by Barbara Ebel
He nodded at the secretary at the desk. Although he grabbed a sheet, he peered over at the case board. Two OB/GYN doctors had morning cases and one of them was Jessy Winter.
The Director of Surgical Services sneaked back to his office to think through his plan of action. Only once before had he needed to revoke a physician’s hospital privileges.
Jeffrey held the paper and studied it at his desk. Dr. Winter should be done with both cases by noon, he figured. Maybe he could catch him in the doctor’s lounge where he’d be eating lunch, and ask him back to his office. Cathy Banker, the CEO, made it clear that the OB/GYN doc needed to receive his walking papers today, so Jeffrey could deliver the blow over his last hospital croissant sandwich.
He dreaded his assignment. At his core, Jeffrey was a softy, with a heart of gold. As his career had progressed, he had toughened up his exterior to appear more dogmatic and strict than he really was. Overseeing the hospital operations and staff he was in charge of, was no easy feat, but it came with the territory.
Jeffrey just wished that no matter what Dr. Winter’s personal problems were, he hadn’t taken up residence in the hospital’s call room, putting them in an awkward position. He unclenched the schedule and leaned back. Friday’s were the busiest day of the week for him, tidying up all business for the week, and especially making sure too many things weren’t going to hang over his head for Monday morning.
He rolled up his sleeves for the day, took a big sigh, and put Jessy Winter out of his mind until lunchtime.
-----
Bleary-eyed, Jeffrey stepped out of the Patient Financial Services Director’s office at twelve-thirty. For two hours, they had analyzed last month’s patient payer mix, and the result showed a non-desirable financial outcome for the hospital. He wished someone would wave a magic wand and let health care costs benefit both patients and caregivers at the same time.
He deviated into the OR and looked at the scheduling board. Lucky for him, Jessy Winter’s morning cases were erased. The doctor may still have office hours the rest of the day, he figured, but that had nothing to do with the hospital. In actuality, he grimaced, his group would be in a quandary once their colleague was stripped of Masonville General Hospital’s privileges. How could he possibly work in the group’s practice when he couldn’t do cases in the hospital?
Jeffrey headed to the doctor’s lounge as he rehearsed the careful dialogue he needed to spill on Dr. Winter. He opened the door and spotted Jessy at his own table. He was eating, making Jeffrey’s plan to lure him to his office more difficult. The lounge would have to do, so he stepped over to the counter to check the coffee pot.
Satisfied with the freshness of the coffee, Jeffrey poured a cup. He also scouted around for the interim female anesthesiologist. It would be nice to mix doling out bad news with a more satisfying, short interaction, he thought, but no such luck. He had not seen her all day.
Jeffrey strolled over to Jessy Winter. “Mind if I sit down?”
Jessy speared a piece of cantaloupe from a small plate of mixed fruit and glumly nodded.
“Are your OR cases done for the day?” Jeffrey asked.
“Elective ones, yeah.”
The OB/GYN doc slouched over his plate, making butterflies twirl in Jeffrey’s stomach. He wanted to deliver the blow in a soft, gentle manner, and a bit of social chitchat beforehand would be beneficial.
Jessy swallowed and twisted his mouth. “I just thought of something. My status changed yesterday. I guess I better go change my personal physician staff information on record with the hospital. Like there isn’t a ‘Mrs.’ anymore.”
Horrors, Jeffrey thought. The man’s divorce decree came through. However, Dr. Winter opened up the door for him to tell him his bad news. He held off raising his cup to his lips.
“Actually, no update on your part is necessary, Dr. Winter. Masonville General Hospital has decided to revoke your staff privileges.”
The lines around Jessy’s eyes twitched. “Did you say ‘revoke,’ like ‘take away?’”
“Yes sir.”
“You are kidding? Right?”
“No.”
“How can you do that? Hospitals are capable of pulling crap on physicians, so I’ve heard, but how can you do that to me?”
“I’m sorry, Dr. Winter. This comes straight from the president of the hospital and the Board of Directors. They’ll be sending you a letter with more detail. There have been complaints about you living in the hospital and your personal upheaval … which spills into your work and interactions with patients and staff. They have documentation.”
Jeffrey held his coffee cup tightly. “Holy shit,” he mumbled. “When is this supposed to happen?”
“Technically, this is your last day on staff.”
Jessy reeled back so his body was flat against the wooden chair. He inhaled deeply and blew it out. “Just like that?”
“I’m sorry.”
Dr. Winter pried his back off the chair and leaned in. “Your demand may be difficult. I am the OB/GYN doctor on call tonight. Officially, I go off call at 7 a.m. tomorrow morning. I don’t see how my colleagues would be able to juggle around the present arrangement.”
Jeffrey was in a position of authority and knew he needed to make a judgement call and a decision. “I understand the implications. Yes, then, fulfill your on-call duties through to the morning. We’ll date and time your revocation of staff privileges to reflect tomorrow at 7 a.m. I will inform the hospital administration.”
Jessy eyed the fruit plate and slowly pushed it to the center of the table.
Jeffrey waited for a response, and when none was forthcoming, he stood slowly. “Good luck, Dr. Winter. Thank you, especially for all the babies you delivered while here the last few years.”
“Yeah, right,” Dr. Winter said under his breath.
-----
The clouds overhead moved swiftly, low and elongated like they were imitating the contrails many miles higher up. Viktoria took in a deep breath while Buddy lifted his leg on the curb. Luck was shining down on her since the weather was pleasant, and she was free until night call.
With Buddy at her side, they trotted to the coffee place where she claimed an outside wrought iron table. She tethered him to a chair and went inside. Linda was not working, but she made an amicable purchase from a young male with a bulky studded earring and a decorative neck tattoo.
Viktoria brought out a large cappuccino. Although gone but a few minutes, Buddy greeted her with his heart and his body. His back end swayed, his tail swished back and forth, and his paws danced on the cement. She sat, grabbed the dog’s snout in her hands, and kissed and nestled him.
She thought back over the last few days since she arrived in Masonville. As always, hospital dynamics were a challenge, but her cases and patients had done well and that was what counted the most. With one week over, there were only three more left and, by then, she would know where and what her next position would be.
As she looked down at Buddy, she realized he was the highlight of her week and her position there. She had taken his bandage off earlier in the morning to check his stitches and, pleased with his healing, she rewrapped his leg with new gauze. Each day she was growing fonder of her four-legged pet. She already couldn’t imagine going anywhere without him.
She sipped the hot beverage and then pulled out her cell phone. Communication between her and her husband had waned over the last two days, so she went to text messages and began typing.
“Did you finish the client’s roof repair insurance claim the other day?”
With no indication that he was actively texting her back, she re-read another text which she had not yet answered from Regina at the locum tenens agency.
“Hope you’re well settled in by now at Masonville. It always amazes me how fast you accommodate yourself to a new place. I’m looking ahead for you, so let me know if you have any geographic preferences for next month. A group in Florida needs somebody, but it’s all pediatric anesthes
ia.”
Viktoria thought it over. Pennsylvania had been a long drive and Florida would be further. Plus, she frowned at the idea of putting Buddy through that long of a drive. Now she had to consider him as well.
“Regina, can you imagine? Me being a little less flexible? While here this week, I took in a stray, abused dog. We’ll count Florida out for now. That would be a burdensome drive for me and a puppy.”
Unlike her husband, her phone dinged with a quick response.
“That’s big news. He sounds restrictive, but I’m glad for you.”
Viktoria stooped over. Buddy was lying flat with his ears alert and his eyes glistening. She snapped a picture and sent it off.
“Precious! Does the dog have a name?”
“He’s a he and his name is Buddy.”
“All right then. Welcome him to the locum tenens lifestyle. He’ll be going places!”
“Thanks. Keep me posted. Make sure all my future accommodations are pet friendly!”
Viktoria slowly finished her drink while the number of customers picked up going in and out of the door. Buddy accumulated pats on the head from strangers and gazes from drivers heading through the drive-through line. She was about to take off when a text came through from Rick.
“Finished the claim work yesterday, the client found a roofer, and work will start next week. Not like you to text from work.”
“I’m pulling a call tonight, so I have ‘off’ during the day. Will take a nap this afternoon.”
“Heck of a way to spend a Friday night.”
“Wouldn’t be doing anything special anyway, but now I’ll be earning time and a half.”
“That’s worth it.”
She frowned. More money to subsidize his lifestyle, she thought.
“Depends on how busy it’ll be. Or how hospitable the night staff is compared to the day staff.”
“Good luck then. I won’t disturb you. How’s the dog?”
“Peachy. Talk to you tomorrow.”
She slid her phone into her pocket, pitched her empty cup, and jogged back to the hotel where she relaxed with her favorite companion.
CHAPTER 15
Viktoria seldom worked night calls while on assignments. Usually it was under special circumstances, like working the whole job on nights, having off during the day, and being extra-well compensated. This one-night call on Friday was an exception, but it was going to work out fine since she was going right into Saturday and Sunday when she could catch back up on her sleep if she needed to.
The trick was planning her day and, luckily, Buddy cooperated like a charm. She took her nap, fed him dinner, and walked him an extra couple of blocks.
“Good night, Buddy,” she said at the door. “You mind the room. I’m trusting you out of the crate, so you can have your way on the bed. Keep my spot warm for tomorrow.”
Buddy sat and cocked his head to the left. She could not resist his sweet face, so she stooped down and kissed him. As she turned on the engine, she was glad to see the next-door man’s car missing.
She was due in the OR in another half hour, so had plenty of time to zip through the drive through and order a grande cold drink which automatically came with two shots of espresso.
Linda reached out the window and placed it in her hand. “Kind of late for that espresso fix, isn’t it?” she asked and laughed.
“Not since I’m going to work all night. It’s just what the doctor ordered.”
“Literally!”
Viktoria raised the cup. “Thanks.”
Down the road, the hospital parking lot was less jammed than during the day, so she parked close to the entrance and grabbed her overnight bag. She sipped the iced mocha in the elevator, stepped out, and headed to the changing room. Since most of the OR staff presently working started at 3 p.m., the locker room was empty. She was off to a pleasant start since there was no other female present to give her the cold shoulder or talk unpleasantries to others about the “outlander.”
She found the correct size scrubs in a meager pile and changed, intermittently stirring and sipping the treat. Over the course of the evening, she planned to pick over whatever real food the docs had left in the lounge during the day, especially in the refrigerator. That and a baggie of Sukkulaoihjupaour lakkris in her scrub jacket pocket should satisfy her appetite and sweet tooth.
Viktoria showed up at the OR main desk five minutes early.
“Doctor Viktoria!” Dr. Huff exclaimed. “Right on time.” He flinched his narrow shoulders like a bird ready to take flight to go home.
“Always,” she said, sucking through the straw and eyeing the board. “What can you tell me?”
“You’re coming on to a typical evening around here. The last elective case is on the table, a teenager receiving a skin graft to close the wound of a prior fasciotomy. The kid is totally healthy except for a rare type of epilepsy for which he’s on no medication and, of course, what happened to him due to an original sports injury.”
“Arm or leg?”
“Arm.”
“Who’s in there?”
“A nurse anesthetist named Bobby Wright. He’s on call. His back up is Susan Rust, whom you worked with yesterday. She’s finishing up preop rounds upstairs for the two elective cases on for the morning.”
“Nothing else to follow? Susan Rust can leave when she’s finished?”
“As of right now, yes.”
Viktoria nodded. “Enjoy the wedding tomorrow. See you next week.”
“Thanks. Don’t forget, I’m your back-up doctor in case all hell breaks loose, but I don’t expect to hear from you. Also, the doc relieving you at 7 a.m. is Everett Benson.”
He glanced at the circular wall clock and announced, “I’m out of here.” She thought she heard the last from him as he swiveled around. “And by the way, the squatter obstetrician got canned from the hospital today. He’s ‘out the door,’ but he is on call tonight. I’m only telling you in case the two of you cross paths tonight.”
Dr. Huff showed no interest in elaborating and kept walking. Viktoria squinted her eyes. Truly, she thought, what a shame. Hadn’t poor Jessy Winter had enough?
Viktoria rubbed her hands and interlocked her fingers together as if in prayer. She hoped she would run into the OB doctor because she had promised to lend him support if he needed it. She slipped her empty cup in the trash can, donned an OR bonnet and paper shoes, and went straight back to the OR. It was time to get on with her overnight duties.
“Bobby Wright,” the CRNA said when she stepped into the surgery case and straight into his work space. He stood attentive, backing off on his anesthesia, as the surgeon finished his work.
“We haven’t worked together this week. I’m Doctor Viktoria. Dr. Huff mentioned that our patient has a rare epilepsy.”
“Correct. Jay had to look it up—idiopathic photosensitive occipital epilepsy.”
“Never heard of it.”
“Dr. Huff was clueless too. He went straight to a medical textbook.”
“There doesn’t seem to be many medical books in the anesthesia office.”
“Only a handful. He went to his private office where he keeps old-fashioned bookcases with medical information.”
“I would also like to read about it. Do you think he would mind if I checked his resources?”
“I doubt it. His office is in the opposite direction of Jeffrey Appleton’s, past the doctor’s lounge. Last door on the right. In the meantime, there are no problems here.”
Bobby smiled under his mask. “Maybe we’ll have a quiet night.”
“A Friday night without trauma surgeries is rare, but perhaps at Masonville General Hospital.”
“Dr. Viktoria, the big trauma stuff goes up the road towards the lake. And if not, the ER docs ambulance patients to the hospital up there.”
“Thanks for letting me know.”
She stopped and introduced herself to the surgeon. The lanky patient’s arm was a scary sight to behold but on the way to he
aling. “Poor guy,” she said. “No high school sports for him for a while.”
“Next season he’ll be good as new,” the surgeon said.
-----
Viktoria first went to the anesthesia office and scoured the bulk of the books which qualified as anesthesia related and not in-depth material on medical diseases, especially rare ones. Susan Rust popped in and, with a big breath, sat on the couch.
“Good evening,” Viktoria said. “How are you today?”
“Better than I deserve at my age.”
“Well, if you’re finished seeing those two elective cases for tomorrow morning, you can go home and rest your ankles, knees, and hips, and everything in between.”
“Appreciate that.”
“Anything important to know about those two cases?”
“No Ma’am.”
“Marvelous. You are free to go home. Perhaps your husband is finished in his store and you two can go out to eat—if you’ve caught your breath by then.”
“Thank you. Sounds like a fine idea, if I have the stamina left.”
“To eat, why not?” She reached in her pocket and handed Susan a chocolate liquorice.
“A white malted milk ball?”
“Not at all.”
Susan put it in her mouth. “On that note, I’m leaving. I’ll figure out what I’m eating on the way out.”
“Suck on it,” Viktoria said.
“Oh, I plan on it.”
“It’s an Icelandic treat,” Viktoria said as she also exited the office. She went straight out to the hallway and quietly padded down the corridor to the end. A name sign next to the door said “Jay Huff, M.D.” She frowned at the closed door, wondering if it was locked.
With a twist to the doorknob, she discovered Jay’s office was open. She went in, flicked on the light, and left the door ajar. The room was half the size of Jeffrey Appleton’s, but messier. There were a lot of books, more than she would have guessed. Probably every book he had accumulated since medical school, which suited her just fine.