Richard Mabry - Lethal Remedy

"Listen, I already have something going on tomorrow afternoon, and I don't know how long it's going to take. Can we talk about this another day?" "Sure. And while I have you on the phone, have you discovered anything more about Jandramycin's side effects?" John Ramsey's words came back to her. "He's sharp, he's solid, and you can trust him."

Maybe three heads would be better than two. "Listen, are you free tomorrow afternoon?"

"Dr. Ramsey, are you ready to start seeing patients?" John wanted to tell Verna that he wasn't ready, might never be ready again. You work for forty years and never have a complaint lodged against you, much less a malpractice suit filed, and then one day, Bam! You're sued for trying to save the life of a woman experiencing a non-survivable event. He was ready to walk out of the clinic, go home, forget about practicing medicine. Instead, John did what he'd been doing for years, rain or shine, good mood or bad. He followed his calling. "Sure. Who's first?" Somehow John made it through the morning, pleased to find that he was still able to compartmentalize, putting his personal worries into quarantine while his professional self handled problem after problem. "That's it. You had one more patient, but he was a no-show."

"Thanks, Verna. I'm going to return these phone messages, then I'll get some lunch." John sighed when he saw the pink slips Verna had left in his dictation cubicle, held down by a paperweight advertising the latest wonder drug from some pharmaceutical company or other. But first things first. He dialed the number for Mark's office. After four rings, he heard the rhythm of the rings change and realized the call was rolling over to an answering service or voicemail. Oh, it's lunchtime. He hung up without leaving a message and dialed Mark's cell phone. John let it ring until he heard, "This is Mark Wilcox. Please leave a message." "Mark, this is John Ramsey. I've been… I've been served. I guess we need to talk. Are you available this evening?

Call my cell and leave a message." John had hardly hung up when his cell phone vibrated in his pocket. Was Mark getting back to him already? "Dr. Ramsey." "Doctor, this is Bill Alexander." He'd almost forgotten about his earlier call to his malpractice insurance carrier.

Maybe his coverage extended to the incident at the medical school.

Maybe things were going to work out. A spark of hope flared. "Yes.

Thanks for getting back to me." "You won't thank me after you hear what I've found out." The spark flickered and died, leaving nothing in John's heart but a chill that no sun could warm. "Let me guess. I'm not covered." The conversation lasted another five minutes, but the upshot was what John originally feared. His malpractice coverage was not in force for new events. And it was the opinion of the company's lawyers that it was unlikely the medical center would cover the actions of an employee who hadn't even officially gone to work yet. In other words, John was on his own. He thanked Alexander and hung up. He wondered what would happen if he just walked out, packed a suitcase, and took off for parts unknown. "John, God's in control. Hang on."

Beth's words were as real as though she were in the room with him.

Those words seemed to be her solution for everything bad that happened in their lives: an employee who embezzled a huge chunk of money from his practice, the sudden deaths of his parents in a terrible accident, the news that John's brother had terminal cancer. All these were times when he wanted to walk away from it all. And Beth always reminded him-God's in control. So he'd hung on. And sure enough, things worked out. Maybe they would this time, as well. He squared his shoulders and began to work his way through the message slips. He was wrapping up a conversation with an insurance claims representative, trying to keep his temper in check while convincing her that the presence of asthma in childhood didn't constitute a pre-existing condition in the case of a patient with pneumonia, when Verna appeared outside his door. He held up one finger in a "just a minute" gesture and ended the conversation, gratified that he'd been able to convince the sentry on the other end of the phone to let his patient pass into the realm of the insured. "What's up?" he asked. "That no-show is here. I'm not sure how he got into the general internal medicine clinic, though.

He's got an infected wound on his arm that looks pretty bad. Probably needs debridement and some antibiotics. Want me to send him to general surgery?" John was already on his feet. "No, he's here. I'll take care of it. In forty years of practice, I've seen my share of infected wounds." The patient was a middle-aged man, lean and tough as a buggy whip. He wore a flannel shirt with the sleeves rolled past the elbows.

A folded baseball cap peeked out of the hip pocket of his jeans.

"Sorry I was late, Doc. Had trouble with those valet parkers out there." He pronounced the word valett. "Told 'em I was gonna have to pay to see you, pay for my medicine, and I wasn't about to pay for some guy to park my pickup when I could do it myself." John smothered a smile. He'd had the same thought a number of times. "No problem.

You're here now. Let's see that arm. What happened?" While the patient related a story of coming out second best in a fight with a piece of rusty machinery at his auto repair shop the preceding week, John slipped on a pair of gloves and examined the man's left arm. It was swollen, hot to the touch, red from the elbow to the wrist. A weeping crust covered a six-inch gash on the side of the forearm. "Thought it would be okay if I kept a bandage on it and used some of that antee-beeotic ointment. Looks like I was wrong." "I'm going to clean that up and get you on some pills to fight the infection," John said.

"I may have to snip away some dead tissue, but I don't think it will hurt enough to need a local anesthetic. Think you can take it?" "I've had worse," the man said. While Verna cleansed the wound with peroxide and painted it with antiseptic, John took the dirty bandage from the treatment table and looked around for a spot to dispose of it. Blood, tissue, pus, and similar material were to be placed in a special container, one that was lined with a red plastic bag prominently labeled "biohazard." "Over in the corner," Verna said, nodding in that direction. "Thanks." John opened the container to drop in the bandage, but it hung on the rim. He swatted the dirty gauze into the almost overflowing bag, but when he did he felt a sharp pain in his hand.

"Ow!" "What happened?" Verna asked. John took a pair of forceps from the treatment table and stirred the top layer of debris in the biohazard bag. His throat tightened when he saw the glint of a syringe and needle peeking out of the container. He tried to keep his voice calm. "Verna, I'm going to need to talk with someone in Infectious Disease. Could you page them while I finish cleaning up this wound?"

"Sure. Is it about the antibiotic for this wound?" "No, it's about our needle-stick protocol. It's for me."

"Jandra Pharmaceuticals, how may I direct your call?" The voice was cheery, but the inflection told Sara that this was a message the woman repeated a hundred times a day. "This is a doctor in Dallas, calling about one of your new drugs. Is there someone there who can give me some details about Jandramycin?" There was a moment's silence.

"I'm sorry. I don't believe we have a drug by that name. Are you sure?" Sara shrugged to relieve the tension that had become a permanent fixture in her shoulder muscles. "I'm sure. Jandra Pharmaceuticals, Jandramycin. Think about it." She decided on a different tack. "Who's your public relations manager?" "That would be Mr. Olson, but he's on vacation." Sara waited, but apparently that was as much help as she was going to get. "Okay, your director of research?" "That would be Dr. Wolfe. Would you like me to ring him?"