Prescription for Trouble - 03 - Diagnosis Death Read online

  Cathy struggled to lift her bulk, making use of the chair arms to lever herself to her feet. "I'm going to the hospital to make rounds. Would you like to go?"

  Elena hesitated.

  "C'mon," Cathy said. "I'll sweeten the deal. Come with me, I'll introduce you to some more of the staff, and then Will and I'll take you out for dinner. This is Dr. Brown's weekend on call. Turn it loose for a few hours. You deserve an evening out."

  An hour later, Elena stood at Charlie Lambert's bedside in the ICU, looking through his chart while Cathy answered Mrs. Lambert's questions. Now, three days after his craniotomy, he showed a few encouraging signs. There were some spontaneous efforts to breathe, although they were too shallow and slow to allow removal from the ventilator. Currently, the small bag of IV fluid with added Dopamine piggybacked into Lambert's main line was shut off, which told Elena he was maintaining his blood pressure on his own.

  Elena eased her hand down to the foot of the bed, where Lambert's right foot protruded from the covers. She squeezed his Achilles tendon and was sure she felt him withdraw his leg a fraction of an inch. Reacting to pain now. Another good sign.

  Cathy wound up her conversation with Mrs. Lambert. "Do you have any questions for me?" she asked.

  "Nothing medical, I guess. You and Dr. Shelmire have made it pretty clear. There's progress, but we won't know the final outcome for a while."

  "There may be progress. It's too early to be sure. And if he does improve, we don't know if he'll recover fully," Cathy warned. "He might have weakness, difficulty speaking, all sorts of problems. And he'll probably need physical therapy."

  "I don't care," Mrs. Lambert said. "Just as long as he's alive, I'll devote my life to caring for him." She dabbed at her eyes with the end of a balled-up tissue. "But we have another problem."

  "What's that?"

  "You see, Charlie lost his job a while back, and our insurance has lapsed. He's not quite old enough for Medicare. I work and bring in a little money—barely enough to keep us going, but too much for us to qualify for Medicaid. And this morning the administrator was arguing with Dr. Shelmire outside the door. Mr. Godwin, I think his name is. He wanted Charlie transferred to another hospital. He said something about 'we're not a charity hospital, and we can't afford this.' "

  "I hope Dr. Shelmire—"

  "Oh, the doctor stopped that really quick. He said Charlie wasn't going to be moved just to help a . . . I can't say the words he called Mr. Godwin . . . just to help him meet his budget. But it worries me that there's this problem. I don't know how we're going to pay the hospital bill."

  Cathy patted the woman's arm. "You let Dr. Shelmire and me take care of this. Your concern is with your husband." She nodded toward Elena. "Either Dr. Gardner or I will be by tomorrow morning. If you need anything before then, ask the nurses to call."

  As they waited for the elevator, Elena said, "Sounds like Nathan Godwin is a piece of work. Did I tell you how he and Marcus Bell clashed over my hospital privileges?"

  "Nathan wants everyone to kowtow to him. When I first came here, Marcus and I had our differences, but I'll say this for him. He puts the best interests of the patients ahead of anything else. It's too bad they cut back his authority as chief of staff."

  "Why was Godwin brought in?"

  "This is a municipal hospital with an elected board. Some of the board members thought it was time to take the control out of the hands of the doctors. They called it 'being fiscally responsible.' I call it posturing. But we make do. Most of us have learned to work around Nathan."

  "Where to next?" Elena asked.

  "I thought we'd go by—" Cathy stopped, bent over, and clutched her abdomen with both hands.

  Elena saw beads of sweat form on Cathy's face. "What's wrong?"

  "I've been having contractions all day. At first I thought they were just Braxton-Hicks contractions, and they'd stop. But this one was pretty severe. Would you go back to the ICU and get a wheelchair for me? I think I'd better go down to OB and have them call my doctor."

  Dr. Milton Gaines leaned against the window ledge in Cathy's room in the OB ward and rolled his head from side to side in an obvious effort to ease tight muscles. "Tough day. I'll be happy when my new associate arrives."

  "I know what you mean," Cathy said. She lay in bed, clothed in a hospital gown. There was an IV running at a slow drip into a vein on the back of her hand. A vital signs monitor beeped softly in the background. "It's a good thing Dr. Gardner is here a bit early, since you tell me I'm going to be on enforced bed rest for a while."

  "Let's take it a day at a time," Gaines said. "You know the drill for pre-term labor. We'll watch you here overnight. If you don't have more contractions and your exam doesn't change, I'll probably let you go home. But I'd like to let the baby get a little more mature before you go into actual labor, and the best way to do that is to keep you on bed rest for a week or so. After that, we'll see."

  Cathy felt as though she was being tugged in opposite directions by a team of horses. Since starting medical school, she'd taken pride in working despite all kinds of hindrances: snowstorms, flooded roads, unbelievable fatigue, and headaches that would fell a bull elephant. But now the health of her baby was at stake. Milton Gaines said she needed to be at bed rest, so bed rest it would be.

  Will was by her side, where he'd been since responding to the OB nurse's phone call. He held Cathy's hand and gave it an occasional squeeze. He'd been uncharacteristically silent during Gaines's exam and the discussion afterward. Now he broke that silence. "Cathy, if you don't do just exactly what Milton says, I swear I'll hog-tie you and nail the door to your bedroom shut."

  Cathy laughed in spite of herself. This was about as blunt as she'd ever seen Will. "Don't worry, honey. I'll be a good girl. Elena can fill in, and I'll bet Dr. Brown will help out as well."

  She kept the smile plastered on her face, but Cathy was already wondering how her patients would react to the choices presented to them in her absence: a Latina female or an African American male. Well, it was time that the population of Dainger was introduced to a little ethnic diversity.

  Elena took one last look at the number on the slip of paper. She raised the phone but paused when she heard the cry of an infant rising above the noise of the OB ward. Life was still going on all around her, and a new one had just been added.

  She took a deep breath and punched in the number. "Dr. Brown? This is Elena Gardner. I'm Cathy Sewell's new associate." The word still sounded strange to Elena. Associate. She was part of a practice. And, for who knew how long, she would be the only doctor in that practice. "I'm sorry we haven't had a chance to meet personally. I've been here less than a week, and it's been a whirlwind."

  Brown's voice was as soft and smooth as the mocha fudge ice cream that Elena favored, with not a hint of an accent, either regional or ethnic. "Think nothing of it. I've been worried that Cathy didn't have any help lined up. I'm glad you're here, and I can only imagine how busy you've been since you arrived."

  Elena gripped the receiver tighter. "I'm afraid I'm going to be busier, and so are you. Cathy was admitted to the OB ward at Summers County General tonight in pre-labor. The contractions have stopped, and the baby's fine, but her OB wants her on bed rest for at least a week. Of course, I'll do as much as I can, but until I get a bit more familiar with practice patterns here in Dainger, you may find yourself seeing more patients as well."

  There was no real mirth in Brown's low chuckle. "I'm happy to see as many as necessary, but I think you'll find that there are a number of the fine citizens of our community who balk at treatment by a doctor of color."

  Elena's cheeks burned. "If they have reservations in that regard, they may find themselves driving a ways to get medical care. I neglected to tell you. My maiden name is Perez."

  If Brown was surprised, his voice didn't show it. "Interesting. Well, I'm glad you're here. Don't hesitate to call me if I can help you. And after you've had a bit of time to catch your breath, you must have di
nner with me and my wife. She's Jamaican, and her jerk chicken is wonderful."

  Elena hung up, looking forward to meeting Emmett Brown in person and reassured that he'd be a good man to have in her corner if she needed medical backup.

  She saw Will come out of Cathy's room. "How's she doing?"

  "She's fine. No more contractions after those she had earlier. She's going to take a nap while I get her some magazines."

  "Anything I can do?"

  "You're doing enough." He took a few more steps away from Cathy's door. "We both think you're going to do fine here. I think the practice is in good hands."

  She was in the parking lot, halfway to her car, when her cell phone rang. When she checked the caller ID, she could feel the smile spread across her face. "David. So good to hear from you."

  "I've been intending to call all week, but it's been crazy. One of the other residents was sick, and I ended up pulling a couple of thirty-six-hour shifts."

  "I thought the new regulations—"

  "They do, but babies don't know about Resident Review Commission rules against working long hours. When they're ready to get here, they're ready, and I figured someone should be here to welcome them."

  Elena climbed into her car and leaned back in the seat. "I've lost all track of time. How many more days until you arrive?"

  "That's another reason I called. The guy I've been covering for is back at work now, and he's going to take my shifts next week. Dr. Cobb said I could leave after today. Tomorrow morning I'm going to head for Dainger. How about dinner tomorrow night?"

  "You bet. My treat. Call me after you get into town."

  "Sounds great. But what about you? What's new with you?"

  "Oh, David. Where do I begin?"

  14

  Elena pulled her car out of the hospital parking lot, anxious to get home and put this week behind her. Talking with David had made her anxious to see him tomorrow. It would be good to have him here. A phone conversation was a poor substitute for physical presence. And their separation had made her think about what he meant to her. You shouldn't go there. It's too soon. Nevertheless, even if David just provided a friendly shoulder to lean on, she'd be happy to see him.

  The long summer day was fading to night, and she flicked on her headlights. She'd heard somewhere that the most dangerous time to drive was the hour before full darkness descended. The last thing she needed was an accident.

  She'd gone about three blocks when she glanced into the rearview mirror and saw a set of headlights. Stop worrying. Not every car behind you belongs to a stalker. Elena wondered if she knew the town well enough to make a few turns. Should she risk getting lost, possibly in a bad neighborhood?

  She chanced a left turn. A half-minute later, the headlights appeared behind her. A right turn, then another left put her back on course for home, with the headlights trailing along. There was no doubt in her mind now. The question was what to do about it.

  The intersection coming up was a major one, with a four-way stop sign. Elena was pretty sure that a right turn would take her toward the sheriff's office. Without turning on her blinker or hitting the brakes, she decelerated and cranked the wheel hard right. She wrestled the car into submission and stared into the rearview mirror. Don't be there. Don't be there. A few seconds later, a set of headlights appeared. The car was far enough back that all Elena saw was two bright white dots in the center of a vague black shape. But that was enough.

  Now what? She knew roughly where she was. The sheriff's office was a few blocks ahead. She decided to drive there, pull in, and park as close to the front door as possible. If the car behind her followed suit, she'd lock her doors, dial 911 on her cell phone, and honk her horn until help arrived or her follower left.

  There it was, ahead on the right, a squat stone building painted institutional gray on the outside (and, as Elena recalled, inside as well). She swerved into the parking lot at full speed, her left wheels barely touching the pavement. She wove through the vehicles in the lot and skidded to a stop outside the front door in a space marked "Official Vehicles Only." Two floodlights above the doorway spilled a bright pool of light onto the area. She kept the car running, in case she had to make a quick getaway, but eased down until her head was below the level of the seat back. In a moment, headlights appeared in her mirror.

  She thumbed the numbers 9-1-1 into her cell phone and had her finger on the "send" button when the vehicle pulled up beside her and parked. When she saw it was a black and white SUV with a light bar on top, she eased up in her seat and cleared the numbers from her phone.

  The door of the sheriff's cruiser opened and Frank Perrin stepped out. He leaned against the passenger side of Elena's car and tapped his finger against the window until she rolled it down. He grinned. "Hey, Elena. You know, you ran a stop sign back there. Took a couple of corners awfully fast too. If I didn't like you so much, I could write you up for about half a dozen violations."

  "Frank, I'm sorry. I thought you were following me. There was a Peeping Tom at the house last night, and I'm a nervous wreck."

  "I heard about it. When I saw you pull away from the hospital, I figured I'd better follow you and make sure you got home safely." He ran his fingers through his hair, the dark strands falling back into a wave that Elena envied. "Didn't mean to frighten you."

  "And I'm sorry I took those turns like a race driver."

  "No harm," Frank said. "You know, I'd like to cash that rain check sometime soon. How does dinner at RJ's on Saturday night sound?"

  "I'm sorry. I'm really not trying to put you off, but a friend is coming into town tomorrow. I promised to take him out to dinner and catch up. But can we do it some other time?" She summoned up her brightest smile and hoped it took the sting out of her reply. For some reason, she was beginning to feel uneasy with this encounter.

  "This friend of yours—is he a 'special' friend?" Frank's voice put the word in quotes.

  "He's a doctor I trained with. Now he's moving here to go into practice with Dr. Gaines."

  "I look forward to meeting him. Tell him if he has any trouble he should give me a call. I might be able to help."

  "I'll do that. Now I guess I'd better be getting home." She held up her hand. "And I'm pretty sure I can find my way there in the dark, so you don't have to follow me."

  "I'll see you around." Frank touched his hand to his forehead in a mock salute, turned on his heel, and disappeared into the building.

  As soon as the deputy was through the doors, Elena rolled up her window and took a deep breath. She double-checked to make sure the doors were locked. The first time she met Frank Perrin, she'd been flattered with his attention, but now she felt a little uneasy around him. What had changed? Him? Or her?

  Elena worried the thought like a cat with a ball of yarn as she navigated her way to the Kennedys' house. She was sure of one thing. Frank wasn't going to like having David around.

  "More coffee?" Dora Kennedy held up the pot like an auctioneer offering a valuable item for sale. "There's plenty, and I can always make more."

  Elena shoved her cup across the kitchen table. "Please. It's a lot better than what I'll get at the hospital."

  "Do you have to go there this morning? I mean, it's Saturday, and I thought I heard Will and Cathy mention that this was Dr. Brown's weekend on call."

  "It is, but Cathy has a patient in the ICU—a man who's recovering from a brain hemorrhage—and I need to check on him. Besides, I want to drop by and see Cathy."

  Dora put the last breakfast dish into the dishwasher and wiped her hands on her checked apron. "Tell her we're praying for her. When she gets home, I'll bring meals for her and Will."

  Elena savored the coffee. She was so fortunate to be here with the Kennedys. Not just for the coffee and food, either. It had been refreshing to watch them quietly live out their faith. It was almost enough to give her hope that her own could be rekindled some day.

  Despite Elena's earlier fears, Matthew Kennedy hadn't gone all evangelisti
c trying to get her back to church. The only praying she'd experienced here was a simple grace before meals, and not only did Elena appreciate the way Matthew and Dora talked with God, she'd have sat through almost anything to enjoy one of Dora's meals.

  Her cell phone rang. She retrieved it from the pocket of her slacks and answered the call.

  "Elena, this is David. Did I call too early?"

  "You know the answer to that. I'm a doctor. I've had breakfast and was about to leave for the hospital. When will you be in town?"

  "I'm here now. I drove in last night after we talked. Just couldn't wait."

  "Where are you staying?"

  "I'm at the Ramada Inn on Highway 287," David said. "My apartment won't be ready for another week or so."

  "Tell you what. Grab some breakfast in the coffee shop there, and I'll pick you up in an hour. I was about to make rounds, but I should be finished by then."

  "Sounds great."

  Elena ended the call and looked up to see Dora Kennedy smiling at her. "What?" she said.

  "Whoever that was, and I suspect it was a young man, you were glad to hear from them."

  Elena felt warmth spread across her cheeks. "Am I that transparent?"

  "Dear, when you've been a pastor's wife in a small town for so many years, you learn a lot about people." Dora poured herself a cup of coffee and held it to her face, sniffing the aroma. "But don't worry. You also learn how to keep what you discover to yourself." She took a sip from the cup. "Now go do your rounds, then enjoy your time with that gentleman friend. And bring him by here for lunch. I'd like to meet him."

  How could Cathy look so good while lying in a hospital bed? In marked contrast to most patients Elena saw in these circumstances, Cathy's hair was combed, her makeup was perfect, even her hospital gown looked fresh and unwrinkled. The glow of pregnancy added the finishing touch.