Medical Error (7 page)

"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.

She still hadn't bought groceries, so Anna ate a piece of dry toast and a cup of coffee for breakfast. What she'd give for a doughnut fix from the medical school's food court, but she couldn't bring herself to go back there. At least, not yet.

After her second cup of coffee, she sat down with a yellow legal pad and began a list. She'd start by addressing the effect of the identity theft on her credit. Based on her experience yesterday, she figured it wouldn't be simple.

More than an hour later, Anna finished the last of several phone calls and heaved a sigh, not so much of relief as of exhaustion. She'd advised all three major credit-reporting entities of the identity theft. They'd promised to make the necessary adjustments to her record, although it might take a little time. That was the good news. The bad news was that, in order to formalize a fraud alert, she had a laundry list of hard-copy material to forward to each company. Then there was something called a security freeze, so no one could open accounts in her name in the future. And it was all going to require copies—lots of copies.

Her first thought was a trip back to the medical school to use the copy machine in the Surgery Department offices. But the prospect of the stares, the questions she was bound to get, made her stop and think. Maybe she could go to Kinko's instead. She probably had enough in her checking account to cover the cost.

On the other hand, the copier in the department was nice, and it wouldn't cost her a cent to use it. After all, she should probably try to conserve money, since she didn't know how all this would finally shake out. And maybe she'd drop by and see Nick while she was there. Maybe he had more information about the cause of Hatley's death. Besides, she'd enjoyed their time together last night. And she could certainly use a friend right now.

Anna decided it was a wonder Nick had been interested in seeing her again, as distracted as she'd been when they first met. But last night had been better. The meal, the company, Benny's antics—all had brought a smile to her lips when she needed it most. That had to be a good sign.

She gathered up the material she'd need to copy. In the process, Anna paused before the mirror in the hallway. Hair looked okay. Makeup could be a bit better. And maybe she'd change into that new blouse and skirt before she left.

On the drive to the medical school, her little Toyota seemed a bit balky, but Anna put it down to an extension of the bad luck she was having. Maybe she'd gotten some bad gasoline. Maybe it was time to change the spark plugs. She could never recall how often that was supposed to happen. She'd ask around. One more thing to add to the list. She was about a mile from home when the engine coughed three times like a two-packa-day smoker, then quit.

She was sitting behind the wheel, trying to restart the car, when there was a tap on the driver's side window. The middleaged Hispanic man standing there looked pleasant enough. The name over the pocket of his blue work shirt was Ramon. Anna looked beyond him and saw a faded blue pickup parked across the street, a woman in the passenger seat.

"Can I help?" the man said in a voice with only a hint of accent.

Anna measured her options and decided that Ramon was her best one. "Yes, please. It just quit."

After about ten minutes, Ramon peered at Anna from beneath the open hood of her car and said, "I believe it is probably the fuel pump." His brown eyes mirrored the sorrow that was in his voice.

"Can you fix it?"

Ramon shook his head. "No, I am sorry. My wife and I can give you a ride somewhere if that would help."

Anna recalled the Toyota dealership she passed every day on her way to the medical center. She'd never paid any attention to it until now. "Thanks, but I have a cell phone. I can call for a tow."

Forty minutes later, Anna sat in the waiting room of the dealership, turning the pages of a year-old copy of a magazine without any recognition of the words and pictures. The car had served her faithfully through medical school and residency, as well as two owners before her, owners who had probably not been particularly kind to the vehicle. If this episode wasn't the final chapter for the car, that couldn't be far away. Should she look at another car while she was here?

"May I help you while you're waiting?" It was as though the salesman had read her thoughts.

"I'm waiting for my car to be repaired."

"Why don't I show you some of the bargains we have? You might decide to trade up."

"No, thank you."

"If you change your mind, let me know."

The salesman had no sooner left than Anna heard, "Dr. McIntyre?"

She turned in her chair to find the service advisor standing behind her. "Your car needs a new fuel pump. And we've found a couple of other things." He held out a clipboard. "Here's what it will take to repair it. If you want us to do it, we can get right on it and have you out of here in two or three hours."

Anna looked at the figures. She could afford the repairs— just barely. But maybe she'd be better offputting the money into a new car.

"Let me think about it." She looked around for the salesman, and found him at the coffee machine.

The salesman led Anna on a whirlwind tour of the lot, and after half an hour she sat in his office while his fingers flew over the keys of his computer. "Well, Doctor, I believe we can put you in that car at a price you can afford. Let me get a little information, and I'll run a credit report."

Ten minutes later, the salesman swiveled away from the computer screen, and the look in his eyes told Anna everything she needed to know. "I've done a credit check. I think we might have some trouble financing that car. We can probably do it, but I can't get the interest rate I wanted. And that would make the payments—."

"No, I understand." Anna wanted to argue, but realized how futile it would be. The red flags were already up. Her credit had become suspect. And even though the credit reporting companies had promised to put things right, it wasn't going to happen today.

She found the service advisor and said, "Okay, just do the repair. I'll wait."

"Thanks anyway." Nick Valentine hung up the phone and rummaged through the books and journals scattered in front of him. The desk of his academic office, never the most organized eighteen square feet in the Pathology Department, looked like a war zone. He was computer-literate and often did online searches for information, but at times it was comforting to feel the heft of a textbook in your hands, to mark an important passage with a yellow highlighter. For this problem, he'd pulled out all the stops: a computer search, back issues of journals from the department library, textbooks—old and new— taken from his shelves. And now he'd just hung up from a short, albeit rather unsatisfactory, conversation with the head of the Allergy Division. His head swam with information overload.

He let his gaze rest on Eric Hatley's chart and the notes he'd made when he reviewed it again. Nothing he'd found changed his mind about the cause of Hatley's death. However, there was one bit of information that puzzled him. Maybe he'd go downstairs and get some coffee to help him think.

"Got a minute?"

The voice brought him instantly alert. Anna McIntyre stood in the doorway. Her shoulders sagged just a bit, even though she had a faint smile plastered on her face. Nick wondered if something more had gone wrong. Then he noticed the two paper cups in Anna's hands.

"I come bearing gifts from Starbucks," she said, advancing and placing one of the containers on his desk like a priest laying a sacrifice on the altar. "I wanted to thank you for the dinner last evening, and for the work you're putting in on the Hatley case."

Nick flipped the lid offthe cup and tossed it into his wastebasket, barely hitting his target. He nodded his appreciation and took a deep sip. "No thanks necessary, but you don't know how much I needed this pick-me-up. I've been working all afternoon trying to find a blood test for allergy to Omnilex. Unfortunately, there isn't one, at least not one that's reliable. Mainly because the drug's too new."

Anna eased into the chair across the desk from Nick and took a taste of her coffee. "So there's no way to know for sure whether Eric Hatley had his anaphylactic reaction because of the antibiotic we gave him."

Nick recognized this as a statement, not a question. "His tryptase level came back this morning—sky-high. Hatley defi- nitely had a severe anaphylactic reaction. I just finished the microscopic exam on the tissue samples from the autopsy. Nothing else showed up. Bottom line, there's no question that a massive allergic reaction was the final event. But we can't prove the cause."

"Could this be due to the anesthesiologist giving him a wrong medication of some kind?"

"What makes you ask?"

"The staffman was out of the room. JeffMurray is a first- year resident, not experienced, not necessarily good under stress. At the time I didn't make too much of it, but as I thought about it later, I wondered if maybe he didn't give Hatley something other than the antibiotic Luc ordered."

Nick shook his head. "No way. I went so far as to go up to surgery this morning and look through one of the anesthesia carts. Other than various antibiotics, I couldn't find anything there that could have done this."

"So I can't blame anesthesia for this."

"Afraid not. But this should interest you." Nick reached past the pile of articles and books on his desk, moved aside Hatley's hospital chart, and picked up a thin file held together by a metal fastener strip threaded through two holes punched at the top.

"What's that?"

"I had them pull the emergency room record for Eric Hatley, the visit that was the basis for your choice of antibiotics. Have a look."

He held out the folder and watched Anna thumb through it the way physicians learn to do, scanning the pages and picking out the important nuggets of information. He could tell when she got to the part that had stopped him cold.