第十章

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There were too many patients, too few doctors and nurses, and too few hours in a day. He felt like the captain of a sinking ship, running around vainly trying to plug up the holes.
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Seymour Wilson, the chief of medicine at Embarcadero County Hospital, was a frustrated man with an impossible job.
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At the moment, Dr. Wilson's immediate concern was Honey Taft. While some doctors seemed to like her a great deal, reliable residents and nurses kept reporting that Dr. Taft was incapable of doing her job.
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Wallace remembered Honey. She was the one who had the extraordinarily high grades and glowing recommendation. "I don't understand it," he said. "There must be some mistake."
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He was thoughtful for a moment. "I'll tell you what we'll do, Seymour. Who's the meanest son of a bitch on your staff?"
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Wilson finally went to see Ben Wallace. "I want to get rid of one of our doctors," he said. "The residents she makes rounds with tell me she's incompetent."
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"Ted Allison."
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"All right. Tomorrow morning, send Honey Taft out on rounds with Dr. Allison. Have him give you a report on her. If he says she's incompetent, I'll get rid of her."
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"I know him," Paige said. "He has a miserable reputation."
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At lunch, Honey told Paige that she had been assigned to make the rounds with Dr. Allison the following morning.
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"Fair enough," Dr. Wilson said. "Thanks, Ben."
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"That's what I hear," Honey said thoughtfully.
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Seymour Wilson was saying, "I want you to keep a close eye on Dr. Taft. If she can't cut it, she's out. Understood?"
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"Understood."
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At that moment, in another part of the hospital, Seymour Wilson was talking to Ted Allison. Allison was a hard-bitten veteran of twenty-five years. He had served as a medical officer in the navy, and he still took pride in "kicking ass."
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He was looking forward to this. Like Seymour Wilson, Ted Allison despised incompetent doctors. In addition, he had a strong conviction that if women wanted to be in the medical profession, they should be nurses. If it was good enough for Florence Nightingale, it was good enough for the rest of them.
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At six o'clock the following morning, the residents gathered in the corridor to begin their rounds. The group consisted of Dr. Allison, Tom Benson, who was his chief assistant, and five residents, including Honey Taft.
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The first patient in Ward One was a teenage girl lying in bed, covered with heavy blankets. She was asleep when the group approached her.
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Now, as Allison looked at Honey, he thought, Okay, sister, let's see what you've got. He turned to the group. "Let's go."
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Honey stood there, frowning, silent.
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Dr. Allison was looking at her in surprise. "What… what makes you say that?"
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"All right," Dr. Allison said. "I want you all to take a look at her chart."
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The residents began to study the patient's chart. Dr. Allison turned to Honey. "This patient has fever, chills, general malaise, and anorexia. She has a temperature, a cough, and pneumonia. What's your diagnosis, Dr. Taft?"
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"Well," Honey said thoughtfully, "I would say she probably has psittacosis -- parrot fever."
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"Well?"
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Allison nodded slowly. "That's… that's very good. Do you know what the treatment is?"
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"Her symptoms are typical of psittacosis, and I noticed that she works part-time as a clerk in a pet shop. Psittacosis is transmitted by infected parrots."
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"Yes. Tetracycline for ten days, strict bed rest, and plenty of fluids."
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It became even more impressive. In the next two hours, Honey diagnosed a rare case of Reiter's syndrome, osteitis deformans polycythemia, and malaria.
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Dr. Allison said, "If you'll examine his chart, you'll find that he has mesothelial tumors, bloody effusion, and fatigue. What's the diagnosis?"
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Dr. Allison turned to the group, "Did you all hear that? Dr. Taft is absolutely right."
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When the rounds were over, Dr. Allison shook Honey's hand. "I'm not easily impressed, doctor, but I want to tell you that you have a tremendous future!"
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Ted Allison could not conceal his admiration. "Excellent! Excellent! Do you happen to know what the therapy is?"
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Honey looked thoughtful. "Offhand, I'd say it was fibrous pneumoconiosis, a form of asbestos poisoning. His chart shows that he works in a carpet mill."
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One of the residents said, hopefully, "It sounds like some form of pneumonia."
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"Unfortunately, no specific therapy is available yet."
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They moved on to the next patient.
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A second resident spoke up. "It could be cancer."
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Dr. Allison turned to Honey. "What is your diagnosis, doctor?"
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One day, as Paige and Kane were walking toward the operating room, Paige asked, "What are we going to operate on, doctor?"
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And, "I may be short, honey, but not everywhere. You know what I mean?"
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"What do you mean, you won't go out with me? You must be getting it from someone else."
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Tom Benson, Allison's senior assistant, looked at Honey and smiled. "I'll meet you in half an hour, baby."
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Time after time, Paige watched Kane perform unnecessary surgery and take out organs that were healthy.
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"He should be working in a butcher shop," Paige later said angrily to Kat. "He has no right to be operating on people."
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"And I intend to tell Ben Wallace so," he said as he walked away.
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But at every opportunity, Kane asked for Paige to assist him with operations. And each time, he would become more offensive.
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She came to dread the occasions she had to work with him.
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"His wallet!" He saw the look on Paige's face. "Just kidding, honey."
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Honey blushed. "Thank you, Dr. Allison."
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Paige tried to stay out of the way of Dr. Arthur Kane -- 007.
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"Someone should report Dr. Kane," Paige said. "He's murdering his patients!"
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It was all Paige could do to contain her anger. She decided to have a talk with Tom Chang.
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"Take it easy."
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"What good would it do? You'd have to get other doctors to testify against him, and no one would be willing to do that. This is a close community, and we all have to live in it, Paige. It's almost impossible to get one doctor to testify against another. We're all vulnerable and we need each other too much. Calm down. I'll take you out and buy you lunch."
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After a particularly inept liver operation, Dr. Kane turned to Paige and shook his head. "Too bad. I don't know if he's going to make it."
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"I can't! It's not right that they let a man like that operate. It's criminal. He should be brought up before the credentials committee."
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Paige sighed. "All right, but it's a lousy system."
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At lunch, Paige asked, "How are you and Sye doing?"
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He took a moment to answer. "I… we're having problems. My work is destroying our marriage. I don't know what to do."
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The following morning, Arthur Kane was scheduled to perform a kidney operation. The chief of surgery said to Paige, "Dr. Kane asked for you to assist him in OR Four."
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The scrub nurse handed Dr. Kane a scalpel.
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A moment later a CD began to play.
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Paige's mouth was suddenly dry. She hated the thought of being near him.
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Paige sighed. "Right."
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The patient's abdomen had been painted with an iodine solution and an incision had been made in the right upper quadrant of the abdomen, just below the rib cage. So far, so good, Paige thought.
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"He's waiting for you, doctor."
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"I'm sure it will work out," Paige said.
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Chang said fiercely, "It had better."
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By the time Paige had scrubbed up, the operation was already in progress.
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Dr. Kane kept cutting. "Let's have something a little peppier." He looked over at Paige. "Start the bovie, sweetheart."
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Paige said,' 'Couldn't you get someone else to…?"
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"Give me a hand here, darling," Kane said to Paige.
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"Scalpel!"
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Paige looked up at him.
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"I would kill myself if she left me."
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He looked up. "Put some music on."
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"Sponge."
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Sweetheart. Paige gritted her teeth and picked up a boviean electric cautery tool. She began to cauterize the arteries to reduce the amount of blood in the abdomen. The operation was going well.
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Thank God, Paige thought.
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For once, everything had gone well, yet something was bothering Paige. She took a closer look at the kidney. It looked healthy. She frowned, wondering if…
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The X-ray had been put up backward. Dr. Kane had removed the wrong kidney.
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The scrub nurse handed Kane a sponge.
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"Good. Let's have some suction." He cut around the kidney until it was exposed. "There's the little devil," Dr. Kane said. "More suction." He lifted up the kidney with forceps. "Right. Let's sew him back up."
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As Dr. Kane began sewing up the patient, Paige hurried over to the X-ray in the lighted wall frame. She studied it for a moment and said softly, "Oh, my God!"
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"He took out a healthy kidney and left in a diseased one!" Paige's voice was trembling. "The man should be put in jail!"
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Thirty minutes later, Paige was in Ben Wallace's office.
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Paige knew what that meant: a group of physicians would review what had happened, but it would be done in confidence.
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"We'll keep a closer eye on Dr. Kane." He leaned forward in his chair. "I'm going to give you some advice. When you get into private practice, you're going j to need the goodwill of other doctors for referrals. Without that, you'll go nowhere, and if you get the reputation! of being a maverick and blowing the whistle on your: fellow doctors, you won't get any referrals. I can promise you that."
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"Believe me, we're going to have a peer review evaluation."
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"A mistake'? That patient is going to have to live on dialysis for the rest of his life. Someone should pay for that!"
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"He has no business working in this hospital. Or any other hospital."
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"You're part of our team, Paige. You've got to be a team player.''
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Benjamin Wallace said soothingly, "Paige, I agree with you that it's regrettable. But it certainly wasn't intentional. It was a mistake, and --"
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The information would be withheld from the public and the patient.
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"You've got to look at the whole picture. If he were removed, there would be bad publicity and the reputation of the hospital would be hurt. We'd probably face a lot of malpractice suits."
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"Dr. Wallace…"
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"What about the patients?"
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"It's a deal. I'll organize things," Honey told them. "We'll do it tomorrow after rounds."
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"Or they wouldn't be here," Kat pointed out.
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Kat shook her head. "Nobody said life has to be fair."
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"That's it."
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"It's not fair," Paige said. She was in the cafeteria having lunch with Kat and Honey.
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Paige thought for a second. "You know," she said, "that's not a bad idea. Let's do it!"
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"I told you, we're going to do a peer review evaluation."
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Honey's voice was suddenly filled with enthusiasm. "We could order up some decent food and liquor, and have a celebration! I think we could all use a little cheering up."
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"Why don't we give a party?" Honey suggested.
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"A party? What are you talking about?"
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Arthur Kane approached Paige in the corridor. There was ice in his voice. "You've been a naughty girl. Someone should teach you to keep your mouth shut!" And he walked away.
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Paige rose. "So you aren't going to do anything?"
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Paige looked around the antiseptic white-tiled room. "This whole place depresses me. Everybody is sick."
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"And that's it?"
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Paige turned to Honey. "This was a great idea!"
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Paige looked after him in disbelief. Wallace told him what I said. He shouldn't have done that. 'If you get the reputation of being a maverick and blowing the whistle on your fellow doctors…' Would Ido it again? Paige pondered. Darned right I would!
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An announcement came over the loudspeaker. "Dr. Finley and Dr. Ketler to the ER. Stat." And the two doctors, in the middle of downing shrimp, looked at each other, sighed, and hurriedly left the room.
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News of the forthcoming party spread rapidly. All the residents chipped in. A lavish menu was ordered from Ernie's, and liquor was delivered from a nearby store. The party was set for five o'clock in the doctors' lounge. The food and drinks arrived at four-thirty. There was a feast: seafood platters with lobster and shrimp, a variety of pates, Swedish meatballs, hot pasta, fruit, and desserts. When Paige, Kat, and Honey walked into the lounge at five-fifteen, it was already crowded with eager residents, interns, and nurses, eating and having a wonderful time.
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Honey smiled. "Thank you."
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The loudspeaker came on again. "Dr. Chang… Room 7… Dr. Chang… Room 7."
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"I can't believe what's happening," Kat said. "You know how people talk about having a guardian angel? Well, I think the three of us are under the spell of a guardian devil."
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The loudspeaker never stopped. Within thirty minutes, almost every doctor and nurse had been called away on some emergency. Honey heard her name called, and then Paige's, and Kat's.
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And a minute later, "Dr. Smythe… ER Two… Dr. Smythe to ER Two."
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Her words proved to be prophetic.
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Tom Chang came up to Paige. "We ought to do this every week," he said.
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The next Monday morning, when Paige got off duty and went to get into her car, two of the tires had been slashed. She stared at them in disbelief. Someone should teach you to keep your mouth shut!
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"Right. It's --"
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When she got back to the apartment she said to Kat and Honey, "Watch out for Arthur Kane. He's crazy."
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