Medical Error

by Richard Mabry

  Now that he was here, he had to wonder why this had seemed so important to him. Because he wanted to help her solve the question of why her patient died? Or because he was excited about seeing Anna?

  He eased out from behind the wheel of his Honda Civic and squinted to see the numbers on the doorposts of the duplex. There it was, on the left. He marched to the door and rapped firmly. He made himself wait a measured thirty seconds before repeating his knock, this time a bit harder and longer.

  Nick was rewarded with a faint call from inside. "Just a second."

  It was closer to two minutes before the peephole darkened for an instant, then the door opened and Anna McIntyre greeted him. She wore a hip-length Dallas Cowboys T-shirt over faded jeans. Her feet were bare, her red hair tousled. Without makeup, the simple beauty of her face shone through. Nick knew that his heart wasn't really doing somersaults, but it sure felt like it.

  Anna was talking on a cordless phone as she motioned him inside. She waved him to a seat, pointed to the phone in silent apology, and disappeared into the next room, still talking.

  At least she hadn't turned him away at the door. He scanned the living room. Minimal furnishings, but every item obviously chosen with care and taste. He knew how much an assistant professor at the med school made—at least in his department—and he suspected that Anna's personal budget was as tight as his. It appeared that she'd done a nice job with the funds available.

  "Sorry." She strode through the door and replaced the phone in its cradle. She scooped up several sheets of paper and shoved them into a manila folder, which she filed in a bottom drawer of the small desk in one corner of the living room. "I've had sort of a personal crisis around here, and I had to finish trying to deal with it."

  Nick ran his hand through his dark hair and wished he'd gotten that haircut he'd kept putting off. "I should have called first."

  "You wouldn't have gotten through. I've been on the phone for almost an hour, and I refuse to have call waiting. I have trouble enough keeping up with one conversation at a time."She eased down onto the sofa beside him.

  Anna had been tense when he saw her earlier today, and apparently, there were still storm warnings flying. He'd love to see her when she actually relaxed. "I'm glad I caught you," he said.

  "So, what brings you here?"

  Nick hated to jeopardize any chance of turning this into a social occasion by immediately talking about medicine, but that was the reason he was here—or at least, the pretext for the visit. "I got the results of the tests on the blood that Hatley received. Everything checks out. The blood didn't cause the allergic reaction."

  Anna frowned. "So it was the antibiotic."

  "Probably. But you said he tolerated it only a couple of weeks before."

  "Look, I don't have an explanation for it, and right now I have another crisis I'm dealing with." She tucked her feet under her and turned until she faced him. "I know that this afternoon I made a big deal about finding out why Hatley died. Well, it's still a big deal, but unfortunately, it's been overshadowed by some other things—personal things."

  "Anything I can do?" Why had he asked that? It was none of his business. But he wanted it to be.

  She shook her head. "Nothing, but thanks for offering. It's a hassle with my credit card company. I can handle it."

  "Hey, I've been there. They don't cut you much slack, do they?"

  "Not really." Anna rose and took a step toward the door. "I appreciate your willingness to help me dig into the cause of my patient's death. It was nice of you to come here in person to tell me what you've found."

  He stood, but made no move to leave. "No problem. Hatley's death is bothering you, and it's puzzling me. And I'd like to cooperate in the investigation." He paused, choosing his words carefully. "And, to be honest, I enjoyed our time together this afternoon. I'd really like to get to know you better. Think that's possible?"

  Anna looked away. "I'm sorry. I guess you can see I'm pretty preoccupied, and that's one of the curses of being a surgeon. I'm a linear thinker—one thing at a time. I'll worry at this Hatley case like a dog with a bone, and until I get some answers I doubt that I'll be very social."

  "I can wait. Meanwhile, let me help you with the Hatley case."

  "Frankly, I can't even see why you want to get involved. It was my patient who died. I'm the one who had to face the family. I'm the one who'll probably get sued."

  Nick saw the pain in her eyes, heard it in her voice. "You have every reason to want some answers. Maybe I want answers too. One of the things pathologists are good at is piecing together evidence and coming up with conclusions. This is important to me too. If we can pin down the reason Eric Hatley had that reaction, maybe it will keep another patient from dying."

  Anna chewed on her lower lip. "Okay," she said. "We can work together on the Hatley case."

  Nick checked the time. Half past seven. "What would you think about doing it over dinner?"

  She shook her head. "No, I'm just going to—" She stopped, and her face crumpled.

  "What's the matter?" he asked.

  "I started to say that I was just going to cook something for myself tonight. But I can't because I don't have anything here to cook. When I went to get groceries this afternoon—" She looked away. "They told me my credit card was maxed out."

  Nick knew how that felt. "Hey, I've had that happen to me. This is my treat."

  "No, that's not it. The card was maxed out because somebody stole my identity. And I'm in trouble with the DEA. My chairman has put me on what amounts to a two-week suspension so I can hopefully clear my name. And if I can't—" She waved her hand in front of her face as though shooing away a troublesome insect. "I don't know why I'm telling you all this. It's complicated, and it's not your problem."

  Nick decided to go for it. "Why don't you tell me about it over dinner? I'm a great listener. And I know where there's a wonderful little restaurant near here. Do you like Italian?"

  3

  ANNA HAD PASSED THE RESTAURANT SEVERAL TIMES A WEEK FOR ALMOST A year without ever really noticing it. From the outside, it looked like the picture in the encyclopedia next to the phrase, "hole in the wall." But once she preceded Nick through the dark oak door with its leaded glass panes, she was glad she'd followed his suggestion to come here.

  Along the back wall, six high-backed stools stood empty in front of a zinc-topped bar. A dozen tables were scattered around the room, each one covered by a red-and-white checked tablecloth and topped by a Chianti bottle from which a candle sprouted. The air was redolent of oregano, garlic, and other spices that Anna didn't recognize but definitely wanted to taste. She took a deep breath and felt a few of the knots in her neck muscles begin to unwind.

  Anna stole a glance at her companion. She still wasn't sure why she'd agreed to have dinner with Nick. It wasn't simply his dark good looks, although that was certainly a plus. And he was persistent; she had to give him that. But the main thing was that tonight she'd been as low as she'd ever felt in her life, and Nick's offer of a listening ear had seemed sincere. She found herself relaxing with him. For now, that was enough.

  They were greeted by a formidable woman with jet-black hair worn in a bun. "Nicolo," she said, enfolding Nick in a bear hug. "So gooda to see you."

  "Thanks, Maria. This is my friend, Dr. Anna McIntyre. I brought her here so I could show offmy knowledge of Italian— all six words."

  After receiving her own hug, Anna was ushered to a table in the corner and seated with a ceremony that suggested she was a visiting head of state. "Nick," she said, once Maria had scooted away, "this place is marvelous. Do you come here often?"

  "No, my usual dinner venue is Burger King. But the owners are family friends, and every once in a while I treat myself to a real meal."

  Anna opened her menu and was immediately thrown into a panic. The whole thing was printed in Italian. "I think they gave me the wrong menu."

  "You mean because it's not in English? No, that's the way it's done he
re. But don't worry. You won't be able to order, anyway."

  "What do you mean?"

  Before Nick could reply, a balding, mustachioed man with a towel tucked into the waistband of his black pants came hurrying up to the table. He engaged in a brief exchange with Nick in Italian. Then the man turned to Anna and said, "Welcome, signorina." He lifted her hand to his lips and gently kissed her fingertips before moving away.

  "What just happened?" she asked.

  "That's the owner, Maria's husband, Benny. Short for Benedetto. He insisted on ordering for us. I'm pretty sure he'll ply us with food until we burst, so I'd suggest you sample each dish but don't try to eat everything set before you."

  "You understood all that from such a short conversation?"

  "I understood about half the words, but I can promise you that's what he was saying. Trust me. I'm Italian."

  "Did they kiss your date's hand the last time you were here?" She felt the heat of a blush on her cheeks as soon as the words were out. Was she flirting with this man she'd only met today?

  Nick laughed. "Since my 'date,' as you call him, was a former college fraternity brother who now plays professional football, no."

  "Sorry. I didn't really mean to pry."

  "No, that's all right," Nick said. "And to answer your implied question, the last real date I had was almost a year ago. She was an obstetrics resident, and I can't even remember her name."

  "In the interest of a level playing field, are you going to ask about my last date?"

  Nick flashed a shy grin. "No, all I'm interested in is your next date. Can it be with me?"

  It seemed to Nick like only a moment passed before he and Anna were sipping cups of coffee and dabbing the last remnants of cannoli from their lips. The courses had been spaced nicely, allowing ample time for talk. The buffer zone of empty tables around them told Nick that Maria had decided to give them privacy. Benny's service had been efficient and unobtrusive. If only the evening didn't have to end.

  "Nick, thank you for this," Anna said. "I really needed a lift tonight."

  Nick waited while Benny refilled their coffee cups. "Well, I hope this has helped. Do you think you've got things straight with MasterCard now?"

  "It gets better, or worse, I guess," she said. "It's not just my MasterCard. The call I was finishing when you arrived was to VISA. I thought I'd better check my limit there, because I'd need to use that one until my new MasterCard arrives. And that's when I found out that my VISA was over its limit."

  "Same scenario?"

  "Exactly the same. So now both my accounts are closed. The new cards will be here soon, but until they arrive I'm on a cash and carry basis." She shrugged. "It's no big deal. It just complicates things, and I don't need another complication in my life right now."

  "And someone has been papering the area with Vicodin 'scripts using your name and DEA number?"

  "Right again," Anna said. "My chairman put me on leave until that's sorted out, so I'm in limbo. I can't practice for who knows how long. The only thing that could make it all worse is if somebody ran over my dog—if I had a dog."

  Nick could relate to her gallows humor. "You're a victim of the law," he said.

  "Which law is that?"

  Nick grinned. "My favorite—Murphy's Law. If something can go wrong, it will."

  Anna shook her head. "I don't know what to call it, but I certainly don't see how things could get any worse."

  Nick tried to pick his words carefully, tiptoeing around the minefield of the tension he saw in Anna. "Is there something I can do?"

  "You can help most by doing some research on anaphylaxis. I still can't figure out why the antibiotic killed Hatley. He tolerated it a few weeks earlier when they gave it to him in the Emergency Room."

  Nick sneaked a peek at his watch. He'd managed to keep the conversation away from medicine for a half hour or so, but now they were back to the incident that had brought them together in the first place. "And that's all I can do?"

  "The other problems are mine, and I have to deal with them," Anna said. "I'm the one who has to make sure this stolen card doesn't ruin my credit. I've heard friends talk about what a pain it is to get those things taken offyour record. As for finding out why someone's been writing narcotics prescriptions using my DEA number, I don't have a clue how I'll do that. But one thing at a time, I guess."

  "Okay. I'll do what I can. From what I remember, if somebody is allergic to penicillin, they stand a decent chance of being allergic to the class of drugs Hatley received. I'm pretty sure that the generally accepted way to test for penicillin allergy is a skin test, although obviously that's not possible here. What I need is a blood test for allergy to drugs like Omnilex, one I can run on the samples I took at the time of the autopsy. I'll start researching that tomorrow morning."

  "Scusi." Benny seemed to materialize at Nick's side. "Would you like anything else?"

  Nick looked at Anna and received a brief headshake in response. "No, Benny. That's fine. This was a wonderful meal."He pulled out his wallet and handed over a credit card.

  When Benny had shuffled away, Anna said, "Would you at least let me pay my share of this? I can write you a check."

  "No, unless somebody's been charging things to my credit card without my knowledge, I think I've got this one covered."

  In less than a minute, Benny was back, holding the credit card by his thumb and middle finger much as one would hold a dead rat by the tail. "Scusi," he said. "Nicolo, I'm afraid this is no good."

  Nick's heart rate galloped up a notch. He was pretty sure he was below the limit on his credit card. Barely below it, perhaps, but pretty safe until his next paycheck. Had he joined Anna as the victim of credit card theft? "Benny, are you sure?"

  Benny grinned, first at Nick, then at Anna, "Sure, I'm sure. You can't pay with this because we not gonna take you money tonight. Maria and me want this meal to be on us."

  "Thank you. That's very kind," Anna said.

  "It's our pleasure." Benny turned to Nick. "Maria and me agree. This lady's much nicer than that big guy you had in here last time. He was-a not your type at all."

  Nick watched Anna fumble for her keys and wondered why no one had yet invented a woman's purse that would pop out a key ring or wallet with the push of a button. Or maybe they had. He really didn't have any way of knowing, come to think of it.

  Anna unlocked the front door, then turned back with it half open. "Nick, thanks for taking my mind offmy troubles for a while."

  "My pleasure," he said. "Thank you for sharing your troubles with me. And I'll get in touch with you as soon as I research the drug allergy thing a bit more. How shall I contact you? I know your home number, but do you have a cell phone?"

  Anna laughed, and Nick could have turned a cartwheel. That smile, that laugh, made the whole evening a success.

  "Surprisingly enough, I have all the modern conveniences," Anna said. "Answering machine, e-mail account, even a cell phone. Are you fishing for my number?"

  "Busted. I found your phone number and address using the Internet, but your cell and e-mail are another matter entirely. By the way, you can rest assured that tight-lipped assistant of yours didn't spill anything. Matter of fact, I had to hang up before she could sic your chairman on me. I'm brave, but I'm not stupid."

  "Okay, you win. Come on in, and I'll write down that information. And you should probably give me yours, since we seem to be linked in this effort." She pushed the door fully open and flipped on the lights in the living room. "Park somewhere. I'll be back in a moment."

  Nick chose the sofa, then leaned back, closed his eyes, and let the events of the day unroll on the screen in his mind. He'd started out working on the material for his chairman, bored to tears and frustrated with life in general. Then came a routine autopsy that left him with some unanswered questions. That, in turn, led to the beautiful redhead who, if his nose wasn't fooling him, was brewing coffee and would shortly be sitting down next to him. Life was good.

 
In a few minutes, Nick sensed movement in the room. He opened his eyes in time to see Anna set two white ceramic mugs on the coffee table. "Hope you don't have an aversion to drinking coffee this late at night. Black with Sweet'n Low, right?"

  "Right. Good powers of observation, Doc."

  "That's why they pay me the big bucks." Then her smile faded. "Or, at least, why they've paid me so far. Don't know how much longer I'll have a job."

  "Don't let it get you down, Anna."

  She snuggled down at the opposite end of the sofa from him and blew across the top of her mug. "I'm trying not to. I'll work as hard as I can to straighten things out, but in the end I'll have to trust God."

  "I wish I could tell you that'll make everything come out right, but I can't," Nick said. "It's been quite a while since I thought God cared about my problems."

  "You want to talk about it?"

  "Not really. I shouldn't have brought it up." Way to go, Nick. Nice way to spoil a perfectly good evening. He took a sip of coffee and winced when it burned his mouth. "Let's just leave it at this: I'll work as hard as I can to help you out of this mess. If God intervenes, so much the better. But I'm not going to count on it."

  Anna awoke, as she had each morning for years, before the sun came up. She rolled out of bed, stretched, and froze. There was no need to get up early today. No rounds to make. No surgery to perform. No clinics to staff. Not even any paperwork to plow through. She'd been suspended. Well, put on leave, but the effect was the same. Until she could clear herself of the charges against her, she was a doctor without a place to practice.

  In the shower, Anna's mind couldn't stay focused. Her thoughts flitted among the problems in her life, rushing back and forth like a rat in a maze. It felt different— sort of empty— not to be heading out the door, coffee in a travel mug, already planning her day. How long would it be before she could get back into that routine? Days? Weeks? The prospect was too depressing to think about.