridge player studying a critical hand. Sheriff. Insurance Agent. The last call from Dr. Marcus Bell was marked "Urgent." She punched in his number.

"Thanks for calling back," Dr. Bell said.

"I hope it's good news, Marcus. I could use some."

"Actually, it is," he said. "The credentials committee will consider your request for hospital privileges tomorrow night."

"Finally." Cathy saw a glimmer of hope through the gloom that had surrounded her for so long. If she could expand her practice, the extra income might help solve her rapidly multiplying financial worries.

"Would you like to attend the meeting? If you want me to, I'll arrange it."

Cathy turned that thought over for a few seconds. Would her presence improve her chances of a positive response? It couldn't hurt. "Yes, please."

"Great. They meet at six in the conference room," Marcus said. "Would you like to have dinner with me afterward?"

Cathy experienced a return of the guilt she'd felt after turning down Marcus's previous dinner invitation. He'd tried not to show it, but she'd seen the hurt in his eyes. And he seemed like a nice guy, one who might turn out to be a friend—maybe more than a friend. Her lips formed a "Yes," before she stopped herself. Hard on the heels of the tiny flutter she'd felt at the prospect of dating Marcus came memories of her past relationships. No, she wasn't ready to take a chance.

"I'm sorry, Marcus. I want to meet with the committee, but can I take a raincheck on dinner?"