Critical Condition

by Richard Mabry

  The two surgeons started to leave but stopped when Mrs. Hermanson said, “What about the other driver? The one who was going the wrong way and hit Tim? What about him?”

  Shannon turned back and crouched in front of Mrs. Hermanson’s chair. How would she take the news? Would she exult that the driver had paid the ultimate price for his mistake? Shannon put one hand on Mrs. Hermanson’s and said, “I’m sorry. He and his passenger were both dead before help could get to them.”

  Mrs. Hermanson looked down at her lap and shook her head. “I’m sorry to hear that. I’ll pray for their families, too.”

  As she walked away, Shannon thought back to the time when she knelt at Todd’s side, watching him die. How would she have felt if the police had told her the person who shot him had been killed in a car crash just after the shooting? Could she have prayed for their families? Or would she have thought what had crossed her mind this evening when she learned the fate of the wrong-way driver? Serves them right!

  As she started to change out of scrub clothes, the phone in the dressing room rang. Shannon looked around and saw that she was the only person there. She picked up the receiver. “Dr. Frasier.”

  “Doctor, glad we caught you before you left. Dr. Fell called from the ER. They’re bringing up a patient with a gunshot wound of the abdomen for emergency surgery. He asked if you’d scrub in with him on the case.”

  As Shannon hung up, she felt the familiar queasiness. Elective surgery posed no problem for her. Operating on victims of motor vehicle accidents, such as the one she’d just completed, was something she could take in stride. But gunshot wounds still brought a reaction that Shannon couldn’t ignore. True, the symptoms weren’t as bad as they used to be. She wondered if they’d ever disappear completely.

  “READY WHEN YOU ARE,” THE ANESTHESIOLOGIST SAID.

  Shannon fought against the dimming of her vision. She was light-headed. A growing sense of nausea made her gag. She felt her heart pounding in her chest, heard her pulse roaring in her ears. Under her surgical gown, rivulets of perspiration trickled slowly down her back. She looked at her gloved hands and saw a fine tremor, which she attempted to hide by resting them on the draping sheet that covered the patient.

  She looked at Will, who nodded that he was ready. Shannon was glad he was the resident physician on this case. If something happened to her, Will was quite capable of finishing. No! Don’t think about that. You can do it. You’ve done it before, and you can do it again. This will pass.

  She took several deep breaths, then strained, tensing her abdominal muscles to force blood toward her brain, a trick she’d learned early in her battle with these attacks. Shannon swallowed the bile that had crept into the back of her throat and held out her hand. The scrub nurse slapped a scalpel into her palm.

  “I’ll make a midline abdominal incision. Clamp the bleeders as we go. We’ll stop and Bovie the small ones,” she said, looking to make certain the electrocoagulation unit was set up. “We’ll tie off the larger bleeding points later, but for now, just leave the hemostats in place. What’s important is to get good abdominal exposure, locate the damaged areas, and repair them.”

  Will nodded.

  Shannon was sure he wondered why she was telling him what he already knew. But she knew from experience that her symptoms would subside in a matter of minutes, and the longer she could safely delay, the better.

  For the first time since she’d begun battling her attacks, Shannon added one more action. God, please help me get through this one. And with that, she made a clean stroke with the scalpel, dropped it onto the instrument tray, and held out her hand for a hemostat.

  EIGHTEEN

  SHANNON WAS SCHEDULED FOR OFFICE TIME ON MONDAY MORNING, a welcome break from her surgical practice. She stopped by the hospital to check on the two patients from the day before and found that, although Mr. Hermanson had done fairly well through the night, the course of the gunshot victim had been much rockier, requiring medications to keep his blood pressure up.

  She talked with the resident, suggested a couple of changes, and asked him to call her with the results of that morning’s lab tests. “You can get me on my cell,” she said.

  Back in her office, Shannon closed the outer door before calling up the faculty directory on her computer. She noted a number and picked up the phone. Should she do this? She was a female working in what had at one time been the male-dominated domain of surgery, so she remained constantly aware that to show vulnerability might undermine her status as a faculty member at a high-profile institution such as this. But to keep putting off this move might do even more damage—not only to her professional status, but also personally.

  Resolutely, she tapped out the numbers. “This is Dr. Shannon Frasier, in the Department of Surgery. Is Dr. Kershaw available?”

  In a few moments she heard a soft, warm contralto saying, “Shannon? So good to hear from you.”

  Shannon’s first encounter with Dr. Ann Kershaw had taken place shortly after she joined the faculty. Surgery for breast cancer had thrown a patient into deep depression. Shannon requested a consultation by one of the faculty psychiatrists, and it was then that she discovered in Ann Kershaw a psychiatrist who counseled with compassion and common sense. Their paths had crossed only rarely since then, but Shannon knew there was only one person she’d ask to help with the problem that had plagued her for so long.

  “Ann, I need help. I wonder if I could see you.”

  Shannon heard paper rustling, undoubtedly Ann checking her schedule. “I’m afraid the best I can do is at the end of the day. Could you come by my office about five?”

  “I’ll be there. Thanks so much.”

  As she hung up, Shannon wondered if she’d done the right thing. No, she’d had this monkey on her back far too long. It was time to get rid of it, one way or another.

  IN THE PARKLAND HOSPITAL PATHOLOGY LAB, MARK LEANED BACK from the microscope and felt the bones in his back crackle like Rice Krispies. He stared up at the ceiling, changing the focus of eyes that had spent too long scanning blue-and-red-stained slides prepared from surgical specimens. It was time to move around a bit. “I’m going to my academic office for about a half hour,” he told the lab tech.

  His route took him past one of the medical school lecture halls, where he encountered Jay Sanders coming out the door. They nodded and stepped to the side of the corridor to avoid the group of students pouring out of the room.

  “Just lectured to the sophomores,” Sanders said. “Sharp group. Every year the admission standards keep going up, and I find myself wondering if I could get into this med school.”

  “I have the same thoughts when I interview applicants for a pathology residency,” Mark said.

  “How’s Dr. Frasier doing on her antiviral meds?” Sanders asked.

  “I suppose she’s doing okay,” Mark replied. “She hasn’t mentioned any problems, but thanks for reminding me. I’ll ask her specifically. Otherwise, knowing Shannon, she’d probably just ignore them.”

  “Well,” Sanders said, “if she has any side effects, tell her to call me. I may be overly cautious in treating her, but even if there’s only one chance in a thousand that she’d become infected with HIV, I don’t want to ignore the possibility.”

  Mark nodded, reflecting that so much had gone on since then he’d almost forgotten Shannon’s exposure to Radick’s virus-laden blood. He’d have to remember to ask her if she was having any ill effects from the medication. And although his primary connection with Lee Kai was through Shannon, Mark decided he should call him to see how he was feeling as well. True, Sanders was the treating physician in both cases, but Mark felt a degree of responsibility, both as the doctor who’d discovered Radick’s positive HIV status and as Shannon’s significant other.

  As he made his way to his office, Mark decided that he hated that term, significant other. It was a sort of shorthand, a convenient set of words often used to designate partners living together without benefit of marriage, some
thing neither he nor Shannon would ever contemplate. But what was he right now? He was much more than a boyfriend. But he wasn’t her fiancé either.

  Had all they’d been through in the past ten days brought them close enough to each other that Shannon would finally say yes to a proposal of marriage? His gut instinct told him to hold off a little longer. Maybe after Crosley no longer posed a danger, perhaps after Shannon’s father’s health status was clearer, possibly after Megan was settled into her new job and there was no charge of murder hanging over her head—maybe then he could talk with Shannon about marriage. Until then, he’d continue to play the role he currently occupied: the “almost fiancé.”

  DR. ANN KERSHAW USHERED SHANNON INTO HER OFFICE, CLOSED the door, and gestured her to a seat on the sofa against the wall to the right of her desk. The shelves on the opposite wall were loaded with books and journals, some in piles that threatened to spill over, others neatly stacked or shelved. By contrast, Kershaw’s desk was a model of neatness. Apparently the psychiatrist thought some things were worth taking care over, others were not.

  Kershaw had short brunette hair with just a hint of silver beginning to show. Horn-rimmed reading glasses hung from a chain around her neck. She took a seat on the sofa beside Shannon and smoothed her navy skirt over her knees. Half turning to face Shannon, Kershaw asked, “So what’s going on?”

  Shannon had spent much of her free moments today trying to decide how to approach this. Part of her wanted to simply say, “Nothing, it was a mistake,” and flee. But she was here, and she might as well proceed. “I’m having panic attacks.”

  If Kershaw was surprised, she didn’t show it. “Tell me about it.”

  “They’re not as bad as they once were, but I’ve been having them since my first experience with surgery as a medical student. The symptoms are always the same—queasiness, cold sweats, a feeling that I might pass out. They’re tolerable, more so now than when these first started, but I still get them.”

  “And yet you went into the field of surgery. Why do you suppose that’s the case?”

  Shannon had wondered the same thing dozens, if not hundreds of times. “I’m not sure. Some sense of ‘I’ll beat this,’ I guess. And once I finished my residency, I didn’t want to change my specialty.”

  “Is there a trigger?”

  Shannon nodded. “Yes. They’re pretty specific. I only get the attacks when I’m caring for a patient with a gunshot wound. I can still function, but it takes effort.”

  “And this isn’t simply the reaction anyone might have to blood and trauma?”

  “Just yesterday I scrubbed in on the case of a man injured in a car crash, tearing a hole in his stomach. The abdominal cavity was almost filled with blood and gastric contents, and I did fine.” She took a deep breath. “The next case was a gunshot wound, and I had a minor panic attack while I was helping the resident with it.”

  Kershaw leaned forward, her chin resting on her hand. “When’s the first time you recall having one of these attacks?”

  “I’ve been trying to pin it down, and I’m pretty sure they started in med school when I took some elective time on general surgery. I scrubbed in on the case of a man who’d been shot multiple times. He didn’t make it, and all during the case I thought I was going to throw up. I wondered if it was the old ‘can’t stand the sight of blood’ thing, but I had no problem with similar cases. Just gunshot wounds.”

  Kershaw stood and began to pace in front of her desk. “And ever since, you’ve had these attacks when caring for a patient in such a situation?”

  Shannon nodded. “They were slowly getting better. Then a man was shot in my front yard. Lee Kai was at dinner with us that night, and he and I tried to help the man, but there was nothing we could do. Since then the attacks have been worse again.”

  “You’re smart enough to know what I’m going to ask next. Was there some incident with a gunshot wound earlier in your life?”

  That was what Shannon was afraid she’d hear. She’d hoped Ann would give her a magic bullet, maybe prescribe a betablocker or something similar to prevent these spells. Instead, she’d gone right to the episode Shannon still saw unreeling behind her closed eyelids some nights.

  “Yes. It was at the start of my freshman year in medical school. Things were getting serious between my boyfriend and me. We were out for a nice dinner . . .”

  MARK PULLED TO THE CURB OUTSIDE SHANNON’S HOUSE. NO LIGHT showed through the partially open blinds. At half past seven in the evening, even with daylight saving time, sunlight was fading and some people had turned on one or two lights. The closed garage door gave him no clue as to whether Shannon was at home. To his eye, the house looked deserted. Where was Shannon? Was she okay?

  He’d tried to call her, both at her office and on her cell, with no response. His call was triggered by concern for her safety, and now that concern increased.

  You’re worrying about nothing, Mark. On an intellectual level, he realized there was probably a logical explanation for Shannon’s absence from her home and her failure to respond to his call. But his heart kept telling him that something bad had happened to her.

  Maybe she met up with Crosley again, and this time there was nothing to intervene and let her escape. He wished she’d taken him up on his offer of a gun.

  Megan’s car wasn’t in its usual place at the curb. Perhaps the two sisters were having dinner out. Then again, maybe Crosley had them both. Mark’s fears multiplied moment by moment.

  He climbed out of his car, strode up the walk, and rang the bell. No response. He rang it again, with the same results. He was about to pull out his cell phone and try calling Shannon one more time when he heard the rumble of the garage door opening. In a moment, a blue Toyota Corolla pulled into the driveway and parked in the garage.

  Mark felt himself let out a breath he didn’t know he was holding. He relaxed a bit and started toward her.

  Shannon waved to him, then emerged with two grocery sacks in her arms. “You’re just in time to help me carry these in,” she said. “There are two more sacks in the car.”

  Once inside, he hurriedly set his burdens on the kitchen counter before drawing Shannon close to him and kissing her. Then he said, “I was worried about you.”

  “Sorry,” Shannon said. “I’m fine.” She gestured to a chair at the kitchen table. “Have a seat.”

  Shannon moved about, putting away groceries. “I was going to cook for Megan and me tonight, but she called to tell me she was eating out with some of her colleagues from work. So it’s just the two of us.” She opened a cabinet door, set several cans of food on a shelf, and said, “How about spaghetti?”

  “Fine,” Mark said, but he refused to be sidetracked. “Surely you know why I was worried about you. As I was ready to leave the campus, I tried calling you. I thought I could walk you to your car. You know, as long as Walt Crosley is loose, you’re not safe.”

  “I appreciate your worrying about me, although I certainly didn’t mean to do that to you,” Shannon said as she filled a pot with water and put it on to boil. “Honestly, I had an appointment at five, and I’ve been a bit preoccupied since then.” She started toward the living room, calling back to say, “I turned off my cell phone when I got to the appointment, and I must have forgotten to turn it back on.” She picked up her purse and extracted the phone. “Yep, still turned off. Thanks for the reminder.”

  Back in the kitchen, she opened a jar of spaghetti sauce, dumped it into a saucepan, and put it on to simmer. Then she reached into the refrigerator for a Diet Dr Pepper. “Want one?”

  “No thanks.”

  Shannon took the chair next to Mark. “Are you curious about my five o’clock appointment?”

  “I figured if you wanted me to know . . .”

  “I saw Ann Kershaw.” She waited, but when she saw he wasn’t going to react, she went on. “I’ve been having panic attacks, anything from full-blown ones to minor episodes, every time I’m called on to deal with a gunshot
wound. I finally decided it was time to get to the root of them. That’s why I saw Ann today.”

  Mark searched his memory. He didn’t think Shannon had ever told him about panic attacks. He knew they were more common than the general public thought, and that it was possible to get through them. Many actors had episodes, ranging from nervousness to vomiting, before every performance. Some surgeons, when they would admit it, told of similar reactions when faced with major surgery or extremely stressful situations. But he had no idea Shannon was afflicted with them. “So what did Ann say?”

  Shannon walked to the stove, stirred the sauce, dumped a handful of pasta into the boiling water, and returned to her chair. “Panic attacks usually stem from a feeling of helplessness, either at the time or in the past. In my case, they probably arose from Todd’s shooting.”

  Mark had heard the story, although he was certain there were some details he’d never been told. “And ever since your boyfriend was shot, you’ve been blaming yourself because you couldn’t save his life?”

  Shannon turned down the burner under the sauce, then took a wooden spoon and lifted out a strand of spaghetti. She looked at it, then dropped it back into the boiling water. “I guess that’s part of it.” She pulled down a bowl and started making a salad. “But I think it was more than that—the loss of a man I thought I could marry, the shock of the way it happened, my feeling of total helplessness as I crouched over his body, his blood on my hands.”

  “So from then on, blood has been a trigger?” He shook his head. “No, that’s not true. You see blood every time you operate. These episodes are tied to gunshot wounds.” Mark took a deep breath and paused to organize his thoughts. “That’s pretty specific.”

  She looked up from her work. “There should be a package of crispy bread sticks in the cupboard. Would you get those?”

  Mark shuffled through the contents of the cupboard, found the package of bread sticks, and put them on the table. “So what did Ann think was the catalyst? What specifically happened when Todd was shot that sets you off with every gunshot wound victim?”