Code Blue (9 page)

She was anxious to see the prescription. After that she wanted to talk with the person who filled it. Jacob had made it plain that, with only a two-man crew, they didn't bother to make that notation on the prescription or the bottle. Cathy knew it was good pharmacy practice to keep those records, but she got the impression that Jacob made the rules for Collins Pharmacy.

Persistent rumors. Economic pressure. Delayed hospital privileges. Now a prescription with a mistake a third-year medical student wouldn't make. Was this part of the ongoing campaign to drive her away? Or had her paranoia progressed to the next stage: out of touch with reality?

She stood up to walk out of her office when another thought hit her and she dropped into her chair. What if she had experienced a dissociative reaction when she wrote that prescription? What if she'd thought one thing and wrote another? That would explain the discrepancy between what she'd charted and what was on the prescription. She was no psychiatrist—she'd have to ask Josh about it to be sure— but as she recalled, dissociative reactions were common in patients with schizophrenia.

"That's your last patient," Jane said. "For the day and for the week. What are your plans? Will you promise to relax this weekend?"

Cathy handed the file to Jane and shrugged out of her white coat. "Promise. After I stop by the pharmacy, I'm going home and collapsing into a hot bath. Then tomorrow I think I'll take a drive in the country and get away from everything."

"How about Sunday?"

Cathy's initial impulse to dissemble died quickly. By Monday, everyone would know anyway. "I'm going to church with Will."

"Good. Enjoy your weekend."

Cathy retreated to her office and sat there with her eyes closed. The noises of drawers shutting and doors closing finally died away. She heard Jane call, "Night," before silence settled in.

Cathy decided she needed to talk with Josh about her mistake. She wanted him to evaluate her, assure her that her mind wasn't really slipping. Did it merit a phone call now? No, it could wait until her regular session next week.

She opened her eyes and leaned forward, pressing her hands to her temples to still the pounding. She hoped Josh could help her. She started to run down the list of available antipsychotic drugs.

"Stop it," she said out loud. "Stop thinking you can be your own doctor."

Still, the symptoms paraded through her mind like a marching army: A constant sense that someone was out to get her. Actions that were out of character for her. Emotions that went up and down like a roller coaster. Cathy reached for a tissue and dabbed at the tears that rolled down her cheeks. Now she knew what the writer meant when he referred to the "dark night of the soul." A permanent midnight had descended on her heart and soul. She wished she still believed that God heard and answered prayer. Right now, though, all she could do was cry.

Whoever designed Jacob Collins's drugstore had done a bang-up job: wide aisles, bright lighting, and attractive displays.Judging from the number of people lined up at the two cash registers, the merchandising efforts had paid off.Now Cathy could see how Jacob afforded that big house.

The pharmacy department repeated the modern look of the rest of the store. Despite growing up in a doctor's family, despite being a physician herself, Cathy had never been beyond the mysterious wall of frosted glass and faux marble that blocked out the public. Behind these barriers, men in white or pale blue smocks took prescriptions passed to them by anxious hands and dispensed bottles full of hope in return.Like elves in Santa's toy assembly line, they bustled back and forth, pulling bottles from the hundreds on the shelves and measuring out pills and capsules into little containers before slapping computer-generated labels on them. Now Cathy would step through the looking glass herself.

"Wait for me back here," Jacob Collins said. "I've got to take care of a problem at the front of the store." He punched a four-digit code into the lock and pushed the Dutch door open for Cathy before hurrying off.

She stepped inside and looked around. Large stock bottles of every kind of medication were arranged in alphabetical order on shelf after shelf. One shelf looked different, though.Set at eye level, it featured a display of pharmacy implements from a prior era. She recognized several glass and ceramic mortar and pestle units for grinding substances into a smooth powder. A shiny brass balance scale stood in the center of the shelf, its weights arranged in an orderly row in an open walnut case beside it. At the end of the shelf she spied another small wooden case, open to display a group of metal dies and pegs. She had no idea what that was, but the display was impressive.

"What are you doing back here?"

Cathy looked around to see a stocky woman whose most notable feature was flaming red hair that appeared to owe its distinctive color to Clairol rather than genetics.

"I'm waiting for Jacob. I'm Dr. Cathy Sewell."

"Oh. Sorry, I should have recognized you." The woman's tone softened. She moved a step closer. "Sherri. Sherri Collins." She extended her hand. "I was Sherri Clawson when we were in school."

Cathy took the hand, while her mind conjured up a yearbook picture, and decided that the years had not been kind to her classmate. When she was in high school, Sherri had a figure that turned the heads of all the boys and was the envy of all the girls. Back then, when most of the kids still wore glasses, Sherri had contact lenses—blue contacts that complemented her faultless complexion and long, light brown hair.

The yearbook picture faded. Long-buried memories scrolled through Cathy's mind. Two senior girls vied for Homecoming Queen in a close race. Too close. That changed after a few words whispered in the right ears: "Oh, Sherri would be a great Homecoming Queen. After all, she's on close terms with almost the whole football team—very close."

During halftime at the Homecoming Game, every eye in the stadium followed Cathy as quarterback Will Kennedy escorted her to the center of the field to receive her crown.Runner-up Sherri Clawson trailed behind, escorted by second-string tackle, Jacob Collins.

Cathy forced the images back into hiding and smiled."Sorry I didn't recognize you. It's been a while. Jacob told me you two were married."

Sherri's eyes narrowed. "As soon as Jacob graduated from high school," she said. "After we married, I got a job in the drugstore. I wanted to go to college, but someone had to make a living." She made a face. "We lived with Jacob's parents to save money, and he commuted to his pre-med classes at TCU."

"I didn't know he'd gone pre-med." Cathy could have cut out her tongue. Obviously, Jacob hadn't gotten into medical school.

By this time, Sherri looked like she'd chewed and swallowed a lemon. "Medical school didn't work out. So Judge Lawton pulled a few strings, and Jacob got into pharmacy school."

Cathy decided that no good could come from going farther down this road. "He seems to be doing well now."

Just then Jacob hurried in. "Sherri, why don't you go up front and get a Coke out of the machine? Get one for me too. I'll only be a few minutes here."

"Sure," Sherri said. "Nice seeing you, Cathy." She wheeled and hurried away.

Jacob eased onto a high stool at the chest-high work counter. "Let's get this done. I'm in a hurry."

"I appreciate your letting me see the prescription." Cathy pulled up another stool next to the pharmacist, careful not to disturb the pill containers and prescriptions lying on the counter. "It's really important."

"Let me find it." He pulled open the top drawer of one of the half-dozen small filing cabinets arranged under his workspace. He thumbed through the prescriptions in practiced fashion before pulling one out with a flourish usually reserved for rabbits emerging from a magician's hat."I hope you realize that I can't let it out of my sight. Matter of fact, when you're through, I plan to seal it in an envelope and lock it in my safe. I suspect it will be an important piece of evidence in the near future."

Cathy ignored the jab and focused on the slip of paper in front of her. Little by little, like a child peeking between her fingers at a scary movie, she let her eyes move across the prescription. The top line carried the notation "Milton Nix (DOB 6-29-57)." Cathy's NPI number was handwritten in the space at the bottom right. One refill was authorized. An X appeared in the box for "generic may be dispensed." Her signature at the bottom left no doubt about who had written the prescription: Catherine Sewell, MD.

When she could no longer put it off, Cathy directed her gaze to the body of the prescription. As with all her prescriptions, the information was printed in a bold hand.

DIGOXIN TABS
0.25 mg

DISP: [# 30]

SIG:
2 TABS Q DAY

Two tablets a day of a medication twice as strong as was needed. Milton Nix would be taking four times the normal dose of the heart medication. It looked like her printing. It looked like her signature. But then she realized what was wrong, and she knew this wasn't the prescription she'd written for Milton Nix in her office.

Maybe she wasn't losing her mind. Maybe someone really was out to get her. And they'd almost killed Nix in the process.

T
HE CHURCH SERVICE SUNDAY MORNING DID LITTLE TO CALM CATHY.True, the handshakes and hugs seemed genuine. The songs brought back memories of happier times, sitting between her parents not far from the pew she and Will occupied today. The sermon spoke of the love of God, and that was where Pastor Kennedy lost her. If God was so loving, why hadn't He protected her parents? Why had she been left orphaned? And where was God's love in all the troubles she had—professional roadblocks and financial pressure and attempts on her life?

As she sat with the Kennedy family at lunch, Cathy let the conversation flow around her like rapids around a rock in a stream. She remained occupied with her own thoughts, and they weren't thoughts of peace and love.

"You seem quiet today." Pastor Kennedy took the bowl of mashed potatoes from his wife and dropped a large spoonful on his plate. "Is there something you'd like to talk about?"

Cathy shook her head. Talking to the pastor about her personal and professional troubles wouldn't help. She was the target for someone—some unknown person who didn't care who got in the way—but what could she do about it?

When Will spoke from across the dining room table, it confirmed the concern she'd read on his face when he'd picked her up that morning. "I don't want to pry, but if you're having problems, this is the place to talk about them. I mean, I'm your lawyer, Dad is your pastor, and we all care about you. You can tell us anything."

"No." The sharp retort came out before Cathy could stop it, but like a genie once out of the bottle, she couldn't get it back. She took a deep breath, put down the fork she'd been using to push food around on her plate without actually eating, and looked around the table. "Will, it may be a legal matter, but I'm not ready to talk about it right now. And Pastor Kennedy, I'm sorry. I don't mean to be disrespectful.But I have to confess—God and I haven't exactly been on speaking terms for the past few years."

"You mean, since your parents were killed?"

"Yes. I guess it was no secret that my mother had—" Cathy couldn't bring herself to say the word. "She had emotional problems. And as a result, she and Dad had some difficulties in their marriage. But he told me she was better.He thought they'd worked things out. My family would be together again. Then God let them get killed!" She squeezed her eyes shut to keep the tears from flowing.

This time it was Dora Kennedy who replied. "Dear, everyone knew about Betty's mental illness. It's nothing to be ashamed of. And even when your mother got so bad, your daddy saw to it that she was cared for."

Pastor Kennedy pushed aside his plate and leaned toward Cathy. "You know, God didn't 'let' your parents get killed, anymore than He 'lets' murders happen or children die in their cribs. Since Adam and Eve, this has been a fallen world. It's not perfect like God intended it to be. But there's a way for folks to—"

"Please," Cathy tried without success to keep her voice level. "I don't want to talk theology. My experience has been that I can't depend on God. Just like I couldn't depend on Rob—" She let the word die unsaid. "Just like I've learned not to depend on any man."

Pastor Kennedy picked up the thread of conversation."Perhaps not, although I think you're being a bit harsh on the masculine gender." He flashed a smile at his son. "But you can depend on God, you know. You just have to learn to trust Him."

"How can I trust Him?" Cathy said. "I can't even bring myself to pray."

"He already knows your heart. You don't have to say a word. Just listen."

Cathy wished she could let go, take the hand of this kindly man, and tell him everything that was bothering her. But that would involve trust, and right now she couldn't bring herself to trust anyone. Not even God.

Cathy squirmed around in the seat of Will's pickup so she could look at him. "I'm sorry I went offlike that."

Will kept his eyes on the road. "No need to apologize.You're under a lot of stress. I want you to feel free to be open with me, and I know my folks feel the same way."

Cathy tried to say thanks, but the words stuck in her throat. She turned toward the window and watched the familiar scenery roll by.

When Will wheeled the vehicle to the curb outside Cathy's apartment, he killed the engine and turned with his right arm over the back of the seat. "You know, when we went offto college I had a dream that I'd come home for Christmas vacation our senior year and propose to you. We'd move to Dallas. I'd go to law school and work nights to support us. You'd go to medical school there. Then we'd come back to Dainger, settle down, raise a family."

The lump in Cathy's throat grew. She stifled a sob.

"What happened to drive us apart?" Will said. "You stopped coming home on vacations. I wrote you letters, but you didn't write back. I called and it was like talking with a cousin. You know, 'I'm fine, how are you?' but no warmth, no feeling. Did I do something to upset you? I need to know."

She kept her gaze forward, looking at his reflection in the windshield. "No one knows this. I didn't even tell my parents.My sophomore year at college, I met someone. A graduate student named Carter Lyles. He was handsome, rich, selfassured, a few years older than me. I guess you could say he swept me offmy feet. He promised me we'd be married after he finished his master's degree. But then I discovered he'd made the same promise to two other girls on campus."

Cathy focused on Will's reflected image. "I confronted him. He said it was the way men were. Then he walked away. After that, I'd see him around the campus, but it was as though I didn't exist. He'd look right through me—walk by without a word."

Will took in a deep breath and held it a long time. "So you decided men couldn't be trusted?"

Cathy shook her head. "For a while, I hoped that maybe there was a man out there who was trustworthy. But my fiancé Robert topped them all. That's when I decided that maybe it was a mistake to trust any man." She wiped at her cheeks with her fingers. Will handed her a clean handkerchief, and she blotted the wet tracks. Between sobbing breaths she told him the story of how she and Robert had broken up. "I don't know who I can trust anymore."

Only Cathy's soft weeping and the whoosh of an occasional passing car broke the silence. Will reached out and turned her head with a gentle finger under her chin. "Cathy, I can see where you might think you can't trust anyone again. But, believe me, you can trust me. You can depend on me. After all these years, my feelings for you have never changed."

Could she believe him? She wanted to. Cathy envisioned a scene where she melted into Will's arms, turning loose her fears and worry, preparing to live one of those "happily ever after" stories she used to love in childhood. But the lessons of the past were too strong. Instead, she simply reached over, patted his hand, and said, "Thank you, Will. I hope you'll be patient with me."

"Dr. Gladstone, Mrs. Gladstone, thank you for coming."

Cathy waved the couple to the chairs in front of her desk.She adjusted her white coat before easing into her own chair. Emma Gladstone's chart lay on her desk, the pathology report inside, but there was no need for Cathy to open the folder. She knew what it said. After she'd received it, she'd spent the better part of that evening poring over her textbooks, then online at sites from M. D. Anderson Cancer Institute and the National Institutes of Health.

Cathy made a conscious effort to avoid the mistake she'd seen several times during her training. Ernest Gladstone was a doctor, but his role here was as a husband. It was Emma's health that was the subject of discussion. Cathy would speak to her, not to Dr. Gladstone, and she'd do it in language that was layman-simple.

"Mrs. Gladstone, the biopsies I took confirmed my initial impression of a cancer of your cervix, the neck of your womb. Remember I told you that my examination suggested the cancer hadn't spread, and the imaging studies we did confirmed this. It's what's called a stage zero tumor."

She looked for the first time at Dr. Gladstone. He sat in silence, holding his wife's hand. His jaw was set, his expression grim. He was a man prepared to do battle. Right now, Ernest Gladstone epitomized the downside of being a doctor.He knew too many of the bad things that could happen, and he was powerless to do anything about them.

Cathy looked back at Emma. "There are several treatment options. I'd like to outline them for you and then I'll answer any questions you might have. I'll be glad to assist you in getting an appointment with whomever you choose to treat you."

"Dr. Sewell," Emma said, "this is the diagnosis Ernest and I expected. We're ready to proceed with treatment." She turned to her husband and some unspoken communication passed between them.

"I've been in contact with a couple of my friends," he said.He mentioned the chairs of the Department of Gynecology at two of the most-respected cancer institutes in the nation."I'd like the pathologist who read the biopsies to send the slides to both of them for confirmation, but I have no reason to doubt your diagnosis. Both of them have recommended a wide total hysterectomy. Emma and I agree with that, but we see no need to go elsewhere, since Art Harshman is well-trained and quite experienced in the procedure."

Cathy bit back the comment that leaped into her mind.She remembered how hard she'd worked not to embarrass this dear lady during her examination. She could only cringe at the thought of how Harshman would treat Emma. But there was nothing she could do.

"Very well. I'll arrange for the slides to be sent out today," Cathy said. "Jane will have you sign a release form on your way out, and we'll send copies of your records to Dr. Harshman. I presume you don't need us to set up the appointment for you."

"No," Emma said. "But I do have one favor to ask. Ernest tells me that the surgeon will require an assistant for this procedure. I want you to be that assistant. I want you to be scrubbed in and participate."

"I don't think Dr. Harshman will—"

Emma was firm. "I know. You flinched when I said it before, and I imagine you were hoping I'd forget about it by now. And before you start making excuses, I'm aware you and Arthur have butted heads. There's not much that happens in the medical community that I don't hear, usually from one of the doctors' wives. But I'm convinced you're not only well-trained, you care about your patients as persons.Arthur is a machine. A good one, but without an ounce of compassion. I want someone to balance that out while I'm on the operating table." She leaned back and took a deep breath. "Would you do that for me?"

Cathy turned her head a few inches and looked at Ernest Gladstone for a sign, but found none. This was Emma's decision, and he wasn't about to fight her.

"Of course, Mrs. Gladstone," Cathy said. "I'll mention your wishes to Dr. Harshman when I call to tell him about your case." And wouldn't that be fun?

The settlement for her accident had been enough for Cathy to pay offher old car and make a down payment on a small Chevrolet, last year's model that the dealer assured her was absolutely perfect for her needs. In her heart, she wished she'd been able to afford something bigger, sturdier: a Hummer, perhaps, or a Sherman tank. Nowadays, she imagined that every approaching black SUV edged near her car. Today that sense caused her to repeatedly jerk the steering wheel to the right. She figured that if she made it to Fort Worth and back without being pulled over on suspicion of DUI, it would constitute a minor miracle.