by Barbara Ebel
Roosevelt scanned the monitor. “Your baby’s heart rate looks good.”
“Baby Bobby is going to be a skier like his mom,” Harry said, “so his heart better be healthy.”
Amy grabbed the bedsheet in her hand and squeezed while a tinge of pain passed over her lower abdomen. Her husband wrapped his hand on her forearm and then let go.
Roosevelt let the contraction pass. “Do you mind if I examine you while my team is here?”
“Most certainly, I don’t mind.”
“Even though we teach here, I still like to ask. Occasionally, there is a patient very sensitive to groups and, unless it’s an emergency, we can render a bit more privacy.”
Caleb closed the door and Dr. Harvey pulled on gloves. Amy scooted further down on the bed and spread her legs. Roosevelt quietly examined her and rolled back on his stool. She resumed a more comfortable position and Harry helped cover her up.
The attending snapped off his gloves. “Do you mind if I talk shop to the resident and student?” His tone was soft and reassuring. “Otherwise, I can do it outside.”
Amy and Harry glanced at each other. “Please, I’d love to listen in,” she said.
“Then you’re included.” Roosevelt took a spot facing them all. “Generally, if the cervix is dilated beyond two to three centimeters, the patient has a favorable cervix. Mrs. Wagner is at or passing six centimeters. Dr. Tilson, that means she is making continued progress and has reached the active phase. What labor parameter is next?”
“Second stage of labor?”
“Precisely. Explain, please.”
“Second stage is the complete dilation of the cervix to expulsion of the infant.”
“And normally, in a multiparous woman, how long should that take?”
“I don’t know.”
“Caleb, tell Annabel.”
“Up to two hours; an hour longer if an epidural is in place.”
Roosevelt scanned all their faces.
Harry touched his wife. “Maybe our baby will be here by lunchtime.”
Dr. Harvey laughed. “That may be cutting it a bit close. Hopefully, by dinner time, baby Wagner will be suckling at Mom’s breasts and you two will be blowing out his first-day candles.”
Roosevelt herded Annabel and Caleb out, leaving wide smiles on the faces of Amy and Harry. In the hallway, he closed their door again.
“So,” Roosevelt said, “I want to start with some basics for Annabel about the pelvic exam. The formal teaching of the exam in medical school is fraught with anxiety, especially for the guys. Students are always taught to consider the concerns and fears of the patients, yet I also think about the concerns and fears of the student. Yes, the student!
“The exam of the patient in labor is always a bit easier on both parties because both sets of people know that the woman is going to deliver and all focus is on that part of her body. However, during other physical exams, there is a huge interaction going on between the two individual human beings, each one bringing his or her own knowledge, beliefs, status, attitudes, and experience to the process. The interaction needs to be mastered by the clinician to make the patient relax and feel comfortable and they themselves must do the same. There is a layer of complexity to the clinician’s examination of genitalia and breasts.”
A visitor passed by and Roosevelt quieted.
“Anyway, just know that an obstetric exam and a gynecologic exam is a rare breed. When you perform one, it is an art. At no other time is a woman’s body touched by a stranger or a semi-stranger in that manner. Try to master it with sensitivity for the patients and also be cognizant of your own feelings. Your attitude may also give you clues as to whether the field is something you’d be interested in as a specialty. I also recommend any of the books that address the feelings students may encounter while examining a patient.”
A nurse stopped, waiting to interrupt. Roosevelt seemed to read her mind. “I just examined her. Active phase. Oxytocin working like a charm.”
“Thank you, Dr. Harvey,” she said. “By the way, there is an admission in the ER. Dr. Watson was informed, but no one went to see her yet.”
“I am going to break away,” Roosevelt said. “Caleb, you go see the patient with Annabel. I am a beep, a phone call, or a text away. I’ll be back after going over to the chairman’s office.”
-----
With his usual tranquil manner and confidence, police officer Dustin Lowe entered his favorite diner. He walked in solo, but was meeting another officer he worked most closely with. It was late morning and the place bustled with patrons.
Dustin grinned at Sean as he walked to where he was sitting at a window booth. The older officer had twenty more years on the job than him and as Dustin slid into the booth, he recognized that more space was allotted to Sean’s side. His paunch needed the room.
“You order yet?” Dustin asked.
Sean nursed a cup of coffee. “No sense in waiting. I take longer than you.”
A familiar waitress came over. “What’ll ya have, Dustin?”
He scanned other tables. It was fifty-fifty. Half the plates were piled with remnants of waffles, eggs, hash browns, and sausage, and the other half were in front of the afternoon eaters, with cheeseburgers and French fries.
“Do you all ever serve anything that is green?”
“I can put food coloring in a glass of milk for ya.”
“I’m yanking your chain, but that was very funny.”
“Yeah, you must like it here. You bring that girl of yours in here once in a while.”
“Annabel. Annabel Tilson. I think of her when I come in during work. I also think of my former partner.”
“When are you bringing her back in here? You must be taking her out more to fancy restaurants.”
“Sometimes. I see her less than I’d like. Her being in medical school and all.”
“Okay, since she’s not here, order what you want and not what she’ll tell you to eat because she’s concerned about your health.”
“What a fine idea. How about a couple of eggs over easy, bacon, and toast? Don’t forget the coffee.”
“You got it.” Like a salute, she tapped her pink diner cap.
“So what’s the update on her and you?” Sean asked.
Dustin rubbed his chin. He could hear the staff washing dishes. Off to his right, the parking lot was like a pit stop off an interstate. Cars pulling in and out and doors opening and closing. He looked back at Sean.
“Sometimes I don’t know whether to be ecstatic or cautious. She’s getting under my skin.”
“Then what are you cautious about?”
“Her past dating history was a bit indiscriminate. I believe she’s over that. So more than that, I’m afraid our relationship is too good to be true, and the more I see her, the more I like her. She’s barging in on my thoughts all the time. I guess I’m guarded because I don’t know if she feels the same way; I don’t want to press the relationship to another level if she’s not up to it.”
The waitress passed and set down Dustin’s steaming black coffee and Sean’s order.
“What does an old married guy think about that?” Dustin continued.
“Love is a flower. You have to let it grow.”
“Love? I didn’t say I was in love with her.”
“Perhaps you’re not, but from where I’m sitting, you seem pretty close to it.”
Dustin’s heart thumped. He stared out the window. A lanky older teen with straight, combed-back blonde hair got out of a sedan. He yanked the hoody of his jacket up on his head.
“Women,” Dustin said. “How do you find out what they really think about you?”
Sean laughed out loud. “I asked the love of my life to marry me. She said yes, so that’s how I found out.” He chuckled again and reached for the salt and pepper.
“You have to be kidding.”
“Nope. In your case, you better not try it. She might say no and you would not be pleasant to work with after that.”
>
“You’re preposterous. I’ve known her a little less than a year and we’ve only been dating a couple of months.”
“What difference does that make?”
Dustin shook his head. “That potbelly of yours has gone to your head.”
The waitress set down Dustin’s food, topped off Sean’s coffee, and left. He watched the old kid with the hoodie walk behind a woman coming towards the diner, his right hand jammed into his pocket. The guy looked both ways as if monitoring for traffic crossing an intersection.
Dustin twitched his mouth. In general, it was not cool enough outside for a man that age to really need a thick fleece hoodie, but a bit more suspicious to use it to cover his head while entering a public building.
The front door of the diner opened as Dustin swiveled in the booth to look towards the door. The young man shoved the woman aside and yanked a gun out of his jacket pocket. Without flinching, he aimed the weapon to the side of the cash register and pulled the trigger.
The man at the register grabbed his left bicep in pain as the young man aimed instead at the manager off to his side.
Dustin slid out and stood. The manager was about to be shot, so his hand gripped his firearm and, with no hesitation, he fired.
Dustin’s bullet made contact with the young man before he pulled the trigger again. With a fast rush, Dustin tackled him to the floor and then pinned him down. Sean followed and attached handcuffs to the assailant.
After flipping him over, the man winced with pain. Sean called EMS and two ambulances arrived. Dustin stood watch while the paramedics secured the cash register employee on one stretcher and the assailant on another.
“Officer,” the employee said to Dustin, “EMS says I’m going to live. Thanks to you.”
The paramedic nodded his head. “A bullet to the biceps. After the docs fix that up, you’ll be fine … except they’ll be restricting your gym workout to less than a hundred-pound weights for a while.”
Two professionals picked up the stretcher and loaded him in the back of the vehicle.
The man, now without his hoodie and gun, was spread on another stretcher where a paramedic held pressure on his bleeding. His partner started an IV and they slipped him into the second ambulance.
“I can’t thank you both enough,” the manager said when Dustin walked back inside. “I remember that guy. He worked here months ago. Not only did he skim money out of the cash register, he was late for work half the time and would disappear out back to smoke. I fired him as nicely as I could, but I was uneasy about him. I guess my instincts were correct.”
“Appears so. Another patrol car will be here soon, since Sean could use some help. I’m leaving to follow the ambulance.”
“Again, thanks. Paramedics would be taking me and a lot more customers with them if you two hadn’t been here.”
A group of customers nodded and added their thanks.
Dustin left his partner and followed the medical sirens in his own vehicle. The diner, he thought, was a stomping ground for him and Annabel on occasion. The two of them could have been sitting there when he was off from work … the two of them instead of him and his partner. He may not have been carrying his weapon off duty. He shuddered. It was one thing if he were to get hurt, but he wouldn’t be able to bear it if she was injured.
Life was too short, he thought. Things can happen in a second. How could he, or anyone, count on their future? He thought about Annabel; her warm smile, earnest yet fun personality, and her tall, slender build. Her eyes, he thought, depending on the light, appeared blue or brown, and her long hair was like a model’s curls pampered by a beautician’s magic. Yet Annabel’s was as natural as sunshine. Plus, he never before dated someone as smart as her.
Dustin wondered about the man in the ambulance ahead of him lying flat and receiving medical care. Being fired was his own fault and revenge had been his sad response. More importantly, he turned back to thinking about his current relationship.
Annabel was special and his mischievous partner had actually mentioned the “M” word. That was a new idea he had not considered. With such uncertainty in the world these days, like what had just happened, maybe he should kick the idea around in his mind. Sean’s idea was refreshing. Or considering a pun on words, his “proposal” was interesting!
-----
Roosevelt tried to hurry to the chairman’s office, but he wasn’t getting any younger. After crossing into his fifties, his right knee bothered him. It felt like there were opposing forces at work around his knee cap pulling in opposite directions. Retiring early in his fifties, or having an early knee replacement was not on his agenda, so he listened to his knee each day and walked an appropriate pace to not aggravate it. He grimaced when he realized the foolish thing he had done before leaving the house … he had neglected to take the single over-the-counter NSAID he took each morning.
He opened the OB/GYN department door and greeted the secretary. “Is Dr. Watson here yet?”
“She is. Would you like me to get her?”
“No, not yet. Dr. Winstead and I are going to talk first.”
“He has visitors. He said for you to go in when you arrive.”
Roosevelt absent-mindedly began tidying his shirt into his trousers. “Who’s with him?”
She glanced at the note in front of her. “A Kathleen and Mike Chandler.”
Dr. Harvey sighed. He had spent quite a bit of time with them already, as had the medical examiner. Maybe they were still looking for closure, although he doubted that would come any time soon. He couldn’t imagine how anyone would move forward after the death of their only daughter and unborn grandchild, especially under the circumstances that took their lives. He patted his toupee and knocked on the chairman’s door. Dr. Winstead was not behind his desk, but was across from the couple on the couch. The three of them made a small attempt to rise, but Dr. Harvey motioned for them to stay put. “May I?” he asked, pointing to the nearest leather chair.
Roger nodded and wore a serious expression. Kathleen wore a black skirt and crossed her legs and her husband finally looked like he’d gotten rest since yesterday.
Dr. Winstead leaned forward, appealing to both of them. “Would you mind if I encapsulate to Dr. Harvey what we talked about?”
“No.” Kathleen sighed.
“The Chandlers have hired attorneys from a well-known law firm which specializes in medical cases. They are preparing a lawsuit against the hospital that will claim negligence for the deadly medical mistake responsible for their daughter’s death. Against the wishes of their attorney, they are not going to name the OB/GYN doctors involved or our department.”
Kathleen rubbed her dry eyes. “We read everything we could get our hands on in such a short time. Even the medical consultant for the law firm said that magnesium sulfate was the correct treatment for Mary’s preeclampsia and in the correct dosage as you all ordered.”
“In other words,” Mike said, “we are not people who want to milk this occurrence and try to profit from it. We are just and fair people. The doctors in this case were doing every single thing to help our daughter. And, actually, we have no beef against nursing staffs, but an overt error was made.” He tried, but failed to contain the spark of anger rising in his voice. “We would go after you too, if one of the doctors had written for phenobarbital or whatever it’s called instead of magnesium sulfate.”
“We understand,” Roosevelt said, his concern for them genuine.
“Also,” Dr. Winstead said, “Mary is being cremated this afternoon. There is a service at the funeral home tomorrow morning. I would love for one of the team members to attend. I know you can’t, because your presence on the ward is now imperative. Mr. and Mrs. Chandler also understand that I have duties here tomorrow that I cannot leave.”
“We will be represented,” Dr. Harvey said, “I guarantee it. And for those of us who can’t make it, our hearts and souls will not forget your daughter and what happened.”
Dr. Winstead st
ood and shook Mike’s hand. Dr. Harvey did likewise at the door.
“There’s one more person I would sue if I could,” Mike added. “The father of the baby. Our daughter clammed shut to tell us who it was and she didn’t seem to care. But all along, I had a sneaky suspicion about the circumstances which led her to be pregnant in the first place.” He fought back a tear. “And now, like my wife so flatly stated, she’s downright dead.”
CHAPTER 20
“My heart bleeds for that couple,” Dr. Harvey said when the Chandlers left the chairman’s office.
“Who do you have in mind to represent the department at their daughter’s service tomorrow?” Dr. Winstead asked.
“Annabel Tilson. I need Caleb to help me with patient care. Plus, Mary Chandler was one of Annabel’s first patients who she spent time with. There is also another problem. Ling Watson is scheduled to present grand rounds next week, but we’re taking her out of the picture until she is straightened out to assume patient care again.”
“Ask Caleb to do it.”
“Then I’d be lumping him with way too much responsibility. I want him focused only on patient care. Patients and the department cannot afford another crisis.” He frowned. “What if we asked the medical student? She would undertake the ultimate early experience at speaking before her colleagues and medical staff as well as what it takes to prepare something like this. I would be careful to cut her slack on the wards and also make sure she is getting enough study time.”
“Talk to her about it. I’ll approve it only if she agrees and if the responsibility doesn’t totally rattle her composure. If she commits, please help her out if you can.”
“I’ll be sure to give her guidance.”
“Let’s talk to Ling Watson. She’s not going to take this well and I hope she’s not in denial about her behavior.” He pressed the intercom and asked the secretary to send in their chief resident.
When Ling entered, she flicked back her ponytail and squared her shoulders.
“Have a seat,” Dr. Winstead said, pointing to the chair across from his desk. “I think you know why Dr. Harvey took you off the ward this morning.”