Lynn watched Wykoff fish her phone from her pocket and check it, “You are so right,” she said. “Apologize for me!”
“It isn’t a problem, except they wanted to let you know your first case has been canceled. The patient forgot her pre-op instructions and had a full breakfast.”
“Okay, I got it. I appreciate your letting me know.”
“We’ll let Dr. Barker, your second case, know as well. It is now scheduled for late morning. Maybe it can be moved up. We’ll keep you informed.”
“That would be terrific. Thank you.”
As if on cue, the moment the intercom clicked off, the murmur of other conversations in the locker room recommenced.
Dr. Wykoff looked over at Lynn, who was regarding her with a wide-eyed gaze. “Better to find that out in admitting rather than up here in the OR,” Dr. Wykoff said to make conversation.
“I suppose,” Lynn answered. She looked away, suddenly realizing she had been staring. What to do, was the question. It seemed much too serendipitous not to take advantage of this fortuitous meeting. She had spent a number of hours during the night reading up on standard anesthesia procedure, so she felt confident she could hold up her end of a technical conversation about Carl’s case. Yet was this the time and the place to bring up what would undoubtedly be a touchy subject, as Michael had reminded her? Lynn donned her white coat over her scrubs and closed the locker in which she had put her clothes. Impulsively she decided to give conversation a try. “Excuse me, Dr. Wykoff,” she began, still unsure of what she was going to say, especially while struggling to keep her emotions in check.
After closing her own locker, Dr. Wykoff directed her strikingly bright blue eyes at Lynn.
“I understand you were the anesthesiologist attending Carl Vandermeer yesterday,” Lynn said.
Instantly Dr. Wykoff’s eyes narrowed and bore into Lynn’s. She didn’t respond immediately but proceeded to look Lynn up and down, as if appraising her. She then warily nodded and said: “I was the attending. Yes. Why do you mention it?”
“I read your note in the chart in the neurology ICU yesterday. I need to talk to you about the case.”
“Really?” Dr. Wykoff questioned with a whiff of guarded incredulity. “And who are you?”
“My name is Lynn Peirce. I am a fourth-year medical student.” She specifically avoided making any reference to why she had been in the neuro ICU and why she had been looking at the chart. She knew that the excuse of being on an anesthesia rotation wouldn’t play with an anesthesia attending.
“Why exactly do you want to discuss this unfortunate case?” Dr. Wykoff asked warily.
“I’ve learned that a million people a year go into a hospital with one complaint and then end up with another serious medical issue they didn’t have before being admitted. I think it is an important issue that we medical students aren’t taught. The Vandermeer case might apply.”
“I suppose we could talk,” Dr. Wykoff said as she relaxed a degree. “But this is not the time or the place. You heard that my seven-thirty case has been canceled. If my next case is not moved up, I suppose I could speak with you this morning.”
“I would appreciate it,” Lynn said. “How will I get in touch with you?”
“Ask Geraldine at the OR desk. She’ll know where I am.” Then the anesthesiologist walked out.
15
Tuesday, April 7, 6:33 A.M.
Michael pulled his medical student white coat over his scrubs. When he emerged from the men’s locker room, he didn’t want to hang out in the surgical lounge for fear of getting into a conversation with someone who might feel obligated to ask what the hell Michael, as a fourth-year medical student, was doing in scrubs. Instead he went out into the hall by the elevator to wait. He didn’t have to wait long.
“Of all people, I bumped into infamous Dr. Sandra Wykoff,” Lynn said in a forced whisper when she appeared. As usual, there were other people waiting for an elevator. “She was changing right next to me.”
“And who might Dr. Wykoff be?” Michael asked, his voice rising for effect.
“Oh, come on!” Lynn complained irritably. “She was Carl’s fucking anesthesiologist, who was responsible for what happened. How could you forget?”
“I’m trying to make a point, my dear. You don’t know that she was responsible. That’s the kind of comment that is going to get you in a whole shitload of trouble.”
“Technically you’re right,” Lynn snapped. “But she was in charge when whatever happened happened. There’s no denying that. If she didn’t cause it, she could have stopped it or prevented it.”
“You don’t know that, girl. I’m telling you straight. You are going to crash and burn.”
The elevator doors opened. The car was full. Lynn and Michael and several others had to squeeze on as people reluctantly made room. The two students didn’t try to talk as the elevator rose, stopping on each floor. Once they got out on the sixth floor they walked slowly and let the other people who had gotten out pass by. Most were nurses and nursing assistants who were coming in for the morning shift.
“Wykoff’s first case for today was canceled,” Lynn said when she was sure no one would overhear. “She agreed to talk to me, provided her second case doesn’t get moved up.”
“I better come along just to keep you in line,” Michael said. “You are on a self-destructive roll.”
“Do you really want to come along?” Lynn said with a touch of disdain. “I thought you weren’t going to help.”
“Like I said. Somebody’s got to protect you from yourself and make sure you cut this woman some slack, you know what I’m saying?”
As they got closer to the neuro ICU, Lynn’s pulse began to rise and her anxiety ratcheted upward. If there had been a change in Carl’s status, she would not have heard one way or the other, as she wasn’t in the immediate family loop. Although she expected little change, she knew there was a slight chance that he could be better or worse. Unfortunately, with a provisional diagnosis of extensive brain necrosis, his chances of improvement were mighty slim, which left the downside much more probable.
Outside the double doors, Lynn hesitated out of worry about what she was going to confront. Michael sensed her reluctance. “You want me to go in and see what’s up?” he suggested. “Then I could fill you in.”
“No,” Lynn said. “I want to go in and see him. I’ll be all right.”
As Lynn and Michael had hoped, the nurses were busy at rounds. As the door closed behind the medical students, they could see that the nursing team going off-shift and the team coming on were all congregated in bay number 5, going over a new arrival. For the moment all the other patients, including Carl, were on their own.
At the central desk, the ward clerk, Peter Marshall, was already on duty, watching over the monitor feeds. His day had already begun, even though technically it wasn’t supposed to begin until seven. Lynn remembered that had never bothered Peter. He always arrived early to get a jump on the day.
A female attending physician was also at the desk, busy at work with a number of charts stacked in front of her and one open. Lynn and Michael could tell from her long white professorial coat that she was an attending, and not a resident. They didn’t recognize her.
The medical students went directly to cubicle 8, with Lynn lagging slightly behind, afraid of what she was going to see. Carl wasn’t sitting up having breakfast, but he wasn’t dead, either. He looked as serene as he had the day before, with his eyes closed, as if asleep. He was still in the exact same supine position, with the CPM flexing and extending his operated leg. His IV was running as it had been, but it had been repositioned as a central venous line and now went into his neck.