“Where’s Lester? I need a tech to wheel this patient to—”
“He took Mrs. Barrows to Radiology,” Lauren said. “Do you need me to—”
“I need you to discharge some patients. Where’s Emma?”
“She’s taking a break.”
Beau came rushing out of an exam room that had just been vacated. He had a fresh set of sheets in his hands and a spray bottle of disinfectant under his arm. “You need me for something, Dr. Caine? I can take—”
“I don’t want a high-school student touching my patients. Vivian, page Emma. Why is she taking a break at this time of night?”
“Because she didn’t have a chance until now and she was nearly fainting from hunger.” Vivian’s face reddened. “I’m not paging a tired nurse to come back and do something a tech can do just as well. Let Beau take him.”
A sudden tense silence drifted like invisible ice pellets over the department. Caine focused his steely glare on Vivian.
Beau stepped into the breach. “Room’s done, Dr. Caine. What patient do you want to—?”
“Take the shoulder in five to Radiology. Send Lester back. I need him here.” The doctor pivoted and plunged through the next doorway.
Lauren shrugged and glanced at the clock. She would be out of here soon.
***
“So let me get this straight.” Jay leaned back in his chair and rolled his sleeves up. “You had no knowledge about the missing information until you read the records this past spring.”
“That’s correct.”
“Vital information was lost.”
“I entered the addendum on the computer but I never had a chance to check it afterward. I should have been more observant and asked questions when it didn’t show up in the chart for my signature.”
Jay placed the last page of a report on an inch-thick stack, leaned back, and sighed. “My friend, you’re being railroaded.”
Grant pulled out a folder of papers he hadn’t faxed to Jay. “These are my handwritten notes about the patient’s symptoms and my treatment, the tests I ordered and my differential diagnosis. I dated it and filed it away in my home office as I do any questionable case. Since the hospital doesn’t even have the information I submitted, this probably won’t fly in court.”
Jay read the pages while the grandfather clock serenaded them and the pleasant aroma of Greek food wafted through the office. It hadn’t taken long to eat. They’d been starved. It also didn’t take Jay long to read Grant’s papers.
He stacked the pages neatly with the rest. “You say they can’t find the copies you gave them.”
“That’s right.”
“Convenient for them.”
Grant rubbed his face wearily. “There’s something else you need to know that could complicate this case.”
“That sounds ominous.”
“It has nothing to do with the particulars of the case but I’m afraid it might become an ethical concern.”
“You? Grant, you’re the most ethical person I know. If I remember correctly, you and Annette practically lived in that church of yours when you weren’t studying.”
“Church doesn’t necessarily make one ethical. Walking in God’s will makes one ethical.” Grant hesitated. Jay was not a believer. He had a high standard of moral conduct and a compassionate heart but he had always demurred when Grant tried to speak with him about his faith. What would he think about this dark secret?
“Things changed after Annette was killed, Jay.”
“You lost your faith?”
“No.” Why had this been so much easier to share this with Lauren? “Remember when I told you about my drug addiction in high school?”
“Yes.”
“After the accident I developed a new addiction.”
“To what?”
Grant hesitated again. Was that alarm in Jay’s face? “To the prescription pain medication I was taking for my injuries.”
Jay’s expression relaxed and he shook his head. “Big deal. They can’t deny a man legitimate treatment.”
Grant gestured to the case information stacked neatly beside their empty food containers. “If they had tested me for drugs the day this patient presented to the ER there would have been a positive result.”
“But that didn’t happen and the drug was legal.” He caught Grant’s gaze. “Wasn’t it?”
“I had a prescription from two different physicians and I was filling them at different pharmacies, paying for one prescription myself so it wouldn’t alert my insurance company. At the time it was easier to do that. Maybe it was legal because I was in so much pain but I question the ethics.”
Jay frowned. “Did you question them at the time?”
“No. I apparently don’t have the receptors that cause a narcotic high, because all it did was ease my pain. I had myself convinced that I needed that much medication and that I owed it to my patients to keep the pain under control. Physical pain wasn’t the problem, though. That went away in less than two months. It was the emotional pain that nearly destroyed me.”
Fine lines of sympathy cast a shadow across Jay’s face. “Grant, I’m so sorry. I should have known. We saw each other so seldom after the accident and I took for granted you were okay. You were always so strong in school.”
“Annette was the strong one. I didn’t realize how much I depended on her until she was gone.”
“I told myself your church would take care of you,” Jay murmured, rubbing his face wearily. “You had family nearby ... and I got caught up in my own business. I should have kept in touch.”
“I wouldn’t ask for help or accept it. If it hadn’t been for the fact that Beau needed me during his reconstructive surgeries, I still don’t know if I’d have come out of it. As it was, I kicked the habit soon after this incident took place.” He gestured to the stack. “But that won’t help us if they ask me about it.”
Jay spread his hands and looked at them instead of Grant. “It obviously didn’t impair your judgment about this case. I know you aren’t lying about these notes. You did everything right.”
“Do I detect a tone of concern that wasn’t there a few minutes ago?”
Jay stared at his hands a few seconds more. “I know it’s too late but I’m going to ask for a summary judgment before the deposition. Your interrogatories are all in order. Since I’m new on the case and they know I can raise a stink about the way they’ve treated you, they might accept my request. If the judge reads what we have there’s still a chance your name may be dropped from the suit.”
Grant didn’t allow himself to hope that a summary judgment would be granted this close to the deposition date. “Perhaps we should prepare for the worst.”
Jay picked up the stack of reports, fanned them in the air thoughtfully and frowned. “It never hurts to be prepared.”
***
For the third time in ten minutes, Lauren looked at her watch. Her right foot did an impromptu dance on the tile floor. She had already worked an hour overtime. Beau had gotten off thirty minutes ago and he’d caught a ride with his impatient sister, who wanted the car to go cruising. On a weeknight. When they’d walked out the door of the ER waiting room they were in argument mode. Lauren didn’t have time to referee.
But she couldn’t, in good conscience, leave Muriel alone to work with an inexperienced nurse in an ER full of patients. They definitely needed to get a nurse practitioner or physician assistant but that wasn’t an option right now with the financial difficulties the hospital and the town were having.
Lauren entered exam room four and saw Dr. Caine completing a lumbar puncture on Mrs. Lindeman, who had come in earlier with a severe headache that had started the night before. The new nurse, Lela, held the patient in a seated position, leaning forward over the tray table with a pillow beneath her chin for comfort.
“Okay, Mrs. Lindeman, we’re going to pull the needle out now.” Dr. Caine nodded at Lela, who stared back at him blankly. “Bandage, please.”
Lel
a’s reached for the tray. Her hand accidentally nudged the bed railing and sent the tray sliding.
Lauren rushed forward and steadied the tray, pulled a bandage from it then opened it and held it over the site. Dr. Caine pulled out the needle and she sealed the puncture site with the bandage.
“Aren’t you off duty?” he asked.
“We’re busy.”
“If this nurse can’t do the job she shouldn’t be here. You don’t need to baby-sit and I don’t need you lurking around telling me to hurry and see patients.”
She felt the bite of his words. So he had taken offense this morning with Jamey’s case. Taking a last glance at Lela’s scared-kitten eyes, she stepped from the room.
Becky, the night secretary, was working at the computer as Lauren reached beneath the counter for her purse.
“Home to the kids?” Becky grinned and winked.
“I guess so. I thought I might stick around to help Lela but...” Lauren shrugged.
“Poor Lela,” Becky said. “I thought Dr. Caine had scared her off for sure the last shift she worked with him. You should have heard him yell when she got the patients mixed up. He had her in tears before her first break.”
Lauren could identify. But she also remembered the way he’d treated Jamey. She’d caught him several times showing specific gentleness with some patients. His moods seemed to fluctuate all over the place and she couldn’t help wondering about some of the things she’d heard about him.
“Good morning, ladies.”
They turned to find Archer Pierce leaning with casual grace against the workstation counter. He flashed them his characteristic grin.
Dr. Caine chose that moment to look up from his chart. His frown deepened. He tucked the chart beneath his left arm and strode toward them.
“Great,” Becky muttered under her breath. “You’d better duck, Brother Pierce. He’s looking for victims. I know that look in his eye.”
Dr. Caine stepped to the counter. “Reverend Pierce, I didn’t know you had obligations with us this evening.”
“No obligations, doctor.” Archer held his hand out to shake.
Dr. Caine looked down at it, took it in a brief clasp, released it, and stepped away. “What brings you to our department?”
“I try to make a habit of stopping in on my way home from work in case I’m needed by a church member.”
“Aren’t you busy enough with that church of yours?”
Archer’s smile didn’t waver at the sharpness of the doctor’s voice. “Could be. It’s a weakness of mine.”
“If a patient should request you in the next few hours I’m sure someone will send word.”
“I would appreciate it. Lauren, if you’re getting ready to leave why don’t I walk you to your car?”
She was happy to comply.
“Sorry about that,” she said as they stepped outside. “Dr. Caine has a depressing way with words.”
Archer walked beside her in thoughtful silence for a moment. “He isn’t the same Mitchell Caine I remember from high school.”
“You knew the guy? He practically treats you like a stranger.”
“Let’s just say I knew him the way a junior-high kid knows his graduating basketball hero. Mitchell was a happy person then.”
That was hard to believe. “Life does change people.”
“Tragedy changes people. Which reminds me, I received a telephone call from the high school this morning about Beau’s misdemeanor.”
“Sorry I sicced them on you.”
“I’m glad you did. I think the principal felt this constituted an emergency. I assured him that if Beau wasn’t where he was supposed to be, he had a reason.”
“I never had a chance to ask him about it when he came to work,” she said. “We were too busy.”
“Brooke called me this afternoon and took the blame, told me it wouldn’t happen again. I don’t think we need to make a special call to Grant about it.”
“He has enough to worry about.” Lauren pressed the unlock mechanism on her key chain and her truck welcomed her arrival with a friendly wink of headlights.
“There’s definitely something that bothers me a lot more, Lauren.”
“What’s that?”
Archer peered into the front and back seats, glanced into the pickup bed then opened Lauren’s door for her. “I got a call from Tony Dalton today. He warned me to keep a closer watch on Evan Webster.”
“Our Evan? Why?”
“He’s like a hunting dog on a strong scent. I’m afraid he’s not only going to get himself into trouble but his friends as well. Were you on duty last week when the dog-attack victim was brought in by his little girl?”
“Yes. Did Tony’s men find something?”
“They called the drug dogs in and they discovered a makeshift lab suddenly abandoned within a mile of the place where Cam was attacked. Things are heating up, Lauren. Want me to follow you home?”
She grinned at him. “I don’t live in the forest.”
“I keep thinking I would want someone to make sure Jessica made it home safely from the theater.”
“Don’t take it out on me. You two will be married in less than two weeks and you can protect her all you want.” She climbed into the truck, switched on the engine, said goodnight, and drove to the Sheldon home.
Chapter 12
In the early hours of the Tuesday evening night shift, Mrs. Lindeman sat forward on the ER exam bed kneading her forehead with the fingers of her right hand. “I don’t think I can take it much longer.” Tears gathered at the corners of her eyes and seeped down the faint worry lines that traced her rosy skin. She rubbed her head with her left hand, fingers splayed wide as if to cover as much territory as she could reach.
Lauren remembered this patient from last night. Mrs. Lindeman had received a lumbar puncture from Dr. Caine just before he snapped at the new nurse about being unfamiliar with the procedure.
“Your chart says Dr. Caine gave you pain medication for a headache last night. Did that help?” Lauren asked.
“This pain feels different.”
Lauren continued questioning her as she took vitals. “I remember seeing you briefly last night when Dr. Caine was doing the puncture. Can you tell me what you did after you were released?”
“My husband drove me home and I went to bed. Why?”
“You went straight to bed?”
“That’s what the doctor told me to do.”
“You didn’t do any household chores or lift anything?”
“Nothing but my purse. I didn’t feel like doing any chores last night.”
“Did you do any other moving about your house before you went to bed?”
“No. I told you, no. I went upstairs and straight to—”
“You climbed stairs?”
Mrs. Lindeman gave her a level look. “That’s where the bed is.”
Lauren sat down in the chair beside her. “When you make any excessive movements within six hours of a lumbar puncture, spinal fluid could leak from the injection site and that causes a painful headache.”
Mrs. Lindeman’s face darkened. “Why didn’t the doctor tell me that last night? He could have told me something helpful instead of griping at that poor nurse.”
“We always give our patients a discharge sheet for that reason. If your extra movements are the cause of your pain, it can be corrected. The anesthesiologist can do a blood patch—he will withdraw some of your own blood and inject that blood into the affected area to seal up the leak.”
“You mean I’ve got to have a needle stuck in my back again?” Her voice rose in conjunction with the flush of anger on her face. “Because the doctor couldn’t do the job right the first time?”
Lauren refrained from reminding the patient that the doctor in question had done the job right and had given the proper instructions, even if he hadn’t verbally explained the reason behind them. “Mrs. Lindeman, the doctor will have to determine exactly what your problem is. I’ll speak
with Dr. Caine and let him know you’re here.”
***
After two and a half years of cooking for his family, Grant Sheldon found his elbows relegated to Mom’s kitchen table while she wielded a spoon over the cast-iron skillet.
He experienced conflicting emotions of nostalgia and concern as he watched her work. “Mom, I thought we decided this morning that I would take you out to dinner tonight.”
She turned from the stove with pursed lips, short strands of her gray hair feathering untidily over her forehead. “We did?”
“Yes. You told me you loved that country-fried steak down at Rosie’s Place.”
Her confusion didn’t clear. She turned back to her work. “I don’t like to get out in traffic at this time of night.”
“You don’t have to worry about the traffic,” he reminded gently. “I’ll drive.” He pulled two napkins from the plastic holder and tried to wipe some crumbs from the faux wood surface of the table. They dragged across a sticky puddle of strawberry jam and became part of the mess. “Why don’t we plan to go out tomorrow? I didn’t come here to stay so you could wait on me.”
“I still don’t understand why you didn’t bring the family with you. There’s room for everybody.”
“The kids have school,” he explained for the second time in the past fifteen minutes. He pulled another napkin from the holder then risked his mother’s displeasure by getting out of his assigned seat and walking to the sink to wet the napkin. If he didn’t get that jam off the table, he’d have a sticky elbow for the rest of the night.
“It’s been such a long time since I’ve seen those little sweethearts.” Her voice faded to silence. She gave a tiny sigh and the permanent frown lines deepened around her eyes and mouth.
The greasy odor of cooking beef assailed Grant along with a wave of guilt. He had never told Mom that hamburger gravy and fried okra had ceased to be his favorite foods when he was twelve. When Dad moved out the first time.
“Does Rita know you’re here?” Mom asked. “She’ll want to come and see you.”
Grant swallowed his frustration. Mom didn’t seem to realize that Dogwood Springs was almost as close to his sister’s house as she was to St. Louis—Rita and her family had moved to Kansas City years ago.
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