Operation Subdue

by R. J. Castille

  “So, this document,” her first question came as soon as I stopped long enough to take a breath, “this memorandum, directive, whatever you called it…where did it come from exactly? How do you know it’s real and not just something whoever gave it to you made up?” I knew that was coming. It did sound like something from a Hollywood script.

  “I would have to show you, it is hard to describe. If you did see it, you would know. If you touched it with your own hand, you would be assured. The paper, the seal, the way it is written. It all speaks to something controlled by a force that is stronger than any of us could ever be. Please believe me, Ragan, I am quite serious. If you don’t believe me, go ahead, try and stand up for yourself next time you go in. You will be dismissed, as you always have, and will continue to suffer despite your cries for help. Hasn’t that been your experience with them so far? I would say that, even if the document itself is a fake, what it outlines makes perfect sense when you think about it.”

  Ragan hovered in a space of disbelief. Her eyes searched my face for any sign that I was kidding. I wasn’t, of course, and I hoped that she would believe the knowledge I was handing her. For her own good, I needed her to stand up for herself, to demand answers from her doctor and her specialists and not just go down the path blindly and without protest. If she was going to survive, it would be the only way. As long as she remained complacent, following their orders without question, she would not likely survive in the end.

  Before we parted ways that afternoon, I reiterated my request to her. Next time she went in and was seen by anyone at Kellogg Premier, I wanted her to demand answers, asking for a second opinion, to speak with the supervising physician, whatever it took. If nothing else, she would go down kicking and screaming if I had anything to say about it. At the very least, I needed her to call them into question, if she did and we could convince others of the apparent danger they were in, maybe they would be forced to finally stop putting their patients at risk.

  As I made my way back to my car, I should have been more observant, more cautious. If I had, I would have noticed two figures lurking in the shadows, just a few paces behind. Out of sight and out of mind but watching and waiting. It was too late, of course, they had already seen me step outside of their directive and leak their precious plan to someone on the outside. I was in for it, I just didn’t know when. At that point, I no longer cared what happened to me. I had to do something about the patients, to help them save themselves, and it all started with the patient who had exposed the whole thing to me: Ragan Jensen.

  I drove away from the mall that afternoon satisfied that I had done something to help Ms. Jensen. No longer concerned with what was going to happen to me, I wanted to initiate a plan to expose the government and their role in the failing health of the citizens of our great nation. Weaving through the surface streets on my way back to my humble abode, I couldn’t help but smile. If it was the last thing I did, I would tell the world what they were really doing, that the doctors involved did very little for them on purpose and with malice. Everyone would know what they were up to if I had anything to do with it.

  Deep in thought, I never saw it coming until it was too late. I was stopped at an intersection halfway home, my car idling while I waited for the light to turn green. As soon as it did, I pulled forward instead of pausing for a brief second to make sure no one came barreling through. I heard the sound of a motor revving up and looked to my left, just in time to see the front end of a large truck heading straight for me, the Ram on the grill larger than life as it slammed into my window and my car went flying.

  I rolled several times, the sound of busting glass and smashing metal deafening as I came to rest on the roof and slid to a stop. My vision faded in and out several times as I tried to look around and get my bearings. Unable to move, suspended upside-down by my seatbelt, I watched helplessly as two sets of military boots ran toward me. Before I was plunged into darkness completely, I heard them shouting to get me out before the vehicle caught on fire. I was being dragged out as my eyes closed and I faded out, spiraling down into nothing.

  -15-

  Ragan

  The things that Elaine Cooper told me was something right out of a movie and, like your favorite thriller series. I was in a state of disbelief after she left me sitting in the middle of the mall food court. It was hard to believe that our very own government would do such things. We voted them in, essentially hiring them to do the positions and the jobs that they were doing. It was us who gave them all of that power and control, if it was true. So the question was: how do we remove the same power that we gave them?

  Ms. Cooper had been adamant, telling the story in great detail. She was either a complete nut, spreading her tales of conspiracy and doom, or she was spot on and I needed to heed her warning. All Elaine asked me to do was stand up for myself, demand answers the next time I was at Kellogg Premier, and see what happens. That was exactly what I intended on doing.

  I sat waiting to see Dr. Garrison alone. Roger had to go to work, leaving me to get the results of my nuclear stress test without him. That was unfortunate, considering he was the one who caused me to suddenly have a spine. It was always difficult for me to stand against the norm and it was no different when it came to my health care. I wish I knew how to do it; it was not like me to say or do anything against whatever those in control said. In the back of my head, egging me on, the voice of Elaine Cooper drifted through my psyche, reminding me of what I

  needed to do.

  The test itself had been tough, difficult to endure. They had me come in early, before any of the other departments were even open. I was made to watch an educational video while I filled out several pages worth of information. It dawned on me that they should already have all of the information I was giving them, but instead of arguing, I sat and scribbled away. Distracting myself with something like that was a tactic I was using so that I didn’t have to think about what was about to happen.

  Two nurses strapped me up, wiring me to another machine meant to read my heart rate, blood pressure and other vitals. When they finished, the shorter nurse was doing her best to explain to me what she was about to do. It was the most attention I had had since I started coming to Kellogg Premier months ago with my chest discomfort, I was truly not used to it. Instead of taking my basic vitals and shoving me into a room in the corner, like they always did, they were all over me. It was refreshing, but almost like they were trying too hard, trying to prove a point.

  While she talked, another nurse started an IV, pushing through the tough, outer layer of my skin before withdrawing the needle and leaving the tiny catheter behind. I watched as she inserted a needle into an opening halfway down the tubing that led from the bag of fluids to my arm and pressed down on the plunger. It didn’t take that long for me to feel the effects and I was immediately sorry I had agreed to the procedure I was now enduring.

  It felt like I was running a marathon, although I was sitting still. As my heart pounded away, threatening to burst through my ribcage and out of my chest, another individual entered the room and helped me onto a platform where I was made to stand upright. They had me line my feet up with a piece of red duct tape. I moved quickly to oblige as a screen was pulled down across my body to chest-level where it waited to be powered up.

  I was fascinated when they turned the device on. I could actually see my heart beating on the screen above my head. It pounded away, the rate increasing with each second as they watched, took notes and recorded everything that was happening. The feeling itself was horrific. My chest burned with the effort my body was going through and I was quickly becoming light-headed. I grasped the safety bars in front of me to keep from falling over as the test continued.

  The nuclear stress test was similar to the regular, treadmill stress test, only they were watching what my heart was doing in real-time. If something happened inside me, they would definitely see it as it and hopefully the mystery would be solved. I stared at the screen as I attempted to
do deep breathing techniques to keep calm. It was what they had suggested on the educational video. I prayed that they would find something quickly and stop the test short. It felt horrible and I wanted to get away from that sensation as quickly as I could.

  Within two weeks, I received a phone call directly from the Cardiology department. They set up a follow-up appointment with me and told me that I would receive a reminder via text message and email. That was pretty standard, nothing exceptional in the slightest. I acknowledged the information, jotted down the date and time and ended the call.

  As I waited to be seen, I ran through several scenarios in my head. The first being that I would, yet again, be dismissed and told that nothing was amiss or out of the ordinary. Despite the sensations in my chest and the associated symptoms, that was how everything had gone in the past, so I expected nothing different. On the other hand, it seemed they were actually being more responsive as of late. Actually, contacting me to set up a date to follow up with Dr. Garrison had been something lacking before. Perhaps they were just too big for their britches, had too many patients and those who screamed the loudest were the ones who were actually cared for. In that case, Nurse Cooper was being paranoid and spreading her fear along with a conspiracy theory that made me cringe.

  A stoutly woman peeked her head out the door across the waiting area and called out my name, her eyes grazing the crowd briefly. I gathered my things and stood quickly so she would see me. Our eyes met for a moment before she diverted her attention and turned to head back the way she had come. It was clear that I was expected to follow her, which I did without so much as a word. The woman went through the usual routine, recorded my vitals and asked me the various questions they always did, before ushering me into one of many exam rooms that lined the hall.

  “Dr. Garrison will be in shortly to see you, Ms. Jensen,” was all she said before exiting the room, closing the door and going on about her business. I waited inside that room for quite some time before I heard a soft knock. As I looked up, Dr. Garrison’s face appeared in the crack of the door, the same plastic smile as before.

  “Good afternoon, Ms. Jensen,” her greeting was brief as she made her way directly to the computer that waited to my right. Several clicks of a mouse and a few strokes of the keyboard and she was in my chart looking around. She said nothing for a while, leaving me waiting with bated breath to hear what the tests had revealed.

  “So, doctor, is there any news?” I just couldn’t wait any longer. I had gone so long without any answers I just had to know if they finally found something underlying that was causing my issues to begin with.

  “Well, Ms. Jensen,” Dr. Garrison didn’t even look up as she scrolled through what looked like a lengthy report on her screen. I could not quite read what it said as the font was too small but knew it may take her some time to digest the contents. That made me wonder why those things were not done in advance. If they knew the patient was coming in for those results, why would they not look ahead of time, so they were properly prepared to answer any questions?

  Several moments passed that way. Dr. Garrison was clicking and reading, opening a picture or a chart while reviewing the information in front of her the entire time. The anticipation was killing me and just when I thought I could not take any more delays, she looked up at me, cleared her throat and opened her mouth to speak.

  “It seems, Ms. Jensen,” her voice sounded bright, cheerful even, which only got my hopes up even more, “that you have developed a Mitral Valve Prolapse that we had not detected before. I realize you have had multiple tests and have waited for a long time, but it finally seems as we are getting somewhere. We will need to develop a treatment plan and start you on some medication to decrease your heart rate initially. As we try different things out, you will need to keep a journal of what you feel and when you feel them, so we can make any adjustments necessary.” Dr. Garrison typed along as she spoke before asking me if I had any questions so far.

  “I do actually, Dr. Garrison. I was just wondering, what was different about this time around, why was this test successful in identifying what is wrong and none of the others? I have had an echocardiogram, treadmill stress test, and even a cardiac event monitor for a month, and nothing seemed to be wrong then. It wasn’t until I ended up in the emergency department and you finally ordered a higher-level test that you found something wrong. Is there a reason for that? Can you explain why?” I really wanted to know. Mostly, it was so that I could put the information that Nurse Cooper had given me to rest. I felt like I was owed an explanation and was prepared to do whatever it took to get somewhere that time.

  “Just like yourself, Ms. Jensen, doctors are actually human beings too,” Dr. Garrison laughed, the sound echoing off the walls around us, “these things can be misdiagnosed, it happens all of the time, and it isn’t until a high-level test has been completed that we can actually detect what is happening. The fact that the nuclear stress test shows your heart in action, in real-time, may have given us an advantage and allowed us to definitively say what is happening.” It all sounded well and good, but my mind kept wandering back to what Elaine Cooper had divulged. What Dr. Garrison was telling me seemed a little too convenient. Several tests, many months and a couple of doctors later, and I was finally getting somewhere? Something just didn’t add up. Either that, or my over-active imagination was attempting to find some holes in her explanation.

  “Well, at least you finally found something,” I was actually extremely relieved, and I was being genuine. “I don’t know how much longer I would have made it without some kind of medical intervention. That last spill had both my boyfriend and I extremely nervous. Thank you very much for digging deeper and finally getting to the bottom of things.” I really was grateful. If it took a pill and constant monitoring of my symptoms to find some relief, I was all for it. Regardless of what Nurse Cooper said, the doctor actually did appear concerned and she herself relieved that she had a direction in which to go.

  “I have put in a prescription for some blood pressure medication and one that will control your heart rate. We will start there and work our way toward something else, if necessary. In the meantime, I will put your case on the agenda for the next quality assurance meeting to discuss with the Chronic Care Management team. I assure you, Ms. Jensen, we will get this under control sooner rather than later.” The more Dr. Garrison spoke, the better I started to feel. I came in that afternoon ready to defend myself with guns blazing but, as it turned out, none of it would be necessary after all.

  “How can I get a direct number, in the event that I have any questions? I could call the main line, but then would likely be patched around the facility before actually getting to you,” based on the look on her face, I concluded that she completely understood. Kellogg Premier did not make it easy to get in direct contact with anyone, let alone a specialist charged with my care.

  “The nurse will give you our direct number on your way out. I want you to follow up in two weeks, and every two weeks for the next several months, so that I can monitor your progress closely. It may be necessary to bump that up to weekly, but we will see how this schedule goes first. Sometimes, it is more stressful for the patient to keep coming in only to be told there is nothing further that can be done for them, so I prefer to start that way. It has been my experience that, with this kind of ailment, frequent monitoring is required, just in case something else crops up that needs to be addressed along with it.” Dr. Garrison seemed to know exactly what to say.

  “Should I be worried that something else could happen to me because of this?” What she was telling me had my mind in overdrive yet again. It was good to know what was wrong, but also scared me to the core. Heart problems was not something that I would have taken lightly, no matter what, but my experience in the last several months continued to have me on edge.

  “Not necessarily,” Dr. Garrison remained calm, cool and collected as she assured me that everything was going to be fine. “It just so happens tha
t heart conditions, such as MVP, are closely associated with other difficulties that we will now need to watch for. The fact that you already passed out and ended up in the emergency room makes me feel like we caught it just in time before other systems started to fall offline because of it. Before too long, you may have started experiencing that more and more frequently, along with a number of other symptoms. I am glad that I finally got to the tier of treatment in which Kellogg will allow me to do something to assist you.”

  Dr. Garrison’s last statement did not sit well with me. It seemed strange that she was the specialist, yet the agency controlled what she was permitted to do and when. That explained a lot. She was made to go through the motions, made to do each test subsequently before she would be permitted to do the next, and so on. It made me want to get into contact with whoever made those decisions at the top. They had to know that, tying the doctors’ hands in such a manner only put the patients at further risk of injury.

  After Dr. Garrison finished up and all my questions for the moment had been answered, I exited the exam room and stopped in front of the nurses’ station, waiting for my exit paperwork and the direct phone number I had been promised. The nurse behind the desk rolled her eyes at me, obviously annoyed that I had disturbed her in the middle of whatever task she was doing.