“The nurse and Dr. Lee should be coming any minute. I just rang them. They can tell you more about Laura,” says Bess.
Dylan, Dr. Lee, and a petite nurse in a bright pink smock with Yorkshire terriers spread throughout the shirt walk in.
“How can we help you?” asks the nurse.
“This is the prosecutor on my daughter’s case, Ms. Ruiz. She was asking how Laura is doing. It’s fine with me if you guys speak with her,” says Bess. “I was thinking that I would like to speak to someone about filling out DNR forms,” continues Bess.
“We are not authorized to discuss the Do Not Resuscitate forms with you. But I can notify Organ Donation that you’d like to speak with them,” the nurse says.
“Yes. I’d like that. I’ve made the decision. And I don’t want there to be any confusion if God forbid something happens to Laura. She has been through enough already and I don’t want her to continue suffering,” says Bess adamantly.
“Laura was so vain, she would not have wanted her head shaved. Now she has a scar with staples that looks like a horseshoe on the side of her head where her hair will never grow back. She would never have wanted that. Isn’t that right, baby?” Bess says, rubbing Laura’s face.
Laura, completely lifeless, with her cheek nudging into her neck area from the back of Bess’s fingers petting her face, doesn’t respond.
“My thought is to just end the life support now. I don’t know why she is being fed with all these tubes. That was never her wish and not mine,” says Bess hopelessly.
“Well, she came in as a Jane Doe and immediately went into brain surgery. The standard procedure is to keep her on support. Come with me and I will put you in touch with Organ Donation,” says the nurse before leaving the room with Bess.
It makes sense that hospital staff can’t discuss DNR forms with Bess, so they don’t become organ hungry to clear out a bed for the next patient. It would be like jail deputies deciding who to charge with a crime based on how many jail beds they have available that day. But the idea of giving up on Laura, who might still have a whole life ahead of her, makes me sick.
Dr. Lee and Dylan’s eyes get bigger and bigger as they stare at Laura.
I hear a grunt that sounds like a barking dog.
“Laura, can you hear me? What is it?” I ask. Laura’s eyes are wide open like her mouth. Dr. Lee, Dylan, and I move closer to her bed. The stench from her mouth is like a beached otter groaning; remnants of the fish it’s been eating all summer sticking between its teeth leaving a terrible smell with each bark. As quickly as Laura’s eyes open, she shuts them. A bloody tear falls down her face.
“Laura, could you hear what your mother was talking about?” I ask.
Her eyelids pulsate at a tremor speed like she has an overactive twitch, or she is possessed. After a few seconds of silence, she let out a long sigh before her eyelids begin to rest.
Nothing.
“I think it’s a sign. I think she could hear what her mom was saying,” I say.
Dylan looks at me like I’m crazy.
“Maybe she doesn’t want any part of it,” I say.
“Or maybe it was just a reflex, which is common in comatose patients. Look. She has not been responsive since she hit the door here. She’s on a ventilator and hasn’t been recovering as well as we expected from surgery,” says Dr. Lee.
Dr. Lee, who’s rubbing Laura’s forehead, looks adverse to my theory. It dawns on me why I don’t trust MDs like Dr. Lee or my ex-husband Neil; their practice is not based on miracles, prevention, or signs. Insurance companies and pharmaceutical companies would probably never allow that.
“What is the procedure for removing Laura from life support?” I ask.
“Well, if she was removed from it today, I would estimate she would live for no more than forty-eight hours,” Dr. Lee replies.
“However, the more time that goes on with her being nourished, hydrated, and nursed back to health, the healthier she will become and the longer she will continue living once removed from life support. You hear about those cases, where the patient stays alive for days, weeks, or even longer. I just can’t give a definite time frame. It just depends on the patient.
“It also looks like she’s having the onset of gangrene around her thumb. We noticed a gash on her thumb. But we’re going to monitor it. I may have to amputate any areas that turn black,” says Dr. Lee.
Dr. Lee pulls up the blanket that is covering Laura’s hands.
Laura has a darkened right thumb area with a chipped French manicure and crinkled skin. It resembles the webbed and wrinkled foot of a bird. Her hand is inverted and the skin around the base of her thumb leading up to her pointer finger is purple. What looks like bruising is actually gangrene. Marks around her right thumb that show a dark red pooling of blood next to the stitches catch my attention.
“That is the gangrene. It’s caused from the compression to the nerve,” says Dr. Lee.
“Is that because the belt was too tight around her wrists?” I ask.
“It could be from being too tight or if she was holding her head, whatever struck her could have clipped her thumb. And if she was struggling when she was restrained causing the gash, that could damage the nerves, too,” Dr. Lee says.
“Thank you, Doctor. Here’s my card. My cell phone number is on the back. Please contact me if there is any decision made regarding the life support or if there is any significant change in her status,” I say.
“Of course,” he replies. “To be honest, I’m not looking forward to calling you. I haven’t had the best experience with your office. I don’t know how you do your job. I save lives, but you people seem to wreck them. You call people into court to testify, you arrest people, and you call people for jury duty. I can go on and on at how your profession never ceases to amaze me.”
I never looked at doctors in the same light after I married one. Neil, my ex-husband, grew into the biggest asshole I knew after graduating medical school. His head grew bigger each year his residency brought him closer to starting his own medical practice. I started noticing why when I went to a hospital holiday party with him. Nurses in stilettos, fishnet stockings, and backless dresses were gushing over all the doctors. Neil was right there eating all of it up.
“Yes, if you are asking, someday you will need to come to testify about Laura’s condition and how your trauma unit treated her or, as you say, ‘saved her life,’” I reply.
“Okay, whatever you need.”
The sarcastic tone of Dr. Lee’s voice sent a wave of goose bumps down my arms and thoughts back to Neil’s paternalistic down-talk that I put up with for four years.
“Dr. Lee, we need people like you to come to court on these cases and tell the jury what procedures you did,” I explain. “What if the defense later came back and said it was by some fault of the hospital or you that caused Laura to die, rather than her hematoma or beating? Not only would that mean a lawsuit for you, but it would be a huge waste of time and resources. It’s in your best interest to cross your t’s and dot your i’s with this case, so you can explain all the necessary medical procedures you did on Laura.”
Dr. Lee looks like his head is about to erupt as he tightens his lips together and squints his eyes at me.
“I run one of the top centers in Tuckford County. I know how to cross my t’s and dot my i’s.”
I give Dr. Lee one of my fake smiles.
“Has any of the brain matter, which I’d assume was removed during surgery, been sent to pathology?” I ask.
Sometimes brain guts are removed by a surgeon, like a clot or hematoma caused by some blunt force trauma or beating. They can be sent for testing to see how large the clot is to show how slow the brain bleed was and when the injury occurred. The look on Dr. Lee’s face is an obvious sign he didn’t dot this i.
“Ma’am, we don’t typically do that; but I will check with Dr. Mai to see if she can send that over for you.”
“It’s all part of crossing those t’s,” I say as Dr. Lee leaves the room and the VAT nurse walks in.
I used to think one of the most intrusive examinations a woman can undergo is a pap smear. But a sexual assault exam is a hundred times worse. Danielle, dressed in a dark blue uniform with white skulls and crossbones on top and bottoms, shows up to perform this exam on Laura. She is from VAT, the Violent Assault Team. She conducts her exams quickly, but not always the most thoroughly. Dylan and I stand by Laura’s bed at a distance, close enough to observe, but far enough to give the nurse space. Bess walks in and sits next to Laura, holding her hand. Two of Laura’s hospital nurses walk up and stand near the doorway.
In most exams, the nurse will conduct a full interview with the victim, asking her all kinds of questions to get a complete history about the incident and what her private parts have been exposed to in the past two weeks. But Laura is unconscious.
“Has she had any surgeries you know about?” asks Danielle.
“She had an abortion when she was thirteen,” says Bess.
“Was the father known at the time?” Danielle asks.
“Well. She claimed it was her stepfather,” Bess says.
“It
was
Javier,” I say dramatically.
“That was the allegation. It was never confirmed,” Bess retorts.
“Why would she lie about that?” I ask.
I can’t stand Bess right now. This is the typical denial that mothers have about their daughters being sexually abused. Her tone that suggests Laura would have made this up irritates me to the point I almost ask that she be removed from the room. But I remember not to miss the opportunity to keep my mouth shut. I know this must be hard for her.
“Do you know the date of her last menstrual period?” asks Danielle.
I laugh. “Yeah, actually, she was laughing with her neighbor Christina, who’s in The Mamacita Club, a couple weeks ago saying she had just started her period. I told them that we women are so reactive to our environments, even our menstrual cycles become synchronized to each other,” I say.
“You told that to my daughter?” asks Bess disgustedly.
I glare at Bess.
“Do you know whether she’s had intercourse in the past five days?” Danielle asks.
“I don’t know. Probably. She did leave with a young man the night before this happened,” says Bess.
“That probably wasn’t the only person she was having sex with,” I say.
“Do we know if she had multiple partners?” Danielle inquires.
“We don’t know for certain, but word on the street was that she was being used as a sex worker,” I say.
“I see,” says Danielle. “So we may have the presence of semen from multiple men inside her.”
“Please excuse me. This is a little too much for me. I’m going outside to have a smoke,” says Bess, while standing up and leaving the room.
“Do we know whether she used condoms?” asks Danielle.
“I doubt it,” I reply.
“Well, it sounds like we have quite an upstanding young lady. She’s had an abortion, has multiple partners, doesn’t use condoms, and may be prostituting herself out. And you were mentoring her?” asks Danielle in a sarcastic tone.
“I was trying to. I don’t know if you realize this, but she was sexually abused by her stepfather. In fact, it was the man that Bess, the lady who just walked out, has been trying to protect. I think that was obvious by her comment about Laura’s abortion.”
“Yes, I gathered that. I’m just trying to collect as much information as I can about this girl. I know nothing about her and am not here to judge her. All I’m thinking is that there may be factors interfering with findings. It’s just something I need to document,” says Danielle, backtracking.
“Thank you for your insight. I’m well aware of the factors that may affect the findings in these types of cases. Laura may be a troubled girl, but she is still a victim and didn’t deserve what happened to her,” I assert.
“How was she tied up?” asks Danielle.
“Her wrists were tied together with a belt,” I say.
“To what?” says Danielle.
“Nothing. They were tied together. And she was blindfolded,” I say.
“So she could have gotten up?” Danielle asks.
“Assuming she wasn’t unconscious, yeah. I guess,” I say.
Danielle squints her eyes and shakes her head like something is not making sense to her.
“Do you know whether she’s lost memory?” asks Danielle.
“She’s in a coma, for crying out loud. I’m sure she’s not going to remember pretty much anything,” I yell.
Why is it that Danielle wants to be thorough in filling out this questionnaire when she’s dealing with a comatose patient? She’s never this thorough.
“Let me ask you this. Why do you think she was raped? You’re the ones that called me down here for this exam. From your answers, it seems like she was a willing party in any sexual activity,” says Danielle.
“The man we have in custody is her pimp. There’s only one reason he would have done this; to discipline her if she was trying to leave the ring. It’s pretty common for them to rape their sex worker,” Dylan says.
Danielle shuts her notepad and puts her pen down.