Wonders Never Cease (4 page)

A
nd how are we doing this evening, Mr.”—the man took a quick glance at the patient's chart—“Jablonski, is it?”

“Not so good. I'm not sleeping.”

“That's a common complaint in a neurological ICU. You'll get used to it.” He flipped through the chart and quickly scanned the attached medical records. “Who's your attending?”

“My doctor? I think his name is ‘Smithson' or something.”

The man looked unimpressed. “Smithson—did his residency at UVA.”

“Is that good?”

“It'll do.”

“Who're you?”

“My name is Kemp McAvoy. I see from your chart here that your initial diagnosis is CIDP.”

“That sounds familiar. What is that, exactly?”

“Chronic inflammatory demyelinating polyneuropathy. It's a disorder of the peripheral nerves caused by damage to the myelin sheathing. Essentially, your body's immune system is attacking the covering that insulates your nerves—they begin to short-circuit like a bundle of stripped wires. Let me try something here. Can you sit up for me?”

The man sat up and dangled his legs over the edge of the bed. “I hate these gowns. They leave your whole backside open.”

“That's the least of your worries, Mr. Jablonski.” Kemp tapped the man's knee with a rubber percussion hammer—there was no response. “Hmm.”

“What?”

“No reflex—just as I expected. Tell me, have you been experiencing weakness in your legs and arms?”

“That's why I'm here.”

“Have they drawn spinal fluid yet to test for elevated protein levels?”

“What? No, I don't think so. Does that hurt?”

“Tell me about the onset of weakness in your legs and arms. Did it happen over a period of months? Or was it more like weeks or days?”

“I don't know . . . over a week or two, I suppose.”

“Hmm.”

“What? You keep saying that.”

“I'm not convinced of the original diagnosis. Considering the fairly rapid presentation of symptoms, a better diagnosis might be Guillain-Barré syndrome.”

“What's that?”

“You'll need a lumbar puncture to confirm it, but I'm fairly confident of the diagnosis.”

“Is that bad? What's a ‘lumbar puncture'?”

Just then the door opened and another man stepped inside. He wore a white lab coat with a UCLA Medical Center ID that said smithson, md. Dr. Smithson took one look at his patient sitting upright in bed and Kemp holding the percussion hammer beside him and said, “What's going on here?”

Neither man answered.

The neurologist pointed an accusing finger at Kemp. “I'm asking you.”

Kemp shrugged. “Just looking in on a colleague's patient while she's on break.”

“A
colleague
,” Smithson said. “You mean another nurse.”

Mr. Jablonski squinted at Kemp. “You're a
nurse
?”

Smithson swung the door open wide. “I want to talk to you outside—right now.” He charged out the door and into the hallway.

Kemp looked at Mr. Jablonski. “It's pronounced
Ghee-yan
Bah-ray
—just tell them GBS. Somebody around here should know what it means—even if he went to UVA.” Kemp calmly followed the neurologist into the hallway and closed the door behind him.

Smithson was waiting for him. “What do you think you're doing, McAvoy?”

“My job,” Kemp said.

“What were you doing with my patient's chart?”

“Checking to see if there were any orders. That's what nurses are paid to do.”

“I know what nurses are paid to do, and what they're
not
paid to do—like second-guessing a physician's diagnosis and dispensing medical advice. Don't bother denying it—I've heard complaints about you from two other neurologists. I know about you, McAvoy. I've heard the rumors—and judging by the size of your ego, you probably started them. They tell me you went to med school at Johns Hopkins and even started your residency there. Is that right?”

“Yes.”

“Well, aren't you the bright boy. What was your specialty?”

“Anesthesiology.”

“But I hear you never finished your residency. Is that true?”

“It's true.”

“How far did you get?”

Kemp paused. “Third year.”

“You were in your final year of residency and you quit to become an RN? That was a shrewd career move. What happened?”

Kemp didn't answer.

“I don't really care what happened,” Smithson said. “What I do care about is that you seem to think you're a doctor—and you're not. Maybe you've got an MD and maybe you've got a license, but without that residency you're not board certified, mister. You want to practice medicine? Go right ahead—move out to Bakersfield or Fresno and hang up your shingle there. But without that residency you'll never have hospital privileges and you'll never work in a place like UCLA—except as a nurse.
You're not a doctor here
—got it? So why don't you just check the vital signs and empty the Foleys and leave the practice of medicine to those of us who bothered to finish school?”

Kemp just shrugged.

Smithson wheeled around to storm off but turned back for a final word. “And if I ever catch you second-guessing one of my diagnoses again, I'll have you brought up on ethics charges so fast it'll make your head swim.”

Kemp watched until the neurologist disappeared around a corner; when he turned around he found three of his colleagues at the nurses' station diplomatically staring at the floor. “And that,” Kemp said loudly, “is the problem with health care in this country today.” He turned to the charge nurse. “I'm taking my break now, Shanice. Have someone look in on my patient for me, will you?”

He walked down the hall to the nurses' break room. The room was empty and quiet except for a small television chattering in the corner. Kemp flopped down on a natty plaid sofa and stretched his legs out on a coffee table littered with magazines and paperbacks.

Idiots
, he thought.
My talents are wasted here. The average
nurse in California has a two-year community college degree,
and look at me—four years of med school and three years of
residency, and at Hopkins no less. And I'm supposed to be
draining catheters while fools like that are building vacation
homes in Malibu? I've forgotten more about medicine than he'll
ever know. Where's the fairness? Where's the justice
?

He hooked his right toe behind his left heel and pried off his shoe; when the shoe fell to the side it landed on top of a glossy paperback that caught Kemp's eye. He slid the book out from under his shoe and looked at it. The title read:
Lattes
with God
:
An Encounter with the Almighty over Caramel
Macchiatos
.

He let out a groan and tossed the book aside—but not before noticing a golden seal on the corner of the cover that announced, “Runaway Best Seller—Over 12 Million Copies in Print.”

The door quietly opened and Natalie stepped inside. “I heard you were taking your break,” she said.

Kemp rolled his eyes. “And what else did you hear from my distinguished colleagues?”

“I heard you got a dressing-down from one of the neurologists. What happened?”

“Same old thing—professional jealousy.”

Natalie sat down on the sofa beside him. “You know, Mrs. Rodriguez can only work another couple of days. What are we going to do?”

“Do?”

“About Leah, Kemp. We've both been working nights, and that's been working out great. We both work seven-to-seven, and that lets us get home just in time to take her to school—then I can grab a few hours of sleep and pick her up again. I get the afternoons with her and we all get to have dinner together—how good is that? And Mrs. Rodriguez helps out in the evenings and sleeps over. It's been a great fit—but now there isn't going to be a Mrs. Rodriguez anymore. Now what do we do?”

Kemp shrugged. “Find another
mamacita
.”

“Maybe it would have helped if you didn't call her that.”

“So now I'm the reason she's leaving?”

“I'm just saying, what are we going to do?” She waited for his response, but there was none. At last she said, “You're going to have to switch to days.”

“Me? Why me?”

“Because she's my daughter, Kemp—isn't that what you're always telling me? Think about it: When I work nights I get afternoons and dinners with her. If I have to work days I'll never see her—she'll be asleep when I leave for work and ready for bed when I get home. You've got to switch—it's the only way.”

Kemp shrugged. “Then I wouldn't get to see her.”

Natalie glared at him. “Maybe I should just cut back on my hours—switch to half-time.”

“Forget that,” Kemp said. “We're barely scraping by right now. How are we supposed to make it on half your salary?”

“It would be worth it.”

“Not to me.”

“Then switch to days—it's the only way.”

“I happen to like nights, Natalie. The pace is slower; there are fewer procedures, fewer interruptions—fewer morons poking their nose in your business. Let's not panic here. Mrs. Rodriguez isn't gone yet—we'll find somebody else.”

“How? Where? It could take weeks, and she'll be gone in just a couple of days. You've got to switch to days, Kemp—at least for a little while.”

“Forget it.”

“Then I've got to cut back. You decide.”

Kemp allowed several seconds to pass. “Maybe I should just move out.”

“What?”

“It's a fifty-fifty deal, honey. You chip in, I chip in, and together we make it work. Now you're expecting me to work full-time while you cut back? How is that fair? I'd be better off on my own.”

She shook her head. “I can't believe you said that.”

“Hey, fair is fair.”

“It's always about money with you, isn't it?”

Kemp turned to face her. “That's right, Natalie—it's always about money. It's about that moron out there who's making four hundred grand a year while I draw thirty-five bucks an hour plus four bucks more because I work nights. It's about a miserable two-bedroom, one-bath, eleven-hundred-square-foot hovel in Culver City that we shell out twenty-two hundred a month for. It's about the $700,000 it would take to buy that miserable dump—$700,000 that we'll never have because it takes every penny we've got just to scrape by each month. Yeah, it's about money—you bet it is.”

“What's eating you tonight? What's the problem?”

“I'll tell you what the problem is—the problem is
this
.” He picked up the copy of
Lattes with God
and held it up in front of her face. “Look at this—do you see what it says?
Twelve million
copies in print
. Some idiot thinks he sees God because he's overdosing on caffeine, so he scribbles it all down and presto—
twelve million copies
. Do the math, Natalie. A writer makes, what—fifteen, twenty percent of net? So this guy's making maybe a buck or two per book. Multiply that by twelve million and you know what you get? You get
my life
—the life I was supposed to have.”

Natalie let out a groan. “Not this again.”

“And the thing that absolutely kills me is that people actually read this garbage! This is a nurses' break room in a neurological intensive care unit—that means one of our ‘colleagues' out there bought this book and she's been reading it during her breaks.”

“Or
his
breaks.”

“Whatever.”

Just then they heard the sound of the door opening again and they both turned to see an elderly African-American man quietly poke his head into the room and reach for a garbage can just inside the door.

“Maybe
that
explains it,” Kemp said. “Hey, you, come in here for a minute.”

The old man straightened and took a step into the room. “Me?”

“I think you forgot your book,” Kemp said, sailing it across the room so that it landed at the old man's feet.

“His name isn't ‘Hey, you,'” Natalie scolded. “That's Emmet, Kemp. You know Emmet—he's worked here for years.”

“Oh yeah, Emesis. How you doing, Emesis?”

“
Emmet
,” Natalie whispered.

“You left your book here in the nurses' break room, Emesis. Better take it with you.”

Emmet stooped down and picked up the book. “Don't believe this belongs to me.”

“No? Tell me, what are the custodians reading these days?”

“Don't have much time for it myself,” the old man said.
“Can't speak for the others.” He held up the book. “Is this what the nurses are reading?”

“No,” Natalie said. “Kemp mostly reads
Sports Illustrated
, especially if there happens to be a swimsuit inside. Sorry to bother you, Emmet. It's nice to see you again.”

“I'll just leave this with you then,” he said, setting the copy of
Lattes
back on the coffee table. “I'll take the rest of the trash with me.”

When the old man closed the door Natalie turned on Kemp. “Why do you always have to be so—”

“Now that's really discouraging,” Kemp said.

“What is?”

“It wasn't his book—that means one of our ‘peers' is actually reading this drivel. These are supposed to be educated people, Natalie—they should know better.” He sank back on the sofa. “It can't be that easy to make money. Seven years of graduate education and I'm making thirty-five bucks an hour. I must be missing something.” He looked at Natalie again. “It's not fair. I'm brilliant, you know.”

“Yes, I know. You've told me.”