ON CALL
MICHAEL PALMER
St. Martin’s Press
New York
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Contents
On Call
Preview
On Call
July is a very bad month to be sick at Eisenhower Memorial. In truth, it’s the worst month to be admitted to any teaching hospital anywhere, Washington, D.C., being no exception. Medication errors rise by at least 10 percent. Death certificates spike like a child’s coxsackie fever. The sick seem to get sicker, and those teetering between breathing and not have a statistically higher probability of getting toe-tagged. So why would one chunk of the calendar be deadlier than the rest? July just so happens to be the month when all the newly minted interns, three weeks from their med school graduation, suddenly find themselves MDs.
On this particular early July morning, the Silverman Auditorium at Eisenhower was half-filled with about two hundred well-intentioned but exceedingly anxious interns and residents, most of whom were sitting as close to the front as possible. I was in the back, sandwiched between my two best buds, Paul Brosnan on my right, and Lou Welcome on my left. For years, they had called me Cowboy, on account of my Wyoming pedigree—Cowboy Gabe Singleton. But given as how my rodeo skills have waned since I took up big-city living, the moniker no longer quite fit. Over the four years since we arrived at EMH, the three of us had become known as “Los Tres Médicos.”
Paul, two years younger than I am, and a year older than Lou, is more than just a swarthy, brown-eyed, handsome man with an academic GI practice in his future. He’s also the new chief resident of the Department of Medicine. He’s effectively a role model, problem solver, morale booster, intellectual leader, and team mascot—which is to say, everything that I am not. The truth is, I couldn’t get Paul’s gig even if I wanted it. A year ago, still troubled by a fatal automobile accident I was involved in during my third and last year at the Naval Academy, I took a leave from my training, and haven’t gone back. I’ve been working as a lab assistant for the second-year students, and picking up hours wherever I could while waiting for some celestial sign as to what I should do with my life. Sweet Lou, as I call him, is done with his medical residency, and is doing a year of pathology research in Professor Hannah Radcliffe’s lab while waiting to take his ER boards.
Los Tres Médicos.
Thanks to managed care and the politics governing patient treatment, I’ve developed an ennui surrounding my profession, and haven’t yet decided if I even want to be a doctor. My pals seem to have other ideas for my future. The few but increasing times I’ve threatened to move back to my beloved Wyoming, they have taken it upon themselves to send me photos of ranch hands inseminating cattle, a reminder of the future awaiting me in the plains outside of Cheyenne. Not pretty.
Onstage at the moment was Dr. Annabelle Stern, aka the gloriously gorgeous, raven-haired, high-cheekboned, wholesomely delicious Annabelle Stern, aka our outgoing chief resident. In just a few minutes, she will ceremoniously hand over her stethoscope (our equivalent of the beauty queen’s crown) to Paul, who will assume her duties for the coming year. Seated to Annabelle’s right was George Kincaid, lean, brilliant, and distinguished. George is the chief of medicine, and someone I have always admired, although not as much as I revere his wife, Professor Radcliffe, an icon in the medical school community.
This being our fourth orientation lecture, we knew exactly what was coming before it happened. For Los Tres Médicos, the scene came off like a long-running Broadway play. After Annabelle finished her speech about what to expect in the coming year, Dr. Radcliffe went through the orientation schedule. Then she made a few stale (to us), slightly risqué jokes and introduced her husband. As he ambled to center stage, one or two of the women in the audience whistled approvingly. He was slapping a long, hefty bone against his palm.
“Can someone tell me what this bone is?” Kincaid asked, his stentorian voice catapulting from his clip-on microphone.
“A femur,” one fearless newbie shouted out.
“A natural guess, but wrong.”
“A humerus,” another ventured.
“A little large unless you believe in Sasquatches,” Kincaid said. “The point is, we all make assumptions based on what we see, or what we think we see. Assumptions, my dear residents, are what will make your patients dead.”
I looked at Paul, Paul looked at Lou, and we nodded in unison. This would probably be our last assembly together, so we had decided to go balls to the wall.
Paul stood first. “Is it possibly Oliver’s Twist, sir?” he asked.
Kincaid managed a knowing grin. After just a few seconds, he was already on to what was coming.
“I say it’s Huckleberry’s fin,” Lou chimed in.
“How about Herman’s Melville?” I contributed.
By now, even the most intense, nerdy resident had caught on. Kincaid’s real message to them was Relax and Have Fun When You Can. Rapturous laughter erupted in the hall. Kincaid paused, slapping the bone harder against his palm.
“Very creative suggestions this year, gentlemen, well done. Okay, everyone, as you appear to have been shown the right place to insert an apostrophe and ess, you know that what I am holding in my hand is in fact the baculum, or penis bone, of a sperm whale. Present in most placental mammals, but absent in humans, the bone aids sexual intercourse, thereby making the most descriptive answer—”
“Moby’s Dick!” the assemblage called out.
Kincaid droned on. Nothing we hadn’t heard before. About halfway through his vast PowerPoint presentation, the auditorium doors to our right burst open. Judging by the flashlight beams that followed, at least three people entered. When my eyes adjusted to the light, I saw that the party crashers were in fact a uniformed police officer, a man in a rumpled sports coat who had detective written all over him, and Susan Bickford the director of Human Resources. At first I thought it was part of Kincaid’s theatrics.
Then, directed by Bickford, the flashlight beams intersected on Paul’s face.
With startling quickness, the police officers hoisted Paul up by his arms and, faster than a rodeo calf roper, cuffed his hands behind him. Everybody stood, necks craning in that car accident kind of way. There was a lot of murmuring, but all I could hear was the detective reading Paul his rights as they marched him out of the auditorium.
Drugs. Those always seem to be at the heart of a downfall—drugs or booze or lust. For me, booze was my Four Horsemen. I haven’t had a drop of the stuff since the accident years ago, and God willing, one day at a time, I won’t have a drop of it tomorrow.
Hours after Paul’s arrest, we had a sit-down with the hospital’s top brass and learned more about his stunning fall from grace. Word from HR was that someone called an anonymous tip line and reported seeing Paul dealing drugs in the hospital parking lot after work. That was enough to get a search warrant for Paul’s locker, where the police found three shoe boxes of oversized pill bottles filled with OxyContin, plus a good-sized bag containing vials of morphine. Although I never had even the slightest hint of it, I assumed that in addition to dealing, Paul was also using.
The police checked the hospital and local pharmacies for any inventory shortfall, but the drugs, it turned out, came from the Silk Road Marketplace—an anonymous Web site that NPR has referred to as the “Amazon.com of illegal drugs.” I later learned that to keep an
onymity as strong as possible, buyers have to use crypto-currency to make a transaction. I didn’t know Paul had such tech smarts in him. But then again, this whole stunning turn of events was full of surprises.
The younger two Medicos smoked pot on rare occasions, and would drink when the time was right. But Paul kept a tight rein on himself, and Lou, who was the wild one of our trio, had other crowds he hung with when he wanted to get rowdy. Sobriety has taught me that my disease does not discriminate. Young or old, rich or poor, black, yellow, or white, anybody with a working brain is at risk for trouble. That included a guy with everything going for him—a guy like Paul Brosnan.
A few days after Paul’s arrest, Lou approached me while I was in line for lunch at the hospital cafeteria. He looked worried about something. Make that totally freaked out.
“Can we talk?” he asked. “I’ve got problems. Big ones.”
“I hope your locker’s clean.”
“Empty as a dodo bird nest. I’ve even put a new lock on it.”
“Does it have anything to do with those gouges on your hand?”
Sweet Lou looked down at the rows of scratches as if he were noticing them for the first time. “Hell no. Those are from the rats I work with. They hate me, probably because they’ve figured out what Dr. Hannah of Radcliffe has me doing to them for our research.”
“So, what, then?”
We sat down at a remote table.
“Kincaid came to see me.”
“And that made you this squirrelly?”
“He asked me to be chief resident.”
“I know. The hospital grapevine is faster than a speeding bullet.”
“Paul isn’t speaking to me anymore.”
“Yeah,” I said. “I was going to talk to you about that as soon as I figured out what I wanted to say. He’s pretty upset.”
“The rumor’s taking root that I planted the drugs in Paul’s locker because I wanted the chief resident job. Now, Paul thinks that it’s true. You’ve got to help me, Gabe. Kincaid wants my answer by the end of today. If I accept, that’s only going to make the rumors worse.”
“Just so you know, I never thought for a minute you had anything to do with the drugs.”
“I know, but thanks for saying it anyway.”
“But you do want the job?”
Lou broke eye contact. “I’m not sure how I feel about that,” he said. “But chief resident is a plum.”
I hadn’t ever known Lou to be overly ambitious, and this was like seeing the dark side of someone’s moon. “I see…,” was all I could manage.
“Over the long haul, it would help,” Lou said. “The job market out there is more competitive than ever.”
“But if you take the job, Paul is going to believe the rumors.”
“Which is why I need you to go and talk to Annabelle.”
“Annabelle? What’s your thinking there?”
“I’m thinking she’s the one spreading the rumors about me.”
I took a bite of my now cold mac and cheese and wished I had gotten the pizza. “What makes you think she’s behind this?” I asked.
Lou took several furtive glances, leaned across the table, and whispered, “We were sleeping together for a while. She wanted to keep it a secret until after the training year was over, but I couldn’t take sneaking around and ended up breaking it off a couple of months ago. I thought she was okay with it.”
“Lou,” I said, “everyone from physical therapy to housekeeping knows that you were seeing Annabelle Stern.”
“Everyone?”
“More powerful than a locomotive.”
“That’s some grapevine. Why didn’t you say anything to me?”
“I respect your privacy. Besides, I didn’t want to jinx your mojo. Annabelle Stern is quite the catch, amigo. A part of me was actually a bit jealous. You can probably guess which part.”
“So you’ll talk to her for me?” Lou asked. “I’ve tried, but all of a sudden she won’t return my calls.”
“Pardon me for saying so, but it’s a little hard to believe that you’d call off an affair with the belle of the hospital. We all think she’s perfect.”
“Go figure, but there was just something about her that didn’t work for me.”
“In bed?”
“No, that worked. Too well, in fact.”
“So what was problem?”
“Just a vibe. It’s hard to explain. There’s something about her and her secrecy that I couldn’t handle.”
“So you think she’s the kind of girl who could start a rumor just to get back at her ex-lover?”
“I don’t know. If she did start the rumor, or even just supported it, all I want her to do is come clean so Paul will talk to me. I really love the guy.”
“So do I. He’s in a pretty bad place right now. He’s out on bail, suspended from the program, and facing felony drug charges. He’s looking at some serious prison time, too. Even if Annabelle owns up to starting the rumor, Paul might still want someone to direct his anger at. I’m just saying don’t expect this to be a miracle cure.”
“I get it. But I’ve got to do something. Without Paul’s blessing, I’m not taking the job, and honestly, Cowboy, my CV needs all the pumping up it can get.”
Work got in the way, and it wasn’t until eight o’clock that night when I finally got a chance to go looking for Annabelle, who was staying around as chief until Paul’s replacement could be selected. A telemetry nurse thought she might be taking a nap in one of the on-call rooms. Despite laws designed to protect the house staff and patients from excessive hours on the job, no one stopped when they were supposed to, and everyone was in a chronic state of exhaustion.
Most departments have an on-call room where house staff can grab a few hours—or even minutes—of sleep. The rooms are often little more than glorified closets, but they’re clean and the beds are comfortable enough. Besides, most docs simply don’t care where they collapse. The chief resident is covering the whole hospital, and has no specific on-call room. If Annabelle was taking a nap somewhere, it might be in one of the resident on-call rooms on, like, orthopedics or cardiology. More likely, though, she’d take a stab at the legendary On-Call #6, so that’s where I headed.
On-Call #6 is located on the fourteenth floor of the Strother Building, but to get there, you have to take an elevator to the thirteenth floor, and then a flight of stairs that opens up into a back corridor. In contrast to the other on-call rooms, On-Call #6 has a queen bed, locker, shower, and freshly stocked linens. There’s even a linen closet with a lot of sheets, and a metal hamper outside the room to dispose of dirty laundry. By tradition, the janitorial staff doesn’t go into this room. The rules governing use are pretty simple: If you use the room, you clean the room. It’s an honor code system that nobody, at least to my knowledge, has ever violated.
Since it’s also known as the Love Shack, it is well understood that sleep is usually the last thing that happens in On-Call #6. For this reason, I checked to make sure the brass number 6 on the door was not flipped to a 9, which would indicate that the room was in use. Maybe Annabelle was so tired, she forgot to flip the number. That’s happened several times to the embarrassment of the couple within, who forgot that the keypad could open the door even if it’s locked from the inside. I knocked, first gently, then loudly. No response. Getting the combination to On-Call #6 is a rite of passage at Eisenhower, and though I’ve been so tired, I sometimes couldn’t remember where I lived, I’ve never forgotten the code.
I opened the door just a crack and peeked inside. Early evening light from a single small window bathed the otherwise unlit space. My eyes adjusted to the gloom. I saw a motionless figure on the bed and figured it was Annabelle, sleeping off some of the stressful events swirling about all of us. Then I noticed that her arm was dangling in an odd way off the side of the bed. I called to her tentatively.
“Annabelle? You awake?”
No response. My doctor radar went from dormant to white-h
ot in a blink. I flipped on the light as I called out her name again. My breath caught in my throat. The sight was one that will live inside me forever. Annabelle Stern lay on her back, gazing sightlessly at the ceiling. Her clinic coat was thrown over the single chair, her blouse partially torn open with two buttons ripped off. Her eyes, normally bright and absolutely riveting, were foggy. Her mouth had fallen open as though begging for one last gasp of air. I could see the welts, red and raw, around her neck where somebody had choked the life out of her. Not believing what I knew was fact, I raced over and checked for pulses in her carotid and radial arteries. Her skin was cool and slightly mottled, her limbs totally limp.
I had seen death before, many times, in fact.
But this was my very first murder.
The police, of course, interviewed me. I went voluntarily to the station to give my account of the incident. Two detectives joined me inside the interview room. One, who was there for Paul’s arrest, looked like he could have eaten the other—the Abbott and Costello of law enforcement. The large one was Detective Anderson and the slighter of the pair was Detective Rodriquez. I told them why I went to On-Call #6, and that got their attention.
“So your friend Lou Welcome recently broke things off with Annabelle?” Rodriquez asked.
“He said he had reservations about the relationship.”
“Did he know that Paul Brosnan was also interested in Annabelle?”
The cramped room, with two-way glass, whitewashed concrete brick walls, and a pine-top desk, instantly got a whole lot smaller and more than a pinch hotter. I swallowed hard, sensing the coming storm. My feet tapped a nervous rhythm against the gray, nappy carpet.
“Paul is dating Annabelle’s roommate, a woman named Victoria,” I said.
“Well, Annabelle kept a diary, or a notebook,” Anderson said, interlocking his meaty fingers. “We found it locked in her gym bag. There are a bunch of entries about your pal Lou and another bunch about Brosnan. Only her version is different from yours. She wrote that she broke things off with Welcome. I don’t think they had even gotten laid when she did.”
On Call: An Original Short Story Page 1