Trapped (20 page)

Chapter Thirty-Seven
(Weeks 7-11)

Hundreds of white sails dotted the blue-grey waters of San Francisco Bay as Lisa stared through the west-facing ICU windows.

“I don’t like the way he looks this morning,” Lisa said
, turning as Jack and Phoebe arrived at Mike’s bedside.

“I don’t know what you mean,” Jack
said, scratching his head. He flipped through the clipboard. “His vital signs are stable and his temperature is ninety-nine degrees.”

It was
Mike’s fifth week, and his IV lines had become a perpetual source of infection. Jack placed him on intravenous nutrition as each time they tried tube feedings into his stomach, he’d develop one problem or another.

“Maybe he’s developing an infection,” she said.

“We remain healthy largely because our body’s integrity,” Jack said. “Every natural orifice has its own protective mechanism that works well until we insert a tube or a catheter. The most effective protector is the skin, and each time we breach it, the risk increases.”

Lisa stared at Mike. “I look at all this, the IVs, the endotracheal tube attached to the ventilator
, and the drains from his head and his abdomen. I understand them, but the rubber catheter protruding from his penis feels like an invasion of his persona, some kind of primitive violation.”

Jack rolled his eyes. “Every man winces with the sight of that tube. It’s like talking about a circumcision.”

Phoebe brought the lab results to Jack. He reviewed them and said, “His white blood cell count is up. He’s got an infection somewhere.”

Jac
k carefully examined Mike, checking each IV and drain site. “I don’t see a thing, Lisa. I’ll get the lab to culture his blood and all the sites, just to make sure.”

As they pulled up the sheet to cover Mike, the blood pressure monitor alarmed. The flashing red LEDs read 86/40.

“Shit,” Jack said. “He’s got to be septic, maybe it’s staph.”

Lisa grabbed her abdomen. She
grunted in pain and collapsed into the lounge chair by the bedside.

“Are you okay?” Jack
asked.

“I’ll be fine.”

“Phoebe, get her out of here,” Jack
said.

“No, Jack,” Lisa
said. “Don’t.”

“Get her out. I can’t worry about her
, too.”

Phoebe sat Lisa in the nurse’s lounge. “I’ll keep you posted. Try not to worry.”

“You’re kidding.”

Jack increased the IV rate
, and then added blood volume expanders. Mike’s pressures were now in the 100/60 range. “I want those blood cultures, stat, and then I’m writing antibiotic orders.”

Thirty minutes later, after the first infusion of powerful antibiotics, Phoebe said, “Where is the source of infection, Jack?”

“Pick a place. He has so many possibilities. Your guess is as good as mine.”

Lisa paced the nurse’s lounge waiting for Phoebe to return. Suddenly, the pain recurred. She held her lower abdomen, feeling the cramps. When she went to the ladies room, the pinkish blood stains on her panties jolted her. Oh, my God, this can’t be happening.

She dialed Harvey Russo.

“Come right over to the office,” he said.

She left a message in ICU for Phoebe to meet her.

As Lisa sat in the waiting room, Phoebe hurried in, and hugged her. “Don’t worry. It’s probably nothing. Spotting is common in early pregnancy.”

“How’s Mike?”

“We started him on antibiotics. He may be septic.”

“Septic?”

“We have it under control. His pressure’s up. Let’s worry about you, for the moment.”

Harvey came into the waiting area
, and escorted Lisa and Phoebe to the examining room. He obtained a sample of Lisa’s urine, and then performed a quick physical and pelvic examination. Afterward, he said, “I can’t find anything wrong, Lisa.”

“Then why am I bleeding?”

“I don’t know for sure,” Harvey said. “About a third of women bleed during the first trimester from several causes, including inflammation of the cervix, to implantation, to some retained menstrual tissue, as well as other rare causes. They’re all benign and shouldn’t put your pregnancy at risk.”

Lisa braced herself.

“What are my chances of losing the baby?”

“Don’t talk that way.”

“Harvey, please, the chances?”

“We used to think about 30 percent, but recent studies put it in the range of 5 percent. I’m going to order some hormone levels and tomorrow we’ll get an ultrasound.”

Lisa stood. “I’m going back to see Mike.”

“Hell you are
,” Phoebe said. “You’re going home.”

The nurses called her every hour or two on Mike’s condition, which remained stable.

Lisa fell asleep on the couch with Daisy
, and awoke at 2 in the morning. She felt relieved when the night nurse reported, “No change.”

When they returned the next day to Harvey’s office, Lisa said, “I’m still spotting, but it’s not as much.”

Harvey took her into the ultrasound room. “You
r hormone levels are increasing as they should. Let’s take a peek at your baby.”

Lisa lay on the hard
gurney while Harvey applied the cold jelly and ran the probe over her belly. She watched the screen and recognized the sac. When Harvey turned up the volume, her baby’s heart beat reverberated through the room. Suddenly, Lisa flushed with emotion. “Can you tell if it’s a boy or a girl?”

“No, it’s too early, but I’m pleased to say that everything looks great.”

When they left Harvey
’s office for ICU, Phoebe held Lisa’s arm, preventing her from breaking into a run. When they reached the unit, Lisa slid open the door, expecting the worst. The atmosphere was calm as she walked to Mike’s bed, finding it freshly remade. As usual, he looked asleep. She stared at the monitors, especially the blood pressure numbers, and when the monitor read120/70, she felt a great sense of relief.

Lisa awoke the next morning with no further bleeding.

Lisa read everything she could put her hands on. She scanned the internet for sites seeking advice on how to preserve her pregnancy. They ranged from standard recommendations about general health, rest,
and diet to alternative approaches, including herbal medications and acupuncture.

Absent bleeding
, and with Mike’s condition, stable, Lisa felt much better.

“Anything’s better than the fatigue, Phoebe,” Lisa said. “You can deal with almost anything if you have energy.”

“You amaze me, s
weetheart. They’d be sponging me off the floor, or I’d be in a padded room by now. I don’t know how you do it.”

“What choice do I have?”

“I guess it’s true when they say: what doesn’t kill us, makes us stronger. I used to think people like you were simply brave. Now I know that you can’t help yourself.”

“Can’t help myself?” Lisa
said. “Am I not the master of my own fate?”

“The captain of your soul?”

Lisa laughed. “Invictus.”

“Who really is? Look at you,” Phoebe said, smiling. “If you survived Sandy and Rudy, you can get through anything.”

“I survived, but like the Peanuts character, I carry a dark cloud over my head. Mike did his best to blow it away, but he never really succeeded.”

“Let’s get you on the analyst’s couch.”

“Whatever it takes, Phoebe. Whatever it takes.”

“Let’s go shopping,” Phoebe
said. “They’re having all kinds of sales at the mall.”

“Just for an hour
, or so. I want to be with Mike by noon.”

Phoebe drove under overcast skies. Light rain fell as they parked at the Sun Valley Mall in Concord.

They walked through the mall, mostly browsing.

When they stood in front of
A Pea in the Pod,
a maternity clothing store, Phoebe said, “Let’s take a look.”

“I’m not showing
, yet, and I’m not crazy about maternity clothes.”

“I wasn’t crazy about those clothes,
either, but you’ll need them, eventually. I saved some cute things for you.”

As they walked into the store, Lisa felt a strong cramp in her lower abdomen. The pain was so severe that she
bent over. Suddenly, she felt the flow of warm blood from her vagina. She rushed to the ladies room, and gasped at the deluge of bright red blood with clots. Oh God. Please God, not again. I can’t stand this.

Phoebe got several menstrual pads from the dispensers in the
ladies room.

Lisa called Harvey Russo
and they agreed to meet at Brier Emergency.

The drizzle had become
a heavy rain as they drove toward Brier Hospital. Lisa sobbed, “This can’t be happening to me, Phoebe. It’s just not fair.”

“Since when does
fair
matter.”

After Harvey’s examination and another ultrasound
, he said, “Everything looks normal. The baby’s growing and has a strong heartbeat. There’s nothing to do, except put you to bed.”

Sandy came by bus from Grass Valley the next day. Phoebe picked her up at the bus terminal, and helped with her things.

When Sandy came into Lisa’s bedroom, she placed her suitcase on the floor
, and bent over to kiss her daughter.

Lisa looked at the bag. She recognized the battered 40s tan suitcase with a striped fabric cover.

“You still have that relic?”

“There’s not a thing wrong with it
. I think it was your grandfather’s.”

Sandy cleaved to her role as the anxious, but helpful mother.

Lisa thought that, for the first time since Rudy’s death, Sandy was doing something meaningful.

Every time Lisa tried to get out of bed, Sandy stood there shaking her head
, and pointing her finger at her daughter. “Dr. Russo said…”

“Give me a break, Mom. The doctor said I could get up to pee, didn’t he?”

“Don’t use such crude language in front of your mother.”

God save me
, Lisa thought.

Lisa cramped through the night, but it eased off as morning approached. She’d changed her pad four times since midnight, each soaked with blood and clots.

She stood before the bathroom mirror, splashed cold water on her face, combed her hair back, and rubbed the thin scar over her left eyebrow, a token of life with father.

Harvey Russo called at
seven a.m. “What’s happening, Lisa?”

She told him about the cramps and the pads.

“I’m sending a lab tech right over to draw some blood. As long as we have a strong heartbeat and the hormone levels are okay, we just have to wait. If you continue to bleed, there’s still nothing more to do but wait. That’s okay by me, and a lot better than the alternative. I know how difficult this is, and I wish I had something else to offer.”

“All right, Harvey, but would you tell nurse Ratched
, here, that I can get up to pee?”

Lisa handed the phone to Sandy
. She listened and then nodded her head emphatically. “Of course, Doctor. Anything you say, Doctor.”

Lisa talked with the ICU twice in the morning and once, so far, in the afternoon. She dozed until five p.m., and when she opened her eyes, the sun was setting.

Something’s wrong
. She felt the warmth surrounding her buttocks, and when she pulled the sheet back, her bottom was swimming in a pool of bright red blood and clots.

“Mother,” Lisa
cried.

Sandy looked into Lisa’s bed. She screamed, ran to the phone
, and dialed 911.

Chapter Thirty-Eight

Once notified of impending litigation, Harvey Russo’s malpractice carrier assigned Jackie Barnes, an experienced attorney, to his case. He and Jackie had a history.

When Harvey arrived at Jackie’s Emeryville office, the receptionist had him wait in the library.

When Jackie entered, she hugged Harvey. “It’s a shame that we meet again under these circumstances.”

“I’m glad they assigned you to the case, Jackie. This one really pisses me off.”

Jackie was in her late 50s, but looked in her 30s. She wore a business suit that highlighted her figure, and a silk blouse to emphasize her femininity. Her clear complexion and unlined face suggested she’d had some help in maintaining her youthful appearance.

“Lately, they’re all pissing me off, and it’s not because I’m a defense attorney. Juries have become so threatening
, and so out of touch with reality that we try to settle any case with an iota of merit. This one’s a topper. I can’t wait to get Edna-Sue Jones under oath.”

“What do you know about Richard Boardman?”

“He’s a prick,” Jackie said, with a ladylike smile, “but a smart one. He’ll try to argue the facts, but he can’t. He’ll try to argue the law, which is useless, so he’ll make this as unpleasant as possible, hoping we’ll settle.”

“You attorneys created a hell of a system.”

“Don’t put me in that group, Harvey. I’m on your side.”

As the date of Harvey’s deposition approached, he felt more than ever that his world was spinning out of control. First, Mike Cooper’s illness, then Lisa’s pregnancy problems, and his daughter, Roberta, the arguments with his partners, and now this malpractice suit.

What’s next
? He thought.

Teresa and Harvey finished dinner, cleared the table, and filled the dishwasher.

As they left the house for their evening constitutional, Harvey looked at the grey cumulus clouds, and said, “We’d better make it quick, before it rains.”

“I know something’s bothering you,” Teresa
said, “but you’ve hardly said a word.”

“I’ve been sued before, Teri. It
’s never easy answering charges, and having your work misrepresented, especially by the professional whores who’ll say anything a plaintiff’s attorney wants. Combine that with the fact that you never know what a jury will do. This hasn’t been a good year for us.”

“Nothing’s really changed.”

“My tolerance for all this crap isn’t what it used to be. Maybe I’m getting old.”

“There’s no doubt about that, s
weetheart, but you’re every bit the vibrant man I married so many years ago.”

“Maybe it’s time to make a change. Life’s supposed to get easier as you age
. Maybe we should shuck it all and go cruising, or full-time RVing. Who knows how many years—how many good years we have left?”

“Now
, you’re depressing me. Step back a second. We’re having a great life. I love you today as much as ever. If we think about a major change, we should be running toward a new life, not running away from the old one. Our problems, unpleasant as they may be, are likely to be fleeting in nature.”

“They’re taking my deposition tomorrow.”

“I know.”

“You go for me.”

“I would if I could. You’ll do fine. You always do.”

Harvey and Jackie drove through the downtown Oakland congestion to an office building on Clay Street across from the Federal Courts Building.

When they opened the door with Richard Boardman, Attorney at Law
, engraved in gold, his secretary said, “Mr. Boardman’s expecting you. He’s in the conference room.”

They entered the long narrow room with a large window
at the distant end. Richard Boardman sat at the far end of the long oak conference room table, while the stenographer set up her machine.

“Good to see you again, Jackie,” said Boardman
, standing. He approached Harvey and extended his hand, “Dr. Russo, how delightful to meet you.”

Harvey shook Boardman’s clammy hand, but said nothing.

Harvey and Jackie sat next to each other, across from Boardman.

“You’re looking great, Jackie. I haven’t seen you since the Olivetti case.”

“You mean the Olivetti fiasco?”

“That’s my Jackie
,” he said with a smile. “always ready to draw first blood.”

“Let’s get on with it,” Jackie
said.

The court reporter swore Harvey in
, and then Boardman opened with a statement that identified the date, place, time, the people present, and the case:
Jones v. Harvey Russo, Brier Hospital…

“I’ll stipulate to Dr. Russo experience, training, academic appointments, and awards if that’s okay with you
, Jackie?”

“No, Ritchie, I’d prefer to have them on the record.”

Ten minutes later, after Harvey finished, Boardman continued, “Have you been sued for malpractice before, Doctor?”

“Yes, I…”

Jackie leaned over and whispered into Harvey’s ear, “The shortest answer possible. A ‘yes’, for instance.”

“What was the outcome?”
Boardman asked.

“The outcome?”
Harvey replied.

“Yes, what happened?”

“They dropped the suit.”

“Did the plaintiff’s attorney depose you?”

“Yes.”

“So you’re familiar with the deposition process?”

“Yes.”

“Why did you remove my client’s uterus without her permission?”

Here it goes,
thought Harvey.

“We had consent.”

“Whose?”

“Her mother’s.”

“Were you there when Mrs. Rachael Carter gave her permission?”

“No, but…”
He felt Jackie’s hand grasping his arm.

“So you don’t know what information she received?”

“No.”

“Why didn’t you inform Ms. Jones that she might lose her uterus?”

“She wouldn’t talk with me.”

“So, that was enough for you?”

“Objection,” Jackie said. “Don’t answer that.”

“How many hysterectomies,
Doctor, have you performed on nineteen-year-old girls?”

“Three or four
.” Harvey stopped and thought. “Maybe five.”

“You think it’s a good idea to deprive a woman, in the fruit of
her childbearing years, of her womb?”

“Give me a break,” Harvey
shouted. “Good idea?”

“Take it easy, Harvey,” Jackie
whispered. “Don’t let him get to you.”

“You took her uterus, did you not?”

“Yes.”

“Just like that, D
octor?”

Hold on
,
Harvey thought. “I had no choice.”

“No choice, D
octor? You had any number of choices, and we have expert witnesses who will testify to that fact, but you chose the easy way out, a way that cost this teenage girl the ability to bear children.”

“She has five children, Mr. Boardman.”

“And you think that’s enough?”

“What I think does not affect my decision
-making in her care.”

“So you’d say to a jury, D
octor.”

“There’s no jury here, Ritchie,” Jackie
said. “Ask your questions and cut out the theatrics.”

“Theatrics? If you don’t want your client to answer, then let’s get it on the record.”

Boardman turned back to Harvey. “There was no way to save my client’s uterus?”

“Trying to save it could
have cost your client her life,” Harvey said. “Then you’d have me up here for wrongful death.”

“If you acted in a negligent way, you bet
your ass I would.” Boardman paused and glanced at his yellow legal pad and continued, “What were the alternatives, Doctor?”

“None, in my opinion.”

“Our expert witnesses tell me there are alternatives.”

“Good, then ask them.”

“Could you have tried to repair the uterus?”

“No.”

“No?”

“No.”

“Did you try to get control of the arteries to the uterus, or consider getting a radiologist to block the bleeding arteries?”

“No.”

“No? Maybe if you tried, Doctor, you could have saved the uterus of this nineteen-year-old girl.”

Harvey shook his head in disgust.
“I made a decision that only a surgeon who had his hands on that uterus could make. In my mind, the answer was simple, save the patient, not the uterus.”

“Couldn’t you have controlled her labor and reduce
d the threat of damage to her uterus?”

“Your client wouldn’t let us near her.”

Boardman flipped the page on his yellow pad. “Ms. Jones arrived at Brier Emergency at five-thirty in the morning, is that correct?”

“I believe so.”

“Nobody saw her for three and a half hours. Was that a good idea?”

“The admitting nurse saw your client. She
was drunk and stoned on cocaine, and she said nothing about being pregnant. She couldn’t give a coherent history, but the nurse found her condition to be stable.”

“But it wasn’t stable, was it?”

“In retrospect, Mr. Boardman,” Harvey said, we’re all geniuses.”

“The staff knew she’d been pregnant several times. She was of childbearing age. Shouldn’t someone have considered the obvious
, that she was pregnant?”

“With the time constraints of a busy ER, the need to triage patients, and her intoxicated and belligerent attitude, the ER functioned appropriately.”

It went on this way for hours, until, finally, Boardman said, “No further questions.”

Afterward, with Harvey still steaming from his reaming, Jackie said, “Let’s go down to Jack London Square. I’ll buy you a drink.”

“I need one.”

They sat by the window of Scott’s Restaurant, overlooking the Oakland Estuary. Boats of every size and shape passed by, going to, or coming from, the San Francisco Bay.

Jackie raised her glass of chardonnay to Harvey. “I’d say we’re in good shape, but you don’t look so good to me.”

“It's Roberta. She’s on a downward spiral with meth, and,” he paused, “one of these days we’ll hear from the police or the coroner—it's driving us nuts.”

“Methamphetamines are the worst. I have contacts in the drug program, maybe they can help?”

“She’s been through it all. Nothing works.”

Jackie placed her glass down and grasped Harvey’s hand. “You know
, if there’s anything…”

“I know. Thanks.”

Jackie waited a respectful few moments, then said, “You did well, Harvey, except you got into it more than I’d prefer. When you mix it up with a guy like Ritchie Boardman, you’re giving him too much information. I’d prefer that he hear it first at trial.”

“You know I don’t think much of malpractice litigation, but if they can win on these facts, they can win on anything.”

“Welcome to my world, Harvey.”