“Well? What does it say?”
For the first time, he grew serious. “Technically, it’s just for staff to read. I could get into trouble.”
I counted to ten, and then to twenty. Silence fell while he pondered what to do. He clicked back and forth between different screens on his computer, and the puzzled look on his face continued to deepen.
“I’ve never seen anything like it,” he said. “I’ve never seen anything like it! And honestly, I don’t see why he should get away with it.”
Then he read out the secret note:
Do not treat this patient. She was sent to the States to receive care for anorexia nervosa. She should not be at this hospital. She should not be in Germany. She and her mother . . .
That was all I heard.
She and her mother?! What had I ever done besides exactly what this man had wanted? When had I opposed his demands? He hadn’t consulted with us, and he hadn’t educated us. He had gotten his hospitalization just as he had wanted, and he had gotten his medical evacuation, too.
What was wrong with this man? Was he insane?
“I’ll put the referrals back into the system,” the doctor told us. “But I don’t think they’ll do any good. I think it’s just going to keep kicking them out. I’m sorry. I don’t know what to do.”
I was still boiling with rage as we walked out to the parking lot. But rage wasn’t a luxury I could afford, so I turned my back on it and went into planning mode.
“We’ll fight it, of course,” I said to Elena. “I’ll find out the complaint procedure as soon as we get home.” And my mind started making a list: ombudsman, commander, insurance company appeals process. “Not that it will help right now since the hospital is on a full-scale war footing. We civilians are an afterthought these days.”
Elena didn’t speak. She was still smiling. She looked as if she were thinking about a funny joke.
“So he thinks he’s got us, doesn’t he?” I said. “He thinks we’re typical Americans, tied to the military hospital over here for all our medical care. Well, what he doesn’t realize is how good our German is and how good the German doctors are. We’re civilians. He didn’t think of that. Civilians don’t have to use this hospital. I’ll schedule you an appointment with my German doctor, the Doctor with the Three First Names. He’s thoughtful and very conscientious. I like him better than any of the American doctors I’ve seen here.”
“Also, he’s sexy as hell,” Elena pointed out—which was true. All the little old German ladies dressed up and put on lipstick when they got sick and had an appointment with the Doctor with the Three First Names.
“Now, it’s a little tricky dealing with his appointment system,” I continued. “But we can go in next Thursday during his extended consulting hours. And then, he can put in consults for you to local specialists. Germans need cardiac care, too.”
When the phone rang the next day, I didn’t even feel stressed about it. The ax had already fallen, and I was actively dealing with the aftermath. I felt ready for anything.
“Mrs. Dunkle? This is Dr. White.” The voice was pleasant. “I’d like to set up an appointment with you and your husband, if that’s convenient.”
“Of course, we’ll be happy to see you,” I said. “Am I correct that you work in the ombudsman’s office at the hospital? Is this about our complaint?”
“No, I work for the commander at your husband’s base. And this appointment . . . well, it’s just a discussion, really.” The voice continued to sound warm, and also amused and slightly apologetic, as if Dr. White and I had been caught in the rain together and he needed to share my taxi. “It’s really just a chance to get to know you and Mr. Dunkle.”
A chance to get to know us?
“Dr. White, exactly what is this about?”
“There’s been an allegation made,” Dr. White explained. “An allegation of child abuse.”
This time, I was the one who laughed. I couldn’t help it; the whole thing was just so over the top. After having accompanied Elena through weeks of stays at four different hospitals, after having allowed her to undergo every single medical or psychological test more than a dozen different experts could dream up—after lavishing our savings on doctor bills and driving her over thirty-two hundred miles to receive the very best care we could find—Joe and I had been accused of child abuse.
I didn’t feel angry. I had felt angry yesterday because the note denying Elena hospital treatment had actually threatened her welfare. But this, now—this was just stupid.
“The meeting is purely informal,” Dr. White told me cordially. “I investigate this sort of thing all the time. In fact, it’s all I do. And I want to assure you, I don’t let anybody influence me. I’m on your side here. I keep an open mind.”
“Am I right,” I asked, equally cordially, “in assuming that this allegation comes from the hospital?”
“No,” he said. “It comes from your daughter’s school.”
The school, was it? We’d deal with them. Yes, indeed, we would.
“Dr. White,” I said, “we’d like to see you as soon as possible.”
So, once again, Joe and I packed up our paperwork, lab results, discharge papers, and big blue plastic MRI sheets—even the DVD of Elena having her blackout. And the next day, we went to see Dr. White. He was as pleasant and engaging as he had seemed on the phone, and his office was pleasant, too. It had a large, comfy couch with a big coffee table in front of it, which was good because we needed that room to spread out all our forms.
“Thank you very much for coming in,” he said, shaking our hands. “I want you to know that you are not obligated to talk to me. But it will help me get a handle on what this is all about, so I’d very much appreciate it if you would.”
“We’re happy to talk to you,” Joe said. “We’re glad to have a chance to be heard.” Joe had been as practical as I had been about this meeting, but I could tell that he was much more angry.
I still didn’t feel all that upset. I saw the whole thing as just one more attempt on Dr. Petras’s part to bully our family. As attempts went, it was nasty, but it was considerably less dangerous and stressful than locking Elena up and yelling at her—and I’d watched him do both of those already. This particular method of bullying was so extreme that it just felt silly to me. It felt about as destructive and serious as peeing in somebody’s Jell-O. It was juvenile, that’s what it was—juvenile.
Besides, this time, as Joe pointed out, we had a chance to tell our side.
One by one, we handed Dr. White Elena’s records from the summer. First, we showed him the treatment letter Dr. Harris had written for us to take to her future psychiatrists, the one that said he was sending her back to Germany. Then we went through every piece of paper we had been given, from the lab sheets and the doctors’ summaries to the four hospital discharge forms. And we pointed out that nowhere, not on a single one of all those papers, had Joe and I denied Elena the recommended care. Nowhere had we gone “Against Medical Advice.”
As I watched Dr. White read through the paperwork from Drew Center, I felt grateful once again to that nice older doctor who didn’t like Dr. Moore. I wonder who he was, I thought. Maybe if he had been there to talk to me instead of Dr. Moore, I wouldn’t have had to go all the way to Texas to get answers.
“So, it says here that Elena needs follow-up cardiac treatment,” Dr. White noted. “Have you already set that up?”
Joe and I exchanged glances.
“Here’s where it gets a little surreal,” I said. “We tried to get that arranged. But Dr. Petras put a note into Elena’s hospital file that says she’s to be denied care.”
“In other words,” Joe said, “the same people who don’t think Elena is getting enough medical care are preventing her from getting medical care. And then they’re coming back and blaming us for not getting that medical care. Although, that’s just my assumption,” he added bitterly. “Since no one has reached out to discuss this with us directly, we ha
ve no idea what they’re actually blaming us for.”
“You don’t need to take our word for this,” I added. “You probably have access to the hospital computer system, so you can look up that note for yourself. That note . . . this accusation . . . it all feels like a vendetta at this point. God knows why.”
And that phrase, she and her mother, pricked at my nerves again.
Dr. White nodded. He didn’t seem at all surprised to hear about the note in Elena’s file. He must already know about it. And he was so warm and engaged that he really did feel like a person on our side. He must be very good at his job.
Or—had he already had run-ins with Dr. Petras?
“If you can’t get her care at the hospital, what have you decided to do?” he asked. “Of course, with your language skills . . .” And he looked at us expectantly.
“Exactly,” I said. “We don’t need the American doctors. Elena already has an appointment with our local German doctor. He’s fantastic; he used to be a hospital surgeon before he decided to return to his hometown and do family practice. He’ll be sure Elena gets the care she needs.”
Dr. White nodded.
“Thank you for coming to see me,” he said. “I feel completely satisfied with your answers, and I’m closing this child-abuse inquiry. It stops right here, with me.”
Then he paused and sighed, and he seemed to be searching for the right thing to say.
“It’s a byword in our business,” he mused, apropos of nothing. “The social workers: they’re just about saints. A lot of times, I’d swear there are no better people on this earth. And we psychologists: most of us have our heads screwed on straight. But the psychiatrists! I tell you, they’re either great—or they’re just God-awful!”
Yes, I was right. This nice man was on our side. This was not the first time he’d heard of Dr. Petras.
Dr. White might be finished with his work, but Joe and I weren’t. We drove straight from his office to Elena’s high school. We had been put through enough pain that summer. It was time to spread some of the pain around.
“We need to see Mr. Temple and the principal,” Joe told the office secretary. “We need to see them right now.”
“Of course,” she said. “I’ll see if they’re both free.”
The principal came out and shook our hands. I hadn’t spoken to him before that day. He was a short man with a comfortable, boyish face and eyes that were asking questions.
Mr. Temple trailed along behind the principal. His eyes asked no questions. In fact, he looked distinctly unhappy to see us.
The four of us went into an empty conference room. “Now, what can we do for you?” asked the principal.
“We just came from a child-abuse investigation,” Joe said. “It was initiated by a staff member here at this school.”
The principal looked grave. “Of course, you know I can’t divulge anything about that,” he said. “These sorts of matters are confidential.”
“We know that,” Joe said impatiently. “We’re not here to ask things. We’re here to say things.”
Then, one after another, Joe and I laid out all the forms and papers that we had just showed to Dr. White. Step by step, we walked both school officials through Elena’s care that summer. We even showed them Dr. Harris’s four-page curriculum vitae, which detailed his extensive experience with eating disorder clients.
“Now,” Joe said when we were finished. “Your staff member”—and here, he glared at Mr. Temple—“alleged that we were negligent in bringing our daughter back to Germany. You’ve seen the whole picture for yourselves. What do you think we should have done? Should we have kept Elena in the States, where she would have had to go through the stress of changing schools for her senior year and make a whole new circle of friends? Or should we have taken the advice of Dr. Harris, an eating disorder expert, and brought Elena back here, where she could take the courses she’s already signed up for, in an environment she knows and loves?”
The principal nodded. “I see what you’re saying,” he said. “I support your decision to bring her back. Nothing I see here warrants uprooting her like that.”
“Well, you’ll be happy to hear,” Joe said caustically, “that the child-abuse investigator agrees with you. He’s closed our case, with no further action warranted.”
“Very good,” said the principal, in the voice of one summing up a discussion. He, too, seemed to feel that no further action was warranted.
“We’re not done here,” Joe told him. “You brought up confidentiality. Okay, let’s talk about confidentiality.”
“That’s right,” I said. “Let’s talk about the confidentiality laws your staff have to follow.”
The principal looked puzzled. “I’m not sure I understand you.”
But I didn’t speak to him. I turned to Mr. Temple, and the unhappy look on his face told me everything I needed to know.
“I spoke to you the other day,” I said, “about confidential matters. I had every right to assume that you would protect my daughter’s privacy. But I happen to know that you shared my daughter’s medical information with a man whom you knew was not her doctor.”
“He has training I lack,” Mr. Temple said. “I defer to his training.”
“You knew that man wasn’t her doctor,” I repeated, staring him down.
But Joe looked as if he could hardly believe what he was hearing. “So you admit it!” Joe said. “You admit that you broke patient and student confidentiality laws.”
Mr. Temple didn’t look as if that’s what he had intended to admit at all, but he couldn’t very well take it back now. “He’s a specialist, an expert,” he explained stiffly. “I often consult with him.”
“So, you picked up the phone,” Joe ground out, “and you discussed details of my daughter’s psychiatric and medical care with—what? With a buddy of yours? You weren’t consulting about hypothetical cases here. You used her name!”
Mr. Temple opened his mouth. But then he shut it again.
“You knew that man wasn’t her doctor,” I reminded him. “You knew that we wouldn’t agree to that man knowing anything about her care. And you know perfectly well why!”
Mr. Temple looked away from us, and from the keen stare his boss was giving him, too. “Yes,” he said. “Yes, I knew that. I did know that.”
Joe drew himself up. Not for nothing had my husband spent years in management. He looked formidable, and he knew it. “You violated every rule that exists,” he said, “concerning patient and student confidentiality!”
Mr. Temple started to speak, but Joe wasn’t done.
“You turned us in for child abuse!” Joe said. “You instigated a completely unfounded investigation. We would have been happy to meet with you to answer any concerns you might have had. We would have been down here the minute you said the word! But you didn’t ask. You didn’t let us know you were concerned. Instead, you discussed the details of our daughter’s care with that quack, and you broke the law!”
Mr. Temple started to speak again. Again, he changed his mind. He looked as uncomfortable and upset as a grown man can look.
As uncomfortable as we were supposed to look, I thought, if that child-abuse case had gone differently.
But that brought me out of my anger. I found my good mood again, and I began to feel sorry for Mr. Temple. He wasn’t the enemy here. He was just another victim of Dr. Petras’s lunacy. I had no doubt that Dr. Petras had managed to convince him that Joe and I were dangerously obstructive. He had probably whipped the whole situation into a frenzy.
Mr. Temple wasn’t a bad man. I felt sure of that. He’d made a terrible mistake, and he shouldn’t have done it, but he hadn’t meant to cause our daughter harm.
“You did what you did because you were concerned for Elena,” I said. “I’m sure you had her best interests in mind. But if you had concerns, you could have brought them to us.”
Joe swept all of Elena’s records into a pile and stood up with them under his arm.
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“We are done here,” he said in clipped and distinct tones. “If you have any further concerns about my daughter—for any reason—you had better bring them up to me. And if you ever—ever!—violate confidentiality laws again, I will know what to do about it!”
Joe and I walked out of the room, and that was the end of the Summer from Hell.
But it wasn’t the end. That’s what I came to realize. It couldn’t end—not anymore.
We couldn’t repair what the Summer from Hell had broken.
CHAPTER TWENTY-ONE
Elena’s eighteenth birthday fell on a weekday just a few weeks after the start of school. She had invited over a few good friends to help her celebrate. But fifteen minutes before they were supposed to arrive, I found her in bed, sound asleep. I hated to wake her up. She got so little rest these days.
“Elena,” I whispered.
She didn’t stir. She hardly seemed to be breathing.
My daughter was running herself ragged, wedging into her busy schedule as many committee meetings, study sessions, and volunteering opportunities as she possibly could. She didn’t allow herself to rest. She seemed to be saying, No senior year? I’ll show you a senior year!
It was a battle, and I wasn’t sure who was winning.
“Elena,” I said again. “They’re almost here.”
She opened her eyes and blinked at me without recognition. Then she closed her eyes again.
I hesitated. Could I call off the get-together? No, by the time I could find the right phone numbers, it would be too late. And besides, what would Elena think if I did that? Wouldn’t she just think I was interfering?
These days, that’s all she thought I did.
“The party,” I said, prodding her. “It’s in fifteen minutes. Your friends will be here soon.”
This time, Elena’s eyes stayed open.
“Why?” she wailed. “Why do you have to bother me when I’m sleeping? I hurt so much, I couldn’t get to sleep all night long last night! You woke me up. I was finally asleep!”
These days, everything on Elena seemed to hurt: her chest, her head, and her bones. Scoliosis had started curving her spine several years ago, but it seemed to be getting rapidly worse.
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