Death Rounds (5 page)

“I accredited that hospital a month ago,” he continued. “There was no mention of
Legionella
in the minutes of the Infection Control Committee then. If those sons of bitches think they can cover up...”

I let him rant. His tirade wasn’t bothering anybody, and I was still trying to shake off what had happened in ICU. Miller’s cold anger wasn’t a surprise, nor was Rossit’s quick attempt to stir him up, but both were unnerving. Rossit must have heard them paging me and—like a shark catching the scent of blood—rushed over to see if it was about Sanders.

“Why shouldn’t I check them out?” Michael demanded, grabbing my full attention.

“Because they’d say it was an abuse of your powers as a hospital accreditor for the state of New York,” I answered. Accreditors were the medical equivalent of tax auditors. They checked out hospitals to assure they complied with the clinical and academic standards necessary for public safety. Only the most credible physicians were chosen to render these judgments, and Michael Popovitch was chosen more often than most. By convention, they always assessed hospitals other than their own to protect themselves from retaliation by their colleagues and administration should they issue a particularly critical report.

“Nonsense!” he scoffed. “I worked on the Sanders case. Nosocomial infection is suspected. She’s a nurse at University Hospital. Doesn’t that give me cause to alert them to a possible problem? I’ll call Cam tonight. If he’s as forthright with me as he was with you, I’ll offer to look at the charts of those other two cases. I’ll tell him that at this stage it could be kept informal. Believe me, with the jockeying for primacy going on between the two hospitals because of the amalgamation, he’ll jump at the chance to settle this privately. The last thing University Hospital wants right now is a public review of a
Legionella
scare.”

“I don’t know, Michael—”

“A follow-up visit’s in order here, Earl, and if your tests for
Legionella
are positive, then University Hospital is going to get hit with a full official visit from our team. Who knows if they’re as clean as they think? One teaching hospital I visited that claimed it had never had
Legionella
had missed the diagnosis in fourteen percent of its nosocomial infections. We found the organism in two-thirds of the hospital’s water supply sites—drinking water, shower water, whirlpool bath water—”

“Cam assured me they’d checked all that,” I interrupted.

“Hey, Earl. He’s the best, but he’s under the same kind of pressures to cut costs and cover up bad news that we are. Besides, the organism’s even harder to find in water than it is in sputum, and the tests are costly. Bottom line. Earl, there’s something really screwy going on over there, and it could be dangerous for anybody in the place, patients or staff.”

I knew he was using me as a sounding board, to test just how defensible his twisting of the rules was going to be. But instead of continuing to try to dissuade him, I found myself wanting him to go, to find out what I’d been up against in the Sanders case after all. And I found myself thinking of Janet. “Yeah, I suppose you’re right,” I answered.

* * * *

I drove home in the rain around 6:00.1 wanted Janet to be there. I wanted to hold our baby son, Brendan. I wanted sanctuary.

What I got at the back door was our fifty-pound poodle, Muffy. As she leaped and wiggled for attention, I managed to get by her and into the kitchen. The house seemed quiet. A note on the kitchen table from Amy Hollis, our live-in nanny, informed me that she’d gone to bed early, that Brendan had been fed, bathed, and put in his crib, and that Janet had phoned to say she’d be at a meeting until 10:00.

The only one thrilled to have me to herself was Muffy. I hooked up her leash and took her outside. She normally loved walks, but she hated rain. We were back in no time.

After drying her paws and giving her a biscuit, I headed upstairs to the baby’s room. Though it wasn’t completely dark outside, I turned on the night-light when I reached the side of his crib. He was lying on his back, his little fists up by his head. I never tired of watching him, even in his sleep.

Unable to resist, I reached down and picked him up. He was still so small and weightless that I held him easily in one arm as I pulled a rocking chair over near his bedroom window. He gave a few little grunts, moved his fists around, and found his thumb. Three halfhearted sucks, and he was back to sleep. I sat with him listening to the rain until the last gray light of evening had turned to night.

Then I put him back in his crib, had a bowl of soup, and climbed into bed to wait for Janet.

                        * * * *

We had started making love in our sleep, unconsciously moving against each other, becoming aroused, until I awoke already in her, both of us thrusting and straining to climax.

“God, where did that come from?” whispered Janet afterward, rolling over to lie against me.

I was flopped on my back. still trying to get my breath. It wasn’t the first time we’d made love since Brendan was born, but it had felt like it. The fierceness had surprised me.

“We gotta have sex more often,” I said. “That was incredible.”

Janet gave a throaty chuckle. “Three
A
.
M
. feedings and a live-in nanny make that kind of hard. But pent-up lust
is
nice.”

“I didn’t even hear you get home.”

“You’re the perfect obstetrician’s spouse, Earl. You can sleep through anything.”

“Do you think
we
woke anybody?” I asked, listening for sounds from the baby’s room. There were none.

“Do you think we made him a brother?” asked Janet, nestling her head against my chest.

“Janet!”

“Hey, you didn’t exactly give me much warning, you know. I may deliver babies, but I can’t change the rules of nature, especially that one about how they’re made.” She raised her head and looked at me, resting on her elbow and cupping her chin on her hand. In the moonlight from our bedroom window, I saw her smile. “You aren’t ready for the next one? What’s so hard on you about having another baby, apart from having a little fun with me?”

“I thought you might want to wait a little bit.”

“Really! I may be your tall sexy blond, but I’m also forty-one, and it’s family time if you really want all those other little Garnets we talked about.”

I grinned. “No argument from me there, ma’am. Just let me know when and where you next need my services, and I’ll be ready.”

She giggled, then lay down and snuggled up at my side. “Can you fifty-year-olds do it more than once a week?” she asked slyly.

“Forty-eight, smart-ass.”

“And a half,” she corrected sleepily, laying her thigh over my groin.

“Do you think Amy will hear us?” I whispered, feeling encouraged.

“Earl, I think she knows we do it.”

“I love you, Janet,” I declared, suddenly clinging to her, trying to keep away thoughts of the hospital. Damn it! I thought, don’t rob us of this.

“You just want my smart ass,” she murmured into my ear while sliding on top of me and straddling my hips.

Brendan started to cry.

Three
A
.
M
.

I groaned. “Oh no.”

* * * *

I did the night feedings.

Twenty minutes later I was sitting in our darkened living room holding Brendan and listening to him smack up the remains of his bottle. Even by the streetlight I could see his brilliant blue eyes as he kicked and punched with his pudgy little limbs, then grabbed the rubber nipple and noisily finished gorging himself. I settled back on the couch, refusing to be distracted by my worries, and tried to enjoy the spectacle. His funny small fingers were practically holding the plastic container.

“I gave birth to him; you can feed him,” had been Janet’s decree on the division of labor. Her real worry was being called away from him all the time for deliveries. “Besides,” she’d added, “don’t guys your age have to get up at night anyway?”

Nearly six months old, Brendan was sleeping through most of the time, but occasionally, he got an urge for the good old days. And I didn’t mind, not even with tonight’s interruption.

The phone rang, and I snapped up the receiver. If it was for me, I didn’t want Janet wakened needlessly.

“Dr. Garnet here.”

“Oh, Dr. Garnet, it’s the case room at University Hospital. I’m sorry to bother you, but we need Dr. Graceton.”

“No problem. I’ll get her for you.”

But already Janet had picked up the bedside extension. “It’s okay, Earl. I’ve got it.”

I hung up, then sat watching Brendan suck at the dregs of his feed. I was putting him over my shoulder to burp him when Janet descended the stairs in her OR greens, obviously having been called in for a delivery. Even in that shapeless garb, she was a terrific-looking woman. She finished hooking up her hair into a ponytail with an elastic band, then walked over to take Brendan from me. “I’ve got twenty minutes. Why don’t you make us some coffee?”

Brendan replied with a loud burp and spewed out some formula onto Janet’s shoulder. “That’s okay, my little angel,” she said. “This outfit will see a lot worse before the night’s out.”

On my way to the kitchen, I had to step over a large, dark mound in the hallway that gave a low growl. Muffy had gone into a sulk when Brendan arrived and moved out of our bedroom into the downstairs hallway to sleep. Tripping over her was now part of the nighttime feeding routine.

Five minutes later Brendan was asleep on the couch between Janet and me. It was 3:40. Muffy had deigned to come and lie at our feet but wouldn’t look at the baby.

“Longest mope I ever saw,” said Janet, reaching down to ruffle the drooping ears.

“Are you going to be back for breakfast?” I asked, hoping for a chance to talk.

“No, I’ll stay at the hospital. I’ve got a lot to do today.”

I felt a twinge of disappointment but wasn’t going to say anything. Janet looked straight at me. “Cam told me what happened with Phyllis Sanders, Earl. The meeting tonight was an emergency session of his Infection Control Committee. My, you certainly set the cat among the pigeons. Even your buddy Michael Popovitch showed up later, as an observer. He got Cam on his cellular halfway through our session—calling about Sanders—and got himself invited over. The trouble is, none of us came up with anything.”

I looked at her, astounded. “Why did he act so quickly?”

“He had to. Whether Sanders has staph pneumonia with an unheard of prodrome, or the equally unlikely combination of
Legionella
and staph, the nosocomial implications have to be looked at. Besides, he’s really spooked, like the rest of us, by the mystery of why and how the nurses got sick only after they left on vacation. Two cases might be a troubling coincidence, but he couldn’t sit on a third.”

I didn’t know what to add. “Did he tell you about Rossit?” I asked, after a few seconds.

“He mentioned it, privately, and told me not to worry. But I’d like you to tell me what happened.”

* * * *

I must have talked for five minutes. The whole time Janet cradled Brendan and stroked Muffy’s ears. Even my admission of how I’d resented Sanders didn’t change her expression. She simply listened and let me unburden myself. I felt knots I didn’t know I had let go in my stomach.

When I finished, she kept staring out the window. I waited for her to say something, but she remained silent. “Janet?” I asked, starting to feel uneasy.

“They were all bitches,” she said in a faraway voice.

“Janet!” I protested, not believing what I’d heard.

She turned to me, suddenly becoming animated. “You’re right, Earl. It’s a terrible thing to say, even to think, and that’s why no one has seen what those three nurses have in common.”

“C’mon Janet, you can’t call—”

“Earl, Phyllis Sanders has always made people resent her. Doctors and nurses at University Hospital have been resenting her for years without your giving them permission to do it.”

“Janet!” I protested again but smiled in spite of myself.

“She’s exactly like the other two nurses in that regard. I know, because time and time again my patients have complained to me about all three of them.”

I listened without another word. I had no idea where she was going with this.

“You know the kind of nurse who makes a patient feel humiliated for needing help, who seems to resent their demands, particularly the emotional demands put on them by those in their care. I’m not talking about the occasional loss of patience; we all have those. I mean systematic cruelty in little ways—delaying giving a bed pan, holding back pain medication, leaving someone on a toilet too long, accusing someone who’s afraid or in pain of ‘being a baby.’”

I winced. I’d had to reprimand some of my own staff for such behavior, and they weren’t all confined to nursing.

“Sanders had some nerve invoking my name,” Janet continued. “I’ve forbidden her to go anywhere near my patients in the delivery room. The second timers insist on it.”

“So what are you suggesting?” I asked, feeling uneasy again.

“I’m suggesting that they’re women who make people angry.”

I sat there stunned. “My God!” was all I could reply at first. What she was implying couldn’t be. “You think that someone is deliberately infecting them?”

She sighed and gave Muffy’s ears an extra rub. Brendan smacked his lips, and Janet smiled down at him. “It’s crazy, I know. But, well, maybe I had those kind of crazy thoughts for a reason.”

If there was one thing I knew about Janet, she always had a reason, for everything.

She looked up from watching the baby. “Did you ever hear rumors about the Phantom of University Hospital?” she asked, her smile for Brendan quickly fading.

“The what?” I said, not believing I had heard her correctly. “Come on; give me a break.”

She flushed. “Hey! Don’t laugh. It was serious at the time.”

“Janet, what the hell are you talking about?” I still thought she was kidding.

She sighed again and stared out the window. “A few years ago there were some incidents that were brought to the attention of the ID committee. They were little things, but the staff was worried. People would suddenly have unexplained but explosive vomiting and think something had been slipped into their food or coffee, but nothing was found. Another time an orderly came down with a brief bout of bradycardia, dizziness, asthma, and diarrhea. He was sure he’d been poisoned but couldn’t prove it. There were other occurrences, all brief, all nonspecific, and thank God, nothing serious or fatal.”