Code Blue pft-1

by Richard L Mabry

  Today, Ella Mae Mercer looked every bit the model of a bank vice president in her tailored navy suit and white blouse, accented by a designer scarf. Cathy bet the scarf alone cost as much as she spent on clothes in a month. The faintly tinted lenses of Ella Mae's glasses-different frames this time-made it hard to read the woman's expression. Cathy wondered if she had several pairs to match her outfits.

  "I'll bet you thought I wouldn't be back." The mild sarcasm of the words was tempered by the apparent sincerity on Ella Mae's face.

  "I hoped you would," Cathy said. "How are you doing now?"

  "Still stressed to death, but handling it better, thanks to the pills you were kind enough to renew. And, since you didn't want to continue the prescription without knowing my medical status, I'm back for all the testing, poking, and prodding you want to carry out, so long as it keeps the medicine coming while I need it."

  "Fair enough. If you'll get undressed and put on that gown hanging behind the door, I'll be right back to check you over. Meanwhile, I want to review the new patient checklist you completed on your last visit."

  Most of the information on Ella Mae's history form was unremarkable. Cathy found one thing that grabbed her attention, though. The date Ella Mae Mercer listed as the last time she'd consulted a doctor was a week before the car crash that killed Cathy's parents. She hadn't given the doctor's name, but Cathy knew it was her dad from the name on the pill bottles. The reason for the visit was left blank.

  Why had her father treated Ella Mae? And why had he prescribed a tranquilizer for the woman? Cathy remembered her dad talking on the phone at home, calls where he frequently said, "I'm a surgeon. You'll have to see your family doctor if you want those. I don't give that kind of medication."One of his favorite expressions had been, "If there's a problem, I cut it out. Then, once the incision's healed, I move on to the next patient. Let the internists and GPs handle all the rest."

  For the next half hour, Cathy "poked and probed," as Ella Mae had called it. The woman seemed in excellent physical shape. Finally, Cathy shoved her stethoscope into the pocket of her white coat and stepped away from the exam table."Jane will draw some blood for routine baseline studies, and I'll let you know if anything turns up there. Right now, I'd say you're pretty healthy."

  "Good. How about my medications?"

  "The dose of estrogen you're taking could probably be cut back a bit. We're finding that smaller doses carry less risk of breast cancer. The vitamins and supplements are fine. I don't want to discontinue the tranquilizer suddenly, but if you can, I think we should plan for you to eventually get offthem."

  Ella Mae shook her head no before Cathy finished speaking."Ordinarily, I'd agree with you. Until I saw you last, I hadn't taken those for several years. But I need them now."

  "Why?" Probably not the most diplomatic way to put it, but Cathy felt she had a right to ask for justification before authorizing more of the tranquilizer.

  "I'd prefer not to say. Let's just say that I'm dealing with some powerful emotions. I don't drink. I don't do drugs. I need something to take the edge off."

  "These emotions. Would you like to share them with me? Perhaps I can help."

  Ella Mae shook her head. Then she turned her palms up like a supplicant. "No use talking about them. It's about something that happened years ago. I thought I'd put all that behind me, but it keeps coming back to haunt me."

  Cathy's heart hammered in her chest. "And you won't let me try to help you?"

  Ella Mae shook her head, and Cathy was struck by the sadness in her eyes. "No, I don't think anyone can help. But thank you for offering."

  Ella Mae Mercer stood at Jane's desk, her prescriptions in hand, completing the checkout procedure. Cathy took one last look at the woman whom she suspected had been the cause of her father's near-estrangement from his wife. She hungered for details, but Ella Mae appeared to have no plans to elaborate.

  Cathy grabbed a can of diet soda from the workroom refrigerator and took several gulps. She shrugged her shoulders and tried to loosen the muscles in her neck, but the tension wouldn't budge. Probably just stress. She wished she could write herself a prescription for the same tranquilizer Ella Mae took, but all she needed to further complicate her life right now was to start self-prescribing potentially habitforming drugs.

  Cathy made sure that the waiting room was empty before she retreated to her office and closed the door. She collapsed into her chair, leaned back, and put her feet on the desk. Decorum be hanged! She was exhausted.

  She sat that way for perhaps five or ten minutes. Then her sense of duty overcame her fatigue. She sat up, pulled the phone toward her, and punched in Marcus Bell's number.

  "Marcus, this is Cathy. What did you need?" She regretted her tone as soon as the words left her mouth. No need to alienate him. She needed all the allies she could muster."Sorry, didn't mean to snap at you. Bad day."

  "I'll try not to make it any worse. The credentials committee will be meeting again in a couple of weeks. I thought you might like to know that the way you handled Nix's arrhythmia and your care of Mr. Phillips impressed Evan Baker. He seems to be on your side right now. Carl Rosenberg is also coming around. So there's a chance they may reconsider extending your privileges."

  Cathy felt her muscles relax a bit. "Great. I was afraid you were about to suspend them, not extend them. I had visions of being on probation as a result of this malpractice suit."

  "Actually, they could do that. But I haven't heard any rumbles to that effect. I- Hang on. My secretary's asking me something."

  While Cathy waited, she tried to honestly assess where she stood with the credentials committee. And, in case of another tie vote, she wondered if Marcus would come down on her side this time or choose to remain neutral. She wished she could be sure.

  She heard more murmurs, then Marcus was back on the line. "Sorry. Administrative problem. Anyway, I thought you should know about this."

  "Thanks." She had the phone receiver halfway to the cradle when she heard Marcus say something else.

  "Pardon me? I didn't get that last bit."

  "I asked if there was any chance of us having that dinner I keep asking you about."

  Make a choice, she thought. True, Marcus was handsome and charming. There was no doubt that having him on her side would be important. But she couldn't bring herself to fully trust him. And it would be weird to see Marcus when she hadn't fully decided how she felt about Will. No, she didn't need any more tension in her life.

  "Marcus, I appreciate it. But… no."

  Cathy paused at the water fountain outside Josh's office to wash down a couple of Tylenols. She recalled the advice she'd given so many times to others. If symptoms persist, see your doctor. Well, here she was, about to see a doctor-and probably the one whose services she needed most.

  She had hardly settled into her chair when Josh asked, "How's your love life?"

  Cathy looked up, startled. "I beg your pardon?"

  "I asked, 'How's your love life?' Surely you recognize the relevance of that question. If you don't, I can remind you of what we've been talking about for the past several weeks."

  She squirmed and rearranged her skirt. "All right. As you know, there are two men who seem to be interested in me. One is the surgeon who's Chief of Staffat my hospital. The other is the attorney who's helping me with a malpractice case that's been filed against me."

  "Your high school boyfriend."

  Didn't the man forget anything? He never took a note. She'd never seen evidence of a tape recorder in the office. She decided on a simple answer. "Yes."

  "Do you have feelings for either of them?"

  "Actually, I haven't sorted that out. I know I'm fond of at least one of them."

  "Fond? That's not the kind of feeling I'm asking about. Does it go deeper than fond?"

  "Do you want to talk some more about my not being able to trust men?" Cathy asked. "Because my father died just as I finished medical school, just when I needed him? Because two me
n I was ready to marry disappointed me?"

  Josh shook his head, an unusual display of emotion for him. "No, but think about those three men we've been talking about: your father, Carter, Robert. What did you admire most about them? Until they let you down, that is."

  She didn't even have to think. "Strong, competent. I felt safe and secure when I was with them."

  "What do you think that says about the way you feel about yourself?"

  She reached for the carafe and poured a glass of water.

  "Cathy, you know you do that when you want to put off answering."

  She put the glass down. "All right. I guess I don't feel secure. I act like it-I have to-but I'm not. I feel like I have to prove myself again and again. Can you imagine how hard it is for a woman to make it in medicine? And then to establish yourself in your hometown, where everyone remembers every mistake you and your family ever made? A place where all the male doctors in their 'old boys club' think you can't hack it in the real world?"

  "I recognize those feelings, and they're legitimate," Josh said. "But put them aside and try to analyze your feelings for the men who are currently in your life, the ones you're drawn to."

  She took a deep breath. "I need Marcus on my side when I come up against the medical staff. I need Will on my side when my suit comes to trial." She felt the way she always felt when Josh peeled away another layer of the protection she'd built up: vulnerable and shaky.

  "And?"

  "So I guess I need to be clearer about my feelings for them. Do I value them for what they can do for me or just for themselves."

  "That would be a good idea. I'd suggest you begin by considering whether you'd be attracted to them if they had nothing to offer you. Picture them as furniture salesmen, plumbers, perhaps airline pilots. When you do that, you'll know the difference between what you're feeling from your head-even subconsciously-and your heart. And then you can start thinking about love-not need, but love. There's a big difference."

  Josh had given her a lot to think about on the drive back to Dainger. A lot.

  The morning had been frustrating. Not busy-just frustrating. Three patients cancelled, giving no reason. Several sizable bills arrived in the mail, but no payments came to offset them. Cathy wanted to scream. Instead, she grabbed a cold Diet Coke and retreated to her office. She'd hardly settled into her chair when Jane rapped on the doorframe."SheriffDunaway's here."

  "Please send him in." There was movement behind the nurse. Cathy rose and extended her hand. "Sheriff, I'm Dr. Cathy Sewell."

  The sheriffstrode confidently across the room, and all Cathy's preconceived images fled. The man was in his late fifties or early sixties, muscular but certainly not fat. He wore starched, sharply pressed chinos. His white dress shirt bore a modest-sized shield on its breast pocket. A silver replica of the state of Texas secured his black bolo tie. He carried a snub-nosed revolver high on his right hip. He could have been a detective in Dallas, rather than the sheriff of a moderate-sized Texas county. Certainly, this was no country bumpkin.

  "Pleasure to meet you. I'm J. C. Dunaway." He gave her a brief handshake, firm but not aggressive, and settled into the chair across from her. When he crossed his legs, she saw that his black snakeskin boots were shined to a high gloss.

  "Thank you for coming here. Do you have some pictures for me?"

  He placed a manila folder on the desk and flipped it open. Inside were a dozen or more sheets of photo stock, each with a large picture of a vehicle. "You know, in the old days I'd have sent a deputy to a bunch of dealerships for pamphlets. Now we go on the Internet, find the picture we want, and print it out. Took less than half an hour to get all these." He tapped a finger on the top picture. "Any of them look like the vehicle that's been giving you trouble?"

  Cathy shuffled through them quickly, setting aside two or three, which she studied with care. Finally, she said, "I'm pretty sure it's this one."

  He pulled the photo toward him and looked at it, then turned it over and nodded. "Ford Expedition. Are you sure?"

  "Not really. You have to admit, they all look pretty much alike, but I think this is it."

  "That's a really common vehicle around here, but we'll do some digging. See if someone who owns a black Ford Expedition might have something against you." He scratched his chin. "Or maybe they had a grudge against your family. Know if your daddy had any enemies?"

  "Sheriff, he was a physician. The people he helped loved him. I guess there are always a few folks who hold it against the doctor when he can't cure the incurable, or when the time comes to pay for their care, or when he does something they don't like." Cathy clamped her lips shut. She'd thought of another reason for someone to have a grudge against her father. Had he broken offa relationship a woman thought would end in marriage?

  "Dr. Sewell, are you prepared to assist me?" Arthur Harshman's tone implied that he was as likely to get help from a trained baboon as from this upstart family practice doctor.

  Cathy forced a smile. "Absolutely. May I go in and say hello to the Gladstones?"

  Harshman waved her request away as though he were shooing a particularly pesky fly. "I suppose so, but be quick. I've already spoken with them. I answered her questions, the permit's signed, and Ernest knows that I don't want him in the operating room looking over my shoulder. Don't do anything that might cause problems."

  Emma Gladstone lay on a gurney in the pre-op holding area. Her husband stood at her side, holding her hand and occasionally smoothing her hair. They both turned when Cathy slipped between the curtains that gave them the limited amount of privacy available in that setting.

  "Mrs. Gladstone, I just wanted you to know that I'm here. Is there anything I can do for you?"

  "Yes, dear. Will you pray with us? I think I'd feel much better if you did." Her reply so nonplussed Cathy that it took her a moment to process it.

  To Cathy's surprise, Dr. Gladstone nodded at his wife's request. In Cathy's home, her father's praying had been confined to a rote-memorized grace that he said at mealtimes, primarily, she suspected, to appease her mother. In her residency Cathy had encountered a few doctors who mentioned that they prayed before every operation, but like her colleagues she'd tended to dismiss them as a rather unusual minority in the profession.

  "I… I suppose so," Cathy stammered.

  "Ernest, will you pray first? Then Dr. Sewell can pray."Emma reached out her other hand, careful not to put traction on the IV taped to it, and grasped Cathy's hand.

  Dr. Gladstone cleared his throat. "Dear God, I love this woman. She's good and kind and the most caring person ever to walk this earth. Please carry her through this procedure safely. Give her the grace to tolerate whatever comes afterward, and help me be the kind of husband and helper she deserves." There was a moment of silence. Then Gladstone murmured, "And give skill and discernment to Arthur, Cathy, and all those who help them. In your name, Amen."

  Cathy was so startled by Dr. Gladstone's use of her first name that it took a gentle squeeze from Emma for her to stammer out her own prayer. "God, please help all of us through this. Help me to do my very best and to be worthy of the trust of these people. Amen."

  11

  More traction." Harshman tapped the retractor with the hemostat in his hand. "I need to see right here."

  Cathy pulled a bit harder. She'd bent over the operating table opposite the surgeon for over two hours and could hardly bear the pain in her back. Her head throbbed with every movement she made. The air conditioning in the operating room didn't come close to overcoming the heat from the high-intensity lights that glared down on the surgical field, and a constant stream of sweat trickled down her back.

  Cathy decided she had to risk the surgeon's wrath. She flexed her shoulders, even though it meant a momentary easing of the pressure she held on the retractor.

  "You're doing a nice job," she ventured.

  "I should hope so," he grumbled. "I've done dozens of these." He dropped a clamp onto the instrument tray. He straightened
, took a deep breath, and used a gauze square to blot blood from the surgical area. "Did a fellowship in gynecologic oncology at M.D. Anderson. Some of us live in Dainger because the pace is slower, and we like the town. Not all of us here are incompetent old coots who couldn't make it in a larger medical center."

  Cathy realized she'd made exactly that assumption about Harshman. "I'm sorry. I-"

  Harshman tapped on the retractor with his finger, "Take that out now. I think the self-retaining retractor will be enough at this point." Then, like a flashback to her days as a resident, Harshman asked, "What's the most critical part of the operation to this point?"

  Cathy gave the answer automatically. "Avoiding damage to the ureter or bladder."

  "Have I come close to cutting either one?"

  "No. No, you haven't."

  "Good. Do you think you could have done this operation?"

  Cathy considered that for a moment. She'd known most of the steps, but there were a few points where she wasn't sure where Harshman's next cut would be, while his movements never appeared to be anything less than sure and certain. "No, I don't think so."

  "Do you think you deserve privileges to do a modified radical hysterectomy?"

  "Dr. Harshman, I never asked for anything like that. I recognize that I'm a family practitioner, and I'm proud of it. But, if you'd read the letters I presented to the committee you'd know that I had a great deal of exposure to obstetrics and gynecology during my FP residency. Actually, I originally planned to go into OB-Gyn, but I changed my mind. What I want now are privileges to perform deliveries. You'll notice that I didn't ask for C-section privileges, even though I've had the training. I recognize that there are competent obstetricians available in town, and they should be doing those cases. I'm not about to steal your patients. I only want to offer more complete care to my patients, especially the women, many of whom would prefer a female physician."