Authors: Goldie Browning
“God, that was intense,” said Dr. Ballew.
“I wish he’d get a haircut.” Rachel wrinkled her nose. “He looks disgusting.”
“You don’t think he’ll cause any trouble, do you?”
“Am I the only one with any balls around here?” Rachel rolled her eyes and stared at Dr. Ballew with distaste. “Shut the door.”
Rachel got up from her desk, walked to the window, and stared down at the street below. She could still see the fat, sniveling excuse for a man out of the corner of her eye. Dr. Wilson’s insubordination had infuriated her, but Dr. Ballew’s meek compliance was worse. He’d quietly done as he was told, which irritated her further. She counted to ten before she returned to her desk and composed herself.
“Okay, now that the unpleasantness is over we can get down to business.” Rachel crooked her finger at Dr. Ballew. He jumped to attention, his eyes wide with fright. “How long until we can contact the Senator?”
“Oh, I don’t know,” Dr. Ballew replied. Sweat beaded on his forehead and his hands shook. “We’re being a little premature, don’t you think?”
“Frank, I thought I explained everything to you. Time is running out for Monica Talmedge.”
“Yes, but it’s too soon to tell about Mrs. Fuller’s recovery yet.”
Rachel sighed and picked up a piece of paper. “I’ll repeat what I told you earlier. She signed an Advance Health Care Directive of her own free will. Let me read what it says.
END-OF-LIFE-DECISION: I direct that my health care providers and others involved in my care provide, withhold, or withdraw treatment in accordance with the choice I have marked below; Initials EJF—check mark on (a) Choice NOT to Prolong Life. I do not want my life to be prolonged if (1) I have an incurable and irreversible condition that will result in my death within a relatively short time, (2) I become unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, or (3) the likely risks and burdens of treatment would outweigh the expected benefits. Then it goes on and she’s marked the box that says ‘Upon my death I give any needed organs, tissues, or parts for the purposes of transplant.
’ How much more clear could it be?”
“But it hasn’t even been forty-eight hours yet. We don’t know if she’s going to die or not,” Dr. Ballew argued.
“There’s a young woman who is
definitely
going to die if she doesn’t get this heart. Her father is an extremely important man. Who knows? He may be the President someday. Do you want to be the one responsible for letting his little girl die?”
“Of course not, but…”
“But nothing!” Rachel felt her anger rise at his ignorance. “All you have to do is go through the motions. Just fill out the paperwork and certify her as PVS. You and I both know that even if she comes out of this coma she’ll probably be severely disabled.”
“That’s not necessarily true. People come out of comas all the time and make full recoveries. It could happen.”
“Yes, and you could win the lottery, too. But what are the odds?”
“She’s my patient now. Don’t I have an obligation to her?” his voice took on a shrill quality.
“Yes, and we both have an obligation to the Board of Directors.” Rachel waved her arms and paced. “Can’t you imagine all the accolades and rewards if
we
were instrumental in saving Senator Talmedge’s daughter? Why, it’s no telling what he would do for the hospital in gratitude.”
“Does Richard know about all this?”
Rachel laughed. “Of course not. Why do you think I pulled Sir Galahad from the case? You know he’d mess everything up. That’s why we’ve got to hurry up and push this thing through before any of the do-gooders have time to start screaming.”
Dr. Ballew hung his head, clasped his hands together and stared at the floor. Rachel watched him intently. He was weak and a coward. She knew she had him where she wanted him.
“Do what you have to do. I’ll be notifying Senator Talmedge we have a heart donor at precisely three o’clock tomorrow afternoon. Let’s keep a low profile until then.” Rachel’s eyes glistened. “I want her dead before anybody has a chance to react. Do
not
let me down.”
Zan pulled his tired body from the chair beside Emma’s bed in the Intensive Care Unit, cracked his neck back and forth and then stretched. He glanced at his watch—just after four in the afternoon. He tried to remember the day of the week. Oh yeah, Tuesday. Three days since the accident. For three days he’s been talking to her, telling her how much he loved her and how happy he’d be to have a whole houseful of kids with her, if only she’d wake up. He glanced up in surprise at a man in a white coat standing in the doorway, holding a clipboard and looking nervous.
“Hello, Mr. Fuller. I’m Dr. Ballew.” The doctor smiled and extended his right hand.
“Where’s Dr. Wilson?” Zan returned the shake, but did not smile.
“He had to leave for a while. I’ll be your wife’s attending physician from now on.” Dr. Ballew motioned toward the hallway. “Do you think we could go into my office and talk?”
“Sure.” Zan lovingly caressed the only patch of skin on Emma’s arm that wasn’t covered with IV tubes or pressure cuffs and then followed the doctor down a short corridor.
“Have a seat,” Dr. Ballew pointed to a chair and then sat behind a desk. He rummaged through some files, avoiding eye contact with Zan. “Let’s see, I believe Dr. Wilson already showed you the results of the CT scan.”
“Yeah, she has a blood clot that needs to be removed. Are you going to do that now?”
“Well, Dr. Wilson installed the ICP Monitor and he’s got a shunt drawing off the excess fluid from the brain. But her EEG’s not showing much activity…I’m not sure surgery will do any good at this point. She can’t breathe without a respirator. I’m worried about damage to her brain stem.” Dr. Ballew knitted his brows, shook his head and rambled on. “Let’s see…she’s classified a three on the Glasgow Coma Scale…rostral-caudal deterioration…cerebral anoxia…probable persistent vegetative state…”
Zan’s mind reeled as he listened. As a medical professional, he understood enough to realize Emma was in serious trouble. But he sensed a reticence in this man’s demeanor. Something didn’t seem right. What was he trying to hide?
“When will Dr. Wilson be back? I think I’d feel more comfortable with him.”
“What?” Dr. Ballew looked flustered. “Oh, he won’t be caring for your wife any more. The hospital’s reassigned her to me.”
“With all due respect, Doctor…I believe I have the right to decide who I want to treat my wife.” Zan stood up and headed for the door. He shook with anger and suspicion. “I’d like to speak to whoever’s in charge.”
“Mr. Fuller, please. Wait. I understand you’re upset.”
Zan stopped, turned around and stared at Dr. Ballew. “You’re damn right I’m upset. You’re acting like my wife is dead already. Like there’s no hope.”
“Please, Mr. Fuller. I know this is hard for you. I’m just trying to explain the futility of continuing treatment.”
“Look.” Zan’s eyes widened. He clenched his fists to suppress an impulse to punch the doctor in the nose. “I’ve got insurance. I’ve got money. You do whatever it takes to get her through this. I don’t care how much it costs or how long it takes.”
Dr. Ballew sighed. “If only it were that easy—by law we can’t continue treatment.”
Zan felt as if his breath was cut off. A cold numbness invaded his body. “What are you talking about?”
The doctor appeared almost as anxious as Zan before he replied. “Apparently your wife executed a valid Advance Health Care Directive. She’s requested not to have her life prolonged by extraordinary means if she finds herself in the—ahem—position she’s now in.”
Zan felt like he’d been pole axed. “When the
hell
did she have time to do something like that? She’s been unconscious for three days!”
“Yes, yes. But apparently she signed it last week when she pre-registered with the hospital in Dallas.” Dr. Ballew fished in his pocket for a handkerchief to wipe the sweat from his forehead. He handed Emma’s chart to Zan and pointed to her signature on the form. “They faxed it along with her other paperwork.”
Zan paced the room and read the form. “Okay, let me get this straight. You’re saying that just because my wife signed this
bogus
form—which by the way, was thrust on her very quickly—we’re just supposed to undo all the machines and let her die?”
“Basically—yes. According to the law, that’s what we have to do.”
Zan closed his eyes and composed himself before he spoke. “Look, I was there at the doctor’s office with her that day. They were in a hurry to get everything buttoned up, so they just shoved forms at her to sign. She had no idea of the implications when she signed this.”
“I understand your concerns, Mr. Fuller.” Dr. Ballew spread his hands in a helpless gesture and wrinkled his brow. “But there’s nothing we can do. The law clearly states we must follow her wishes.”
“Isn’t there some sort of waiting period?” Zan pleaded. The reality of the situation began to set in and he grew frightened. “Dr. Wilson said we had to wait and see…”
Dr. Ballew interrupted. “Dr. Wilson is not a neurosurgeon. He doesn’t understand the complexities of the human brain the way I do.”
“I’m her next of kin. I want a second opinion.”
“Sir, I’m very sorry, but that’s not an option. She was a rational, consenting adult when she made her wishes known. Her records don’t indicate a Power of Attorney assigning you or anyone else as her advocate. We have no other alternative.”
“I
demand
she be evaluated by somebody else right now!” Zan approached the doctor and pounded his fist on the desk.
Dr. Ballew flinched and shrank back before he took a deep breath and continued. “Mr. Fuller, I assure you I did not make this diagnosis lightly. We’ve followed all the rules. I’ve consulted extensively with two other specialists and they concur with my opinion—you’ve got to accept reality and let her go.”
Numb with rage, Zan felt an overpowering urge to start breaking things. He began backing out of the office, frightened of losing control. Something evil was happening, but he didn’t know what. He pointed his index finger at the doctor. “You’d better not unplug one single machine or so help me God, I’ll kill you!” He turned toward the hallway and yelled. “Allen—Dad—where are you?”
“Please lower your voice.” Dr. Ballew followed him into the hall, glancing nervously at the staring onlookers. He returned to his office and slammed the door when Zan entered the waiting room.
“Zan, what’s wrong?” asked Jonathan.
“They’re trying to kill Emma,” said Zan. His shoulders slumped in despair. “We’ve got to do something.”
Gasps of disbelief echoed throughout the group.
“Mr. Fuller.” Bridget, one of Emma’s ICU nurses walked toward Zan and motioned for him to follow her to the TV in the waiting room. She glanced nervously around the room, put her finger to her lips, and turned up the volume.
Zan stared in confusion at the reporter on the television. What was she talking about? And then realization set in. When he understood the implications of the news report he was stunned. His mouth felt like old paper, dry and dusty. He sensed his father’s hand on his shoulder, but he was too numb to actually feel it. He heard someone in the room sobbing uncontrollably, but didn’t even realize the person crying was himself.
“Good evening. This is Lora Lapinski, reporting live from Northwest General Hospital in Rogers, Arkansas with breaking news. An anonymous source has revealed that a suitable donor for Monica Talmedge’s long-awaited heart transplant has at last been located right here in Rogers. Monica is the daughter of US Senator Grayson Talmedge, who is regarded as one of the front-runners in a bid for the White House next term…we have Senator Talmedge on the line right now…Senator, congratulations on your good news…so tell me, how does it feel now that the wait is almost over?”