Nothing Lasts Forever (11 page)

B
y the beginning of her fourth year of residency, Paige had assisted in hundreds of operations. They had become second nature to her. She knew the surgery procedures for the gallbladder, spleen, liver, appendix, and, most exciting, the heart. But Paige was frustrated because she was not doing the operations herself.
Whatever happened to “Watch one, do one, teach one
”? she wondered.

The answer came when George Englund, chief of surgery, sent for her.

“Paige, there’s a hernia operation scheduled for tomorrow in OR Three, seven-thirty A.M.”

She made a note. “Right. Who’s doing the operation?”

“You are.”

“Right. I…” The words suddenly sank in. “
I
am?”

“Yes. Any problem with that?”

Paige’s grin lit up the room. “No, sir! I…thanks!”

“You’re ready for it. I think the patient’s lucky to have you. His name is Walter Herzog. He’s in 314.”

“Herzog. Room 314. Right.”

And Paige was out the door.

Paige had never been so excited.
I’m going to do my first operation! I’m going to hold a human being’s life in my hands. What if I’m not ready? What if I make a mistake? Things can go wrong. It’s Murphy’s Law.
By the time Paige was through arguing with herself, she was in a state of panic.

She went into the cafeteria and sat down to have a cup of black coffee.
It’s going to be all right
, she told herself.
I’ve assisted in dozens of hernia operations. There’s nothing to it. He’s lucky to have me.
By the time she finished her coffee, she was calm enough to face her first patient.

Walter Herzog was in his sixties, thin, bald, and very nervous. He was in bed, clutching his groin, when Paige walked in, carrying a bouquet of flowers. Herzog looked up.

“Nurse…I want to see a doctor.”

Paige walked over to the bed and handed him the flowers. “I’m the doctor. I’m going to operate on you.”

He looked at the flowers, and looked at her. “You’re
what
?”

“Don’t worry,” Paige said reassuringly. “You’re in good hands.” She picked up his chart at the foot of the bed and studied it.

“What does it say?” the man asked anxiously.
Why did she bring me flowers?

“It says you’re going to be just fine.”

He swallowed. “Are you really going to do the operation?”

“Yes.”

“You seem awfully…awfully young.”

Paige patted his arm. “I haven’t lost a patient yet.” She looked around the room. “Are you comfortable? Can I get you anything to read? A book or magazine? Candy?”

He was listening, nervously. “No, I’m okay.”
Why was she being so nice to him? Was there something she wasn’t telling him?

“Well, then, I’ll see you in the morning,” Paige said cheerfully. She wrote something on a piece of paper and handed it to him. “Here’s my home number. You call me if you need me tonight. I’ll stay right by the phone.”

By the time Paige left, Walter Herzog was a nervous wreck.

A few minutes later, Jimmy found Paige in the lounge. He walked up to her with his wide grin. “Congratulations! I hear you’re going to do a procedure.”

Word gets around fast
, Paige thought. “Yes.”

“Whoever he is, he’s lucky,” Jimmy said. “If anything ever happened to me, you’re the only one I’d let operate on me.”

“Thanks, Jimmy.”

And, of course, with Jimmy, there was always a joke.

“Did you hear the one about the man who had a strange pain in his ankles? He was too cheap to go to a doctor, so when his friend told him he had exactly the same pain, he said, ‘You’d better get to a doctor right away. And tell me exactly what he says.’

“The next day, he learns his friend is dead. He rushes
to a hospital and has five thousand dollars’ worth of tests. They can’t find anything wrong. He calls his friend’s widow, and says, ‘Was Chester in a lot of pain before he died?’

“’No,’ she says. ‘He didn’t even see the truck that hit him!’”

And Jimmy was gone.

Paige was too excited to eat dinner. She spent the evening practicing tying surgical knots on table legs and lamps.
I’m going to get a good night’s sleep
, Paige decided,
so I’ll be nice and fresh in the morning.

She was awake all night, going over the operation again and again in her mind.

There are three types of hernias: reducible hernia, where it’s possible to push the testicles back into the abdomen; irreducible hernia, where adhesions prevent returning the contents to the abdomen; and the most dangerous, strangulated hernia, where the blood flow through the hernia is shut off, damaging the intestines. Walter Herzog’s was a reducible hernia.

At six o’clock in the morning, Paige drove to the hospital parking lot. A new red Ferrari was next to her parking space. Idly, Paige wondered who owned it. Whoever it was had to be rich.

At seven o’clock, Paige was helping Walter Herzog change from pajamas to a blue hospital gown. The nurse had already given him a sedative to relax him while they
waited for the gurney that would take him to the operating room.

“This is my first operation,” Walter Herzog said.

Mine, too,
Paige thought.

The gurney arrived and Walter Herzog was on his way to OR Three. Paige walked down the corridor beside him, and her heart was pounding so loudly that she was afraid he could hear it.

OR Three was one of the larger operating rooms, able to accommodate a heart monitor, a heart-lung machine, and an array of other technical paraphernalia. When Paige walked into the room, the staff were already there, preparing the equipment. There was an attending physician, the anesthesiologist, two residents, a scrub nurse, and two circulating nurses.

The staff were watching her expectantly, eager to see how she would handle her first operation.

Paige walked up to the operating table. Walter Herzog had had his groin shaved and scrubbed with an antiseptic solution. Sterile drapes had been placed around the operating area.

Herzog looked up at Paige and said drowsily, “You’re not going to let me die, are you?”

Paige smiled. “What? And spoil my perfect record?”

She looked over at the anesthesiologist, who would give the patient an epidural anesthesia, a saddle block. Paige took a deep breath and nodded.

The operation began.

“Scalpel.”

As Paige was about to make the first cut through the skin, the circulating nurse said something.

“What?”

“Would you like some music, doctor?”

It was the first time she had been asked that question. Paige smiled. “Right. Let’s have some Jimmy Buffet.”

The moment Paige made the first incision, her nervousness vanished. It was as though she had done this all her life. Skillfully, she cut through the first layers of fat and muscle, to the site of the hernia. All the while, she was aware of the familiar litany that was echoing through the room.

“Sponge…”

“Give me a bovie…”

“There it is…”

“Looks like we got there just in time…”

“Clamp…”

“Suction, please…”

Paige’s mind was totally focused on what she was doing. Locate the hernial sac…free it…place the contents back into the abdominal cavity…tie off the base of the sac…cut off the remainder…inguinal ring…suture it…

One hour and twenty minutes after the first incision, the operation was finished.

Paige should have felt drained, but instead she felt wildly exhilarated.

When Walter Herzog had been sewn up, the scrub nurse turned to Paige. “Dr. Taylor…”

Paige looked up. “Yes?”

The nurse grinned. “That was beautiful, doctor.”

It was Sunday and the three women had the day off.

“What should we do today?” Kat asked.

Paige had an idea. “It’s such a lovely day, why don’t we drive out to Tree Park? We can pack a picnic lunch and eat outdoors.”

“That sounds lovely,” Honey said.

“Let’s do it!” Kat agreed.

The telephone rang. The three of them stared at it.

“Jesus!” Kat said. “I thought Lincoln freed us. Don’t answer it. It’s our day off.”

“We
have
no days off,” Paige reminded her.

Kat walked over to the telephone and picked it up. “Dr. Hunter.” She listened for a moment and handed the telephone to Paige. “It’s for you, Dr. Taylor.”

Paige said resignedly, “Right.” She picked up the receiver. “Dr. Taylor…Hello, Tom…What?…No, I was just going out…I see…All right. Ill be there in fifteen minutes.” She replaced the receiver.
So much for the picnic,
she thought.

“Is it bad?” Honey asked.

“Yes, we’re about to lose a patient. I’ll try to be back for dinner tonight.”

When Paige arrived at the hospital, she drove into the doctors’ parking lot and parked next to the new bright red Ferrari.
I wonder how many operations it took to pay for that?

Twenty minutes later, Paige was walking into the visitors’ waiting room. A man in a dark suit was seated in a chair, staring out the window.

“Mr. Newton?”

He rose to his feet. “Yes.”

“I’m Dr. Taylor. I was just in to see your little boy. He was brought in with abdominal pains.”

“Yes. I’m going to take him home.”

“I’m afraid not. Peter has a ruptured spleen. He needs an immediate transfusion and an operation, or he’ll die.”

Mr. Newton shook his head. “We are Jehovah’s Witnesses. The Lord will not let him die, and I will not let him be tainted with someone else’s blood. It was my wife who brought him here. She will be punished for that.”

“Mr. Newton, I don’t think you understand how serious the situation is. If we don’t operate right away, your son is going to die.”

The man looked at her and smiled. “You don’t know God’s ways, do you?”

Paige was angry. “I may not know a lot about God’s ways, but I do know a lot about a ruptured spleen.” She took out a piece of paper. “He’s a minor, so you’ll have to sign this consent form for him.” She held it out.

“And if I don’t sign it?”

“Why…then we can’t operate.”

He nodded. “Do you think your powers are stronger than the Lord’s?”

Paige was staring at him. “You’re not going to sign, are you?”

“No. A higher power than yours will help my son. You will see.”

When Paige returned to the ward, six-year-old Peter Newton had lapsed into unconsciousness.

“He’s not going to make it,” Chang said. “He’s lost too much blood. What do you want to do?”

Paige made her decision. “Get him into OR One. Stat.”

Chang looked at her in surprise. “His father changed his mind?”

Paige nodded. “Yes. He changed his mind. Let’s move it.”

“Good for you! I talked to him for an hour and I couldn’t budge him. He said God would take care of it.”

“God is taking care of it,” Paige assured him.

Two hours and four pints of blood later, the operation was successfully completed. All the boy’s vital signs were strong.

Paige gently stroked his forehead. “He’s going to be fine.”

An orderly hurried into the operating room. “Dr. Taylor? Dr. Wallace wants to see you right away.”

Benjamin Wallace was so angry his voice was cracking. “How could you do such an outrageous thing? You gave him a blood transfusion and operated without permission? You broke the law!”

“I saved a boy’s life!”

Wallace took a deep breath. “You should have gotten a court order.”

“There was no time,” Paige said. “Ten minutes more and he would have been dead. God was busy elsewhere.”

Wallace was pacing back and forth. “What are we going to do now?”

“Get a court order.”

“What for? You’ve already
done
the operation.”

“I’ll backdate the court order one day. No one will ever know the difference.”

Wallace looked at her and began to hyperventilate. “Jesus!” He mopped his brow. “This could cost me my job.”

Paige looked at him for a long moment. Then she turned and started toward the door.

“Paige…?”

She stopped. “Yes?”

“You’ll never do anything like this again, will you?”

“Only if I have to,” Paige assured him.

A
ll hospitals have problems with drug theft. By law, each narcotic that is taken from the dispensary must be signed for, but no matter how controlled the security is, drug addicts almost invariably find a way to circumvent it.

Embarcadero County Hospital was having a major problem. Margaret Spencer went to see Ben Wallace.

“I don’t know what to do, doctor. Our fentanyl keeps disappearing.”

Fentanyl is a highly addictive narcotic and anesthetic drug.

“How much is missing?”

“A great deal. If it were just a few bottles, there could be an innocent explanation for it, but it’s happening now on a regular basis. More than a dozen bottles a week are disappearing.”

“Do you have any idea who might be taking it?”

“No, sir. I’ve talked to security. They’re at a loss.”

“Who has access to the dispensary?”

“That’s the problem. Most of the anesthetists have pretty free access to it, and most of the nurses and surgeons.”

Wallace was thoughtful. “Thank you for coming to me. Ill take care of it.”

“Thank you, doctor.” Nurse Spencer left.

I don’t need this right now,
Wallace thought angrily. A hospital board meeting was coming up, and there were already enough problems to be dealt with. Ben Wallace was well aware of the statistics. More than 10 percent of the doctors in the United States became addicted, at one time or another, to either drugs or alcohol. The easy accessibility of the drugs made them a temptation. It was simple for a doctor to open a cabinet, take out the drug he wanted, and use a tourniquet and syringe to inject it. An addict could need a fix as often as every two hours.

Now it was happening at his hospital. Something had to be done about it before the board meeting.
It would look bad on my record.

Ben Wallace was not sure whom he could trust to help him find the culprit. He had to be careful. He was certain that neither Dr. Taylor nor Dr. Hunter was involved, and after a great deal of thought, he decided to use them.

He sent for the two of them. “I have a favor to ask of you,” he told them. He explained about the missing fentanyl. “I want you to keep your eyes open. If any of the doctors you work with have to step out of the OR for a moment, in the middle of an operation, or show any other signs of addiction, I want you to let me know. Look for any changes in personality—depression or mood swings—or tardiness, or missed appointments. I would
appreciate it if you would keep this strictly confidential.”

When they left the office, Kat said, “This is a big hospital. We’re going to need Sherlock Holmes.”

“No, we won’t,” Paige said unhappily. “I know who it is.”

Mitch Campbell was one of Paige’s favorite doctors. Dr. Campbell was a likable gray-haired man in his fifties, always good-humored, and one of the hospital’s best surgeons. Paige had noticed lately that he was always a few minutes late for an operation, and that he had developed a noticeable tremor. He used Paige to assist him as often as possible, and he usually let her do a major part of the surgery. In the middle of an operation, his hands would begin to shake and he would hand the scalpel to Paige.

“I’m not feeling well,” he would mumble. “Would you take over?”

And he would leave the operating room.

Paige had been concerned about what could be wrong with him. Now she knew. She debated what to do. She was aware that if she brought her information to Wallace, Dr. Campbell would be fired, or worse, his career would be destroyed. On the other hand, if she did nothing, she would be putting patients’ lives in danger.
Perhaps I could talk to him,
Paige thought.
Tell him what I know, and insist that he get treatment.
She discussed it with Kat.

“It’s a problem,” Kat agreed. “He’s a nice guy, and a good doctor. If you blow the whistle, he’s finished, but if you don’t, you have to think about the harm he might do. What do you think will happen if you confront him?”

“He’ll probably deny it, Kat. That’s the usual pattern.”

“Yeah. It’s a tough call.”

The following day, Paige had an operation scheduled with Dr. Campbell.
I hope I’m wrong,
Paige prayed.
Don’t let him be late, and don’t let him leave during the operation.

Campbell was fifteen minutes late, and in the middle of the operation, he said, “Take over, will you, Paige? I’ll be right back.”

I must talk to him,
Paige decided.
I can’t destroy his career.

The following morning, as Paige and Honey drove into the doctors’ parking lot, Harry Bowman pulled up next to them in the red Ferrari.

“That’s a beautiful car,” Honey said. “How much does one of those cost?”

Bowman laughed. “If you have to ask, you can’t afford it.”

But Paige wasn’t listening. She was staring at the car, and thinking about the penthouse, the lavish parties, and the boat.
I was smart enough to have a clever father. He left all his money to me.
And yet Bowman worked at a county hospital. Why?

Ten minutes later, Paige was in the personnel office, talking to Karen, the secretary in charge of records.

“Do me a favor, will you, Karen? Just between us, Harry Bowman has asked me to go out with him and I have a feeling he’s married. Would you let me have a peek at his personnel file?”

“Sure. Those horny bastards. They never get enough, do they? You’re darn right I’ll let you look at his file.” She went over to a cabinet and found what she was looking for. She brought some papers back to Paige.

Paige glanced through them quickly. Dr. Harry Bowman’s application showed that he had come from a small university in the Midwest and, according to the records, had worked his way through medical school. He was an anesthesiologist.

His father was a barber.

Honey Taft was an enigma to most of the doctors at Embarcadero County Hospital. During the morning rounds, she appeared to be unsure of herself. But on the afternoon rounds, she seemed like a different person. She was surprisingly knowledgeable about each patient, and crisp and efficient in her diagnoses.

One of the senior residents was discussing her with a colleague.

“I’ll be damned if I understand it,” he said. “In the morning, the complaints about Dr. Taft keep piling up. She keeps making mistakes. You know the joke about the nurse who gets everything wrong? A doctor is complaining that he told her to give the patient in Room 4 three pills, and she gave the patient in Room 3 four pills, and just as he’s talking about her, he sees her chasing a naked patient down the hall, holding a pan of boiling water. The doctor says, ‘Look at that! I told her to prick his boil!’”

His colleague laughed.

“Well, that’s Dr. Taft. But in the afternoon she’s absolutely brilliant. Her diagnoses are correct, her notes are wonderful, and she’s as sharp as hell. She must be taking
some kind of miracle pill that only works afternoons.” He scratched his head. “It beats the hell out of me.”

Dr. Nathan Ritter was a pedant, a man who lived and worked by the book. While he lacked the spark of brilliance, he was capable and dedicated, and he expected the same qualities from those who worked with him.

Honey had the misfortune to be assigned to his team.

Their first stop was a ward containing a dozen patients. One of them was just finishing breakfast. Ritter looked at the chart at the foot of the bed. “Dr. Taft, the chart says this is your patient.”

Honey nodded. “Yes.”

“He’s having a bronchoscopy this morning.”

Honey nodded. “That’s right.”

“And you’re allowing him to
eat
?” Dr. Ritter snapped. “
Before
a bronchoscopy?”

Honey said, “The poor man hasn’t had anything to eat since—”

Nathan Ritter turned to his assistant. “Postpone the procedure.” He started to say something to Honey, then controlled himself. “Let’s move on.”

The next patient was a Puerto Rican who was coughing badly. Dr. Ritter examined him. “Whose patient is this?”

“Mine,” Honey said.

He frowned. “His infection should have cleared up before now.” He took a look at the chart. “You’re giving him fifty milligrams of ampicillin four times a day?”

“That’s right.”

“That’s
not
right. It’s
wrong
! That’s supposed to be
five hundred
milligrams four times a day. You left off a zero.”

“I’m sorry, I…”

“No wonder the patient’s not getting any better! I want it changed immediately.”

“Yes, doctor.”

When they came to another patient of Honey’s, Dr. Ritter said impatiently, “He’s scheduled for a colonoscopy. Where is the radiology report?”

“The radiology report? Oh. I’m afraid I forgot to order one.”

Ritter gave Honey a long, speculative look.

The morning went downhill from there.

The next patient they saw was moaning tearfully. “I’m in such pain. What’s wrong with me?”

“We don’t know,” Honey said.

Dr. Ritter glared at her. “Dr. Taft, may I see you outside for a moment?”

In the corridor, he said, “Never,
never
tell a patient that you don’t know. You’re the one they’re looking to for help! And if you don’t know the answer, make one up. Do you understand?”

“It doesn’t seem right to…”

“I didn’t ask you whether it seemed right. Just do as you’re told.”

They examined a hiatal hernia, a hepatitis patient, a patient with Alzheimer’s disease, and two dozen others. The minute the rounds were over, Dr. Ritter went to Benjamin Wallace’s office.

“We have a problem,” Ritter said.

“What is it, Nathan?”

“It’s one of the residents here. Honey Taft.”

Again!
“What about her?”

“She’s a disaster.”

“But she had such a wonderful recommendation.”

“Ben, you’d better get rid of her before the hospital
gets in real trouble, before she kills a patient or two.”

Wallace thought about it for a moment, then made his decision. “Right. Shell be out of here.”

Paige was busy in surgery most of the morning. As soon as she was free, she went to see Dr. Wallace, to tell him of her suspicions about Harry Bowman.

“Bowman? Are you sure? I mean…I’ve seen no signs of any addiction.”

“He doesn’t use it,” Paige explained. “He sells it. He’s living like a millionaire on a resident’s salary.”

Ben Wallace nodded. “Very well. I’ll check it out. Thank you, Paige.”

Wallace sent for Bruce Anderson, head of security. “We may have identified the drug thief,” Wallace told him. “I want you to keep a close watch on Dr. Harry Bowman.”

“Bowman?” Anderson tried to conceal his surprise. Dr. Bowman was constantly giving the guards Cuban cigars and other little gifts. They all loved him.

“If he goes into the dispensary, search him when he comes out.”

“Yes, sir.”

Harry Bowman was headed for the dispensary. He had orders to fill. A
lot
of orders. It had started as a lucky accident. He had been working in a small hospital in Ames, Iowa, struggling to get by on a resident’s salary. He had champagne taste and a beer pocketbook, and then Fate had smiled on him.

One of his patients who had been discharged from the hospital telephoned him one morning.

“Doctor, I’m in terrible pain. You have to give me something for it.”

“Do you want to check back in?”

“I don’t want to leave the house. Couldn’t you bring something here for me?”

Bowman thought about it. “All right. I’ll drop by on my way home.”

When he visited the patient, he brought with him a bottle of fentanyl.

The patient grabbed it. “That’s wonderful!” he said. He pulled out a handful of bills. “Here.”

Bowman looked at him, surprised. “You don’t have to pay me for that.”

“Are you kidding? This stuff is like gold. I have a lot of friends who will pay you a fortune if you bring them this stuff.”

That was how it had begun. Within two months, Harry Bowman was making more money than he had ever dreamed possible. Unfortunately, the head of the hospital got wind of what was going on. Fearing a public scandal, he told Bowman that if he left quietly, nothing would appear on his record.

I’m glad I left,
Bowman thought.
San Francisco has a much bigger market.

He reached the dispensary. Bruce Anderson was standing outside. Bowman nodded to him. “Hi, Bruce.”

“Good afternoon, Dr. Bowman.”

Five minutes later when Bowman came out of the dispensary, Anderson said, “Excuse me. I’m going to have to search you.”

Harry Bowman stared at him. “Search me? What are you talking about, Bruce?”

“I’m sorry, doctor. We have orders to search everyone
who uses the dispensary,” Anderson lied.

Bowman was indignant. “I’ve never heard of such a thing. I absolutely refuse!”

“Then I’ll have to ask you to come along with me to Dr. Wallace’s office.”

“Fine! He’s going to be furious when he hears about this.”

Bowman stormed into Wallace’s office. “What’s going on, Ben? This man wanted to search me, for God’s sake!”

“And did you refuse to be searched?”

“Absolutely.”

“All right.” Wallace reached for the telephone. “I’ll let the San Francisco police do it, if you prefer.” He began to dial.

Bowman panicked. “Wait a minute! That’s not necessary.” His face suddenly cleared. “Oh! I know what this is all about!” He reached in his pocket and took out a bottle of fentanyl. “I was taking these to use for an operation, and…”

Wallace said quietly, “Empty your pockets.”

A look of desperation came over Bowman’s face. “There’s no reason to…”

“Empty your pockets.”

Two hours later, the San Francisco office of the Drug Enforcement Agency had a signed confession and the names of the people to whom Bowman had been selling drugs.

When Paige heard the news, she went to see Mitch Campbell. He was sitting in an office, resting. His hands were on the desk when Paige walked in, and she could see the tremor in them.

Campbell quickly moved his hands to his lap. “Hello, Paige. How’re you doing?”

“Fine, Mitch. I wanted to talk to you.”