The Children's Ward (12 page)

Forty-nine

Abigail kept her eyes fixed on the wind chimes while she listened to them talk.

“One time when I got sick in Los Angeles, the nurse who took my blood forgot to take off that thing they tie around your arm.”

“Tourniquet,” Russell offered.

“Yeah…she just pulled out the needle and bent my arm up like they do. Then she went out of the room and I straightened my arm to look at it, and blood was just pouring out.” Tessi’s voice quavered only slightly. “It was dripping on the floor.”

“Did you take the tourniquet off?” Courtney spoke in a whisper.

“I was afraid to.”

“What happened?”

“Well, the doctor came in and saw the blood dripping all over everything and he untied the thing and put a big thick pad of cotton over the hole and held it real hard. I heard this sound— like you hear in a seashell—in my ears and got real sick at my stomach. He told me to put my head between my knees but every time I did, I saw the blood…my blood…and it made me even sicker.”

“Then what?”

“Then they held this thing under my nose—”

“Ammonia,” Russell said.

“Whatever it was, it smelled terrible and made me cough. Then they made me lie down and gave me a glass of water. And then I heard the doctor yelling at the nurse.”

“The first time I got an I.V.,” Courtney said in her soft voice, “it took them five tries to get it in the vein.”

“Them?”

“Two nurses and finally a doctor. They just kept sticking me and then moving the needle around under the skin…”

“Ouch.”

“Finally they wound up putting it in the back of my hand.”

“I’ve had one there,” Russell said.

“My arm was black and blue; I could hardly move it. Then the I.V. got blood in it and they had to take it out…” her voice trailed off.

“Did they put in another one?” Tessi asked.

“Don’t they always put in another one?” Courtney sounded resigned. “What about you, Russell?”

“There’ve been so many things.” He hesitated, sighing. “The thing that bothered me the most was the night I…fell. The medics put me on a back board and strapped me in, with sandbags on either side of my head. They kept saying ‘Don’t try to move…keep your body still.’ So I was very still, lying with my eyes closed, and they were talking about me. They weren’t talking loud, and the siren was going, so I couldn’t hear everything they said, but…they said I’d probably broken my back.”

Abigail, facing away from them, could feel Russell’s pain.

“When I got to the hospital, everyone was prodding me, could I feel this, could I feel that, don’t move, be still…then this male nurse comes in and starts to take my clothes off, for the x-rays, and he’s very rough, tugging on my jeans and it hurts and I’m not supposed to move at all but he’s
moving me.
Then he looks at me and I guess I was crying and he makes a face and says ‘This isn’t the worst thing that’s going to happen to you tonight…save your tears.’ “

“How mean,” Tessi said.

“Then they take the x-rays and I’m alone in the room, and all I can think about is that I wasn’t supposed to move. When Dr. Fuller came, I’d lost most of the feeling in my legs…so they put me in traction and took me to ICU.” His voice took on a different tone. “I had a lot of time to think about it, and I think I would have been all right if that nurse hadn’t moved me.”

They lapsed into silence.

Abigail closed her eyes, allowing her anger to grow.

Fifty

“I hate this job, I hate it, I quit.”

Marci looked over at Nadine. “What’s your problem?”

“This computer.” Nadine smacked the side of the computer console.

“You’d better not let anyone see you do that,” Marci warned. “Administration thinks the sun rises and sets in these things.”

“Well, administration can have them and I even have an idea where they can put them…”

“Wow, you
are
upset. What in the world happened?”

Nadine, despite department policy prohibiting smoking at the desks, lit up a cigarette and took a deep drag. “I’ve spent all morning entering those God-damned DRG codes in for the November discharges, so utilization can have their stinking statistics. All day,” she emphasized, “and it’s gone.”

“Gone?”

“Gone. Like, poof!”

“How could that be?”

“You tell me how could that be
. I
don’t know.”

“You must have hit the delete key by accident.”

Nadine shook her head. “No way.”

“Well, you must have done something…”

“I didn’t do anything. I didn’t hit the delete key, I didn’t read it into another file, I didn’t look at the stupid screen cross-eyed. But my file is gone.”

“Gone.”

“Poof.” Nadine exhaled a cloud of smoke. “And I don’t care.”

“What does that mean, you don’t care?”

“I’m not going to spend another four hours inputting, that’s what. I don’t care whether utilization gets their statistics or not.”

Marci frowned. “I think you’d better start another file.”

“Why? To feed this monster?” She swatted at the computer.

“Well, it’s your ass,” Marci said, returning her attention to her VDT. “But if I were you, I’d get started on that data before you get in trouble.”

Nadine stared serenely at the ceiling.

“I still think you must have hit the delete key,” Marci said, fingers flying over the keyboard.

Nadine did not answer, but blew smoke in the air.

“Hey,” Marci said after a few minutes had passed. “Hey!” she said louder.

“What?”

“My file…it ate my file!” Her expression was outraged.

“You must have hit the delete key,” Nadine said, smiling sweetly.

Fifty-one

Betty Jo tried to concentrate on reading the nursing progress notes on Mr. Calhoun. It was a hard thing to do with sweat dripping down the middle of her back.

“Did you call engineering to turn down the thermostats?” she asked the unit secretary.

The secretary did not look up from her reading. “Yes, I did,” she said in a sing-song voice. “An hour ago.”

“What did they say?”

“They said they’d take care of it.”

“Did they say
when
they would take care of it?”

“Not exactly.”

“Either they said when or they didn’t,” Betty Jo said, displaying what she thought was a mountain of patience when what she wanted to do was conduct exploratory surgery to see if she could locate the secretary’s brain.

“They said sometime today,” the secretary smiled. “They did not say the precise minute it would be done.”

“Great,” Betty Jo said. She got up from the desk, flipped the patient chart closed, and walked toward the nurses’ lounge.

It wasn’t much cooler in the lounge, but she got a soft drink out of the refrigerator and sat down to put up her feet.

It was just plain sweltering under all those lights at the nurse’s station. It wasn’t quite as bad in the patients’ rooms, but she didn’t think it would be kosher to wander from room to room, just to get a little air.

She almost never worked on the medical floor, but it was just her luck to get tagged on the day their heating went on the fritz.

Well, her shift was more than half over, so she’d gotten through the worst of it. And there was always a chance that engineering would get around to cooling things off.

How hard could it be, anyway? All of the environmental factors—temperature, air filtration and circulation, even the lights—were programmed into the computer. Someone had made a mistake when they were entering the settings. A simple mistake to make, a simple mistake to fix.

They had better do something about it soon, she thought. Even if they didn’t care about the nurses—and she often suspected that nurses were regarded as a necessary evil in the eyes of administration—they should think of all the money this excess heating was going to cost them.

The hospital had gotten very cost-conscious of late, and she wouldn’t be at all surprised to hear that whomever had made this particular mistake got called on the carpet for it.

If they put the punishment up for a vote, she was voting for a hanging.

Fifty-two

Her experience with magnetic resonance scans was, at best, limited, so she took her time reviewing them. The medical community was very excited about the technology which promised to replace computed tomography as
the
diagnostic imaging modality. She had read with interest arguments in favor of either method but, looking at the clear MR images, there seemed little doubt of its superiority.

Behind her, Tucker Smith was helping the engineer who appeared to be less than enthusiastic about his assistance.

“If you’d get out…move…”

“What? Over here?”

“There or anywhere but where you’re at.”

Quinn smiled to herself and put up the sagittal scans on the viewer, glancing at her watch as she did so. Eleven-thirty. The morning had passed slowly.

She was used to more activity than this. Seeing patients and doing work-ups was what she was used to; caring for only four patients was scarcely enough to keep her occupied. The other work, especially reviewing the videotapes, was more time-consuming but definitely less satisfying.

Joshua was still seeing private patients in addition to the children but he had turned down all of her offers to assist with those cases.

“You’re really the primary physician for the kids,” he’d said. “I want you to be readily available when they need you. I don’t want you to get hung up treating my private patients— some of whom are very ill—and not be able to respond quickly to calls from the ward.”

He’d made it easy for her to assume care for them, and in fact gave her total autonomy within the limitations of the research protocol. But it was his program and, now in motion, there was little for her to do besides evaluate test results, view the tapes, and respond to problems as they arose. Russell’s fainting spell and Courtney’s seizure, even occurring on the same day, did not begin to approach the level of intensity she was used to working with.

She returned her attention to the scans.

“You’re sure that thing is off?”

“Power’s totally off,” Tucker Smith said.

“Then I’m going inside to cut the hole for the speaker.”

Quinn turned as the engineer went through the door into the scanning room. “Would it be possible for me to look at some other scans? These look normal to me but…”

“Sure,” Tucker bounded across the room. “We haven’t taken many yet but I’ve got tons of reference scans…I’ve been collecting them.”

The sound of an electric saw filtered into the room. Even with the door closed, Quinn could smell the wood dust.

Tucker found what he was looking for and brought a stack of large manila envelopes over to the viewing area. The envelopes were marked with the anatomical areas and he thumbed through them.

“Brain scan, right?” “Yes.”

“Got a lot of those.” He handed her three bulging envelopes. “Transverse, sagittal, and coronal. I don’t have them divided into adult and juvenile, but the ages should be marked somewhere on the scans themselves.” He nodded his head emphatically.

“Thank you.” His eagerness to please reminded her of a puppy she’d once had; she was tempted to scratch behind his ears.

Then he was off, sticking his head around the door to ask the engineer if he needed any more help.

Quinn looked through the stacks of scans until she located what she wanted: a series labeled Jane Doe, age nine, diagnosis normal brain.

They were essentially identical to Abigail’s scans.

There were no masses, no abnormalities, in Abigail’s brain.

Even though she had read all of the consultations, reports, and conclusions from the various medical experts—which all pointed to the presence of a tumor—for some reason, Quinn was not surprised.

“What? What’s going on here?”

Quinn turned, recognizing panic in Tucker Smith’s voice. He was standing in front of the console, trying to remove the dustcover.

“What’s wrong?” She joined him at the console.

“Power’s coming up,” he said tersely, finally wrenching the cover off the machine.

The power button was glowing amber.

He pushed at the button. “It’s stuck…get him out of there.”

Looking through the window she saw the engineer flying backward toward the scanner, his face frozen into a grimace. The saw was imbedded in his upper chest. He struck the scanner with an impact that they heard in the shielded room.

Quinn started toward the door.

“No, wait…don’t go in there. If there’s any loose metal…” Tucker began to pound on the console with the side of his fist. “Off, God damn it.”

“Is there an electric breaker we can throw?”

“I think…wait…it’s off.”

Without thinking Quinn hurried into the scan room where the engineer, released from the magnetic pull of the saw to the machine, had slumped to the floor. Kneeling beside him, she felt for a carotid pulse.

Blood was welling from the chest which was split by the saw blade.

“Get some help,” she called to Tucker who stood in the door, eyes wide with fear.

The toothed edge of the saw blade was buried in the man’s sternum and she was unable to pull it free. The only thing she could do until help arrived was try to keep pressure on the bleeders, to try and staunch the flow.

The code team, when they arrived, worked rapidly to try and save the dying man. They worked in silence, without the customary bits of conversation which generally served as an outlet for tension. Someone managed to get the saw blade free from his chest.

They transferred him to a gurney just as his heart stopped.

They were unable to bring him back.

Someone handed Quinn a towel and she wiped her hands.

“I’ve called the coroner,” someone said.

As she passed through the control room she noticed Tucker Smith standing, looking at the computer console, tears running down his face.