“Nurse Potts! Be careful! You’ll pull the plug from the wall!”
Mary whirled around to face Dr. Skelton. All dressed up that way, she barely recognized him,
“Is Dr. Spezia here yet?”
“No sir. He jus’ went home a few hours ago.”
“Really? And why is that?”
“I had to call him in when Dr. Freeman overdosed.”
“You what?”
“Didn’t you hear?”
“No. Are you certain? I came to discuss Miss Hixson, actually. Where is Freeman?”
“I believe he be in the morgue right about now.”
Dr. Skelton stared at the crucifix on the wall. He said nothing. “When Dr. Spezia arrives, please have him beep me immediately.” He turned to leave and then, paused to face Mary. “Oh, and Nurse Potts? No one touches that ventilator without my express permission. Do you understand me?”
Mary nodded.
“I knew you would.” He left the room. His heels clicked down the hall.
Mary fumed in silence. With the steady help of the ventilator, Starr breathed.
Starr was breathing when I arrived. I knew I looked disheveled and hassled, but from the expression on Mary’s face, I also knew I was needed.
“Dr. Skelton was already here, wasn’t he?”
“Yeah, he was in here all right. Telling me my business.”
“I’ll have to go to his office.” I gestured to Starr. “How’s she doing?”
“Look at the EEG yourself. It’s in the chart. Looks like a flatliner to me. She’s as good as gone.”
I examined the test results. “Well, no. Not quite.”
“Why you want to help keep that piece a trash around here? After all she done to everybody? Tell me that.”
“Mary, it’s not about what I want or think I want. It’s about making the best choice in a given situation.”
“Same thing.”
“No, it’s not. The problem is Miss Hixson doesn’t appear to have any family members that can be contacted or identified, and Dr. Freeman has taken himself out of the picture, whether he meant to or not. Like it or not, we need to act as her family members, and make decisions for her that would be in her best interest. Clearly, we have some messy choices ahead of us.”
“Well, I’d be real happy to make them for both of us,” Mary said. “I got no problem wid it.”
Spezia smiled at the nurse. “Mary, remember when D’Yan was in trouble?”
“Yeah. Where you going with this?”
“I did what I thought was best for her and her baby. I don’t even recall what I felt, because I don’t allow myself that luxury. My personal feelings are never a consideration. And yes, it would be a luxury to let down for once and ask myself how I really feel in a particular situation. But, that is not what the physician does. A good doctor puts the patient first.”
“You mean you didn’t want to help D’Yan? You didn’t want to save her baby?”
“Of course I did. I don’t mean that at all. I’m just saying that during my time at this hospital, I have learned that I must regard each patient as a member of my family. I find that if I care for each person as I would a member of my family, I will always do what is best. I did my best for D’Yan, and I will do my best for Miss Hixson. It’s the only way, Mary.”
“You’re a good man, Dr. Spezia. You might be the only man I know like that. You better than Miz Hixson deserve, that’s for sure.”
“Well, this good man better get himself over to see Dr. Skelton before his first patient shows up. Eddie Raines is due here at 8:30 this morning, and he needs to be seen by me. No one else. When he gets here, please ask him to wait until I return. I will come back to examine him, and he will get as much time as he needs. Unfortunately, I have no idea how much time to allow for the meeting with Dr. Skelton.”
“Will do. I guess you gone do your best for him, too?”
I nodded and shut the door behind me.
Immediately, Dr. Skelton noticed it: the self-assured demeanor, the confident stride, the solid handshake. This was not the nervous intern he had interviewed. This was a young doctor, a colleague. A shiver coursed through his body. You always hope for it, but…
“Have a seat, Dr. Spezia.”
“Good morning, Dr. Skelton. I’m sorry I missed you.”
“Well, it sounds like you had quite a night. Tell me about it.”
“I don’t know if you heard or not, but—” I struggled to maintain my composure. I needed to confront the ugly truth.
“Dr. Freeman died of an overdose last night. Nurse Potts called me and I came in, but he was already gone when I got there. There was nothing I could do for him—not even get him a priest for the Last Sacraments.”
“For the what?”
“The Last Sacraments.”
“I doubt that Freeman would have wanted that, Dr. Spezia. Don’t torture yourself.”
“I don’t think we can know what a patient might or might not want in a given situation. I believe it should always be an option.”
Dr. Skelton grinned as if he had heard an amusing joke. “Well put, Spezia. Still, I doubt Freeman worried too much about Last Sacraments. If he worshipped any God, it was Morpheus. But, that is neither here nor there.” He folded his hands and leaned forward to speak. “Did you know that I’m going to receive an honor this year?”
“No, I didn’t know. Congratulations. What kind of award?”
“Humanitarian of the Year.” Dr. Skelton grinned broadly. “I’m very proud of it.”
“Congratulations.”
An awkward silence consumed the time and space.
“That’s all you have to say? Don’t you want to know why I’m receiving the award?”
“Why are you receiving the award?”
“As you know, I am Director of the Outreach Clinic here at City Hospital Number 1.”
I nodded.
“Yes, well. For some reason, it’s just crazy, it never happened before this year, but the Dean of the Medical School—and here’s the real kicker—even the Mayor’s Office received letters about a “Dr. S.” who treated them so well over at the Outreach Clinic. Respect was the word they used, over and over again. So, they both called me up and said this was the kind of thing the people in the City of St. Louis need to hear. So, they created this award just for me, Spezia. What do you think about that?”
I stared at Dr. Skelton in disbelief. Did he really believe that those letters had been written about him? Why, yes. Yes, he did. But, I was virtually certain that no one else would.
“Did any of the people sign the letters, Dr. Skelton?”
Dr. Skelton tossed the hospital newsletter into the trashcan.
“How would I know?”
“I just thought that perhaps you might want to know which patients thought so highly of you.”
Dr. Skelton stared at him. A quizzical expression lined his face.
“I’m sure it doesn’t matter, Spezia. An award is an award is an award. Surely you know that by now. You just accept it and move on.” He gestured to the walls around him, lined with frames of various sizes and styles. “Obviously, I get them all the time. I’m quite used to awards, you know. This is just one more.”
It’s not yours. I wanted to say those words so badly, and yet, I didn’t feel I could. Dr. Skelton would never accept the truth. I swallowed hard and cleared my throat.
“I checked the database for Starr Hixson’s family members.”
“And who did you find, hmm?”
“No one. There’s no family that I can find.”
“Did you talk to the police?”
“Actually, yes, I certainly did.” Gabrielle did an extensive background check on Miss Hixson. It revealed more than I ever wanted to know about her, uh, background.
“And?”
“She has no one to contact.”
“Well then, it seems that we will be making her health care decisions, Dr. Spezia. Cheer up, it will be good experience for
you.”
“I’m fine with it.”
“How is she today?”
“I haven’t personally examined her, but Nurse Potts told me that she was as good as gone.”
“Yes, well. Nurse Potts doesn’t like Ms. Hixson. I think we’d better leave her out of this.”
“I always intended to do that. I just thought you might be interested in what she had to say. By the way, she told me that Ms. Hixson’s IVs were pulled out last night. She blamed Dr. Freeman.”
“Do you?”
“I don’t think there’s any way to know who pulled the IVs from her arm. Clearly, it’s someone who doesn’t want to see her alive.”
“My point exactly. It could have been anyone. Remember that, Spezia. Now let’s go to the ICU and see how Ms. Hixson’s getting along, shall we?”
TWENTY-FIVE
Mary saw them before they saw her. She hoped that Dr. Spezia didn’t become another Dr. Skelton. So many times at City Hospital, she’d witnessed such a transformation. In this case, in her opinion, it would be a crying shame. Ugly one too.
Dr. Skelton rummaged in the stack of charts at the nurses’ station. “Who’s in charge here?” he said. He rose from the battered chair and flung the files across a desk. “It’s impossible! They’re supposed to be in some kind of order!” Furious and indignant, he strode down the hall towards Starr’s room. I lingered at the nurses’ station for a few more seconds.
“Mary, have you seen Eddie Raines yet this morning?”
“No sir.”
“It’s 9:15. His appointment was at 8:30. I’d better give him a call.”
“You’d better get your behind into Miz Hixson’s crib.”
“Spezia!”
“I’m coming, Dr. Skelton.”
“If you have a minute, Mary, please give Mr. Raines a call for me, will you do that?”
“Yeah, sure.” She stared at the piles of paper and charts. “I got minutes all over the place.”
“You’re a gem, Mary.”
“Spezia!” Dr. Skelton’s voice echoed in the hall. “Where are you?”
“Miss Hixson’s IVs are out again,” Dr. Skelton said. “Will someone please call Nurse Potts?”
“I’m right in front of ya’ll.” She crossed her thick arms across her wide chest. “And jes’ so you know before you say anything else to me—for the second time—I didn’t touch anything in here.”
“Nurse Potts, I did not accuse you of anything.”
“Look at Starr’s hands,” I said.
“She’s not terminal yet, that’s for sure.” Dr. Skelton stared at the results in disbelief. “She must be one tough tomato.”
“She is.” Nurse Potts shook her head. “Not much doubt about that.”
“Watch her hands,” I said. “She grabs at her arm.”
“Spezia, have you lost your…” Dr. Skelton gawked at the bony fingers that rambled and plucked at the IV site. “If I hadn’t just seen that with my own eyes, I would have said it was impossible.”
“I tole you, I didn’t touch a thing.” Nurse Potts straightened her stance in indignation.
Dr. Skelton glanced at me. “Here’s what I propose we do. Ms. Hixson appears to be rallying. Let’s take her off of the ventilator now, and let her tell us what she wants to do.”
“But, she can’t talk,” I said. I felt as confused as he looked.
“Her body can. If she can’t make it on her own, it’s out of our hands.”
“But what if she can?”
“Then it’s out of hers.” Dr. Skelton paused and took a deep breath. “I really feel it’s the right thing to do. The patient is counting on us to act in her best interest. Always remember that, Spezia. It will help when you make a mistake. And mark my words, until the day you see your last patient, you will make them.” He turned to Nurse Potts. “Okay, let’s turn off the ventilator.”
“You mean it?”
“It’s truth time.”
“Yes sir.” Mary did as instructed, all the while stifling the smile that crept onto her lips. She shouldn’t be happy that Miz Hixson gonna die. Wasn’t right. She should be ashamed of herself.
“She’s still breathing!” I approached the bed. Starr’s breaths were shallow and sporadic, but they belonged to her. “What about the IV?”
“It seems she will try to remove it,” Dr. Skelton said. “I say we leave it out and see what happens. Honestly, she’s going to have a rough road ahead of her if she survives this, so—”
“What do you mean?” I said.
“She may not have much reserve, mentally or physically—it’s really impossible to tell at this point. The mix of cocaine and morphine in her blood should have killed her. Apparently, she and Freeman shared some speedballs. She must have quite a tolerance built up to still be with us. Oh, why do people do this?”
“Are you saying it would be better if Miss Hixson died?”
Dr. Skelton paused and faced me.
“If you are asking what I personally think, the answer is yes, without a doubt. But, after all of these years in practice, I have come to accept that there are things I will never understand and can never explain. We removed life support. Now, the answer is out of our hands. We cannot murder people.”
“Dr. Spezia?” Nurse Potts waited outside the door.
I raised my head.
“You got the police here to see you.”
TWENTY-SIX
I headed for the ER as fast as my feet could take me. I was beginning to think that Gabrielle was right. I did wish I could fly. In fact, anything that could put more hours in my day would be great, thanks.
Hey, there she was, waving at me from the end of the hall. A certain reality struck me, first between the ears, and then, my eyes. Gabrielle must be “the police” that asked to see me. What a relief! For once, there was no emergency. My pace slowed to a leisurely stroll. Still, I didn’t like the expression on Gabrielle’s face.
“You don’t look very happy to see me, honey.”
“Didn’t anyone tell you?” Gabrielle said.
“Yeah, Mary said the police wanted to see me. I assume that would be you.”
“Tom, it’s about Eddie Raines. We got a call from his neighbor. He saw him through the kitchen window, lying face down on the floor.”
My pulse began to race. I recalled the mound on the gurney, the one the EMTs wheeled through the sliding doors, and their conspicuous lack of urgency. By now, I knew that in an Emergency Room, lack of urgency usually meant one thing.
“Is he dead?” I said.
Gabrielle nodded. “Looks like he’s been gone at least one day, maybe two. He’s pretty swollen. Found him lying in a bloody pile of broken glass. From the smell, I’d say that once upon a time, they were bottles of cheap wine.”
“He had an 8:30 appointment this morning. I wondered why he didn’t show up.”
“He had his own agenda, Tom. Or maybe someone didn’t deliver a message.”
“Yeah.” I shook my head. “Man, I can’t believe what’s going on around here. I mean, Starr Hixson is back and breathing on her own, while Eddie Raines moved on, just like that. I mean, I just saw the guy a few days ago, and it seemed like he was coping pretty well. It must have all been too much.” I took a deep breath and sighed. “I didn’t do enough for him, Gabrielle.”
Gabrielle stared back at me. She began to laugh. “Sometimes, you are really amusing, you know that?”
“Why? What’s so funny?”
“You seem to think that you can save people from themselves. The truth is, no one can—not even you, Superman. We’re all on our own journey, walking our own path. You couldn’t change Eddie’s life or anything about how it ended—that was his business. Stop blaming yourself. Eddie was the only one who could do that. Your job was to be the best doctor you could be. Did you do that?”
The question shocked me. “Of course I did.”
“Then, you did your best. Look, you can’t save everyone. My first few months as a cop, th
at was the hardest thing to accept. That, and the idea that if you’re going to help anyone else, you have to take care of yourself first. I’ve been around you for a while now, and I figure you sleep about four hours a night. If you eat anything, it’s a takeout pizza or a frozen TV dinner, washed down with beer. Exercise? Forget it. And you know why? It’s all because you care so much about your patients. You put them first, and that’s great. But, who is going to take care of them when you’re gone, because you didn’t take care of yourself?”
“Why are you lecturing me? Do you think that’s what I need right now?”
“Yes, because that’s what happened to Eddie. According to his neighbors, whatever else he did, he took good care of Lori, at least until he started to burn out. Then, he took up with Starr, and the rest is history. He ignored what was going on with his own health, if you could call it that. From what I hear, by the time he went for help, the guy was puking up blood. I mean, give me a break. I don’t want that to happen to you.”
“Okay thanks,” I said. “I mean it.”
“I know you do.”
“You really care about me, don’t you?”
“Yes, I really do.” She smiled. “You’re a great guy.” She put her arms around my neck and pulled me closer. “Okay, Tom. This is the part where you say the same thing to me.”
I stared back at the woman that made me forget my name and the color of the sky. “What if I want to say something else?”
“Sure.” Gabrielle’s shoulders slumped. “You can say something else. I just thought—”
“Let’s go out somewhere special tonight. I’d like to be somewhere besides a hospital when I decide to say it.”
I managed to confuse a cop, at least for a moment. This was fun.
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