Angels on the Night Shift (28 page)

“Susan!” he called. Then he saw me standing in front of him he said, “Great! Dr. Lesslie, come on in here, we need some help!”

“Susan!” he turned again to the secretary. “We need a portable X-ray in here stat!”

I stepped around Darren and over to the stretcher. Liz Kennick was standing by the counter, making some notes on the patient’s chart. Looking up at me as I entered the room, she said, “Good, glad you’re here, Robert.” Then she looked back down at the clipboard.

“Dan Perkins,” she said to me, her voice steady and businesslike. “Fifty-seven-year-old with left flank pain and blood in his urine. No history of kidney stones, but that’s what it looks like. I’m just trying to get his pain relieved.” She didn’t look up, but kept writing on his chart.

I turned to the man on the stretcher and stepped closer to him.

He looked up at me, his face pale and covered with sweat. There was obvious pain in his eyes, but also fear.

His hands were desperately clutching the raised rails of the stretcher, and his arms were shaking a little.

“Doc, I need some help,” he said quietly, his voice trembling. “This pain is killing me.”

I put my hand on his left arm. His skin was cool and clammy, and I asked Darren, “What’s his blood pressure?”

“100 over 60, last time we checked,” he told me. “That was about twenty minutes ago. Want me to get another one?”

“Not right now,” Liz answered without turning around.

Darren looked at me questioningly. Without saying anything, I nodded once, and he leaned over to get the blood-pressure cuff out of its holder on the wall.

“When did this pain start?” I asked Mr. Perkins.

“About half an hour before I got here,” he answered, glancing up at the clock on the wall beside him. “That’d make it about two hours ago.”

Two hours? What has Liz been doing all this time?

“Have you had any relief from the pain?” I asked him.

“No, not at all,” he said quietly. “It’s still killing me.”

Darren moved beside him and said, “Let’s try to sit you up a little, Mr. Perkins. I’m going to check your blood pressure again.”

When the nurse raised the head of the bed and Perkins tried to move, he let out a loud scream.

“Aaghh! I can’t!”

He clutched the rails of the bed even tighter and looked up at me, pleading.

“Don’t make me move!” he begged. “I can’t stand it!”

Liz spun around, saw Adler trying to take the man’s blood pressure, and demanded, “Darren, just what are you doing! I told you we didn’t need to do that now!”

Then she looked at me with daggers flying and said, “Do you want to take over here?”

Her eyes moved to the clock on the wall. “It’s time for me to go, anyway. So here, he’s all yours.”

She was trying to hand me the man’s clipboard, but I just stood and stared at her. I had never seen her behave like this before.

Then it hit me.

I whirled around and looked down again at Mr. Perkins. He wasn’t moving at all. Instead, he was desperately trying to remain absolutely still.

That’s what wasn’t making any sense! A person with a kidney stone
can’t
keep still. Their pain won’t let them. They will pace and squirm and move around, anything in an attempt to find some relief. This man wasn’t doing any of that. Instead, he was doing just the opposite. He was trying
not
to move.

“80 over 60,” Darren told us, putting the blood-pressure cuff back up.

“Probably just the morphine we’ve been giving him,” Liz muttered from behind me. “Here, take this. I’m outta here.” She pushed the clipboard into the small of my back.

“Just a minute, Liz,” I said without turning around.

Then I moved right beside the stretcher and reached out, gently placing my hand on Mr. Perkins’s abdomen.

“Are you having any pain here?” I asked him, pressing down a little, palpating different areas of his belly. He was slender and easy to examine.

“No, the pain is in my back,” he told me, his eyes searching mine. “Aaghh! That hurt!” he hollered, reaching down to move my hand away.

“Liz,” I said. “Come over here and feel this.”

“I’m off duty,” she replied curtly, turning to leave the room.

“Liz, come over here and feel this.” This time my voice was low and firm, and there was no mistaking my intent.

She hesitated, but only briefly. Then she moved over beside me.

“Where?” she scoffed. It was obvious she was becoming increasingly annoyed. Darren looked up at her and then over to me.

“Put your hand right here,” I directed her, pointing to an area just above and to the right of his navel.

“I don’t feel—” She stopped mid-sentence and her entire body tensed. Then she placed both hands on the man’s abdomen and began to examine him more carefully.

She was feeling his aorta. It was enlarged, forcefully pulsating, and was about to burst, if it hadn’t already.

It all came together. This man had an abdominal aortic aneurysm and it was getting ready to blow.
This
was causing his back pain, and not a kidney stone. And it explained his low blood pressure, the blood in his urine, and his determination to remain completely still. He needed to be in the OR, probably an hour ago.

“Did you feel his belly when he first came in?” I asked her quietly.

Across the stretcher, I saw Darren look up at Liz, waiting for her response. He had been in the room from the first moment Dan Perkins had come to the ER.

“Of course I did,” she answered defensively. Darren shook his head and looked down at the patient.

I studied her for a moment and then turned to Darren.

“We need to get in touch with the vascular surgeon on call. And we’ll need another IV, some blood typed and crossed, and a portable chest X-ray. I’ll send Lori in to help.”

Then stepping toward the entrance, I turned to Liz and said, “Come out here with me for just a second.”

She followed me as we moved out of the room and to the back of the nurses’ station.

Facing her and carefully considering my words, I said, “Liz, we all make mistakes. The key is to be sure we learn something from them. And—”

“Look!” she exclaimed angrily, then pointed her finger at me, not more than an inch from my nose. “If you’re going to hand me that stuff again about
making assumptions
, you can just save your breath.”

Over her shoulder, I could see Susan and Lori turn and stare at the two of us, their mouths hanging open.

“Just calm down, Liz,” I said quietly, reaching up and slowly moving her hand from in front of my face.

“I’m not the one who needs to calm down!” she yelled. “So I missed an aneurysm! What’s the big deal? You’ve never missed anything before?”

She was quickly spinning out of control, her body shaking and her face a deep red.

“Liz—”

“Don’t
Liz
me!” Her hand went up again, this time with her palm in my face. “I’m outta here!”

She turned, walked around the nurses’ station, and disappeared down the hallway.

I was hot, and was about to follow her back to our office when I remembered Dan Perkins. Quickly stepping over to Susan and Lori, I told them what we needed. Within a few minutes, the surgeon was on his way to the ER and Mr. Perkins was almost ready for the operating room.

“There, that should do it,” I told Lori, sliding the man’s chart over to her. “I’ll be right back.”

She looked up at me but didn’t say anything as I headed down the hallway.

I was still angry, still trying to get control of my emotions. Liz had really ticked me off, and I was wondering what in the world had flipped her switch.

She was standing by one of our bookshelves when I walked into the office. Her head jerked in my direction, and she began fumbling with some of the heavy texts on one of the upper shelves.

“What do you want?” she sputtered angrily, looking first at me and then back up at the bookshelf. She clumsily tried to straighten up the jumbled books but quickly gave up and turned to face me.

“Look, if you’re going to try to lecture me, I don’t want to hear it!”

Where has all of this anger come from?

“Liz, why don’t you just hold on and have a seat for a few minutes,” I told her as calmly as I could. “We need to talk.”

“There’s nothing to talk about!” she almost yelled. “I told you, I’m off duty and I’m getting out of here!”

Then she backed away and reached down for her sweater, quickly putting it on. She must have just taken off her lab coat and tossed it onto one of the chairs in front of the desk.

But I had seen it. And I stood there, looking into her eyes.

She had seen my glance and now turned her head away from me, patting the sleeves of her sweater. She became more agitated and started looking around the office for something. When she finally spotted her shoulder bag, she walked over, grabbed it, and headed for the door.

“Liz,” I said quietly.

Her hand was on the doorknob and she hesitated for just an instant.

“I saw your arm.”

She stood there, staring down at the handle, and her shoulders slumped. Then she sighed heavily and dropped her bag to the floor.

She didn’t say anything. She didn’t have to. The needle tracks in her left elbow said it all.

How have we missed this? Surely
something
should have tipped us off.

Then I remembered some of the simple mistakes she had been making, and her lack of patience with some of our “regulars.” But this had escalated so quickly. It had not even been a couple of months since we had first noticed the missing Vistaril.

It’s been Liz all along. But what about Amy? How could Liz have…

The shock of all this was beginning to subside and now I was more than angry—I was livid. We had brought this young woman into our midst, into our family, and she had almost destroyed it. Maybe she
had
destroyed it.

I wanted to walk over, grab her by her shoulders, and shake her until…

When I looked at her again, she was still standing by the door with her head hanging on her chest. She had put her arms around herself and was slowly rocking from side to side.

I turned back to the shelves and looked up at the toppled medical books. Reaching up, I moved them aside and felt behind them. When I turned around, Liz was looking at me, her eyes reddened and her lips trembling.

I opened my hand and showed her four syringes. They were each filled with a clear liquid, the morphine intended for Dan Perkins.

Liz Kennick collapsed into one of the chairs, her head in her hands, and she began to sob uncontrollably.

I walked around behind the desk, picked up the phone, dialed the nurses’ station, and said, “Susan, would you ask Lori to come back to our office.”

A
few days later, Virginia and I were in the medicine room, discussing the tumultuous events of the past few weeks.

It had taken us several phone calls, but with the help of the state medical board we were able to locate a drug rehab center for Liz Kennick. She was on her way to a facility in Virginia that specialized in the treatment of professionals, and she had a tough road ahead and some hard work to do.

She knew that, and she knew her medical license would be revoked. Whatever flaw in her character, whatever weakness that had allowed her to fall into this trap, it would have to be overcome if she was to continue a career in medicine. More important than that, it would need to be overcome if she was to regain control of her life.

“I hope that young woman knows how lucky she is,” Virginia said, shuffling through some purchase orders. “The hospital had every right to press charges against her, and she might be looking at jail time in addition to losing her license. She has Bill Chalmers to thank for that.”

“Still, she’s going to be paying a heavy price for what she’s done,” I told her.

“Hmm,” Virginia grumbled. “She’s leaving some real damage behind her. And speaking of Bill Chalmers, he came by my office yesterday.”

I was leaning against the counter, watching her do her paperwork.

“What was that about?” I asked her.

“It was interesting,” she said, putting her papers aside and looking up at me. “He wanted to talk about Amy Connors. He had tried to call her a couple of times, after all of this happened, but never talked with her. He had left messages but she never returned his calls. So then he found out where she lives and went to see her.”

“He
what?
” I exclaimed. “When was the last time—”

“I know,” she interrupted. “When have you ever heard of that happening? And it may never happen again. But he was determined to talk with her, and that’s what he did. He drove out to her house.”

“Wow. I never would have expected that. I hope Amy’s husband wasn’t at home. That would have been some fireworks!”

“You’re right about that,” she laughed. “But Charlie wasn’t there. It was just Amy, and they talked for a good while. He apologized as best he could and asked her to come back to the hospital.”

“I hope she knows how much it took for him to do that,” I said. “It was the right thing…but still, that surprises me. How did she respond?”

“He told me he couldn’t be sure,” she explained. “She listened to him, and she accepted his apology. But she told him she’d have to think about ever coming back to the hospital and the ER. He didn’t sound too hopeful. Oh, and he told her about Walter Stevens.”

“What about Stevens?” I asked. I hadn’t heard anything about the vice president and didn’t know what she was talking about.

“You need to pay more attention to the hospital grapevine,” she said knowingly. “Stevens has been given a sideways promotion—actually it’s a
demotion
, and everyone knows it. Bill relieved him of his duties and put him in charge of facilities management.”

“You mean housekeeping and making sure the grass is mowed?” I chuckled.

“It’s a little more than that, but yes,” she replied. “Bill’s idea is to give him some time to mature a little, to gain more management experience.”