With nothing to do, George turned on Laney’s phone. He pressed the iDoc app icon just as he had with Kasey’s. He saw that, as with Kasey’s, the iDoc app had been shut down and wiped clean more than an hour previously. Knowing what he did, he guessed it meant that Laney had not had a heartbeat for all that time.
“I think she’s been dead an hour,” George announced. He held up the phone. “According to iDoc, anyway.”
“An hour!” The leader of the resuscitation team motioned to the man doing the chest compressions to stop. “Now we know why we haven’t been able to get any cardiac activity. An hour? Christ! This patient is long dead! That’s it. Let’s pack it up, guys! Even if we managed to get a heartbeat, the brain would be gone.”
The team began gathering up their gear. George, Kelley, Carlos, and Christine appeared transfixed by the situation.
On his way out of the room, the head of the resuscitation team approached George, who he knew was a senior resident. “Dead an hour? That doesn’t look good for our ER. How long was the patient left alone?”
“Almost two hours,” Kelley said, answering for George. “I’m the junior resident assigned to the patient.”
“What is this, your third day?” the team leader questioned. He let out a long, slow whistle. “They’ll have fun with this one at the morbidity and mortality conference. Let’s hope the media doesn’t find out about it. But I suppose we shouldn’t be surprised. It is July!” He snickered as he herded his team out the door.
It was a devastating parting shot to the first-year resident. Everybody in the room knew what he meant by “July.”
For a moment George couldn’t speak. Laney’s death had brought back the horror he had felt waking up next to Kasey’s corpse. She, too, had been dead long enough to be cold. Again the question came back: Why was death stalking him? Or was it rather that he was somehow the culprit, bringing death to everyone around him, starting with his own mother?
“Oh, my God!” Kelley said, forcing back tears. “What a disaster. I feel so bad. I should have checked on her.”
One of the ER nurses put her arm around Kelley’s shoulders. “It wasn’t your fault. Don’t listen to that resident. Nurses and orderlies should have checked on her, too. If it was anybody’s fault, it was everybody’s.”
“What that resident said was completely uncalled-for and mean,” Carlos said, waiting for George as the most senior resident to speak.
“If it was anybody’s fault, it was ours,” Christine said. “OB shouldn’t have made her wait. Sometimes the system just doesn’t work. We should probably have one resident in charge of ER consults rather than just relying on who happens to be free.”
George remained silent, staring at Laney’s lifeless face. He wandered out of the room, ignoring the others. He couldn’t shake the sense that something was wrong in his world. Very wrong.
25
Carlos brought up a chest X-ray on the monitor and gave the pertinent history of the patient to George, sitting next to him. Carlos was still chafing at George for not standing up for Kelley. Like everybody else, Carlos knew that Laney’s death was a system error, meaning there were a number of people who could be faulted. The senior medical resident’s picking on a first-year resident amounted to bullying.
“What’s your take on this film?” Carlos asked, his voice reflecting his disappointment at George’s reaction to the incident. “Do you think there’s a secondary finding?” The X-ray had been taken to evaluate probable rib fractures, but Carlos had spotted a possible secondary finding. He wasn’t sure whether or not there was hilar lymphadenopathy, or swollen lymph nodes, at the portion of the lung that carried all the blood vessels to and from the lung as well as the bronchial tubes. Carlos knew that lymphadenopathy was a finding common with a number of infectious diseases but could also signify lung cancer. Although detecting it obviously carried a great significance, it wasn’t a black-and-white call.
George was staring blankly at the monitor and didn’t respond.
“Are you okay?” Carlos asked. His disgruntlement was changing to concern.
George broke from his trance. “Sorry. I’m a little preoccupied, I guess.” He stood up. “Excuse me. We’ll finish up with this current batch of films later.”
George left the imaging room, aware that Carlos was most likely mystified by his behavior and wondering when George was going to snap out of his reaction to Laney Chesney’s death. He imagined that Carlos would have believed that George, as a fourth-year resident, should be inured to such incidents.
George was on a mission. He knew he was supposed to be at the radiology conference at four, which didn’t leave much time, but he decided he needed to talk to Kelley Babcock. As bad as he felt about Laney, he was sure she felt worse. He found her sitting alone in the doctors’ lounge, hunched over a cup of coffee.
“Kelley?”
She looked up. George could see her eyes were red.
“You mind?” He nodded to the empty chair next to her.
“I don’t own it.”
Not the most welcoming of invitations to join someone, but he took it anyway.
“Dr. Warren Knox,” Kelley said unbidden.
“Pardon?”
“You asked me who the ER resident in charge of the DeAngelis case was. It was Dr. Knox. But he has the day off.”
“Thanks. I’ll talk to him the next time he’s on duty. But that’s not why I’m here.” He cleared his throat and began. “I recently had two people on whom I’d done MRIs pass away.” He paused, thinking of the best way to phrase what he wanted to say. “I take it personally when a patient dies, too. Maybe I should have learned better how to compartmentalize, put it in a box — I mean, it’s not like I don’t put it in a box. I do. But I only pretend the box is shut tight, and things leak out.”
Kelley looked up at him, curious.
“I guess what I’m trying to say is that I’m sorry. I was upset and… I should have stood up for you with that medical resident. He was definitely out of line when—”
“Thanks. But it’s not just me or my guilt I’m upset about. I mean, I should have gone back to check on her, I accept that lapse. But it is also something else. It’s just… the unfairness of who gets dealt a bad hand. Why have I been so lucky? She was so young.” Kelley stirred her coffee absently. “When my father died I thought my life was over. I was home alone with him….” She paused. “I was just a dumb thirteen-year-old teenager, and there I was with my father having a heart attack right in front of me. She shook her head at the memory. “I wanted so badly to be able to help.” She looked up at George. “It’s probably why I went into medicine, and emergency medicine in particular. But now that I’m here, my great fear is about somebody coming in that ER door needing and expecting Superwoman and getting a very ordinary, scared little girl from Kansas who can make mistakes.”
George watched Kelley as she went back to stirring her coffee. He thought she was possibly more beautiful on the inside than on the outside. Now, that was something.
“I don’t know what you think about my opinion,” George said. “But I am one hundred percent sure you are going to be a super ER doctor. I mean it.”