Instead she sat down at her laptop and went into her e-mail inbox. There at the top was the JPEG she’d just sent to herself. Immediately below were two other e-mails from Michael. As promised, they were Scarlett Morrison’s and Carl’s anesthesia records. Lynn checked to be sure. Then she loaded all three into a flash drive, which she would take down to the student common room on the first floor to utilize the communal printer. But before doing so, she Googled gammopathy as she had done in the neuro ICU and immediately found the same article: “Monoclonal Gammopathy of Undetermined Significance.” She downloaded a PDF version into the same USB device. Then she downloaded Wikipedia articles on multiple myeloma and serum protein electrophoresis. The last article she knew she wanted was on monoclonal antibodies, but when she rapidly read through it before downloading it, she realized there was one more she needed. It was on hybridoma technology. From an immunology lecture in her second year she remembered that monoclonal antibodies were made by hybridomas.
So armed, Lynn went down to use the printer. She had to swipe the magnetic tape on her student ID to get the machine to operate. While the machine did its thing, she sat in one of the leather club chairs and practically fell asleep.
With her printouts in hand, she went back to her room and lay down on her bed. For a few minutes she debated which of the printed pages she should read first. She thought about looking at the anesthesia records but decided she needed a completely clear head for those. Instead she turned to the articles. She settled on the gammopathy article, since it would be a review, as she had already read it once before in the neuro ICU. After that, she planned to read the one on multiple myeloma. But the reality was that she managed only four or five sentences of the first article before falling into a deep, dreamless sleep.
23
Tuesday, April 7, 1:52 P.M.
With a sense of relief Sandra Wykoff left the PACU after making sure her second and final case was fully awake and functioning normally. It had been a hip replacement, and she was confident the patient would be going back to the fifth floor in short order. During both cases, when it came time for her to wake them up, she’d had a degree of anxiety, but both had awakened as expected, just as all the other cases she had done in her career, except for Carl Vandermeer’s.
Once out in the main hallway, Sandra walked down to check the whiteboard to make sure she had not been scheduled for another case since her first case had been canceled. Although she was confident Geraldine Montgomery, the OR supervisor, would have let her know, she wanted to be certain. After the tongue-lashing she’d suffered from Benton Rhodes that morning, she wanted to be absolutely certain she didn’t do anything to provoke the man further. She had known about his reputation for having a short fuse but until that morning had never experienced it personally.
The more Sandra thought about the Vandermeer case, the less harsh she became on herself. She was absolutely confident that she hadn’t done anything wrong during the procedure. She had not even taken so much as a shortcut, which she knew other people in the department did on occasion, particularly neglecting to manually check the anesthesia machine before each use. Most relied completely on the automatic check, which she thought was a mistake.
It had taken only a little more than an hour after Rhodes had stormed out of the communal OR anesthesia office for Sandra to be again totally convinced that whatever had happened during the Vandermeer operation was not her fault. She was absolutely sure of this, since she had, as she had told the students, gone back over the case in minute detail, questioning every step and consulting with several other anesthesiologists whose opinion she admired and trusted.
Sandra had even tried to have a conversation with Mark Pearlman, who had had a strikingly similar case the previous Friday, but he had refused to talk with her about his case or hers. He had chosen to follow Rhodes and Hartley’s orders to the letter, even to the extent of not talking to a fellow anesthesiologist. Sandra thought that was a mistake despite what the hospital counsel felt. She knew that complications often led to advances in medicine.
The long and short of it was that if there was a lawsuit, Sandra was confident that no one would find the hospital or herself culpable. And, contrary to what Benton Rhodes had said, she was sure that the two students were Mason-Dixon family and could be trusted. She had made the effort to call the dean of students to ask about Lynn Peirce prior to seeing her and had learned that Miss Peirce was going to graduate number one in her class, just as Sandra had done over at MUSC almost seven years before. There had been no reason not to talk to her and her classmate and perhaps salvage something from the disaster. Students had to learn that medicine was not all-powerful or completely predictable.
And there had been a positive aspect to the conversation with the students. For Sandra, talking about the case in detail had helped ameliorate the guilt that had been haunting her since the tragedy had struck and boost her confidence in her professional abilities. Confidence was important if she was to continue being an anesthesiologist.
The other thing the conversation with the students had done was remind her of the blip that had occurred on the monitor. It had been so insignificant, but considering it was the only thing about the case that was at all unusual, she now thought it was worth checking. The problem was that doing so necessitated calling Clinical Engineering, something she was reluctant to do, since it meant risking having to deal with Misha Zotov.
Steeling herself against such a possibility, Sandra walked back down the main OR corridor whence she had come and headed for the room where the extra anesthesia machines were stored. Her hope was to corral one of the Clinical Engineering technicians and ask a few questions about the blip she’d seen on the monitor. She wasn’t looking forward to going all the way down to the Clinical Engineering Department, located in the hospital basement, where she had first encountered the irritating Russian.
The good news was that Misha Zotov wasn’t in the room. The bad news was that no one else was, either. Turning around, Sandra retraced her steps to the main desk. It seemed that if she was going to ask about the blip, she would have to go to the Clinical Engineering office, after all.
At the busy main desk, Sandra got Geraldine’s attention and told her she was leaving the floor and that if she was needed for anything, she could be texted. Geraldine gave her a thumbs-up to indicate she got the message.
After retrieving a long white lab coat from her locker in the women’s lounge, Sandra was able to put off going down to the basement, at least for the time being. Thinking about Carl Vandermeer made her want to check on the man’s status. She had gone into the neuro ICU for a quick visit the previous afternoon before leaving the hospital and also early that morning on her way in to work. Although she was aware of the MRI and CT scan results and had read the neurology residents’ notes, she couldn’t help but harbor a bit of hope that there might be a change for the better, knowing how little hypoxia he had suffered.
Once in the neuro ICU, she went directly to cubicle 8. Seeing Carl, Sandra could immediately tell there had been no change in his condition. A nurse had rolled him onto his left side so that she could wash and powder his back. Sandra shuddered at the enormity of the situation for which she, on some level, was responsible for causing. She knew that dealing with a comatose patient required almost constant care and attention. She also knew that Carl would probably need a percutaneous gastric tube. Doing so required an operation. Sandra shuddered again, wondering how she would feel if it fell to her to do the anesthesia.