Could I Have This Dance? (29 page)

“He figured right. Shall I teach you how?” Claire stood up.

Diana spoke up. “Better not, Dr. McCall. Better not let the CT surgeons come through this ICU and not find an intern at the bedside of a fresh post-op.”

“I’ll stay here,” Martin offered. “I’m sure I’ll get the chance to do plenty of chest tubes.”

“Okay. Where’s the patient?”

“Room four. They should be all set up for you.”

“Thanks.”

Claire walked briskly to the ER, thankful for the chance to be on her feet again. It certainly made staying awake easier.

She found the patient in need, put in a chest tube, and wrote admit orders. She was just finishing up when she heard a familiar voice.

“I thought I might find you here, Dr. McCall.”

She looked up to see Sierra Jones’s father. He appeared to be wearing the same clothing as he had the night before. Black circles beneath his eyes highlighted sunken cheeks and a day’s worth of prickly stubble on his chin.

He glared at her, his eyes intense with hate. Terrified, she pushed back, thankful that there was a counter between her and Mr. Jones. Her heart quickened and seemed to lodge in her throat. She calculated the time it would take to sprint to the exit.

She tried in vain to wet her lips with her parched tongue. “Hello, Mr. Jones,” she responded, her voice barely above a whisper.

“Where are you from, Dr. McCall?”

“V-Virginia.” Claire shifted her eyes to an empty chair to her right. Where was the ward clerk when you needed him?

“I’m gonna bury my daughter this week. She died on her birthday, did you know that?”

Claire felt her throat tighten. “I know.”

“I heard what the other doctor, that man, said to you, when my baby was getting the CT scan.” He raised a finger. “Don’t think I don’t know what went on. My baby went in there alive, but you didn’t watch her. You let that tubing on her chest come apart. I heard the other doctor say so.”

Claire stood and backed away. “Mr. Jones, I’m so sorry. Your daughter died because of internal bleeding.”

“My daughter died because you made a mistake!” He jabbed his index finger in the air toward Claire’s chest and lunged toward the counter.

Claire shrieked and jumped back. Thankfully, his loud voice had alerted the ER staff, and a crowd quickly gathered around Claire. A large African-American orderly stepped up beside her.

“Don’t think I don’t know what happened. I’ll see to it you go back to Virginia where you belong,” he shouted, his voice trembling. “You killed my baby.” He put his hands to his face. “Someone’s gonna pay.” His eyes were wide with terror. He slowly backed away from the crowd and out through the automatic doors which opened to the outside.

Claire put her hand to her mouth. The scene around her blurred. Tears welled in her eyes and she steadied herself with her hands on the counter. A strong arm nestled around her shoulder, and she heard the soft voice of the head nurse, Gwen Thomas.

“Dr. McCall? Are you going to be okay?”

Claire sniffed and nodded. She slipped free from Gwen’s supportive embrace and hurried to the door leading to the hall. She needed to go somewhere to regroup. She was frightened, exhausted, and alone.

I wish John were here.

She found little solace in a women’s rest room, but she dried her tears with a paper towel, then wadded it up and tossed it at a trash can. Unable to suppress a fresh round of tears, she pulled frantically at the toilet-paper roll. She closed the door to the little stall and sat on the commode to dry her tears. When she heard the bathroom door squeak a few minutes later, she blew her nose and left the bathroom. She could see the sunshine through a window at the end of the hall.
I just need some fresh air. And a strong shoulder. I need John Cerelli.

She walked through the lobby and into the muggy afternoon heat. Swallowing the tightness in her throat, she crossed the street to the blue glass research facility. She found Dr. Rogers’ GI lab on the third floor, and Brett Daniels alone in a tiny corner office. She knocked timidly on the door before letting herself in. She stood in the doorway for a moment before she started to cry. “Oh, Brett,” she gasped. “I’m so afraid.”

He stood and opened his arms, receiving her warmly, enveloping her gently, then more tightly as her body racked with sobs.

She pressed against him, burying her face in his chest and neck.

She felt his lips brush against her forehead, then move away, and come to rest against her forehead again. “There, there,” he whispered, not moving his lips from her forehead.

She rested for a minute, then pulled away and looked in his eyes.

“What’s wrong, Claire?”

She wasn’t sure what to say. She didn’t want to cry again.

She suddenly felt foolish. She thought of how silly she must look to Brett.
I’m supposed to survive this residency by being a man. So why am I bawling my eyes out over this?

She sniffed and shrugged. “I’ve had a bad day.”

Brett listened as Claire unloaded her story behind a closed office door. She held her head in her hands, looking at the floor. “What am I going to do, Brett? Mr. Jones might just be crazy enough to come after me.”

“I doubt it. He’s just trying to deal with his grief. Some people don’t know any other way to deal with it, so they just lash out at the easiest target.” He closed a book on his desk. “You just got in the way, that’s all.”

“He’s gonna sue.”

“I doubt he has the sophistication. He’s just venting. It will all blow over in a few days.”

“You know what bothers me the most?”

He shook his head.

“I think he’s right. My negligence may have killed her. If I’d only been watching her, I’d have seen the IV pop apart. I could have run right in and reconnected it, and Mr. and Mrs. Jones might still have their baby girl.”

“You can’t know that, Claire. And you can’t torture yourself over and over with the ‘if onlys.’”

Her beeper sounded. She looked at the number. “CT ICU.” She sighed. “I’d better run.”

They stood and faced each other again. He smiled. “You’re going to make it. Okay?”

She bobbed her head rapidly without speaking. Her throat tightened again.

He reached out and brushed her eyes with the back of his hand, then lightly tapped her mouth. “Stiff upper lip.”

She forced a smile. “Okay.”

He gazed at her a moment, his hand now on her chin, drawing her face to his.

She stiffened, and pushed her hand to his chest. “No.”

He stepped away, yielding to her now extended arm. “Claire.”

“Y—you can’t,” she stammered. “I can’t. We’re not like that.”

“Like what? A couple?” Hurt registered on his face.

“I’m sorry, Brett. I didn’t come to you for—”

“So what am I to you? A stand-in for your fiancé? You can’t deny what I know you’re feeling.”

She looked down and shut her eyes. She took a deep breath before speaking. “You’re a friend, Brett. And I needed a friend’s shoulder to cry on. That’s all.” She shook her head. “Look, I shouldn’t have come. I’m sorry that I’ve confused you.”

She opened the door. “I have to go.”

He nodded without speaking.

“Sorry,” she added, her voice barely above a whisper.

Claire smoothed the front of her lab coat, cleared her throat, and walked away, glancing back only once to see Brett standing in the doorway with his head against the frame.

Chapter Twenty

C
laire endured her first night of CT call by strict adherence to the Oman’s second rule of intern survival: “Everyone teaches a tern.”

Stephanie Dickson recorded the data from the pulmonary artery catheter and looked at Claire. “It gets easier once you’ve seen everything a few times.”

Claire nodded. She understood that Stephanie knew what she was talking about. An ICU nurse for nearly twenty years, Stephanie had seen thousands of open-heart patients and hundreds of interns come and go. She knew the protocols. She knew when to ask for help. And if the rumors coming out of the surgery resident’s lounge were correct, Claire would be crazy to question Steph’s judgment.

At two A.M., the nurse pointed to a cardiac rehab chair. “That’s your spot. If I have any problem you need to know about, I’ll call.”

Claire nestled into the padded leather chair and closed her eyes. She slept intermittently for four hours. She was awakened hourly with reports of patient’s vital signs, potassium levels, mediastinal tube and urine outputs, and anything else that Stephanie thought important enough to tell her. The hourly updates fell into a comfortable routine. The nurse gave the report and looked to Claire to give the appropriate order in response, but kindly informed the intern of the most customary response desired by the CT surgeons for that particular clinical situation. Claire, in return, ordered what the experienced nurse suggested. It worked well because Claire understood what was needed for most of the situations, but to have the nurse clue her in on the particular likes and dislikes of the attending surgeons was very helpful.

In this way, Stephanie allowed Claire the feeling of being in charge, while subtly guiding her to make the right decisions. “Dr. Lewis gives blood to every open-heart patient with a hematocrit below thirty. Dr. Blanton waits until the crit is below twenty-five,” she instructed. “Dr. Lewis uses crystalloid when the patient needs more volume. Dr. Blanton uses Hespan.”

Since Wednesday was a clinic day, Claire and Martin were expected
to write notes and finish the scut list in the hospital while the medical students helped work up the outpatients in the clinic. This arrangement was fine with Claire, as the new medical students only slowed her down. At noon, Claire and Martin headed for the cafeteria to obey Overby’s rule number one: “Eat when you can.”

At two, just when Claire had finished gathering the latest lab values on the CT ICU patients, her beeper sounded. Claire answered the unfamiliar extension.

“Risk management, this is Wanda.”

“This is Dr. McCall. I was paged.”

“Yes, Dr. Andrews would like you to meet him in our office. Is now a convenient time?”

“Now?” Claire looked at her watch. “What is this about? Who did you say this is?”

“My name is Wanda Miller. I work in physician support services, especially in the area of risk management.”

“Risk management?”

“We often review clinical cases where there is a potential concern for medical liability.”

“And Dr. Andrews is asking for me?”

“Yes. He’s here in the office. We thought you should be made aware of our concerns. It would really be better to do this in person. I know this is short notice, but we’ve only just become aware of some potential problems regarding a case you were involved in. Can you come to my office?”

Claire felt a knot growing in her stomach. “Sure.”

She followed Wanda’s instructions and found the office on the second floor of the main hospital. She knocked on the door and entered. A secretary led her to a conference room with a large table. Seated around the table were Dr. Walter Andrews, the pediatric surgeon, another man Claire didn’t recognize, and a short, plump woman in a business suit.

The woman stood. “Dr. McCall?”

Claire felt her throat tighten. “Yes.”

“I’m Wanda. Thanks so much for coming.” She pointed at the men. “You know Dr. Andrews. This is Peter Ondrachek, a hospital attorney.”

An attorney? What’s going on?

Wanda gestured to a chair. Claire sat, but didn’t allow her back to touch the spindled support behind her.

Dr. Andrews smiled and folded his aging hands. “Hi, Claire.”

“Hi.” Seeing him here made her more comfortable. He looked like Walter Cronkite. Or maybe all Walters looked that way … calm, wrinkled, with bright eyes.

“I’m sure you’re wondering what this is all about. Let me put your mind at rest. You aren’t being sued.” She paused. “At least not yet. But Gwen Thomas, head nurse in the ER, told me you had been threatened by …” She glanced down at her paper. “Roger Jones.” She lifted her eyes to Claire’s. “We like to get a record of everyone’s memory of sentinel events as soon as we are made aware of them. That way everyone’s memory is fresh.”

“A sentinel event?”

Wanda nodded. “A term we use for any clinical event that results in significant patient morbidity or death or an event that results in significant risk of patient morbidity or death.” She took a deep breath. “Since Dr. Andrews was the attending of record, he needs to be involved in the process. Mr. Ondrachek is here to represent the hospital’s interest.”

Claire’s eyes narrowed. “What about my interests?”

Wanda smiled sweetly. “Any legal action initiated against a resident in this hospital is automatically against the university hospital. Mr. Ondrachek will also represent you.” She glanced at her notes, then pointed to the hospital record on the table. “We’ve had a chance to review the legal patient record, and we’ve talked to Gwen, but we would like to hear from you. Did Mr. Jones threaten you with a lawsuit?”

“Not exactly. He approached me in the ER and claimed that I made a mistake responsible for his daughter’s death. I don’t remember his exact words, but I believe he said that someone was gonna pay.” She felt her voice thickening. “He said he would see to it that I went back to Virginia.”

Wanda and the attorney exchanged glances. “That verifies what Gwen told us.”

Mr. Ondrachek smoothed the lapels of his three-piece suit and leaned forward. “Can you give us your version of the events that surrounded Sierra Jones’s death?”

Claire shifted in her seat, feeling like she was on a witness stand. Mr. Ondrachek’s legalese manner of speaking unnerved her. “Well, she came in with abdominal bloating and tenderness, and hypotension. She didn’t have an IV, so Dr. Roberts started a central line.”

The lawyer scratched a note. “Was that the line that was in her chest?”

Claire pointed to a spot beneath her right collarbone. “Yes. It was a subclavian line that entered into her subclavian vein and extended down into her superior vena cava. I took the patient to the CT scanner with a medical student with instructions to go over the scan with the radiologist and call the chief resident. The patient’s blood pressure was down a few points again, so I sped up the IV fluids and instructed the medical student to go to the blood bank to get some blood. We got the scan, and I was going over the scan with the radiology resident when the tech called my
attention to the patient’s cardiac monitor. It looked like the patient was in ventricular tachycardia. I ran into the room and found that she had no respirations or pulse. She had blood on her chest and on the floor beside the CT scanner. I started CPR and called a code.”