by Barbara Ebel
“Yes. Start titrating it slowly.”
Casey nodded. “Potent selection for the end of the case. Wouldn’t have thought …”
“The one thing that anesthesia is not, is a recipe from a cook book.”
“What about cook books?” Tom asked.
“Nothing, Dr. Parker,” she said. “Just making sure your patient’s postop period is without pain and trouble free.”
With his wife’s help, Tom sutured up Mr. Sutherland’s abdomen. The nurse and tech counted lap sponges and Viktoria and Casey added up fluids, and turned off the inhalation anesthetic agent.
With other personnel, they both transported Mr. Sutherland straight to the ICU, bypassing the recovery room. Satisfied with his vital signs and respiratory support, Viktoria finally changed and left for the day. She didn’t mind the time she put in over three o’clock, but didn’t want to make a habit of it.
After all, she thought, she had one soulful puppy waiting on her. She had taken him on as a responsibility and she was going to adhere to her commitment.
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Viktoria waltzed into her hotel room, joyful to be free for the remainder of the day. Her OR hours had been full and stressful, and she longed to kick back and relax. Not left in the crate, Buddy popped off the bed and cowered at her feet.
“Uh, oh, what did you do? Besides hanging out on the bed?”
She rustled his belly full of long hair as he laid supine like he was dead.
“Let’s go before you pee upside down.” She leaned forward and picked up a small throw pillow in the corner. “You monkey. Not again.”
Viktoria buckled him to his leash and went back outside, straight to the front office. The bell jingled as she went in. “Sit, Buddy.”
Buddy did as he was told while Mason was fixing a one-cup brew on the side table.
“Hi, Mason. It’s me again. Same pillow mischief to report, just a different day.” She wiggled a second frayed pillow in the air and set it down on the counter.
Mason held his coffee up high while he bent down and patted Buddy on the head. “Must we make exceptions for him since his leg is bandaged up? Or because he’s bored to death all day with nothing to do?”
“Maybe both,” Viktoria responded. She wished like a kid blowing out a birthday cake that Mason would be tolerant of Buddy’s actions.
He smacked his lips after a sip of coffee. “I’ll put the cost of another pillow on your bill.”
“That’s fair. How about this? I’ll bring the other two from the room up here for safe keeping. And, I’ll buy Buddy his own. That’ll make everyone happy.”
“It’s a deal.”
Viktoria smiled. “Buddy and I thank you.”
With canine in tow, Viktoria went back to the room. She chowed down a few Sukkulaoihjupaour lakkris and then lugged the last two pillows to the front desk.
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By nightfall, Viktoria replaced four decorative pillows on the bed. Chances were that Buddy would have his way with them, but it was a small price to pay for the dog’s entertainment. She went to a biscuit box on the counter and pulled out a handful.
With the handy treats, she worked on teaching Buddy some natural, almost innate, tricks for border collies. After he got the hang of spinning in front of her, circling her, and weaving between her legs, she taught him to roll over. He took to the challenges like a Chesapeake Bay Retriever retrieving a duck in water. She settled into bed and for a few more minutes, Buddy gnawed at a toy which was stuffed with a biscuit.
She grabbed her iPhone and snapped Buddy’s picture. During the last several days, she had not sent Rick a photo of him, nor had her husband asked for one. The picture zipped off to his cell phone number with her statement, “Buddy Being Busy.”
“Being busy” didn’t last long because the dog extracted the milk bone from the rubber toy. He stretched, lapped up some water, and then jumped up on the bed. As he planted kisses on Viktoria’s face, she clicked “photo” again. The picture was a keeper—a full head shot displaying his alert and loving eyes.
Her cell phone dinged back from Rick. “Bet he needs attention after you working all day.”
She frowned. Although she never shut off her phone at night in case she needed to make an emergency call, she turned off her iPhone volume. No sense in texting him any more tonight. She knew he was high.
She placed the phone on the nightstand. Buddy curled alongside her, and she draped her arm over him. The last thing she thought before succumbing to a deep sleep was how soft the animal felt as her hand rested on his silky fur.
CHAPTER 11
The roads were wet from rain during the night as Viktoria drove along Hospital Road. She almost turned into the coffee shop, but decided instead to walk that way late in the day with Buddy.
At Masonville General, she first changed in the locker room. The piles of scrubs on the three racks of shelves were all mixed up, and she hunted for the labels in the tops and bottoms for mediums. They must have been the going size that morning, because they were damn near impossible to find.
An RN came in whom she recognized from the other day because she wore the same dangling layered earrings she wore on Tuesday. She popped open her locker, pulled out scrubs, and started to change.
So that’s it, Viktoria thought, they hoard scrubs around here. “Excuse me, would you happen to have any medium-sized scrubs in your locker?”
The woman looked Viktoria over as if she didn’t believe her size. She took her stash out and laid them on the bench. “Help yourself.”
Viktoria grabbed a set, making sure they were medium. “Really appreciate this, otherwise I would have been tripping around in large all day.”
“Don’t mention it.”
The door swung open and Dr. Parker’s RN wife came strolling in. She smiled at the nurse and made an abrupt stop upon seeing Viktoria. “My husband did a great job with Mr. Sutherland yesterday, but you had to end the ordeal last night with an apparent pitifully unhappy patient and ICU nurses.” She pranced straight into the bathroom and left the other nurse staring at Dr. Thorsdottir.
Viktoria gritted her teeth. She needed to change quickly and grab a cup of coffee before learning what the anesthesiologist-in-charge had in mind for her. Dr. Parker’s wife acted way out of line, and certainly, Viktoria had no idea what she was talking about.
In the doctor’s lounge, Viktoria weaved between three groups of physicians and their assistants. The coffee was piping hot and robust, and she filled a mug to the brim. Dr. Winter, who lacked a belt on his trousers, nodded to her from the end of the counter.
The only round, stocky person in there proved to be Phillip Nettle. He bobbed his head up from a bowl of cereal and glared at her. “Brace yourself. Tom Parker is going to chew you out. He better, because he used me to practice on.”
Viktoria let some coffee slip down her esophagus and sighed before Dr. Parker marched right up to her. “Dr. Thorsdottir, Mr. Sutherland was extubated earlier and just gave me a mouthful on my a.m. rounds. The nurses hounded me all night about his high blood pressure and I relied on constant morphine doses to get him through the night. You suggested late yesterday that you would keep his postop pain under control with your anesthesia wizardry.”
Dr. Nettle, although sitting down, looked from one to the other. He hated that an anesthesiologist was trashing the department’s fine reputation.
“I wondered if there was some other issue going on,” he continued, “but that wasn’t the case at all. With horrid detail this morning, he described to me … what sounded like … he was paralyzed and in severe pain. In the unit last night, aware, and intubated. He did not make that up!”
Tom Parker whirled around and stormed out of the lounge. Dr. Nettle raised his eyebrows. “I told you,” he said, putting put down his spoon. “See me after you go talk to Mr. Sutherland yourself.”
Viktoria wrapped her mind around Tom Parker’s every word. There was something amiss and the worst thing she should do is to act
defensively. But, damn, she was a conscientious and skilled anesthesiologist and needed to get to the bottom of the problem. She always did her own postop visits on her patients and Mr. Sutherland maintained the foremost position on her list.
She washed her mug in the sink and Dr. Winter approached her. “It’s always something, isn’t it? If it makes you feel any better, our OB patient from yesterday is not complaining.”
Viktoria nodded as Jessy leaned against the counter. She could swear he needed a shower as she reached overhead to put the mug away.
“Here, I’ll take it.” Jeffrey Appleton extended his hand and slipped it from her fingers.
“Good morning,” Viktoria said. “Aren’t you keeping early hours for the Director of Surgical Services?”
“Not at all.” His amber eyes twinkled. “How are the two of you this fine day?”
“I’ve fared worse,” Jessy said, “but Viktoria is ramping up demerits. Don’t mind me saying, Viktoria, because news travels fast around here and there is nothing that Mr. Appleton doesn’t eventually hear.”
Jeffrey slid his rolled-up shirt sleeve a little further and poured coffee. “Viktoria,” he said, trying not to linger his eyes on her, “sometimes this place gets a bit melodramatic. Don’t worry, the law goes for medicine, too. You’re innocent until proven guilty.” He chuckled and gave her a warm smile.
“She’s not being charged with a crime,” Jessy said, “at least I don’t think so.”
Since the place was a verifiable rumor den, she decided not to add a word. Let all the men say what they will. “If you will excuse me, gentlemen, the person I need to speak to is one of my patients from yesterday.”
Jeffrey raised his mug, acknowledging her departure. He focused instead on Jessy Winter, the doc about whom remarks were so rampant, they were spilling out of the OR.
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The nurses’ station in the ICU was quiet after shift change and Viktoria thumbed through each section of Mr. Sutherland’s chart since yesterday. Since Dr. Parker had relied on Viktoria’s promise to deliver excellent postop analgesia, he had not written standing orders for immediate pain relief. According to the nurses’ notes, the patient did not move even while his blood pressure crept too high, and traces of his general anesthetic should have been gone, except for the residual pain management which she’d promised.
Dr. Parker, and naturally his wife, had received too many calls from the unit when they should have been sleeping.
She closed the chart and rose. Through the window, staff was unhooking Mr. Sutherland from all the monitors in preparation for his transfer to a regular floor. Medically, he was doing stellar, and was ecstatic about that. After all, abdominal aortic aneurysms were nothing to sneeze about.
Viktoria walked into the room where Mr. Sutherland patted down his mustache, eyeing himself in a hand-held mirror. An orderly placed wound-up EKG cables into the upper shelf and the nurse hep locked the patient’s forearm IV.
Mr. Sutherland squinted. “It’s you. The one I trusted.” His expression changed and he became bleary-eyed. “I woke up from anesthesia late yesterday, but I couldn’t move. Silently, I was screaming in pain. You did that to me.”
The volume of his voice rose and the orderly turned his head quickly toward her. “You did that to me,” he repeated. “After all that malarkey about my anniversary and taking excellent care of me, you failed at your job. And I was your guinea pig.”
“Mr. Sutherland, I …”
“My wife says I should sue you. She has a brother who’s an attorney, you know. No, you’re not aware of that, but you will be.”
The nurse shrunk from the bed as much as possible and the orderly walked half backwards out the door.
“Mr. Sutherland, I gave … “
“I don’t want to talk to you. The wonderful people here need to continue their postsurgery plans for me and you need to leave me alone.”
Viktoria gulped. Tension mounted in her chest, making it hard to breathe. She wadded up with emotion because he had such an awful, painful postop period, but she also felt like his dartboard.
She almost missed a step as she took the staircase back down to the OR. The more she fought thinking about the personal attack against her, the more she tried to conjure up what someone had said. The OB doc, Jessy Winter had said, “If it makes you feel any better, our OB patient from yesterday is not complaining.”
She still needed to see Wilma Lancet sometime during the day after she had anesthetized the woman for her C-section entirely by herself—she had not supervised a CRNA, nor did anyone give her a break during the case. That fact struck her as being important. When she solely does her own cases at Masonville General Hospital, there do not seem to be any problems!
-----
Jeffrey Appleton watched Viktoria leave the doctor’s lounge. The medium-sized hospital’s OR did not have a decent track record for the number of female surgeons or anesthesiologists now represented in most modern hospitals. He thought that was a shame because if many of them were like Viktoria, he would be happy to see a dozen of them.
Although he could not judge her anesthetic skills, Viktoria seemed more professional than most of the docs there. She spoke well, seemed empathetic, and had to be damn self-confident to jump into a new OR environment when she took on a new locum’s position. He didn’t think he could regularly work like that.
Jessy Winter still lingered over the breakfast fare. He stuck a fork in a hot pan, speared two sausages, and with two fingers, slid them on his plate. They stood a chance of rolling off to the floor since what was underneath them was already a mound.
Jeffrey pulled a chair out for him and the two men sat. “So, what was that all about regarding Dr. Thorsdottir?” he asked.
“Dr. Parker had his panties in a wad. Something about a case she did yesterday for him. She fell short with her promise regarding his patient’s postop pain relief.”
Jeffrey frowned with disappointment. “Not justifiable for an anesthesiologist, I suppose.”
Jessy stopped listening. He made sure he downed the accessible, free breakfast before going to the office.
The cell phone hooked to Jeffrey’s waist came alive with a loud ding, and he excused himself. He often had direct and spur-of-the-moment access to the President of the hospital, Cathy Banker, today was no exception. The fifty-year-old Ivy league schooled business woman wanted to see him. “Can you come up right away?” she texted.
Mr. Appleton backtracked and poured another coffee in a to-go cup. He took the elevator up to the top floor and thought back to Dr. Thorsdottir. Too bad she’s married, he thought. All the good ones seem to always be taken.
He ambled through the hallway upstairs and peered into Mrs. Banker’s outside room where a secretary smiled and simply waved him to the open door. He followed the natural light, where inside her office was one of the finest views of Masonville to be had. On a clear, bright morning like today, it was even possible to imagine the swells on Lake Erie.
Jeffrey went straight over to Cathy’s desk where she finished a phone call, nodded at him, and took a seat. Maybe he imagined it, but he thought her usual optimistic smile waned, which was understandable. She had recently been diagnosed with breast cancer, but no one knew yet what she planned to do about it or what stage she had.
“Good morning, Cathy.”
“Likewise. Glad I caught you available.”
“Always for you,” he said, putting his hot cup on the edge of her desk.
“We need to nip a problem in the bud. We can settle this ourselves. I’d rather not disturb the CEO with it, and in turn, bother the Board. I talked to our attorney already and what I propose seems legitimate enough to pull off and not be second guessed or sued over. Although, these days, you can never be too sure.”
“You have my undivided attention.”
“Of course, your opinion is important before I ask you to do the dirty work.”
Not many people felt the same way about Cathy, but Jeffrey
appreciated her candidness. “Shoot,” he said.
“Last time we talked, we brushed over this topic. Now I hear about it whenever OR talk from downstairs weaves its way up here to my office. I also get an earful when I attend hospital staff meetings and business meetings.
“Dr. Jessy Winter is apparently an eyesore: unkempt, disheveled, and fragrant. At first, I heard he was living in our hospital, but after my own research, that gossip has been confirmed to be true. He has taken over one of our call rooms here and transformed it into his own private bedroom and living facility. So much so, that he thinks he is entitled to a wife or a girlfriend stupid enough to pick up after him. In this case, our housekeeping services.”
“I have no reason to dispute what you’re saying. I see evidence of his 24/7 presence here myself. You may be going somewhere with this, however, is there any unprofessional feedback about his work?”
“Nurses are beginning to grumble, as well as patients. Here’s the thing. Under the circumstances, we can’t wait for him to deliver a bad outcome. We cannot jeopardize patients because his private life is all screwed up and his professional actions are taking a toll. And to tell you the truth, I don’t fully know what all his problems are, except that he’s going through a divorce.”
She tilted her head, enticing Jeffrey to comment.
He frowned and shook his head. “I suppose the wisest thing to do is to follow the attorney’s advice. Make sure that we log records of any complaints. I can jot down what I know as well. What do you want to be done with him?”
“Take away his hospital privileges.”
“Makes total sense, especially because that would require him to ‘move out.’ We’d probably feel the shortage as far as OB docs on call, but I suppose that’s the obstetricians’ problem. They are dedicated enough to fill in the gap.”
“If push comes to shove, we can always allot the money to hire another one just like we did for the anesthesia department. How’s that outlander physician working out anyway? I heard our closed-minded staff is giving her grief.”