I shake my head and sit down.
“Sure you’re up to working today? We’d all understand.”
“Got to get back up on the horse, don’t I?” I answer in a quavery voice.
“Well…” He purses his lips together and blinks. “You’ve probably already talked to the malpractice company. Do you have a meeting set up with them yet?”
I let my breath out. I’ve been concentrating so hard on not crying, I’m almost relieved to switch to the procedural mechanics of this death. “It was so late when I got home, I was going to call later this morning.”
Phil nods, pressing his lips together in a taut line. His hands are clasped in a thick, square lattice, his nails thoroughly scrubbed. His blue surgical cap is pushed up high above his brow, leaving a red indentation across his forehead. “Sure. We’ve already talked to them, of course, so they have the basic information. I imagine they’ll try to reach a quick settlement.”
“A settlement? Is she…is the mother suing us?”
He grimaces briefly before adopting a perfunctory smile. “Not yet. I doubt any lawyers have gotten to her yet. But in a situation like this—a healthy girl and a low-risk operation—the hospital will want to move straight to a settlement offer. Resolve it before the media puts it on the front page.”
I slump forward on my chair and press the heels of my hands against my eyes. “I hadn’t even thought about that yet—any kind of legal thing. I’d been thinking about sending her mother flowers or food, or starting a donation fund or something.” An involuntary laugh escapes me. “I guess that sounds stupid, doesn’t it?” I trail off. He is staring at me with a mixture of sympathy and alarmed perplexity, as if I have no inkling of what he sees charging at my back.
“Actually, it sounds kind. I hope it stands in your favor.” His tone is almost paternal. “Marie, I’ve worked with you for seven years. I know how thorough you are, how compassionate. No one here blames you for this death.”
Tears start to well up and I have to hold my breath for a minute to get control. “It’s a little hard to believe that right now. But thanks.”
He returns to a more professional sobriety. “Let me know as soon as you talk to the insurance representative—I want to set up a meeting with all of us by the end of the week.”
My hands are crossed in my lap, dry and chapped from washing between surgeries, and I have a sudden flash of them pumping on Jolene’s chest when I gave her CPR. I blurt out another question. “So, if we settle, is that like an admission of a mistake?”
“No. Well, technically yes, in that it’ll go into the national database, but outside of some miracle of ignorance, there’s no chance this mother won’t seek damages. If she doesn’t think of it, someone else will. So you either settle or let it go to a full-tilt trial.”
The database Phil is referring to is a public record of doctors who have paid an insurance claim to a patient. It doesn’t matter if the claim was defensible, or justified, or even moral. It doesn’t even matter if it never blew up into an actual lawsuit. It cost the malpractice insurer money, and is therefore published like a slash mark across the physician’s reputation.
“Could a trial clear my name?” I ask.
“It could clear it, or it could cost you multiple times what a settlement would. You and the hospital. Not to mention the publicity.” He drops his voice back to a more calming note. “Look, even if the mother—what’s her name? Jason?—does get carried away and pushes this all the way to a trial, I can’t imagine the autopsy will expose any problems with your care.”
“Ms. Jansen refused an autopsy. There won’t be one.”
“She can’t.”
“What do you mean?”
“She can’t refuse. This will be a medical examiner’s case. The girl was ASA One, right? No health problems? Unanticipated deaths in ASA One and Two patients almost always get an autopsy.”
A knot twists in my stomach remembering the horror on Bobbie’s face when Don asked about an autopsy. Phil leans closer. “You should be glad about this, Marie. An autopsy will just confirm you did everything right. Maybe even…I guess we shouldn’t talk about any particularities without the lawyers here. Look, are you sure you don’t want to take the day off?”
I haven’t thought about an autopsy before now. I’ve written all Jolene’s death forms and reports assuming she died of bronchospasm, from anaphylaxis or asthma, even if I’m not sure what triggered the reaction.
“Where is she now? Jolene—the little girl?”
“King County morgue, I guess. The medical examiner took her shortly after the mother left.”
I’ve had a picture in my head of Jolene lying in a trundle bed, with children’s toys around her instead of flowers, her mother sitting beside her in an armchair, smoothing her hair. It’s ridiculous—a fabricated scene I wasn’t even conscious of until it metamorphosed into an eviscerated child on a pathologist’s slab.
“Do you have any idea when the funeral will be?” I ask.
Phil blinks as if his eyes burn. “Marie, I know you feel for this family, but it would be foolish to show up at the funeral. Even if you’re not to blame, you should keep your distance here. Anything personal has to come second to legal issues. Maybe you could make some gesture after there’s a settlement.”
Three hours later, in the middle of a laminectomy, Frank Hopper pages me, asking me to come to his office before I leave for the day. Frank is First Lutheran’s CEO. Stepping into his office is like opening a door from Wal-Mart to Saks Fifth Avenue. The nubby print carpet changes to lush wool, the vinyl chair coverings transform to Italian leather. The only other time I was in this sanctum was when I signed my contract.
Frank invites all of us to address him by his first name, and begins every conversation with intense, direct eye contact that dissolves into a scan over my face, my hair, my clothes, my posture—a measuring assessment that usually leaves me feeling inadequate. He reassures me that he has complete faith in my medical judgment and how I handled the “crisis,” skillfully avoiding the word death. He and the whole staff understand that these next months will be trying for me and they want to keep all avenues of support and communication open. His elbows perch on the arms of his swiveling chair, and now and then a cufflink peeps out of his sleeve—onyx, I guess, with what looks like a diamond embedded in its belly. It makes me wish I had at least worn earrings today—something in blue to complement my crumpled and overlaundered scrubs.
“We’re working with a great malpractice company. Top-notch lawyers. John Donnelly—he’s helped us before. The child…a girl?”
I nod.
“She was…from what Don Stevenson said, she was handicapped?”
“Jolene was mentally retarded. Yes.”
“That’s to our benefit, you know. No lost wages to compensate. When are you meeting with the insurance representative?”
“I haven’t had a chance to call yet. Today…”
“Make it soon. You need to do it while you still remember details. You’ve charted everything, right?”
“Completely. Right after it happened. We called a code, of course, so Matt Corchoran was there—he’ll have all the medication records.” I realize my hands are twisted together in fists and I unclench them. “I’ve rechecked all my drug doses, gone over every step of it, Frank. I don’t think there’s anything I could have done differently.”
He holds a hand up in the air. “This is your first experience with this sort of thing, am I right? So take my advice: don’t talk about it. Only with the lawyers and insurance people. Anything else becomes fair game to be used against you.”
My brother-in-law answers the phone on the first ring. I can tell he’s disappointed it’s me.
“Hey, Gordon. Is Lori free? She can call me back if she’s putting the kids to bed.”
“Lori!” I hear through a muffled mouthpiece. “She’ll be here.” His voice lightens some, as if he’s given up hope that I will transform into whatever business contact he
was waiting to hear from. “So how’s the Sandman?”
“I’m OK.”
I picture him running his stubby hand through his thinning hair, waving the phone at her and mouthing that he’s waiting for an important call. I’ve worked to appreciate all that my sister sees in Gordon. He has a capricious sense of humor, laced with a keener edge, lately. But he has made Lori happy, for the most part, over seventeen years, three children, six houses and multiple cycles of real estate booms and busts. Boom for the last four or five years, which seems to have inspired enough self-confidence in him to probe into my own income.
“You make money putting people to sleep, and I make money waking them up. I wake people up to possibility. That’s what real estate development is all about, when you boil it down. Possibility. Abandoned, weed-covered plots turned into bedrooms, restaurants and cash machines,” he tells me at any chance, never deterred by my explanation that student loan repayments absorbed most of my disposable income for five years, and now the rest goes into the retirement account I’m a decade behind in funding. Tonight I am spared when Lori grabs the phone from him.
“Perfect timing. I was just about to call you.”
“Claire Voyance here,” I say, our joke for the startling frequency with which we both reach for the phone at the same time. But tonight my voice twists in the middle of the words. I tuck into my reading chair, and pull my nightgown over my knees like some small wood creature curled in protection. Everything I need to tell her is flooding up from my chest, pushing up against the base of my skull, churning into cries and images, begging for relief.
And I can’t let go.
There is a wail in the background, and Lori shushes a child. “I need doctorly advice. Lia fell on her arm about an hour ago—jumping on a pogo stick wearing roller skates. Go figure! How can I tell if it’s broken?”
And here is my alibi. Everything that hurts is instantly swallowed inside the emotional vacuum of logic and professional advice. “Is it swollen? Does it look crooked at all? Can she wiggle her fingers? Bend her elbow?”
I have Lori splint Lia’s arm in a rolled-up magazine, give her Tylenol and call her pediatrician in the morning. Lori wants to know if it matters whether she chooses Rolling Stone or Harper’s. From there she glides into descriptions of a disagreement with one of the teachers, how unusually rainy it’s been in Texas, “as if we lived in Seattle,” the fact that my father’s birthday is approaching and we should plan something together for him. The telephone is wedged between my face and shoulder and tears flow down my cheek along the hard plastic receiver until it becomes slick. I wonder if it is possible to cause a short circuit should they flood the tiny holes that carry my voice over fifteen hundred miles between here and Fort Worth.
6
It’s easy to get the information about the funeral. I call up the medical examiner’s office on Saturday, when only a low-level assistant is likely to be on duty (even so, I’m tempted to alter my voice, ready to conjure a pseudonym). She perfunctorily tells me which funeral home received Jolene’s body; the funeral director consolingly tells me the date, time and place. Half my closet is on the floor by the time I’ve chosen a simple navy skirt and sweater, having given up on composing an outfit at once somber, tasteful and capable of making me thoroughly invisible.
The first truly springlike day of April, cherry trees quaking with proud blossoms, the air a purified blue, is the day Jolene is buried. I park across the street from a small chapel attached to Massins’ Funeral Parlor and grip the steering wheel while I reiterate all the reasons I’m justified in being here: funerals are a chance for resolution, a chance to seek peace; funerals are events where wealth, power and status acquiesce to equalizing fate—events where cautionary legal prudence should hold no ground. I’ve come here to show respect for Jolene’s life, for Bobbie’s loss—to acknowledge that even if we end up in adversarial roles in lawyers’ suites, I can grieve with her. I can do something to make her feel less abandoned. I have come here because I could not stay away.
A few minutes after the service is scheduled to start a man in a black suit walks onto the porch, checks his watch and closes the doors. I slip into the chapel and let my eyes adjust to the dim light. It is the simplest of rooms, no crosses or stars, everything cut to square without peaks rising up to point at God. I have no idea whether Bobbie is a religious woman. Is she having her daughter memorialized in this allegorical sanctuary because she is godless? Or just because she is poor? Did she raise Jolene to pray each night before sleep, begging the Lord her soul to keep? And when she did not wake, would never wake, was Bobbie prepared for God to take her child’s soul? Sunshine spills through the dusty panes of a high row of windows in shining bundled blades. Only seven or eight other people are scattered through the pews.
In the absolute stillness all I can hear is my heart pounding. It’s to be expected, I tell myself—so much guilt to work through. Of course I feel anxious about seeing Bobbie. I’m more ashamed to admit that I’m scanning the room for anyone here from First Lutheran who could recognize me. I slide onto the farthest edge of the last oak pew, as distant from the other guests as I can get.
Bobbie is sitting in the first row. Her hair is gathered into a loose bun at the nape of her neck, exposing the vulnerable bones of her cervical vertebrae, a rippling ladder from the collar of her black sweater to the curving base of her skull. She looks so much smaller than I had remembered. Jolene’s child-sized white coffin is directly in front of her on a raised platform, a bouquet of star lilies and white roses draped over the half-closed lid. There aren’t any other flowers—two large urns at the sides of the central stage stand empty. The teddy bear Jolene was clutching when I met her in the preoperative holding area must be lying on her breast—I can see the pink nylon of its stuffed belly curved above the wooden rim.
A middle-aged man and woman sit in the same pew with Bobbie, though not close to her. She seems isolated here, among the people I would assume she knows best. I glance at the faces I can see and try to guess at any family resemblance. The door swings open again and sunlight slices across the stone floor. Backlit by white light, two men, both dressed in dark suits, are silhouetted against the entrance. They’re coming toward me, looking right at me. I know them—Phil Scoble and Frank Hopper. They must be here to represent the hospital. I should have anticipated this. It would be the politically smart thing to do—to show up in a gesture of sympathy. Smart for First Lutheran and foolish for me. I’m about to stand and face them both when they cross out of the light and I see they are complete strangers. My head falls into my hands as if I were praying; I’m enraged at my relief.
The man who closed the chapel doors stands up at a lectern, clears his throat and opens a notebook. He drops his chin to survey his meager audience over his glasses, then welcomes us to this service honoring the life of Jolene Marielle Jansen. He reads a touching, generic eulogy. I wonder if they have prewritten speeches at a place like this, abbreviated psalms for children. Bobbie doesn’t look up. She doesn’t even move.
The speaker takes his seat and the chapel is quiet except for a few stifled coughs. The silence builds to an awkward shifting of weight and creaking of benches until people gradually begin to drift outside. The woman nearest Bobbie stands up and walks over to her, touches her shoulder and says something too low to hear. I gather my purse and a small spray of iris and daisies tied with a pink ribbon. I recognize now that I chose pink because of the bear—guessing that was Jolene’s favorite color. She was at an age when girls like to have a favorite color, I think. And the blue iris because her eyes were so blue, almost a cornflower blue, but I couldn’t find any cornflowers.
I have it all planned out, how I will walk up to Bobbie at the end of the service and hand her the flowers, tell her how sorry I am for all she’s going through, maybe touch her sleeve and then go before she feels like she has to talk to me. Nothing, certainly, that would upset my malpractice insurers or any lawyers. She might not even recognize me, d
ressed in normal clothes with my hair down. I can’t introduce myself to her again here—the thought of it paralyzes me.
The two men I mistook for Phil and Frank stand up and approach her. One kneels down, blond and boyish-looking, out of kilter somehow with anyone who might be a relative. He talks to her for several minutes, eventually helps her up and guides her down the aisle. They pass me and I can’t even stand up to intersect her. My heart turns over when I see her face-on. I’ve seen the same deserted eyes on trauma victims in the emergency room, a mask of stunned incomprehension as they struggle to recognize their exploded world. I am obviously invisible to her—we all are.
Walking out to my car, I see the three of them standing together under the boughs of a massive cherry tree, pruned into stubby wings bisected by a power line. A gusting breeze frosts them with a snowfall of petals. The blond man pulls a white business card out of his suit pocket and folds it into her hands, holding them in his own for a moment much as a minister might bless a parishioner after services. He escorts her down the street to an older beige Ford sedan with one mismatched blue panel on the passenger side. Then the two men walk to a black Lexus and chat together. In the daylight the balding man looks more juvenile, almost obsequious in the way he chuckles and agrees with the blond. There’s an abrasive self-confidence about their posture that makes it clear they’re used to choosing who stays excluded. Whatever they’re discussing, it couldn’t be the death of a little girl. It is suddenly as obvious to me as if I had read this man’s business card. He’s not a minister. He’s a lawyer.
In the evening, after I’ve showered and changed into a nightgown, I pick up the strewn contents of my wardrobe. I hardly ever wear anything but scrubs or jeans or running shorts anymore. I bought most of these dresses in the first few years after First Lutheran hired me, when I could finally afford to treat myself occasionally. So many of them look dated now, if I paid much attention to fashion. There was another spurt of consumerism at the end of my last student loan payment, this condominium and some furniture. It was the first time I owned an entire refrigerator, not just one borrowed shelf. The first time I could sit up late reading a novel in my own living room and not worry which roommate would come stumbling in from a party. And a new car—at last. No mismatched door panels in my life these days.
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