Corruption in the Or

by Barbara Ebel

  “Sure.”

  Viktoria draped her jacket on the back of the cart and walked out. She hated to admit it to herself because she immensely loved her career in anesthesia, but she looked forward to later when her exit from OR 7 would be the last one for the day.

  -----

  With his feet widened out in an authoritative stance, Jay Huff studied the OR white board like he was playing a game of chess. The goal was to maximize the usage of his anesthesia personnel before the elective surgery cases were finished and the OR went down to one room with the potential to run an emergency case.

  Jay cluttered the middle of the hallway, so Viktoria stopped for small talk with him. “The locum agency mentioned that this group is a nice size. Not too big, not too little.”

  “With the hospital’s blessing, I run this place with nine CRNAs and seven MDs. A nurse and a doctor are always on vacation, and one each are always off postcall. Leaves me with six CRNAs in a room daily and one to give breaks. Three docs supervise the CRNAs daily, one doc runs the schedule, and one of them does their own cases. Of course, a female doc is on maternity leave and you’re making my fifth MD.”

  Viktoria nodded. “Feel free to put me in a room or supervise the nurses. I’m flexible.”

  “Since you are a gypsy anesthesiologist, I don’t doubt it.” Thinking his comment was original and clever, he patted his thigh twice. “Are you a vagabond in your personal life too?”

  “Absolutely. My footloose lifestyle came about after watching the stagnant anesthesia chiefs who count personnel and cases in front of OR schedule boards and lose their hands-on-anesthesia skills. A superior skill set comes from working in brand-new places with unknown geographic situations and healthcare personnel. Sometimes I spot things about patients, surgeons, and hospital employees that staff doesn’t admit is right under their noses or are blinded by denial.”

  Jay spun forty-five degrees and exaggerated his already wrinkled forehead. “Did you just denigrate me?”

  Viktoria held her gaze at the OR schedule. “I never, ever do that to anyone. Unless, of course, I am criticized first.”

  Jay held his tongue. This anesthesiologist was a lot more spirited than he gave her credit for, and so much different from his pliable colleague who was at home nursing a newborn. This one is confident with a capital “C,” he thought. “Good. Verbally sparring with the scheduler is not a wise idea.”

  “I clock out soon, regardless. At three o’clock. One of the perks of being a gypsy anesthesiologist.”

  Dr. Huff glanced at his wrist watch as she hastened away. After a bathroom break, she went down from Jeffrey Appleton’s office where she’d previously seen a sign for the doctor’s lounge. Two men were inside, absorbed with charts. The coffee pot was empty, so she chugged down a small bottle of water and then her ten minutes was up.

  Back in OR 7, Viktoria noted the enthusiasm of the caretakers in the room when she arrived. Whatever they’d been talking about simmered down to a muffled few words as she went around the anesthesia equipment to Casey.

  “How is she doing?” Viktoria asked.

  “One little spike in blood pressure, so I gave her two more ccs of fentanyl. That Dr. Berry stimulated her too much.”

  Dr. Berry shook his head. “Hey, what I do must hurt patients sometimes otherwise I wouldn’t be doing my job.”

  “Other than that, all is well.”

  “Thanks for the break.”

  “You’re welcome.”

  They changed position as Viktoria scanned the top of her cart. “I don’t see the other vial of fentanyl that you checked out.”

  “Contents are right here. I snapped open the vial and drew it up.” He pointed to a labeled syringe with the five ccs. “It’s ready in case you need to use it.”

  “Okay, thanks.”

  Casey left and Viktoria frowned at the syringe. For a laparoscopic cholecystectomy, her patient had had enough narcotics and, unless she didn’t know anything about anesthesia, she wouldn’t need to be dosing out anymore. The drawn-up contents of the syringe would go to waste, the patient would have to be charged, and she would need to chart and corroborate dumping it with someone at the end of the case.

  After relentless manipulation of the laparoscopic instruments while looking at the monitor, Dr. Berry finally slithered Mrs. Parker’s gallbladder out from the main incision. “Another bile sac bites the dust. You can close the incisions,” he said to his assistant. He shed his blue gown at the door before leaving.

  After returning the OR table flat from the Trendelenburg position and with the anesthesia turned off, Viktoria’s patient soon breathed adequately on her own, and she removed the endotracheal tube. While she was preoccupied with her patient, the door opened again, and Casey tapped her on the shoulder.

  “Dr. Huff sent me in to relieve you because the time is three o’clock. I can take her to recovery room and give report.”

  “I’m fine. Relief right now would be too disruptive and not in my patient’s best interest. I’ll bring her over myself.”

  “Suit yourself.”

  Viktoria picked up the five-cc syringe of narcotics. “Initial the wastage,” she said and squirted the liquid into the garbage can. Casey cosigned her chart note and left.

  After settling her patient in the recovery room, Viktoria went to the locker room and changed out of scrubs. Since it was half past three, the seven to three shift OR workers had left and the afternoon shift was already on the job. She clutched her shoulder bag and was free for the rest of the day.

  -----

  A grove of trees stood just outside the entrance of the hospital and Viktoria stopped beside them to take in the sunshine and a big, fresh breath of air. It was a conscious thing she did every time she left any hospital, like someone who was programmed to chant a meditation mantra. It psychologically cleansed her of the confinement of being in an OR and helped balance her with the great outdoors for the remainder of any day. Even if she was stationed in a larger city, nature was somewhere. She only had to look for it.

  Her commitment at Masonville General Hospital was for four weeks— the whole month of September. She had driven the almost five-hundred miles from Long Island; a no-brainer straight-shot along I-80 of eight and a half hours. Provisions with the agency allowed her to rent a car, but she preferred to take her own. It afforded a little familiarity with something of her own away from home.

  She scurried off the curb and went to find her white Honda Accord. Visitors, patients, and health care workers came and went. Most were dressed in long sleeves and a few wore light jackets. She wore a crisp checkered blouse with the collar open, and she was aware that the temperature seemed no different from Long Island’s. There, the Atlantic or the Long Island Sound was not too far away, and here they had Lake Erie to contend with. The giant body of water created a lake effect which influenced the weather patterns most times of the year, especially winter.

  Arriving beside her car, she threw in her bag and jumped in. It was time to learn the layout of the land, especially between the hospital and her hotel. The initial scouting around was how she always did it. By the time she was ready to leave an assignment, she had figured out her favorite places. Today, however, she had a heads up after listening to Alice Coleman’s conversation which did not include her.

  She drove down Hospital Road and kept her eyes peeled for the coffee franchise. With a tall sign over the top of the building, she couldn’t miss it. It was smack between the ten-minute drive to where she was staying, so it would be an easy walk in the next few weeks. She parked, went inside, and stood at the counter. The decision was whether to grab the iced mocha Venti with the three-shot espresso or skip coffee all together.

  A double-braided barista waited.

  “On the recommendation of Nurse Alice Coleman who used to work here, I’ll take a Venti iced mocha.”

  “Don’t know her, but that’s a decent stepping stone from barista to nurse.”

  “What’s yours going to be?�
�

  “I’m in college and want to be a veterinarian. I also put in a few hours at a vet’s office.”

  “Hard worker. Good for you.” She read “Linda” on the girl’s name tag.

  Viktoria slipped to the end of the counter and was going to carry the drink back to her car, but her phone rang with a call from the locum tenens agency.

  “Dr. Thorsdottir here.”

  “So, did they ‘hold your place?’”

  Viktoria knew the voice of Regina, the head agent she always dealt with, and smiled. The woman had recently told her that ‘locum tenens’ was a term based on a loose Latin translation that meant “hold your place.”

  “The anesthesia department at Masonville General Hospital waited for my arrival with bated breath. Although I’m saving their butts by helping them out, they applied a new term to my locum tenens work.”

  “I sense it may not be complementary.”

  “They called me a gypsy.”

  “I like the term you use for yourself instead.”

  “Doc on the road. Yes, I am a ‘Doc on the Road.’ I don’t qualify as a gypsy. Not yet, anyway. My understanding is that gypsies dress more flamboyantly than I do.”

  “I haven’t met you personally to comment one way or the other, but I suspect anesthesiologists dress drab like an extension of being outside the OR.”

  “For me, it’s quite the opposite. Since I’m in a strict ‘uniform’ all day, I beef up my personal attire. But I don’t qualify as dramatic.”

  “Sounds reasonable. Anyway, I’m calling to make sure the first day worked out. Persons, place, time etc. was what all parties agreed on?”

  “All in order. Even met the hospital director. This is another anesthesia group that lost their independence and is paid a salary by the hospital.”

  “Such a pity.”

  “It’s one of the nice things about doing locums. I’m not involved with the politics and financial downfalls of either being in a private, self-billing group, or a minion physician paid directly by a hospital.”

  “True. Although there may be some downfalls to doing locums but I can’t think of any.”

  “Now, now, Rebecca. It’s a doc-on-the road lifestyle and it isn’t for everyone.”

  “The alternative to a traditional anesthesiologist’s job does work for you.”

  “For a person at a desk job, you possess intuition about people.”

  “I’m less at a desk than you think. Here’s something you’re not aware of. I’m in a wheelchair, so this job really suits me. I’m also in my fifties in case you were wondering.”

  “I wasn’t wondering. So, your job is right for you too. Glad to hear it.”

  “By the way, that Dr. Huff called here an hour ago. Wanted to know if you might want to work a night shift or two if they needed that coverage.”

  “I must have been tolerable enough for him to request that, despite being treated like some second-class citizen.”

  “I don’t know how you put up with the occasional prejudiced ‘outsider’ mentality from others that comes with the job.”

  “That mentality is one of the downsides and, like I said, there are pluses and minuses. Tell Jeff Huff to make the request again if a dire need for night coverage arises.” She set a straw in her drink and headed to the car.

  CHAPTER 4

  Viktoria parked in front of the railing at her “Stay Long Hotel.” It was a three building, single floor complex, and she was in the first building which was closest to the front desk. When available at a destination, she chose to stay with the franchise. The spacious suites offered a lot more than a standard hotel or motel room. She liked the fully equipped kitchens, Wi-Fi, flat-screen TV, and laundry facilities. Besides being pet-friendly, the office area even offered a few breakfast items, and the locums agency paying the bill loved the long-term budget rates.

  Viktoria unlocked the door and went into the large, clean room with plenty of leg room to be comfortable. First, there was the kitchen and bathroom on either side after walking in, next was a desk with her computer, and then came the spacious bedroom and sitting area. The shiny gold bed scarf matched the material on the headboard and the gold/brown indoor/outdoor carpeting.

  She placed her bag on the counter and enjoyed a cold drink without so much as a glance at her cell phone. No text messages, or emails, or apps blaring unwanted information at her. Now was her time. The rest of the September day would not go to waste. She would get her blood moving by going for a run.

  Viktoria finished the drink and changed into striped running pants and a purple long-sleeved cotton shirt. In front of the mirror, she took a long look. She had a full face with a wide forehead and dark eyebrows, almost as black as her shiny hair which she usually wore back with an elastic hair tie. Her lips were full and wide, as distinctive as what a fine artist would paint on an impressive canvas portrait.

  All told, she looked rugged—which was what she was. All one hundred and thirty-five pounds of her. Her DNA was handed down from the Viking age when a mixed Norse and Celtic population explored and settled Iceland. Viktoria’s upbringing on the island nation was shades easier than the people who founded the continent one thousand years ago, but it was still fraught with hard-work and a laborious childhood. Her hands and body had always toiled away at outdoor chores and now she used her firm and able hands in the very physical surgical field of anesthesia that she had chosen.

  Although she was rugged, Viktoria was handsomely pretty, and her five-foot seven body was toned and firm. She tried to maintain her physique; a doable task since she did not work fifty hours a week like most doctors.

  Viktoria stepped back, sat on the bed, and pulled on a top-line pair of running sneakers. Now she was ready to pound the ground. Outside, she decided to head north on Hospital Road. She cut across the parking lot between scattered areas with landscaping and past the other two hotel buildings.

  On purpose, Viktoria’s pace was medium-slow, allowing her to get the lay of the land. She passed a small gas station convenience store, a waffle joint, a “Loans, Loans, Loans” place, and a do-it-yourself car wash. The breakfast joint made her smile. She could live on breakfast food and often did.

  Viktoria stayed on the sidewalk and at the half-to-one-mile mark, the white stripes on the traffic road disappeared and the road assumed a name change to “Erie Trail.” At that point, a concrete three-foot wall was on both sides as the road formed a small overpass across a creek. She slowed and gazed down at only two inches of water trickling its way underneath. Approaching the other side, something below caught her eye.

  She grasped the top of the concrete wall. Her eyes focused on a barely perceptible movement. An animal on its back? Her heart sped and her pulse quickened. Horrors! she thought. How atrocious.

  The incline appeared to be about six feet and not steep enough that she couldn’t manage going down. She eyed the heavy cover of old leaves, creek rocks, and the scattering of human trash and calculated the risk of falling. If she hurt herself, she’d be of no help to the helpless life left to die below her.

  The importance of rescuing an animal far outweighed the small peril to herself. She grabbed the edge of the overpass, slipped to the other side, and carefully chose her footing.

  One step at a time, Viktoria changed her opinion. It wasn’t as soggy as she had assumed, but she still focused on her balance and the placement of her attractive footwear. Regardless of how trashed they get, to hell with my sneakers, she thought.

  She put her legs astride a helpless dog. Belly up, he now saw her above him but no relief registered on his wide-open, terrified eyes. If a human being had done this to him, why would the next human being who showed up be less of a Hitler than the last one?

  Viktoria’s face contorted with a multitude of wrinkles filled with sorrow. Tossed like the surrounding garbage, he’d been thrown out of sight from the road, left to suffer a horrific fate and left to die.

  Several inches wide, silver duct tape secured the dog’s
mouth shut and went back as far as his snout.

  She sniffled and wiped her eyes. The dog’s back paws were also brought together. More adhesive tape spiraled around them. He was bound into a terminal captivity by some torturing masochist.

  At the core of who she was, Viktoria was a caretaker. On top of that, her physician common sense kicked into gear. She squatted down and evaluated the security of the tape. Whoever had secured it, made sure it would hold. Trying to peel it off could be disastrous. She was too afraid it would pull off whiskers and hair and possibly peel off skin.

  Maybe because she was an anesthesiologist, she considered the pain to the dog. Whoever did this to him had at least not occluded his nostrils, so that he was still able to breathe. She figured they didn’t know any better because they wanted him dead, and yet left his nostrils open.

  She should get him to a vet where he could be sedated to remove the duct tape and evaluate him for other injuries. He seemed like a pup, not quite a year old, and still had growing to do. Certainly, he appeared too lean.

  Viktoria couldn’t waste any more time. Her heart would not allow her to leave him there while she went back for her car. She felt the ground for two smooth areas to rest her knees, positioned herself, and wrapped her arms under him. Belly up, limber, and practically cooperative, she braved the incline holding the grubby dog.

  Clasping him like a beloved baby, she walked the sidewalk back to the hotel. She figured him to be around thirty-five or forty pounds, and she stopped only once to take a break. A handful of vehicles passed. She almost wished someone would stop and give them a lift. Perhaps the situation looked too strange, perhaps people had no time in their schedule, or perhaps they didn’t notice the bundle in her arms. Lucky for her, the dog was lanky and his weight was distributed nicely in her arms. Although he was dirty and his hair soiled, he appeared to be only black and white, so she wondered if he was a border collie.

  ----

  Viktoria arrived back at the Stay Long Hotel clenching the dog. At the third building, there were three pickup trucks she did not pay attention to before. A ladder extended over the top of one of them and an open cargo bed of another displayed worker’s tool boxes, planks of wood, and cans of paint.