“I understand.”
“Do you?”
“Yes. Yes, I do.”
Alma Young reached over and gave Sarah a reassuring hug. “In that case, Dr. Baldwin, I don’t want to see you beating up on yourself because a horrible condition you had nothing to do with took that girl’s baby and arm. I want to hear you bragging from the rooftops about what you did yesterday to help save her life. It was big, big stuff for this hospital. And everyone who cares about MCB will be crowing right alongside of you. Got that?”
Sarah managed a smile.
“Cock-a-doodle doo,” she said.
The doors to the SICU glided open, and Lisa was wheeled in by a transportation worker and a nurse. Andrew Truscott followed moments later. The night he had just spent in the OR showed in the faint shadows enveloping his eyes, but no one would have guessed that he was into his second straight day without sleep. It was a phenomenon Sarah had noticed in herself as well. With each passing year of surgical training, sleep deprivation had fewer biologic effects—as far as she could tell.
“How’s she doing?” she asked.
“Not the most elegant of surgeries, those amputations. Sorry we couldn’t pull off the alternative.”
“You and me both. But I’ll bet she’s going to do all right from here on out.”
“Well, what do you expect? You cured her with those spiffy little pins of yours.”
“Nonsense.” As often happened, Sarah was uncertain whether Andrew’s sarcastic tone reflected his real opinion.
“Sarah, Dr. Truscott,” Alma Young called out, “could one of you M. Deities please come help us transfer this girl?”
“I’ll be right there,” Sarah responded.
“That’s grand, old shoe,” Truscott said, “because I’ve got a consult I must do on Med Five. Why don’t we plan to meet for coffee in the caf in, say, an hour. I have some questions to ask you about yesterday’s magic show. Alma, the postop orders for our young charge are tucked under the mattress. Dr. Muscles, here, is coming to assist you straightaway.”
With Sarah’s help, Lisa was transferred from the recovery room stretcher to Bed 8. Then Sarah stepped aside as Alma and another nurse quickly hooked up Lisa’s IV infusion pumps, cardiac monitor, and urinary catheter.
“She’s all yours,” Alma said, moving out of earshot. “It’s going to be a long haul for her—especially with no money and no family support.”
“I’ll get social services on her case as soon as possible.”
“You might consider a psych consult, too. She hasn’t spoken a word to anyone since she heard about the baby.”
“I know. Thanks, Alma. That’s an excellent suggestion.”
She moved over to the bedside. Lisa lay motionless, staring up at the ceiling. Her lips, still dotted by a few obstinate flecks of dried blood, were cracked and puffy. Her bandaged, shortened right arm protruded from beneath the starched sheet. As she talked, Sarah examined the site of the cesarean. Not once did Lisa respond.
“Hi, Lisa, welcome to the ICU.… Are you having much pain?… Well, just be sure to tell the nurses if you do. You don’t have to talk to me or anyone else until you’re ready.… I’ll just say a few things for now, then I’ll leave. The bleeding and clotting problems seem to be gone. That means no more transfusions.…” Sarah looked for some spark of understanding in the woman’s eyes but saw none. “Lisa,” she went on finally, “you know we all feel terrible about what’s happened to you and …” She took a calming breath. “… and to Brian. We’re going to do everything in the world to help you deal with all this, and to find out why it happened. Please try to be strong.…”
Sarah waited half a minute for a response. Then she brushed Lisa’s cheek with the back of her hand. “I’ll be back to check on you a little later.”
She turned away, thinking that somewhere there had to be an explanation for all of this. Two such similar cases in one hospital in just a few months. Somewhere there was an answer. And, she promised herself, whatever she had to do to find that answer, she would do.
She glanced back at the young artist lying in bay eight and tried, with little success, to fathom what it must be like to endure such sudden, inexplicable tragedy. Then she headed out of the SICU. There were forty-five minutes remaining before she was to meet Andrew, and she had a dozen patients to see on morning rounds.
• • •
“Where are you going?”
“Just out.”
“Just out has never been an acceptable answer to that question, and it is not an acceptable answer tonight.”
“Daddy, I’m eighteen years old. The other kids don’t—”
“You are not like the other kids. You are not supposed to be like the other kids.”
“But—”
“You are an eighteen-year-old who plays polo, vacations in Europe, and will be attending Harvard in the fall and, most of all, who has a twenty-million-dollar trust fund waiting for her when she turns twenty-five. That is not like the other kids, and it never will be. Now, who were you going to see tonight?”
“Daddy, please.…”
“Who? That … that greaseball, low-life Chuck you think likes you for your spirit and your soul? He was voted best-looking boy in his high school class, he expects to make it as a model and isn’t even planning on going to college. Did you ever stop to wonder why such a boy would suddenly become attracted to a Stanhope Academy girl who not only has absolutely nothing in common with him but is forty pounds overweight to boot?”
“Daddy, stop. Please stop.”
“I will not. These are things you’ve got to hear. Things you’ve got to know. Your wonderful Chuckie is dirt. He spends almost every night when you’re not sneaking off to be with him shacked up with a cheerleader named Marcie Kunkle. The pictures my man took of the happy couple are right upstairs in my desk. Would you like to see them?”
“You had someone follow him?”
“Of course I did. I’m your father. It’s my job to protect you until you have enough sense and experience in the world to be able to protect yourself.”
“How could you?”
“Honey, listen. You know that I love you. That man is interested in one thing and one thing only. Money. That’s the name of the game. And the sooner you learn that, the better. You are who you are. And the only way you’re ever going to be sure a man really cares for you is when he has more money than you do.”
“You bastard.”
“Don’t you dare speak to me like that!”
“You bastard! You fucking bastard! You ruin everything for me. Everything! … Don’t touch me.… You touch me, and I swear you’ll never see me again.”
“Go to your room.”
“Go to hell.”
“Come back here. Right now.”
“Go to hell.… Let me go! I told you not to touch me! Dammit, let me go! … I hate you! … I hate you!”
“Lisa, wake up. It’s the nurse. Lisa, you’re all right. You’ve got to stop screaming.… That’s it. That’s better now. Much better.”
Lisa Summer’s eyes fluttered open. Everything was blurred. Gradually the concerned face of the nurse came into focus.
“You were having a nightmare,” Alma Young said. “Anesthesia does that to some people.”
Lisa averted her eyes and once again stared at the ceiling.
“Can I get you anything? Some ice chips? Something for pain?… Okay. I’ll be here if you need me.”
Alma Young partially closed the curtains on each side of the bed and returned to the nurses’ station.
Behind her, softly, Lisa began to cry.
“Daddy,” she said. “Oh, Daddy.”
CHAPTER 7
SARAH BOUGHT A STICKY BUN AND COFFEE AND TOOK them to the corner of the expansive cafeteria reserved for physicians. Two staff internists were chatting at one Formica-topped table, but the other four tables were unoccupied—no surprise, given that this was the busiest time of day in the hospital. Andrew was already fiv
e minutes late, but Sarah had long ago learned that most surgeons showed up late for everything, assuming they showed up at all.
She had been able to make rounds on three of her patients, one of whom had already heard about her performance the previous day. And as Alma Young had predicted, her dramatic and successful use of nontraditional therapy did seem to be the talk of the hospital. In the few minutes she’d spent on the OB/Gyn floor, she had gotten calls from the director of medical education asking her to present grand rounds and from Glenn Paris’s secretary, requesting that she stop by his office later in the afternoon. Nurses shook her hand or pumped their fists as she came by, and the chief resident on the OB/Gyn service asked her to lunch so that he might hear the details of the “save” firsthand.
Just as Sarah was wondering whether it would be gauche to sit somewhere other than with the two internists, they gathered their things and stood up. One of them, a scholarly endocrinologist named Wittenberg, came over and shook her hand.
“George Wittenberg,” he said.
“I know. We met at Glenn Paris’s reception last year. Calcium metabolism and parathyroid disease, yes?”
“You have an excellent memory.”
“I read some of your papers for a research project when I was in medical school. They were very interesting.”
“Why, thank you. I came over to congratulate you, but I’ll take the compliment just the same. From what I hear, you pulled off a miracle yesterday.”
“Lisa had a number of people working on her. What I did was only one of the reasons she made it.”
Sarah felt relieved that she sensed only a passing urge to point out the negative aspects of the “miracle.”
“Well put,” Wittenberg said. “But if what the hospital drums are pounding out is true, you were a most significant reason. The story made both the Globe and the Herald. And whoever has been leaking all those negative MCB stories to Axel Devlin really blew it this time. Devlin happened to have written another of his Down with MCB columns for today. So page three has this glowing article about East meets West to save a life at the Medical Center of Boston, and Devlin sounds like a fool for not at least acknowledging the event. Have you seen the paper?”
“No. No, I haven’t.”
“Here,” Wittenberg said, handing over his copy. “I’m done reading this, and I just changed my parakeet’s cage, so I have no further use for it.”
“Thanks.”
“No problem. You know, I’m not exactly on Devlin’s wavelength, but I am one of those who’s been skeptical of being associated with a place that tenures an Indian Ayurvedic physician and has a chiropractor working in the orthopedic clinic. But after what you accomplished yesterday, I’ve resolved to keep a more open mind and to learn more about alternative medicine.”
He shook her hand warmly and headed off. Sarah spread the paper on her table and skimmed the sensationalized, but reasonably factual, account on page three. A pro-MCB article in the Herald—maybe there had been a miracle after all. Then she folded the paper open to Axel Devlin’s column.
TAKE IT OR LEAVE IT
by Axel Devlin
July 2
… And finally, I give you Axel’s Axe, absent from this column for a few days, but always poised to take a good chop at the tires of those who would try to take us all for a ride.
Today, the ol’ blade swishes through the air and once again thwacks into your favorite hospital and mine, Crunchy Granola General, otherwise known as the Medical Center of Boston. Hospital president Glenn Paris, a.k.a. California Glenn, presented his state-of-the-hospital message yesterday at the annual residents’ change day assembly. That’s when the new residents start their training and the old ones move up a notch.
And although the hospital shogun didn’t come up with any innovations as spectacular (or embarrassing) as his breast implant raffle or his free crystallography clinic, he did pledge that nothing was going to stop the resurgence of his hospital back to the topmost ranks of academia. “And,” he blustered, “you can take that to the bank!”
Well, at that moment, at that very moment, the power—and all the lights—went out in the entire hospital. Get the message, Glenn? Your approach might have worked in San Diego. But here in Boston we like our doctors to do it by the book, not by the alignment of the planets.
“I don’t believe it.”
“Don’t believe what?” Andrew Truscott slid a plate of watery scrambled eggs and suspect hash browns onto the table and took a seat catty-cornered from Sarah.
“This—this vicious, unprincipled … crap.”
“I gather that’s a copy of the Herald there before you.”
“Why’s Devlin got it in for this place so badly?”
“You don’t know?”
“I guess not.”
“Five years ago—I know because it was right after I started here—his wife needed gallbladder surgery. Devlin wanted her to go to White Memorial, but she liked Bill Gardner and the newly ordained, touchy-feely atmosphere here. Two days after Gardner did the operation, she had a massive pulmonary embolism and croaked on the spot.”
“That’s terrible, but it could happen to anyone at any hospital.”
“Apparently that’s what the malpractice lawyers told Devlin. So he set about getting retribution his own way.”
“How sad.”
“Maybe not. For some people vendettas of one kind or another are therapeutic. Don’t get mad—get even. Lashing out at MCB like he does probably helps to keep him going.”
“And how do you think he gets his information? This article sounds almost as if he was sitting in that amphitheater when the lights went out.”
“Sarah, I hope this doesn’t come as too much of a shock, but not everybody is as gung ho about this place as you are. But enough about Devlin. I thirst for knowledge.”
“Knowledge about what?”
“Don’t be coy now. You are currently the doc of the hour around here, and I want to know exactly what you did in there yesterday.”
Sarah smiled.
“Just what you saw,” she said. “The only way I could think of to stop her bleeding was to slow Lisa’s heart rate and circulatory speed while she was mentally doing what she could to seal off the bleeding points in her body.”
“Excuse me for saying so, but Lisa Summer mentally stopping an arterial pumper is a bit hard for this swag-man to swallow.”
“Except that you saw her do it, Andrew. Listen, a good hypnotist can tell a hypnotized subject that he is going to be touched on the arm by a hot poker. When the subject is touched with a pencil eraser instead, he raises a welt, then a blister on that spot. How do you explain that? You know, the real problem is that western physicians are taught about the autonomic nervous system by physiologists and anatomists. If we were taught by yogis or acupuncturists as well, our concepts of what humans can and cannot control in their bodies would be quite different.”
“Believe in your limitations and they are yours, huh? Well, I for one am certainly impressed. Maybe you can ask young Miss Summer to look inside her body and tell us exactly what in the hell happened—how she got into this pickle to begin with. Does she know she’s not the first?”
“I don’t think so.”
“Well, she ought to. Maybe if she knew how lucky she was to survive this at all, she’d perk up a bit.”
“There’s plenty of time for her to perk up. She just lost her baby and her arm. Andrew, do you have any idea what might be going on? Did you ever see that other girl as a patient?”
“No. Et tu?”
“I haven’t a clue as to what’s going on, and I was on vacation when the other woman came in and died. But I did see her in the clinic.”
“And?”
“And she was a healthy young woman with an uncomplicated pregnancy. Just like Lisa. I put her on the herbal supplement I like to use and wished her well with her delivery. That was the only time I saw her.”
“Herbal supplement?”
“
Yes. Almost all pregnant women are given some kind of prenatal vitamins by their doctors. In our OB clinic, it’s standard fare. Well, in the mountain villages where I worked in Thailand, the women all took prenatal supplements as well—a combination of roots and herbs, crushed and taken as a tea twice a week. The only study done of these women showed higher birthweights and better infant survival than in women who delivered in the teaching hospital in Chiang Mai. And believe me, the nutrition in the Meo villages was not very good, and the hygiene even worse. I helped conduct that study with an M.D. from the public health service and the herbalist who taught me most of what I know.”
“Remarkable.”
“It was, actually.”
Sarah was excited to have the chance to talk about the Thai study and her work with the Meo and Akha tribes. It had been a wondrously happy and peaceful time in her life. She might still be working and studying there had it not been for the sudden death of Louis Han and the subsequent entry into her life of Peter Ettinger.
“So you use this herbal mix instead of prenatal vitamins?”
“Ever since I found a herbalist in town who could put it together, I have. I give every woman I see in the OB clinic the choice of taking whatever vitamin samples we happen to have on hand or the tea. Some pick one, some pick the other. I’ve been keeping some notes on birthweights and infant health, but the numbers are still too small to see any difference.”
“Fascinating. What sort of herbs and roots are we talking about here?”
“Do you know about herbal medicine?”
“Not unless you consider having an assortment of Celestial Seasonings teas as being knowledgeable. I am interested in being enlightened, though.”
“In that case, here’s the handout I give to all the women I see in the clinic. It lists the nine ingredients in the supplement, and what each does.”
“Angelica, dong quai, comfrey,” Andrew said, scanning the list. “This is exotic-sounding stuff.”
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