by Robin Cook
Kim started to protest, but it was all too obvious it was a waste of time to try to talk with this woman. It occurred to him that she might not even know what the term “on staff” meant. With growing frustration, humiliation, and irritation, Kim returned to Tracy.
“I don’t know where they find these people,” Kim complained. “They’re like automatons.”
“I’m impressed by how your exalted position in this hospital has greased the skids for us.”
“Your sarcasm doesn’t help one iota,” Kim snapped. “It’s all because of the merger. I’m not known down here. In fact, I can’t remember ever coming to this ER.”
“If you’d taken Becky’s complaints seriously over the weekend, we probably wouldn’t have to be here now,” Tracy said.
“I took them seriously,” Kim said defensively.
“Oh, sure,” Tracy said. “By giving her some over-the-counter diarrhea medications. That’s really an aggressive approach! But you know something? I’m not surprised you didn’t do more. You’ve never taken seriously any symptoms Becky has ever had. Or mine either, for that matter.”
“That’s not true,” Kim said hotly.
“Oh, yes, it is,” Tracy said. “Only someone married to a surgeon would know what I’m talking about. From your perspective, any symptom less than what would call for immediate open-heart surgery is a kind of malingering.”
“I resent that,” Kim said.
“Yeah, well, so do I,” Tracy said.
“All right, Miss Know-It-All,” Kim snapped. “What would you have had me do with Becky over the weekend?”
“Have her be seen by somebody,” Tracy said. “One of your many colleagues. You must have a thousand doctor friends. It wouldn’t have been too much to ask.”
“Wait a second,” Kim said, struggling to control himself. “All Becky had was just simple diarrhea and some cramps, both of short duration. And it was the weekend. I wasn’t going to bother someone with such symptoms.”
“Mommy!” Becky called. She’d come up behind Kim and Tracy. “I have to go to the bathroom!”
Tracy turned and, reminded of her daughter’s discomfort, her anger immediately mellowed. She put her arm over Becky’s shoulder. “I’m sorry, dear. Sure! We’ll find you a bathroom.”
“Wait,” Kim said. “This could be helpful. We’ll need a sample. I’ll get a stool-sample container.”
“You must be joking,” Tracy said. “I’m sure she has to go now.”
“Hold on, Becky,” Kim said. “I’ll be right back.”
Kim walked deliberately and quickly into the depths of the ER. Without Becky and Tracy, he wasn’t challenged as he passed the nurses’ desk. For the moment the mammoth Molly McFadden was nowhere to be seen.
The interior of the ER was a series of large rooms divided into separate cubicles by curtains that hung from overhead tracks. In addition, there were individual trauma rooms replete with state-of-the-art equipment. There were also a handful of examination rooms used primarily for psychiatric cases.
Like the outer waiting area, the ER proper was packed and chaotic. Every trauma room was occupied and staff physicians, residents, nurses, and orderlies swirled between them in continuous motion.
As he walked, Kim searched for someone he recognized. Unfortunately he didn’t see anyone he knew. He stopped an orderly.
“Excuse me,” Kim said. “I need a stool-sample container ASAP.”
The orderly gave Kim a rapid once-over with his eyes. “Who are you?”
“Dr. Reggis,” Kim said.
“You got an ID?”
Kim produced his hospital identification card.
“Okay,” the orderly said. “I’ll be right back.”
Kim watched the man disappear through an unmarked door that apparently led to a storeroom.
“Coming through,” a voice called.
Kim turned around in time to see a portable X-ray unit bearing down on him. He stepped to the side as the heavy machine was trundled past by an X-ray technician. A moment later the orderly reappeared. He handed Kim two clear plastic bags with plastic containers inside.
“Thanks,” Kim said.
“Don’t mention it,” the orderly said.
Kim hurried back the way he’d come. Tracy and Becky were still in line although they had moved up a few feet. Becky had her eyes shut tight. Tears streaked her face.
Kim handed one of the plastic bags to Tracy. “Cramps?” he questioned.
“Of course, you lunkhead,” Tracy said. Tracy grabbed Becky’s hand and led her back to the restroom.
Kim held their place in line as it advanced by one more patient. Now there were two check-in clerks. Apparently the other had been off on break.
By nine-fifteen the ER waiting room was filled to overflowing. All the molded-plastic chairs were occupied. The rest of the people were leaning up against the walls or sprawled on the floor. There was little conversation. In one corner, a television hung suspended from the ceiling. It was tuned to CNN. A number of unhappy infants drowned out the newscaster. Outside it had started to rain; the smell of wet wool filled the air.
Kim, Tracy, and Becky had eventually found seats together and had not moved, except for Becky, who’d made several more trips to the restroom. Kim was holding the stool-sample container. Although there had been some spots of bright red blood originally, now the contents appeared a uniform light brown. Becky was miserable and mortified. Tracy was exasperated. Kim was still seething.
“I don’t believe this,” Kim said suddenly. “I truly don’t believe this. Every second I think we’ll be called, but it doesn’t happen.” He glanced at his watch. “We’ve been here an hour and a half.”
“Welcome to the real world,” Tracy said.
“This is what Kelly Anderson should have done her merger story about,” Kim said. “This is ridiculous. AmeriCare closed the ER at the Samaritan to cut costs and make everyone come here. It’s all just to maximize profits.”
“And maximize inconvenience,” Tracy added.
“It’s true,” Kim agreed. “AmeriCare definitely wants to discourage emergency-room usage.”
“I can’t think of a better way,” Tracy said.
“I can’t believe that not one of the staff people has recognized me,” Kim growled. “It’s incredible. Hell, I’m probably the best-known cardiac surgeon in the department.”
“Isn’t there something you can do?” Tracy pleaded. “Becky’s miserable.”
Kim stood up. “All right,” he said. “I’ll try.”
“But don’t lose your temper,” Tracy admonished. “It might make everything worse.”
“How can it be worse?” Kim replied.
Kim walked out of the waiting room on his way to the nurses’ desk. He’d gone only a few steps when the wailing of an ambulance siren reverberated through the main swinging doors to his left. A moment later a flashing red light was seen through the doors’ glass panels. The siren died off and soon the doors burst open. Several bloodied people—apparently auto-accident victims—were rolled in and whisked into the ER proper.
Kim could not help but wonder if these new arrivals meant Becky would have to wait that much longer.
Kim approached the nurses’ desk. Again he looked for Molly McFadden, but she was still out of sight. The people there were a clerk, who was on the phone transcribing laboratory values, and a solitary nurse doing paperwork while sipping coffee. Her name tag read: MONICA HOSKINS, ER Staff Nurse.
Forcing himself to be civil, Kim got her attention by gently tapping the countertop.
“Good evening,” he said when she looked up at him. “Perhaps you recognize me?”
Monica narrowed her eyes slightly as she gazed at Kim.
“No, I don’t think I do,” she said. “Should I?”
“I’m on the surgical attending staff,” Kim said. “But right now I’m here with my daughter, and we’ve been waiting for over an hour and a half. Could you tell me when she’ll be seen?”
“Dr. Reggis,” Kim said. He squared his shoulders.
“No, the patient’s name,” Monica said.
“Rebecca Reggis,” Kim said.
Monica picked up a stack of ER sign-in sheets. After wetting the tip of her index finger with her tongue she rapidly flipped through the papers.
“Okay,” she remarked as she withdrew one of them. “Here it is.” She read the chief complaint and then raised her face to Kim. She arched her eyebrows.
“Diarrhea, two days’ duration,” she commented. “Not exactly a four-plus emergency.”
Kim lifted the stool-sample container to bring it into her line of sight. “She’s been passing a little bit of blood this afternoon,” Kim said.
Monica leaned forward. “Doesn’t look like blood.”
“It did earlier,” Kim said. “And it has her mother upset.”
“Well, we’ll get to her as soon as we can,” Monica said noncommittedly. “That’s about all I can say.” She replaced Becky’s sign-in sheet to its former location in the stack.
“Listen,” Kim said in a deliberately controlled voice. “As a member of the staff, I expect some consideration, and after waiting this long already, I want her to be seen shortly. I hope I’m making myself clear. She’s in considerable discomfort.”
Monica treated Kim to a patently false smile. “As I said a moment ago, we’ll get to her as soon as we can. We have limited resources. If you’ve been here for an hour and a half, I’m sure you’ve seen the auto accidents that have come in, and now the police have alerted us a shooting victim is on his way.”
No sooner had these last words escaped from Monica’s lips than the familiar sound of an arriving ambulance could be heard.
“In fact, I’d wager that’s them now,” Monica said as she got to her feet. She moved over to an intercom and pressed a button. Talking to someone in one of the trauma rooms she informed them to get ready. Then she herself disappeared back into the depths of the ER.
With little satisfaction for his latest efforts, Kim headed back to the waiting room. As he passed by the main entrance doors, a team of EMT’s rushed in with the shooting victim on a gurney. The patient had an oxygen mask strapped over his face and an IV running. His color was ashen.
“Well?” Tracy asked as Kim reclaimed his seat.
“They said they’d see her as soon as they could,” Kim said. He was embarrassed to relate the rest of the conversation. He noticed that Becky had curled up in her seat as best she could and had her eyes closed.
“That’s pretty vague,” Tracy said. “What does it mean? Fifteen minutes, an hour, tomorrow morning?”
“It means exactly as soon as they can,” Kim snapped. “A shooting victim just came in and victims from an auto accident came in a few minutes ago. It’s a busy night.”
Tracy sighed and shook her head in frustration.
“How’s Becky doing?” Kim asked.
“She just had another bout of cramps,” Tracy said. “So you guess. You’re the doctor.”
Kim looked away, gritting his teeth. It was hard not to lose his temper. And on top of everything else, he was hungry.
For the next hour Kim was sullenly silent. He was busy brooding over this ridiculous ER experience and eager to complain to his colleagues about it. They would understand. Tracy and Becky seemed more resigned to the wait.
Every time one of the nurses or residents came to the waiting-room threshold to call out a name, Kim expected it to be Rebecca Reggis. But it never was. Finally Kim looked at his watch.
“It’s been two and a half freaking hours.” He stood up. “I truly can’t believe this. If I were the slightest bit paranoid, I’d think it was some kind of screwy conspiracy. This time I’m going to make something happen. I’ll be right back.”
Tracy glanced up at her former husband. Under more normal circumstances, she’d be concerned about Kim’s temper, but after having been kept waiting so long, she didn’t care. She wanted Becky seen. She didn’t comment as Kim stalked off.
Kim marched directly back to the nurses’ desk. A number of the ER staff was scattered about the station, engaged in desultory conversation punctuated by laughter.
Upon reaching the counter, Kim scanned the group for a recognizable face. No one looked familiar and none seemed to recognize him. In fact, the only person to notice his presence was the clerk, a young college-aged boy who was most likely a student at the university.
“I’m Doctor Reggis,” Kim said. “What’s happening?” He motioned to all the people.
“They’re just taking a breather,” the clerk said. “The shooting victim and the last car-accident patients just went up to surgery.”
“Who’s the acting head of the emergency department for the evening shift?” Kim asked.
“That would be Dr. David Washington,” the clerk said.
“Is he here at the moment?” Kim asked.
The clerk glanced around the area to be sure. “No,” he said. “I believe he’s back with an orthopedic case.”
“How about a head nurse or nurse supervisor?” Kim asked.
“That would be Nora Labat,” the clerk said. “She’s with a psych patient.”
“I see,” Kim said. “Thanks.”
Kim proceeded down the counter until he was at the very center. Raising his hand, he called out: “Excuse me, everybody! Hello!”
No one acknowledged Kim’s voice or gesture.
For another moment he glanced around, trying to make eye contact with anyone. It was impossible. Instead he reached across the counter and lifted a metallic in-and-out basket from the desk top. Holding it above his head for a moment, he thought someone might notice. They didn’t.
Kim brought the metal basket down to crash onto the Formica counter. He smashed it down twice again, each time with more force until the basket became distorted to the shape of a three-dimensional parallelogram.
That got everyone’s attention. Conversations stopped in midsentence. Residents, nurses, and orderlies all stared at Kim. A security man who’d been standing over near the bank of elevators came running over, his hand holding the clutch of keys attached to his belt.
Having worked himself up to a fury, Kim’s voice was tremulous. “I know you all are busy, but you certainly don’t look busy at the moment. I’ve been waiting here for two and a half hours with my daughter. As a professional man myself, my time could be spent in much more valuable ways.”
“Excuse me, sir,” the security man said. He took hold of Kim’s arm.
Kim yanked his arm free and spun around on the man. “Don’t you touch me,” Kim snarled. The security man wisely stepped back while he grappled for his two-way radio. Kim was not only a half a foot taller but also significantly more muscled.
“No need to contact anyone,” Kim said. He pulled out his hospital ID and held it up to the security man’s face. “I’m on the staff here, even though no one here in the emergency department seems willing to concede it.”
The security man’s eyes narrowed as he read Kim’s ID card. “Sorry, Doctor,” he said.
“That’s quite all right,” Kim said with a controlled voice. He turned back to the desk. Monica Hoskins had stepped forward.
“I’d like to talk with Dr. David Washington,” Kim said.
“I’m sorry you’ve had to wait,” Monica said. “We’re doing the best we can.”
“Nonetheless I’d like to speak to the acting head of the department,” Kim said.
“Dr. Washington is tied up with a pneumothorax,” Molly explained.
“I want to see him now,” Kim said evenly. “I’m sure there must be at least one resident competent to handle a pneumothorax.”
“Just a moment,” Monica said. She stepped back, and out of earshot from Kim, conferred with Molly and several of the other staff. In less than a minute, she returned to Kim. In the background one of the nu
rses she’d been talking with picked up a phone.
“We’ll have someone here in authority to talk with you momentarily,” Monica said.
“It’s about time,” Kim remarked.
Kim’s mini-tantrum had unnerved the staff and most of them vacated the nurses’ desk for the interior of the ER. Monica took the in-and-out basket Kim had bent and tried to bend it back. She was unsuccessful.
Kim’s pulse was racing. A sudden commotion behind him made him turn around. A teenage girl was being escorted by a vanguard of EMT’s. She was sobbing. Both wrists were bound with bloody dishtowels: a clear suicide attempt, no doubt in this young woman’s case a desperate cry for help.
Kim looked expectantly into the ER depths after the teenager was taken in. He expected to see the doctor-in-charge appear at any moment. Instead he felt a tap on his shoulder.
Turning around, he was surprised to see Tracy.
“Where’s Becky?” Kim asked.
“In the restroom,” Tracy answered. “It’s a routine visit this time, but I have to get right back. I just came in here to beg you not to have one of your narcissistic rages. When you stood up in the waiting room to come in here, I didn’t think I cared whether you got into a furor or not, but I do. I’m convinced it won’t improve an already bad situation. In fact it might cause Becky to have to wait even longer.”
“Spare me your psychobabble,” Kim spat. “All I’m planning on is a sane but pointed conversation with the man who runs this place. I mean, this is unacceptable. Plain and simple.”
“Just try to control yourself,” Tracy said icily. “When you’re done, you’ll know where to find us.” Tracy turned around and walked back toward the waiting room.
Kim drummed his fingers impatiently on the counter. After a while he looked at his watch. Another five minutes had passed. Once again he leaned out into the corridor to peer back into the ER depths. He saw plenty of staff but no one came striding in his direction. Kim’s eyes met the clerk’s who immediately averted his gaze. The rest of the ER staff avoided looking at Kim, instead busying themselves with paperwork.