MAYA HOPE, a medical thriller - The Dr. Nicklaus Hart series 1

by Timothy Browne, MD

Nick held up hands in surrender.

  The elevator stopped, and the girls walked out. As the door closed, the taller student turned and smiled at the men.

  “See how hard my job is?” Nick grinned.

  “Stand down, soldier,” Sergeant Hanson ordered.

  “Whoa, Buck, I bet you’re a tough drill sergeant.”

  “You have no idea.”

  He sounded gruff, but Nick admired Buck for being a man of principle, and he was embarrassed for his elevator antics.

  What’s wrong with me?

  “Don’t be so hard on yourself,” Buck said, reading Nick’s body language and putting a hand on his shoulder. “You’ve had a tough go of it yourself. Come on, let’s go see this boy.”

  The elevator door opened to the orthopedic ward.

  “Jeremiah is in that room,” Nick said, pointing to a room a few doors down.

  When they walked through the door, Jeremiah’s father got up from the chair next to the bed. His mother, sitting in a chair in the corner, looked up, marking a page in a book with a soft, well-worn leather cover. She smiled brightly at Dr. Hart and the uniformed soldier. Jeremiah sat in bed with a heavy affect, scowling as usual and staring blankly out the window.

  Jeremiah refused to look Nick in the face, and Nick understood. He was the bearer of bad news—more tests, more shots, more surgery, more pain.

  Jeremiah’s father met them halfway into the room.

  “This is the special guest I told you about,” Nick said. “This is Sergeant Blake Hanson. These are the Berglunds.”

  Mr. Berglund shook Buck’s hand. “Sergeant Hanson, thank you so much for coming to see our son. It means so much to us that you would take the time.”

  Nick saw Jeremiah steal an admiring glance at the tall, muscular soldier with a chest full of colorful ribbons. Then, as if he knew Nick was watching, Jeremiah turned back to the window.

  “Sir, the honor is mine,” Buck said, returning the handshake.

  The sergeant ducked under the overhead bar attached to the bed that suspended the trapeze patients use to pull themselves up. “Ma’am,” he extended his hand to Mrs. Berglund.

  She stood, dwarfed by the soldier, and shook his hand. “Thank you.” She smiled broadly. “My father was a Marine. Thank you for serving our country.”

  “You’re welcome, ma’am. Good book you’re reading.” Nodding at the book in her hand. She smiled back in agreement.

  Buck stood at the end of the bed and looked at Jeremiah, not saying a word. If it had been Batman himself standing at the foot of his bed, the boy would have probably ignored him as well.

  Buck and Jeremiah were locked in a silent battle.

  Nick glanced from one to the other, not sure what to do. Then he saw a tear roll down Buck’s massive cheek.

  Mr. Berglund broke the silence and went to Jeremiah’s bedside. “Son, this is Sergeant Hanson, a friend of Dr. Hart’s. He’s come to see you. You know your manners.”

  “Yes, sir,” the boy answered without conviction.

  Nick sensed that Jeremiah was trying hard to conceal his surprise. Like many boys, Jeremiah probably played with GI Joes, and he must have been surprised to find a real one standing in front of him—flat top haircut, radiant green eyes, and a large jagged scar down the left side of his face.

  A male nurse poked his head in the door. “What do you need?”

  After exchanging puzzled looks, they realized Jeremiah had accidentally pushed the nurse’s call button.

  “Give us a minute,” Nick snapped at the unwelcome intrusion. He guessed he probably overreacted, but the nurse was one of his least favorites.

  “Whatever,” the nurse sneered, turned on his heels, and slammed the door behind him.

  Nick fumed.

  Jeremiah took it all in.

  “Doc Hart always grouchy like that?” Buck winked at the boy.

  Jeremiah stared at the sergeant without blinking, sizing him up.

  Poor kid. There were probably not many people in this place that he trusted. Nick watched the encounter. Probably the last thing he remembers is having fun around the trains and then waking up here in incredible pain. And having no legs.

  “You want me to smack him one?” Buck said lifting his fist toward Nick.

  Jeremiah almost smiled. It was the first near smile they had seen for days. Then he turned swiftly back to the window, fighting a full smirk with little success, the corners of his mouth twitching with a concealed grin.

  Buck took the opportunity to sit in the chair next to the bed. “What do your friends call you?” Buck offered his hand to shake.

  Jeremiah turned to him, his eyes widening at the massive hand, and pulled himself up slightly with the overhead trapeze. “JJ. They call me JJ.”

  “My friends call me Buck. You can call me Buck.”

  “Yes, sir,” Jeremiah pulled himself higher and put his little hand in the man’s huge grip.

  “I hear you’ve had a pretty tough go of it, my friend.”

  Nick sensed that Jeremiah was tempted to pull away, far away, out the window, but he could tell something about this man gave the boy comfort.

  “I hear you’ve been one tough soldier.”

  Jeremiah grinned and refocused on the man with the military ribbons in brilliant colors.

  “You know what a lot of those mean, don’t you, son?” Jeremiah’s father said. “He loves to pore over his grandfather’s ribbons,” he told Buck. “I’ve watched him spend hours running his fingers over the awards. He bugged us to death to tell him stories of the man.”

  Buck watched the boy admire his ribbons. “Would you like to touch them, JJ?”

  “Oh no,” the mother stood and moved toward the bed. “He shouldn’t…”

  Buck softly motioned her to stop. “I really don’t mind, ma’am.” He moved closer so Jeremiah could touch the ribbons.

  Jeremiah reached out but stopped. He glanced at both of his parents to make sure he wouldn’t be in trouble. They nodded slowly.

  “It’s okay, JJ,” Buck said. “I would be honored.”

  Jeremiah ran his finger over the ribbons, mesmerized. He stopped at the purple ribbon.

  “You know that one?” Buck asked.

  Jeremiah hesitated. “That’s a purple heart. My granddad had one. Ma tells me that’s when he was shot,” he said turning back to the window, “and when he died.”

  “I’ve had many friends who have laid down their lives for this country, just like your granddad,” Buck reassured him. “He must have been an honorable man.”

  Jeremiah looked back at Buck.

  Nick saw trust build.

  “Hey, I have something for you.” Buck announced. He stood and dug into the front pocket of his uniform shirt. He pulled something out and held his closed fist to Jeremiah.

  The boy didn’t know how to respond.

  “Hold out your hand,” Buck said.

  Jeremiah held his tiny hand under Buck’s fist. Buck opened his hand and dropped a heavy, metallic coin into the boy’s palm and closed the boy’s fingers around it. Jeremiah lifted his fist to his face and opened his hand.

  The coin was the size of a super-sized silver dollar. Jeremiah’s eyes got wider and wider. He saw the image on the front of the coin; it was the Purple Heart medal coin.

  “Turn it over, son.”

  Jeremiah turned it over and read the engraving: Jeremiah Berglund.

  Jeremiah’s parents began to cry, and tears formed in Nick’s eyes. What a guy. A replica coin with a Purple Heart image engraved with the kid’s name. Above and beyond the call.

  Buck stood, snapped to attention, and smartly saluted the boy. Jeremiah sat up straight. He looked like he’d grown a foot taller.

  “Ooh Rah,” Buck grunted the marine call. “You’re a good soldier, son.”

  Jeremiah’s parents rushed to thank the Sergeant.

  “I can’t tell you how much this means to all of us,” Mr. Berglund said and Mrs. Berglund nodded enthusiastically.

>   Then a small voice said, “Sergeant Buck, can you tell me how you got your Purple Heart? I mean, I can see the scar on your face and all.”

  It was Jeremiah. His parents were surprised to hear his voice, as he had not uttered many words all week.

  “Well, you see…” Buck stumbled over his words, as he didn’t much care to remember the day he was nearly killed. “That’ll be a story for another day, but just two years ago I was in a bed just like this. Dr. Hart here was one of my doctors. He took real good care of me, like he’s doing for you. He’s a good guy.”

  Nick was embarrassed with the focus on him, but he saw Jeremiah’s look soften toward him.

  “Do as he says, and he’ll fix you up as good as new. Just like me.”

  Jeremiah’s face was doubtful.

  Buck leaned toward him. “Can I show you something, JJ?”

  Jeremiah had to lean over the bed to follow Buck’s hands down to the bottom of his pant legs. He admired Buck’s highly-polished black shoes, but he wasn’t sure that was what he was supposed to see. Then Buck lifted his pant legs. Jeremiah couldn’t believe it. His eyes filled with wonder as he beheld Buck’s metallic prosthetic legs. Not just one leg but two.

  “You see, son, we have a lot in common, you and I.”

  Jeremiah saw truth in his eyes.

  “JJ, you do as Dr. Hart says, and you will get a pair of these babies, and you will do everything you ever dreamed of doing.”

  Tears streamed down the boy’s cheeks. “I really like baseball…I just thought…Do you really think?”

  “I don’t think, son, I know. I see your mama reading the Good Book there.” He indicated the Bible in her lap. “I’m a Christian, too, and I’ll be praying for you. ‘You can do ALL things through Christ who strengthens you,’ ” Buck added, quoting from the book of Philippians.

  * * *

  Buck and Nick said their goodbyes at the front of the hospital.

  “Oh here, give Jeremiah this card with my phone number and let him know he can call me anytime. It will give you some brownie points when he starts to forget that you’re the good guy.”

  Both chuckled. “Buck, you’re the good guy. Thank you so much for coming over.”

  “Well, thank the Wounded Warrior Project. Besides you, they are the ones that really helped me get back on my feet.”

  Buck gave Nick a sharp slap on the back. “I’ll be praying for you.”

  Nick considered letting it go and returning to sanctum of the hospital, but turned back toward Buck. “You really believe that stuff?”

  “In Christ, you mean?”

  “Yeah, and what you said to Jeremiah and about prayer?”

  “Brother, when you’ve been to hell, you’re glad when someone has been there before you to conquer it. It’s not a place you want to linger.” Buck looked into Nick’s eyes. “You okay?”

  Nick sighed loudly.

  “When’s the last time you had a vacation?” Buck asked. “Nick, man, I’ve known you as a doctor and a friend. You’re looking ragged around the edges. You know that ‘physician heal thyself’ thing?”

  Nick looked down to hide the anger and hurt inside him. “Hmmm,” he uttered, trying to find words to respond.

  Buck was probably right. He had not only fought for his country, he had fought for his life.

  Buck was the only other man beside John that Nick would truly ever want next to him in battle. He would trust him with his life.

  “Look, man, you are the best surgeon I know,” Buck continued, “and a true friend. Believe you me, I know how hard it is to be vulnerable, to be mortal. It’s time to take off the cape, Superman, and take a rest.”

  Buck gave Nick one of his famous bear hugs wrapped in a belly laugh. “It’s going to be okay, my friend. I WILL be praying for you.”

  Somehow, Nick knew there was truth in both statements.

  CHAPTER 11

  * * *

  Decision Time

  Nick hit the button on the wall that gave him access to the operating room. The automatic doors swung open.

  “Oh, Dr. Hart,” Anita Roe called out from behind him in her southern drawl.

  He took two steps forward.

  “Dr. Hart,” she clipped the drawl. “I do need to talk with you.”

  Nick turned to see the woman walking quickly down the hallway, her large breast implants bouncing with every step. She wore a bright turquoise jumpsuit with a gaudy necklace of large colored beads and a matching, jangling bracelet.

  “Ms. Roe,” he said pleasantly. He was in a relatively good mood after time spent with Buck and the possibility that they could finally close Jeremiah’s wounds. He hadn’t felt this good for a while. Not even she could ruin his mood.

  He was wrong.

  “I’ve come from the Value Analysis Committee meeting and want to tell you the good news myself.”

  Nick frowned. This was the committee responsible for approving new equipment for the OR and evaluating new techniques. It was a rubber stamp group of Roe’s bidding that said a big NO to anything new or innovative. He had requested a new OR table six months ago because the table in Room 2 was being stabilized with wooden blocks from someone’s garage.

  That could be good news.

  “Two months ago, I brought in a consultant to review the orthopedic service.”

  “Did I meet him?”

  She ignored his question. “He reviewed the procedures we do, insurance coverage, how long ya’ll take to do a procedure, hospital stay, those sorts of things.”

  “I don’t remember him. Did any of the other staff talk with him?”

  She continued to ignore his questions and pressed on. “One of the metrics that he analyzed was the orthopedic implants ya’ll use. All your expensive little toys. He has helped many other hospital systems around the country save millions of dollars doing this sort of thing. So I had him look at the implants we use here.”

  Nick crossed his arms. Now what?

  “He noted that ya’ll use the Zenith brand of implants. All your screws and plates and iron rods and such. Isn’t that right, Dr. Hart?”

  “Well, titanium and stainless steel would be more accurate,” he said, knowing she knew nothing about what they really do.

  “Well, the good news is this. We are going to switch to use Plymouth products. And that, my dear Dr. Hart, will save us two and a half million dollars a year,” she said, turning on her fake charm.

  Nick stared at her, his good mood fading fast.

  “Isn’t that good news, Dr. Hart?” She raised her eyebrows and nodded, trying to will him to agree.

  “They break.”

  “But isn’t that why ya’ll use those things—to fix those broken bones?”

  “The plates, the nails, the screws. Plymouth imports all their implants from a developing country. The implants break.”

  “Well, I’m sure they don’t break all the time. Besides, other places don’t have the quality surgeons that we pride ourselves on, now do they, Dr. Hart?”

  “They break about ten percent of the time.”

  “I can live with that.”

  “So, you are going to condemn every tenth patient to a disaster and more surgery so you can save money?” His face flushed. He was getting angry.

  “With this whole Affordable Health Care Act thing, we have no idea what it’s going to do to us.” She raised her voice. “We have to look at ways to cut back, and this is my decision.”

  “Let me get this straight. You brought in some hired gun to whom you probably paid a bundle to tell you to use cheap implants so you could prepare for something you don’t know will affect us or not? Is that right?”

  “You have my decision.”

  “You know, Ms. Roe, when we choose an implant, we base our decisions on what is best for our patients. We prescribe that implant for that patient. Like a medication type and dose tailored for that patient. We go through four years of medical school and five years of residency to make these kinds of decisions.” H
e felt his blood pressure rising. “Are you telling me you are now prescribing these implants?”

  She looked away from him and smiled at two surgeons passing by. “Dr. Hart, that’s not exactly true.”

  “Ms. Roe, that is exactly what you are doing.” He turned toward the OR. He didn’t know if he could hold his temper much longer. “This is unbelievable.”

  She took a step toward him and lowered her voice. “Dr. Hart, when you signed your contract, you came to work for us. Not the other way around. We hired you, we can fire you. It’s that simple.” She leaned into him and stared him down.

  He could smell her sour breath. “Yeah, you hired me. But not to commit malpractice.”

  Nick stepped into the doorway.

  “I am not done with you.”

  Nick glowered at her. “There’s more good news?”

  “I know that you are going into the OR to close the wounds on that boy that got hit by the train,” she announced and pressed her case. “With all the OR time, his stay in ICU for a couple days and the rest, that family owes us well over a hundred-thousand dollars. They have no insurance. We aren’t going to see a dime out of this. His dad is a logger, and the mom is a stay-at-home type, wouldn’t you know? You need to get him out of here tomorrow.”

  Nick had had it with this woman. “Are you kidding me?” He took a step toward her. “Don’t you dare tell me how to treat my patients. He has just started turning the corner. There is way more to do, work on his stumps to mature them, get him up on temporary prosthesis, get him some permanent ones.”

  “At $30,000 apiece, there is no way on earth that I’m getting that boy legs.” She had lost any semblance of charm. “He can go to the Shriners or somewhere else, for all I care.”

  “You know we are called to serve the poor of this community,” Nick raged, loud enough that the crew at the OR desk inside the door heard and craned their necks to see what was happening.

  “Oh, Dr. Hart, spare me the sermon. I know what kind of car you drive. You think we can pay your salary by giving all our care away? Wake up.”

  Nick’s fists tightened at his sides. He was overwhelmed with a mixture of anger and embarrassment. “I’ve got to go.”