скачать книгу бесплатно
“Things change.” Krissie rubbed her eyes, trying to hold back a tidal wave of despair. Before long, the second-guessing would set in. It always did and seldom helped. A lot of medical people, herself included, belonged to a secret society of flagellants, beating themselves up when they lost a patient they felt they shouldn’t have. Given another half hour, she’d probably be telling herself it was all her fault for taking a break.
“Damn it, David, we both know how fast things can change. She’d evidently had a heart attack in the past. Hence the arrhythmia that caused the congestive heart failure.”
“I know that,” he snapped. “And I was treating all of that. The arrhythmia, the edema…”
“I know.” She almost snapped back.
“Maybe I shouldn’t have cut so much diuretic.”
Krissie shook her head. “That change shouldn’t have caused such a big effect so fast.”
“No, you’re right.”
Astonished that he had so quickly accepted her judgment after snapping at her, she blinked and stared at him.
He turned to the monitor and hit the buttons to play back the hour before the attack.
“Coffee?” Krissie asked finally. Every nerve in her body seemed to be firing. “I can’t just sit here.”
“Sure. Thanks. Black, please.”
Forcing herself to stand, she walked back toward the nurses’ break room. She didn’t want to wonder if things might have been different if she hadn’t gone on break, if Julie and Nancy hadn’t been so obviously overtaken by the enormity of what they were facing. Training. She’d need to give them more training. They were little more than kids, really.
And none of those thoughts helped. A woman had died, and no one in the medical profession would ever be comfortable with that outcome if there was the remotest possibility they might have prevented it.
She filled two cups, paused to look at her sandwich, then, realizing she wouldn’t be able to eat it, swept the remains into the trash.
Back at the ward, she found David peering intently at the monitor. “There it is,” he said, when she came up and put the coffee beside him.
“What?”
“See that? Major slowdown. Like it just wound down.”
“Arrhythmia?”
“For about fifteen seconds before the slowdown. Easy enough to miss. The monitor should have alarmed.”
“Maybe it did. It was screeching when I got here, and Julie and Nancy were in the patient’s room.”
He nodded slowly. “It was fast.”
She scanned the playback as he ran through it again. “Awfully fast.”
“Looks more like SCA, sudden cardiac arrest.”
Krissie nodded. “Not much time to do anything.”
“No.” He lowered his head for a moment. “I need to call her family.”
The worst task of all, Krissie thought. “I’ll talk to Julie and Nancy, see if I can learn anything additional. For the report.”
He nodded. “Thanks. God knows what I’m going to tell the family.” He pushed forward on the ECG readout, then said, “It’s clear compressions were started in about a minute.” The spikes showed that clearly. “You weren’t too late.”
It struck her then that he was trying to let her know she couldn’t have done any more. His generosity, when he was sitting there blaming himself, was all the more touching. And totally unexpected after the way they had started.
“David—”
He cut her off. “I need to call the family.” He rose and strode away, looking lonely as only a doctor at a time like this could.
The phlebotomist emerged from Mrs. Alexander’s room with his cart, trundling all the blood samples to the lab. Moments later the orderlies came out, carrying away trash, pushing the crash cart with them to restock it and prepare it for another code. Then came Julie and Nancy, both with hanging heads.
“We messed up,” Nancy said as they joined Julie behind the counter and sat. “We called the code and called you, but we should have started CPR.”
“Yes, you should have.” But Krissie took pity on them, too. “I was there in less than a minute. Compressions started soon enough anyway.”
They nodded. “We never had anyone die before,” Julie said softly. “Never.”
Krissie looked at them, not knowing quite what to say. “It never gets any easier,” she managed finally. “Now just make sure Mrs. Alexander is ready to be seen by her family. I’m going to check on the other patients. If any of them awoke, they’re probably disturbed by this. Tomorrow, we’ll talk about managing these events a little better.”
Rising, she touched their shoulders in turn. “We learn from our mistakes. I still do. But there was nothing you could have done that would have saved her.”
The two girls nodded, but neither looked particularly relieved.
To her dismay, she found the boy with the broken leg, Tom Mason, wide awake and looking frightened. He was only ten. “Am I going to die, too?”
“Of course not!” Krissie pulled a chair closer to his bed. “You’re young and healthy. The person who died was very old and sick. There’s a difference.”
He nodded and allowed her to pat his hand as she sat beside him.
“I know it’s scary for you,” she said calmly. “It’s scary for everyone. But you don’t even have a heart monitor, which should tell you something.”
“Okay.”
She waited, giving him space to talk, to say whatever he needed to, but he remained quiet, as if trying to sort through things in his own mind his own way.
“Look,” she said presently, “Some people are sick and come to hospitals to die. Others, like you, just managed to break their legs jumping out of a tree, and they come here to get better. Before you know it, you’re going to be hobbling around on crutches and asking your friends to sign your cast. Just tell them not to use dirty words.”
At that, a shy smile peeped out. “Mom would be furious.”
“You better believe it. She’ll probably go get a can of white paint to cover it up. And what if she just keeps painting the rest of you?”
A tired little laugh escaped him. “She’d paint my bottom, and it wouldn’t be with a paintbrush.”
Krissie forced a grin. “You think she’d spank you?”
He shook his head after a minute. “She never hits me. She doesn’t have to.”
“Oh,” Krissie said knowingly. “The mother voice.”
“Yeah. And Dad says her looks can kill.”
“Oh, I know all about that. My mother never spanked me, either, but one look and I’d practically burst into flames or something.”
“I go hide. I hate it when she’s mad at me.”
“Somehow I think she doesn’t get mad at you often.”
“No,” he said with confidence. “I’m pretty good most of the time.”
“I believe you.”
He looked at her from the corner of his eye. “But she was mad when I jumped out of that tree. Especially when she saw my leg.”
“Probably more worried than mad.”
“Yeah, that’s what she said later.”
“Do you want me to call your mom, ask her to come in?”
He hesitated, then shook his head. “I’m okay. You’re right. I’m not old and sick.”
“No, you’re not.” She headed for the door, but when she got there, his voice stopped her.
“Can you leave the door open?”
She smiled back at him. “Sure. And why don’t you turn on the light on your bed and read one of those comic books. But don’t turn the TV on, okay? Not with the door open.”
“Okay.” He reached for a comic book from one of the stacks on the table beside the bed and flipped on the fluorescent light at the head of the bed. “Thanks, Miss Tate.”
“Just call me Krissie, okay? Can I get you anything? A drink? Jell-O?”
“I’m okay. Thanks.”
“Use that call button if you want anything.”
“I will.” At that he grinned, then turned his attention to the comic book.
Am I going to die, too? Outside, Krissie had to stop and lean against the wall, closing her eyes and reaching for balance. How many times had she heard that question from boys only a few years older than this one? From men, women and children. And how many times had she had to lie about it?
Am I going to die, too? The question haunted her nightmares. Bloody hands gripping her arm. Shattered bodies, shattered faces, shattered lives. Death riding her shoulder as if he were her partner.
God!
After a minute, she regained her equilibrium and was able to continue her ward check. Everyone else still slept, apparently unaware the grim reaper had paid a visit.
Mrs. Alexander’s son—a rawboned man who looked as if he had worked hard outdoors his entire life—arrived and went into the room with David, then emerged ten minutes later by himself, walking away with a tight jaw and reddened eyes. David came out a minute later and approached the station.
“She can go to the morgue now. They don’t want an autopsy.”
“But…”
“I told him we needed to do one anyway, to find out what happened. He said he doesn’t care what happened. It’s enough she’s gone, let her be.”
Krissie nodded slowly.
“We got the blood samples and we have the urine bag, right?”
“Yes, I saw the lab guys take it all.”
“Okay, then. We’ll have to rely on toxicology, a BUN test, the other tests I ordered. It’ll probably be enough.”
She understood, though. He wanted to know exactly what had gone wrong, and if the blood and urine tests didn’t show anything, questions would plague him for a long time.
He reached for the now-cold cup of coffee he’d left on the desk an hour ago and drank it down. Then he gave her a kind of cockeyed smile. “That was awful.”
“I can get you fresh.”
“Tell you what. Let me buy you breakfast at Maude’s. You get off at seven, right?”
“Right.” Part of her hesitated, saying no, this would be stupid, but another part didn’t want to go straight home, not after this night. “It’s a deal. I’ll meet you there as soon as I get out of here.”
“Deal. A little artery-hardening food is what I need right now.” Then, with a nod, he left.
The sun was already well up and growing hot when Krissie left the hospital shortly after seven. Dressed again in her street clothes, carrying her small backpack, she walked across the pavement to her car. Her eyes felt gritty, a sure sign she needed some sleep, but she’d toughed this out before countless times. Impatiently, she ran her fingers through her short, streaked hair.
As she started to pull out of the parking lot, a small wave of panic washed over her and she almost turned for home rather than downtown and Maude’s diner.
This was purely professional, she told herself. Two colleagues getting together to eat and unwind a bit before going home to bed. There was nothing to be afraid of.
But her recently defunct relationship had left its own set of scars, among them her fear and dislike of controlling men. That little outburst from David last night about his expectations of her as a nurse had been controlling. She still squirmed a little when she thought about it, but reminded herself that he hadn’t behaved that way during their encounters the rest of the night. Still, he had the potential to become a problem of the kind she had just shucked.
But only if she let him, she reminded herself. Keep it professional, keep it purely social and don’t let him get close. That was a recipe for avoiding trouble, one she intended to follow.
Feeling more comfortable about it, she found a parking space near Maude’s and walked the rest of the way to the diner. For some reason, Maude had added a Café sign to her window, even though the neon above announced City Diner. Not that it mattered, she supposed. Everyone still called it Maude’s, or Maude’s Diner.
Inside, wonderful aromas filled the air, and the clanking of flatware and the clatter of crockery joined the hum of early-morning conversation. Like many such places, the early-morning weekday crowd was composed mostly of older people, men, women and couples, who had no need to think about getting ready to go to work. Later in the day, the composition would change, first with the lunch crowd, then the dinner crowd.
David stood out: a man in his prime, maybe around forty, with dark hair that didn’t yet show a dash of gray. In his dark blue polo shirt and khaki slacks, he looked lithe and fit. He’d taken a table near the window and already had a cup of coffee in front of him. He started to get up as she approached, but she waved him back into his seat and then slid onto the vinyl-covered chair facing him.
Before she had a chance to say a word, a cup slammed onto the table in front of her and started to fill with coffee. She looked up and saw Maude’s daughter, Mabel; the younger woman was surely a clone of her mother.
“Good to see you back, Krissie,” Mable said as she topped off the mugs. “Menu? Or do you know what you want?”
Krissie knew better than to ask for anything unusual or healthful. This wasn’t a place for healthful eating. “Two-egg onion omelet and rye toast, please.”
Mabel nodded, then looked at David. “The usual?” “Please. With some extra hash browns.” “Got it.” Mabel sort of smiled and walked away, coffee carafe in hand.
Krissie smiled. “You’re going for broke.” “The hash browns, you mean? Yeah. I need every calorie I can get. I still have office hours, starting at nine.”
