Code 15

by Gary Birken

  CHAPTER 57

  DAY TWENTY-FIVE

  Following Will Johnson’s instructions, Morgan followed a broad flagstone path past his two-story Georgian-style home until she reached the backyard.

  She estimated Will’s property to be at least two acres, making it a distinct departure from South Florida’s usual monotonous, zero-lot-line parcels. When she passed the garage, she saw the white guesthouse that Will used as his office. It was a cozy, palm-shaded building with a red Spanish-tile roof.

  Taped to an urn-shaped brass doorknocker was a note from Will requesting she go inside, make herself comfortable, and that he would join her shortly. After a twinge of hesitation, she opened the door and stepped inside. From the foyer, Morgan gazed into the smartly decorated living room. Especially impressive were the silk-paneled window treatments and the large red area rug that lay in front of a long leather couch.

  Morgan closed the door and then strolled across the teak floor and sat down on the couch. The most striking thing about the room was that there was nothing that even remotely resembled a physician’s office. Conspicuously absent was a desk, a computer station, or any medical charts. What struck her as even more peculiar was the absence of any framed medical diplomas, degrees, or certificates on the walls.

  Morgan heard the door open. She glanced at her watch and started to come to her feet.

  “Don’t get up,” Will said from a distance. Dressed in jeans and a gray sweater vest over a white T-shirt, he held a large container of coffee in each hand. He stopped next to her and handed her one.

  “I’m sorry I’m a little late. I can’t start a session without Mudslide coffee.”

  “Mudslide?”

  “Try it. It’s incredible. I’m addicted to the stuff.”

  Morgan set the container down on an end table. “As much as I’d love to drink this, I’m pregnant. My limit’s one a day and I’m already into next month.”

  “Congratulations,” he said with chuckle.

  “You have a beautiful family,” Morgan said, pointing to a large studio photograph of his wife and children mounted above the fireplace.

  “They’re great. I don’t know what I’d do without them.”

  Unable to shake the uneasy feeling of her first therapy session, Morgan kept her eyes glued on the wall. Next to the family portrait, there was a grouping of photos of Will rock climbing.

  “Do you climb?” he asked her.

  “I’ve done some inside climbing. Nothing like that,” she said, pointing at the photos.

  “Which club?”

  Ignoring the tempting aroma of the coffee that was begging her to reach over and take a sip, she said, “The one in Fort Lauderdale.” Morgan looked at the photos again. “Do you really free climb?”

  “In my younger, more high-spirited days. Now I use a rig. What do you like to do when you’re not running the emergency room?”

  “I fly.”

  He looked up with a smile. “How long have you been a pilot?”

  “Since college.”

  “How often do you go?”

  “A couple of times a week. I keep my plane at North Perry.”

  “I envy you. It’s something I’ve always wanted to try.”

  “I have my instructor’s rating. If you feel like it sometime, I’ll take you up for an introductory lesson.”

  “If my wife says okay, I just might take you up on that.”

  Will sat down in a deep leather chair that faced Morgan. He popped off the lid of his coffee with his tapered fingers and took three quick sips before setting it down.

  “If you don’t mind my asking, how did you become the hospital’s designated therapist to the doctors?”

  “I volunteered,” he answered.

  “That sounds too simple for Dade Presbyterian.”

  “As it turns out, very few therapists are interested in doing this kind of work. Most hospitals have a hell of a time finding doctors who are willing to work with other doctors.”

  “How did you get interested in this type of therapy?”

  “I started out by seeing a few physicians. One referral led to the next and from then on it kind of took on a life of its own. In less than a year, I was seeing doctors exclusively. When I decided to officially limit my practice to working with physicians, I went to see Eileen Hale.”

  “I assume she was receptive,” Morgan said.

  “It was kind of like walking in to the Salvation Army and offering to ring a bell and collect money at Christmas time.” Morgan chuckled. “Eileen started sending me physicians right away.” Will used a remote to lower the classical music filling the room. “Did you have any trouble finding the place?” he asked.

  “Your directions were perfect.”

  “Good. Tell me about yourself,” he said in a relaxed voice.

  “Just like that?”

  “Just like that,” he answered.

  With some subtle coaxing from Will, Morgan spent the next hour talking about her childhood, her marriage, and her role as the director of the emergency room. Will had an obvious knack for putting people at ease, which made it easier for her to talk. She found him to be bright and unpretentious. She assumed he went into psychiatry because he tended to see the best in people.

  Will finished making a few notes, capped his pen, and looked up.

  “Tell me about how you’re coping with the death of your father.”

  His request was direct but didn’t put Morgan off.

  “I don’t have many heroes. It was hard to lose him.”

  After a few less probing questions, he asked, “Do you think losing your father has affected your work?”

  “I still think about him often, and I’d be lying if I said I didn’t miss him. But I realize that losing a parent is a reality. It’s something we all go through.”

  “So you’re saying . . .”

  “I’m saying that I’m going through a grieving process—but I’m handling it. So my answer to your question is no, I don’t think his death is affecting my work.”

  “Eileen told me about a problematic case you recently had in the ER. I believe the patient’s name was . . .” Will stopped and began flipping through his pad.

  “Her name was Faith Russo.”

  “Do you have any idea why Bob Allenby is concerned that your care might have been impaired by stress?”

  Morgan simply shrugged. “I guess you’d have to ask Bob.”

  “He’s not here.”

  “In that case, I’d tell you to consider the source.”

  “Which means what exactly?” he asked with an arched brow.

  “I’m not sure I’m comfortable saying anything further.”

  “That’s fine. We can talk about whatever—”

  Morgan felt obligated to explain her answer. “When we first spoke, you told me you would need my permission to speak with Eileen Hale regarding our sessions.”

  “There’s something you should understand, and maybe I should have clarified it before we began. Nothing we talk about in this room will ever leave this room. My job is to offer an opinion as to whether the recent stress in your life is impairing your performance as a doctor. I don’t have to divulge the specifics of what we discuss to do that.”

  Hoping she hadn’t offended him, she said, “I didn’t mean to imply that you would violate my—”

  “I’m not a referee, Morgan, nor do I have any interest in hospital politics, Code Fifteens, or what makes Bob Allenby nervous. I’m bound by the same code of ethics you are.”

  Feeling a minor wave of nausea, which she attributed to both the moment and her pregnancy, Morgan stood up and walked around to the back of the couch.

  “Are you okay?” he asked.

  “Could I trouble you to make it a little cooler in here?”

  “Sure,” he said, coming to his feet and walking over to the thermostat.

  “Bob Allenby’s an experienced and highly effective hospital administrator. You don’t get that way unless you’re pol
itically savvy. Bob’s problem is that he’s prone to tripping over his job.”

  “I’m not sure I understand what you mean by that.”

  “Suffice it to say, his vision’s sometimes impaired by corporate blinders.”

  “Is that what’s going on in the Faith Russo case?”

  “In my opinion, yes. I don’t think Bob’s interested in finding out what really happened that night. The truth might be embarrassing or damaging to Dade Presbyterian. The corporation will always come first. Patient care issues, including patient safety, will get elbowed if he perceives them to be a threat to the hospital. Faith’s death came on the heels of two Code Fifteens that involved patients in our Cardiac Care Center. Both patients died as a direct result of catastrophic errors. Bob’s approach to the root cause analysis was to find scapegoats and quick explanations to satisfy the AHCA investigation team. He had no interest in discovering the truth.”

  “I assume you shared your concerns with Bob directly.”

  “I did, and I think we both know that’s why I’m here today. He told me my conclusions regarding the Code Fifteens were, at a minimum, far-fetched, and at the most, irrational.”

  “Eileen Hale said that you suggested the Code Fifteens may have been intentionally orchestrated by somebody.”

  “Leaving emotion and politics out of it, and objectively examining the facts, it seems like a distinct possibility.”

  “But don’t most medical mishaps have a logical explanation? The medical literature’s full of case reports about bizarre coincidences and mistakes that have led to devastating patient injuries.”

  “But those are the exceptions. More than eighty percent of medical mistakes are the result of easily identifiable human negligence, not bad luck. There are no simple explanations to account for a whopping dose of protamine winding up in a nitroglycerine bottle—or for a magnetized cross to mysteriously find its way around the neck of a Jewish patient with a newly placed pacemaker.” Will looked down for a few seconds to make some notes. After a brief silence, she said with dismay, “You have the same disbelieving look on your face that Bob had when I told him what I had discovered.”

  “Is it important to you that I be convinced?”

  “Yes,” she answered, without knowing why.

  “I know the basics about the Faith Russo case, but I’d like to get your impression of what happened.”

  “The entire thing was a setup to make me look incompetent. There was no way that woman had a lethal injury to her spleen the first time I saw her.”

  “Why would somebody want to set you up?”

  “Because this individual believes I committed malpractice in the care of his family.”

  “So, you know who this person is.”

  “His name’s Mason Kaine.” Morgan realized she was sounding more paranoid with each answer, but she had come this far and her lines of retreat were for all intents and purposes nonexistent. She spent the next few minutes telling Will everything she suspected about Kaine.

  Will set his pad down on a small glass table next to his chair.

  “I guess the concern of the hospital is that this conspiracy theory of yours is distracting you from your work—or worse, making you an unsafe physician.”

  “That’s totally absurd. Physicians lose parents and grieve just like anybody else. That doesn’t mean we turn into paranoid, nonfunctioning doctors.”

  “But in Bob’s—”

  “Bob’s dealings with me have been ethically unconscionable. I’ve never been treated so unfairly in my life.”

  Will didn’t respond immediately. Morgan knew he was giving her time to compose herself.

  “Hypothetically, what would you do if it turned out that Bob was right and you were wrong about how these patient errors occurred?”

  “I’d be in his office the same day to apologize. But if I’m right about what’s going on at Dade Presbyterian, more innocent patients are going to die—a lot more.”

  Staring at Will’s solemn face, Morgan realized her tone and vehemence were flirting with inappropriate.

  Will looked at his watch.

  “We’ve been talking for almost two hours. I think that’s enough for one day.”

  After taking a few moments, Morgan inquired, “Would I be out of line to ask you for some feedback?”

  “I don’t think so. An unraveling marriage, your father’s death, and the pressure of running an emergency room and the Patient Safety Committee. I think that entitles you to feel a little downcast.” Before Morgan could press Will for more specific information, he said, “I think we should talk again. Are you available next Monday afternoon, say around three?”

  Morgan leisurely came to her feet. Intent on not sounding discouraged, she said, “I’ll check my schedule, but I’m pretty sure I can. I’ll call you tomorrow to confirm.”

  Will walked with Morgan to the front door and then back down the flagstone path to her car.

  “I know things look pretty gloomy right now, and at the risk of this sounding a little trite and corny—these things do generally work themselves out.”

  With her lips pressed together, she managed a brief smile. “After they work themselves out, who do I see about getting my reputation back?”

  “I wish I could answer that, Morgan.”

  “You think I’m out of my mind, don’t you?”

  “I hope so,” he answered. “Because if you’re not, there’s an insanely dangerous man out there somewhere.”

  PART THREE

  CHAPTER 58

  DAY TWENTY-EIGHT

  After three years of backbreaking studies at the University of Florida, Michael Allenby remained unconvinced that he was cut out to be an electrical engineer.

  With midterms onrushing like Colorado rapids, Michael had been hitting the books ten hours a day. His only hedge against the stress of exams was his inviolate five-mile run he took every night at exactly ten p.m.

  The small college town of Gainesville had been a major change from the urban upscale neighborhood and private school environment of south Florida that he had been raised in. The strange irony was that he preferred the more bucolic setting of northern Florida and had been recently toying with the idea of pursuing a career in academics instead of trying to claw his way to the top in the private sector.

  Studying at the kitchen table, Michael looked up from his electromagnetics text at a wall-mounted clock that hung over the refrigerator. It was five minutes to ten. Michael removed his reading glasses and flipped the book closed. Andi Crit tenden, the young lady he had been living with for the past two years, was asleep on their couch. He got up from the table and quietly went into the only bedroom to put on his sweats and sneakers.

  Right before he slipped out of their third-story apartment, he checked Andi one last time and put on his Gators cap.

  Michael spent a couple of minutes in the parking lot stretching out. He looked overhead at a crescent moon playing peekaboo with a skeletal sheet of clouds. It was unseasonably cool, which he viewed as a godsend as it would make his mini-marathon less demanding. Michael hadn’t changed his route in several months. The five-mile course took him through the quiet side streets of Gainesville in a gradual loop. What he liked most about it was that it kept him well away from the main campus with its abundant temptations.

  When he was finished stretching, he zipped up his sweat top, ran in place for a few seconds, and then took off. Once he was out of the parking lot, he turned north along Archer Road until he reached the entrance to one of the city’s oldest neighborhoods. As he always did, he ran along the left side of the road so he could watch the oncoming traffic. He had been running about fifteen minutes when he reached a narrowly inclined hill. The hill was approximately a quarter of a mile and lined by tall spruce trees.

  Inhaling deeply, he charged up the hill. Once he reached the top, he slowed his pace and started down. Jogging lazily, he did everything possible not to think about electrical engineering or his exams. Instead, he continue
d without a care, thinking about Andi and their upcoming spring break cruise to the western Caribbean.

  He watched as two cars passed him. The first flashed its brights, which Michael acknowledged with an appreciative wave. As an experienced nighttime jogger, he knew the greatest hazard to him was the careless motorist. He was about two hundred yards from the bottom when he spotted another car just starting up the hill. As he sometimes did, he glanced over his shoulder. There were no cars coming from the opposite direction. When the oncoming car was about a hundred yards away, he suddenly heard the late-model sedan’s engine gun. He assumed it was a high school kid experimenting with his father’s car. Keeping a careful eye out, Michael immediately moved as far left as he was able without tumbling into the sewer ditch that bordered the road.

  The car rapidly accelerated but it never wavered from its lane. In the next instant, the car’s high beams came on, but instead of a flash, they remained on, forcing Michael to shield his eyes from the piercing light. It took only a few seconds more for the car to close the distance between them. With the sedan still traveling in its lane, Michael assumed they would pass each other without incident. But it was exactly at that moment, just when his apprehension was fading, that the car suddenly made a violent swerve to the right. Even though the glare of the onrushing lights obscured his vision, Michael could still make out the outline of the sedan barreling down on him.

  His bloodstream surged with adrenaline.

  Drawing on nothing more than instinct, he dove to his left. His reaction time was near instantaneous. Three feet off the ground, with his arms outstretched in a headlong dive, he sailed toward the ditch. He prayed once he was airborne, the out-of-control car would blow past him. Unfortunately, his prayer went unanswered. There was no screeching of breaks. The first and only sound he heard was the explosive thud of three tons of high-speed steel tearing through the lower half of his body. The incredible force of the collision sent his entire body into a wild flat spin, catapulting him another five feet into the air before tossing him facedown in the ditch.