Conscious Bias

by Alexi Venice

  Giving her a cautious glance, he leaned down from the rack, and stretched out his long arm. His tiny black fingers reached for her phone, which was resting on her knee, but she calmly covered it with her hand.

  “Uh, no. This is my phone, but we can listen to music together.” She smiled a shaky smile, hoping he wouldn’t make a play for her phone.

  He scrunched his face and clucked a few times but didn’t move from his spot or try to swipe her phone. They sat calmly, listening, Monica mostly avoiding eye contact. She could see from the corner of her eye, however, that he was intently studying her.

  When the song ended, she reached into her bag and removed an RX power bar that she had purchased from MoFit on her way out that morning. Marcus’s ears perked up as she slowly tore open the wrap and removed the bar. The small brown square was peanut butter flavored.

  As she was bringing it to her mouth, he quickly swung out from the rack, anchoring himself with the tip of his tail around the metal pole, and extended his arm longer than she thought possible. His small hand reached out and stole the bar from her, startling her.

  “Holy crap, little guy!” she exclaimed in a whisper. “You sure are fast.”

  He patted himself on the head and gave her a look that said, “I SCHOOLED YOU, DUDE!”

  She smiled as she watched him nibble on the bar. Half way through his snack, there was a light tap on the door, which sent him to the top of the rack again, his long tail twitching at the end like a nervous cat.

  Monica stood and went to the door. “Yes?”

  “This is Howard—”

  “—and Darcy!” she yelled.

  “Is that you, Ms. Spade?” Howard asked.

  “Yes,” Monica said. “I’m in here with Marcus.”

  “Can you open the door?” Darcy asked.

  “I can, but do you think Marcus will try to escape when I do?”

  “I doubt it,” Darcy said. “I’ll come in first with my pet container. It will be fine.”

  Marcus made a series of high squeaks at the sound of Darcy’s voice. He didn’t come down from the top rack, but his body shivered with excitement.

  Keeping a wary eye on him, Monica quickly cracked the door for Darcy to rush in. She set the container on the floor and shrieked a sigh of relief. “Marcus! I’ve missed you so much.”

  He let loose a loud squeak, followed by a chortle, then jumped to her shoulder from the top rack in one amazing move. Darcy pet him as he nuzzled into the hair at the nape of her neck.

  “I assume you’re going to put him in his pet container now?” Monica asked.

  “Oh yes,” Darcy said. “He doesn’t like it, but I want him home safely.”

  “Good plan,” Monica said. Because if you don’t, I’m calling those guys to tranquilize him, and you, too, if necessary. Both of you need to leave this hospital NOW!

  Monica watched politely while Darcy tossed some treats into the container, luring Marcus inside. She closed the metal door behind him.

  “Nice move,” Monica said.

  “Thanks.”

  Monica opened the supply room door to several security guards. “Hi Howard. I’ll be leaving to join Al for our meeting now. You might want to get the housekeeping crew in here to clean. There are feces sprinkled all over and a nest in the top rack.”

  “Will do,” Howard said, holding his nose at the smell.

  “I know, right?!” Monica rushed out to the main corridor, grateful for the blast of fresh air. She ran up the stairs to the administrative conference room where Al was meeting with the Seif family and physicians.

  Chapter Twenty-One

  Monica quietly entered the conference room, careful not to disturb the solemn atmosphere or interrupt Dr. Rice explaining her neurosurgical care of Abdul. Sitting beside Dr. Rice was Dr. Khouri, who Monica assumed had already explained the care he had provided in the Emergency Department.

  She respectfully maneuvered around the large conference table and sat in the empty chair next to Al, nodding to the family, who was engrossed in what Dr. Rice was saying.

  “I ordered hourly neurological assessments by the nursing staff and a repeat CT Scan every twelve hours to monitor the brain for bleeding and possible edema,” Dr. Rice said.

  Dr. Rice waited while Mohamad translated for his family.

  “We saw some oozing of blood on the brain in the CT Scan on admission, later on Sunday, and again on Monday. The amount of blood didn’t increase, though, so we expected it to reabsorb into the tissue over the next several weeks.”

  “Since Abdul was awake and alert, a little groggy from the sedative, but nonetheless moving his arms and legs and talking, we were hopeful that his brain wouldn’t swell. We kept him sedated and in bed to help with that. I was outside his room when he was talking to you on the phone, and I interpreted his ability to converse with you as a very reassuring sign of recovery. Unfortunately, it was misleading. I’ve treated many head traumas but have never seen rapid edema like Abdul had.”

  She shook her head. Monica’s eyes fell to Dr. Rice’s hands, resting on the table, her nails bitten back as far as they could go, and her cuticles jagged with wisps of skin sticking up. Monica wondered if Dr. Rice realized she manifested her stress through obsessive nail trimming, by her own teeth no less.

  “I evaluated Abdul in person three times on Monday, and he looked well, progressing according to plan. When I left the hospital at seven o’clock that evening, Abdul’s Glascow Coma Score was 15, which is the highest score for evaluating eye movement, verbal skills and body movement. I truly thought he would recover. Brain trauma usually takes several weeks, if not months, to resolve, so I encourage families to be patient, but he looked good.”

  She sighed then continued in an ominous tone. “However, like in other parts of your body, swelling of the injured tissue can happen very quickly. Later that evening, about nine o’clock, Abdul’s neurological assessment by the nurse indicated something had changed. His eyes were fixed and dilated, and she couldn’t arouse him,” Dr. Rice said.

  Mohamad translated, and Mrs. Seif started crying.

  “Fixed pupils are a sign of brain swelling,” Dr. Rice said, “so I ordered a medication known as Mannitol to be administered intravenously, and another CT Scan to be performed right away. While Abdul was in the CT scanner, I came to the hospital. I looked at the results while Abdul was in the scanning machine, confirming swelling. When I evaluated him, he looked very different than when I had seen him a few hours earlier.”

  In an effort to help the family assimilate the bad news, Dr. Rice said in a soft voice, “I don’t think Abdul was in any pain. He had plenty of sedative in his system and was unconscious.”

  She continued in her serious surgeon mode, “I took him to the Operating Room and performed a well-recognized surgery, bilateral craniectomies, to remove a piece of skull on each side of his head, so the brain would have room to swell without causing injury.”

  Mohamad translated, and Mr. Seif moved to the edge of his chair. He spoke for the first time, asking his question in perfect English. “Why didn’t the Mannitol medication stop the swelling?”

  Monica was impressed by the specificity of his question. He obviously had spoken to a doctor about Abdul’s case. Dr. Rice nodded respectfully. “Mannitol doesn’t work in every situation. In Abdul’s case, the brain swelling came on so fast that it outstripped the Mannitol’s effectiveness.”

  Mr. Seif nodded then gestured with his weathered hand for her to continue.

  “When I removed the small pieces of skull in the OR, Abdul’s brain swelled suddenly and irreversibly, cutting off all blood flow. There was nothing we could do to save him, so we returned him to the CCU for stabilization and more testing.”

  Mohamad spoke in Arabic, directing most of his commentary to his mother, Basmah. Mr. Seif’s English was perfect, and Monica assumed a young person like Ameerah knew English.

  Basmah leaned in and whispered into Khalid’s ear. When she finished, he asked, “Did
the Imam arrive in time?”

  “Yes,” Dr. Rice said. “He performed religious prayers over Abdul, both before and while Dr. Khouri and I were speaking to you by phone.”

  “And he performed those in Arabic?” Mohamad asked.

  “Of course,” Dr. Khouri said, jumping in.

  The Seifs nodded in relief, and Basmah hiccupped into another sob, covering her face with a handful of tissues. Ameerah wrapped her arm around her mother’s shoulders, comforting her.

  The senseless loss, Monica thought, her heart aching for them.

  Dr. Khouri used the break in Dr. Rice’s story to say several things in Arabic, none of which Monica understood. Mike sort of followed along, nodding here and there. She assumed Dr. Khouri was explaining how the religious rights and practices had been performed by the Imam. When Dr. Khouri finished, Mr. Seif’s elderly, wise eyes filled with tears that bubbled against his long, black lashes.

  “And his body?” Khalid asked in English. “Was it prepared properly?”

  “Yes,” Dr. Khouri said. “The soles of his feet were facing Mecca, which is to the Northeast from the hospital.”

  “How did you confirm?” Khalid asked.

  “With a compass,” Dr. Khouri said.

  “And, his body?” Khalid asked.

  “I personally closed his eyelids and assisted the Imam in wrapping Abdul’s head with gauze, so his mouth remained closed. We placed his right hand on top of his left and lay them across his chest. Then we wrapped gauze around them,” Dr. Khouri said, indicating with his own hands.

  Mr. Seif’s substantial lashes couldn’t contain the tears any longer. They spilled over and freely ran down his face.

  “We also held his feet together, but not crossed, with the gauze wrapping,” Dr. Khouri said. “Finally, we shrouded him with a clean sheet, then the representatives from the embassy arrived. They worked with the police to transport Abdul’s body to the Medical Examiner for autopsy.”

  He hesitated while the family absorbed the details, both Ameerah and Basmah openly crying. Mohamad remained dry-eyed, and Mr. Seif wiped the tears from his cheeks with the back of his hand.

  Monica’s heart ached for them.

  After giving the family time to collect themselves, Al turned to Drs. Rice and Khouri. “Is there anything else about his medical care that you’d like to share?”

  “Only that we did everything we could without delay as his symptoms developed,” Dr. Rice said. “I’m so very sorry. His death was tragic and unexpected.”

  “We thank you for your care,” Mohamad said in a broken voice.

  “When you’re ready, would you like to visit Abdul’s patient room in the CCU?” Al asked.

  The women looked at Khalid with pleading eyes. He said, “Yes, if possible.”

  “Of course,” Al said. “Take your time. We can all go together when you’re ready.” He stood and motioned for the physicians and Monica to follow him out.

  They left the conference room, Al closing the door behind them. The air in the hallway was several degrees cooler, but the weight of the family’s grief lingered on them as they stood in silence for a few seconds.

  “Is it okay if I go back to clinic now?” Dr. Rice asked, her wiry body charged with energy.

  “Yes,” Al said. “Thank you for coming.”

  “My pleasure,” she said, then turned to Monica. “You’ll call me when I have to testify?”

  “I’ll text you first, so we can make a plan,” Monica said.

  “I’ll wait for your text then.” Dr. Rice turned and walked away, her white doctor coat rustling against her blue scrubs.

  “Do you have time to walk with us down to the CCU?” Al asked Dr. Khouri.

  “Of course.” He waved his hand as if he wouldn’t have considered doing anything else.

  The door to the conference room opened, and Al led them out of Administration. Mr. Seif fell in step beside Dr. Khouri, who spoke in hushed Arabic to him as the processional made its way through the hallways toward the CCU. Mike and Monica brought up the rear, looking as somber as the rest of the group. Monica wanted to tell Mike about her Marcus experience, but chatting would have been disrespectful.

  They arrived at the double doors to the CCU, and Al scanned his badge for them to open automatically. He led the group the short distance into the CCU and turned into a vacant patient room. He gestured for the family to enter but didn’t go in himself. Only Dr. Khouri joined the family, while Al, Mike and Monica lingered outside the door.

  Even though Al had warned them in advance, the CCU staff stole curious glances over the counter from the nurses’ station.

  Al closed the extra wide door to the patient room and walked a few feet down the hallway, motioning for Monica and Mike to follow him. “Mike told me you were sidetracked by Marcus-the-monkey. What happened?”

  “Right after we spoke at the Chaim Gross art collection,” she said, “I spied Marcus trotting down a hall. I followed him into a supply room where he had a little nest on the top rack.”

  Al covered his face in disbelief, making Monica smile.

  “I closed the door and called Security. In a very short time that seemed like forever while Marcus was staring me down, Howard brought Darcy from the picket line, and she reunited with Marcus, peacefully removing him in a pet container.”

  “Awesome,” Al said, relief flooding his expression. “I can’t tell you how grateful I am.”

  “My pleasure,” she said. “You’re going to owe your housekeeping staff hazard pay after they finish with that room, though. Lots of monkey feces in there.” She held her nose.

  “Will do,” Al said. “I wonder when Marcus moved from the basement to the first floor.”

  “Judging by the smell, my guess is on day-one,” Monica said.

  “I’m surprised our security video didn’t see him up there,” Al said.

  “Maybe they weren’t looking at the first floor that closely,” Monica said.

  “Maybe.” Al scratched the back of his neck. “How do you think the meeting with the Seifs went?”

  “As well as can be expected under the circumstances,” Mike said.

  “To be honest,” Al said, “I was a little nervous when Mr. Seif asked if we were a Jewish hospital. I’m Jewish you know, but I thought better of saying that while explaining that we were nondenominational.”

  “Good use of discretion,” Monica said. “No need for me to blurt out that I’m a perpetually guilty Catholic either.”

  They all smiled.

  “I think Dr. Khouri is a reassuring presence for the family,” Mike said.

  “Did you track what he was saying in Arabic?” Monica asked.

  “Some of it,” Mike said. “He was using religious terms I wasn’t familiar with.”

  “Let me know if they have any follow-up questions or want to meet again,” Al said.

  “I will,” Mike said, “although I’m sure we’ll turn our attention to the trial for the next few days.”

  “Do they really plan to sit through the entire thing?” Monica asked.

  “That’s what they told me last night,” Mike said.

  “I’ll try to attend for a few days myself,” Al said. “The atmosphere in the courtroom will be tense with the McKnight family on one side, and the Seif family on the other.”

  “Plus friends and supporters and the media,” Monica said.

  Just then, the Seifs emerged from the patient room, Ameerah holding her sobbing mother as they entered the hallway. Red-eyed and bearing tear-stained cheeks, the women looked especially uncomfortable in the clinical surroundings. Monica’s heart went out to them, picturing herself supporting her mother in the same situation if Monica’s older sister, Lauren, were to pass suddenly. She wanted to hug them.

  “I’m so sorry,” Al said.

  “I think the family is ready to leave now,” Dr. Khouri said.

  “We’ll walk them to their cars,” Al said.

  The sad group walked in silence, retracing thei
r steps through the winding corridors of the campus that were familiar to Monica. When they arrived at the Walnut Street entrance, Monica, Dr. Khouri and Al bid the Seifs adieu and watched as they got into the black Suburbans.

  After they departed, Dr. Khouri said, “That went as well as we could have hoped.”

  “Thank you for being here, speaking to them in Arabic, and reassuring them,” Al said.

  “My pleasure,” Dr. Khouri said. “They had a lot of questions confirming that Islamic religious practices were observed, so I’m glad I was here to assure them that everything was done properly.”

  “Again, thank you,” Al said.

  Dr. Khouri turned to Monica, “When do I need to testify?”

  “I’m not sure,” she said. “I expect to hear from the DA today. I’m guessing it will be tomorrow or the next day.”

  “I’ll make myself available whenever I’m needed,” he said. “What happened to Abdul isn’t fair, and I hope my testimony will help.”

  “I agree, and I think it will.” Monica nervously rubbed the knuckles of her left hand between her right thumb and forefinger. “I suspect the courtroom will get ugly, though, so I’d like you to prepare yourself for the McKnight lawyer to be a jerk.”

  “I’ve dealt with jerks before,” Dr. Khouri said.

  “Hopefully, the Seifs will realize that we support them,” Al said. “Monica will be at the entire trial representing the hospital and sitting with the Seifs.”

  Monica looked at Al in surprise. He hadn’t mentioned sitting with the Seifs before, and she hadn’t realized he was paying her to attend the entire trial. Her usual practice when hospital personnel testified was to prepare them the day before, sit in the back of the courtroom while they testified, and leave after they finished.

  She didn’t know how she felt about being thrown into the heart of the dramatic, local-versus-foreigner battle. As long as Al was paying her, though, she would do what he asked. That calculation was a no-brainer.

  “Thanks for capturing Marcus today.” Al shook her hand. “I never expected our lawyer to be the one to get him.”